WM0401359_Monitoring Well Permit Application_20220428

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: 3/18/22
2. County: Alamance
FOR OFFICE USE ONLY
PERMIT NOW f N L `3 clk ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: USACE (Dena Thompson)
A`ig
Telephone: [phone]
Applicant's Mailing Address: 101 W York St, Savannah, GA 31401
Applicant's Email Address (if available): Dena.B.Thompsonusace.army.mil
5. Contact Person (if different than Applicant): Ethan Dinwiddie - Terracon Telephone: [phone]
Contact Person's Mailing Address: 2401 Brentwood Road, Suite 107, Raleigh, NC 27604
Contact Person's Email Address (if available): ethan.dinwiddieterracon.com
6. Property Owner (if different than Applicant): Ronald Lee Norton Telephone:
Property Owner's Mailing Address: 2121 NC Highway 54 Graham, NC 27253
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 1702/1704 Hilton Rd (...1 (.(1
City Burlington County Alamance Zip Code 27217
8. Reason for Well(s): groundwater contamination
(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: Former Tarheel Army Missile Plant
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
10. Are there any current water quality permits or incidents assocated with this facility or site? If so, list permit and/or incident no(s).
Federal Remediation Branch # NC7210020544
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, 10+
Existing Monitoring or Recovery Well Construction Permit No(s).: Unknown
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 1100 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: Larry Opper
Certification No.: 3322
Well Contractor Address: PO Box 1161 Wake Forest, NC 27588
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? Temporary Well,
material: 1 (temporary) abandoned same day
3. Number of wells to be constructed in bedrock: 0 6. Estimated beginning construction date: 5/4/22
4. Total Number of wells to be constructed: 1
(add answers from 2 and 3)
7. Estimated construction completion date: 5/4/22
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
Staff Geologist
Signature of Applicant or *Agent Title of Applicant or *Agent
Ethan C. Dinwiddie * 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 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]
WI
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]
ngton
Otqk
ae
GW-22MR Rev. 3-1-2016

Well ID: RI-GW-01 through RI-GW-06
Project No. : 7021P145
Site Name: Former Tarheel Army Missile Plant
Field Personnel: Ethan Dinwiddie/Dan Govert
Date: 3/18/2022
Alamance County PINs 139443, 139764,
Location: 139783, and 139787
Drilling Method: DPT
Driller: Larry Opper (NC Cert No. 3322)
lierracon
2401 Brentwood Road Suite 107
Raleigh, NC 27604
919.873.2211
Temporary Grab Monitoring Well Construction Diagram
Riser Pipe
Land Surface
Diameter 1-inch
Length 15 ft
Material PVC
Well Screen
Diameter 1-inch
Length 5 ft
Slot Size 0.010
Material Steel or PVC
Depth Below Land Surface (feet)
Bottom of Screen 20 ft
Bottom of Borehole 20 ft
2 Borehole Diameter (inches)
Note: Grab groundwater samples collected through DPT drilling rods using GeoProbe® SP-16
or similar tooling.

NHD7 Unnamed Tributary
of Service,Creek
(Perennial Stream)
139483
139482
139480
'139478
139476
139468Ie
Legend
City of Burlington ROW (ROW agreement
dated 11/14/2018)
= Properties without ROEs (Needed)
CI Properties without ROEs (Would be helpful)
O Properties with ROEs
Proposed Soil Vapor Sample
• Proposed Grab Groundwater Sample
• Proposed Surface Water Sample
°Proposed Deep Monitoring Well
9 Proposed Shallow Monitoring Well
Existing Monitoring Well
TAMP Site Boundary
0 Alamance County Parcel Boundary
MW-112
41CAY,��p� s j
Notes:
- Properties identified and labeled by Alamance
County parcel ID number. See corresponding ROE
table for addresses.
- City of Burlington Right -Of -Way agreement should
be updated based on potential offsets of proposed
locations.
. MW-115t
MW-109 4
MW-'1081
11 T^l^ MW-107
M W_.103:
r.
Service Layer Credits: NC Statewide Orthoimagery, NC One Map
Server, 2018; Site Boundary approximated from Alamance County GIS.
Project No.:
7021 P145
Date:
March 2022
Drawn By:
ECD
Reviewed By:
DRM
I I 1 I
75 150 300 Feet
Disclaimer The Inlormat ion deptled
this file for informational purposes
only and not prepared or and k
rot Unlade was
legal onengineering purposes
TN for 4o p led nd l eg at ry
review and a Intended for use only by a
Proteaaional Lard S eye p' t gut loop N
lirerracon
2401 Brentwood Road, Suite 107 Raleigh, NC 27604
Phone: [phone] Fax' (919} 873.9555
Proposed and Existing Sampling Locations
Tarheel Army Missile Plant
N. Graham Hopedale Road
Burlington, Alamance County, North Carolina
EXHIBIT
NO
1

