Bradshaw Site_20050920

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SITE ASSESSMENT REPORT
BRANDON BRADSHAW SITE
2673 BRADSHAW ROAD, KEENER i
SAMPSON COUNTY, NORTH CAROLINA
LATITUDE/LONGITUDE: 35° 24' 42" N/78 1 57' 21" W
NCDENR GROUNDWATER INCIDENT O.: 87.463
RANK 135 A
Prepared By:
P. Sean Boyles, L.G.
Fayetteville, North Carolina 28301
Telephone; [phone]
Facsimile: [phone]
Issue Date: September 20, 2005
9
0

Date: September 20,2005
Site Name: Brandon Bradshaw Site
Address: 2673 Bradshaw Road, Keener
Sampson County, North Carolina
Responsible Parry for Release or Discharge:
Current Property Owner:
Release Information
Date of Discovery: 1996
Estimated Quantity of Release: Unknown
Cause of Release: Agricultural Activities
Source of Release: Unknown
Latitude of Release*: 350 24' 42" N
Longitude of Release*: 780 57' 21" W
*GPS location of Brandon Bradshaw Supply Well
Prepared by:
P. Sean Boyles, L.G..
Hydrogeologist H
Fayetteville Regional Office

TABLE OF CONTENTS f '
1.0 EXECUTIVE SUMMARY.................................................................................................... 1
1.1 SOURCE INFORMATION............................................................................................................. 1
1.2 INITIAL ABATEMENT/EMERGENCY RESPONSE INFORMATION ................................................ 1
1.3 RECEPTOR INFORMATION......................................................................................................... 1
1.3 SAMPLING/INVESTIGATION RESULTS............................. :........ .I................................................ 2
2.0 SITE HISTORY/SOURCE CHARACTERIZATION..................................................... 2-3
3.0 RECEPTOR INFORMATION ............................................. I................................................ 3
4.0 SITE GEOLOGY AND HYDROGEOLOGY........................ 1........ .................................... 4-5
f
5.0 SOIL SAMPLING RESULTS...................................................................................:........... 5
6.0 'GROUNDWATER SAMPLING RESULTS ......................... I............................................. 5-6
6.1 BRANDON BRADSHAW'S RESULTS............................................`................................................ 5
6.2 EDNA KOTTLER'S RESULTS....................................................................................................... 5
6.3 FRANCES BRADSHAW'S RESULTS ........................................ :...... i........ 1...................................... 5
6.4 CLYDE BRADSHAW'S RESULTS.................................................................................................. 6
7.0 DISCUSSION/CONCLUSIONS AND RECOMMENDATIONS ................................... 6-7
8.0, REFERENCES...................................................................•i•..............................................7
i .
APPENDICES,
APPENDIX I
Tables
APPENDIX H
Drawings
APPENDIX III
Well Construction Records
APPENDIX IV
Certificates of Analysis and Chains of Custody
LIST OF TABLES
Table 1 Groundwater Supply Well Data
Table 2 Monitor Well Groundwater Data
LIST OF FIGURES
Figure- I Site Location Map
Figure-1 3/26/03 GW Flow Direction
Figure- 2 3/21/03 GW FlowDirection
Figure- 3 4/3/03 GW Flow Direction

1.0 EXECUTIVE SUMMARY
The Brandon Bradshaw Site in Keener, North Carolina
of Honrine Rd (SR 1819) and Bradshaw Rd (SR 1817)
is located in a rural area with mixed residential and agrii
In 1995-96, a large number of private water supply well
staff of the North Carolina Department of Environm
(NCDENR's) Fayetteville Regional Office (FRO) due
contamination from swine and poultry operations. The
of the areas where sampling was conducted and based o
was found that a significant number of private well
concentrations: In 2002, the US . EPA conducted an
Kenneth Bradshaw Farm site on Honrine Rd. Needir.
February 2003 NCDENR's FRO and Field Investigatii
groundwater investigation of the area containing the
.Brandon Bradshaw, Edna Kottler, Frances Bradshaw an(
i
located near the intersection
n Sampson County. The site
iltural uses.
were sampled for nitrates by
ant and Natural Resources'
to concerns about potential
Kenner community was one
1 the analytical test results; it
contained elevated nitrate
investigation' at the nearby
g additional information, in
n Group (FIG) conducted a
residential supply wells of
Clyde Bradshaw.
Results of the NCDENR groundwater investigation showed groundwater flow toward
the west-northwest, with nitrate -nitrite concentrations ranging from 0.02 Parts Per
Million (PPM) to as high as 38 PPM. The elevated nitrate concentrations appears to
be an on site source, possibly a septic tank at Brandon �Bradshaw's supply well and
agricultural residuals from row crops at the Edna Kottler ,and -Frances Bradshaw
supply wells. The source of Clyde Bradshaw's supply well impact is indeterminate as
property access was refused and no monitor wells could' be constructed on his
property to investigate further.
1.1 Source Information
• Type of contaminant
• Source of release
• Amount of release
nitrate
multiple sources including
fertilizer from agricultural
application
unknown
1.2 INITIAL ABATEMENT/EMERGENCY RESPONSE
eptic tanks, commercial
ractices. and animal waste
TION
To the best of our knowledge, none of the impacted properties have connected to the
county water system although it is reportedly available in' the area.
1.3 RECEPTOR INFORMATION
Based upon the available information, four private water supply wells in the
investigation ' area have been impacted with nitrate at levels above the regulatory
drinking water limit of 10 mg/l [equivalent to 10 pas per million (PPM)]. The
nearest surface waters are tributaries of the Great Coharie Creek and Ward Swamp
located less than %4 mile away from the site. The project site is located in the Cape
Fear River Basin of the Coastal Plain Geologic Province of North Carolina. The site
Brandon Bradshaw Site 1 Site Assessment Report
Sampson County, North Carolina September 20, 2005

1.4
2.0
is not located within a wellhead protection area. Subsu
site appear to be limited to septic tanks and drain fielc
and water lines. Land use in the immediate area of
agriculture that receives nutrient input from commerci:
and liquid swine waste. Two concentrated animal feed
within close proximity, the Kenneth Bradshaw Swine F
Poultry Farm. The Kenneth Bradshaw Farm has its clo,,
640 feet west of the site, while the Clyde Bradshaw 1
adjacent to the site. The remainder of the surroundir
residential and woodland.
SAMPLING/INVESTIGATION RESULTS
..face structures in the project
s and some buried electrical
the -site includes row crop
1 fertilizer, dry poultry litter
ng operations (CAFO) exist
trm and the Clyde Bradshaw
-st spray field approximately
arm is located south of and
area is sparsely developed
From May ' 17th through May 19th 2003, NCDENR's FIG 'installed seven shallow
monitoring wells at the site. Nitrate -Nitrite was present at levels as high as 25 to 38
mg/1 (milligrams/liter) in two of the monitoring wells, which is above the 10 mg/1
regulatory drinking water limits for nitrate. The other five monitor wells had lower
concentrations ranging from 0.02 to 9.3 mg/l. The maximum nitrate concentration of
the three private water supply wells originally found to be impacted above the
groundwater standard varies from 13.76 mg/l in Edna Kottler's well to 18.49 mg/1 in
Brandon Bradshaw's well to 14.94 mg/l in Clyde Briadshaw's well. During the
course of the investigation, Frances Bradshaw's water supply well was sampled and
found to contain 10.32 mg/l of nitrate.
SITE HISTORY/SOURCE CHARATERIZATION
The investigation site is located near the intersection o
Bradshaw Rd (SR 1817) in the Keener community, Sam
(Site Location Map' -Figure 1 a in Appendix II). The ins
rural area with mixed residential and agricultural use.
vicinity of the site are undeveloped. Topography in tl
elevation differences in the project site not varying more
In late 1995, the Fayetteville Regional Office (FRO) of 1
assist Sampson County residents with sampling their wa
general water quality concerns associated with the
northern portion of Sampson County contained an abnc
of nitrate in well water at levels above the state star
conducted a groundwater investigation in the area c
approximately 1500 feet west of the Brandon Bradshaw
was directly adjacent to the Kenneth Bradshaw Farm
investigation indicted other sources of nitrate were lik
well water issues in the area of the Brandon Bradshav
water supply wells were. found to contain nitrate conce
drinking water MCL of 10 mg/L. The apparent sour
Honrine Rd (SR 1819) and
son County, North Carolina
stigation site is located in a
The. remaining areas in the
: area is relatively flat with
han 'ten feet, ' in general.
ie NCDENR was directed to
er supply wells as a result of
xpansion of CAFO's. The
rmal number of occurrences
3ard: In 2002 the USEPA
F a group of private wells
residence. This investigation
The results of the USEPA
ly to blame for causing the
residence. Three domestic
itrations exceeding the EPA
e of contamination was not
Brandon Bradshaw Site ' 2 Site Assessment Report
Sampson County, North Carolina I September 20, 2005

known at that time. Therefore, additional field and
conducted to determine the source including the followii
• the performance of geoprobes along general north -so
the site to develop a subsurface profile on the near surf
boundaries,
• the installation of seven monitoring wells off -site and
sampling and analysis of the upper unconfined aquifer,
• laboratory analysis of the groundwater- samples obta
parameter testing of nitrate -nitrite.
laboratory evaluations were
Each residence utilizes a private supply well as a water
system for wastewater disposal. This is an area with an
ft. below the ground surface, coarse textured well draiy
turkey litter, sprayed swine waste and commercial fertili
agricultural fields making any nearby shallow. supply
impacts from the use of nutrients on agricultural crops.
3.0 . RECEPTOR INFORMATION
While public water .is available in thearea, .water is sup
by individual water supply wells. There appears to be
wells.within 1,500 feet of the project site. The -nearest
mile away from the -site but some connecting drainag
boundaries. The site is not located.within a wellhead 1
previously noted the use of the surrounding area is scat
or undeveloped. Potential human exposure appears
impacted water for residential drinking, water. W
Bradshaw's supply well, none of the contacted res
concerning well depth or any other construction details
Clyde Bradshaw's well was installed forty years prior
depth. Nevertheless, the common well. construction pra
none of the other impacted supply wells are constructe
feet below.the land surface.
4.0 SITE GEOLOGY AND HYDROGEOLOGY
and east -west lines across
soils within the project site
of the site for the
at the site by combined
supply source and a septic
average water table of 5-10
d upper soil material where
;er have been applied to the
wells. vulnerable to nitrate
)lied to most of the residents
no community water supply
irface waters are less than %a
features lie within the site
rotection area. However,. as
ered'residential, agricultural,
o be limited to use of the
th the. exception of Clyde
dents had any information
or their private supply wells.
and ,'is reportedly 25 feet in
;tices in the area suggest that
l to a depth of more than 30
Since no .deep boreholes were advanced in the area of investigation, we relied on a
combination of a geoprobe soil collection system and existing available resources to
estimate the depth to various formations in the area. We were able to obtain one
complete core using the geoprobe sampler.. The soil cuttings were examined and
logged for each of the ' geoprobes advanced at the site (Appendix IV -Well
Construction Records). A general boring log for the recovered core is shown in the
table below.
Brandon Bradshaw Site 3 Site Assessment Report
September 20, 2005
Sampson County, North Carolina

Haring Log of Recovered Core
INDICATE DEPTHS AT WHICH WATER IS ENCOUNTERED. I
Show Color, texture, hardness, and Formation
Sandstone, shale, limestone, gravel, clay, sand, etc.
From
-
To
Dark Gray Fine Sand
0
6"
Light -Brown Fine Sand (
6"
10"
Red -Brown Loamy Sand
(
10"
45"
Mottled Red Clayey Loam
(
45"
10'
Gray Clay Loam
10'
12'
Gray to Red Mottled Loamy Sand
12'
14'
Gray Fine to Medium Sands w/Mottled Red Zones
14'
27'
Yellow Brown Fine Sand
27'
28'
Fine Sand of Various Colors
28'
38'
(
3 8'
40'
Boring terminated @ 40 feet
(
Using existing well logs from the FRO files and USGS c
Report 87-690 we were able to estimate the location of
unit which marks the top of the Black Creek Aquifer. A
below ground a layer of relatively impermeable clay (ab
be present at this site. Residents of this area should cons
supply wells to a depth of at least 80 to 100 feet to drill
that may have an accumulation of nutrients.
Based upon measurements obtained in the field, it appe,
direction within the upper unconfined aquifer is in a gen
the site (Figs. la, 2, 3). However, changes in the 1
observed after a rainfall event, that coincided with
performed on April 3, 2003. As indicated in figure
groundwater flow direction toward the northwest was
general, it is believed that the groundwater flow throug]
east to west and mimics the natural surface water drainaf
Using the equation below, the hydraulic gradient (i) b
determined to be 1.439 x 10"3 ft/ft as shown below.
ass -sections from Open File
.e underlying first confining
approximately 60 to 80 feet
at 20 feet in thickness) may
ler installing any new water
eyond shallow groundwater
rs that the groundwater flow
;ral westerly direction across
roundwater flow path were
water level measurements
a slight fluctuation in the
ietermined at that time. In
out most of the year is from
MW-3 and MW-4 was
i = h_ = 184.56 ft—182.53 ft = 2.03 ft='0.001439 ft/ft
L 1410 ft 1410 ft
where, i and hL = represent the hydraulic gradient
L
hL = head loss between monitor wells
L = horizontal distance between the monitor wells
Brandon Bradshaw Site 4 Site Assessment Report
Sampson County, North Carolina I September 20,2005

The linear groundwater velocity (vh) was determined
per year (0.108 ft/day) based on a modification to
equation from hydraulics. The modified equation for
is shown below.
vh= 365.2% i = 365.25 (15 ft/d)(1/0
n
An assumed hydraulic conductivity (kh value) of 15 ft/d
(n) of 0.20 was used in making this calculation. I
calculated may be similar to what exists at the site. H
this site could easily be an order of magnitude greater tl
simple equation as no aquifer tests or other quantit
establish the values for porosity or hydraulic conductivit
6.0 GROUNDWATER SAMPLE RESULTS
Groundwater sampling occurred on March 19, 2003. Ea(
of at least three well volumes (or until dry) with a perist,
24 hours of recovery. Samples were collected in 473 ml
preserved with acid to a pH of 2.0, labeled and store
NCDENR laboratory for inorganic analysis of nitrate/r
show the nitrate -nitrite concentration ranging from 0.02
summary of the analytical results along with their respec
in the Monitor Well Groundwater Table.
be approximately 39.45 feet
arcy's law and the velocity
.izontal groundwater velocity
6.1 BRANDON BRADSHAW'S RESULTS
Following Honrine Road in a general westerly directior
flow direction, the nitrate -nitrite concentration starts at
Tommy Bradshaw's agricultural field it then decreas
Brandon Bradshaw's property then increases again to
agricultural field on Edna Kottler's property. Because
supply well detected a level of 18.49 mg/l and a much lc
in the up -gradient monitoring well (MW-1), it appears
nutrients from Tommy Bradshaw's property may be only
to Brandon Bradshaw's supply well. It appears likely
nearby septic tank is contributing to the higher .level of
supply well.
6.2 EDNA KOTTLER'S RESULTS
Monitor wells upgradient (MW-5) and side -gradient
Kottler's supply well found elevated to low levels
ranging from 7.8 mg/l, 3.8 mg/l and 9.3 mg/l. MW-5 is
supply well and shows a lower level of nitrate than the
her supply well. In addition, the side -gradient monitc
well also show lower levels of nitrate contamination.
located down -gradient of her supply well but an agri
ft/1410 ft) = 39.45 ft/yr
y with an estimated porosity
is believed that the value
wever, the linear velocity at
In was determined using this
Live methods were used to
monitoring well was purged
.c pump and sampled within
lastic water bottles and were
on ice for transport to the
-ite. Monitor well samples
V1 to as high as 38 mg/l. A
,e GPS location is presented
parallel to the groundwater
5 mg/1 (MW-4) adjacent to
s to 4.4 mg/1 (MW-1) on
38 mg/1 (MW-2) near the
3andon Bradshaw's private
ver concentration (4.4 mg/1)
hat surface contributions of
a minimal contributor if any
hat another source such as a
citrate that" was found in his
1W-6 and MW-7) to Edna
nitrate -nitrite respectively
p-gradient of Edna Kottler's
3.76 mg/l that was found in
wells closest to her supply
&a Kottler's septic tank is
.ltural field where nutrients
Brandon Bradshaw Site 5 Site Assessment Report
Sampson County, North Carolina I September 20, 2005

have been applied seasonally is located within 10 feet
the analytical data and groundwater flow direction, the
the contamination in Edna Kottler's supply well appear
fertilizer on nearby agricultural fields.
6.3 FRANCES BRADSHAW RESULTS
Monitor wells upgradient (MW-5) and side -gradient (1\
supply well show slightly elevated levels of nitrate —nit
7.8 mg/l to 9.3 mg/l, Frances Bradshaw's supply well
which is a similar order of magnitude as, was found
east in MW-5. Although construction details for Francf
unknown, an agricultural' field owned by Tommy Brad!
of her well and is in a direct flow path of the field
Bradshaw's septic tank is located behind the house furtl
her supply well. Based on these findings, it is presu
Frances Bradshaw's supply well is most likely associ
fields and generally reflective of background nitrate levl
6.4 CLYDE BRADSHAW'S RESULTS
As for the nitrate contamination found in Clyde Brac
unable to determine a source for the contamination
refused to grant property access preventing any monito
on the property. It was however, observed that the le
one monitor well down -gradient (MW-4) to his sup]
nitrate -nitrite which is higher than the 14.94 mg/l of
supply well.
7.0 DISCUSSION/CONCLUSIONS &
►f her supply well. Based on
cost plausible explanation for
to b;e from the application of
V-7) to Frances Bradshaw's
e respectively ranging from
.owed 10.32 mg/l of nitrate,
)roximately 500 feet to the
Bradshaw's supply well are
iw pis located within 10 feet
In; addition, since Frances
west and down -gradient to
A that the nitrate found in
-d with nearby agricultural
in the area.
haw's supply well, we were
because the property owner
wells from being constructed
el of contamination found in
ly well detected 25 mg/l of
citrate earlier reported in his
S
A review of the information obtained from the site indicates nitrate impacts to
domestic water supply wells may be result of several factors including but not limited
to:
• Existing septic systems
• Inadequate installation of domestic water supply wells
• , Off -site sources including agricultural practices in the
In summary, the source of contamination in Brandon B.
related to his septic tank while the contamination foun
Kottler and Frances Bradshaw appears to be from agri
adjacent properties. There does seem to be a potential
(i.e., agricultural use) of nitrate in the vicinity of Cl
without any further drilling investigation the source iml
be determined. Although the potential on -site sources
shallow with no grout)
undiniz area
3shaw's supply well may be
in the supply wells of Edna
iltural activity on nearby or
,r an up -gradient contributor
le Bradshaw's property but
sting this supply well cannot
snot be totally eliminated, it
Brandon Bradshaw Site 6 Site Assessment Report
Sampson County, North Carolina I September 20, 2005

would probably be advisable for the residents to_ connect to the county water system
to eliminate their exposure to nitrates from drinking water. It is ' possible that deeper
supply wells could be drilled into the next aquifer if a confining layer exists. at depth
and provided that there have been no impacts to this, unit. Based on all of the
available information, there may be such a confining unit 60 to 80 feet below ground
surfaceJhat consists of relatively impermeable clay.(about 20 feet in thickness) and
would be a boundary to the vertical migration of nitrates in the groundwater.
Residents of this area who install a new. water supply well should consider drilling to
a depth of at least 80 to 100 feet and be aware that an extensive grout collar should
also be used to: prevent the vertical migration of contaminants into the underlying
aquifer.
8.0 'REFERENCES
R. Allan Freeze and John A. Cherry, 1979 ls` edition, Groundwater
Ralph C. Heath 1991 6th edition,. Basic Groundwater Hydrology -USGS
Water Supply Paper 2220
USGS Open File Report 87-690 '
i
i
Brandon Bradshaw Site 7 Site Assessment Report
Sampson .County, North Carolina September 20, 2005

APPENDIX I
TABLES

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Tax Bill
Deed
PIN:
04017456702
OWNER: BRADSHAW, TOMMY
OWNER ADDRESS:
2071
BRADSHAW RD
OWNER CITY:
CLINTON
OWNER STATE:
NC
OWNER ZIP:
28328
ACREAGE:
2
APN:
15904121
BK PG:
1790/307
DATE RECORDED:
2/1/2011
LAND TAX DEFERRED:
Null
ASSESSED VALUE:
34726
TOTAL TAX VALUE:
34726
TWP CODE:
4
TAX CODE:
F08
SEG TYPE: HOMESITEICROPLAND
CONSIDERATION:
17000
SITE ADDRESS: 2854
BRADSHAW RD
APPR SEG VALUE:
$10,5001$7,155
USE DESC:
RANCHISHED
APPRAISED BLDG VAL:
Null
PARCEL CLASS:
AGRICULTURE
DEED:
17900307
_ _
GIS_APN:
159000121
GEO_PIN:
1590796095
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PIN: 04012426401
a . OWNER: KOTTLER, EDNA BRADSHAW
OWNER ADDRESS: 2901 CHURCH RD
OWNER CITY: CLINTON
OWNER STATE: NC
OWNER ZIP: 28328
ACREAGE: 61.67
APN: 1590-78-0850
s, BK PG: 1144/190
DATE RECORDED: 8/11/1992
LAND TAX DEFERRED: '81755
ASSESSED VALUE: 117954
TOTAL TAX VALUE: 117954
TWP CODE: 4
TAX CODE: F08
SEG TYPE:
HOMESITEICROPLANDIWOODLAND
CONSIDERATION: 0
SITE ADDRESS: 2849 BRADSHAW RD
a APPR SEG VALUE:
$10,5001$76,8501 $36,056
USE DESC:
CONVENTIO NALISH EDIGAZEBO
APPRAISED BLDG VAL. Null
PARCEL CLASS: AGRICULTURE
A x , DEED: 114401901
�GIS APN: 1590000062
GEO_PIN: 1590685853
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PIN: 04011868019
. .. ... OWNER:
J4, PHILLIPS, FRON22E MONROE JR.
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OWNER ADDRESS: 821 HONRINE RD
OWNER CITY., CLINTON
OWNER STATE: NC
OWNER ZIP: 28328
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-1590 APN:
BK PG: 1891/477
DATE RECORDED: 6/24/2014
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4� LAND TAX DEFERRED: 0
ASSESSED VALUE: 85768
TOTAL TAX VALUE: 85768
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CONSIDERATION: 145000
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APPR SEG VALUE: $10,5001$3,176
USE D 'ESC: RANCHIMISCELLANEOUS BUILDN
APPRAISED BLDG VAL Null
PARCEL CLASS: AGRICULTURE
DEED: 18910477
�, �` aa� ' ) E GIS APN: 1590000138,
jj GEO-PIN: 15907750651
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Parcels (Yellow)
t Ky
Tax Bill
Deed
PIN:
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OWNER:
JORDAN, MICHAEL
OWNERADDRESS:
744 HONRINE RD
OWNER CITY:
CLINTON
OWNER STATE:
NC
OWNER ZIP:
28328
ACREAGE:
1.5
APN:
15904094
BK PG:
1537/486
DATE RECORDED:
4/21/2004
LAND TAX DEFERRED: Null
ASSESSED VALUE:
35050
TOTAL TAX VALUE:
35050
TWP CODE:
4
TAX CODE:
F08
SEG TYPE: HOMESITEICROPLAND
CONSIDERATION:
23000
SITE ADDRESS: 2673
BRADSHAW RD
APPR SEG VALUE:
$10,500I$4,240
USE DESC: CONVENTIONALISHED
APPRAISED BLDG VAL: Null
PARCEL CLASS:
AGRICULTURE
DEED:
15370486
GIS APN:
159000094
GEO-PIN:
1590788003
less
Legend
Display Labels - Display 50 Results
Ittp://sampson.connectgis.com/MapOld.aspx 11/25/2014

Groundwater Supply Well Data Brandon Bradshaw Site
Well Owner County Address GPS Long GPS Lat 1st Sample Date Sample Parameter 1st Results (PPM) Comments
2673 Bradshaw Rd, Clinton,
Bradshaw, Brandon
Sampson
NC 28328 910-564-4490
-78.337962000
35.143915000
1/27/2003
nitrate
18.49
2854 Bradshaw Rd, Clinton,
Bradshaw, Frances
Sampson
NC 28328
-78.338183640
35.146418143
5/14/2603
nitrate
10.32
821 Hornrine Rd, Clinton,
25 foot
Bradshaw, Clyde
Sampson
NC 28328
-78.336207773
35.142605632
06/04/02
nitrate
14.94
buried well
Drinking
2849 Bradshaw Road,
_ _
bottled -
Kottler, Edna
Sampson
Clinton NC 28328
-78.339092511
35.146285661
01/10/96
nitrate
13.76
water

Monitor Well Groundwater Data Brandon Bradshaw Site
Monitor Well. Nitrate -Nitrite Nitrate -Nitrite Water Level (ft) Water Level (ft) Water Level (ft)
Location GPS Lono GPS Lat 1st Samnle (PPM1 Duplicate (PPM) 3/26/2003 3/21/2003 4/3/2003
MW-1
-78.337799245
35.143860477 "
0.02
4.4
184.54
184.21
183.61
MW-2
-78.339140467
35.144068762
38
38
183.52
183.24
182.97
MW-3
-78.339846795
35.145937095
0.02
0.02
182.53
182.09
181.72
MW-4
-78.336486364
35.143156104
25
25
184.56
184.27
183.68
MW-5
-78.337331057
35.146670767
7.8
7.9
181.41
181.48
180.39
MW-6
-78.339064548
35.146612985
3.7
3.8
183.62
182.61.
181.59
MW-7 _
-78.338604374 _
35.145-63:0.675 _.
__,. _ 0:2_ _ _
9.3-
_ 183.45
183.04 -- -
- ---182.07 -

APPENDIX II
DRAWINGS

Brandon Bradshaw Site MapFig1 Aj
C.
Legend
* geoprobe mw
* ws wells
Em spray fields
edna kottler'
tommy brad§haw
brandon bradshal
MW-6
mW-5
Frances\
,XCIna
mw-
N
Br don
W-*E
•
•
MW-4
Clyde Bra(
-�420 O.`--
840
Feet

Ground Water Flow Fig 1
Legend
® SiteWLs
wl contours 26-
' spray fields
-_. Ms Edna Kottler
Brandon Bradsh
it-03
0 235 470 940 1,410 1,880
Property Feet

Ground Water Flow Fig 2
�s z ' 2 * g jj
77p �
183.62. rF`
18 3 w '� y
184.56
. �`+:' `r•.'' j 'y,� gyp-�.. Q ... .. � I� � Q a
# aq y+ • y jj,, _ jy. S Tve
'�iy rJt
Legend
0 SiteWLs
wl_contours 21-mar-03
spray fields
-YL Ms Edna Kottler Property
Brandon Bradshaw,Proplerty 0 237.5 475 950 1,425 1,900
Feet
i

