WM0701305_Application_20230621

Labrador Environmental Consultants, P.C.
June 21, 2023
Mr. David May
NCDEQ
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889
RE: Application for Permit to Construct a Monitoring or Recovery Well System
Former Mallard Food Mart #14 — 3603 Neuse Boulevard
New Bern, Craven County, North Carolina
Incident Number: 7143
Risk Classification: Intermediate
Site Rank: I 115R
Dear Mr. May,
Please find attached one (1) "Application for Permit to Construct a Monitoring or Recovery
Well System" document (e.g., Form GW-22MR, Rev. 3-1-2016) and associated attachments for the
referenced site petroleum -fuel underground storage tank (UST) system release. The location of the site
incident is shown in Figure 1 of the permit application. The permit application is for the
installation/construction of one (1) proposed Type II monitoring well (e.g., MW-26R) that will be
located on property owned by David K. Bailey (e.g., Parcel ID 8-243-106) and formally owned by
Christ Episcopal Church. The proposed monitoring well will replace monitoring well MW-26, which
was permanently abandoned on April 12, 2022 due to unrepairable damage to the well. The
installation/construction of the proposed monitoring well is being conducted in response to the North
Carolina Environmental Quality (NCDEQ), Division of Waste Management (DWM), UST Section
Washington Regional Office (WaRO) June 8, 2022 Notice of Regulatory Requirements issued to
Mallard Oil Company (Mallard).
A petroleum -fuel UST release was initially discovered at the referenced site in October 1991
when light non -aqueous phase liquid (LNAPL) contamination resembling gasoline was observed on
one of the site driveways. The release was confirmed by pressure testing the USTs and associated
product lines. Each UST and product line passed the pressure tests except for one gasoline product
line, which was subsequently found to have a hole. The damaged product line was repaired and the
UST systems placed back into operation. In addition, petroleum -fuel contamination was observed in
the soil surrounding the USTs and product lines at concentrations exceeding the TPH cleanup level
during the permanent closure of the UST systems in June 1993. Soil and ground -water analytical data
for the site indicate a petroleum -fuel release from the former site UST systems that subsequently
impacted both ground water and unsaturated zone soil at the site. The locations of source areas at the
site are shown in Figure 2 of the permit application.
There are a total of ten (10) on -site Type II monitoring wells (e.g., MW-1, MW-2, MW-3,
MW-5, MW-11, MW-14, MW-16, MW-17, MW-18, and MW-21); two (2) on -site Type III monitoring
wells (e.g., DCW-1 and DCW-2); and twelve (12) off -site monitoring wells (e.g., MW-4, MW-12,
Soil and Ground -Water Specialists
P.O. Box 1379, Huntersville, North Carolina 28070 1450 Johnson Drive, Williamston, North Carolina 27892
[phone] • [e-mail] [phone] • tjbecesC5 suddenlink.net
Charlotte, N.C. Roanoke Rapids, N.C. Williamslon, N.C.

MW-13, MW-15, MW-19, MW-20, MW-22, MW-23, MW-25, MW-27, MW-28, and MW-29) that
have been installed/constructed for the assessment and remediation of ground -water contamination for
the release that currently exist. Note that Type II monitoring wells MW-6, MW-7, MW-8, and MW-24
have been destroyed and Type II monitoring wells MW-9, MW-10, and MW-26 have been
permanently abandoned. The locations of the existing monitoring wells for the site incident are shown
in Figure 3 of the permit application.
The latitude and longitude of proposed monitoring well MW-26R is 35.137165 N and -
77.097861 W, which is on property owned by David K. Bailey. The location of the proposed
monitoring well is located approximately 800 feet southwest of NGS geodetic monument Y188, which
is located at 35.138056 N and-77-100287 W. The location of proposed monitoring well MW-26R is
shown in Figure 4 of the permit application.
The proposed monitoring well will be installed/constructed in accordance with North Carolina
Administrative Code 15A Subchapter 2C, Section .0100 "Well Construction Standards" by a North
Carolina licensed driller (e.g., Thomas J. Benthall, Jr. — Certification Number 4508-B) with a drill rig
using 4.25-inch inside diameter hollow stem augers (HSAs) to drill the well borehole.
The proposed monitoring well will be constructed of 2-inch diameter Schedule 40 PVC casing
and screen with 0.010-inch slots. The total depth of the proposed monitoring well is 20.0 feet with a
screen interval of 10.0 to 20.0 feet. The bottom of the well screen section will be flush -threaded and
fitted with a threaded plug. The monitoring well screen will be positioned as to intersect the water
table so dissolved phase petroleum -fuel contaminants and LNAPL contamination can be effectively
monitored. Once the monitoring well is set; filter sand, bentonite grout, and concrete grout will be
placed around the well screen and casing by gravity flow in a manner to ensure complete filling of the
borehole annulus. Approximately same -sized filter sand will be placed along the entire screen interval
of the well to filter soil particles from migrating into the well. A bentonite grout seal will be placed on
top of the sand pack and hydrated with potable water. Concrete grout will then be used to fill the
remainder of the annulus space between the bentonite seal and surface completion. To complete the
construction, a flush -mount bolt -down 8-inch round vault will be placed over the wellhead and set in
concrete grout flush with the existing ground surface as to not impede any mowing. The wellhead will
be fitted with a watertight expandable cap secured with a keyed lock. The construction detail for the
proposed monitoring well is shown in Figure 5 of each permit application of the permit application.
9130.
Should you have any questions or concerns, please contact me at [phone] or (252) 809-
Sincerely,
Labrador Environmental Consultants, P.C.
Thomas J. Benthall, Jr.
Environmental Geologist
Attachments
Cc: Mallard Oil Company
IV

