NC0003433_Cape Fear AMEC PZ Records CHATH-075_20150902

December 7, 2015
Mr. Dale Smith
Program Manager
Duke Energy
526 South Church Street
Charlotte, North Carolina 28202
Submitted by email: [e-mail]
Subject: Record of Piezometer Installation
Cape Fear Steam Station 1956 Ash Pond
State Dam ID CHATH-075
Chatham County, North Carolina
AMEC Project No.: 7810-14-0154
Mr, Smith,
ameO
As part of the Reconstituted Design project for Cape Fear Steam Station (Cape Fear),
AMEC installed a total Of four new piezometers in the existing 1956 Ash Pond (CHATH-
075). Details regarding the piezorneter installation are attached including a location plan, a
summary table, field installation records, and well construction records. The
piezometers constructed in CHATH-075 were completed on December 18, 2014.
The piezorneters were constructed in accordance with the requirements of 15A NCAC
Subchapter 2C — Well Construction Standards by a certified well driller licensed in the State of
North Carolina under the supervision of the Professional Engineer (PE) licensed in the state of
North Carolina whose seal is attached to this letter. Details of the piezometers installed are
attached and include field installation records reviewed by the Engineer of Record (EOR) and
well construction records prepared by the certified driller. The field installation records are
surnmarized in Table 1. The work was completed in accordance with approved work plans and
piezometer installations were completed with a standard of care commensurate with accepted
industry standards and in a manner that did not alter the existing function or stability of the dam
structure.
The piezometers were installed to provide data to be used during the Reconstituted Design but
are also intended for long term data collection by Duke Energy. AMEC will collect monthly
readings in the piezometers until March of 2015 at which time responsibility for obtaining the
readings will be transferred to Duke Energy personnel as a part of their plant specific
instrumentation monitoring program. Additional readings between the normal scheduled
frequency may be taken as deemed necessary to support data collection needs. Duke Energy
shall maintain a record of the readings as part of their dam monitoring program that will be
available to the Division of Energy, Mineral, and Land Resources upon request.
Correspondence;
Amec Foster VAteler Environment Mnfnastructure, Inc
2801 YorkiriontRipad,Suiw 100
Chadom, Nonh Carolina 28208
Tel [phone](K)
Fax [phone]
Liveii,,tirc:NCr::T)ViIICCI'illgF-1253 NCGeology C-2247

Record of Piezometer Installation — CHATH-075
December 6, 2015
Page 2
Sincerely,
AMEC Environment S Infrastructure, Inc.
R. Bradford Tripp, P.E,
E©R- Project Engineer
Cape Fear Steam Station
AMEC Project No.: 7610-14-0154
+"411114AII,,►r
.., �+
'r+��r���rl�ll►1
Attachments:
Piezometer Location Plan, Figure 1
Summary of Piezometers Installed in 1956 Ash Pond, Table 1
Typical Piezometer- Field Installation Record, CHATH-075-P100
Well Construction Record, CHATH-075-P100
Typical Piezometer- Field Installation Record, CHATH-075-P'l09
Well Construction Record, CHATH-075-P101
Typical Piezometer- Field Installation Record, CHATH-075-P102
Well Construction Record, CHATH-075-PI02
Typical Piezometer- Field Installation Record, CHATH-075-P103
Well Construction Record, CHATH-075-P103

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TYPICAL PIEZOMETER -FIELD INSTALLATION RECORD (FLUSH MOUNT)
JOB NAME Cape Fear Phase 2 Reconstitution of Ash Pond AMEC NUMBER 7810-14-0154
PIEZOMETERNO CHATH-075-P100 INSTALLATION DATE 1211712014
LOCATION' NORTHING: 672,718.8' FASTING; 1,985,333.1' GROUND ELEV: 175.20'
AMEC FIELD REPRESENTATIVE 13. Mabie DRILLER] CONTRACTOR SAEDACCO
GRANULAR BACKFILL MATERIAL GP #2 Quartz Sand DRILLING TECHNIQUE Hollow Stem Auger
SCREEN MATERIAL 2" I.D. Flush Joint Slotted PVC (Sch. 40 BOREHOLE DIAMETER 8" Nominal
SLOT SIZE 0.020" Machine Cut REFERENCE POINT"" ELEVATION"
RISER MATERIAL 2" I.D. Flush Joint Solid PVC (Sch. 40 LOCK TYPEIKEY CODE Dolphin 1600
Preliminary -Final locationlelevation to he determined by As -Bunt Survey
Reference point is notch cut in the top of PVC casing
WELL CAP
BOLTED FLUSH MOUNT COVER
(approx. V BELOW GRADE)
CONCRETE PAD
(2'X2'X6")
GROUT
DEPTH TO TOP OF
BENTONITE SEAL
13.0 FEET
BENTONITE SEAL (Min. 3 feet)
DEPTH TO TOP OF
GRANULAR MATERIAL
18.0 FEET
SCREEN
GRANULAR BACKFILL
CENTERING DEVICES INSTALLED
(APPROXIMATE DEPTHS)
= NIA.
