WM0401281_Monitoring Well Permit Application_20210304

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: March 3, 2021
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: AZ Development, LLC (Petitioner for DSCA Site DC410047)
Telephone: [phone]
Applicant's Mailing Address: NCDEQ DSCA Program, 1646 Mail Service Center, Raleigh, NC 27699-1646
Applicant's Email Address (if available): [e-mail]
5. Contact Person (if different than Applicant): Sam Martin - Hart & Hickman, PC Telephone: [phone]
Contact Person's Mailing Address: 2923 S. Tryon Street, Suite 100, Charlotte, NC 28203 Contact
Person's Email Address (if available): [e-mail]
6. Property Owner (if different than Applicant): Green Valley Property Investors, LLC Telephone: [phone]
Property Owner's Mailing Address: 1410 Mill Street Suite100, Greensboro, NC
27408 Owner's Email Address (if available): [e-mail]
7. Property Physical Address (Including PIN Number) 300 W Gate City Boulevard (PIN 7864532568)
City Greensboro County Guilford Zip Code 27406
8. Reason for Well(s): Environmental assessment for DSCA Program (DSCA Site DC410047)
(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: Dry-cleaning facility
(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).
No
11. Type of contaminants being monitored or recovered: chlorinated solvents
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes - 9
Existing Monitoring or Recovery Well Construction Permit No(s).: WM0401064, WM0401065, WM0401066, WM0401137,
WM0401138, WM0401139
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 500-550 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: Geologic Exploration, Inc. Certification No.: 4163-A
Well Contractor Address: 176 Commerce Boulevard, Statesville, NC 28652
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
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)

2. Number of wells to be constructed in unconsolidated 5. How will the well(s) be secured Bolted manhole and
material: 1
3. Number of wells to be constructed in bedrock: 0
4. Total Number of wells to be constructed: 1
(add answers from 2 and 3)
locking expansion plug.
6. Estimated beginning construction date: 3/15/2021
7. Estimated construction completion date: 3/19/2021
1.
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(f)(5), 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,
intersections, 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.
e. 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. 143-215.10B(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
on behalf of petitioner for DSCA Site DC410047 Agent for Petitioner for DSCA Site DC410047
Signature of Applicant or *Agent Title of Applicant or *Agent
Sam Martin, Hart & Hickman, PC
* If 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 Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached property owner access agreement See attached property owner access agreement
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (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
Swannanoa, NC 28778
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22MR Rev. 3-1-2016

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: March 3, 2021
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: AZ Development, LLC (Petitioner for DSCA Site DC410047)
Telephone: [phone]
Applicant's Mailing Address: NCDEQ DSCA Program, 1646 Mail Service Center, Raleigh, NC 27699-1646
Applicant's Email Address (if available): [e-mail]
5. Contact Person (if different than Applicant): Sam Martin - Hart & Hickman, PC Telephone: [phone]
Contact Person's Mailing Address: 2923 S. Tryon Street, Suite 100, Charlotte, NC 28203
Contact Person's Email Address (if available): [e-mail]
6. Property Owner (if different than Applicant): Green Valley Property Investors, LLC Telephone: [phone]
Property Owner's Mailing Address: 1410 Mill Street Suite 100, Greensboro, NC 27408
Property Owner's Email Address (if available): [e-mail]
7. Property Physical Address (Including PIN Number) 610 S. Eugene Street (PIN: 7864534831)
City Greensboro County Guilford Zip Code 27406
8. Reason for Well(s): Environmental assessment for DSCA Program (DSCA Site DC410047)
(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: Dry-cleaning facility
(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).
No
11. Type of contaminants being monitored or recovered: chlorinated solvents
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes - 9
Existing Monitoring or Recovery Well Construction Permit No(s).: WM0401064, WM0401065, WM0401066, WM0401137,
WM0401138, WM0401139
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 150-500 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: Geologic Exploration, Inc. Certification No.: 4163-A
Well Contractor Address: 176 Commerce Boulevard, Statesville, NC 28652
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
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)

2. Number of wells to be constructed in unconsolidated 5. How will the well(s) be secured Bolted manhole and
material: 1
3. Number of wells to be constructed in bedrock: 1
4. Total Number of wells to be constructed: 2
(add answers from 2 and 3)
locking expansion plug.
6. Estimated beginning construction date: 3/15/2021
7. Estimated construction completion date: 3/19/2021
1.
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(f)(5), 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,
intersections, 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.
e. 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. 143-215.10B(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
on behalf of petitioner for DSCA Site DC410047 Agent for Petitioner for DSCA Site DC410047
Signature of Applicant or *Agent Title of Applicant or *Agent
Sam Martin, Hart & Hickman, PC
* If 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 Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached property owner access agreement See attached property owner access agreement
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (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
Swannanoa, NC 28778
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22MR Rev. 3-1-2016

