WI0600067_Well Records_20131115

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NON. RESIDENTIAL
WELL CONSTRUCTION RECORD
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North Carolina Department of Envirorunent and Natural Resources- Division of Water Quality
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WELL CIEdB'I')i)t+gCA']CJl®N # 3580
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.CONTRACTOR
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor jlndividual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone -number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT,-#.(ifaplicable)
SITE WELL ID #(if applicable)106-� .
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery O'Injecton,
y
Irrigation❑ Other ❑ (list use)
DATE DRILLED1 1/23/13
4. WELL LOCATION:
.Hwy,1_=5�50�1�O�i��yPa s�
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley Wf lat []Ridge []Other
LATITUDE 34 @ °47 '50 "DMS DD
LONGITUDE 79 (9) ° —27,40 " DMS DD
Latitude/longitude source: OPS (]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form ifnot using GPS)
5. FACILITY (Name of the business where the well is located.)
formerEaton Cororatio
Facility Name
Facility ID# (if applicable)
.see above
Street Address
see above
NC
City or Town
State Zip Code
Mike Stanforth
Contact Name
-
PO Box 6172
Mailing Address
Gastonia
NC 28056
City or Town
State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
: d. TOP OF CASING IS -.25 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance
with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING:. Depth
Diameter Weight Material
Top.,0 Bottom 12
Ft.1" Sch 40 PVC
Top Bottom
Ft
Top Bottom
Ft
8. GROUT: Depth
Material Method
Top 0 Bottom 8
Ft. Portland tremmie
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter, Slot Size Material
Top 12 Bottom 27
Ft. 1 in. .020 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. ' in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10 Bottom 27
Ft. Med. Quartz
Top Bottom
Ft.
Top _ Bottom
Ft.
: 11. 'DRILLING LOG
Top Bottom
Formation Description
0 . / 21
brown clayey sandy silt
silty sand
H11 v2;V[.ul3
12. REMARKS:DEC
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTS I Ct(3 ` D � CE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT X -%IS
: :RECORD *HAS BEEN PRO E O THE WELL OWNER.
11 /15/13
SIGNATO RE OF CERTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 clays; of completion toE Division of Water'. uality Information Processing, Rev. 2/09
11617-Mail Service Cenier. Raleiah.°NC•2i699-161, Phone: (919)',QV-6300 .

NONRESIDENT'L4L WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR C1ERTIFICATRON # 3580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor f Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327.,
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-7
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /23/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LaUrenburg COUNTYSCotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope []Valley WOPlat ❑ Ridge ❑ Other
LATITUDE 34 8 -47 '50 " DMS DID
LONGITUDE 79 0 ° 27 ' 40 " DMS DD
Latitude/longitude source: OPS oTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)•
see above
Street Address
see above NC
City or Town State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
- Gastonia NC 28056
City or Town State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing: 19 FT. .
(Use "+" if Above Top of Casing)
A d r•y I") n
a A. d 1 0 1
d. TOP OF CASING IS -.25 FT. Above Land Surface".
`Top of casing terminated atior below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
: g. WATER ZONES (depth)
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
:7. CASING:
Depth
Diameter
Weight Material
Top 0
Bottom 12
Ft. i"
SCh 40 PVC
Top
Bottom
Ft
Top
Bottom
Ft.
: 8. GROUT:
Depth—
Material Method
Top 0
Bottom 8
Ft. Portland tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top 12
Bottom 27
Ft. 1 in.
.020 in. PVC
Top
Bottom
Ft. in.
in.
Top
Bottom
Ft. in.
in.
: 10. SAND/GRAVEL PACK:
Depth Size
Top 10 Bottom 27 Ft. Med.
i
Top Bottom Ft.
Top Bottom Ft.
: 11. DRILLING LOG
Material
Quartz
Top Bottom Formation Description
0- /21
21 /27
brown clayey sandy silt
silty sand
AI(11l d bD Ah�r •:n.t�
12. REMARKS:
BE ' R
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRO DANCE WITH
I 1M
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AWF THIS
RECORD HAS BEEN PRO IDE O THE WELL OWNER.
11 /15/13
SIGN&TURE OF C RTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of -comp' ietiora_to: bivisi6mof 11!later QuPilty.- lnforlrnation.Processeng; Rev. 2/09
1617Niaii.Service Center. Raleiah. NC27699-161, Phone :'[phone]