NOTE: NOT TO SCALE, ALL DEPTHS RECORDED
ARE RELATIVE TO EXISTING GROUND SURFACE
AT TIME OF INSTALLATION
GROUND
TOTAL. DEPTH
OF PIEZOMETER
LENGTH OF RISER/ - 30.0 FEET
SOLID SECTION
= 20.0 FEET
DEPTH TOP OF
SCREEN SECTION
20.0 FEET
LENGTH OF SCREEN/
SLOTTED SECTION
10.0 FEET
DEPTH BOTTOM OF
SCREEN SECTION
30.0 FEET
OF SUMP & CAP
STABILIZED WATER
LEVEL AFTER
DEVELOPMENT
N/A FEET
BELOW TOP OF
STICKUP
MEASURED ON
N/A DATE
SUMPICAP
0391-71 - BOTTOM OF PIEZOMETER
:A
,fir ry=■' ��f�,�q •.; "C.T1N+�'�!'y4�}y1`
eo
Site Manager ReviewDate: ! I
AMEC_N+eA lnstallatian Record, Rev 0

WELL CONSTRUCTION RECORD
This form can be used for siuglo or multiple weirs
1. Well Contractor Inforrnalion:
William J. Mabie
Well C.entrncwr Nnme
3137A
NC Well Contractor Certification Number
AMEC
Company Name
i 2. Well Construction Permit 9:
List all applicable ivell perait(s (I. e. Colmly. Stale, parinrlee, Iglacllon, etc)
3. Well Use (cheek well use):
Witte], Supply Well:
OAgricultural DMunicipnMblic
❑Geothermal (Reating+Cooling Supply) f3Residontial Wnteir supply (single)
i ❑hldustriallCoinrncreial OResidenllal Water Supply (shared)
❑Irri ation
Non -Water Supply Nell:
Injection Well:
j
13Agnifer Recharge
©Groundwater Remediation
ClAquiferStorage and Recovery
d5aiinity Barrier
OAquifcr Test
1=15tormwater Drainage
DExperimentat Technology
❑Subsidence Control
Meothermal(Closed Loop)
[]Tracer
00cothermal (1-leatinglC0olin Return)
ClOther (explain under P21 Remarks)
4. Date. Wells) Compteted: 12/17/2014Well ID# CHATH-075-Pl 00
So. Well Location:
i
DUKE ENERGY -CAPE FEAR STEAM STATION
rocitity/owner Name
Facility ID# (if applicnble)
500 CP&L ROAD, MONCURE, NC 27559
Physicid Address. City, and Zip
CHATHAM
For Internal Use ONLY:
14aVATM ZON1
ft. ft.
ft, ft.
10.0 ft. 120,0 ft, 12 in• I SCH 40 1 PVC l
A. ft.
fL ft.
rr]atnror zo nrAnrsrea SLOT$IZL -rutcKNEss rer 'ruw�r.
20.0 ft. 30.0 Et, 2- in, 0.02 SCH 44 PVC
ft. I In.
0.0 ft, 110 it, Cement Slurry
ft. ft.
El. ft.
Rhos TO NIATOFAL L
18.0 ft' 30.0 Et' Quartz Sand
ft. ft.
EENT©NiTE SEAL FROM 13,0 TO 18,0 FEET
County Parcel ]dent ifcation No. (PW)
56, Latitude and Longitude in degreesltnhrriteslseconds or dechnol degrees:
x2Certific
(ifvvcll field, one IaVlong is snfficiont)
, iton;
350 35' 54,22" 790 02' 57.62" W
/
Signature of arilicd I atr Date
G. Is (arc) the well(s); ®PermAnent or ClTemporary
By sigering flits form, h eby cer•tyy drat die +vell(s) was (were) constructer! In accorxkrnce
7. Is this a repair to an existing well: Oyes or, LINO
ivlth 15A NCAC 02C . 40 or 1SA NCAC 02C .0200 Wall Construdlon Standards and lbal a
copy of this record has been prailded to the well owner:
{arts Is a repah•, fill out known ivell conshY+cllon Infomiallori turd explain the natura of the
repair mrder921 rewm-1 ssectlon or on (lie ban$ afllrifJor+n,
21 Site diagram or.additionni well details:
.s
I
S. Number of
You may use the back of tilts page to provide additional well site (letai s or well
wells
construction decails. You may also attach additional pages if necessary.
