Feed Mill Investigation-Sampson_20050218

Report of Investigation
f
Feed Mill Road Project
r Sampson County
North Carolina
Fayetteville Regional Office
0 9;
-ANI U-1
NCDENR!w
North Carolina Department of Environment.and Natural Resources
Division of Water Quality
Aquifer Protection Section
Prepared By:
AIM,
illiam F..G fo
Hydrogeologist I --_------
William Shanahan
Hydrogeological Technician II
February 18, 2005

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Report of Investigation
Feed Mill Road Project
Sampson County
North Carolina
Fayetteville Regional Office
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Aquifer Protection Section
Prepared By:
olfff7"
r
i liam F. to orth
Hydrogeologist I
February 18, 2005

North Carolina Department of Health and Human Services
Division of Public Health
Epidemiology and Communicable Disease Section
V, R
1912 Mail Service CenterORalpigh, North Carolina 27699-1912
7
2728 Capital Boulevard 0 Courier 56-32-00 0 (719) 733;-3421
J. Steven Cline, D.D.S., M.P.H., Section Chief 0,11-D -.1, r� e S
UFN-19 - F11YUF1-.V1LLE RraG!0'M1qL OffiCE
DATE
MEMORANDUM
TO: flT. A414JI-RA
(TQ-
FROM: Kenneth Rudo, Ph.D., Toxicologist
Medical Evaluation and Risk Assessment Unit
Occupational and Environmental Epidemiology Branch
SUBJECT:
Attached is/are the Occupational and Environmental Epidemiology Branch's drinking
water health risk evaluation(s) for the well water sample(s) listed from the above site(s).
Recommendations for continued water use are also provided.
If you have any questions, please call me at [phone].
KR:Ip
Attachment(s)
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EvenjMera. EvcnjDay. EveryBody. An Eqtial OpportunitylAffirinative. Action Eniployer

'North Carolina DepartmenUof Health and Human Servic s `
Division of Public Health
Occupational..and' Environmental Epidemiology B nch
Medical Evaluation and Risk Assessment Unit `
Drinking Water. Health Risk Evaluation. OS -'"ALM
General "
-
"OUNTY
DATE ti3 LABORATORY NUMBER.1'�
O Based on these analytical results, this water" should be considered safe for: normal .
usage
O Chemical analysis did not show any contamination. Water'should be,re'sampled if
odor or taste persists. .
(X) The water should not be used for drinking or -cooking purposes,.
O Based on these analytical results,.this water is highly contaminated_and should not
be used for drinking; cooking or bathing/showering.
:-o
4; .
( ) " The laboratory results are -not conclusive, please resample: .o
W; C3
PLEASE INDICATE -ON, LAB SHEET THAT IT IS ARESA.MPLE AID_
PROVIDE PREVIOUS SAMPLE NUMBER(S) cn
(X) COMMENTS -
The -nitrate drinking Waterstandard 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,, 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 (11/99)
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North Carolina Department of Health and Human Services
Division of Public Health °AQ
'�
Occupational and Environmental Epidemiology BranchUIFE
�- Medical Evaluation and Risk Assessment Unit
.� t` '� t y� 041 V,0V _? A1, L: 52
<-. Drinking Water Health Risk Evaluation
General
Uh f h OLTNTY
DATE b� LABORATORY NUMBER
() Based on these analytical results, this water should be considered safe for normal
usage
() Chemical analysis did not show any contamination. Water should be resampled if
odor or taste persists.
(X) The water should not be used for drinking or cooking purposes.
() Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or bathing/showering.
( ) The laboratory results are not conclusive, please resample:
PLEASE INDICATE ON LAB SIJEET 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, 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 (11/99)
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North Carolina Department of Health and HTapeUvices n S,,j q .�.
Division of Public Healtlr,,QIJIFER PROTECT[ IMSES.
Occupational and Environmental Epidemiology Branch
edical Evaluation and Risk Assess a nit,
t=01 8: S 2
i �
Drinking Water Health Risk Evaluation
[DE%R-_IA tli `VkLEfiELICO N.I_OFi10E
_ ,__, �--..�-._. General
f h ---COUNTY
DATE LABORATORY NUMBER 0(2_1 Al 11 M_ A_V1,
() Based on these analytical results, this water should be considered safe for normal
usage
() Chemical analysis did not show any contamination. Water should be resampled if
odor or taste persists.
(X) The water should not be used for drinking or cooking purposes.
() Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or 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 nitratelevel 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 (11/99)
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North Carolina Department of Health and Human S,e�ui PE[J/D&ff, ,9— VIQ
Division of Public Health tIHil-ER PRO i I C i ICit, SEC.
Occupational and Environmental Epidemiology Branch
Medical Evaluation and Risk Assessment Uni
b4 N 0 V -3 A i °: 52
GEibR-Fp;r,- UI[I EERcGI0%0 ;CL
DATE b-3
Drinking Water Health Risk Evaluation
General
—COUNTY
LABORATORY NUMBER
() Based on these analytical results, this water should be considered safe for normal
usage
() Chemical analysis did not show any contamination. Water should be resampled if
odor or taste persists.
(X) The water should not be used for drinking or cooking purposes.
() Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or 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 niirate'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 (11/99)
OEEB (Rev. 1 1/00)

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r1"t'iUGIF^fl� E ROTEE' '4A' Carolina Department of Health and Human Services
Division of Public Health 1
Occupational and Environmental Epidemiology. Bra ch
04 NOV -3 A i 8: 52 Medical Evaluation and Risk Assessment Unit I P I
Drinking Water Health Risk Evaluation Ci�t�i --FA � t ri.! �FGIpPt! OriCC
General
COUNTY
DATE n� LABORATORY NUMBER /Iff
() Based on these analytical results, this water should be considered safe fornormal
usage
() Chemical analysis did not show any contamination. Water should be resampled if
odor or taste persists.
(X) The water should not be used for drinking or cooking purposes.
() Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or 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 pprri.'-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 (11/99)
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Report to _FRO
GROUNDWATER SECTION
CHAIN OF CUSTODY (COC) RECORD
Page _1_ of _1_
NC DENR/DWQ LABORATORY (check one): -s. [X I CENTRAL [ ]. ARO . - [ ] WaRO
For Investigation of: CAFO Operations along Feed Mill Rd., Sampson County
Incident No.
Sample collector (print name)
and GW -54 forms completed by: _Bill Shanahan
Sample collector's signatur .
Field storage conditions and location (when applicable):
Lab Use Only,
LAB NO.
SAMPLE ID
QUAD. NO.
LOCATION
DATE
SAMPLED
TIME
SAMPLED
NUMBER
OF
CONTAINERS
MW-ti
Feed Mill Rd., Sampson County
5/25/04
Sf
2
MW-7
Feed Mill Rd., Sampson County
5/25/04,
2
MW-8
Feed Mill Rd., Sampson County
5/25/04
2
G / �(,
MW-9
Feed Mill Rd., Sampson County.
5/25/04
2
1/1O
MW-10
Feed Mill Rd., Sampson County
5/25/04
2
on
Relingj ' ed b (si ture):
Date
Time
e i by (signatur
to
a
Time,
-
Relinquishe 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
Hand -delivered Federal Express UPS
Other:
Security Type and Conditions:
Sealed by: Bi
naha
ke
INTRALAAORATORY CHAIN OF CUSTODY - Lab Use Only
LAB NUMBERS
FROM THROUGHL�
F;UMBER ,
BOTTLES
ANALYSES
REQUESTED
P.ELENT SHED
BY:
RECEIVED
B�Yn:
DATE
TIiV1E,
--------------
�1JA
J U N 01 2004
? tit 1V DEN
- FAYEMLLE RFCIONAI
vv

For Investigation of: CAFO Operations along Feed Mill Rd., Sampson County
Incident'No.
Sample collector (print name)
and GW-54 forms completed by:
_Bill Shanahan ".-Sample collector's signature:
/
Field storage conditions and location (when applicable): .
Lab Use Only
LAB N0.
SAMPLE ID
QUAD NO.
LOCATION
DATE'
TIME
SAMPLED
NUMBER
OFSAMPLED
CONTAINERS
MW-1
Feed Mill Rd., Sampson County
5/25/04
2
Co (SA
MW-2
Feed Mill Rd., Sampson County .
5/25/04•
l/.•?-Ra.
2
T1
CJ
MW-3
Feed Mill Rd., Sampson County
5/25/04 '
2
VG
MW-4
Feed'Mill Rd.,.Sampson County
5/25/04
2
MW-5
Feed Mill, Rd., Sampson'County
5/25/04
(y
2
ui edy;rgnature)
Date
Time
tecelii a
Time
Relinquish d by (signature):
Date
Time
Received by (signature -
Date
Time
Relinquished by (signature):
Date
Time
Received by (signature):
Date
Time
Method of Shipment (circle one):
ate Courier Hand -delivered Federal Express . UPS
Other:
Security Type and Conditions:
Sealed by: Bill Sha ahan
INTRAT,ABORATORV CHATN OF CTT.4TOT)V - T.nh TTep O.,TV
LAB NUMBERS
FROM THROUGH
NUMBER
BOTTLES
ANALYSES
REQUESTED
'RELINQUISHED
BY:
RECEIVED
BY:
DATE
TIME
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JU.N 0 A
004
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RxTRANSMISSION
DENR
FAYETTEVILLE REGIONAL OFFICE
FAYETTEVILLE, NORTH CAROLINA 28301-5043
VOICE: 910-486-1541
Fax: '910-486-0707
To: � 4 Dale:
Fax #: 'Alq - 7 3 3 - Ot:5sly Pages (including cover):
Subject:
COMMENTS:

MEMORY TRANSMISSION REPORT
TIME SEP-19-2003 10:44AM
TEL NUMBER
NAME
FILE NUMBER
:630
DATE
SEP-19 10:42AM -
TO
19197339555 .
DOCUMENT PAGES.
014
START TIME
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END TIME
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014 .
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FILE NUMBER
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North Carol ind'Stale Laboratory of Public Healtli
Department of Health and Human Services
P. O. Bok 28047 306. N. Wilmington St... Raleigh, N. C. 27611-8041
-INORGANIC CHEMICAL. ANALYSIS --NITRATE ONLY
Name of System( Jackson Sr., Billy Source of Water. Ground
Address-. 2050 Feed Mill Rd
Roseboro, NC 21p: 28382 Source of Sample:
-
County: FRODWQGYV Type of Sample: Raw
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan jype of Treatment:, None
Wachovia Bid, Suite 714
Type of Analysis: Nitrat6
Fayetteville, NC 28301
'Category:, ILO
40
Courier. 14-56-;25
Collected By: B, SHANAHAN r Date:,
Location of sampling point:House Tap -
Remarks:
Parameters suil­
-
Nitrite as.N.
Nitrate as N 1546
Time: 3:42.00 PM
9/3/03
�5-1�12 942 610.54 Vl."V W
ILLE K, _21%_ L nFRPT
-w
-
A-_Vxr
0 U CD 7j
n_,,,iU '
tF
kt <
't ­CNJIN-i WZIRZ� 11 N
co
CA
EXPLANATION -OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than"or,equal to 10 mg/l
Private Well Guidelines, - Nitrite-N'level should. be 5 1.0 mg/l,and NitraterN-< 10.0 mg/l
Sample Temperature on RReceipt:'3.Q 0 C.
Date Received:, -9/3/03:... Report Date: 9/11/03- Reported By:
-Number: RA
Today's Date: 1_/03­' Reference: - 12420 Login Batch 0309000 SampleiAA99954

North Carolina Statd-Laboratory of Public Health
a - n Services
'
Department of Healthnd.
" Hum6
P.-O." Box 2804.7 -.'306 N. Wilmington St.'.- Raleigh, N. C.'27611-8047
-INORGANIC CHEMICAL ANALYSIS - NITRATE -ONLY.
Name of System: Jackson Jr:, Billy Reed Source of Water Ground
r Addess: 1958 Feed Mill Rd
. . I I - I . . : -
Roseboro, NC. Zip: 28382 Source of Sample:
County: FRODWQGW Type,of Sample: Raw
Report. To: NCDENR-DWQ GW
Wachovia Bld, Suite 714
Fayetteville, NC 28301.
Courier: 14-56-25
Coll - e . c-B ted,By: ,SHANAHAN!
Location of sampling point: Well Tap
Remarks:
ATTN: Bill Shanahan .
Type of Treatment: None
of Analysis: Nitrate
R
W `�_,Zll"
2'" P , P% � ' � %
1'6 A
fl
0�1 %N?
'EL-JON, 4 N, a
C:P
M:51
EXPLANATION OF RESULTS:
F6ster/TherapeuticHorrles: Nitrate-N: level acceptable
if less than, or -equal to 10 mg/l
Private Well Guidelines: Nitrite-N level should be< 1.0 mg/l and- Nitrate-N_< 10--0 -mg/l -
Sample Temperature on Receipt: 3.5 C
Date Received: 9/3/03 Report Date: 9/11/03 Reported By:. AMA
Today's Date: 9/11/03 Reference: 12419, Log! n1latch '�0309.00 Sample Number: AA99953.

