Clay_Co.Historic_Well_Permits

NORTH CAROLINA ✓ "
F-P BOARD OF WATER AND AIR RESOURCES
P E R M I T
For the Construction of a Well
In accordance y tIT the provisions of Article 7, Chapter 87, North Carolina General
Statutes, and other applicable laws, rules and regulations,
PERMISSION IS HERESY GRANTED TO
To Tom or RAYRSVXM
FOR THE CONSTRUCTION OF A W.�AM' at Tyeoill2ls
in Cle; County, in accordance with the application dated ftmoft 31, 1971 ,
and in conformity with specifications and supporting data, all of which are filed with the
Office of Water and Air Resources and are considered a part of this Permit.
This Permit is for well construction only, and does not waive any provisions or require-
ments of the Water Use Act'of 1967, or any other applicable laws or regulations.
Construction of a well under this permit shall be in compliance with the North Carolina
Well Construction Regulations and Standards, and any other laws and regulations pertaining
to well construction.
This Permit shall be subject to other specified conditions, limitations, or exceptions
as follows:
Permit issued this the Wh day of ` 19
B)'
PERMIT NO.
Chief, Ground Water Division
Office of Water and Air Resources
GW-26

l��vO NORTH CAROLINA
�\o� BOARD OF WATER AND AIR RESOURCES
�
V )kPPLICATION FOR PERMIT TO CONSTRUCT A WELL
R
TO: North Carolina Board of Water and Air Resources
Gehlemen:
In a arC�wi h 'tfie'pravi�i a-efArti Chapter 87, General Statutes of North
Tina d regulations suant thereto; ap ication is hereby made by
r o1a u' A F " rl. c c c= for a permit to construct a well
name of w 1 owner
as escri ed below an in mpanying data submitted as a par of this application.
(a) Name of property owner ��JUdI 9,� �e.5 1' 1Gc 6- � . �.
(b) Location of property
(Road, Community Subdivision, Lot No. wn
un
(c) Purpose of well 1 C ell,.
(d) Will proposed well replace an existing well 4 .1
(e) Total capacity of existing system: gallons per day
Well No. Yield Well No. Yield
// 0 �M
(f) Proposed well:
Construction type (open-end, screened, gravel-packed, etc.)
Estimated depth /�z Estimated yield m
Estimated date of construction: 7� Complete 9
(g) Drilling contractor: JAIA Q !) yl/tf_ C / Ao l f_ a e vd CO )NC ,
(h) Location of Well: Provide a detailed map showing the location of the proposed well
and any wells in the existing system to at least two (2) nearby reference points such
as roads, intersections, and streams. Identify roads with State Highway road identi-
fication numbers. Show all existing water supply wells within a radius of 1 ,006 feet
of the proposed well.
(i) Well Construction Diagram: Provide a diagram showing proposed construction
specifications. (See Form GW-22A) �.f
Yfiye3J'14G ��Cra Syd
The Applicant hereby agrees the proposed Maili Address of Well Owner Require
well will be constructed in accordance with
approved specifications and conditions of
the Well Construction Permit. , a C �` �� , '7 5 f e j
Mailing Address of Agent
Signature of Well Owner or Agent
Title
PERMIT NO. J66 issued 19�.
-r7—
FORM GW-22

AECEIV
NORTH CAROLINA IAAY 21 i•
BOARD OF WATER AND AIR RESOURCES
p
APPLICATION FOR PERMIT TO CONSTRUCT A WELL GROUrvR DBE qH ,- �VN
p�
May 17,1973
TO: North Carolina Board of Water and Air Resources
Gentlemen:
In �a��� . ovisions of Article 7, Chapter 87, General Statutes of North
C`ad3lina, and regulatio su t ther ttoo, application is hereby made by
"ity of Haye��rt�i Caro�ina for a permit to construct a well
well owner
as describe ow and in the accompanying data submitted as a part of this application.
(a) Name of property owner City of Hayesville
Location of property J mile North o: Hayesville city limits .
'Road, Community, Subdivision, o. o C
(c) Purpose of well Additional city water supp y i '
(d) Will proposed well replace an existing well no
(e) Total capacity of existing system:_ 200,000 gallons per day
Well No. Yield Well No. Yield
1 103 gal, per minute
2 98 gal. per minute
3 90 gal, per minute
( , Proposed well:
Construction type open-end (open-end, screened, gravel-packed, etc.)
Estimated depth 200 Estimated yield 100 gal. per minute
Estimated date of construction: Begin May 24 Complete May �5
Drilling contractor: Ward Well Drilling Co.
,h) Location of Well: Provide a detailed map showing the location of the proposed well
and any wells in the existing system to at least two (2) nearby reference points such
as roads, intersections, and streams. Identify roads with State Highway road identi-
fication numbers. Show all existing water supply wells within a radius of 1 ,006 feet
of the proposed well.
i) Well Construction Diagram: Provide a diagram showing proposed construction
specifications. (See Form GW-22A)
Candler Carroll, Mayor
The Applicant hereby agrees the proposed Mailing Addr ss of W@@ 1 Owner Required
wellwillbe constructed in accordance with �ity of ayesvil-e
approved specifications and conditions of hayesville, North Carolina
the Well Construction Permit. Davenport We 1-1 and Supply
Mailing Address of Agent
Ron Davenport
-� P. 0. Box 580
Signature of Well Owner or Agent Blairsville, Georgia 30512
rg) ) v -
2�
U l� t «GQ PERMIT NO. issuedy /f
FORM GW-22
G 44 ��xy"5� }' `t q � yy yy t• R+i3.rye'`'Y �lE3e i !i

