WM0401315_Monitoring Well Permit Application_20211005

Letter of Transmittal
1400 Weston Way
West Chester, PA 19380
TO: Jim Gonsiewski — PG, Hydrogeologist
North Carolina Dept. of Envir. Quality
Division of Water Resources
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
[phone]
WE ARE SENDING YOU:
Date:
September 14,
2021
Job No.: 11621.043.011
RE:
Nokia -Lucent Cotton Mill Square Site, Greensboro
NC — CAT 100 Performance Monitoring Wells
Permit Application
Attached
Under Separate Cover
Drawings
Affidavit of Compliance
Sample(s)
Manuals
Schedule
Change Order
Report
X
Other (Work Scope)
Transmittal
No.
Copies
Date
Submittal
No.
Description
1
1
09/14/21
-
Application for Permit to Construct Monitoring and Injection
Wells, Nokia -Lucent Cotton Mill Square Site, Greensboro NC
WE ARE TRANSMITTING as checked below:
X
For Approval
For Your Use
Copies for Approval
As Requested
Returned After Loan to Us
Copies for Distribution
X
For Review and Comment
Other (explain)
Corrected Prints
Signed:
Weston Solutions, Inc.
Date: 09/14/2021
REMARKS:
Jim - Please find attached an application for performance monitoring wells installation in Greensboro NC associated
with Nokia (formerly Lucent) Cotton Mill Site remediation. A separate well permit request has also been forwarded to
the Guilford County Dept. of Environmental Health. We hope to install these wells the week of the third week of
October 2021 provided all approvals are in place.
Please do not hesitate to contact me with any questions you may have. Best Regards,
Best Regards -David Kane- [phone] [e-mail]
COPY TO:
G. Mao— Guilford County Dept. of Health

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: 09/14/2021
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Infection and Monitoring
4. Applicant: David Kane Telephone: [phone]
Applicant's Mailing Address: 1400 Weston Way, West Chester PA 19380
Applicant's Email Address (if available): [e-mail]
5. Contact Person (if different than Applicant): N/A Telephone: N/A
Contact Person's Mailing Address: N/A
Contact Person's Email Address (if available): N/A
6. Property Owner (if different than Applicant): Burkely Communities Telephone: [phone] (owner rep)
Property Owner's Mailing Address: 3643 Clifton Road, Greensboro NC 27407
Property Owner's Email Address (if available): Owners Rep — Jordan Roling [phone]
7. Property Physical Address (Including PIN Number) Blunt Street, south of Hewitt Street, Block 43 Apartments
City Greensboro County Guilford Zip Code 27407
8. Reason for Well(s): Injection monitoring wells, monitor gw quality downgradient of injection points
(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: Former Manufacturing Facility now residential
(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).
Non -discharge Permit # WQ0036621
11. Type of contaminants being monitored or recovered: volatile organic compounds
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes; —49
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): 500 feet
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: Geologic Exploration Certification No.: 2580
Well Contractor Address: 176 Commerce Blvd., Statesville NC 28625
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
3. Number of wells to be constructed in bedrock: 2
4. Total Number of wells to be constructed: 3
(Add answers from 2 and 3)
5. How will the well(s) be secured? Flush mount pad
bolted with locking expansion cap
6. Estimated beginning construction date: 10/18/2021
7. Estimated construction completion date: 10/19/2021
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
Senior Project Manager
Signature of Applicant or *Agent Title of Applicant or *Agent
David Kane, P.G. * 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).
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: (252
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
41Ir
tilY
Wil ngFan
C 27105
-9800
7

Legend
Former Injection Well
■ Former Extraction Well
Bedrock Monitor Well
▪ Saprolite Monitor Well
+ Transition Zone Monitor Well
• CAT100 Injection Point
• • Cotton Mill Square Property Boundary
Approximate Location
for New Well Cluster
_ J Pilot Test Area
0
W E
S
70
140
Figure 1
Proposed Injection
Point Locations
t Feet
Cotton Mill Square Facility
Greensboro, North Carolina
File: Y:\CMS\MXD\ProposedInjLocs Well Cluster.mxd, 2/10/2021 3:49:37 PM, johna