City of Burlington
Installation within public rights -of -way Authorization
April 27, 2022
Mr. Joe Mellon
US Army Corp of Engineers
100 W Oglethorpe Road
Savannah, GA 31401
Subject: Utility Excavations Permit # 1389 — Monitoring Wells at Camp Road, Patrick Ave., Cobb Ave.,.
Hilton Road
Mr. Melton:
The City of Burlington does hereby grant access to the public right-of-way for the installation of the above
referenced utility as shown on the attached plan. The City makes no guarantee of adequate public right-of-way
to support the proposed installation as shown on the submitted plan. This is the responsibility of the applicant.
Note that this is not an authorization to construct. Any installation or disturbance within the public
street or within public right-of-way will require a preliminary field meeting with a representative of the
Engineering Department before authorization to construct will be given. Contact the City of
Burlington Engineering Department (John Hammond) at 336-222-5050 (o), 336-512-7646 (m) or by
email JHammond(a,burlingtonnc.gov, to set this meeting. Deviation from the attached plan noting
alignment or methods of installation must be approved through this office. All work within NCDOT rights -of -
way will require a separate approval through the District Engineer's office.
All work that requires an adjustment to normal traffic flow shall be performed in a manner that complies with
FHWA traffic control practices as noted in the MUTCD manual. Pedestrian and vehicular traffic must be
maintained at all times. Please note day and time restrictions (if any) noted on the attached ROW use
application.
It is the applying utility's responsibility to locate all other utilities prior to installation. All utilities shall be a
minimum of 30" below the nearest roadway surface —or- depth required by the governing utility code. The
new installation shall be a minimum of 48 inches measured perpendicularly from the center of any City
maintained utility and 24" clear separation when crossing any City maintained utility.
The utility owner shall agree to remedy any possible conflicts regarding the permitted utility, which the City
may encounter while performing maintenance of a City owned utility, with no cost borne by the City. The
utility shall agree to restore all infrastructure in accordance with applicable City of Burlington specifications.
Note that all restorations performed by the utility within public right-of-way shall be guaranteed by the utility
against any settlement or failure.
Sincerely,
W. Todd Lambert, P.E.
City Engineer
cc: file
Austyn Howell
Streets Superintendent
John Hammond
R/W Inspector

RIGHT-OF-WAY USE APPLICATION (required for all work in the City maintained ROW)
City of Burlington NC
Engineering Department
425 S. Lexington Ave.
Burlington, North Carolina 27215
P: [phone], F: [phone]
APPLICANT INFORMATION:
Name of Company: USACE Savannah District
Contact Name: Joe Melton
Address: 100 W Oglethorpe Rd, Savannah GA, 31401
Telephone Number: 864-650-4998
Email: [e-mail]
Contractor Information: (if contractor is applicant, note such and provide applicable contact info)
Contractor Name: Northwind Engineering, LLC
Subcontractor Name: Terracon
Telephone Number: [phone]
Telephone Number: [phone]
24-HR Contact Name: Danielle Hughes Telephone Number: [phone]
(Contact during construction)
FROM TO
Project Address/Location: North Cobb Avenue near Parcels 139467 and 139475
FROM TO
Project Address/Location: Hilton Road near Parcels 139478, 139768, 139787, and 139788
FROM TO
Project Address/Location: Patrick Avenue near Parcel 139783
The proposed locations of the borings are provided on the attached figures and will be placed within the
50 foot right-of-way that the city has along these roads. All utilities will be cleared prior to
commencement of work. There are eight total wells included in this permit application. Please see the
final page of this application for a table outlining well locations and quantities.
(provide location sketch)
(Complete as Applicable)
Reason for Need to locate in City public right-of-way: ( i.e. Utility service, Video Services, fiber optic
connectivity, local telephone service, natural gas service, electrical service, etc.)
The need to locate the borings in the right -of way arises from assessment of the contamination plume from
the Former TAMP Facility. USACE cannot properly address this issue without sampling off of the TAMP
facility. Wells installed during the assessment will be completed as temporary or flush mount monitoring
wells that will be completed at the existing grade so that no vertical obstruction will be left. The US
Government will abandon any permanent monitoring wells at the end of the assessment and any requisite
remediation.

