WM0801151_Application_20200604

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: 5/28/2020
2. County: Pender
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: Rolfe Lann, VP of Environmental for GPM Southeast, LLC Telephone:
Applicant's Mailing Address: 8565 Magellan Parkway, Suite 400, Richmond, VA 23227
5.
H
Applicant's Email Address (if available):
Contact Person (if different than Applicant): Aaron Williamson, CES of NC, PLLC Telephone:
Contact Person's Mailing Address: 5104 Reagan Drive, Suite 7, Charlotte, NC 28206
804-730-1568
980-819-9333
Contact Person's Email Address (if available): [e-mail]
Property Owner (if different than Applicant): Norwood Blanchard / NCDOT Telephone: [phone]
Property Owner's Mailing Address: PO Box 1425, Burgaw, NC 28425 / 295-A Wilmington Hwy, Jacksonville, NC 28540
Property Owner's Email Address (if available): [e-mail] / [e-mail]
7. Property Physical Address (Including PIN Number) 910 E Fremont St, 3229-64-9102-0000 / Eastern Shoulder of US Hwy 117, N/A
City Burgaw County Pender Zip Code 28425
A
a
Reason for Well(s): Groundwater assessment
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
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).
UST Incident Number 19300
11. Type of contaminants being monitored or recovered: Organics
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many?
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):
Yes, 21
150 feet to former UST area
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s):
15. Well Contractor: Regional Probing Services Certification No.: NC 3322-A
Well Contractor Address: PO Box 1161, Wake Forest, NC 27588
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 5. How will the well(s) be secured? steel vault,
material: 2 lockable expanding plug
3. Number of wells to be constructed in bedrock: " 6. Estimated beginning construction date: 6/28/2020
4. Total Number of wells to be constructed: 2 7. Estimated construction completion date: 7/4/2020
(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 hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this 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
le&�±l Z_a�
Sign ure of Applicant or *Agent
Rolfe Lann
Printed name of Applicant or *Agent
VP Env
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
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
wells as outlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached access/encroachment agreements
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 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 Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
R Rev. 3-1-2016

-I�
WELL CONSTRUCTION
LOCKABLE CAP
PROTECTIVE COVER
MATERIAL
DIAMETER
LENGTH
SETTING DIMENSIONS
HEIGHT ABOVE GROUNC
WELL CASING / RISER
MATERIAL
DIAMETER
LENGTH
JOINT TYPE
ANNULAR FILL
MATERIAL
THICKNESS
ANNULAR SEAL
TYPE
THICKNESS
FILTER PACK
TYPE
DISTANCE ABOVE SCREEI
WELL SCREEN
MATERIAL
DIAMETER
LENGTH
SLOT SIZE
DEPTH TO BOTTOM OF WELL
DEPTH TO THE BOTTOM OF
FILTER SAND
BOREHOLE DIAMETER
NAW�NVIRONMENTAI
SERVICES
Steel Traffic -Bearing
8-inch
0.5-feet
2-foot x 2-foot x 0.5-foot
0
polyvinyl chloride (PVC)
2 inches
5 feet
locking thread
Cement grout slurry
0.5 feet
Sodium-bentonite pellets
1 feet
#2 filter sand
0.5 feet
PVC
2 inches
10 feet
0.01-inch horizontal slot
12.5 feet
12.5 feet
8 inches
WELL ID:
TBD
L1 =
0.5
feet
DRILLING METHOD: 4.25" Inner Diameter HSA
INSTALL DATE:
TBD
L2 =
5.0
feet
SURFACE COMPLETION: Concrete Pad At Grade
PROJECT:
GPM 3059
L3 =
10.0
feet
PROJECT NUMBER:
9.0625
L4 =
12.5
feet

FIGURE I
Site Location Map
GPM 3059 (Former Scotchman #3059)
115 US Highway 117 South
Burgaw, North Carolina
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Bur aW, North Carolina Project: Groundwater v
C^ a g Monitoring Report
�v Source: U.S.G.S Topographic Map of the Client: GPM Southeast, LLC
Burgaw Quadrangle, Indiana, 7.5 Minute S,
5104 Reagan Drive, Suite 7 Series (2016)
Charlotte, NC 28206 Scale: 1:24,000 Contour Interval: 5 Feet CES NC Job #: 9.0363 Latitude:
Vertical Datum: National Geodetic Vertical 349311.4"N
Datum 1988 Longitude:
540-343-6256 (office) 540-343-6259 (fax) Horizontal Datum:North American Datum 1983 Date: 1/21/2020 77°54'50.111W