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, Jeff Source of Water:, Ground
Address: 1783 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan Type of Treatment: None
Wachovia Bid, Suite 714 .x.,: ' ` :Type of Analysis: Nitrate
Fayetteville, NC 28301
Courier: 14-56-25 Category: ILO
Collected By: BILL SHANAHAN Date: 9 3/03 Time: 3:10:00 PM
1
Location of sampling point: Well Tap bra ti
F 'c
Remarks:..3
,
Parameters Results Units ��F Date Analyzed
Nitrite as N <0.10 mg/I ;' 9/4/03- , --
Nitrate as N 9 86 n `rng/I. 9/4/03
,t
y
s
ct$
r. Rt
C>
3
SSw eN-
i;M
yeJ j 635
15.
���Is:1;14'ill
�'
EXPLANATION OF RESULTS:
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 -I-< 10.0 mg/I
Sample Temperature on Receipt: 7.0 0 C
Date Received: 914/03 Report Date: 9/11/03
Today's Date: 9/15/03 Reference: - 12500 Login Batch
Reported By: oflm d
Sample Number: AB00007

No I rth Ca I rolina' tatd-Laboratory'of Public Health,
e
Department of Health 'and Hum -an ServicesP. O. r� Box 28047 306: N. Wilmington "St.'.--.Ra1eigh, N." I C..'27611.-8047.
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Lane John Source of Water: Ground
Address: 2241 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan Type of Treatment: None
VVachovia Bld; Suite 714
Type of Analysis:. Nitrate
Fayetteville, NC 28301- $'-'Cate -
Category: 11-0
Courier: 14-56-25 -
Collected By: BILL SHANAHAN 'Date— 9/3103 Time: 2:52-00PIVI
Location of sampling' point: House Tap
Remarks:.
lk
Parameters
Nitrite as N
Nitrate as N
Results Units6 1 Q te A a yzed
_
Aj 9/4/0j—'
CD
?'j
'n18 05 ex mg/I, Sri ti 9/4/03
jqn,
'94 -5,
C.
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EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: 'Nitrate-N level acceptable if less than or equal. to 1 0'mg/1
Private Well Guidelines: Nitrite-N level should be< 1.0 mg/l and.Nitrate-N—<- I O.Or Mg/1----
Sample Temperature on Receipt: 5.5 c
Date -Received:. 9/4/03 Report Date: 9/11/03 Reported By: 01 mon&
S'
Today's Date: 9/15/03 Reference: 12499 Login B'atch 7 aniple Number: A1300006

c ea
North Carolina State. Laboratory,of P'ublli H �:.Ith
Department of Health and Humah Servic6s,,
P. 0-."Box 28047"--! 306- N'. Wilmington St. Raleigh,' U.-C.' 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System:. Bradshaw, David Source of Water:
Ground
Address: 2120 Feed Mill Rd
Roseboro, NC Zip: .2838Z Source I of Sample
Type of. Sample:
Raw
County: FRODWQGW
Type of Treatment:
None
Report To: NCDENR-DWQ GW ATTN:.BI IlShanahan
Wachovia Bid, Suite 714 of Analysis'
Nitrate
-41�'
Fayetteville, NC. 283.01 s '-category:
11-0
Courier: 14-56-25
A�
Date: 45s
ql;�4 - -00
Collected By" BILL SHANAHAN Time:
p
PM
P-111
.Location of sampling point:: Well Tap .A I
Remarks:
Res
d' n Parameters Results
A Dat 'A" aly?:ed!
Nitrite as N 9/4/03-1
9
Nitrate as N A 3 �Mg 9/4/03
bt
3�-
01,�t'
-bO
C:)
C
A
4!; e
1—In r1T
V,
C-
DrMIR-FAYE Mit 'ILEK"GIMALOFRECE
EXPLANATION OF RESULTS:
Fosterfrh&apeutic Homes: Nitrate=N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-.!5,1.0 mg/Land Nitrate-N—< 10.0 mg/1
Sample Temperature . perature on Receipt: -5.5 6 C
Date Recelviad:.9/4/03. Report Date:. 9/11/03 Reported By:
qp'09
Today's Pate' - 9/15/03 Reference: 12498 Login Batch Io.3 Sample Number: AB00005

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: Tart, Twilla
Source of Water:
Ground
Address: 1986 Feed Mill Rd
Roseboro, NC
Zip: 28382
Source of Sample:
County: FRODWQGW
Type of Sample:
Raw
Report To: NCDENR-DWQ GW
ATTN: Bill Shanahan
Type of Treatment:
None
Wachovia Bid, Suite 714
''
-Type of Analysis:
Nitrate
Fayetteville, NC 28301
Y`
, -1.
`-Category:
ILO
Courier: 14-56-25
Collected By: BILL SHANAHAN
Date: 9L3/03
Time: 3:30:00
PM
Location of sampling point: Well Tap
`
Remarks:
Parameters Results # 1 'lJnits Date Analyzed.
f �
Nitrite as N <0.10', r u mg/ I 9/4/03 --`
v, k
Nitrate as N 10:29 mg/I 9/4/03
..
Y
r.
N' F
fL.•f.j
,
{ -OKI FAYC ILV hECi!OkAL Q FIR,f
F � 73
EXPLANATION OF RESULTS: _
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/I
Sample Temperature on Receipt: _ 3.0 '3 C
Date Received: 9/4/03 Report Date: 9/11/03 Reported By:
Today's Date: 9/15/03 Reference: 12495 Login Batch r ` ` -' Sample Number: AB00002 ,0309,001�1�==�� p

North Carolina State Laboratory of Public Health
Department.of Health and, Human Services.
P. O. Box 28047 -- 306 N. Wilmington St. -- Rgleigh', U. C'. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Jackson, Robin
Address: 164 Sessoms Naylor Ln
Roseboro, NC
County: FRODWQGW
Report To: NCDENR-DWO GW
Wachovia Bid, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
Collected By: BILL SHANAHAN
Location of sampling point: Well Tap
Remarks:
Zip: 28382
ATTN: Bill Shanahan
ate:
Source of Water:
Ground
Source of Sample:
Type of Sample:
Raw
Type of Treatment:
None
"`Type,of Analysis:
Nitrate
Category:
ILO
Time: 3
Parameters 1 Results units E Date,AnAlyzed:
,
Nitrite as N 9/4/03'­
Nitrate as N 9
9/4/03
PIVI
F 9110
7
S
MILLE U'LOFFICE
EEREGM
4,
ED
r-1
3
c-n
EXPLANATION OF RESULTS:
le if less than or equal to 10 mg/1
Foster/Therapeutic Homes: Nitrate-N level acceptable
-Private Well Guidelines: Nitrite-N level should be 1.0 mg/l and Nitrate-N—< 10.0 mg/I
0
Sample Temperature on Receipt: 6.5 C
Date, Received: 9/4/03 Report Date: 9/11/03 Reported By:
Today's Date: 9/15/03 Reference: 12496 Login Batch i0,309Q011 Sample Number:
AB00003

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: Jackson, Ms: 4GV9l-t
Address: 2018 Feed Mill Rd
Roseboro, NC Zip: 28382
County: FRODWQGW
Report To: NCDENR-DWQ,GW
Wachovia Bid, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
Collected By: B SHANAHAN
Location of sampling point: Well Tap
Remarks:
Parameters
ATTN: Bill Shanahan
Source of Water: Ground
Source of Sample:
Type of Sample: Raw
Type of Treatment: None
Units:;_ Da
)e of Analysis: Nitrate
"Category: ILO
Time: 4:06,00 PM
Nitrite as N ti <0 1:0 mg/I - 9/3/03
Nitrate as N 12 68 mg/l 9/3/03
t
d+d
S7
+.
n� E
ED•: N M1
1
G�jiti �IR _ rA'il.L E REGO©i LO ME
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EXPLANATION OF RESULTS:
cn
cr>n
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/I and Nitrate-N-< 10.0 mg/I . -..
Sample Temperature on Receipt:. _ 4•0 0 C
Date Received: 9/3/03 Report Date: 9/11/03
Today's Date: 9/11/03 Reference: 12421
Reported By: AMT-(4
Login Batch 03Q9�0008 Sample Number: AA99955

North Carolina State --Laboratory of Public Health J
Department.of Health and Human Services =
P. O: Box 28047 ---306 N. Wilmington St. - Raleigh, N. C. 2761'1-8047, ,.
INORGANIC .CHEMICAL ANALYSIS.- NITRATE ONLY
Name of System:: Bass, Mary Lou Source of Water: Ground
Address: "2034 Feed Mill Rd
Roseboro, NC Zip: 28382•. Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan Type of Treatment: None
Wachovia Bid, Suite 714`"
`•'� '''Type of Analysis:.. Nitrate ,
Fayetteville, NC 28301 - =.
Courier:. 14-56-25 ,,r s' Category: ILO
;5.
Collected By: B SHANAHAN Date: 9/2703 Time: 3:50 00 PM
Location of sampling point: House Tap A A.
Remarks:
Parameters
Nitrite as N i <0110 9/3/0�
,..,�..=s
5
Nitrate as NS 11 07 kmg/Is 9/3/03
x,s
Is
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EXPLANATION OF RESULTS: .
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/1 and Nitrate -I-< 10.0 mg/l
Sample Temperature on Receipt: 5 5 0 C
Date Received: 9/3/03 Report Date: 9/11/03
Today's Date: 9/11/03 Reference: 12422
.Reported By: Y}�.
Login Batch Ol Q90 00 Sample Number: 99956

North Carolina State:Laboratory of Public Health _
Department of' Health -and: Human Services:
P 0 Box 28047 =- 306 N. Wilmington St -- Raleigh; N. C. ' 27.611-8047
INORGANIC CHEMICAL ANALYSIS -,NITRATE ONLY .` . .
Name of System:, Tyndall, Edwan Source of Water: Ground.
Address: 2119 Feed Mill Rd
Roseboro', NC Zip: ,28882 Source of Sample: .
County: FRODWQGIN -Type of Sample:,Raw
Report To:' NCDENR-DWQ GW ATTN: Bill Shanahan Type of Treatment: None
Wachovia Bld, Suite 714
'Type of Analysis: Nitrate:
Fayetteville, NC 28301
- Courier: 14-56-25 Category: ILO l�� � � .
Collected By: BILL SHANAHAN- Date 9/4/03 Time: 2 00 00 PM
A22 r
Location of sampling point: P 9 p House Tap _ r__5 .
Remarks:
Parameters . Results Units ;;k Date,( alyze&', Y
,
Nitrite as N �,<<0 10
Nitrate as N . 6 80 L 9/5/03 <`
h g _
P
• � 1 � "i�� t'S{fib t 1."� f s�F*,��''t�� �T�>�w �`��r x 5j � �'S' -n p. •
a m 3 i fr L@ai a
S �y � �`Vs ��r� rR� $ `'•,�. "�, ,rl' � 2, � a xvi•a `t * � .,x•� � 1 � - .
PI- i a v� '-� jet, '_ 's $�°+( Imo.
Via
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,, DENR
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes:' Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/I and Nitrate-N-<-10:0 mg/1 - - --
Sample Temperature on Receipt: 3•0 0 C
Date Received: .9/5/03 Report Date: 9/15iO3 Reported By:
Today's. Date: 9/15/03 Reference: 12578 Login Batch0 Sample Number:-AB00111-

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: Tew, Branden
Address: - 2027 Feed Mill Rd
Roseboro, NC
County: FRODWQGW
Report To: NCDENR-DWQ GW
Wachovia Bid, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
Collected By: BILL SHANAHAN
Location of sampling point: House Tap
Remarks:
Parameters
Source of Water: Ground
Zip: 28382 Source of Sample:
Type of Sample: Raw
Type of Treatment:
None
ATTN: Bill Shanahan
of Analysis:
Nitrate
" Category:
ILO
Date: 9/.3/0,3
Time: 4:00:00
PM
Y
i a :✓
"
Its Units
Date"Analyzed
Nitrite as N �mg 9/4/03
Nitrate as N 4 94 mg/1 9/4/03
'µ
r
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7
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EXPLANATION OF ^SP
C3 �:-
-RESULTS:'
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/l co
C
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/I and Nitrate-N-< 10.0 mg/l -n
Sample Temperature on Receipt: 5•5 0 C
Date Received: 9/4/03 Report Date: 9111/03
Today's Date: 9/15/03 , Reference: 12501 Login Batch
Reported By:
Sample Number: AB00008

North Carolina Laboratory of, Public. Health
Department of HealthandHuman .Service's. -
P. OiBox 28047 -- 306 N. Wilmington. St.''-- Raleigh, C. 27611-8047
,
INORGANIC CHEMICAL ANALYSIS - NITRATE� ONLY
Name of System:_-'011is, James P. Source of Water; Ground
Address: 2115 Fee'd Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
Type of -Sample: Raw
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: House Ta
Remarks:
Parameters
Nitrite as N
Nitrate as N
ATTN: Bill Shanahan
YG Date: 9/3/03
4''�
Results
65­.
....
TypeofTreatment: None
Type of Analysis: Nitrate
4ACp e ILO
ory
Time: 2:30:00 PM
914/03
aivzea:,
5 �4 j
R _1 gig vp�--- "i
DENR - FAYEI I�IILLE
RE I NAL 0, CE
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& ......
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EXPLANATION OF RESULTS:
co
C)
Foster/Therapeutic Homes: Nitrate-N levelacceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-.5 1.0 mg/land Nitrate-N—<-10.0 mg/l.,--
Sample Temperature on Re . ceipt: 6.5 C
Date Received:. 9/4/03 Report Date: 9/11 ib3 Reported By:
Date: Reference: 12497 Login Batch Sample Number:.
Today's 9/15/03

