WS0801057_Application_20210316

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: 03/08/2021
2. County: Pender
3. Applicant Sidbury Development LLC
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
Applicant's Mailing Address: 6626 Gordon Road, Wilmington, NC 28411
Applicant's Email Address (if available): [e-mail]
4. Contact Person (if different than Applicant): C.J. Corvette
Contact Person's Mailing Address: P.O. Box 882, Hampstead, NC 28443
Contac Person's Email Address (if available): [e-mail]
5. Property Owner (if different than Applicant): Sidbury Development LLC
Owners Mailing Address: 6626 Gordon Road, Wilmington, NC 28411
Telephone: [phone]
Telephone: [phone]
Telephone: [phone]
Owner's Email Address (if available): [e-mail]
6. Property Physical Address (including PIN Number): 3271-12-6568-0000, 3261-76-0456-0000
City: Wilmington County: Pender Zip Code: 28411
7. Intended use of Well or Well System: Consumption/water supply well
(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? No.
(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): 3 Wells at 250 gpm = 1,080,000 gpd
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
11. Is this a public well or well system? Yes If yes, give Public Water ID Number: NC7071063
If yes, give Project Engineer and contact information:Tony Boahn, McKim & Creed, [e-mail]
12. Well Contractor: James Cornette
Well Contractor Certification No.:
2424A
Well Contractor Address: Applied Resource Management, 257 Transfer Station Road, Hampstead, NC 28443
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:
3. No. of wells to be constructed in bedrock: 3
4. Total No. of wells to be constructed: 3
(add answers from 2 and 3) 3/15/2021
5. Estimated beginning construction date:
6. Estimated construction completion date: 5/01 /2021
Continued on Reverse

ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(0(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. AD 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. 143-215.1 OB(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
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./Mm.ncwater.org)
SIGNATURES
The Applicant hereby agrees that the proposed wall(s) will be constructed in accordance with approved specifications and conditions of
the Water Supply Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina
Administrativ de, Su hapter 2C) and accepts full responsibility for compliance with these rules
Signature of Applicant or *Agent Title dI&Icant or •Agent
m G� t rt • 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
water supply wells as outlined in this Water Supply Well Construction Permit application and that it shall be the responsibility of the
appli nt t i ensure that the water supply well(s) conform to the Well Construction Standards (Title 15A of the North Carolina
Administrative Code, Subchapter 2C).
L - AJon., G. Saw
Signiffure 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
Swannenoa, 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]
GW 22W Rev. 3-1-2016

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1" X 40' PVC
Measuring Conduit
With Cap —
40' Portland
Cement Grout
140' Portland
Cement Grout
5' Bentonite�`
Grout JJ
3543
Gravel Pack
Applied Resource
Management, P C.
Hampstead, NC 28443
Well Vent 2' X 8" Riser With
I Sanitary Well Seal
TITLE:
40' X 16"
Certa Lok SDR 17
PVC Riser/Outer Casing
Top Of Castle Hayne
Limestone Aquifer
150' X 8"
Certa Lok SDR 17
PVC Riser
8" X 16" Stainless Steel
Centralizers at 50', 100',
150' and 200'
30' X 8"
0.030' Slot Well Screen
TD = Approx 180'
Proposed High Capacity
Well Construction Diagram
J 20371 I SCALE: NTS I DATE: DRAWN BY
3/09/2021 I JLLC/CJC
FIGURE:
2

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
Preliminary Well Site Approval Letter
January 13, 2020
Grady Gordon
McAdams Homes, LLC
6626 Gordon Road, Unit C
Wilmington, NC 28411
Re: Preliminary Well Site Approval
Silo Ridge Water System
NC7071063
Dear Mr. Gordon:
On January 6, 2021,1 met with Grady Gordon, McAdams Homes, and Jim Cornette, ARM, to
conduct a preliminary investigation of the proposed amended well sites W01 and W02.
The original well sites for W01 and W02 were approved in the approval letter dated
December 3, 2020. Poor water quality was found which necessitates revising the locations
of W01 and W02. The original site for W03 remains unchanged. The proposed wells have
been assigned Water System Facility (WSF) Identification Numbers and Sampling Point
Codes as indicated below.
WSF ID
Sampling
Description of Well Site
Preliminary Latitude and
No.
Point Code
Lon itude
W01
RW1
—110' NE of Sidbury Rd
34.326514,-77.772458
—125' SE of Ho ans Trail
W02
RW2
—780' W of Blake Farm Blvd.
_
34.328367,-77.767764
—900' SE of Ho ans Trail
W03
RW3
—250' NE of Sidbury Road
34.338217,-77.788814
This letter is provided by Public Water Supply (PWS) Section, in accordance with
rule .0305(b) of the Rules Governing Public Water Systems (15A NCAC 18 C), to provide
permission to drill wells at the listed sites in order to establish water quality and quantity
and suitability of the wells as a source for a public water system.
In addition, this "preliminary well site approval" is to acknowledge that according to the
information and documentation provided, we understand that the proposed wells are
North Carolina Department of Environmental Quality I Division of Water Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, North Carolina 28405
�� /'� 910.796.7215