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PIN: 3229-74-0115-0000
Owner: COASTAL CAROLINA CAR WASH LLC
1202 N LAKE PARK BLVD
CAROLINA BEACH, NC 28428
Deed Ref: 1903/296
Property
Address: 109 U HWY 117 S
Description: L 99,100,101,102,BLK 4
Sale Price: $140,000
Sale Date: LAST —SALE —DATE
Plat: NOPLAT
Account No: 831610
Township: BURGAW
Subdivision:
Tax Codes: G01 C52 R40
Acres:0.54
Pender County
Land Value: $171,920
Building Value: $131,696
Total value: $303,616
0 0.025 0.05 5
0.1 mi
Deferred Value: $0
Exempt Amount: 0
0 0.04 0.08
0.16km
PCL Class: C
1 inch = 290 feet
N
Heated Sq Feet:
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May 28, 2020
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NCDEQ - Division of Water Resources, Public Water Supply Section,
NC Dept. of Environmental Quality, Division of Water Resources,
Public Water Supply Section, Sources: Esri, HERE, Garmin,
Intermap, increment P Corp., GEBCO, USGS, FAO, NPS, NRCAN,
NC Public Water Supply
State of North Carolina DOT, Esri, HERE, Garmin, INCREMENT P, USGS, EPA, USDA I NCDEQ - Division of Water Resources, Public Water Supply Section I NC Dept. of Environmental Quality, Division of Water Resources, Public Water Supply Section

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FIRST
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ASPHALT
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CLIENT: GPM Southeast, LLC
LOCATION115USHighway777South Figure 2
Burgaw, North Carolina
j/i
j GRASS
/ tY�i.ISPENSER
GPM 3059 (FormerScotchman #3059)
Site Map
\
ASPHALT
/ BROWNS MINUTE
MARKET
\
Groundwater Monitoring Report

RIGHT OF ENTRY 1 LICENSE AGREEMENT REQUEST
(the "License")
"Owner(s)" Property:
_.wlr_Blanchard-Norwood.
Parcel #: 3229-64-8100-0000 — Commercial Land
Property "Owner(s)" Mr. Blanchard Norwood has sole right to possession of the above Property and grants this right -
of -entry request to allow environmental investigations associated with the neighboring property to be conducted:
Neighboring Property:
Former Scotchman 3059
115 US Highway 117 South, Burgaw, Pender County, North Carolina
Parcel#: 3229-74-0115-0000 — Commercial Automotive Station
Planned activities to be conducted on the Owner's property include:
Survey of property for underground utilities prior to monitoring well installations.
Installation of monitoring wells within the parcels outlined on the attached figure in accordance with the
North Carolina Department of Environmental Quality Regulations.
o Monitoring well locations will be field determined based on site conditions and the presence of
underground utilities. The monitoring wells will be installed along the eastern property boundary
(please see attachment A for ideal locations)
o Monitoring well will be advanced to a maximum of 15-feet below ground surface.
o Monitoring wells will be finished with a flush mount cover with a concrete pad to prevent any
obstructions for future property development.
Periodic groundwater sampling events of newly installed monitoring wells.
o Actual sampling frequency will be determined by the state regulator. At a minimum, one round of
groundwater sampling will be conducted following the installation of the monitoring wells.
Monitoring well abandonment after incident closure is granted.
o Once the NC DEQ grant incident closure for the subject Site, the monitoring wells will be
abandoned in accordance to regulations.
The current and any future Owner(s) of the property grant GPM Southeast, LLC. and its environmental consultants
("Licensee") the right to enter upon the Property.
All activities will be performed as required by the North Carolina Department of Environmental Quality (NCDEQ)
until incident closure is granted. All activities will be conducted to eliminate or minimize disru ti n to the Pro ert .
Work will typically be performed Monday through Friday, 8:00 AM to 5:00 PM excluding holidays. Work related to
well installation, removal, and repair will be conducted during hours as agreed to by the Owner(s).
Licensee will notify the Owner(s) a minimum of 24 hours prior to performing minimally disruptive and short -duration
work such as groundwater monitoring. Well installation and similar activities will be coordinated with the Owner(s)
for approval in advance of scheduling. Reasonable advance verbal or written notification will be made to Owner(s)
should the planned work or schedule change.
This License may be immediately terminated by the Owner(s) through written notice following any breach of this
License by Licensee,
This License is effective upon signing. Licensee agrees to repair any damage to the Property resulting from entry by
Licensee and affiliates by restoring, to the extent reasonably possible, the Property to the its condition immediately
prior to entry.

Month:.� Day: , 2019
Owners) _ Licensee
GPM Southeast, LLC.
8565 Magellan Parkway, Suite 400
Richmond, Virginia 23227
ig ture Anatu
ea as
rinted Name Printed Name
qlD oZ.S f 2 t o
Telephone �. y
Lee
Email �13In, C d I8$�� l' -
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STATE
F y
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
May 26, 2020
GPM Southeast, LLC
Attn: Amanda Gapski
8565 Magellan Parkway, Suite 400
Richmond, VA 23227
SUBJECT: Encroachment Agreement on US 117BYP
Pender County (E031-071-20-00061)
Dear Ms. Gapski,
J. ERIC BOYETTE
SECRETARY
Attached for your files is a copy of Right of Way Encroachment contract properly
executed. This contract covers the following:
Located on US 117Byp, 220ft N. of the intersection of US 117Byp and E. Fremont St
(non -system), construct one permanent, flush with grade -mounted environmental
monitoring well installed in the eastern shoulder of the route associated with the NCDEQ
required assessment of nearby UST facility. This approval is subject to this work being
done in accordance with the attached plan sheet and special provisions:
No lane closures shall be allowed between the hours of 6:00 am to 9:00 am, and
4:00 pm. To 7:00 pm, (Peak hours restricted.) Further restrictions may apply due
to traffic conditions. No Lane Closures on weekends.
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
295 A WILMINGTON HWY
JACKSONVILLE, NC 28540
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: ncdot.gov
Location:
DIVISION OF HIGHWAYS
295 A WILMINGTON HWY
JACKSONVILLE, NC 28540