I.
yr
Waste Management
ENVIRONMENTAL QUALITY
PROPERTY ACCESS CONSENT
This document may not be modified without the Program's approval.
If you have questions on how to fill out this form or about the activities
at this site, please call the Dry-cleaning Solvent Cleanup Program's
contractor for this project, Ms. Rebecca Deal with Hart & Hickman,
P.C. at [e-mail] or [phone]. If you still have
questions after contacting Ms. Deal with H&H, please contact the DSCA Program
Project Manager, Mr. Patrick Watters at [e-mail] or 919-
70 7-83 63
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
MICHAEL SCOTT
Division Director
For DSCA Use Only
DSCA ID No.
DC410047
Please Print
Kotis Holdings, LLC c/o Marty Kotis
(Name of Property Owner or Tenant in Residence)
300, 302, & 348 W. Gate City Blvd (PIN: 7864532568)
(Street Number and Street Name of Property)
Greensboro, NC Guilford County 27401
(City or Town in Which Property Is Located) / (County in Which Property is Located) / (Zip Code)
I voluntarily consent to the Division of Waste Management (Division) and its independent
contractors (contractors) entering and having continued access to my property for the
following purposes:
(1) taking such soil, groundwater and/or air samples as may be necessary;
(2) taking other actions related to the investigation of surface or subsurface conditions;
(3) taking response actions necessary to mitigate any threat to human health or the
environment.
Other conditions:
(1) The Division and its contractors shall attempt to perform any activities at the Property
in a manner that minimizes interference with use of the Property.
(2) On conclusion of all activities, the Division and its contractors shall, to the extent
practicable, restore the Property to the original condition it was in prior to any activities
conducted by the Division or its contractors. All monitoring wells will be properly
State of North Carolina I Environmental Quality I Waste Management
1646 Mail Service Center 1 217 West Jones Street I Raleigh, NC 27699-1646
919 707 8200 Telephone

Page 2of2
DSCA Site ID No.
•
DC410047
abandoned in accordance with applicable laws and regulations, unless other
arrangements are agreed to by the Property Owner.
(3)The Division or its contractors will make reasonable attempts to notify the Property
Owner at least 48 hours prior to entering the Property for any purpose. In situations
that the Division determines to be of an emergency nature, the Division or its
contractors shall have immediate access to the property.
(4) Property Owner shall not willingly destroy, damage, remove, pave over or cover any
monitoring wells at the site without prior consent of the Division.
By signing this consent document, I acknowledge that I am the legal property owner
or tenant in residence that has the authority to allow this work on the property and
have contacted all tenants (if there are tenants) occupying the property and all tenants
agree to the conditions of this "Property Access Consent".
(Signature o
erty Ow er or Tenant in Residence)
(etcl-b) 4tt-kG ta4Ri DAviso bos'non
0(0Jjtj
bp
(Date)
(Telephone Number for Property Owner or Tenant in Residence for schedur g work/notification)
0-011 citNfiottCdn's prn . cct
Owner or
(Email Address for Property
p ty t in Residence if you prefer to be contacted via email)
Please return form to the DSCA Program's contractor for this site:
Ms. Rebecca Deal
Hart & Hickman, P.C.
2923 South Tryon Street, Suite 100
Charlotte, NC 28203
Or via email to: [e-mail]

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
MICHAEL SCOTT
Director
NORTH CAROLINA
Environmental Quality
PROPERTY ACCESS CONSENT
This document may not be modified without the Program's approval.
If you have questions on how to fill out this form or about the activities
at this site, please call the Dry -Cleaning Solvent Cleanup Act (DSCA)
Program's contractor for this project Sam Martin with Hart & Hickman, P.C. at
[e-mail] or [phone]. If you still have questions after contacting Mr.
Martin with H&H please contact the DSCA Program Project Manager, Ms. Sue Murphy at
[e-mail] or 919-707-8359.
For DSCA Use Only
DSCA ID No.
DC410047
Please Print
Green Valley Property Investors, LLC (formerly Kotis Holdings, LLC) c/o Marty Kotis
(Name of Property Owner or Tenant in Residence)
610 S Eugene Street (PIN: 7864534831)
(Street Number and Street Name of Property)
Greensboro, NC Guilford County 27401
(City or Town in Which Property Is Located) / (County in Which Property is Located) / (Zip Code)
I voluntarily consent to the Division of Waste Management (Division) and its independent
contractors (contractors) entering and having continued access to my property for the following
purposes:
(1) taking such soil, groundwater and/or air samples as may be necessary;
(2) taking other actions related to the investigation of surface or subsurface conditions;
(3) taking response actions necessary to mitigate any threat to human health or the environment.
Other conditions:
(1) The Division and its contractors shall attempt to perform any activities at the Property in a
manner that minimizes interference with use of the Property.
..1:1ECO7)
North Carolina Department of Environmental Quality I Division of Waste Management
217 West Jones Street 1 1646 Mail Service Center I Raleigh. North Carolina 27699.1646
919.707.8200

