WM0401345_Monitoring Well Permit Application_20220202

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: 1/26/2022
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery):
Permanent Monitoring Wells
4. Applicant: MJC Enterprise, Inc. (petitioner for DSCA Site #DC410023) Telephone: Scott Stupak [phone]
Applicant's Mailing Address: DSCA Program, 1646 Mail Service Center, Raleigh, NC 27699-1646
Applicant's Email Address (if available): Scott.Stupak©ncdenr.gov
5. Contact Person (if different than Applicant): Robert Harrell, Hart & Hickman, PC Telephone: [phone]
Contact Person's Mailing Address: 3921 Sunset Ridge Rd, Suite 301, Raleigh, NC 27607
Contact Person's Email Address (if available): rharrell©harthickman.com
6. Property Owner (if different than Applicant): City of Greensboro- Richard Lovett (Environmental Compliance Support Manager)
Telephone: [phone]
Property Owner's Mailing Address: 401 Patton Ave., Greensboro, NC 27406
Property Owner's Email Address (if available): [e-mail]
7. Property Physical Address (Including PIN Number) Two wells are to be located in the right of way along N. Holden Road.
These locations are south of PIN numbers 7855485547 and 7855388520. One well is to be located in the right of way along
Shady Lawn Drive. This location is east of PIN number 7855387959. See attached map for details.
City Greensboro County Guilford Zip Code 27408
8. Reason for Well(s): Environmental Assessment for DSCA Program
(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: Dry-cleaner
(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).
NCDEQ DSCA Site ID #DC410023; Note that the groundwater plume is comingled with another nearby site under NCDEQ DSCA Site ID #DC410051. Additional wells are permitted under this site.
11. Type of contaminants being monitored or recovered: Chlorinated Solvents
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? Yes, 16
Existing Monitoring or Recovery Well Construction Permit No(s).: WM0401164
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): Approximately 1,200 to 1 500 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: Regional Probing Services
Certification No.: 3322
Well Contractor Address: PO Box 1161 Wake Forest, NC 27588

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 5. How will the well(s) be secured? Bolted flush -mount
material: 3
well with lockable well cap
3. Number of wells to be constructed in bedrock: 0 6. Estimated beginning construction date: March 2022
4. Total Number of wells to be constructed: 3 7. Estimated construction completion date: March 2022
(add answers from 2 and 3)
ADDITIONAL INFORMATION
1. 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
•4ffiz--1 r f .R*-ELL on behalf of Petitioner for DSCA Site DC410023 Agent for Petitioner for DSCA Site DC410023
Signature of Applicant or *Agent Title of Applicant or *Agent
Robert Harrell
* 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 property access agreement (Attachment 3) See attached property access agreement (Attachment 3)
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
Phone: [phone]
Fax: [phone]
GW-22M (Rev. 5/11)
GW-22MR Rev. 3-1-2016

Attachment 1

(<0.00050)
(0.019)
A CLEANER CITY
(DC410023)
MW-15D
W-4,
(0.005)
MW-10
(0 0014)
T-MW-5- " (0.034)
M W-8
(0.0011)
(0.017)
0.011)
MW-1
(0011
MW-3
(1.80)
AMW-13
(0.038)
AMW-16
n (0.007)
(<0.001)
/
(0.0041)
7
7
FORMER
TOPS
CLEANERS
_(DC410051)
<0.00050)
PINEDALE ROAD
LEGEND
FORMER DRY-CLEANER PROPERTY
BOUNDARY
PARCEL BOUNDARY
* DC410023 A CLEANER CITY TYPE II
SHALLOW MONITORING WELL
DC410023 A CLEANER CITY DEEP TYPE II
SHALLOW MONITORING WELL
* DC410051 TOPS CLEANERS TYPE III
MONITORING WELL
SEWER SERVICE LINE
ABOVEGROUND SURFACE WATER
DRAINAGE FEATURE
STORMWATER PIPE
SEWER GRAVITY MAINS
A SURFACE WATER SAMPLE LOCATION
(0 0011) PCE CONCENTRATION (mg/L)
-0.007- PCE ISOCONCENTRATION (mg/L)
(DASHED WHERE INFERRED)
NOTES:
•PROPOSED GROUNDWATER MONITORING
WELL
PROPOSED SURFACE WATER/PORE
WATER SAMPLE LOCATION
PROPOSED MONITORING WELL SAMPLE
LOCATION
1 PCE=TETRACHLOROETHYLENE
2. MW-1, MW-3, MW-6, MW-9, MW-13, C-MW-17, T-MW-1, SW-1,
AND SW-2 SAMPLED ON 5/9/19. T-MW-7 RESAMPLED ON
7/24/19.
3. MW-16 SAMPLED ON 10/16/15.
4. MW-2, MW-4, MW-7, MW-8, MW-10, MW-11, MW-12, AND
MW-14 SAMPLED ON 5/14/14.
5. * = TWO VALUES SHOWN FOR T-MW-7 REFLECT RESULT
OF 5/8/19 AND 7/24/19 SAMPLING EVENTS.
6. STORMWATER AND SEWER LINE LOCATIONS ARE BASED
ON FIGURES PROVIDED BY GUILFORD COUNTY.
0
APPROXIMATE
250
SCALE IN FEET
500
PROPOSED MONITORING WELL AND SURFACE
WATER/PORE WATER SAMPLE LOCATIONS MAP
FF: JFCT
A CLEANER CITY (DC410023)
TOPS CLEANERS (DC410051)
GREENSBORO, GUILFORD COUNTY
hart hickman
SMARTER ENVIRONMENTAL SOLUTIONS
3921 Sunset Ridge Road, Suite 301
Raleigh, North Carolina 27607
919-847-4241(p) 919-847-4261(f)
License # C-1269 / #C-245 Geology
DATE: 7-30-21
JOB NO. DSO-126 / DSO-141
REVISION NO. 0
ATTACHMENT NO. 7

