WM0501591_Final Permit_20231030

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Mr. William Regenthal
Geological Resources Incorporated
3502 Hayes Road
Monroe, NC 28110
Sent Via Email
NORTH CAROLINA
Environmental Quality
October 30, 2023
Subject: Monitoring Well Construction
Permit # WM0501591
Apex Food Mart (Incident #19167)
321 South Salem Street
Apex, NC 27502 — Wake County
Mr. Regenthal:
In accordance with the application received on October 30, 2023, we are forwarding herewith Monitoring
Well Construction Permit No. WM0501591 dated October 30, 2023, issued for the construction of a
monitoring well system (installation of two wells). Please be aware that some counties have well
construction programs, and you 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 Michael Hall at [phone] or via email at
[e-mail].
Sincerely,
ocuSigned by:
1�D
& f.
2916E6AB32144F...
Vanessa E. Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
Enclosure
-Permit
-Application Package
cc:
Laserfiche
D E Q ,fJ North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1611 Mail Service Center I Raleigh, North Carolina 27699-1611
NORTH CAROLINA (J1(�.'�O'�.(�OQO
Department of Emlmnmenfal Duali�

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
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 Incorporated
FOR THE CONSTRUCTION OF A MONITORING WELL SYSTEM consisting of two monitoring wells owned by
Geological Resources Incorporated at mailing address 3502 Hayes Road, Monroe, NC 28110. The wells will
be located on the property owned by the North Carolina Department of Transportation, at 321 South
Salem Street, Apex, NC 27502. This Permit is issued in accordance with the application received on
October 30, 2023, in conformity with specifications and supporting data, all of which are filed with the
Department of Environmental Quality 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.
ocuSigned by:
E�D
& -E.
2916E6AB32144F...
Vanessa E. Manuel, Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number: WM0501591
D E Q �J North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1611 Mail Service Center I Raleigh, North Carolina 27699-1611
NORrH CAROLINA �/ 919.707.9000
oepanmem or environmental auaii

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Permit Issued: October 30, 2023
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1611 Mail Service Center I Raleigh, North Carolina 27699-1611
NORTH CAROLINA 919.707.9000
Depanmem of Envlmnmenml Dual

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
IYVRI rl IiNRVLII9N I.JCrNRI Mr- IY I yr Lim vIRVIJMENTAL 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: 10/30/2023
2. County: Wake
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: Geological Resources, Inc. Telephone: [phone]
Applicant's Mailing Address: 3502 Haves Road, Monroe NC 28110
Applicant's Email Address (if available): wlr(c-)geologicalresourcesinc.com
5. Contact Person (if different than Applicant): William Regenthal Telephone: [phone]
Contact Person's Mailing Address: Geological Resources, Inc., 3502 Haves Rd., Monroe NC 28110
Contact Person's Email Address (if available): wlr(a)geologicalresourcesinc.com
6. Property Owner (if different than Applicant): NCDOT Telephone: [phone]
Property Owner's Mailing Address: 1575 Mail Service Center, Raleigh NC 27699-1575
Property Owner's Email Address (if available): unknown
7. Property Physical Address (Including PIN Number) 321 S Salem Street
City
County Wake Zip Code
8. Reason for Well(s): Assessment
(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: UST
(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).
11
12
13
14
UST Incident # 19167
Type of contaminants being monitored or recovered:
(ex: organics, nutrients, heavy metals, etc.)
Are there any existing wells associated with the proposed well(s)? If yes, how many? 12
Existing Monitoring or Recovery Well Construction Permit No(s).:
Distance from proposed well(s) to nearest known waste or pollution source (in feet): range from 25' to 100'
Are there any water supply wells located less than 500 feet from the proposed well(s)?
If yes, give distance(s):
15. Well Contractor: Justin Radford Certification No.: 3270A
Well Contractor Address: 3502 Haves Road, Monroe NC 28110
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
b. Estimated well depth
C. Screen intervals
d. Sand/gravel pack intervals
Type of casing material and thickness
Grout horizons
Well head completion details
Continued on Reverse

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
r,mur-var_v vvr-L-L- %.viva i mUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated
material: 2
3. Number of wells to be constructed in bedrock: 0
5. How will the well(s) be secured? Locking
expansion cap and bolt down manhole cover
6. Estimated beginning construction date: Nov 2023
4. Total Number of wells to be constructed: 2 7. Estimated construction completion date: Nov 2023
(add answers from 2 and 3)
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 assumes total responsibility for ensuring that the well(s) will be located, constructed, maintained, and abandoned in
accordance with 15A NCAC 02C.
Project Manager
Signature of Applicant or *Agent Title of Applicant or *Agent
William Regenthal, 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
well(s) as outlined in this Well Construction Permit application and acknowledges that it shall be the responsibility of the Applicant to
ensure that the well(s) will be located, constructed, maintained, and abandoned in accordance with 15A NCAC 02C.
See attached DOT encroachment approval NCDOT
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 28405
Phone: [phone] Phone: [phone] Phone: [phone]
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 A
Mooresville, NC 2£
Phone: (704) 663•
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]
GW-22M/R (Rev. 5-26-2022)

