WI0300488_Notification of Intent (NOI) – GW Remediation_20240821

NC Department of Environmental Quality—Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule"and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C.0200(NOTE: This form must be received at least 14 DAYS prior to infection)
AQUIFER TEST WELLS(15A NCAC 02C.0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION(15A NCAC 02C.0225)or TRACER WELLS (15A NCAC 02C.02291:
1) Passive Injection Systems - In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks,iSOC systems, and other gas infusion methods(Note: Injection Event Records(IER)do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small-Scale Injection Operations —Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation,and where the
surface area of the injection zone wells is located within an area that does not exceed five percent of the land surface
above the known extent of groundwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
5) In-Situ Thermal Wells(IST)—Used to `heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: 8/21 ,2024 PERMIT NO. W10300488 (to be filled in by DWR)
NOTE-If this NOI is being submitted as notification of a modification of a previously issued NOI for this site(e.g.,
different injection wells,plume,additives,etc.)and still meets the deemed permitted by rule criteria,provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No.WI 0300488 Issued Date: 09/25/2024
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) X Air Injection Well....................................... Complete sections B through F,J,M
(2) Aquifer Test Well....................................... Complete sections B through F,J,M
(3) Passive Injection System............................... Complete sections B through F,H-M
(4) Small-Scale Injection Operation...................... Complete sections B through M
(5) Pilot Test................................................. Complete sections B through M
(6) Tracer Injection Well................................... Complete sections B through M
(7) In-Situ Thermal(IST)Well........................... Complete sections B through M
B. STATUS OF WELL OWNER: Choose an item.
Deemed Permitted GW Remediation NOI Rev.2-17-2020 Page I

C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): NCDEQ Division of Waste Management- UST Section
Mailing Address: 1646 Mail Service Center
City: Raleigh State: NC Zip Code:27699 County:Wake
Day Tele No.: 919-707-8168 Cell No.:
EMAIL Address:[e-mail] Fax No.:
D. PROPERTY OWNER(S)(if different than well owner/applicant)
Name and Title: Malinda and James Smith
Company Name
Mailing Address: 1139 East Memorial Highway
City: Harmony State: NC Zip Code:28634 County: Iredell
Day Tele No.: 704-902-0902 Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT(Typically Environmental Consulting/Engineering Firm)
Name and Title: Kyle Harris, Project Manager
Company Name ATC Associates of North Carolina, P.C.
Mailing Address: 7606 Whitehall Executive Center Drive, Suite 800
City: Charlotte State: NC Zip Code:28273 County: Mecklenburg
Day Tele No.: 704-529-3200 Cell No.:
EMAIL Address: [e-mail] Fax No.:
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name&Address: Jones Grocery(UST Incident 10782)
1156 E. Memorial Highway
City: Harmony County: Iredell Zip Code: 28634
(2) Geographic Coordinates: Latitude": " or 35 0 918499
Longitude": " or-80 0 720954
Reference Datum. UST Basin Accuracy:
Method of Collection:Google Earth
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: square feet
Land surface area of inj.well network: square feet(< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: (must be<5%of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev.2-17-2020 Page 2

H. INJECTION ZONE MAPS—Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells;and
(2) Cross-section(s)to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells,and existing and proposed injection wells.
(3) Potentiometric surface map(s)indicating the rate and direction of groundwater movement,plus existing
and proposed wells.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE —Provide a brief narrative
regarding the cause of the contamination,and purpose, scope,goals of the proposed injection activity:
The site is a UST incident with dissolved gasoline compounds in the groundwater and light non-aqueous phase liquid
present.Air sparging in the groundwater is planned using well AS-1 as a method of site remediation.
J. WELL CONSTRUCTION DATA
(1) No.of injection wells: Proposed Existing(provide NC Well
Construction Record(GW-1)for each well)
(2) Appx. injection depths(BLS): 75 feet
(3) For Proposed wells or Existing wells not having GW-1s,provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following(indicate if construction is proposed or as-built):
(a) Well type as permanent,Geoprobe/DPT,or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen,and sand pack
(c) Well contractor name and certification number
K. INJECTION SUMMARY
NOTE: Only iniectants approved by the gpidemiolo, y section of the NC Division ofPublic Health,Department
of Health and Human Services can be injected. Approved iniectants can be found online at
hllp:Hdeg.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Program for more info if you wish to get approval for a deferent additive. However,please
note it may take 3 months or lonzer. If no iniectants are to be used use N/A.
Injectant: Total Amt. to be injected(gal)/event:
Injectant: Total Amt. to be injected(gal)/event:
Injectant: Total Amt. to be injected(gal)/event:
Injectant: Total Amt. to be injected(gal)/event:
Deemed Permitted GW Remediation NOI Rev.2-17-2020 Page 3

Injectant: Total Amt. to be injected(gal)/event:
Total Amt.to be injected(gal/event):
No.of separate injection events: Total Amt.to be injected (gal):
Source of Water(if applicable):
L. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
Groundwater sampling for volatile organics using Standard Method 6200B is planned to be conducted approximately
30 days following the injection event.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "I hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the 15,4 NCAC 02C 0200 Rules."
I//-— Digitally signed by Kyle Harris
Signature of Applicant Print or Type Full Name and Title
Property Owner(if the property is not owned by the Well Owned/Applicant):
"As owner of the property on which the injection well(s)are to be constructed and operated,I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(1 SA NCAC 02C C.0200)."
"Owner"means any person who holds the fee or other property rights in the well being constructed.A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Signature*of Property Owner(if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (one)hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two(2)weeks prior to injection to:
DWR—UIC Program
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev.2-17-2020 Page 4

ROY COOPER
Governor
ELIZABETH BISER
Secretary
Waste Management MICHAEL SCOTT
ENVIRONMENTAL QUALITY Director
May 13, 2024
Mr. Scott Ryals
Environmental Engineer
DWM UST Section
1637 Mail Service Center
Raleigh, NC 27699-1637
RE: State-Lead Acceptance
Jones Grocery
1156 E. Memorial Highway
Harmony, Iredell County, NC
Incident Number 10782
Dear Mr. Ryals,
am/We are the owner(s)of a parcel of property, located at or near the incident in question,
and hereby permit the Department of Environmental Quality(Department) or its contractor to enter
upon said property for the purpose of conducting an assessment and/or remediation of the
groundwater and/or soils under the authority of G.S. 143-215.94G.
I am/We are granting permission with the understanding that:
1. The investigation shall be conducted by the UST Section of the Department's Division of
Waste Management or its contractor.
2. The costs of construction and maintenance of the site and access shall be borne by the
Department or its contractor in accordance with the acceptance of the site into the State-Lead
Program. The Department or its contractor shall protect and prevent damage to the
surrounding lands. Any damages will be restored by the Department or its contractor to as
close to the pre-work condition as practicably possible.
3. Unless otherwise agreed, the Department or its contractor shall have access to the site by the
shortest feasible route to the nearest public road. The Department or its contractor will notify
the landowners 48 hours prior to entry and may enter upon the land at reasonable times and
have full right of access during the period of the investigation.
4. Any claims which may arise against the Department, or its contractor 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.
5. The information derived from the investigation shall be made available to the owner upon
request and is a public record, in accordance with G.S. 132-1.
Nothing Compares!�-._,
State of North Carolina I Environmental Quality I Waste Management
1646 Mail Service Center 1 217 West Jones Street I Raleigh,NC 27699-1646
919 707 8200 T

6. The activities to be carried out by the Department or its contractor are for the primary benefit
of the Department and of the State of North Carolina. Any benefits accruing to the owner
are incidental. The Department or its contractor is not and shall not be construed to be an
agent, employee, or contractor of the landowner. No representations or warranties, either
expressed or implied, have been made to me/by the Department, the State of North
Carolina, or its/their contractor(s) regarding the results that may be obtained or the quality of
work to be performed.
I/We agree not to interfere with, remove or any ways damage the Department's well(s) or its
contractor's well(s) and equipment during the investigation.
Sincerely,
Signature
Type/Print Name of Owner or Agent
Owner
Phone Number/ E-mail Address /
Address
�Ci y/ tate/Zip Code
9
Date
RE: State-Lead Acceptance
Jones Grocery
1156 E. Memorial Highway
Harmony, Iredell County, NC
Incident Number 10782
Nothing Compares_
State of North Carolina I Environmental Quality I Waste Management
1646 Mail Service Center 1 217 West Jones Street I Raleigh,NC 27699-1646
919 707 8200 T

TABLE 3
GROUNDWATER ELEVATION DATA
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
Screen Top of Depth to LNAPL Groundwater
Well ID Gauging Interval Casing Water Thickness Elevation
Date (ft-bgs) Ele(aation (ft-toc) (ft) (ft)
01/31/08 40.39 0.00 59.61
12/22/08 41.24 0.00 58.76
07/09/09 39.50 0.00 60.50
10/26/09 39.28 0.00 60.72
10/30/09 41.69 0.00 58.31
11/30/09 39.38 0.00 60.62
05/17/16 35.54 0.00 64.46
12/08/16 37.70 0.00 62.30
07/21/17 38.45 0.00 61.55
MW-1 06/21/18 40-50 100.00 38.87 0.00 61.13
11/13/19 33.97 0.00 66.03
03/01/21 28.62 0.00 71.38
03/05/21 36.19 0.00 63.81
03/22/21 28.32 0.00 71.68
03/28/22 34.02 0.00 65.98
01/30/23 34.84 0.00 65.16
02/03/23 38.13 0.00 61.87
02/27/23 34.12 0.00 65.88
01/31/08 40.75 0.00 59.34
07/29/08 40.55 0.00 59.54
12/22/08 41.48 0.00 58.61
07/09/09 39.56 0.00 60.53
11/30/09 40.46 0.00 59.63
12/08/16 37.71 0.00 62.38
MW-1 D 07/21/17 60-75 100.09 39.12 0.00 60.97
6/21/18* 39.40 0.00 60.69
03/01/21 28.98 0.00 71.11
03/05/21 37.99 0.00 62.10
01/30/23 35.02 0.00 65.07
02/03/23 57.90 0.00 42.19
01/31/08 43.33 -3.00 59.23
12/22/08 Dry 0.00 Dry
07/09/09 41.03 1.62 60.35
10/26/09 40.61 1.60 60.75
10/30/09 44.79 0.00 55.20
11/30/09 39.57 0.05 60.46
05/17/16 35.65 0.00 64.34
12/08/16 37.58 0.00 62.41
07/21/17 38.66 0.00 61.33
MW 2 06/21/18 30-45 99.99 39.00 0.00 60.99
11/13/19 33.83 0.00 66.16
03/01/21 28.60 0.00 71.39
03/05/21 29.04 0.00 70.95
03/22/21 28.29 0.00 71.70
03/28/22 34.28 0.00 65.71
01/30/23 35.14 0.00 64.85
02/03/23 37.60 0.00 62.39
02/27/23 34.39 0.00 65.60
Page 1 of 4

TABLE 3
GROUNDWATER ELEVATION DATA
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
Screen Top of Depth to LNAPL Groundwater
Well ID Gauging Interval Casing Water Thickness Elevation
Date (ft-bgs) Ele(fation (ft-toc) (ft) (ft)
01/31/08 38.91 0.00 59.99
12/22/08 39.65 0.00 59.25
07/09/09 37.90 0.00 61.00
MW-3 11/30/09 30-45 98.90 37.80 0.00 61.10
12/08/16 36.14 0.00 62.76
07/21/17 36.94 0.00 61.96
06/21/18 36.64 0.00 62.26
01/31/08 38.81 0.00 59.91
12/22/08 39.56 0.00 59.16
07/09/09 37.65 0.00 61.07
MW-4 11/30/09 30-45 98.72 37.43 0.00 61.29
12/08/16 35.57 0.00 63.15
07/21/17 36.61 0.00 62.11
01/31/08 38.54 0.00 60.06
12/22/08 39.20 0.00 59.40
07/09/09 37.25 0.00 61.35
MW-5 11/30/09 35-50 98.60 37.20 0.00 61.40
12/08/16 35.51 0.00 63.09
7/21/2017 36.35 0.00 62.25
01/31/08 39.93 0.00 59.86
12/22/08 40.73 0.00 59.06
07/09/09 39.03 0.00 60.76
10/26/09 38.75 0.00 61.04
10/30/09 46.70 0.00 53.09
11/30/09 38.92 0.00 60.87
05/17/16 35.02 0.00 64.77
12/08/16 37.16 0.00 62.63
MW-6 07/21/17 35-50 99.79 DAMAGED-COULD NOT OPEN
11/13/19 33.39 0.00 66.40
03/01/21 27.99 0.00 71.80
03/05/21 28.29 0.00 71.50
03/22/21 26.65 0.00 73.14
03/28/22 33.51 0.00 66.28
01/30/23 34.29 0.00 65.50
02/03/23 35.48 0.00 64.31
02/27/23 33.53 0.00 66.26
01/31/08 41.00 0.00 59.23
12/22/08 41.71 0.00 58.52
07/09/09 39.90 0.00 60.33
10/26/09 39.75 0.00 60.48
10/30/09 48.33 0.00 51.90
11/30/09 39.90 0.00 60.33
05/17/16 35.12 0.00 65.11
12/08/16 38.56 0.00 61.67
07/21/17 39.01 0.00 61.22
MW 7 06/21/18 35-50 100.23 39.33 0.00 60.90
11/13/19 34.24 0.00 65.99
03/01/21 29.15 0.00 71.08
03/05/21 28.14 0.00 72.09
03/22/21 28.89 0.00 71.34
03/28/22 34.68 0.00 65.55
01/30/23 35.32 0.00 64.91
02/03/23 35.78 0.00 64.45
02/27/23 34.68 0.00 65.55
Page 2 of 4

TABLE 3
GROUNDWATER ELEVATION DATA
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
Screen Top of Depth to LNAPL Groundwater
Well ID Gauging Interval Casing Water Thickness Elevation
Date (ft-bgs) Ele(fation (ft-toc) (ft) (ft)
01/31/08 40.21 0.00 59.95
12/22/08 41.16 0.00 59.00
07/09/09 39.33 0.00 60.83
MW-8 11/30/09 35-50 100.16 39.29 0.00 60.87
12/08/16 37.64 0.00 62.52
11/13/19 33.81 0.00 66.35
03/22/21 28.35 0.00 71.81
01/31/08 40.50 0.00 59.03
12/22/08 41.20 0.00 58.33
07/09/09 39.29 0.00 60.24
11/30/09 39.28 0.00 60.25
05/17/16 35.51 0.00 64.02
MW-9 12/08/16 35-50 99.53 37.76 0.00 61.77
07/21/17 38.10 0.00 61.43
06/21/18 38.74 0.00 60.79
11/13/19 34.01 0.00 65.52
03/22/21 28.51 0.00 71.02
02/27/23 CNL
01/31/08 41.65 0.00 58.36
12/22/08 42.38 0.00 57.63
MW-10 07/09/09 35-50 100.01 40.34 0.00 59.67
11/30/09 40.30 0.00 59.71
12/08/16 38.40 0.00 61.61
01/31/08 41.27 0.00 58.88
12/22/08 42.06 0.00 58.09
MW-11 07/09/09 35-50 100.15 40.25 0.00 59.90
11/30/09 40.08 0.00 60.07
12/08/16 37.98 0.00 62.17
01/31/08 40.91 0.00 59.34
12/22/08 41.71 0.00 58.54
07/09/09 40.04 0.00 60.21
MW-12 11/30/09 35-50 100.25 39.80 0.00 60.45
12/08/16 37.63 0.00 62.62
07/21/17 38.72 0.00 61.53
06/21/18 39.09 0.00 61.16
07/29/08 37.06 0.00 60.86
12/22/08 38.33 0.00 59.59
MW-13 07/09/09 35-50 97.92 36.15 0.00 61.77
11/30/09 36.20 0.00 61.72
12/08/16 34.50 0.00 63.42
07/29/08 40.29 0.00 59.79
12/22/08 41.43 0.00 58.65
07/09/09 39.70 0.00 60.38
MW-14 11/30/09 35-50 100.08 39.51 0.00 60.57
12/08/16 NM
02/27/23 CNL
07/29/08 36.88 0.00 60.72
12/22/08 38.23 0.00 59.37
MW-15 07/09/09 35-50 97.60 35.92 0.00 61.68
11/30/09 36.30 0.00 61.30
Page 3 of 4

TABLE 3
GROUNDWATER ELEVATION DATA
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
Screen Top of Depth to LNAPL Groundwater
Well ID Gauging Interval Casing Water Thickness Elevation
Date (ft-bgs) Ele(fation (ft-toc) (ft) (ft)
07/29/08 36.41 0.00 61.10
12/22/08 37.97 0.00 59.54
MW-16 07/09/09 35-50 97.51 35.80 0.00 61.71
11/30/09 36.41 0.00 61.10
07/29/08 38.84 0.00 58.59
12/22/08 40.22 0.00 57.21
MW-17 07/09/09 35-50 97.43 37.97 0.00 59.46
11/30/09 37.84 0.00 59.59
07/29/08 31.65 0.00 57.38
12/22/08 32.80 0.00 56.23
MW-18 07/09/09 25-40 89.03 29.57 0.00 59.46
11/30/09 30.35 0.00 58.68
07/09/09 38.09 0.00 62.26
11/30/09 40.22 0.00 60.13
TW 2 12/09/16 105-110 100.35 37.66 0.00 62.69
12/09/16 37.66 0.00 62.69
03/01/21 29.03 0.00
03/05/21 29.05 0.00
03/28/22 34.45 0.00
VE-1 01/30/23 10-25 34.70 0.00
02/03/23 34.94 0.00
02/27/23 1 34.53 0.00
03/01/21 29.33 0.00
03/05/21 74.23 0.00
AS-1 01/30/23 70 75 35.16 0.00
02/03/23 55.72 0.00
03/01/21 30.06 0.00
OW-1 03/05/21 10-60 32.43 0.00
01/30/23
CNL
02/03/23
03/01/21 25.22 0.00
03/05/21 36.36 0.00
OW 2 01/30/23 10-70 35.01 0.00
02/03/23 36.88 0.00
03/01/21 16.33 0.00
03/05/21 33.51 0.00
OW-3 01/30/23 10-60 34.72 0.00
02/03/23 36.19 0.00
03/01/21 27.97 0.00
03/05/21 31.46 0.00
OW-4 01/30/23 10-70 35.26 0.00
02/03/23 39.23 0.00
03/01/21 29.33 0.34
03/05/21 32.15 0.00
03/28/22 35.62 1.16
OW-5 01/30/23 10-70 36.16 0.86
02/03/23 37.78 0.00
02/27/23 34.70 0.00
Notes:
ft-bgs=feet below ground surface
ft=feet
ft-toc=feet below top of casing
Top of casing elevation relative to an arbitrary datum of 100 feet for the MW-1 top of casing
*Based on observations during the groundwater sampling event,it appears that monitoring well TW-2 has been mis-
identified as MW-1D.
LNAPL-Light Non-Aqueous Phase Liquid
Page 4 of 4

TABLE 4
FIELD PARAMETERS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
Well Date Temperature Conductivity pH ORP DO
(-C) (mS/cm) (su) (mV) (mg/L)
11/13/19 18.6 0.102 4.6 NA 8.4
MW-1 03/22/21 20.5 0.178 6.3 101 2.3
03/28/22 17.3 0.236 5.7 256 2.7
02/27/23 18.6 0.247 4.8 229 2.6
11/13/19 16.1 0.141 4.7 NA 9.2
MW-2 03/22/21 20.7 0.211 4.2 306 5.5
03/28/22 17.5 0.738 6.8 246 3.6
02/27/23 18.5 0.277 4.7 258 2.9
11/13/19 18.9 0.062 4.8 NA 5.2
MW-6 03/22/21 20.3 0.160 4.5 284 4.0
03/28/22 18.7 0.335 4.6 226 4.0
02/27/23 18.0 0.159 4.8 263 8.7
11/13/19 17.7 0.056 4.8 NA 9.3
MW-7 03/22/21 19.3 0.133 8.3 75 2.1
03/28/22 17.8 0.771 4.7 69 2.9
02/27/23 19.5 0.340 5.6 -25 9.0
MW 8 11/13/19 17.7 0.060 4.7 NA 8.3
03/22/21 20.3 0.059 5.2 205 4.0
11/13/19 16.9 0.140 5.2 NA 8.0
MW-9 03/22/21 20.3 0.184 5.4 122 1.9
02/27/23 Not Sampled - CNL
MW-14 02/27/23 Not Sampled - CNL
OW-5
03/28/22 18.0 0.615 4.3 235 2.8
02/27/23 18.0 0.217 5.2 245 8.0
03/28/22
VE-1 02/27/23 Not Sampled - Insufficent Volume
TW-2 02/27/23 18.0 0.125 6.5 129 9.0
Notes:
°C = Degrees Celsius
mS/cm = miliSiemens per centimeter
su = Standard Units
ORP = Oxygen reduction potential in millivolts (mV)
DO = Dissolved oxygen (milligrams per liter, mg/L)

TABLE 5
RECENT GROUNDWATER ANALYTICAL RESULTS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident #10782
>,
m w c4 ca t c t t
d m +�+ W N N N N O O
N d L L d d ^ d Q C CDC C V V
Well Sample N m >, L m ° o a w L � Q Q
ID Date X �. w o o a
d O W t cV L G Q Q t t
m O >+ c� Oa O p fA N N Q m
W Z p rn a a E E
N N 1 O L L
d 0 N C r0+ r0+
2L Standard 1 600 600 500 20 6 0.02 0.4 70 70 70 70 400 400 40 10
GCL 5,000 260,000 80,000 50,000 20,000 6,000 50 400 70,000 30,500 26,100 70,000 28,500 24,100 40,000 10,000
MW-1 02/27/23 5,840 19,300 2,110 9,490 146 420 252 293 3,870 57.5J 161 <62.5 1,070 291 8,010J <6,250
MW-2 02/27/23 9,160 36,300 3,700 19,500 <125 672 262 285 2,980 1101 294 129 2,150 592 <25,000 <12,500
MW-6 02/27/23 3,980 26,100 3,240 18,500 <100 636 178 <100 1,440 105 302 <100 2,270 614 <20,000 <10,000
MW-7 02/27/23 19,000 38,700 3,020 15,200 313 666 124J 1,220 17,200 <125 238 <125 1,540 477 28,100 22,600
OW-5 02/27/23 19,300 38,500 3,060 15,100 312 437J 513 792 9,620 94.7J 248 244 1,550 410 <25,000 <12,500
TW-2 02/27/23 11.90 55.40 9.80 35.30 <0.50 0.97J 0.32J 0.46J 2.40 0.41 J 0.85 <0.50 3.90 1.30 <100 <50.0
Notes:
Concentrations are reported in micrograms per liter (µg/1)
"<" = Not detected at or above the laboratory reporting limit
2L Standard = 15A NCAC 2L .0202 Groundwater Quality Standard
GCL = Gross Contamination Level
J = Estimated value above or equal to Method Detection Limit and less than Quantification Limit.
Values in BOLD print indicate concentrations above 2L Standards
Values in BOLD UNDERLINED ITALICS indicate concentrations above GCL

