WS0500157_Application_20210615

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: 6/15/2021
2. County: Wake
3. Applicant Will MacNair / Premiere Homes
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
Applicant's Mailing Address: 8310 Bandford Way Raleigh, NC 27615
Applicant's Email Address (if available): Willt7o premierehomesinc.com
4. Contact Person (if different than Applicant): See above
Telephone: [phone]
Telephone:
Contact Person's Mailing Address:
Contac Person's Email Address (if available):
5. Property Owner (if different than Applicant): Ceres investments LLC / Carlton Midyette Telephone: [phone]
Owner's Mailing Address: 8310 Bandford Way Raleigh, NC 27615
Owner's Email Address (if available): [e-mail]
6. Property Physical Address (including PIN Number): 3016 Beechtree Camp Drive (PIN 0799102780) 3020 Beechtree Camp
Drive (0799104731) , 4805 Green Tunnel Ln (PIN 0798095683) **AII contiguous parcels with the same owner**
City: Raleigh
County:
7. Intended use of Well or Well System: Consumption
Wake Zip Code: 27613
(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? Yes
(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):
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
Bayleaf Public Water Supply System — 123 + ground water wells
11. Is this a public well or well system? Yes If yes, give Public Water ID Number: NC03-92-373
If yes, give Project Engineer and contact information: Mike Schneider / Piedmont Land Design, LLC (919-845-7600)
12. Well Contractor: Kidd Well Drilling LLC
Well Contractor Certification No.: 2143 - A
Well Contractor Address: 13408 Old Creedmoor Road Wake Forest NC 27587
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
b.
c.
d.
e.
f.
g•
Estimated well depth
Screen intervals
Sand/gravel pack intervals
Type of casing material and thickness
Grout horizons
Well Head completion details
2. No. of wells to be constructed in unconsolidated
material: 0
3. No. of wells to be constructed in bedrock: 5
4. Total No. of wells to be constructed: 5
(add answers from 2 and 3)
5. Estimated beginning construction date: 6/28/2021
6. Estimated construction completion date: 8/15/2021

Continued on Reverse
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. 143-215.106(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://www.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
Administrative Code, Subchapter 2C) and accepts full responsibility for compliance with these rules
�� ////�/�/., * Developer
ignature of Applicant or Agent Title of Applicant or *Agent
Will MacNair
* 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
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).
Ce(?s Caa1// d- ce zes tN wte�%s
Prin
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d !lame of Property Owner (if different than Applicant)
ure of Prope wn r if differen 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]
Fax: [phone]
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]
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(MIN 30 FT. OUTSIDE OF CASING)
SCREENED STEEL VENT
WELL DRILLER TO LEAVE
12" MIN CASING LENGTH
ABOVE GRADE
12" MIN.
FROM GRADE
LAND SURFACE
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MINIMUM 14" BORE HOLE
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1" PVC PIPE FOR
ACOUSTIC OR MANUAL
SOUNDING
OUTSIDE CASING
ASTM F480
HARDENED
DRIVE SHOE
SANITARY
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NOTES:
1. MOTORS SHALL BE MANUFACTURED BY FRANKLIN OR CENTRI—PRO AND OF THE HIGHEST PSI
THRUST BEARING AVAILABLE.
2. PUMP SIZE AND TYPE SHALL BE DESIGNED AND SPECIFIED BY UTILITY.
3. SIMMONS SPRING CHECK VALVE SHALL BE INSTALLED AT THE PUMP,
4. THERE SHALL BE MINIMUM 20 FEET DROP CABLE OUTSIDE OF WELL.
1/4" P.E. TUBING
SCREENED
STEEL VENT
PLAN VIEW
MAKING NO.
W-21
REVISION DATE
02/2019
8" WELL DETAIL
AQUA
Aqua North Carolina, Inc.

