WM0501488_Permit (Issuance)_20220616

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR,
Director
NORTH CAROLINA
Environmental Quality
June 16, 2022
Attn: Rae Brown
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
Subject: Monitoring Well Construction
Permit # WM0501488
Webb's Mini Mart
900 Poole Drive
Gamer, NC -Wake County
Dear Ms. Brown:
In accordance with the application received on June 2, 2022, and the additional requested
information received on June 15, 2022, we are forwarding herewith Monitoring Well Construction Permit
No. WM0501488 dated June 16, 2022, issued for the construction of a monitor well system (installation of
three wells) at the subject property (in the NCDOT ROW for SR 2710). Please be aware that some
counties have well construction programs, and von may be required to obtain a well construction
permit before installation.
This Permit will be effective from the date of its issuance and shall be subject to the conditions and
limitations as specified therein. Please note the addition of stipulation #3 to the permit enclosed. If you have
any questions about this permit, please contact Eric Rice at [phone].
Enclosure
cc: RRO Files.'Laserfiche
Wake County Health Department
1:1EQ�
Sincerely,
�DocuSigned by:
S. Off Vll/1,561A,
. '-BCDA9D825D4A46D...
Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center 1 Raleigh, North Carolina 27699-1611
919,707,9000

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other applicable Laws,
Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Geological Resources, Inc.
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM (Webb's Mini Mart) consisting of three monitoring
wells owned by Geological Resources, Inc. at mailing address 3502 Hayes Road in Monroe, N.C. The wells will be
located on the property owned by the N.C. DOT in the right of way for SR 2710 near 900 Poole Dr. & 1400 Aversboro
Road in Garner, N.C.-Wake County. This Permit is issued in accordance with the application received on June 2, 2022,
and the additional requested information received on June 15, 2022, in conformity with specifications and supporting data,
all of which are filed with the Department of Environment and Natural Resources and are considered integral parts of this
Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any other applicable law or
regulation. Construction of any well under this Permit shall be in strict compliance with the North Carolina Well
Construction Regulations and Standards (15A NCAC 02C .0100), and other State and Local Laws and regulations pertaining
to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an adjudicatory hearing upon
written request within 30 days of receipt of this Permit. The request must be in the form of a written petition conforming
to Chapter 150B of the North Carolina General Statutes and filed with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these wells are being
installed as part of an investigation for contamination from an underground storage tank or dry cleaner
incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another
agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the Permit
application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water Quality's
Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC 02C
.0113 and a well abandonment record (GW-30) shall be submitted to the Division of Water Quality's
Information Processing Unit within 30 days of the well abandonment.
7. If the well penetrates any water -bearing zone that contains contaminated waters, the upper three feet of the
well shall be grouted within one day after the casing is set or the well abandoned.
Permit issued the 16th of June 2022
DocuSi ned b :
FOR THE NORTH CAROLINA IVIRONI�IEITAL MANAGEMENT COMMISSION
Vl.
Scott Vinson 'Re inal Supervisor
f waeKeurces By Authority of the Environmental Management Commission
Permit No. WM0501488
D_E CI?)
North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center 1 Raleigh, North Carolina 27699-: t 1 I
919.707 9000

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: 6/2/22
2. County: Wake
3.
4.
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
What type of well are you applying for? (monitoring or recovery): Monitoring
Applicant: Geological Resources. Inc. Telephone: [phone]
Applicant's Mailing Address: 3502 Haves Road, Monroe NC 28110
Applicant's Email Address (if available): rtbegeologicalresourcesinc.com
5. Contact Person (if different than Applicant): Rae Troiano Brown Telephone: [phone]
Contact Person's Mailing Address: 3502 Haves Road. Monroe NC 28110
Contact Person's Email Address (if available): rtbOgeologicalresourcesinc.com
6. Property Owner (if different than Applicant): NC DOT
Property Owners Mailing Address: 1555 Mail Service Center, Raleigh. NC
Property Owners Email Address (if available): NA
Telephone: [phone]
7. Property Physical Address (Including PIN Number) 900 Poole Drive (PIN 1710387331) /1400 Aversboro Road (PIN 1710386088)
City Garner County Wake Zip Code 27529
8. Reason for Well(s): assessment ground water 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 petroleum retail facility
(ex: non -discharge facility, waste disposal site, landfill. UST, etc.)
10. Are there any current water quality permits or incidents associated w,th this facility or site? If so, list permit and/or incident no(s).
No
11. Type of contaminants being monitored or recovered. petroleum
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes, 5
Existing Monitoring or Recovery Well Construction Permit No(s).: N/A
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 25'
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 Geological Resources, Inc.
Well Contractor Address: 3502 Haves Road. Monroe NC 28110
Certification No.: 3270A
PROPOSED WELL CONSTRUCTION INFORMATION
1. As required by 15A NCAC 02C .0105(0(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
matenal 3
3. Number of wells to be constructed in bedrock 0
4. Total Number of wells to be constructed _ _ 3
(add answers from 2 and 3)
5 How will the well(s) be secured?
Bolted manhole cover with locking well cap
6. Estimated beginning construction date: June 2022
7. Estimated construction completion date: June 2022
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
i nature of,icant o�ent Title of Applicant or *Agent
Rae Troiano Brown
Proiect Manager, P.G.
* 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 DOT NC DOT
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 Dnve
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 Dnve 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

A
0
25 50
100 ft
1 1 1 1 1 1 1 1
1 inch equals 50 feet
ONNalmr
Naps makes every effort to prodrres and puDMsh
the most current and accurate information possdW,
However, the maps ars produced far information purposes,
am! are MOT surreys. No warranties. erpresred or 'mailed
are proWdedfor the dale therein. its ase,nrits interpretation

