WM0401445_Monitoring Well Permit Application_20230424

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
2.
3.
4.
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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.
Date: 4/19/2023
County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
What type of well are you applying for? (monitoring or recovery): Monitoring
Applicant: NCDEQ-DWM, UST Section, State Lead Program, Attn: Mark Petermann Telephone: [phone]
Applicant's Mailing Address: 1646 Mail Service Center, Raleigh, NC 27699-1646
Applicant's Email Address (if available): mark.petermann(a).ncdenr.gov
Contact Person (if different than Applicant): David Vail, Environmental Scientist, WithersRavenel Telephone: [phone]
Contact Person's Mailing Address: 115 MacKenan Drive, Cary, NC 27511
Contact Person's Email Address (if available): dvail withersravenel,com
Property Owner (if different than Applicant): NCDOT Div. 7 — District 2 Telephone: [phone]
Property Owner's Mailing Address: 1584 Yancevville St. PO BOX 14996, Greensboro, NC 27415-4996
Property Owner's Email Address (if available): bnorris cDncdot.gov
7. Property Physical Address (Including PIN Number) Southeast and Southwest corners of intersection of Ellisboro Rd (SR-2046
and NC HWY 65. PIN: N/A
City: Stokesdale County: Guilford Zip Code: 27357
8. Reason for Well(s): Groundwater assessment and possible remediation
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
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12.
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14.
Type of facility or site for which the well(s) is(are) needed: UST
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
Incident # 30168 (Former Barrow Oil Companv — NCDEQ-DWM. UST Section State Lead Site)
Type of contaminants being monitored or recovered: Petroleum Hydrocarbons
(ex: organics, nutrients, heavy metals, etc.)
Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes — 1
Existing Monitoring or Recovery Well Construction Permit No(s).: Unknown
Distance from proposed well(s) to nearest known waste or pollution source (in feet): <150
Are there any water supply wells located less than 500 feet from the proposed well(s)? Yes
If yes, give distance(s): WSW-1 (70-ft), WSW-2 (229-ft), WSW-3 (370-ft), and WSW-4 (385-ft)
15. Well Contractor: John Allen — Ameriprobe, LLC Certification No.: 4196-B
Well Contractor Address: PO BOX 135 Huntersville, NC 28070
PROPOSED WELL CONSTRUCTION INFORMATION
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? Locking well cap at the
material: 2 top of casing, enclosed in an 8-inch flush mount steel
manhole set in concrete.
3. Number of wells to be constructed in bedrock
6. Estimated beginning construction date: 6/1/2023
4. Total Number of wells to be constructed: 2
(add answers from 2 and 3) 7. Estimated construction completion date: 6/1/2023
ADDITIONAL INFORMATION
1. 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
Signature of Applicant or *Agent
Printed name of Applicant or *Agent
Environmental Scientist, WithersRavenel, Inc. on behalf of
NCDEQ-DWM, UST Section State Lead Program (Inc# 30168)
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
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 NCDOT Agreement E0720412300037 NCDOT, Division 7, District 2
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 Raleigh Regional Office Wilmington Regional Office
2090 U.S. Highway 70 3800 Barrett Drive 127 Cardinal Drive Extension
Swannanoa, NC 28778 Raleigh, NC 27609 Wilmington, NC GW-22M (Rev. 5/11)
Phone: [phone] Phone: [phone] Phone: (910) 7
Fax: [phone] Fax: [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]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
OR Rev. 3-1-2016

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PROPOSED ENCROACHMENT AREA
MIN. 10' FROM EDGE OF PAVEMENT
LEGEND
®
WATER SUPPLY WELL
TYPE II MONITORING WELL
TYPE II MONITORING WELL (DESTROYED)
NOTES:
1.) AERIAL OBTAINED FROM THE GUILFORD COUNTY GIS DEPARTMENT.
GRAPHIC SCALE
0
1
1 inch = 30 ft.
AP OXIMATE EXTENTS
OF GASOLINE USTs
EXCAVATION
PROPOSED
MONITORING
WELLS
MW-4
9
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APPROXIMATE EXTENTS
OF KEROSENE USTs
EXCAVATION
NC HWY 65 (BELEWS CREEK ROAD)
PROPOSED ENCROACHMENT AREA
MIN. 10' FROM EDGE OF PAVEMENT