NONRESIDENTIAL ONRESIDENTIAL
WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATI®N # 3580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC" 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERM IT#(if applicable)
SITE WELL ID #(if applicable) IW-8
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ ,
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection le
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /23/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg , • COUNTYSCotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑Valley (flat ❑Ridge ❑Other
LATITUDE 34 �'i✓, .47 .50 " DMS DID
LONGITUDE 79 0 , 27 - 40 " DMS DC
Latitude/longitude source: OOPS ElT'opographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above NC
City or Town State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia NC 28056
City or Town State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
`« p�tf4
d. TOP OF CASING IS -.25 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
: Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0
Bottom 12
Ft. 1"
SCh 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
Top 0
Bottom 8
Ft. Portland tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top-12
Bottom 27
Ft. 1 in.
.020 in. PVC
Top
Bottom
Ft. in.
- in.
Top
Bottom
Ft. in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 10
Bottom 27
Ft. Med.
Quartz
Top
Bottom
Ft.
Top
Bottom
Ft.
: 11. DRILLING LOG
Top Bottom Formation Description
0 / 21 brown clayey sandy silt
21 /27
/
Ji
/
silty sand
NOV Z U rtj 6
I ITsI,-
12. REMARKS: DEC 16 2013
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED Ill- O�� � &ANEE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDEP TO THE WELL OWNER.
11 /15/13
SIGNA RE OF Q�-:RTIFIED WELL CONTRACTOR DATE
Bryan Vest
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days off completion to: Division of Water "Ouale Information Processing,,,Form Gw-1 b
�/ !0 - Rev. 2/09
1617 Mail Service Center,'Raleigh,.NC 27699-161, Phone: [phone]

NON J1KmES'IDE1 TML WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION 4 3580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor f Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Str et Address
W�lispering Pines NC 28327
City or Town State Zip Code
910 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
W1 . _ CONSTRUCTION ,:,ERM
( ­' ' 60CIATED PERMIT#(if applicable)
TC WELL ID #(if applicable)IW-9
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection 1,
Irrigation❑ Other ❑ (list use)
DATE DRILLEDI 1 /23/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley What []Ridge ❑Other
LATITUDE 34 (D -47 '50 ° DMS DID
LONGITUDE 79 0 ° 27,40 ° DMS DD
Latitude/longitude source: ops Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS) r
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name
Facility ID# (if applicable)
see above
Street Address
NC
see above
City or Town
State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia
NC 28056
City or Town
State Zip Code
(704 )' 853-0800
Area code Phone number
6. WELL DETAILS:
27
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO OV
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS -•25 FT. Above Land Surface*
*Top of casing terminated attor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e.
YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type I Amount
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom _!
Thiakn—'
7. CASING: Depth
-roT-�—Bottom 12 Ft. 1" _ SCh 40 PVC
Top
Bottom
Ft
Top
Bottom
Ft,
8. GROUT:
Depth
Material
Method
tremmie
9. SCREEN: Depth Diameter Slot Size Material
Top 12 Bottom 27 Ft. 1 in. .020 in. PVC
: Top Bottom Ft in. in.
Top Bottom Ft. in. in.
: 10. SAND/GRAVEL PACK:
Depth Size Material
Top 10 Bottom 27 Ft. Med. Quartz
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0 / 21 brown clayey sandy silt
21 / 27 silty sand
I
/ NInv 9. �n1�
: 12. REMARKS: DEC 16 2013
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTEDI1'N;AG'r rJWANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
: RECORD HAS BEEN PRO E O THE WELL OWNER.
nr�A 11 /15/13
SIGNAYURE OF C TIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Subunit within 30 s9 ys of completion to: ®ivisi®n of Water Qualify = Information Processing, Rev. 2109
1617 Mail Service Center. Raleigh. NC 27699-161, Phone : [phone]