(2) On conclusion of all activities, the Division and its contractors shall, to the extent practicable,
restore the Property to the original condition it was in prior to any activities conducted by the
Division or its contractors. All monitoring wells will be properly abandoned in accordance
with applicable laws and regulations, unless other arrangements are agreed to by the Property
Owner.
(3) The Division or its contractors will make reasonable attempts to notify the Property Owner at
least 48 hours prior to entering the Property for any purpose. In situations that the Division
determines to be of an emergency nature, the Division or its contractors shall have immediate
access to the property.
(4) Property Owner shall not willingly destroy, damage, remove, pave over or cover any
monitoring wells at the site without prior consent of the Division.
By signing this consent document, I acknowledge that I am the legal property owner or tenant
in residence that has the authority to allow this work on the property and have contacted all
tenants (if there are tenants) occupying the property and all tenants agree to the conditions
of this "Property Access Consent".
(Signature of Property Owner or Tenant in Residence)
011 22,12D2.l
(Date)
(-2)6) —CCC°
(Telephone Number for Property Owner or Tenant in Residence for scheduling work/notification)
j t ri tO Zia -PISS conGe.pt5 . Ga►r-k
(Email Address for Property Owner or Tenant in Residence if you prefer to be contacted via
email)
Please return form to:
Sam Martin
Hart & Hickman, PC
2923 5. Tryon Street, Suite 100
Charlotte, NC 28203
Or via email to: [e-mail]
,DEQ-?)
North Carolina Department of environmental Quality. I Division of Waste Management
217 West Jones Street 11646 Mad Service Center l Raleigh. North Carolina 27699.1646
919.707.8200

aster Projects\DSCA - DSO\DS0-109 Odorless Cleaners\Report\2019-03 Quarterly GW sampling\Figures\DC410047_20200120.dwg, ATT.6C, 2/10/2020 5:40:15 PM, sperry
0
C—
MW-7
— (<0.00050)
MW-8
(<0.00050)
MW-8D
TRACKS BAZAAR
SHOPPING MALL
GREENSBORO
URBAN MINISTRY
FURNITURE
WAREHOUSV
MW-6
43- (0.011)
COMMERCIAL BUILD G
M_g CITGO GAS STATION
(<0.00050)1000 S. EUGENE STREET)
1 n
LEGEND
— — — — SOURCE PROPERTY BOUNDARY
PARCEL BOUNDARY
PERMANENT MONITORING WELL
TEMPORARY MONITORING WELL
(0.33) PCE CONCENTRATION (mg/L)
PCE ISOCONCENTRATION CONTOUR
—0.007— (mg/L) (DASHED WHERE INFERRED)
DESTROYED MONITORING WELL
NOTES:
1. SAMPLES MW-1 THROUGH MW-4, MW-4D, AND MW-6 THROUGH MW-9 COLLECTED ON
12/12/19. TMW-1 THROUGH TMW-4 WERE SAMPLED ON 12/19/16.
2. PCE=TETRACHLOROETHYLENE
NS =NOT SAMPLED
3. MW-4D NOT USED FOR CONTOURING
4. MONITORING WELL MW-5 FOUND DESTROYED DURING AUGUST 2018 SAMPLING
EVENT DUE TO CONSTRUCTION ACTIVITIES ON 300 W. GATE CITY BOULEVARD.
PROPOSED PWR WELL (120 BARNHARDT ST)
PROPOSED BEDROCK WELL
Gq TF co_
0
MW-3
117 (<0.00050)
TMW-1
GIBBS
BRE
(205 W. LWIS ST
TMW-2 IY
MW-1
(0.0030)
TMW-3 I
MW-2
(<0.00050)
PARKING LOT
TMW-4
APPROXIMATE
100
200
SCALE IN FEET
TITLE
PCE ISOCONCENTRATION MAP
(DECEMBER 2019)
PROJECT
FORMER ODORLESS CLEANERS
DSCA ID: DC410047
205 W. LEWIS STREET
GREENSBORO, NORTH CAROLINA
hart hickman
SMARTER ENVIRONMENTAL SOLUTIONS
2923 South Tryon Street -Suite 100
Charlotte, North Carolina 28203
704-586-0007(p) 704-586-0373(f)
License # C-1269 / #C-245 Geology
DATE: 1-24-20
JOB NO. DSO-109
REVISION NO. 0
ATTACHMENT NO. 6C