North Carolina State Laboratory of Public, Health
Department. of Health and. Human Services,.:
P.Q. Box 28047 -- 306•N. Wilmington St. -- -.Raleigh, N.C.`2761..1-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Holley, Tim Source of Water: Ground
Address: 2087 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:.
County: FRODWQGW ' Type of Sample: Raw
ATTN.: Bill Shanahan
. Type of Treatment: None
Report To: NCDENR-DWQ GW n
Wachoyia Bld, Suite 714 `-Type of Analysis:, Nitrate
Fayetteville, -NC 28301 - u ""'Category:' ILO
Courier: 14-56-25
Collected By:. JOHN MCNEIL� Date 9/2/03 Time: 4 3000 PM
Location of sampling point: well tap.01
.
Remarks: 4 ,3
Parameters y ResultsUnit �'l Date'Analyzed y
Nitrite as N A <0'10 'L r ` mg/Is b J� 9/3/03- — i ,1
x ,
Nitrate as N 9/3/03
r r i Fr c �y3 y f
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,���L f..i
�h, JYY 4 'is. 7z •.'�M { .„-f °i+e., a ..+ v. $ a. u,.
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EXPLANATION OF -RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
--Private- Well Guidelines: , Nitrite -IN level should be-5 1.0 mg/i and Nitrate-N-< 10.0 mg/I
Sample Temperature on Receipt: 3•0 C
Date Received: 9/3/03 Report Date: 9/11/03 .
Today's,Date' 9/11/03 Reference: 12418 Login Batch
Reported By:
00 Sample Number: AA99952

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O0 0'7�" = Michael F. Easley, Governor
William G. Ross'Jr., Secretary
t• North Carolina Department of Environment and Nariiral Resources
'-i Alan W. Klimek, P.E. Director
Q C Division of Water Quality
r
Assessment Report i
Feed Mill Road Project
Sampson County
North Carolina
Fayetteville Regional Office
November 2004
�1
l
n�
r`
Prepared By:
William F. Goforth, P.G.
Hydrogeologist
/ �� (/V /9�
o'w Carolina
7F171, ;
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone] 623 6748
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

Executive Summary
Elevated nitrate concentrations were detected in private drinking water supply wells in an area
along Feed Mill Road, .in northern Sampson County, North Carolina. The area is generally in
low-lying Coastal Plain terrain. Waste from animal production facilities has been applied to
agricultural fields in the area.
The Fayetteville Regional Office (FRO) of the North Carolina Department of Environment and
Natural Resources (NC DENR) detected elevated concentrations of nitrates in groundwater
samples collected from private drinking water supply wells in the area subject area. The FRO
then requested that the Aquifer Protection Section of the NC DENR's Division of Water Quality
conduct an assessment to ascertain if any relationship existed between the detected nitrates and
the applied animal waste.
Ten shallow groundwater monitoring wells were installed and sampled. Collected samples were
analyzed for nitrates. These samples had concentrations of nitrates comparable to those detected
in the private wells.
The direction of shallow groundwater flow was estimated, based on water levels measured in the
monitoring wells.
Based on the groundwater flow, the distribution of nitrates in the groundwater, and the areas of
waste application, it appears that some elevated nitrates correspond to the area where poultry
waste has been applied historically. Elevated nitrates in one area appear to be the result of
discharge from a single family dwelling septic waste disposal system. There is no apparent
indication that the application of hog waste has contributed to the elevated nitrate concentrations.
s -,

.e
Table of Contents
Executive Summary
1. Introduction
2. Investigation
2.1 Regional Hydrogeology
2.2 Drilling and Well Installation
2.3 Sampling and Analytical Results
3. Findings and Conclusions
3.1 Area 1
3.2 Area 2
4. Reference
List of Tables
Table 1. Monitoring Well Construction Data
Table 2. Ground Water Analytical Results
Table 3. Groundwater Levels
List of Figures
Figure 1.
Figure 2.
Site Location
Water Supply Well Locations and Nitrate Concentrations
Figure 3.
Fields Receiving Animal Waste
Figure 4.
Monitoring Well Locations (Areas 1 & 2)
Figure 5.
Water Table Configuration -Area 1
Figure 6.
Water Table Configuration -Area 2
Figure 7.
Nitrate Distribution -Area 1
Figure 8.
Nitrate Distribution -Area 2
Appendix A
Well Construction Records
Appendix B
Analytical Laboratory Reports

1. Introduction
Elevated nitrate concentrations, as compared to the North Carolina 2L Standards, were
detected in water samples collected from local private drinking water supply wells along
a section of Feed Mill Road in Sampson County, North Carolina. The site location in
indicated on Figure 1.
1.1 Background
The locations of these supply wells and corresponding concentrations of nitrates
are indicated on Figure 2. The wells are generally of undocumented and
unknown construction, but are shallow, withdrawing water from the water table
aquifer.
The area of concern in this assessment is predominantly agricultural. Liquid
waste from hog production facilities is sprayed on several fields in the area.
Solid poultry waste has been applied to other fields within the area of assessment.
Fields receiving animal waste are indicated on Figure 3.
1.2 Purpose
In response to a request from the Fayetteville Regional Office of The North
Carolina Department of Environment and Natural Resources (NC DENR), an
assessment of shallow ground water in the vicinity was conducted.
This investigation is to assess the possible effects of animal waste on the shallow
groundwater in the immediate area of the homes where samples containing
elevated nitrate concentrations have been detected.
2. Investigation
To assess the configuration of the water table and groundwater quality, ten shallow
groundwater monitoring wells were installed and sampled in the project area.
2.1 Regional Hydrogeology
The project site lies within the Inner Coastal Plain region of the North Carolina
Coastal Plain. The eastern part of the Inner Coastal Plain, including Sampson
County, is characterized by broad flat uplands, often swampy, between major
streams. Surface elevations are range from about 50 feet (NGVD) near the
Tidewater boundary to slightly in excess of 700 feet (NGVD) inland, westward.
Elliptical depressions called Carolina Bays are a prominent part of the landscape.
(Winner & Coble, 1996)
Coastal Plain sediments are characterized by clastic rocks ranging from clay to
gravel, with lesser amounts of marine limestone, resting on crystalline basement
rock. The sediment layers generally dip to the east and individual layers thicken
to the east. (Winner & Coble, 1996)
The Coastal Plain groundwater flow system consists of aquifers made up of
permeable sand, gravel, and limestone layers separated by confining units
composed of less permeable sediments. These units constitute the sediments
described above. A shallow unconfined surficial aquifer consisting of
Quaternary age deposits overlies the deeper hydrogeologic units. This surficial
aquifer transmits water laterally to streams and serves as a source for recharge to
or

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the deeper aquifer units. (Winner & Coble, 1996) The surficial aquifer serves as
a source of drinking water in many rural Coastal Plain areas, as in the Feed Mill
Road project area.
2.2 Drilling and Well Installation
The ten groundwater monitoring wells were installed utilizing Direct Push
Technology (DPT), by NC DENR personell. The wells are installed in the
unconfined surficial aquifer. Monitoring well locations are shown on Figure 4.
A GeoProbe was used in the installation. Soil sampling was attempted
initially, but was not successful. However based on the few samples seen and
drilling characteristics, soil soils consist of sand and sand/clay mixtures. The
wells were constructed of one -inch diameter PVC pipe with pre -packed screens.
Additional sand was placed around the screen interval. The remaining annular
space above the sand was filled with bentonite or by collapse of natural material.
Well construction data is provided in Table 1. The wells were completed above
grade with locking steel covers. Wells were developed by pumping until the
discharge was relatively clear and free of sediment.
2.3 Groundwater Sampling and Analytical Results
Groundwater levels in the wells were measured on four occasions, 4, 9, 14, and
28 April 2004. These measurements are tabulated in Table 3. Utilizing Water
levels measured on 4 April 2004, the configuration of the water table surface was
estimated and is shown on Figures 5 and 6.
Groundwater samples were collected from the monitoring wells on three
occasions, 22 March 2004, 28 April 2004 and 25 May 2004. Samples were
collected utilizing a peristaltic pump by NC DENR personnel. Samples were
preserved and transported to the DENR laboratory. Collected samples were
analyzed for. nitrates. The analytical results are tabulated and presented in Table
2. The estimated distribution of nitrates in the shallow groundwater, based on the
28 April 2004 sampling results, is depicted on Figures 7 and 8.
3. Findings and Conclusions
For the purpose of data evaluation the assessment area has been divided into the
following two areas: Area 1, which includes monitoring wells MW-01, MW-02, MW-03,
MW-04, MW-05 and MW-06; Area 2, which includes MW-07, MW-08, MW09 and
MW 10.
3.1 Area 1
Groundwater exists under water table conditions and is relatively shallow, ranging from
about seven (7) feet to about fifteen (15) feet below the land surface, averaging about ten
(10) feet. The predominant direction of groundwater is to the west; with slight
components of flow to the northwest and southwest toward the two local streams.- The
groundwater gradient, from monitoring well MW-1 to MW-6, is slightly downward,
approximately 0.009 feet/foot. ,1.
Nitrate concentrations in the samples collected from the monitoring wells are
approximately comparable to those of the samples collected from the private drinking
water wells, ranging from 1.1 mg/L to 15.97 mg/L. An iso-concentration map (Figure 7)

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OF W ATFR 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
Assessment Report
Feed Mill Road Project
Sampson County
North Carolina
Fayetteville Regional Office
November 1004
oe
Prepared By:
William F. Goforth, P.G.
Hydrogeologist
9- a Carolina
Natura!!ry
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Ph6ne..[phone] Customer Service
Internet: http://h2o.etir.state.nc.us 2729 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax `[phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper

Executive Summary
Elevated nitrate concentrations were detected in private drinking water supply wells in an area
along Feed Mill Road, in northern Sampson County, North Carolina. The area is generally in
low-lying Coastal Plain terrain. Waste from animal production facilities has been applied to
agricultural fields in the area.
The Fayetteville Regional Office (FRO) of the North Carolina Department of Environment and
Natural Resources (NC DENR) detected elevated concentrations of nitrates in groundwater
samples collected from private drinking water supply wells in the area subject area. The FRO
then requested that the Aquifer Protection Section of the NC DENR's Division of Water Quality
conduct an assessment to ascertain if any relationship existed between the detected nitrates and
the applied animal waste.
Ten shallow groundwater monitoring wells were installed and -sampled. Collected samples were
analyzed for nitrates. These samples had concentrations of nitrates comparable to those detected'
in the private wells.
The direction of shallow groundwater flow was estimated, based on water levels measured in the
monitoring wells.
Based on the groundwater flow, the distribution of nitrates in the groundwater, and the areas of
waste application, it appears that some elevated nitrates correspond to the area where poultry
waste has been applied historically. Elevated nitrates in one area appear to be the result of
discharge from a single family dwelling septic waste disposal system. There is no apparent
indication that the application of hog waste has contributed to the elevated nitrate concentrations.

Table of Contents
Executive Summary
1. Introduction
2. Investigation
2.1 Regional Hydrogeology
2.2 Drilling and Well Installation
2.3 Sampling and Analytical Results
3. Findings and Conclusions
3.1 Area 1
3.2 , Area 2
4. Reference
List of Table's
Table 1. Monitoring Well Construction Data
Table 2. Ground Water Analytical Results
Table 3. Groundwater Levels
List of Figures
Figure 1. Site Location
Figure 2. Water Supply Well Locations and Nitrate Concentrations
Figure 3. Fields Receiving Animal Waste
Figure 4. Monitoring Well Locations (Areas 1 & 2)
Figure 5. Water Table Configuration -Area 1
Figure 6. Water Table Configuration -Area 2
Figure 7. Nitrate Distribution -Area 1
Figure 8. Nitrate Distribution -Area 2
Appendix A Well Construction Records
Appendix B Analytical Laboratory Reports

1. Introduction
Elevated nitrate concentrations, as compared to the North Carolina 2L Standards, were
detected in water samples collected from local private drinking water supply wells along
a section of Feed Mill Road in Sampson County, North Carolina. The site location in
indicated on Figure 1.
1.1 Background
The locations of these supply wells and corresponding concentrations of nitrates
are indicated on Figure 2. The wells are generally of undocumented and
unknown construction, but are shallow, withdrawing water from the water table
aquifer.
The area of concern in this assessment is predominantly agricultural. Liquid
waste from hog production facilities is sprayed on several fields in the area.
Solid poultry, waste has been applied to other fields within the area of assessment.
Fields receiving animal waste are indicated on Figure 3.
1.2 Purpose
In response to a request from the Fayetteville Regional Office of The North
Carolina Department of Environment and Natural Resources (NC DENR), an
assessment of shallow ground water in the vicinity was conducted.
This investigation is to assess the possible effects of animal waste on the shallow
groundwater in the immediate area of the homes where samples containing
elevated nitrate concentrations have been detected.
2. Investigation
To assess the configuration of the water table and groundwater quality, ten shallow
groundwater monitoring wells were installed and sampled in the project area.
2.1 Regional Hydrogeology
The project site lies within the Inner Coastal Plain region of the North Carolina
Coastal Plain. The eastern part of the Inner Coastal Plain, including Sampson:
County, is characterized by broad flat uplands, often swampy, between major
streams. Surface elevations are range from about 50 feet (NGVD) near the
Tidewater boundary to slightly in excess of 700 feet (NGVD) inland, westward.
Elliptical depressions called Carolina Bays are a prominent part of the landscape.
(Winner & Coble, 1996)
Coastal Plain sediments are characterized by clastic rocks ranging from clay to
gravel, with lesser amounts of marine limestone, resting on crystalline basement
rock. The sediment layers generally dip to the east and individual layers thicken
to the east. (Winner & Coble, 1996)
The Coastal Plain groundwater flow system consists of aquifers made up of
permeable sand, gravel, and limestone layers separated by confining units
composed of less permeable sediments. These units constitute the sediments
described above. A shallow unconfined surficial aquifer consisting of
Quaternary age deposits overlies the deeper hydrogeologic units. This surficial
aquifer transmits water laterally to streams and serves as a source for recharge to

