HomeMy WebLinkAboutWM0501453_Permit (Issuance)_20211008ROY COOPER
Governor
ELIZABETH S. BISER
Seaway
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Qualify
October 8, 2021
Miller Oil Company
P.O. Box 1858
Norfolk, VA 23501
Subject: Monitoring We11 Construction
Permit # WM0501453
Kildaire Farm Road Grocery
3498 Kildare Farm Road
Cary, NC -Wake County
To Whom It May Concern:
In accordance with the application received on September 30, 2021, and the additional requested
information received on October 7, 2021, we are forwarding herewith Monitoring Well Construction Permit
No. WM0501453 dated October 8, 2021, issued for the construction of a monitor well system (installation
of one well) at the subject property (3300 Ten Ten Road). P a : , t ..� , hay w
pae(ructioa proarama._pad you may be required to o item a we contra 'on perm t ore
This Permit will be effective from the date of its issuance and shall be subject to the conditions and
limitations as specified therein. Please note the addition of stipulation #3 to the permit enclosed. If you have
any questions about this permit, please contact Eric Rice at (919) 791-4242.
Sincerely,
cg
DocuSigned by:
et 1J,4411/4,
BCDA9D825D4A48D.
Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
Enclosure
cc: RRO Files/Laserfiche
Wake County Health Department
Email: rdkerinsf terraques pc.com Terraquest, 100 E. Ruffin St, Mebane, NC
North Carolina Department of Environmental Quality I Division of Water Resources
Raleigh Regional office i 3800 Barrett Drive I Raleigh. North Carolina 27609
919.791.4200
NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other applicable Laws,
Rules and Regulations. PERMISSION IS HEREBY GRANTED TO
Miller Oil Company
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM (Kildaire Farm Road Grocery) consisting of one
monitoring well owned by Miller Oil Company at mailing address P.O. Box 1858 in Norfolk, VA. The well will be
located on the property owned by Living Light Properties at 3300 Ten Ten Road in CaryNC-Wake County. This Permit
is issued in accordance with the application received on September 30, 2021, and the additional requested information
received on October 7, 2021, in conformity with specifications and supporting data, all of which are filed with the
Department of Environment and Natural Resources and are considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any other applicable law or
regulation. Construction of any well under this Permit shall be in strict compliance with the North Carolina Well
Construction Regulations and Standards (15A NCAC 02C .0100), and other State and Local Laws and regulations pertaining
to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an adjudicatory hearing upon
written request within 30 days of receipt of this Permit. The request must be in the form of a written petition conforming
to Chapter 150B of the North Carolina General Statutes and filed with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these wells are being
installed as part of an investigation for contamination from an underground storage tank or dry cleaner
incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another
agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the Permit
application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water Quality's
Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC 02C
.0113 and a well abandonment record (GW-30) shall be submitted to the Division of Water Quality's
Information Processing Unit within 30 days of the well abandonment.
7. If the well penetrates any water -bearing zone that contains contaminated waters, the upper three feet of the
well shall be grouted within one day after the casing is set or the well abandoned.
Permit issued the 8t of October 2021
FOR THE NORTH CAROLINA IBR+A/IMENTAL MANAGEMENT COMMISSION
e 4.41A,
Scott inson, Re Tonal Supervisor
Divisio 18Sources
By Authority of the Environmental Management Commission
Permit No. WM0501453
North Carolina Department of Environmental QuaNty 1 Division of Water Resources
Raklph Regional office 13800 Barrett Drive I Raleigh. North Carollna 27609
919.7914200
NORTH CAROLINA DEPARTINENT OF ENV Rec 9/3
ON OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING ORDIVISiRECOVERY 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: 9/30/21
2. County: Wake
FOR OFFICE USE ONLY
PERMIT NO. WA05p/4f ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Moniforino
4. Applicant Miller Oil Company .
Applicant's Mailing Address: PO Box 1858 Norfolk. VA 23501
Applicant's Email Address (ff available):
Telephone:
5. Contact Person (if different than Applicant):
Rvan Kerins Telephone:
Contact Person's Mailing Address: 100 E Ruffin St. Mebane. NC 27302
919-583-9091
Contact Person's Email Address (if available): Jdkennseterraauestoc.c m
6. Property Owner (if different than Applicant): Livina Uaht Properties Telephone:
Property Owner's Mailing Address: 3035 Banks Rd. Raleigh. NC 27603-9684
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 3300 Ten Ten Rd. PIN 0761008958
City- Cary County Wake Zip Code 27518
8. Reason for Well(s): petroleum UST release assessment
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, rernediation, etc.)