NORTH CAROLINA
Pr BOARD OF WATER AND AIR RESOURCES
P E R M I
For the Construction of a Well
In accordance with the provisions of Article 7, Chapter 87, North Carolina General
5 : _tc-tes, and other applicable laws, rules and regulations,
PERMISSION IS HEREBY GRANTED TO
CJl'!'!' CtPftAtm"1�
FOR 7I E CONSTRUCTION OF A WELIJOKLMSOM at NOSY
County, in accordance with the application dated May 17
in conformity with specifications and supporting data, all of which are filed -h the
J_ e of Water and Air Resources and are considered a part of this Permit.
This Permit is for well construction only, and does not waive any provisions cr require-
m .t; of the Water Use Act'of 1967, or any other applicable laws or regulations.
Construction of a well under this permit shall be in compliance with the North Carolina
If _1 onstraction Regulations and Standards, and any other laws and regulations pertaining
to well construction.
This Permit shall be subject to other specified conditions, limitations, or exceptions
a: follows: -
Farmit issued this the 2 th day of Kly , 19 •
By
]RMIT NO. 1�47 IL P**
Chief, Ground Water Division.
Office of Water and Air Resourc :c

�E s
T! 1
tIl �
RECEIVED
w M02 PAID
` ODUND WATER urwsfON.
H RAIIIGH, N. C.
d
A
1p
O
q � o
IS
4
I a:
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pppppp.
DIVISION OF ENVIRONMENTAL MANAGEMENT
December 16. 1982
Mr. Hugh Powell
Torun of Hayesville
P. D. Box 438
Hayesville, North Carolina 28904
Subject: Nell. Construction Pemit 110. 21-0019-WC-OOD4
Town of Huyesville
Clay County, North Carolina
Dear.Mr. Powell :
In accordance with your application received December 19. 1982, we
are forwarding herewith Well Construction Permit No. -21-0019-WC-0004
dated December 16. 1982m issued to the Town of Hayesville for the
construction of a 187.200 gallon per day water supply well system.
This Permit will be effective from the date of its issuance and
shall be subject to the conditions and limitations as specified therein.
Sincerulys
ORIGINAL SIGNED BY ROY M. DAVIS
Roy M. Davis
Regional. Supervisor
RMD/ar
Enclosure
cc: Mr. Perry Nelson
Mr.-Ed Seagle
N. C. Department of Human Resources

PPPPF"'
NORTH CAROLINA
ENVIRONMENTAL MAHAGEMEWT CONBiISSION
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
ASHEVILLE. NORTH CAROLINA
PERMIT• FOR THE CONSTRUCTION OF A WELL OR WELL SYSTEM
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
TOWN OF HAYESVILLE
FOR THE CONSTRUCTION OF A WELL SYSTEM located off SR 130B, SR 1140 and U. S..64
1n Clay County; in accordance with•the •application dated November 22, 1982, and
in conformity with specifications and supporting data, all of which are filed
with the Department of Natural Resources and Community Development and are
considered, a part of this Permit.
This Permit is for well construction only, and does not waive any provisions
or requirements of the Water Use Act of 1967, or any other applicable laws-or
regulations.
Construction of a well under this Permit shall be in compliance with the
North Carolina Well Construction Regulations. and Standards, and any other laws
and regulations pertaining to well construction.
This Permit will be effective from the date of its issuance until May 229
1983, and shall be subject to other specified conditions. limitations, or
exceptions as follows:
1. Prior notice of the pumping test date must be given to Donald R. Link,
P. 0. Box 370, Asheville, N. C., 253-3341 at least 48 hours prior to
the start of the test.
2. Well site approval must be obtained from the Division of Health
Services of the North Carolina Department of Human Resources in
Black Mountain, N. C.