NOATRES`IDENTIAL wFLL CONSTRUCTION RECOR D
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-10
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection W,
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /23/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley (O•lat ❑Ridge ❑Other
LATITUDE 34 0 °47 -50 " DMS DD
LONGITUDE 79 0 ° 27 ' 40 " DMS DD
Latitude/longitude source: OPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name ofthe business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above NC
City or Town State
Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia NC
28056
City or Town State
Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
27
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑
NO OV
c. WATER LEVEL Below Top of Casing: 19
FT.
(Use "+" if Above Top of Casing).
d. TOP OF CASING IS -.25 FT. Above Land Surface'
'Top of casing terminated attor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
' To 0 Bottom 12 Ft 1" Sch 40 PVC
P
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
:,Top 0
Bottom 8
Ft. portland tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot Size Material
Top 12
Bottom 27
Ft.1 in. .020 in. PVC
Top
Bottom
Ft, in. in.
Top
Bottom
Ft. in. in.
: 10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10
Bottom 27
Ft. Med. Quartz
Top
Bottom
Ft
Top
Bottom
Ft,
: 11. DRILLING LOG
Top
Bottom
Formation Description
0
/ 21
brown clayey sandy silt
21
/ 27
silty sand
2 0 Ctl13
I
12. REMARKS: 01 E 7013
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUc,I ckyl�yp}�Vij1�ANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND 7}{Ary X1dG° P lF THIS
RECORD HAS BEEN PROyIDEHE WELL OWNER.
11 /15/13
SIGNA RE OF CEF� IFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
3'1"y
v uN17
Form GW-1 b
Submit Within 30 days of cornplet60n to: Division of Water Quallty - Infor' coition Processing, Rev. 2/09
1617 Mail Service_ Center, Raleigh, INIC 27699-161, Phone: [phone]

.r' STATE'ri �,
NoNRESIDENTML WELL CONSTRQJCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION 43580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor f Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
(910 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERM
OTHER ASSOCIATED PERMIT#(ifapplicable)
SITE WELL ID #(ifapplicable)IW-11
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ �
Industrial/Commercial ❑ Agricultural ❑ Recovery [I Injection Injection W
Irrigation❑ Other ❑ (list use)
DATE DRILLED' 1 /23/13
4. WELL LOCATION:
Hwy 1.5-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley Wflat ❑ Ridge ❑ Other
LATITUDE 34 0 .47 ,50 " DMS DD
LONGITUDE 79 0 ° 7,40 " DMS DD
Latitude/longitude source: OPS Dropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation_,
Facility Name Facility ID# (if applicable)
see above
Street Address NC
see above
City or Town State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
NC Gastonia
28056
City or Town State
Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
TOTAL DEPTH: 27
a.
b. DOES WELL REPLACE EXISTING WELL? YES ❑
NO Sll�'
c. WATER LEVEL Below Top of Casing: 19
FT.
(Use "+" if Above Top of Casing)
/.t e 1-1 (? 11, 11
y _i e I J ••.J t
d. TOP OF CASING IS -•25 FT. Above Land Surface*
*Top of casing terminated atfor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
g. WATER ZONES (depth):
: Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth. Diameter Weight Material
Top O Bottom 12 Ft.1" SCh 40 PVC
: Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0 Bottom 8 Ft portland tremmie
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 12 Bottom 27 Ft 1 in. .020 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
: 10. SAND/GRAVEL PACK:
Depth Size Material
Top 10 Bottom 27 Ft. Med. Quartz
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0 /21
21 /27
/
/
Formation Description
brown clayey sandy silt
silty sand
F=�1107 IF
- A,(1\,
IN V 2 5� an 2192
12. REMARKS: Wr I. fi
ALI
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTrD ftf WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND T IS
: RECORD HAS BEEN_P�VID TO THE WELL OWNER.
/) 11 /15/13
SIGN URE OF C TIFIED WELL CONTRACTOR DATE
:.Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit vuithin 30 days of c®rnp➢et on Y®: Division of U!later Qua - Worinatiori Processing, Rev. 2/09
1917 Anil Seevice Center. Raleigh: NC 27699-161, Phone : (919),801-6300