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
MUTE.,
o,�
ry
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GoVERNOR
October 24, 2023
County: Wake
Subject: Encroachment Contract
NC 55
E051-092-23-00874
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
Dear Sir or Madam,
J.R. "JOEY" HOPKINS
SECRETARY
Attached for your files is a copy of Right of Way Encroachment Agreement, which has been properly
executed. This contract covers the following:
Constructing 2 type II monitoring wells
This encroachment is approved subject to the Standard and Special Provisions which are attached to
and made a part of the Encroachment Contract.
Sincerely
Daniel T. Boulware, PE, District Engineer
for B. H. Jones, PE, Division Engineer
BHJ/DTB/mj n
cc: Daniel T. Boulware (w/ orig)
Town of Apex
Attachment
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION 5 — DISTRICT 1
1575 MAIL SERVICE CENTER
RALEIGH, NC 27699-1575
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: wwwmcdot.¢ov
Location:
4009 DISTRICT DRIVE
RALEIGH, NC 27607

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Encroachment Special Provisions
NCDOT WORK ZONE TRAFFIC CONTROL QUALIFICATIONS AND TRAINING PROGRAM:
A. Effective July 1, 2010, all flagging operations within NCDOT Right of Way require qualified and
trained Work Zone Flaggers.
B. Effective July 1, 2011, qualified and trained Work Zone Traffic Control Supervisors will be
required on Significant Projects.
C. Training for this certification is provided by NCDOT approved training sources and by private
entities that have been pre -approved to train themselves. If you have questions, contact our web site
at http://www.ncdot.org/doh/preconstruct/wztc/WZTCTrainingPrograni/default.html, or contact
Kenneth Thomwell with NCDOT Work Zone Traffic Control Unit at [phone].
2. Before work begins, please forward the contact information of the general contractor to the District
Engineer, Daniel Boulware, P.E. at [e-mail]. Include contact name, emergency phone
number and email.
3. Current and future state projects take precedence over this encroachment.
4. This encroachment agreement only covers work within NCDOT Right -of -Way as shown on the
attached plans.
5. Any work requiring equipment or personnel within five feet of the edge of any travel lane of an
undivided facility and within ten feet of the edge of any travel lane of a divided facility shall require
a lane closure with appropiate tapers and signage in accordance with the MUTCD and the MUTCG.
No lane of traffic shall be closed or restricted between the hours of 6:00 AM to 9:00 AM and 4:00
PM to 7:00 PM Monday thru Friday, during any time of inclement weather, or upon District
Engineers' directive. Traffic shall be maintained at all times. Any violation of these hours will result
in termination of the Driveway Permit and liquidated damages in the amount of $2,000.00 per hour
or any portion thereof will be assessed by the District Engineers Office.
Nighttime and weekend operations will NOT be allowed unless written approval is received from the
District Engineer. If nighttime or weekend work is allowed or required, all signs must be retro-
reflective, and a work zone lighting plan must be submitted for approval prior to construction. If
written approval is needed, please contact the District Office at 919-814-6115.
6. Notify the District Office at 919-814-6115 a minimum of 48 hours prior to beginning work. Please
provide name and contact number for the contractor in case of emergency.
7. Notify the Town of Holly Springs before starting work.
8. All Traffic signs moved shall be reinstalled as soon as possible to meet NCDOT specifications.
9. Sight distance shall be free and clear of any debris, foliage and/or earth material for a minimum
distance of 450 feet on NC 55 and SR 1011 (S. Salem Street). Vegetation removal and/or grading
may be necessary to achieve the required sight distance. If the sight distance requirement is not
achieved NCDOT reserves the right to deny/close/restrict this/these access(es).
10. All bare and disturbed areas must have a sufficient stand of vegetation. Address any erosion issues
that may arise during time of construction. Monitor these areas as needed to assure this requirement
is satisfied.
E051-092-23-00874 Page 2 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
11. The roadway shall be kept free of silt, mud and debris at all times.
12. NCDOT is able to approve the placement of the subject monitoring wells, with the knowledge and
acceptance that at such time that other roadway improvments are needed in the area, either by
NCDOT, the local municipality, or a private development, that these wells are in the ROW and will
need to be removed. It is likely that these wells will be able to get a few years of data prior to
construciton beginning at this intersection due to planned NCDOT projects.
E051-092-23-00874 Page 3 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Encroachment Standard Provisions
An executed copy of this encroachment agreement will be present at the construction site at all times
during construction. NCDOT reserves the right to stop all work unless evidence of approval can be
shown.
2. NCDOT reserves the right to revise, restrict, suspend and/or void this encroachment agreement if the
execution and/or operation of said permit is found to be a hazard to the traveling public.
This encroachment agreement only covers work within NCDOT Right -of -Way. The encroacher is
responsible for verifying all right of way. NCDOT does not guarantee the right of way on this road.
If the right of way was not obtained by the fee simple method, it is the responsibility of the
encroacher to obtain permission from the underlying property owner/owners.
Encroacher shall be responsible for obtaining all necessary permanent and/or temporary
construction, drainage, utility and/or sight distance easements. All Right of Way and easements
necessary for construction and maintenance shall be dedicated to NCDOT with proof of dedication
furnished to the District Engineer prior to beginning work.