For )-non-rncted:
n+irltlpte h�ecilou ar non-rmtar supply nwtfs ONLI' wirh lice srrnsr raaslrncllarr, yar ran
subrnit oneforrn,
S1J11rvIITTAL INSTUCfIONS
9. Total well depth below l;tncl surface: 30.0 00
24a, For All Wells; Subunit this form within 30 days of completion of well
11ornadltple wells Ilsl all depilis Y"di/fererrl {"example-3©200' and 2@_1017)
Construction to the fallowing:
10. Static wAter level below top of ensing: NIA (ft,)
Division of Water Resources, Information Processing Unit,
If molar level is above wising, rise "+"
1617 fVInil Service Center, RnIeigh, NC 27699-1617
I1. Borehole dinarcter: (in.)
24b. FQr Injection Wells ONLY. In addition to sending the fdnn to the address in
12. Well AUG24a
above, also submit a copy of this farm within 30 bays of completion of well
construction method:
construction to the following:
(im. auger, rotary, cable, direct ptish, ctc.)
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY:
1636 Mail Service Center-, Raleigh, NC 27699-1636
13n. Yield (gpm) Method of test:
24c. For Waters° Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
13b. Disinfection type: Amount:
well construction to the county healdn department of the county where
constructed.
Form GW-1 North Carolina Deparlmeat of Environment and
Natural Resanrces —Division of Waler Resources Revised Aqust2013

TYPICAL PIEZOMETER -FIELD INSTALLATION RECORD (FLUSH MOUNT)
JOB NAME Cape Fear Phase 2 Reconstitution of Ash Pond AMEC NUMBER 7810-14-0154
PIEZOMETER NO CHATH-075-P101 INSTALLATION DATE 12/17/2014
LOCATION* NORTHING: 672,294.1' EASTING: 1,985,551.7' GROUND ELEV: 184.39'
AMEC FIELD REPRESENTATIVE D. Atkinson DRILLER/ CONTRACTOR Mid -Atlantic Dril
GRANULAR BACKFILL MATERIAL GP #2 (Quartz Sand) DRILLING TECHNIQUE Hollow Stem Au
SCREEN MATERIAL 2" I.D. Flush Joint Slotted PVC (Sch. 40 BOREHOLE DIAMETER 6" Nominal
SLOT SIZE 0.02.0"° Machine Cut REFERENCE POINT- ELEVATION'
RISER MATERIAL 2" I.D. Flush Joint Solid PVC (Sch. 40) LOCK TYPEIKEY CODE Dol abhin 1600
' Preliminary -Final location/elevation to be determined by As -Built Survey
" Reference point is notch cut in the top of PVC casing
WELL CAFE
BOLTED FLUSH MOUNT COVER
(approx. 1' BELOW GRADE)
CONCRETE PAC]
(2'X2'X6")
GROUT
NOTE: NOT TO SCALE, ALL DEPTHS RECORDED
ARE RELATIVE TO EXISTING GROUND SURFACE
AT TIME OF INSTALLATION
DEPTH TO TOP OF RISER
BENTONITE SEAL
- 5.0 FEET
BENTONITE SEAL (Min. 3 feet)
DEPTH TO TOP OF
GRANULAR MATERIAL
= 8.0 FEET
SCREEN
GRANULAR BACKFILL
CENTERING DEVICES INSTALLED
(APPROXIMATE DEPTHS)
- N/A
�;;�,
LENGTH OF RISER/
SOLID SECTION
= 10.0 FEET
DEPTH TOP OF
SCREEN SECTION
- 10.0 FEET
LENGTH OF SCREEN/
SLOTTED SECTION
- 10.0 FEET
��
�•
DEPTH BOTTOM OF
r''+,,+ SCREEN SECTION
OC '+r 20.D FEET
SUMP/CAP
ameO
Site Manager Review
:?qp l = 0.4FEET
0
G
GROUND
TOTAL DEPTH
OF PIEZOMETER
r 20.4 FEET
STABILIZED WATER
LEVEL AFTER
DEVELOPMENT
NIA FEET
BELOW TOP OF
STICKUP
MEASURED ON
NIA DATE
BOTTOM OF PIEZOMETER
AMEC Wef! 7nglaffalfan Record, Rev 0

WELL CONSTRUCTION RECORD
'rliis form can be used for single or multiple wells
1, Well Contractor Information:
William M. Wiggins
Well Contractor Name
3470
NC Well Contractor Cerrification Number
MID -ATLANTIC DRILLING, INC.