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Page 2
Permit issued this the 16th day of December. 1982.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COW4ISSION
ORIGINAL SIGNED BY ROY M. DAVIS
Roy M. Davis. Regional Supervisor
Division of Environmental Management
By Authority of the Environmental Management
Commission
PERMIT NO. 21-0019-WC-0004

North Carolina Department of Natural
Resources &Community Development
James B. Hunt, Jr., Governor Joseph W. Grimsley, Secretary
December 14, 1982
Mr. Hugh Powell
Town of Hayesville
P. 0. Box 438
Hayesville, North Carolina 28904
Subject: State Permit Application
Well Construction
Town of Hayesville
Clay County, North Carolina
Received: December 13, 1982
Dear Mr. Powell :
The North Carolina Department of Natural Resources and Community
Development hereby acknowledges the receipt of subject permit applica-
tion. This application has been forwarded to the Department's Division
of Environmental Management in Asheville for appropriate action. You
can expect the Division of Environmental Management to contact you
concerning the issuance of this permit.
Should you have any questions or require any assistance regarding
this permit, please do not hesitate to contact the,- lvi 'on of Environ-
mental Management in this office.
Sin ,
d P. s ael
R g 'onal nager
evill Region Office
EPI :ar
cc: Perry Nelson
Asheville Regional Office Interchange Building, 159 Woodfin Street,P.0. Box 370,Asheville,N.C.28802-0370;Telephone [phone]
An Eauai OUOOrtunity Aff nnative Action Emninver

NORTH CAROLINA A
��ENVIR-....'ENTAL MANAGEMENTCOMMISSl. .. EEILJPPPFDEPARTMENT OF NATURAL AND ECONOMIC RESOURC (
DEC
APPLICATION FOR PERMIT TO CONSTRUCT A WELL
on
yy 77 (Jil.e
To: NORTH CAARROLINA ENVIRONMENTALL MANAGEMENT COMMISSION L� 4r �( X 19�
Gentlemen: !/II S /1�f7 �C /� Z /U l 5 �Ur- 'D 1) r0/3el_:'C-4C WCI � 5
—Tow,) 0 N
3 A es ; 11e
In accordance with the provisions of Article 7, Chapter 87, General Statutes o
Nor h Carolina, nd regulations pursuant thereto, application is hereby made by
OtUn rSt �A4'9'S.ttIIE. for a permit to construct
name of well owner)
a well as described below and in the accompanying data submitted as a part of this
application. ---i- r
(a) Name of Property owner C L0 C` - -
(b) Location of Property. S .I
le
(Road, Community, Subdivision, Lot No. ) To4n County
(c) Purpose of well OLIJ n UJ , 5' S Y ir 0 /
(d) Will proposed well replace an existing well d Ct'%r
(e) Total capacity of existing system: gallons per day
Well No. Yield Well No. Yield
(f) Proposed well:
Construction type en a l screened,/ gravel packed, etc.)
Estimated depth 3 fJ U / Estimat d Yield ! 3 O Ci :O i7ti
Estimated date of construction: Begin 80 b Com let, C' C- U
(g) Drilling Contractor: 0_4eerne O` �C? �/ �n--1 /I—I1-� 1) /VC
(h) Location of Well: Provide a detailed map showing the location /of the proposed well
and any wells in the existing system to at least two (2) nearby reference points such
as roads, intersections, and streams. Identify roads with State Highway road
identification numbers. Show all existing water supply wells within a radius of
1,000 feet of the proposed well. n
(i) Well Construction Diagram: Provide a diagram sho ing proposed construction l4(/l/{o'� r_owcj/
specification. (See Form GW-22A) b, _DUK 4-3 �j TPSut !I o
The App2ieant hereby agreea .the propoaed T6 3oX 035 ALieso / e a�k9d+
weft wilt be eon.a.thuated .in accordance WitA (Mailing Address of Well Owner (Required)
approved 6peci6ieati.on6 and eondit:onb o6
.the WetE C .tieA,�ue tion Pennu.-t. '
r Mailing -Address of Agent
Signature df Well Owner or Agent
Title PERMIT NO. issued 19
GW-22

DIAGRAM OF PROPOSED
CONSTRUCTION SPECIFICATIONS
Straight-Screened
or Open-End Well
Gravel-Packed Well (Con9tructed in cousolid-
(Conatructed in unconsolidated formations) ated formations)
land surface
I
F2)
asing: �_�a�
) Inner: type I. D. lbs./ft. C e m Pn
ft. (depth) ft. (into rock)
Outer: Jp� type� I. D.� lba./ft.
ft. (depth)
rock c U�".,
B) Cement:
1) Inner Casing: ft. to ft.
i
2) Outer Casing:_ L/) ft. to ft.
Rock Rock
C) Screen(s): type I. D.
ft. to ft.
ft. to ft.
1-0- 350
D) Gravel: it. to ft. in. le
(size) -�o -
(Fill in each blank that applies and use appropriate diagram
to show proposed construction including, but not limited to,
casing (outer and inner), sealing material (cement, clay,
etc. ), packers, screens, gravel, chemical feed lines, etc.)
Location Diagram: (Previously prepared maps may be submitted provided they con-
tain information required in item (g) of the application).
5c E jQ4C1C �JVI�e.A

