wm0501386_Application_20200116

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations oursuant thPrato.
application is hereby made fi
1 Date: January 10, 2020
2. County: Wake
or a permit to construct monitoring or recovery wells.
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery); Monktiag
4_ Applicant: Avis Budget Group Telephone: [phone]
Applicant's Mailing Address: 6 Sylvan Way, arsiooanv NJ 07054
Applicant's Email Address (if available): abgtanks-env@Id2env com
5. Contact Person (if different than Applicant): Trey Marchant Telephone: [phone]
Contact Person's Mailing Address: 409 Rogers View Ct Raleigh NC 27610
Contact Person's Email Address (if available): tmarchantgDmaeonline com
6. Property Owner (If different than Applicant): Raleigh -Durham Airport Authority Telephone: [phone]
Property Owner's Mailing Address: P.O. Box Q00911,113DU Ai , rt. NC 2762a
Property Owner's Emall Address (if available): _ Michael.landauth®rdu com
7. Property Physical Address (Including PIN Number)_ 1000 Rental Car Drive
City RDU Airport County. Wake Zip Code 27623
8. Reason for Well(s): _ Suspected contamination (NCAEQ reauldna site check)
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9. Type of facility or site for which the well(s) Is(are) needed: UST
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
10. Are there any current water quality permits or Incidents associated with this facility or site? If so, list permit and/or Incident no(s).
rdo
11. Type of contaminants being monitored or recovered: Organics, (gasoling)
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existing Monitoring or Recovery Well Construction Permit No(s).:
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): ARM& 80D it
14. Are there any water supply wells located less than 50D feet from the proposed well(s)? No
If yes, give distance(s):
15. Wag Contractor: Geologic Exploration. Inc. Certification No.: 1175 (NC)
Well Contractor Address: 176 Commerce Blvd Statesville NC 28625
PROPOSED WELL CONSTRUCTION INFORMATION
1. As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons
C. Screen Intervals g. Well head complefion detalls
d. Sand/gravel pack Intervals
Continued on Reverse

PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
Number of wells to be constructed in unconsolidated
material: _ 1
Number of wells to be constructed in bedrock: 0
Total Number of wells to be constructed: 1
(add ansvmrs from 2 and 3)
5. How will the well(s) be secured? Flush mounted
bolt -down lid mgnhgle. locking can ant lock
6. Estimated beginning constructlon date: 1130120
7. Estimated construction completion date: 1/30/20
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(fx5), attach a scaled map of the site showing the locations of the following:
a. All property boundaries, at least one of which is referenced to a minimum of two landmarks such as identified roads.
Intersectlorls, streams, or lakes within 500 feet of the proposed well or well system.
b. All existing wells, Identified by type of use, within 500 feet of the proposed well or well system.
C. The proposed well or well system.
d. Any test borings within 500 feet of proposed well or well system.
a. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chemical or fuel
storage areas, animal feedlots as defined In G.S. 143-215.10113(5), landfills, or other waste disposal areas) within 500 f"
of the proposed well or welt system.
SIGNATURES
The Applicant hereby agrees that the proposed wall($) WIN be constructed In accordance with approved specifications and conditions of
this Well Constriction Permit as regulated under the Well Construction Standards (Tfda 15A of the North Carolina Administrative Code,
=S;Z
nd accepts full responsibility for compliance with these rules
_ Princical Geologist
SIgnstutsild Applicant or *Agent Title of Applicant or *Agent
Raymond S. Merchant III 'tf signing as Agent, attach authorization agreement stating
Printed name of Applicant or *Agent that you have the authority to act as the Agent.
If the property Is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined In this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the Well Constriction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
J.
Slgnature.of PmPf(if different than Applicant) Printed name of Property Gamer (If different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office
2090 U.S. Highway 70
Raleigh Regional Office
Wilmington Regional Office
Swannanoa, NC 28778
3800 Barrett Drive
Raleigh, NC 27609
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Phone: [phone]
Fax [phone]
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: (910) 48"707
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax [phone]
Washington Regional Office
943 Washington Square Mail
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax [phone]
AR Rev. 3-1-2016

untitieci map
Write a description for your map.
4V 1 te
'Approximate well/
;boring location
_J
ft 00 Legend
all 100ORentalCar Dr
Feature 1
77Y
A 0
s-

LOCKABLE CAP
FLUSH MOUNT
WELL PROTECTOR
DEPTH TO TOP OF
BEMNITE SEAL 3 F
DEPTH TO TOP OF
GRANULAR MATERIAL 4
SCHEDULE 40 PVC
WELL CASING AND
SCREEN
DEPTH FROM GROUND SURFACE
TO TOP OF CASING ('IOC)
0.5 ET
PRE —PACKED
SC-1 il OF
"ON
ti: PIPE
CEMENT OR CONCRETE GROUT
BENTDNITE
GRANULAR BACKFILL (#2 sand)
SURFACE
TOTAL DEPTH
OF WELL
—1-15--ET
STABILIZED WATER
LEVEL — FEET
BELOW 70P OF
CASING
MEASURED ON
TYPE 11 MONITORING WELL
DRAWN
SCHEMATIC
DRAFT
CHECK:
Atlantic
BUDGET CAR RENTAL
1000 RENTAL CAR DRIVE
NG
elEwFrie.
RDU AIRPORT, NC
REFERENCE:
NOT TO SCALE
DATE. JAN 2020
JOB
NO: R3530.00
NO TYPE 11 MW—FLUSH-201
DWG

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