4. Notify the District Engineer's Office at [phone] or at 4009 District Drive, Raleigh, NC
27607, prior to beginning and after completion of work.
5. The encroacher is responsible for any claim for damages brought by any property owner by reason of
the installation.
6. The Encroacher shall notify the public, including all adjacent property owners and businesses, a
minimum of 2 weeks prior to beginning work.
7. Any and all changes noted in red on the plans shall be incorporated into and made part of the
approved permit.
8. The encroaching party shall comply with all applicable local, state and federal environmental
regulations, and shall obtain all necessary state and federal environmental permits, including but not
limited to, those related to sediment control, storm water, wetland, streams, endangered species, and
historical sites.
9. All materials and construction shall be in accordance with NCDOT standards and specifications,
including but not limited to, the NCDOT Standard Specifications for Roads and Structures 2018, the
NCDOT Roadway Standards Drawings, and NCDOT Utilities Accommodation Manual.
Additionally, projects with a January 2024 let date shallbe prepared in accordance with the 2024
Standard Specifications and 2024 Roadway Standard Drawings.
E051-092-23-00874 Page 4 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
10. The encroacher 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 road users 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 or Specifications, comply with the Manual on Uniform Traffic Control Devices
for Streets and Highways and Amendments or Supplements thereto. No work shall be performed in
the Right of Way unless this requirement is satisfied. NCDOT reserves the right to require a written
traffic control plan for encroachment operations.
Sidewalk closures shall be installed as necessary. Pedestrian traffic shall be detoured around these
closures and shall be signed appropriately and in accordance with The American with Disabilities
Act Accessibility Guidelines.
11. No parking or material storage shall be allowed along the shoulders of any NCDOT roadways.
12. Two-way traffic shall be maintained at all times.
13. No lane closures shall be permitted between the hours of 6:00 AM to 9:00 AM and 4:00 PM to 7:00
PM, Monday through Friday unless otherwise specified in the Special Provisions of this
encroachment agreement.
14. At the end of each working day, equipment shall be parked outside of the clear recovery zone in
order to avoid any obstruction to the travelling public. This clear recovery zone is measure from the
edge of the nearest travel lane.
15. Work shall not be performed on both sides of the road simultaneously within the same area.
16. Ingress and egress shall be maintained to all businesses and dwellings at all times.
17. The paving of this roadway shall be in accordance with the revised NCDOT 2018 Standard
Specifications, Sections 610, 1012 and 1020. The Contractor shall follow all procedures of the
attached Quality Management System (QMS) for asphalt pavement - Maintenance Version. The
Contractor must adhere to all testing requirements and quality control requirements specified. The
Contractor shall contact the NCDOT Division 5 QA Supervisor at [phone] prior to
producing plant mix and make the Supervisor aware that the mix is being produced for a future
NCDOT road. Only NCDOT approved mix designs will be acceptable. A quality control plan shall
be submitted to the District Engineer's Office prior to asphalt production. Use form QMS-MV 1 for
the Quality Control Plan submittal. Failing mixes and/or densities are subject to penalties including
monetary payments or removal and replacement.
18. Roadway certification reports sealed by a Professional Engineer shall be submitted to the North
Carolina Department of Transportation at 4009 District Drive, Raleigh, North Carolina, indicating
the following:
* Pavement thickness by type
* Pavement density, core and/or test locations
* Base thickness
* Base density
* Subgrade density
Test frequency and method shall be in conformance with the NCDOT "Materials and Tests"
Manual. Test must be performed by a Certified Technician including name and Certification number
on report.
E051-092-23-00874 Page 5 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
19. Any existing driveways, pavement, sidewalk, curb and gutter or drainage structures that are damaged
during construction shall be repaired to their original condition.
20. When surface area in excess of one acre will be disturbed, the Encroacher shall submit a Sediment
and Erosion Control Plan which has been approved by the appropriate regulatory agency or authority
prior to beginning any work on the Right of Way. Failure to provide this information shall be
grounds for suspension of operations.
21. All erosion control devices and measures shall be constructed, installed, maintained, and removed by
the Encroacher in accordance with all applicable Federal, State, and Local laws, regulations,
ordinances, and policies. All earth areas shall be regraded and seeded in accordance with NCDOT
Standards Specifications for Roads and Structures 2012.
22. The applicant is responsible for identifying project impacts to waters of the United States (wetlands,
intermittent streams, perennial streams and ponds) located within the NCDOT right-of-way. The
discharge of dredged or fill material into waters of the United States requires authorization from the
United States Army Corps of Engineers (USACE) and certification from the North Carolina Division
of Water Quality (NCDWQ). The applicant is required to obtain pertinent permits or certification
from these regulatory agencies if construction of the project impacts waters of the United States
within the NCDOT right-of-way. Additional information can be obtained by contacting the USACE
or NCDWQ.
23. The applicant is responsible for avoiding impacts to federally protected species during project
construction. Bald eagle, Michaux's sumac, smooth coneflower, dwarf wedgemussel, harperella, red -