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the deeper aquifer units. (Winner & Coble, 1996) The surficial aquifer serves as
a source of drinking water in many rural Coastal Plain areas, as in the Feed Mill
Road project area.
2.2 Drilling and Well Installation
The ten groundwater monitoring wells were installed utilizing Direct Push
Technology (DPT), by NC DENR personell. The wells are installed in the
unconfined surficial aquifer. Monitoring well locations are shown on Figure 4.
A GeoProbe was used in the installation. Soil sampling was attempted
initially, but was not successful. However based on the few samples seen and
drilling characteristics, soil soils consist of sand and sand/clay mixtures. The
wells were constructed of one -inch diameter PVC pipe with pre -packed screens.
Additional sand was placed around the screen interval. The remaining annular
space above the sand was filled with bentonite or by collapse of natural material.
Well construction data is provided in Table 1. The wells were completed above
grade with locking steel covers. Wells were developed by pumping until the
discharge was relatively clear and free of sediment.
2.3 Groundwater Sampling and Analytical Results
Groundwater levels in the wells were measured on four occasions, 4, 9, 14, and
28 April 2004. These measurements are tabulated in Table 3. Utilizing Water
levels measured on 4 April 2004, the configuration of the water table surface was
estimated and is shown on Figures 5 and 6.
Groundwater samples were collected from the monitoring wells on three
occasions, 22 March 2004, 28 April 2004 and 25 May 2004. Samples were
collected utilizing a peristaltic pump by NC DENR personnel. Samples were
preserved and transported to the DENR laboratory. Collected samples were
analyzed for nitrates. The analytical results are tabulated and presented in Table
2. The estimated distribution of nitrates in the shallow groundwater, based on the
28 April 2004 sampling results, is depicted on Figures 7 and 8.
3. Findings and Conclusions
For the purpose of data evaluation the assessment area has been divided into the
following two areas: Area 1, which includes monitoring wells MW-01, MW-02, MW-03,
MW-04, MW-05 and MW-06; Area 2, which includes MW-07, MW-08, MW09 and
MW10.
3.1 Area 1
Groundwater exists under water table conditions and is relatively shallow, ranging from
about seven (7) feet to about fifteen (15) feet below the land surface, averaging about ten
(10) feet. The predominant direction of groundwater is to the west, with slight
components of flow to the northwest and southwest toward the two local streams. The
groundwater gradient, from monitoring well MW-1 to MW-6, is slightly downward,
approximately 0.009 feet/foot.
Nitrate concentrations in the samples collected from the monitoring wells are
approximately comparable to those of the samples collected from the private drinking
water wells, ranging from 1.1 mg/L to 15.97 mg/L. An iso-concentration map (Figure 7)

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TABLE 2
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" NITRATE`CONCENTRATIONS IN GROUNDWATER SAMPLES
..Feed Mill Road. Project
Sam son Coun' %`North Carolina .
`SAMPLE IDEI�tTIFIER
NITRATE (mg/1)
NITRATE (zri 1)
NITRATE(Mg/1)
22-23, MARCH 2O04...
28 Ap.ItIL 2,004
251VIAX 2004 ;r
MW-01
91
11.97
12.98
MW-02
1.1
4.2
7.78
_
MW-03
16
15.97
13
Q
MW-04
13
11.98
14
MW-05
10
8.03
10
MW-06
15
13.99
18
MW-07
22
19.98
20.99
N
MW-08
8.4
7.08
9.39
MW-09
6
5.55
6.19
MW-10.
5.6.
5.59.
6.3

AMA AREA
:- o 0 0 0 0 0 0 6 0 o
O \.O 00 �] CN vi ? W N
E
Vl C1 Vl CV (-AC/1 LA 01 OV O\
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illustrating the distribution of nitrates in Area 1 shows an elongated oval plume oriented
northwest -southeast, parallel to the direction of groundwater flow: The highest
concentrations appear to generally be under the field that receives poultry waste. This
distribution generally corresponds with the distribution of concentrations detected in
samples collected from the local drinking water wells (shown on Figure 2). There is no
indication that the elevated nitrate concentrations originate from the fields to the east,
where waste from hog production facilities is sprayed.
3.2 Area 2
Groundwater exists under water table conditions and is relatively shallow, ranging from
about eleven (11) feet to a little over twelve (12) feet below the land surface, averaging
about ten (10) feet. The predominant direction of groundwater is to the east, with a
mounding effect, likely due to discharge (i.e. artificial recharge) from the nearby, and up
gradient, household septic disposal system, indicated on Figure 6.
Nitrate concentrations in the samples collected from the monitoring wells are
approximately comparable to those of the samples collected from the private drinking
water wells, ranging from 5.5 mg/L to 22.0 mg/L. An iso-concentration map (Figure 8)
illustrating the distribution of nitrates in Area 2 shows the highest concentrations down
gradient of the nearby household septic system, directly correlating with the groundwater
mound, described above. There is no indication that the elevated nitrate concentrations
originate from the nearby fields, where waste from hog production facilities is applied.
4. Reference
Winner, M.D. and Coble, R.W., Hydrogeologic Framework Of the North Carolina Coastal
Plain, U.S, Geological Survey Professional Paper 1404-I, United States Government Printing
Office, Washington, D.C., 1996.

Appendix A
Well Construction Records

Appendix B
Analytical Results

Station I ?6 HI FS I Elevation
R
M
i
TERMS
Bench Mark (BM)
A relatively permanent point. of known or assumed elevation.
Turning Point (TP)
A temporary intermediate station used to advance the level
instrument, from which a Backsight and a Foresight is made.
Station
The point at which the level or elevation number is shot
Backsight (BS)
A sight or shot taken to the level rod held at a point of known
elevation. (a BM or TP); also call Buckshot.
Height of Instrument (HI)
The elevation of the line of sight of the level or telescope.
HI = BS + elevation
Foresight (FS)
A sight or shot taken on any point to determine its elevation; also
called Foreshot.
Elevation
The relative elevation of -the station being sighted or shot. '
Elevation = HI - FS

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Feed Mill Road, Sampson County
MW-#
Nitrate Levels mg/I
MW-1
9
MW-2
1.1
MW-3
16
MW-4
13
MW-5
10
MW-6
15
MW-7
22
MW-8
8.4
MW-9 6
MW-10 5.6

Feed Mill Road, Sampson County
MW-#
Nitrate Levels mg/I
MW-1
9
MW-2
1.1
MW-3
16
MW-4
13
MW-5
10
MW-6
15
MW-7
22
MW-8
8.4
MW-9
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MW-10
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Water Level
GW Elev.
Water Level
GW Elev.
21 Apr 04
21 Apr 04
28 Apr 04
28 Apr 04
11.2
167.01
11.24
166.97
9.79
165.02
9.91
164:9
12.14
160.49
12.16
160.47
10.21
158.53
10.22
158.52
10.24
158.39
10.17
158.46
17.32
156.26
17.22.
156.36
12.03
159.49
12.2
159.32
13.96
158.84
14.11
158.69
12.35
161.78
12.51
161.62
14.38
158.61
14.46
158.53

Elevation
Water Level
GW Elev.
Water Level
GW Elev.
Water Level
GW Elev.
Well ID
TOC
4 Apr 04
4 Apr 04
9 Apr 04
9 Apr 04
14 Apr 04
14 Apr 04
M W 01
178.21
10.91
167.3
11.15
167.06
11.03
167.18
MW02
174.81
' 9.52
165.29
9.81
165
9.64
165.17
MW 03
172.63
11.78
160.85
12.04
160.59
12.02
160.61
MW04
168.74
9.92
158.82
10.14
158.6
10.05
158.69
M W 05
168.63
10.24
158.39
10.31
158.32
10.13
158.5
M W 06
173.58
17.57
156.01
17.5
156.08
17.44
156.14
MW 07
171.52
11.48
160.04
11.83
159.69
11.87
159.65
M W 08
172.8
13.44
159.36
13.76
159.04
13.83
158.97
MW 09
174.13
11.8
162.33
12.81
161.32
12.27
161.86
MW 10
172.99
13.98
159.01
14.21
158.78
14.21
158.78

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13.98
12.18
14.21
12.27
14.21
12.35
14.38
12.51
14.46
6 5.6
5.55 5.9

FAx TRANSMISSION
DEER
FAYETI EVILLE REGIONAL OFFICE
FAYETTEVILLE, NORTH CAROLINA 2830174043
v
VOICE: 910-466-1541
Pax-, 910486-0707
T
Fax
From
Subl c-':
COMMENTS:
Date,
pages (including cover):
410H VidWN VOOZ-[?-NVr

REQUEST FOR INVESTOGATOGN
DRILLING INFORMATION
Proposed drilling method:
Proposed decontamination Iscation:
Prop' sed disposal facility for ccntamij
soils; IYA RR
Number of proposed monitoring wells
�� Estimated depth to bedrock:
Estimated 'depth to groundwater:
water and Source of clean drilling water:
HEALTH AND SAFETY INFORMATION lease provide only site -specific inn
Chemical SNPosure potential (on -site chemical storage, drums, pesticides, fuel tanks, etc.):
6101agical exposure potential (on -site poisonous plants and animals, other wild animals, etc.):
Physical/eiectricailradialogical — --re potential enn-site nower tines. open ditches or trench
traffic, farm moohinery, etc.):
Name and location of nearest emergency gaoility
Emergenc facility phone number:
on on attached map):
911 service available: es� no
50H £00/ W d 01£-1
-WOU HdWU v00Z-IZ-Wr

JAN-21-2004 02:49PM FROM- T-870 P.00SAOS F-605
Can)
C-0
Ara

DIVISION OF WATER QUALITY
FRO GROUNDWATER SECTION
October 29, 2003
MEMORANDUM
TO: Arthur Mouberry
DWQ-GW Section, RCO _ _
Parker -Lincoln Bldg. 4.ni
Through: Art Barnh f
FRO GW Sup
rT
From: Bill Shanaha�i
Technician II, Q-GW Section, FRO
SUBJECT: Request For Investigation -
Nine impacted wells on Feed Mill Rd., Roseboro, NC
Installation of 10 Temporary Monitoring Wells
The Fayetteville Regional Office requests an investigation of concentrated animal waste
application fields around the homes on Feed Mill Rd., Roseboro, NC, Sampson County.
This investigation is to determine whether the land application is impacting groundwater
and water supply wells in that area.
10 Monitoring wells are required to complete the investigation criteria.
If you have any questions please feel free to contact William Shanahan at (910) 486-
1541.
M
J
T_
CD
w
Q
rl
C'7
O
Z

REQUEST FOR INVESTIGATION
non i Mr. IMPnRMATInN
Proposed drilling method:
f� �lt
Estimated depth to bedrock: .
Qll-' I 1%.. 1 r
/
Proposed decontamination location:
Estimated depth to groundwater:
Prop sed disposal facility for contaminated water and
Source of clean drilling water:
soils: 41
I/I,
�/'
Number of proposed monitoring wells and proposed depths:
DonPPRTV nWKIFRS /PIPasP use letter to identify property owners on local area map)
. Name:
Address:
Phone number:
LUA?
a.
b.
C.
d.
e.
9•
h.
i.
j,
WPM TN ANn SAFETY INFORMATION (please provide only site -specific information)
. Chemical exposure potential (on -site chemical storage, drums, pesticides, fuel tanks, etc.):
wa"�
Biologiica/l.exposure potential (on -site poisonous plants and animals, other wild animals, etc.):
Physical/electrical/radiological exposure potential (on -site rower lines, open ditches or trenches, heavy
traffic, farm machinery, etc.):
Name and location of nearest emergency facility (mark location on attached map):
Emergency facility phone number: 911 service available: <;� no

REQUEST 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: .
L Transmittal memo from/through Regional Supervisor to Central Office requesting this
/ investigation
Completed Request for Investigation form and checklist
❑ Pollution Incident Reporting Form (PIRF)
S Site Health and Safety Planning Form
Lkf Signed Land Use Agreements (LUA) for all properties to be included in the investigation (includes
all drilling and/or sampling locations)
MAPS:
EK Regional map showing directions to site from main highway or other major artery (please use one
of the following reaps: 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 • .
LT Directions, phone number, and location map for the nearest hospital
SUPPORTING INFORMATION (IF AVAILABLE):
LS Laboratory report(s) of previous sampling and testing
❑ 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.)
❑ Other supporting information (please list):
Other relevant information not included with this RFI package, but available in Regional Office project files
(consultant's reports, newpaper articles, etc.):
Signature
Signature,