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor David R. Spain
S. Thomas Rhodes, Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
June 7, 1988
Mr. Gary Reffit
P. 0. Box 124
Warne, North Carolina 28909
SUBJECT: Well Construction Permit No. 21-0022-WM-0005
Gary Reffit Laundromat
Clay County, North Carolina
Dear Mr. Reffit:
In accordance with your application received May 27, 1988, we are
forwarding herewith Well Construction Permit No. 21-0022-WM-0005 dated June
7, 1988, issued to Gary Reffit for the construction of three monitor wells
at Gary Reffit Laundromat in Warne, Clay County.
If any parts, requirements, or limitations contained in this Permit are
unacceptable to you, you have the right to an adjudicatory hearing before a
hearing officer upon- written demand to the Director- within 30 days following_.. _
receipt of this Permit, identifying the specific issues to-be contended.
Unless such demand is made, this Permit shall be final and binding.
This Permit will be effective from the date of its issuance until
December 7, 1988, and shall be subject to the conditions and limitations as
specified therein. Attached are Well Construction Records to be completed
and signed by the drilling contractor. These forms should be submitted to
the Department upon completion of the wells.
Sincerely,
\�
Roy M. Davis
Regional Supervisor
R!ID:LKD:ar
Attachments
cc: Perry Nelson
Roger Donaldson
Interchange Building,59 Woodfin Place, P.O.Box 370,Asheville,N.C.288020370•TelephoneJ704-251-6208
IAn Equal Opportunity Affirmative Action Employer

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
PPPFFF�DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
ASHEVILLE, NORTH CAROLINA
P E RM S T F O R TH E
C O N S T RU C T=ON O F A W E L'L
O R W E L L S Y S T E M i
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
GARY REFFIT
FOR THE CONSTRUCTION OF three monitor wells in the Residuum System of the
Great Smoky Mountain Hydrogeologic Unit, located at Gary Reffit Laundromat
on Old Highway 64 West in Clay County, in accordance with the application
dated May 27, 1988, and in conformity with specifications and supporting
data, all of which are filed with the Department of Natural Resources and
Community Development and are considered a part of this Permit.
This Permit is for well construction only, and does not waive any
provisions or requirements of any other applicable laws or regulations.
Construction of a well under this Permit shall be in compliance with
the North Carolina Well Construction Regulations and Standards, and any
other State and local laws and regulations pertaining to well construction.
This Permit will be effective from the date of its issuance until
December 7, 1988, and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. Each well shall have permanently affixed an identification plate
constructed of durable material and shall contain the following
information: drilling contractor's name and registration number;
date well completed; total depth of well; a warning that the well is
not for water supply and that the groundwater may contain hazardous
materials; and depth to screens.

Page 2 '
2. The wells shall be constructed with well casing and well screens that
conform to requirements of the "Criteria and Standards Applicable to
Water Supply and Certain Other Type Wells" (15 NCAC 2C .0100) .
3. The wells shall be constructed to a depth of ten feet below the
seasonally low water table.
4. Well completion, well abandonment, and water quality reports are to be
submitted to the Division of Environmental Management's Groundwater
Section Central Office in Raleigh.
5. All wells shall be afforded reasonable protection against damage
during construction and use.
6. When the wells have served their purpose and are of no further use,
they shall be permanently abandoned according to the requirements of
Section .0113 of the "Criteria and Standards Applicable To Water
Supply and Certain Other Type Wells" (15 NCAC 2C) .
7. Provisions shall be made on the well cover to prevent surface water
with possible contaminants from entering the well pit and
contaminating the monitor wells.
8. The well driller shall notify the Asheville Regional Office prior to
actual construction of the well.
Permit issued this the 7th day of June, 1988.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
9�" �
Roy M. D vis, Regional Supervisor
Division of Environmental Management
By Authority of the Environmental Management
Commission
PERMIT NO. 21-0022-WM-0005

FOR OFFICE 118E ONLY
ne fAL MANA(E/.E NKX24DWATM aECT10N
jjjjpppprlft�--.�M��'Tm��'
27ee7- LLEKIH.N.C.276' ONE(a/D 733-5083 a 40. 10,0A Serial No.
Lat. Lora. Pc_
Minor Basin
WELL CONSTRUCTION RECORD Basin Code
Header Ent. OW-1 Ent.
DRILLING CONTRACTOR
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Vapn P County: GlQ74
(Road, Community, or Subdivision and Lot No.) Depth DRILLING LOG
M RP- - , From To Formation Description
2. OWNER �lah•
ADDRESS
Street or Route No. THREE COPIES OF THIS FORM WERE SENT
—
TO THE WELL DRILLER City or Town State Zip Code _
3. DATE DRILLED USE OF WELL
4. TOTAL DEPTH CUTTINGS COLLECTED ❑Yes ❑ No
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes ❑ No
6. STATIC WATER LEVEL: FT. ❑ above TOP OF CASING,
❑ below
TOP OF CASING IS FT. ABOVE LAND SURFACE.
7. YIELD (gpm): METHOD OF TEST
8. WATER ZONES (depth):
9. CHLORINATION: Type Amount
10. CASING: Wall Thickness If additional space is needed use back of form.
Depth Diameter or Weight/Ft. Material
LOCATION SKETCH
From To Ft. (Show direction and distance from at least two State Roads,
From To Ft. or other map reference points)
From To Ft.
I1. GROUT:
Depth Material Method
From To Ft.
From To Ft.
12. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Fl. in. n.
13. GRAVEL PACK:
Depth Size Material
From To Ft.-
From-To- Ft. /
14. REMARKS: TA 64 J1'rue- rAl B
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C. WELL CONSTRUCTION
STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF CONTRACTOR OR AGENT DATE
n'w t 111Ra Submit original to Division of Environmental Management and copy to well owner.

