ML14316A379

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Well AA-V Installation Report - Appendix a - Monitoring Well Certification Form B
ML14316A379
Person / Time
Site: Salem  PSEG icon.png
Issue date: 03/31/2014
From:
ARCADIS U.S.
To:
Office of Nuclear Reactor Regulation, Public Service Enterprise Group
Shared Package
ML14316A124 List:
References
LR-E14-0148
Download: ML14316A379 (11)
v • d • e


Text

I Site Remediation Program

  • ~Now Jersey Department of Environmental Protection Monitoring Well Certification Form B - Location Certification Dt Stamp tm Date (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400006995
2. Site Well Number (As shown on application or plans): W
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 44.55" Longitude: West 75 32' 12.02"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 230,777 East 199,449

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 8.57 Elevation Top of Outer casing: 8.90 Elevation of ground: 8.90 Check one: El NAVD 88 [] NVGD29 El On Site Datum El Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete,/.ardl aware that there are significant penalties for submitting false information including the po i, lity of fine and ipprisonment.

Professional Land Surveyor's Signature:.  :--.f{,.' / Date 3,/A 3' Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of I Version 1.3 02/26/13

b _ New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007831
2. Site Well Number (As shown on application or plans): BG
3. Geographic Coordinate NAD 83 to nearest 1(100 of a second:

Latitude: North 39 27' 54.91" Longitude: West 75 32' 15.20"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,829 East 199,212

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 13.42 Elevation Top of Outer casing: 14.10 Elevation of ground: 10.82 Check one: S] NAVD 88 13 NVGD29 E] On Site Datum [] Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including *he ,ssjbility of fine aný,impdsonment.

Professional Land Surveyor's Signature: ,_,_____________"-__"______Date / '/' 3 Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02126113

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (P1) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007832
2. Site Well Number (As shown on application or plans): CA
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 2T 49.92" Longitude: West 75 32' 07.77"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,317 East 199,789

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 12.04 Elevation Top of Outer casing: 12.67 Elevation of ground: 9.21 Check one: E] NAVD 88 El NVGD29 El On Site Datum nI Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). Ifan on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including)t--1 ossibility of fine a imprisonment.

Professional Land Surveyor's Signature: ,*-b-. b,./>,[A* Date (e/,  ;]

Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02/26/13

, , New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): E201006610
2. Site Well Number (As shown on application or plans): DA
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27- 47.67" Longitude: West 75 32'10.63"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,092 East 199,562

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 9.12 Elevation Top of Outer casing: 9.47 Elevation of ground: 9.4 Check one: DJ NAVD 88 El NVGD29 F1 On Site Datum El Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including'th-ipossibility of fineand imprisonment.

Professional Land Surveyor's Signature:. ('-1.... Date 7/1,., Ai Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02/26/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp I(For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007817
2. Site Well Number (As shown on application or plans): BW
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 52.35" Longitude: West 75 32' 06.49"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,562 East 199,892

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 11.70 Elevation Top of Outer casing: 12.28 Elevation of ground: 9.2 Check one: NJ NAVD 88 El NVGD29 El On Site Datum [] Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted inthis document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete . I am aware that there are significant penalties for submitting false information includin.46 posibility of fine anr* imprisonment. D Professional Land Surveyor's Signature: - S 'Date 7/

Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1,3 02/26/13

)~~~ New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Hope Creek Generating Satation List all AKAs: PSE&G Salem Generating Facility Street Address: Alloyways Creek Neck Road Municipality: Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner The Francis Corporation
2. Well Location (Street Address) Alloyways Creek Neck Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing):
2. Site Well Number (As shown on application or plans): V
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 50.33" Longitude: West 75 32' 09.54"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,360 East 199,650

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 11.80 Elevation Top of Outer casing: 12.54 Elevation of ground: 9.07 Check one: S NAVD 88 E] NVGD29 E3 On Site Datum nl Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are m significant penalties for submitting false information includingfthe possibility . of fine rid imprisonment.

.J-:(p, Professional Land Surveyor's Signature: ';i /1 "/ /v6-" Date /

Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02126/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400006994
2. Site Well Number (As shown on application or plans): U
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 50.42" Longitude: West 75 32' 09.95"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,369 East 199,618

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 11.54 Elevation Top of Outer casing: 12.55 Elevation of ground: 9.31 Check one: NI NAVD 88 E] NVGD29 E On Site Datum L] Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including/tiepssibility of fine anifnprisonment.

