HomeMy WebLinkAboutWM0401265_Monitoring Well Permit Application_20201125NORTH 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: November 13, 2020
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring Wells
4. Applicant: Sherwin-Williams Company (c/o Jennifer Deka) Telephone: 216-566-1618
Applicant's Mailing Address: 101 Prospect Avenue, Cleveland, OH 44115
Applicant's Email Address (if available): Jennifer. L.Deka6a�sherwin.com
5. Contact Person (if different than Applicant): Nick Shore (AECOM) Telephone: 919-461-1485
Contact Person's Mailing Address: 1600 Perimeter Park Dr, Suite 400, Morrisville, NC 27560
Contact Person's Email Address (if available): nick.shore6a�aecom.com
6. Property Owner (if different than Applicant): Norfolk Southern Telephone: 757-629-2817
Property Owner's Mailing Address: Three Commercial Place, Norfolk, VA 23510
Property Owner's Email Address (if available): Diane. HoganCa�nscorp.com
7. Property Physical Address (Including PIN Number) Norfolk Southern Right -of -Way (PIN NA)
City Greensboro County Guilford Zip Code 27407
8. Reason for Well(s): environmental assessment
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9. Type of facility or site for which the well(s) is(are) needed: industrial
(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).
none
11. Type of contaminants being monitored or recovered: chlorinated solvents and metals
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes, 7
Existing Monitoring or Recovery Well Construction Permit No(s).: Unknown
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 125
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: Geologic Exploration Certification No.: 2580A
Well Contractor Address: 176 Commerce Blvd., Statesville, NC 28626
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 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
material: 1
3. Number of wells to be constructed in bedrock: 0
5. How will the well(s) be secured? Locking well cap
6. Estimated beginning construction date: 12-14-20
4. Total Number of wells to be constructed: 1 7. Estimated construction completion date: 12-18-20
(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
Z�>dA2, Env. Project Manager
Sign�Applicant or *Agent Title of Applicant or *Agent
Jennifer Deka * If 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
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 agreement
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: (828) 296-4500 Phone: (919) 791-4200 Phone: (910) 796-7215
Fax: (828) 299-7043 Fax: (919) 571-4718 Fax: (910) 350-2004
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: (910) 433-3300
Fax: (910) 486-0707
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: (704) 663-1699
Fax: (704) 663-6040
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: (252) 946-6481
Fax: (252) 975-3716
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: (336) 776-9800
Fax: (336) 776-9797
JR Rev. 3-1-2016
SHERWIN-WILLIAMS.
November 16, 2020
The Sherwin-Williams Cam pany
101 W. Prospect Avenue
1180 Midland Building
Cleveland, Ohio 44115
Subject: Authorization to Sign Monitoring Well Permit Applications
Jen:
You wish to submit, on behalf of The Sherwin-Williams Company, six Monitoring Well Permit Applications.
Three applications will be submitted to Guilford County, North Carolina and three to the North Carolina
Department of Environmental Quality. The Permits are in relation to property at 3125 Spring Garden St.,
Greensboro, NC. The application requires that you have written authorization from Sherwin-Williams to
act as its agent regarding the application. This letter serves as such authorization.
Sincerely,
Stephen J. Perisutti
Vice President, Deputy General Counsel and Assistant Secretary, The Sherwin-Williams Company
r
NORFOI-K SOUMERN �
Norfolk Southern Corporation
Law Department
Three Commercial Place
Norfolk, Virginia 23510-9241
Writer's Direct Dial Number
Phone: 757.629-2817
Fax: 757-629-2607
E-mail: Diane.Hogan@nscorp.com
June 18, 2019
Ms. Jennifer L. Deka
The Sherwin-Williams Company
Corporate Environmental Health, Safety & Regulatory Affairs
101 West Prospect Avenue
Cleveland, Ohio 44115
Diane Hogan
Paralegal
RE: Greensboro, NC -- Yd Extension to Right of Entry Agreement between The Sherwin-Williams
Company and Norfolk Southern Railway Company; Norfolk Southern Law File No.
ROE00048
Dear Ms. Deka:
Enclosed is a fully executed Right of Entry Agreement regarding the referenced matter for your file.
If you have any questions, please feel free to contact our office.
