WM0401514_Permit (Issuance)_20240227

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Ms. Rachael Dickinson
Mavis Tire Supply, LLC
358 Saw Mill River Road
Millwood, New York 10546
NORTH CAROLINA
Environmental Quality
February 27, 2024
SUBJECT: MONITORING WELL CONSTRUCTION
PERMIT NO.
COUNTY:
FILE NAME:
Dear Ms. Dickinson:
WM0401514
Davie
Cooper Creek Drive Site
In accordance with your application received on February 27, 2024, we are forwarding herewith:
1. Monitoring Well Construction Permit No. WM0401514 for the construction of three (3)
monitoring wells at Cooper Creek Drive, Mocksville, North Carolina in Davie County.
Henceforth, correspondence and data relating to this well shall be designated as specified in the
subject heading above. This Permit will be effective from the date of issuance and shall be subject
to the conditions and limitations as specified therein. If you have any questions regarding this
permit, please contact me or Caitlin Caudle at [phone].
Sincerely,
DocuSigned by:
0D2D3CE3F 1 B7456...
Jennifer F. Graznak
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ — WSRO
cc: Ron Navarro, ECS Limited (electronic copy)
Leconte Equities Group, LLC, Property Owner (electronic copy)
DffNorth Carolina Department of Environmental Quality I Division of Water Resources
oan caaouNn
Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 I Winston-Salem, North Carolina 27105
M336.776.9800
oep.m.m or em�nmen� Qualm

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES — WATER QUALITY REGIONAL OPERATIONS
SECTION
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
Mavis Tire Supply, LLC
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of three (3)
monitoring well owned by the Mavis Tire Supply, LLC. The well will be located at Cooper Creek
Drive, Mocksville, North Carolina in Davie County, PIN #5729869087. This Permit is issued in
accordance with the application received on February 27, 2024 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).
D North Carolina Department of Environmental Quality I Division of Water Resources
✓ Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Winston-Salem, North Carolina 27105
NORTH CAROLINA 336.776.9800
onparhnem of EmironmanW 9uallly

5. Well construction records (GW-1) for each well shall be submitted to the Division of Water
Resources' 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 Resources' Information Processing Unit within 30 days of the well
abandonment.
7. The County Health Department may require a county monitoring well construction permit.
Please contact the health department for their requirements.
Permit issued the 27th day of February 2024
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Docu Signed by:
1�-- -,!� ,,a�
OD2D3CE3F167456...
Jennier F. Graznak, Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - WSRO
By Authority of the Environmental Management Commission
NORTH CAROLINAD � ��
Permit No. # WM0401514
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Winston-Salem, North Carolina 27105
336.776.9800