If. NON RESIDENT'UL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION 93580
.,•
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
910 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-12
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ , Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /23/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check) appropriate box)
❑Slope ❑Valley plat ❑Ridge []Other
LATITUDE 34 @ .47 '50 " DMS DD
LONGITUDE 79 0 ° 27 , 40 " DMS DC
Latitude/longitude source: OPS Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above
NC
City or Town
State
Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia
NC
28056
City or Town
State
Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
27
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL?
YES ❑
NO lV
c. WATER LEVEL Below Top of Casing: 19
FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS -•25 FT. Above Land Surface*
*Top of casing terminated
at/or below land surface may require
a variance in accordance
with 15A NCAC 2C .0118.
: e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
:.Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0 Bottom 12
Ft.- SCh 40 PVC
Top Bottom.
Ft -
To pBottom
Ft.
8. GROUT: Depth
Material Method
Top 0 Bottom 8
Ft. portland tremmie
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 12 ' Bottom 27
Ft.1 in. .020 in. PVC
Top Bottom
Ft in. in.
Top. Bottom
Ft in. in.
:-10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10 Bottom 27
Ft. Med. Quartz
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0 / 21
brown clayey Sandy silt
21 / 27
/
/
/
/
/
: 12. REMARKS:
silty sand
n Inlr i nnan
14 6Y Ei "y
�•r a n•rrnP • ItlImp
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTR I ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AN F THIS
RECORD HAS BEEN PROVI D TO THE WELL OWNER.
J�_, 111 11/15/13
SIGNA URE OF RTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of cornpleti®n to: Division of Water Quality. -_ Intorrhatio'n Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, -NC. 27699-161, Phone: (919) 807,-6300

NONRESIDENTM WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION 93580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERM
OTHER ASSOCIATED PERMIT#(ifapplicable)
SITE WELL ID #(if applicable)IW-13
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /24/13
d. TOP OF CASING IS -.25 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): METHOD OF TEST_
: f. DISINFECTION: Type Amount
g.J WATER ZONES (depth):
Top
Bottom
Top
Bottom
: Top
Bottom
Top
Bottom -
Top
_ Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0
Bottom 12
Ft.-
Sch 40 PVC
: Top
Bottom
Ft
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0
Bottom 8
Ft. pordand
tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
4. WELL LOCATION:
: 9. SCREEN: Depth
Diameter Slot Size Material
Hwy 15-501 + 401 Bypass
: Top 12 Bottom 27
Ft. 1 in. .020 in. PVC
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
:Top Bottom
Ft. in. In.
CITY: Laurenburg COUNTYScotland
Top Bottom
Ft in. in.
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Wflat []Ridge ❑Other
:10.SAND/GRAVEL PACK:
Depth
Size Material
34 47 50
LATITUDE @ ° " DMS DID
: Top 10 Bottom 27
Ft. Med. Quartz
LONGITUDE 79 ° 27 ' 40 " DMS DID
; Top Bottom
Ft.
Latitude/longitude source: OPS Uopographic map
; Top Bottom
Ft.
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
; 11. DRILLING LOG
Top Bottom
Formation Description
former Eaton Corporation
0 / 21
brown clayey sandy silt
Facility Name Facility ID# (if applicable)
21 / 27
silty sand
see above
/*
° �r U, \'rt �! v R—J
Street Address
see above NC
/
City or Town State Zip Code
/
hI Q \/ 9 IT11 i I
Mike Stanforth
/
/
rR ,a ,rzs l ' 6F-( 1fION
Contact Name
PO Box 6172
1oprl(..F,';MGUNI
Mailing Address
Gastonia NC 28056
/
/
City or Town State Zip Code
: 12. REMARKS:
�F'
(704 ) 853-0800
Area code Phone number
n. r i �D1�
+d�tB
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCOR8ANCE 9TH
6. WELL DETAILS:
27
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HASBEENP OVI ELL OWNER. qI�°�
a. TOTAL DEPTH:
N1 �l/13
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
:. SIGN TURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 19 FT.
Bryan Vest
(Use "+" if Above Top of Easing)
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Within 30 days Of odipietlon t0: ®iV151on off Water Quality - Information "Processing, Rev. 2/09
,Submit
11617Mil Service Center,.Ralei 6-NG.27.699-161, Phoe�e":,(919)'SOP-6300

