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11/09/2022
Rockingham
Monitoring
NCDEQ-DWM, UST Section, Trust Fund Branch, Attn: Herb Berger, LG 919-707-8170
1646 Mail Service Center, Raleigh, NC 27699-1646
[e-mail]
David Vail, Environmental Scientist, WithersRavenel 919-469-3340
115 MacKenan Drive, Cary, NC 27511
[e-mail]
NCDOT, Div. 7, District 3 336-520-6060
1101 E. Wendover Ave., Suite 200, Greensboro, NC 27405
[e-mail]
Traffic circle at intersection of Boone Rd, W. Meadow Rd, and Church St
Eden Rockingham 27288
Groundwater assessment and monitoring
Former UST Systems on property
Incident No. 30022 (NCDOT - Eden Traffic Circle (NCDEQ-DWM, UST Section Trust Fund Branch))
Petroleum Hydrocarbons
No
Unknown
~100-ft
No
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Environmental Scientist, WithersRavenel, Inc. On Behalf of NCDEQ-DWM, UST Section for TF#30022
Vail, David Digitally signed by Vail, David Date: 2022.11.09 13:24:06 -05'00'
See Attached NCDOT Encroachment Agreement (E0730792200240)NCDOT Division 7, District 3
DCV
EAA
DRAWN BY:
NONE
09/26/2022 02172214.67
1
SCALE:FIGURE NO.:
PROJECT NO.:DATE:APPROVED BY:
TYPICAL TYPE II WELL SECTION
WithersRavenel
Engineers | Planners | Surveyors
115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: F-1479 | www.withersravenel.com
NCDOT - EDEN TRAFFIC CIRCLE - TF#30022BOONE RD, W MEADOW RD, & CHURCH ST INTERSECTION, ROCKINGHAM COUNTY, NC
25
10
LANDSCAPED / MULCH SURFACE (TRAFFIC SAFE)
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500-FT RADIUS OF SITE
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NCDEQ INC.#
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NCDEQ INC.#
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NCDEQ INC.#
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NCDEQ INC.#
30023
NCDEQ INC.#
30032 K:\17\17-2210\172214.67-NCDEQ - Eden Traffic Circle\Enviro\CAD\Eden_Taffic_Circle_BASE_MAP.dwg- September 26, 2022 - DVAIL1"=100 'GRAPHIC SCALE
1 inch = 100 ft.
10050 2000 DCVEAADRAWN BY:09/26/202202172214.672SCALE:FIGURE NO.:PROJECT NO.:DATE:APPROVED BY:MONITORING WELL PERMITAPPLICATION MAPWithersRavenelEngineers | Planners | Surveyors115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340license #: F-1479 | www.withersravenel.comLEGEND
PROPOSED TYPE II MONITORING WELL LOCATION
EXISTING TYPE II MONITORING WELL LOCATION
NOTES:
1.) AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT.EDEN TRAFFIC CIRCLE TF# 30022INTERSECTION OF BOONE RD, W MEADOW RD, &CHURCH STEDEN, ROCKINGHAM COUNTY, NC
f^- o ~~> 3ta7'» C^ooe-fo
ROUTE SR 3002 & SR 3003
STATE OF NORTH CAROLINA
PROJECT NCDOT - EDEN TRAFFIC CIRCLE COUNP< OF ROCKtNGHAM
DEPARTMENT OF TRANSPORTATION
-AND-
NCDEQ - DWM, UST Section, State Lead Program
217 West Jones Street
Raleigh, NC 27603
RE ?itelF<(;Wi'Rf^OACHMENT AGREEMENT
!Nei<l-LM-lArY feNbROACHMENTS ON
PRIMARY AND SECONDARY HIGHWAYS
NOV 08 2022
THIS AGREEMENT, made and entered into this MP- Q^^ Tds\?(
of Transportation, party of the first part; and NCDEQ.DWM
PT.U-.' ,/ul<bt.'-l-lt';4<liu!'i:!%"c^i(^^^S_'_bya"dbetwee"the_Department
tib'h^StiiteTUad P.roaram;^r ^.^^^30022 (NCDOT - Edsn Traffic Circle site:.DWM.tU3rg^dib'h/Sf5teT:(!ad l=lr6aram:ferlBISWiuTENGINiEER'S'i party of the second part,
WITN ESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) SR 3002 & SR 3003 ^ located in the traffic circle at Boons Rd, West Meadow Road, and Church Street
with the construction a nd/or erection of: One (1) Type II Groundwater monitoring well for the purposes of assessment and possible remediation of
groundwater contamination from a former gas station that was located at the traffic circle. The srte is now known as NCDOT. Eden Traffic Circle (TF#30022).