Attachment 2

TYPE II MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
LOCKABLE WELL CAP
L3
L1
L2
L1 =
L2 =
L3 =
10
10
20
FT.
FT.
FT.
DIAMETER OF
BOREHOLE
4.25 in
CONCRETE PAD
FLUSH METAL WELL COVER
CONCRETE PAD
BACKFILL AROUND CASING
MATERIAL
LENGTH
WELL CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
BACKFILL AROUND CASING
MATERIAL
LENGTH
SEAL
TYPE OF SEAL
TH ICKNESS
FILTER PACK
TYPE OF FILTER
THICKNESS
WELL SCREEN
SCREEN MATERIAL
DIAMETER
LENGTH
SLOT SIZE
DEPTH TO BOTTOM OF
MONITORING WELL
cement grout
3 ft (0 to 3 ft)
schedule 40 PVC
2 inches
flush threaded
10 ft
bentonite/grout
3 ft (3 ft to 6 ft)
bentonite
2 feet (8 ft to 6 ft)
No. 2 Sand
12 ft (20 ft to 8 ft)
schedule 40 PVC
2 inches
10 feet
0.010 inches
20
TITLE Monitoring Well Diagram
Hart & Hickman, PC
3921 Sunset Ridge Road, Suite 301
Raleigh, North Carolina 27607
FILE
PREP. BY
RBH
REV. BY
GKO
DATE
11/29/2021
PROJECT NO.
DSCA ID: DC410023/ DC410051

Attachment 3

r City of Greensboro
MIN North Carolina
January 19, 2022
Hart & Hickman, PC
3921 Sunset Ridge Rd,
Suite 301
Raleigh, NC 27607
RE: City of Greensboro Permit Number DW01192022 for three permanent groundwater
monitoring and four soil gas samples.
Dear Sir or Madam;
The City of Greensboro has reviewed the installation request for three monitoring well. These
monitoring wells are to be installed to investigate groundwater Impacts related to a dry cleaner
site which is under investigation by the NCDEQ North Carolina Dry-cleaning Solvent Cleanup
Act (DSCA) Program. Based on the information provided, Hart & Hickman, PC (Hart &
Hickman) proposes to install the three groundwater monitoring well and four temporary soil gas
samples. Since the work is proposed to occur near the roadway, Hart & Hickman may need to
obtain an additional temporary ROW closure permit and comply with any conditions that GDOT
requires (see item #4).
The proposed work includes the following:
Hart & Hickman will install three permanent groundwater monitoring well (see attachment #1 in
the enclosures). However, the location may change slightly based on access, underground
utilities, and conditions observed during site reconnaissance.
The approval is given contingent on the following requirements:
1) All restoration shall be in accordance to the City of Greensboro/NCDOT Specifications
and any additional requirements as per City Inspections. Tunneling under sidewalk,
driveway aprons, or curb & gutter is not permitted. All concrete removal must be from
control joint to control joint. Concrete used for repair and/or replacement of sidewalk must
be 3000 psi minimum using NCDOT approved mix design.
2) All installations using the boring method must be bored without water assistance. Bore
depths at street crossings must be equal to 1 foot per '/2" aggregate cable(s) diameter with
a minimum depth of 3 feet measured from the road surface. Installations parallel to streets
shall be a minimum depth of 2 feet measured from the existing top of curb or edge of ribbon
pavement due to future roadway and sidewalk improvements.
640 P.O. Box 3136 • Greensboro, NC 27402-3136 • www.greensboro-nc.gov • (336) 373-CITY (2489) • TTY # 333-6930

