WV0400056_Application_20200901

North Carolina Department of Environmental Quality (DEQ) — Division of Water Resources (DWR)
VARIANCE APPLICATION FOR WELL CONSTRUCTION STANDARDS:
WATER SUPPLY WELLS UNDER 15A NCAC 02C .0107
All water supply wells not considered "Private Drinking Water Wells "and including irrigation, industrial, and commercial wells.
WELLS OTHER THAN WATER SUPPLY UNDER 15A NCAC 02C .0108
Including monitoring and recovery wells.
PRIVATE DRINKING WATER WELLS UNDER 15A NCAC 02C .0300
Print clearly or type information. Illegible submittals will be returned as incomplete.
DATE: August 10 2020
Existing permit number (if applicable) W[ Issued Date: Exp. Date:_
Permit No. for new projects (to be completed by DWR/DPH): W10400551 (Permit Application Number)
A. WELL OWNER(S) — For single family residences, list all persons appearing on property deed. For all others, list name
of the business/government agency and person and title with delegated signature authority:
James Wells, Vice President EHS
Mailing Address: 526 South Church Street, Mail Code EC13K
City: Charlotte State: NC Zip Code: 28202 County: Mecklenburg
Day Tele No.: 980-373.6800 Cell No.:
EMAIL Address: [e-mail] Fax No.:
B. PHYSICAL LOCATION OF WELL SITE
(1) Parcel Identification Number (PIN) of well site: 6982642715, 6982185694
County: Stokes
(2) Physical Address (if different than mailing address):
Belews Creek Steam Station
3195 Pine Hall Road
City: Belews Creek County: Stokes Zip Code: 27009
C. WELL DRILLER INFORMATION (if known)
Well Drilling Contractor's Name: Geologic Exploration (GEX)
NC Well Drilling Contractor Certification No.: 2851-A
Company Name:
City: Statesville State: NC Zip Code: 28625
Contact Person: Steve Taylor
County:IredeO
Day Tele No.: 704-872-7686 Cell No.:
EMAIL Address: stavlor0)2exnc.com Fax No.:
OW-22V Variance Request Form Rev. 7.13-2020 Page I

D. REASON FOR VARIANCE REQUEST — Include type of well(s) to be constructed; rule for which the variance is
being requested; description of how the alternate construction will not endanger human health and welfare and the
environment; and reason why construction and/or operation in accordance with the standards is not technically feasible
and/or provides equal or better protection of the groundwater (refences to attached documents are acceptable).
Based on the distribution of COI and the vertical hydraulic connection through the saprolite, transition, and bedrock
zones, Duke Energy is proposing to install the extraction wells with well screen and/or sand pack material across all
three zones. Given the interconnectivity of the hydrostratigraphic zones, Duke Energy is submitting the attached
variance form for "Wells Other Than Water Supply" under 15A NCAC 02C .0108 based on the following:
Construction of the extraction wells with screens across the three water -bearing units will allow for more effective
remediation of groundwater.
Site -related COI are present in groundwater in all three zones.
Corrective action to address these COI in groundwater is also proposed in all three zones.
Extraction of groundwater provides the necessary hydraulic connection between the COI- affected groundwater
zones and the proposed clean water infiltration.
The proposed well construction is not expected to generate a potential risk to human health or groundwater.
Water supply wells are not located within 500 feet of the proposed extraction wells.
DI. ATTACHMENTS — Provide the following information as attachments to this application:
(1) A map showing general location of the property (including road names, NC State Route Number, distances, any
key landmarks, etc.) sufficient for finding the well location.
Reference Figures D-1 and D-2 of UIC Permit Application No. W10400551.
(2) Detailed site map with scale showing location of proposed well relevant to septic system(s), building
foundations, property lines, water bodies, potential sources of contamination, other wells, etc.
See Figure F-1. There are no septic systems, building foundations, properly lines, water bodies or potential
sources of contamination within 250-feet of the proposed extraction wells. Existing monitoring wells are
shown on the figure.
(3) Submit a copy of the local well permit application and site evaluation map (if applicable).
Not Applicable
(4) Any other information relevant to the variance request such as a well construction diagram showing proposed
well liner or atypical construction materials/methods.
See Attachment D
F. SIGNATURE(S) C I WV4Ai
of
James Wells, Vice President EHS Programs and Environmental Sciences
�Prrriiinttt or Type Well/Property Owner(s)
,
Signature of Person Resp�ble�Construction
(Typically, the well driller)
GW-22V Variance Request Fonn Rev. 7-13-2020 Page 2

Steve Taylor, Geologic Exploration
Print or Type Name of Person Responsible for Well Construction
(Typically, the well driller)
N/A
Signature of County Environmental Health Specialist (for Private Water Wells)
N/A
Print or Type Full Name and Title of County Environmental Health Specialist (for Private Water Wells)
Per I5A NCAC 02C.0118 the Secretary of the Division of Water Resources or the Division of Public Health may require
submittal of information deemed necessary to make a decision on the variance, may impose conditions as part of the
decision, and shall respond in writing to the request within 30 days of receipt of the variance request. A variance
applicant who is dissatisfied with the decision of the Director may commence a contested case by filing a petition as
described in G.S. 150B-23 within 60 days after receipt of the decision.
G. SUBMITTAL INSTRUCTIONS
(1) For the following types of water supply wells only:
(a) Private Drinking Water Wells under 15A NCAC 02C .0300
(b) Irrigation Wells underl5A NCAC .02C .0107 with a designed capacity of less than 100,000 gallons per day
and located on the same property as an on -site wastewater system permitted by a local health department. .
Prior to submittal of the variance for these types of wells, please contact your regional environmental health specialist
by visiting: hap://ehs.ncpublichealth.com/contacts:htm
Submit one copy of the completed variance application to:
North Carolina Department of Health and Human Services
Division of Public Health — Environmental Health Section
On -Site Water Protection Branch
1632 Mail Service Center
Raleigh, North Carolina 27699-1632
(2) For the following types of wells only:
(a) All Water Supply Wells under I SA NCAC 02C .0107 other than the ones listed under (1) above
(b) Wells Other than Water Supply under 15A NCAC 02C .0108. If these wells are to be constructed on property
not owned by the well owner or applicant, please also attach and submit a completed Application to Construct
a Monitoring or Recovery Well System (GW-22MR) found on our website at:
hgg //de nc aov/about/divisions/water-resources/water-resources-permits/wastewater-brancWground-water-
protect i on/ground-water-application s
Submit one copy of the completed
variance application to the Division
of Water Resources Regional Office
serving the area in which the well
will be located:
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Telephone: [phone]
Fax: [phone]
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Telephone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Telephone: [phone]
Fax: [phone]
OW-22V Variance Request Form Rev. 7-13-2020 Page 3

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FIGURE D-1
SITE LOCATION MAP
BELEWS CREEK STEAM STATION
PILOT STUDY WORK PLAN
BELEWS CREEK, NORTH CAROLINA
BRAWN BY T'ISNEER DATE 05/0512020 GRAPHIC Si
REVISED BY. DATE- 1000 0
CHECKEBBY. DATE
APPROVED BY', DATE'. IN FEEL
PROJECT MANAGER.
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