The construction tocation will be in the western portkinof the traffic circle approxlmateiy38-ft northwest of the centeriine intersection of Boone Rd &W Meadow Rd/Church St.
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the
party of the first part in the exercise of authority conferred upon it by statute, Is willing to permit the encroachment
within the limits of the right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the firet part hereby grants to the party of the second
part the right and privilege to make this encroachment as shown on attached plan sheet(s), specifications and
special provisions which are made a part hereof upon the following conditions, to wit:
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe
and proper condition that it wifl not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper
maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways
and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the
party of the first part shall require the removal of or changes in the location of the said facilities, that the said party of the second
part binds himself, his successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said
requirement, without any cost to the party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signallights, flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic
Control Devices for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules and
regulations may be obtained from the Division Engineer of the party of the first part,
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages
and claims for damage that may arise by reason of the installation and maintenance of this encroachment.
It is clearly understood by the party of the second part that the party of the first part will assume no responsibility for any
damage that may be caused to such facilities, within the highway rights of way limits, in carrying out its construction and
maintenance operations.
That the party of the second part agrees to restore all areas disturbed during instailation and maintenance to the satisfaction of
the Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution
during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, resen/oJrs, other water
impoundments, ground surfaces or other property; or poltutton of the air. There shall be compliance with applicable rules and
regulations of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and
with ordinances and regulations ofvartous counties, municipalities and other official agencies relating to pollution prevention and
control. When any installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the
second part agrees to remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division
Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessaryby the Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the encroaching site, at all times during construction, a copy of
this agreement showing evidence of approval by the party of the first part. The party of the first part resen/es the hght to stop all
work unless evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the
second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has
been completed. Unless specrfically requested by the party of the first part, written notice of completion of work on highway
projects under construction will not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first partreserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to
the party of the first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein
is not begun within one (1} year from the date of authorization by the party of the first part unless written waiver is secured by the
party of the second part from the party of the first part.
FORM R/W16.1A (Revised February 2021)
R/W (161 A): Party of the Second Part certifies that this agreement is true and accurate copy of the form
RA/V (161A) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
DEPARTMENT QF^ERANUBPt^. 'w^
DIVISION ENGINEER
David Vail, Environmental Scientist I
Agent for NCDEQ-DWM, UST Section for TF#30022
Elizabet+i A. Allyn, PG, Environmental Project Geologist II
Agent for NCDEQ-DWM, UST Section for TF#30022
Second Party
INSTRUCTIONS
When the applicant is a corporation or a municipality, this agreement must have the corporate seal and
be attested by the corporation secretary or by the empowered city official, unless a waiver of corporate
seal and attestation by the secretary or by the empowered City official is on file in the Raleigh office of the
State Utilities Manager, tn the space provided in this agreement for execution, the name of the
corporation or municipality shall be typed above the name, and title of all persons signing the agreement
should be typed directly below their signature.
When the applicant is not a corporation, then his signature must be witnessed by one person. The
address should be included in this agreement and the names of all persons signing the agreement
should be typed directly below their signature.
This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the
following applicable information:
1. Ati roadways and ramps.
2. Right of way lines and where applicable, the control of access lines.
3. Location of the proposed encroachment.
4. Length and type of encroachment.
5. Location by highway survey station number. If station number cannot be obtained, location
should be shown by distance from some identifiable point, such as a bridge, road,
intersection, etc. (To assist in preparation of the encroachment plan, the Department's
roadway plans may be seen at the various Highway Division Offices, or at the Raleigh
office.)
6. Drainage structures or bridges if affected by encroachment.
7. Typical section indicating the pavement design and width, and the slopes, widths and
details for either a curb and gutter or a shoulder and ditch section, whichever is applicable.
8. Horizontal alignment indicating general cun/e data, where applicable.
9. Vertical alignment indicated by percent grade, P.I. station and vertical curve length, where
applicable.
10. Amount of material to be removed and/or placed on NCDOT right of way, if applicable.
11. Cross-sections of all grading operations, indicating slope ratio and reference by station
where applicable.
12. All pertinent drainage structures proposed. Include all hydraulic data, pipe sizes, structure
details and other related information.
13. Erosion and sediment control.
14. Any special provisions or specifications as to the performance of the work or the method of
construction that may be required by the Department must be shown on a separate sheet
attached to encroachment agreement provided that such information cannot be shown on
plans or drawings.
15. The Department's Division Engineer should be given notice by the applicant prior to actual
starting of installation included in this agreement.
16. Method of handling traffic during construction where applicable.
17. Scale of plans, north arrow, etc.