Sincerely,
DocuS i�g%n�ed�by�:,�
ne
Asst. District Engineer
For Chad Kimes,
P.E. Division Engineer
KEC/DR/jkd
Attachments
cc: Jeff Garrett, Pender County Maintenance Engineer (Electronic File)

STATE OF NORTH CAROLINA
ROUTE US117 PROJECT GPM 3059 COUNTY OF Pender
DEPARTMENT OF TRANSPORTATION RIGHT OF WAY ENCROACHMENT AGREEMENT
FOR NON -UTILITY ENCROACHMENTS ON
-AND- PRIMARY AND SECONDARY HIGHWAYS
GPM Southeast, LLC
Gapski
8565 Magellan Parkway, Suite 400 Amanda
Richmond, Virginia 23227 804-730-1568
568
THIS AGREEMENT, made and entered into this the day of , 20 _ , by and between the Department
of Transportation, party of the first part; and GPM Southeast. LLC
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) US117 (US Hwy 117 Byp S) located within 220-feet north of the intersection of US117
And East Fremont St within the eastern shoulder of US1
with the construction and/or erection of: one permanent flush with grade -mounted environmental monitoring well installed in
the eastern shoulder of the Route associated with NCDEQ required assessment of nearby UST facility.
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 parry 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 parry 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 Finds 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 an 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 retailing 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 parry 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 parry 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 (January, 1981)

R/W (161A) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
RAN (161A) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
ATTEST OR WITNESS:
. ■
u9n nasssrau
CFO
GPM Southeast, LLC
DEPAR TuWnne'ERANSPORTATION
BY: For Chad Kimes, P.E.
wwo
Division Engineer
n, VP o nvironmenta , G Sout east, LLC
emu, U-,,�r��_
Second GPM Southeast, LLC
6
INSTRUCTIONS
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
Manager of Right of Way. 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.

Encroachment Agreement Standard Conditions
District Office Contact Information:
295 Wilmington Hwy
Jacksonville, NC 28540
[phone]
The Standard Conditions in this document apply to this and all encroachment agreements issued by District 1.
SC1 A Pre -Construction Meeting is required prior to beginning work. Contact the District Office to schedule.
SC2 An Initial Construction Inspection is required after the completion of the work. An Initial Inspection Report will
be issued upon satisfactory completion of the work and begins the one-year warranty period. Contact the District
Office
to schedule.
SC3 A Final Inspection is required for release of the bond after the one-year warranty period. Contact the District
Office to schedule this final inspection. Once the final inspection has been deemed satisfactory by NCDOT, the bond
will be
released.
SC4 All bonds will be held for a minimum of one year from the time of the Initial Construction Inspection Acceptance.
SC5 All traffic control, asphalt mixes, structures, construction, workmanship and construction methods, and materials
shall be in compliance with the most -recent versions of the following resources: Manual on Uniform Traffic Control
Devices, Policies and Procedures for Accommodating Utilities on Highway Rights of Way, NCDOT Standard
Specifications for Roads and Structures, NCDOT Roadway Standard Drawings, NCDOT Asphalt Quality Management
System manual, and the approved plans.
SC6 Prior to beginning work, it is the requirement of the Encroaching Party to contact the appropriate Utility Companies
involved and make arrangements to adjust or relocate any utilities that conflict with the proposedwork.
SC7 If the work is located within 1/2 mile of a signalized intersection, the Encroaching Party shall contact NCDOT Traffic at
[phone] no less than one week prior to beginning work, for the location of all traffic signal and detection
cables. Location is required prior to excavation. Cost to replace or repair NCDOT signs, signals or associated
equipment shall be the responsibility of the Encroaching Party.
SC8 Prior to beginning work, if the area of work is within a municipality limit, it is the responsibility of the Encroaching
Party to notify the municipal authorities.
SC9 The approval of this agreement does not preclude the Encroaching Party from complying with any and all statutes,
rules, regulations, and ordinances that may be imposed by other governmental agencies (local, state, and federal)
which have jurisdiction, including but not limited to, those related to sediment control, stormwater, wetlands,
streams, endangered species, and historical sites.
SC10 All wiring and related work shall conform to the latest edition of the National Electrical Safety Code.
SC1 1 No alteration of the approved plan will be allowed without written approval by NCDOT.
SC1 2 The Encroaching Party shall follow any and all revisions shown in RED on attached plan(s).
SC1 3 A readable, executed copy of this Encroachment Agreement shall be present at the work site at all times while
performing work. NCDOT reserves the right to stop all work unless evidence of approval can be shown. Additionally,
NCDOT reserves the right to further limit, restrict, or suspend operations within the right-of-way.
SC14 All flagging operations within NCDOT right-of-way require qualified and trained Work Zone Flaggers. Qualified and
trained Work Zone Traffic Control Supervisors will be required on significant projects. Training for this certification is
provided by NCDOT approved training sources and by private entities that have been pre -approved. For more
information, visit https://connect.ncdot.gov/projects/WZTC/Pages/Training.aspx or contact Steve Kite, PE with the
NCDOT Work Zone Traffic Control Unit at [phone], or [e-mail].
SC1 5 No lane closures shall be allowed on State Holidays (day of, day before, and day after) or during Localevents.
SC16 No lane closures or impediment to traffic shall be allowed on weekends without prior written approval from the
District Engineer.
SC1 7 One lane must be open to traffic, only one lane closure in each direction. Ingress and egress shall be maintained to
all businesses and dwellings affected by the project. Special attention shall be paid to Police and Fire Stations, fire
hydrants and Hospitals.
Division 3, District 1 Updated 02/08/2019