Ground Water Flow Fig 3
Legend
N
® SiteWLs
spray fields W E
Ms Edna Kottler Property
Brandon Bradshaw, Property
wi_contours_3-apr-63 0 237.5 475 950 1,425 1,900
Feet

DRILLING COST SUMMARY
Project Name: 13 R -p
3-1?,03-_.
jDate Completed: 3-A-03
Incident #:
Icounty: Sam sow
Quad Name:
Personnel
Hrs.
Da�
Driller 'IB 111
3(o
Helper TOTn,
30
1"
Helper pill
Helper Tim
5
Driller
Helper
Helper
Helper
Equ P. PmO1866
Drill Rig # (' oe
z
Service Truck #
Pipe Truck.# 302-q.
Utility Trailer #
Steam Jenny #
Air Comp #
Bladder Pump #
,P(!V1-rVsRl44c,
Welder (Elec.) #
Generator
Pump Truck
Pump
GrundfosI/2HP
Guick Gel
Sand
Bentonite
Cement
rmerOOCK
1-)911 X
c ft?-5 LI 0
DfzoFDPAAs
Pipe
F— PVC I SST I Steel 1 211 4!.' 67- �61/4
Screens
Above Gd
Surfs.
Other Exp
30
.)0,00
-3 0
7, co
I D
7 L/I 3
ROY-L-I i 4141 L fl,,

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: BILLY RAY CASPER
MW # 7 WELL CONTRACTOR CERTIFICATION #- 2009
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE Check Applicable Box): Residential ❑ ' Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring CK
Recovery] Heat Pump Waterl Injection ❑ Other ❑ If Other, List Use: Lat 35.145642 long 78.33855904
2. WELL LOCATION: (Show sketch of th
Nearest Town- Clinton
at intersection of SR 1819 and SR181
3. OWNER
Address 2728 Capital Blvd.
location below)
County: Sampson
idon Bradshaw Site
i
N.C. 27604
City or Town State
4. DATE DRILLED 03/19/03
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES
7. DOES WELL REPLACE EXISTING V
8. STATIC WATER LEVEL Below Top o'.
(Use'
9. TOP OF CASING IS 18 FT. F
`Top of casing terminated atlor below land surfac
dance with 15A NCAC 2C.0118
1 0. YIELD (gpm): 2 METHOD OF
11. WATER ZONES (depth)* 20'-25'
12. CHLORINATION: Type
13. CASING:
Lip code
NO®
ELL? YES NO®
Casing: 9.05 FT.
'if Above Top of Casing)
)ove Land Surface -
requires a variance In accor-
TEST Paraslstic
ount
Wall Thickness
Depth
Diameter or y�ei t. V Material
4�
From 0
To 20'
Ft.
1 in. sch pvc
From
To
Ft.
From
TO
Ft.
14. GROUT:
Depth
Material Method
From 0
To 13'
Ft.
holeplug POURED
From
To
Ft.
15. SCREEN:
Depth Diametei
From 20' To 25' Ft 1" i
From To Ft i
From To Ft i
16. SAND/GRAVEL PACK:
Depth Sizt
From 13' TO 25' Ft.m
From To Ft.'
17. REMARKS: Will be pull out and aban
DRILLING LOG
DEPTH
From To
Formation Description
01- 4'
Orange to red fine to med.
sand w/ some clay mixed
in.
4'-8'
Tan, brown, and red clay
w/ fine sand.
8'-12'
Red, brown, and white clay
w/ fine sand. (wet)
12'-16'
White sand fine to med w/
some clay mixed in. (wet)
16-20'
Off white to white sand .
(wet).
20'-24'
Tan to red sand fine to
med. w/ white sand. (wet)
24'-25
Red clay w/ fine sand. wet
If additional space is
needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
Slot Size Material
.010 in pvc
in.
in.
Material
t fill
oned after water samples are taken.
,rpir �.i rr.
2!
0
w
M
N
rn
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS B EN ROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY Billy R. Casper � / 03/19/03
Quad No: SIGNATI.ViE OF PE ON CONSTR TING THE WELL DATE
Submit original to Division of Water Quality Groundwater Section within 30 days
Serial No. GWA REV. 121199

North Car olina - Department of Environment and Naiutal Resources - Division of Water Quality - Groundwater Section 1636 Mail
Service Center - Raleigh, NC 27699: 1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ A ricultural ❑ Monitoring
Recovery Heat Pump Water Injection❑ Other: El if Other, List Use: Lat. 35.1456 2 Long. 78.33855904
2. WELL LOCATION: (Show a'sketch of the location on back of form.)
Nearest Town: Clinton ' I County Sampson. MW97
at intersection of SR 1819 and SR 1817
(Road Name and Number, Community, Subdivision, LotNo.) Quadrangle No.
3
NCDENR / Brandon Bradshaw Site
4. ADDRESS: Raleigh NC 27
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
(circle one)
6. TOTAL DEPTH: 25' DIAMETER 1 in.
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hypoc
9. SEALING MATERIAL:
Neat Cement
bags of -cement 1
gallons of water6
Other
Type material N/A.
Amount
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole) and stayed.
11. DATE WELL
4/ 16/03
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
c
wInn
W K7
� n
ry �
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the wellBilly Casper"h ` . i Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division
from completion of abandonmf
Water Quality, Groundwater Section, one copy to the owner within 30 days
i v , 7: - yGWy30 Revised 12/99
SY:

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 276 i9-1636-Phone [phone]
WELL CONSTRUCTION, RECORD WELL CONTRACTOR: BILLY RAY GASPER
MW # 6 WELL CONTRACTOR CERTIFICATION #- 2009
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE Check Applicable Box): Residential ❑ Municipal ❑ Industrial El Agricultural ❑ Monitoring
Recovery] Heat Pump Wate I Injection Other If Other, List Use: Lat.35.1466459 long 78.33902608
2. WELL LOCATION: (Show sketch of the
Nearest Town- Clinton
at intersection of SR 1819 and SR1817
(Road Name and Numbers, Communi{y' or Sul
3. OWNER N.C. DENR.Brandon Bradsl
Address 2728 Capital Blvd.
Ralei
location below)
Sampson Page 1 of 2
County:
an
C. 1 27604
city or i own male
4. DATE DRILLED 03/17/03
5. TOTAL DEPTH
-
6. CUTTINGS COLLECTED YES
7. DOES WELL REPLACE EXISTING
8. STATIC WATER LEVEL Below Top c
11 (Use
9. TOP OF CASING IS 18 FT.
'Top of casing terminated atlor below land surfa
dance with 15A NCAC 2C.011 8
1 0. YIELD (gpm): 2 METHOD O
11. WATER ZONES (depth)'
12. CHLORINATION: Type
13. CASING:
Depth
IDiar
From 0
-To 20' _
Ft.. 1 in.
From
To
Ft.
From
TO
Ft,
14. GROUT:
Depth
From 0
To 10�
Ft. hole
From
To
Ft.
15. SCREEN:
NOD
ELL? YES NO®
Casing: 8.50 FT.
' if Above Top of Casing)
Dove Land Surface-
; requires a variance In accor-
TEST Paraslstic
mount
Wall Thickness
sch 4UhtIFt. p caterial
aterial Method
ug POURED
Depth Diameter Slot Size Material
From 20' To 25' Ft 1" in, .010 in pvc
From To F+ in. in.
From To Ft in. in.
16. SAND/GRAVEL PACK:
Depth Size
From 10, TO 36' Ft. Nat. Fill
From To Ft.
17. REMARKS: Will be pull out and abandoned after water
I DO HEREBY CERTIFY THAT THIS I
CONSTRUCTION STANDARDS, AND
FOR OFFICE USE ONLY
Quad No:
serial No.
Material
DRILLING LOG
DEPTH
From To
Formation Description
01- 4'
Orange to red fine to med.
sand w/ some clay mixed
in.
41-8J
Tan, brown, and red clay
w/ fine sand.
8'-12'
Red, brown, and white clay
w/ fine sand. (wet)
12'-16'
White sand fine to med w/
some clay mixed in. (wet)
16-20'
Off white to white sand .
(wet).
20'-24'
Tan to red sand fine to
med. w/ white sand. (wet)
24'-28'
Red clay w/ fine sand w/
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
are taken.
C
G7
zE
W
D
3
n^
-<
C�
C�
G
f.
- WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
,T A COPY OF THIS RECORD HAS B ENS OVIDED TO THE WELL OWNER.
Billy R. Casper ' ' 03/18/03
SIGNAT RE OF PER96N 6ONSTR6CTING THE WELL DATE
bmlt original to Division of Water Quality Groundwater section within 30 days
GW-1 REV.12199

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - tbsb matt
Service Center - Raleigh, NC 27699-1639 -Phone No. (919) 733=3221
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable iBox): Residential ❑ Municipal ❑ Industrial ❑ Agricultural p Monitoring
Recovery Heat Pump Water Injection❑ Other: ❑ If Other, List Use: Lat. 35.1466459 Long. 78.33902608
2. WELL LOCATION: (Show a
Nearest Town: Clinton
at intersection of SR 1819 and
(Road Name and Number, Cor
3.0
etch of the location on back of form.)
County Sampson MW46
1817
inity, Subdivision, Lot No.)
NCDENR / Brandon Bradshaw Site
4. ADDRESS: Raleigh NC
5; TOPOGRAPHY: draw, slope, hilltop, valley, flat
(circle one)
6. TOTAL DEPTH: 36' DIAMETER 1 in.
7. CASING REMOVED:
feet
3 6'
8. DISINFECTION: N/A
(Amount of 70% hypo(
9. SEALING: MATERIAL:
Neat Cement
bags of cement 2
gallons of water 12
Other
Type material
Amount
NIA
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
11. DATE WELL ABANDON]
I do hereby certify that t
standards, and that a copy of the
Signature of person abandoning
WELL LOCATION: Draw a
of the v
Submit original to the Division i
from completion of abandonmel
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
kCEMENT OF MATERIAL.
with water and uoured down
4/ 16/03
Quadrangle No.
RAM: Draw a detailed sketch of the
total depth, depth and diameter
of
ning in the well, gravel interval,
F
sing perforations, and depths and
aterials used.
0
0
w
0
�
N �
c
—
o
J
tv
CA
c-)
a�
o
z
.s well was abandoned in accordance with 15A NCAC 2C, well construction
,cord has been provided to the well own.
he weRBilly Casper Date4/16/03
Dcation sketch on the reverse of this sheet, showing the direction and distance
fll to at least two (2) nearby reference points such as roads, intersections and
Identify roads with State Highway road identification numbers.
'Water Quality, Groundwater Section, one copy to the owner within 30 days
GW-30 Revised 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1.636 Mail Service Center - Raleigh, N.C. 276 i 9-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: BILLY RAY CASPER
MW # 5 WELL CONTRACTOR CERTIFICATION #r~ 2009
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE Check Applicable Box): Residential ElMunicipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Recovery] Heat Pump Water,' Injection ❑ Other ❑ If Other, List Use: Lat 35. 1466982 long 78.337342
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town- Clinton County: Sampson
at intersection of SR 1819 and SR1817
(Road Name and Numbers, Community, or Sul
3. OWNER N.C. D E.N.R./Brandon Brad
Address 2728 Capital Blvd.
Raleigh N.C.
arty or i own state
4. DATE DRILLED 03/19/03
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES
7. DOES WELL REPLACE EXISTING'
8. STATIC WATER LEVEL Below Top c
(Use
9. TOP OF CASING IS 18 FT.
'Top of casing terminated atior below land surfa
dance with I5A NCAC 2C.01 18
1 0. YIELD (gpm): 2 METHOD 0
11. WATER ZONES (depth)* 20'-25'
12. CHLORINATION: Type N/A
13. CASING:
sion ana Lot NO.)
w Site
27604
NO®
ELL? YES ❑ NO®
Casing: 9.90 FT.
' if Above Top of Casing)
)ove Land Surface -
requires a variance In accor-
TEST Paraslstic
mount
Wall Thickness
Depth Diameter or y�eiefft. Material
From 0 To 20' Ft. 1 in. sch 4y pvc
From To Ft.
From To Ft. —
14. GROUT:
Depth Material Method
From 0 To 14' Ft. holeplug POURED
From To Ft.
15. SCREEN:
Depth Diametc
From 20' To 25' Ft 1
From To Ft
From To Ft
16. SAND/GRAVEL PACK:
Depth Si;
From 14' To 25 Ft.
From To Ft. _
17. REMARKS: Will be pull out and aba
I DO HEREBY CERTIFY THAT THIS 1
CONSTRUCTION STANDARDS, AND
FOR OFFICE USE ONLY
Quad No:
Serial No.
Slot Size Material
.010 in pvc
in.
in.
fill
Material
DRILLING LOG DEPTH
From To Formation Description
0'= 4' Orange to red fine to med.
sand w/ some clay mixed
in.
41-8'
Tan, brown, and red clay
w/ fine sand.
8'-12'
Red, brown, and white clay
w/ fine sand. (wet)
12'-16'
White sand fine to med w/
some clay mixed in. (wet)
16-20'
Off white to white sand .
(wet).
20'-24'
Tan to red sand fine to
med. w/ white sand. (wet)
24'-25
Red clay w/ fine sand. wet
If additional space is needed use back of form .
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
after water samples are taken.
�
ttC=)
>> c
a
G
.WAS CONSTRUCTED IN ACCORDANCE WITH
,T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Billv R.
SIGNATU4E OF PE119N CONSTR&CTING THE WELL
Submit original to Division of Water Quality Groundwater Section within 30 days
03/19/03
DATE
GW-1 REV. 12199

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-i639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring CK
Recovery❑ Heat Pump Water Injection❑ Other: ❑ If Other, List Use: Lat. 35.1466882 Long. 78.337342
2. WELL LOCATION: (Show,
Nearest Town: Clinton
at intersection of SR 1819 and
ame and Number,
3. OWNER: NCDENR / B
4. ADDRESS: Ralei..gh NC
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: - N/A
(Amount of 70% hypo<
9. SEALING MATERIAL:
Neat Cement
bags of cement 1
gallons of water6
Other
Type material N/A
Amount
sketch of the location on back of form.)
County Sampson MW95
iR 1817
imunity, Subdivision, Lot No.) Quadrangle No.
Site
hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
1 in.
used:) ..
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole and stayed.
F
RAM: Draw a detailed sketch of the
total depth, depth and diameter of
ning in the well, gravel interval,
sing perforations, and depths and
aterials used.
c
o
w
r
11. DATE WELL ABANDONED 4/16/03�
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well constmeticn
standards, and that a copy of the record has been provided to the well owner. Q' 2
� 4/ 16/03
Signature of person abandoning the well Billy Casper ��/ Date
WELL LOCATION: Draw a location sketch on the reverse of this. sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams.1 Identify roads with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
s.� _ , - GWu3:0-Revised 12/99
ll,.�`1 _. �?��i �.l �f._�'L:.l.. t-•'•:nff 2i'! �1 —:��

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 2769i -1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: BILLY RAY GASPER
MW # 4 WELL CONTRACTOR CERTIFICATION #- 2009
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring CK
Recovery] Heat Pump Wated Injection Other ❑ If Other, List Use: Lat 35.143197 long 78.3364225
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town- Clinton I County: Sampson
at intersection of SR 1819 and SR18
(Road Name and Numbers, Community, or
3. OWNER N'C F N R /Rrandnn Ri
Address 2728
RE
Raleigh N.C.
City or Town State
4. DATE DRILLED 03/19/03
5. TOTAL DEPTH 2-51
6. CUTTINGS COLLECTED YES
7. DOES WELL REPLACE EXISTING'
8. STATIC WATER LEVEL Below Top t
(Use
9. TOP OF CASING IS 18 FT.
*Top of casing terminated atior below land surfs
dance with 15A NCAC 2C.01 18
1 0. YIELD (gpm): 2 METHOD C
11. WATER ZONES (depth)* 20'-25'
12. CHLORINATION: Type N/A
13. CASING:
Depth Dian
From 0 To 20 Ft. 1 in.
From To Ft.
From -TO- Ft.
14. GROUT:
27604
Zip Code
NO®
ELL? YES 0 NO®
Casing: 7.20 FT.
' if Above Top of Casing)
)ove Land Surface -
requires a variance In accor-
TEST Paraslstic
ount `
Wall Thickness
r, 4�fft. p Material
Depth Material
From 0 To 14' Ft.,holeplug
From To Ft.
15. SCREEN
Depth Diameti
From 20' To 25' Ft I "
From To Ft
From To Ft
16. SAND/GRAVEL PACK:
Depth Si
From 14' TO 25 Ft. _
From To Ft. _
17. REMARKS: Will be pull out and abz
I DO HEREBY CERTIFY THAT THIS 1
CONSTRUCTION STANDARDS, AND
FOR OFFICE USE ONLY
Quad No:
Serial No.
Method
POURED
Slot Size Material
.010 in pvc
in.
in.
fill
Material
DRILLING LOG
DEPTH
From To
Formation Description
01- 4'
Orange to red fine to med.
sand w/ some clay mixed
in.
41-81
Tan, brown, and red clay
w/ fine sand.
8'-12'
Red, brown, and white clay
w/ fine sand. (wet)
12'-16'
White sand fine to med w/
some clay mixed in. (wet)
16-20'
Off white to white sand .
(wet).
20'-24'
Tan to red sand fine to
med. w/ white sand. (wet)
24'-25
Red clay w/ fine sand. wet
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
after water samples are taken.
. WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEAN PROVIDED TO THE WELL OWNER.
R.
SIGNATUF(E OF OERSdrfl CONSTRICTING THE WELLj1
mit original to Division of Water Quality Groundwater Section within 30 days
{
03/19/03
DATE
GW-1 REV. 12199

North Car olina - Department of Environment and Naiival Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-11639 - Phone No. [phone]
WELL ABANDONMEN RECORD WELL CONTRACTORBilly Casper
WELL. CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Recovery❑ Heat Pump Water )injection❑ Other: ❑ Ir Other, List Use: Lat. 35.143197 Long. 78.3364225
2. WELL LOCATION: (Show
Nearest. Town: Clinton
at intersection of SR 1819 an
(Road Name and Number, Ci
3. OWNER: NCDENR / Brandon
4. ADDRESS: Raleigh NC 2
sketch of the location on back of form.)
County Sampson MW#4
3R 1817
Subdivision,
Site
5. TOPOGRAPHY: draw, slope, hilltop; valley, flat
%% (circle one)
6. TOTAL DEPTH: 25' DIAMETER 1 in.
7. CASING REMOVED:
feet
25' —
8. DISINFECTION: N/A
(Amount of 70% hypoc
9. SEALING MMATERIAL:
Neat Cement
bags of cement 1
gallons of water6
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of.waterN/A
kCEMENT OF MATERIAL.
with water and poured down
9
11. DATE WELL ABANDONED 4/16/03
Quadrangle No.
RAM: Draw a detailed sketch of the
total depth, depth and diameter
of
ning in the well, gravel interval,
sing perforations, and depths and
aterials used.
F
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O
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.1
p.
J�
m3b
rn
cV
v'
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I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the wellBilly Casper 471 �' t— Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams.1 Identify roads with State Highway road identification numbers.
Submit original to the Division oTf Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
°6W*0 Revised 12/99
- s

North Carolina - Department of EnVironment and Natural Resources - Division of Water Quality Groundwater Section
1636 Mail Service Center- Raleigh, N.C. 27699-1636-Phon6 [phone].
WELL CONSTRUCTION 'RECORD, WELL CONTRACTOR: BILLY RAY GASPER
MW # 3. 1 WELL CONTRACTOR CERTIFICATION.#- 2009
STATE WELL CONSTRUCTION, PERMIT#779
1. WELL USE (Check Applicable Box): ReslidentialE� Municipal Industrial 1-1 Agricultural IMonitoring
Recovery -Heat Pump Water njection El Oiher'E] Af Other,List Use: Lat 35.1459500 long 781398883
2. WELL LOCATION: (Show sketch of the location below)
Clinton Sampson
Neare.st'Town- County:
at intersection of SKIS 19 and -SR18117.
(Road Name and Numbers, Community, or SUbdivision and Lot No.) DRILLING LOG DEPTH
N.C. D E.N.R./Brandon Bradshaw SiteFrom To Formation Description
Address 2728 Canital Blvd. 01-' 4' Orange to red fine to med.
Raleigh N:C.
City or Town State
4. DATE DRILLED 03/18/03
,5. TOTAL DEPTH 25'
6.'CUTTINGS COLLECTED YES
7. DOES WELL REPLACE EXISTING V
8. STATIC WATER LEVEL Below Top o
(Use'
9. TOP' OF CASING, 1S 1811 FT.
*Top of casing terminated at/or below land,'surfac
dance -with 15A NCAC 2C.01 18
1 0. YIELD (gpm): —2 METHOD OF
11. WATER ZONES (depth)*20'-25"
----.;--
-1 2.'CH LORI NATION: Type N/A.
13. CASING:
Depth
0 20'
From,. To --.Ft.
7
From To Ft.—,
From To Ft.—'
14. GROUT:
sand w/ some clay mixed
27604
in.
Zip Code
Tan; brown, and red clay
w/ fine sand.
NO[K
.8'-12' Red, brown, and white clay
:_LL? YES❑ N 0 2]
w/ fine sand. (wet)
'asing: 5.5.0 FT.
I2'-16' White sand fine to med w/
if Above Top of Casing)
some clay mixed in. (wet)
ove Land Surface-
16-20' Off white to white sand .
requires a variance,ln accor-
(wet).
LEST Paraslstic
20'-24' Tan to red sand fine to
med., w/ white sand. (wet)
24'-25 Red clay w/ fine sand. wet,
—Amount N/A
If additional space is'needed use back of form
Wall Thickness
LOCATION SKETCH
r orOetiFt. Material
4 vac
(Show direct ' ion and distance from at least two State
sc
Roads, or other map reference points)
Depth
Material
Method
From 0
To - 14 Ft. , Weplug
POURED,
From —
To
Ft.
15. SCREEN:
Depth
Diameter'Slot
Size
Material
From 20'
To' .2:5'
Ft Itt ' in.
.010
in. Pvc
From, —To
—Ft—
in.
in.
-From
To
'Ft in.
in.
16. SAND/GRAVEL PACK:
Depth' -
i Size!
Material
14'
From —
�T 0 18'
Ft. fine
sand
18'
From —
-
To25' —
Ft. n at fill
17. REMARKS: Will be pull out and,aband�oned
after water samples al
I DOHEREBY CERTIFY T ' HAT THIS I
CONSTRUCTION STANDARDS, AND
FOR OFFICE USE ONLY
Quad No:
Serial No.
C=>r.
M
C")
taken.
WAS CONSTRUCTED.IN ACCORDANCE WITH15A NCAC 2C, WELL
TACOPY OF THIS RECORD HAS BE P VIDED TO THE WELL OWNER.
el
Billy X. Casper ", 1 03/18/03
;F­==f
SIGNATXIEI&'FPERS6,46ONSt,,R'ti6-' TING DATE
;mlt orIgInal to Division of Water Quality Groundwater Section Within 30 days
GW-11 REV. 12199

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ , Industrial ❑ Agricultural ❑ Monitoring
Recovery❑ Heat Pump Water Injection❑ Other: ❑ If Other, List Use: Lat. 35.1459306 Long. 78.3398883
2. WELL LOCATION: (Show a
Nearest Town: Clinton
at intersection of SR 1819 and
(Road Name and Number, Con
3. OWNER: NCDENR / Brandon
4. ADDRESS: Raleigh NC
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
S. DISINFECTION: N/A
(Amount of 70% hypoc
9. SEALING MATERIAL:
Neat Cement
bags of cement 1
gallons ofwater6
Other
Type material N/A.
Amount
;ketch of the location on back of form.)
County Sampson MW#3
1817
inity, Subdivision, Lot No
Site
hilltop, valley, flat
rcle one)
DIAMETER 1 in.
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole and stayed.
Quadrangle No.
WELL'DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
c
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n
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11. DATE WELL ABANDONED 4/16/03
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the wellBilly Casper, ti Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads*with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
__ �-- �---GW-30 Revised 12/99

North Carolina - Department of Environmentland Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: BU-LY RAY CASPER
MW # 2 WELL CONTRACTOR CERTIFICATION #- 2009
STATE WELL CONSTRUCTION PERMIT#: ITA
1. WELL USE Check Applicable Box): Residential Q Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Recovery Heat Pump Water Injection [:] Other 0 If Other, List Use: Lat 35.1440780 long 78.3391044
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town- Clinton I County: Sampson
at intersection of SR 1819 and SR1817
(Road Name and Numbers, Community, or!Su
3. OWNER N.C. D E.N.R.Brandon Brad
Address 2728 Capital Blvd.
Ral
.0
city or Town State
4. DATE DRILLED 03/19/03
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES [
7. DOES WELL REPLACE EXISTING'
8. STATIC WATER LEVEL Below. Top c
(Use
9. TOP OF CASING IS 19 FT.
'Top of casing terminated at/or below land surfa
dance vvith 15A NCAC 2C.01 19
1 0. YIELD (gpm): 2 METHOD O
11. WATER ZONESL (depth)* 20',25'
12. CHLORINATION: Type
13. CASING:
n and
Site
27604
Zip Code
NO®
ELL? YES Q NO®
Casing: 5.40 FT.
' if Above Top of Casing)
)ove Land Surface -
requires a variance In accor-
TEST Paraslstic
Amount ""
DRILLING LOG
DEPTH
From To
Formation Description
01- 4'
Orange to red fine to med.
sand w/ some clay mixed
in.
4'-8'
Tan, brown, and red clay
w/ fine sand.
8'-12'
Red, brown, and white clay
w/ fine sand. (wet)
12'-16'
White sand fine to med w/
some clay mixed in. (wet)
16'-20'
Off white to white sand.
(wet).
20'-24'
Tan to red sand fine to .
med. w/ white sand. (wet)
24'-25
Red clay w/ fine sand. wet
If additional space is needed use back of form
Wall Thickness
LOCATION SKETCH
Depth
Diameter
or 1�elghtlFt. Material
(Show direction and distance from at least two State
From 0
To 20
Ft.
1 in.
i sch 4y vc
Roads, or other map reference points)
From
To
Ft.
From
To
Ft.
— —
14. GROUT:
Depth
Material Method
��•�
From 0
To 14'
Ft
holeplug POURED
From
To
Ft.
15. SCREEN:
W
Depth DiametE
From 20' To 25' Ft I"
From To Ft
From _ To Ft
16. SAND/GRAVEL PACK:
Depth Sit
From 14 To 25 Ft. r
From To Ft.
17. REMARKS: Will be pull out and abai
Slot Size Material
.010 in pvc
in.
in.
Material
fill
oned after water samples are taken.
N
Xm
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PR VIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY Billy R. Casper 03/19/03
Quad No: SIGNATU E OF PERS CONSTR , TING THE'WELL"" DATE
Submit original to Div sion or Water Quality Ground,ivater Section _within 30 days
Serial No, j ` GW-1 REV. 12199
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G
Z