City of Greensboro
MRNorth Carolina
3) Pavement repair shall be according to the City of Greensboro Standards & Specifications,
Std. #107 Rev. 09-03 and be one solid patch around the wells. However, 3' parallel and
longitudinal shelves are required, for trenching greater than 5' in width, depth, or in roads
designated as major thoroughfares. The final inch of surface course for the pavement repair
must be places with a paving machine and compacted with a tandem roller normal to
standard asphalt paving in final repair sections greater than 100 square feet. Paving
equipment must be preapproved by City Inspections. Any additional requirements will be
as per City Inspections.
4) Pedestrian and/or vehicular traffic must be maintained at all times, which should be
addressed by a traffic control plan submitted to GDOT if required by same. Any other
stipulations will be made by GDOT at the time of lane closure permit issuance. Equipment
and materials must be places so as not to interfere with site distance for vehicular traffic.
Temporary ROW closure permits can be obtained at http://gsoapps.greensboro-
nc.gov/publicTRAClosure/
5) As usual during construction phase, your construction manager will be requires to e-mail
my office before 8a.m. each day a copy of where your construction crew will be working.
E-mail address is [e-mail].
6) Any work outside the City's right-of-way will require and be the responsibility of Hart &
Hickman or their designated representatives to contact the property owners.
7) Noncompliance with any stipulation either verbal or in writing from any City official of
authority, can be cause for permit suspension and/or revocation.
8) Richard Lovett shall be given a minimum of 24-hour notice prior to beginning this work at
336-373-4188.
9) Repair seeding shall be according to COG/NCDOT specifications including a lawn type
finish in residential and/or landscaped areas.
10) The permit fees associated with this permit shall be $125 per monitoring well for the three
proposed monitoring wells. In addition to payment, Hart & Hickman indemnify and save
harmless the City of Greensboro from any and all damages and claims for damage as per
the global access agreement and must further insure the City that it currently has liability
insurance in the minimum amount of $1,000,000.00 to cover all risks involved with this
authorization and that such insurance will remain in full force and effect during the
activities hereby authorized.
11) An attached figure shows location of the proposed monitoring well which will drill in the
ROW but not in a stream buffer which addresses the comments from City of Greensboro
Staff:
a) 811 (ULOCO) and a private utility locator will be utilized prior to drilling.
b) All soil cuttings from drilling will be containerized and storm drains protected. The soil
and associated containers will be removed immediately following the completion of
the drilling activities at each location
640 P.O. Box 3136 • Greensboro, NC 27402-3136 • www.greensboro-nc.gov • (336) 373-CITY (2489) • TTY # 333-6930

��`1' 7City of Greensboro
��oti'd�dd�f�li'dd�iWbi�tinns. feel free
o GO- i bons, feel to contact me at [phone].
Thank you,
Richard P. Lovett
Environmental Compliance Support Manager
City of Greensboro
Field Operations Department
401 Patton Ave.
Greensboro, NC 27406
Phone - 336-373-4188
Fax - 336-373-2988
[e-mail]
Enclosures: Encroachment Agreement
Hart and Hickman Letter dates December 14, 2021
cc:
David Ortega, Department of Transportation, City of Greensboro
Tracy Peters, Department of Water Resources, City of Greensboro
Brian Gilles, Department of Engineering and Inspections
640 P.O. Box 3136 • Greensboro, NC 27402-3136 • www.greensboro-nc.gov • (336) 373-CITY (2489) • TTY# 333-6930