TYPE II MONITORING WELL
TYPICAL CONSTRUCTION DETAILS
CONCRETE PA
GROUND SURFACE
o'
;
GROUT CEMENT
4.
BENTON/7E SEAL
SAND FILTER PACK
PROPOSED WELL DEPTH 20' 8GS
MANHOLE COVER
Traffic bearing; flush mounted; domestic steel
LOCKING WELL CAP
4
AA
•
2 INCH DIAMETER
SCHEDULE 40 PVC CASING
(PROPOSED CASING LENGTH
OF 2 FEET)
rop OF BENTONI1E 2' 8GS
TOP OF SAND PACK 3' BGS
0.010 INCH SLOTTED
2 INCH DIAMETER
SCHEDULE 40 PVC SCREEN
(PROPOSED SCREEN LENGTH
OF 10 FEET)
CND CAP
Webb's Mini Mart
900 Poole Drive
Gamer, Wake County
GRI 5456
Geological Resources, Inc.
Note:
t This diagram is not to scale.

STATE OF NORTH CAROLINA
ROUTE SR 2710 PROJECT Webb's Mini Mart COUNTY OF Wake
DEPARTMENT OF TRANSPORTATION
-AND-
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
RIGHT OF WAY ENCROACHMENT AGREEMENT
FOR NON -UTILITY ENCROACHMENTS ON
PRIMARY AND SECONDARY HIGHWAYS
THIS AGREEMENT, made and entered into this the 23rd day of May , 20 22 , by and between the Department
of Transportation, party of the first part: and Geological Resources, Inc.
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) SR 2710 , located Garner, Wake County
with the construction and/or erection of: Three Type II Monitoring Wells for the purpose of assessing petroleum impacted ground
ground water associated with Webb's Mini Mart
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the
party of the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment
within the limits of the right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second
part the tight and privilege to make this encroachment as shown on attached plan sheet(s), specifications and
special provisions which are made a part hereof upon the following conditions, to wit:
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe
and proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper
maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways
and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the
party of the first part shall require the removal of or changes in the location of the said facilities. that the said party of the second
part binds himself, his successors and assigns. to promptly remove or alter the said facilities, in order to conform to the said
requirement, without any cost to the party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal
lights. Bagmen and other waming devices for the protection of traffic in conformance with the latest Manual on Uniform Traffiq
Control Devices for Streets and Hiahways and Amendments or Supplements thereto. Information as to the above rules and
regulations may be obtained from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first pert from all damages
and claims for damage that may arise by reason of the installation and maintenance of this encroachment.
It is clearly understood by the party of the second part that the party of the first part will assume no responsibility for any
damage that may be caused to such facilities, within the highway rights of way limits, in carrying out its construction and
maintenance operations.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of
the Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution
during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and
regulations of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and
with ordinances and regulations of various counties, municipalities and other official agencies relating to pollution prevention and
control. When any installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the
second part agrees to remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division
Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary
by the Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the encroaching site, at all times during construction, a copy of
this agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all
work unless evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the
second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has
been completed. Unless specifically requested by the party of the first part, written notice of completion of work on highway
projects under construction will not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part
reserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to
the party of the first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein
is not begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the
party of the second part from the party of the first part.
FORM RNV 16.1A (Revised February 2021)

R/W (161A) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (161A) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above wriite i.
ATTEST OR WITNESS.
Geological loc.
DEPARTMENT OF TRANSPORTATION
BY: Jeremy Warren Da:2gsedaby1hwmycwamn
for DIVISION ENGINEER, Brandon H. Jones, PE
Geological Resouces, Inc
7vlu . 430,56/4
woswaud.a AccotmlManQnrY
Second Party
INSTRUCTIONS
When the applicant is a corporation or a municipality, this agreement must have the corporate seal and
be attested by the corporation secretary or by the empowered city official, unless a waiver of corporate
seal and attestation by the secretary or by the empowered City official is on file in the Raleigh office of the
State Utilities Manager. In the space provided in this agreement for execution, the name of the
corporation or municipality shall be typed above the name, and tide of all persons signing the agreement
should be typed directly below their signature.
When the applicant Is not a corporation, then his signature must be witnessed by one person. The
address should be included in this agreement and the names of all persons signing the agreement
should be typed directly below their signature.
This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the
following applicable information:
1. All roadways and ramps.
2. Right of way lines and where applicable, the control of access lines.
3. Location of the proposed encroachment.
4. Length and type of encroachment.
5. Location by highway survey station number. If station number cannot be obtained, location
should be shown by distance from some identifiable point, such as a bridge, road,
Intersection, etc. (To assist in preparation of the encroachment plan, the Department's
roadway plans may be seen at the various Highway Division Offices, or at the Raleigh
office.)
6. Drainage structures or bridges if affected by encroachment.
7. Typical section indicating the pavement design and width, and the slopes, widths and
details for either a curb and gutter or a shoulder and ditch section, whichever is applicable.
6. Horizontal alignment indicating general curve data. where applicable.
9. Vertical alignment indicated by percent grade, P.I. station and vertical curve length, where
applicable.
10. Amount of material to be removed and/or placed on NCDOT right of way, ff applicable.
11. Cross -sections of all grading operations, indicating slope ratio and reference by station
where applicable.
12. All pertinent drainage structures proposed. Include all hydraulk data, pipe sizes, structure
details and other related information.
13. Erosion and sediment control.
14. Any special provisions or specifications as to the performance of the work or the method of
construction that may be required by the Department must be shown on a separate sheet
attached to encroachment agreement provided that such information cannot be shown on
plans or drawings.
15. The Department's Division Engineer should be given notice by the applicant prior to actual
starting of installation included in this agreement.
16. Method of handling traffic during construction where applicable.
17. Scale of plans, north arrow, etc.