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: June 15, 2023
2. County: Craven
FOR OFFICE USE ONLY
[PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): monitoring
4. Applicant: Mallard Oil Company Contact: Titus Smith Telephone: [phone]
Applicant's Mailing Address: P.O. Box 1008, Kinston, NC 28503
Applicant's Email Address (if available): tituss0mallardoil.com
5. Contact Person (if different than Applicant): Thomas Benthall. Jr. — Labrador Environmental Consultants, P.C.
Telephone: [phone] or [phone]
Contact Person's Mailing Address: 1450 Johnson Drive Williamston, NC 27892
Contact Person's Email Address (if available): tibeces(a)suddenlink.net
6. Property Owner (if different than Applicant): David K. Bailey Telephone: [phone]
Property Owner's Mailing Address: P.O. Box 717, Newport, NC 28570
Property Owner's Email Address (if available): dkbaileyl Paol.com
7. Property Physical Address (Including PIN Number) 3530 Neuse Boulevard (Parcel ID 8-243-106)
City
County
Zip Code 28560
8. Reason for Well(s): monitoring well replacement (e.g., MW-26) for assessment of 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: former convenience store with former USTs
(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).
Yes UST Section Incident No. 7143 and Well Construction Permit No. WM0701274 (expired March 22, 2023)
11. Type of contaminants being monitored or recovered: dissolved phase petroleum -fuel (e.g., BTEX. MTBE. IPE, naphthalene. etc
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Twelve (12) on -site and twelve (12) off -site
monitoring wells
Existing Monitoring or Recovery Well Construction Permit No(s).: NA
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): Approximately 310 feet NE of former
petroleum -fuel USTs and approximately 276 feet NE of nearest fuel dispenser island (Former Mallard Food Mart #14 located at
3603 Neuse Boulevard Parcel ID 8-243-070)
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s): NA
15. Well Contractor: Thomas J. Benthall. Jr. (Labrador Environmental Consultants P.C.) Certification No.: 4508-B
Well Contractor Address: 1450 Johnson Drive, Williamston. NC 27892
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 I. Grout horizons
C. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated 5. How will the well(s) be secured? watertight expandable
material: one (1) cap secured with a keyed lock and 8-inch bolt -down
vault set in gravel concrete
3. Number of wells to be constructed in bedrock: zero 0
6. Estimated beginning construction date: July 6.2023
4. Total Number of wells to be constructed: one (1)
(add answers from 2 and 3) 7. Estimated construction completion date: July 6.2023
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.
to. 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. 143-215.1013(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
Environmental Geologist
Signat icanl or *Agent Title of Applicant or *Agent
Thomas J. Benthall. Jr. (Labrador Environmental Consultants. P.C. ' If signing as Agent, attach authorization agreement stating
Printed name of Applicant or *Agent that you have the authority to act as the Agent. (SEE
ATTACHED APPROVED PRE-APPROVALTASK
AUTHORIZATION FORM)
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 9onstruction Standards (Title 15A of the N h Carolina Administrative Code, Subchapter 2C).
ignatureof Property wner (if d ffe ent than Applicant) Printed name of Property Owner (if diffe nt 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]
{-1-2016

Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22MR (6111)