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Appl
Recovery ❑ Heat Pump W
2. WELL LOCATION: (Sh
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number,
3. OWNER: NCDENR /
4. ADDRESS: Raleigh NC 2
5. TOPOGRAPHY: draw, sl
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hypoc
9. SEALING MATERIAL:
Neat Cement
bags of cement I
gallons ofwater6
Other
Type material N/A
Amount
e Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Injection❑ Other: ❑ If Other, List Use: Lat. 35.144080 Long. 78.3391044
a sketch of the location on back of form.) .
County Sampson MW#2
SR 1817
mmunity, Subdivision, Lot No.
Bradshaw Site
e, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPIACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole and stayed.
11. DATE WELL ABANDONED 4/16/03
Quadrangle No.
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
c
CD Q
w
—G c
— o-
w
rn
n
� o
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the wellBilly Casper -, Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division
from completion of abandonmc
Water Quality, Groundwater Section, one copy to the owner within 30 days
�`6W=330�Revise�d 12/99

North Carolina-- Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 276 j 9-1636-Phone' [phone]
WELL CONSTRUCTION RECORD'- WELL CON.TRACTOR:. BILLY RAY CASPER .
MW # 1 WELL CONTRACTOR CERTIFICATION #2009
STATE WELL CONSTRUCTION. PERMIT#: NIA
1. WELL USE Check Applicable Bo Re idential,0 Municipal -I Industrial Q Agricultural ❑ Monitoring
Recovery].' Heat•Pump;Watei Injection Other.�'.,lf Other, List•Use: Lat.35.1439417 long'78.3377806,
2. WELL LOCATION: (Show sketch of ttie location below)
Nearest Town- .Clinton' . j County: Sampson Page 1 of 2
1
at intersection of SR 1819 and' SR1817
(Road Name and Numbers, Community or Subdivision and Lot No) DRILLING LOG DEPTH
3. OWNER N.C. DENR.Brandon Bradshaw Site From To Formation Description
Address , 2728 Capital Blvd: ;� 01- 4' Orange to red fine to med.
sand w/~some clay mixed
Raleigh N.C. 27604,in.
City or Town.. State Zip Code :. ',
4. DATE DRILLED 63/18/03. ; 4'-8' Tan; brown, and red clay
5. TOTAL DEPTH w/ fine sand.
6. CUTTINGS COLLECTED.YES NO 8'-12' Red, brown, and -white clay
7. DOES WELL REPLACE EXISTING WELL? YES F_­I N0E] "
w/ fine sand. (wet)
8. STATIC WATER LEVEL Below,Top of Casing: 7.50 -FT.: 12'-16' White sand fine to med w/
(Use j+' if Above Top of Casing) some clay mixed in. (wet)
9. TOP OF CASING IS - 251_'' FT. Above Land Surface- 16-20' Off whiteto white sand .
`Top of casing terminated atlor below land surfaee'requires a variance In accor-
dance with 15A NCAC 2C:01 18 19 (wet). ,
1 0.,YIELD (gpm): 2 METHOD OF TEST Paraslstic 20'-24' Tan to red sand fine to
20'-25'
11. WATER ZONES (depth)* med. w/ white sand. (wet)
i 24'-28' Red clay w/ fine sand w/
12. CHLORINATION:: Type N/A' Amount N/A If additional space is needed. use back of.form
13. CASING:
;I LOCATION SKETCH
Wall Thickness
Depth Diameter or Wei hYR. Material (Show direction and distance from at least two State
0 20' I 1 in. J sch 4� pvc
From To Ft.. Roads, or other map reference points)
From To Ft., o
From To Ft''
14. GROUT:
Depth Material Method
_t''
From 0 To 10' Ft.holeplug POURED
From To Ft.i �c .
15 SCREEN: 1 N V; � •
Depth Diameter Slot Size Material M70
From 20' To 25' Ft 1; in. 010 in. pvc
?=
_— y
I -�
From. - To Ft ijl. in. _zy
From To Ft in. in. a f'
16. SAND/GRAVEL PACK:
De th Size Material
1Fro.m 10� 0 40' Ft Nat. Fill R`
- From" To -Ft.!
17. REMARKS: Will be pull out and abandoned after water samples are taken.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTEDIN ACCORDANCE WITH '15A NCAC 2C, WELL
CONSTRUCTIONSTANDARDS, AND THAT A COPY OF THIS RfiC.ORD HAS EE OVIDED TO THE WELL OWNER.
t
FOR OFFICE USE ONLY Billy 1?,. Casper , _ 03/18/03
Quad No; SIGNATU E OF PER N CONST UCTING THE WELL DATE
Submit original to Div Ion of Water Quality Groundwater Section within 30' days _
Serial No: GW=1 REV. 12199''
i

North Car olina - Department of Envirol ment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Recovery❑ Heat Pump Water Injection❑ Other:❑ If Other, List Use: Lat. 35.1439417 Long. 78.3377806
2. WELL LOCATION: (Show
Nearest Town: Clinton
at intersection of SR 1819 ani
(Road Name and Number, Cc
sketch of the location on back of form.)
iR 1817 County Sampson MW#1
ty, Subdivi
3. OWNER:. NCDENR / Brandon Bradshaw Site
4. ADDRESS: Ralei.izh NC
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
(circle one)
6. TOTAL DEPTH: 40' DIAMETER 1 in.
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hypo(
9. SEALING MATERIAL:
Neat Cement
bags of cement 2
gallons of water 12
Other
Type material N/A
Amount
diameter
1 in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement1with water and poured down
hole until it came out top of hole and stayed.
11. DATE WELL ABANDONI
I do hereby certify that tl
standards, and that a copy of the i
Signature of person abandoning
WELL LOCATION: Draw a l
of the w
streams.
Submit original to the Division c
from completion of abandonmen
Quadrangle No.
F
RAM: Draw a detailed sketch of the
total depth, depth and diameter of
ining in the well, gravel interval,
asing perforations, and depths and
aterials used.
G
0 0
W
w
N m�
4/16/03
z
well was abandoned in accordance with 15A NCAC 2C, well construction
cord has been provided to the well owner.
e wellBilly Casper Date4/16/03
cation sketch on the reverse of this sheet, showing the direction and distance
1 to at least two (2) nearby reference points such as roads, intersections and
dentify roads'with State Highway road identification numbers.
Water Quality, Groundwater Section, one copy to the owner within 30 days
GW-30 Revised 12/99

North Carolina - Department of Environment and Natural Resources -Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACToRBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural [IMonitoring
Recovery[]Heat Pump Water Injection[]Other: ❑ If Other, List Use: Lat. 35.145642 Long. 78.33855904
2. WELL LOCATION: (Sholw a sketch of the location on back of form.)
Nearest Town: Clinton County Sampson MW#7 -
at intersection of SR IS 19 dnd SR 1817
(Road Name and Number, Community, Subdivision, Lot No.) Quadrangle No.
3. OWNER: NCDENR/Brand
4. ADDRESS: Raleigh NC 2
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH' 25'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hypo(
9. SEALING MATERIAL:
Neat Cement
bags of cement I
gallons of water6
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
Bradshaw Site
ope, hilltop, valley, flat
(circle one)
DIAMETER 1 in:
diameter
1 in.
orite used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
'LACEMENT OF MATERIAL.
!nt with water and poured down
le and stayed.
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
' c
0
w
C)
In. r
W
N C/O
rT,
11. DATE WELL ABANDONED 4/16/03 Z
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well Billy Casper Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
GW� 30 Revised 12/99

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. (919) 73,3-3221
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
I WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial 0 Agricultural ❑ Monitoring
Recovery El Heat Pump Water Injection[]Other: ❑ If Other, List Use: Lat. 35.1466459 Long. 78.33902608
2. WELL LOCATION: (Sho
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number, 1
3.OWNER: NCDENR / B
4. ADDRESS: Raleigh NC 2
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 36'
7. CASING REMOVED:
feet
36'
8. DISINFECTION: N/A
(Amount of 70% hypoc
9. SEALING MATERIAL:
Neat Cement
bags of cement 2
gallons of water 12
Other
Type material N/A
Amount
a sketch of the location on back of form.)
County Sampson MW96
I SR 1817
, Subdivision, Lot N
Bradshaw Site
e, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
1 in.
used:)
Sand Cement
bags of cement . N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole and stayed.
Quadrangle No.
RAM: Draw a detailed sketch of the
total depth, depth and diameter
of
ning in the well, gravel interval,
Fintervals
sing perforations, and depths and
aterials used.
O
w
c
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W
a
r
N
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c�
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cp
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11. DATE WELL ABANDONED 4/16/03
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well own.
Signature of person abandoning the wellBilly Casper ,L Date4/16/03
WELL LOCATION: Draw I location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Divi
from completion of aban&
of Water Quality, Groundwater Section, one copy to the owner within 30 days
GW-30 Revised 12/99

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 -Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Appl
RecoveryEl Heat Pump W
2. WELL LOCATION: (Sh
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number,
3.OWNER: NCDENR /
4. ADDRESS: Ralei.gh NC 2
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hypo(
9. SEALING MATERIAL:
Neat Cement
bags of cement I
gallons of water6
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
e Box): Residential ❑ Municipal ❑ Industrial ❑ Agntcultural ❑ Monitoring
Injection❑ Other: O If Other, List Use: Lat. 35.1466882 Long. 78.337342
a sketch of the location on back of form.)
SR 1817 County Sampson MW#5
, Subdivision, Lot
Bradshaw Site
e, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
1 in.
used:)
o.)
Sand Cement
bags of cement N/A
gallons of waterN/A
kCEMENT OF MATERIAL.
with water and poured down
Quadrangle No.
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
c
o
-t c
11. DATE WELL ABANDONED 4/16/03 Cl c
NZ,
N
rT:
I do hereby certify 'that this well was abandoned in accordance with 15A NCAC 2C, well constMctiof: ;
standards, and that a copy of the record has been provided to the well owner. o
z
Signature of person abandoning i the wellBilly Casper Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
Revised 12/99

'North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION 4 2009
1. WELL USE (Check Appl
Recovery[] Heat Pump W
2. WELL LOCATION: (Sh
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number,
3. OWNER: NCDENR / Bran
4. ADDRESS: Raleigh NC
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
S. DISINFECTION: N/A
(Amount of 70% hvDO(
9. SEALING MATERIAL:
Neat Cement
bags of cement I
gallons of water6
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
le Box): Residential ❑ -Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Injection❑ Other: ❑ If Other, List Use: Lat. 35.143197 Long. 78.3364225
a sketch of the location on back of form.)
I SR 1817 County Sampson MW#4
Community, Subdivision, Lot No.)
Ion Bradshaw Site
7699
Slope, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
1 in.
lorite used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
'LACEMENT OF MATERIAL.
,nt with water and poured down
Quadrangle No.
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
0
w
—C c
w
J_
v70
� G
2
11. DATE WELL ABANDONED 4/16/03
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of th j record has been provided to the well owner.
Signature of person abandoning the well Casper �' Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
- - -'-= 7 — GW-30 Revised 12/99
r �
i

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27699-1639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL, CONTRACpORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Aggricultural ❑ Monitoring
Recovery[]Heat Pump Water Injection[] Other: El If Other, List Use: Lat. 35.1459506 Long. 78.3398883.
2. WELL LOCATION: (Sho a sketch of the location on back of form.)
Nearest Town: Clinton I County Sampson MW#3
at intersection of SR 1819 and SR 1817
(Road Name and Number, Community, Subdivision, Lot No.
Quadrangle No.
3. OWNER: NCDENR / Brandon Bradshaw Site
4. ADDRESS: Raleigh NC 2
5. TOPOGRAPHY: draw,
6. TOTAL DEPTH: 25'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hvpoc
9. SEALING MATERIAL:
Neat Cement
bags of cement I
gallons of water6
Other
Type material N/A
Amount
e, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
I in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL.
pulled casing out, mixed cement with water and poured down
hole until it came out top of hole and stayed.
11. DATE WELL ABANDONED 4/16/03
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
c
o
W
N m=
�7 0
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the 'record has been provided to the well owner.
Signature of person abandoning the wellfli�Casper Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet; showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division
from completion of abandonn is
Water Quality, Groundwater Section, one copy to the owner within 30 days
GW-30 Revised 12/99

North Car olina - Department of
Service Center - Raleigh, NC:
)nment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
1639 -Phone No. [phone]
WELL ABANDO
1. WELL USE (Check Appl
Recovery[] Heat Pump W
2. WELL LOCATION,: (Shc
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number.
3. OWNER: NCDENR / Branc
4. ADDRESS: Raleigh NC 2
RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
ble Box): Residential ❑ Municipal ❑ Industrial ❑ Aggricultural ❑ Monitoring
r Injection[] Other: ❑ If Other, List Use: Lat. 35.1440780 Long. 78.3391044
r a sketch of the location on back of form.)
d SR 1817 County Sampson MW#2
ommunity,
Bradshaw Site
vision, Lot No.
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
6. TOTAL DEPTH: 25' (circle one). DIAMETER 1 in.
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hvnoc
9. SEALING MATERIAL:
Neat Cement
bags of cement 1.
gallons ofwater6
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until.it came out top
11. DATE WELL
diameter
1 in.
Trite used:)
Sand Cement
bags of cement N/A
_ gallons of waterN/A
LACEMENT OF MATERIAL.
nt with water and poured down
e and stayed.
ED 4/16/03
Quadrangle No.
WELL DIAGRAM: Draw a detailed sketch of the
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials -used.
c
O 'o
w
— o-
w �.
r
>a _Hq
N cn'
rn
n
J o
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided to the well owner.
Signature of person abandoning the wellBilly Casper Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams Identify roads with State Highway road identification numbers.
Submit original to the Division
from completion of abandonme:
Water Quality, Groundwater Section, one copy to the owner within 30 days
GW-30 Revised 12/99

North Car olina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section - 1636 Mail
Service Center - Raleigh, NC 27691M639 - Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTORBilly Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE (Check Appl
Recovery[] Heat Pump W
2. WELL LOCATION: (sh
Nearest Town: Clinton
at intersection of SR 1819
(Road Name and Number,
3. OWNER: NCDENR / B
le Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Injection❑ Other: ❑ If Other, List Use: Lat. 35.1439417 Long. 78.3377806
a sketch of the location on back,of form.)
l SR i R i 7 County Sampson MW# 1
ty, Subdivision, Lot No.)
Bradshaw Site
4. ADDRESS: Raleigh NC 27699
5. TOPOGRAPHY:. draw,
6. TOTAL DEPTH: 40'
7. CASING REMOVED:
feet
25'
8. DISINFECTION: N/A
(Amount of 70% hvpoc
9. SEALING MATERIAL:
Neat Cement
bags of cement 2
gallons of water 12
Other
Type material N/A
Amount
10. EXPLAIN METHOD
pulled casing out, mixed
hole until it came out top
e, hilltop, valley, flat
(circle one)
DIAMETER 1 in.
diameter
I in.
used:)
Sand Cement
bags of cement N/A
gallons of waterN/A
Quadrangle No. .
WELL DIAGRAM: Draw a detailed sketch of th
well showing total depth, depth and diameter of
screens remaining in the well, gravel interval,
intervals of casing perforations, and depths and
types of fill materials used.
o
w �
A "
,ACEMENT OF MATERIAL.
t with water and poured down w,
and stayed. I v
m
11. DATE WELL ABANDONAD 4/16/03
I do hereby certify that this well was abandoned in accordance with 15A NCAC 2C, well construction
standards, and that a copy of the record has been provided.to the well owner.
Signature of person abandoning the well Billy Casper Date4/16/03
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
of the well to at least two (2) nearby reference points such as roads, intersections and
streams. Identify roads with State Highway road identification numbers.
Submit original to the Division of Water Quality, Groundwater Section, one copy to the owner within 30 days
from completion of abandonment.
:. _i , W-30 Revised 12/99

APPENDIX IV
r, RTIFICATES OF ANALYSIS
AND
CHAIN OF CUSTODY

Report to: I l O GROUNDWATER SECTION Page of
NC DENR/DWQ LABORATORY (check one):
CHAIN OF CUSTODY (COC) RECORD
[ i CE\TRAL [ ] ARO [ j WaRO
For Investigation of:. I l
Incident No.
Sample collector (print name)
and GW-54 forms completed by: 4
r
jol 4 5RIW,4�4V Sample collector's signature: �s
Field storage conditions and location (-when apil licable):
Lab Use Only
LAB NO.
SAMPLE ID
I
J
QUAD'. N(D.
LOCATION
DATE
SAMPLED
TIME
SAMPLED
NUMBER
OF
CONTAINERS
/J
iz 1✓�Jf l<i -
St �i� Sol L ✓
/ �3.
I�G
Ao
l�/
1
1
1
1
in b bnature):
Date
3 If 63
Time
,5�a
ived by (si a
D to
�4 0
Time
Relinquished by (signature):
Date
Time
Received by (signature):
ate
Time
Relinquished by (signature):
Date
Time
Received by (signature):
Date
Time
Method of Shipment (circle one):
State Courier
I
Hand -delivered Federal res UPS
Other:
Security Type.and Conditions:
eti e y:
!/
(/,(1✓
Bro n by:
INTRALABORATORY CHAIN OF CUSTODY - Lab Use Only
LAB NUMBERS
FROM THROUGH
I NUMBER
I BOTTLES
ANALYSES
REQUESTED
RELINQUISHED
BY:
RECEIVED
BY:
DATE
TIME
l
tc
,i.7
g
QA\FormslSampleReceiving%COC form GW 4/10/01dbs

-OUNTY SAMPSON
2UAD NO:
ZrPORTTO FRO. Regio
OLLECIOR(S) ,, B'SUANAIfAN
3Al E: 311812003
I'IME:
'URI'OSE: -
,ABORA'1'ORY ANALYSIS.
DIVISION Of NVATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE DEME.RGENCY
nal Office .X� CI IAIN OI--CUSTODY
MWl
lV SA�II'I.li'1'YI'li
Owner: - - UENR -
Location or Site:
Description of samplin}; point
Sampling Method:
Remarks:
BOD 310
m •/ L
COD High 340
m /L
COD Low 335
m / L
Coliform: MF Fecal31616
/100m1
Coliform: MF Total31504
/100ml
TOC
mg/1
Turbitity
NTU
Residue., Suspended 530
mg/ L
Total Suspended solids
m /L
pit
units
Alkalinity to pH 4.5
m /L,
Alkalinity to pH 8.3
m /L
_
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color: True'80
C.U.
C anidc720
m /L
'OMMENTS
Diss. Solids 70300 mg/ 1.
Fluoride 951 mg/ L
Hardness: total 900 m /L
Hardness: (non-carb) 902 m /L
Phenols 32730 u /L
Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide745 m /L
WAS m /L
Oil and Grease mg/ L
Silica mg/ L
Boron
,Formaldehyde m /L
NJ13asN610 mg/ L
TKN as N 625 m /L
X
NO2+NO3 as n 630 0.02U,Q2 m /l.
P: Total as P 665 m /L
PO4 mg/ L
MAY — 5 2oo.3 �
[ Lab Number 3G0249
E ak t ale Received 3/19/2003
ime Received 9:00 AM
Received 0y S
�.
� Qeased ny : R
Dale reported: 5/l/200.3
A-Silver46566 v•/L
M-Aluminum46557 u /L
As-Arsenic46551 u /L
Ba-Barium46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
_
Cr-Chromium46560 v /L
Cu- Copper 1042 u / L
Fe- Iron 1045 u /L
11- Mercury 71900 u /L
K-Polassium46555 mg/ L
Mg- Manesium927 mg/ L
Mn-Man anese 1055 a /L
Na- Sodium 929 mr/L
Ni-Nickel u . /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
'4
LEI"—
r
Or •anuchlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid 1-lerbicides
l lVolatile Oreanics (VOA bottle) I
Gasoline
3g0249

f,
North Carolina
GROUNDWATER FIELD/LAB FORM •� Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMP TYPE SAMPLE PRIORITY
County_ j. - Scit'E141ter ❑ Routine Lab Number
,-�- 4-q-------------
❑ Soil ❑ Emeraencv l�
Quad No__Serial No --
Date Received-.3 jo �-Time-_ �
Lat._ Lon -- ❑ Other--------------------
9•Rec'd By:.0� rom:Bus, n , Hand Del.,
�. barn of Custody Other:_
Report To: AROCF_Q, MRO, RRO, WaRO, WiRO, _ - - --� ---- --------------------
Dala Entry By:--------.----- Ck: -----------
WSRO, Kinston FO, Fed. Trust, Central Off., Other:— Data
---- _ - - Reported:-----------------------
Shipped by: Bus, ou• r, Hand Del., Other: _ _ _ _ Purpose:
Collector(s):--&a�_.��f.4.�/fi Al—_ Date ,3 /� —43— Time D Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, C3tTi �:� ✓�'� `�1��:�
�•_
(cirdeonc)
-FIELD ANALYSES Owner—i��_�i�'
----------------------- - ---
pH 400-------------------- Spec. Cond.ynat 25eC Location or Site —/3 r_r
Temp.,o_ —_ _eC Odor —_—_ Description of sampling point
Appearance--------------------------- _ - — Sampling Method— r----- ---- Sample Interval
Field Analysis B :_----- --- -- - �`'----- ---- - f
Y Y----------------------------- - Remarks-LLrS�'(! —-1f�`-----r'iTmo.—aTer_eic.j'---- --------------
LABORATORY ANALYSES (Pumping lime, air temp., etc.)
BOD 310 mg/L
COD High 340 rr,g/L
COD Low 335 mq/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 ug1L
Color: True 60. Cu
Cyanide 720 mg/L
Let)
GW-54 REV. 12/87
Mrs. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: 'total 900 mg/L
Hardness (lion-carb 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhos/cm
Sulfate 945 rng/L
Sulfide 745 mg/L
Oil and Grease mg/L
NHS as N 610 mg/L
TKN as N 625 mg/L
NO7 + NO., as N 630 v/ mg/L
P: Total as P 665 mg/L
For Dissolved Analysis -submit filtered sample and wrile'DIS' in block.
Ag-uilver 46566 ugll.
AI -Aluminum 46557 ug/I '
As -Arsenic 46551 ugh.
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L.
Cu-Copper46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg;L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mq/L
Ni-Nickel uq/L
Pb-Load 46564 ug/L
Se -Selenium ugiL
Zn-Zinc 46567 ug/1-
O,gnnochlorinn Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organics
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival:
'�% "' ... • raj
Itit:'. fir i...,-..,.i.1% I;'•.r;.i ""}•tr
ij'{..•.L1=�'Is�I;�aJt'S �L{'�`o ei-•;

_OUNTY : SAMPSON
ZUAD NO:
(SPORT TO FRO
Regional Office
:OLLECTOR(S) : - B SHANAHAN
)ATE: 3/18/2003
1ME:
'URPOSE:
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
LABORATORY ANAT.YCTC
BOD 310
m /L
COD High 340,
m /L
COD Low 335
m /L
Coliform: MF Fecal 31616
/100ml
Coliform: MF Total315(4
/100m1
TOC
m /I
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
Alkalinity to pH4.5
m /L
Alkalinity to pH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color: True 80
c,u,
Cyanide 720
m /L
)MMENTS :
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
X❑ CHAIN OF CUSTODY
MW-1DUP
1N� SAMPLE TYPE J
DENR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total900 m /L
Hardness: non-carb 902 m /L
Phenols 32730 u /L
ISpecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldeh de m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2 +NO3 as n 630 4.5 m /L
P. Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
Al-Aluminum46557 u /L
As-Arsenic46551 u /L
Ba-Barium46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium 46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc46567 u /L
Lab Number
3GO250
Date Received :
3/19/2003
Time Received :
9:00 AM
Received By
3
DS
101
e eased By .
AR
MARI 2003
Date reported : 3/27/2003
Pesticides
Pesticides
Gasoline
oLiR�FA',rtiTTVii.1_li:ul�T,AI UFI� 4L
.. 3g0250

GROUNDWATER FIELD/LAB FORM
County_�ITn-------------
Quad No_.__—___— Serial No.
Lat.------------ Long. ---
Report To: ARO,(Q. MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., _Other:__
Shipped by: Bus, older, Hand Del.- Other•
VLE TYPE
ter
❑ Soil
❑ Other__� _
91 hain of Custody
SAMPLE PRIORITY
❑ Routine
❑ Emeraencv
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Lab NumAi
Date RecTime
Rec'd By:us
Other:------------
Cotiri Hand Del.,
. ,
Data Entry By: .........
Data
.
---- Ck:- -----
Reported:—___
�a.- , t - ,L, _I-imezAi. ►_P_:�.� Baselines-Complaint,-Complialice-LUST-Pesticide Study, Federal Trust, f '
nH 4- ANALYSES --- p :1��
Owner 7 `— (circle one) �-
pH 400---- ���'_----�--------------
_______—_ Spec. Cond.s,______ _—at 25°C Location or Site i3.•.?.,
Temp.lo °C Odor _
--------_--_—_ _- Description of sampli point _
Appearance-- --------------------------------------------�
Field Analysis By:_________ ------------ Sampling Method— <<A-r ,
Y —---------_-___ Sample Interval
bailer. etc 1 ----
LABORATORY ANALYSES -----
BOD 310 m /L —(Pumping------
9
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100m1
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 mg/L
Bicarbonate 440 mg/L
Carton dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color. True 80 CU
Cyanide 720 mg/L
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 Gre mg/L
J,eas
10 mg/L
TKN as N 625 mg/L
NOz + NO3 as N 630 mg/L
P: Total as P 665 mg/L
Ag-Silver 46566 ug/L'
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Chromium 46559
ug/L
THg-Mercury
Capper46562 ug/L
ron 46563 ug/L
71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel uq/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567
ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organics
TPH-Diesel Range
Volatile Organics (VOA battle)
TPH-Gasoline Range
TPH-STEX Gasoline Range
LAB USE ONLY
Temperature on arrival:
-------------------
GW-54 REV, 12/87 For Dissolved Analysis -submit filleted sample and write'DIS' in block.----`--------------

OUNTY : SAMSPSON
!UAD NO:
EPORTTO FRO Regional Office
OLLECTOR(S) : B SHANAIIAN
ATE: 311912003
[ME:
URPOSE: Owner:
Location or Site:
ABORATORY ANALYSIS
BOD310
m /L
COD High 340
m /L
COD Low 335
m /L
Coliform: MF Fecal 31616
100m1
Coliform: MF Total 31504
/100m1
TOC
mg/1
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
Alkalinity to pH 4.5
m /L
Alkalinity to PH8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color: True 90
C.U.
Cyanide 720
m /L
7MMENTS :
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
CHAIN OF CUSTODY
MW2
W❑ SAMPLETYPE
DF,NR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non-carb 902 m /L
Phenols 32730 u /L
,Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldeh de m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2+NO3 as n 630 38 m /L
P: Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
Al-Aluminum46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium 46559 u /L
Cr-Chromium 46560 u L
Cu- Copper 1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium46555 m /L
Mg- Maesium927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
Lab Number 3GO266
Date Received : 3/20/2003
Time Received : 9:50 AM
R�ece�ived3By DSI
`i Iteteased-It
YI
Date reported: 3/27/2003
Pesticides
I I Acid Herbicides I
" W r
ra126�
Gasoline
3g0266

