WV0400058_Variance Request Application_20230103

North Carolina Department of Environmental Quality (DEQ) — Division of Water Resources (DWR)
VARIANCE APPLICATION FOR WELL CONSTRUCTION STANDARDS:
WATER SUPPLY WELLS UNDER 15A NCAC 02C .0107
All water supply wells not considered "Private Drinking Water Wells" and including irrigation, industrial, and commercial wells.
WELLS OTHER THAN WATER SUPPLY UNDER 15A NCAC 02C .0108
Including monitoring and recovery wells.
PRIVATE DRINKING WATER WELLS UNDER 15A NCAC 02C .0300
Print clearly or type information. Illegible submittals will be returned as incomplete.
DATE: December 13, 2022
Existing permit number (if applicable) N/A Issued Date: Exp. Date:
Permit No. for new projects (to be completed by DWR/DPH) WI
A. WELL OWNER(S) — For single family residences, list all persons appearing on property deed. For all others, list name
of the business/government agency and person and title with delegated signature authority:
Alamance County
Richard Hill — Director Solid Waste
Mailing Address: 2701 Austin Quarter Road
City: Graham State: _NC_ Zip Code:27253 County: Alamance
Day Tele No.: [phone] Cell No.: [phone]
EMAIL Address: [e-mail] Fax No.:
B. PHYSICAL LOCATION OF WELL SITE
(1) Parcel Identification Number (PIN) of well site: #157517
County: Alamance
(2) Physical Address (if different than mailing address): 2701 Austin Quarter Road
City: Graham
County: Alamance Zip Code: 27253
C. WELL DRILLER INFORMATION (if known)
Well Drilling Contractor's Name: Jacob Messick
NC Well Drilling Contractor Certification No.: 4252-A
Company Name: Geologic Exploration Contact Person: Jason Mantak
City: Statesville State: NC Zip Code:28625 County: Iredell
Day Tele No.: [phone] Cell No.:
EMAIL Address: [e-mail] Fax No.:
GW-22V Variance Request Form Rev. 7-13-2020 Page 1

D. REASON FOR VARIANCE REQUEST — Include type of well(s) to be constructed; rule for which the variance is
being requested; description of how the alternate construction will not endanger human health and welfare and the
environment; and reason why construction and/or operation in accordance with the standards is not technically feasible
and/or provides equal or better protection of the groundwater (refences to attached documents are acceptable).
Current regulations require monitor wells to be abandoned by filling well casing with bentonite or cement
type grout from the bottom of the casing up to the land surface. The Division of Waste Management, in
their Permit to Construct, requires monitor wells within the proposed landfill footprint to be abandoned
such that the grout is terminated below current land surface, to the proposed landfill subgrade elevation.
A variance from 15A NCAC 2C .0113(d) (2) will be required for 11 monitor wells to allow grout to be
terminated below land surface. Additionally, two wells completed within bedrock have grout extending
8.5ft and 9ft below Top of Rock (TOR) within the annular space. 15A NCAC 2C .0113(d)(3) requires
loft of grout to extend below TOR. Request variance to loft requirement since the wells will have 8.5ft
and 9ft of grout, and to avoid added costs to mobilize an air rig to drill wells an extra 1 — 1.5ft with minimal
added protection value offered. Grout will extend from the base of the subgrade excavation, to either the
bottom of the well or for the 2 wells in bedrock, to either 8.5 or 9 ft. into the bedrock. The landfill liner
constructed on top of the abandoned wells will consist of 2 ft of compacted clay, a GCL liner (bentonite
clay), a 40 mil HDPE liner and 2 ft of soil for added protection.
E. ATTACHMENTS — Provide the following information as attachments to this application:
(1) A map showing general location of the property (including road names, NC State Route Number, distances, any
key landmarks, etc.) sufficient for finding the well location.
(2) Detailed site map with scale showing location of proposed well relevant to septic system(s), building
foundations, property lines, water bodies, potential sources of contamination, other wells, etc.
(3) Submit a copy of the local well permit application and site evaluation map (if applicable).
(4) Any other information relevant to the variance request such as a well construction diagram showing proposed
well liner or atypical construction materials/methods.
F. SIGNATURE(S)
ignature(s) of Well/Pro
Richard Hill - Alamance County
erty Owner(s)
Print or Type Well/Property Owner(s)
Signature of Person Responsible for Well Construction
(Typically, the well driller)
Jacob Messick
Print or Type Name of Person Responsible for Well Construction
(Typically, the well driller)
N/A
Signature of County Environmental Health Specialist (for Private Water Wells)
NIA
Print or Type Full Name and Title of County Environmental Health Specialist (for Private Water Wells)
Per 15A NCAC 02C .0118 the Secretary of the Division of Water Resources or the Division of Public Health may require
submittal of information deemed necessary 10 make a decision on the variance, may impose conditions as part of the
GW-22V Variance Request Form Rev. 7-13-2020 Page 2