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SURFACE WATER BODY
ADDITIONAL RECEPTOR IDENTIFICATION
NOTES:
1. 2014 AERIAL OBTAINED FROM THE GUILFORD COUNTY GIS DEPARTMENT.
2. SEE TABLES B-5A AND B-56 FOR INFORMATION RELATING TO RECEPTORS NOTED HEREON.
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1 inch = 300 ft.
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER J. ERIC BOYETTE
GOVERNOR SECRETARY
April 13, 2023
Guilford
Subj ect: Encroachment Agreement - WithersRavenel, Inc. on behalf of NCDEQ-DWM, UST
Section - Installation of (2) Type II Groundwater Monitoring Wells for purposes of
assessment & possible remediation of groundwater contamination from former UST
systems on NC 65 & SR 2046 (Ellisboro Rd.), NCDEQ TF#30168, EA230413 (E072-041-
23-00037)
Ms. Elizabeth A. Allyn, Environmental Project Geologist
WithersRavenel, Inc. on behalf of NCDEQ-DWM, UST Section
217 W. Jones Street
Raleigh, NC 27603
Dear Ms. Allyn:
Attached is a Right of Way Encroachment which has been properly executed.
The Department of Transportation does not guarantee the right of way on this road, nor will it be
responsible for any claim for damages brought by any property owner by reason of the installation.
Approval is contingent upon adhering to the attached special provisions.
If you need additional information, please advise.
WRA/bin/so
Attachments
cc: B.L. Norris, PE, District Engineer
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DISTRICT II OFFICE
P. O. BOX 14996
GREENSBORO, NC 27415
Sincerely,
'�,;
W. R. Archer III, P.E.
Division Engineer
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.nedot.gov
Location:
1584 YANCEYVILLE ST.
GREENSBORO, NC 27405

Special Provisions
16.1A, EA230413 (E072-041-23-00037)
NCDEQ-DWM, UST Section
NC 65, SR 2046 (Ellisboro Road)
An executed copy of this Encroachment Agreement shall be present at the construction
site at all times during construction. If safety or traffic conditions warrant such an
action, NC DOT reserves the right to further limit, restrict or suspend operations within
the right of way.
This approval is for the Installation of (2) Type II Groundwater Monitoring Wells for
purposes of assessment 8v possible remediation of groundwater contamination from
former UST systems on NC 65 & SR 2046 (Ellisboro Rd.).
Any work (equipment and or personnel) within 5' of the roadway (pavement) shall
require a lane closure. If a lane closure is needed, then all lanes of traffic are to be
opened during the hours of 6:00 A.M. to 9 :00 A.M. and from 4:00 P.M. to 6:00 P.M.
Traffic will be maintained at all times. No road closure shall be allowed. No work shall
be allowed during holidays.
NC DOT does not guarantee the right of way on this road, nor will it be responsible for
any claims for damages brought about by any property owner by reason of this
installation.
Contact Mr. James Marley with the Greensboro District Office (336-487-0100 or
Jimarleygnpdot.gov) a minimum of three (3) business days prior to beginning work
in the right-of-way on this state maintained road.
All suitable backfill material shall be compacted to 95% density in the shoulder areas,
100% density under pavement areas and in accordance with AASHTO T99 as modified
by the North Carolina Department of Transportation.
Excavation material shall not be placed on the pavement. Drainage structures shall not
be blocked with excavation material.
The encroaching party is required to contact the appropriate Utility
Companies prior to beginning construction. It shall be the responsibility of the
encroachment party to determine the location of the utilities within the
encroachment area. NCGS 87-115 through 87-130 of the Underground Utility
Safety and Damage Prevention Act requires underground utilities to be located by
calling 811 prior to construction. The encroachment party shall be responsible for
notifying other utility owners and providing protection and safeguards to prevent
damage or interruption to existing facilities and maintain access to them and also
to resolve any conflicts prior to the installation of this encroachment.
Strict compliance with the "Policies and Procedures for Accommodating Utilities on
Highways Rights of Way" manual shall be required.
The encroaching party shall comply with all applicable federal, state and local
environmental regulations, and shall obtain all necessary federal, state and local
environmental permits, including but not limited to, those related to sediment control,
stormwater, wetland, streams, endanger species and historical sites.