GROUNDWATER FIELD/LAB FORM
----- SAME TYPE
County— -1•►•� ��W/
ater
Quad No_—_ Serial No. ❑ Soil
Lat. _ - —
Long.___ ❑ Other__ 1
Report To: ARO,(Q, MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bus, ou r, Hand Del., Other:
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY
❑ Routine !/Z) Lab NumberV� r„
❑ Emeroencv —
.1 Date Received 3��-Time.
Rec'd By: OS rom:Bus, ouri ,Hand Del.,
s dy Other:—____— --- Data Entry By--___--_— — Ck:
Data ------
Reported:
Purpose: --- — —__
FIELD ANALYSES —'--� 111e ''-ZLyQ« Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, 0✓�;_��.,.�
Owner=i7�/�' (circle on
e)
pH 400-- Spec. Cond.ga-_— —at 25-C Location or Site
Temple — eC Odor
Appearance——----------- -------- Description of samplinq point______ __ — —-------
Field Analysis By:_____ Remarks ----- — ----- Sampling Method— d _-------------- Interval
LABORATORY ANALYSES —
p<rr .- ,� %� fPumo. bailer. etc 'Sample1----- ------_--___— -�
BOD 310 mg/L (Pumping time, air temp., etc.) ------ — -----_--
COD High 340 mg/L
COD Low 335
mg/L
Coliform: MF Fecal 31616
/100ml
Coliform: MF Total 31504
/100ml
TOC 660
mg/L
Turbidity 76
NTU
Residue, Suspended 530 mg/L
PH 403 units
Alkalinity to PH 4.5 410 mg/L
Alkalinity to pH 8.31415 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 mglL
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total goo mg/L
Hardness (non-carb 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhm1cm
mg/L
mg/Lse
mg/L
E
mg/L
TKN as N 625 mg/L
NOi + NO, as N 630 '7 s v�r mg/L
P: Total as P 665 mg/L
Pesticides
rus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
semivolatile
TPH-Diesel I
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
Temperature on arrival: / ,0
-------------=----
---- -----
W-54 REV, 12/67 For Dissolved Analysts -submit filtered sample and write -DIS' in black. —--`-------------—__—_--__

RUNTY : SAMPSON
UAD NO:
:PORT TO FRO Regional Office
JLLECTOR(S) : B SHANAHAN
ATE: 3/19/2003 '
ME:
JRPOSE Owner:
ABORATORY ANALYSIS
BOD 310
m /L
COD High 340
m /L
COD Low 335
m /L
Coliform: MF Fecal 31616
/100ml
Coliform: MF Total 31504
100ml
TOC
m /I
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
Alkalinity to pH4.5
m /L
Alkalinity to pH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color: True 86
C.U.
Cyanide 720
m /L
IMMENTS :
Location or Site:
Description of sam
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
CHAIN OF CUSTODY
MW2DUP
W❑ SAMPLE TYPE
DENR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non-carb 902 m /L
Phenols 32730 u /L
S ecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldehyde m /L
NH3 as N 610 m /L
TKN as N 625 m / L
X
NO2 +NO3 as n 630 38 m /L
P. Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
AI -Aluminum 46557 u /L
As-Arsenic46551 u /L
Ba-Barium46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 v /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium 46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
ice. ` � `.'�.."� y ....... .............
i I✓Q
Lab Number 3GO267
Date Received : 3/20/2003
Time Received : 9:50 AM
Received By
R—eleased By . AR
Date reported: 3/27/2003
Pesticides
I I Acid Herbicides I
Gasoline
V
DEN.9-FAY1 tPit.: `u`NALGFl=10E390267
_� u

GROUNDWATER FIELD/LAB FORM
-- ---LE3
:SAPLF TYPE SAMPLE PRIORITY
at"
❑ Routine
Quad No_—_—__— Serial No. il ❑ Emeroencv
Lat. ---_— Long. — — her I �
� ham df Custody
Report To: ARO,(-ZQ, MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:_ _
Shipped by: Bus, ' r, Hand Del., Other: Purpose:
Collector(s):_��.c Time `� = ��"�t �-1 Baseline, Complain
pH 400Spec. Cond.94_-- —at 25eC
Temp.lo °C Odor
Appearance — --------------------
Field Analysis By:
LABORATORY AAIAI----
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 8.3 415 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
Lou vv11111 RA
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
iq Lab Number��_b---
a Date Receed 3Q Time ' —_
Pup Rec'd By: Fr m:Bus ourie Hand Del.,
Other:______
---- ----------
Data Entry By: ____—_---
Data ----
Reported:—
L
Location or Site
Description of sampling point — — ------
i��_� ---------------
Sampling Method_ ------------------------------
��_--_Sample Interval
Remarks
IPumo, bailer. ell----------
----------------
(Pumotna limn air l­ n 1 --- ----'
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total goo mg/L
Hardness (non-carb 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhosfcm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
NH3 as N 610 mgfL
TKN as N 625 mg/L
NO= + NO, as N 630 ,' `Yr mg/L
P: Total as P 665 mg/L
GW-54 REV. 12187 For Dissolved Analysis -submit tillered sample and write -DIS- in block.
Ag-Silver 46566 ug/L
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organics
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival:

:OUNTY : SAMPSON
2UAD NO.
',EPORTTO FRO Regional Office
:OLLECfOR(S) : B SHANAHAN' -
)ATE: 3/1912003
]ME:
'URPOSE: - Owner:
,ABORATORY ANALYSIS
BOD310
m /L
COD High 340
m /L
COD Low 335
m /L
Coliform: MF Fecal 31616
/100m1
Coliform: MF Total 31504
/100m1
TOC
m /l
Turbitity
NTU
Residue., Suspended 530
m /L:
Total Suspended solids
mg/L.—
PH
units
Alkalinity to PH 4.5
m /L
Alkalinity to pH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color. True 80
C.U.
Cyanide 720
m /L
DMMENTS :
Location or Site:
Description of sam
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
CHAIN OF CUSTODY
M W3
W❑ SAMPLE TYPE
DENR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: noncarb 902 m /L
Phenols 32730 u /L
iSpecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldehyde m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2 +NO3 as n 630 0.02U m /L
P. Total as P 665 m /L
PO4 m /L
A-Silver46566 'u /L
AI-Aluminum46557 u /L
As -Arsenic 46551 u L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium 46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 -u /L
No- Sodium 929 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc46567 u /L
Lab Number 3GO268
Date Received : 3/20/2003
Time Received : 9:50 AM
Received By DS
e eased B 3 .� AR
�
y
Date reported : 3127/2003
Pesticides
P—K,l
Acid Herbicides
Semivolatiles
Gasoline
E""HIVED rt
yy� p
3g0268
DENIR M rAYEi EALLE KEG.10M OFFICE

GROUNDWATER FIELD/LAB FORM
County��l±!X511 c—_—_--__-----
Quad No_—____— Serial No. _
Lat.— _--_— Long.
Report To: AR0,(0, MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Deparlment of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Lab NumberPdus(
Date ReceivedTime:Rec'd By: o ner and Del.,
Other:_—__ _
Data Entry By:—___—_ — — Ck:
Data ---
Shipped by: Bus, ou ' r, Hand Del., Other:_ Reported:_— - - - --
--- —_-- Purpose: --
Collector(s):--&, ; Date. - - v3 Time f ,' ��+�� Baseline, Complaint, Compliance, -LUGS e, P_esticide_Study,-Federal Trust, :�ii_✓�Jf FIELD ANALYSES Owner 'i7c t,1,e _ i
pH 400-- ______—_ Spec. Cond.9e_ —at 25°C Location or Site
Temp.lo�����
°C Odor _ — Description of samplip point -- --
Appearance ___ -----_--__--__----_ _____
-- Sampling Method '-------------
Field Analysis By:- — `"`="'+�--------_____—__ Sample Interval
Remarks
LABORATORY ANALYSES —
r r y� 1 �: fpum°. bailer, etcl --
Boo 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 Mooml
Coliform: MFTotal 31504 /loom)
TOC 680 mg/L
Turbidity 76 Wu
Residue, Suspended 530 mg/L
I FpH
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
SA- MPLE TYPE SAMPLE PRIORITY
ater ❑ Routine
❑ Soil ❑ Emeraencv
❑ Other
ilCu�,tdy
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total goo 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
NHi as N 610 mg/L
TKN as N 625 mg/L
NO= + NOS as N 630 - f mg/L
P: Total as P 665 mg/L
Ag-Silver 46566 ug/L'
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs '
Semivolatile Organics
TPH-Diesel Range
Volatile Organics (VOA bot'
TPH-Gasoline Range
TPH-BTEX Gasoline Rangr
LAB USE ONLY
Temperature on arrival:
—--- ----------- --------------
GW-54 REV. 12/87 For Dissolved Analysis -submit filtered sample and write DIS in block.-- ------------
VA"

:OUNTY : SAMPSON
PAD NO:
EPORT TO FRO Regional Office
.OLLECTOR(S) : B SHANAHAN
iATE: 3/1912003
IME:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
❑ CHAIN OF CUSTODY
MW3DUP
W❑ SAMPLE TYPE
URPOSE: Owner. DENR
Location or Site:
Description. of. sampling.point
Sampling Method:
Remarks:
,ABORATORY ANALYSIS
BOD 310
m L
COD High 340
m /L
COD Low 335
m /L
Coliform: MF Fecal 31616
/100m1
Coliform: MF Total 315(4
/100ml
TOC
m /I
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
Alkalinity to PH 4.5
m /L
Alkalinity to pH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium Hex 1032
u /L
Color: True 80
C.U.
Cyanide 720
m /L
)MMENTS :
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non Garb 902 m /L
Phenols 32730 u /L
iSpecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldeh de m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2+NO3 as n 630 0.02U m /L
P: Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
Al -Aluminum 46557 u /L
As-Arsenic46551 u /L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium 46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 u / L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium 46555 m /L
Mg- Ma esium927 m /L
Mn-Man anese 1055 u /L
Na- Sodium 929 m /L
Ni-Nicke( u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
RECEIVED
®fie
�t /opd-% �f iec ���
V
Lab Number : 3GO269
Date Received : 3/20/2003
Time Received : 9:50 AM
Received By DS
3 aI �c
eleased BY : AR
Date reported: 3/27/2003
Or anochlorine Pesticides
Or ano hos horns Pesticides
Nitrogen Pesticides
Acid
Gasoline
WO
3g0269

GROUNDWATER FIELD/LAB.FORM
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
! -_---� [ A]4e TYPE SAMPLE PRIORITY �j �n
County ���►►�f1 <f,,ti ---_— L—i.}�IV/ater ✓�
--�= ❑ Routine 41 �J Lab Number__ ✓
Quad No_---_— Serial No. _ ❑Soil ❑ Emeraencv 3 Date Received Lat. ---_— Long. _ ❑ Other (� -Ti _
— L{ Rec'd By: From:Bus ou '. ,Hand Del.,
h in o Custody O
Report To: ARO,, MRO, RRO, WaRO, WiRO, Other:_—___— --—__-_--
By:Ck
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Data Entry _ Data `---
Shipped by: Bus, ou ' r, Hand Del., Other:—___ Reported:
_— Purpose: Collector( Purpose:
�� , ,22±6 LFZ� l/ Date 3 // - o� Time l� "3 /..cr., Baseline, Complaint, Compliance, LUST, Pesticide Study,Federal Trust, r ' FIELD>ANALYSES:�Q✓f'J�h
Owner 'i�C �V ,�' t"r`'°°^e)
PH Spec. Cond.94__ at 25°C Location or Site----
Temp.lo °C Odor--- Q-�
----------------- Description of sampling point_ — ---
Appearance ___ _ ----------------------------=--------
Sampling Method—/ `l.rr ------
Field Analysis By: -- — -----,�------__—_—_ _-- Sample Interval
- Remarks .� � v;� IPum°. bailer. etc.t — ----
LABORATORY ANALYSES - - —`�—'�-------- ---
Boo 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MFTMal 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
-Alkalinily'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
Lau %JUlllltlUI
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
NO2 + Ng as N-630 s-v/ mg/L
P: Total as P 665 mg/L
GW-54 REV. 12167 For Dissolved Analysis -submit filtered sample and write'DIS" in block.
(Humping time, air temp., etc.)
Ag-Silver 46566 ug/L•
AI -Aluminum 46557 ug/L
As- Arsenic 46551 ug/L
Ba-Barium 46556 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper 46562. ug/L
Fe -Iran 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 4655.4
mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
organochlorine Pesticides
Organophosphorus 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: I I \

` MAY - 52003
DIVISION Or WATH R QUALITY
Chemistry Laboratory Report / Ground Water Quality'
/J
`""'^- --._....
Lab Number
3GO271
Date Received :
3/20/2003
)UNTY : SAMPSON
SAMPLE PRIORITY
1
_ . M. rW_
;. Time Received
9:50 AM
JAD NO:
.PORTT'O IF Regional Office
F-IROUrINEEMERGENCY
CI IAIN Of CUS'I'UDY
__..
Received By
I 1
DS
i
O _
)LLECrOR(S) : B,SIIANAIIAN ;
MW4
a —Released 8y
AR
\TE: 3/19/2003
W SAMPLE TYPH
Date reported:
5/1/2003
NE:
IRPOSE: Owner:
DENR
00RATORY ANALYSIS
WD310
m /L
,COD Iii h340
m /L
-COD Low 335
m '/L
:Coliform: MF Fecal 31616
/100m1
Coliform: MF I'otal31504
/100m1
TOC
mg/1
'rurbitity
NT U
Residue., Suspended 530
m /I.
Total Suspended solids
mg/ L
11
units
Alkalinity to pI14.5
mg/L.
Alkalinity to pi18.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
mg/ L
Chromium: Hex 1032
u /L
Color: True 80
C.U.
Cyanide 720
m /L
MMENTS :
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
Diss. Solids 76300 m /L
Fluoride951 mg/ L
Hardness: total 900 m /L
Hardness: min-carb 902 m /L
Phenols32730 - u /L
Specific Cond.95 umhos/cm2
Sulfate mg/ 1.
Sulfide7,15 m /L
MBAS mg/ L
Oil and Grease m /L
Silica m /L
Boron
.Formaldehyde m /L
N113asN610 m /L
rKN as N 625 m /L
X—
NO2- NO3-1s,n630 25-Q2—m /1.
P: Total as P 665 m p/L
104 m / L
A-Silver46566 ' u /L
AI -Aluminum 46557 u /L
As-Arsenic46551 u /L
Ba-Barium46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium46560 u /L
Cu-Copper IM2 u /L
Fe- Iron 1045 u /L
I l - Mercury 71900 u /L
K-Potassium46555 mg/ L
Mg- Magnesium 927
Mn-Manganese 1055 u /L
Na-Sodium 929 m /L
Ni-Nickel u /L
—
Pb-L-ead-46564 u /L
Se -Selenium a /l.
7_n_Zinc46567 u /L
3g0271

North Carolina
GROUNDWATER FIELD/LAB FORM> Department of Environment and N.-Aural Resources
DIVISION OF WATER QUALI TY-GROUNDWATER SECTION
SAMPLE TYPE SAMPLE PRIORITY
County_ cf � iT------------- -- ----- L—ia'W/aler _309 D -- I-
❑ Routine �yl �J Lab Number
Quad_ No ----
--------
Serial No ----------------- ❑ Soil ❑ Ernemencv �?
----------- Dale Received 1:1f�51 Ttme:_______
Lal.------------- Lon --------- ❑ Other_. t lip '(�� -
- g•----- � �-----------•---------- p Ftec'd By: (�j om:Bus our a Hand Del.,
pain f Custody Other:_
Report To: ARO, -f34 MRO, RRO, WaRO, WiRO, _ --_-- Gala Entry By:_--•---------__-- Ck:__-____-- _-- _--
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Data
------ ---- --- Reported:
Shipped by Bus ou 'fir, Hand Del Other _ _ Purpose: --------------- ----- ---- -
Cvllector(s)..� SL�,4,_V,>tra/___� Dale S _(�_-LI Tirne 1�.:�1 4-- Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, �i[TieF:�=�'�/< •,7i�:�
FIELD ANALYSES Owner (`''deem') '�---
pH 400------ —---------- - Spec. Cond.94------ — — -� �R-----,
------------------ ------
____al 25°C Location or Site—%3 ,_^"K!r ,—G �_l�(„s�a ,�, �, . r'<_—__—_—
emp.t0 — °C Odor---------------------- ---- Description of sampling point-------------------- ---------------------------
Appearance------------'
Sampling Method— r Sample Interval_
---- ---------------------- p ----------------
Field Analysis By:—___---___--_—_—_--_ Remarks---c ----
LABORATORY ANALYSES --------------- �• . (Pumping lime, ax temp.. etc.) �
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 1100m1
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-lo-pH-8:3-415 m�/L
Carbonate 445 mg/L
Bicarbonate 440 mg/tr
Carbon dioxide 405 mg/L
Chloride 940 - mg/L
Chromium: Hex 1032 ug/L
Color: True BO Cu
Cyanide 720 mg/L
LaD
GW-54 REV, 12/07
Diss. Solids, 70300 mg/L
Fluoride 951 mg/L
Hardness: 'rolal 90o mg/L
Hardness (rion-carb 902 mg/L
Phenols 32730 ug/1
Specific Cond. 95 uMhos/cm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
NHS as N 610 mg/L
TKN as N 625 mg/L,
NO: + NCh as N 630(j� �.`,�- mg/L
P: Total as P 665 mg/L
For Dissolved Analysis -submit fillered sample and write 'DIS- in block.
Ag-Silver 46566 ug/L
AI -Aluminum 46557 uglL
As -Arsenic 46551 rig/L
Ba-Barium 4655B ugh
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L'
Cr-Chromium 46559 ug/L
Cu-Capper46562 ug/L
Fe -Iran 46563 ug/L .
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/l.
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ugh.
Na-Sodium 46556 mg/L
-
NI -Nickel - - ug/L
Pb-Lead 46564 ug/1-
Se-Selenium 119/1
Zn-Zinc 45567 ug/L
Pesticides
rus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCOs
TPH-Diesel
Volatile Organics (VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Ranoe
Temperature on arrival:I

DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
:OUNTY :. SAMPSON SAMPLE PRIORITY
PAD NO: FjROUTINE EMERGENCY
EPORTTO FRO Regional Office El CHAIN OF. CUSTODY
:OLLECTOR(S) ";B'SHANAHAN';
PATE: 3/19/2003 W❑ SAMPLE TYPE
IME:
URPOSE: Owner. DENR
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
ABORATORY ANALYSIS
BOD 310
m /L _
'COD High 340
m /L '
7,COD.Low 335
m /L
Coliform:,MF Fecal 31616
100mI
Coliform: MF Total 31504
/100ml
TOC
mg/1
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspinded'solids
m /L
H
units
Alkaliniiv to pH4.9
m /L
Alkalini .to H8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex-1032.
— - - u /L
Color. True 80
C.U.
Cyanide 720
m /L
)MMENtS :
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non-carb 902 m /L
Phenols 32730 u /L
.Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease in /L
Silica m /L
Boron
,Formaldehyde m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2 +NO3 as n 630 25 m /L
P: Total as P 665 m /L
PO4 -- — -- — m /L
Lab Number
3GO270
Date Received :
3/20/2003
Time Received :
9:50 AM
Received By
DS
qCasedSBy :
a
Al
Date reported :
3/27/2003
A-Silver46566 u /L
Al -Aluminum 46557 u /L
As-Arsenic46551 u /L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium,16559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium 46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel
Pb-Lead 46564 u /L
Se -Selenium v /L
-'
Zn_Zinc46567 _ u /L
390270

GROUNDWATER FIELD/LAB FORM North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
l -- :Tatr
TYPE SAMPLE PRIORITY
County �1I�dn
❑ Routine � `� Lab Number���
Quad No — Serial No. ❑ Soil ❑ Emeraencv , !-----
Lat. --_— Long. ❑Other_ � Date Recei d_ -
Rec'd By:'
F om:Bus, ours. r, Hand Del.,
ha�tCustody
Report To: ARO,Q, MRO, RRO, WaRO, WiRO, Other:_—___— -- —
Data Entry By: ------ --—
WSRO, Kinston FO, Fed. Trust, -Central Off., Other: Data — -----
Shipped by: Bus, ou r, Hand Del., Other: Reported: _
Collector(s):_&.c Sffi¢,cj�,(% Date 3_' O Purpose:
FIELD ANALYSES Time N_'e) V4K, Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, t'1 1i R:Z2z 112 .�
Owner_7�/iQ (urGeone) --
TepH p ---- Spec. Conds,__— —at 25°C Location or Site /3 ,-.r„-
Temp.la °C Odor ___— Description of samplin point — —
Appearance ---- Sampling Method «�,—`--------------------------------------- z
Field Analysis By: _ ----- -- ,�----____—____ — Sample Interval
-- — Remarks:r K _ i%�— fPumo. bailer, elal
LABORATORY ANALYSES -----
SOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L-
Coliform: MF Fecal 31616 /100m1
Coliform: MF Total 31504 /100m1
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
.--u vvun((c(
Diss. Solids 70300 rrig/L
Fluoride 951 mg/L
Hardness: Total 906 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
NH, as N 610 mg/L
TKN as N 625 - mg/L-
NOz + NO, as N 630 t ,,AZ mg/L
P: Total as P 665 mg/L
GW-54 REV. 12/87 For Dissolved Analysis -submit lillered sample and write'DIS' in block.
Ag-Silver 46566 ug/L'
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper 46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L. -
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
(Pumping time, air temp., etc.) _--_-- ----_—_---
Pesticides
rus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organic
TPH-Diesel Range
Volatile Organics (V(
TPH-Gasoline Rang(
TPH-BTEX Gasoline
Temperature on arrival:

-OUNTY : SAMPSON
QUAD NO:
tEPORT TO : FRO Regional Office
-OLLECTOR(S) : B SHANAHAN -
)ATE: 3/19/2003
TIME:
'URPOSE: 0
,ABORATORV ANAT.VRTR
BOD 310
m /L
COD High 340
m / L
COD Low 335
m /L
Coliform: MF Fecal 31616
/100ml
Coliform: MF Total 31504
/100m1
TOC
m /I
Turbitity,
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
Alkalinity to pH 4.5
m /L
Alkalinity to PH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color: True 80
e.u.
Cyanide 720
m /L
IMMENTS :
caner.
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
.Chemis(ry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
TJ CHAIN OF CUSTODY
mws
W I SAMPLE TYPE
DENR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non Garb 902 m /L
Phenols32730 u /L
Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldehyde m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2 +NO3 as n 630 7.9 m / L
P: Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
Al -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /L—
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
Lab Number 3GO272
Date Received : 3/20/2003
Time Received : 9:50 AM
Received By : DS
�a�a3
fiReTe..edj
AR
Date reported: 3/27/2003
a� ,_._- _e_ • ;,; ��,,:. ;f;3�.Fn�;ir.'Oi�'t+LOrr'iCE
3g0272

GROUNDWATER FIELD/LAB FORM North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
l SAMETYPE . SAMPLE PRIORITY
County A►•,o on ------ --194ater
❑ Routine %11�(J Lab Number—�,� 0� p�
Quad No — Serial No. ❑ Soil ❑ Emeraencv'�--- --
i
Lon - `5 Date Receiv � . g._ ❑ Other _Time _
,�,� Rec'd By: From;Bus, ours ., Hand Del.,
Report To: ARO���� Ly'Chain of Custody
�ttjtd, MRO, RRO, WaRO, WiRO, Other:_—__— ---
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Data Entry By:___Ck:
Data ------
Shipped by: Bus, or r, Hand Del., Other:_ _ Reported:
Collector(s):�_;� rPur�ose;
—� L.!� Dated Time t� �Jer.,. Baseline, Complaint, Compliance, LUST, Pesticide Stud ,Federal Trust,
FIELD ANALYSES Owner_? ccircleonel y
_ -� =-
_ Spec..Cond.94--_ —at 250C Location or Site i3 �• --` Temp.lo ----- c,C Odor----
Appearance _ -------- _— Description of samplin point — - --
Field Analysis By: --- Sampling Method— c�
--------- Sam le Int I
Boo 311 mg/L
Diss. Solids 70300
COD High 340 mg/L
Fluoride 951
COD Low 335 mg/L
Hardness: Total 90o
Coliform: MF Fecal 31616 /100ml
Hardness (non-carb 902
Coliform: MFTotal 31504 Mooml
Phenols 32730
TOC fi80 mg/L
Specific-Cond. 95
Turbidity 76 NTU
Sulfate 945
Residue, Suspended 530 mg/L
Sulfide 745
Oil and Grease
PH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L—
Carbonate 445 mg/L
NHS as N 610
Bicarbonate 440 mg/L
TKN as N 625 -
Carbon dioxide 405 mg/L
NO2 NO, as N 630
Chloride 940 mg/L
P: Total as P 665
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
GW_5d RFV ��fra� ---
Remarks�rr �+ fPumo. bailer. et41 P efVa —
(Pumping time, air temp., etc.) — ------
mg/L
Ag-Silver 46566
mg/L
AI -Aluminum 46557
mg/L
As -Arsenic 46551
mg/L
Ba-Barium 46558
ug/I
Ca -Calcium 46552
uMhoslcmJer
admium 46559
mg/Lhromium
46559
mg/Lapper
46562
on 46563
71900
mg/Lercury
tassium 46555
agnesium 46554
anganese 46565mg/Lodium
46556mg/Lckelmg/Lad
46564mg/Leleniumnc
46567
�•.alaiysis-suomlt Filtered sample and write 'DIS- in block.
Organochlorine Pesticides
Orqanophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Fig/L
ug/L
mg/L
Semivolalite Organics
TPH-Diesel Range
—mg/L—
ug/L
mg/L
- —
Volatile Organics (VOA both
TPH-Gasoline Range'
ug/L
TPH-BTEX Gasoline Range
ug1L
ug/L
ug/L
LAB USE ONLY
Temperature on arrival: —
a
a r+
e rf�^-I'�v`t'�r r -I1 1:c+Lii�SL OFi7GE
i P F • _
'i
4
1•