pp,
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
APPLICATION FOR PERMIT TO CONSTRUCT MONITOR/RECOVERY WELL(S) v
To: NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION S' a 19 a
Gentlemen:
In accordance with the provisions of Article 7, Chapter 87, General Statutues of
North Carolina, an regulations pursuant thereto, application is hereby made by
�4 r 4 /E teW,`?' for a permit to construct a
name of well owner
monitor/recovery well(s) as described below and in the accompanying data submitted as a
part of this application.
(a) Name of property owner:
(b) Location of property: n juw y wi4rivLc p/y y cuEs! C L,s�y
(Roo In ustry, Community, etc. Town County
(c) Type of facility or site being monitored: 4A1-4/Or y iyjgr
(d) Types of contamination being monitored or recovered:
(e) Existing monitor well numbers: lyo�j
(f) Existing monitor wells showing contamination (well no.): Ns vE
(g) Estimated water-table depth: -:?e feet
(h) Estimated date of construction: Begin 5- ? S Complete $ --2 !o
(i) Drilling constractor: f/4{E�tU «E tuELL �r•L�.�y� l� c
(J) Location of well: Provide a detailed map showing the location of the proposed well(s),
and of any wells in an existing monitoring system (if applicable), in relation to the
pollution source(s) being monitored and to at least two (2) nearby permanent reference
points such as roads, intersections, and streams. Identify roads with State Highway
road identification numbers. (Show all existing water supply wells within a radius of
1,000 feet of the proposed well.)
(k) Well construction diagram: Provide a diagram showing proposed construction specifications,
including diameter, estimated depth, screens, sand pack, grout, type of materials, etc.
The Applicant hereby agrees the proposed
well will be constructed in accordance with io � L3oL ft� WA,z,vL �.c . 25�/U5
approved specifications and conditions of Mai rng Address of We1TOwner-Required)
the Well Construction Permit. As regulated
under the Well Construction Standards (Title
15 - North Carolina Administrative Code, (Mailing Address of Agent-if other
Subcha ter C) than above)
Signature Well QWftr or Agent
FOR OFFICE USE ONLY
Title (if applicable) PERMIT NO. issued 19
GW-22B

Locking Cap i
7( If
l outer Cdbing NOTE
lastic Inner Casing) I. Borehole to .be six inches
larger than ouh4de diameter
LAND N SURFACE of casing.
X 2. Casing and screen to be
1A centered in borehole.
Neat Cement Grout
T.
3. Top of well screen should
m not be above mean high
c" or larger diam. > seasonal water level.
Well Casing
_ 4. Casing and aoreen material
to be compatible with type
w
of contaminant being man
a Pelletized Bentonite stored.
-
5. Well head to be labeled
with highly visible warning
saying Well is for moni-
Clean Washed -- toring and not considered
Sand or Gravel safe for drinking " .
Must Extend at o
least I Foot = 6 6. Well to be afforded reason.-
Above the Screen --_ s L0� able protection against
damage after construction.
= m
_-= a)
Well Screen
required for
unconsolidated ===
formations =-=
Recommended Construction Details for a Pollution Monitor Well

I
JW r,to well X
Note lyp
/ / O DilfttbV.TiGJ ;
G SOR 35 Pt �0 D ermpnv �tnf i
17
� 2S0a 2 c o✓c
)r-osrr, rf UlLr/.acy
CAR�••r+i _=EC SPecIVIC4110a.S�1�k�
essION
A.
1"= too• 1
.,,,.,..•' ;,�,:�; _\, /AST Y•nTE2 7>? A77H NT '�•
U. s=ra' —.LAUN � GMAT 'i
_NARY FFIT !�
'P'Oe
a
/1nK1 {`

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor Ann B. Orr
William W. Cobey,Jr., Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
October 6, 1989
Mr. V. A. Edwards, Division Engineer
North Carolina Department of Transportation
Post Office Box 37
Sylva, North Carolina 28779
Dear Mr. Edwards:
Subject: Well Construction Permit No. 21-0024-WM-0007
Clay County Department of Transportation
Groundwater Incident No. 5056
Clay County, North Carolina
In accordance with your application received September 29, 1989, we are
forwarding herewith Well Construction Permit No. 21-0024-WM-0007 dated October
6, 1989, issued to Clay County Department of Transportation for the
construction of monitor wells as needed at the North Carolina Department of
Transportation in Clay County.
If any parts, requirements, or limitations contained in this Permit
are unacceptable to you, you have the right to an adjudicatory hearing
before a hearing officer upon written demand to the Director within 30 days
following receipt of this Permit, identifying the specific issues to be
contended. Unless such demand is made, this Permit shall be final and
binding.
This Permit will be effective from the date of its issuance until April 6,
1990, and shall be subject to the conditions and limitations as specified
therein. Attached are Well Construction Records to be completed and signed by
the drilling contractor. These forms should be submitted to the Department
upon completion of the wells.
Sincerely,
Roy Davis
RMD/MEU/gc Regional Supervisor
Attachments
cc: Perry Nelson
Chris Niver
EMA Consultants
Interchange Building, 59 WoodBn Place, Asheville, N.C. 28801 •Telephone [phone]
An Eoual Oonnmmiev AH,,- - A,,,:,..,