SC1 8 All roadway signs removed during project work, shall be reinstalled immediately after completion of work. All
equipment and materials shall be removed from the NCDOT right-of-way when not in use.
SC19 Any work requiring personnel or equipment within 5' of the travel lanes on an undivided roadway, or 10' of the
travel lane, on a divided roadway shall require a lane closure per the latest edition of the MUTCD and the NCDOT
Standard Specifications. The more stringent standards shall apply.
SC20 Material shall NOT be unloaded or stockpiled on the roadway at any time without proper lane closure during the
project. Work is not permitted when the shoulder material is wet or during adverse weatherconditions.
SC21 All erosion control devices shall be placed as needed prior to disturbance and maintained throughout the project.
All areas disturbed (shoulders, ditches, removed accesses, etc.) shall be graded and seeded within 15 calendardays
with an approved NCDOT seed mixture (all lawn type areas shall be maintained and reseeded as such).
SC22 The placement of curb and gutter is not allowed within shoulder sections of roadway.
SC23 It shall be unlawful to place any highway obstruction, including a driveway headwall, fence, rural mailbox, newspaper
delivery box, or other roadside obstruction, so as to interfere with the traffic or maintenance of the roads and
highways of the state highway system. See North Carolina Administrative Code 19A NCAC2E.0404.
SC24 Fire Hydrant(s) shall be placed a maximum of 1 foot from the right-of-way line. (STD. 1515.02 in the NCDOT
Roadway Standard Drawings).
SC25 Directional drilling methods have not been given statewide approval for use on NCDOT right-of-way. Under no
condition shall jetting alone or wet boring with water be used for the installation of utilitypipelines.
• Directional boring is not allowed in embankment material. Directional boring is allowed beneath embankment
material in naturally occurring soil.
• Any changes shall be submitted to the District Engineer for approval prior to construction.
• Directional bores are not allowed beneath bridge footings, culvert wingwall footings or retaining walls.
• HDPE pipe installed by directional boring shall not be connected to existing pipe or fittings for one (1) week
from the time of installation to allow tensional stresses to relax.
• Directional boring using jetting with a Bentonite (or equivalent material) slurry is approved with the following
conditions:
o Minimum depth of ten (10') feet below the pavement surface of roads with no control of access or
fifteen (1 5') feet below the surface of roads with partial or full control ofaccess.
o Minimum depth of five (5') feet below any ditch line and/or creekbed.
o Minimum depth of (4') for parallel installations. Must be outside the theoretical 1:1 slope fromthe
existing edge of pavement except where the parallel installation crosses a paved roadway.
o Minimum horizontal distance of ten (I O')feet from the nearest part of any structure, including but not
limited to bridges, footings, pipe culverts, and box culverts.
o Minimum vertical distance of ten (10') feet from the nearest part of pipe culverts or box culverts.
o Tip of the drill string shall have a cutter head and detection wire installed with non-ferrous material.
o All directional drilled piping for sewer force mains and waterlines shall be a minimum ofSDR-9.
o Minimum horizontal separation of five (5') feet between each conduit which is part of a multiple
conduit installation (including perpendicular and parallel installations). Alternatively, install
multiple
conduits within a single duct.
o Overbores shall not be more than two (2") inches greater than the diameter of the pipe or encasement.
o An overbore exceeding two (2") inches greater than the diameter of the pipe or encasement will be
considered if the encroachment agreement includes a statement signed and sealed by a North Carolina
Registered Professional Engineer indicating that an overbore in excess of two (2") inches of the diameter
of the pipe or encasement will arch and no damage will be done to the pavement orsub-grade.
SC26 All excavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of the nearest
trench wall shall be done in accordance with the following conditions:
• Any excavation encroaching upon the theoretical 1:1 slope from the edge of pavement of any NCDOT
maintained road shall require temporary active shoring that must be reviewed and approved by
NCDOT prior to work.
• All trench excavation inside the limits of the theoretical 1:1 slope, as defined by the policy, shall be
completely backfilled and compacted at the end of each construction day. No portion of the trench shall be
Division 3, District 1 Updated 02/08/2019

