WS0801052_Application_20200310 (9)

DocuSign Envelope ID: B1C27C72-54D5-4721-AEA6-92CB01F2467B
PERMIT NO. WS0801052
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION OF A WELL OR WELL SYSTEM
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
Pender County Public Utilities
FOR THE CONSTRUCTION OF two (2) large capacity water supply wells in accordance with the application
received on March 9, 2020 in conformity with specifications and supporting data, all of which are filed with the
Department of Environmental Quality and are considered part of the Permit. The wells will be located at the
following locations in Hampstead, Pender County:
• W04/RW4 Kiwanis Park Well: 586 Sloop Point Loop Road (PIN# 4204 81 8064 000)
W06/RW6 Annex Well: 15060 Hwy 17 (PIN# 4204 81 8064 0000)
This Permit is for well construction only and does not waive any provisions or requirements of the Water Use Act
of 1967, or any other applicable laws and regulations. Well construction shall be in compliance with the North
Carolina Well Construction Regulations and Standards.
This Permit will be effective from the date of its issuance until March 10, 2021, and shall be subject to other
specified conditions, limitations, or exceptions as follows:
1. The well(s) shall be constructed in accordance with 15A NCAC 02C .0100.
2. The well(s) shall be constructed and located as shown on the attachments submitted as part of the permit
application.
3. A well construction record and copies of well logs, if generated, shall be submitted to the Division.
4. A 24-hour yield test shall be conducted for each well in accordance with 15 NCAC 2C .0110(b) and
submitted within 30 days of completion.
5. Well construction records (form GW-1) for the well must be supplied to the Division of Water Resources'
Information Processing Unit within 30 days of well completion.
6. Issuance of this Permit does not obligate reimbursement from State trust funds, if the well is being installed
as part of an investigation for contamination from an underground storage tank or dry cleaner incident.
7. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another
agency.
8. The well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C.0108 (o).
9. When a well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC 02C.0113
and a well abandonment record (form GW-30) shall be submitted to the Division of Water Resources'
Information Processing Unit within 30 days of well abandonment.
If any requirements or limitations of this Permit are unacceptable, you have the right to an adjudicatory hearing
upon written request within 30 days. 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 demand is made, this Permit is final and binding.
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DocuSign Envelope ID: B1C27C72-54D5-4721-AEA6-92CB01F2467B
PERMIT NO. WS0801052
Permit issued this 10' day of March 2020
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DocuSigned by: AtbmUA S,w�A_J
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Morella Sanchez King, PhD, PE, Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
cc: Applied Resource Management, P.C. (Well Contractor - via email)
DWR-Public Water Supply Section (via email)
DWR files (Laserfiche upload)
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