Professional Land Surveyor's Signature: , Date 7/ A,,3 Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02/26/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007815
2. Site Well Number (As shown on application or plans): BX
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 52.54" Longitude: West 75 32' 06.72"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,581 East 199,874

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 11.87 Elevation Top of Outer casing: 12.39 Elevation of ground: 9.47 Check one: Ej NAVD 88 DI NVGD29 [I On Site Datum LI Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is.used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including-t possibility of fine and imprisonment.

Professional Land Surveyor's Signature: . Y/,.. Date -//.7 Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02/26/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Sation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): E201305775
2. Site Well Number (As shown on application or plans): AA-V
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 42.80" Longitude: West 75 32' 10.68"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 230,599 East 199,552

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 10.88 Elevation Top of Outer casing: 11.12 Elevation of ground: 9.29 Check one: DJ NAVD 88 E] NVGD29 E] On Site Datum F] Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). Ifan on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the Information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information includinbe possibility of finndiiprisonment, Professional Land Surveyor's Signature/ iiyofieand imprsnet ______________

Date 7/Z.__,_,

Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02/26/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION

1. Name of Well Owner PSEG Nuclear LLC
2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007825
2. Site Well Number (As shown on application or plans): BB
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 39.91" Longitude: West 75 32' 09.95"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 230,306 East 199,606

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 12.26 Elevation Top of Outer casing: 13.44 Elevation of ground: 9.88 Check one: &J NAVD 88 [] NVGD29 E] On Site Datum El Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information including.th possibility of fine af'd imprisonment.

Professional Land Surveyor's Signature: P&--i/.-! ( 2:z,./ Date 7/ Z A' 3 Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of I Version 1.3 02/26/13

New Jersey Department of Environmental Protection Site Remediation Program Monitoring Well Certification Form B - Location Certification Date Stamp (For Department use only)

SECTION A. SITE NAME AND LOCATION Site Name: Salem Generating Satation List all AKAs: PSEG Nuclear Street Address: Hope Creek Road Municipality: Lower Alloways Creek Township (Township, Borough or City)

County: Salem Zip Code: 08079 Program Interest (PI) Number(s): Case Tracking Number(s):

SECTION B. WELL OWNER AND LOCATION 1, Name of Well Owner PSEG Nuclear LLC

2. Well Location (Street Address) Hope Creek Road
3. Well Location (Municipal Block and Lot) Block# 26 Lot # 4 SECTION C. WELL LOCATION SPECIFICS
1. Well Permit Number (This number must be permanently affixed to the well casing): 3400007829
2. Site Well Number (As shown on application or plans): BF
3. Geographic Coordinate NAD 83 to nearest 1/100 of a second:

Latitude: North 39 27' 49.71" Longitude: West 75 32' 13.72"

4. New Jersey State Plane Coordinates NAD 83 datum, US survey feet units, to nearest foot:

North 231,301 East 199,322

5. Elevation of Top of Inner Casing (cap off) at reference mark (nearest 0.01'): 11.53 Elevation Top of Outer casing: 11.84 Elevation of ground: 9.18 Check one: NJ NAVD 88 El NVGD29 Fl On Site Datum [] Other
6. Source of elevation datum (benchmark, number/description and elevation/datum). If an on-site datum is used, identify here, assume datum of 100', and give approximated actual elevation (referencing NAVD 88).

GPS observation from Leica RTK Network

7. Significant observations and notes:

To arrive at site datum add 90.0 feet to NAVD 88 SECTION D. LAND SURVEYOR'S CERTIFICATION SEAL I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the submitted information is true, accurate and complete I am aware that there are significant penalties for submitting false information includipc tnh possibility of final,and imprisonment. I Professional Land Surveyor's Signature: ," /

(4 Date ?t17,/ 'I Surveyor's Name: Richard C. Mathews License Number: 29353 Firm Name: Stires Associates, P.A. Certificate of Authorization #:

Mailing Address 43 West High Street City/Town: Somerville "State NJ Zip Code: 08876 Phone Number 908 725 0230 Ext.: Fax: 908 707 0831 Monitoring Well Certification Form B - Location Certification Page 1 of 1 Version 1.3 02126/13

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