Company Name
2. Well Construction permit I►:
►,isi all applicable +raft permits f,e. County, Srale, I an"lrce, lnjecrion, vie.)
3. Well Use (check well use):
Wn ter Supply Well:
OAgricultural
❑Geothermal (Heating/Cooling Supply)
❑ Indust ria I/Commercial
131rri tion
Yon -Water Supply rt'W'ell:
[AMonitoring
❑Aquifer Recharge
Cl Aquifer Storage and Recovery
DAquifer Test
[)Experimental Technology
❑Geothermal (Closed Loop)
IlGeothcratat (Hea inu/Coolinc 1
❑Munict`pal/Public
❑Residential Water Supply (single)
OResidential Water Supply (shared)
ORecovery
❑Ground,,vwer Remediation
DSalimty Barrier
OStormwatev Drainage
0Subsidence Control
❑Tracer
130ther (explain under #21 Remarks
4. Datewell() Completed: 12/15/2014Well t139 CHATH-075-P101
5a, Well Location:
DUKE ENERGY - CAPE FEAR STEAM STATION
Facili[ -- Owner Name Facility IDN (ifapplicahte)
500 GP&L ROAD, MONCURE, NC 27559
Physical Address, City, and Zip
CHATHAM
County
Parcel lden6Ee pion No.1P1N)
5h. Latitude and Longitude in degrees/minuteslseconds or decimal degrees:
(ifwell field, one IaL'long is sufficient)
350 35r 50.02"
N 79e 02' 54.97"
6. Is (are) the well(s): OP'trmanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or FINo
Ohl -I it a repair, fili our brown well consrrurnon uformation and explain oho rraturr of the
,"ir under R 21 m nar#s .rec+ion or on ilia hock of thlr%arm.
R. Numbcr orwells coustructed. i
for malriple inje•cnon or nor -wirer supply wells ONLY will, the seine consirurrlon, 1-urr Can
mlinut onefom,
9. Total well depth below land surface. 20A A)
For rntd0plr. well r #st all depths if d(fer em (example- 3 gg?t70' and ?C 100' I
to. Static water level below top of casing: N/A
I/uvior local is above casing, use "- "
I I. Borehole diameter. 8 (in.)
12. well construction method: AUG ER
(i C auger, Totay, cable, direct push, otc.)
For Internal last ONLA':
l i. W ATE
ZONES
FROM
TO
nFsCRiYf of
ft.
ft.
ft.
ft.
15. OUTER CARING (for
mull -rased wells) O l
FRO61
TO
DIAMEnft
TRe
M,
d?.0 ft
10,0 rt.
P sn
SCH 40 PVC
16. INNER
CASING o'R TUBING eotbertnal
closed -too
FROM
TO
uG+tig:rER
TAICKNVSS
MATERL4L
ft.
ft.
ln.
ft.
ft.
17. SCREEN
FROM
To
AIA1lfTER SLOT SME
"flflCKNFSS
MATERl41.
10.0 fr.
20.0 ft.
2 in. 0.01
1 SCH 40
PVC
ft.
ft.
in
IS. GROUT
FROM
TO
aLkTERIAL
FAW ACEMENT NILTHOP & A.MOLN-17
ft.
ft.
ft.
ff.
ft.
ft.
I9. SANDIGRA'VEL PACIti
tfa ncable
PROM
I to
I MATERIAL
F.1tPLACF11iEh'r 1tE7TiOtF
8.0 ft,
20.4 rr,
Quartz Santa
ft.
ft
20. DRILLING
LOG an$ch addirional sheers ifnece.s;ary
FROIAt
TO
nESCR1PCION .uiur; hzrilne% 1011/rocktypt, gnN star. el r,
V.
ft.
rt.
fr.
ft.
fr.
ft
rt.
ft.
ft.
ft,
ft.
ft.
fY.