left open overnight.
• The length of parallel excavation shall be limited to the length necessary to install and backfill one (1) joint of
pipe at a time.
• Traffic shall be moved to a travel lane outside the limits of a theoretical 1:1 slope from the bottom of the
nearest trench wall to the pavement surface.
• Installation of trench shoring shall be accomplished with minimal over -excavation. Trench boxes shall not
be used as shoring.
• An NCDOT Inspector, the cost of which is to be borne by the Encroaching Party, shall be assigned to this
project if deemed necessary by the Division Engineer.
• The trench backfill material shall meet the Statewide Borrow Criteria. The trench shall be backfilled, in
accordance with Section 540-6 of the latest NCDOT Standard Specifications for Roads and Structures, which
requires the backfill material to be placed in thicknesses between 4" and 8" loose and compacted to at least
97% of the maximum density obtained by compacting a sample in accordance with AASHTO T 180, as
modified by the Department.
• At the first sign of trench failure, a trench shall be immediately backfilled with materials consisting of A-1, A-
3, A-2-4 soils or A-4 soils having a maximum of 45% passing a No. 200 sieve and a maximum P.I. of 6. All
work shall cease, and the Division Engineer shall be contacted. The Encroaching Party shall be required to
repair any damage to the pavement caused by the excavation.
• No part of any pit shall be within three (3) feet of edge of pavement or back of curb.
• Detection tape shall be buried in the trench approximately one foot above the utility or fiber optic cable,
whenever conduit is installed in right-of-way and is not of ferrous material.
SC27 The Encroaching Party shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
SC28 Approval is only for work within NCDOT right-of-way and excludes area(s) within Railroad right-of-way.Approval is
with the understanding that NCDOT does not guarantee the right-of-way on any road.
SC29 The proposed manholes, handholes, valves or other appurtenances shall not be located in the existing ditch line,
front slope of a ditch, or in a manner that would restrict the maintenance or flow of the existing ditch line.
SC30 The Encroaching Party is responsible for any and all damages caused from project work within the right-of-way,
including damage to drainage structures, pavement, vegetation, etc.
SC31 Any plant or vegetation in the NCDOT planted sites that is destroyed or damaged as a result of this encroachment
shall be replaced with plants of like kind or similar shape. Contact the Division Roadside Environmental Engineer at
910-259-4919.
SC32 Any pavement damaged because of settlement of the pavement or damaged by equipment used to perform
encroachment work, shall be re -surfaced to the satisfaction of the District Engineer. This may include the removal of
pavement and a 50' mechanical overlay. All temporary and final pavement markings are the responsibility of the
Encroaching Party.
SC33 Any open cutting of pavement shall be repaired using the following method:
• Pavements shall be cut full depth and removed.
• After trench work is complete, the edges of the existing pavement along the trench shall be recut a
minimum of 1' wider on each side of the trench. If the pavement is undermined, the edges of the existing
pavement along the trench shall be recut to 1' beyond the undermined portion and the pavement removed.
The design section stated below is to be placed in those areas.
• The pavement repair shall be performed using the following method and pavement designsection:
o 11.0" B25.00 or B25.OB Asphalt Concrete Base Course (accomplished in 2 lifts minimum) according to
NCDOT Standard 654.01.
o Mill the entire area a depth of 2.0", starting from 15' in front of the edge of the final pavement cut.
o Overlay entire area (a minimum 50' length mechanical overlay) with 2.0" S9.5C or S9.5B Asphalt Concrete
Surface Course for a total asphalt depth of 13". Butt joints are required with no feathering ofjoints.
• All open cuts shall be backfilled, paved and traversable prior to removing lane closure.
SC34 Bore pits and open trenches should remain at least four (4) diameters away from the signal equipment
foundations. A bore should be at least Three (3) feet from the signal equipment foundation. If this item cannot
be satisfied, please contact the NCDOT Geotechnical unit to discuss alternatives for the location of concern.
Division 3, District 1 Updated 02/08/2019