02/08/2008 10:42 CITY ATTORNEY'S OFFICE a 919198710335
NO.675 P02
RESOLUTION APPROVING AN•AMENDMENT TO THE GLOBAL
ENCROACHMENT AGREEMENT INTO CITY STREET RIGHTS -OF -WAY TO
INSTALL TEST WELLS PURSUANT TO TILE STATE OF NORTH CAROLINA
SOLVENT CLEANUP ACT
WHEREAS, ATC Associates, Inc. is a testing company that is acting as agent
pursuant to an Agreement with the North Carolina Department of Environment and
Natural Resources to install test wells and borings inside of the City pursuant to the North
Carolina Solvent Cleanup Act;
WHEREAS, on June 5, 2007, City Council approved a Global, Encroachment
Agreement allowing testing within street'rights of way upon approval of, the City's
Engineering and Inspections Department and the providing of notices, environmental and
closure reports to the City's Director. of Environmental Services;
WHEREAS, the current Global Encroachment Agreement provides for test Wells,
borings, and Agreements between the contractor and the adjoining property owners;
WHEREAS; ATC has recently requested to extend it's testing to sites owned by
the City, but outside of street rights of way and the current Agreement does not cover
these sites;
WHEREAS, the approval of the Amendment to the Global -Encroachment
Agreement will allow further testing to be done without repeated Council approval, but
subject to the approval of the Greensboro Department of Transportation, Environmental
Services and the Engineering Department, said Amendment presented herewith this day.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF GREENSBORO:
That the Amendment to the Global Encroachment Agreement between the City of
Greensboro and ATC Associates, Inc. presented herewith this day to allow ftirther testing
to be done to sites owned by the City, but outside of street rights of way without repeated
Council approval, but subject to the approval of the Greensboro Department of
Transportation, Environmental Services and the Engineering Department is hereby
approved.
TM foregoing resolution was adopted
by the City Council of the City of
Greensboro, NC on
City Clerk

hart hickman
SMARTER ENVIRONMENTAL SOLUTIONS
December 14, 2021
Mr. Richard Lovett
Environmental Compliance Support Manager
City of Greensboro — Field Operations Department
401 Patton Avenue
Greensboro, NC 27406
Reference: Sampling in City Right -of -Way (ROW) or on City -Owned Properties
Shady Lawn Drive, Hill-N-Dale Drive, & North Holden Road ROW
2605 Shady Lawn Drive (PIN 7855388520)
1704 North Holden Road (PIN 7855377908)
Greensboro, Guilford County, North Carolina
Dear Mr. Lovett:
Hart & Hickman, PC (H&H), under contract to the North Carolina Dry-cleaning Solvent
Cleanup Act (DSCA) Program, is requesting authorization to perform sampling in the
right-of-way (ROW) or properties outside the ROW owned by the City of Greensboro
(City). The City and H&H previously entered into a Global Encroachment Agreement
which covers sampling in the City ROW. H&H is requesting an amendment to this
agreement specifying that the agreement also covers sampling on properties owned by the
City but outside the ROW. H&H understands that similar amendments have previously
been executed by other contractors working for the DSCA Program. Please let us know
if this amendment is acceptable.
The Global Encroachment Agreement specifies that sampling activities require
authorization from the City representative. This letter details the proposed scope of work
related to the referenced project for your review. The scope of work includes temporary
surface water/pore water sampling locations, temporary soil gas sampling locations, and
permanent monitoring well locations, as detailed further below. Proposed sampling
locations are indicated on the figure included in Attachment 1.
Temporary Surface Water/Pore Water Sampling Locations
H&H proposes to collect five collocated surface water and pore water samples from a
tributary to North Buffalo Creek which traverses property owned by the City and outside
the ROW. Three sample locations are located on the 2605 Shady Lawn Drive property
(PIN 7855388520), and two sample locations are located on the 1704 North Holden Road
property (PIN 7855377908). The surface water samples will be collected using a grab
2923 South Tryon Street, Suite 100
Charlotte, NC 28203
704.586.0007 main
3921 Sunset Ridge Rd , Suite 301
Raleigh, NC 27607
919.847.4241 main
www.harthickman.com

