WM0701257_Application_20211005

ATC
ENVIRONMENTAL • GEDTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcgroupservices.com
N.C. Engineering License No. C-1598
September 22, 2021
Mr. Robert Tankard
North Carolina Department of Environmental Quality
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Re: Permit to Construct Monitoring Well
Former Eastern Car Care
703 East Main Street
Murfreesboro, Hertford County, North Carolina
ID No. NONCD0002368
State Contract No. N091319
Dear Mr. Tankard:
Enclosed please find an application for a permit to construct one temporary groundwater
monitoring well. The temporary groundwater monitoring well will be located at 701 East Main
Street in Murfreesboro, Hertford County, North Carolina. The permit application, site map with
the proposed location of the monitoring well, well construction details and other relevant
information are enclosed as attachments. Please review this package and return the approved
permit to this office or via email to [e-mail].
If you have any questions or require additional information, please contact our office at (919)
871-0999.
Sincerely,
ATC Associates of North Carolina, P.C.
/PI )L."---r--
Larry George, P.G.
Senior Project Manager

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: 9/21/2021
2. County: Hertford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery):
Monitoring
4. Applicant: NC DEQ, DWM. Telephone: [phone]
Applicant's Mailing Address: NCDEQ IHSB- Superfund Section, 217 West Jones Street, Raleigh, North Carolina 27699-1646
Applicant's Email Address (if available): Send to contact person listed below
5. Contact Person (if different than Applicant): Larry George, ATC Associates of NC, PC Telephone: [phone]
Contact Person's Mailing Address: 2725 E. Millbrook Road, Suite 121, Raleigh, NC 27604
Contact Person's Email Address (if available): [e-mail]
6. Property Owner (if different than Applicant): Katie V. Parker
Telephone: [phone]
Property Owner's Mailing Address: PO Box 437, Murfreesboro, NC 27855
Property Owner's Email Address (if available): Unknown
7. Property Physical Address (Including PIN Number) 701 East Main Street (PIN # 5968-15-1456)
City Murfreesboro County Hertford Zip Code 27855
8. Reason for Well(s): Groundwater contamination
(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: Inactive Hazardous Site
(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).
NONCD0002368 Inactive Hazardous Sites List for Eastern Car Care located at 701 East Main Street. Eastern Car Care was a
former UST Incident #6629. The Eastern Car Care site was referred to the Inactive Hazardous Sites Branch due to the presence
of chlorinated solvents in groundwater.
11. Type of contaminants being monitored or recovered: VOCs
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? 40
Existing Monitoring or Recovery Well Construction Permit No(s).: N/A
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 100 ft.
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No (based on a 2000 CSA Report for the
Former Eastern Car Care UST Incident No. 6629 prepared by NorthEast Environmental, P.C.)
If yes, give distance(s):
15. Well Contractor: Innovative Environmental Technologies, Inc. Certification No.: 3287-B
Well Contractor Address: 232 Highway 49 S, Concord, NC 28025
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: 1 Temporary
3. Number of wells to be constructed in bedrock. 0
4. Total Number of wells to be constructed: 1 Temporary
(add answers from 2 and 3)
5. How will the well(s) be secured? Locking well cap,
6. Estimated beginning construction date: 10/15/2021
7. Estimated construction completion date: 10/15/2021
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
/
Agent for NCDEQ DWM (will include power of attorney
Signature of Applicant or *Agent Title of Applicant or *Agent upon request)
Larry George, P.G. (Agent for NCDEQ DWM) * 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 access agreement See attached access agreement
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: [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
hen: (3-3& 6-9800
797
GW-22MR Rev. 3-1-2016

r
1
Well finished at surface with locking
well cap.
#2 Filter Sand Pack From Ground Surface to
Bentonite Seal (0-11 feet)
1" Diameter Schedule 35 PVC Casing Extending
From Ground Surface to Top of Screen (0-35 feet)
2-Foot Bentonite Seal (11-13 feet)
15 Feet of 1" Diameter Schedule 40 Well Screen
(0.010" Slot) (35-50 feet)
1
TW-1
Groundwater Table
#2 Filter Sand Pack Extending 2 Feet Above Screen
(33-50 feet)
ATC
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
2725 E. Millbrook Road, Suite 121
Raleigh, NC 27604
[phone]
PROJECT NO: IHSB038P01
DATE: September 21, 2021 REVIEWED BY: LG
TEMPORARY MONITORING WELL
CONSTRUCTION DETAIL
Former Eastern Car Care
701 East Main Street
Murfreesboro, Hertford County, North
Carolina
ID No. NONCD0002368

