WM0501615_Monitoring Well Permit Application_20240117

North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center Raleigh, North Carolina 27699-1611
919.707.9000

January 17, 2024 Ms. Erin Ireland North Carolina Department of Environmental Quality Division of Waste Management, Inactive Hazardous Sites Branch 1646 Mail Service Center Raleigh, NC 27699-1646 Sent Via Email Subject: Monitoring Well Construction Permit # WM0501615 Weldon Mills (Former) Southeast Corner of East 11th and Sycamore Streets (PIN 1202224) Weldon, NC 27890 – Halifax County Ms. Ireland: In accordance with the application received on January 16, 2024, we are forwarding herewith Monitoring Well Construction Permit No. WM0501615 dated January 17, 2024, issued for the construction of a monitoring well system (installation of six 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,
Vanessa E. Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ Enclosure -Permit -Application Package Ec: Larry George, ATC Associates of North Carolina, PC Corinne Lally, ATC Associates of North Carolina, PC Laserfiche

DocuSign Envelope ID: 597CFF25-C813-4533-BECA-418796BB625F
North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center Raleigh, North Carolina 27699-1611
919.707.9000
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other applicable Laws,
Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO North Carolina Department of Environmental Quality, Division of Waste Management FOR THE CONSTRUCTION OF A MONITORING WELL SYSTEM consisting of six monitoring wells owned by North Carolina Department of Environmental Quality, Division of Waste Management, at mailing address 1646 Mail Service Center, Raleigh, NC 27699-1646. The wells will be located on the property owned by Richard Shane Early Trust at Southeast Corner of 11th and Sycamore Streets (PIN 1202224) in Weldon, NC 27890. This Permit is issued in accordance with the application received on October 25, 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.

____________________________________
Vanessa E. Manuel, Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission

Permit Number: WM0501615
Permit Issued: January 17, 2024
DocuSign Envelope ID: 597CFF25-C813-4533-BECA-418796BB625F
2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcgroupservices.com
N.C. Engineering License No. C-1598

January 16, 2024

Mr. Michael Hall, PG Geologist/Hydrogeologist
North Carolina Department of Environmental Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628

Re: Permit to Construct Groundwater Monitoring Wells
Weldon Mill
East 11th and Sycamore Streets
Weldon, Halifax County, North Carolina
ID No. NONCD0002124
State Contract No. N091319

Dear Mr. Hall:

Enclosed please find one application for a permit to construct six temporary groundwater
monitoring wells. The groundwater monitoring wells will be located at East 11th and Sycamore
Streets (PIN 1202224), Weldon, Halifax County, North Carolina. The permit application, site
map with the proposed locations of the monitoring wells, well construction details and other
relevant information are enclosed as attachments. The work is being performed for the Division
of Waste Management, Inactive Hazardous Sites Branch (IHSB). Please review this package and
return the approved permit to this office or via email to [e-mail]. Drilling is
currently scheduled to commence on Monday, January 29, 2024.

If you have any questions or require additional information, please contact our office at (919)
948-3549.

Sincerely,

ATC Associates of North Carolina, P.C.

Larry M. George, P.G.
Principal/Senior Project Manager

FOR OFFICE USE ONLY

PERMIT NO. ISSUED DATE
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: January 16, 2024

2. County: Halifax

3. What type of well are you applying for? (monitoring or recovery): Monitoring

4. Applicant: NCDEQ, DWM Telephone: [phone]

Applicant’s Mailing Address: NCDEQ IHSB – Superfund Section, 1646 Mail Service Center, Raleigh, NC 27699-1746

Applicant’s Email Address (if available): Send to contact person listed below

5. Contact Person (if different than Applicant): Larry George, ATC Associates of NC, PC Telephone: [phone]

Contact Person’s Mailing Address: 2725 E. Millbrook Road, Suite 121, Raleigh, NC 27604

Contact Person’s Email Address (if available): [e-mail]

6. Property Owner (if different than Applicant): Richard Shane Early Trust Telephone: [phone]

Property Owner’s Mailing Address: 3288 Page Avenue, Unit 1411, Virginia Beach, VA 23451

Property Owner’s Email Address (if available): Unknown

7. Property Physical Address (Including PIN Number) E. 11th St. and Sycamore St (PIN 1202224)
City Weldon County Halifax Zip Code 27890

8. Reason for Well(s): Assess for potential groundwater 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: Inactive Hazardous Site
(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, Weldon Mill, IHSB Site (ID NONCD0002124)

11. Type of contaminants being monitored or recovered: PFAS, VOCs, SVOCs, metals
(ex: organics, nutrients, heavy metals, etc.)

12. Are there any existing wells associated with the proposed well(s)? If yes, how many? none

Existing Monitoring or Recovery Well Construction Permit No(s).: N/A

13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): Unknown

14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Unknown

If yes, give distance(s):

15. Well Contractor: Geologic Exploration (GEX) Certification No.: NCWC 2581-A

Well Contractor Address: 716 Commerce Blvd, Statesville, NC 28625

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 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
material: 6

3. Number of wells to be constructed in bedrock: 0

4. Total Number of wells to be constructed: 6
(add answers from 2 and 3)
5. How will the well(s) be secured? Locking well cap

6. Estimated beginning construction date: 1/29

7. Estimated construction completion date: 1/31

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.

Agent for NCDEQ DWM (will include power of attorney upon request)
Signature of Applicant or *Agent Title of Applicant or *Agent

Lawrence M. George, P.G (Agent for NCDEQ DWM) * 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 access agreements See attached access agreement
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (if different than Applicant)

DIRECTIONS

Please send the completed application to the appropriate Division of Water Resources’ Regional Office:

Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone: [phone]
Fax: [phone]

Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]

Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]

Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]

Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]

Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]

Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22M/R (Rev. 5-26-2022)
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Feet
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@A Temporary Monitoring Wells
Halifax County Parcels
500 ft Buffer 1" = 150'
2725 E. Millbrook Road, Suite 121
Raleigh, NC 27604
[phone]
PROJECT NO: IHSB051P01
TEMPORARY MONITORING WELL
CONSTRUCTION DETAIL
Weldon Mill (FRMR)
East 11th and Sycamore Streets
Weldon, Halifax County, NC
ID No. NONCD0002124REVIEWED BY: LGDATE: January 16, 2024
2” Diameter Schedule 40 PVC Casing Extending
From Ground Surface to Top of Screen (+3-20 feet)
2-Foot Bentonite Seal (6-8 feet)
#2 Filter Sand Pack Extending 2 Feet Above Screen
(8-20 feet)
15 Feet (or 10 Feet) of 2” Schedule 40 Well
Screen (0.010” Slot) (10-20 feet)
Well finished at surface with locking
well cap.
Groundwater Table
TMW’s
#2 Filter Sand Pack Extending to the surface
(0-6 feet)