Zl, REi1AR#iS
BENTONITE SEAL FROM 5.0 TO 8.0 FEET
22. Certification:
Siynatirre of Certified Well Contractor r%/ Date
kv signing Arts form. I here4v cerltfv that the vswll(sl r+tss (ireror canstrx+cted in aceapdarrce
wnh 15.4 NCAC' 02C.o10(i or ]Sri NCAC 02C' ,0200 Well Cmtoruction Standards and that a
copy, of this record has been pmvided to the well Owner.
23. Site diagram or additional well details:
Yon may use the back of this page to provide additional %yell site details or hell
construction details. You may also anach additional pages if necessary.
SUBDIMAL INSTUCTIONS
24a. For All N%rells: Submit this form within 30 days of completion of well
construction to the follonring'
Divislon of Water Resources, Information Processing Urrit,
1617 MAI Service Center, Raleigh, NC 27699-1617
24b. For Irdectign wells ONLY: In addition to sending the Form to the address in
24a above, also submit a copy of this Form within 30 days of completion of welt
construction to the following:
Division of Water Rtsourecs, Underground Injection Cnntrul Program,
FOR WATER SUTPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test- lac. For Witter Supply & Injection Wells:
Also submit cane copy of this form within 30 days of completion of
13b. Disinfection tape: Amount: well construction to the county health department of the county where
constructed,
Form CrW-I Nord, Carolina Dcparuticnt of Environment and Natural Resources - Division of Water Resources Revisal Auttusi 20 13

TYPICAL PIEZOMETER -FIELD INSTALLATION RECORD FLUSH MOUNT
JOB NAME Cape Fear Phase 2 Reconstitution of Ash Pond AMEC NUMBER 7810-14-0154
PIEZOMETER NO CHATH-075-P102 INSTALLATION DATE 12116/2014
LOCATION* NORTHING., 672,684.0' FASTING: 1,985,320.3' GROUND ELEV: 187.01
AMEC FIELD REPRESENTATIVE B. Mabie DRILLER/ CONTRACTOR Mid -Atlantic Drill
GRANULAR BACKFILL MATERIAL GP #2 Quartz Sand DRILLING TECHNIQUE Hallow Stem Aut
SCREEN MATERIAL 2" I.D. Flush Joint. Slatted PVC (Sch. 40j BOREHOLE DIAMETER 8" Nominal
SLOT SIZE 0.020" Machine Cut REFERENCE POINT— ELEVATION'
RISEN MATERIAL 2" I.D. Flush Joint Solid PVC (Sch. 40) LOCK TYPE/KEY CODE Dolphin 1600
" Preliminary -Final locationlelevation to be determined by As -Built Survey
" Reference point is notch cut in the top of PVC casing
WELL CAP
BOLTED FLUSH MOUNT COVER
(approx. 1 ° BELOW GRADE)
CONCRETE PAD
(2'X2'X6")
GROUT
NOTE: NOT TO SCALE, ALL DEPTHS RECORDED
ARE RELATIVE TO EXISTING GROUND SURFACE
AT TIME OF INSTALLATION
DEPTH TO TOP OF RISER
BENTONITE SEAL
- 8.0 FEET
BENTONITE SEAL Min. 3 feet)
)
DEPTH TO TOP OF
GRANULAR MATERIAL
= 13.0 FEET
SCREEN
GRANULAR BACKFILL
CENTERING DEVICES INSTALLED
(APPROXIMATE DEPTHS)
= NIA
LENGTH OF RISER/
SOLID SECTION
= 15.0 FEET
DEPTH TOP OF
SCREEN SECTION
15.0 FEET
LENGTH OF SCREEN/
SLOTTED SECTION
= 10.0 FEET
DEPTH BOTTOM OF
SCREEN SECTION
- 25.0 FEET
k" H OF SUMP & CAP
GROUND
TOTAL DEPTH
OF PIEZOMETER
25.0 FEET
STABILIZED WATER
LEVEL AFTER
DEVELOPMENT
NIA FEET
BELOW TOP OF
STICKUP
MEASURED ON
NIA DATE
SUMP/CAP K:
Q3g1�1 BOTTOM OF PIEZOMETER
•A
amedy
"�'"rrariitiwti►x�►
Site Manager Review J _ % 6,C2) Data: 11 y111' .