ROY COOPER
Glsrmar
DI©NNE DEW-GATTI
Secrriart'
S. DANIEL SMITH
Director
Carlton Midyette
8310 Bandford Way
Raleigh, NC 27615
Re: Preliminary Well Site Approval
BEECHMOOR S/D
Water System No.: NC4092209
Wake County
NORTH CAROLINA
Environmental Quality
May 11, 2021
Dear Mr. Midyette:
On April 29, 2021, I along with Daniel Taylor, met with you and Mr. Will MacNair to conduct a
preliminary investigation of the proposed well sites listed below. The proposed wells have been
assigned a Water System Facility (WSF) Identification Number and Sampling Point Codes as
indicated below.
WSF
Sampling
Description of Well Site
Preliminary Latitude and
ID No.
Point Code
Longitude
WO1
RW1
100-foot radius surrounding Well
35°55' 19.7073" N 78°41'27.8391
#1 in the northeast corner of the
property
W
WO1
RW2
100-foot radius surrounding Well
35°55' 19.3658" N
#2 in the northeast corner of the
property
78°41'28.9261" W
W03
RW3
100-foot radius surrounding Well
35°55' 13.151.9" N
#3 in the south of the property
78°41'35.8739" W
W04
RW4
100-foot radius surrounding Well
35°55'20.6462" N
#1 in the northwest corner of the
property
78°41'45.3338" W
W05
RW5
100-foot radius surrounding Well
35°55' 17.6504" N
#5 in the northwest corner of the
property
78°41'47.0047" W
This letter is provided by the Public Water Supply (PWS) Section, in accordance with Rule
.0305(b) of the Rules Governing Public Water Systems (15A NCAC 18C), to provide permission
to drill wells 1,2,3,4 and 5 at the listed sites in order to establish the quality and quantity of water
and the suitability of the wells as sources 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 located on
124e.trewdant at Fri* fireakt,i, :gee."
North Carolina Department of Environmental Quality ! Division of Water Resource,
Raleigh Regional Office MOO Barrett Drive i Raleigh. North Carolina 27,Oq
asa :or .c !AA

ROY COOPER
Gmrrncv
DIONNE DELLI-GATTI
Secrriarl'
S. DANIEL SMITH
Dircctcr
NORTH CAROLINA
Ertvironmmml rWaGty
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
15A NCAC 18C .0203(a)(1). In addition, we understand that you have determined that the
proposed well locations satisfy the minimum horizontal separation distances specified in 15A
NCAC 18C .0203(a)(2) and summarized in the following table:
Distance (in
feet)
Potential Source of Pollution
100
•
o
•
o
o
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
o
From a subsurface sanitary sewage treatment and disposal system designed for 3,000
or more pitons of wastewater a day, unless your well water source is a confined
aquifer.
300
o
From any cemetery or burial ground.
500
0
•
®
•
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
e
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 wells shall not have greater than a 1
percent chance of flooding in accordance with 15A NCAC 18C .0203(a)(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 15A NCAC 18C .0305(a) no
construction shall be undertaken until the PWS Section issues an "Authorization to Construct"
letter. In addition, in accordance with 15A NCAC 18C .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
North Carolina Department of Environmental Quality I Division of Water Resources
Raleigh Regional Office 3800 Barrett Drive ! Raleigh. North Carolina 27609
010 701 A 71tet

ROY COOPER
Governor
DONNE DEW-GATTt
Sea Mary
S. DANIEL SMITH
Director
NORTH CAeROLINA
Environmental' Quality
https://files.nc.gov/ncdeq/Water%20Resources/files/pws/planreview/EPDWGuidance july2019.p
df
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, call 919-707-3668 or go to:
https://deq. nc. gov/about/divisi ons/water-resources/water-resources-permits/wastewater-
branch/ground-water-protection/well-program#largecapwell
Sincerely,
"ll
Joel Martinez
Environmental Engineer
Public Water Supply Section
Raleigh Regional Office
Cc: Central Files — Public Water Supply Section
Regional Files — Public Water Supply Section
Will MacNair - Premiere Homes, Inc.
Wake County Health Department
North Carolina Department of Environmental Quality i Division of Water Resources
Raleigh Regional Office 3800 Barrett Drive Raleigh. North Carolina 27604
010 701 A 7!{R