REQUEST FOR.INVESTIGATION
r_���Qei i�uGnRnneTinti
Incident/Proojec'�tAAname:
.49 e
Incident number:
N
Regional Office:
Couh y: .
Requester's name: 11 Date submitted:
.GP-30-03
Site rank:
Type of contamination expected (list compounds, if known):'
�� �. ,
Nature of complaint (number of contaminated wells, synopsis of any previous sampling or other, activities
to date, etc.):
//
�n Cro� Cnh��cm;k�7 ee / 6oeM-0,
SITE LOCATION
Nearest city/town: USGS 7.5' quadrangle name:
PO 5 ,e. c o 4 /VC 77,- e L4
Address/location: Latitude and Longitude:
Site description (urban, rural, wooded, busy traffic, equipment accessibility, etc.):

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Site Health and Safety Plan (Page 1 of 2)
Inspector: ' �? �((,`a ,,,,, � a.,, �t�<�_w Region:. F R (I
Inspection Date: 10 -.a t_ 0 3 Time: i 0 1 c) O eL .�
Original Safety Plan: YES —"NO _ Modification No:
Site Name and Incident No: J�:'� e el Pat
Site Address: City: 120s e /Oo i-a ; Ale
County: s o State:
Site Contact: Lo (� ;'a� E-) ��a,.,n Phone: al i v
Directions to Site:
INCIDENT .DESCRIPTION:
A. Regulated/Non-regulated UST Site GW Contamination Site a/
Spill Air Release Fire Other
B. Assessment Sampling r/ Emergency Response
Cleanup/Removal Other (Specify)
C. Urban Residential ✓ Commercial
Rural Remote
D. Type of Contaminant: Chemical ✓ Petroleum
Biological,.
Industrial
Radioactive
PERSONNEL EXPOSURE HAZARDS: (H=High, M=Moderate, =Low' =Unknown)
Inhalation Skin Contact Ingestion Radioactive
Biological Fire Explosion Unknown
PERSONNEL PHYSICAL HAZARDS:
Heat Cold Noise Underground Utilitiesy'
Overhead Utilities ✓ Heavy Equipment Slip, Trip, Fall
Sharp Objects Pressurized Airlines Wildlife/Insects _
Ladders Scaffolds Unguarded Openings — Wall, Floor
Liquids in Open Containers, Ponds, Lagoons
ACTIVITIES TO DATE:
PERSONAL PROTECTIVE EQUIPMENT USED:=�/,►-
Other Notes:

Site Health and Safety Plan (Page 2 of 2)
SAMPLING Performed Bv: 1 ).M'4 w. � Z -- .-Sampling Plan ' N)
No. of Samples: Solid Liquid ✓ Gas
Has lab been no 'feed of potential hazards? Yes o
Analysis: 0�
Sampling Comments: .1 u
jr v — 3 ! d --03
(Signature) � r�L(Date)
DOCUMENTATION
Type: Photo
Performed By:
Log Book L-,� Recorder
Video _
PUBLIC IMPACT:
Distance to Nearest:. Residence Y-:5-1 School
. N,k, Hospital /y,k
Public Building /V-1 A x Business
Other
Evacuation: Yes No ✓ Number
By Whom
ENVIRONMENTAL IMPACT:
Nearest Waterway: (Nc r1� �!• l l f J K Distance j o j
Condition: Observed
Potential None
Surface Water Contamination
Groundwater Contamination
Drinking Water Contamination ✓
Air Contamination
�—
Soil Contamination
Stressed Vegetation
Dead Fish, Other Animals
PERSONNEL INVOLVED (Name(Agency _bn or Off Site)
SITE MANAGER: fi %/, a
SITE SAFETY COORDINATOR'
Have read and understand the safety plan (Please sign)

Stephen Barnhardt
NCDENR - DWQ
Groundwater Section
Fayetteville Regional Office
225 Green Street
'Suite 714 ,
Fayetteville, NC 28301-5043
Re: Agreement for the Use of a Site fora Groundwater Study
Dear: Mr. Barnhardt
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:
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 of the Study, unless otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected by it and shall permanently abandon all wells constructed by it.
5. Any claims which may arise against DENR shall be governed by Article 31
of Chapter 143 of the North Carolina General Statutes, Tort Claims
Against State Departments and Agencies, and as otherwise provided by
law.
F. The information derived from the Study shall be made available to the
owner Upon request and is a public record, in accordance with the G.S.
132-1 eL seq.
7. The activities to be carried out by DENR are for the primary benefit of
DENR-DWQ and the. State of North Carolina and any benefits accruing to

the Meer are incidental. DENR is not and shall not be construed to be an
a :.�-, t, employee, or contractor of the owner of the land.
I agree not to int?: `ore with, remove, or in any manner tamper with or damage DENR's
well(s) and equi ..::,:,t during the Groundwater Study.
Sincerely,
Signz::,_:re of O,v... gent
Type or Print cf Owner or Agent
Date
Addr-rc113hone i

41y
i
Stephen Barnhardt
NCDENR - DWQ
Groundwater Section
Fayett-ville Regional Office
225 Green Street
Suite 714
Fayetteville, NC 28301-5043
Re: Agreement for the,Use of a Site for a Groundwater Study
Dear: P.'r. Barn;::irdt
am " owner/,- 3nt of a parcel of property, as described in the cover letter and hereby
perr . IJorti .:.. arolina Department of Environment and Natural Resources (DENR)
to er, _.pon the r;roperty for the purpose of testing the ground waters under the
auth ..y of G.S. ; 'ti"-215.3 (a) 2 and G.S. 143-466 (e).
am rr?nting pe.r!—i-Tsion with the understanding that:
1. TI `-'reundwater Study (Study) shall be conducted by DENR-DWQ.
2. Tl-, _ osts of construction and maintenance of the site and access shall be
bc.... i)y :DENR-DWQ. DENR-DWQ shall protect and prevent damage to
ti unding lands resulting from Study activities.
3. Unln� ss otherwise agreed, DENR-DWQ,shall have access.to the site by the
sIh . -: i6asible route to the, nearest public road. DENR=DWQ may enter
Ur.�7 ; the land at reasonable times and have full right of access during the
pc, d ..J the Study.
�!. A. end of the Study, unless otherwise provided for by prior written
DENR-DWQ shall remove from the site all structures placed.
o,. _ icy it and shall permanently abandon all wells constructed by it.
which may arise against DENR shall be governed by Article 31
of _.r 143 of the North Carolina General Statutes, Tort Claims
G, iate Departments and Agencies, and as otherwise provided by
IU..
6. TI .if:" i tion derived from the Study shall be made available to the
o .. ; request and is a public record, in accordance with the G.S.
7. TI-: I',i­s to be carried out by DENR are for the primary benefit of
B_ 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.'
Sincerely,
nG; era ct Qwner or agent
Type cr Print Name of Owner or Agent
Date
Addr-�F!'Dhone No.

Stephen Barnhardt
NCDENR - DWQ
Groundwater Section
Fayetteville Regional Office
225 Green Street
Suite 71.4
Fayetteville, NC 28301-5043
Re: Agreement for the Use of a Site for a, -Groundwater Study
Dear: Mr. Barnhardt
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-DW.Q 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 of the Study, unless otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected by it and'shall permanently abandon all wells constructed by it.
5.. Any claims which may arise against DENR shall be governed by Article 31
of Chapter 143 of the North Carolina General Statutes, Tort Claims
Against State Departments and Agencies, and as otherwise provided by
law.
6.. The information derived from the Study shall be made available to the
owner upon request and is a public record, in accordance with the G.S.
132-1 et seq...
7. The activities to be carried out by DENR are for the primarybenefit of
DENR-DWQ and the State of North Carolina and anybenefits 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.
Sincerely,
401un \, - � G
Sig pure of Owner or Agent
J P, VnE�C--- M � Q
Type or Print Name of Owner or Agent
26-
Date
04 1/ 410
Address/Phone No.

3 ,
Stephen. Barnhardt
NCDENR: - DWQ ,
Groundwater Section
Fayetteville Regional Office
225 Green Street
Suite 714
Fayetteville,. NC 28301-5043
Re: Agreement for the Use of a Site for a Groundwater Study
Dear: Mr.'Barnhardt
I am the ownertagent of aIparcel 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 of the Study, unless otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected by it and shall permanently abandon all wells constructed by it.
5. Any claims which may arise against DENR shall be governed by Article 31
of Chapter 143 of the North Carolina General Statutes, Tort Claims
Against State Departments and Agencies, and as otherwise provided by
law.
6. The information derived from the Study shall be made available to the
. -owner upon request and is a public record, in accordance with the G.S.
132-.1 et seq.
7. The activities to be carried out by DENR are for the primary benefit of
DENR-DWQ 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.
Sincerely,
Signature of Owner or Agent
&- ejT- t' ' (T14- 6 H�5 �✓
Type or Print Name of Owner or Agent
/0 --15-0-3
Date
Address/Phone No.

Stephen Barnhardt
NCDENR - DWQ
Groundwater Section
Fayetteville Regional Office
225 Green Street
Suite 714
Fayetteville, NC 28301-5043
Re: Agreement for the Use of a Site for a Groundwater Study
Dear: Mr. Barnhardt
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:
This Groundwater Study (Study) shall be conducted by DENR-DWQ.
2. The costs of construction and maintenance of tt-ie 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 of the Study, unless -otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected by it and shall permanently abandon all wells constructed by it.
5. Any claims which may arise against DENR shall be governed by Article 3'1
of Chapter 143 of the North Carolina General Statutes, Tort Claims
Against State Departments and Agencies, and as otherwise provided by
law.
6. The information derived from the'S.tudy shall be made available to the
owner upon request and is a public record, in accordance with the G.S.
132-1 et seq.
7. The activities to be carried out by DENR are for the primary benefit of
DENR-DWQ 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.
Sincerely,
i
ttgn'afure—of Owner or Agent
Type or Print Name of Owner or Agent
Date
/) a U Fz -r-2 m 1 z L -RU
1,710 -� S 6 �'._ � Z Z 0
Address/Phone No.

Stephen Barnhardt
NCDENR - DWQ
Groundwater Section
Fayetteville Regional Office
225 Green Street
Suite 714
Fayetteville, NC 28301-5043
Re: Agreement for the Use of a Site for a Groundwater Study
Dear: Mr. Barnhardt
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 of the Study,. unless otherwise provided for by prior written
agreement, DENR-DWQ shall remove from the site all structures placed
or erected by it and shall permanently abandon all wells constructed by it.
5. Any claims which may arise against DENR shall be governed by Article.31'
of Chapter 143 of the North Carolina General Statutes, Tort Claims
Against State Departments and Agencies, and as otherwise provided by
law.
6. The information derived from the Study shall be made available to the
owner upon request and is a public record, in accordance with the G.S.
132-1 et seq.
7. The activities to be carried out by DENR are for the primary benefit of
DENR-DWQ and the State of North Carolina and any benefits accruing to

J
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,
Signature of Owner or Agent
ML. ty CY, 'lpc1Tsn/1/
Type or Print Name of Owner or Agent
l 0 -- % S' — D 3
Date
9 16—'5-G�L --4-V d
Address/Phone No.