V 7', '✓Ot
1. WELL CONTRACTOR:
Bryan Vest
NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3580
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-14
3. WELL USE (Check One Box) Monitoring [IMunicipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLEDI 1 /24/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYSCotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope []Valley Wl flat []Ridge ❑Other
LATITUDE 34 (D .47 '50 " DMS DD
LONGITUDE 79 @ ° 27, 40 " DM5 DD
Latitude/longitude source: OPS Qropographic map
(location of well must be shown on a USGS topo map andaifached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name
Facility ID# (if applicable)
see above
Street Address
see above
NC
City or Town
State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia
NC 28056
City or Town
State Zip Code
7( 04 ) 853-0800
Area code Phone number'
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO e
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS -•25 FT. Above Land Surface*
*Top of casing terminated attor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
: f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0 Bottom 12
Ft. 1" SCh 40 PVC
Top Bottom
Ft.
Top Bottom
Ft
8. GROUT: Depth
Material Method
Top 0 Bottom 8
Ft. portland tremmie
:,Top Bottom
Ft.
Top Bottom
Ft.
: 9. SCREEN: Depth
Diameter Slot Size Material
Top 12 Bottom 27
Ft. 1 in. .020 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10 Bottom 27
Ft. Med. Quartz
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0 / 21
brown clayey sandy silt
21 / 27
silty sand
/
/
:12 REMARKS:
"'1! tj d tf'•`° ti i? F. f li= t� l
UV 2 0 ZU13
vntCrl,duei,_Jt Y b L,IIUN _
Via I if1R. uwl 17, IIVl� Uiut
l�r° aerAn
I DO HEREBY CERTIFY THAT THIS WELL WAS CONS-NOC'FED Ih ACCORDANCE WITH'
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
: RECORD HAS BEEN PROVIDE TO THE WELL OWNER.
�
SIGNATrJRE OF CERTIFIED WELL CONTRACTOR DATE
Bryan Vest ,
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit Within 30 days'of completion to: Division of Water Qulality information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone :[phone]

y'
NONRESIDENTIAL
<< � vp `
WELL CONSTRUCTIONRECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
3580
WELL CONTRACTOR C)EI3TIIF'ICATI®N #
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(ifapplicable)
SITE WELL ID #(if applicable)IW-15
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ �g
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection Lwl
Irrigation❑ Other ❑ (list use)
DATE DRILLED11124/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley Wfiat []Ridge []Other
LATITUDE 34 @ .47 50 " DMS DD
LONGITUDE 79 0, 27,40 " DMS DID
Latitude/longitude source: OPS ElT'opographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name
Facility ID# (if applicable)
see above
Street Address
see above
NC
City or Town
State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia
NC 28056
City or Town
State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
27
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ , NO e
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if�Above Top of Casing)
d. TOP OF CASING IS -.25 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0
Bottom 12
Ft,
Sch 40 PVC
Top
Bottom
Ft
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
Top 0
Bottom 8
Ft. portland tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:.
Depth
Diameter
Slot Size Material
Top 12
Bottom 27
Ft.1 in.
.020 in. PVC
Top
Bottom
Ft. in.
in.
Top
Bottom
Ft: in.
in.
10. SAND/GRAVEL
PACK:
Depth
Size
Material
Top 10
Bottom 27
Ft. Med.
Quartz
Top
Bottom
Ft.
Top
Bottom
Ft.
: 11. DRILLING LOG
Top Bottom Formation Description
0 /21
21 /27
/
/
/
/
/
: 12. REMARKS:
brown clayey sandy silt
silty sand
nlny
I DO HEREBY CERTIFY THAT THIS WELL & = rC( 6 E WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN
PROVIDED TO THE WELL OX%NER, 16 20
, 1 /15/13
SIGNATORE OF CERTIFIED WELL CONWO G DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
UNP
Form
S�Ubft It Within 30 days ®f coirnpletion to: Division of Wat-r 6091lty information -Processing, Rev. 2/09 1b
1617 Mail Service Center, Raleigh,' NC 27699-161, Phone [phone]

