WS0801055_Application_20200608

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: 6/4/2020
2. County:
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
3. Applicant Turner Farms LLC Telephone: [phone]
Applicant's Mailing Address: PO Box 1139 Wallace NC. 28466
Applicant's Email Address (if available):
4. Contact
Person (if different than Applicant):
AJ Linton
Telephone: [phone]
Contact
Person's Mailing Address: PO Box
1139 Wallace NC, 28466
Contac Person's Email Address (if available): alinton(o�murfam.com
5. Property Owner (if different than Applicant):
Owner's Mailing Address:
Owner's Email Address (if available):
Telephone:
6. Property
Physical Address
(including
PIN Number):
160 Farrow
Wood Lane
PIN#248600618836
City:
Warsaw
County:
Duplin
Zip Code: 28398
7. Intended use of Well or Well System: poultry farm
(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? yes
(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): 86,650
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
4" well 86,650 GPD x 2 2" well 43,325
11. Is this a public well or well system? no
If yes, give Project Engineer and contact information:
If yes, give Public Water ID Number:
12. Well
Contractor: Skippers
Well Drilling
&Puma
Well Contractor Certification No.: 2481A
Well
Contractor Address:
107 Oakland
Ave. Leland
NC 28451
PROPOSED WELL CONSTRUCTION INFORMATION
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
2. No. of wells to be constructed in unconsolidated
Continued on Reverse

NORTH CAROLING 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
n 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: 06/03/2020
2. County: Duplin
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
3. Applicant Envirotech Farms LLC Telephone: [phone]
Applicant's Mailing Address: PO Box 1139 Wallace NC 28466
Applicant's Email Address (if available):
4. Contact
Person
(if different than Applicant):
AJ Linton
Telephone: [phone]
Contact
Person's
Mailing Address: PO Box
1139 Wallace NC 28466
Contac Person's Email Address (if available): alinlonCa murfam.com
5. Property Owner (if different than Applicant):
Owner's Mailing Address:
Owner's Email Address (if available):
Telephone;
6. Property Physical Address (including PIN Number): 579 Tapp Farm Road PIN#346600326631
City: Pink Hill County: Duplin Zip Code: 28572
7. Intended use of Well or Well System: poultry farm
(examples: irrigation, consumption, etc.)
8. Will the proposed water supply well or well system replace or be added to an existing well or well systems yes
(If yes, complete questions 7 and 8) (lf 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): 173.300
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields
4" well 86 650 GPD 2" well 43 000 GPD
11. Is this a public well or well system? no
If yes, give Project Engineer and contact information:
If yes, give Public Water ID Number:
12. Well
Contractor: Skippers
Well Drilling
&Pump
Well Contractor Certification No.: 2481A
Well
Contractor Address:
107 Oakland
Ave. Leland.
NC 28451
PROPOSED WELL CONSTRUCTION INFORMATION
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
b. Estimated well depth
c. Screen intervals
d. Sand/gravel pack intervals
e. Type of casing material and thickness
f. Grout horizons
g. Well Head completion details
2. No. of wells to be constructed in unconsolidated
material: 2
3. No. of wells to be constructed in bedrock:
4. Total No. of wells to be constructed: 2
(add answers from 2 and 3)
5. Estimated beginning construction date: 6/10/2020
6. Estimated construction completion date: 6/10l2020
Continued on Reverse

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.
G. 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://www.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
the Wat 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
Vice President
Agent Title of Applicant or *Agent
etfml„urner__�,.�` * If signing as Agent, attach authorization agreement stating
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
Administrative Code, Subchapter 2C).
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 sion 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]
GW-22W Rev. 3-1-2016

DIAGRAM OF PROPOSED
Straight -Screened CONSTRUCTION SPECIFICATIONS
or
Gravel -packed Well
(Constructed in unconsolidated formations)
� r
Open -End Well
(Constructed is consolid-
ated formations)
A) Casing: �f
Y 1) Inner ; 3•pla
ft. (depth) ft. (into rock)
ib 2) Outer: t e
�)lti z e� yp I. D- lbs./ft.
ft, (depth)
c o
C I) Inner Casing: ft. to
2) Outer Casing: ftm to f t.'rj %rrrrrrrnr
c C) Screed 4. n Rock
( type. D.
u 3 c ft, to- PaS ft.
cl
. 01
cacc a
a tL ro
f bL C�
Gk' 22A
(size)
(Fill in each blank that applies and use appropriate diagram
to show proposed construction including, but not limited to,
casing (outer and inner), sealing material (cement, clay,
etc.), packers, screens, gravel, chemical feed lines, etc.)
(Previously
prepared maps may be submitted provided they con-
tain information required in item (g) of the application),
Rock r

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.
2. As required by 15A NCAC 02C .0105(g)(3)1 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://www.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed wells) will be constructed in accordance with approved specifcations and conditions of
the Water Supply Well onstruction 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
Signature of Appli _ g® Title of Applicant or *Agent
ieff Turner---"`-----J�"" * If signing as Agent, attach authorization agreement stating
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
Administrative Code, Subchapter 2C).
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 sion 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]
GW-22W Rev. 3-1-2016

�: �a w
is, 1F .

DIAGRAM OF PROPOSED
Straight -Screened CONSTRUCTION SPECIFICATIONS
or
Gravel -Packed Well
(Constructed in unconsolidated formations)
1 Div i ko
Open-E_ Well
(Constructed in consolid-
ated formations)
A) Casing:
i(
1) Innef--_.">'pe S. D.
ft. (depth) ft. (into rock)
2) Outer;
))(li z e, te I. D. lbs./ft.
ft. (depth)
6 �
;tea Z''p� B) -- f• �%�t� t}�u
1 d3C
Iuaer Casing; 1 ft. to � ft.
2) Outer Casing: ft. to
ft.TntTrrr'7
�� Rock
C) Screed(s� J . v_type_I. ➢.
5 � C) ft. to ft.
e o
a ft* to_.. ft.
0�
tev ro
c` OLr>
f by D�
GW 22A
n.�
(size)
(Fill in each blank that applies and use appropriate diagram
to show proposed construction including, but not limited to,
casing (outer and inner), sealing material (cement, clay,
etc.), peckers, screens, gravel, chemical feed lines, etc,)
�------�
(Previously prepared maps may be submitted provided they con—
tain information required in item (g) of the application),
Rock _

6< `