WS0801059_Application_20210401

2.
4.
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.
Date: �/-I- / IFOR OFFICE USE ONLY
County: // a( / �iN PERMIT NO. ISSUED DATE:
Applicant l�oa11SOyAn-I tV.11S /Ale,715 ..�Cnc. Telephone:
Applicant's Mailing Address: Pa 80X All 6-1z 93 6y
Applicant's Email Address (if available):
Contact Person (if different than Applicant): LAj,,,g& C�Telephone: Q5_ ZU 1O 3K'0s _
Contact Person's Mailing Address: _/-7© /3tyl0 k g 9 // ! ?", t. 0 p l //k" / /l C o2 F 3,dr!5,
Contac Person's Email Address (if available): _ 7 o TS �.41 S-Alcl1l/ c-Al. --V M
Property Owner (if different than Applicant):
Owners Mailing Address:
Owners Email Address (if available):
Telephone:
Property Physical Address (including PIN Number): pi:y# 3 50000 b 8 118 S 110 ? L/r m r l OALI
City: mOvKf' A/. f. County�Z l// Zip Code: a836S
7. Intended use of Well or Well System:
(examples: irrigation, consumption, e
8. Will the proposed water supply well or well system replace or be added to an existing well or well system?
(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): 7). 000
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?
If yes, give Public Water ID Number.
If yes, give Project Engineer and �coontact information: A
12. Well Contractor: cJ0_11O. ap l Am;oD i ka q / I Well Contractor Certification No.: 3y6 S— A
Brl1'5 W[.!/ 0rr//!n9 r!o0(J6 h Trl 9r� r 'l� ,/V/� D-
Well Contractor Address: c r cr.r ayc"f'✓ZQyI 2r G J p 3 !!
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 denth
No. of wells to be constructed in unconsolidated
material:
Nn of urvllc In he mnefn,nfcd in bedrn�L
Zs-s t/ �fb-2ba

e. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chgmical or fuel
storage areas, animal feedlots as defined in G.S. 143-215.106(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:/Iwww.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(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
J� Administrative Code, Sub apter 2C) and accepts full responsibility for compliance with theserules
�ier��G1d�/'DN
XSigoWre of Applicant or *Agent Title of Applicant 6r *Agent
'I04141A0/ "1Cam G�- IfsigningasAgent,attachauthorizationagreementstating
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
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).
Sin ure of Property Owner (if different than plirant) Printed name of Property Owne (if differenr 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]
: Win rc5alem
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

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Jim Best Rd
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3000 ft

BILL'S WELL DRILLING CO.
800 McArthur Road
Fayetteville, North Carolina 28311
Office [phone]
[e-mail] www.billswelldrilling.com
Date: 2/21/2021
Goodson & Wells Farms
Drilling Log Lithology - Test Hole
Davis Farm -Jim Best Rd, Mt Olive, NC Duplin Co
From
To
Formation Description
0
5
Orange Sand & clay
5
11
Mixed Sand
11
16
Orange Sand
16
17
Gray Silty Clay
17
37
Gray Clay w/streaks of fine sand, large
gravel, glaucanite & wood
37
47
Silty Gray Clay
47
55
Hard Gray clay
55
111
Fine Sand & Clay, Glaucanite & wood
111
117
Mostly Dark Gray Clay & wood
117
137
Mostly Clay w/small streaks gray sand
137
165
Sand & Clay streaks w/Gray medium sand
165
175
Clay
175
177
Soft Rock Sandstone
177
182
Salt & Pepper Sand
182
192
Solid Gray Clay
192
197
Streaks fine Sand & Clay
197
222
Dark Gray Clay
222
237
Light Gray Clay Softer clay w/some sand
237
265
Light Gray Clay turning to darker Gray
265
277
Streaks of Sand w/some clay
277
284
Clay
284
290
Streaks of Coarse sand mostly clay
290
297
Clay
297
357
Small streaks fine sand & some clay
BI
WELSDRI
Jonathan Kamionka
3465-A

ROY COObER-
Governo,
DIONNE DGATT]
secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
March 18, 2021
Mr. Lawrence Edge CERTIFIED MAIL
Goodson & Wells Farms, Inc. — Davis Farm RETURN RECEIPT REQUESTED
P.O. Box 28 7018 0680 0001 7705 6198
Mount Olive, NC 28365 9590 9402 5494 9249 0060 00
Subject: CCPCUA Permit No. CU3349 for
Goodson & Wells Farms, Inc. — Davis Farm in Duplin County
Dear Mr. Edge:
In accordance with your application dated February 1, 2021, and associated documentation, we are forwarding
Permit No. CU3349 for water use in the Central Coastal Plain Capacity Use Area in Duplin County. This
permit allows for the withdrawal of water for the purpose of agricultural irrigation.
Enclosed with this package are forms DWR CCPCUA-4 and DWR CCPCUA-6. Form DWR CCPCUA-4 is
for reporting water withdrawals, in accordance with Sections I. C. and IV. A. of your permit. Form DWR
CCPCUA-6 is for reporting ground water levels, in accordance with Sections II. B. and IV. B. of your permit.
If you are not already doing so, DWR requests you submit your monthly water withdrawal and water level
information using our online system. By doing so you will not need to mail the Division a signed hard copy.
The CCPCUA online permit renewal application, water withdrawal and levels reporting forms are at:
http:/1www.newater.org/CCPCUAreportonline
If you do not have internet access then please make as many copies as necessary and send forms on a monthly
basis to the address on the top of the forms.
This permit is effective from the date of issuance until February 28, 2026, and is subject to the conditions
and/or limitations contained therein. In order for this permit to continue uninterrupted, please apply for permit
renewal at least three (3) months before the expiration date.
Sincerely,
JLs
Gabrielle Chianese, CCPCUA Program Coordinator
Ground Water Management Branch
Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street + 1636 Mail Service Center Raleigh North Carolina 27699 1636
�w,u, � 919.707.9000