TABLE 6
HISTORICAL GROUNDWATER ANALYTICAL RESULTS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
m
T C
7 N C a) C d C d O O
N to m y R C N d C to L 4) 0N y y L t
C d C t d y N C E d y W _ N :a N N N O 0
N y N C i d N d N C R i d Q w C y C C U U
C C N d 0 i O C 0 C N L O O O �+^ 0 0 d N d C d d
Sample m c >, m ca m O r- .0 c � U a W r c Y W >, (L y � � ins Q Q
Well ID X � s w Ep �cw T O L o oQ co-,, f0 xm >, Q N>, �? >, >, w
Date m s y Hw a 0w Q � � 3 C 0 yr Q` _ � a o `�' � Q w � t rt E
W H L Z m y m m () V U 0, N W N a O r v O N N N Q m
d c C N 0 0 N Q H H d
2L Standard 1 600 600 500 20 6 0.02 6,000 4,000 70 70 3,000 70 100 0.4 70 4,000 40 70 25 100 70 70 400 400 40 10
G C L 5,000 260,00 80,00 50,00 20,00 6,000 50 6,000,000 4,000,000 6,900 8,800 NE 70,00 NE 400 70,00 4,000,000 40,00 30,50 11,700 100,00 26,100 70,00 28,500 24,100 40,00 10,000
01/31/08 26,600 44,600 3,140 15,500 <200 842 V 963 -- -- <200 <200 -- -- -- 2,320 29,200 -- -- <200 <200 -- <200 -- 1,430 330 -- --
07/09/09 32,700 57,000 4,300 21,900 <165 <500 406 <165 <165 2,510 26,400 - <500 <165 - 218 J 1,380 377 J -
11/30/09 25,500 46,000 3,390 18,800 <100 629 488 -- -- <72.0 <56.0 -- -- -- 820 23,000 - <60.0 <80.0 - 220 J -- 1,710 457 -
05/17/16 26,500 46,600 3,140 16,900 180 J 400 B 520 <63 <63 1,870 26,500 - <63 <63 - 182 J 1,280 333 -
12/08/16 36,600 60,100 4,050 20,400 366 J 632 J 724 J -- -- <250 <250 -- -- -- 2,320 31,500 - <250 <250 - 258 J -- 1,760 460 J MW-1 -
07/21/17 16,500 31,000 2,970 14,800 85.6 J 382 338 3,670 1850 <31 <31 <50 <31 <31 417 6,470 - 79.6 J <31 - 221 <31 1610 449 -
06/21/18 25,000 55,000 3,700 17,600 140 810 470 <2400 1,500 <38 <32 <70 <55 <30 490 7,700 - 88 <38 - 220 <38 1500 360 -
11/13/19 31,800 55,700 3,790 19,800 665 700J 713 NA 8,860 <176 <123 <292 <176 <104 1,650 25,700 - <119 NA - 220J <128 1,650 414 -
03/03/21 13,900 31,600 2,440 13,550 367 497J -- - -- -- -- -- -- -- -- 12,300 - <83.2 - - -
03/22/21 10,300 25,200 1,740 10,400 150 402J 220 -- 1,480 <122 <100 <162 <88.2 <80.2 375 4,730 - <119 <83.2 -- - <85.0 <73.0 1,040 <83.0 -
03/28/22 8,610 30,000 2,580 13,700 959 780 848 31,300 8,840 <18.0 <20.0 <43.0 <22.0 <20.0 1,260 16,600 14,000J 950 75 <8.90 391 215 108 1,690 408 -
02/27/23 5,840 19,300 2,110 9,490 146 420 252 -- -- <62.5 1 <62.5 <125 <62.5 1 <62.5 293 3,870 <25,000 -- 57.5J - -- 161 <62.5 1,070 1 291 8,010J <6250
01 31 08 2,260 3,140 614 2,720 3.13 70.6 V 16.9 -- -- 2.56 2.01 -- -- -- 75.6 1,050 -- 19.8 5.77 - 44.5 -- 359 69.1 -
07/29/08 1,670 2,200 625 2,530 <0.24 86.1 16.0 3.56 2.04 84.9 1,310 - 16.5 5.92 - 45.2 449 87.3 -
07/09/09 2,460 1,920 693 2,110 <6.60 88.9 8.25 -- <6.60 <6.60 -- -- -- 103 934 - 27.4 J <6.60 - 50.2 -- 300 82.9 -
MW-1D 12/01/09 2,110 1,700 562 2,020 <5.00 56.5 11.3 J <3.60 273 49.0 1,020 19.8 J <4.00 - 46.8 308 70.0 -
12/08/16 13,500 19,300 1,120 7,090 73.4 J 192 J 295 -- -- <63 <63 -- -- -- 1,010 15,900 <63 <63 - <63 -- 556 168 J -
07/21/17 100 64.9 154 49.7 <0.13 15.7 <0.13 <2.0 <1.3 0.75 0.53 <0.20 <0.13 0.35 J 8.9 70.6 6.4 0.23 J - 13.4 <0.13 5.7 3.0 -
6/21/18* 170 560.0 240 360 <0.090 15 <0.15 <9.7 <2.4 1.4 0.71 <0.28 <0.22 <0.12 7.5 80 6.9 0.33 - 16 <0.15 45 11 -
01/31/08 LNAPL
07/09/09 LNAPL
11/30/09 LNAPL
05/17/16 42,800 181,000 26,600 128,000 <130 15,900 B 551 -- -- 3,490 1,490 -- -- -- 1,200 11,200 - 5,240 876 - 19,700 -- 25,400 32,700 -
12/08/16 28,100 79,500 12,100 61,700 <310 2,230 586 J -- -- 324 J <310 -- 1,400 10,400 - 656 J <310 - 2,370 13,800 4,000 MW-2 -
07/21/17 20,200 47,300 4,940 26,300 217 J 624 317 J 5,960 J 2,460 J <130 <130 200 130 <130 928 7,250 - 144 J <130 - 409 J 274 2,970 819 -
06/21/18 20,000 50,000 4,900 24,800 200 1,000 320 <4800 <1200 <75 <65 <140 <110 <60 620 6,900 - 160 <75 - 410 220 2,800 770 -
11/13/19 20,600 50,000 4,040 239400 <222 782J 799 NA 2,750 <176 <123 <292 <176 <104 1,120 8,050 - <119 NA - 349 <128 2,710 679 -
03/03/21 2,150 7,090 844 4,430 36.8J 238 -- - -- -- -- -- -- -- -- 836 - 46.1J - - -
03/22/21 10,800 35,800 3,590 189800 <106 947 607 -- <990 <122 <100 <162 94.8J <80.2 458 2,860 -- 246J 132 -- - <85.0 184 2,520 <83.0 -
03/28/22 18,300 539800 5,390 25,100 167 958 582 2,590 618 58.7 32.3J <43.0 <22.0 <20.0 708 5,670 <4,200 442 223 <8.90 199 603 241 4,150 1180 -
02/27/23 9,160 36,300 3,700 19,500 <125 672 262 -- -- <125 <125 <250 <125 <125 285 2,980 <50,000 -- 110J -- -- 294 129 2,150 592 <25000 <12500
01/31/08 43.8 101 72.1 1,490 <1.0 17.6 14.5 1.29 1.71 -- -- -- 14.0 266 -- 4.98 6.69 7.41 -- 341 174 -- --
07/09/09 29.7 41.5 159 2,350 <6.60 <20.0 4.96 <6.60 <6.60 9.58 J 212 - <20.0 14.1 J - 18.8 J - 706 358 MW-3 -
11/30/09 25.8 31.9 104 1,990 <1.25 20.0 8.47 - <0.900 6.52 2.83 J 347 - 14.5 <1.00 - 20.0 - 787 478 -
12/08/16 6.7 3.2 J 1.7 J 323 <1.3 34.2 4.8 J - <1.3 <1.3 12.0 413 - <1.3 <1.3 - <1.3 - 85.1 418 -
07/21/17 5.1 2.4 J 1.4 J 241 <1.3 30.4 2.8 J <1.3 <13 <1.3 <1.3 2 1 1.3 60.9 8.2 281 - <1.3 <1.3 - <1.3 <20 69.1 560 -
06/21/18 0.21 0.5 <0.13 0.59 <0.090 <0.12 <0.15 <9.7 <2.4 0.15 <0.13 <0.28 1 <0.22 <0.12 <0.19 <0.18 - <0.12 <0.15 - 0.4 <0.15 1.6 1.4 -
Page 1 of 4

TABLE 6
HISTORICAL GROUNDWATER ANALYTICAL RESULTS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
m
T C
7 N C a) C d C d O O
N to m y R C N d C to L 4) 0N y y L t
C d C t d y N C E d y W _ N :a N N N O 0
N y N C i d N d N C R i d Q w C y C C U U
C C N d 0 i O C 0 C N L O O O �+^ 0 0 d N d C d d
Sample m c >, m ca m O r- .0 c � U a W r c Y W >, (L y � � ins Q Q
Well ID X � s w Ep �cw T O L o oQ co-,, f0 xm >, Q N>, �? >, >, w
Date m s y Hw a 0w Q � � 3 C 0 yr Q` _ � a o `�' � Q w � t rt E
W H L Z m y m m () V U 0, N W N a O r v O N N N Q m
d c C N 0 0 N Q H H d
2L Standard 1 600 600 500 20 6 0.02 6,000 4,000 70 70 3,000 70 100 0.4 70 4,000 40 70 25 100 70 70 400 400 40 10
G C L 5,000 260,00 80,00 50,00 20,00 6,000 50 6,000,000 4,000,000 6,900 8,800 NE 70,00 NE 400 70,00 4,000,000 40,00 30,50 11,70 100,00 26,100 70,00 28,50 24,100 40,00 10000
01/31/08 <1.0 1.24 <1.0 <3.0 <1.0 <1.0 <0.010 -- -- <1.0 <1.0 -- <1.0 <5.0 -- -- <1.0 <1.0 -- <1.0 -- <1.0 <1.0 --
07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00946 - <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 - <0.330 - <0.330 <0.330 -
MW-4 11/30/09 0.631 J 3.09 <0.150 1.33 <0.250 <0.500 <0.240 - <0.180 <0.140 <0.220 <0.200 - <0.150 <0.200 - <0.220 - <0.150 <0.180 -
12/08/16 <0.13 <0.13 <0.13 <0.31 <0.13 <0.13 <0.13 - <0.13 <0.13 <0.13 <0.13 - <0.13 <0.13 - <0.13 - <0.13 <0.13 -
07/21/17 <0.13 <0.13 <0.13 <0.25 <0.13 <0.13 <0.13 <2.0 <1.3 <0.13 <0.13 <0.13 0.42 J 0.13 <0.13 <0.13 - <0.13 <0.13 - <0.13 <0.13 <0.13 <0.13 -
01/31/08 <1.0 32.1 348 1,640 <1.0 145 <0.010 -- -- 16.4 13.1 -- <1.0 <5.0 - 91.1 47.5 - 208 -- 1,070 588 -
07/09/09 <2.00 90.4 205 981 <3.30 86.0 <0.00962 -- -- <3.30 14.9 -- --
-- <3.30 <16.7 - 61.8 <3.30 - 159 -- 700 463 -
MW-5 11/30/09 <0.700 192 260 1,210 <1.25 104 <1.20 -- <0.900 21.1 <1.10 <1.00 - 71.9 <1.00 - 217 -- 797 604 -
12/08/16 <0.13 <0.13 0.17 J 0.52 J <0.13 0.30 J <0.13 -- 0.38 J 0.46 J -- -- -- <0.13 <0.13 - 0.63 0.36 J - 2.1 -- 11.5 21.3 -
07/21/17 <0.13 <0.13 0.64 1.7 <0.13 1.2 <0.13 27.2 <1.3 3.7 2.0 0.46 J I <0.13 2.7 1 <0.13 <0.13 2.8 1.1 - 12.1 1 <0.13 24.9 23.4 -
01/31/08 7,750 31,600 3,210 17,700 <200 366 201 -- <200 <200 -- -- -- 268 3,260 <200 <200 - 224 -- 1,720 430
07/09/09 4,510 19,400 2,370 18,600 <66.0 636 58.4 -- <66.0 <66.0 139 J 1,570 <200 <66.0 - 263 -- 2,290 725
11/30/09 5,980 20,400 2,270 15,200 <50.0 338 129 J -- -- <36.0 <28.0 -- -- -- <44.0 2,440 - 95.1 J <40.0 - 211 -- 1,800 536 -
05/17/16 9,070 35,600 3,610 24,100 <130 711 B 242 J -- <130 <130 300 J 4,100 - <130 <130 - 395 J -- 2,950 903 MW-6 -
12/08/16 10,100 36,500 2,910 19,100 <63 554 337 -- <63 <63 -- -- -- 321 5,080 - 73.1 J <63 - 225 J -- 1,800 500 -
11/13/19 1 7,510 33,300 3,300 1 21,900 <111 671 323 NA 2,330 <88.2 <61.5 <146 <88.2 <51.8 222 3,670 - 98.5J NA - 264 <64.0 2,240 622 -
03/03/21 1,020 5,850 722 4,470 <21.1 328 -- - -- -- -- -- -- -- -- 580 - 25.1J - - -
03/22/21 3,910 23,500 2,680 16,700 <84.4 712 191 -- 1,250 <98.0 <80.0 <130 <70.6 <64.2 124 1,660 -- 249J 89.2J -- - <68.0 <58.4 2,070 <66.4 -
03/28/22 6,260 39,400 4,360 225300 37.6J 858 351 3,650 1,510 25.OJ <20.0 <43.0 <22.0 <20.0 153 3,160 <4,200 463 145 <8.90 190 430 <22.0 3,020 871 -
02/27/23 3,980 26,100 3,240 18,500 <100 636 178 -- -- <100 <100 <200 <100 <100 <100 1,440 <40,000 -- 105 -- -- 302 <100 2,270 1 614 <20000 <10000
01/31/08 24,600 42,500 3,450 13,000 26.8 325 729 -- -- <20 <20 -- -- -- 3,090 29,900 -- 99.6 22.0 - 206 -- 1,500 423 -- --
07/09/09 27,400 51,600 3,300 19,100 <165 <500 428 -- <165 <165 2,660 22,400 - <500 <165 - <165 -- 1,180 398 J -
11/30/09 28,900 53,900 3,890 20,200 <100 417 486 -- <72.0 1,390 -- -- -- 1,510 25,300 - <60.0 <80.0 - 236 J -- 1,550 448 -
05/17/16 23,800 47,700 3,350 19,800 120 J 514 B 356 -- <63 <63 1,720 19,600 - 74.9 J <63 - 246 J -- 1,960 575 -
12/08/16 23,200 45,500 3,820 20,100 388 J 558 454 J -- -- <130 <130 -- -- -- 1,890 21,100 - <130 <130 - 282 J -- 1,860 534 MW-7 -
07/21/17 24,200 44,900 3,460 19,500 242 J 481 J 432 J 12,500 5,270 <130 <130 <200 <130 <130 1,610 18,900 - <130 <130 - 248 J <130 1,830 609 -
06/21/18 20,000 39,000 2,900 14,400 100 600 320 <3900 2,400 <60 <52 <110 <88 <48 940 14000 - 76 <60 - 190 <60 1400 370 -
11/13/19 23,400 47,200 3,820 19,900 300 633J 406 NA 4,990 <141 <98.4 <234 <141 <82.8 1,550 19.3 - 113J NA - 283 <102 1,850 532 -
03/03/21 13,400 25,400 2,070 10,550 243J 370J -- - -- -- -- -- -- -- -- 12,700 - <83.2 - - -
03/22/21 3,180 7,040 837 5,160 182 692 105 -- 449 <24.5 <20.0 <32.4 <17.6 <16.0 296 2,780 -- 116J 49.5 -- - <17.0 <14.6 899 431 -
03/28/22 18,500 40,900 4,040 19,600 715 927 175 11,600 5,050 24.9J <20.0 <43.0 <22.0 <20.0 1,410 1 17,100 <4,200 1,520 173 73 421 438 <22.0 2,860 941 -
02/27/23 19,000 38,700 3,020 15,200 313 666 124J -- -- <125 <125 <250 <125 <125 1,220 17,200 <50,000 -- <125 -- -- 238 <125 1,540 477 28,100 22600
01/31/08 16.8 38.7 4.80 31.2 <1.0 3.07 0.137 - <1.0 <1.0 -- -- -- <1.0 69.1 -- <1.0 <1.0 - <1.0 -- 5.65 3.84 -- --
07/09/09 1.63 J 3.38 J <2.68 <5.32 <1.32 <4.00 <0.00933 - <1.32 <1.32 <1.32 12.1 J - <4.00 <1.32 - <1.32 - <1.32 <1.32 11/30/09 0.65J 2.45 <0.150 <0.220 <0.250 <0.500 <0.240 - <0.180 <0.140 <0.220 29.0 - <0.150 <0.200 - <0.220 - <0.150 <0.180 -
MW-8
12/08/16 <0.13 <0.13 <0.13 <0.31 0.59 <0.13 <0.13 - <0.13 <0.13 0.19 J 65.3 - <0.13 <0.13 - <0.13 - <0.13 <0.13 -
11/13/19 1.1 6.4 0.99 6.7 1.1 1.7J <0.23 NA <3.6 <0.35 <0.25 <0.58 <0.35 <0.21 0.31J 92.1 - <0.24 NA - <0.24 <0.26 1.4 <0.23 -
03/22/21 1 <0.34 1 <0.48 I <0.30 <0.34 1 0.75 <0.64 1 <0.27 -- <4.0 <0.49 I <0.40 <0.65 I <0.35 I <0.32 I <0.32 43 - <0.48 1 <0.33 - <0.34 <0.29 <0.50 <0.33 -
Page 2 of 4

TABLE 6
HISTORICAL GROUNDWATER ANALYTICAL RESULTS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
d
T N N L N
O O
N ql
42)
O w y c
C N N
tQ>O. LQO
O N N N
N
O 0 O O �cY U )
O C CYO
Sample >, w O N
o m . . csiCL
M M oWellID > ,`Dat
'51 W E O
la c � W O O L V N
W Z U
y N Q O y Q m
N C N O N _ O N y d E E N N
N y Q F- � r y+
2L Standard 1 600 600 500 20 6 0.02 6,000 4,000 70 70 3,000 70 100 0.4 70 4,000 40 70 25 100 70 70 400 400 40 10
GC L 5,000 260,00 80,00 50,00 20,00 6,000 50 6,000,000 4,000,000 6,900 8,800 NE 70,00 NE 400 70,00 4,000,000 40,00 30,50 11,70 100,00 26,100 70,00 28,50 24,100 40,00 10,00
01/31/08 4,630 8,200 912 5,230 <10 155 79.1 -- -- <10 <10 404 2,140 -- -- 37.5 17.2 -- 72.6 -- 745 259 -- --
07/09/09 4,770 9,080 926 5,130 <33.0 167 J 31.2 - -- <33.0 <33.0 268 1,500 -- <100 <33.0 -- 82.4 J -- 698 240 --
11/30/09 1,610 1,920 434 1,990 <1.25 102 8.58 - -- <0.900 <0.700 142 517 -- 28.7 <1.00 -- 60.9 -- 495 259 --
05/17/16 81.9 1.8 57.2 38.4 0.15 J 25.2 B <0.13 - -- 1.7 2.1 46.9 197 -- 5.9 1.8 -- 12.4 -- 38.4 91.5 --
MW-9 12/08/16 187 32.5 105 1 145 <0.63 1 27.0 0.98 J - -- 4.2 5.2 58.7 228 -- 10 4.6 -- 21.8 -- 38.3 249 --
07/21/17 423 105 271 302 <1.3 100 <1.3 <20 <13 4.6 J 5.9 <2.0 <1.3 35.2 124 427 -- 21.4 4.5 J -- 37.5 <1.3 169 306 --
06/21/18 250 95 120 198 <0.45 77 <0.74 <48 <12 <0.75 4 <1.4 <1.1 <0.60 94 300 -- 12 3.6 -- 16 <0.75 71 270 --
11/13/19 16.6 48.7 6.6 42.6 <0.44 5.2 0.88 NA 4.8J <0.35 <0.25 <0.58 <0.35 <0.21 5.0 33.5 -- -- <0.24 NA -- 0.89 <0.26 6.7 9.1 -
03/22/21 16.5 2.4 3.4 13 <0.42 1.4J <0.27 -- <4.0 <0.49 <0.40 <0.65 <0.35 <0.32 31.5 147 -- <0.48 0.44J -- -- <0.34 <0.29 <0.50 2.1 -
01/31/08 1.01 1.76 <1.0 <3.0 3.65 <1.0 <0.010 -- -- <1.0 <1.0 -- -- -- <1.0 <5.0 -- -- <1.0 <1.0 -- <1.0 -- <1.0 <1.0 -
07/09/09 <0.200 0.361 J <0.670 <1.33 <0.330 <1.00 <0.00941 - <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 -
MW-10
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
12/08/16 <0.13 <0.13 <0.13 <0.31 <0.13 <0.13 <0.13 -- <0.13 <0.13 <0.13 <0.13 -- <0.13 <0.13 -- <0.13 <0.13 <0.13 --
01/31/08 <1.0 <1.0 <1.0 <3.0 186 <1.0 <0.010 -- <1.0 <1.0 <1.0 <5.0 -- <1.0 <1.0 -- <1.0 <1.0 <1.0 MW-11 --
07/09/09 2.67 J 5.68 J <6.70 <13.3 319 <10.0 <0.00951 - <3.30 <3.30 <3.30 <16.7 -- <10.0 <3.30 -- <3.30 <3.30 <3.30 --
12/01/09 <0.140 <0.190 <0.150 <0.220 52.3 <0.500 <0.240 <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 -
12/08/16 <0.13 <0.13 <0.13 <0.31 2.5 <0.13 <0.13 <0.13 <0.13 <0.13 <0.13 -- <0.13 <0.13 -- <0.13 <0.13 <0.13 -
01/31/08 16.4 29.5 2.95 7.96 <1.0 <1.0 0.0490 <1.0 <1.0 <1.0 8.18 -- <1.0 <1.0 -- <1.0 <1.0 <1.0 -
07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00959 - <0.330 <0.330 <0.330 4.27 J -- <1.00 <0.330 -- <0.330 <0.330 <0.330 -
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 4.54 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
MW-12
12/08/16 <0.13 <0.13 <0.13 <0.31 <0.13 <0.13 <0.13 -- <0.13 <0.13 <0.13 3.1 -- <0.13 <0.13 -- <0.13 <0.13 <0.13 --
07/21/17 <0.13 <0.13 <0.13 <0.25 <0.13 <0.13 <0.13 <2.0 <1.3 <0.13 <0.13 <0.20 <0.13 <0.13 <0.13 1.8 -- <0.13 <0.13 -- <0.13 <0.50 <0.13 <0.13 -
06/21/18 0.30 1.5 0.25 1.48 <0.090 <0.12 <0.15 <9.7 <2.4 <0.15 <0.13 <0.28 <0.22 <0.12 <0.19 1.4 -- <0.12 <0.15 -- <0.13 <0.15 0.45 0.13 -
07/29/08 <0.31 <0.28 <0.31 <1.2 <0.12 <0.41 <0.0027 -- -- <0.39 <0.47 -- -- -- <0.12 <0.15 -- <0.24 <0.34 -- <0.30 -- <0.26 <0.27 --
07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00962 <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
MW-13
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 - <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
12/08/16 <0.13 <0.13 <0.13 <0.31 <0.13 <0.13 <0.13 -- <0.13 <0.13 <0.13 <0.13 -- <0.13 <0.13 -- <0.13 <0.13 <0.13 --
07/29/08 <0.31 <0.28 <0.31 <1.2 59.0 <0.41 <0.0027 -- <0.39 <0.47 <0.12 0.1601 -- <0.24 <0.34 -- <0.30 <0.26 <0.27 --
07/09/09 <0.200 <0.330 <0.670 <1.33 93.7 <1.00 <0.00949 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
MW-14
12/01/09 <0.140 <0.190 <0.150 <0.220 144 <0.500 <0.240 <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
12/08/16 NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS
07/29/08 <0.31 <0.28 <0.31 <1.2 <0.12 <0.41 <0.0027 <0.39 <0.47 <0.12 <0.15 -- <0.24 <0.34 -- <0.30 <0.26 <0.27 --
MW-15 07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00946 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
07/29/08 <0.31 <0.28 <0.31 <1.2 <0.12 <0.41 <0.0027 -- <0.39 <0.47 <0.12 <0.15 -- <0.24 <0.34 -- <0.30 <0.26 <0.27 --
MW-16 07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00933 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
Page 3 of 4