Workforce Safety Plan: COVID-19 NCDOT Encroachment ID#:
E031-071-20-00061
WORKFORCE SAFETY PLAN
FOR ENCROACHMENT ACTIVITIES: COVI D-19
EFFORTS THE N.C. TRANSPORTATION INDUSTRY IS TAKING TO STOP THE SPREAD OF COVID-19
The North Carolina Department of Transportation (NCDOT) and their partners expect all parties involved in
the delivery of transportation projects to abide by the guidelines issued from the Centers for Disease
Control and Prevention (CDC) and the North Carolina Department of Health and Human Services (NCDHHS).
Response to COVID-19 is rapidly evolving; new information and guidelines may be issued from the CDC,
NCDHHS, or other state or federal agencies. NCDOT and their partners should review the current CDC and
NCDHHS guidance, including the resources listed at the end of this document, for up-to-date information
on how to respond to COVID-19. Additional guidelines may be issued by state or federal agencies that
should be followed in addition to the guidance included in this document.
Though certain Americans with Disabilities Act (ADA) requirements have been relaxed in response to the
pandemic, employers must still maintain all information about employee illness as a confidential medical
record in compliance with the ADA. If an employee is suspected of having or tests positive for COVID-19, it
is essential that management keep the identity of the employee and details related to the employee's
health confidential.
Below are precautions required by NCDOT and from encroaching parties and their contractors performing
construction within NCDOT Rights of Way. The term employee refers to any person on a job site within
NCDOT right of way for the purpose of constructing or inspecting the work related to construction of a
facility under an approved encroachment agreement and where that employee may or may not be under
employment by or under contract to NCDOT.
EMPLOYEE WELLNESS
• If an employee has not yet reported to work and develops any COVID-19 symptoms (i.e. fever,
coughing, or shortness of breath) — STAY HOME and immediately:
o Call a health care provider
o Self -Isolate
o Communicate with your supervisor
o Remain calm and follow all instructions from your health care provider
• Employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath)
upon arrival to work, or become sick during the day, should be separated from others and sent
home immediately. The potentially affected employees should immediately follow the steps
outlined above, which includes immediately contacting a health care provider.
• Should an employee show symptoms of acute respiratory illness or be diagnosed with COVID-19, all
other employees who have worked in close proximity to the affected employee during the last 14
Updated: 411112020 Page 1

Workforce Safety Plan: COVID-19 NCDOT Encroachment ID#:
E031-071-20-00061
days and all encroachment points of contact indicated at the end of this plan should be notified of
potential exposure to the disease without identifying the affected employee.
• Consideration should be given to employees at "High Risk" of severe illness from COVID-19, who,
per NCDHHS, include employees:
o Over 65 years of age, OR
o With underlying health conditions including heart disease, lung disease, or diabetes, OR
o With weakened immune system
• "High Risk" Employees should be given the opportunity to discuss alternate work
arrangements/duties with their employer or take leave according to their company policies.
• For guidance on confirmed positive tests for COVID-19, refer to the most recent version of the
"COVID-19 Guidance for Employees on Encroachment Job Sites within NCDOT Right of Way"
located on last page of this plan.
PERSONAL HYGIENE
• Clean hands often by washing with soap and water for 20 seconds. If soap and water are not
available and hands are not visibly dirty, an alcohol -based hand sanitizer that contains 60%-95%
alcohol may be used.
• Avoid touching your eyes, nose, mouth, or other parts of your face.
• Do not breathe, cough, or sneeze on another person or into the open air. Employees should cover
their noses and mouth with a tissue when coughing or sneezing (or an elbow or shoulder if no
tissue is available).
• A facemask for covering nose and mouth is encouraged on the job site.
• Appropriate gloves are encouraged while performing functions of the job.
CLEANING/DISINFECTING
• Wash stations and/or hand sanitizer are encouraged on each project site.
• Appropriate cleaning staff should clean frequently touched surfaces and objects with disinfectants
at a minimum of once per day.
o Office/buildings: door knobs, light switches, phones, computers/keyboards, copy machines,
elevator buttons, toilets, faucets, sinks, countertops, paper towel dispensers, desktops,
handrails, folders, vending machines, counters, tables, cabinets/knobs, etc.
o Shop Yard/Jobsite: vehicle/equipment door handles, keys, gear shifts, steering
wheel/operator controls and levers, fuel pump dispensers, touch points on machinery, etc.
o Electronic equipment: cell phones, computers, keyboards, etc.
• Appropriate cleaning staff should sanitize/disinfect facilities and work areas after persons
suspected/confirmed to have COVID-19 have been in the facility or work area.
Updated: 411112020 Page 2

Workforce Safety Plan: COVID-19 NCDOT Encroachment ID#:
E031-071-20-00061
GENERAL
o It is recommended to close off access to areas used by the ill persons and wait as long as
practical, 24 hours if possible, before beginning cleaning and disinfection to minimize
potential for exposure to respiratory droplets. Open outside doors and windows to increase
air circulation in the area if possible.
o Appropriate cleaning staff should clean and disinfect all areas used by the ill persons,
focusing especially on frequently touched surfaces.
• Increase communication measures between all parties regarding schedule, daily activities, etc. to
reduce/minimize worker exposure in accordance with but not limited to the requirements below.
• Minimize on -site personnel such as subcontractors, work crews, QC personnel, and inspection staff
to those required for that day's activities. If work is postponed or cancelled, immediately notify
appropriate parties.
• Practice "Social Distancing" whenever feasible. Social Distancing is designed to limit the spread of a
disease by reducing the opportunities for close contact between people. All personnel have the
responsibility to remind each other to stay 6 feet or more apart. Examples of Social Distancing
include:
o Reducing face-to-face exposure by using conference calls and video conferencing
■ If an in -person meeting is absolutely required and cannot be rescheduled or
attended remotely, the meeting is limited to a maximum of 10 people while
maintaining Social Distancing of 6 feet or more.
o Avoiding unnecessary travel
• Do not congregate at lunch or breaks. Bringing your lunch is encouraged.
• No communal coolers or drink stations are allowed. Supervisors should confirm with employees
prior to beginning work for appropriate hydration and nutrition availability to employees for the
duration of the employee's shift and without direct contact with others on the job site.
• First line of communication should be by phone, rather than in -person.
• Do not shake hands.
• Do not share iPads, tablets, pens, or clipboards for signing or any other purpose. Take pictures as
proof of attendance at meetings.
• Sharing of Personal Protective Equipment (PPE) is strictly prohibited.
• Vehicles, equipment, and tools
o Limit the number of people riding in a vehicle together.
o Wipe down and disinfect vehicles after each trip.
o As much as possible, do not share tools or equipment. If a tool or piece of equipment must
be shared, the parts of it that are touched should be sanitized between uses.
Updated: 411112020 Page 3