:OUNTY ; SAMPSON
MD NO:
:EPORT TO FRO Regional Office
:OLLECTOR(S) :' B SHANAHAN
)ATE: 3/19/2003
IME:
,ABORATORV ANAT.VCT.Q
:.BOD310
m /L
'COD High 340
m /L
COD Low 335
m /L
.Coliform: MF Fecal 31616
/100ml
Coliform: MF Total 31504
/100`nl
TOC
m /I
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
H
units
"Alkalinity to pH4.5
m /L
Alkalinity to PH 8.3
m /L
Carbonate
m /L•
Bicarbonate
m /L
Carbon dioxide
m /L
Chloride
m /L
Chromium: Hex 1032
u /L
Color. True 80
Co.
Cyanide 720
m /L
IMMENTS :
Owner:
Location or Site:
Description of sampling
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
F-IROUTINE EMERGENCY
X❑ CHAIN OF CUSTODY
MW5DUP
W❑ SAMPLE TYPE
DF,NR
Diss. Solids 70300 m /L
Fluoride 951 m /L
Hardness: total 900 m /L
Hardness: non-carb 902 m /L
Phenols32730 u /L
Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldehyde m /L
NH3 as N 610 m /L
TKN as N 625 m /L
X
NO2 +NO3 as n 630 7.8 m /L
P: Total as P 665 m /L
PO4 m /L
A -Silver 46566 u /L
Al -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium 46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper 1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Potassium46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /.L—
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
Lab Number 3GO273
Date Received : 3/20/2003
Time Received : 9:50 AM
Received By :1
(IDS
Re eased�I yy : � AR�
Date reported : 3/27/2003
� d 6�, tr.l.�l �-;�,1 d J
3g0273

GROUNDWATER FIELD/LAB FORM
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
l
County,
SAvY TYPE � SAMPLE PRIORITY
f,,r ----- -----
L�'ater ❑ Routine
?,
/Z%w Lab Number-_��Q�✓
Quad No_ __ — Serial No. ____
Lot._ —_ _ Lon
—
❑ SO1I ❑ Emercencv
❑Other
&�, //
-------
Date Received _
�kp Rec'd B : T ~�
Y om:Bus, uric Hand Del.,
����
Report To: ARO,(Q, MRO, RRO, WaRO, WiRO,
Ly'Chain of Custody '
Other: `—A
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
— -- —
Data Entry By: --------- --Ck:
— —`--
Shipped by: Bus, ou . r, Hand Del_, Other:-
_ Data
Reported:
Collector(s):��c ,� �f,¢,ti/r��,(l , --- Date -` Purpose: ---
FIELD ANALYSES --- Time �'/•5�,� /� Baseline, Complaint, Compliance,Pesticide Study, Federal Trust, QiF-i�:�������,:,TiJ,�•
pH Spec. Cond.sa_-----_�
Owner —ram 1/,� (LUST,,)
_
Tem la
p °C Odor_
—at 25°C Location or Site—i3 r �r----
Appearance ---------------
__— Description of samplin point
�,g
Sampling
Field Analysis By:
--—.
"LABORATORY ANALYSES
Method_, � Lr,, d
_ — Remarks A,_ .�_ - Sample Interval
— ` —(Porn°. bail_ec elc.l,+ ---
BOD 310 mg/L
COD High 340
mg/L
COD Low 335
mg/L '
Coliform: MF Fecal 31616
/100m1
Coliform: MF Total 31504
/looml
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 60 CU
Cyanide 720 mg/L
Lab Comments
GW-54 REV. 12187
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total goo 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
NOT + NO, as N 630 '7 mg/L
P: Total as P 665 mg/L
�• . Iu,.uu mllarysis-suomil filtered sample and write'DIS' in black.
lrumpmg time, air temp., etc.) ------
Ag-Silver 46566 ug/L'
AI -Aluminum 46557 ug IL
As -Arsenic 46551 lig/L
Ba-Barium 46556 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Capper46562 ug/C
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 uglL
Pesticides
rus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile
TPH-Diesel I
Volatile Organics (V(
TPH-Gasoline Rangi
TPH-BTEX Gasoline
y1u uJC VIVLT
Temperature on arrival: .�
iit4ff.LF19,, GIONALOFFCF

1UNTY : SAMPSON
IAD NO:
PORT TO FRO
Regional Office
iLLECT'OR(S) :.' B SIIANAIIAN.; -:,,. -
TF: 3/17/2003
RPOSE:
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
LBORATORY ANAI.YSIS
BOD310
m /L
'COD I li h 340
m /L
COD Low 335
m /L
Collform: MF Fecal 31616
/100ml
Coliform: MF Total 31504
/100m1
TOC
m /I
Turbitity
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
oil
units
Alkalinity to 1-I4.5
m /L
Alkalinity to pf18.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
ni /I—
Chloride
m /L
Chromium: I lex 1032
u /L
Color. True 80
C.U.
Cyanide 720
m /L
6It11F.NTS :
DIVISION OF WATER QUALITY
Chemistry Lsborston• Report / Ground Water Qu011y
SAMPLE PRIORITY
ROUTINE EMERGENCY
C1IAINOFCUSTODY
MW6
W SAMPLEIYPE
UF.NR
Diss. Solids 70300 mg/ L
Fluoride951 mg/ L
Hardness: total900 mg/ L
Hardness: non-carb 902 m /L
Phenols 32730 u /L
,Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
WAS m /L
Oil and Grease mg/ L
Silica mg/ L
Boron
Formaldeir de mg/ L
NH3 asN610 m /L
TKN as N 625 m /L
R—
NO2 +NO3 as n 630 3:7 m /L
P: Total as 11665 m / L
PO4 m /L
Ft-
A-Silver46566 u /L
AI-Aluminum46557 u /L
As-Arsenic46551 u /L
Ba-Barlwn46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
Cu- Copper1042 u /L
Fe- Iron 1045 u / L
11- Mercury 71900 u /L
K-f'otassium46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel uy,/L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567- - — u /L
Lab Number 3GO239
Date Received : 3/18/2003
Time Received : 9:15 AM
Received By JG
3Oq
,
R ased By : AR
Date reported: 3/24/2003
R17CRVEED
c�J J -
it 3g0239
0"dR-FAYt-iliEVILLFREG!ONALOFFICE]

North Carolina I
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
l�
Courtly on -------=-----------
CQuad No-_----___— Serial No._--____-_____
Lat------------ Long.------ ---
Report To: ARO,(:f@, MRO, RRO, WaRO, WiRO,
' Lab Number36 AR� va`3—q----
Date Rec 've __[i5 �_O�_Time:�- J.
Rec'd From:B , ourier, nd Del.,
Other: ZJ
-- ----------_ -
- ----------
Data Entry By:------------- Ck:-----------
WSRO, Kinston FO, Fed. Trust, Central Off., Other:-- " " Data
------ -`- Reported: _____________________
Shipped by: Bus,(GO ' r, Hand Del., Other:____ — _ Purpose: —
<:
Colleclor(s):_ is _S�fif,U,4/ ,tl Datepajq- o Time 3: C 1 _ Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, CEle �;ejil 7 0,e ,
FIELD ANALYSES Owner '� '- __ _ (r_"r1c_one)
----E�If--------- - ------------
pH 400-_-_--------- —_- Spec. Cond.94 ------ ._al 25°C Location or Site—i3.-.r•+__� t— � — t+
Temp.io —_ eC Odor_________________ Description of sampling� point
Appearance-------=----------- Sam lin Method �`�.�r ----------------------------------------------------------
P 9�________ Sample Interval
--------- il'unio baTe�. �lq.�-----`--
Field Analysis By:-------- ------------------ Remarks_:.L_,J_ i�L _ ------------
-----
DRAT RY ANALYSES (Pumping time. air temp.. etc.)
DOD 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-8.3-4.15 mq/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
GW-54 REV. 12/87
SAMPLE TYPE
SAMPLE PRIORITY
(_►}�/V/aler
❑
Routine
❑ Soil
❑
Enteroencv
❑ Other--------.----------
P1 hain of Custody
No
G 0& —l3
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total 900 mg/L
Hardness (non-carb 902 mg/L
Phenols 32730 ug/1
Specific Cond. 95 uMhos/cm
Sulfate 945 mg/L
Sulfide 745 mg/l_
Oil and Grease mg/L
NHS as N 610 mg/L
-
-TKN as N 625 - mg/L
NO=+ NO, as N 630 'Z �v! mg/L
P: Total as P 665 mg/L
For Dissolved Analysls-submil fillered sample and write -DIS' in block.
Aq-Silver 46566 ug/L
AI -Aluminum 46557 ug/L
As -Arsenic 46551 „g/L
Da -Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Polassium 46555 mg/L
Mg -Magnesium 46554 mg/L
—
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ----- ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
Pesticides
rus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile
TPH-Diesel I
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
Temperature on arrival:
r
R CrEiV ED
MAR 3 12003
.^„i T '1(<< 1 T: 07RR1111 0FRGE

Comments: IZAY /G
/"L-cm
Corrective Action:
❑:.. 'Sampleswere reje
❑ epted and ana
Accepted and ana
❑ Sample(s) on-
-hold
NC DENR/DWQ Chemistry Laboratory
Condition Upon Receipt Anomaly Report (§CUR)
F . ..• r
T7 s
county:
t T7
Date Begin ,� / Q,�j Time BegiQ:LQ _�7
Collector
..Sample Type.*"-
.._ .
Affected Parameters •.
4 li
1
The condition of these samples were not acceptable because (check all that apply):
ElSamples (affected samples are described below)
❑ Coolers
❑ Samples not received, but listed on fieldsheet
❑ Samples were not received on wet ice
C3 Samples received, but not listed on Fieldsheet
❑ No temperature blank submitted
❑ Samples not received, but listed on COC
❑ Cooler T° reading: °C
�mles but listed on COC
❑ Temperature >6°C. T° reading: °C
preceived, not
❑ Mislabeled as to;tests, preservatives, etc.
❑ Samples frozen
❑ Holding time expired
❑ Improper container used
❑ Containers
❑ Insufficient quantity for analysis
❑ Leaking
❑ Broken
❑ Chain of Custody
El Without labels
❑ No custody seals
❑ VOA vials with headspace
❑ Custody seals not intact
❑ Sulfide samples with headspace
❑ Not relinquished.
❑ No date/time relinquished
❑ Container Labels.
❑ No signature
❑ Not the same ID/info. as on COC
❑ Incomplete information
❑ Not the same ID/info. as on Fieldsheet
❑ Incomplete. Missing the following:.
❑ Documentation
❑ Station #/Sample ID
❑ Fieldsheet
wet/illegible
❑ Collection date
❑ Fieldsheet
incomplete:
❑ Collector
❑ Records not
written in indelible ink
❑ Analysts
❑ Preservative
❑ Other:
❑ Markings smeared or illegible
❑ Torn
__ 'Ie'a
ar 4t.
❑ Other (sp
✓��
� I y ur
v
cted by D WQ Lab.= Authorized by:
lyzed per.collecs tor'request after notifying the collector.
lyzed after. notifying the client and determining that another sample could not be secured.
until:..:
Unit Leader Review (initial):
NUT
WCH
Form complet d� by`
VOA SVO4
PEST
Date: (3o—/ J 2 fi ? ..
_Date: a_/ ` /eo
MET
3/29/0 l dbs
QA\Forms\Sample Receiving\SCUR

)UNTY :
SANIPSON
]AD NO:
POR'TTO
FRO Regional Office
)I.LriCrOR(S)
:-B.SllANAllAN ..
rrr•.:
3n 7/2003
--
MORATORV ANALYSIS
BOD310
m /L
.COD i ll h 340
m / L
COD Low 335
m /L
Coliform: MF Fecal 31616
1 Wml
Coliform: MF Total 31504
/ 1 W ml
TOC
mg/1
Turbitily
NTU
Residue., Suspended 530
m /L
Total Suspended solids
m /L
oil
units
Alkalinity to pH 4.5
m /L
Alkalinity to pH 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon -dioxide
mg/ L—
Chloride
m /L
Chromium: Flex 1032
u /L
Color: True 80
C.U.
Cyanide 720
m /L
4MENTS:
DIVISION OF WATER QUALITY
Chemistry Laborelory Report / Ground Water Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
CIIAIN OF CUSTODY
MW60UR
W SAMPIXINPE
Owner: UF:NR
LAxation or Site:
Description of sampling point
Sampling Method:
Renmrks:
Diss. Solids 703W mr1l,
Fluoride951 m /L
hardness: total 900 m /L
Hardness: non-carb 902 rn L
Phenols32730 u /L
,Specific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /L
Boron
Formaldeh de m /L
NF13 as N 610 m /L
TKN as N 625 m /L
X-
NO2 +'NO3 as n 6303:8 m /L
P: Total as P 665 m /L
PO4 m /L
A-Silver46566 u /L
AI -Aluminum 46557 u /1.
As-Arsenic46551 a /L
Ba-Barium 46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium46560 u /L
Cu- Copper1042 u /L
Fe- Iron 1045 a /L
Fig- Mercu71900 u /L
K-Potassium46555 ro/L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na-Sodium929 m /L
Ni-Nickel u /L
Pb--Lead 4-6564 u /[-
Se -Selenium u /L
Zn_Zinc 46567 - u /L -
Lab Number 3GO240
Dale Received : 3/1812003
Time Received : 9:15 AM
Received By JG
l�3.I a �
sed By . AR
Dale reported: 3/24/2003
CENP 1
5
prNR-FAyEjTEVELLL :GIGL�LI�FfIC
3
3g0240

orth
GROUNDWATER FIELD/LAB FORM Department of Environment alnd Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAS TYPE SAMPLE PRIORITY
County_ tiJ! -+ � .... —.....
—.....
--- ^I� V/Vater _Jj//��
-- ❑ Routine jytCrJ Lab NumberL�1 i� j%'�/�/ D -----
Serial No.Soil ec
Quad No __ ❑ ❑ Erl,eroencv �f Dale Received ��D '(J:��
Long._ ❑ Other_--.—____—_----__-___- Date From:d Del.,
ly61,ain of Custody Co Other; -
--------------------------------
Report To: ARO, f3, MRO, RRO, WaRO, WiRO, Data Entry B Ck:
----------------
WSRO, Kinston FO, Fed. Trust, Central Off., Other:—_ Data
Shipped ---- - ---- Reported:—=------------- -------- _
by: Bus ou 'er, Hand Del., Other: _ Purpose:
Collector(s):__�.a�!__,�f�i}.c%•�r�?,t%-- Date_-L =Q� Time 3_{7Z,�� Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, t7iTi�T:ZJ. r�/%<•.�Ti�;t
FIELD ANALYSES (ri,de vm)
Owner_ �� is/�'-------- —
pH 4u'-------------------- Spec. Cond.9,------ —----- al 2511C Location or Sile—i3'-_Hr.��s—�%�.T��z.,�---------------------------•--------•-
Temp. r�eC Odor___ ____ Description of sampli� point
---------- �'
Appearance-_______-___ --- - •----------------___. __- _ Sampling Method _ ------------------
Sample Interval
ield — --- r`'---- - --- - - -- - - - f - ------------- -
FABORalORY:.---------__ _ Remarks_ :cy-cr.L_.,'�-
A OR TRY ANALYSES (Pump(ng limn, Pir lamp., nlc.)
BOD 310 m9/L
COD High 340 n,g/L
COD Low 335 nmg/L
Colirorm: MF Fecal 31616 /100ml
Colirorm:. MF Total 31504 /100ml
TOC 600 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pdi 4.5 410 mg/L
—
-Alkalinity-to-pH-8.3.4-15 mg/L—
Carbonate 445 mg/L
Bicarbonate 440 rag/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color; True 80 Cu
Cyanide 720 mg/L
L—IL] 1-.ununer
GW-54 REV. 12/07
Diss. Solids 70300 mg/L
Ag-Silver 46566 ug/L
Organochlorine Pesticides
Fluoride 951 mg/L
AI -Aluminum 46557 ug/L
Organophosphorus Pesticides
Hardness: Total 900 mg/L
As -Arsenic 46551 oq/L
Nitrogen Pesticides
Hardness (non-carb 902 mg/L
Da -Barium 46558 ug/L
Acid Herbicides
Phenols 32730 ug/I
Ca -Calcium 46552 mg/L
MD.
Specific Cond. 95 Whos/cm
Cd-Cadmium 46559 ug/L
Sulfate 945 mg/L
Cr-Chromium 46559 ug/L
Sulfide 745 mg/L
Cu-Copper 46562 ug/L
Fe -Iron 46563 ug/L
Semivolalile Organics
Oil and Grease mg/L
Hg-Mercury 71900 ug/L
TPH-Diesel Range
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Volatile Organics (VOA bottle)
NH.1 as N 610 mg/L
Na-Sodium 46556 mg/L
TPH-Gasoline Range
TKN as N 625 mg/L
NI -Nickel ug/L
TPH-BTEX Gasoline Range
NO, * NO, as N 630�Ify7.ve' mg/L
Pb-Lead 46564 ug/L
P: Total as P 665 mg/L
Se -Selenium ug/L
Zn-Zinc 46567 n
For Dissolved Analysts -submit littered sample and wrfle'DIS- in block.
roc ve o �dG Te
Temperature on arrival: /
:,
�,F,,4-6L)MFVUERECi -10A Otr;?CF

Sample Condition Upan Receipt Anomaiy Report (SCUR)
•:',-{'�. `.�1� 'tits.••- - - J..a;?."��;�:� •�.,�, i-~- . ,• '
berz
:Station ocatiori;;CJ~%��. .. ..
k1otin - � ";, :•;Rivers _ - .. ._ .. ' - -
- :..on.......�
'•w�t .� .y..�v. is t '= ."..••;'.!t'e`�_,':t; i\e'�u.;��` '� a•. ^• .J: •/ _ Time Be,iq�DI
Collector`" '".�'-.o�„„. -. r:.:.:Date Begin::-_
�!'4 T.%,`r]r',3•/1��h�- s.'_1:.r...r.1!•avayi�t•�.e.. .�..,-._ -��- _.S►!t': _ ... - .
Type:=
Priority: _ -
Affected.Parameteii
The condition of these samples were not acce,
❑ Coolers
❑ Samples were not received on wet is
0 No temperature blank submitted
❑ Cooler T° reading: °C
p Temperature >6°C. T° reading:
❑ Samples frozen
❑ Containers
❑
Leaking
❑
Broken
,❑
Without labels
❑
VOA vials with headsoace
❑
Sulfide samples with headspace
❑ Container Labels
❑
Not the same ID/info. as on COC
❑
Not the same ID/info. as on fields
❑
Incomplete. Missing the followin,
❑ Station #/Sample ID
❑ Collection date
❑ Collector
Cl Analysis
. ❑ Preservative
❑ Other:
❑
Markings smeared or illegible
❑
Tom
enu:
Z
1
coC ar �.
table because (check all that apply):
❑ Samples (affected samples are described below)
❑ Samples not received, but listed on fieldsheet
❑ Samples received, but not listed on Fieldsheet
❑ Samples not received, but listed on COC
°C Qr1"§`amples received, but not listed on COC
❑ Mislabeled as to -tests, preservatives, etc.
❑ Holding time expired
❑ Improoer container used
❑ Insufficient quantity for analysis
❑ Chain of Custody
❑ No custody seals
Custody seals not intact
Not relinouished.
❑ No dateitime relinquished
❑ No signature
❑ Incomplete information
❑ Documentation
❑ Fieldsheet wet/illegible
❑ Fieldsheet incomplete:
❑ Records not written in indelible ink
❑ Other (specify):
Corrective Action:
❑ Samples were rejected.by D WQ Lab. Authorized by: —
❑ epted and analyzed per collector's request after notifying the collector.
Accepted and analyzed after. notifying the client and determining that another sample could not be secured.
❑ Sample(s) on -hold until:.
❑ Other (explain):v
-. -
_
Date:
Person Contacted 1/rJ�GJ / I
.Form completed byz
F:✓ 17`. Date:
. li ,U
Unit Leader Review (initial): OA -MET
VOA 111AR 3 L _7t'5Y
UT PEST MIC
WCH I 05ifl—(' FE("ft_ViLLE 1'O;l0 ALOfTC 329/0Idbs
QA\Forms\S=ple Receiving\SCUR `

COUNTY: SANIPSON
QUAD NO:
REPORTT'O FRO
Regional Office
ZOLLECTOR(S) : ' D SIIANAIIAN
WIT.: 3/11/2003
TIME:
'URPOSG
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
LABORATORY ANALYSIS
d BOD310 - rile/L
Coliform: MF Fecal 31616 /100m1
Coliform: MF Total31504 /1001111
Intlil
1 I
units
Alkalinity to .114.5
mg/ L
Alkalinity to pli 8.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
m /L—
Chloride
m /L
Chromium: Ilex 1032 _
u /L
Color. True 80
C.U.
Cyanide 720
mg/ 1.
ONIhIENTS :
DIVISION Or R'A'1'F12 QUAIXl'V
Chcmisiry Laboratory Report / Graund Waler Quality
SAMPLE PRIORITY
ROUTINE EMERGENCY
CIIAINOFCUSTODY
MW7
N' SAMI'LErym-
Diss.Solids.70300 m /L
Fluoride951 mg/ L
Hardness: total 900 mg/ L
Hardness: non-carb 902 m /L
Phenols32730 u /L
iSpecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide 745 m /L
MBAS m /L
Oil and Grease m /L
Silica m /1.
Iloron
Formaldehyde m /t.
N113asN610 mg/ L
TKN as N 625 mg/ L
X
NO2 +NO3 as n 630 9.2 m / L
P: Total as 11665 m /L
I OI - m /L
A-Silver46566 u /L
Al-Aluminum46557 u /L
As-Arsenic46551 u /L
Ba-Barium,46558 u /L
Ca-Calcium,46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium 46560 u /L
_
Cu- Copper1042 u /L
Fe- Iron 1045 u /L
H - Mercury 71900 u /L
K-Polassium46555 mg/ L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na- Sodium 929 m /L
Ni-Nickel u /L
I'll -Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc 46567 u /L
Lab Number
3G0241
Dale Received
3/18/2003
Time Received :
9:15 AM
Received By
c cased By
JG
AR
Date reported:
3/24/206
AR 3 1 2003
nE.NR-Wi I ALLERCGiORALOFRCE
3g0241

GROUNDWATER FIELD/LAB FORM
Report To: ARO,(O' MRO, RRO, WaRO, WiRO, l
l
--- SAMPI 1= TYPE
afar
Quad No. ___—...... Serial No. El soil
-----------------
La(.__ .-------- Long .------------ _1 ❑ Other- --- -----
Bain of Custody
WSRO, Kinston FO, Fed. Trust, Central Off., Other:_____
Shipped by: Bus, ou - r, Hand Del., Other:________
Collector(s):_1$�__:�/fiq�(/��¢,(l—_ Date 3 - (2 U3
FIELD ANALYSES
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY
❑ Routine 0/41/ Lab Number-_ ( /,�_
❑ Emeroencv 11 Dale Received��_ :v T'Ime:
+-/--------- Rec'd From: B Cour d Del.,
V e C 0 6 0 ---- -
Data Entry By:______-----_— -Ck:-----------
Data ----- Purpose: Time :5 3 Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Offj- LtLaPrli h> v,�
OWnef (rircla one)
PH ion-------------------- Spec. Cond.g7------ — ----- at 25°C Location or Site
Temp.lo_ _eC Odor----- -----------------------
Descri lion of
Appearance _ _ _
Field Analysis'By
800310 mg/L
Diss. Solids 70300
COD High 340 mg/L
Fluoride 951
COD Low 335 mg/L
Hardness: Total 900
Coliform: MF Fecal 31616 1100ml
Hardness (non-carb 902
Coliform: •MF Total 31504 /100ml
Phenols 32730
TOC 680 mg/L
Specific Cond. 95
Turbidity 76 NTU
Sulfate 945
Residue, Suspended 530 mg/L
Sulfide 745
Oil and Grease
pH 403 units
Alkalinity to pH 4.5 410 m"I(_
Carbonate 445
mg/L
Bicarbonate 440
rn
Carbon dioxide 405
mg/L
Chloride 940
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
Cu
Cyanide 720
mg/L
------------
GW-54 REV. 12187 For Dissolvei
t,
p sa p In poln -----------------
Sampling _Melh�od— —_,-;j_- a— --------i—Sample Interval
Remarks�imo�T%r_`-
---_
----
—--- --------- -------- ----------- --------------
-
(Pumping time, air temp., etc.)
mg/L
mg/L
mg/L
mg/L
ug/I .
uMhos/cm
mg/L
mg/L
mg/L
NHS as N 610
mg/L
TKN as N 625_- —
mg/L
NOi + NO, as N 630 FvC
mg1L
P: Total as P 665
mg/L
Analysis-submil
sample and write -DIS- in block.
Ag-Silver 46566 ug/L
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper 46562 ug/L
Fe -Iron 46563 ug/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
So -Selenium ug/L
Zn-Zinc 46567 , I
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organics
TPH-Diesel Ranqe
Volatile Organics (V(
TPH-Gaso line Rangl
TPH-BTEX Gasoline
Temperature on arrival: (/
----------
--------------
._._
�r
tYdG atii 3.
DEidR — FAYTi�1 LLE REGIONAL GHICE
�`"

I
NC DELMUD W tl Lncutu�rr a.auv. �..,i 1
Sample Condition Upon Receipt Anomaiy Report (SCUR)
sue a.--.4.,� -�7�,� .i-ar- �•
Air
IQJI
�amp,Ie:ID • .�— _' Station��y'oca�tion� P� Y' .. • ... _ . �. •
r�River_.Bastti:• ,--,Y� _ , _ : �� G
_`Jun,'.:.y �.. s.• �* �".. egD teB•-..•� _" Time Begie;�'D%
oClct
tr {••iy�N�i�+�di7 L., Irk . 1 . �.K%a Y.i{.j.. �.'� =_+A W-.•••�,� f. / y�
:Sample Type:Q.ty w�. •.
The condition of these samples were not accep,
❑ Coolers
❑ Samples were not received on wet ice
❑ No temperature blank submitted
❑ Cooler TO reading: °C
❑ Temperature>6°C. To reading:
❑ Samples frozen
❑ Containers
❑ Leaking
❑ Broken
❑ Without labels
❑ VOA vials with headspace
❑ Sulfide samples with headspace
.❑
Container Labels
❑ Not the same ID/info. as on COC
❑ Not the same ID/info. as on fieldsh
❑ Incomplete. Missing the following.
❑ Station #/Sample ID
❑ Collection date
❑ Collector
❑ Analysis
Cl Preservative
❑ Other:
❑ Markings smeared or illegible
❑ Tom
le because (check all that apply):
❑ Samples (affected samples are described below)
❑ Samples not received, but listed on fieldsheet
❑ Samples received, but not listed on fieldsheet
❑ Samples not received, but listed, on COC
oC e---S—amples received, but not listed on COC
❑ Mislabeled as to tests, preservatives, etc.
❑ Holding time expired
❑ Improper container used
❑ Insufficient quantity for analysis
❑ Chain of Custody
❑ No custody seals
❑ Custody seals not intact
❑ Not relinquished.
No dateltime relinquished
o No signature
0 Incomplete information
❑ Documentation
Cl Fieldsheet wetlillegible
❑ FieIdsheet incomplete:
❑ Records not written in indelible ink
❑ Other (specify):
Corrective Action:
❑ . Samples were rejected by D WQ Lab. Authorized by:
❑ Aeeepted and,analyzed per collector's ,request after notifying the collector.
Accented and analyzed after. notifying client and determining that another sample could not be secured.
❑ Sam P.le(s) on -hold until:..
❑ Other (explain): l�I
_Date:
Person Contacted.V�L:e
Form completed by R * 'r
- �� Date:
Unit Leader Review (initial): i=I�',R 3 1 2003 SVOA t MET
NUT VOA iv1iC
WCH PEST
iK;CI �NL IF'riG , 3P-9/0 I dbs
QA\Forms\Sample Receiving\SCUR

