WM0501389_Application_20200203

Geological Resources, Inc.
January 30, 2020
Mr. Brion Byers
NCDEQ, Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699
Re: Monitoring Well Permit Application
Red Apple Market #4
Intersection of East Main Street and Pine Street
Conway, Northampton County
Incident No: 8963
GRI Project No: 3652
Dear Mr. Byers:
NC Dept
ofFnvironmeptal
Oualirt
Reciol7a1 Office
Please find enclosed a monitoring well permit application for the replacement of one Type II monitoring
well at Red Apple Market #4 located at the intersection of East Main Street and Pine Street in Conway,
Northampton County. GRI plans on installing the monitoring well in February 2020.
Your prompt attention to this matter will be greatly appreciated. If you have any questions or require
additional information please do not hesitate to contact me at [phone].
Sincerely,
P44
William Regenthal, P. G.
Project Manager
enclosures
cc: file
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY — AQUIFER PROTECTION SECTION
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 pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: January 24, 2020
FOR OFFICE USE ONLY
PERMIT NO. _ A d 0iM_ ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: North East Oil Company, Inc.
Telephone: [phone]
Applicant's Mailing Address: Post Office Box 1386, Ahoskie NC 27910
Applicant's Email Address (if available):
NA
5. Contact Person (if different than Applicant): William Regenthal Telephone: [phone]
Contact Person's Mailing Address: 113 W. Firetower Road, Suite G, Winterville NC 28590
Contact Person's Email Address (if available): wlr(pb_geologicalresourcesinc.Com
6. Property Owner (if different than Applicant): _Sharnn H_ Davis Telephone:
Property Owner's Mailing Address: Post Office Box 578, Conway NC 27820
Property Owner's Email Address (if available):
NA
7. Property Physical Address (including zip code) and PIN Number _ ptor
8. Reason for Well(s): Assessment County
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc
9. Type of facility or site for which the well 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).
LIST Incident 8963
11. Type of contaminants being monitored or recovered:
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many?
Existing Monitoring or Recovery Well Construction Permit No(s).:
w
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 0 ' o
iv
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s): NA
z
15. Well Contractor: Justin Radford Certification No.: 3270
Well Contractor Address: 3502 Haves Road, Monroe NC 28110
PROPOSED WELL CONSTRUCTION INFORMATION
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 completion details
d. Sand/gravel pack intervals
Continued on Reverse

Type 11'.i Monitoring Well
Typlc 1 Construction Details
concrete pad mxnhola cover
ground surface
looklnd WOU cap
b � .
grout cement
2 Inch dlameler
schedule 40 PVC caalnp
benionlie seal 3r
0,010 Inch sldtled 21nch diameter
schedule 40 PVC sorean
f
sand filler peck
i
' I cnd oxls

Geological Resources, Inc.
January 30, 2020
Mr. Brion Byers
NCDEQ, Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699
Re: Monitoring Well Permit Application
Red Apple Market #4
Intersection of East Main Street and Pine Street
Conway, Northampton County
Incident No: 8963
GRI Project No: 3652
Dear Mr. Byers:
Please find enclosed a monitoring well permit application for the replacement of one Type II monitoring
well at Red Apple Market #4 located at the intersection of East Main Street and Pine Street in Conway,
Northampton County. GRI plans on installing the monitoring well in February 2020.
Your prompt attention to this matter will be greatly appreciated. If you have any questions or require
additional information please do not hesitate to contact me at [phone].
Sincerely,
P*llb
William Regenthal, P. G.
Project Manager
enclosures
cc: file
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] a [phone] • Fax [phone]

LEGEND
O TYPE // MONITORING WELL
TYPE Ill MONITORING WELL
PROPERTY BOUNDARY LINE
0 0 o FUEL DISPENSER ISLAND
------------ UNDERGROUND STORAGE TANK
Note:
7his Site Map is based on data from the Northampton
County G/S of NC as well as a Site Plan dated October 31,
1994 that was prepared by Coastal Environmental Services,
Inc.
Elizabeth
rtnson
Residence
Former 4—K Gallon
Gasoline UST
Former Pun
Island
Former 1—K—
Gallon
Gasoline USTs
(2)
1
Former Pump
)71ms
Is/and
7
Former RAM
14
Cncrete/
Gras
OMW-1
MW-2
O
MW-5
O
�ros�
Former 280 Gallon MAIN STREET / U- S HI GHW A Y 158
Kerosene UST
MW-8
O
Moye's
MW-6 Fam/ly Care
O Nome
Hood's
Funeral
Home
S/TE MAP
0 30 60 120
RAM 0 U.S. Highway 158 & Pine Street
iiiiiii Incident No. 8963 Conway, Northampton County,
6R( IN FEET ) GRI Project No. 3652 NC
Geological Resources, Inc. 1 inch = 60 ft Date: 11/16/17 1 Drawn by. DTH I Figure: 2

LEGEND
• SOURCE AREA CENTER
5928-22-5448 PARCEL /D NUMBER
SUB✓ECT PARCEL
- — - PARCEL BOUNDARY
RAILROAD TRACKS
Note,•
This mop is based on dote from the
Northampton County GYS of NG
N.N> tA-to,��►s
w;ik,'VA is P
POPLAR DR'
HUNDLEYS CIRCLE
O
W
Z
5928-23-5225 4
U.S. H/GHWA Y 158 / MAIN STREET
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p
MERCHANTS ALLEY
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W
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5928-22-451
w,
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n 59A - 6j31
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5928-22-3358
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5928-22-538
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TREET
Wl•//TE SLl
h
O
Z
I
W
h
2
1,500—FT RADIUS
L 00047 RAD/US
500—FT RADIUS
250—FT RADIUS
I
s-
SITE VICINITY MAP
0 200 400 800 RAM 14 U.S. Highway 158 & Pine Street
Incident No. 896J Conway, Northampton County,
( IN FEET) GRI Project No. J652 NC
Geo%gica/ Resources, Inc. 1 inch = 400 ft Date: 06/29/16 Drawn by. ECH Figure. 2