Sincerely,
Jaxo_ dcr",—
Diane Hogan
/dh
Enclosure
NS Law File No. ROE00048
ENVIRONMENTAL RIGHT OF ENTRY AGREEMENT
THIRD AMENDMENT
This Amendment is entered into as of 11 , 2011, between THE
SHERWIN-WILLIAMS COMPANY ("Licensee"), and NORFOLK SOUTHERN
RAILWAY COMPANY ("Company"), a Virginia corporation.
WHEREAS, Company and VALSPAR COATINGS, INC. had entered into an
Environmental Right of Entry Agreement ("Agreement"), made as of January 11, 2005
and as amended by First Amendment, January 11, 2008, and a Second Amendment,
January 11, 2011, (collectively, the "Agreement"), covering the entry of Licensee onto
Company's Property at 3215 Spring Garden Street, Greensboro, North Carolina for the
purpose stated in the original Agreement
WHEREAS, The Sherwin-Williams Company has assumed responsibility for
obligations of Valspar Coastings, Inc. related to the Property as set forth in the
Agreement.
WHEREAS, The Agreement expired January 11, 2014 and Licensee wishes to
renew and extend the term of the Agreement, subject to the terms and conditions set
forth in the Agreement and as set forth in this amendment to the Agreement (the "Third
Amendment").
WHEREAS, Licensee wishes to amend the scope of work covered by the
Agreement as outlined in the scope of work in Exhibit A to include monitoring of existing
wells and installation of additional wells, subject to the terms and conditions set forth in
the Agreement and as set forth in this Third Amendment.
NOW, THEREFORE, the parties, acknowledging mutual consideration and
intending to be legally bound, agree as follows:
The Agreement is hereby renewed, effective as of January 11, 2014, including all
Exhibits thereto, and as amended herein.
2. The term of the Agreement is extended to and includes May 10, 2022.
3. The scope of work covered by the Agreement is amended to include monitoring
of existing wells and installation and monitoring of additional monitoring wells, as
set forth in the scope of work in Exhibit A hereto. Figure 1 to Exhibit A depicts
the approximate location of the existing monitoring wells.
4. Paragraph 2 of the Agreement is hereby modified to include a new subsection 2.
e. and 2. f.
2. e. To the extent any statements in the scope of work included in
Exhibit A contradict or are inconsistent with the terms of this
Agreement, the terms of this Agreement control.
FNS Law File No. ROE00048
2. f. Licensee agrees to keep a copy of this Agreement at the Property
while conducting any of the work contemplated hereunder and to
make it available upon demand by any employee or agent of
Company.
5. Paragraph 3 of the Agreement is hereby modified to reflect that Company's
Division Engineer is Justin Brooks at (765) 618-2039.
6. Paragraph 9 of the Agreement is deleted in its entirety and replaced with the
following:
9. No work of any character shall be started on the Property until:
a. Certificates of Insurance, specifying that the policies are applicable
to the particular work, have been furnished to and accepted by Company as
evidence that Licensee and/or its contractor and subcontractor maintain the
following insurance coverages:
(i) Workers' Compensation Insurance in satisfaction of statutory
requirements of the state where the property covered by this
agreement is located. Also, Employers' Liability Insurance having
limits of not less than $500,000 each accident, $500,000 per
disease - policy limit, and $500,000 per disease - each employee.
(ii) Comprehensive General Liability Insurance having a combined
single limit of not less than $2,000,000 per occurrence for all loss,
damage, cost and expense, including attorney's fees, arising out of
bodily injury, liability and property damage liability during the policy
period. Such policy shall be endorsed to name Company as an
additional insured and shall include a severability of interests
provision. In addition, the policy of Licensee and/or its contractor
and subcontractor shall be endorsed to reflect Contractual Liability
Insurance specifically relating to the indemnity provisions of this
agreement and any exclusion for construction or demolition
activities (including installing wells or boring holes, but not for work
done by means of a hand augur) conducted within 50 feet of
railroad tracks shall be deleted from Licensee's policy.
(iii) In the event Licensee cannot obtain contractual liability insurance to
cover the obligations assumed under this Environmental Right of
Entry Agreement, Licensee or its contractor shall procure and
furnish to Company either:
(A) a risk financing fee of $1,000.00 (herein called the "Risk
Financing Fee"), in exchange for which Company will include
the project under Company's Master Railroad Protective
Liability Insurance Policy; or
2
F
S Law File No. ROE00048
(B) a Railroad Protective Liability Insurance Policy having a
combined single limit of $2,000,000 per occurrence and
$6,000,000 in the aggregate applying separately to each
annual period. Said policy shall provide coverage for all
loss, damage, or expense arising from bodily injury and
property damage liability, and physical damage to property
attributed to acts or omissions at the job site. Said policy
shall name Company as the named insured and the policy
shall be underwritten on Insurance Services Offices Form
No. CG 00 35 10 01 or its equivalent.