TABLE 6
HISTORICAL GROUNDWATER ANALYTICAL RESULTS
Jones Grocery
1156 East Memorial Highway
Harmony, Iredell County, North Carolina
NCDEQ Incident#10782
d
T N N L N
O O
N ql m 41 C N N C t y d O y N t L
C N O w N N N C N w W N N 3 r N N N O O
N y N O S'' G1 N N N C <0 L 3 N Q O C O C N y C C U t)
O C L N Om O cY N r 0 O 0U >, O CY O 01 y c O N Q Q
Sample d m >, m o m .. L a W �, a Y m �?)
Well ID K Ls Eo ;oW c o 0 oQ oa xm >, a L N >, r>->, >. w
Date c T � W a � W � � w 3 c o O � N " 7- r m � a o `� � a w _r � � E
la Q m, 7 m L t O W S LO Q >. O � N
W H L Z 0 N m V V V U Q v y N Q O y Q m
N C N O N _ O N y d E E N N
N y Q F- � r y+
2L Standard 1 600 600 500 20 6 0.02 6,000 4,000 70 70 3,000 70 100 0.4 70 4,000 40 70 25 100 70 70 400 400 40 10
GCL 5,000 260,00 80,00 50,00 20,00 6,000 50 6,000,000 4,000,000 6,900 8,800 NE 70,00 NE 400 70,00 4,000,000 40,00 30,50 11,70 100,00 26,100 70,00 28,50 24,100 40,00 10,000
07/29/08 <0.31 <0.28 <0.31 <1.2 <0.12 <0.41 <0.0027 -- <0.39 <0.47 <0.12 <0.15 -- <0.24 <0.34 -- <0.30 <0.26 <0.27 --
MW-17 07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00946 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
07/29/08 <0.31 <0.28 <0.31 <1.2 <0.12 <0.41 <0.0027 -- <0.39 <0.47 <0.12 <0.15 -- <0.24 <0.34 -- <0.30 <0.26 <0.27 --
MW-18 07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00928 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
03/03/21 17,700 45,000 4,010 19,970 332J 721J - -- -- -- 9,030 -- <133 -- -- --
OW-5 03/28/22 23,100 45,300 4,050 18,600 615 741 612 4,980 1,630 37.3J 21.9J <43.0 <22.0 <20.0 1,140 15,200 <4200 543 148 <8.90 236 432 369 2,810 802 --
02/27/23 19,300 38,500 3,060 15,100 312 437J 513 - -- <125 <125 <250 <125 <125 792 9,620 <50,000 94.7J -- 248 244 1,550 410 <25000 <12500
03/03/21 16,800 52,300 3,740 24,310 1,060 703J - -- -- -- -- -- -- -- 15,600 -- <133 -- -- --
VE-1 03/28/22 Not Sampled-Insufficent Volume
02/27/23 Not Sampled-Insufficent Volume
07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 <0.00956 -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
TW-2
12/08/16 <0.13 <0.13 4.3 <0.31 <0.13 <0.13 <0.13 -- <0.13 <0.13 0.88 10.7 -- <0.13 <0.13 -- 0.24 J <0.13 <0.13 --
02/27/23 11.90 55.40 9.80 35.30 <0.50 0.97J 0.32J - -- <0.50 <0.50 <1.0 <0.50 <0.50 0.46J 2.40 <200 0.41 J -- 0.85 <0.50 3.90 1.30 <100 <50.0
07/09/09 <0.200 <0.330 <0.670 <1.33 <0.330 <1.00 - -- <0.330 <0.330 <0.330 <1.67 -- <1.00 <0.330 -- <0.330 <0.330 <0.330 --
WSW-5 12/01/09 <0.140 <0.190 <0.150 <0.220 <0.250 <0.500 <0.240 -- <0.180 <0.140 <0.220 <0.200 -- <0.150 <0.200 -- <0.220 <0.150 <0.180 --
06/21/18 <0.12 <0.17 <0.13 <0.26 <0.090 <0.12 <0.15 <9.7 <2.4 <0.15 <0.13 <0.28 <0.22 <0.12 <0.19 <0.18 -- <0.12 <0.15 -- <0.13 <0.15 <0.18 <0.13 --
Notes: < : Less than the method detection limit specified in the laboratory report.
• Results reported in pg/L(micrograms per liter) LNAPL: Light Non-Aqueous Phase Liquid
• 2L Standard as specified in 15A NCAC 2L.0202. NE: Not established.
• GCL: Gross contamination levels. NA: Not applicable
• Concentrations in BOLD exceed 2L Standard, concentrations in BOLD UNDERLINED ITALICS exceed GCL I or J: Estimated value
Based on observations during the 6/21/18 groundwater sampling event, it appears that monitoring well TW-2 has been mis-identified as MW-1 D. B&V: Present in laboratory method blank.
Page 4 of 4

GUILFQ�
- 901
'1
SITE
c% LGI GANWAY RD / ~
rn �/
� z
100
IMA SOU CE: I s�s T O CALAH N, 046 2016A4RA�GL�
0 500 1000 2000
APPROXIMATE SCALE IN FEET
TITLF FIGURE 1
SITE LOCATION MAP
NCDEQ INCIDENT NO. 10782 — JONES GROCERY
1156 EAST MEMORIAL HIGHWAY ASSOCIATES OF NORTH CAROLINA,P.C.
HARMONY, I R E D E L L COUNTY, NORTH C A R O L I N A charlotte,North Carottna 28M (704)529-3M FAX [phone]
F�82SM
PREP.BY REV.BY SCALE DATE PROJECT NO.
LB EG AS SHOWN 01/21/2020 SLP1078203

N
N
M
0)
N _
n p O
V z N
U 00
�MW-17 x a
CD
a- < a
z o J
J N U)
O 04
0
N
,u U
= o O
C N
O O
0
FORMER
w
1,000 GALLON 1 O UJ
1 UJ
r- N
GASOLINE USTs c \
1 Q N Q
-- -- -- _- -- OC
-�--
�--
mMW-11 a
I ILI MW-10
J------- -- °
ZIDISPENSER z
z
a =
m MW-12 I
w� m Q
IL
°I MW-4
a
JONES MW-2I z }
GROCERY O �5 � FORMER PUMP U 0 � CD
I ISLAND O � f w
-oMW-13 -4 Q
M -1 W-1 O U
W-5 OW-3
MW-6 W-7 MW-9 z >
—-- -3-- - - D O w m
Ml
= z a
RIMROCK ROAD AS- 0C c�
VE- c _ �
LARRY'S o
FORMER 550 & -0-MW-8 Q O
1,000-GALLON BODY SHOP V U o
-oMW-15 USTs O J
} 1-- w o
_ -0-MW-18 N w � �
Q — Q z
2 CD 1 c� Ld
LliJ W (_0 w
Q LU 0 Lo LL
Cif
O
2
LU �-
f'-
a
W ,
LEGEND: MW-16
MONITORING WELL LOCATION
0 25 50 100
w
z
APPROXIMATE SCALE IN FEET o

N
N
M
0)
' N �
N O
Z N
v U 00
r �MW-17 a 3 o
u- a
Z o J
u J � u�
N
o
= O �
O
Fn
FORMER Z w N
40 0 ¢ \
1,000 GALLON _ 1
GASOLINE USTs 1
w N
.� Q N 0 ti O
U m
MW-11 ¢ c z>
I
>I ---- -- L
Zll�' DISPENSERS �-- MW-10 o W o
Z ¢ _
m MW-12>- o
• ofI m Q
�- a' IJ U
,ml MW-4 I
' a N 64.85 Q
JOf LNAPL(0.86')x W-2 Q z }
GROCERY ` O 5 FORMER PUMP J
65.08 ; ISLAND 1 0 Q
Q
`MW-13 W-1 D 65.16 O -4
MW-5 OW-3 '
W-1
MW-6 W-7
- - - - �
64.91 iNL9 z °0 < ~
- - - - - - - - - - -—65.5�1LU.3--65.50 _ I O = o a m
RIMROCK ROAD AS-1 01 zo c�
- -65.0 VE-1 z =
� w z
FORMER 550 & MW-g 4 LARRY'S Q o J
1 4 BODY SHOP >
w
,000-GALLON z Q o
-,�`MW-15 USTs
w O �
C)" >- w o
-�MW-18 LLI � w
2 w Q C--) ~
2 z w o
o w (o � w
Q
w 0- J
- � O Ln Q o
-D
w
o
w �
W :. 0 z
I U
' w zLEGEND: �-<<. � � Z
r--� -1 o
MONITORING WELLtL ;` � t < >
Z
VERTICAL EXTENT WELL MW-16 -j w
♦ AIR SPARGE WELL A:- Lu Z)
65.52 GROUNDWATER ELEVATION IN FEET ~o
0 N Z
GROUNDWATER ELEVATION CONTOUR j N 0
(DASHED WHERE INFERRED) 25 5O �� 0 M
GROUNDWATER FLOW - w 0 o 2
MIA APPROXIMATE SCALE IN FEET z - N

N
N
M
0)
' N �
N O
Z N
v U 00
r �MW-17 a 3 o
u- a
Z o J
u :1 � u�
N
o
= O �
O O
u- N
FORMER - W
1,000 GALLON 0 M N
❑
GASOLINE USTs 11 cq
�
.• ti 1 U
Wco
N 0
O
O c
IMW-1 1
o t
Zll�' DISPENSERS ° W o
T MW-12ml I 10,0001ag/L Z�, U
of 5,000lag/L 0 t Q
W ___ 1 000 lag/L z
Jo ~' �a MW-4 —9 160
1 lag/L Q
I JONII,%%19300 MW-21 z }
GRJ6CVY 61,07 FORMER PUMP Jco
11.9 LAND � ui Q
BMW-13 W-1 D -1 -4 1 1 Q Q
- / I I 7 W-11 I I �
MW-5 I IM "3 W-1 I D, Do >-
>
- - - - - - - - - - �AUV-3- o m
35980�
RIMROCK ROAD C
VE-1 z w = ~
CD
o z
FORMER 550 & �MW-8 LARRY S Q c-5 Q o
1,000-GALLON BODY SHOP w z U o
-,�`MW-15 USTs - z
w �
w w
-�MW-18 Lo o o
w U �
_ o o
O = Q
w w z
2 � Lz o
—� N w (D W
Q
W z Z Ln LL
u w o — Q ❑
O m -D _
W
c�
W :. w z
0
• ''� .. W z
1 Imo+ a O
LEGEND:
o
MONITORING WELL MW-16 w U)
VERTICAL EXTENT WELL < co O
♦ AIR SPARGE WELL Z o Z
16.6 BENZENE CONCENTRATION IN Ng/L 0 25 50 100 O N
BENZENE ISOCONCENTRATION CONTOUR w W o
(DASHED WHERE INFERRED) APPROXIMATE SCALE IN FEET z - N

N
N
M
0)
' N �
N O
Z N
v U 00
r �MW-17 a 3 o
u- a
Z o J
u J � u�
N
o
= O �
O O
FORMER u- o
1,000 GALLON
W
M N
GASOLINE USTs 11 cq
�
.• ti 1 U 0 N
O
O c
1 MW-1
---ji z
Z ll�' DISPENSERS ° W o
�I z v =
MW-12 - I 200 Ng/L o co
W' - —— i � 50 �g/L t Q
MW-4 i'262` 0.0211g/L v
Q
JOfy S00513 MW-21 z ,
GR ��tY O 5 ' FORMER PUMP J
0.32J � I X ISLAND
� � w <
BMW-13 1 Q MW-1O 7� Q
W 1/
O N S
M -5 I ow- W-7/ CDDo >-
1 ly/IW- 124JMW%� z o < wo m
O = z
- - - - 1 8
EL
RIMROCK ROAD u c�
AS-1� o l
- VE-1 z z z
w
O z
1 FORMER 550 & ��tMW-8 000
BODY SHOP Q z
1,000-GALLON o
-,�`MW-15 USTs O
>- Lv >- Iw o
-�MW-18 10 z
�
w
2 O ~
2 w o
—► W (D :> w
Q
w m c J
_ u 0 - Q o
O LLJ -D - S
W
c�
:. •� w
W Y z
I W
0
w O
a U
prim- t •' < Q z
LEGEND: {-`
U o
MONITORING WELL M6 ys w
VERTICAL EXTENT WELL �T < c O
♦ AIR SPARGE WELL Z N z
16.6 EDB CONCENTRATION IN Ng/L 0 25 50 100 O N
EDB ISOCONCENTRATION CONTOUR w 0 o 2
(DASHED WHERE INFERRED) MIAAPPROXIMATE SCALE IN FEET z - N

N
O W-S MW-2 M
February 27, 2023 February 27,2023 04
Constituent Detection Constituent Detection Z o
Benzene 19,300 ++� Benzene 9.1&0 0
Toluene 38,500 I r !MW-17 Toluene 36,300 U Q o 0
Ethylbenzene 3,060 Ethylbenzene 3,700 Q LL a J
Total Xylenes 15,100 Total Xylenes 19,500 N U)
O 1?MTBE 312 Naphthalene 672 12f Q 0)Naphthalene 437J EDB 2$2 U
EDB 513 1,2-DCA 285 N
1,2-DCA 792 IPE 2,980 O v O
IPE g 620 Isopropylbenzene 110J Z \
FORMER a
0 0 �
Isopropylbenzene 94.7J 1,000 GALLON n-Propylbenzene 294 1 w \
n-Propylbenzene 248 �►w J Styrene 129 N
GASOLINE USTs 11 ¢ 00
Styrene O1,2,4 Trimethylbenzene 2,150
m
1,2,4-Trim ethyl benzene 1,550 1,3,5-Trimethylbenzene 592 0 .c
0
MW-11 a °
1,3,5-Trim ethyl benzene 410 } L
Q, MW-1 r
M -10
Z' DIS NSERS�----- ° w o
MW 1 D February 27, 2023 Z v _
February 27,2023 ml MW-12 I Constituent Detection U
o U�
Constituent Detection f Wi Benzene ,840 L Q
Benzene 11.90 I Toluene 19,300 U
CL MW_4 Ethylbenzene 2,110 Q
EDB 0.32J JONES MW- Total Xylenes 9,490 z m 1,2 DCA 0.46J _ GROCERY -5 ' FORM AND MTBE 146 0 ' Q
Naphthalene 420 Q
`MW-1 W-1 D M-7 , -4 EDB ZU IZ U
OW-3 -1
1,2-DCA 293 Q N =
'I MW-5 W-7 � 00 >-
MW-6 �MW-9 IPE A70 r\ Q � a m
---------- -
- - /_$_ _ - _ �_ n-Propylbenzene Z O1,2,4-Trimethylbenzene �RIMROCK ROAD AS-1 TAA ~
VE-1 z z =
VE-1 w
4W
FORMER 550 & MW-g INSLARRY'S o J
1,000-GALLON - BODY SHOP
R,_ � z o 0
-,NW-15 USTs �
I o
I
L-
Legend } P cU) >- Lw o
Constituent 2L GCL Q _ _ '�MW-18 zLLJ LI-
Benzene 1 5� _ \ "y � Z O
Toluene 600 260,000
Ethylbenzene 600 80,000 MW 6 (� MW 7 - CO Q z
Total Xylenes 500 50,000 February 27,2023 = February 27,2023 Q o
Methyl Tertiary Butyl Ether Constituent Detection J Constituent Detection w cD -7 w
(MTBE) 20 20,000 Benzene 3,980 J�� Q Benzene 19,000 C) z Q o
Naphthalene 6 6� Toluene 26,100 ` Toluene 38,700 ~ o _
1,2-Dibromcethane 0.02 50 Ethylbenzene 3,240 Ethylbenzene 3,020
(EDB) Total Xylenes 18,500 W Total Xylenes 15,200 N
1,2 Dichlorcethane 0.4 400 Naphthalene 636 MTBE 313 07
(1,2-DCA) Z
70 70,000EDB
Di-Isopropyl Ether EDB 178 r Naphthalene 666 Z o
(IPE) IPE 1,440 ti : LUU 1,2 DCA 1 Q U
Isopropylbenzene 70 30,500 Isopropyl benzene 105 X
n-Propylbenzene 70 a40,OO
n-Propylbenzene 302 IPE 17,200 w z
Styrene 70 n-Pro Ibenzene J Z
1,2,4-Trimethylbenzene 2 270 pY 238 a O_ 0
1,2,4-Trimethylbenzene 400 '4� 1,2,4 Trimeth Ibenzene 1,540 Q P _
1,3,5-Trimethylbenzene 400 1,3,5-Trimethylbenzene 614 Y < Q o7
tert-Amyl Alcohol (TAA) 40 LU
MW-16 1,3,5-Trimethylbenzene 477 w z
tert-Butyl Alcohol (TBA) 10 10,06 TAA 28,100 < w U)
LEGEND: NS I. TBA 22,600 o co o
MONITORING WELL 0 25 50 00 z O o
[ 0O N J Z
VERTICAL EXTENT WELL bi Of NZ �
♦ w C7 0 0 r)
♦ AIR SPARGE WELL ! APPROXIMATE SCALE IN FEET O N
z

-------------------------
Z
O
O Z
COO } ❑ W
w Z O m a J ¢ 2 } Z
0 J
=_ a❑ ❑ w ccnn Uw= Q z
O W = ❑ Z ~ c O U O
j Z a Ox
HLL} W O ❑
a ¢ z0 m ❑
3r O ¢ 0
cn v
❑ ❑ V! a m Z > W _j cn � E m
OJ H H m w p 2 a ❑ p Cl) ❑W W x �W
w J J a Z O❑ ~ w U'- LLI d a LL Q
❑ ❑ Z H }¢ O Q _ z 0 v a O
z ¢ 0 U p z¢ F_ II-- W =O z `n Q C) Q �
w C� cn O a ] o w In
It
� z ° p Z w ❑ ❑0 ❑ Q O p
W U U ❑ O z -j ❑ � LL LLJ Y W a w Li w z wLu F
❑ ❑ p � L � w a z Q J co a e � m ¢ C7 a a
W W O 0 0 a a u� Or w w
ICY. J W a' 2 2 (f W m CO ¢ Q � J J J ¢ ❑
z z w ¢ 0 m z ¢ zO o O can a a 0cy, v' u x O ~ Q
O O ❑ H x 0 I- [r c� 0° Z Q ¢ Q O Q w O I- w 0 O
m m Q Z a J m z cn °' z ❑ z ❑ a z a) a z H
N wO
LL__
Z W
7 �
Q O a
U o 0 0 0 0 0
o- --------------- T-----------------
L -noo3a
N
4-1
o �
U
�
<jw LU
_ co
o
y^^/ Hld3(] LO 0 N N N N M c7 LO
S``l�
L^
I co
m EO
M m
N (D CO
00
N I�
Z (V W d� L~L
Ln In z o LLl 3 m
� O O W <o cn
J p0 � o o
J Y a w w
fY S
O >- LU w LL F LLo LU W
.L ❑ Q Jmj LL ~U LL
MO w = ❑ >� Ln zwrl. (V ❑
W ~ J ~ Q O 1, z LL
Q
❑ z J 'a.0 � 0'p da. O p _ O UA C
} OOLU
d O d� O 4
W LU ❑ z_ J
¢
7 O Z w .-0-. D.O' v. p,0 _ I— �L. W
J U)
2 cn � F a = w ❑
U Q z D r ❑O o co W❑ wN Z
Fz-
W
V W p z10
z Z
Lr) H o LLJZ D !Z Z 0 <j Zz O O Iri J I- > m _j( z Do
LO W < EL y
O = UA w W
Q ° xZ LLJ
°a U> _ ~ Y m W
U � W Mz °m = za �jwUO p
li < N Z -M y o Q LLI cn F-
~ � QW aF I O a N ~ Z
W w H ❑ W U �� o Z Z W cn w II
p a U 00 LL. o F J a > F- o
J IW- � Q Fes- =w tD E Q [Y O O z
I j IW- 0 a 3 ❑ (n U' (� U
} 1 � F- Cl)UU IL (A Q o

�
------------
0
/ LU
o 2 q <
\ j } » } [ F-
/ / 2 § \ § L a A
\ \ \ \ 0 \ / \ \ w \ \
/ o o e e / e o o o e / o e
e e o IDc o e e = z c e
l. f ƒ ƒ ƒ § z f R { ƒ } f ƒ @
I � t t t § \ E \ R () S \ G % t LO
' [ a e a o e } § § E 7 / a / z 7 f
e e a o c n e
w ( \ j a- § § � ƒ Cl) ƒ G / . ƒ E
7 w \ � } o ) z c > _ ) a J ) e
z z =
\ } } \ \ \ \ \ \ \ / \ \ \ § }
n
E/
2j
$nO \�\
Uw,
4-1
—m
�\ D0/C) @FL
.
_[ .
\\
mz
Lo
$ #3, o G \ F)l I
It
�
>
� ® _
2 \ CO
@ G ¥ a \ \ ; /
E z § _j §wo_
O
o <:
\ \ 0 \ / \\
) / ƒ $ )
\) / � }\ \ . E
e z §[�� / 2 LL
O L « 2 =° a :®z o
j j / \ ) « 3;d2 »,a[ 2 \ \
} ® \ P�, % @ ± 04
a
9 \ j \ `m%!w%Jy}2 � \ / } }
\ . \ \ : §~ »\ . \ \ * M \ ]
§ ) \ & ° (( _ 62 /z [; k z E
/ , / § Ij \/ / w° �\ �� \ \ \ § \ \
\ {_ 6 ) ) / /§ } /( § \ j
% § / ] z n 3® § o / ƒ 2 a e
§ w / § 2 \ [( i j \ §
q I Q / = L g g 2 § > @ I ®
] \ / w \ § § ) / } / ƒ \ \ }
E e ± e O = g o m o
R = = r \ @ 0 G