ppppppp
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
ASHEVILLE, NORTH CAROLINA
P E RM=T F O R THE
CONSTRUCT 2 ON O F A W E L L
O R WE L L S Y S T E M
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
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION - CLAY COUNTY
FOR THE CONSTRUCTION OF monitor wells as needed for Groundwater Incident
No. 5056 in the Residuum System of the Great Smoky Mountain Hydrogeologic
Unit, located at the North Carolina Department of Transportation in Clay
County, in accordance with the application dated September 26, 1989, and in
conformity with specifications and supporting data, all of which are filed
with the Department of Environment, Health, and Natural Resources and are
considered a part of this Permit.
This Permit is for well construction only, and does not waive any
provisions or requirements of any other applicable laws or regulations.
Construction of a well under this Permit shall be in compliance with
the North Carolina Well Construction Regulations and Standards, and any
other State and local laws and regulations pertaining to well construction.
This Permit will be .effective from the date of its issuance until
April 6, 1990, and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. The well driller shall notify the Asheville Regional Office prior
to actual construction of the wells.

Page 2
2. The wells shall be constructed with well casing and well screens
that conform to requirements of the "Criteria and Standards
Applicable to Water Supply and Certain Other Type Wells" (15 NCAC
2C .0100).
3. All wells shall be afforded reasonable protection against damage
during construction and use.
4. The well screens shall be set at a depth where the anticipated
high water table would be below the top of the screens so that
any floating petroleum products could enter the monitor wells and
of sufficient depth so there is water adequate for sampling
during the seasonally low water table.
5. Provisions shall be made on the well covers to prevent surface
water with possible contaminants from entering the well pits and
contaminating the monitor wells.
6. Each well shall have permanently affixed an identification plate
constructed of durable material and shall contain the following
information: drilling contractor's name and registration number;
date well completed; total depth of well; a warning that the well
is not for water supply and that the groundwater may contain
hazardous materials; and depth to screens.
7. Well completion, well abandonment, and water quality reports are
to be submitted to the Division of Environmental Management's
Groundwater Section Central Office in Raleigh.
8. When the wells have served their purpose and are of no further
use, they shall be permanently abandoned according to the
requirements of Section .0113 of the "Criteria and Standards
Applicable To Water Supply and Certain Other Type Wells" (15 NCAC
2C) .
Permit issued this the 6th day of October, 1989.
NORTH CAROLINA ENVIRONNMMENNTTAL MANAGEMENT COMMISSION
Roy M. Davis, Regional Supervisor
Division of Environmental Management
By Authority of the Environmental Management
Commission
PERMIT NO. 21-0024-WM-0007

PV
VCIIVISPJON
EPARTI.ENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT FOR OFFICE USE ONLY
ENVIRONMENTAL MANAGEMENT -GROl1NDWATER SECTION X 27687-RALEIGH,N.C.27e11.PHONE[phone] Wed No. l/01 Serial No.
Lat. Long. pc_
Mirror Basin
WELL CONSTRUCTION RECORD Basin Code
Header Ent. GW-1 Ent.
DRILLING CONTRACTORMTT
w� STATE WELL CONSTRUCTION
`j`�
DRILLER REGISTRATION NUMBER PERMIT NUMBER: Al—Gez4 —1QA4 Wc,7
1. WELL LOCATION: Show sketch of the location below)
Nearest Town: Ik!16�41II IV County:
(Road, Community, or Subdivision and Lot No.) Depth DRILLING LOG
2. OWNER Akl7�r' From To Formation Description
--�
ADDRESS re I
�Y Street or R ute No.
A - Z�r.✓
City or Town state Zip Code rTtPTFC (F 9AIS R�1_5k7� S(NT 10 Tf1E IItIIIFR
3. DATE DRILLED USE OF WELL
4. TOTAL DEPTH CUTTINGS COLLECTED ❑Yes ❑ No
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes ❑ No
6. STATIC WATER LEVEL: FT. ❑ above TOP OF CASING,
❑ below
TOP OF CASING IS FT. ABOVE LAND SURFACE.
7. YIELD (gpm): METHOD OF TEST
8. WATER ZONES (depth):
9. CHLORINATION: Type - Amount
10. CASING:
Wall Thickness It additional space is needed use back of form.
Depth Diameter or Weight/Ft. Material
LOCATION SKETCH
From To Ft. (Show direction and distance from at least two State Roads,
From To Ft. or other map reference points)
From To Ft.
11. GROUT:
Depth Material Method
From To-Ft.—
From To Ft.
12. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. In. in.
From To Ft. in. in.
13. GRAVEL PACK:
Depth Size Material
From To Ft.—
From-To- Ft..
14. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C. WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CONTRACTOR OR AGENT DATE
GW-1 Revised 6/88 Submit original to Division of Environmental Management and copy to well owner.

y NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
APPLICATION FOR PERMIT TO CONSTRUCT MONITOR/RECOVERY/WELL(S)
To:` : NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSIONT• Z�a 19 SDI
d.
Gentlemen: I
In accordance with the provisions of Article 7, Chapter 87, General Statutues of
,North Carolina, and regulations pursuant theretol application is hereby made by
NDP r ckVk? _� w�¢ �lC o� t c3vL5�sta Ito yq for a permit to construct a
name of well owner
monitor/recovery well(s) as described below and in the accompanying data submitted as a
part of this application.
(a) Name of property owner: O
(b) Location of property: Tvsj j� a.L
(Roams, industry, Community, etc, own Co——G y
(c) Type of facility or site being monitored: y,
E14 cu i._1 yria.n {-
(d) Types of contamination being monitored or recovered:
q:Cro Q l d f e ( tns
(e) '.'Existing monitor well numbers: O
(f); Existing monitor wells showing contamination (well no. ): Q
(9) Estimated water-table depth: S'. o feet
(h) Estimated date of construction: Begin (26 Complete O IgB�J
s ( ) Drilling constractor: e<_wSu/fh/dIS &IE,�/7 AJ- 6,
(j) Location of well: Provide a detailed map showing the location of the proposed well(s.),
and of any wells in an existi.ng monitoring system (if applicable), in relation to the
pollution source(s) being monitored and to at least two (2) nearby permanent reference
points 'such as roads, intersections, and streams. Identify roads with State Highway
road identification numbers. (Show all existing water supply wells within a radius of
1,000 feet of the proposed well .)
(k) Well construction diagram: Provide a diagram showing proposed construction specifications,
including diameter, estimated depth, screens, sand pack, out type of m terials, etc.
The Applicant hereby agrees the proposed U �dkaard5 �� dab near
well will be constructed in accordance with ?0• &X 3:7" ZY/✓a, /U• C : 8 L
approved specifications and conditions of (Mailing Address of Well Owner-Required)
the Well Construction Permit. As regulated
under the Well Construction Standards (Title y8®9' ,�!d k• 1L�/ , 10-C a?6®.6
15 - North Carolina Administrative Code, (Mailing Address of Agent-if other
Subchapter 2C) than above)
Signature of Well Ow per or Agerrt
FOR OFFICE_ USE ONLY
PERMIT NO. issued 19
Title i applicable)
' GW-228 r

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} r
�Y
State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor Ann B. Orr
William W. Cobey, Jr., Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
October 3, 1989
Mr. Mark Ledford, Project Manager
Vaughn and Melton Engineers-Architects
BB&T Building
Suite 810
Asheville, North Carolina 28801
Subject: Well Construction Permit No. 21-0023-WS-0006
William Leisy - Mountain Harbor
Clay County, North Carolina
Dear Mr. Ledford:
In accordance with your application received September 25, 1989, we are
forwarding herewith Well Construction Permit No. 21-0023-WS-0006 dated
October 3, 1989, issued to William Leisy-Mountain Harbor for the construction
of seventeen (17)-144,000 gallons per day water supply wells.
This Permit will be effective from the date of its issuance and shall be
subject to the conditions and limitations as specified therein. Attached are
Well Construction Records to be completed and signed by the drilling con-
tractor. These forms should be submitted to the Department upon completion of
the wells.
Sincerely,
R Davis
Regional Supervisor
RMD:HEM:gc
Attachments
cc: Perry Nelson
N. C. Department of Human Resources
William Leisy
Interchange Building, 59 Woodfin Place, Asheville, N.C. 28801 •Telephone 704-25"208
An Equal Opportunity Affirmative Action Empbver

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION ;
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
ASHEVILLE, NORTH CAROLINA
PEnmM-P FOR THE
CONSTRUCT 3E O1V O F A W E L L
O R WE L L S Y S T E M
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
WILLIAM LEISY - MOUNTAIN HARBOR
FOR THE CONSTRUCTION OF seventeen (17) water supply wells in the Bedrock
System of the Great Smoky Mountain Hydrogeologic Unit, located at NCSR
1330, near Hayesville in Clay County, in accordance with the application
dated September 22, 1989, and in conformity with specifications and
supporting data, all of which are filed with the Department of Natural
Resources and Community Development and are considered a part of this
Permit.
This Permit is for well construction only, and does not waive any
provisions or requirements of any other applicable laws or regulations.
Construction of a well under this Permit shall be in compliance with
the North Carolina Well Construction Regulations and Standards, and any
other State and local laws and regulations pertaining to well construction.
This Permit will be effective from the date of its issuance until
April 3, 1990, and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. Prior notice of the pumping test date must be given to Donald R.
Link, 59 Woodfin Place, Asheville, N. C. 28801, 251-6208, at
least 48 hours prior to the start of the test.
2. Well site approval must be obtained from the Division of Health
Services of the North Carolina Department of Environment, Health,
and Natural Resources in Black Mountain, N. C.