ONRE `IIDEATTML WELL CONSTRUCTION RECORD C
North Carolina Deparhnent of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR ®R CERTIFICATION # 3580
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor( Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-16
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection 01
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /24/13
4. WELL LOCATION:
,Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley .Wflat ❑Ridge ❑Other
LATITUDE 34 0 -47 e50 " DMS DD
LONGITUDE 79 0 ° 27.40 " DMS DD
Latitude/longitude source: OPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above NC
City or Town State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia NC 28056
City or Town State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS -.25 FT. Above Land Surface*
*,Top of casing terminated
at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
;Top Bottom
Top Bottom
Thickness/
:7. CASING: Depth
Diameter Weight Material
Top 0 Bottom 12
Ft. 1" SCh 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0 Bottom 8
Ft. portland tremmie
Top Bottom
Ft.
Top Bottom
Ft.
: 9. SCREEN: Depth
Diameter Slot Size Material
Top 12 Bottom 27
Ft. 1 in. .020 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10 Bottom 27
Ft. Med. Quartz
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0 /21
21 / 27
/
/
/
/
/
Formation Description
brown clayey sandy silt
silty sand
REMARKS:12.
- t, r"- I, �, 4 f+�
,rn�UH�-'•� 7it� IVi�
100 HEREBY CERTIFY THAT THIS WELL WAS CO ,S RUOTEQ IN 1;aC4RDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, D THA`TA a0' OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
11 /15/13
SIGNATIJREOFCKRTIFIEDWELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days f of .cornpleh to: Division of Water Quality. - InforrMation Or®cessing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

r` ra STATE Z ,
®ITT REsiDE'N7I'm WELL coNsTIiI cTioN REco"
1 V
North Carolina -Department of Environment and Natural Resources- Division of Water Quality
CERTIFICATION if 3580
WELL CONTRACTOR
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor (,Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
910 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(ifapplicable)
SITE WELL ID #(if applicable)IW-17
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED11 /24/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley eflat []Ridge ❑Other
LATITUDE 34 @ °47 '50 "DMS DID
LONGITUDE 79 (D° 27 .40 "DMS DC
Latitude/longitude source: OPS []Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above NC
City or Town State
Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia NC
28056
City or Town State.
Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
TOTAL DEPTH: 27
a.
\
b. DOES WELL REPLACE EXISTING WELL? YES ❑
NO OV
c. WATER LEVEL Below Top of Casing: 19
FT.
(Use "+" if Above Top of Casing)
i
d. TOP OF CASING IS -•25 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance
with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0 Bottom 12 -
FtJ SCh 40 PVC
Top Bottom
Ft
Top Bottom
Ft
: 8. GROUT: Depth
Material Method
Top 0 Bottom 8
Ft. portland tremmie
: Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 12 Bottom 27
Ft.1 in. .020 in. PVC
Top Bottom
Ft in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 10 Bottom 27 ,
Ft. Med. Quartz
Top Bottom
Ft.
Top Bottom
. Ft.
11. DRILLING LOG
Top "
Bottom
Formation Description
0
/ 21
brown clayey sandy silt
21
/ 27
silty sand
/
/
/
'fin,
/
'+a n All norNPCCCIP,IC I IN'P'
: 12. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS NQ ���r�r!!
C\OPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WE OW �pY � _ R
�! 11 /15/13
SIGNS OF CERTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit Within 30 days of compieiiion,tto: Division of Water Quality Int'ormi anion Processing, Rev. 2/09
IM7 Mail Service Center, Raleigh, NC 27699461, Phone : [phone]