Construction Activity general work description:
Excavation Area: Length 1 (FT) Width 1 (FT)
The wells be installed in holes with a diameter less than 12 inches.
Pavement Cut: Length (FT) Width (FT)
(Includes benching perimeter)
Pavement will not be cut unless a suitable offset location cannot be identified that is also within the
right-of-way.
Anticipated begin date: Mobilization 1 - 5/2/2022 Work duration: 7 (days)
Anticipated begin date: Mobilization 2 - 5/23/22 Work duration: 14 (days)
Construction plan or sketch submitted? Y N Material shop drawings submitted? Y N (attach)
Mill and overlay street for pavement restoration? Y N
Traffic control plan submittal:
Traffic control measures may vary based on location. Basic traffic control measures would include closure of a
section of the road shoulder using cones with a taper towards oncoming traffic. Road work signs would also be
displayed on both sides of the road at distances determined by City of Burlington or NCDOT requirements.
Additional measures required by the City of Burlington will be added if requested.
Print Name: Joe Melton Title: Contract Officer Representative
��m�'t :,,a ...a 19 Apr 2022
Signature: Date:
Signed by Joe Melton
Digital version on file

CITY USE
Permit #: 1389
Issue Date:4/26/22
Permit Fees: $ N/A
Utility Pavement Cut Fees: $ N/A (per Utility Pavement Cut Policy)
Public Works restoration fee: $ N/A (Does not apply if contractor restoring pavement)
TOTAL FEES DUE:
$ 0.00
Preconstruction Meeting Required.' N
Traffic Control Approvals: Traffic control plan for any disruption in traffic must be submitted prior to commencement of
construction, this includes but not limited to loading / unloading material and equipment and
Traffic Control Plan: Y construction within 5' of the travel lane. All traffic control to be installed by NCDOT and
Detour Plan: Y © MUTCD Guidelines.
Street Closure: Y 0
Permit Approval:
Engineering Department Signature:
Work Acceptance
Engineering Department Signature:
Permit Closed
Engineering Department Signature:
Project Notes:
4/26/22
date:
date:
date:
See following sheets for Locations included in this permit.
This permit shall only apply to City Streets, all NCDOT required encroachments shall be procured by the applicant and is not considered part of this
permit. The City does not guarantee that adequate right-of-way exist to support the proposed installation, R/W verification is the responsibility of the
applicant. This permit does not guarantee private utility easements or their use there of.
No lane reductions, closures or work between to 4pm and gam; no work may reduce travel lanes within a school zone during school zone times.
No handholes may be placed in a location that conflicts with proposed sidewalks or else relocated at AT&T at such time the conflict arises.
All sidewalk impacts shall be left passable at the end of each work day with compacted gravel fine stone, level with adjacent grades. Any sidewalk
impacts shall be replaced in full panels; partial panel replacement is not allowed.
No trees, shrubs, or landscaping may be trimmed, removed, damaged or disturbed without prior, specific approval from the City of Burlington
(Engineering Department).
Pavement Repairs shall follow the City's adopted Utility Pavement Cut Policy which include pavement restoration within 24 hours of completion of
work.
No handholes may be placed within driveways or roadside drainage ditches.
Failure to meet Project Permit conditions shall revoke work permit.