(iv) Automobile Liability Insurance having a combined single limit of not
less than $1 million per occurrence. Said policy shall name
Company as an additional insured and shall include a severability
of interests provision.
b. Company has advised Licensee that limits, form, and substance of
insurance policies and certificates of insurance are satisfactory to Company. The
original Railroad Protective Liability Insurance Policy if applicable and certificate
of liability insurance should be forwarded to Risk Manager, Norfolk Southern
Corporation, Three Commercial Place, Norfolk, Virginia, 23510. The furnishing
by Licensee of such insurance and the acceptance of the same by Company is
not intended to and shall not reduce, limit, affect, or modify the primary
obligations and liabilities of Licensee under the other provisions of this
agreement.
C. Authorized representatives of Licensee have met with Company's
Division Engineer or his representative and also with a representative of
Company's Communications and Signals Department to receive any instructions
Company may have concerning Licensee's activities on the Property. Licensee
agrees to follow, at its expense, all such instructions, and in such manner as is
satisfactory to Company.
7, Paragraph 11 of the Agreement is deleted in its entirety and replaced with the
following:
11. Within 30 days of termination of this Agreement or completion of any
groundwater sampling project, whichever first occurs, Licensee agrees to remove
any well(s) in accordance with state procedures and provide Company evidence
of such removal. Removal procedures shall include pulling or reaming the well
casing(s) and grouting the hole(s) to ground surface in accordance with U.S.
Environmental Protection Agency and state standards and/or guidelines,
including at a minimum grouting from the bottom of the borehole/well to the
surface. Within 30 days of termination of this Agreement, Licensee also agrees to
restore the Property and shall leave it free of debris and holes in the ground and
in such condition as is satisfactory to Company.
NS Law File No. ROE00048
8. Paragraph 14.b. of the Agreement is deleted in its entirety and replaced with the
following:
14. b. Licensee agrees to provide Company with complete copies of the
results of the analyses of any samples taken from the Property,
along with maps depicting locations of such samples, and any
reports generated using such data, as well as any notices or
materials submitted to or received from any governmental or quasi -
governmental entity relating to the Property. The foregoing
sentence includes copies of any waste manifests, profiles, or
characterization, as applicable, of impacted soil and/or groundwater
removed from the Property. Licensee shall provide to Company
documentation, including without limitation location, dimensions,
and GPS coordinates, of areas of contamination of the Property
and soil and/or groundwater thereunder that is the subject of the
investigation and/or cleanup addressed by this Agreement.
Licensee also agrees to advise Company of any planned corrective
action, closure of any well(s), and any regulatory closure involving
the Property. Such materials shall be provided to Company in
electronic format, addressed to Company's System Director
Environmental Protection, c/o Norfolk Southern Corporation, 1200
Peachtree Street, NE, Box 13, Atlanta, Georgia 30309, or via email
address provided by Company.
9. The last paragraph in the Agreement is deleted in its entirety and replaced with a
new Paragraph 17 as follows:
17. Licensee agrees to waive any and all statutes of limitations applicable to
any controversy or dispute arising out of Paragraph 16, and Licensee further
agrees that it will not raise or plead a statute of limitations defense against
Company in any action arising out of Licensee's failure to comply with Paragraph
16.
10. A new Paragraph 18 is added to the Agreement as follows:
18. Licensee will remove from the Property all soil, fill, debris or other
materials (whether solid or liquid) removed during the activities covered by this
Agreement, including any such material that is contaminated and/or potentially
contaminated. Company assumes no responsibility for any such material and
shall not be a signatory on any waste manifests, bills of lading or other
documentation concerning this material.
11. A new Paragraph 19 is added to the Agreement as follows:
19. The provisions of Paragraphs 1, 8, 11, 16 and 17 shall survive the
expiration or earlier termination of this agreement.
4
N5 Law File No. ROE00048
In the event of any inconsistency or ambiguity between the provisions of the
Agreement and those of this Third Amendment, the provisions of this Third
Amendment shall prevail. However, except as expressly modified by this Third
Amendment, the terms and conditions of Agreement shall continue in full force
and effect.