F- F-
J_ J
Q ❑ Cn CO
z zCD
o 0
F_ J N N
J Q Q
z Z
a a a
F-
p Cl Cn fn LL
+ C� °O 00 W W Ln
O } Q ❑ z Z d
W a..l J J g Q Q LL LL
> U U U U U) o o LL
❑ ID ❑ Q W LLI z Uj N N Q
d Q LLLL a a ZQ LL LL O ❑ Q J
o o O O F-
U J } J J p p >- W F- W F- O
� VJ CO U) U) U) N N -J-- U W U W F-
W
p ❑ Z Z Z Z
z z = a a
U � U � ❑
i g } g y
O O O O O cA z ¢ z a
m m m ofm m } U U n
O O D 0 p O Q a O ❑ 0 (D F_
coLLJ ` mQ ma
U) °wo
Z�n, W
W
nCC
a C
0 Iloa I
4-4
�aa
L I
-noo3a
N
O
FLca
U
am
¢Z)
U)z
Q� Fild30
O Ln O ll'7 N N co M V V
Q.
L2 0
N C Z
00 h ..
v U m W d J LL
r W z J o Lu Ln
Q ~ � Z O �--<
W
pJ O C >o Q o
V/ J > LL w
J O = Ilw
W w LL F 0- -
m LL 2
O w _ z > W j- N 0 LL
Q 2 - J a a Z 00
0 a Z J
V r� LL O II I'I'I'I III'll II' I I III I I� F'-
co
LL O J . Q II I I I
NU Z N
W
ch U Wd
WO 0
I CO
� Li
F U LU
a Z Z O
Ow
z I
m I
O
L( z w � LL No0� IO J Z z O nIW I
O
F- o r z o =Cl) = U) p Z W
Qk 'In I O LY m a U> F- W Y O m Lu W
U W (n (+� Z a a' = i s W U O
-� o a
F- a W ZIQ a.� N OI C7 N O
Z W Z � U �3 O` Z J Z Z
LLI iLi z cn W
d Q W J �_
J W
O 11
N o W H O U K LL < Q 0 0
J W d =W�' � a � J O Z
W F ~ O D- ¢ O [n C9 (n U
(n 4. CO J I- o Cl)

D _ \
e
j § z a \ § LO §
LO
\ ) co / / < Cl
o z =
\ Lb < CO
/ » e ƒ E
j 2 § t § } / \ 0
u < > ® g d \ e 2 a \
§ j a C 0- w ® u w <
$ t g { { z G » \ § /
e Qz » < < < a I o z e
® e � m = _ z £z z ¥
' ) I Ek \ < / / § \ ƒ \ <
j § \ / \ 7 2 / 2 § § § \ \ \ {
o / z = a o } / } ƒ z < 2 ® a
% § \ 0 ° j / / / < U)
0 o m = o o < � < < _
E § G 0 < < < ± � § 2 }
�\ E / R z \ § § § ƒ / / 0 § < \ z 7
\ u § ƒ $ ) § ƒ ± / ± a m m < _
/
. Lu/ \
� )(
2 / \
O .
�
�
�/—
7
/)
6/
$ .
2
)§\j
mz
¢ wa£ ° m rco
cl .
°
E \ 2
/ \ j j (: §
U 0 \/ W }KQ]
6 o o \. LL
\ [�
� ) / $ ƒ
\ f 6 / ( § %§ § ±
/ j / z \� ~ / LU CD & \ 9 §
° < ®\; \S® s»[ 7 ) \
} / \ : \ ( aL \ .
E c . + o z
/ \ / ) ° %/m%Jw22 ( ( E \
_ .
\ .. � ` e 110
= 0 \ / \ E
2 \ \ § ee �� \§ �k 6 2 0 j
0 o 8 \ °§ ° G5 �° 2 0 § o e a
¥ e = L §& z ,=m 0 I ® \ § /
) \ § \ i }§ \ g/ \ w / 0 10 [
§ ± ƒ § 2E -} § \ / ƒ § / \
Iz < § o
\ LLJ \ 0 0 � �� j j \ \ §
0 U \ } < i j 0 / |
§ « J / e 0 /\ \ c = O = Q
\ ƒ § \ / 0

Q ❑ ❑ ❑ x J_ O
O O O O O U) ❑ U) m 0
0 LO 2 LO LO
❑ ❑ ❑ ❑ ti Q ti
W W W W J ❑ W ❑ ❑
Z J Z z
C� O o O UJ u) u) LO
O a d D- � w 2
LLJj ¢ g ¢ ¢ ¢ LL ¢ m o Oz w °w Q w
U U U U U N U O U) 0 O ❑
LL ❑ ❑ ❑ ❑ ❑ ❑ ❑ W Z W W W W CC J
0� z z z z z Q z 0 z Z z z ❑ ¢
U ¢ ¢ a ¢ ¢ w ¢ w LL ¢
U) I [if
LL LL ❑I- I- - I
I— [ifO
~ ❑ o ~ o o o 0
w Q J W O Lll Q LO LO
❑ U) (1) U) U) U) U) J N O N N N ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ V) ❑ O Z Z U) Z Z J J J J
LL, Q- L a IZ
Z Z Z Z Z F- Z a. CC J CL' X J of, J ¢ a a a
2 �: W C U m U CO U m y V) U) W U)
(� O5 ❑ ❑ ❑ ❑ 00 ❑ ❑ F r
N � x Of � x -j CC O w z w Z w z W z O O O O
m m m m m (n m w a a ¢ � ¢ z z z z
}n,' W 0
W LLS
uj
uj
0 (D
U -T,T,l
� na3
-A003a
0
UU w Of
am
Q D
Ln z
o o Ln o Ln o Ln o o
H1d30 N N M M d'
C) I I I
- 03Ln ❑ LL LO
N CD Z � 111= �o �
c 00 N N V) —III LL H °
U N ° III OW LL tY
W z J W O 1= F 0 LO H
o aU O
0 ~ O 00 W IIII) o� °LU� ❑
J O ° U > LL III=
oY Q � m � III= off`° oW � o
Lu WLL z
O m 111- 0 o a o
} w cn a s M z° w (an
M w _ P Z j .1 d'A > o s oa e >' o' M U LLLL
o W e. e l e. .e �e a J Cl)
❑ a Z W co
d' QO `� d o ,d ✓ F W c0
W J ❑ o U) (f) z J
❑ C) W �: C7 W W
cn a o r > p e O v I- W
U) a !. v , m o0 s o. 2 Z J
Ww � j ¢ ° a uj . O � a
z O `Ln° LO J III w c� U) x z z a L)) p 0 N z U
LO W —� a Z a_ z w U W n p (n O w W J
III a 0 EE a U) ~ �of °m o 2 I— Y o m ❑ aIIII ° m a cui ° S L N o w g Q p I¢—
u r W (n Z O
LL = W a0 a m r a U Z N z II z
z W H LLl U I co Z = OJ Z_ W 0 W ❑
d
o U ❑p ❑ W IIII Z J d >
J � Wa � O z III- y N g Lo J g a 0 z z
a J O
W � H ~ O ° 11 IT °of ❑ O cn v
U) IL Fn a — =w
O a~¢o
w3:a
'N
V

Geological Resources, Inc. Phone: [phone]
2301-F Crown Point Executive Drive Fax: [phone]
Charlotte, NC 28227
SUBSURFACE LOG
Project Jones Grocery
Address 1156 East Memorial Highway, Harmony, NC
Boring Number Tw-2 Date Drilled 07/07/09
Sample Method Drilling Method Air Rotary 7"Drag Bit
Completion Details
Set casing at 1 10'w/5.0'of screen& tremme grouted to Mud Rotary at 50'
bentonite to 103.0'to 101.0'and neat cement 101.0'to surface.
Driller Log By Hollis Keech
Lab Sample OVA
Depth Sample Interval(ft) ppm LITHOLOGY
0-5.0'Gravel
0
2
4
5.0'-8.0'Reddish Brown Silts
6
8 8.0'-50.0' Dark reddish brown silt& mica,w/petroleum odor
10
12
14
16
18
20
22
24
26
28
30
32
34
Page 1 of 3

Geological Resources, Inc. Phone: [phone]
2301-F Crown Point Executive Drive Fax: [phone]
Charlotte, NC 28227
SUBSURFACE LOG
Project Jones Grocery
Address 1156 East Memorial Highway, Harmony, NC
Boring Number TW-2 Date Drilled 07/07/09
Sample Method Drilling Method Air Rotary 7"Drag Bit
Completion Details
Set casing at 110'w/5.0'of screen& tremme grouted to Mud Rotary at 50'
bentonite to 103.0'to 101.0'and neat cement 101.0'to surface.
Driller Log By Hollis Keech
Lab Sample OVA
Depth Sample Interval(ft) ppm LITHOLOGY
36
38
40
42
44
46
48
50 50.0'-90.0'Dark reddish brown silts wl fine sand &mica
52
54
56
58
60
62
64
66
68
70
72
Page 2 of 3

Geological Resources, Inc. Phone: [phone]
2301-F Crown Point Executive Drive Fax: [phone]
Charlotte, NC 28227
SUBSURFACE LOG
Project Jones Grocery
Address 1156 East Memorial Highway, Harmony, NC
Boring Number Tw-2 Date Drilled 07/07/09
Sample Method Drilling Method Air Rotary 7" Drag Bit
Completion Details
Set casing at 110'w/5.0'of screen & tremme grouted to Mud Rotary at 50'
bentonite to 103.0'to 101.0'and neat cement 101.0'to surface.
Driller Log By Hollis Keech
Lab Sample OVA
Depth Sample Interval(ft) ppm LITHOLOGY
74
76
78
80
82
84
86
88
90 90.0'-93.0'Reddish brown silts&fine medium sand &mica
92
93.0'- 100.0'Brown silts&fine-medium sand with mica
94
96
98
100 100.0'- 101.0' Rock layer, black&white weathered quartz
101.0'- 103.0' Brown quartz sand medium fine sand w/mica
102
103.0'- 105.0'weathered rock black&white saprolite
104
105.0'- 110.0' Brown quartz sand w/medium fine silts
106
108
110 Boring terminated at 110.0'
112 of 3

MW-1
WELL CONSTRUCTION RECORD
North Carolina—Department of Environment and Natural Rcseurecs—Division nf WaterQur3lity—Groundwater Section
WBLL CONTRACTOR(!INDIVIDUAL)NAME(print) Milton(Ray) Rogers CERTIFICATION 4 2429
WII.L CONTRACTOR COMPANY NAME SM Environmental_Inc. PHONE# [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT 0
(if applicable) (if applicable)
1. WELL USE(Check.Applicable Box): Residential ❑ hlunicipal/Publid'❑ Industrial❑ Agricultural Q
Monitoling® Recovery❑ Heat Pump Water Injection❑ Other❑ If Other,list Use
2. VJRL LOCATION: DEPTFI .DRILLING LOG
Nearest Town: Harmony County lrede11 From To Formation Description
1156 Easy Memorial Highway 28634 0 - 5.0 Brown red clay and silt dry
(Street Name,Numbers,Community,or Subdivision and Lot No.,Zip Code) 5.0 8 Not Sampled
3, OWNER Parks Jones 8 10 _Brown red clay and silt with white&
ADDRESS lVl_1156Eestetttorial _yellowmottling,-pusbed spoon
Highway 10 13 Not Sam Ted
(Street or Route 1�0.) 13 15 Lt.brown red wiih red&yellow
Harmony NG_ 28634 City or Town State Zip Cade
brown mottling clay and silt,pushed
�
(704)546 25I0' spoon
Area Code—Phone Number 15 - 18 Not Sampled
18 20 _Strang petroleum Odor,19.2 20'is
4. DATE DRILLED 5125/05 80%fine-medium sand with silt 6c
5. TOTAL DEPTH 55 feet clay.Lt.brown red wired white and
6. DOES WELL REPLACE EXISTING WELL? YES© NO 119 minor blacic mottling,dry
7- STATIC WATER LEVEL 13clow Top of Casing: 36.76 FT. 20 - 23 Not Sampled
(Use"+^if Above Top of Casing) Z3 25 Damp,strong petroleum odor.Same
8, TQP OF CASING IS. 0,0 FT.Aboyc Land Surface* matrix as previous sam le
^Top of casing terminated atlor below land surface requires a variance in accordance 25 28 Not sampled
with I5ANCAC2C.0118. 28 30 Damp,60%Ane-mediumsand,40%
9- YIELD(Mm): N/A METHOD OF TEST N/A silt&clay.Petroleum odor
10. WATER ZONES(depth): 30 ' 38 Not Sampled
C 38 - 40 _95%Fn�medium sand,5%silt,wet
1 i s CASING:
Typo NIA Amoynt N!A _Lt.red.br6wri w/large areas of white
12. CASING; _Slight petroleum odor:
Well Thickness- 40 55 _blot Sample&Saturated by 45 feat-
Depth
Diameter or weight/Ft. NTaterial _TdW Depth=55 feet HGS.
FROM 0 TO 40 FT 2" Sch40 PVC LOCATION SKETCH
,PROM TO FT Show direction and distance in miles from at least two State Roads
FROM TO FT or County Reads;include the road numbers and common names,
13. GROUT: t sl
Depth Material Method / I
FROM 0 TO 31.. FT Portland Slurry
FROM TO FT
p r
14. SCREEN:
Depth Diameter Slat Sisc Material
FROM 40 TO 55 FT 2 in 0.010 in PVC
FROM TO FT in in ---- --- xerr$awr.----`- ------ --- - "^.,"
15. SAND/GRAVEL PACK: v"wan,wua.uer '�
Depth Sizc Material RIMRocXnQA0
FROM 35 TO 55• FT #2 Fine Silica Sand
Topographic/Land setting �
❑Ridge q Slope ❑Valley W Flat
IS6AN0;
(check appropriate box) o mcu NanRwunawcu
Latitude/tangitude of well location ® '"E"Haman o»ux
N35"5511I WORON3257^
(deg[ees/minutaa/sexvndfs) Nmn�yOn Nu fAC.wRN[soLus,w,inr+oL
LatitudeRoagitude source:®GPS® Topographic maP
/li'1JIIIMm!3Gi[ NNan1^.NC�
' owcr.oalYn OPUYNBY:JC!
16 REMARKS.Bentonite seal 31-35 feet
I DO HEREBY LERTfFY ONSTRUCIED IN ACCORDANCE WTM 15 NCAC 2C,WELL CONSTRUCTION STANDARDS,AND
THAT A COPY OF THIS`RECORD HAS BEEN RO D TO THE WELL OWNER
SIGNAT F.0 CTOR OR AGENT DATE
Submit original to the Division of Water,Quality,Groundwater Section,1636 Mail Service Center—Raleigh,NC 27699-1636 Phone No.[phone],within 30
(11W-1 RRV 07I7DO1
Zoo IRS H110`IHVH0 'IV,LNHIiINOHIANH IRS VT69Z£8 XVH 0£:60 NON 90/ZZ/80

MW-ID
WELL CONSTRUCTION RECORD
North Carolina-Department of Environment and Natural Resources,-Division of Water Qudlity-Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NAME(print). Milton(Ravi Angers CERTIFICATION# 2428
WELL CONTRACTOR COMPANY NAME SEI Environmental,Inc PRONE# [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE(Cheek Applicable Box): Residential E] Municipal/Public Q Industrial❑ Agricultural 11
Monitoring[E Recovery f] Beat Pump Water Injection Q Other❑ If Other,-list Use
2, WELL LOCATION;
Nearest Town: Harmony County lredell
1 156 East Memorial Highway 28634 DEPTH pRILLANG
(Street Name,Numbers,Communh LOG
ty,or Subdivision and Lot No.,Zip Code) From To Formation Des Lion
0 5 BF❑Wn red clay and silt
ADDRESS 1156 East Memorial Highway3. A Parks Jones 5.0 10 Brown red clay and sift m petroleu--
(Street or Route No.) odor
Harmony
10 - 15 Hrown red clay and silt petroleum
N 2R634
City or Town State Zip Code odor
[phone] 15 20 Brown red clay and silt petroleum
Area Code-Phone Number odor
20 25 _Brown red clay find silt,petroleum
4. DATE DRILLED 7/14-15105 odor
5. TOTAL DEPTH' 75 feet 25 - 30 Brown red clay and silt,strong
r
6. DOES WELL REPLACE EXISTING WELL? YES El NO d petroleum odor,sli htmaisture at
7. STATIC WATER LEVEL Below Top of Casing: 42.00 FT. 27 feet
(Use"+"if Above Top of Casing) 30 - 35 Brown red cla�and silt moist some
s. T6F OFCASING IS OA FT.Above Land Surface* _petroleum odor
'Top of casing terminated at/or below land surface requires a variance in accordance 35 - Red brown 20%fine sand 80%clay
with 15A NCAC 2C,0118.. - and silt,moist miner pet.odor
9, YIELD(gpm): N/A METHOD OF TEST N/A 40 45 Red brawn 25%fioe-medium sand
10. WATER ZONES(depth): 75%clay end gilt saturated no odor
45 50 Red brown 25%fine medium sand,
l l_ DISINFECTIOt�1: Type N/A Amount 73%clay and silt
U. CASING: 50 - 55 Red brown 25%brie-medium Land
Wall Thicknes's '. 95°!°clay and silt
Depth Diameter or WajghtlFC. Material55 75 Not Sampled.Mud rotary
.i FROM 0 TO 65 FT 6" Sch40. PVC Total Depth 75 Feet
'FROM 0 TO 65 FT 2_' Sch40 PVC LOCATION SKETCH
FROM TO FT Show direction and distance in miles from at least two State Roads
13. GROUT: or County Roads;include the road numbers and common names.
Depth Material Method r
FROM 0 TO 65 FT Portland Slurry
FROM 0 TO 61 FT Portland Slurry
, sa
14. SCREEN: /
/ 6TnRE sF°VNi,o i i
�Mfl�j
Depth Diameter S16tSize Material
FROM 65 TO 75 FT 2 in 0.010 iti PVC
FROM TO FT 'in in
j, 01AW-1 II
15. SAND/CRAVELPACK: -- ------- ---=t'pr" roR,+eRsawc.uer <'
Depth t°
Size
Material ti
RIM RoMpoAt) Funr�xt,o,00n�uer `x
FROM. 63 TO 75 FT #2 Fine Silica Sand
Topographic!Land setting;
❑Ridge 01Slope R Valley IE Flat �
(check appropriate box) � u
Latitude/langitude of welI location:
N 35°5Q1"WOHM43,257" ® hPe mucR mgiRaweu
(degregs/minutes/seconds)
LatitudeRongitude source;0 CPS© Topographic map
' � O f6 iE FT. {LN igR[IM
JGEs cppQgV
Ls![Atf gII11CRY,MY
urnul...n,rus Nu4CNY,4cLgY
a.1;aD5tq °ATE Yt.Lm
Con•;i°Otapq pgAWN6'n,.C�
16 REMARKS: Bmtonite I-fi feet
F
I DO HEREBY CERTIFY THAT THIS:1WWE:LL-WAS N UCTBD IN ACCORDANCE WITH 15 NCAC 2C,WELL CONSTRUCTION STANDARDS,AND
THAT A COPY OF THIS RECORD HEN PRO ED! THE WELL OWNER
SIGNATURE OF 1CONTRA TOR R AGENT DATE
Submit ariginal to the Division of Water Quality,Groundwater Section,1636 Mail Service Center-Raleigh,NC 27699-1636 Phane No.[phone],within 3D
days. GW-I REV,07/2001
900[n IHS HZZO'IVHG 'IVSN9WN02IIANH IHS VT62ZCS YVtl ££t 60 NOW 50/ZZ/90

-z
WELL CONSTRUCTION RECORD
North Carolina-Department of Environment and Natural Resci7rces-Division of Water Quality=Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NAME(print)_Milton(Ray)Rogers CERTIFICATION# 2428
WELL CONTRACTOR COMPANY NAME SEI Ersyiranmental.Inc. PHONE 4 (9191 832-2535
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE(Check Applicable Box): Residential ❑ Municipai/Public❑ Industrial 0 Agricultural❑
Monitoring® ' Recovery❑ Heat Pump Water Injection El Other❑ If Other,list Use
2. WELL LOCATION: Latitude/langlMde source:0 GPS lad Topographic map
Nearest Town: H2rmanv County Iredell
_ 1156 East tv cmnrial Highway 28634
(Street Narne,Numbers,Community,or Subdivision and Lot No.,Zip Code) DEPTH DRILLING LOG
3. OWNER Parks lanes From To Formation Description
0 510 Brown red clay and silt to 5 feet.
ADDRESS 1156 East Memorial Hiakwav 5.0 10 Purple red clay and silt
(Street or.Routc No,) 10 15 Purple red clay an'd silt,strong
Harmony NC 28634
City or Town State Zip Code del odor
(7041546-251 0 15 20 _Brownn red clay-and silt very dry.
�.Area Code-Phone Number strong petroleum odor
q0 25 _Brown red clay and silt
4. DATE DRILLED 7113105 25 30 Brown red clay and sitt very d
5. TOTAL DEPTH 45 feet strong petroleum odor
6, DOES WELL REPLACE EXISTING WELL7 YES❑ NO 19 30 - 35 Brown red clay and silt,dry
7- STATIC WATER.LEVEL Below Top of Casing: 35.89 PT. Damp by 32 feet.
(Use'4t 'i£Above Tap of Casing) 35 40 Brown red clay and sift
8 TOP OF CASING 1S 0.01 FT.Above Land Surface's Wet by 38 feet,stronger petroleum
*Top of easing'terminated at/or below land surface requires a• variance in accordance odor
wi th l 5A NCAC 2C.0118, 40 45 Brown red clay and silt,wet,
9. YIELD(gpm). NIA METHOD OF TEST N/A Saturated by 45 feet
10. WATER ZONES(depth): Tat a}Depth 45 feet.
11, DISINFECTION; Type N/A Amount N/A LOCATION SKET-C
12. CASING: Show direction and distance in miles from at least two State Roads
Will Thioknesis or County Roads;include the road numbers and common names.
Depth Diameter or Weight/Ft. Material
FROM 0 TO 30 -FT 2" Sch40 PVC
FROM TO FT fl
FROM TO FT I 11'
NM1Y4 0 rock 1
13. GROUT:
Depth Material Method 1 it
f au�pMo '� ii
FROM 0 TO 25 FT Portland -Slurry-
FROM TO FT _ ., _ , _ —r_i�anm•, g
14. SCREEN:
Depth Diameter Slot Size Material - -
f6I0AER
FROM 1D TO 45 •FT 2 in 0,010 in PVC RIM ROCK ROAD
z
FROM TO FT in -in �
u1
15. SAND/GRAVEL PACK:
ui
Depth Size Material
FROM 28 TO 45 FT 42 Fine Silica Sand ""°'""""1N0W�`
® 1TP6IR M°tT°RM°WFII• -
Topographie/Land setting:
URidge 0 Slope Cl Valley El Fiat 661Fsg�nBB Gpd GeaogkalSb�Xxx P.e,
(check appropriate box ° / �� 6Re� , IR bbe Rcum,,lNlws�
( h . ) rt rRe�ni°crm
Latitude/longitude of well location:
N 35°55:7 I"W080 43 Z57" ewer.,nolx9s Rw.wuseo,m
(degrees/minutes/seconds)
16 REMARKS:Bentonite Seal25-28 feet
l DO HEREBY C RTIFY THAT THI AS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C,WELL CONSTRUCTION STANDARDS,AND
THAT A COPY OF THIS RECORD HAS B N FkQVIDED TO THE WELL OWNER
SIGNAtURE 0VtMRACTDR OR AGENT DATE
Submit original to the Division of Water Quality,Groundwater Section,1636 Mail Service Center-Raleigh,NC 27699-1636 Phone No.[phone],within 30
days. OW-1 REV.0712001
s00 in IHS H110'1HVHD FFF 'IF LAIHXN0HIANH IHS PT69ZCS YVA TC:60 NON 90/ZZ/96