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Report to: f= Q b
NC DENR/DWQ.LABORATORY (check one)
GROUNDWATER SECTION
CHAIN OF CUSTODY (COC) RECORD
[YIENTRAL [ l ARO [ 1 WaRO
Page / of /
For Investigation of: / "
IS""'(1 /.t7• // L "+-- � ..
Incident No.
Sample collector(print name -
and GV-54 forms completed by:
`
/�ha1/<Sample collector's signature�/
Field storage conditions and location (when applicable):
Lab Use Only
LAB NO,
SAMPLE ID
QUAD. NO.
LOCATION
DATE
SAMPLED
TUvIE
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Method of Shipment (circle one):
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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: Holley, Tim
Source of Water:
Ground
Address: 2087 Feed Mill Rd
Roseboro, NC Zip: 28382
Source of Sample:
County: FRODWQGW
Type of Sample:
Raw
Report To: NCDENR-DWQ GW ATTN: Bill Shanahan
Type of Treatment:
'None
Wachovia Bid, Suite 714
Type of Analysis:
Nitrate
Fayetteville, NC 28301
Category:
ILO
Courier: 14-56-25
Collected By: JOHN MCNEIL Date: 9/2/03 Time: 4:30:00 PM
Location of sampling point: well tap
Remarks:
Parameters Results Units Date Analyzed:
Nitrite as N <0.10 - mg/I 9/3/03
Nitrate as N 619!95 mg/I 9/3/03
q
i� 1! ELRIERG,,%!AL FICIE
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/l and Nitrate-N—< 10.0 mg/I
i
Sample Temperature on Receipt: 3`0 o C
Date Received: 9/3/03 Report Date: 9/11/03. Reported By:
Today's Date: 9/11/03 Reference: 12418 Login Batch 03090Q08,'`- Sample Number: AA99952

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: 011is, James P. Source.of Water: 'Ground
Address: 2175 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample: _
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW
ATTN: Bill Shanahan Type of Treatment:. None
Wachovia Bid, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC 28301 Category: ILO
Courier: 14-56-25
k.
EXPLANATION OF RESULTS:
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/I
Sample Temperature on Receipt: ..6.5_o C
Date Received: 9/4103 Report Date: 9/11/03
Today's Date: 9/15/03- Reference: 12497
Reported By:
Login Batch 0309001.1,_,__. Sample Number: AB00004

J.
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: Tew, Branden Source of Water: Ground
Address: - 2027 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw.
ATTN: Bill Shanahan '
Report To: NCDENR-DWQ GW , Type of Treatment: None .
Wachovia Bld, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC .28301 Category: ILO
Courier: 14-56-25 g rY�
Collected By: BILL SHANAHAN, Date: 9/3/03 Time: .4:00-:00 PM . .
Location of sampling point: House Tap
Remarks:
Parameters Results Units, Date Analyzed:
Nitrite as N <0.10'" .- mg/I 9/4/03
Nitrate as N . 4.94 mg/I- 9/4/03
l'
EXPLANATION OF RESULTS:
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/I
Sample Temperature on Receipt:. ._5_5 C'
Date Received: 9/4/03 Report Date: 9/11/03 Reported By:. ' G,
Today's Date: 9/15/03 Reference:. 12501 Login Batch 0309Q01;1_ Sample Number: AB00008

North Carolina State Laboratory of. Public Health
Department of Health and Human Services
P. O. Box 28047 -- 30.6 N. Wilmington St. -- Raleigh, ,N. C. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Tyndall, Edwan
Address: 2119 Feed Mill Rd
Roseboro, NC
County: FRODWQGW
Report To: NCDENR-DWQ GW
Wachovia Bid, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
Zip: 28382
ATTN:.Bill Shanahan.
Source of Water:
Ground
Source of Sample:'
Type of Sample:
Raw
Type of Treatment:.
None
Type of Analysis:
Nitrate
Category: ILO
y. ^...
LE ED,
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes:. Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/I and Nitrate-N-< 10.0 mg/I ,
Sample Temperature on Receipt: 3A _0 C
Date Received: 915/03 Report Date: 9/15/03 Reported By:
Today's Date: 9/15/03 Reference: 12578 Login Batch :03090Q15: r Sample Number: A800111

North Carolina State Laboratory of Public Health
Department of Health and Human Services
P. O. Box 28047 -- 3d6 N. Wilmington St. -- Raleigh,. N. C. 27611-8047
INORGANIC CHEMICAL ANALYSIS - NITRATE ONLY
Name of System: Bass, Mary Lou
Source of Water:
Ground
Address: 2034 Feed Mill Rd
Roseboro, NC Zip: 28382"
Source of Sample:
.
County: FRODWQGW.
Type. of Sample:
:Raw
Report To: NCDENR-DWQ GW ATTW Bill Shanahan
Type of Treatment:
None
Wachovia Bld, ' Suite 714
Type of Analysis:
Nitrate
Fayetteville, NC 28301
Category:
ILO
Courier: 14-56-25
Collected By: B SHANAHAN Date: 9/2103
Time:' 3:50:00
PM
Location of sampling point: House Tap
Remarks:
Parameters Results Units '
Date Analyzed:
Nitrite as N <0.10 . „ mg/I
9/3/03
Nitrate as N 11.07 `.rrig/1 ..,
9/3/03
j.
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/l
Private Well Guidelines:. Nitrite-N level should be-5 1.0 mg/I and Nitrate-N_10.0 mg/I
Sample Temperature on Receipt: ._ 5•5_ C I•
p
Date Received: 9/3/03
Report Date: 9/11/03 Reported By:(�
Today's Date:.,, 9/11/03 Reference: 12422 Login Batch 030.90008;� Sample Number: 99956
^

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: Jackson, Ms.'AJ2 t"t K
Source of Water:
Ground
Address: 2018 Feed Mill Rd
Roseboro, NC Zip: 28382
Source of Sample:
County: FRODWQGW
Type of Sample:
Raw
Report To: NCDENR-DWQ GVV ATTN:. Bill Shanahan
Type of Treatment:
None
Wachovia Bid, Suite 714
Type of Analysis:
Nitrate
Fayetteville, NC 28301
Category:
ILO
Courier: 14-56-25 .
Collected By: B SHANAHAN Date: 9/2/03
Time: 4:00:00
PM
Location of sampling point: Well Tap
Remarks:
Parameters Results Units'
Date Analyzed:
Nitrite as N <0:10,.: =::. Mg/ I
9/3/03
Nitrate as N 12.68.. mg/I '
9/3/03
B
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I . .
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/1 and Nitrate-N-< 10.0 mg/I .
Sample Temperature on Receipt: . 4_02
C
Date Received: 9/3/03 Report Date: 9/11/03 Reported By:
Today's Date: g/11/03 Reference:. 12421 Login Batch ,03090008 Sample Number:: AA99955

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: Jackson, Robin Source of Water: Ground
Address: 164 Sessoms Naylor Ln
Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW ATTN.: bill Shanahan Type of Treatment: None
Wachovia. Bld, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC 28301 1 Category: ILO
Courier: 14-56-25
Collected By: BILL SHANAHAN Date: 9/3103 Time: 3:43:00 PIVI
Location of sampling point: Well Tap
Remarks:
Parameters
Results
Units :i
Date Analyzed:
Nitrite as N
",0.10
9/4/03
Nitrate as N
16.45
mg/I
9/4/03
EXPLANATION OF RESULTS:
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-5 10.0-mg/I
0
Sample Temperature on Receipt: _ 6.5 C zyp
Date Received: 9/4/03 Report Date: 9/11/03 Reported By:Today's Date: 9/15/03 Reference: , 12496', Login Batch 03b4b01t',_` Sample Number: A1300003

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
J
Name of System: Tart, Twilla Source of Water: Ground
Address: 1986 Feed Mill Rd
Roseboro, 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: 28382
ATTN: Bill Shanahan
Source of Sample:
Type of Sample::, Raw
Type'of Treatment: None
Type of Analysis: Nitrate
Category: ILO
Date: 9/3/03 Time: 3:30:00,PM .
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes:. Nitrate-N level acceptable.if less than or equal to 10 mg/I
Private Well Guidelines: Nitrite-N level should be 5 1.0 mg/I and Nitrate-NL< 10.0 mg/I
Sample Temperature on Receipt: _ 3•0 0 C
Date Received: 9/4/03. Report Date: 9/11/03,
Today's Date: 9/15103 Reference:, 12495
Reported. By: 6-d-
Login Batch 03090011,, Sample Number: AB00002
----

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, David Source of Water: Ground
Address: 2120 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
County:. FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ. GW ATTN: Bill Shanahah Type of Treatment: None
Wachovia Bld, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC 28301 Category: ILO
Courier: 14-56-25
Collected By: BILL SHANAHAN Date: 9/3/03 Time: 2:45:00 PM
Location of sampling point: Well Tap
Remarks:
Parameters
Results
Units
Date Analyzed:
Nitrite as N
<0.10 .,,' :
mg/1 ' . -
9/4/03
Nitrate as N
11..39
mg/I ..
9/4/03
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
Private Well Guidelines:' Nitrite-N'level should be-5 1.0 mg/I and Nitrate-N—< 10.0 mg/l
0
Sample Temperature on Receipt: 5•5 C
Date Received: 9/4/03 Report Date: 9/11/03 Reported By:
Today's Date: 9/15/03 Reference: 12498 Login Batch 0309001.1_ Sample Number: AB00005

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
:System: Lane, John
2241 Feed Mill Rd
Roseboro, NC
FRODWQGW
ro: NCDENR-DWQ GW
Wachovia Bid, Suite 714
Fayetteville, NC 28301
Courier: 14-56-25
-d By: BILL SHANAHAN
n of sampling point: House Tap
S.
peters
Zip: 28382
ATTN.- Bill Shanahan
Date: 9/3/03
Source of Water:
Ground
Source of Sample:
Type of Sample:
Raw
Type of Treatment:
None
Type of Analysis:
Nitrate.
Category:
ILO
I Time: 2:52:00 PM
Results Units - _ Date Analyzed:
as N
<0.10 :.
mg/l
9/4/03
as N
18.05
frig/I.
.9/4/03
.ANATION OF RESULTS:
r/Therapeutic Homes: Nitrate-N level acceptable if less than or equal to 10 mg/I
:e Well Guidelines: Nitrite-N level should be-5 1.0 mg/l and Nitrate-N-5 10.0 mg/1
0
e Temperature on Receipt: ._5`5_ C
P
teceived: 9/4/03
Report Date: 9/11 /03 Reported By:
,'s Date: 9/15/03 Reference: 12499 Login Batch ,03090011.'..: Sample Number: AB00006

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, Jeff Source of Water: Ground
Address: 1783 Feed Mill Rd
-Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW
ATTN: Bill Shanahan' Type of Treatment: None
Wachovia Bid, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC 28301 Category: ILO
Courier:- 14-56-25
EXPLANATION OF RESULTS:
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/I
Sample Temperature on Receipt: .-7•00^ C
Date Received: 9/4/03 Report Date: 9/11/03 Reported By:
Today's Date: 9/15/03 Reference: 12500 Login Batch 0309.0011 :: Sample Number: AB00007

,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: Jackson Jr., Billy Reed Source of Water: Ground.
Address: 1958 Feed Mill Rd
Roseboro, NC Zip: 28382 Source of Sample:
County: FRODWQGW Type of Sample: Raw
Report To: NCDENR-DWQ GW
ATTN: Biil Shanahan Type of Treatment: None
Wachovia Bid, Suite 714 Type of Analysis: Nitrate
Fayetteville, NC 28301 Category: ILO
Courier: 14-56-25 g ry'
EXPLANATION OF RESULTS:
Foster/Therapeutic Homes: Nitrate-N level acceptable if less than or egdal to 10,mg/I
Private Well Guidelines: Nitrite-N level should be-5 1.0 mg/1 and Nitrate-f L< 10.0 mg/1
0
Sample Temperature on Receipt: ._ 3_5_ C
Date Received: 9/3/03 Report Date: 9/11/03 Reported By: y�j'ok
Today's Date: 9/11/03 Reference: 12419 Login Batch 030.90008, Sample Number: AA99953

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: Jackson Sr.,"Billy
Source of Water:
Ground
Address: 2050 Feed Mill Rd
Roseboro; NC Zip: 28382
Source of Sample:
County: FRODWQGW
Type of Sample:,
Raw
Report To: NCDENR-DWQ GW ATTN:
Bill Shanahan
Type of Treatment:
None -
Wachovia Bid,- Suite 714
Type of Analysis:
Nitrate
Fayetteville, NC 28301
Courier:. 14-56-25
Catego
g ry'
ILO
Collected By: B SHANAHAN , Date:
9/2/03
Time: 3:42:00
PM
Location of sampling point: House Tap
Remarks:
Parameters Results
Units;
Date'Analyzed:
Nitrite as N <0.10' '
mg/I
9/3/03
Nitrate as N 15.46 :..
mg/l
9/3/03
EXPLANATION OF RESULTS:
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/l and. Nitrate-N—<,,10.0 mg/I
Sample Temperature on Receipt: _3 0 _0 C
Date Received: 9/3/03 Report Date: 9/11 /03
Today's Date: 9/11/03 Reference: 12420
Reported By:
t
Login Batch 03090008 -., Sample Number: AA99954

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DRILLING COST SUMMARY
Project n-ame: Mill Rd.
-Feed
Incient No. Non Point
Source
lCounty: Sampson 'Low,
lig,
Personnel
WFreriMam