v
•
•
•
■
P rf a etera me mat
arsmorro r} E o WiViltWa rIEU
tYPE AH +YAW rAFl441G !! L
SFNER AIAM-Oft
WA MR WIER
WATER KUYr
Diral
PorOPERTY &WE
CFAKT
CiarrnaV
RANT dF MLrI Y
5.4.4974Rr2I€ tAE
FELEAMYTIE LAC
1 Ws p44 adtp baura a. o +ohWr.a $Wwy
doMd aid It71j Ma .w p rrd by
Remdrr Lone sr,.erg.
2 AdiRvros hurt betf nod. [o S!!a Mop bnsad orr
MAI obsrrwdbrrs made b*GIN PurzWeevf
LL/A S S
!00 25
121
a
ET
+Ivw-25
C
Proposed Temporary Monitoring Well
I
* jial,34 DANCE ,STREET
--• —
)IW-,355
ATC
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
2725 E. Millbrook Road, Suite 121
Raleigh, NC 27604
[phone]
PROJECT NO: IHSB038P01
DATE: September 21, 2021
REVIEWED BY: LG
TEMPORARY MONITORING WELL
500 FOOT RADIUS MAP WITH
EXISTING WELLS
Former Eastern Car Care
701 East Main Street
Murfreesboro, Hertford County, North
Carolina
ID No. NONCD0002368

M.
I
1
T
1
�la
5966 05-6503
609 E MAIN
5866.154503
KIRBY BROWN, LLC
106 N SECOND ST
586045-0660
MASHAL LA, LLC
* Proposed Type II Temporary Well
Former Eastern Car Care
Hertford County Parcels
— 500 Foot Radius From Proposed Work
:704 E MAIN ST
5 96 6-15-4214
M (`J ONALOS
•
TOW
C ORR.321119
800 E ry"AI N ST
oakTto
-
Note:
ATC was unable to visually identify any water supply wells by
looking at aerial photographs or from using Google Street View.
Additionally, no private water supply well data is available on the
Hertford County GIS website.
ATC
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
2725 E. Millbrook Road, Suite 121
Raleigh, NC 27604
[phone]
PROJECT NO: IHSB038P01
DATE: September 21, 2021
REVIEWED BY: LG
TEMPORARY MONITORING WELL
500 FOOT RADIUS MAP
Former Eastern Car Care
701 East Main Street
Murfreesboro, Hertford County, North
Carolina
ID No. NONCD0002368

ROY COOPER
Governor
MICHAEL S. REGAN
Seer f r
MICHAEL scan
-
Director
NORTH CAROLINA
Environmental Quality
PROPERTY ACCESS & SAMPLING PERMISSION
I am the owner of the property located at 701 E. Main St., Murfreesboro, NC. I grant the Division of Waste Management
and/or its contractors permission to access my property and collect samples as indicated below from my property.
Potable Well. Does your well have a treatment system (Yes/No)?
How many wells are located on your property?
_X Soil (Surface Grab Sample)
_X Soil Gas Probes
_X_ Groundwater
Crawlspace Vapor Sampling
Indoor Air Vapor Sampling
Other (Include Description)
K6t-lit V. ParlvAr c2W aag—auo�
(Print Name) (Telephone Number)
16iVP0144A1 aarmaci 1',2-07-4
(Signature) (Date)
Please return this signed form in the enclosed stamped envelope to:
Eastern Car Care
Murfreesboro, Hertford County, NC
IHSB ID NONCD0002368
Sue Robbins
Division of Waste Management
Inactive Hazardous Sites Branch
387 Brickyard Road
Hampstead, North Carolina 28443
North Carikna Department of Environmental Qualtly j Diviskon of Waste Management
127(:arilinall)riv.•l':.urn,i„ii l It1ilmingitm,Nl:28IOA l [)Il1-7'ili-72IT