WM0501412_Application_20201009

FOR OFFICE USE ONLY

PERMIT NO. ISSUED DATE
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 pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.

1. Date: 10/9/2020

2. County: Person

3. What type of well are you applying for? (monitoring or recovery): Temporary Monitoring Well

4. Applicant: Christopher Gilbert, Duke Energy Telephone: [phone]

Applicant’s Mailing Address: 526 South Church Street, Charlotte, NC 28202

Applicant’s Email Address (if available): [e-mail]

5. Contact Person (if different than Applicant): Jackie Roddy, ERM Telephone: [phone]

Contact Person’s Mailing Address: 4140 Parklake Avenue, Suite 110, Raleigh NC 27612

Contact Person’s Email Address (if available): [e-mail]

6. Property Owner (if different than Applicant): Alsco Metals Corporation Telephone:

Property Owner’s Mailing Address: 25825 Science Park Drive, Suite 400, Beachwood OH 44122

Property Owner’s Email Address (if available):

7. Property Physical Address (Including PIN Number) David Lane (PIN 0904-11-66-5164.000)
City Roxboro County Person Zip Code 27573

8. Reason for Well(s): Collection of groundwater samples to complete property due diligence
(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: AST
(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).

AST Incident No. 9642

11. Type of contaminants being monitored or recovered: Mineral Oil
(ex: organics, nutrients, heavy metals, etc.)

12. Are there any existing wells associated with the proposed well(s)? If yes, how many? N/A

Existing Monitoring or Recovery Well Construction Permit No(s).:

13. Distance from proposed well(s) to nearest known waste or pollution source (in feet):

14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No

If yes, give distance(s):

15. Well Contractor: Carolina Soil Investigations, LLC (CSI) Certification No.: 2107

Well Contractor Address: 132 Gurney Road, Olin, NC 28660

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 completion details
d. Sand/gravel pack intervals
Continued on Reverse
Jeff Drzewiecki
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FILE: \\USBDCFS02\Data\Raleigh\Projects\0490021 Duke Energy Corporation Due Diligence Program.BW\0566487 - Roxoboro Alsco Metals\5 - GIS\MXD\Figure_2b.mxd, REVISED: 09/14/2020 , SCALE: 1:1,440 when printed at 11x17DRAWN BY: Allison.GuzmanThis information is for environmental review purposes only.
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ERMERM NC, Inc.www.erm.com
Source: Esri, DigitalGlobe, GeoEye, Earthstar Geographics, CNES/Airbus DS, USDA, USGS, AeroGRID, IGN, GIS User Community, NCOneMapOld Durham RoadFigure 1Site Layout Map
Temporary Well
Construction Alsco Metals Corp. Property David LanePerson CountyRoxboro, NC
Residential
Undeveloped, Wooded Land
Duke EnergyRoxboro Substation
ALSCO MetalsCorporation
Residential
Heavily Vegetated Land
Wooded LandDavid LaneWooded Land
Approximate Site Boundary
Parcels
Historical AST and Relative Topographic Depression Fence
Unknown Subsurface Line
Underground Sanitary Sewer Line
Underground Natural Gas Line
Overhead Electrical Distribution LineUnnamed Creek
Dirt Path
Temporary Well and
Groundwater Sample
Location
Temporary Well
Construction
Ground Surface
Ground Surface
(drawing is of 2"well)