Y • '."(' .rq-.-.+.-,• rrY'^N`w'.'"".`-w—�.'.. ....y.-s-�.- V...,v^.,....,.'^''�^...-'. rM^ t'.e...+'^'`...•r..�+.-..r•y.i 4 �I
1 LL'CON'STRUCTtON RECORD `
WE •
North Carolina-.- Department of'E' Wror ment and Natural+,Resources Division of Water,oualrty Grodhdwatet Section , ,. _-1
WELL CONTRACTOR (INDIVIDt1AL) NAME;( lint FBiny gay Casper CERTIFICATION #: 2009
WELL CONTACTOR COMIzaNY NAME 4 D.E.N.R. / GROUNDWATER SECTION PHONE;# 252-523-3620
STATE WELL CONSTRUCTION PERMIT#. NIA ^,ASSOCIATED VYQ:PERMIT # N/A
a applicable): ` fia Gcatile uc I
s 1.• WELL -USE (Check Applicable Box ❑ Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
�0 Monitoring ❑ Recovery ❑Heat Pump Water Infection Other �If Other List Use MW# 4
i2 WELL LQCATIO,N . " ,6,.,, w Y �yTopograpf WLand,Setting
I
Nearest Town....• I ROSEBORD? County. SAMPSON . ❑ Ridge ❑ Slope ❑ Valley d❑ Flat
.,.
` FEED MILL RD. (Check theappropnafebox)
{Street Name Nu.tubersCommurnty Subdivision LotNa 'zip Code) a' Latitude/Longlttade,of'tiell lOcatlon j
w 78 4871 tlg eeslminut
6033135.136518825
�'c
` }(
3 OWNE�t D E N R GROUNDWATERVILL RD. ( SECTION / FEED M y� h 3 7 ES._es/seconds} t
Address" 1636 MAIL SERVICE CENTER LatttudeAongitudesource� QGPS ❑Topo Map
—-
` (Str"eetor•Road No) - hN (Checi� Box)
i RALEIGH N.C. 27699-1636 DEPTH '7 DRiLLI4G1OG
�., 4 , Ci ;o,r T4wn State Zip Code From` _To Formation D`escri tion
252-523-3620
(area_code -•phone number)
14,.DATE DRILLED , 3/171
5: TOTAL btPTH '
6' DOES UltELL REPLACE! EXISTING WALL YES � No
? `;STATIC ATER LEVL' (Below Top of Casing)FTC
(use "+ f Above Top of Casing}
8; TOP OF CASING IS 2.5' w Above Land. Surface*
'Top;of casing terminated atlor'below land surface regwres a
vartapc�e n accordance with=15A NCAC -2C 0118.
9 YIELD (gp[p) ;, 1 PT. METHOD OF1EST.9 PUMP
0'--6"
; GRAY TO LIGHT TAN
SANDY CLAY TOP
SOIL).
6"--4'
LIGHT TAN SAND W/
SOME CLAY.
4'--8'
= LIGHT TAN SAND W/
SOME CLAY.
8'--12'
LIGHT TAN SAND W/
','SOME CLAY, WET
12'--16'
`LIGHT TAN SAND W/
YELLOW SAND,WET
WATERIONES (depth
�F OCAT[ON SKETCH
11. DISINFECTION Type) N/A Amount ; N/A Show direchori and distance m miles from at ►east two
CASING p g Roads or;County Roads Include the road 1Z Wall Thickness State
„ffi 5 . De th ry x j Diame#er or Wei ht/Ft� Matenat,. , numbers and common'roail names
From. 0' To SCH PVC
from To Ft!
From., To Ft:;-
13: GROUT
u. Depth Material Method
from 0' To`. 8.5' Ft;" BENSEAU SAND w' POURED
`From'"' To
Frorri Ito, Ft:'
14: SCREEN ` - .
Depth : Diameter Slot Size Material`: h
From 11' To" 16 Ft., 0.5 in O 10 t) ; PVC
;From.; To.
Ft. lit Ira'`
i From: To Ft: In m;
15:. SANDWGRAVEL PACK
' Deptn _.` Size, Material ' r
Froms' 8.5' To 16' Ft; NAT FILL
' From To Ft
77.
From To
"? {.
1.6 REMARKS 1 EXPENDABLE POINT
I'DO HEREBY,.CERTIFY,THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WFfH"15A NCAC:2C, WELL CONSTRUCTION
5 STANDARDS` {AN .THAT A COPY OF THIS RECORD HdS BEEN PROVIDED TO:THE WELT OWNER;
„
SIGNATURE OF PERSON CONSTRUCTING.THE WELL DATE
,Submit the ongiral to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center Raleigh, NG 27699 1636 Phone,
:No. [phone];Nithin 30 days Gw;:1 REv oRoo

:�k �;� = WELL CO.NSTRU.CTI�NRECO.RD �� -
FWELC'CON
TRACTOR=(INDIVIDUAL► NAME (oririt)`' Billy Rav Casper CERTIFICATION'#: 2009
IWELL CONTACTOR COMPANI( NAME �:, D.E.N.R. / GROUNDWATER SECTION -,PHONE,# 252-523-3620
STATE WELL CONSTRUCTION PERMIT# IN
..
ASSOCIATED 1NQ' PERMIT # N/A
lictile fi l
1. WELL USE (check Applicable Box) i ❑ Residential ❑Municipal/Public
El Industrial ❑Agricultural
., N❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other If 0& Lrst Use ` MW# 5
4
2 WELL LOCATION ° , ".
``Topograptic/Land Setttrrg, , ui
Nearest T:owrt .'- ROSEBOR C'ounty SAMPSON
_
❑ Ridge ❑ slope❑ Valley ❑ Flat
FEED MILL RD.
; (Checktheappropnatebox)�
' ' (Str6k Name Numbers;,, ommUho,. Subd`Vision Lot Nb ,ZipCode)
Lat►tudelLongitude' of'well loca#ion.
78.488849830 / 35.135094025
.,
3 DWNER f D.E.N.R. GROUNDWATER SECTION / FEED MILL RD.
(degreeslminute§lseconds) ~<_
=;4ddress`i 1636 MAIL SERVICE CENTER
Latitutle/Inngrtudeaourc�� r QGPS [:]Top, Map
Streetor'Road No.),-
(Check t3ox) -�
t _ = RALEIGH N.C. 27699-1636
DEPTH °`° . 'DRILLING`LOGt
City or,Town: " State Z. Code ` From` , ":.3o Formation Descri tion
rt
252 523 3620
w urea COde p116ie number)
i4:`:pATE DRILLED ;� 3/17/04
5 TOTAL DEPTH; 16'
6 ,DOES WELL REPLACE'EXiSTING WELL ❑'ems ❑ No
7 STATIC WATER LEVEL (BefOW Top of Casrng) 10.24 FT
tiff (use +' Above`Top of Casmg)t .;,
8 `TOP OF,,CASING IS 2 5' Above Land Surface*
*Top of casing terminated atlar,,below land surface requires a
variance m accordance with-15A NCA02C 0118.
9 ,YIELD°(gpM) 1 PT. '° METHOD OF T,EST:' PUMP
0'--6"
: GRAY TO LIGHT TAN
z SANDY CLAY TOP
SOIL).
6"-4'
LIGHT TAN SAND W/
SOME CLAY.
4'--8'
LIGHT TAN SAND W/
SOME CLAY.
8'--12'.'
LIGHT TAN SAND W/
SOME CLAY, WET
LIGHT TAN SAND W/
YELLOW SAND,WET
10 WATER ZONES (depth} - I T— 16'
LOCATION SKETCH '
11,: DISINFECTION Type, N/A Amount. f N/A Showcdirecbon; and distance rn miles from at least tvJo
n,
12: CASING mfcGthi`, ess'° State Roads or.County;Roads Include the roatl
Depth Diameter .or V1leigftlFt ,. ='Material ,- numbers and cgmmon.road names,r
From,, 0' To 11' Ft 0 5 - ' SCH 40 PVC
'From: To '' Ft. -'
From To Ft r `
Depth Matenai Method
'From` 0' To' 8.5' Ft BENSEAL/SAND h POURED t'4
From To;I Ft: `
From To;� Ft.� � F
14. SCREEN "
i Depth '_ "biameYer, Slot Size Matenal' ;
:From 11' To 16 Ft 0.5 'an O 10 m? PVC x
.,,
From ` To: Ft, to th l3S7!{ I
From To Ft ; to rn
15_ SAND/GRAVEL PACK%t
:• k , Depth r Size rt ..Matenai .,.'
From 8.5' TT 16' Ft NAT FILL f
From To Ft "'
( from To Ft.
16 REMARKS 1EXPENDABLE POINT
x�
3
�tr
d.
Subm
sion of Water Quality, ter;Secti!
G THE WELL r` tSATE`'
IaiLService Center Raleigh NC 27699 1636 Phone '
GW=.1 FV.07/2001

VIFELL CONSTRUCTIQN RECORD _-_
North Carolina-ADepartment of Enyironitient and'Natural` Resources - DNision of Water Qualify Graundwafer $ectipn
WELL CONTRACTOR (INDfVIDUAL);NAME .{' n
LCONTACTOR COMPANY NAME D otE N R. Bill Ray GROUNDWATER SECTION
Casper CERTIFICATION#: 2009
CTION PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# N/A ASSOCIATED WGL PERMIT # N/A
WEL/
R
I v.,4•x, (Ifapplicable)`-^�-
1
9: WELL USE (CheCK Applicable Box) ❑ Residential ❑ Municipal/Public ❑ Industrial El Agricultural 5
l ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other If Other List Use MW# 6
i2 ;Vi/ELL LOCATION ToPograpliic/Latiti SeitirYg'
'Nea'test Town ' ROSEBORO tCounty`': SAMPSON ❑Ridge El slope ❑ Valley Flat
-� -
FEED MILL RD. (Check the apropnate box)
(Street'Name Numbers`,'Gommunr<y Subdnrision Lot,No:; Zip,Code) Latitude%Congitud'e of'well location
3.`OWNER D.E.N.R. GROUNDWATER SECTION / FEED MI 78 488707213 / 35.136616011
E
LL RD. ,4`(degrees/rriinutes/secontls)
Address 1636 MAIL SERVICE CENTER Latdude116 gR desourc2 ° ❑CPS ❑Topo Map
(Street or Road No ` :. (Check Box)~
RALEIGH N C 27699 1636 DEPTH DRILLING LOG
Cit}r,or Town; . ` State Zip' Code From' To F.oimafion Descn tion..
252 523-3620
(area code phone number)
i g
4. DATE DRILLED, 3/17/04
5 TOTAL:DEPTH.
6 ,DOES WELL REPLACE EXISTING IN,ELL ❑YEs NO
7: STATIC'WATER LEVEL ($61'4w Top,of Casing): 17.57 FT
' v ,a (use ;' tfAboyeTopof,�asing)
8 ,TOP OF.'CASinNG IS 2.5' h Above Land Surface*
p ` - ` "Top;bf casing terminated k6r below land surface requires a
k ,
-vaiiange in'accordaiice,with 1,5.A NCAC 2C 0118:
9 ,YIELD 1 PT. METHOD OF.TEST PUMP
GRAY TO LIGHT TAN
SANDY CLAY TOP
SOIL .
6"-4'
LIGHT TAN SAND W/
,? SOME CLAY.
4'--8'
`' LIGHT TAN SAND W/
SOME CLAY.
LIGHT TAN SAND W/
SOME CLAY, WET
LIGHT TAN SAND W/
YELLOW SAND,WET
I
10, WATER 20NES (depth); 11'— 16'
LOCATION SKETCH
11' DISINFECTION Type Jra N/A Ainounti : N/A Showbirectidn,'anddistance in miles from at least two.,
12: `CASING 4,, Wall Thickness;" State'Roatls or County Roatls Include the'road
1..z. , Depth - r,' ;:.Diamet r or Weight/Ft Material ; niirirbers and.common^^'road names
a i, ,
To. 11'
m, Ft.'0.5 . SCH 40 PVC
'From�> To� Ft '>
FroTo Ft
(3:.GROUl r' i e
Depth Material _ avlethod
From; 0' To`, 8 5' Ft"' BENSEAU SAND POURED o ��
From' To Ft: k �
From To Ft;
1.4. SCREEN",
Depth Diameter "°_SlotSiza- . -Matenal'°i`
From 11' To 16 Ft. 0.5 'ln O 10 ln„ :. PVC
:,From,� To' Ft
rrom Ta : Ft m ins i
15; SIA WG_RAVEL PACK r
Depth.,;;, ;Size, . "� Material,
From 8.5' To. 16' Ft. NAT FILL
From: TO Ff. N
- --- �--
Front To, Ft
w
'16. REMARKS 1 EXPENDABLE POINT
T DO HEREBY CERTIFY THAT TkiIS WELL WdS COfVSTRUCT ED IN ACCORDANCE WITH 5A NCAC 2C, WELL CONSTRUCTION
LL OWNER; ,
Y
STANDARDS SAND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WE
" SIGNATt RE OF;PERSON"GONSTRUCTING;THE WELL= DATE
Submitw the ongmal to the Division of Water Quality, GroundwaterJSechon, 1636 Mail ;Seance Center RaleighNC 27699 1636 Phone
t o. _f9191 733 322' ithin.30 days.