Owner Name: NORTON RONALD LEE
2121 NC HIGHWAY 54
GRAHAM, NC 27253
GPIN: 8875950571
PID: 148-598-74
Address Points
• Address
• TaxAddress
O Preliminary Address
Heavy Industrial Development Applicants
0 APPLIED FOR PERMIT
April 27, 2022
1:312
0 0.0035 0.007 mi
I r (
DISCLAIMER'
The dataseta and maps avaiable are notsurvey g ade ora legal
document They are a best approximation of what is on the
grornd, but du contain errors. The data comes tom various
sources nalonay, fie slate of Nor M1 Carolina. and here in
Aram ante Ccuny. Alamance Corny wil not be held responsible
for be misuse. misrepresentation. or misinterpretation of the data or
AlamanceColnty GIS maps These maps and data are a service provided for the benefit
Namance County Tax Department IorAlama epaounty cite encus. Wecanstantystrvetoimprove the
ityaide p. tINCREm NT P. NR( avertable.
Sources: Esri, HERE, Garrrin, USbS, Irdermap. INCREMENT P, NRG�an,
Esri Japan, ME11, E sti China (HApzc.Ukmijr,p(fKbrticsamo(IT�gqari,yar«s,
NGCC, (c) CpenStreelMap con IN butitiS?'8?fdltfeSI5t19eil' t Vff& � provided regadess or
how caused:or any decision made or acr taken or not taken by
user 'n relance open any reformation or data furnished hereunder.
The user knovArgy waves any and al claims for damages against
any and all of the entities comprising the Alamance Cointy GIS
System that may arise tom the mapping data. Dale: 4/27/2022

1805
se „Ik'impoea eft
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:.ati4itta ;r
136° 6'0 10"N, 79°24'28.97"W
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Owner Name: NORTHSIDE PRESBYTERIAN CHURCH
1805 VAUGHN RD
BURLINGTON, NC 27217
GP I N: 8875955682
PID: 148-599-102
Address Points
▪ Address
O Tax Address
O Preliminary Address
Heavy Industrial Development Applicants
O APPLIED FOR PERMIT
0
April 27, 2022
1:768
0.009
0.018 mi
DISCLAIMER:
The dataseb and maps avatable are notsurvey g ado ora legal
document They we a best approximation of what is on the
ground but do contain errors. The data comes tom various
sources nafonay, he state of Nor Corolla, and here in
Al am ante Count/. Alain ante Count/ wit not be held responsible
for he misuse. misrepresentation. cr misinterpretation of the data or
AlemanceCounty GIS maps These maps and data ere aservice provided for thebenefn
Alamance County Tax Department fora amante Cot.tty cd"aens. we con stormy strive to improve the
ty ntern ap, me amain oNTta P.
NR avlada.
Sources: Esri, HERE, Garnrn, US�S, Intermap, INCREMENT P, NRG�an,
Esri Japan, MET), E se China(HecapRotngpHet'YKaba.EreMo(tTiM4 gt pyerrors.
NGCC, (c) CpenStreeIMap conlributdrtrettl9h@qSPSTIStit'C".l9rfVN' n Provided regerdess of
hoer caused; or any decision made or act taken or not taken by
user n re t once upon any abrmation or data furnished hereunder.
The user knowingly waves any and al claims for damages against
any and all of the entaios comprising the roam once County Gls
System that may arise tom the mapping data. lob: 4/27/2022

Hilton Road
aim WM!f
36° 5158.2211, 79°24'40.32"W
BURLINGTON
'1`394 g
Owner Name: BAUGUESS PROPERTIES LLC
1013 NORTHCLIFT DR
RALEIGH, NC 27609
G PI N: 887 5854353
PID: 146-593-14
Address Points
• Address
• Tax Address
O Preliminary Address
Heavy Industrial Development Applicants
0 APPLIED FOR PERMIT
April 27, 2022
1:204
O 0.002 0.004 mi
DISCLAIMER:
Thedatasam and maps available ere notsurvey gale era legal
docanent thegas a best approrunetionof whet m on the
gro,md but do ccntan tines. -toe data comes tom vanes
sources relonafy. Ire State of Nah Carona, end hem on
Namante Canty. Alanante Coati wil net be rail responsible
lot t'-C m hose, misrepresentation a ngslrteroretebn elite data o'
Alamance County GIS maps. These maps and data ore a service prattled for leo bandy
Ajamance County Tax Departrneet 'oraanandcu Getnty cez ties. We cerslany smva to tepmve the
ttyaneexap, INCREMENT
NR evapMe.
Sources: Esri, HERE, Garrrin, US�S, Interns p, INCREMEtJT P. NRG�an,
Esri Japan, METI, Esri China 1Hetkpl(ortp9EEMI araFro. erivir2ti/Abdinr eras.
NG CC, (c) Open SEeetMap con Uibut'QB Rttl9h@0`.sy'StISVPdiffrtYhahifn pm'.ded regaraose
'eal
how caused: or sly dace en made a ecl' n taken a net taken by
user is reeance wen any informalon or data facetted haeurder.
The use knowitgiy waves any end al dates for damages against
any and ell of the moles comprising the Alamo -ice Sourly GE
System that may arise tom'le mapping data. Dam: U2712022