:OUNTY : SAMPSON
ZUAD NO:
tEPORTTO FRO Regional Office
:OLLECTOR(S) B`SNANANAN
)ATE: 3/1712003
]ME
'URPujP.: Owner:
,ABORATORY ANALYSIS
BOD310
m /L
COD High 340
m /L
COD Low 335
m / 1,
Coliform: MF Fecal 31616
/ 100ml
Coliform: MFTotal 31504
/100ml
TOC'
m /I.
Turbitity
NTU
Residue., Suspended 530
m /L
Totnl Suspended solids
m /L
I1
units
Alkalinity to pH 4.5
m /L
Alkalinity to pf18.3
m /L
Carbonate
m /L
Bicarbonate
m /L
Carbon dioxide
mg/ L
Chloride
m /L
Chromium: -Hex 1032 --
u /I:
Color: True 80
C.U.
Cyanide 720
M811.
DMMENTS :
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
Diss. Solids 70300 m /L-
1-luoridc 951
I lardness: total 900 m /L
Ilardness: non-carb 902 m /L
Phenols32730 u /L
iSpecific Cond. 95 umhos/cm2
Sulfate m /L
Sulfide745 mg/ L
WAS m /t.
Oil and Grease m /L
Silica to /L
Boron
Formaldeli de m /L
NH3 asN610 m /L
rKN as N 625 nr / L
X
NO2 +NO3 as n 630 9.3 m /L
P. Total as P 665 m / L
-
PO4 - m /L
DIVISION OF WATER QUALITY
Chemistry Iabnrelory ltepnrt / Grouud Water Quality
SAMPLE PRIORITY
ROUTINE
0rmrRGrNCY
CHAIN OF CUSTODY
MYV.7DUP•
w SAMPLE YPI:
DENR
A-Silver46566 u /L
AI-Aluminum46557 u /L
As-Arsenic46551 u /L
Ba-Barium46558 u /L
Ca-Calcium46552 m /L
Cd-Cadium46559 u /L
Cr-Chromium46560 u /L
Cu-Copper 1042 u /l,
Fe- Iron 1045 u /L
II - Mercury 71900 a /L
K-Potassium 46555 m /L
Mg- Magnesium 927 m /L
Mn-Manganese 1055 u /L
Na-Sodium929 m /L
_
Ni-Nickel u /.L—
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn_Zinc46567 - u /[
I.n1%Number
3(70242
Date Received
311812003
Time Received :
9:15 AM
Received By
JG
3
�ay
Re cased By .
AR
Date reported :
3/24/2003
4 � 1
R . mAli -4PJO
DENR - rAYETTN LC RTGiDi�RL
OF�10E 3g0242

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
County_ fir_—,L� �_n — -----
SAMPLE TYPE SAMPLE PRIORITY
ater ❑ Routine
❑Soil ❑ En,eroencv
other_ __—
�''/J�� Lab Number� =G 01
lj (Dll f) 211j �O � �CJ
Date Received _ J 9 � Time.
'o
------
(quad No____---__— Serial No. ---------------
Lat. .------------- Lon g•_
---- -----
-
�
hain of Custody
Rec'd From: r d Del.,
Other:
Report To: ARO�-Rd, MRO, RRO, WaRO, WiRO,
G�
____ _
—
__ _ _
Data Entry By _ —_� __-- Ck __—___
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Data
Shipped--- ---- ----- Reported:--------------- ----
by: Bus, ou ' r, Hand Del., Other: _ _ _ _ Pu ose:
Collector(s):_ i•c< _;��f.4,�/,9 ,cj_ Date-&_/c)3 Time_j, irLeaseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, QTfa� i 1F ' 7"
Owner i,
FIELD ANALYSES (rirde one) —� —
'i�K �,�'
pH 400-... --............ Spec. Cond.s4----------------`------------------------- -----
----at 25eC Location or Site—,?,
---------------------
emp.,o_ — eC Odor -----------------
------- Description of sampling point_
----____--___----_--_____— Sampling Method �,.rr
---,�----------------------- Sample Interval ............ — ...
Field Analysis By: --_ --__—_ Remarks_ <:,- .- - �-�, IPunro. baiter. rlr..l
�'—— ----------------------------------- -----------------
LABORATORY ANALYSES ,p„m ; ,;� ;.r _,
BOD 310 mg/L
COD High 340 rng/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliformt MF Total 31504 /100ml
TOC 680 mg/L
Turbldity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
—
Alkalinily_lo-pH-8.3-4-15 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
GW-54 REV. 12/67
Otss. 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 Whos/cm
Sulfate 945 mg/L
Sulfide 745 mq/t_
Oil and Grease mg1L
NHS as N 610 mg/L
TKN as N 625 mg/L
NO7 + NO3 as N 630Vr mg/L
P: Total as P 665 mg/L
For Dissolved Analysis -submit filtered sample and wrlle -DISin
Aq-Silver 46566 ug/L
AI -Aluminum 46557 ug/L
As -Arsenic 46551 ug/L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mq/L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper46562 ug/L
Fe -Iron 46563 uq/L
Hg-Mercury 71900 ug/L
K-Potassium 46555 mg/L
Mg -Magnesium 46554 mg/L
Mn-Manganese 46565 uglL
Na-Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se -Selenium ug/L
Zn-Zinc 46567 ug/L
RE �V - J
x

NC DEINRIDWQ ClIeMISIry La,UUI ULU$ j
Sample Condition Upon Receipt Anomaly Report (SCUR)
-Z
e blE *' .5 M Mug
Sao�- -
.,ocanon:.
am --7...,.
In.
j`'
T-:�
Date Beginime BegiR
.
Collector _.
sample Type:
Priority,`
-
'Affected Parameters•
The condition of these samples were not acceptable because (check all that aSpy):
s a amplples (affected samples are described below)
u Cooleramples were not received on et ice U Samples not received, but listed on fieldsheet
C3 S
Q No temperature blank submitted :: Samples received, but not listed on fieldsheet
cl Cooler T' reading- �-C c :Samples not received, but listed on COC
:ea �0C 2"Samples received, but not listed on COC
C3 - Temperature >6°C. T' reading: cl -Misiabeled as to tests, preservatives, etc. -
u.' Samples frozen C2 Holding time -expired'
cl Improper container used
a Containers 0 Insufficient quantity for analysis
C2 Leaking
C3 Broken o Chain of Custody
C3 Without labels c3 No custody seals
cl VOA vials with headspace o Custody seals not intact
a Sulfide samples- with headspace ci Not relinquished.
c2 No date/time relinquished
a Container Labels 0 Nosignature
C1 NorthesarrielD/info..asonCOC
U Nat the same ID/info.. as on fiel I heet. C2 Incomplete information
C3 Incomplete. Missing the following.
Q Documentation
cl Station ",r/Sample ID Fieldsheet wVillegible
C2 e
u Collection -date C1 Fieldsheet incomplete:
c3 Collector c3 Records not written in indelible ink
C2 Analysis
o Preservative c2 Other (specify):
c3 Other:
C3 Markings smeared or illegible
C3 Tom
Comments: _/
A
Corrective Action:
a.. Samples . . . . we . re rejecte . d.by DWIQ Lab. Authorized by:
fter notifying the collector.
��epted and.analyzed per collector's request a
Accepted and analyzed after. notifying the client and determining that another sample could not be Secured.
a 'Samp.le(s) on'hold until: -------
ci Other (explain):
Da
te:
Pe'rs6n:c6ntacted:."' (it.
Date:
Form completed b,
Unit Leader Review (initial): PE 1 1�i E -0 Svo k MET
NUT VOA 'A
WCH PEST MAR 3 1 2 MIC 3r-9/01dbs
QA\Forms\S=P1e Receiving\SCUR u DENR-FA(��E. ILLIHEGIONAL0 E'

Brandon Bradshaw Site Map Fig 1'A
MW-6 -5
\ B dsha ,Frances
e,ttle,, dna
N
eM -2
Leend r , BC don w E .
g
s
o geoprobe mw
o ws wells
0 spray fields . i W-4
® edna kottler
Clyde Bradsha
® tommy bradshaw 105 210 420°F 630 840
Feet
brandon bradshaw 1 inch equals 288:553634 feet
i

Ground Water Flow Fig 1'
z
r
v82. L7k ,.'"'k' 4�`omx.x
1 .54
" /1184.56
OO�am j
1
• j
Legend N
A SiteWLs W E
wl contours 26-mar-03
s
spray fields
i .
L..-!,Ms Edna Kottler Property
0 .235 470 940 1 1,410 1,880
Brandon Bradshaw Property, Feet

Ground Water Flaw Fig 2
M-O
', _° h 183:62 184 sr
€ r
• sue.' �-�'�t' g-
�."s.„'��s 3 5 fj 11 "'`�,.•.tu + z'3�f rs 3%r.'[
uOrmk-
- tt�Y y yL � • I
§&$-re-"•"� L{Y 111 i � .
�'�.$ � � 3 � ""^,sue •.-. f
�+
1 .iY'F
184.56 aI
f ���
x r
VMS.IN,
MUM
legend
N
0 SiteWLs
wl contours 21-mar-03
W E
spray fields S
k Ms Edna Kottler Property �I
Brandon Sradshaw Property 0 23..7.5 475 950 1,425 1,900
Feet

Ground water Flaw Fig
Legend
• SiteWl_s
spray fields
ray
Ms Edna Kottler Property
Brandon Bradshaw Property
wi_contours_3-a pr-03
0 237.5 475 950
I
t25 _ 1,900
Feet
I

Ground Water,Flew Fig
Legend
0 SIteWLS
----- wl contours 26-mar-03
spray fields
rm Ms Edna, Kottler Property
Brandon Bradshaw Property
0 235 470 940
t10 1,880
Feet

..ground Waterflow Fig
�z.
r
� �. YI
OR
%'.` fir' ,+- '� {`- "%•s 183.82
,j�4y�. C"'j'5+.-NygP MY Q.,SI kY,
184.56INK
g
3
I IN
RK-
a� j'z ref �,z�2 s�y��,�s� x;, r� %��k•.�,�z'`� ��
-�
'F�� } - :Nm 4,. ,a C�x���.�t .T••'S' r'��'tA�_ �d ,
y��y, s-� :r? e,, �„?•Fsy.`t �.E -�, .i,�.� �',� y"' -1�,�, n��#, �•��3� � rr- �; i�t� ,
» ���'..' 'av '. ss a �` .5�t K. _ ��': w>"is `5:.'%Tr.��.'._ `�.�r?_" ��.=:� �:��c�:-R•d - .. _
i
Legend
46 SiteVtwLs
wl contours 26-mar-03
spray fields I
'Ms Edna Koftler Property '
0 235 470 - 940 1, 410 1, 880. '
Brandon Bradshaw Property Feet

Ground Wa- ter Flow Fig
Legend
i SiteWl-s
—�— wl contours. 21-mar-03
ED spray fields
Ms Edna Kottler Property
Brandon Bradshaw Property
0 237.5 4.75 950
N-
W E
S

Ground Water Flow Fig 2
Legend
r siteWLs
wl_contours 21-mar-03
spray fields
�y
t Ms Edna Kottler Property
Brandon Bradshaw Property
!1 1)07 C A71:
1,900
m Feet
!A'

Ground water Flow Fog 3
Legend
• SiteWl-s
spray fields
Ms Edna Kottler Property
Brandon Bradshaw Property
wl_contours_3-a pr-03
n I)a7 G n7r,
•11

Ground water Flow Fig 3
Legend
i SiteWl-s
spray fields
Ms Edna Kottler Property
Brandon Bradshaw Property
wl_contours_3-a pr-03
1,900
= Feet
13

i
Brandon Bradshaw Site Map Fig 1 A
MW-6
MW-5
a
s
B dsha ,Frances
e ottler, dna
O.
MW-
o
I N
M -2
r Br don W E
Legend •o
s
o geoprobe mw
o Ws Wells
spray fields e W-4
® edna kottler
Clyde Bradsha
® tommy bradshaw 105 .210 420 630 84Feet
® brandon bradshaw 1 inch equals 28M 53634 feet

Brandon Bradshaw Site Map Fig 1 A
A
Legend
o geoproUamvv
a vxaxveUa
spray fields
adnok)ttler
tonnnnybnadshovv
LIJ
.
-°n—'/ 105 210 420
1inoh equals ku288'
'
/
i mW-5
�.
M

Brandon Bradshaw Site Map Fig 1A
i
MW-5
MW-6 •
B dsha , Frances
0 ottler, dna
Legend
• geoprobe mw
• ws wells
spray fields
® edna kottler
® tommy bradshaw
brandon bradshaw
Clyde
840
Feet

Brandon Bradshaw Site Map Fig 1A
Legend
o geoprobe mw
o ws wells
I spray fields
® edna kottler
® tommy bradshaw
brandon bradshaw
MW-5
MW-6 s
B dsha Frances
<ottler, dna
MW-
N
M -2
r Br don W E
10 o
S
MW-4
e
Clyde Brat
105 210 420: 630 840
Feet
1 inch equals 288.553634 feet

Legend
• ws wells
wl contours 21-mar-03
edna kottler
brandon bradshaw
0 70 140 280 420
1 inch equals 240.635629
low Map Fig
Feet
0

Brandon Bradshaw Groundwater Flow Map Fig

(0 Development Dimensions Int'l, Inc., 1997-2000.
Intended for use by registered OPAL users only.

Legend
• . ws wells
wl contours 21-mar-03
® edna kottler,
brandon bradshaw
0 70 140 280 420
1 inch equals 240.635629 feet
low Map -Fig
Feet,
0
i

Legend
A ws wells
wl contours 21-mar-03
edna kottler
brandon bradshaw
0 70 140 280 420
1 inch equals 240.635629
I
1
low Map. Fig
N
-W-*
Feet. S
0

i
Brandon Bradshaw Groundwater Flow Map Fig 2
Legend. , N
® ws wells
W-*
wl_contours _26-mar-03
® Feet' S
edna kottler
0 70 140 280 420 560
brandon bradshaw 1 inch equals 240.635629 feet

i
Brandon Bradshaw Groundwater Flow. Map Fig 2
Legend .
A ws wells
wl contours 267mar-03
® edna kottler
brandon bradshaw
N
W
Feet : S
0, 70 140 280 '420 5I
1 inch equals 240.635629 feet

Legend
• ws wells
wl_contours 26-mar-03
® edna kottler
brandon bradshaw
lovu Map Fig 2
N
w
Feet! S
0 70 140 '280 420, 560
1 inch equals 240.635629 feet

Legend
• ws wells
wl contours 26-mar-03
edna kottler ,
brandon bradshaw
0 70 140 280 420
1 inch equals 240.635629 feet
t
low Map Fig 2
N
w
Feet S

Legend
• ws wells .
wl_contours26-mar-03
edna kottler
brandon bradshaw
low Map Fig 2
Feet
0 - .70 140 280 420 560
1 inch equals 240.6356A feet
r

Brandon Bradshaw Groundwater
Legend
• ws wells
wl_contours 3-apr-03
® edna kottler
brandon bradshaw
low Map Fig 3
N
w
(Feet , S
0 70 140 280 420 560
1 inch equals 240.635629 feet I

Legend
• ws wells
w I_co n to u rs_3-a p r-0 3
® edna kottler
Brandon Bradshaw
lowv Map Fig 3
Feet
0 70_.140 280 420 560
1 inch equals 240.635629 feet

Legend
• ws wells
wl_contours 3-apr-03
edna kottler, .
brandon bradshaw
0 70 140 280 420
1 inch equals 240.635629 feet
low Map Fig 3
N
W4
Feet' S
0

Legend
• ws wells
wl_co n to u rs_3-a p r-0 3
® edna kottler,
brandon bradshaw
0 70 140 280 420 5
1 inch equals 240.635629 feet
low Map Fig 3
i

Monitor Well Groundwater Data Brandon Bradshaw Site
Monitor Well Nitrate -Nitrite Nitrate -Nitrite Water Level (ft) Water Level (ft) Water Level (ft)
Location GPS Lona GPS Lat 1st SamDle (PPM) Duplicate (PPM) 3/26/2003 3/21/2003 4/3/2003
MW-1
-78.337799245
35.143860477
0.02
4.4
184.54
184.21
183.61
MW-2
-78.339140467
35.144068762
38
38
183.52
183.24
182.97
MW-3
-78.339846795
35.145937095
0.02
0.02
182.53
182.09
181.72
MW-4
-78.336486364
35.143156104
25
25
184.56
184.27
183.68
MW-5
-78.337331057
35.146670767
7.8
7.9
181.41
181.48
180.39
MW-6
-78.339064548
135.146612985
3.7
3.8
183.621
182.61
1 181.59
MW-7
-78.338604374
135.145630675
9.2
9.3
183.451
183.04
1 182.07

Ground Water Flow Fig
Legend
O SiteWLs
® spray fields
Ms Edna Kottler Property
Brandon Bradshaw Property
wl_contours 16-apr-03
0 237.5 475
N
W E
S
950 1,425 1,900
Feet

Site Location Map Fig 1
Legend
® SiteWLs
® spray fields
r�
Ms Edna Kottler Property
Brandon Bradshaw Property
e DENR MWs
Water Supply Wells 0 120 240 480 720 960
Feet
I
!

NORTH-CAROLINA DEPARTMENT OF ' ' (GV L I � � ` 11
ENVIRONMENT AND NATURAL RESOURCES141
,'. �� -''•'L iC �""�
22S GREEN STREET - SUITE 714
NCDENR FAYETTEVILLE, NC 28301-SO43 v avvp��
�r
FMe
North Carolina Departmentof-Environment and-Natur laResourcesLU
Groundwater Section
AA S M B�II anahan
225 Green Street
Suite 714
Fayetteville, NC 283{{01-`5043 i {{ 11jj till
t {{
�l7in�� 3t5 QYS.r 'rit �ilIt MIl�lf't1�S��.t!{!1l��1�•i�{1111{{il A till till 11f111 fill I{1

DIVISION OF WATER QUALITY
FRO GROUNDWATER SECTION
February 27, 2003
'MEMORANDUM
TO: Arthur Mouberry
DWQ-GW Section, RCO.
Parker -II incoln Bldg.
Through: Art Barnhard
FRO GS�
Ii
From: Bill °Shanahan
Technilan II, DWQ-GW Section, FRO
SUBJECT: Request For Investigation
Brandon Bradshaw impacted well
Installation of 8 -10 Geoprobe Wells
15
The Fayetteville Regional Office requests an investigation of concentrated animal waste
application fields around Mr. Brandon Bradshaw's home at 2673 Bradshaw Road,
Clinton, NC. This investigation is to determine whether the land application is impacting
groundwater and water supply wells in that area.
8-1 1 0 Geoprobe wells are required to complete the monitoring to meet the investigation
criteria.
If you have any questions please feel free to contact William Shanahan at (910) 486-
1541. 1 -

REQUEST FOR INVESTIGATION
(;FNFRAL INFORMATION
Incident/project name:
Incident number:
4JrG%�G'iCti��Tj:,;ctSL�c.��
J,fiL' ,�:z vn5 �,';3n. 1_•`cc�
Al/r
Regional Office:
County:
Requester's name:
Date submitted:
Site rank:
/
Ala
Type of contamination expected
(list compounds, if known):
Nature of complaint (numb'er
of contaminated wells, synopsis of any previous sampling or,other activities
to date, etc.): p "r �. %1f,
�F •-!' S�2e f
SITE LOCATION
Nearest city/town:
USGS 7.5' quadrangle name:
Address/location: I
Latitude and Longitude:
Site description (urb rural}wooded,
busy traffic, equipment accessibility,, etc.):
_T
/
1

QUEST FOR INVESTIGATION (RFI)
Instructions for Request for Investigation form: Please verify that the RFI package contains all of the
following items. Please compile the package in the order listed below and secure using a paperclip or
binder clip. PLEASE DO NOT STAPLE. Failure to include all items may result in a delay in processing
the request. Please use black or blue ink if filling out the forms by hand; avoid highlighters or other non -
reproducible writing instruments on maps.
FORMS:
LJ Transmittal memo from/through Regional Supervisor to Central Office requesting this
investigation
©r Completed Request for Investigation form and checklist
4.1v Pollution Incident Reporting Form (PIRF)
r
❑ Site Health and Safety Planning Form
Signed Land Use Agreements (LUA) for all properties .to be included in the investigation (includes
all drilling and/or sampling locations)
MAPS:
ET Regional map showing directions -to site from main highway or other major artery (please use one
of the following maps: USGS 7.5' quad, DOT county road map, NC Atlas and Gazetteer
1:150,000 scale map)
[� Local area map showing affected properties with owners name(s); location of contaminated
well(s), and proposed drilling locations (county tax map is preferred, an aerial photo or neatly
hand drawn map are acceptable). Include written directions to site on attached sheet
L� Directions, phone number, and location map for the nearest hospital
SUPPORTING INFORMATION (IF AVAILABLE):
❑ Laboratory reports) of previous sampling and testing
" lA Well construction records of any previously installed monitoring wells
Well construction data for affected private supply wells (type, installation date, total depth, casing
depth, screened interval(s), well logs, etc.)
El supporting info rmation (please list):
Other relevant information not included with this RFI package, but available in Regional Office project files
(consultant's reports, newpaper articles, etc.):
i
.Signature of person vgrifying revie `and completeness of attached RFI package:
fj� r 'i 6G
Signature�l�,.G�� � - �= Date

REQUEST FOR INVESTIGATION
DRILLING INFORMATION
Prop sed drilling method:
Estimatedd.depth to bedrock:
C-' -e"", E" C."/C."/!A//
/;I'-
Proposed decontamination
location:
Estim ted depth to groundwater:
Proposed disposal facility for contaminated water and
Source of clean drilling water:
soils:
/,,"
Number 6f proposed monit�oring wells and proposed depths:
PROPERTY OWNERS Please use letter to identify propert owners on local area map
Name:
Address:
Phone number:
LUA?
a. f-Y' � es G G
b.
C.
d.
e.
f.
9•
h.
i.
J• 1
HEALTH AND SAFETY INFORMATION (please provide oniv site-saecific information)
Chemical exposure potential
(on -site chemical storage, drums, pesticides, fuel tanks, etc.):
Biological exposure potential
(on -site poisonous plants and animals, other wild animals, etc.):
Physical/electrical/radiologi'caI
traffic, farm machinery, etc
exposure potential (on -site power lines, open ditches or trenches, heavy
): (le? f4 eName
and
ee and to/cation of nearest
/I
emergency facility (mark location on attached map):
'mil e le
Emergency facility phone niumber:
911 service available es no

i
02/27/03 LAND USE AGREEMENT SENT TO:
CLYDE BRADSHAW
821 HONRINE RD
CLINTON NC 28328
[phone]
TOMMY BRADSHAW
2071 BRADSHAW RD
CLINTON NC 28328
[phone]
EDNA B KOTTLER
2849 BRADSHAW RD
CLINTON NC 28328
[phone]
BRANDON BRADSHAW
2673 BRADSHAW RD
CLINTON NC 28328
[phone]

1
J
Nearest Hospital
10
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North -Blvd Northwest BI dI f, S� Falrfa St
a
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Omi 0.2 0.4 0.6 0.8
Streets98 .
Copyright ©1988-1997, Microsoft Corporation and/or its suppliers. All rights reserved. Please visit our web site at http:/Imaps.expedia.com. Page 1

Nearest Hospital
SAMPSON REGIONAL
607 Beaman Street
Clinton, NC
910-592-8511
910-590-8700
ICAL CENTER INC

/' 17
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/1725
G a / 1 A\ \ 1757 ' b 733
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•3 G0.S ry /I It11}I''� 1821 J, n !.: \ 1829 �•01703 ! :'l'. \ '•ti, 1,46 17ab I 1830 i 13 I844 \ •/ ;1 :l' 1636 181a 1 'f: 0 .a f > �, 3 6 � rytr 862 ,a ,/_ - -
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' 701
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> �;, see :; > > s. '� ' �. — •L^ azi \._ �i
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Map
Printed by RouteMAP from ESRI.