Mr. Richard Lovett
City of Greensboro
Page 2
sampler from the bank of the surface water body. The pore water samples will be
collected by inserting a stainless -steel PushPointTM sampler into the sediment below the
surface water body. Once the sampler reaches the desired depth, pore water will be
extracted using a peristaltic pump or syringe. We anticipate initiating this work in
January 2022, pending approval of the City of Greensboro.
Temporary Soil Gas Sampling Locations
H&H proposes to collect four soil gas samples in the ROW for Shady Lawn Drive and
one soil gas sample in the ROW for Hill-N-Dale Drive. The work will be conducted in
the grass shoulder and no lane closures are necessary. The borings will consist of 1-inch
diameter borings advanced using hand tools and will be utilized for installation of
temporary Beacon Passive Soil Gas (PSG) samplers. The soil gas sampling probes will
be constructed by advancing a boring to a depth of 1-foot below ground surface (ft bgs),
installing a metal pipe, placing a hydrophobic adsorbent PSG sampler at the base of the
boring, and capping the boring with an aluminum foil plug. The passive samplers will
remain in place for approximately 14 days. Following sampling, the samplers will be
removed and the borings will be properly abandoned and patched to match surface
conditions (i.e., soil and grass seed). Utilities will be located prior to installation of the
temporary PSG samplers via NC One Ca11 and a private utility locator.
Deployment of the PSG samplers will take one day and then retrieval of the samplers will
take one additional day to complete. We anticipate initiating this work in January 2022,
pending approval of the City of Greensboro.
Permanent Monitoring Well Installation and Sampling
H&H proposes to install three permanent monitoring wells in the City of Greensboro
Right -of -Way. One of the wells will be located along Shady Lawn Drive, and the other
two will be located along North Holden Road in Greensboro, North Carolina. The work
will be conducted as close as reasonably possible to the curb on Shady Lawn Drive and in
the grassy area adjacent to the roadway along North Holden Road. No lane closures are
considered necessary. The monitoring wells will be installed using 4.5-inch augers on a
truck -mounted Geoprobe drill rig. The monitoring wells will be constructed by advancing
a boring to an estimated depth of 20 ft bgs, and installing a 2-inch PVC well with
approximately 10 ft of screen. Filter sand will be placed around the screened area to 2
feet above the screened interval, a hydrated bentonite seal will be placed above the sand
with a minimum thickness of 2 feet, a mixture of bentonite and grout will be placed
above the bentonite seal, and a minimum of 3 feet of cement grout will be placed above
the bentonite seal to surface. The monitoring wells will be completed with concrete pads
and steel flush -mount man covers. A monitoring well construction detail is included as
Attachment 2 for your review. Utilities will be located prior to installation of the
monitoring wells via NC One Call and a private utility locator.

Mr. Richard Lovett
City of Greensboro
Page 2
The monitoring well installation is expected to take one day to install and an additional
day to complete the pad construction and develop the monitoring wells. Following
installation, the wells will be sampled periodically. We anticipate initiating this work in
January 2022, pending approval of the City of Greensboro.
If the information detailed in this submittal appears acceptable, please respond with your
authorization.
If you have any questions or require any additional information, please do not hesitate to
contact me at [phone].
Sincerely,
Hart & Hickman, PC
Genna K. Olson, PG
Principal Geologist
Attachment 1 — Proposed Sample Locations Map, Attachment 2 — Monitoring Well
Diagram

Attachment 1
Proposed Sample Locations Map

Proposed sampling locations in City of
Greensboro right-of-way or on properties
owned by the City of Greensboro are
outlined in yellow for ease of reference.
IECEND
- LEANER PROPERTY
BOUNDARYPARCEL BOUNDARY
* OC410023 A CLEANER CITY TYPEu
SHALLOW MONITORING WELL
G D CLEANER CITY DEEPTYPE II
S IALLOW MONITORING WELL
* DC410.1 TOPS CLEANERS TYPE III
SEWER SERVICE LINE
ABOVEGROUND SURFACE WATER
DRAINAGE FEATURE
STORMWATER PIPE
SEWER GRAVITY MAINS
♦ SURFACE WATER SAMPLE LOCATION
(0,0011) POE CONCENTRATION (mp(L)
-0.007—
PCE sOCON0ENTRnTION (mg4.)
(DASHED WHERE INFERRED)
PROPOSED PERMANENT GROUNDWATER
MONITORING WELT.
PROPOSED TEMPORARY SURFACE
WATER/PORE WATER SAME, LOCATION
PROPOSED TEMPORARY SOIL GAS
NOTES SAMPLE LOCATION
1 PCE= TETRACNLOROETHYLENE
z W.13, C•MW-17, T--1,SW-1,
AND SW-2 i snMl LED ON 5l9r19 r MVVRESAMPLED ON
7/24/19
3 WV 16 SAMPLED ON 10/16/15
s • - REFLECT RESULT
OF SIBI. AND M24/19 SAMPLING EVENTS
6 STORMWATER AND SEWER LINE LOCATIONS ARE BASED
ON FIGURES PROVIDED BY GUILFORD COUNTY
APPROXIMATE
250
SCMI=E IN FEET
°' PROPOSED SAMPLE LOCATIONS MAP
A CLEANER CITY (DC410023)
TOPS CLEANERS (DC410051)
GREENSBORO, GUILFORD COUNTY
harts hickman
DATE: 7-30-21
JOB NO. DSO-1261 D50.141
REVISION NO.0
ATTACHMENT NO.