MdECL Well fnstaRak?n Retard. Rev 0

i
WELL CONSTRUCTION RECORD
This foray nun be used for single or nsultfple walls
1. Well Contractor Infarmadow
William J. Mabie
Well Contractor iN8nie
3137A
NC Well Contractor Certification Number
AMEC
Cou111.741y Nanue
2. Well Construction Permit #:
Lest all arppRouble wallperrnfts (i.e. Cotprty, Stale, G'arlartce, IlVecdlorr, etc.)
3. Well Use (check well use):
Water supply 1Well-
❑Agricultural ❑Municipal/Pubt is
00cother11101 (Hcating/Ceoling Supply) OResidential Water Supply (single)
111ndustrial/Commercial ❑Residential Wetter Supply (shared)
Non -Writer Supply Well:
telMonitoring
r7Recovery
Injection Well:
-
DAquifer Recharge
El Groundwater Remediatioii
[Aquifer Storage and Recovery
USalinily Harrier
fdAtluifer Test
❑Sloanwnter Drainage
❑Experinacnial Technology
❑Subsidenco Control
❑Crcothermat(Closed Loop)
❑Tracer
11 Gcollierm ul (1leoting/CooIing Return)
❑Other (exuinin under 021 Remarks)
4. Date Wells) Completed: 12/16/2014Well ID9 CHATH-075-P102
Sn, Well Location:
DUKE ENERGY - GAPE FEAR STEAM STAT*N
Facility0yaor Name Pacilily ID# (if applicable)
500 CP&L ROAD, MONCURE, NC 27559
Phyaioal Arhlress, City, nod Zip
CHATHAM
County Parcel Identification No. (PIN)
Sb. Lalitude and Longitude In degrees/111hintes/seconds or decimal degrees:
(if well field, one latltong is sufficient)
350 35' 53.87" N 790 02' 57.77"
6. Is (are) the well(s): oPermnnent or LITempernry
.v
7. Is tilts a repair to tin existing well: ❑Yes or FiNo
if thds Is a repair. fit out Amami Nell waste-mlfon hrforraation and explalo the mature of lie
repair rurder• 921 remarks seettos or an the back of!lily for•ar.
8. Number of wells eonstructcll: 1
Fa• muktple lydjcctdan or non -water supply svel£s ONLY with Me same corrstrrtelfprr. yolt can
subndtoueform.
9. Total well depth helow land surface: 25.0 (ft.)
For ruaktple wells list all depths {rd((J"ereul (eaanrple- 3@200'nad 2Q10')
10. Static water level below top of easing, NIA
11'Wier laver/ is above cashrg, use "+'.
11. I3orehoie dintncter: 8
12.Well construe (ion meth od: AUGER
For bitemal Use ONLY;
FROM
TO
UkSCRIPTION
ft.
ft,
%
tt,
t!
PRO;+1
TO
DIAMETER
TRIChrUss d41ATERl.\I.
0 rt.
15.0 «
2 in,
SCH 40 PVC
,"i , A
FROM
TO
f t tbe!'41 el"x f-tong _
Dipt11£.T&R THICKNESS AIATEMAL
ft.
fl.
In.
ft,
ft.
lu.
�_�
FROM
'10 DiANm u smyrs1ZE T111f'-K-r iSS
tFW7'EmIAL
15.0 ft.
25.0 n' 2 il'' 0,02 5CH 40
PVC
ft,
tt. fn,
0.0 ft. 8.0 ft, Cement slurry
rt, fl,
.. Z'�l� '�R stlMi1t�17Te'I
13.0 ft. 25.0 ft, Quartz Sand -
ft. I ft.
L44HENIARKS
EENTONITE SEAL FROM 8.0 TO 13.0 FEET
22. Certification:
Signature of Corti red Wo ontrrlctar Gate
By signing thls for7a I reby earthy that (lie ivell(s) was (were) oortstPr{edetl I,, accordrurce
Ivlti 13rf thCrlC �2C. 100 or 13R NCIC 02C.0200 Yell CmarlructImi Slaardardr and that a
copy offing record has been pravlded to the well owner.
23. Site diagram or additional well details.
You ¢say use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL LNSTUCTIONS
24a. For All 'Wells: Submit this form within 30 days of completion of welt
construction to the following;
Division of Water Resources, Information 1 r•ocessing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
29b. TgrSntectfon Wclls CJNI.Y: I addition 10 sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following;
(ix, augar, rotary, cable, direct push, etc,) j
Division of Water Rosoarces, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 MaP Service Center, Raleigh, NC. 27699.1636
i
13a. Yield (gpm) Method of test: 24c, For Water Snnnly & Injection Wells;
Also submit one copy of this form within 30 days of completion of
13b. Disinfection type: _ - Amount: well cnn.4miction to file county health department of the county where
constructed.