Special Provisions
16.1A, EA230413 (E072-041-23-00037)
NCDEQ-DWM, UST Section
NC 65, SR 2046
page 2
The party of the second part shall provide traffic control devices, lane closures, road
closures, positive protection and/or any other warning or positive protection devices
necessary for the safety of motorists and workers during construction and any
subsequent maintenance. This shall be performed in conformance with the latest
NCDOT Roadway Standard Drawings and Standard Specifications for Roads and
Structures and Amendments or Supplements thereto. When there is no guidance
provided in the Roadway Standard Drawings and Specifications, comply with the
Manual on Uniform Traffic Control Devices for Streets and Highways and Amendment
or Supplement thereto. Information as to the above rules and regulations may be
obtained from the Division Engineer of the party of the first part.
All personnel performing an activity inside of the highway right of way
(R/W) are required to be familiar with the NCDOT Maintenance/Utility
Traffic Control Guidelines (MUTCG). No specific training course or test is
required for qualification in the Maintenance/Utility Traffic Control
Guidelines.
All flagging, spotting or operating Automated Flagger Assist Devices
(AFAD) inside the highway R/W requires qualified and trained Work Zone
Flaggers. Training for this certification is provided by NCDOT approved
training resources and by private entities that have been pre -approved to
train themselves.
All personnel in charge of overseeing work zone Temporary Traffic Control
operations and installations inside the R/W are required to be qualified
and trained Work Zone Supervisors. Training for this certification is
provided by NCDOT approved training resources.
For questions and/or additional information regarding this training
program please refer to our web site at
https:IIconnect.ncdot.gov/ProjectsIWZTCLPagesLTraining.aspx-or call J.
S. (Steve) Kite, PE at [phone] or skitegacdot. ov or Roger Garrett
at [phone] or rmgarret ,ncdot.,gov, both with the NCDOT Work
Zone Traffic Control Section.
NCDOT (or its contractors) shall not be responsible for damage to monitoring wells
due to roadway construction or maintenance activities.
Ground water monitoring wells shall not be allowed in the pavement, medians, or traffic
islands.
Well caps shall be flush mounted with the ground surface with the frames and covers of
a NCDOT approved design for HS 20 loading when installed within clear recovery area
or within routine mowing boundaries.

Special Provisions
16. IA, EA230413 (E072-041-23-00037)
NCDEQ-DWM, UST Section
NC 65, SR 2046
page 3
Wells proposed outside of the clear recovery area and outside of the boundaries of
routine mowing shall be flush mounted but are not required to be designed for HS 20
loading.
Any conversion of a monitoring well to an extraction or remediation system will require
a separate encroachment agreement requiring review by NCDOT's Project Services Unit.
Spoils from the well installation shall be disposed of outside NCDOT right of way at an
approved site. Any contaminated soils encountered in construction as spoiled from the
well installation shall be removed from NCDOT right of way immediately upon
discovery and properly disposed of in accordance with the governing regulations.
A copy of all tests from the well(s) within the NCDOT right of way shall be made
available to the NCDOT District Engineer's Office.
After the monitoring well(s) has served its intended purpose, the well(s) shall be filled in
a manner approved by NCDENR and NCDOT. Any flush mounted or above ground
obstructions shall be removed from the right of way and the site shall be returned to a
condition satisfactory to the District Engineer.
Any drainage structure disturbed or damaged shall be restored to its original condition
as directed by the District Engineer.
Excavation within 500 feet of a signalized intersection will require notification by
the party of the second part to Ms. Dawn McPherson, Division Traffic Engineer at
[phone]. All traffic signal or detection cables must be located prior to
excavation.
Ingress and Egress shall be maintained to all businesses and dwellings affected by this
project.
All driveways altered during construction shall be returned to a state comparable with
the condition of the driveway prior to construction.
Any and all roadway signs that are removed due to construction shall be reinstalled as
soon as possible.
All disturbed areas shall be repaired with the following rates of seed, fertilizer, and
limestone in pounds per acre, and the areas properly mulched and tacked:
2 5 # Reliant Hard Fescue
10 0 # Alta of Ky. 31 Tall Fescue
2 5 # Kenblue Ky. Bluegrass
10 0 # 5 -10 -10 Fertilizer
4000# Limestone