Workforce Safety Plan: COVID-19 NCDOT Encroachment ID#:
E031-071-20-00061
RETURN TO WORK
• The following criteria must be followed for an employee who is tested for Covid-19, or asked to
self -quarantine by health officials, or has contact with another employee with a positive test result
to return to work:
o at least a 14-day quarantine; OR
o release by a health care provider.
• In accordance with CDC guidance, the following criteria must be followed for an employee with a
positive test result to return to work:
o at least 14 days from positive test notification; AND
o at least 3 days (72 hours) have passed since recovery defined as resolution of fever without
the use of fever -reducing medications and improvement in respiratory symptoms (e.g.,
cough, shortness of breath); AND
o at least 7 days have passed since symptoms first appeared.
NCDOT may require certification of fitness to work from a health care provider.
ADDITIONAL RESOURCES
NCDOT and their partners should review the CDC and NCDHHS resources listed below for up-to-date
information on how to respond to COVID-19. Additional guidelines may be issued by state or federal
agencies that should be followed in addition to the guidelines included in this document.
• NCDHHS COVID-19 Resources:
o https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-
response-north-carolina
• NCOSHR Communicable Disease Emergency Policy
o https:Hoshr.nc.gov/policies-forms/workplace-wellness/communicable-disease-emergency
• OSHA Guidance on Preparing Workplaces for COVID-19
o https://www.osha.gov/Publications/OSHA3990.pdf
• CDC COVID-19 Resources:
o https://www.cdc.gov/coronavirus/2019-ncov/index.html
AGREEMENT
The encroaching party shall adhere to the requirements of this plan in order to continue work under their
approved encroachment agreement. Violations to this plan could result in the violating entity not being
allowed to continue work or all work ceasing as determined by the NCDOT District Engineer or Resident
Engineer.
PROJECT POINTS OF CONTACT
Updated: 411112020 Page 4

Workforce Safety Plan: COVID-19
DocuSignN lSf i:" OT
Name: �d4`& R"4-t
60327ANC80B486—
Phone #: [phone]
NCDOT Encroachment ID#: E031-071-20-00061
Encroaching Party (Primary Contact)
Name: Amanda Gapski
Phone #: [phone]
Primary Contractor to Encroaching Party
(Point of Contact)
Name: Aaron Williamson
Phone #: [phone]
Updated: 411112020 Page 5

Updated: April 11, 2020
COVID-19 Guidance for Employees on Encroachment Job sites within NCDOT Right of Way
Relationship to
I
CONTACT GROUP
What your CREW Should Do What PROJECT SITE Personnel
Confirmed
POSITIVE Test
What YOU Should Do
Should Do
Exposure within 6' and longer than 10 minutes
No exposure within 6' and longer than 10 minutes
YOU
Advise of POSITIVE test without identifying
Advise of POSITIVE test without identifying the
the affected employee*
affected employee*
Employee
Ak
Notify your supervisor
Directly exposed crew self -quarantine for 14
Site personnel without direct contact may
follow
/ LTA
I—H
Self-quarantine for 14 days
days
continue onsite work or their company
policy
Continue hygiene & disinfecting measures
Continue hygiene &disinfecting measures
+ You
Advise of POSITIVE test without identifying
Direct Contact
the affected employee*
Interaction with an
W W
Self -quarantine for 14 days
Crew may continue onsite work or follow
Advise of POSITIVE test
infected person
within 6' and longer
their company policy
Continue hygiene & disinfecting measures
than 10 minutes
Continue hygiene & disinfecting measures
You
You may continue onsite work or follow
Secondary
W W W
your company policy
Continue hygiene & disinfecting measures
Continue hygiene & disinfecting measures
Contact
�� �� ��
Continue hygiene &disinfecting measures
♦ You
Two or more
Ak AILPersons
Continue hygiene & disinfecting measures
Continue hygiene & disinfecting measures
Continue hygiene & disinfecting measures
Removed from
Contact
NCDOT District Engineer/Resident Engineer notifies Encroaching Party's primary point of contact and Contractor Point of
*Notification
NCDOT employee / agent tests
Contact, CDC and, if Resident Engineer has oversight for the job site, FHWA any Consultant Firms working for NCDOT
Protocol
POSITIVE
Encroaching party representative notifies other Contractors, Sub -Contractors and Suppliers with exposed Employees
(Comply with HIPAA
& ADA
Encroaching party representative or Contractor point of contact notifies appropriate NCDOT District Engineer or Resident
confidentiality
Encroaching Party or Contract crew
Engineer and all other Contractors, Sub -Contractors and Suppliers with exposed Employees
requirements)
member on job site tests POSITIVE
NCDOT notifies CDC, and as appropriate, FHWA and any Consultant Firms working for NCDOT
Joint Workforce Safety Plan: COVID-19 Page 6

