WM0100491_Monitoring Well Construction Application_20210525

NORTH 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: May 25 2021
2. County: Henderson County
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: Mr. Brian Wasser Telephone: [phone]
Applicant's Mailing Address: 100 Verdae Blvd., Suite 401 Greenville South Carolina, 29607
Applicant's Email Address (if available): BJWasserCa)drhorton.com
5. Contact Person (if different than Applicant): Don R. Marlor, P.G., ECS Southeast, LLP Telephone: [phone]
Contact Person's Mailing Address: 1900 Hendersonville Road, Suite 10, Asheville, NC 28803
Contact Person's Email Address (if available): DMarlor6c�ecslimited.com
6. Property Owner (if different than Applicant): Michael R. Corn; Mary Louise Corn; Willian F Johnston: Nancy M. Johnston;
Timothy M. Johnston; Bradley A. Johnston; Bradley A Trustee Johnston Telephone:
Property Owner's Mailing Address: 735 Butler Bridge Road, Fletcher, North Carolina 28732
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number)_ 93 Tap Root Dairy Road (PIN: 9642823681)
City Fletcher County Henderson County Zip Code 28732
8. Reason for Well(s): Suspected contamination from onsite waste manure storage ponds
(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: Agricultural
(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).
AST Incident # 95885
11. Type of contaminants being monitored or recovered: Organics
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? No, not for proposed well, existing
water supply wells, reportedly five on the subject property
Existing Monitoring or Recovery Well Construction Permit No(s).: Not that ECS is aware of
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): Located approximately 50 feet on
downgradient side of waste manure storage ponds
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Unsure
If yes, give distance(s):
15. Well Contractor: (Chris Schappel) Geologic Exploration Certification No.: 2332A
Well Contractor Address: 176 Commerce Blvd. Statesville. NC 28625
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

Sand/gravel pack intervals
Continued on Reverse
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated 5. How will the well(s) be secured? Expansion cap
material: 3 temporary
3. Number of wells to be constructed in bedrock: 0
4.
Estimated beginning construction date: June 1, 2021
Wells will be completed as temporary wells and will be abandoned within 48 hours of construction. The dates shown above are intended to represent the window when these
activities will occur.
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 Cons."ctionNtermit as regulated under the Well Construction Standards (Title 15Aqj
4AU� �) of the North Carolina Ad inistrative Code,
v Subchapter 2C) and accepts full responsibility for co liance with � �les s
Signature of Applicant or *Agent Title of Applicant or *Agent
* 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
wAeof
lined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
conform to e Well Constructi tandards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).u� ose
Si n perty Owner (if different than Applicant) Printed name f Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone: [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]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
GW-22MR Rev. 3-1-2016
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
fax: [phone]

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- -- ---'- FIGURE 1
SOURCE: r SITE LOCATION MAP
USGS TOPOGRAPHIC MAP 93 TAP ROOT DAIRY ROAD
SKYLAND, NORTH CAROLINA QUADRANGLE DATED FLETCHER, HENDERSON COUTNY,
2019 NORTH CAROLINA
SCALE: 1:24,000
ECS PROJECT NO. 49 14086
F T,m

o.lm
NOT TO SCALE
FIGURE 3
PROPOSED WELL CONSTRUCTION
DIAGRAM
93 TAP ROOT DAIRY ROAD
FLETCHER, HENDERSON COUTNY,
NORTH CAROLINA
,'1 1,1 ECS PROJECT NO. 49-14086

3.0 TOOLS AND EQUIPMENT
The follow" equipment is required to install a permanent monitoring well with Geoprobe Z5-inch OD
prepacked screens. Refer to Rqures1ll and 3.2 for illustrations of well components.
1.0-in. X 2.54n. Prepack WL41 Coulp2nz ;ts Part Nurn er
I-0-in. x 2.5-lin, Prepacked Screen, 5-ft. 17467
T-0-in. x 2.5-in. Reldpacked Screea Tw/o sand), s-k length—.— . ......
1 %79
x 15-in- Fieldpacked Screen lWo sand), 3-k Eength__._..._.__..__GW2,43G
PVC Riser 1 -0-in. sch. 40, 5-ft. . . ...... . .....
___12876
G-rings for 1.0-in- PVC Riser, Pkg.,of 25
13196
PET op Pkw1.0-in.sch,40 riser ... . ...... . . ......
13227
Locking Weil Plug, for 1.0-m.sch.40riser . . ......
710
PVC Bottom Phig, 1.0-in. sch-40 flush thread
12891
Expendable Drive Point 15 cf 3.25-in. rods / 3.6-in. 0D._._.._________AT321 S
LockingWefl Pkjq,
for I D-in. SrhAO Ope PE Top PV3
1WP1 71 cf� .4 413227
lbw,
1'o-in-sch.40,
S-ftIM31h
[12976)
JM%�
Repacked Screen,
tl-in.z 23m, 5-ft_k-Tqzh (1746j
(or)
Fieldpacked Screen jvda swK!j
12-imx 2.541, Wtkngth (t 16191,
100
Firldpwked Screen Wo sand]
x 2.5 4 n, 1-ft k-mgth (WN-A
PVC Bottom FlLkg, 1 .NrL SdiAD RushIlirezd 112581)
Expendable Diw Point 3-5-in. IJ54n.na�s) 3_&in.OD
FIGURE3.1:
1.0-in, x 25-in. Prepaocked and fieltkmcked Screen Monitoring Weil Parts
Standard Operating Procedure
NOT TO SCALE
Page 6
I J:Y-in_a nd 1.54n. Prepack s
FIGURE 4
PREPACKED WELL COMPONENTS
93 TAP ROOT DAIRY ROAD
FLETCHER, HENDERSON COLITNY,
NORTH CAROLINA
ECS PROJECT NO. 49-14086