ROUTE SR-2046 & NC HWY 65
F®r7a"04)-23- 60039 STATE OF NORTH CAR OLI NA
PROJECT Former Barrow Oil Company COUNTY OF Guilford
DEPARTMENT OF TRANSPORTATION
-AN D-
NCDEQ-DWM, UST Section, State Lead Program
217 West Jones Street
Raleigh, NC 27603
RIGHT OF WAY ENCROACHMENT AGREEMENT
FOR NON -UTILITY ENCROACHMENTS ON
P R I MARY A),r�,; HWAYS
.r: ,
THIS AGREEMENT, made and entered into this the 13774 day of AAcTL- , 2 , by and between the Department
of Transportation, party of the first part; and NCDEQ-DWM, UST Section, State Lead Program" 1V1E''01"�ormerarrow Oil Company)
party of the second part,
W I T N E S S E T H
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-2046 & NC HWY 65
(Belews Creek Rd) in Stokesdale, Guilford County, NC.
, located Near the intersection of SR-2046 (Ellisboro Rd) & NC HWY 65
with the construction and/or erection of: Two (2) Type II Groundwater Monitoring Wells for the purposes of assessment and possible remediation of groundwater contamination
from former UST systems located on the former Barrow Oil Company site (NCDEQ TF#30168). Construction location 1 (MW-5) is located approximately 25' west and
49' south of the intersection of SR-2046 & NC HWY 65. Location 2 (MW-6) is located approximately 72' east and 27' south of the intersection of SR-2046 & NC HWY 65.
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 right 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, flagmen and other warning devices for the protection of traffic in conformancE., with the latest Manual on Uniform Traffic
Control Devices for Streets and Highways 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 part 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 R/W 16.1 A (Revised February 2021)

R/W (161 A) :Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (161 A) 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 written.
ATTEST OR WITNESS:
David C. Vail, Environmental Scientistll, WithersRavenel, Inc.
DEPARTMENT OF TRANSPORTATION
BY:
DIVISION ENGINEER
Elizabeth -A. n AllY 1Geologist, Environmental Project WithersRavenel Inc.
Agent for NCDEQ-DWM, UST Section for TF# 30168 Agent for NCDEQ-DWM, UST Section for TF# 30168
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 title 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.
8. 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, if 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 hydraulic 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.

-WithersRavenel
1. Our People. Your Success.
January 27, 2023
North Carolina Department of Transportation
1584 Yanceyville St.
P.O. Box 14996
Greensboro, NC 27415
Subject: Two -Party Non -Utility Encroachment Agreement
Former Barrow Oil Company
Ellisboro Road (SR-2046) and NC HWY 65 Intersection
Stokesdale, Guilford County, North Carolina
NCDEQ Incident No. 30168
WithersRavenel Project No. 02170214.80
To Whom It May Concern:
WithersRavenel has a contract with the North Carolina Department of Environmental Quality
(NCDEQ) to perform assessment activities at the Former Barrow Oil Company site (NCDEQ
Incident #30168). As part of the proposed work for this site, WithersRavenel has been asked to
place two monitoring wells in the right-of-way at the intersection of Ellisboro Road (SR-2046)
and NC HWY 65.
Applicant Contact Information:
David Vail / WithersRavenel, Inc.
[e-mail]
984-758-1431 (mobile)
115 MacKenan Drive
Cary, NC 27511
Currently, the well installation activities are not scheduled. The well installation activities are
expected to take less than two days to complete. The estimated area of disturbance for each
well installation is 2-ft by 2-ft. The proposed monitoring wells will be installed using 8.25"-
diameter hollow -stem augers to an anticipated depth of 15 feet below ground surface. The
traffic -safe monitoring well covers will be flush mounted with the ground surface. The metal well
vaults will be placed within a 2-foot by 2-foot concrete pad at each well location.
Sincerely,
WithersRavenel
Z/
David Vail Environmental Scientist II
115 MacKenan Drive I Cary, NC 27511
t: 919.469.3340 1 f: 919.467.6008 1 www.withersravenel.com I License No. F-1479
Asheville I Cary I Charlotte I Greensboro I Lumberton I Pittsboro I Raleigh I Southern Pines I Wilmington

