HomeMy WebLinkAboutWM0801175_Application_20210628NORTH 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: June 28, 2021
2. County: New Hanover County
3.
4. Applicant: CF Smith Property Group
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
What type of well are you applying for? (monitoring or recovery):
Monitoring (temporary)
Telephone: 910-977-2544
Applicant's Mailing Address: 20 Cochrane Castle Circle, Pinehurst, NC 28374
Applicant's Email Address (if available): strythall@cfsmithpg.com
5. Contact Person (if different than Applicant): Erin Warren Telephone: (910)599-6285
Contact Person's Mailing Address: ECS Southeast LLP 6714 Netherlands Drive, Wilmington NC 28405
Contact Person's Email Address (if available): ewarren@ecslimited.com
6. Property Owner (if different than Applicant): Peter Spirakis Telephone: 910-470-0120
Property Owner's Mailing Address: 7928 Sanderlinq PL, Wilmington, NC 28411
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 5214 Market Street — PIN: R04916-001-001-000
City Wilmington County New Hanover County Zip Code 28405
8. Reason for Well(s): Assessment
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9. Type of facility for which the well(s) is(are) needed: Shopping Center
10. Are there any current water quality permits or incidents associated with this facility or site? Unknown
11. Type of contaminants being monitored or recovered: VOCs
12. Are there any existing wells associated with the proposed well(s)? No
Existing Monitoring or Recovery Well Construction Permit No(s).: NA
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): Unknown
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: Mid -Atlantic Drilling, Inc. (MAD) Certification No.: 2540-A
Well Contractor Address: jstewart@midatlanticdrilling.com 426 Landmark Drive Wilmington, NC 28412
PROPOSED WELL CONSTRUCTION INFORMATION
1. 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: 2
5. How will the well(s) be secured? Same day
abandonment
3. Number of wells to be constructed in bedrock: 0
4. Total Number of wells to be constructed: 2
(add answers from 2 and 3)
6. Estimated beginning construction date: June 2021
7. Estimated construction completion date: June 2021
1.
ADDITIONAL INFORMATION
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
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Signature of Appli nt or *Agent Title of Applicant or *Agent
Director of Leasing & Development
Steve Trythall
* 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 Peter Spirakis
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
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone: (828) 296-4500
Fax: (828) 299-7043
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
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: (919) 791-4200
Fax: (919) 571-4718
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: (252) 946-6481
Fax: (252) 975-3716
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: (910) 796-7215
Fax: (910) 350-2004
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: (336) 776-9800
Fax: (336) 776-9797
'1
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Ile Y� GW-22MR Rev. 3-1-2016
GW-22M (Rev. 5/11)
GW-22MR (6/11)
ECS SOUTHEAST, LLP
PROPERTY OWNER ACCESS AUTHORIZATION
Proposal Na_: 491=24957P
Scope of Work: Proposal for Environmental Assessment Services
Project: Multi -Tenant Retail Building
Location: 5214 Market Street, Wilmington, Plew Hanover County, North Carolina
As part of the proposed real estate transaction, ECS Southeast, LIP (ECS) has been requested by the
purchaser to conduct subSvrface sail and groundwater sampling at the site. This sampling requires that
ECS procure a permit from the Furth Carolina Department of EnvirtinrineMeG axiality {NCDE
ECS respectfully requests that the owner of the property grant permission to ECS to access the property
to conduct the soil and groundwater sampling. By signed below, the property owner authorizes ECS to
conduct the aforementioned sampling at the site.
PropertyOwner (please print): r?-e14-6(
Property OrnrrrerTelephone %pI I f
Property OwerSignatur :
ECs Proposal No 49:23719P
Page l 8
.(91-c-)L4-To-o12.1
SOURCE:
NEW HANOVER COUNTY GIS
AERIAL PHOTOGRAPHY DATED 2016
SCALE: AS SHOWN
FIGURE 1
PROPOSED GROUNDWATER SAMPLE LOCATIONS
5214 Market Street
Wilmington, North Carolina
New Hanover County
ECS Project No. 49-14147-A
GROUND
TOP OF DIRECT PUSH STEEL
RODS ABOVE THE LAND
._.."`
SURFACE
15 FEET
A
NATURAL FORMATION
BACKFILL
GROUNDWATER
-
1.5-INCH STEEL DIRECT
PUSH RISER
2--INCH BORE
HOLE
SLOTTED STEEL SCREEN
0.01-INCH SLOT WIDTHS
SET TO INTERSECT GROUNDWA1
ESTIMATED 10 FEET IN LENGTF
V
V
WELL CONTRUCTION DIAGRAM
REPRESENTATIVE OF DIRECT PUSH
Pf1INT SAMPI FP
NOT TO SCALE
ER
IS
CREEN
FIGURE 2
PROPOSED TEMPORARY SCREEN
POINT SAMPLER