Each of the parties therefore has caused this Third Amendment to be executed
by its duly authorized representative.
NORFOLK SOUTHERN RAILWAY
CO PANY
;V_
Title:_.,
Date: _ c� .- 1 � aG I I
THE SHERWIN-WILLIAMS COMPANY
By:
Title: V' gh,l
Date: 0141
NS Law File No. ROE00048
Exhibit A
SHERMN-MUMMS
THE SHERWIJ-WILLIPMS COMPANY
Envionmertel, Heath & Regulatoryv,ervices
101 West Presped Avenue
Cleveland, Oho 44115-1075
April 12, 2019
Sherwin-Williams would like to collect groundwater samples from the monitoring wells
on Norfolk Southern property adjacent to 3125 Spring Garden St. in Greensboro, North
Carolina.
The access agreement was in place for Valspar Coatings Inc. from approximately 2005
to 2014. Sherwin-Williams acquired Valspar in 2017 and will be resuming the
environmental remediation work on the property. See the scope of work below
describing the groundwater sample collection from MW-6 & MW 7 already installed on
the property.
The scope includes collection of groundwater samples from existing monitoring
wells MW-6 and MW-7. The scope will also include any necessary repairs to the
existing monitoring wells. It is assumed that each well is still present and in
suitable condition for sampling. A figure showing the locations of the monitoring
wells is provided as Figure 1. Multiple rounds of groundwater sampling are
planned and each sampling event will take approximately one day to complete.
Purge water generated during the sampling activities will be containerized in a 55-
gallon drum, labeled and staged at 3125 Spring Garden Street pending disposal
at a permitted disposal facility. Based on the results of the initial phase of work,
subsequent phases of investigation as deemed necessary to pursue site closure
may be conducted, including the collection of soil samples or installation of
additional monitoring wells.
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SHEWIN WILLIAMS
FORMER VALSPAR MIRROR COATINGS FACILITY
GREENSBORO, NORTH CAROLINA
Project No.: 04191420.4168 Date: 2020-04-20
SITE MAP
LEGEND
—XX—
BUILDING / STRUCTURE
PARCELBOUNDARY
FENCE LINE
RAILROAD TRACK
TOPOGRAPHIC SLOPE
MW-4 MONITORING WELL LOCATION
QQ DP-7 DIRECT PUSH SAMPLE LOCATION
® SB-3 SOIL BORING LOCATION
• Proposed Monitoring
Well Location
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APPROX. SCALE, ft.
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Site Location 3125 Spring Garden Street
AECOM Environment
1600 Perimeter Park Drilve C 1 1/2 Mile Buffer S Greensboro, NC
Suite 400 C
Morrisville, North Carolina 27560 Parcels Feet V
Phone: (919)461-1100
Fax: (919) 461-1495 Suspected WSW 0 280 560 1 ,1 20
www.aecom.com August 2019 Project #: 60603968
Client: Sherwin-Williams Greensboro
WELL ID: Proposed Type II Well
_ Project Number: 60635569
A:COM Site Location: 3125 Spring Garden Street, Greensboro, NC Date Installed: 14-Dec-20
Well Location: Coords: Inspector:
Method: 4.25"ID HSA Contractor: Geologic Exploration
PROPOSED MONITORING WELL CONSTRUCTION DETAIL
Depth from G.S. (feet) Elevation (feet)
Datum
12-inch diameter flush -mount steel vault to be set in 2'x2'x0.5' concrete pad
Top of Riser Pipe 0.0
Ground Surface (G.S.) 0.0
Describe Measuring Point:
Note: Depths are
Riser P
ipe:
Length
Diameter (ID)
Type of Material
Thickness
Grout:
Type
Thickness
Top of Bentonite
20
2"
PVC
Sch 40
neat cement
16'
Benton ite Seal Thickness
3'
Top of Sand
Top of Screen
Screen:
Len gth
10
Dia meter (ID)
2"
Slot Size
10 slot
Type of Material
PVC
Thickness
Sch 40
Type/Size of Sand
#2
Sand Pack Thickness
12
Bottom of Screen
Bottom of Tail Pipe:
Bottom of Borehole
Borehole Diameter 4.25" ID HSA
Signature
and will be adjusted based on field conditions. Not to scale.
16
19
20
30
30
30
Date