cockaded woodpecker and tar spinymussel are federally protected species that have been identified
within NCDOT right-of-way in Durham, Person, Granville, Wake, Franklin, Vance, and Warren
counties. Additional information can be obtained by contacting the North Carolina Natural Heritage
Program or the United States Fish and Wildlife Services.
24. The applicant is responsible for complying with the Neuse and Tar -Pamlico Riparian Buffer Rule as
regulated by the NCDWQ. The Rule regulates activity within a 50-foot buffer along perennial
streams, intermittent streams and ponds. Additional information can be obtained by contacting the
NCDWQ.
25. All proposed landscaping and plantings located within the NCDOT right of way shall be approved
by the Division Roadside Environmental Unit. Contact Corey Sudderth at [phone].
In the event these plants require relocation or removal for highway construction, reconstruction, or
maintenance of safety, such removal or relocation will be done immediately by the permittee upon
notification by the NCDOT entirely at the expense of the permittee.
26. Existing drainage patterns shall be maintained at all times throughout the proposed construction. The
encroacher shall keep the roadway clean of dirt and debris at all times throughout the duration of the
project.
27. The Division Traffic Engineer, shall be notified at [phone] prior to any excavation within
500 feet of a signalized intersection or if there are existing NCDOT signs in or near the proposed
work zone. All traffic signal or detection cables must be located prior to excavation. All signal
work and traffic signs shall be coordinated with the Division Traffic Engineer. Costs to relocate,
replace, or repair NCDOT signs, signals, or associated equipment shall be the responsibility of the
Encroacher.
E051-092-23-00874 Page 6 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
28. All temporary and final pavement markings, reflective pavement markings, raised pavement markers,
non -cast iron snowplowable pavement markers and signage are the responsibility of the Encroacher.
All final pavement markings shall be thermoplastic. Any pavement markings/markers that are
damaged or obliterated shall be restored at no expense to NCDOT.
29. All Traffic signs moved shall be reinstalled as soon as possible to meet NCDOT specifications.
30. Strict compliance with the Utilities Accommodation Manual on Highway Right of Way manual shall
be required.
31. It shall be the responsibility of the Encroacher to determine the location of other utilities within the
encroachment area. The Encroacher shall be responsible for notifying other utility owners and
providing protection and safeguards to prevent damage or interruption to existing facilities and to
maintain accessibility to existing utilities.
32. All earth areas disturbed shall be regraded and reseeded in accordance with Division of Highways
Standards and Specifications.
33. The Encroacher shall remove all trees, stumps and vegetative material from the right of way and
dispose of in a licensed landfill or disposal site.
34. Excavated material shall not be placed on the roadway at any time.
35. Trenching, bore pits and/or other excavations shall not be left open or unsafe overnight. The
Contractor shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
36. All excavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of
the nearest excavation wall should be made in accordance with the following conditions. Traffic
should be moved to a travel lane outside the limits of a theoretical one-to-one slope from the bottom
of the nearest trench wall to the pavement surface. Active excavation shoring, such as sheet piling,
shall be installed. The design of the shoring shall include the effects of traffic loads. The shoring
system shall be designed and sealed by an engineer registered in North Carolina. Trench boxes shall
not be accepted as shoring. The trench backfill material should meet the Statewide Borrow Criteria.
37. Excavated areas adjacent to pavement having more than a 2 inch drop shall be made safe with a 6:1
or flatter slope and shall be designated by appropriate delineation during periods of construction
inactivity, including, but not limited to, night and weekend hours.
38. Backfill material is to be placed at a maximum of 6 inch loose layers and each layer thoroughly
compacted. All embankment backfill shall be compacted to 95% density and all subgrade to 100%
density in accordance with AASHTO T-99 as modified by NCDOT. They shall be signed by a
Professional Engineer and sent to the District Engineers Office at 4009 District Drive, Raleigh, NC
27607.
39. No commercial advertising shall be allowed within NCDOT Right of Way.
40. Guardrail shall be installed where warranted and in accordance with the guidelines shown in the
2018 Highway Design Branch Roadway Standard Drawings.
Guardrail removed or damaged during construction shall be replaced or repaired to their original
condition.
E051-092-23-00874 Page 7 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
41. Poles shall be located/relocated at or as near as possible to the right-of-way line, shall beset outside
the Clear Recovery Area as outlined by AASHTO and outside sight distance triangles.
Poles located within guardrail sections shall be installed a minimum of 5 feet behind any guardrail.
When applicable, poles shall be placed behind sidewalk.
Any associated guy wires to ground anchors and stub poles shall not be placed between a pole and
the travel way and should be located outside the clear recovery area.
Minimum vertical clearance shall be 18' for aerial crossings over NCDOT roadways and 15'-6" for
installations parallel to the roadway.
42. Fire Hydrants shall be of the break -away type. Hydrants shall be placed a maximum of one foot
inside the right of way in ditch sections or a minimum of 6 feet behind the curb in curb and gutter
sections.
43. Retaining walls or other vertical structures shall not be permitted inside NCDOT right of way.
44. Current and future state projects take precedence over this encroachment.
E051-092-23-00874 Page 8 of 8