DIRECTED - CAB ONLY
ELECTRONIC PREAPPROVAL TASK AUTHORIZATION FORM
Dept of Environmental Quality - Division of Waste Management
Site Name Mallard Food Mart #14
City / County New Bern / Craven Incident #1 7
Resp Ply Name / Contact Mallard Oil Company / Titus Smith
Incident Mgr Allison Ward Region WAS
RP Type (Owner/Opemtor/Landowner/Attny-in-fact) Owner/Operator
Change Order? No Prev. TA # 7143-25
Consultant / Project Mgr Eastern Carolina Env. Ser., Inc. / Thomas J. Bentha11, Jr.
(Reserved for Incident Manager)
Telephone / Fax Number 252-508-4509 / NA
Task Authorization Number: 26 ChangeOrd:
Project Mgr Email [e-mail]
Site Risk/Rank/Abatement: 111SR RRA Date: 512312012.
Proposal# / Scope Dates 7143-2023-026 / March/April 2023
% Commercial (C=100% NC=O% Both=1%-99%) 100.00%
Has STF Eligibility Been Determined? (Y/N)
ISIte Status (Active or NFA Date) ACTIVE
Note: This Electronic Preapproval Task Authorization (ePATA) shall be used to receive preapproval from the UST Section. A proposal. including maps w9figures. must b—a attached j:e
elaborate go the, costs far isle tasks listed below Milt describe Ia scope of work ajd the rationale for —the proposed activities. If, following completion of this ePATA, you discover that
unexpected tasks must be performed, incurring costs for tasks not originally Included with this form, you must complete and submit a separate ePATA request designated as a "Change
Order" In the provided space above prior to conducting those tasks. Include a copy of the prior ePATA form for confirmation. Please attach this form to the cover of the corresponding
claim when requesting reimbursement. IMPORTANT: Only one claim may be submitted per ePATA and all V&J Qp )fie ePATA must have been completed within J2 months of Ile
completion date of the FIRST completed task to remain within flLe Statute of Limitations. All ePATAs submitted within a claim are closed with that claim, and may not be re -used In a
separate submittal, even for costs or tasks that were not originally claimed. Final reimbursement of costs associated with the Total Claimed amount below may be affected by the
eligibility status of the site (i.e., deductibles, apportionment, etc.), and the documentary validation of Incurred costs as reasonable and necessary expenses per 15A NCAC 2P .0402 and
.0404.
With Claim: [ J All Main Consultant/Contractor Invoices attached? [ I Proof of payment attached directly to the front of each invoice?
• Important: The date of reimbursement Is dependent on the Trust Fund balance. There may be a delay in the reimbursement of claims for work under this ePATA.
PREAPPROVAL
(See Instructions /RRD for
/ TASK
AUTHORIZATION
Task Authorization)
FINAL REIMBURSEMENT
(Must Complete with Claim
Submittal)
Tasks requiring
Preapproval/
c
a
m
Task #
Lab /
SubCode
Proposed
Units / Type
(consultant)
a
2
a:
Proposed
Rate/Price
(consultant)
a
a
H o
o0c Q
Proposed Task
Subtotal
(consultant)
Final
Preapproved
Subtotal
(UST
(usrsection)
Dates of Work
(Consultant)
Started' / Completed=
Claimed
Amounts
(Consultant)
4.031
1 17 / well
y
$110.00
1 Y
$1,870.00
$1,870.00
/
4.090
#272
17 / analysis
y
$66.00
Y
$1,122.00
$1,122.00
/
4.091
S/H
1 / cooler
y
$110.00
Y
$110.00
$120.00
/
6.090
1 / repart
y
$1,125.00
Y
$1,125.00
$1,125.00
/
12.050
1 / mobe
y
$250.00
Y
$250.00
$250.00
/
12.055
1 / Til mobe
y
$50.00
Y
$SO.00
$SO.00
/
Requested
Preapproved
C161med'
TOTAL: $4,527.00
$4,S27.00
TOTAL:
Total Standard Costs (Not Third Party) $4,527.00 $4,527.00
Total Standard Costs
Total applied as Third Party Deductible/Damage Costs $0.00
$0.00
Total Third Pty Costs
Process Tracking
(Date)
(initials)
TA Submittal:
3/21/23
by: TJB (PM)
(ReservedforRO)
RO Review:
3/22/23
by: ALW (IM)
Joint CAB Preapproval Confirmed By:
+r"�
`�`^'" Date' 3/23/2023
RO Supv. Review:
3/22/23
by: SNH (ROS)
RP or Designee Receipt Confirmed By:
Date 4
i -This ePATA expires one year from the Joint UST Preapproval date. This does not extend, alter, or supersede any regula de
(e.g., NORR's, NOV's, Enforcements, etc.)
2 -THE ONE YEAR STATUTE OF LIMITATIONS APPLIES TO EACH INDIVIDUAL TASK. Costs must be claimed within one year completion of that task to be reimbursable.
3 - Only Tasks Included on this ePATA may be claimed. Do not include other Tasks or claimed costs (i.e., Claim preparation) that were not preapproved or the claim will be returned.
4 - Preapproval is not valid (i.e., claimable) until receipt Is signed as'Confirmed' by the RP or their designee within a week of approval. The signed pre -approval must be submitted
In the submitted claim. Signature indicates acknowledgement of the tasks and amounts approved. Any objections/appeals must be submitted via Change Order prior to work
prcceeding. Scope/cost negotiations do not supersede other regulatory deadlines as described in #1 above. Also, any ePATA that has been signed as'Confirmed' by both the
UST Section and RP is not to be modified without written consent by all signatories.
S - Tasks approved on Directed - CAB Only ePATAs must be performed In accordance with all applicable rules, statutes, and RRD Task Scopes of Work to be reimbursed In full.
DW M/UST ePATA 4/l/2022