ST
'-TY
NoNRESIDE'NLT'1�Ai� WELL CONSTRUCTION RECORD
21 North Carolina Department of Environment and Natural Resources- Division of Water Quality
3580
WELL CONTRACTOR CERTIFICA'I`I®N #
1. WELL CONTRACTOR:
Bryan Vest
Well Contractor f Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town State Zip Code
9( 10 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(ifapplicable)IW-18
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ �
Industrial/Commercial ❑ Agricultural ❑ Recovery ElInjection @01
Irrigation❑ Other ❑ (list use)
DATE DRILLEDI1124/13
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name,'Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC /LAND SETTING: (check appropriate box)
[]Slope []Valley y�Plat []Ridge []Other
LATITUDE 34 ® .47 50 " DMS DD
LONGITUDE 79 (g ° 27, 40 " DMS DD
Latitude/longitude source: OPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name
Facility ID# (if applicable)
see above
Street Address
see above
NC
City or Town
State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia
NC 28056
City or Town
State Zip Code
7( 04 ) 853-0800
Area code Phone number
6. WELL DETAILS:
27
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IV
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
i! a Cia
�i1 v0
.•
d. TOP OF CASING IS -•25 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom .
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter.
Weight Material
Top 0
Bottom 12
Ft. 1"
SCh 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
Top 0
Bottom 8
Ft. portland tremmie
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top 12
Bottom 27
Ft.1 in.
.020 in. PVC
Top
Bottom
Ft. in.
in.
Top
Bottom
Ft. in.
in.
10. SAND/GRAVEL
PACK:
Depth
Size
Material
Top 10
Bottom 27
Ft. Med.
Quartz
Top
Bottom
Ft.
Top
Bottom
Ft.
: 11. DRILLING LOG
Top Bottom Formation Description
0 / 21 brown clayey sandy silt
21 127 silty sand
IVUV 2 U Ui.,
12. REMARKS:
DEC 16 [0
100 HEREBY CERTIFY THAT THIS WELL WAS CONS T D IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AN OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
11/15/13
SIGN • URE OF CERTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality'..;..Information Processing, Form /09
'� Rev. 2/09
16'17 Mail Service center, Raleigh, NC 27699-161, Phone :,(919..1807-6300

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NON R 'ONS'TRUCTION RECORD
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North Carolina Department of Environment and Natural Resources- Division of Water Quality
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WELL CONTRACTOR CERTIFICATION # 35�0
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1. WELL CONTRACTOR:
'Bryan Vest
Well Contractor (Individual) Name
Ransier Environmental Drilling, Inc.
Well Contractor Company Name
1 Piney Point
Street Address
Whispering Pines NC 28327
City or Town, State Zip Code
(910 ) 690-6688
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERM
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-19
3. WELL USE (Check: One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection v
Irrigation[] Other ❑ (list use)
DATE DRILLE011 /24113
4. WELL LOCATION:
Hwy 15-501 + 401 Bypass
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Laurenburg COUNTYScotland
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope .❑Valley y0hat ❑Ridge []Other
LATITUDE 34 @ .47,50 " DMS DD
LONGITUDE 79 ® ° 27,40 " DMS DD
Latitude/longitude source: OPS OTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
former Eaton Corporation
Facility Name Facility ID# (if applicable)
see above
Street Address
see above NC
City or Town State Zip Code
Mike Stanforth
Contact Name
PO Box 6172
Mailing Address
Gastonia NC 28056
City or Town State Zip Code
(704 ) 853-0800
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NOV
c. WATER LEVEL Below Top of Casing: 19 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS --25 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm):
METHOD OF TEST
f. DISINFECTION: Type
Amount
g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top -
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0
Bottom 12
Ft. 1"
Sch 40 PVC
Top
Bottom
Ft
Top
Bottom
Ft
8. GROUT:
Depth
Material Method
Top 0
Bottom 8
Ft portland tremmie
Top
Bottom
Ft.
= Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top 12
Bottom 27
Ft.1 in.
.020 in. PVC
Top
Bottom
Ft, in.
in.
Top
Bottom
Ft. in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 10
Bottom 27
Ft. Med.
Quartz .
Top
Bottom
Ft.
Top
Bottom
Ft.-
1. DRILLING LOG
Top Bottom Formation Description
0 / 21 brown clayey sandy silt,
21 / 27 silty sand
F, IA P i it
12. REMARKS:
100 A NCAC 2C, WELL CONHA
HEREY CERTIFY TT STRUCTIONT ARS WE S fflIN A COPY OF THIS WITH
RECORD HAS BEEN P'VIDED TO THE WELL OWNER.
,tit l�U 11 /15/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
Bryan Vest
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GWA b
Submit within 30 days of completion to: Division of-Watelr QuMity - Inforritation Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC.27699-161, Phone : [phone]QQ