F �4 WELL CONSTRUCTION RECORD ;
$ :x North Carolina `DepaitrJ ent of Epwronmentand Natural'Resources: ,'DiVision,o`f:INafer Qualdy G`roundwafer Secfiun
- WELL CONT
- TRACTOR (INDIVIDUAL) NAME': not ,T Bill gayCasper ._CERTIFICATION.#: 2009
WELL CONTACTOR COMPANY NAME ; D.E.N.R. / GROUNDWATER SECTION t PNONE#: 252-523-3620
STATE WELL CONSTRUCTION PERMIT# N/A ASSOCIATED WQ PERMIT # N/A
[- (rf app6.able) 0 epplicablel t'
t; WELL USE (Check A �hca le Box ? ❑ Residential ❑ Municipal/Public pp ; p . }, � El industrial ❑Agricultural � r , .•; ,,; ?'•`
`3 ❑✓ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑Other If Other List Use
MW# 7
�2 =WELL LOCATION , i, Topograpflc/Land Setting _
I °Nearest�Town. .,:' ROSEBOR® County SAMPSON �0 Ridge ❑ Slope ❑ Valley ❑ Flat
} FEED MILL RD. (Checkthe appropriate box)
(Street"Name •Nurpbers Community; Subtlniision Lot No Zip Gode) Latt#ude/Longitude'of well location
• ` °" 8.492456451 / 35.134883273
3.`OWNER , D.E.N.R. G
7
GROUNDWATER SECTION FEED MILL RD. ; (iiegreesfrillRutes/seconds)'
Atldress; 1636 MAIL SERVICE CENTER Latrtude/Inngltude sources,: t ❑GPS ❑Topo Map
(Street or Road No (Check Box) -
;, RALEIGH N.C. 27699-1636 DEPTH DRILLING.LOGN ,
Ci � ct,Town; ;° State 2tp Code Fro'm,: , '� rTo Formafio' Descnptior
` 252-523-3620 0'--6" GRAY TO LIGHT TAN
' (area code phone number)° SANDY CLAY TOP
DATE.DRILL'ED 3/17/04 k SOIL).
5 TOTAL:DEPTH 16' �;:} ",' 6"--4' LIGHT TAN SAND W/
6 DOES WELL REPLACE EXISTING WELL , -.L❑YES ENO ` SOME CLAY.
7 STATIC WAT..ER LEVEL (Below Top~of Casing)' 11.48 Fi 4'--8' ^ ;LIGHT TAN SAND W/ '¢
i ,i (use
dAboveiop- of: Casmg) = , SOME CLAY.
�8 TOP OF;GAS(NG IS ; 2.5' Above Land Surface* 8'--12' >' LIGHT TAN SAND W/ n
Top of casing terminated atfoc.below lartd,surfece regpires a SOME CLAY, WET
variance m,accoriiance,with 1`5A NCAG'2C 0118. 12'--16' LIGHT TAN SAND W/
9 :YIEL,D140M) 1 PT. METHOD OF TEST:' PUMP `' YELLOW SAND,WET k
10. WATER ZONES (depth) 1 T-- 16'
z LOCATION SKETCH
19'.DISINFECTION T e k; N/A Amount, N/A
YP , Showrdrecttorl;and distance,in miles from st least two
12 CASING W.all;Thickness"' State;'Roads or'County Roads Include the``toatl
Depth Diattieter of UVeiglit/Ft : Mate'nat , riumhews and commo�a n. road names
..:
From 0' To ` I T Ft." 0.5 . _ SCH 40 PVC r.
a
k.'F�om; To Ft
From To Ft
GROUP ' I F
Depth Material Y_. Method
Erom;i 0' Ton: 8.5' Ft. BENSEAU SAND N POURED l
From`' To F.t.
?From.' Toy;'
14; SCREEN r
Depthr Dlarneter SIotS�ze ,Matenal
From 11' Toy,; 16 Ft� 0.5'in O 10 In': PVC
From To: Ft. in iri-
From ` To, Ft in Ins
15. SAND/GRAVEL PACKS
Sl MaterlaI
-From 8.5' To 16' F#:' NAT FILL "
From`
From
To`. Ft.
16REMARKS: ` 1 EXPENDABLE POINT
HEREBY CERTIF`(THAT tHIS WECL-WAS`CONSTRUC7ED IN ACEORDANCE WITIi'1SA NCAG`2C. WELL CONSIR6&1 SON'=
c 51 ANDARDS -AND THAT A , OF THIS RECORD HAS BEEN PROVIDED To THE WEIL QNINER •:
,
s 's`'' SIGNA Cl3kRE OF.PERSON CONSTRUCTING TfiE VVElJL' * DATE
Submit the original fa the Division of Water Quality, Groundw&t ,. cdon, 1636 Mail Sernce Center Raleigh, NC 27699 1636 Phone
No. `(919} 733 3221rwithin 3i) days. o�,' �. .. �Gvli REV of/zo0t,�.

j WELLtiCONSTRUCTION RECORD
North Carolina�,bepartrnent of Enwronment;and`Natural; Resourc-'e's -Division of.VlTafer Qnaliiy Groundwater sbatibn
WELL CONTRACTOR (INDN, IDIJAl) NAME"(' riot) Bill RayCasper CERTIFICATION#. 2009
!WELL CONTACTOR COMPANY NAME D.E.N.R. / GROUNDWATER SECTION PHONE;# 252-523-3620
STATE WELL CONSTRUCTION PERMIT#,, N/A ASSOCIATED WQ PERMTI. # `. N/A
-.
hcabie _.. ilia � licabl")'
i 1,. WELL USE (Check Applicable:Box) _ ` ❑ Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural !
i i Q Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other if Othbr G Use MW# 8
2 :,WELL LOCATION f Top ograpkiid LandNSetting , ;
Nearest Town. ROSEBOR� Gou''n SAMPSON ��❑wage El slope ❑Valley 0 Flat
FEED MILL RD (Check theappropriate'box)
(Street Name, Numbers, Commundy SubdNision Lot No zip Coae) Latitude/L=`ongitute of well location
78 492878248 / 35 134850179
3�~OWNER;, D.E.N.R. GROUNDWATER SECTION / FEED MILL RD. � �t(degrees/tninutes/seconds), .
Address;, 1636 MAIL SERVICE CENTER LatitudeA9ing►tude source .M; �GPS ❑Topo Map
r .(St' or Road No) , ; (Check Box)
RALEIGH N.C. 27699-1636 DEPTH: , �" DRILLING LOG"
Ci ;;qr Town;_" State 7rp Code From;. . . _ To tit _ ; FormaUon'Descri tiori'.
252 523 3620 0'--6" GRAY TO LIGHT TAN
code pf�one number)„ ;SANDY CLAY TOP'
4 DATE DRILLED 3/17/04 SOIL). I
5 TOTAL DEPTH'. 16' . 6"--4' LIGHT TAN SAND W/
6 'DOES WELL REPLACE EX15T1NG WELL❑YEs No i SOME CLAY.
7 rSTA jIC WfiTER LEVEL (Beiow Top of Casing) 13.44 FT 4'--8' LIGHT TAN SAND W/
use +' rf Above Top of Casing) SOME CLAY.
8�TOP OFCASING IS q2.5' Above Land Surface* - 8'--12' > 'LIGHT TAN SAND W/
Top of casing terminated atfor below land surface regwres a SOME CLAY, WET J
variance`iri,accordancewdh-15ANCgC:2G 0118. 12'--16' LIGHT TAN SAND W/
•,
9 'YIELD�gprn) 1 PT.METHOD OF7E8T ` PUMP YELLOW SAND WET
Id WATER ZONES (depth) 11-- 16
LOCATION SKETCH t
11. DISINFECTION TypeS'xF N/A Ainounr.: N/A show`iLrechon''and distance in miles frortl;at least tvuo
12: CASING Wall Thickness; s state'Roads or County Roads Include theroatl
" Depth Diarrieter .or.We�ghi/Ft - Matenal numbers and common road names ry
Frain 0' Ta: 11' Ft 0.5 SCH 40 PVC
From To F.t
( From To Ft -
13.
Depth Matena! Method
Erorp 0' To;`' 8.5' Ft;� BENSEAU SAND POURED =e
From To:,!
From. To Ft
14.SCREEN.
_ _Depth Diameter Slot Size, ;Material.
{. From 11' To': 16 Ft 0.5 `In ; 0.10 i�':-"•' ' PVC
From To `" Ff.:
From To,'Ft. n i11..,
15; SANb/GRAVEL PACFt
Depth` Size, Maienal
From; 8.5' To 16' Ff.' NAT FILL t
'From Ta `` Ft: `: je _ Iti
From: JTO'., Ft s � i
4
�6: REM- Al 1 EXPENDABLE POINT
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ] 5A NCAC.2C, WEt L CONSTRUCTION
' STANDARDS A THAT COP.jl OF',THI5 RECORD HAS BEEN PROVIDED.TO THE WELIrOWNER, c't i
. :- ,
7
u SIGNATURE OF PE)-ZSON`CONSTRIIGTING THE WEt l%, D1'TE
Submit the original to the D!vision of Water Quaiity, Groundwater Secbon, 1636 Mail Service Center Raleigh, NC 27699 1636 Phone
iVo(919)'.;733 3221 withiti:30 GWpi REV D7/2001

WELL CONSTRUCTION RECORD }'
. p
North Carolina - De artment of Ettvironment and`Natural; Resources -: Dmsion,of`•1ll(ater,Quahiy GKountlwater Section , ..
WELL CONTRACTOR (IND11/IDUAL) NAME` ``nnt : ` Billy Ray Casper
CERTIFICATION #: 2009
WELLrCONTACTOR COMPANY NAME D.E.N.R. / GROUNDWATER SECTION
:PHONE;# 252-523-3620
STATE WELL CONSTRUCTION PERMIT# NIA ASSOCIATED WQ PERMIT # N/A
I if applicable) "
(if applicable)
1 WELL USE (Cfreck A lic ble Box ❑ Residential ❑ Municipal/Public al/Public pp ' p ) p
❑industrial []Agricultural
2 ❑ Monitoring ❑ Recovery ElHeat Pump Water Injection El other If Other List Use MW# 9
77
2 -WELL LOCATION
Topographic/Land Setting
Nearest Town `.. " ROSEBOR5 County: SAMPSON
Ridge 0 Slope 0 Valley 0 Flat
FEED MILL RD.
(Check the appropnate box) -F
s
', (Street Name; Nombers".Community; ubtlivision, Lot NO Zlp.Code)
Latitude/Longitude, of w ell ldcafidhs
78 492630831 / 35.134549576
3 OWNES D.E.N.R. GROUNDWATER SECTION / FEED MILL RD.
a (degrees7r)1nuteslseconds)
`
Address;' 1636 MAIL SERVICE CENTER
Latitude/lnngitudesource' d DG Ps ❑Topo Map
a ,, kStreetor Road No } .'.•' =
(Check BoX}
RALEIGH N.C. 27699-1636
DEPTH DRILLING LOG
-C' ` T ' $t t 'Z' " C de
F'r" rri� To '� Fo matidn'Descri tion
252-523-3620
code pj)one number}"
L.: DATE D. RILLED 3/17/04 a
.;.
5, TOTAL, DEPTH ` 16'
6 `DOESnVi►ELLfEP1ACE EXISTING WELL OYES p
7 STATIC WATER LEVEL �Befow Top of Casing) 11 8 JF
8 ;TOP OFGASING IS= 2.5' Ab'ove LaniiSurface*
'Top of casing terminated at/or below land surface requi[es a
variance in acoorrlance with-T5 - NCAC`2C 0118:
9 YIELD (pmj,'' 1 PT. METHOD O`FTEST' PUMP
0'--6"
GRAY TO LIGHT TAN
w: SANDY CLAY TOP
SOIL).
6"--4'
pa LIGHT TAN SAND W/ T
SOME CLAY.
f LIGHT TAN SAND W/
SOME CLAY. v.
8'--12
LIGHT TAN SAND W/ 4;
t SOME CLAY, WET
12'--16'
; _° LIGHT TAN SAND W/
YELLOW SAND,WET r
110 WATER ZONES (depth)-
`ll
LOCATI'C?N SKETCH
11; DISINFECTIONType N/A Amount • N/A Show direction``and distance in miles from atJeast two '.
u
12 CASING fi" Wall Thickness State`Roads,or-County.Roads. Include th�';road
bepth • Diametor orWeightlFt` Material,. nuribers"andcommon road names r ',
Frorn. 0' To=_ 11' Ft;.. 0 5 6 SCH 40 ���
_ PVC
s ;From: To ` Ft G
From To Ft
k13- GROu;i
Depth Material , Method, '
From a 0' Ta„ 8.5' Ft --' BENSEAU SAND POURED i
From To. Ft. �'
<From Tod ' Ft ?
14-."SCREEN
} Depth. =4 Diameter Siof Size: Material .. w
From 11' To 16 Ft , 0.5 'aft 0.10 117 PVC
From To•'x F#: in irl.
t'
From To; Ft In in, t
From 8 5' To 16' Ft. NAT FILL
From To ; Ft.
y. • .,; ,
r
REMARKS,., 1 EXPENDABLE POINT
I DQ HEREBY CERTIFY THAT THIS WELL.WAS CONSTRUCTED IN ACCORDANCE WTTH 15A NCAC,2C, WELL CONSTRUCTION"
STANQARQS ANQ Tt111T A COpY{OF THIS RECORD IiAS BEEN PROVIDED TO THE, OWNER s4 WX
M:
x 4 ;SIGNATURE OF, PEl2S0WGONSTRUCT(NG,THE WELl!: z DATE
Submit the original to the Division of°Water Quality, Groundwater Section, 1636 Mai(Service Center Raleigh, NC .21699 1636 Phone
No. 1919i:?33 3221:T within"30 days. e. ,GW-1 REV A7/2001'

Feed Mill Road MW Water Levels
Date
MW-1
MW-2
MW-3
MW-4
MW-5
MW-6 MW-7
MW-8
01-04-04
10.91
9.52
11.78
9.92
10.24
. 17.57
11.48
13.44
09-04-04
11.15
9.81
12.04
10.14
10.31
17.5
11.83-
13.76 -
14-04-04
11.03
9.64
12.02
10.05
10.13
17.44
11.87
13.83
21-04-04
11.2
9.79
12.14
10.21
10.24
17.32
12.03
13.96
28-04-04
11.24
9.91
12.16
10.22
10.17
17.22
12.2
14.11
Feed Mill Road
MW Nitrate Samples
22-03-04
9.
1.1
15.98
12.98
10
15
22
8.37
28-04-04
11.97
4.2
15.97
11.98
8.03
13.99
19.98
7.08