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
STATE OF NORTH CAROLINA
ROUTE NC 55 PROJECT Apex Food Mart COUNTY OF Wake
DEPARTMENT OF TRANSPORTATION
-AND-
ical Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
THIS AGREEMENT, made and entered into this the
RIGHT OF WAY ENCROACHMENT AGREEMENT
FOR NON -UTILITY ENCROACHMENTS ON
PRIMARY AND SECONDARY HIGHWAYS
day of 120 23 , 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) NC 55 - E. Williams Street , located In ROW of NC Hwy 55-E Williams Street near
intersection of S Salem Street - NCSR 1101 (911 address - 321 S Salem Street, Apex, Wake County, NC)
with the construction and/or erection of: Two Type II monitoring wells. Wells are being constructed to assess the need to
remediate environmental contamination at the site.
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 16.1A (Revised February 2021)

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
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 WHERE -OF, each of the parties to this agreement has caused the same to be executed the day and
year first above writte i.
DEPARTMENT OF TRANSPORTATION
0 1) L cis : BY:
For the DIVISION ENGINEER
ATTEST ORWITTNESS° -:
Geological Resouces, Inc.
Secretary
INSTRUCTIONS
Geological Resouces, Inc.
Vice President, Account Management
Second Party
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.

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Geological Resources, Inc.
July 17, 2023
N.C. Department of Transportation
Division 5 Right of Way Office
815 Stadium Drive
Durham, North Carolina 27704
Re: Encroachment Agreement
Apex Food Mart
321 South Salem Street
Apex, North Carolina
Dear DOT Reviewer:
Geological Resources, Inc. (GRI) is currently conducting ground water assessment activities associated
with a subsurface release of petroleum products at the Apex Food Mart located at 321 South Salem Street
in Apex, Wake County, North Carolina. A Site Map is attached. The work is being completed under the
direction of the North Carolina Department of Environmental Quality (NCDEQ). In order to complete
corrective action to remediate environmental contamination, GRI has determined that two Type II
monitoring wells will need to be installed on NC 55 (E. Williams Street) near the intersection of S. Salem
Street (NCSR 1101). These wells will have to be installed in the North Carolina Department of
Transportation (NCDOT) right-of-way (ROW). Therefore, an approved NCDOT Encroachment
Agreement must be obtained before the work can be conducted. A completed Right Of Way Encroachment
Agreement For Non -Utility Encroachments On Primary And Secondary Highways (FORM R/W 16.1A)
has been attached for your review.
A Site Map showing the proposed well locations is attached. The wells will be installed to total depths of
approximately 20 feet each and will be completed with a 2' x 2' pad and locking manhole cover. The wells
will not impede any day-to-day traffic and will be completed to grade level.
The activities are scheduled to occur as soon as access to the area is granted by the NCDOT. The activities
are expected to be completed in one day. Prior to startup of the activities, the NCDOT will be notified of
the date for which the work is scheduled.
Your prompt attention to this matter will be greatly appreciated. If you have any questions or require
additional information, please do not hesitate to contact me at [phone] or
[e-mail].
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
DOT Encroachment Agreement
Apex Food Mart
Page 2 of 2
Sincerely,
Geological Resources, Inc.
��A 4'
�Zo
Project Manager
enclosures
cc: file
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
LEGEND
J
TYPE II I.IONITOF.ING HELL
&
TYPE III I•.IONITORING ',TELL
Q
CATCH B.;SIN
=y
V,'r.TER '.IFTFR
®
OBSER',.AT!ON V ELL
FENCE
ss
E7 NIT,4-,Y SE.'.'ER LINE
a
STORI.i DF, IN LINE
:'viJER LINE
Note:
This Site lJop i^ based on ❑ 'ite Plan sated
06.;ember 200? that ,.o- FreF-ired b. Kleinfelder
EXISTING LIGHT
AND SIGN
7!_.5-PHALTLL
I—
lu
CITGO
GAS
STATION
J `UST
PIT
O
Cr,NOPY
MW-11
ss �ss �ss ss ss —
:�_.EM STREET / SR 1011
SQ
W-12
GRA.E r V, — 4
<_1
S44,
2A-rBARBER
SHOP J 1� r r/7
�IJ II III i l a l "W— 5
EXISTING
'ID IIo ;i m it r
-III ii iTANK P!T
y*
III >
RESIDENTIAL 11�3 LJ
PROPERTY
R.,ILROAD 200'
C 3!,II tERCIAL
PROPERTY
COr.111.1EF CIAL
PROPERTY
SITE MAP
0 2v 50 104 ;pex Food Llart 321 `_'outh Salem Street
Incident No. 13167 apex, North Carolina
( IN FEET) GRI Project No, 2982 Wake Count;
Gea'egc:' Resc_-ces, mac. 1 inch = 50 ft Date: 07/27/2022 1 DraAn b.: DTH I Figure: 2

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
TYPE II MONITORING WELL
TYPICAL CONSTRUCTION DETAILS
LL...111
cc
L L CAP
GROUND SURFA CE
GROG
METER
40 PVC CASING
BEN
V SL 0TTED
AMETER
40 PVC SCREEN
SAND Fl,

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Ngo, Nguyen Q
From: Hayes (Alfred Benesch & Company), Raymond J
Sent: Thursday, July 27, 2023 2:57 PM
To: Fathi, Ahmad J
Subject: RE: E051-092-23-00874 and T-2021-01
The TM-0026 project has been completed.
Raymond J. Hayes, P.E.
Local Projects Manager — Division 5
North Carolina Department of Transportation
919 628 8999 Mobile
[e-mail]
2612 North Duke Street
Courier # 17-27-03
Durham, NC 27704
.,nil..
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Fathi, Ahmad J <[e-mail]>
Sent: Tuesday, July 25, 2023 12:42 PM
To: Hayes (Alfred Benesch & Company), Raymond J <[e-mail]>
Subject: RE: E051-092-23-00874 and T-2021-01
Dear Mr. Hayes,
Thank you for responding back to me. Just to make sure I captured the LAPP project on the GIS map via a screenshot. I
am not sure if the map has been updated.

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Yr
LAPF*_Projects_Universe: T-2021-01
LPP 1D
T-2021-01
ubmitteclC<ycleFFY
2021
ApprovedCrycleFFY
2021
Project Description
The project would
constru ct
improvements at
41 proposed bus
stops to serve the
first local bus
route in the Town
of Apex, called
GoApcx Route 1
Zoom to Get Directions
y
Thank you so much for your time and assistance. I appreciate your help.
Sincerely,
Ahmad J. Fathi
Division 05 District 01 Office
From: Hayes (Alfred Benesch & Company), Raymond J <[e-mail]>
Sent: Monday, July 24, 2023 11:04 AM
To: Fathi, Ahmad J <[e-mail]>
Cc: Holmes, Benjamin W <[e-mail]>; Holloway (Summit Design & Engineering), Magda P <ext-
[e-mail]>; Upshaw, Ben <biupshaw@ncdotgov>
Subject: RE: E051-092-23-00874 and T-2021-01
I am not aware of a LPA project at the intersection of Salem and Williams St in Apex. I have no comments.
Raymond J. Hayes, P.E.
1
W
4