Owner Name: NORTON RONALD LEE
2121 NC HIGHWAY 54
GRAHAM, NC 27253
GPIN: 8875951561
PID: 148-598-75
Address Points
O Address
Q TaxAddress
O Preliminary Address
Heavy Industrial Development Applicants
ea�
APPLIED FOR PERMIT
April 27 , 2 022
1:312
0 0.0035 0.007 mi
l f r I
DISC LA M ER
The data5et5 and maps avaiable are notsurvey gads or a bgal
document They ate a best approximation of what a on the
ground but dacontan errors. Thedata comes tom venous
sources nainnay. he slate of Noll Carobra, and here in
Atam once County Nam aloe County wil nal be held respornible
for he misuse. misrepresentation. a misinterpretation of the data or
Nangnce County GIS maps. These maps and data are a service provided for the benefit
NamanceCounty Tax Department furNatnenceCotntycd¢ens weca,stamysmvetolmprovethe
afty rrte map, the amwnt of datV, NR avalaae
Sources: Esri, HERE, Gamin, US�S, Inlermap, INCREMENT P. NR�an,
Esri Japan, METI, Esri China (Hetyjt,Mvtgr'oUmYn'Klooes ,Eremo(i ei$eacjpyatraa.
NGCC, (c) OpeeStreetMap con tribul'a'Ss'SrinWf "provided regerdeas at
how caused. or any decision made a action taken or not taken by
user h ref ante upon any norm atlon or data henished hereunder
The user knovnngy waves any and al claims for damages against
any and all otthe entities comprising the Alamance Comfy cis
System that may arise tom the mapping data. Dab: 412712022

Owner Name: BERDUO SALOMON
HERNANDEZ ELENA MORALES
2566 OAKCREST COURT
BURLINGTON, NC 27217
G P I N: 887 58 563 73
PID: 146-596-100
Address Points
• Address
• Tax Address
O Preliminary Address
Heavy Industrial Development Applicants
O APPLIED FOR PERMIT
April 27, 2022
1:360
0 0.004 0.008 mi
r I
DISC LAN ER:
The daasea and maps scalable are not survey g ode ora legal
document They are a best approximation otwhat is on the
ground but docontan errors. The data comes tom venous
sources nalonaly, be state of Nab Carolina. and herein
Alamance Count. Alamarce Court' wit not be hell responsible
for be misuse, misrepresemation, or misinterpretation of the data or
AlamanceCounty GIS maps. These maps and data are a service providedforthe benern
AlamanceCounty Tax Department l rymaceovtl rytheaemer ra nl wofetlaa standMystrivetokimdpeovethe
Sources: Esri, HERE, Garmin, UST,Isternap, NGanav,a
Esri Japan, METI, Esfi China (HOG tttorigrOHigrfr is ,s.Gr»fiw(I141kiktalifnyerras,
NG CC, (c) OpenStreelMap contrilxmpiai trifitiwsv$bire ffiifl' � provided regxdess of
how caused; or any decision made a act' taken or not taken by
user in rejoice upon any hbrmabn or data furnished hacienda.
The uses knovArgy waves any and a1 claims for damages against
any and all of the entities comprising the Alamance County GB
System that may arise tom the mapphg data. Dab: 4,2712022

April 27, 2022
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Owner Name: CHIKHA M KHALIL