FIGURES

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7 Marsh
s— as" l 1 urkn r°ax
PROJECTLOCATION
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USGS 7.5 Minute Topographic Series
SCALE 1:24 000
1 0.5 0 KLOMETERS 1
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1 DA 0 I
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1OW 0 t0W 2000 00W 9W0 SOW 60DO 700D 80W 5000 10000
FEET
CONTWR INTERVALS FEET
NORTH AMErACM VERT[AL DATIMI OF 1988
Labrador Environmental Consultants, P.C. Mallard Oil Company
Figure 1 Former Mallard Food Shop #14
3
Project Location Map 603 Neuse Boulevard
35.136439 N-77.098129 W New Bern, Craven County, North Carolina

N I
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-----PROPERTY LINE---�-��� I
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CHRIST EPISCOPAL VESTRY CHURCH PROPERTY

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\ MW-23---------
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/ ��� MW-1919 I i
% MW-?4r&
-----PROPERTY LINE --MW-14W-151
/ 9 MW-11 `\may MW-22
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MIDYETTE AVENUE
McCURDY PROPERTY WESTOVER PROPERTY ( i
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MW-26 MONITORING WELL LOCATIONS
(PERM.ADANDONED)
(PROPOSED MW-26R)
MW-29
B MW-13
DAVID K. BAILEY PROPERTY
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® PROPOSED MONITORING WELL LOCATION (MW-26R)
1 inch = 100 feet t
Labrador Environmental Consultants, P.C.
Figure 4
Proposed Monitoring Well Location
^4�
' r Y
-243 -16000
Former Mallard Food Shop #14
3603 Neuse Boulevard
New Bern, Craven County, North Carolina
Latitude 35.136439, Longitude-77.098129

PROPOSED MONITORING WELL CONSTRUCTION INFORMATION
CROSS SECTIONAL VIEW
GROUND
CONCRETE GROUT
2" SCHEDULE 40 PVC CASING
SAND
2" SCHEDULE 40 PVC
TOTAL DEPTH 2O.00'
8" STEEL BOLTDOWN MANWAY
(NOT TO SCALE)
O.D. OF BOREHOLE: 8.5"
O.D. OF CASING/SCREEN: 2"
SCREEN LENGTH: 10.00,
SCREEN OPENING: 0.010"
DRILLING METHOD: NSA
DRILLING FLUIDS: NONE
WATER -TIGHT LOCKING CAP AND KEYED LOCK
X 2' CONCRETE PAD O.S' THICK
AERIAL VIEW
6.00' DEPTH TO TOP OF BENTONITE 2.0' X 2.0' CONCRETE PAD
8.00, DEPTH TO TOP OF SAND
10.00, DEPTH TO TOP OF SCREEN
8" STEEL BOLTDOWN
20.00' DEPTH OF BOTTOM OF SCREEN
WELL NUMBER: MW-26R
DRILLER NAME: THOMAS J. BENTHALL, JR.
DRILLER CERTIFICATION #: 4508-B
EST. START DATE: JULY 6. 2023
EST. FINISH DATE: JULY 6, 2023