9. Type of facility or sfte for which the well(s) is(are) needed: UST
(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)
no
11. Type of contaminants being monitored or recovered: petroleum
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wens associated with the proposed well(s)? If yes, how many? 23
Existing Monitoring or Recovery Well Construction Permit No(s).:
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): <50'
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Yes
If yes, give distance(s): <150'
15. Well Contractor: Terraauest Environmental — Jonathan Grubbs
Certification No.: 3001
Well Contractor Address: _ 100 E Ruffin St. Mebane. NC 27302
PROPOSED WELL CONSTRUCTION INFORMATION
1. As required by 15A NCAC 02C .0105(0(7), attach a well construction diagram of each well showing the following:
a. Borehole and wen diameter
b. Estimated wen depth f.eTyou of casing material and thickness
a Screen intervalst: Grout horizons
d. Sandlgravei pack intervals P. Well head completion derails
Continued on Reverse
i
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated 5. How will the well(s) be secured? Manhole
material: 1 end locking wellcao
3. Number of wells to be constructed in bedrock: 0 6. Estimated beginning construction date: _ 10/2021
4. Total Number of wells to be constructed: 1 7. Estimated construction completion date: 10/2021
(add answers from 2 and 3)
ADDITIONAL INFORMATION
1. As required by 15A NCAC 02C .01050)(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 welt or well system.
d. Any test borings within 500 feet of proposed well or well system,
e. Alt 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. 143-215.108(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 Constriction Permit es 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
Project Manager
Signature of Applicant or *Agent Title of Applicant or *Agent
Rvan D. Kerins, Ter aauest Environmental Consultants. P.C. *If signing as Agent, attach authorization agreement stating
Printed name of Applicant or *Agent
that you have the authority to act as the Agent
lithe property is owned by someone other than the applicant, the property owner hereby consents to allow the
aplicant 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 Park view Shooing Center Condominium Association
Signature of Property Owner (if different than Applicant) Printed name of Property
party 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) 683-1699
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
6-9800
797
GW 22MR Rev. 3-1-2016
ACCESS AGREEMENT FORM
Access is hereby granted to Miller Oil Company, Inc., Terraquest Environmental Consultants, P.C.,
and their agents and assigns for the purpose of installing, sampling, and maintaining, one
groundwater monitoring well at 3300 Ten Ten Rd, in Cary, NC 27518 with the tax PIN number
0761006956.
The proposed well location is the northeast corner of the property as shown on the enclosed
Figure 1. Note that the monitoring well location may be adjusted at the time of drilling, should
unanticipated utilities or other obstacles be encountered at the location. The well will be
constructed in accordance with regulations under Title 15A NCAC 2C. Miller Oil will be
responsible for all costs associated with the installation, maintenance, and subsequent
abandonment of the well. Access is hereby granted for personnel to access the well for sampling
and maintenance purposes on a regular basis.
Once the NC Division of Waste Management's Underground Storage Tank Section has issued a
Notice of No Further Action the well will be abandoned by filling with cement or bentonite in
accordance with the rules contained within Title 15A NCAC 2C.
Living Light Properties, LLC
09/30/21
Date
9/30/21
TERRAQUEST ENVIRONMENTAL CONSULTANTS, P.C. Date
Ryan D. Kerins, Project Manager
3'
4'
5'
25'
FIGURE 1 TYPICAL TYPE .I MONITORING WELL DETAIL
6"
8" MANHOLE COVER
LOCKING CAP
CEMENT GROUT
BENTONITE SEAL
TOP OF SCREEN
GRAVEL PACK
BOTTOM OF SCREEN
BOTTOM OF BORING
GENERAL INFORMATION
Groundwater monitoring wells are simple 2"
d'ameter wells used to monitor groundwater
quality. They are constructed using Schedule 40
PVC piping and screen as shown in the diagram
to the left. Upon completion, an 8" round
manhole cover is installed over the well for
protection. In the event that the well is
installed in an area where there exists the
possibility that it could be damaged such as on
agr'cultural field. an aboveground or stickup
manhole will be used. After the manhole is set,
a small concrete pad is poured around the
manhole. Both the manhole and pad are flush
w'th the ground surface. except as noted, and
wall not interfere with driving, mowing, foot
traffic, etc. Type 11 monitoring wells are used
for sampling groundwater from shallow,
unconfined aquifers. They are used to
determ'ne the horizontal extent of contamination.
Well Driller.
Terraquest Environmental Consultants, P.C. —
Jonothon R. Grubbs #3001
!!IRAquest
ErMRONMENTAL CONSULTANTS. P.C.
Ki daire Farm Rood
SSSSSSSSSSS
H3mn48S
SITE LAYOUT MAP
KLDNRE FARM ROAD GROCERY
3400 K0.DNRE FARM ROAD