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821 Honrine Rd, Clinton, NC
'YAxOO',�
-7843
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1 of 1 1 3/4/03 12:47 Pb

1st
Is`
1st
Sample
Sample
Results
Site Name
County
Contact
Address
Long
Lat
Date
Type
m
Comments
2673 Bradshaw Rd, Clinton, NC
Bradshaw, Brandon
Sampson
FRO GW
28328 910-564-4490
-78.337962000
35.143915000
1/27/03
1 nitrate
18.49
1211 Honrine Rd, Clinton, NC
Bradshaw, Grady
Sampson
Grady Bradshaw
28328
-78.342852971
35.143696441
nitrate
20.71
2849 Bradshaw Road, Clinton -NC
Drinking
Kottler, Edna
Sampson
Edna Kottler
28328
-78.339092511
35.146285661
nitrate
13.76
bottled water

MW
LAT
LONG
SAMPLE
SAMPLE_DUP
D_21_WL
D_26 WL
D_3_WL
MW-1
35.143860477
-78.337799245
0.02 mg/I
4.4 mg/I
184.54
184.21
183.61
MW-2
35.144068762
-78.339140467
38.0 mg/I
38.0 mg/I
183.52
183.24
182.97
MW-3
35.145937095
-78.339846795
0.02 mg/I
0.02 mg/I
182.53
182.09
181.72
MW-4
35.143156104
-78.336486364
25.0 mg/I
25 mg/I
184.56
184.27
183.68'
MW-5
35.146670767
-78.337331057
7.9 mg/I
7.8 mg/I
181.40
181.48
180.39
MW-6
35.146612985
-78.339064548
3.7 mg/I
3.8 mg/I
183.62
182.61
181.59
MW-7
35.145630675
-78.338604374
9.2 mg/I
9.3 mg/I
183.45
183.04
182.07

•
r...4.
F'
,. 't i ., MAP
TWO
.�
.. - r 3.
Y 4.y '�r" tom•-„ �� i
sib, 13
vtwo,it
-XT it
sit
va
•
..i
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�ti•m
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b�p C
.`', � . V�� iya
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OT
its;
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i
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91
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rN �. 44y'6!'.1'�x' 1 y • .ei
'�;
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r;e, i
1
�:
�'H �, �.:. �+ ,�'C y$ �•C`f��'
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t � ,{
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Alibi

Site L
tion Map Fig 1a
MW-gmw
K r, Edna '.
s q j
'MVV r:
lit 62
�w
.26.
47,
00
MWv2 a..
'n
d
.. ... . . is--� ' ' ' • � �� ��
...
MW-4
mul
haw Clyde
Legend
® SiteWLs
spray fields
Ms Edna Kottler Property
Brandon Bradshaw Prope
• DENR MWs
Water Supply Wells
I
0 120 240 480 720 960
Feet

-
I �-E vn d 6 14L d4w-20
-
%lac
• /'il c igr , l SITU P% . � � Ienc(C,
c.
lcrance s-
�f
1,3�ql 7,-,A-
rcihcL�
aaC.
r Oda-

t I -
cs _�
me 5.rS%t

North Carolina Department of Health and Human Services
Division of Public Health
Occupational and Environmental Epidemiology Branch
Medical Evaluation and Risk Assessment Unit
Drinking Water Health Risk Evalua
General
_ nT �TTY
DATE gl 02 LABORATORY NUMBER M) 7b
() Based on these analytical results, this water should be co:
usage
() Chemical analysis did not show any contamination. Wav
odor or taste persists.
(X) The water should not be used for drinking or cooking
idered safe for normal
should be resampled if
ses.
( i Racarl nn thaca analwtirral raenitc tl,ic xxratar ie hinl-J%i nnrntaminaterl na A ol�n„lA „nt
be used for drinking, cooking or bathing/showering.
() The laboratory results are not conclusive, please resample:
PLEASE INDICATE ON LAB SHEET THAT IT IS A
RESAMPLE AND
PROVIDE PREVIOUS SAMPLE NUMBERS)
(X) COMMENTS:
The -nitrate drinking water standard is 10 ppm.'-The nitrate"level
in your well water is
either above or close to the drinking water standard. Continued
consumption, especially
of pregnant woman or infants six months of age and younger,
Imay pose an increased
health risk based on these nitrate levels .
For further information, contact Dr. Ken Rudo, Medical and Risk Assessment Unit, (919)
733-34RWENEU
DHHS(I1/99)
J U N 2 12002
OEEB (Rev. 1 1/00)i.
c
DENR
FAYETTEVILLE REGIONAL OF[
'ICE

North Carolina State Laboratory of Public Health
Department of Health and Human Services
P.P. Box 28047 -- 306 N. Wilmington St. -- Raleigh, N. C. . 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Bradshaw, Clyde Mr.
Address: ,821 Hornine Rd
Clinton, NC Zip: 28328
County: FRODWQGW
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan
Wachovia Bid, Suite 714"
Fayetteville, NC 28301
Courier: 14-56-25
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level. acceptable if less than or eq
Private Well Guidelines: Nitrite-N level should be < 1.0..mg/I and Nitrate
Sample Temperature on Receipt: 6_5_0 C
Date Received: 6/5/02 Report Date: 6/7/02
Today's Date: 6/7/02 Reference: 7681 Login Batch 020
of Water: Ground
urce of Sample:
Type of Sample: Raw
of Treatment: None
)e of Analysis: Nitrate
`Category: ILO
Time: 2:41':00 PM
Analyzed:
/02
E (30 E I %V Em D
J U N 21 2002
DENR
YETTEVILLE REGIONAL OFFICE
OCCUPAT'OP'NAL & Et"Vft�!IOENYIAI
d __ENDENNOLOGY SL�iinxi
F^ -
I to 10 mg/Ir
10.0 mg/I y ' j
.
Reported By:
Sample Number: AA77628

North Carolina State Laboratory of PublicHealth
Department of Health and Human Services
.P. O. Box 28047 -- 306 N Wilmington St. -- Raleigh, N. C. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Bradshaw, Clyde Mr.
Address: 821 Hornine Rd
Clinton, NC Zip: 28328
County: FRODWQGW
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan
Wachovia Bid, Suite 714
Fayetteville, ' NC 28301
Courier: 14-56-25
Collected By: BILL SHANAHAN ,� Date: 6/4'%02
Location of sampling point: Outside Tape
Remarks; rF
Parameters Results, 'J Units
J
Nitrite as N
-
0;1<.0.10
-J mgll- L- 3,
Nitrate as N
;,`14.94
mg/I
•
� i } s [� i
I,
_ _
_ - '----
LJ
- ------ -- -
Source of Water:' Ground
ource of Sample:
Type of Sample: Raw
1pe of Treatment; None
rvpe'.of Analysis: Nitrate.
Category: ILO
i
Time: 2:41,:00 PM
�Y
. ' i - !r S 11 1�
�}('� �"�/;�RECEIVED
JYG_
J JL
UN 11402
i- , ,_. :.
' .� �.--'1 � r,.i. �. �7`. "• � .Cs.a I_`�-'.•_,V!1 .l `J
EXPLANATION OF RESULTS:
Foster/Therapeutic.Horries: Nitrate-N level acceptable if less than or equal to 10 mg/I.
Private Well Guidelines: .Nitrite-N level should be; < 1.0, mg/1 and Nitrate-rL< 10.0 mg/I'
Sample Temperature on Receipt: - 6•5 o C.
Date Received: 6/5/02 Report Date: 6/7/02
Today's Date: 6/7/02 Reference: 7681 Login Batch 029
OFRGE
F
Reported By:
)011 Sample Number: AA 628

Explanations
Coliform Analysis:
If coliform bacteria are Absent, the water is considered safe for drinking purposes. If coliform
bacteria are Present, the water is considered unsafe for drinking purposes. Presence of E. coli
(bacteria) generally indicates that the water has been contaminated with fecal material. It must
be remembered that a water analysis refers only to the sample received and should not be
regarded as a complete report on the water supply.
Inorganic Analysis:
Recommended limits for drinking water. Sample should not exceed levels listed below:
Alkalinity
No established limits
Iron
0.30 mg/1
Arsenic
0.05 mg/l
Lead
0.01$5 mg/1
Calcium
No established limits
Magnesium
No established limits
Chloride
250 mg/1
Manganese
0.05 mg/1
Copper
1.3 mg/1
Nitrate
10
Fluoride
4 mg/l
Nitrite
1.0 mg/l (as N)
Hardness
No established limits
pH
Not less than 6.5 units
Zinc
5.0 mg/1

NCPH - Water Laboratory Search
http://204.21 1.171.13/Environmental Sciences/InorganicITcstResult. asp?Action=Report&SNO=AA88594
Close Print
North Carolina State Laboratory of Public Health
Department of Health and Human Services
P.O. Box 28047 -- 306 N. Wilmington St. -- Raleigh, NC 27611-8047
INORGANIC CHEMICAL ANALYSIS
Bp"t wWI K
Name of System:
Bradshaw, Ms
Source of Water:
Ground
Address:
2673 Bradshaw Rd
Source of Sample:
Clinton, NC
Type of Sample:
Raw
Type of Treatment:
None
Type of Analysis:
Nitrate
County:
FRODWQGW
Report To:
NCDENR-DWQ GW
Attn:
Bill Shanahan
Wachovia Bld, Suite 714
Fayetteville, NC 28301
Courier:
14-56-25
Collected By:
BILL SHANAHAN
Date: 1/27/2003
Time: 12:10:00 PM
Location of Sampling Point: Well Tap
Remarks:
Test Results
Parameters__ -„-
- -
_ Results
Units ____
- _ . _ iDate Analyzed_ .
Nitrate as N
18.49 -
mg/1
1/28/2003,
Nitrite as N
<0.10
mg/1
1/28/2003
Date Received:
1/28/2003 Report Date: 2/11/2003
Reported By:
Today's Date:
2/12/2003 Ref: 1094
Login Batch:
03010051 Sample Number: AA88594
I of 1 2/12/03 1:40 PM

3i! - Water L abotmMy Sear
` hilp:I/M.211.171.11JEnviwnmenta[Sciences/inozgadiclTestResu]taV?Action:�Repwt&SMo.=gpg859A
North Catalina Stale laboratory a► Pubic Health "Tl
O
Dcpartint ul/le9ghand Han umSarvicw�
rte
P.O. BOX 2W47 —3" N. VWibPkrjton St- — Raleigh, NC 27014047 (n
O
r
LU H
Cl
_ INORGAMgCHERUCALANAi.YSI. 'u EE t=
(ten
o w m
u
Bradshaw, Ms source of Watm (found [
2673 &edshow Rd Samre ad(sampla: C '01Ljj
-- - -- - - Cruyton, R!C Typea(Saarplm - - --- ---
TvoB a/Tr®buenc Nnna
CMNIIV-
�
FRODIMQCiYIi
NCDENR-DM GW
AMn: �5
W-hCv}a EM. Sum 714
FayetieA1% NG moi
Courier: 14-56 25
CoSr.BOLL.SHANAHAN
Date:
Locationcallon olSam�irrg palrtt
1/27PAM Tire: 1ZIO*DPM
Retanrics
Well Tap
Matra as ld .:.:. . _ _ l�esuil4
Test Beandla
1lei ;f
�•_ . ? ..:; ;: = Ola jJ1 13i�d ' :.
Wile, as N
ISA9
mgll
12&`1009-.
to_io
raga
1128110U3
Date- Readved:
o
ary Rapan Date., 211If2M
Reported By:
,
Ref•• 1094
Lc4n Ba[eh:
03MWSI_ Sample flunber: A496594 .
- rr;
t
r� X
o l6
O
.p
00
GT1
LO
N

i
North Carolina Department of Health and Human Services
Division of Public Health
Occupational and Environmental Epidemiology Branch
Medical Evaluation and Risk Assessment Unit
Drinking Water Health Risk Evaluation
General
DATE 2
() Based on these ar
usage
() Chemical analysis
odor or taste persi
(X) The water should
() Based on these ar
be used for drinki
( ) The laboratory
(X) COMMENTS:
The -nitrate drinking v
r� COUNTY
LABORATORY NUMBER
al results, this water should be considered safe for normal
not show any contamination. Water should be resampled if
be used for drinking or cooking purposes.
tical results, this water is highly contaminated and should not
cooking or bathing/showerin-g.
are not conclusive, please resample:
r standard is 1
1:. -The nitrate "level in your well water is
either above or close to the drinking water standard. Continued consumption, especially
of pregnant woman or infants six months of age and younger, may pose an increased
health risk based on these nitrate levels
For further information, contact Dr. Ken Rudo, Medical -and Risk Assessment Unit, [phone] or-{919) 715-6430
DHHS (l 1/99)
OEEB (Rev. 1 1/00)
r

STATE LABORATORY OF PUBUC HEALTH
f DIVISION OF LABORATORY SERVICES'-
N.C. DEPARTMENT OF_ENVIRONMENT, HEALTH AND NATU
306 N. WILMINGTON ST. —.P.O. Box 28047, RALEIGH,
INORGANIC CHEMICAL ANALYSES -PRIVATE WA'
Complete All Items �bove Heavy Line
(See Instructions on Reverse .Side)
Name. of
: Svstem�iU�:�� •:.
- .... , . , ..:. / ... Source of Water
Ad dress O' o F �` °}L r ih) Ground,
)Surface -
��
:....
•)=
_ Both.. ^ (
( Purchased
�✓�ru . /� _ ZIP Source of Sample
County . 1U.c J ti. ( !) .House Tap
(/. 1 Well Tap
Report To: .p-� �ii1/v —/
Type of :Sample:
AddressRaw
( ) Treated
�i �/� GUi�UxD/j • ,�:��
-jt
.
Type of Tr"—..
�e, /1 /`
�
..
Lime
( ) Soda Ash
( 1 Polyphosphate
Collected "By: /:. '.. ': j1' f i i `'` .
d:
Date Collected:_`,-
j GL _✓
Location of Samp,
Water Softener
(' ) Other
+ ( Both
Remarks:.
Regular Park
-See SCOPE) '-
PH
Results
Arsenic
Lead
Iron. mg/I
i
<
Manganese mg/I ,
Copper
mg/l :
`. •
Zinc �
� mg/I•
f � .. .... - •
.. .
Calcium
i
Magnesium -`
mg/I
-CaCO3 fCa, Mg)
mg/1
Alkalinity-C8CO3
mg/I
Chloride
mg/I
Fluoride
~ mg/I
Date Received Date 'Reported Reported By
Date Analyzed Laboratory Number
DEHNR -1"1 (Rev. 1/93)
Laboratory Services

I �
i
- - - I-_-` S
-- loe,.s-
'JJ/- Rd h - dti� -
i
----------------------
_ y
r
S
----------- - ------ ------------
--
-
_ ---� �-----_l_4_� _ �- to--- ---------- -----
----- ------------- ------ - -- --------------
r
v�
v
�
------ -- -=----------------
,•i
l

Ground Water Flog
Legend
0 Water Supply Wells
0 DENR MWs
wi—contours —3-apr-03
spray fields
Ms Edna Kottler Property
Brandon Bradshaw Property

Locking
Cap
1. Borehole to be at least 4
inchgs larger than outside
Steel Outer Casing
diameter of casing.
(if plastic inner casing)
�--�
a
2. Casing and screen to be
centered in borehole.
Land Surface
lof
Top well screen should
extend from approx.1 — 2
r\�
feet above MSHWT down
Neat Cement Grout
•
7 G
to 2 3 feet below MSLWT.
4. Casing and screen
Well Casing
.'
>
material to�6e compatible
withl type of contaminant
(2" or larger diameter)
being monitored.
Pelletized Bentonite
a
5. Well head to'be labeled
with visible warning
T
saying: "Well for moni-
-�
s-'
toring and,not considered. '
safe for drinking".
Cleaned Washed
~
6. Well to be afforded
Sand or Gravel'
_
.
reasonable protection
against damage after
construction.
-Well Screen.
—
—
y MSHWT
Note: '
;.
> MSLWT
MSHWT = Mean Seasonal High
:=
Water T ble
'-
—
MSLWT = Mean Seasonal Low
`
Water T ble
for
Construction Details
Groundwater Alonitoiing Well,

MW #
Lat
Long Sample
Sample Dup
3-21 WL
3-26 WL
4-3 WL
MW-1
35.143860477
-78.337799245 MW1 .02 mg/I
MW1 4.4 mg/I
MW1 184.54
MW1 184.21
MW1 183.61
MW-2
35.144068762
-78.339140467 MW2 38.0 mg/I
MW2 38.0 mg/l
MW2 183.52
MW2 183.24
MW2 182.97
MW-3
35.145937095
-78.339846795 MW3 0.02 mg/I
MW3 0.02 mg/l
MW3 182.53
MW3 182.09
MW3 181.72
MW-4
35.143156104
-78.336486364 MW4 25.0 mg/I
MW4 25 mg/I
MW4 184.56
MW4 184.27
MW4 183.68
MW-5
35.146670767
.-78.337331057 MW5 7.9 mg/I
MW5 7.8 mg/I
MW5 181.4
MW5 181.48
MW5 180:39
MW-6
35.146612985
-78.339064548 MW6 3.7 mg/I
MW6 3.8 mg/I
MW6 183.62 .
MW6 182.61
MW6 181.59
MW-7
35.145630675
-78.338604374 MW7 9.2 mg/I
MW7 9.3 mg/I
MW7 183.45
MW7 183.04
MW7 182.07

The Sampson Independent
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Monday 24 February; 2003
residents say high nitrate levels in well
)ntinues (2/20/2003)
Independent (2/20/2003) February 21, 2003
This photo was taken from the yard
of Brandon and Michelle Bradshaw,
looking across Honrine Road.
Chicken/turkey litter is spread on the
field across the road up to the road.
Health
Keener. residents say high nitrate
Outdoors
Duplin News
levels in well water continues
W
Weather
(February 20, 2003)
School Menus
Two yea Irs ago, in March 2001, a two-part story in The
Sunday Feature p
Sampson Independent described the presence of high
Vital Statistics ?
levels of nitrate in several private water wells in the Keener
® Real Estate Guide[
area of Sampson County. At that time some well users had
`
been advised by the Epidemiology Division of the state
v Classifieds
Business T_ tl
Health Department to not use their well water for drinking
!Directory
or cooking.
According to some residents of the Keener area and other
D Our Newspaper
information
obtained by this newspaper, that situation still
B Administrative
-- ------------
exists.
Community_
L. E. Brown,
Jr. can be reached at 910-592-8137, ext. 20. or
is Web Guides
email sicity
[e-mail]
1 � Fun and Games
v Consumer Guide fi
a Personal Finance
Well water
continues
d Lifestyles
i` Subscribe—!
(February
20, 2003)
Two years
ago, in March 2001, a two-part story in The Sampson
1 of 7 1 2/24/03 8:38 AN

The Sampson Independent http://www.zwire.com/site/news.cfm?newsid=7131972&BRD=1 I I
��i�.h�ER i=ALL
Do you agree with
Clinton High School's some well users had been advised by the Epidemiology Division of the
decision to name Jeff state Health Department to not use their well water for drinking or
Sawvell as their new cooking.
varsity football coach?
Poll ends February According to some residents of the Keener area and other information
27. obtained by this newspaper, that situation still exists.
YES
No One resident has received notification that an analysis of a water
Submit Vote sample, taken in January, of his well water detected a level of 18.49
view results 10 milligrams per liter (mg/1). Ten milligrams per liter is equivalent to 10
parts per million.
And, in at least three instances, a resident says a hog integrator is
Sign furnishing bottled water free of charge.
Our
Guestbook As far back as 1996, the state Department of Health issued a report
or above the N.C. drinking water standard of 10 milligrams per liter
(equivalent to ten parts per million).
_ One resident has received a letter from the Fayetteville Ground. Water
clic
Here the North Carolina Department of Environment and Natural Resources,
Full ABC Permits advising that his test results have been faxed to the state
epidemiologist, Dr. Kenneth Rudo.
7 $yvk -4
The letter, dated Feb. 13, 2003, and from William P. Shanahan,
hydrogeological technician, informs Brandon Bradshaw, who lives at
the cornea of Honrine Road and Bradshaw Road, that a nitrate analysis
detected a level of 18.49 mg/l in a sample that Michelle Bradshaw,
Brandon Bradshaw's wife, says was taken Jan. 27.
"A detection of any amount above 10.00 mg/I is considered a health
risk," wrote Shanahan.
Michelle says she and her husband became concerned after hearing
about other people in the neighborhood having bad water.
Then an incident happened which led to the couple's contacting, or
having Ricky Bradshaw do it for them, DWQ, said Brandon.
On Jan. 22, as related by Brandon, "chicken manure" was spread on a
"slung" by the spreader onto and across Honrine Road, into his yard
and onto his automobile. Brandon said he called the Sheriffs
Department and was told that he needed to take out a warrant,
because the waste was being spread on private property.
"The day after it was spread," said Michelle, "it snowed, which made
the smell even worse."
The Bradshaws say that chicken/turkey litter is routinely spread onto
the field directly across Honrine Road from their home. Brandon
their home to the area of the field onto which hog waste is sprayed.
The couple said'that Ricky Bradshaw called DWQ on Jan. 24 and that
the following Monday, the 27th, DWQ arrived and took a sample from
the faucet at their. pumphouse. Ricky Bradshaw says that what actually
happened was that he called the federal Environmental Protection
2 of 7 2/24/03 8:38 AM

The Sampson Independent http://www.zwire.com/site/news.cfm?newsid=7131972&BRD=111
I -
Agency (EPA) in Atlanta and that someone there contacted DWQ.
Ricky Bradshaw, who also lives on Honrine Road, within sight of the
Brandon and Michelle Bradshaw area, says he believes the well
contamination comes from either turkey or hog waste. He said turkey
his yard.
Bradshaw says it is not uncommon for hog waste to be scattered while
it is raining or just after a rain. He said both hog waste and turkey litter
I
it," he said..
Ricky Bradshaw says that he got a letter about two years ago from the
state Health Department advising him not to drink his well water. He
said he started boiling the water before drinking it. Today, says
clothing and vehicles.
from David Parker, chief of the Eastern Enforcement Section (Region 4)
of the U.S! Environmental Protection Agency, headquartered in Atlanta,
Ga.
In addition to Ricky Bradshaw, the letters are addressed to Grady
Bradshawland Jeff Leftwich. All addresses are Honrine Road.
taken during August 2002 that their well water contains nitrate at a
concentration of 10 mg/I.
The letter reads, in part, "It is possible that the nitrate levels in your well
water, you may want to consider using an alternate source of water,
such as bottled water, for drinking and cooking. EPA is currently
consulting with the state to determine the cause of nitrate
contamination in your area and will inform you of additional details."
Ricky Bradshaw says he has heard nothing from EPA since the
December letter.
Michelle continued her story by saying that DWQ's Shanahan called
want her to have to wait two days to receive the letter.
water, to quit using it in cooking and to quit using it to brush teeth with,
especially in the children's case.
The Bradshaws have two small children. Christian will be 5 in three
weeks. The little girl, Halley, is 2 1/2 years old.
the enviro mental department at the Sampson County Health
Department. She says she does not know the name of the woman with
whom shei talked, but said, ",She either did not know much about it, or
we quit drihking the water it wouldn't hurt us."
3 of 7 1 2/24/03 8:38 AM

The�Sampson Independent
http://www.zwire.com/site/news.cfm?newsid=7131972&BRD=111...
Brandon says he has been told that it would be at least a year before
he could tap on to county water. He said main lines have already been
installed along Honrine Road and along Bradshaw Road.
has not used the water for bathing since Shanahan called. Brandon
well water, but no more.
Michelle said that Shanahan advised her to have blood tests done on
the children to the doctor)," Michelle said.
The children, said Michelle, had blood work done last November.
the Clinton Medical Clinic, on Tuesday, Feb. 18, and was advised that
appointment is in April, further blood tests could wait until then.
told me that we would be hearing from him or Rudo within a
him no, sh'e said. Shanahan said, according to Michelle, that an
investigation might consist of more water sampling and soil testing.
has checked in the neighborhood. He told me that the nitrates come
from animal feces," said Michelle Bradshaw. He didn't specify what
animal, said Michelle.
The Honrine Road -Bradshaw Road area appears to be the home of
several livestock and poultry operations. The closest to Brandon and
Michelle Bradshaw appear to be a chicken and turkey operation, sited
near each other, owned, according to Ricky Bradshaw, Michelle
Bradshaw and Brandon Bradshaw, by Kenneth Bradshaw. There's also
the trio say are owned by Kenneth Bradshaw and part of them by Elbert
Pearsall. Brandon Bradshaw says, that it is his understanding that all
the hog houses use the same waste lagoon.
The hog operation's pigs, according to the three Bradshaws, are
furnished by integrator Prestage Farms, based near Clinton.
The three say they are not sure who is the integrator for the chicken
and turkey' operations, but Ricky Bradshaw said it appears to be Nash
Johnson Sons, based near Rose Hill. Leading from the south side of
lanes with posted signs. One reads Nash Johnson & Sons, the other
Prestage Farms.
Ricky Bradshaw says he does not believe the hog houses are at least
1995. He says that EPA officials came last summer and put some test
wells down near his home, but not on his property. He said he thinks
they are still there, but hasn't seen anyone checking them for some
time.
Brandon Bradshaw, 29, said he moved to his present house nearly five
years ago !and has experienced much more sickness than before the
4 of 7 1 1 2/24/03 8:38 AM

The Sampson Independent http://*ww.zwire.coin/site/news.cfm?newsid=7131972&BRD=111...
move. Primarily, he said, his sickness has consisted of "throwing up,
upset stomach and heartburn." No one, said Brandon, "can figure out
why I'm getting sick."
"At one time," explained Michelle, "I was boiling water, but then we
The advise not to boil, Michelle said, came from Shanahan.
Brandon said that his plumbing system was replaced two years ago,
including a new pump, new tank and all piping to and inside of the
house.
Ricky Bradshaw says that he has been complaining about the°problem
for some time, contacting various agencies. However, he says, nothing
gets done
However, he said, on Feb. 13, a Thursday, a water company out of
" said. Bradshaw. "and said they would be coming back once
on the porch."
ages 17, 16, and 15.
Bradshaw says free water has also been delivered to the home of
Tammy and Jeff Leftwich and Grady and Loreen Bradshaw. Each, he
said, got 40 gallons. The Leftwich and Grady Bradshaw families use the
same well,l Bradshaw said.
"It's bad when you can't reach for a water spigot and get what you
want," Bradshaw said.
Brandon ON Michelle Bradshaw say they have had no water delivered
"We only use our well water for washing clothes and dishes," Michelle
she cooks'five meals a day, including snacks.
"I don't know what we will do until we hear something," Brandon said,
referring ink part to the high cost of buying bottled water, the
inconvenielnce of going somewhere else to bathe and other factors.
Since begiLng to drink the bottled water, Brandon says he realizes
water has an aftertaste, but bottled water doesn't," he said.
Brandon and Michelle Bradshaw say that, aside from the water
problem, litter on their yard and the odor, they have to contend with
flies. They say that especially when the chicken house doors are
opened in summer, flies swarm in their yard and into the house as
doors are opened and on the outside walls of their house. "You can see
big mounds of flies on the side of the house," Brandon said.
a chicken
II in the house. It's horrible."
5 of 7
2/24/03 8:38 AM

The'Sainpson Independent http://www.zwire.com/site/news.cfm?newsid=7131972&BRD=111
Contacted by telephone Wednesday, David Parker and Lee Thomas,
Thomas, EPA has turned or "delegated" the results of its sampling work
over to DWQ in Fayetteville.
Thomas said six private wells were tested in September 2001 along
Honrine Road. He said he could not, by law, reveal the results of the
of 20C .Thomas added, samples were taken from six private wells in
the Vann Crossroads area. Results showed a range of 8.4 mg/I .to 23
mg/I, he said.
Thomas said EPA does not have any test wells in Sampson County. He
said that temporary wells were installed but that, once sampling was
completed these were removed. He said the test wells Ricky Bradshaw
referred tolwere likely installed by the hog producer.
With regard to free water, Prestage Farms spokesman Dennis Carter
was contacted by telephone this morning and asked if Prestage Farms
check. When he called back he said that he had been unable to contact
personnel who would have firm knowledge but that he does not think
Prestage is furnishing free water to anyone.
L. E. Brown, Jr. can be reached at 910-592-8137, ext. 20. or email
sicitvna.intrstar.net
©The Sampson Independent 2003
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6 of 7 1 2/24/03 8:38 AM

NCPH - Water Laboratory Search
Close Print
North Carolina State Laboratory of Public Health
Department of Health and Human Services
P.O. Box 280147 -- 306 N. Wilmington St. -- Raleigh, NC 27611-8047
INORGANIC CHEMICAL ANALYSIS
Name of System: Bradshaw, Clyde Mr. Source of Water:
Address: 821 Hornine Rd Source of Sample:
Clinton, NC 28328 Type of Sample:
Type of Treatment:
Type of Analysis:
County: FRODWQGW
Report To: NCDENR-DWQ GW
Wachovia Bld, Suite-714.
Fayetteville, NC 28301
Collected By: BILL SHANAHAN
Location of Sampling Point: Outside Tap
Remarks:
Parameters
Nitrate as N
Nitrite as N
Date Received: 6/5/2002 ReportC
Today's Date: 3/5/2003 Ref:
9
Ground
Raw
None
Nitrate
Attn: Bill Shanahan
Courier: 14-56-25
Date: 6/412002 Time: 2:41:00 PM
Test Results
tesuits Units Date Analyzed
4.94 mg/I 6/5/2002
0.10 mg/I 6/5/2002
te: 6/7/2002 Reported By:
7681 Login Batch: 02060011 Sample Number: AA77628
1 of 1. 3/5/03 10:57 AM