located on lots so that the area within 100 feet of the wells is owned or controlled by the
person supplying the water and that the supplier of water will protect the well lots from
potential sources of pollution and construct landscape features for drainage and diversion
of pollution as required in rule .0203(1). In addition, we understand that you have
determined that the proposed well locations satisfy the minimum horizontal separation
distances specified in rule .0203 (2) and summarized in the following table:
Distance (in
Potential Source of Pollution
feet
100
• From any sanitary sewage disposal system, sewer, or sewer pipe (unless sewer is
constructed of water main materials and joints, in which the sewer pipe shall be
at least 50 feet from the well.
• From buildings, mobile homes, permanent structures, animal houses or lots,
cultivated areas to which chemicals are applied.
• From surface water.
• From a chemical or petroleum fuel underground storage tank with secondary
containment.
• From any other potential source of pollution not listed in this table.
200
• From a subsurface sanitary sewage treatment and disposal system designed for
3,000 or more gallons of wastewater a day, unless your well water source is a
confined aquifer.
300
• From any cemetery or burial ground.
500
• From a septage disposal site.
• From a chemical or petroleum fuel underground storage tank without secondary
containment.
• From the boundary of a ground water contamination area.
• From a sanitary landfill or non -permitted non -hazardous solid waste disposal
site.
1,000
• From a hazardous waste disposal site or in any location which conflicts with the
North Carolina Hazardous Waste Management Rules cited in NCAC 13A.
We also understand that the owner will ensure that the lots are graded or sloped so that
surface water is diverted away from the wellheads and that the lots are not subject to
flooding in accordance with rule .0203(4).
PWS Section "Authorization to Construct" and "Final Approval"
Subsequent to well drilling and evaluating water quality and quantity (e.g., collecting and
analyzing samples and performing a 24-hour well drawdown test) the owner must submit
an "Application for Approval of Engineering Plans and Specifications for Water Supply
Systems" to document proposed well completion (e.g., selected pump, wellhead and well
house details) and associated transmission lines, treatment and/or storage facilities and
other critical information about the public water system. In accordance with rule .0305(a)
no construction shall be undertaken until the PWS Section issues an "Authorization to
Construct" letter. In addition, in accordance with .0309(a) the new wells and all associated
treatment, storage or transmission/distributions lines shall not be placed into service until
the PWS Section has issued a "Final Approval." These steps are described in the
Engineering Planning and Development Guidance Document available at

kv-711 ' ,I
Be aware that plans, specifications and reports for the new wells must be certified by a
Professional Engineer. Therefore, it is recommended that a Professional Engineer or
Licensed Geologist (or their designated representative) experienced in the construction of
water supply wells, conduct on -site monitoring of well construction. At a minimum, certain
critical phases of well construction such as installation and grouting of casing should be
monitored. In many situations it may be necessary to go beyond the minimum
requirements in order to protect the public health and ground water resources.
Other Agency Approvals Required
This PWS Section "preliminary well site approval' letter does not address other agency
applicable rules and requirements pertaining to well construction and registration.
Local county well construction rules and ordinances may include additional requirements.
Well construction must meet the standards specified in the Well Construction Standards
(15A NCAC 2C). Be aware that these rules require a permit to be obtained from the Water
Quality Regional Operations Section of the Division of Water Resources before the well is
constructed if it is anticipated that the new well will be part of a water system with a design
capacity of 100,000 gallons per day or greater. In addition, these rules require that wells
be constructed by a properly certified well driller. For more information contact the Water
Quality Regional Operations Section at 919-807-6300 or http://portal.ncdenr.orPJweb/wi/aps
Sincerely,
Je nine Press
Engineer
Wilmington Regional Office
Cc: R.W. (Bob) Midgette, Chief, Public Water Supply Section
Heidi Lane Cox, Regional Engineering Supervisor, Public Water Supply Section
Pender County Health Department -Environmental Health
Morella Sanchez -King, Regional Supervisor, Water Quality Regional Operations
Section
Nat Wilson, Chief, DWR-Groundwater Management Branch
Tony Boahn, McKim & Creed, 243 N Front St, Wilmington, NC 28401