A W-3
WELL CONSTRUCTION RECORD
North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Groundwater Section
WELL CONTRACTOR(INDMDUAL)NAlVTH(print} Milton(Ray)Rogers CERTIFICATION 2428
WELL CONTRACTOR COMPANY NAME SE[Environmentai.Inc, PHONE# [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT 4
(if applicable) (if applicable)
WELL USF_(Check Applicable Box): Residential Cl Municipal✓PublicCI Industrial❑ Agricultural Q
Monitoring 17 Recovery 0 Heat Pump Water Injection O Other❑ If Other,list Use
2. WELL LOCATION; Latitude/longitude source:❑GPS 0 Topographic map
Nearest Town; Hatmonv County Iredell
1 15G East Memorial Highway 28634
(Street Name,Numbers,Community,or Subdivision and Lot No-,Zip Code) DB T DRILLING LOG
From To Forrnafion'Description
3. OWNER Parks Jones 0 9.6 Brawn red clay and silt
ADDRESS 1156 East Memorial Highway 9.0 15 _Red brown clay and silt
(Street or Route Na.) IS 20 Red brown clay and silt
Harmony NC 28634 20 25 Red brown clay and stilt
City or Town Stafe Zip Code 25 30 _Red brown 20%fine sand,so%clay
ROM 546-2510 and silt
Area Code-Phone Number 30 - ;l5 Rcd brown 20%fine sand,Bon%clay
4, DATE DRILLED' 7/14105 and silt,slightly moist
5. TOTAL DEPTH 45 feet 35 40 Brown micaceous 20%6ne sand,
6. DOES WELL REPLACE EX[STING WELL? YES D NO❑x 800/clay and silt,wet
7. STATIC WATER LEVEL Below Top of Casing: 34.24 FT. 40 - 45 Brown micaceous 20%fine sand,
(Use"+"if Above Top of Casing) 801/6 clay and silt,saturated by 45 fL
8. TOP OF CASING IS 0.0 FT.Above Land Surface* Total Depth 45 Feet
*Top of casing terminated atlor below land surface requires it variance in accordance
with 15A NCAC 2C,011S.
9. YTELD(gpm): N/A METHOD OF TEST NIA
10. WATER ZONES(depth):
1 1. DISINFECTION; Type N/A Amount N/A LOCATION SKETCH
12. CASING: Show direction and'distanca in miles from at least two State Roads
Wall Thicknes's or County Roads;include the road numbers and common narnes,
Depth Diameter or Weight/Ft, ' Material
`.FROM 0 TO 30 FT 2" Sch40 PVC t xJ fl
FROM TO FT
FROM TO FT rwug
13. GROUT; J I;
Depth Material Method � low-
FROM 0 TO -26 FT Portland Slurry 1 evanwt I/
FROM TO FT -- ' — — °p- - • — .f ',
r warn°na.ivar J
14. SCREEN: °___-_-=-----�d?��'E��---�c-e�=-e--J❑ -__"w-'n_=;�' i
Depth Diameter Slot Size Matcrfa7 --- --' -- - -- - - t,
FROM 30 TO 45 FT 2 in 0.010 in PVC RIM ROCK ROAD
FROM TO FT in in a
L5. SAND/GRAVEL PACK;
depth Size Material w
FROM 28 TO 45• FT 92 Fine Silica Sand °
0 nmryllgri,vµX9WfLL
® lioEiu,m.nonlld W¢a
Topographic/Land setting:
❑Ridge 4 Slope ❑Valley 0 Flat >6EIFssn°°nparenyrndse ks,r.c
(cheek appropriate box)
rmmevrta
x.an nrocuv
Latitude/longitude of well location:
N 35°55+I1-W080n43.257" o.,,cnma au�°ro�
an r:.w°imrz
.(degrees/minutes/seconds)
16 REMAFXS;13entonite Seal 26-28 feet
I DD HEREBY CERTIFY THA .THIS ELL WA UCTED 1N ACCORDANCE WITH 15 NCAC 2C,WELL CONSTRUCTION STANDARDS,AND
THAT A COPY OF THIS RECORD HAS BEEN PROVI HE WELL OWNER
�. �
SIGNATURE OP CONTRA O 01 AGENT DATE
Submit original to the Division of Watet Quality,Groundwater Section,1636 Mail Service Center-Raleigh,NC 27699-1636 Phone No,[phone],within 30
days. GW-1 REV.(17/2001
foo[n IH5 HZ,LO'IHUD FFF 'IVINHNNOHIANH IHS 6T62M XVA TU:60 NOW SO/ZZ/80

MW 4
WELL CONSTRUCTION RECORD
North Carolina-Department of Environment and Natural.Resources-Division of Water Qua)ity-Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NAME(print)-Milton-(Ray)Rogers CERTIFICATION,# 2428
WELL CONTRACTOR COMPANY NAME SEI Environmental.Inc PHONE# [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQPERMIT#
(ifapplicable) (if applicable)
I. WELL USE(Check Applicable Box): Residential' ❑ Municipal/Public❑ Industrial❑ -Agricultural❑
Monitoring© Recovery© Heat Pump Waterinjeetion❑ Other 0 If Other,list Use
2- WELL LOCATION:
Nearest Town: Harmony County fredell
1 156 East Memorial Highway 28634
(Street Name,Numbers,Community,or Subdivision and Lot No.,Zip Code)
DEPTH DRILLING LOG
3. OWNER Parks)ones From To .Formation Description
ADDRESS 1156 East Memorial Highway 0 4.5 Brown red clay and silt
(Street or Route No.) 4,5 9.0 Gradual color change to red brown
Harmony NC 29634 clay and silt
City or Town State Zip Cude 9.0 - 9.5 -Light brown 15.%fine to medium
[phone]
_ sand,85%clay and silt
Area Code-Phone Number 9,5 - l5 Medium brown 25%fine to medium
4, DATE DRILLED 7/15/05 with some coarse sand,75'/o clay
5. TOTAL DEPTH 45 feet and silt
I5 20 Same 86 previous sa le
6. DOES WELL REPLACE EXISTING W8LL7 YES❑ NO I7 7. STATIC WATER LEVEL Below Top of Casing: 34.29 FT. - 25 Same as.preyious sample
220 - 30 Same as previous sample
S(Use" if Above Top of Casing) 30 35 Red brown I S%fine to medium With
fi. TOP OF CASING IS 0.0 FT.AbaveLand urfaco*
'Top of casing terminated atiorbefow land surface requires a variance in accordance some coarse sand,85"/o clay and silt
with 15A NCAC ZC.011 S. 35 40 Red brown 25%fine,medium,and
9. YIELD(gpm): N/A METHOD OF TEST N/A coarse sand,75%clay and silt wet
i o. WATER 20NES(depth_): 40 45 Saturated brown red 25%sand,751/n
clay and silt
11. DISINFECTION: Type NIA Amount N/A Total Depth 45 Feet
12. CASING: LOCATION SKETCH
Wall.Thicknc s Show direction and distance in miles from at least two State Roads
Depth Diameter or Weight/Ft- Material or County Roads-,include the road numbers and common names.
i FROM 0 TO 30 FT 2" Sch40 PVC
FROM TO FT r
FROM TO FT
I,
13. GROUT: II
Depth Material Method ! M-4w
FROM 0 TO 26 FT Portland Slurry
FROM TO FT
raw.ie _ / II
14. SCREEN:
Depth 'Diameter Slot Size Material
FROM 30 TO 45 FT Z in 0,010 in PVC
ranMFa 6aaaA1. S
FROM TO FT in in Rim ROCK ROAD LW �
15. SAND/GRAVEL PACK: o
w Depth Size Material 2
FROM 28 TO 45. FT #2 Fine Silica Sand W
Topographic/land setting: a TNEe MONpgVNM1W@ L
® Tss ier+nHrtoewaw"u
❑Ridge•0 Slope ❑Valley 0 Flat
(check appropriate box)• set �nE���ou oise„ P.C.
Latitude/longitude of well location:
mmaa,4�T.,IA,tweea
Ise„�
N 355$.11"W080"4 .25T' z °�rr' •n�eoon"����.
,.Re+eb„aseeWt 'IUn1e1H,i,e usu
(degrccs/minuteslseconds) W_1 �� cA-X
utuwxar.�u
Latitude/longitude sojurce:❑GPS 19 Topographic map
16 REMARKS:Bentonire,Seal 26-28-feet
I DO HEREBY CERTIFY THA THI ;WELL WA STRUCTED IN ACCORDANCE WITH 15NCAC 2C,WELL CONSTRUCTION STANDARDS,AND
THAT.A COPY OF THIS RECORD HAS 13BEN PRO TO THE WELL OWNER
SIGNATURE O000NTRACTt'1F`OR AUB&T DATE
Submit original to the Division of Water Quality,Groundwater Section,1636 Mail Service Center-Raleigh,NC 27699-1 63 5 Phone No.[phone],within 30
day;. GW-I REV.n7/2001
611
4�
500 in IHS aLZO'IHVH0 EEE 'I5Jk2[XNOHIANiE[ IHS PT69999 X6d Z£t 60 MON 90/ZZ/90

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350686 Feb. 11 2008 10:54AN P9
Non Residential Well Construction Regord
North Carolina Department of Environment and Natural ReMx0eS4>Ws W of Water Qwlfty
WELL CONTRACTOR CERTIFICATION# 2501
7. WELL CONTRACTOR: d.TOP OF CASI NG IS -0.2 Fr Above Land suram
Michael Ransier 'Top of Casing terminated ayor below land surface may require
Well Contractor(Individual)Name a variance in acowdenoe with 1 sA NCAC 2C.ol ie.
Ransier Environmental Drilling, Inc. e.YIELD(gpm) METHOD OF TEST
Well Contractor Company Name f.DISINFECTION:Type Amount
STREET ADDRESS 1 Piney Point g.WATER ZONES (depth);
Whigiering Pines NC 28327 Fro„ To From fro
City or Town State Zip Code From To From To
910 949-4555 From To From To
Area code Phone Number 8.CASING: Thickness
2. WELL INFORMATION: Depth Diameter Weight Material
Site Well ID#(if applicable) MW-5 From -0.2 To 35 Ft. 2" sch 40 PVC
STATE WELL PERMIT#(if applicable: na From To Ft.
DWO or OTHER PERMIT#(if applicat na From To Ft.
WELL USE (Check Applioe )Manitoring X MAVPublic 7_GROUT_ Depth MWferial Method
IndustriauCommerdal Agricultural Recovery lniacfion From 0.5 To 31 Ft. portland tremmie
irrigation Other (List Use) From To Ft.
Date Drilled 1/28/2008 From To Ft,
Time Completed 12'00 AM PM x e.SCREEN: Depth Diameter Slot Material
3.WELL LOCATION: From 35 To 50 Ft. 2" o.al pvc
CITY Hamlony COUNTY Iredell From To Ft.
1156 E. Harmony Hwy From To FL
(Street Name.Numbers.Community,Lot No..Parcel,Zip Code) 9.SAND/GRAVEL PACK
TOPOGRAPHIC/LAND SETTING yDepth Size Material
Slope valley Flat x Mao Other From 33 To 50 FL medium quartz
(check app(Wate) From To Ft.
LATITUDE 35 55 25.34 rrmy be ndegese.nwte. From _ To __ __ Ft
LONGITUD 80 43'12.93 sees.or In deamet to.DRILLING LOG:
Latitude/Longitude source: GPS x Topo map From To Formation Description
(1cudiort of well must be shown on a USGS logo map and 0 1 gr2veVfill
art whed to this rofm If not uWng GPS) 1 50 red brown sitty clay
4.FACILITY is toss nsms of the buetnew where tha wen a locaked
FACILITY 10# (If applicable)
NAME OF FACILITY Jones Grocery
STREETADDRESS 1156 E_ Harmon
Harmony NC
City or Town State Zip Code
CONTACT PERSON Nicole Long I_REMARKS:
MAILING ADDRESS 2301 Crown PL Exea Dr.
Charlotte NC 28227
City or Town State Zip Code
704 845-4010 r oo HMR W 4,'- n"7V'AT'PW W U WAS OMTRkWFM I N wacormwl=
Area rode Number WITH ISA NGAC 2C VML CONSTRIl=M BTANDARDB AND THAT A
5. WELL DETAILS: copy t tau wr LOVMM.
a. TOTAL DEPTH: 50 2/11/2W$
b. DOES WELL REPLACE EXISTING WELL NO SIGNITURE OF CEW IF1ED WELL CONTRACTOR DATE
o. WATER LEVEL Wm Tap of c_ 38 Michael Ransier
(lose-+•if above mp of ceang) PRINTED NAME OF PERSON CONSTRUCTING WELL
&bmll original to Div.of Wow Quality within 30 day& Attu:MATration Mal. 1917 Mao Sorvkm Canter_ > NC 27BB41617 Phone[phone] @M$W

FROM :RANSIER ENVDRILLING INC FRX NO. :9102350686 Feb. 11 2008 10:54AM P8
Non Residential Well Construin ion Record
North Carolina Department of Environment and Natural RevQurc" XvWon of Water Quality
WELL CONTRACTOR CERTIFICATION# 2501
1. WELL CONTRACTOR: d_TOP OF GASI NG 13 -0.2 FrAbo"Lar eoxfs=
Michael Ransier "roc of wsM fem wted auor new"lane 9WffaW may rewire
Well Contractor(Individual)Name a variance in aomraartoe%film 1 SA NCAC 2C.011 f9.
Ransier Environmental Wiling, Inc. e,YIELD(gM) METHOD OF TEST
Well Contractor Company Name L DISINFECTION-Type Amount
STREET ADDRESS 1 Piney Point g_WATER ZONES (depth):
Whispering Pines NC 28327 From To From To
City or Town State Zip Code From To From To
910 9494556 FrorrL_To _ From To
Area code Phone Number 6.CASING: Thlcknims
2. wELL INFORMATION: Depth Diameter Weight Material
Site Well ID#(if applicable) MW-6 From -0.2 To 35 Ft. 2r' sch 40 pvc
STATE WELL PE=RMIT*(tr applicable: na From To Ft-
DWQ or OTHER PERMIT#F(if appllcat na From To Ft
WELL use (chsdt Applicable)Momlpnng X MuAfPWk 7-GROUT: Depth Material Method
Wu"uueommercW Agricultiaal Recovery MjAawn From 0.5 To 31 Ft- Portland trerttmle
won other Nst use) From To Ft.
Date Drilled 1/28/2008 From To Ft_
Time Completed 1:30 AM PM x a.SCREEN: Depth Diameter Slot Material
3.WELL LOCATION: From 35 To 50 Ft_ 2" 0.01 pvc
CITY Harmony_— COUNTY Iredell From To Ft
1156 E. "armony Hwy From To Ft
(Street Name,Numbers,Community,Lot No.,Parcel,Zip Code) 9.SANDIGRAVEL PACK:
TOPOGRAPHIC/LAND SETTING Depth Size Material
Slope Valley Flat x Ridge other From 33 To 50 Ft medium quartz
(diem appropriate) From To R.
LATITUDE 35 55r 25.34 r be in degrees,arms. From To Ft
LONGITUD 80 43' 12.93 secs.or indownar 10.DRILLING LOG:
Latitude/Longitude source: GPS x Topo map From To Formation Description
(1=11on of well must be shown on a USGS topo map and 0 1 graveWill
attached to this form IT not using GPS) 1 50 red brown silty clay
d_FACILITY ie ama name ar rent i5,sinan where thv wolf ic,ocated
FACILITY ID# (if applicable)
NAME OF!FACILITY Jones Grocery
STREET ADDRESS 1156 E. Harmon
Harmony NC
City or Town State Zip code
CONTACT PERSON Nicole Lon 11-REMARKS:
MAILING ADDRESS 2301 Crown PL EX—. Dr.
Charlotte NC 28227
City or Town Slate Zip Code
704 8454010 100 HERMYCBRM1MTTWAV LWAscorrs►Rvcrsom•ccoRnAnrce
Area code Number wnx tsA NCAC x WELL CONSTRUMON smmDARDe ANGTH&T A
5 WELL DETAILS: I V. qyAi
R
a. TOTAL DEPTH: 50 2/11/2008
b. DOES WELL REPLACE EXISTING WELL NO SIGNITURE OF CERT1F9ED WELL CONTRACTOR DATE
c. WATER LEVEL "CW rap of Cam 38 Michael Ransier
(UM''"if abft&top a►Gelea9) PRWTED NAME OF PERSON CONSTRUCTING WELL
5er"t ofipinel to Div.of WSW quWily wia,n 30 do".Alto:ktommf m Mgt 1617 Mail Boni=canter_RaWigh,W,27OW161 T Phoro(919)7W-7015 ext 60

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350686 Feb. 11 2008 10:53AM P7
Non Residential Well Construction Record
North Carolina Department of Erwlrorxnent and Natural Resounoes-Djv; of water Quality
WELL CONTRACTOR CERTIFICATION# 2501
1. WELL CONTRACTOR: d.TOP OF CAS1 NG IS -0.2 FT Above Land surface
Michael Ransier -Top of casing h-Mited abbr below land surface may require
Well Contractor(Individual)Name a variance in womdanoe with 16A NCAC 2C,l)11e,
Ransier Environmental Wiling, Inc. e.YIELD(gpm) _METHOD OF TEST
Well Contractor Company Name C DISINFECTION-.Type Amount
STREET ADDRESS 1 Pine Point g.WATER ZONES (depth):
Whispering Pines NC 28327 From To From To
City or Town State Zip Code FfQm To From To
910 949-4555 From To From To
Area code Phone Number 6.CASING: Thickness
2. WELL INFORMATION: Depth Diameter Weight Material
Site Well ID#(if applicable) MW-7 Fwom -0.2 To 35 Ft. 2" ach 40 PVC
STATE WELL PERMIT#(if applicable, na From To FL
DWQ or OTHER PERMIT#(if appliCat na From To Ft,
WELL USE (Check Applicable)Monkoring X MmMublic 7.GROUT: Depth Materiel Method
Industrial/Commenaal Agricultural Retmvary Injection From 0.5 To 31 Ft portiand tremmie
Irrigation other (List use) From To Ft,
Data Prilled 1/28/2008 From TO Ft
Time Completed 3:00 AM PM x 8.SCREEN: Depth Diameter Slot Material
3.WELL LOCATION: From 35 To 60 Ft_ 2" 0.01 PVC
CITY Harmony couNTY Iredell From To Ft
1156 E, Harmony Hwy7 From To Ft.
(Street Name,Numbers,Community,Lot No.,Panel,Zip Cade) 9.SAND/GRAVEL PACK—
TOPOGRAPHIC/LAND SETTING Depth Size Materlal
Scope Valley Flat x Ridge Other From 33 To 50 Ft_ medium quartz
(check appropriate) From To FL
LATITUDE 35 55'25.34 kby be in decrees,a". From To Ft,
LONGiTUD 80 43' 12.93 sem.or in dog I a.DRILLING LOG:
Latitude/Longitude source: GPS x Topo map From TO Formation Description
(location of well must be shown on a USGS topo map and 0 1 gravelffill
attached to this form it not using GPS) 1 50 red brnwrl Silty day
a.FACILITY is the nwm of the b aoew vfi v @wm wall is wales
FACILITY ID# (If applicable)
NAME OF FACILITY Jones GEM
STREET ADDRESS 1156 E. Harmon H
Harmony NC
Clty or Town State Zip Code
CONTACT PERSON Nicole Lon 11.REMARKS:
MAILING ADDRESS 2301 Crown Pt. Exec. Dr,
Charlotte NC 28227
City or Town state zip code
704 845-4010 100 HeRIE vCt WMY Tw,T TFMa wsi wwa CONUMUCTM IN ACcoaoAHCE
Arta code Number WTH tsA NCACPC we Lc0►%-rftL CT10N STMMMS AM TNATA
6. WELL DETAILS: opvrOF REcowtws VNELLO ICER.
a. TOTAL DEPTH: 50 2/11/2008
b- DOES WELL REPLACE EXISTING WELL NO SIGNMURE OF CFRTIFlED WELL CONTRACTOR DATE
c_ WATER LEVEL Below Top ofCesi 38 Michael Ranier
(use"+',Tabove top of c9s4V) PRINTED NAME OF PERSON CONSTRUCTING WELL
9Lftw"Val to on.or weer quality within 30 de". AIbI:InNovwtion Mat. 1617 Nw a9mm 0~_Rwwo,No vup%_j617 Plane(919)733-7015 ekt N8

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350686 Feb. 11 2008 10:53AM P6
Non Residential Well Construction Record
Nora,Carolina aepartinent of Environment and NaWMI Reeouroee.Division of Water tluali(y
WELL CONTRACTOR CERTIFICATION# 2WI
1_ WELL CONTRACTOR: d.TOP OF CASI NG IS -0.2 FT Awva t.rtnd suK—
Michael Ransier *TOP of cpwv 1Ltrn rratBa atlor tlelow land surface may rim
Well Contractor(Individual)Name a variance in accordance wim t 5A NCAC 2C.011 B.
Ransier Environmental Drilling, Inc_ e.YIELD(gpm) METHOD OF TEST
Well Contractor Company Name C DISINFECTION:Type Amount
STREETADDRESS 1 Piney Point g.WATER ZONES (depth):
Whispering Pines NC 28327 From To From To
Cit;r or Town State Zip Code From To From To
910 949-4555 From To From To
Area code Phone Number S.CASING: Thickness
2. WELL INFORMATION: Depth Diameter Weight Material
Site Well ID#(i(applicable) MW-8 From -0.2 To 35 Ft. 2" sch 40 PVC
STATE WELL PERMIT#(if applicable' na From To Ft.
DWQ or OTHER PERMIT#(if applicat na From To Ft.
WELL USE (Check Applicable)Monitoring X Mun/Pubrrc 7.GROUT: Depth Material Method
IndusbiauCommarcial Agricultural Rewvery lniectton From 0.5 To 31 Ft. portland tremmle
Irrigation other (List Use) Fran► To Ft
Date Drilled 1/28/2008 From TO Ft
Time Completed 4:00 AM PM x 8.SCAM: Depth Diameter Slot Material
3.WELL LOCATION: From 35 To 50 Ft. 2' 0.01 pvc
CITY Harmony COUNTY Iredell From To Ft.
1166 E. Harmony Hwy From To R.
(Street Name,Numbers,Community,Lot No..Parcel.ZIP Code) 9.SAND/GRAVEL.PACK:
TOPOGRAPHIC I LAND SETTING Depth size Material
Slope valley Flat x Ridge Omer From 33 To 50 Ft medium quartz
(creak appropriate) From TO Ft.
LATrruDE 35 55'25.34 May be in dwe".mina. From To Ft.
LONGIT A)80 43'12.93 Baca.or in dackrRd 10.DRILLING LOG:
Latituo&ongltude source: GPS x Topo map From To Formation Description
(location of wen must be shown on a USGS topo map and 0 1 graveVfill
etWolied to this roan if not dying GPS) 1 50 red brown SKY CIS
4.FACILITY a the name or the Dueness where ev wen is located
FACILITY ID It (if applicable)
NAME OF FACILITY .tones Grocery
STREET ADDRESS 1156 E. Harmon H
Harmony NC
City or Town State Zip Gode
CONTACT PERSON Nicole Long 11.REMARKS:
MAILING ADDRESS 2301 Crown Pt. Exec. Dr.
Charlotte NC 28227
^,�
City or Town State Zip Code
y
f 04 845-4010 1 DO HERMYCERT>FY TMTTNte YVHl WAB C0PJEM CTm 01 AIXOROMM9
Area code Number WfrMIU MAC 20MLLOOl161RUCnONeTANEIMWSANDTHATA
6. WELL VETAILS: COPY OFTI{SRECOWf"UMPROMMTo owNER.
a. TOTAL DEPTH: 50 11/2006
b. DOES WELL REPLACE EXISTING WELL NO SIGNITURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LSVEL rlelbw Top of Cm 38 Michael Ransier
(Use +''it above top of cealny) PRINTED NAME OF PERSON CONSTRUCTING WELL
SLOW original to Div,of Water quality witfvn 30 days.At Inf0ml~Mqt. 1817 Mail Service Critter Moot%NC 27889-1617 Pharo(919)78947015 ext SW