ROY COOPER
Go�
WCHAEL S. REGAN
sandy
NDCHAEL SCOTT
Dhrctar
Mr Rolfe Latin
GPM Southeast, LLC
8565 Magellan Parkway, Suite 400
Richmond, VA 23227
Dear Mr. Latin:
NORTH CAROLINA
&vbona-0V0W Quaft
February 12, 2020
Re: Review of Groundwater Monitoring Report (Feb. 2020)
GPM 3059
115 US Highway 117 South
Burgaw, Pender County
Incident Number: 19300
Risk Classification: Intermediate
Ranking: 10187 D
The UST Section, Division of Waste Management, is in receipt of the Monitoring Report dated February
10, 2020. This report summarizes the recent groundwater monitoring event. The DWM generally agrees
with your recommendations: quarterly free product checks, groundwater sampling, deployment of socks,
and off -site assessment.
If you have any questions regarding the actions that must be taken in this letter, please contact me at the
address or telephone number listed below.
Sincerely*Mike
lone P.G.
Hydrogeologist
Wilmington Regional Office
UST Section, Division of Waste Management, NCDEQ
cc: Daniel Fisher, CES, electronic copy only
North Carolina Department of Environmental Quality J Division of Waste Management
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, NC 28405
910.796.7215

VERIFICATION OF COMPLIANCE WITH
ENVIRONMENTAL REGULATIONS
(Check Appropriate Box)
Permits from the N.C. Department of Environment and Natural Resources and the
U.S. Army Corp of Engineers are not required for this project. However, all applicable
federal and state regulations have been followed.
The required permits from the N.C. Department of Environment and Natural Resources
and the U.S. Army Corp of Engineers have been obtained for this project. Copies of
permits and Completion Certificates are attached.
aAll applicable NPDES Stormwater Permit requirements have been met for this project.
(The applicant should contact the N.C. Division of Water Quality in Raleigh to determine
if a stormwater permit is required.)
❑� The project is in compliance with all applicable sedimentation and erosion control laws
and regulations.
Project Name:
Township:
Project Engineer:
Project Contact:
Applicant's Name:
Date Submitted:
Form VCER-1
June 1, 2006
GPM 3059
Burgaw
David M. Cox, L.G.
Aaron Williamson
CES of NC, PLLC
5/8/2020
County:
Phone No.:
Pender
540-343-6256
P.E. SEAL

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-I�
NAW�NVIRONMENTAL
WELL CONSTRUCTION sERVICES
LOCKABLE CAP
PROTECTIVE COVER
MATERIAL
traffic bearing steel with stainless steel bolts
DIAMETER
8 inches
LENGTH
1 feet
SETTING DIMENSIONS
2.0 x 2.0 x 0.5 d feet
HEIGHT ABOVE GROUNE
0 feet
WELL CASING / RISER
MATERIAL
polyvinyl chloride (PVC)
DIAMETER
2 inches
LENGTH
2 feet
JOINT TYPE
locking thread
ANNULAR FILL
MATERIAL
Cement grout slurry
THICKNESS
0.25 feet
ANNULAR SEAL
TYPE
Sodium-bentonite pellets
THICKNESS
1 feet
FILTER PACK
TYPE
#2 filter sand
DISTANCE ABOVE SCREEI
0.5 feet
WELL SCREEN
MATERIAL
PVC
DIAMETER
2 inches
LENGTH
10 feet
SLOT SIZE
0.01-inch horizontal slot
DEPTH TO BOTTOM OF WELL
12 feet
DEPTH TO THE BOTTOM OF
FILTER SAND
12.25 feet
BOREHOLE DIAMETER
8 inches
WELL ID:
(TBD)
L1 =
0.25
feet
INSTALL DATE:
(TBD)
L2 =
2
feet
PROJECT:
GPM 3059
L3 =
10
feet
PROJECT NUMBER:
9.0625
L4 =
12.25
feet
DRILLING METHOD: 4.25" Inner Diameter Hollow Stem Au
FACE COMPLETION: At Grade

Legend
Mw—t la Monitoring Well (Type II)
T-1 ® Monitoring Well (Type III)
cv Utility/Power Pole
)�c Light Pole
Approximate Property Line
OE Overhead Electric Line
Water Line
Fence
® Stormwater Inlet
Sanitary Sewer Manhole
Water Meter
►� Water Valve
Fire Hydrant
• Bollard
■ Communication Pedestal
® Liquefied Petroleum Tank
Note: Utility and former UST
locations are approximate
0 20' 40' 80'
1 inch equals 40 feet
CF.S@NC-CJL
CLIENT: GPM Southeast, LLC
115 US Highway 117 South Figure 2
LOCATION: Burgaw, North Carolina
GPM 3059 (Former Scotchman #3059)
Site Map
Groundwater Monitoring Report