Scope of Performance Monitoring Well Installation
Three additional monitoring wells will be installed on -site immediately downgradient of the CAT 100
injection points. The approximate location of the new monitoring wells is highlighted on the attached
figure 3-1.
The new onsite performance monitoring wells will be installed to supplement the existing monitoring well
network to monitor groundwater conditions in the upper bedrock, transition zone and saprolite. The
following are the approximate depths for the new monitoring wells: bedrock well 90 feet below ground
surface (ft bgs), transition zone well 60 ft bgs, and saprolite well 30 ft bgs. Each well will be drilled and
installed using auger/air rotary drilling equipment.
For the upper bedrock well, 8.25" inner diameter (ID) augers will be used to advance the borehole to the
top of the transition zone or auger refusal; 8" air rotary drilling will then we used to advance the boring
2-feet into competent bedrock. A 6-inch casing will then be installed and grouted into the top of bedrock.
After the casing has cured, 6" air rotary drilling will be used to advance an open bedrock borehole
approximately 30-feet below the base of the casing. The transition zone and saprolite monitoring wells
will be comprised of 2-inch diameter, schedule 40 PVC riser pipe and a 5- or 10-foot length of PVC screen
(10 slot). A sand pack will be placed around the well screen and bentonite and cement grout seals will be
placed above the sand pack.
All wells will be completed at ground surface with a flush mounted, protective steel cover set in a concrete
pad. The wells will be developed until the discharge water is sediment free and clear as possible. Prior to
the commencement of CAT 100 injections in adjacent points, the newly installed monitoring wells will be
sampled by Weston using low -flow techniques. Weston will submit VOC samples to a North Carolina State
approved laboratory; separate well samples will be shipped to RPIs Project Support Laboratory for
analysis: anions and cations using Method 300.1, and dissolved gases
using RSK 175.

WELL CONSTRUCTION LOG
CLIENT:
SITE NAME:
DRILLING CO.:
LOGGED BY:
Well ID:
Page
DATE OF WELL CONSTRUCTION:
DEPTH TO WATER (ft bgs):
TOTAL WELL DEPTH (ft bgs):
1
of
1
Lithologic Unit of
( ) Saprolite
( ) Transitio
( ) Bedrock
Date Developed:
Vol. Purged:
Purge Rate:
Comments:
Northing (UTM Zone YY, meters)
Easting (UTM Zone XX, meters)
Completion:
/Overburden
n zone
Well ConstrL
Bo
We
Ris
gal.
gpm
Sci
Sci
Sci
ft bgs feet below gal. Gallons
ground surface gpm Gallons Per Minute
Depths are presented as feet below ground surface unless otherwise indicated.
GND Elevation (ft msl)
TOC Elevation (ft msl)
completed as flush -mount well
ction:
ring Diameter (in)
II Diameter (in)
er Material
Top of Bentonite/Sand Seal
Top of Sand
Top of Screen
een Material
een Length (ft)
een Slot (in)
Bottom of Screen
Total Boring Depth
Well-Const_Template

WELL CONSTRUCTION LOG
CLIENT:
SITE NAME:
DRILLING CO.:
LOGGED BY:
Well ID:
Page
DATE OF WELL CONSTRUCTION:
DEPTH TO WATER (ft bgs):
TOTAL WELL DEPTH (ft bgs):
1
of
1
Lithologic Unit of
( ) Saprolite
( ) Transitio
( ) Bedrock
Date Developed:
Vol. Purged:
Purge Rate:
Comments:
Northing (UTM Zone YY, meters)
Easting (UTM Zone XX, meters)
Completion:
/Overburden
n zone
Well ConstrL
Bo
We
Ris
gal.
gpm
Sci
Sci
Sci
ft bgs feet below gal. Gallons
ground surface gpm Gallons Per Minute
Depths are presented as feet below ground surface unless otherwise indicated.
GND Elevation (ft msl)
TOC Elevation (ft msl)
completed as flush -mount well
ction:
ring Diameter (in)
II Diameter (in)
er Material
Top of Bentonite/Sand Seal
Top of Sand
Top of Screen
een Material
een Length (ft)
een Slot (in)
Bottom of Screen
Total Boring Depth
Well-Const_Template