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350686 Feb. 11 2008 10:52RM P5
Non Residential Well COnstruetion Record
North Carolina Dewrynent of Environment and Natural R&Wxces-Divislon of Water Quality
WELL CONTRACTOR CERTIFICATION# 2501
1. WELL CONTRACTOR: d.TOP OF CAST NG IS -0.2 FTAbove Lar>Q surfaw
Michael Ransier 'ro,of fle—nowdatror below lam wxWe may wire
Well Contractor(IndividuaU Name a variance In acaorgarlc s with 15A NCAC 2C,0118,
Ransier Environmental Drilling, Inc_ e_YIELD(") _METHOD OF TEST
Well Contractor Company Name L DISINFECTION:Type Amount
STREET ADDRESS 1 Piney Point 9.WATER ZONES (depth):
Whig rin Pines NC 28327 From Tc From____To
City or Town State Zip Code From TO Frorrl _To
910 949-4555 From To From To
Area code Phone Number fi.CASING= Thickness
2. WELL INFORMATION: Depth Diameter Weight Material
Site Well ID#(if applicable) MW-9 From -02 To 35 Ft. 2" sch 40 pvc
STATE WELL PERMIT#(if applicable; na From To Ft
DWO or OTHER PERMIT#(if applicat na From To Ft.
WELL USE (Check Applicable)Monitoring x M infl;%blic 7.GRC IT: Depth Material Method
Indu8trW C=nrKN I AgrimAural Recovery Injection From 0.5 To 31 Ft. Portland trernmie
Irrigation Outer WSW* From To FL
Date Drilled 1/28/2008 From To FL
Time Completed 5:30 AM PM x 8_SCREEN: Depth Diameter Slot Material
3.WELL LOCATION: �— From 35 To 50 Ft- 2" 0.01 c
CITY Harrnany COUNTY Iredell From To Ft.
1166 E_ Harrnany HWy7From To —Ft.
(Street Nam.Number'&,Community,Lpt No.,Paroal,Zip Code) 9.SAND/GRAVEL PACK:
TOPOGRAPHIC!LAND SETTING Depth Size Material
Slope Valley Flat x Ridge Omer From 33 To 50 Ft medium quartz
(dwok appropriate) From To Ft
LATITUDE 35 55'25.34 May W in deprem,rnins. From To Ft
LONGITUD 80 43' 12.93 swa.or in decimal 10.DRILLING LOG:
Latilude/Longitude source: GPS x Topo map From To Formation Description
(location OF well must be shown on a USCS lopo reap and 0 1 graveVrill
a;itt dmd to M form if not using GPS) 1 50 red brown sifty clay
4.FACILITY ;�use nano or the txaelnase valwm n,e relr a IocaAed
FACIUTY 10 art (if applicable)
NAME OF FACILITY Jones Grocery
STREET ADDRESS 1156 E. Harmony Hwy
Hanmony NC
City or Town State Zip Coda
CONTACT PERSON Nicole Long 11.REMARKS:
MAILING ADDRESS 2301 Crown Pt. Exec. Dr.
Charlotte NC 28227
City or Town State Zip Code
704 8464010 1 Do HEMMY CERTIFY rant»,Is v11lLL WAS CONSTRUMD IN ACCORDANce
Area code NurtlbBr WrrH ISA NGC PC WELL 130farrR cTm STANDUMS AM 7HAT A
S. WELL DETAIN: corer TF#8RECOM BEENDMVIUM TO TW WELL OWNER
a. TOTAL DEPTH: 50 2/11/2008
b. DOES WELL REPLACE EXISTING WELL NO SIGNITUtt OF CERTFIW WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casi 38 Michael Ranier
(use—if above top of easing) PRINTED NMAE OF PERSON CONSTRUCTING WELL
Submit anginal 10 Div.of Water Oualily withn so day& Atrn:W0ffraUm Mpt 1617 Melt Service OwW-Rabok Ne 2MM-1617 Phax(919)7;I 0I5 end 6W

s
Non Residential Well Co ruction Record
North CardM Department of Erwuaiment and Natural Rosowross-mom of water owuly
WELL CONTRACTOR CERTIr ICATION tl 2501
1. WELL CONTRACTOR: d_TOP OF CAM NG IS -0.2 FrAbova land surface
Michael Ranier 'fop of CvWv Iem 1 etror below land surface may require
Well Contractor(IngiMuel)Name a variance in aa=dwme with 15A NCAC 2C.0118.
Ranier Environmental Drilling,Inc. e.YIELD(gpm) METHOD OF TEST
Well Contractor Company Name C DISINFECTION-Type Amount
STREETADDRESS 1 PfnW Point 9-WATER ZONES (depth):
Whisperingfines NC 28327 From-TO Fron_To
City or Town State Zip Code Frm,,,__To FMM__To
910 949AS55 From To From Tc r
Area rode Phone Number S.CASING: Thicknm
2• WELL INFORMATION. Depth Diameter Weight Material
Site Well ID#(rf applicable) MW-r ID From -0.2 To 35 Ft 2" soh 4o Pvc
STATE WELL PERMIT E(if appricabie nil From To Ft
DWO or OTHER PERMIT#(if applicat na From TO Ft.
WELL USE (Chock Applicable)MDniWWV X Mun/Pubia 7.GROUT: Depth Maisf9al Method
k0usbfaWcommerdal Agrm tuml Recovery Ir400fion From 0.5 To 31 Ft. portland tremmle
Irrigation of w (LM Use) From To FL
Date Drilled 1/29/2008 From To Ft.
Time Completed 12:00 AM PM x S.BEN: Depth Diameter Slot MateTiat)
3.WELL LOCATION: From 35 To 50 Ft. 2• 0.01 PVC
CITY Hamaony COUNTY lnedell From TO Ft
1166 E.Harmon H From To Ft.
(Street Name,Numbers.Commuraitsr,Lot No..Parcel Zip Code) L SAN111GGRAVEL PACK:
TOPOGRAPHIC I LAND SETTING Depth Size Material
slope Valley Flat x Rtdga other From 33 To 50 FL medium gwaz
(dteck apWopfiate) From To Ft
LATITUDE 35 55'25.34 may to in depress,mre. From TO Ft.
LONGITUD 80 43'12.93 56M nrindad W 10.DRILLING LOG:
LatiBxielLongitude source: GPS x Topo map From To Formation Dawption. >
(looaWn of well must be shown on aa;tRM iopo map and 0 gravelffill
abdied to this form If not to ft GM 1 50 red bmwn Sffty clay
4.FACILITY is Bra scone at the utwerem%two thv»vac is lgmW
FACILITY ID 0 (If applicable)
NAME OF FACILITY Jong Grocery
STREET ADDRESS 1166 E. Harmony
Hamlorty NC
City or Town state Zip Code
CONTACT PERSON Nloole Long 11.REMARKS:
MAILING ADDRUS 2301 CMWn Pk Exec,Dr.
Mark)& NC 28227
coy a town sum zip Coda =`
704 $464010 ID0►rBercarnrvnvtTrwsrrsLrwe COMMUCTM INA000Amm
Araeacode Number VMwreANCA42CVAILooraFIMPMO WANWAMAMW%TA
5. WELL DETAILS: cawoFi►r<sraoo_tmrsAe>iea�f�reowDta, 5PEvftLowt&Rt
a TOTAL DEPTH: 50 7J11P100tI
b. DOES WELL REPLACE EXISTING WELL No SIGNITUA611 CERTIFIED WELL CONTRACTOR DATE $
C. WATER LEVEL ttaww coo of tail 38 Michael Ranier
lVee^►"Kataw Tao of PRNITED MME OF PERSON CONSTRUCTM WELL
S —M OIW-1 a Div.d W—(miry v,dnrn 304W A@x lntrrnewn tABt 1817 Mail Senioe Caviar a>
�d�f+o�ietT wrervscsta>?ra:�Tots�asara
5 e,.

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350686 Feb. 11 2008 10:52AM P3
Non Residential Well Construction Record
Nodh Carolina DWanment of Environment and Natural Resour0n XVWon of Water Quality
WELL CONTRACTOR CERTIFICATION* 2501
1. WELL CONTRACTOR: d.TOP OF CAST NG is -0.2 rr Abw*u"sLewe
Michael Ransier 'Top of r a=V ts'rrrurmw armor below Tana surface may require
Well Contractor(individual)Name a varierroe in amorda m%ft 15A NCAC 2C_0118,
Ransier Environmental Drilling, Inc. e_YIELD(Wn) MMOD OF TEST
Well Contractor Company Name t DISINFECTION-.Type Amount
STREET ADDRESS 1 Piney Point g.WATER ZONES (depth):
Whispering Pines NC 28327 From Tc From To
City or Town State Zip Code FrWn Ta From To
910 9494555 From To From Tc
Area code Phone Number 6.CASING: Thickness
2. WELL INFORMATION: Depth Diameter Wf3fght Materiel
Site Well ID*(if applicable MW-11 From -0.2 To 35 Ft. 2" sch 40 pvc,
STATE WELL PERMIT 1#(if applicable; na From TO Ft.
DWfl or OTHER PERMIT#(if applicat na From To Ft.
WELL USE (Check AppflaM)Moniroring x MuNPMIC 7.GROUT: Depth Material Method
indusmaUCommercial Agricultural Recovery Ir*ckn From 0.5 To 31 Ft partiand tremmie
Irrigation Other (List Use) From To Ft.
Date Drilled 1/29/2008 From To Ft.
Time Completed 2:00 AM PM x 8.SCREEN: Dep_M Diameter Slot Materlal
3.WELL LOCATION: From 35 To 50 Ft 2" 0.01 PVC
CITY Harmony COUNTY Iredell From To Ft.
1156 E. Harmony HWY From To Ft.
(Street Name.Numbers,Comm-*.Lot NO.,Parcel,Zip CO* 8_SANDIGRAVEL PACK:
TOPOGRAPHIC/LAND SETTING Depth Size Material.
Slope valley Flat x Ridge other From 33 To 50 Ft medium quartz
(dam appropriate) From To Ft.
LATITUDE 35 55'25.34 INay be i+dog.mine From To Ft
LoNGrruD 80 43' 12.93 secs.a In 09 10.DRILLINCs LOG:
Latitude/Longdude Source: GPS x Topo map From To Formation Description
(location of wan must be shown on a USGS two map and 0 1 gravevfill
attached to Cris form if not using GPS) 1 50 red brown sl Cla
4.FACILITY is dw name d the businsm+,flare ore well Is located
FACILITY ID 0 (If applicable)
NAME OF FACILITY Jones Grooery
STREET ADDRESS 1156 E. Harmony Hwy
Harmony NC
City or Town Staft Zip Code
CONTACT PERSON Nicole Long 11.REMARKS:
MAILING ADDRESS 2301 Crown Pt. Exec. Dr.
Charlotte NC 28227
City or Town State Zip Code
704 8464010 i W HERMYC&MFY TM7 0M wall vws CON87MMIr»IN AcooaoANc6
Araeoode Number wmi13ArVACzc WELL mnarraxmoN BMW"AND THATA
S. WELL DETAILS: CCFrOF REooaoW#se@rrraov TOTWEVaLowrm
a. TOTAL DEPTH: 50 2/1112008
b. DOES WELL REPLACE EXISTING WELL NO SIGNITURE OF CERTWIED WELL CONTRACTOR DATE
c. WATER LEVEL f3Mlow Top of reef 38 Michael Ransier
(Use"r"if above top or emov) PRINTED NAME OF PERSON CONSTRUCTING WELL
Submit oripi to Div.Or Watw Oudity witlin 30 days. Aron:Irdwm dInn Mgt 1617 Nla f Sorviw Came-Raleiok NC 27OW16t7 F10*(g1Q)733.7Q16 vA W8

FROM :RANSIER ENVDRILLING INC FAX NO. :9102350696 Feb. 11 2008 10:51AM P2
Non Residential Well Consttuuction Record
North Carolina Department of Envoonment and Ntttlual Resew Dndsan or Watef Quality
WELL CONTRACTOR CERTIFICATION* 2W1
1. WELL CONTRACTOR: d.TOP OF CASI NG IS -0.2 m Above land surfaw
Michael Ransier 'Top of®sing iormMaw avor below land sudeoe may require
Well Contractor(Individual)Name a variance in accordance with 1SA NCAC 2C.0718_
Ransier Environmental Drilling, Inc. e.MELD(gpm) (METHOD OF TEST
Well Contractor Company Name f.DISINFECTION:Type Amount
STREET ADDRESS 1 Piney Point g.WATER ZONES (depth):
.Whisper-in.Whisper-ing Pines NC 28327 From To From To
City or Town State Zip Code From ,.To From-TO
910 949-4555 From To From Ta
Area code Phone Number 6_CASWG: Thkkness
2. WELL INFORMATION: Depth Diameter Weight Material
` Site Well ID#(if applicable) MW-12 From -0.2 To 35 Ft_ 2" sch 40 pvc
STATE WELL PERMIT#(if applicable; na From To Ft
DWQ or OTHER PERMIT it(if applicat na From To Ft
WELL USE (Check AppiieaM)Monitoring X MunrPLftc 7_GROUT- Depth Material Method
utoustriaf/Cornmercial Agricultural Recovery Injection From 0.5 To 31 Ft portland tremmie
uri 1EM Other (List Use) From To Ft.
Data Drilled 1/29/2008 From To Ft-
Time Completed 3:30 AM PM x S.SCREEN: Depth Diameter Slot Material
a.WELL LOCATION: From 35 To 50 Ft 2- 0.01 PVC
CITY Harmony COUNTY Iredell From To Ft.
1156 E. HaE. Harmon H±y From To�FL
(Street Name.Numbers,Community,Lot No.,Parcel,Zip Code) 9.SANDIGRAVEL PACK:
TOPOGRAPHIC f LAND SETTING Depth Sirs Material
Slope valley Flat x Ridge otther From 33 To 50 Ft_ medium quartz
(deck appropriate) From To Ft.
LATITUDE 35 55'25.34 r be in deweee,mime. From To Ft,
LONGITUO 80 43' 12.93 tea.arindaoival 10.DRILLING LOG:
Latltude/Longitude source: GPS x Topo map From To Formation Description
(iocahm of well roust be shown on a UScs tope map aW 0 1 graveWill
attached to this form it not using GPS) 1 50 red brown sifty clay
4.FACILITY it ttw name of itm bueW*so where the wWlt is k=10d
FACILITY IDS (ff applicable)
NAME OF FACILITY Jones Grocery
STREET ADDRESS 1156 E. Harmon Hviy
Harmony NC
City or Town State TV Coate
CONTACT PERSON Nicole Lon 11.REMARKS:
MAILING ADDRESS 2301 Crown Pt. Exec. Dr.
Chariotte NC 28227
City or TOM State Zip code
704 845-4010 t no HOmey CWW THAT has WELL WAe cONSTAUCTM IN ACCORDANCE
Area code Number WITH 115A nrac 2C wa,CO►MUCTION STANDARDS AND TMY A
S. WELL DETAILS: COPY OF',rs r�
l�corm tom► T►EWELLew .
a. TOTAL DEPTH! 50 �/'y.� oN2/11/2008
b_ DOES WELL REPLACE EXISTING WELL NO SIGNITURE OF CSRTIFtED WELL CONTRACTOR DATE
c. WATER LEVEL 04*w Top or Casa 38 Michael Ransier
(Use'-'if above top of c9sing) PRKrED NAME OF PERSON cONSTRUCTTNG WELL,
Submit orowW to Div.of ouster Quality wid,ic 20 days. Attn:rnfamia6m Nip. 1617 Mail SWO W Gunder-Ralelylt.NC 27OW1817 Pf cos(919)739 lots era sea

Jul 30 08 11:38a Michael Ransier 9109494555 p.7
I
Non Residential Well Construction Record
NoM CaoAha Departmedof Envirarmeent and Natural Resoumes-010slon of Wateraualily
WELL CONTRACTOR CERTIFICATION# 2501
1. WELL CONYRACTDR: d.TOP OF CAST NG IS -02 FrAbo goal Shrum
Michael Ranier -rnp of casing temunr�ed Wer below larva mifam nW regrdre
Wen!Contractor i;individuaq Name a wadanoe in aomrdance with ISA N=ZC A71&
RansierEnvironmerrtal Drdling,blur. a YIELD(gprrr) METHOD OF TEST
Well Contractor Company Name t DISINFECTION:Type Amount
STREET ADDRESS 1 Piney Paint U.WATER ZONE$ (depth):
,Whispering Pines NC 28327 Flom To From To
City or Tam state Zip Code From Tc From To
910 949A555 Form Tv Front_ To
Area code Phone Number 6.CASING: Thickness
2. WELL INFORMAIMM Depth Diameter Weight Material
Site Well ID#(d applicable) MW-13 From -02 To 35 Ft. 2" seh.4D pvc I
STATE WELL PERMIT#(NaPPfirabte. rla From To Ft
DWQ or OTHER PERMFF#(Vapplicat ra From To Ft
WELL WE (Check Apl*Cat le)MoniturkV X MmVftbllc 7.GEtOUT: Depth Material Metrhod
t Asrb+bxa( Recovery kqeotkm From 0.5 To 31 FL pordand tremmie
trigatioo Other (fist use) Torn To Ft
Date Dolled 7/24/2008 From TO_FL
rime Completed 12-00 AM PM x a.SCREEN: Depth Diameter slot Material
3.WELL LOCATION: Fmm 35 TO 50 FL r 0.01 pvc
CITY Hammy COUNTY lredell From To FL
1156 E HatmD From To FL
(Steel Name,Numbers.Corrunuluty,tot No..Parcel.TV Code) 9.SANDIGRAVEL PACK:
TOPOGRAPHIC I LAND SETTING Depth size Material
Slope Valley Flat x lodge QUeer From 33 To 50 FL medium qu-U
( aPproprl From To FL
LATITUDE 35 6525.34 Lew bein ,ks. From To FL
LONGrTUD 8D 43' 12.93 >a�.our dearrat 10.oRlillNG LAG:
Lxd1udeA,crQ tude source: GPs x Topo map From To Format,Description
(loeason a(we*must be shown on a USM topo map and 0 1 opsul
alladred to#&form#riot using GIS) 1 50 red brown silt
&FACIL.ITY anenai arfiser�:ress,�r,ae,eweu�rx�rea
FACILITY IO# (if applkabW4
I NAME OF FAC UM .lodes GTxELaq
j STREETADDRFSS 1166 E Harmony
iHannony NC
av or Town Stare Tip Code
courAcT PERSON Nicde Long 11.REMARKS:
MAILING ADDRESS 2301 Crown PL ExeC,Dr.
Chadcde NC 2=7
City Or7own Slate Tp rvde
704 846-4010 IDOHERMYCEWMVMTIMVNU%MOOt=RUaMUMACCOFaMME
Alma code Number wmr/S4HC.A020VMLDONSIR1MMS7ND.YMAMIMTA
S. WELL DETAILS: CCPYOFIHSFECCROU-93 TrEvBLowfm
a. TOTAL DEPTH: 5o =► 7l29t2008
b. DOES MMLL REPLACE MMSTTNG WELL No fSMNMJREOFCERTFIEOla 1NLCONTRhCTOR DATE
c. WATER LEVEL Sob*Topereami 38 MichaetRansier
tuna e tr mwe hap e(cesirre) PRINTIA NAME OF PERSON CONSTRUCTING WBL
subn*=V ml to orv.of water OuaRlr wioii W deya, car Mr«,neuon W. tsn Matt Smvice Cw*w-lalat^NC s709-16r7 ph 0M(etch ra.7et5 ern W8

Jul 30 08 11:37a Michael Ransier 9109494555 p.6
}
i
Non Residential Well Construction Record
North Caroina Deparbnent of Envirarment and Natural ResWrCes4Nvis1on of Wader OwIfty
WELL CONTRACTOR CERTIFICA71ON# 25DI
1. WELL CONTRACTOR d.TOP OF CASI NG IS -0-2
Nkhael l;tansier -Top a cas:V tmwab2d auer below land sruram mat Ternme
Well Contrador(mdnridaal)Name a variance In aomrdarim wnh I SA NCAG 2C_0115_
Ransier Environmental Drilring, Inc. e.YIELD(gpml METHOD OF TEST
wen Coob'odor Company Name L DISDVW-CTIONtType Amount
STREET ADDRESS 1 Piney Point g.WATER ZCM ES (depth):
Whispering Pines NC 2=7 From To From To
City or Town Shale Zip Code From To From To
910 9494555 Fran To From To
Area code Phone Number 6.CASING_ 'Thickness
7- WELL INFORMATION: Depth Diameter We+9ht Material
Site Well ID 0(rf applicable) MW-14 From -0.2 To 35 FL 2" sch 40 pvC i
STATE WELL PERMIT#(if applicable na From To Ft q
DWQ or OTHER PERMIT#(if apPFcal na RIM-TO FL
USE t mck AMUcatte)M-11or190 x MunlPrrAc 7.GROUT: Depth Material Method
Agrioulhrral Reoovery Injection From 0.5 To 31 FL portkuxt trenfmie
Irmalion 001ef 0-mtttse) From To Ft
Date DrMed 7/2412008 From To Ft
Time Completed 1:00 AM PM x 8.SCREEN: Depth Diameter Slot Material
a.WELL LOCATION: From 35 To 50 Ft. 2" 0.01 pvc
CITY Harmony cOIINTY Iredell From To FL
1156 E HaMiony HW From To FL
(Sheet Marne.Numbers.Coaxrwaity,Lot No .Paroel rrp Code) 9.SANDIGRAYE L PACK:
TOPOGRAPHIC i LAND SETTING DepM Size Material
Slope vanes Flat x aidge curer From 33 To 50 FL mediurn 4rartr
(ram apprapdaM From To Ft
LATITUDE 35 55'25.34 tam to in eevees mt a From To Ft
LONGfTUD804T12.93 recs.orinder+rd 10 DRILLING LOG:
atih source:lCe&Qngilude soue: GPS x Topo map From To Formation DesG{pEion
f
00casm or wet must be do"on a USGS two rrrap aw 0 1 topsoil
attached b fhls forty if not usk4 GM 1 50 red brown Silt
4.FACILITY isvieremeanew+s:esswheretrev.aE6loc�»d
FACUTY ID# (N applicable)
NAME OF FAIauTY .Ions G
STREETADDRESS 1156 E Hannon
HarmarW He
ChyorTmn stale 73pcode
CONTACT PERSON Nicole Long di*.REMARKS:
MAILING ADDRESS 2301 Crown PL Exec.Dr.
Charlotte NC 28227
CW or-rcm StA9 Zip Code
7D4 8454070 roosra�resrnFvix+trMswsuwtisooraTaonrmw�000r+ance
Areacode Number YRfF1fY1 NfAC=G rM3LOK'nON ST McNrOSAtD rrNTA
5. WELL DETAILS: cowoa ��s >roUWv.ULpMNeit
a. TOTAL DEPTH_ 50 7/29r2D06
b. DOES WELL REPLACE 03STENG WELL NO s7GtsTuRE OF cEffmFD VVELL COMTRACTOR DATE
c. WATER LEVEL llelowTcpc(Casi 38 Michael Ransier
(ilea F N abura kp d psUg) PRINTED NAME OF PMSOM CONSTRUCTING WELL
amna ortGbd b Div.of Water QuaiywMin 30 days.Avrx lniamseon ML 18fTsna9 Seruim Confer-Ralegr,,lrC 278&s-tar? PIS(91 9)73 3-7015 wd M8