Page 2
Permit issued this the 3rd day of October, 1989.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Roy M. Davis, Regional Supervisor
Division of Environmental Management
By Authority of the Environmental Management
Commission
PERMIT NO. 21-0023-WS-0006

DEPARINptT OF NATURAL I ROES AND COIINUFM DEVE14PMB(T FOR OFFICE USE ONLY
FPOFPF'
BNfWNABlTAL MANAGEMENT-GROUNDWATER SECTION
P.O.BOX 27ea7-RAIEq!(N.C.27e11.PHONE[phone] Ouad. No. Serial No.
Lat. Lora. pc
Minor Basin
WELL CONSTRUCTION RECORD Basin Code
Header Ent.— GW-1 Ent.
DRILLING CONTRACTOR
STATE WELL CONSTRV98,2, ,_aJ5—QOO L DRILLER REGISTRATION NUMBER PERMIT NUMBER:
1. WELL LOCATION: (Show skeetlph�o(ff the
location below)
Nearest Town: �-!r� L� County:
`x— 1-3 BR? Depth DRILLING LOG
(Road, Community, or Subdivision and Lot No.)lit From To Formation Description
(/.A
2. OWNER CC/, !"/ TA(
ADDRESS Q
N Sl/!Gt or Rot o.) S�II�
City or Town State Zip Code
3. DATE DRILLED USE OF WELL ijuC mffmm (IF TM F[IrF1 WM MU To 1W
4. TOTAL DEPTH CUTTINGS COLLECTED ❑Yes ❑No 016MC (R
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes ❑ No
6. STATIC WATER LEVEL: FT. O above TOP OF CASING,
❑ below
TOP OF CASING IS FT. ABOVE LAND SURFACE.
7. YIELD (gpm): METHOD OF TEST
B. WATER ZONES (depth):
9. CHLORINATION: Type Amount
10. CASING: Wall Thickness If additional space is needed use back of form.
Depth Diameter or Weight/Ft. Material LOCATION SKETCH
From To Ft. (Show direction and distance from at least two State Roads,
From To Ft._ or other map reference points)
From To Ft.
11. GROUT:
Depth Material Method
From To—Ft.—
From To Ft.
12. SCREEN:
Depth Diameter Slot Size Material
From To Ff. in. in.
From To Ft. in. in.
From To Ft. in. in.
13. GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
14. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C. WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CONTRACTOR OR AGENT DATE
GW-1 Revised 6/88 Submit original to Division of Environmental Management and copy to well owner.

PV
UGHN & MELT( LEU4C OF 4G3G^aG�]y ZEDVIN&
Engineers-Architects
B B & T Building
One Pack Square
PPASHEV'ILLE, NORTH CAROLINA 22801 DATE 22 oe No. �F�7�5 —o
CDic
704-253.2796 ATTENTID"
FAX [phone] Cart
TO /'N t * / RE.
59 v✓ � � ti
N C Vito I
> WE ARE SENDING YOU X�Attached ❑ Under separate cover via a' the following items:
❑ Shop drawings Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order
r,
COPIES DATE NO. DESCRIPTION
THESE ARE TRANSMITTED as checked below:
624or approval ❑ Approved as submitted ❑ Resubmit copies for approval
For your use ❑ Approved as noted ❑ Submitcopies for distribution
> ❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS �Q
GfiCiC
COPY TO
SIGNED: Z2� /V
1em[1201 mix. .am r.,., It enclosures are not as noted, kindly notify us at ones.

DIAGRAM OF PROPOSED
CONSTRUCTION SPECIFICATIONS
Straight—Screened
or Open—End Well
Gravel—Packed Well (Constructed in consolid—
(Constructed in unconsolidated formations) ated formations)
land surface
A) Casing: , ,/. ty A N
RRR 1) Inner: /I//Q pe I. D. Ibs.�ft. q /� �
ft. (depth) ft. (into rock)
2) Outer:Wk 5+(type��I. D. lbs./ft.
ft. (depth) (m' — I&MIL �bS/��
B) Cement: 3�
1) Inner Casing:Outer
to ft.
2) Outer Casing: ft.
to 20 ft.
A ' Rock r4 Rock
C) Screen(s): type I. D.
ft. to ft.
ft. to ft.
D) Gravel: :t. to ft. in.
(size)
(Fill in each blank that applies and use appropriate diagram
to show proposed construction including, but not limited to,
casing (outer and inner), sealing material (cement, clay,
etc. ), packers, screens, gravel, chemical feed lines, etc. )
hoes lion Diagram: (Previously prepared maps may be submitted provided they con—
tain information required in item (g) of the application).
GW 22A

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