Fomr OW-1 North Carolina Departnrant or Enviroaumnt and Natural Resources - Division of Water Resources Revised August 2013

TYPICAL PIEZOMETER -FIELD INSTALLATION RECORD (FLUSH MOUNT)
JOB NAME Cape Fear Phase 2 Reconstitution of Ash Pond AMEC NUMBER 7810-14-0154
PIEZOMETER NO CHATH-075-P103 INSTALLATION DATE 12/1512014
LOCATION' NORTHING. 672,305.6' FASTING: 1,985,615.8' GROUND ELEV: 165,78'
AMEC FIELD REPRESENTATIVE D. Atkinson DRILLER/ CONTRACTOR Mid -Atlantic Drilling
GRANULAR BACKFILL MATERIAL GP #2 Quartz Sand DRILLING TECHNIQUE Hollow Stem Auger
SCREEN MATERIAL 2" I.D. Flush Joint Slotted PVC (Sch. 40 BOREHOLE DIAMETER 8" Nominal
SLOT SIT 0.020" Machine Cut REFERENCE POINT* ELEVATION"
RISER MATERIAL 21' I.D. Flush Joint Solid PVC (Sch. 40) LOCK TYPEIKEY CODE Dolphin 1600
Preliminary -Final Iocatton/elevation to be determined by As -Built Survey
Reference point is notch cut in the top of PVC casing
WELL CAP
BOLTED FLUSH MOUNT COVER j
(approx. 1' BELOW GRADE)
CONCRETE PAD
(2'X2'X6")
NOTE: NOT TO SCALE, ALL DEPTHS RECORDED
ARE RELATIVE TO EXISTING GROUND SURFACE
AT TIME OF INSTALLATION
GROUND
GROUT - TOTAL DEPTH
OF PIEZOMETER
RISER LENGTH OF RISER/ 15.0 FEET
DEPTH TO TOP OF SOLID SECTION
BENTONITE SEAL = 4.4 FEET
= GROUND SURFACE
BENT©NITS SEAL (Min. 3 feet) STABILIZED WATER
DEPTH TOP OF LEVEL AFTER
DEPTH TO TOP OF SCREEN SECTION DEVELOPMENT
GRANULAR MATERIAL - 4.6 FEET = N/A FEET
2.6 FEET BELOW TOP OF
STICKUP
MEASURED ON
SCREEN LENGTH OF SCREEN/ - NIA GATE
SLOTTED SECTION
GRANULAR BACKFILL = 10.0 FEET
CENTERING DEVICES INSTALLED
(APPROXIMATE DEPTHS) DEPTH BOTTOM OF
- NIA SCREEN SECTION
= 14.6 FEET
�: • NGTH OF SUMP & CAP
SUMP/CAP - •f~ r �� `$4 FEET
9'
SEAL t BOTTOM OF PIEZOMETER
0391/1
o
•Q
ame
s Z2 .,�
FOVID
Site Manager Review �J� Date: Il7�IJ .
AMEC Well insfalfaiiofi Reeord, Rev 0

WELL CONSTRUCTION RECORD
This form can be tried fat single or rrtnitipic wells
1. Well Contractor information:
William M. Wiggins
Wall Cernimctnr Name
3470
NC Well Cnnoactor Certiti moon Number
MID -ATLANTIC DRILLING, 1NC,
Company Mama
2, Well Construction Permit #:
List all orrrphcuhle well permits (r.e. C'ounty' Stale, Yarianrr, inrrrann, Ole,$
3. Well Use (check well use):
Hater Supply
❑Agricultural
❑Geolher mal (Hcating/Cooling Supply)
11 hzdustriaYcomm erc i al
Nun -Water Supply Well:
0monitoring
❑Aquifer Recharge
❑Aquifer Storage and Recovery
OAqui fee Test
OExperimental Technology
❑GetrthemraJ (Closed Loop)
❑N[unicipaUAublic
❑Residential Water Supply (single)
❑Residential Wattrr Supply (shared)
❑1 ccovery
❑Groundwater RemedIation
USalinity Barrier
OStoranrvater Drainage
DSubsidencc Control
❑Tracer
ClGeotherrnal (Heating/Cooling Return) G7Mer (explain under #21 Remarks.