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Local Projects Manager — Division 5
North Carolina Department of Transportation
919 628 8999 Mobile
[e-mail]
2612 North Duke Street
Courier # 17-27-03
Durham, NC 27704
} ' Y
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Fathi, Ahmad J <[e-mail]>
Sent: Friday, July 21, 2023 10:33 AM
To: Hayes (Alfred Benesch & Company), Raymond J <[e-mail]>
Cc: Holmes, Benjamin W <[e-mail]>; Holloway (Summit Design & Engineering), Magda P <ext-
[e-mail]>
Subject: E051-092-23-00874 and T-2021-01
Good morning Mr. Hayes,
I have attached the plans for E051-092-23-00874, which may interfere with LAPP T-2021-01. Please let me know if
you have any comments.
Thank you for your assistance.
Sincerely,
Ahmad Fathi
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Ngo, Nguyen Q
From: Holloway (Summit Design & Engineering), Magda P
Sent: Thursday, August 24, 2023 5:20 PM
To: Ngo, Nguyen Q
Cc: Holmes, Benjamin W
Subject: FW: [External] RE: E051-092-23-00874 and U-2901 B
FYI ......
From: Nolfo, Matthew J <[e-mail]>
Sent: Thursday, August 24, 2023 4:16 PM
To: Holloway (Summit Design & Engineering), Magda P <[e-mail]>
Subject: FW: [External] RE: E051-092-23-00874 and U-2901B
Thanks,
Matthew Nolfo
Senior Assistant District Engineer
Southern Wake County
Wake County District Office (Division S District 1)
North Carolina Department of Transportation
[e-mail]
(919) 814 — 6115
Physical Address
4009 District Drive
Raleigh, NC 27607
Mailing Address
1575 Mail Service Center
Raleigh, NC 27699-1575
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
From: Braxton, John W <][e-mail]>
Sent: Thursday, August 24, 2023 12:13 PM
To: Scott Driscoll<[e-mail]>
Cc: Stephanie Couick <[e-mail]>; Quinn, Beth A <[e-mail]>; Nolfo, Matthew J

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
<[e-mail]>; Boulware, Daniel <[e-mail]>
Subject: RE: [External] RE: E051-092-23-00874 and U-2901B
Scott,
TIP project U-2901B
I support moving forward with the encroachment agreement as originally proposed. Please continue to work with our
Division 5, District 1 Office.
Daniel and Matt will be your contacts.
Thank you,
JB
John W. Braxton Jr.
Division 5 Project Development - DM STIP Engineer
North Carolina Department of Transportation
919 707 6219 office
919 250 4036 fax
0wbraxton(cDncdot.gov Email
From: Scott Driscoll<[e-mail]>
Sent: Thursday, August 24, 2023 11:46 AM
To: Braxton, John W <[e-mail]>; Fathi, Ahmad J <[e-mail]>
Cc: Stephanie Couick <[e-mail]>; Quinn, Beth A <[e-mail]>
Subject: RE: [External] RE: E051-092-23-00874 and U-2901B
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Mr. Braxton,
I spoke with the incident manager for the NCDEQ and they would like to proceed with the encroachment agreement as
originally proposed, without moving the wells, knowing that we will be using the wells for a finite period of time until
your construction project begins. It looks like according to your estimates we will be able to gather data from the wells
for a few years prior to the project. We should be able to get the data we need, multiple times with the permanent
fixture and it be useful and help us reach the project goals and abandon the wells prior to your construction. Please
contact me at 919-920-3662 to discuss or if you have any questions concerning our request.
Let me know if there anything else we need to do to follow up on the request at this point?
Hope you are having a good day.
Scott Driscoll
Project Manager
Geological Resources, Inc.
2021 Winner of the Union County Chamber Excellence In Business Award
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office x2627 1919-920-3662-cell 1704-845-4012-fax
From: Scott Driscoll
Sent: Friday, August 18, 2023 8:31 AM
To: Braxton, John W <[e-mail]>; Fathi, Ahmad J <[e-mail]>

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Cc: Stephanie Couick <[e-mail]>; Quinn, Beth A <[e-mail]>
Subject: RE: [External] RE: E051-092-23-00874 and U-2901B
Oversight by me and sorry you don't need to answer this. I see your construction estimates here. I will discuss with the
NCDEQ incident manager. We may want to go ahead and install the wells as permanent fixtures that can be properly
abandoned at a later date sometime before DOT does any construction. When may be able to get a few years of data
from them before doing a permanent abandonment. I will advise. Thanks for your help in this matter.
Scott Driscoll
Project Manager
Geological Resources, Inc.
2021 Winner of the Union County Chamber Excellence In Business Award
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office 1919-920-3662-cell 1704-845-4012-fax
From: Braxton, John W <[e-mail]>
Sent: Thursday, August 17, 2023 5:37 PM
To: Scott Driscoll<[e-mail]>; Fathi, Ahmad J <[e-mail]>
Cc: Stephanie Couick <[e-mail]>; Quinn, Beth A <[e-mail]>
Subject: RE: [External] RE: E051-092-23-00874 and U-2901B
Mr. Driscoll,
Installing temporary wells instead of permanent wells to collect data about petroleum residues sounds like a reasonable
plan. The wells could be removed / abandon from the North Carolina Right of Way as part of the ROW agreement.
Project U-2901B and U-2901BA will come back online soon. Below is the tentative project Schedule.
Protect U-2901B (Corridor)
• Tentative state of Right of Way Acquisition is schedule for FY 2028 (as early as July 2027)
• Tentative Construction is schedule for FY 2031
Project U-2901BA (Railroad Bridge)
• Tentative start of Right of Way Acquisition is schedule for FY 2027 (as early as July 2026)
• Tentative Construction is schedule for FY 2029
To answer your questions
• The purpose of the project?
Widen to 4 lanes with a divided median. To improve traffic flow and safety.
Definition of the berm and what is the slope.?
Berm is the flat area behind the Curb and Gutter where a sidewalk or multiuse path is constructed. At the edge
of the berm, we grade to meet the existing ground. This can be as flat as a 6:1 slope to as steep as a 2:1 slope.
Whether or not the slope would be backfill or part of the retaining wall.
A retaining wall would help bring the slope in and not impact properties as bad. The retaining wall would hold
back the earth of the gas station parking lot. In other words, the road would be lower that the parking lot.
0 Project U-2901B will widen the road in the future.