Jul 30 08 11:37a Michael Ransier 9109494555 P.5
Non Residential Well Construction Record
North Carolina Departrrreat or Envtr_ent and tsatucal Res�vLston of water Quality
WELL CONTRACTOR CERTIFICATION 9 2501
T_ WE LOOMTRACTOIT~ d TOP OF CAST NG IS -0.2 FrA6ore Lane sr0—
NCtchael Ransier 'Top or casiM termhnaied War below tand surtaee may IUWm
We0 Contractor(Individual)Name a variance In accordance vft I SA NCAC?_C-°»$
Ransier Environmental Dnffing,Inc_ a YIE n(MM) METH i1 OF TEST
Well Contactor Company Name L DISINFECifON:Type Amount
STREETADDRESS 1 Piney Point 9 WATER ZONES (depth):
Whispering Pines NC 2M7 From To From To
City or Town state Zip Code Fran To From To
910 949-455.5 From T° From To
Area code Phone Number 6.CASING: Thickness
Z. WELL INFORMATION: Depth Diameter Weight Material
Site Welt ID ii(dappromlrtr:) MW-15 From -02 To 35 rL 2" sch 40 PVC
STATE WELL PE MIT#(d appicable na From To FL
DWQ or OTHER PERMrf V(if applicat na From To FL
WELL USE (Check Apptirable) X M-"At 6- T.GROUT. Depth Material Method
hdust iavCommodad AM=ftrral Rea—W Inier50n From 0.5 To 31 FL pwitand baemn ie
hripatim other WUse) From To FL
Dale Wiled 7124/20M From To FL
rime Cornpletaed 2:00 AM PM x S.SCREEK: Depth Diameter Slot Material
3.WELL LOCATION_ Fmm 35 To 50 Ft. 2" 0.01 pvc
CITY Harmony OOUNTY Iredell From To FL
1156 E_iTwiniony Hwy Fvom TD Ft
(Sheet Name ttumheM Community,Lot No.,Pat cel.Zip cam) 9.SANDIGRAVEL PACK:
TOPOGRAPHIC f LAND SEFTIVG Depth Sie Material
Sk)pe valley Hat x Rdae Omer From 33 To 50 Ft. medium quartz
( From To FL
LATITUDE 35 66 25.34 be in degree;wraps_ From To FL
LONGiruD E30 43' 1293 �.a� 1o..DRUWG LOG:
Latibudoi
ongilude source:: GPS x Topo map From To Formation Uestxiption
(Iocaom o1 ell must be sham on a uses lopo Snap aria 0 1 -topsail
ai3tarlred tD this rortn It not u**GM 1 50 red brown sift
4.FACILITY is gbe nana dire br A"w where Lhe won is WaaWd
FAMU Y ID N (if aWlicable)
NAME OF FACILITY Jones GrocerY
STREEErADDRESS 1156 E.Hammy Hwy
Harmony NC
[xty orTmm Shale Zip Cody
CONTACTPE RWN Nicole LO 11.REMARKS:
MAILING ADDRESS 2301 Crown PL ExeC_Dr.
Charlotte NC 28227
City or Town State Zip cove
704 845-4010 ruoNea�rr YrrrTnuswo3rwwscor�rwucr�rrrw v+cE
Area node Nuo>Txt �vmtssnrrwexwt�mwsralicrra�zre►orimsaonarw
ti. WEU_DETAILS: e0e^r0F1Mvr HAS EE r waL0wr8R
a TOTAL DE PTit 50 7TE
h_ DOES WELL REPLACE E=TiNG WELL NO SiGNMREUFconwEOWriLCON FACTOR
c. WATER.LtEVE1_ edowTwdcasi 38 1 Michael Ransler
Ouse'*.ifMhww sop orasrng) I IPRWTED NAME OF PERSON CONSTRUCTING WELL
&6mn ori9�:o Oir.of 1Naler'Qual�r w1Wn 30 days.At6r:4rroMtaflM lA9r. 1677 Mall Service Center-RaSeiDh NC 27694+Ifi77 Phase t81�799-7015 ed 56t3
i

Jul 30 08 11:36a Michael Ransier 9109494555 p.4
9
Non Residential well Construction Record
North Carolina Department Of Fnni—metrt and Natural Resources-DNtsim of Water oualmi
WELL CONTRACTOR CERTIFICATION 0 2601
1. WELL CONTRACTOR: d.TOP OF CAST NG IS -02 FT L--d9it
WrKAjad Ranier `TOP Of cash q tencinated abbrbelowbW­Ffam may require
Well Contractor(Individual)Name a varianoe in aoomdanrewM 15A NCAG zc.0116_
Ransier Environmental Drilling,InC. e.YIELD(") METHOD OF TEST
Well ConUadorCompany Name
f DISINFECTION-Type Amount
STREETADDRESS 1 Pinev Point g WATERZOIHES (depth):
WhIsperi2q Pines NC 28327 From To From To
City or Town state yP Code
From To From To
910 949-4555 From To From To
Area code Phone Number S.CASING: ThiClaress
2 WELL INFORMATION: Depth Diarneter Weight Material
SdelAreAID (rrapplicable) MW-1ti From -0.2To 35 FL 2" sch40 PVC
From To Ft
STATE WELL PERMITS(if applicable• na
UWO or OTHER PERWIrr�(if applicat na From To Ft.
wr=LLt)sE (Check APpr�)Mfg x IrunlPUlAc 7.GROUT: Depth Material Method
Agrinritrna► Recovery Infection
From 0.5 JO 31 FL portlandwiclation tremm�
Olives Dist use) From To FL
Date Drilled 70412008 From To Ft
me Completed 3.30 AM PM x a-SCREEN; Depth Diameter Slat Material
Ti
3.WELL.LOCATION: From 35 To 50 FL r 0.01 PVC
CITY Harmony COUNTY Iredell From To FL
1156 E.Harmon H From To Ft.
(street Marro,Numbem Conrrwrdty.lot No..Parcel.Zip Code) S.SAN01GRAVEL PACK:
TOPOGRAPHIC LAND SETTING Depth S¢e Material
Slope Valley Fiat x litiftge Ogw From 33 To 50 Ft mxlium quartz
(dred(app-PdalC) From To Ft.
LATrruDE 35 66 25.34 r .oe gaegrees.rarer Fran To Ft
LONI;m10 80 43'12.93 > ortndea 10.DRwNG LOG:
L votuidenxnvitude soumm GPS x Topo map From To Formation Description
00ca6on or wed must be sham on a USGS t*U tear and D 1 to oil
attachedtvthisform;factmineGPU) 1 50 red brown silt
4.FACILITY rs ara ivrrc d rna ixs wire tlitrwee{s rorared
FACILITY IDV (ifappticaWe)
NAME OF FACUM Jones Grocery
STRE ETADDRESS 1156 E.Hamio H
Harmony NC
City or Tam slate rip Code
cowAcT PERsoN Nicole LonA 11.REMARKS:
MAq JNG ADDRESS 2301 Crown PL Exec.Dr.
Charlotte NC 28227
Ct4 a Tbwn Stobe 2V Gode
704 845-4010 1DO HEREBY Con"n*W1MV9B.LWASCON5UWMIMIN"c°ORD"i'CE
Ama Code Number vM"AW-%Cxwas_coNSWd=Msrnratiwo5MOT ►Ta
5. WELL DETAILS: CO"OF roman TOT>£war
! a. 7l2ff
TOTAL DEPTH: 50
b. DOES WELL REPLACE EXISTING WB-IL NO SIGNITURE OF CERTIFIED W IOR
ELLCOKrRACT DATE
c. WATERLEVEI. eebwToperceat 36 Michaell2ansier
(usewiabwekpdras+p] PRRWff DNAMEOFPERSONCORMLICTINGWELL
Submit aig W 110 Div.d Watwauskyw"30 daye.AftM k*rmsWn Mgt.16171AaII See comes-Ra OWk NO 27W9-1817 Ptnna M91=l-7016 a)d 00

Jul 30 08 11:36a Michael Ransier 9109494555 p.3
4
{
adi
i
_Non Residential Well Construction Record
North Carolina Depariwtof Environment and Natural 0e90urce54Xvisiorr or Water QuaW
WELL CONTRACTOR CERTIFICATION 9 2501
1. WEI-L CONTRACTOR: d.TOP OF CASI NG 6 -0.2 Fr Ab—L—d sur—
ffichael Ransler 'Top or cwM UMM31M BUM bernrr tared—face MaY require
Well ConkacW(Individual)Name a vamnm h accordaw a vrdh 15A W-0Z 2a_0118.
Ransier Environmental Dri1Gn ,Inc. e.YIELD(gpm) MEniOD OF TEST
Well Contractor Company Name L DISINFECTIONType Amount
STREETADDRESS 1 Piney Point g WATER ZONES (depth)_
Whispering Pines NC 28327 From To From To
City or Town State Zip Cade From To From To
910 949A555 FmnL To From To
Area oode Phone Number 6.CASING: thickness
2 VVEM INFORMATION: Depth Diameter Weight Material
Site Well ID#(if applicable) MW-17 rmm -0.2 To 35 FL 2" sch 40 PVC
t
STATE WELL PERMrr#(d vWwable: na From To Ft.
DWQ or OTHER PERMIT#(if appwwt na From To FL
uSE (C o*AppficaW)MwAxing X IAuiil Wic T.GROUT: Depth Material Method
tadw*iavconwme .at AgtbAwal Rey kiec6- From 0.5 To 31 Ft. Portland bernmie
laigalion O1f1er IAA From To Ft.
Date Dulled 7242008 F 0m To FL
Time Completed 5:00 AM PM x S.SCREEN: Depth Diameter Slot Material
3.WELL LOCATION: From 35 To 50 Ft 2' 0.01 Pvc
CITY Harmony COUNTY IredeN From To FL
1156 E Harmony Hwy From To Ft.
(fit Name.?&mtw rs.Commurribr.Lot No..Parcel,Zip Codel !L SMWGRAVEL PACK:
TOPOGRAPHIC!LAND SEIZING Depth size Ntaterial
Slope %ft tey Rat x Ridge other Frm 33 To 50 FL medium quartz
(dxbck appmPr+ste) From To FL
LATITUDE 35 55'25.34 degree; From To Ft.
LownuD 80 43'12.93 secs.orhaea rar 10.DRILLJNG LOG:
Latitude&anglludescurce GPS x Topo map From To Formation Description
QocaUon arweu must be d w+n an a Usm iapo map and 0 1 tapsal
afladwd to dm tam If riot irskV GPS) 1 50 red brom$4
4.FACILITY isIngumeofMbws.r=wnererrevmA1sroceted
FACILITY IDS (if applicable)
NAME OF FACs.ITy Jones G
STREET ADDRESS 1156 E.Harmony
Harmony NC
cdyorTawn State 2ipCode
CONT-ACT PERsoN Nicole Long 11.REMARKS:
MM LM ADDRESS 2301 Crown PL Exec.Dr.
Chadotte NC 2=7
CayorTown state rVCode
7D4 845AOID Ioor+ERMcenrVWKT,..s,rar.vmsca+srxvc WK4AcoormW4=
Area code Number vwntiSrwAo2mV.ULOoNSrRUc=msTMmF4=AM7FNTA
Li. WELL DETAILS: GwvGF OEM 7rE ruE�Lowrl6e
a. TOTAL DEPTH: 50 7/29l20�
b. DOES WELL REPLACE EXISTING WELL NO SIGNnUnEOF CERTIRED VA31 CONTRACTOR DATE
c. WATI3ZL EVEL SabwTop orCam 3B I Michael Ransier
(ilse"+'ti abovetworcashv) I PRINTED NAME OF PERSON CONSTRuenNo wE-L
blbrril orVirrai ro Div.of Water awrlf watrin 30 days.Atw*9wraWn Mgt. t617 Moo Smvke Carrier-RaWgk NC 27699-1017 Ph"[phone] ad W S

Jul 30 08 11:35a Michael Ransier 9109494555 p.2
I
Non Residential Well construction Record
Noah Carolina Depaament of Errrtronmenl and NaWral Regouroes-Division al WaterQualiky
WELL CONTRACTOR CERTIFICATION 9 2501
1. WEUL CONTRACTOR: d.TOP OF CAsl NG Is -0.2 FrAborelam sudacc
Midmost Ranier -rap of awkV lemiml ed aVor baton land surraoe mar IeWft
well Contractor Qn&widuaq Name a vakis =In aaordarrse rrah 15A NGAG 2G.011 ti.
Ranier Environmental DrMing.Inc. e.YIELD(9pm) t&-rHOD OF TEST
Well Contractor Company Name t DISINFECT1 NJ:Type Amunt
STREETAt7DRFS3 1 Piney Point g_WATERZONES (depth):
1N hispering Pines NC 28327 From To From To
City or Town State Zip Cade From To From To
910 949-45ri5 Frarn Tv From To
Area code Phone Number 6.CASING Thickness
2. WELL INFORMATION: Depth Diameler Weight Material
Site well ID#(it applicable) MW-18 Fn m -0.2 To 20 FL 2" sch 40 PVC
STATE WELL PERMIT*(if appGa+ble; 113 From To FL
DWQ or OTHER PEt1 W it(d applical na From To FL
WELL USE (Check Applii M"Monitor V X MvniP1jtie 7.GROUr: Depth Material flhethod
krd„WmVCam*ocW A&-ftxal Recovery to-*m Fran 0.5 To 21 Ft Portland Irerlurnie
lffwtbn oltrer Ojd Use) From To FL
Doe Drilled 7124/2008 From To FL
Trine Completed 7.00 AM PM x &SCR Depth Diameter Slot Ntaterial
3.WF1L LOCI MN. From 25 To 40 Ft. 2' 0.01 pvc
CITY Harmony COUNTY k8dell Fmx To FL
1156 E. Harmon From To FL
(Street Name.Numbers.Cwwmr dy.lot No..Parcel.Tip Code) 9.SANDIGRAVEL PACK:
TOPOGRAPHIC!LAND SETTING Depth Size Material
Slope Valley Flat x MCW- OVrer From 23 To 40 FL medium quartr
"eck ) From To Ft
LATITUDE 35 55'25.34 be t,dq � Frorn To Fl.
in io.DRILLINGLOG:
LONGTiUD8043' 1293 _f�sea.
LalihrdelL.ong)tude source: GPS x Topo map From To Formation Description
(location crf wd1 must be shoran on a USGS topo rasp and 0 1
a,d a Oils fmm If *Q GPM 40 red brawn
silt
>�
4.FACIUTY is iha rnm cf ft busimw where ewwee is bcaked
FAaLlTY 10 aC 01'applicable)
NAME OF FACILITY Jones G
STREETADDRESS 1156 E Harmon
Hammony NC
Cyr or Town stale Tip Code
CONTACT PERSON Nicole Long 11.ROAARKS:
MAILING AODRESs 2301 Crown PL Exec.Dr.
Chadatte NC 28227
Cty crTcwvn State zo code
704 845,4010 rvorra+rarer.roTMkra+stva�""�soaasrsrwr»"'"°cot+w"cE
Areavode Number aJMmaaraCZCVeLCokrsnwcnopWA"WxnseroUKTA
S. YYELLDETAILS: mrroFms m e®r olmwuLamm
a. TOTAL DEPTIt 40 rr,_0W0oa
b. DOES WELL RenACE EIUS nNG WELL NO SIGNRURE OF CIRMFIG WELL CONTRACTOR DATE
c. WATER LEVEL adowToplorcedi 30 Michael Ranier
We-0VAb0 10Pa9RS;,d I PROU12D NAME OFPOWMCONS IIUMINGWELL
"xa on hw to Div.of Water Quaft vA*M Z0 days.Mr.kgwm*m6lpt 1617 Mall Service CenW-Rekiok NO 27690-IW Phone P1B)733-7015 6d W8

Jul LU U�j U4:2Zp ivitcnaei Kansier U1UU494555 p,2
1 V ON ESIDENTML WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of Water Qunl ity
J ✓%
f'ti.iA
WELL CONTRACT oM CERTIFICATION€t 3S80
9.WELL CONTRACTOR: d. TOP OF CASING IS -_25 FT.Above Land Surface'
l3rl/3n yt35t 'Top of casing terminated allor below land surface rnay require
^Weil Contractor(Individual)Name a variance in acoordanw with 15A NCAC 2C .0118,
Ransler Environmental Drilling. Inc. :e. )nELD(gpm): METHOD OF TEST
Well Contractor Company Name ;Ill. DISINFECTION:Type Amount
1 Piney Point
Street Address :g. WATER ZONES(depth):
Whispering Pines NC 28327 :Top Bottom Top Bottom
City or Tam state Zip Code : Top Bottom Top Bottom
gr 10 ) 690_6688 Top Bottom Top Bottom
Area code Phone number Thickness/
2.WELL INFORMATION- :7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# :Top -. 55 Bottom 105 Ft. 2" Sch 4C PVC
OTHER ASSOCIATED PERMITf!<(irapplicable) :Top 0 Bottom 90 Ft. _ SCh 4( PVC
SITE WELL ID Wit applicable) Top Bottom Ft.
3.WELL USE(Check One Box)Monitoring W MunicipaltPublic D 6. GROUT: Depth Material Method
Industrial/Commercial= Agricultural❑ Recovery 0 Injeetion p :Top .5 Bottom 10j_Ft. Portland tremmie
Irrigation[] Otherp(list use) Top Bottom FL
DATE DRILLED 718109 :Top Bottom Ft.
4.WELL LOCATION: :9. SCREEN: Depth Diameter Slot Size Material
1156 E Harmonv Hwv :Top 105 Bottom 110 Fl. 2 in. .010 in. PVC
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,:Np Code) ;Top Bottom Ft. in. in.
ctTY:Harmony COUNTY Iredell ; Top Bottom Ft. in. in.
TOPOGRAPHIC/LAND SETTING: (check appropriate bo)o
E,Slope DVatrey &Fiat oRidge, l3CIther :tQ. SANDlGRAVEL PACK:
Depth Size Material
LATITUDE 34 °55 .25.0000 „DMS OR DO
:Top 1 D3 Bottom 110 Ft, Med. Quartz
LONGITUDE 80 - 43 - 12.0000 -DMS OR DO ;Top Bottom Ft.
Latitudeflongitude source: 03PS CTopographic map :Top sottom Ft.
{location of bvetl must be shown on a USGS(apo map andattached to
this form if not using GPS) : 11. DRILLING LOG
5,FACILITY(Name of the business where the wall is located.) Top Bottom Formation Description
Jones Gre nt 1 11N-2
. _
Facility Name Facility Ill#(if applicable) 1
1156 E Harmony Hwy 0 1 100 LQMM gill
Street Address �1109 1 105 -rock to gartially weathered rock
Harmony NC 105 1. 1.10 Coarse-brown auartz sand
City or Town State Zip Code 1 and tan-Silk
Made Lona /
Contact Name 1
2301-F t^mwn Point Executive Dr 1
Mailing Address 1
_Charlotte NO 28227 --
City or Town Slate Zip Code 12.REMARKS:
( 704 845-4010
Area code Phone number
fi.WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED rN ACCORDANCE WITH
15A NCAC 2C,WELL CONVIRUCTIONSTANDARDS.ANDTHATACOPYOFTHIS
:RE D HAS 6EE7,2
DE TO THE WELL OWNER.
a. TOTAL DEPTH: 11 Cl'
71?0109
b. DOES WELL REPLACE EXISTING WELL? YES L3 NO G/ -SlGNATURE,0F CEIRTIFIED WELL CONTRACTOR DATE
e. WATER LEVEL Below Top of Casing: 61 FT. i3rvan Vest
(Use"+"if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of water Quality Information Processing, Form G 9
Y � tY ' 9 Rev.2J09
1617 Mail Service Center,Raleigh,NC 27699-161, Phone :[phone]