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(INACTIVE)
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AP OXIMATE EXTENTS k
OF GASOLINE USTs APPROXIMATE EXTENTS
EXCAVATION OF KEROSENE USTs
EXCAVATION
7""
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-onvr,
40r
tie
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i
141
PROPOSED ENCROACHMENT AREA
MIN. 10' FROM EDGE OF PAVEMENT
LEGEND
®
WATER SUPPLY WELL
TYPE II MONITORING WELL
TYPE II MONITORING WELL (DESTROYED)
NOTES:
1.) AERIAL OBTAINED FROM THE GUILFORD COUNTY GIS DEPARTMENT.
GRAPHIC SCALE
0
1
1 inch = 30 ft.
MW-5
)SED
)RING
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NC HWY 65 (BELEWS CREEK ROAD)
PROPOSED ENCROACHMENT AREA
MIN. 10' FROM EDGE OF PAVEMENT
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STATUS UNKNOWN) \
SURFACE WATER BODY 0
ADDITIONAL RECEPTOR IDENTIFICATION
NOTES:
1. 2014 AERIAL OBTAINED FROM THE GUILFORD COUNTY GIS DEPARTMENT.
2. SEE TABLES B-5A AND B-56 FOR INFORMATION RELATING TO RECEPTORS NOTED HEREON. ,
GRAPHIC SCALE
0 150 3L 600
1 inch = 300 ft.
APPROXIMATE
EXTENTS OF
GASOLINE USTs
EXCAVATION
APPROXIMATE
EXTENTS OF KEROSENE
OUSTs EXCAVATION
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PROPOSED
MONITORING
WELLS
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TYPE II WELL CONSTRUCTION
(TYPICAL)
2—INCH LOCKING WELL CAP
2—FT SQUARE CONCRETE PAD
LANDSCAPED / MULCH SURFACE '
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8" DIA. STEEL SKIRT
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TOP BENTONITE 2'
TOP SAND 4'
TOP SCREEN 5'
BOTTOM SCREEN 15'
8—INCH DIAMETER METAL FLUSH MOUNT
BOLT DOWN COVER (TRAFFIC SAFE)
NATIVE
SOILS
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.'NEAT CEMENT GROUT (0' — 2')
-'--2—INCH DIAMETER PVC CASING
PELLETIZED BENTONITE
(2' MIN.)
LEAN FILTER "TORPEDO" SAND
—"'-2—INCH DIAMETER PVC SCREEN
(0.01' SLOT)
PVC BOTTOM CAP
DIAMETER OF BORING VARIES
1 0—
DRAWN BY: SCALE: FIGURE NO.:
With
e rs R a v e n e l BARROW OIL COMPANY 30168
1 / 8900 ELLISBORO ROADD DC�/ NONE 3
STOKESDALE, GUILFORD COUNTY, NC
Engineers I Planners I Surveyors APPROVED BY: DATE: PROJECT NO.:
115 MacKenan Drive I Cary, NC27511I t:919.469.3340I license#:F-1479 I www.withersravenel.com TYPICAL TYPE 11 WELL SECTION EAA 01/16/23 02170214.80