Attachment 2
Monitoring Well Diagram

TYPE II MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
LOCKABLE WELL CAP
L3
L1
L2
L1 =
L2 =
L3 =
10
10
20
FT.
FT.
FT.
t
EtEEK
DIAMETER OF
BOREHOLE
4.25 in
CONCRETE PAD
FLUSH METAL WELL COVER
CONCRETE PAD
BACKFILL AROUND CASING
MATERIAL
LENGTH
WELL CASING
MATERIAL
DIAMETER
JOINT TYPE
LENGTH
BACKFILL AROUND CASING
MATERIAL
LENGTH
SEAL
TYPE OF SEAL
THICKNESS
FILTER PACK
TYPE OF FILTER
THICKNESS
WELL SCREEN
SCREEN MATERIAL
DIAMETER
LENGTH
SLOT SIZE
cement grout
3 ft (0 to 3 ft)
schedule 40 PVC
2 inches
flush threaded
10 ft
bentonite/grout
3 ft (3 ft to 6 ft)
bentonite
2 feet (8 ft to 6 ft)
No. 2 Sand
12 ft (20 ft to 8 ft)
schedule 40 PVC
2 inches
10 feet
0.010 inches
DEPTH TO BOTTOM OF
MONITORING WELL 20
TITLE Monitoring Well Diagram
Hart & Hickman, PC
3921 Sunset Ridge Road, Suite 301
Raleigh, North Carolina 27607
FILE
PREP. BY
RBH
REV. BY
G KO
DATE
11/29/2021
PROJECT NO.
DSCA ID: DC410023/ DC410051

NORTH CAROLINA
GUILFORD COUNTY
GLOBAL ENCROACHMEN'
I.
e
IIIIIIII!IJII11111IIIiiiiiii111111iiii
2009004022
GUILFORD CO, NC FEE $20.00
PRESENTED &RECORDED:
01-27-2009 09:47:40 AM
JEFF L. THIGPEN
REGISTER OF DEEDS
SY: LINDA F. ALLRED
DEPUTY -GB
BK: R 6969
PG: 1420-1422
,"C,
THIS AGREEMENT, made and entered into this 16th day of December 2008, by and
between the CITY OF GREENSBORO, (hereinafter the City) party of the first part; and
Hart & Hickman, PC (hereinafter H&H) party of the second part.
WITNES SETH:
THAT WHEREAS, the City of Greensboro owns certain street rights of way located in
Greensboro, North Carolina, and H&H has requested permission, as contractor of the North
Carolina Department of Environment and Natural Resources (Division of Waste Management)
(hereinafter the "Division) to encroach into the City street rights of way at described locations
("the Property"), said encroachments to be in the nature of:
(1)
(2)
(3)
Taking such soil, water and air samples as may be necessary;
Taking other actions related to the investigation of surface or subsurface conditions;
and
Taking response actions necessary to mitigate any threat to human health or the
environment as a contractor for the Division with respect to the North Carolina Dry -
Cleaning Solvent Cleanup Act program.
Other conditions:
(1) H&H shall attempt to perform any activities at the property in a manner that
minimizes interference with use of the Property and that of adjoining private
owners..II&II will provide 72 hour's written notice to the City's Engineering and
Inspections Department, Utility Coordination, P.O. Box 3136, Greensboro, North
Carolina (Tel. [phone]) (Fax. [phone]).
(2) On conclusion of all activities, H&H, to the extent practicable, shall restore the
Property to the original condition it was in prior to any activities conducted by the
Division or its contractors. All monitoring wells will be properly abandoned in
accordance with applicable laws and regulations, unless other arrangements are
agreed to by the Property Owner.
The Division or its contractors shall provide the Property Owner and adjoining
private owners notice prior to entering the Property for any purpose. In situations
that the Division determines to be of an emergency nature the Division or its
contractors shall have immediate access to the Property.
(4) The Property Owner shall not willingly destroy, damage, remove, pave over or
cover any monitoring wells at the site without prior consent of the Division, or its
contractor.
(3)