J. Date Well(s) Completed: 1211512014R,elt met CHATH-075-P103
Sa, Well Location:
DUKE ENERGY - CAPE FEAR STEAM STATION
Facility%Owner NHmr Facility ID# (if appiicablel
500 CP&L ROAD, MONCURE, NC 27559
Physical Address, City, and Zip
CHATHAM
t'orrrrly Parcel Identificatimt No. tPIN)
a`b. Latitude and Longitude in degreeslminuteslscconds or decimal degrees:
(ifwcll field, one latilung issufScicnt)
350 35' 50.13" N 790 02' 54.19" `}
6. Is (are) the well(s): OPernwrient or ❑Temporary
7. Is this a repair to an existing well: El Yes or ElNo
if das as a repair, fill nut known well tamtrucnotr informemarr and explain Nra auluru rtf the
rertair under s 21 reaaurkr.rcedon or on the bark of dris fame.
8. Number of wells constructed: 1
Farmrhiple nn/eclean or non-wurer supply "Its 0.V[ 1' with rho smue rnustruchaft. )vu con
sutrarH one f—I
9, TotaI Sve11 depth below I a a d surface: 15`0 (ft.)
Fur orultrple trolls N.ri all depths ifelolrrenu (e-rumple- 3C20rJ^ and 2rar1(V
t0. Static yvater level below top oreasing: N/A fr. I
l(sralcr level is above casing, rase ^^
I I. Sorehale diameter: 8
12. Well construction method: AUGER
li•e. auger, rotary. cable, direct push,. ere.)
Fur lntcmal Use ONLY
1�
14. WATE ZONES
Frtoat
ro nFscRtt�fro;v
fit,
fit
ft
ft
IS. OUTER CASING. for nsuid-cased wells) [JR LItiER (if s iicsrb1e
F]ttlrT
TO hL TKETFA TFttCIC'vF11 h1_AT$nUL
fit.
_
4.6 fir. 12 W I SCH 40 PVC
16. INNER
CASING OR
TiJBING cothertnad
closed-]oo
FROM
TO
I rot," VVER
TMCMLUS8
riUl'--AT.
h.
ft,
in.
ft.
I %
in.
17. SCREEN
FRONI
TO
nLMNIFTER
SLUT S]ZF;
T1IICECNMS
MATFR"L
4.6 ft,
14.6 fr.
2 iTa
0.01
SCH 40
PVC
-
18. GROUT
FROM
TO
NUTERIAL
EMPLACE.IKEN'Thit-MOD & ARIOUN'T
ft.
ft
ft.
ft.
ft.
ft
19. SAND/GRAVEL
PACT,fifolionficablel
FROM
TO
111A7FMIAL ElrPl_aCF.NiLNrrofETripn
2.6 ft
15.0 ft
Quartz Sand
ft.
fL
20. DRILLING
LOG fattitch additional sheers ifnecessorv)
FROM
to
DES CRIPT10tti (color, 6wrdnev, roitr'eu+ck ts• r, rxhr xirr. rce.l
fu
1t
AL
ft
ft.
fL
ft.
ft
ft.
rt.
ft.
ft
ft
2L RENIARKS
BENTONITE SEAL FROM 0.0 TO 2,6 FEET
22. Certification:
Srgnature o iertrtied IYeit Cnnrraetor i}ate
4v .sigrrrog thtr foray, / herebt- crrr/fv than the wells) wax ftrere) ronstructeel to necurduuce
Nests ISA NCA(' 03C ,0100 or 15rl NCAC 02C' _020o Well C'ottsrnrcriorr S'rornhrrels arul shut a
copy of t/sA rrcnr"1lrene been provaled to the shell oiruer,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBNN ITTAL I+ISTUCI'IONS
24a. For All Wells: Submit this form within 30 days of completion of even
construction to the follokving:
Divlsian orSVarer Re"urees, Information Prareming LlRif,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniccifon 'Wells ONLY: In addition to sending the fort to the address in
24a above. also submit a copy of this form within 30 days of completion of well
construction to Ole fallo«ing,
Division of Water Resources, Underground Injection Control Program,
FOR WATER S[IPPLY WELLS OYLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a, Yield (gpm) Method of test: 24c.. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
13b. Disinfection type: Amount: We construction to the county health department of the county where
constructed.
Form GW-1 Noah Carolina Repanmcnl of[mironincal and Nantral Reso=s — Division at'W=r Res "'s Revised August 1913