TYPE II TOP OF BEDROCK MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
LOCKABLE WELL CAP
L3
L1
L2
L1 =
L2 =
L3 =
45
5
50
FT.
FT.
FT.
DIAMETER OF
BOREHOLE
4.25 in
CONCRETE PAD
FLUSH METAL WELL COVER
CONCRETE PAD
BACKFILL AROUND CASING
MATERIAL
LENGTH
WELL CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
BACKFILL AROUND CASING
MATERIAL
LENGTH
SEAL
TYPE OF SEAL
THICKNESS
FILTER PACK
TYPE OF FILTER
THICKNESS
WELL SCREEN
SCREEN MATERIAL
DIAMETER
LENGTH
SLOT SIZE
DEPTH TO BOTTOM OF
MONITORING WELL
cement grout
3 ft (0 to 3 ft)
schedule 40 PVC
2 inches
flush threaded
45 ft
bentonite/grout
38 ft (3 ft to 41 ft)
bentonite
2 feet (41 ft to 43 ft)
No. 2 Sand
7 ft (43 ft to 50 ft)
schedule 40 PVC
2 inches
5 feet
0.010 inches
50 feet
TITLE Monitoring Well Diagram (MW-8D)
Hart & Hickman, PC
2923 South Tryon St., Suite 100
Charlotte, North Carolina 28203
FILE
PREP. BY
SQM
REV. BY
CEZ
DATE
2/25/2021
PROJECT NO.
DSO-109

TYPE II TOP OF BEDROCK MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
LOCKABLE WELL CAP
L3
L1
L2
L1 =
L2 =
L3 =
45
5
50
FT.
FT.
FT.
DIAMETER OF
BOREHOLE
4.25 in
CONCRETE PAD
FLUSH METAL WELL COVER
CONCRETE PAD
BACKFILL AROUND CASING
MATERIAL
LENGTH
WELL CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
BACKFILL AROUND CASING
MATERIAL
LENGTH
SEAL
TYPE OF SEAL
THICKNESS
FILTER PACK
TYPE OF FILTER
THICKNESS
WELL SCREEN
SCREEN MATERIAL
DIAMETER
LENGTH
SLOT SIZE
DEPTH TO BOTTOM OF
MONITORING WELL
cement grout
3 ft (0 to 3 ft)
schedule 40 PVC
2 inches
flush threaded
45 ft
bentonite/grout
38 ft (3 ft to 41 ft)
bentonite
2 feet (41 ft to 43 ft)
No. 2 Sand
7 ft (43 ft to 50 ft)
schedule 40 PVC
2 inches
5 feet
0.010 inches
50 feet
TITLE Monitoring Well Diagram (MW-10)
Hart & Hickman, PC
2923 South Tryon St., Suite 100
Charlotte, North Carolina 28203
FILE
PREP. BY
SQM
REV. BY
CEZ
DATE
2/25/2021
PROJECT NO.
DSO-109

TYPE III MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
LOCKABLE WELL CAP i CONCRETE PAD
L3
L1
L2
FLUSH METAL WELL COVER
CONCRETE PAD
BACKFILL AROUND CASING
MATERIAL
LENGTH
SURFACE CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
WELL CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
SEAL
TYPE OF SEAL
THICKNESS
FILTER PACK
TYPE OF FILTER
THICKNESS
WELL SCREEN
SCREEN MATERIAL
DIAMETER
LENGTH
SLOT SIZE
DEPTH TO BOTTOM OF
cement grout/bentonite grout
0 - 3 ft/3 - 66 ft
schedule 40 PVC
6 inches
flush threaded
55 ft
schedule 40 PVC
2 inches
flush threaded
70 ft
bentonite
2 feet (66 ft to 68 ft)
No. 2 Sand
12 ft (68 ft to 80 ft)
schedule 40 PVC
2 inches
10 feet
0.010 inches
L1 = 70 FT. MONITORING WELL 80 feet
L2 = 10 FT.
L3 = 80 FT.
DIAMETER OF
BOREHOLE
4.25 in
TITLE Monitoring Well Diagram (MW-4BR)
Hart & Hickman, PC
2923 South Tryon St., Suite 100
Charlotte, North Carolina 28203
FILE
PREP. BY
SQM
REV. BY
CEZ
DATE
2/25/2021
PROJECT NO.
DSO-109