(5) H&H guarantees that the encroachment will neither cause a public nuisance nor
unreasonably interfere with the use of the streets and sidewalks by the public or
public utilities.
(6) H&H hereby agrees to indemnify and save harmless the party of the first part
from any and all damages and claims for damage that may arise by reason of the
encroachment in the street right-of-way, and shall remove any or all of the
structures from encroachment space at the request of the party of the first part,
without any cost to the party of the first part. Such request shall not be arbitrary
or unreasonable. H&H further insures the City that it currently has liability
insurance in the minimum amount of $1,000,000.00 to cover all. risks involved
with this authorization and that such insurance will remain in full force and effect
during the activities hereby authorized.
(7) H&H agrees to maintain the encroached upon area in a safe condition.
(8) H&H is responsible for locating any and all utilities (Public and Private) and
structures in the encroachment area and to prevent damage to the same.
(9) The party of the second part, during the construction of the encroachment for
itself, its assignees and successors in interest agrees the contractor, with regard to
the work performed by it during the construction and maintenance of the
authorized testing, shall not discriminate against any protected group, including
the grounds of race, color, creed, gender, religion, age, disability, or national
origin in the selection and retention of subcontractors, including procurements of
materials and leases of equipment.
(10) H&H shall be responsible for all necessary permits and fees, both annual and job
specific, and all permits shall be in the name of H&II or the DSCA Petitioner.
(11) H&H shall also forward to the following named City Department Head all
abandonment records, preliminary and final environmental reports, closure
reports, and Notices and reports from DENR.
Mail to:
Jeryl W. Covington
Director of Environmental Services
City of Greensboro
P.O. Box 3136
Greensboro, NC 27402-3136
Contact Information:
Phone: [phone]
[e-mail]

IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to
be executed in duplicate originals the day and year first above written.
(Corporate Seal) 44°�®�,�
By: tl,
fA6
re�t1i aii-i1's.
b p
ATTES E0-1,B '° '
By:J "
1. f.
RecomiiIon lr'd::
By:
tj
;niic iiitt��'�'
Engineering Director
Approved as to Form:
City Attorney
(Cit. kr) (�..
Hart & Hickman, PC
By:
CITY OF GREENSBORO
r
By: __��
E y-.Manager.
\11at�e
Ihls 1st ement has boom praaudited in the manner
ay the Local Government Widget and Fiscal Dent,�i het.)
iunnee Director
C- 4-`, S\JL Lk. ex.L .t.,� C3—c) `1. Y Cf,v,. C:Q
(((
rx
LINDA G. PLOURDE
NOTARY PUBLIC
GUILFORD COUNTY, NC
ylp u \...Q, i i i

Lovett, Richard
From: Genna Olson <[e-mail]>
Sent: Friday, January 7, 2022 3:58 PM
To: Hill, Johnnie
Cc: Lovett, Richard; Robert Harrell
Subject: RE: Access for Sampling for Dry-cleaning Solvent Cleanup Act (DSCA) Program
Hi Richard — Hope you had a good holiday. Could you let me know if you are still waiting for more approvals on this, or if
we are good to go? Thank you!
11
okk-
Genna K. Olson, PG, Principal Geologist
Hart & Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2511 • Mobile: [phone]
www.harthickman.com
From: Hill, Johnnie <[e-mail]>
Sent: Thursday, December 16, 2021 3:51 PM
To: Genna Olson <[e-mail]>
Cc: Lovett, Richard <[e-mail]>; Robert Harrell <[e-mail]>
Subject: RE: Access for Sampling for Dry-cleaning Solvent Cleanup Act (DSCA) Program
This addresses my concerns. Thank you for providing the additional information. Water Resources is okay with what
you have shown.
Johnnie A. Hill, Plan Review Supervisor
Water Resources Department
City of Greensboro
Phone: [phone] Fax: [phone]
2602 South Elm -Eugene Street, Greensboro NC 27406
www.greensboro-nc.gov
From: Genna Olson <[e-mail]>
Sent: Thursday, December 16, 2021 2:51 PM
To: Hill, Johnnie <Johnnie.Hill(agreensboro-nc.gov>
Cc: Lovett, Richard <[e-mail]>; Robert Harrell <[e-mail]>
Subject: RE: Access for Sampling for Dry-cleaning Solvent Cleanup Act (DSCA) Program
Mr. Hill,
The locations along the stream and near stormwater drains will be temporary locations and completed in about an hour
each. They will just involve one person collecting a quick surface water sample, then inserting a probe about a foot into
the base of the stream to collect a pore water sample below the stream. We would like to do the work in January.
For the locations in the right-of-way, we would be staying behind the curb. Locations will be in grassy areas with the
possible exception of the monitoring well off Holden Road. For this well, we will need to confirm the specific location
after the utility locate, but there is a chance we may need to put the well in the sidewalk to avoid utilities. The well will
be finished with a flush mounted steel manhole cover. If required, we could replace the concrete in an entire section of
sidewalk (expansion joint to expansion joint) around the manhole, instead of our typical procedure of installing a new 2
ft x 2 ft concrete pad around the manhole.
i

