WS0801050_Application_20200226

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NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY — DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A WATER SUPPLY WELL OR WELL SYSTEM
(Wells or Well Systems with a Design Capacity of 100,000 Gallons Per Day or Greater)
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 water supply wells.
1. Date: 11/05/2019 1 FOR OFFICE USE ONLY a
2. County: Duolin PERMIT NO. W V 01050 ISSUED DATE: a1
3. Applicant: L. J. Beasley Farming LLC- Evans Farm Telephone: [phone]
Applicant's Mailing Address: 810 Nash Johnson Pond Road Magnolia N.C. 28453
Applicant's Email Address (if available): lon.beasley0housoefraeford.com
4. Contact Person (if different than Applicant): Lon Beasley Telephone: [phone] p, p
Contact Person's Mailing Address: 810 Nash Johnson Pond Road Magnolia N.C. 28453
Contac Person's Email Address (if available): Ion.beaslevCdhousoefraeford com
5. Property Owner (if different than Applicant): Telephone:
WDtcr OX!,PI,v ; e lo•,ia
Owner's Mailing Address: p or ti '° 011
Owner's Email Address (if available):
VJilmc�"I '
6. Property Physical Address (including PIN Number): PIN # 248100410238 Nash Johnson Pond Rd
City: Magnolia NC County: Duolin Zip Code:28453
7. Intended use of Well or Well System: Agricultural irrigation
(examples: irrigation, consumption, etc.)
8. Will the proposed water supply well or well system replace or be added to an existing well or well system? No
(If yes, complete questions 7 and 8) (If no, complete question 7 and then skip to question 9)
9. Total design capacity of proposed well or well system in gallons per day (gpd): 792,000,qpd
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
11. Is this a public well or well system? No If yes, give Public Water ID Number:
If yes, give Project Engineer and contact information:
12. Well Contractor: Steve English Well Contractor Certification No.: 2824-A
Well Contractor Address: RO. Box 2797 Surf City. NC 28445
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: 2. No. of wells to be constructed in unconsolidated
a. Borehole and well diameter material: 2
b. Estimated well depth 3. No. of wells to be constructed in bedrock: 0 _
C. Screen intervals 4. Total No. of wells to be constructed: 2
d. Sand/gravel pack intervals (add answers from 2 and 3)
e. Type of casing material and thickness 5. Estimated beginning construction date:
f. Grout horizons 6. Estimated construction completion date: 1/13/2020
g. Well Head completion details
Continued on Reverse
X

ADDITIONAL INFORMATION
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.
2. As required by 15A NCAC 02C .0105(g)(3), for wells screened in multiple zones or aquifers, provide representative data on the
static water level, pH, specific conductance, and concentrations of sodium, potassium, calcium, magnesium, sulfate, chloride,
and carbonates from each aquifer or zone from which water is proposed to be withdrawn.
3. Attach any water use permits (if required). [e.g. Central Coastal Plain Capacity Use Area Permit is required in 15 eastern NC
counties by NC Division of Water Resources, visit: http://w m.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
the Water Supply 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
Owner E&B Water Wells
Sig`Piature bf Applicant or *Aggnt E Title of Applicant or *Agent
Stephen English ' /f 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
water supply wells as outlined in this Water Supply Well Construction Permit application and that it shall be the responsibility of the
applicant to ensure that the water supply well(s) conform to the Well Construction Standards (Title 15A of the North Carolina
n nn ? JAdministrative Code, Subchapter 2C).
�. J Iignarn fPr Lcc �C` ✓r�/j �. J-%3�-- kr. :t ibL - 4c>n T �eksl<y
Signat a of Property Owner (if different than pplicant) Printed name of Property Owner f 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 Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mitt Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]

\ II
DIAGRAM OF PROPOSED
CONSTRUCTION SPECIFICATIONS
Straight -Screened
or
Gravel -Packed Well
(Constructed in unconsolidated formations)
Open-1,nd Well
(Constructed in consolid-
ated formations)
r,
F
t
A} Casing: �
1) Inner: �`f
land surface
type ) `' I. D.
ft. (depth)
lbe./ft.
ft. (into rock)
. -
2) Outer:
type I. D.
lbs./ft.
ft. (depth)
I
U
$) Cement:
I
1) Inner
Casing:
0 ft. to
S ft.
2) Outer
Casing:
ft. to
ft.n'T�T
(�.
I
.,
Rock
C) Screen(s):� / type )- �' �_ I. D.
ft. to, S V f t.
\7, ft. to ft.
i
_ D) Gravel;, C. a. to Ft. in.
(size)
(Fill in each blank that applies and use appropriate diagram
"j to show proposed construction including, but not limited to,
casing (outer and inner), sealing material (cement, clay,
1J, v
etc.), packers, screens, gravel, chemical feed lines, etc.)
Location Diagram; (Previously prepared maps may be submitted provided they con-
tain information required in item (g) of the application).
I
a � ,
`(' /CI �' ) C (' o
Rock

1.
b. No existing wells within a 500 feet.
To whom it may concern:
These wells will be used seasonally for agricultural
irrigation to grow crops such as corn, soybeans, and
wheat. We irrigate using NRCS best management practices
and use center pivots. We only irrigate to supplement
deficits in rainfall to meet crop water demand. This should
mainly be during crop reproduction stages.

Proposed Well proposed Well
a
0
,e
Earth

L. J. BEASEEY NAKMINU, LLC
Parcel #: 12- 457- - - Property Address: OFF 117 W/RR
Account #: 5102744 Mailing Address:259 BEASLEY RD MAGNOLIA NC 28453
Deed Ref: 1619/873 2009 Year BuiIt: 0 Misc. Impry Value:$0
Year Built:0 Last Sale Price: Fire Code:
Deeded Acres:36.5 AssessedValue:23500 Notes: CO NV_ NOTES
Last Sale Date: 2008/04/10 Property Class:1 Remarks:
Year Built:0 Heat SQ Feet:0 Land Value Only:$23500
DUPLIN COUNTY GIS
DISCLAIMER: November27,2019
The information gathered from this site is
for informational purposes only and the
meats) Printed from this site should NOT be
usedas or in placeof an actual survey.
The map(s) should NOT be used In sales
orconvevanres
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