decision, and shall respond in writing to the request within 30 days of receipt of the variance request. A variance
applicant who is dissatisfied with the decision of the Director may commence a contested case by filing a petition as
described in G.S. 150E-23 within 60 days after receipt of the decision.
G. SUBMITTAL INSTRUCTIONS
(1) For the following types of water supply wells only:
(2)
(a)
(b)
Private Drinking Water Wells under 15A NCAC 02C .0300
Irrigation Wells underl5A NCAC .02C .0107 with a designed capacity of less than 100,000 gallons per day
and located on the same property as an on -site wastewater system permitted by a local health department.
Prior to submittal of the variance for these types of wells, please contact your regional environmental health specialist
by visiting: http://ehs.ncpublichealth.com/contacts.htm
Submit one copy of the completed variance application to:
North Carolina Department of Health and Human Services
Division of Public Health — Environmental Health Section
On -Site Water Protection Branch
16321 Lail Service Center
Raleigh, North Carolina 27699-1632
For the following types of wells only:
(a)
(b)
All Water Supply Wells under 15A NCAC 02C .0107 other than the ones listed under (1) above
Wells Other than Water Supply under 15A NCAC 02C .0108. If these wells are to be constructed on property
not owned by the well owner or applicant, please also attach and submit a completed Application to Construct
a Monitoring or Recovery Well System (GW-22MR) found on our website at:
http://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-applications
Submit one copy of the completed
variance application to the Division
of Water Resources Regional Office
serving the area in which the well
will be located:
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Telephone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5043
Telephone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue,
Suite 301
Mooresville, NC 28115
Telephone: [phone]
Fax: [phone]
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Telephone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Telephone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Telephone: [phone]
Fax: [phone]
Winston-Salem Regional
Office
450 W. Hanes Mill Rd.
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22V Variance Request Form Rev. 7-13-2020 Page 3

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(EXISTING)
NOTE:
1. NC ONE AERIAL PHOTO DATED 2014
2. PROPERTY BOUNDARY AND STREAM
LOCATIONS DATA FROM ALAMANCE COUNTY GIS.
PROPERTY LINE (OUTERMOST)
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FIGURE 2
MUNICIPAL ENGINEERING, INC.
8 SHIPNASN DRIVE, GARNER, NC 27529 - PHONE: [phone]
P.O. Box 349, BaaNE, NC 28607 • PHONE: [phone]
LICENSE NUM9ER: C•D281

Well ID
Land
Surface
Elevation
(ft-msl)
Top of
Casing
Elevation
(ft-msl)
Well Screen
Bottom
Proposed
Subgrade
Permanently Abandon
Depth
Elev.
Depth
Elev.
Depth
Elev.
(ft-bls)
(ft-msl)
(ft-bls)
(ft-msl)
(ft-bls)
(ft-msl)
B-3
527.10
-
23.80
503.30
2.94
524.16
2.94 to 23.80
503.30
B-16
521.71
524.17
24.70
497.01
2.70
519.01
2.70 to 24.70
497.01
MW-52
532.28
534.43
50.98
481.30
1.64
530.64
1.64 to 50.98
481.30
0W5-1
516.38
519.21
14.82
501.56
0.65
515.73
0.65 to 14.82
501.56
0W5-6
505.21
507.98
31.19
474.02
8.22
496.99
8.22 to 31.19
474.02
0W5-11
516.10
518.80
48.00
468.10
24.97
491.13
24.97 to 48
468.10
0W5-13
527.38
530.48
21.00
506.38
9.78
517.60
9.78 to 21
506.38
0W5-14
519.45
522.56
55.49
463.96
10.95
508.50
10.95 to 55.49
463.96
0W5-17S
520.21
522.93
21.91
498.30
0.71
519.50
0.71 to 21.91
498.30
0W5-17D
520.23
522.72
47.00
473.23
0.73
519.50
0.73 to 47
473.23
0W5-19
509.33
512.05
29.00
480.33
5.83
503.50
5.83 to 29
480.33
Notes:
Wells listed on this table are planned to be abandoned per 2C rules.
All other wells not listed in the table will remain unless hinders site development.
ft-msl = Feet -mean sea level
ft-bls = Feet -below land surface
proposed depth below current land surface at which point
top of grout interval will be terminated,