NCPH - Water Laboratory Search
Close Print
North Carolina State Laboratory of Public Health
Department of Health and Human Services
P.O. Box 28047 -- 306 N. Wilmington St. -- Raleigh, NC 27611-8047
INORGANIC CHEMICAL ANALYSIS
Name of System: Bradshaw, Ms Source of Water: Ground
Address: 2673 Bradshaw Rd Source of Sample:
Clinton! NC Type of Sample: Raw
Type of Treatment: None
Type of Analysis: Nitrate
County: FRODWQGW
Report To: NCDENR-bWQ GW . Attn: Bill Shanahan
Wachovia Bld, Suite 714
Fayetteville, NC 28301 Courier: 14-56-26
Collected By: I BILL SHANAHAN Date: 1/27/2003 Time: 12:10:00 PM
Location of Sampling Point:
Remarks:
Parameters
Nitrate as N
Nitrite as N
Date Received: 1/28/2003 Report I
Today's Date: 3/5/2003 Ref:
Well Tap
Test Results.
Results Units Date Analyzed
18.49 mg/I 1/28/2003
<0.10 mg/I 1 /28/2003
Date: 2/11/2003 Reported By:
9094 , Login Batch: 03010051 Sample Number: AA88594
1 of 1 1 3/5/03 10:55 AM

From Station 1
shot output
mp elevation (formula)
mp elevation
tape down level 4-3
4-3 WL
tape down level 3-26
3-26 WL
tape down 3-21
3-21 WL
TBM (Road Intersection) 190 asl
0.48
Instrument Elevation
193.96
M W 1
1.22
190.74
190.74
7.13
183.61
6.53
184.21
6.2
184.54
MW2
-1.55
187.97
187.97
5
182.97
4.73
183.24
4.45
183.52
MW3
-3.06
186.46
186.46
4.74
181.72
4.37
182.09
3.93
182.53
MW4
.0.8
190.32
190.32
6.64
183.68
6.05
184.27
5.76
184.56
MW5
0.26
189.78
189.781
9.39
180.39
8.3
181.48
8.381
181.4
MW6
190.26.
190.261
8.67
181.59
7.65
182.611
6.641
183.62
MW7
1.581
191.1
191.1
9.03
182.07
8.06
183.04
7.651
183.45
From Station 2
Instrument Elevation
-193.65
MW3
-2.75
186.77
186.77
MW6
0.74
190.26
190.26
MW7
1.71
191.23
191.23

a
North Carolina State Laboratory of Public Health
Department of Health and Human Services
P. O. Box 28047 --; 306 N. Wilmington St. -- Raleigh, N. C. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Bradshaw, Ms
Address: 2673 Bradshaw Rd
Clinton, NC
County: FRODWQGW
Report To: NCDENR-DWQ GW
Wachovia Bld, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
Collected By: BILL SHANAHAN
Location of sampling point: Well Tap
Remarks:
Zip:
ATTN: Bill Shanahan
Date: 1 /27/03
Source of Water:
Ground
Source of Sample:
Type of Sample:
Raw
Type of Treatment:
None
Type of Analysis:
Nitrate
Category:
ILO
Time: 12:10:00 PM
Parameters Results Units Date Analyzed:
Nitrite as N <0.10 mg/I 1/28/03
Nitrate as N 18.49 mg/I 1/28/03
RECEIVE®
FEB 13 2003
�LLEREGIONAL OFFICE
EXPLANATION OF RESULTS: DENR-FAYEl
I
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-,N level should be < 1.0 mg/I and Nitrate-N < 10.0 mg/1
Sample Temperature on Receipt: I 0 5 C
Date Received: 1/28/03 Report Date: 2/11/03 Reported By:
Today's Date: 2/11/03 Reference: 1094 Login Batch ;03010051 Sample Number: AAA 594

Explanations
Coliform Analysis:
If coliform bacteria are Absent, the water is considered safe for drinking purposes. If coliform
bacteria are Present, the water is considered unsafe for drinking purposes. Presence of E. coli
(bacteria) generally indicates that the water has been contaminated with fecal material. It must
be remembered that a water analysis refers only to the sample received and should not be.
regarded as a complete report on the water supply.
Inorganic Analysis:
Recommended limits for drinking water. Sample should not exceed levels listed below:
Alkalinity
No established limits
Iron
0.30 mg/1
Arsenic
q�q j 9-6frmg/l
Lead
0.015 mg/1
Calcium
No established limits
Magnesium
No established limits
Chloride
250 mg/l
Manganese
. 0.05 mg/l
Copper
1.3 mg/1
Nitrate
10 mg/l (as N)
Fluoride
4 mg/l
Nitrite
1.0 mg/l (as N)
Hardness
No established limits
pH
Not less than 6.5 units
Zinc
5.0 mg/1

North Carolina State Laboratory of Public Health
Department of Health and Human Services
P. O. Box 28047 - i 306 N. Wilmington St. -- Raleigh, N. C. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Benson, Ronny
Address: 6791 Center Rd
Bladenboro, NC
County: FRODWQGW
Report To: NCDENR-DWQ GW
Wachovia Bld, Suite 71
Fayetteville, NC 28301
Courier: 14-56-25
Source of Water: Ground
Zip: 28320 Source of Sample:
Collected By: BILL SHANAHAN
Location of sampling point: Well Tap ;
Remarks:
Parameters
Nitrite as N
Nitrate as N
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nit
Private Well Guidelines: Nitrite l
Type of Sample: Raw
ATTN: Bill Shanahan Type of Treatment: Filtered
Type of Analysis: Nitrate
Category: ILO
;Date: 1/27/03 Time: 10:13;00 AM
Results,
<0.1� 0-
<1.0
Units Date..Analyzed:-� i� Ii
mg/I _ - 1 /28/03
mg/I 1 /28/03
r.
, RECEIppp{{{��1
-=- -- - _. L
D 1 2003 , ,-� r+ 1i7�rjLLEREGIONAL OfFjCF
rate-N level acceptable if less than or equal to 10 mg/I
N level should be < 1.0 mg/I and Nitrate-hL< 10.0 mg/I
Sample Temperature on Receipt: 1.0 O C
Date Received: 1/28/03 Report Date: 2/11/03
Today's Date: 2/11 /03 Reference: - 1095
Reported By:
Login Batch 03010051 Sample Number9595

Explanations
Coliform Analysis:
If coliform bacteria are Absent, the water is considered safe for drinking purposes. If coliform
bacteria are Present, the water is considered unsafe for drinking purposes. Presence of E. coli
(bacteria) generally indicates that the water has been contaminated with fecal material. It must
be remembered that a water analysis refers only to the sample received and should not be -
regarded as a complete report on the water supply.
Inorganic Analysis:
Recommended limits for drinking water. Sample should not exceed levels listed below:
Alkalinity
No established limits
Iron
0.30 mg/1
Arsenic
(fir mg/l
Lead
0.015 mg/1
Calcium
No established limits
Magnesium
No established limits
Chloride
250 mg/l
Manganese
0.05 mg/1
Copper
1.3 mg/l
Nitrate
10 mg/l (as.N)
Fluoride
4 mg/1
Nitrite
1.0 mg/l (as N)
Hardness
No established limits
pH
Not less than 6.5 units
Zinc
5.0 mg/l

u
p Postage
$
�V
O
p Certified Fee
!)
]
ve
02
Return Receipt Fee
7
Required)3Restricted
�/
•7,m,1003
�Endorsement
Delivery Fee
Endorsement Required)
9 Total Postage & Fees
$
9 1
)
J
Sent To
Mr. Tommy Bradshaw
9
3
----------------------------- ---------- -----------------------------------------
Street, Apt. No.;
2,967Bbxibradshaw Road
-
.
(GW Quality Invest,
3
- --- --------------------------------------------------------------------------------------
1�Tinfon; NC
28328
(1590-79-9072)

Certified Mail Provides: a
■ A mailing receipt
■ A unique identifier for your mailpiece
A signature upon delivery
■ A record of delivery kept by the Postal Service for two years
mportant Reminders:
■ Certified Mail may ONLY be combined with First -Class Mail or Priority Mail.
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fc
valuables, please consider Insured or Registered Mail.
For an additional fee, a Return Receipt may be requested to provide proof c
delivery. To obtain Return Receipt service, please complete and attach a Returi
Receipt (PS Form 3811) to the article and add applicable postage to cover th,
fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver fc
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required.
■ For an additional fee, delivery may be restricted to the addressee c
addressee's authorized agent. Advise the clerk or mark the mailpiece with th
endorsement "Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired, please present the arti
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receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry..
�S Form 3800, January 2001 (Reverse) 102595-01-M-104

UNITED STATES POSTAL SERVICE
First -Class Mail
1-1-1-11-1—
Postage & Fees Paid
`LISPS —
Permit No. G-10 ,
v
• Sender:
lease print your name, address, and ZIP+4 in this box •
z
q
M
r
rn
C=
C-71
NUENR-_ --Gro_undwater Section
I ATTN :_ Mr. Bill Shanahan
w ®
22.5. Green Street
o
Suite 714
�
Fayetteville, NC 28301.-5043
m

IN Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
IN Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Mr. Tommy Bradshaw
207.1 Bradshaw Road
Clinton, NC 28328
2. Article Number
(Transfer ffqm service h
PS Form 3811, March
ewed by (Please r(nt ar y)
B. Date of Deliver
C. Signature
X�9�
❑ Agent
----
D.'Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. �Se,yrrvice Type
i�kertified Mail ❑ Express Mail
❑ Registered XX Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D. I
4. Restricted Delivery? (Extra Fee) ❑ Yes
102595-01-M-14:

Certified Mail 7001 2510 0
Return Receirat Reauested
Mr. Tommy Bradshaw
2071 Bradshaw Rd
Clinton, NC 28328
SUBJECT:
Dear Mr'./Mrs. Bradshaw:
The Division is investigati
objective is to determine
DWQ is interested in obtai
This will not costyou any:
an agreement document, v
of a groundwater, monito
Please sign and return the
If you need additional,in
micnaei r. tasiey, Lzovernor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 27, 2003
Ground Water Quality Investigation
Bradshaw Property 36 Acres 1590-79-9072
Bradshaw Rd, Clinton, NC
ground water quality in the Honrine & Bradshaw crossroad area. Our
cause of elevated nitrogen components the investigation area. The
ig access to the your property to install a ground water monitoring well:
)ney and should not interfere with your use of the property. Attached is
ch'will provide the Division with access to the property for installation
�V- well.
ment in the provided addressed envelope at your earliest opportunity.
tion or clarification, please contact me at [phone].
Sincerely
Step e A. Barnhar t, L.G.
Regional Groundwater Supervisor
r�
Division of Water Quality/Groundwater Section
'NCDENi�fia 225 Green Street, Suite 714, Fayetteville, NC 28301-5043
Phone: [phone] FAX: [phone]
Internet: http://gw.ehnr.state.nc.us
Customer Service: [phone]
M

rt
a. Postage
$
l� 6
j Certified Fee
02Po(e•L003
Return Receipt Fee
(Endorsement Required)
)�
1
Restricted Delivery Fee
(Endorsement Required)
a Total Postage $Fees
$�.��
n
u Sent To
Mr. and Mrs. Bradshaw
a-------------------------------------------------------------------------------
r e A No.;
t�aBotaidshaw Road (GW Quality Invest
Ci tete, ZIP+4
CdTiS1 ton, NC 28328 (1590-77-5065)

Certified Mail'Provides:
■ A mailing receipt
e A unique identifier for your mailpiece
■ A signature upon delivery
■ A record of delivery kept by'the Postal Service for•two years
mportant Reminders: ;
■ Certified Mail may ONLY be combined with First -Class Mail or Priority Mail.
■ Certified Mail is not available for any class of international mail.
NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo
valuables, please consider Insured or Registered Mail.
For an additional fee, a Return Receipt may be requested to provide proof c
delivery. To obtain Return Receipt service, please complete and attach a Retun
Receipt (PS Form 3811) to the article and add applicable postage to cover thi
fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver fc
a duplicate return receipt, a USPS postmark on your Certified Mail receipt i
required.
For an additional fee, delivery may be restricted to the addressee c
addressee's authorized agent. Advise the clerk or mark the mailpiece with thl
endorsement "Restricted Delivery".
If a postmark on the Certified Mail receipt Is desired, please present the arti
cle at the post office for postmarking. If a postmark on the Certified Ma
receipt is not needed, detach and affix label with postage and mall.
MPORTANT. Save this receipt and present it when making an inquiry.
'S Form 3800, January 2001 (Reverse) 102595-01-M-104

UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in t LL,
CU
R
O
J
NCDFNR--Groundwater Section L ® Lo
J.9 o c�
�ATTN� Mr. Bill Shanahan-i N
22.5 Green Street LU
Suite 714
Fayettevill.e, NC 23301-5043 UJ
E5
0
t;
,_ �� �II�I��Iiltli�ll"tltiil IIXltlil 11 �T'14-f�-1-i�1.�L1

■ Complete items 1, 2, and 3. Also complete A. Received by (Please Print Clearly) B. Date of Deliver
item 4 if Restricted Delivery is desired. C ,L
■ Print your name and address on the reverse
so that we can return the card to you. C. Signature
■ Attach this card to the back of the mailpiece, X Agent
or on the front if space permits. ✓ . Addressei
Article Addressed to:
Mr. and Mrs. Bradshaw
821 Bradshaw Road
Clinton, NC 23328
D. Is delivery addreYs different from item 19 e,
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered )jX Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number — —' — —
(Transfer from service labs 7 O O �. 2 510 0 00 0 6 6 8 0 1 d 0 3
:IS Form 3811, March 2001 Domestic Return Receipt 102595-61-M-14f

,9,
O�o� W AT �qQG
y 1�
micnaei r. tasiey, vovernur
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
01
Return Receipt Re
Mr./Mrs. Bradshaw
821 Bradshaw Rd
Clinton, NC 28328
SUBJECT:
Dear Mr./Mrs. Bradshaw:
The Division is investigat
objective is to determine
DWQ is interested in obta.
This will not cost you any
an agreement document, N
of a ground water, monit(
Please sign and return the
If you need additional in
Alan W. Klimek, P.E. Director
Division of Water Quality
February 27, 2003
Ground Water Quality Investigation
Bradshaw Property 1590-77-5065
Honrine Road, Clinton, NC
ground water quality in the Honrine & Bradshaw crossroad area. Our
cause of elevated nitrogen components the investigation area. The
ig access to the your property to install a ground water monitoring well.
)ney and should not interfere with your use of the property. Attached is
ch will provide the Division with access to the property for installation
�h well.
t in the provided addressed envelope at your earliest opportunity.
or clarification, please contact me at [phone].
Sincerely
Stephe . Barnhardt, L.G.
Regional Groundwater Supervisor
Division of Water Quality/Groundwater Section
NGDEP�R 225 Green Street, Suite 714, Fayetteville, NC 28301-5043
Phone: [phone] FAX: [phone]
Internet: httI)://gw.ehnr.state.nc.us
Customer Service: [phone]

.71
a
p Postage
$ D
n
n Certified Fee
� (
Postmark
n Return Receipt Fee
� (Endorsement Required)
t f
o j
0 2. Hre 2 0 0 3
jRestricted Delivery Fee
(Enddrsement Required)
a
n
u
Postage & Fees
to
Edna Kottler
a--------------- --------------------------------------
Street Apt. No.;
n r7ojeo�iaadshaw Road (GW Quality Invest)
------ -----
City'� State, ZIP+4
.linton, NC 28328 (1590-78-0850)

jerlified Mail Provides:
A mailing receipt
A unique identifier for your mailpiece +T
A signature upon delivery
A record of delivery kept by the Postal Service for two years
mportant Reminders:
Certified Mail may ONLY be combined with First -Class Mail or Priority Mail.
Certified Mail is not available for any class of international mail.
NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo
valuables, please consider Insured or Registered Mail.
For an additional fee, a Return Receipt may be requested to provide proof c
delivery. To obtain Return Receipt service, please complete and attach a Retun
Receipt (PS Form 3811) to the article and add applicable postage to cover thi
fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver fo
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
For an additional fee, delivery may be restricted to the addressee 0
addressee's authorized agent. Advise the clerk or mark the mailpiece with thl
endorsement "Restricted Delivery".
If a postmark on the Certified Mail receipt is desired, please present the art!
cle at the post office for postmarking. If a postmark on the Certified Ma
receipt is not needed, detach and affix label with postage and mail. -
MPORTANT: Save this receipt and present it when making an inquiry.
'S Form 3800, January 2001 (Reverse) 102595-01-M-104

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
111111 Permit No. G-10
• Sender: Please print your name, address, and ZIP+4
'
® cis
LL
NCDENR--Groundwater Section
C
ATTN : Mr.- Bill _Shanahan
22.5 Green Street
_�cc
®
J
Suite 714
Fayetteville, NC 28301-504
LU
0
is [I I[,Ir1,1111111111l111111it11►1iIIII 111

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Ms. Edna Kottler
2071 Bradshaw Road
Clinton, NC 28328.
A. Received by (Please Print Clearly) B. Date of Deliver.
C. Signat
Agent
Addresses
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
XJCertified Mail ❑ Express Mail
❑ Registered . y,)fR Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes.
2. Article Number -- -
(rransfer from ser4 ice IabE 7 O Q 1 2 51j0 "0 0 0 p Er:6 8 0 a 101 Oi
:4s ., t S4
PS Form 3811, March 2001 Domestic Return Receipt 102E-95-01-M-14:

OF W ATFq
\G Q� .
6
Ms. Edna Kottler
2071 Bradshaw Rd
Clinton, NC 28328
SUBJECT:
Dear Ms. Kottler:
The.Division is investigati
objective is to determine
DWQ is interested in obtai
This will not cost you any
an agreement document, v
of a ground water, monitc
Please sign and return the
If you need additional in
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 27, 2003
Ground Water Quality Investigation
Kottler Property 61.67 Acres 1590-78-0850
Honrine Road, Clinton, NC
ground water quality in the Honrine & Bradshaw crossroad area. Our
cause of elevated nitrogen components the investigation area. The
ig access to the your property to install a ground water monitoring well.
)ney and should not interfere with your use of the property. Attached is
ch will provide the Division with access to the property for installation
1;" well.
t in the provided addressed envelope at your earliest opportunity.
or,clarification, please contact me at [phone].
Sincerely
Stephen . Barnhardt, L.G.
Regional Groundwater Supervisor
y I Division of Water Quality/Groundwater Section
06ENR
225 Green Street, Suite 714, Fayetteville, NC 28301-5043
Phone: [phone] FAX: [phone]
Internet: http://gw.ehnr.state.nc.us
Customer Service: [phone]

14 NORTH CAROLINA DEPARTMENT OF
AW. ENVIRONMENT AND NATURAL RESOURCES
GREEN STREET - SUITE 714
'NCDEINRI -FAY--ETTEV'ILLE, NC 28301-SW3
RECEIVED
MAR 0 5 2003
r
DENR-FAYEMLLEREGIOMLOFRU
PM
<
C"'
84 - �PnTPOQ
North Carolina Department of Environment
and Natural Resources
Groundwater Section
225 Green Street
—Suite-7-14
:-Fayetteville, NC- 28301-5043
I'% Ill$ AL

Stephen Barnhardt.
NCDENR - DWQ
Groundwater Section
Fayetteville Regional C
225 Green Street
Suite 714
Fayetteville, NC 28301
Re: Agreement for thel Use of a Site for a Groundwater Study
Dear: Mr. Barnhardt
M
DENR - FAyETVLLE REGIONAL OFRCE
I am the owner/agent of a parcel of property, as described in the cover letter and hereby
permit the North Carolina Department of Environment and Natural Resources (DENR)
to enter upon the property for the purpose of testing the ground waters under the
authority of G.S. 143-215.3 (a) 2 and G.S. 143-466 (e).
I am granting permission] with the understanding that:
1. This Groundwater Study (Study) shall be conducted by DENR-DWQ.
2. The costs of construction and maintenance of the site and access shall be
born by DENR-DWQ. DENR-DWQ shall protect and prevent damage to
the surrounding lands resulting from Study activities.
3. Unless otherwise agreed, DENR-DWQ shall have access to the site by the
shortest feasible route to the nearest public road. DENR-DWQ may enter
upon the land at reasonable times and have full right of access during the
period of the Study.
4.. At the end lof the Study, unless otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected 1by it and -shall permanently abandon all wells constructed by it.
5. Any claim
of Chapte
Against S
law.
6. The infoi
owner ul
132-1 et
7. The activi
DENR-D%
which may arise against DENR shall b& governed by Article 31
143 of the North Carolina General Statutes, Tort Claims
ite Departments and Agencies, and as otherwise provided by
:ion derived from the Study shall be made available to the
request and is a public record, in accordance with the G.S.
to be carried out by DENR are for the primary benefit of
and the State of North Carolina and any benefits accruing to

the owner are incidental. DENR is not and shall not be construed to be an
agent, employee, or contractor of the owner of the land.
I agree not to interfere with, remove, or in any manner tamper with or damage DENR's
well(s) and equipment during the Groundwater Study.
Sincere,
Signature of Owner or Adent
Type or Print Name of Owner or Agent.
Date
X�
Address/Phone No.

NORTH CAROLINA DEPARTMENT OF
®�
-ENVIRONMENTAND NATURAL RESOURCES
=5 GREEN STREET - SUITE 714
NCDENR
FAYETTEVILLE, NC 28*301 -5043
EIVED
1 0 4 2003
0':Nq FAYJVLLE REGIONAL OFFFICF
14 1 L
V,
Al
PM
el
C- 71 PR
rM
North Carolina Department of Environment
and Natural Resources
Groundwater Section
WAQ MITI M Mr 91 i I I [SR h -
tyglga
tar t. nip
225 Green Street
Suite 7.14'-
Fayetteville, NC 28301-5043.
cn 11,11111,11411 li'li ... 111111 AV1.0 ti►till

i
X*"
the owner are incidental. DENR is not and shall not be construed to be an
agent, employee, or contractor of the owner of the land.
I agree not to interfere with, remove, or in any manner tamper with or damage DENR's
well(s) and equipment during the Groundwater Study.
Sincerely,
Signatur Owner or Agent
I
Type or Print ame of Owner
or Agent
Date
70
Address/Phone No.
RECEIVED
MAR 0 4 2003
DENR - FAYEFVLLE REGIONAL OFFlCE

11 OFF�Ch%L USE
Postage 5 a U
Certified Fee
Return Receipt Fee I 02PoHe%�00
xsement Required)
tricted Delivery Fee
xsement Required)
Total Postage & Fees
Brandon Bradshaw
street, Apt. rvo.;
gB(MX'B?radshaw Road (GW Quality Invest;
---------------------------------------------------------------------------------------------
F , State, ZlPt4
Chlin.ton, NC 28328

Certified Mail Provides: _.
■ A mailing receipt g'
■ A unique identifier for your mailpiece
■ A signature upon delivery
■ A record of delivery kept by the Postal Service for two years
mportant Reminders:
Certified Mail may ONLY be combined with First -Class Mail or Priority Mall._
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fc
valuables, please consider Insured or Registered Mail,
0 For an additional fee, a Return Receipt may be requested to provide proof c
delivery. To obtain Return Receipt service, please complete and attach a Retur
Receipt (PS Form 3811) to the article and add applicable postage to cover th
fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver fc
a duplicate return receipt, a USPS postmark on your Certified Mail receipt i
required. .-
■ For an additional fee, delivery may be restricted to the addressee c
addressee's authorized agent. Advise the clerk or mark the mailpiece with th
endorsement "Restricted Delivery".
e If a postmark on the Certified Mail receipt is desired, please present the art!
cle at the post office for postmarking. If a postmark on the Certified Me
receipt is not needed, detach and affix label with postage and mail.
MPORTANT: Save this receipt and present it when making an inquiry.
'S Form 3800, January 2001 (Reverse) 102595-01-M-104

UNITED STATES POSTAL SERVICE
pm
r N
rat Ycy,name,, address,
a
Z
IF
_M0
_
NCDENR--Groundwater Section
T
_
Af : Mr _ Bz_11 _Slianahari'
soa
225 Green Street _
w
Suite 714
o
Fayetteville, NC 28301-5043
m
a2 IIIl1111AlIIII all IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIAIIIIIIII

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Prin'4your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Mr. Brandon Bradshaw
26,73 Bradshaw Road
Clinton, NC 28328
A. Received by Please P rint Clearly) Y B. Date of Deliver)
C. Signature
Lp p pp (� Agent ,
X i\1-1 �Pna r,? Ac a Addressef
D. Is delivery a5dress different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered XXReturn Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number --- -- — —
(1-ransfer,'from service labe� 7iD D l; 2 510 0i0 D 0 i, i6 6.8 Di 1 1-0 3i4
o f i— ! si ielii i •tip 'v
:IS Form 3811, March 2001 Domestic Return Receipt 102595-01-M-14,

Certified Mail 7001 2510 01
Return Receipt Requested
Mr. Brandon Bradshaw
2673 Bradshaw Rd
Clinton, NC 28328
SUBJECT:
Dear Mr./Mrs. Bradshaw:
The Division is investigat
objective is to determine
DWQ is interested in obta
This will not cost you any
an agreement document, i
of a ground water, monitc
Please sign and return the
If you need additional in
J
micnaei r, tasiey, tzovemor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 27, 2003
Ground Water Quality Investigation
Brandon Property
2673 Bradshaw Rd, Clinton, NC
ground water quality in the Honrine & Bradshaw crossroad area. Our
cause of elevated nitrogen components the investigation area. The
ig access to the your property to install a ground water monitoring well.
►ney and should not interfere with your use of the property. Attached is
ch will provide the Division with access to the property for installation
12 well.
ment in the provided addressed envelope at your earliest opportunity.
tion or clarification, please contact me at [phone].
Sincerely
Step n A. Barnhardt, L.G.
Regional Groundwater Supervisor
Division of Water Quality/Groundwater Section
NC00 - .i� 225 Green Street, Suite 714, Fayetteville, NC 28301-5043
Phone: [phone] FAX: [phone]
Internet: http://gw.ehnr.state.nc.us
Customer Service: [phone]

the owner are incidental. DENR is not and shall not be construed to be an
agent, employee, or contractor of the owner of the land.
I agree not to interfere with, remove, or in any manner tamper with or damage DENR's
well(s) and equipment during the Groundwater Study.
Sincerely,
0 -N i I/
V 9L
Signature of Owner. or Agent
Type or Print Name of Owner or Agent
Date
%a _ C�(-CAe-
, N C . 72.`1 k 5q'
t0
Address/Phone No.
I

i
MEMORY TRANSMISSION REPORT
TIME MAR-05-2003 02:59PM
i TEL NUMBER`:
NAME
i
FILE NUMBER 339
i
DATE MAR-05 02:51PM
TO 19191150588
i
DOCUMENT PAGES 024
START TIME MAR-05 02:51PM
END TIME MAR-05 02:59PM
SENT PAGES 024
STATUS OK
FILE NUMBER 339 SUCCESSFUL TX NOTICE-***
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