WM0501457_Application_20211019

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.
FOR OFFICE USE ONLY
Date: October 13.20211.
PERMIT NO.ISSUED DATECounty: Wake2.
What type of well are you applying for? (monitoring or recovery):
Maple Multi-family Land SE, L.P. - Robert BrooksApplicant-
Monitorino - Temporary Well Points3.
Telephone:[phone]
Applicant’s Mailing Address:
Applicants Email Address (if available):
Contact Person (if different than Applicant): Britt Bickerstaff
[e-mail]
Contact Person’s Mailing Address: 7810 Parkway Drive. Leeds. AL 35094
4509 Creedmoor Road. Raleigh. NC 2
m
Te
7612
5.lephone:67&410-8474
Contact Person’s Email Address (if available):
Property Owner (if different than Applicant): F. Reece Hester
Property Owner’s Mailing Address: PO Box 17046 Raleioh. NC 27619
Property Owner's Email Address (if available): [e-mail]
[e-mail]
6.Telephone:
Property Physical Address (Including PIN Number) 1704501451 - 401 W Lane St & 1704502335 - 219 N Hamnoton St
City Raleioh County Wake .Zip Code 27603
7.
8.Reason for Well(s):
(ex: non-discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
Type of facility or site for which the well(s) is(are) needed:Vacant lot for future residential development
(ex: non-discharge facility, waste disposal site, landfill, UST, etc.)
Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
Environmental Site Assessment
9.
10.
No
11.Type of contaminants being monitored or recovered:
(ex: organics, nutrients, heavy metals, etc.)
VOCs. PAHs. RCRA Metals
12.Are there any existing wells associated with the proposed weil(s)? If yes, how many?
Existing Monitoring or Recovery Well Constaiction Permit No(s).:
Distance from proposed weii(s) to nearest known waste or pollution source (in feet): _
Are there any water supply wells located less than 500 feet from the proposed weil(s)?
If yes, give distance(s):
Unknown
13.Aoproximatelv 250 feet
14.No
15.Well Contractor Bridoer Driitlno
Well Contractor Address: 4837 Carolina Beach Road. Suite 207. Wilmington. NC 28415
Certification No.; 2393A
PROPOSED WELL CONSTRUCTION INFORMATION
1.As required by 15A NCAC 02C .0105(f)(7), attach a well constniction diagram of each well showing the following:
Type of casing material and thickness
Grout horizons
Weii head completion details
Borehole and well diameter
Estimated well depth
Screen inten/als
a.e.
b.f.
c.g-
Sand/gravel pack intervalsd.
Continued on Reverse
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
Number of wells to be constructed in unconsolidated
material: 3
Well points to be removed after sampling2.
6.Estimated beginning construction date: Mid October
Number of wells to be constructed in bedrock: ^20213.
7.Estimated constajction completion date: Mid OctoberTotal Number of wells to be constructed:
{add answers from 2 and 3)
How will the well(s) be secured?Te
34.
2021
mporary5.
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:1.
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.
All existing wells, identified by type of use, within 500 feet of the proposed well or well system.
The proposed well or well system.
Any test borings within 500 feet of proposed well or well system.
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.
a.
b.
c.
d.
e.
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
i
^
Sighature of Applirant or 'Agent
Maple Multi-family Land SE. L.P. - Vice President
Title of Applicant or 'Agent
* /f signing as Agent, attach authorization agreement stating Printed
that you have the authority to act as the Agent.
Robert Brooks
name of Applicant or '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 VVell Construction Standands (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
F Reece Hester
Printed name of Property Owner (if different than Applicant)Signature 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]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington. NC 27889
Phone: [phone]
Fax; [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone; [phone]
Fax: [phone]
GW-22MR Rev. 3-1-2016
Service Layer Credits: Sources: Esri, HERE,Garmin, USGS, Intermap, INCREMENT P,
FIG. 1Title:
Project:
Client:
Prepared:
Checked:
Date:
BWS
—
10/12/21
Project Site Location Map (Street Map)
North Harrington Multifamily
—
Figure Scale
±
Project Site
21-NC-05711-01Project No.
0 400200
1 inch = 300 feet
Service Layer Credits: Source: Esri,DigitalGlobe, GeoEye, Earthstar Geographics,
FIG. 2Title:
Project:
Client:
Prepared:
Checked:
Date:
BWS
—
10/12/21
Project Site Location Map (Aerial)
North Harrington Multifamily
—
Figure Scale
±
Project Site
21-NC-05711-01Project No.
0 400200
1 inch = 300 feet
@A @A @A
EB-1 EB-2 EB-3
Figure 3
SheetTitle:
Project:
Client:
Prepared:
Checked:
Date:
B. Sharp
Proposed TemporaryMonitoring Wells
North Harrington Multifamily
—
Scale:±
21-NC-05711-01Project No.
0 75 15037.5
1 inch = 150 feet
—
Map Index
Note:Original version of this drawing is provided in full-color, black-and-white reproductions may notaccurately depict certain information.
Oct 12, 2021
625 Holcomb Bridge Road, Norcross, Georgia 30071770-209-0029 Fax [phone] www.unitedconsulting.com
References: ESRI (2021)
Legend
Project Site Boundary
@A Proposed TemporaryMonitoring Well
Lee's Hand Laundry & Drycleaning (Former)
Greyhound Facility(Former; LUST)
500' Radius
Powerhouse Square(SHWS)
22
20
18
16
14
12
10
8
6
4
2
0
PROPOSED ID:WELL ID:
PROJECT NAME:
SITE LOCATION:
DRILLING METHOD:
LOGGED BY:SAMPLING METHOD:
CLIENT:
PROJECT NUMBER:DRILLING CONTRACTOR AND EQUIP:
CONSTR. START:
CONSTR. COMP:
WELL/PIEZOMETER LOG
DEVELOPMENT DATE:
STATIC GROUNDWATER DEPTH:Depth (feet)USCSGraphic LogLITHOLOGY SAMPLES SKETCH NOTES
EB-X
N/A Raleigh, NC
North Harrington Multifamily
21-NC-05711-01
Direct Push
TBD
Direct Push Drilling/Low-Flow Sampling
TBD
TBD
TBD
Approximately 15 feet bgs
Surface Elev.:
TOC Elev.:
NOTES
Northing/Lat.:
Easting/Long.:
Surface Completion:
Riser Height (Surface):
Annular Fill Type:
Annular Sealant Type:
Filter Pack Type:
Well Diameter:
Borehole Diameter:
Top of Screen:
Screen Length:
Screen Slot Size:
Bottom of Screen:
Bottom of Well:
N/A Flush #20 Well Slot Sand 10 Feet
0.001 in1 InchN/AN/A
N/A
N/A
Fill Soils
Bentonite Seal
3.25 Inches
10 Feet
20 Feet
20 Feet
Time of Drilling
Groundwater Level
24-Hour
Groundwater Level
Development
Groundwater Level