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Please let me know if you have any additional questions.
Thank you,
JB
John W. Braxton Jr.
Division 5 Project Development - DM STIP Engineer
North Carolina Department of Transportation
919 707 6219 office
919 250 4036 fax
0wbraxton(cDncdot.gov Email
From: Scott Driscoll <[e-mail]>
Sent: Thursday, August 17, 2023 2:59 PM
To: Fathi, Ahmad J <[e-mail]>; Braxton, John W <[e-mail]>
Cc: Stephanie Couick <[e-mail]>
Subject: [External] RE: E051-092-23-00874 and U-2901B
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Thank you ahmad. If either of you two want to contact me directly, I can be reached at 919-920-3662. Thanks for your
time.
Scott Driscoll
Project Manager
Geological Resources, Inc.
2021 Winner of the Union County Chamber Excellence In Business Award
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office 1919-920-3662-cell 1704-845-4012-fax
From: Stephanie Couick <[e-mail]>
Sent: Thursday, August 17, 2023 2:50 PM
To: Scott Driscoll <[e-mail]>
Subject: FW: E051-092-23-00874 and U-2901B
For project # 2982.
Thank you,
Stephanie S. Couick
Operations Coordinator
Geological Resources, Inc.
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office 1704-845-4012-fax
From: Fathi, Ahmad J <[e-mail]>
Sent: Thursday, August 17, 2023 2:24 PM
To: Stephanie Couick <[e-mail]>
Subject: FW: E051-092-23-00874 and U-2901B

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
From: Fathi, Ahmad J
Sent: Thursday, August 17, 2023 2:24 PM
To: 'Braxton, John W' <[e-mail]>
Cc: Holloway (Summit Design & Engineering), Magda P <[e-mail]>; Holmes, Benjamin W
<[e-mail]>
Subject: E051-092-23-00874 and U-2901B
Dear Mr. Braxton,
I hope you are doing well. I just heard back from Scott Dristoll about the monitoring wells he wants to install at the
intersection between NC-55 and Salem St. Mr. Dristoll was wondering when the project U-2901B at that intersection
would start. Since the plans are only 25% complete and have yet to be implemented, he is thinking about installing
temporary wells instead of permanent wells to collect data about petroleum residues in the environment from the road
system. The wells could be removed from the North Carolina Right of Way once enough data is collected. He was also
wondering what is the purpose of the project? You mentioned that retaining walls could be added to the project. Also,
he asked about what is the definition of the berm and what is the slope. I mentioned to him that the berm is part of the
curb. He also asked whether or not the slope would be backfill or part of the retaining wall. Another question he asked
was about whether the road will be widened in the future during the project.
Thank you so much for your assistance as always. We appreciate your knowledge and information.
Sincerely,
Ahmad J. Fathi
Transportation Engineering Associate
Wake County District Office (Division 5 District 1)
North Carolina Department of Transportation
[phone] (office)
[e-mail]
Physical Address
4009 District Drive
Raleigh, NC 27607
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
LEGEND
J
TYPE II I.IONITOF.ING HELL
&
TYPE III I•.IONITORING ',TELL
Q
CATCH B.;SIN
=y
V,'r.TER '.IFTFR
®
OBSER',.AT!ON V ELL
FENCE
ss
E7 NIT,4-,Y SE.'.'ER LINE
a
STORI.i DF, IN LINE
:'viJER LINE
Note:
This Site lJop i^ based on ❑ 'ite Plan sated
06.;ember 200? that ,.o- FreF-ired b. Kleinfelder
EXISTING LIGHT
AND SIGN
7!_.5-PHALTLL
I—
lu
CITGO
GAS
STATION
J `UST
PIT
O
Cr,NOPY
MW-11
ss �ss �ss ss ss —
:�_.EM STREET / SR 1011
SQ
W-12
GRA.E r V, — 4
<_1
S44,
2A-rBARBER
SHOP J 1� r r/7
�IJ II III i l a l "W— 5
EXISTING
'ID IIo ;i m it r
-III ii iTANK P!T
y*
III >
RESIDENTIAL 11�3 LJ
PROPERTY
R.,ILROAD 200'
C 3!,II tERCIAL
PROPERTY
COr.111.1EF CIAL
PROPERTY
SITE MAP
0 2v 50 104 ;pex Food Llart 321 `_'outh Salem Street
Incident No. 13167 apex, North Carolina
( IN FEET) GRI Project No, 2982 Wake Count;
Gea'egc:' Resc_-ces, mac. 1 inch = 50 ft Date: 07/27/2022 1 DraAn b.: DTH I Figure: 2