;-SEAT}'.
1 y DN&SIDENT ML WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION#
1.WELL CONTRACTOR: d. TOP OF CASING IS FT_Above Land Surface-
SAM-try M C� I A i "Top of casing terminated atfor below land Surface may require
re
variance in accordance with 15A NCAC 2C.0118_
Weil Contra (Individual)Name
e. YIELD(gpsl): METHOD OF TEST
Well Contrarxor Company m Gt� QCcr �i -)-RJr✓ f. DISINFECTION:Type Ansount
�J
STREET ADDRESS T'�0, 6('X C1 F' g• WATER ZONES(depth):
_ l + From TO From To
�-!G n% 5 7 C��+Erl►�I /�rt- C��� From To From To
City or Town State Zip Code
(?(W ), .23 a _O-R ja From To From To
Area rode- Phone number 7. CASING: Depth D'tatneter ThlduwssJVWdW Material
2.WELL INFORMATION: From To )a Ft j��v P iK
SITE WELL ID#(if applicable) From TO Ft
WELL CONSTRUCTION PERMIT#(daIVIirade)
From To Ft
OTHER ASSOCIATED PERM)T#F{if applicable)
3.WELL USE(Check Applicable Box)Monitoring❑ Munic"VPublicI3 8. GROUT: Depth Material Method
IndustriaUCommer,ialI3 AgriculturaII3 RecoverArInjection13 From 0 _To S Ft
Inigatlone Othern (fis73 -o
) From Tc Ft
DATE DRILLED From To Ft
TIME COMPLETED— '117) AMD PI� 9. SCREEN: Depth Diamete i Material
�.WELL LOCATION: )� p� From,�o To 9.5 Ft �,. r b DO in. f f1�
CITY: h6gr'Y10a,!T COUNTY
From TO FT in. in.
From To Ft in. in.
(Street Name,Numbers.Cmunmity,StrhdiV}sion,tat No_,Parcel,Zip Code)
TOPOGRAPHIC 1 LAND SE th TTING: 10.5AND/e th PACK
13 Slope El Valley�(at Q Ridge 0 Other Size Material
(diw*appropftatebwt) May be Frnm�To _ S Ft -� ScaNf
in degrees. Front TO Ft
LATITUDE _ minutes,seconds or
—_LONGfTUDE in a decimal fonmit From To FL
__
Latitude/longitude source: D GPS © Topographic map 11.DRILLING LOG
(location of well must be shown on a USGS lopo map and From TO �j,. Ormati¢n Description
attached to this form if not using GPS) all So i
5.FACILITY-is the name of the a,skwss where the well is iocatea.
FACILITY ID#(rf applicable)
NAME OF FACILITY
STREET ADDRESS
fA(-JLrJ-71 r'U:U
City or Town State Zip Code
CONTACT PERSON
MAILING ADDRESS
City or Tam State Zip Code 12.REMARKS: t 1 _
ta.3e�1 V G
r >`
Area code- Phone number
5.WELL DETAILS: I DC HERESY CERT[FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, LL WE CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
a. TOTAL DEPTH' 3S tom,PWMDED TO THE WELL
OW`,KER
b. DOFS WELL RIEPLACE EXISTING WELL? YESt3 "If 2 (�Y�,�v�-+-� I t a D
e. WATER LEVEL Below Top of Casing: FT_ SIGNATURE O ERT NED WELLOCONTRACTOR D TE
(Use'+'if Above Top of Casing) m tp i
PRINTED NAME F PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Infarrnation Mgt, Form GW-1 b
1617 Mail Service Center-Raleigh,NC 27699-1617 Phone No.[phone] ext OGS. Rev.12M7

-r NoNREsmmuw WELL CONSTRUCTION RECORD
y A North Carolina Department of Environment and Natural Resources-Division of Water Quality
1 •ter. ';� �.�
WELL CONTRACTOR CERTIFICATION#
1.WELL CONTRACTOR: d. TOP OF CASING IS FT.Above Land Surface*
'Top of rasing ternrinated atfor below land surface may require
a variance in accordance with 15A NCAC 2C.011 S_
Welt Contra ondividual)Name
e. YIELD(gpm): "' METHOD OF TEST
111 k 'OtA i.," t" f. DISINFECTION:Type Amount
Well Contractor Company Naphe
STREET ADDRESS D O ��>t` -�c! 9. WATER ZONES(depth);
i From To From To
City Or Town State Zip Code From To From To
�- 7 9,:Z —0 2 i3 From TO Frum TO
Area code- Phone number 7. CASING: Depth Diameter Thiclui ssMaight Material
7-WELL INFORMATION: From 0 To 7 V Ft-_�2 ji 04'L
SITE WELL ID#(f app6cab{e} From TO Ft-
WELL CONSTRUCTION PERMtTkd appliahle) From To Ft.
OTHER ASSOCIATED PERMIT#Qf applicable)
3_WELL USE(Check Applicable Sox)MOnilortngf] MuninipauPublica 8. GROUT: Depth Material Method
Induslrial/CommerWIII Agricuftu�IQ Recovery❑ Injection0 From U Ta t o 5 Ft. G�avt %!` n��v r ec
IrrigationG Othe;g' (fist use) �fttr spaCE5i e From To Ft.
DATE DRILLED r a�-�% From To Ft
TIME COMPLETED 7 O Ci AMO PMR 9. SCREEN: Depth Diameter Slot Size Material
4.WELL LOCATION: f i
CITY: )4Ctr ma n: COUNTY 47 t-CA e-li From O To 7�Ft�_in. O in.
From To Ft in. in.
From To Ft. in_ in.
(Street Name.Numbers,Community,Subdivision,Lot No.,Parcel,Tip Cade)
14.SANDlGRAVEL PACK:
TOPOGRAPHIC/ D SETTING:
❑Slope 13 Vat Flat © Ridge 0 Other Depth Size Material
t aPP+OPR� From 0� To 7 5 t=t� 5 cxtk:�
May to in degrees, From-To-Ft.
LATITUDE __ minutes,seconds or
LONGITUDEin a decimal Format From TO Ft.
__
Latitudcllongitude source: 17 CrPS D Topographic map I I.DRiLLING LOG
((option of wetf must be shown On a USES tops map and From TO Formation(Description
attached to this form if not using GPS) t7 -7 S >2e-c So i
6.FACILITY-is Ine name or the b.w.....^where vw vmm is Iocated.
FACILITY ID#(if applicable)
NAME OF FACILITY TO iV e.S C:P rU GIv r
STREETS ADDRESS
City or Town State Zip Code
CONTACT PERSON
MAILING ADDRESS
City or Town State .Tip Cade 12.REMARKS:
4r�11 � RS j
1 }_
Area code- Phone number
6.WELL DETAILS: r I DO HEREBY CERnFYTHAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
a. TOTAL DEPTH: THE 7 RECORD �BEEN PROVIDE TD 0WELL ON�W DIRDS.AND THAT A COPY OF THIS
b. DOES WELL REPLACE EXISTING WELL? YES{] NO/ Cr 1 i l
c. WATER LEVEL Below Tap Of Casing: '/ FT.
SIG RE OF ERTI ED CONTRACTOR DATE
(Use'+-ifAbove Top of Casing) C f p
PRNTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of(Water Quafity within 30 days. Attn:Information Mgt., Form GW-1b
1617Mail Service Center—Raleigh,NC 27699-161T Phone No.[phone] ext568. Pev.12/07

r _ N6TIEESIDENTMWELL CONSTRUCTION RECORD
North Carolina Departrnent of EnviTanmmt aad Nativai Resources-Division of Water Quality
/} WELL CONTRACTOR CERTIFICATION#
1.WELL CONTRACTOR: d. TOP OF CASING IS (Z) FT.Above Land Surface'
'Top of casing terminated at/or below land surface may require
r a,-,, rb C r) iig iA) a variance in accordance with 15A NCAC 2C.A118,
Well Contractor(Individual)Name
�1GLc,�G ��L e. YIELD(gpm): METHOD OF TEST
�dt�
Well Contractor Company ,errg7 f. DISINFECTION:Type �' Amount
STREET ADDRESS P 0 (SCX 3 tc F5 g• WATER ZONES(depth):
From — To From TO
T-f'Gnl S�Ct�r'prLS /��� r �7�� From To From TO
City or Town State Zip Code
•JO :2_3Q 13 From To From To
Area Code- Phone number 7. CASING: Depth Diameter Thi&aesgwesght Material
2.WELL INFORMATION: From To Ft o7rr
SITE WELL ID*(ifapplicable}
Q_ l �
WELL CONSTRUCTION PERMrFWapplirable) From To FL —
From To FL
OTHER ASSOCIATED PERMIT*(tr applicable)
3.WELL USE(Check Applicable Box)MonitoringIr MunicipaVPublic[] 8• GROUT: Depth Material Method
Industrial/Commerciall] AgricuRuralp Recovery[] tnjecSon❑ From_ To t.0Ft. Cnwf �Qb`:�cQ
Ir€igatiora OtherG (list use) From To Ft
DATE DRILLED /ZZ ZE From To Ft
TIME COMPLETED AMP,-MO 9. SCREEN: Depth Diameter Slot Size Material
4.WELL LOCATION:
1 r -- i r
CITY: �-r t-MOVJ N,C, COUNTY l��t��[� From 10 To 60 FL in. ,0i b In. PCIA�—
From To__Ft_ in. in,
From To Ft in. tn.
(Street Nave,Numbers,Cormnunky,5ubdvtson,Lot Na,Parcel,Zip Cade)
TOPOGRAPHIC 1 LAND SETTING: 10.SAND L PACK:
❑Slope 17 Valley l %1: ❑ Ridge p Other Deepthpth Sf Material
(check appropriate box) Fro o� SCe r�
May e in degrees, m�To 7© Ft.
From To Ft
LATITUDE _ minutes,seconds or
LONGITUDE
in a decimal fannat From TO Ft.
_ _
Latitude/longitude source: 0 GPS ❑ Topographic map 11.DRILLING LOG
(location of"it must be shown on a USGS fopo map and From iru1 O / f ormation Description
attached to this form if not us GPS) C`�� �c'�
© —7 O c,i
S.FACILITY-is the name of the W6inasa where the Well is Iorated. —
FACILITY ID fr(if applicable)
NAME OF FACILITY 1_r,,UC5
STREET ADDRESS
City or Town State Zip Code
CONTACT PERSON
MAILING ADDRESS
City or Town State Zip Code 12.REMARKS: #
L-0 Oct;
Area code- Phone number
6.11YELL DETAILS, { I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
75A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
a. TOTAL DEPTH: 7O RECORD
BEEN PROVIDED TO THE WELL OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES❑ NOe✓
t. WATER LEVEL Below Top of Casing: FT. St NATURE OF ERP IED WELL L NTRACTOR 'DATE
(Use"+"if Above Top of Casing) 3 irk rL qz&:. O�"4 1 el y
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Information Mgt, Form GWAb
1617 Mail Service Center-Raleigh,NC 27699-1617 Phone No.[phone] ext 568. Rev,12107

NON RESIDENTL4L WELL CONSTRUCTION RECORD
,1`�•,.,; ,, �. North Carolina Department of Enriranazent and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION#
t.WELL CONTRACTOR: d. TOP OF CASING IS — FT.Above Land Surface`
e 'Top of casing tennlnated atior below land surface may require
a variance in accordance with 15A NCAC 2C.D11 8-
Well Conhador(Ind 'dual)flame
��C� � � �� e. YIELD(gpm); METHOD OF TEST
c1 `1 '`� f. DISINFECTION:Type Amount
Well Contractor Company Na
O g. WATER ZONES{depth):
STREET ADDRESS t� �J �Ox 3 +g
From To From To
3�7r'o&- 5+Ctj ',&Aj lit Cam. �c4d O Fran To From To
City or Town State Zip Code
(2-0 q ) 7 39 -0 —— From To From To
Area code- Phone number 7. CASING: Depth Diameter TNcknesslWerght Material
2-WELL INFORMATION, From Q To )0 Ft
SITE WELL ID#(fTappFrable)
WELL CONSTRUCTION PERMIT#(itapplicable) From To Ft
From To Ft
OTHER ASSOCIATED PERMIT#CIf applicable)
3.WELL USE(Check Applicable Sox)Monitoring Municipal/Publicp g GROUT: Depth Material Method
IndustriaU(',orrrmerdalCl AgricufhTrafi] Recovery[] Injection(} From To--�2—Ft. C P.f V c.13=1
Irrigatlon[l Otherfl (list use) From To Ft.
DATE DRILLED //441!C From Ta Ft
TIME COMPLETED 11%U V AMW PMG 9. SCREEN: Depth Diameter Slot Size Material
4.WELL LOCATION: =(red G I f " P L!
CITY: f'rGt1YrJ�t�rJ� COUNTY c From To 70 Ft. +n. 0 y O in.
—� From To—Ft. in_ In.
From To Ft in_ in.
(Street Name,Numbers,Community,SubilMson,Lot No.,PafCel,Tip Code)
TOPOGRAPHIC I LAND SETTING: 10.SAND L PACK:
0 Slope 13 Valley$'riat 11 Ridge 13 Other Deepthpth Size Material
(Check age box) From5To 70 Ft. tf a 5Ct rV
May e in degrees, From To Ft.
LATITUDE __ minutes,seconds or
LONGITUDE m
in a decimal foment Fro To Ft.
Latitudellongitude source: O GPS 0 Topographic map
11.DRILLING LOG
(location of well must be shown on a USGS topo map and From To Formation Description
attached to this form if not using GPS) 'U 70
5_FACILITY-is the name or the i-nir�wry w the well is lorated-
FACILITY ID#(If applicable)
NAME OF FACILITY_
STREET ADDRESS
City or Town State Zip Code
CONTACT PERSON
MAILING ADDRESS
City or Town Slate Zip Core 12.REMARKS: -tom
Area code- Phone number
G.WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WrrH
! ISA NCAC 2C.WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
a. TOTAL DEPTH: 70 RECORD HAs N PRO%4DED TO THE WELL OWNER.,
b. DOES WELL REPLACE EXISTING WELL? PESO N r i e G�
c. WATER LEVEL Below Top of Casing: FT. SIGNA E OF CE IFI WELL CONTRACTOR DATE
(Use'+'if Above Top of Casing) F }�6U( M C P l rJ
PRINTED F PERSON CONSTRUCTING G THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Infonnat€on Mgt, Form GW-tb
1617 Mail Service Center—Raleigh,NC 27699-1917 Phone No.[phone] ext 568. Rev.12107

NONRESIDENTIAL QNRES'IDENTIAL WELL CONSTRUCTION RECORD
=f North Carolina Depwtment of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTMCATTON#
1.WELL CONTRACTOR: d. TOP OF CASING IS FT.Above Land Surface*
', 7 t! L j "Top of casing terminated at/or below land surface may require
i A) a variance in accoRdanoe with 15A NCAC 2C_0118.
Well Contractor(Ind idual)Name e. YIELD(gpcn): METHOD OF TEST
mctf Q D &1 '� �d)C - f. DISINFECTION:Type Amount
Well Contractor Company e
STREET ADDRESS P(7 13n r FL 9. WATER ZONES(dam):
City or Town state Zip Code
From To From_To
Cn l S a}i l mil,C. �S From To From To
C
O '732^ 0 a f 3 Fran To From To
rea A code- Phone number T. CASING: Depth Diameter 1�kne�IVVei9M Material
2.WELL INFORMATION: From C I To_U Ft. �I
SITE WELL ID*(If appticanie) From To Ft
WELL CONSTRUCTION PERMIT;(Irappricaue) From To FL
OTHER ASSOCIATED PERMIT#(If applicable)
3.WELL USE(Check Applicable Box)MonitndDW2 1knicipaU bticQ 8. GROUT: Depth Material method
IndusUial/GammemialD AgriculturalO RecoveryO tnjectiorJ3 From Ft.Ft. C—em—Aj
IrrigationD Dtherd (list use) From Tc Ft
DATE DRILLED !/ --3"0 51 From To T Ft
TIME COMPLETED a-'0V AM13 PMIY 9. SCREEN: Depth Diameter Slot Size Material
4.WELL LOCATION: From 10 To k'C7 Ft a I I in. I Ui O in,
CITY: COUNTY ;=r,-jd 1
From TD Ft in. in_
From To FL in. in.
(Street Name,Numbels.Cornmuniry.SUbCWSIDn,Lot Na.,Parcel,Zip Coda) 10.SANDIGRAVEL PACK:
TOPOGRAPHIC I LAND SETTING: Depth Size Material
0 Slope 13 Valley,2-Plat D•Ridge D Othe!T
( May n
From_ ? To 7 0 Ft C�
in From To Ft
LATITUDE __ minutes,seconds or
in a decimal format From To Ft
LONGITUDE
Latitudeflongitude source: II GPS 0 Topographic map II.DRILLING LOG
(location of welt must be shown on a USGS tqw map and From To Formation Description
attached to this loan ifnotusing GPS) 60 70 any -�o'
5.FACILITY-is we name of the twaness wt"me well is tomted.
FACILITY ID i(if applicable)
NAME OF FACILRY s.�0,Ve5
STREET ADDRESS
City or Town State Zip Code
CONTACT PERSON
MAILING ADDRESS
City or Town State Zip Code 12.REMARKS; �
Wetl GLA-;,3
Area code- Phone number
S.WELL DETAILS: I 1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1SA NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
8. TOTAL}'?EPTI{• C2 RECORD EEN PROVIDED TO THE WELL OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES13 Nth
rH WATER LEVEL Below Top of Casing: FT SIGNATURE OF C TIFI WELL CONTRACTOR DATE
(Use'+•if Above Top of Casing) Ga g tw 01 C R i A)
PRINTED NAME PF PERSON C STRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attu:Information Mgt, Form GW-1b
1617 Mail Service Center—Raleighr NC 27699-1617 Phone No.[phone] ext 568. Rev.12107

.,,d oa STATF ry`y�
NONRESIDENTIAL ONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of Water Quality
' 49
2 r
WELL CONTRACTOR CERTIFICATION If �J
I. L CONTRACTOR: 1 d. TOP OF CASING IS FT.Above Land Surface'
C/ N "Top of casing terminated aUor below land surface may require
Mn ' ual)Narne _ a variance in accordance with 15A NCAC 2C.0118.
(! r'GC GIJ �G J
e. YIELD(gpm): METHOD OF TEST
W Contra, ompany N e
L DISINFECTION:Type Amount
t
,..preet Address g. WATER ZONES(depth):
�—!'61L� �^��} /(�71� /LJ, r °� ��� :Top Bottom Top Bottom
City or Town State Zip Code :Top Bottom Top Bottom
7 Top Bottom Top Bottom
Area code Phone number Thickness!
2.WELL INFORMATION: :7. CASING: Depth (O D}7 te5 Weight lit!@terial
WELL CONSTRUCTION PERMIT# ;Top _Bottom FL �lcJU
OTHER ASSOCIATED PERMITAV applicable) 'Top Bottom Ft.
SITE WELL ID if(if applicable) :Top Bottom Ft.
3.WELL USE(Check One Box)Monitoring 4!T'MunicipallPublic❑ 8, GROUT: Depth Material Method !�
Industrial/Commercial❑ Agricultural❑ Recovery❑Injection❑ :Top _Bottom_Ft. ' dy ,�A/
Inigation❑ Other❑ (I' u Top Bottom Ft.
DATE DRILLED Top Bottom Ft.
4.WELL LOCATION: ;9. SCREEN: Depth Diameter Slot Size MaterRiaal
JC-
Top It Q Bottom Q Ft, ��r in. ,Ol y In,
(Street Name,Numbam,Community,Subdivision,rot No.,Parcel,Z.ip code) 'Top Bottom Ft. in. in.
CITY: COUNTY �' � //;Top Bottom Ftl in. in.
TOPOGRAPHIC I AND SETTING: (dwck wxop W-box)
❑Slope ❑Valley,,clflat ❑Ridge ❑Other : 10,SANDIGRAVEL PACK:
°_ "DMS OR 3x.XxXXXX7VOC DID ��P 20 Ft. �— e Stm mate
LATITUDE :Top Bottom
LONGITUDE 75 °DMS OR 7X.xx>naxxxx DID :Top Bottom Ft.
LatitudeAongitude source: 03PS aopographic map ;Top Bottom Ft.
(location of wall must be shown on a USGS topo map andattached to
this form ifnot using GPS) : 11.DRILLING LOG
5.FACILITY(Name of the business where the well is located.) : Top Bottom Formations Desa'pd n
JO N tS nx el`y' ZI 7 fQP�P1/ �Di
Facility Name Facility[DO(f applicable) 1
I
Street Address 1
City or Town State Zip Code 1
Contact Name /
Mailing Address
1
City or Town State Zip Code
:12.REMARKS:
Area code Phone number
6.WELL DETAILS: 100 HEREBY TiPY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC LL CONSTRUCTION STANDARDS,AND THAT A COPY OF IS
a. TOTAL DEPTH: 0 RECORD SEEN PROIPEVT50 THE NER.
b. DOES WELL REPLACE EXISTING WELL? YES❑ Nt ( !/
RE OF IF D WELL C L� D TE
c. WATER LEVEL Below Top of Casing: FT.
(Use"+'if Above Top of Casing) :PRINTED NAM OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality- Information Processing, Form Rev,2/09/08
1617 Mall Service Center,Raleigh,NIC 27699-161,Phone:[phone]

tiSrATf4:,,
L `
NONRESIDENT'IA.L WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of Water Quality
• k""' - WELL CONTRACTOR CERTIFICATION# ��
1.WKL CONTRACTOR: y� - 'd. TOP OF CASING IS -� FT.Above Land Sultace'
rcWqI f A.) 'Top of casing tenranated atior bakm land surface may require
mw on (in v' ual)Name _ a variance in accordance with 15A NCAC 2C.0118.
r az �—r(lG J
w Contra mpany N e a. YIELD(gpm): METHOD OF TEST
t� O ;f. DISINFECTION:Type �r Arnount
bz-Peet1 re.'5 /� u.C r a 8-0 yo 9 WATERZOBo,,o, h)= Top Bottom
City or Town -�` 7 State Zip Code ;Tap Bottom Top Bottom
( 2W 7. I J Top Bottom Top Bottom
Area code Phone number Thickness/
2.WELL INFORMATION: .7. CASING: Depth D Weight rlat
WELL CONSTRUCTION PERMrr# :Top_ Q _Bollom /O Ft. oZ U
OTHER ASSOCIATED PERMIT#CdgWcable) :Top Bottom FL
SITE WELL ID#(dappkcaWe) :Top Bott n Ft.
3.WELL USE(Check One Box)Monitoring$.MunicipaltPublic❑ S. GROUT: Depth Material Method
lndustrial/Commercial❑ Agricultural❑ Recovery❑Injection❑ :Top, _Botttsm"L Ft.� dv /
Irrigation❑ Ottrer❑ (li us ) :Top Bottom Ft.
DATE DRILLED 11Z<46 Top Bottom Ft.
4.WELL LOCATION: 4. SCREEN: Depth DlaFrwWr Sint Sim terlall
Topes Bottom 7 0- Ft.��r in. ,QI U in.
(Steak Noma,Numbers,Community,SubdMsian.Lot No,,Parrot,Zip Code) l 'Top Bottom Ft in. in.
CITY: WCv'-1ewV COUNTY t4e I/ Top Bottom Ft. in. in.
TOPOGRAPHIC I(AND SETTING: (dwk appropriate cox)
❑Slope ❑Valley�at ❑Ridge ❑Other '10.SANDIGRAVEL PACK:
LATITUDE 36 "DMS OR 3x.xlaWCXuaoc DD ; Depth Sirne Mato
rw
Top__, Bottom_Q Ft. _
LONGITUDE 75 °DMS OR 7 ."Xx:W_Wt DD :Top Bottom Ft.
Laiitudetongttude source: (BPS Qropographic map :Top Bottom Ft
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS) :11.DRILLING LOG
6-FACILITY(Name air the business where the well is located.) Top Bottom Fommtkin Descrip
Facility Name !T Facility ID#cif applicable)
Street Address r
City or Town State Zip Code
Contact Name
Mailing Address
City or Town State Tip Code :12.REMARKS: „ ]
Area code Phone number
S.WELL DETAILS: t DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NcAc4,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
a. TOTAL DEPTH: 7 :R€ BEEN PR o To THEW ER.
1 //—t1)
b. DOES WELL REPLACE EXISTING WELLY YES❑ N41f� S E TIF CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: FT. t`
(Use•+'K Above Top of Casing) PRTRTED NAM OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality- Inform �� Rev.
Information Processing, ev.2/0909
1817 Mail Service Canker,Raleigh,NC 27899-161,Phone:[phone]