Let me know if you have any further questions.
Thanks!
Genna
Genna K. Olson, PG, Principal Geologist
Hart & Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2511 • Mobile: [phone]
www.harthickman.com 10'
From: Lovett, Richard <[e-mail]>
Sent: Thursday, December 16, 2021 8:34 AM
To: Genna Olson <[e-mail]>
Subject: FW: Access for Sampling for Dry-cleaning Solvent Cleanup Act (DSCA) Program
Please respond to Mr. Hills questions and copy me on the response.
Thank you,
Richard P. Lovett, (he/him) Why are pronouns important?
Environmental Compliance Support Manager
City of Greensboro
Field Operations Department
401 Patton Ave.
Greensboro, NC 27406
Phone - 336-373-4188
Fax - 336-373-2988
rchard.lovett(a�greensboro-nc.gov
From: Hill, Johnnie<[e-mail]>
Sent: Wednesday, December 15, 2021 4:25 PM
To: Lovett, Richard <[e-mail]>
Cc: Ortega, David <[e-mail]>; Gillies, Brian <Brian.Gillies(Wgreensboro-nc.gov>
Subject: RE: Access for Sampling for Dry-cleaning Solvent Cleanup Act (DSCA) Program
I have noted a Capital Improvement Project that we currently have under design in this vicinity. We will be upgrading
the storm drainage system from Robin Hood Drive to the stream below Shady Lawn Drive in the next year or so. Design
is just getting underway. The majority of these are shown as temporary locations — what is that timeframe? There is
one shown right at the outlet of this system which could potentially be impacted. There is also a 8' x 5' culvert under N.
Holden Road where a sampling location is located on each end. We just need to be mindful of that system when it
comes time for installation.
Is the intent to install these behind the curb but still within the right-of-way? At this scale, its hard to tell exactly where
they are located.
Johnnie A. Hill, Plan Review Supervisor
2

Water Resources Department
City of Greensboro
Phone: [phone] Fax: [phone]
2602 South Elm -Eugene Street, Greensboro NC 27406
www.greensboro-nc.gov
3

ANNIZatiMAMF
Proposed sampling locations in City of
Greensboro right-of-way or on properties
owned by the City of Greensboro are
outlined in yellow for ease of reference.
m041000JR CCTV
FORMER DRY.CLEANER PROPERTY
BOUNDARY
• PARCEL BOUNDARY
41 DC410023 A CLEANER CITY TYPE II
SHALLOW MONITORING WELL
O DC410023 A CLEANER CITY DEEP TYPE II
SHALLOW MONITORING WELL
DC410051 TOPS CLEANERS TYPE III
MONITORING WELL
SEWER SERVICE LINE
ABOVEGROUND SURFACE WATER
DRAINAGE FEATURE
STORM WATER PIPE
SEWER GRAVITY MAINS
• SURFACE WATER SAMPLE LOCATION
(0.0011) PCE CONCENTRATION (mg/L)
-0,007- POE ISOCONCENTRATION(mg/L)
(DASHED WHERE INFERRED)
PROPOSED PERMANENT GROUNDWATER
MONITORING WELL
PROPOSED TEMPORARY SURFACE
WATER/PORE WATER SAMPLE LOCATION
POSED TEMPORARY SOIL GAS
NOTES -' SAMPLE LOCATION
PCE= TETRACHLOROETHYLENE
AND SW-2 SAMPLED ON 5/9n9 T•MWT RESAMPLED ON
mans
3 MW.16 SAMPLED ON 10/16/15
4 MRO,MW W12, AND
M W 14 SAMPLED ON 4/14
5 •= TWO VALUES SHOWN FOR T.MW, REFLECT RESULT
OF 5/Sn9 AND 7/24/19 SAMPLING EVENTS
6 ST ORMWATE R AND SEWER LINE LOCATIONS ARE BASED
ON FIGURES PROVIDED BY GUILFORD COUNTY
APPROXIMATE
250
SCALE IN I-ELI
"" PROPOSED SAMPLE LOCATIONS MAP
A CLEANER CITY (DC410023)
TOPS CLEANERS (DC410051)
GREENSBORO, GUILFORD COUNTY
hart hickman 997..101
M 1.LI �PRML1 L,eLmo 9 4,1249/4C211G.obM
DATE: 7-30-21
JOB NO. DSO-126 / DSO-141
REVISION NO.0
ATTACHMENT NO