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
O
N
LA
LO 00
O U
N M
n
O
0`
01
00
10
O 01
M
n
O
00 �
LO O.
Lf ) O
Ln
O O` 0,
M LO M
O Mc,. O
O 00 N
01 n
10
d
N 01 N p
N M N 01 CD M
M co
M d
M.^O ^ N�1I,
O � O
M �
O �
� M
LO M
n 01
��O M
01
M ^ M
O 01 O
M p O
O �
U 01M 00
O U n N
M 00 O U
O
O M M
N LO
00 O .p
O n N
N 01
CN CDp, M
M
I, O
O p.
LO
Ln
O 01O M
It
n
O
10 U
10 M M
00 O
01 LO 10 O 0
n M O O 01
n ^O 01
M O O
n
LO 01 O
01
O N
d'
n
O
N
N
O
O
O J
LO I
O �
Z-4�-.c
L
cn
E
cn
cn
r
N
M
N
to
CD
r

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
TYPE II MONITORING WELL
TYPICAL CONSTRUCTION DETAILS
LL...111
cc
L L CAP
GROUND SURFA CE
GROG
METER
40 PVC CASING
BEN
V SL 0TTED
AMETER
40 PVC SCREEN
SAND Fl,

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969 011,
9/oii
ROY COOPER
Governor
Vtv
ELIZABETH S. BISERSecretary
MICHAEL SCOTT
NORTH CAROLINA
Director
Environmental Quality
April 24, 2022
Amy Jordan
LG Jordan Oil Company
PO Box 220
Apex, NC 27502
Re: Notice of Regulatory Requirements
15A NCAC 02L .0110(d) [Intermediate Risk]
Risk -based Assessment and Corrective Action
For Petroleum Underground Storage Tanks
Apex, Nc 27502
321 S Salem Street, Apex
Wake County
Incident Number: 19167
Risk Classification: Intermediate
Ranking: 1195 D
Dear Amy Jordan:
The file for the above referenced incident has have been reviewed by the UST Section, Division of Waste
Management, Raleigh Regional Office. The risk posed by the discharge or release at the subject site is
classified by the Department of Environmental Quality as intermediate, as stipulated under Title 15A
NCAC 02L .0406. The land use at the site is classified as industrial/commercial. Title 15A NCAC 02L
.0407(a) requires you to notify the Department of any changes that might affect the risk or land use
classifications that have been assigned.
The review indicates that corrective action is necessary to remediate environmental contamination. Title
15A NCAC 02L .0407(d) [Intermediate Risk] requires you to comply with the assessment and cleanup
requirements of Title 15A NCAC 02N .0706, Title I5A NCAC 02L .0106(c), Title 15A NCAC 02L .0110,
and Title 15A NCAC 02L .0111. A Groundwater Monitoring Report prepared in accordance with these
requirements and the most recent version of the UST Section Assessment Guidelines must be received by
this office semiannually.
For additional reference, please refer to the most recent version of the Guidelines for Site Checks, Tank
Closures, and Initial Response and Abatement. Report requirements can be found in the most recent
version of the Comprehensive Appendices for Correction Guidelines. Reports must contain the
information specified in the report template presented in Appendix A of the Guidelines. The report
template is attached for your information.
In accordance with Title 15A NCAC 2L .0407(d), 2L .0110, and 2L .0111; monitoring well MW-3 must be
replaced or located by 06/30/2023. Additionally, the well should be sampled, and the results included in a
D Q
�� North Carolina Department of Environmental Quality I Division of Waste Management
Raleigh Regional Office 1 1628 Mail Service Center I Raleigh, NC 27699-1628 1 (919) 791-
NORTH CAROLINA - 4200
Department of Environmental Quality

DocuSign Envelope ID: 70860879-3BA4-40BC-A031-D6654CD46969
Page 2 of 2
Incident Number -19167
Date — 0412412023
monitoring report submitted to this office by June 30, 2023. Lastly, additional wells may need to be either
replaced or located in the future to delineate the groundwater contaminant plume.
Failure to comply in the manner and time specified may result in the assessment of civil penalties
and/or the use of other enforcement mechanisms.
The Department of Environmental Quality requires that all work not determined to be an emergency
response or associated with risk assessment (i.e., the Limited Site Assessment Report, per Title 15A
NCAC 02L .0405) must be preapproved if State Trust Fund reimbursement is anticipated. To comply
with this requirement, a completed Preapproval/Claim Authorization Form, encompassing the required
remedial activities, must be received in this office within 14 days of the date of this letter. Upon
completion of the preapproved activities, you should submit your claim promptly. Reimbursement funds
are budgeted based on completed preapprovals, but delays in reimbursement or even denial due to
exceeding the statute of limitations on claiming eligible costs can result where claims are not submitted
immediately following work completion.
Because a release or discharge has been confirmed, a Licensed Geologist or a Professional Engineer,
certified by the State of North Carolina, is required to prepare and certify all reports submitted to the
Department in accordance with 15A NCAC 02L .0103(e) and 02L .0111(e) if required.
If you have any questions regarding trust fund eligibility or reimbursement from the Commercial Leaking
Petroleum Underground Storage Tank Cleanup Fund, please contact the UST Section Trust Fund Branch
at [phone]. If you have any questions regarding the actions that must be taken or the rules
mentioned in this letter, please contact me at the address or telephone number listed below.
Sincerely,
i"aDw iA�
Paul M. Mays, P.G.
Hydrogeologist
Raleigh Regional Office
UST Section, Division of Waste Management, NCDEQ
cc: [e-mail], Wake County Health Department
Scott Driscoll — 113 W. Firetower Road, Suite G, Winterville NC 28590 — Geologic Resources, Inc
D Q
�� North Carolina Department of Environmental Quality I Division of Waste Management
Raleigh Regional Office 1 1628 Mail Service Center I Raleigh, NC 27699-1628 1 (919) 791-
NORTH CAROLINA - 4200
Department of Environmental Quality