WM0100506_Monitoring Well Construction Application_20220218

FOR OFFICE USE ONLY

PERMIT NO. ISSUED DATE
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: 2/18/2022

2. County: Buncombe County

3. What type of well are you applying for? (monitoring or recovery): Monitoring

4. Applicant: Buckeye Community Hope Foundation Telephone: NA

Applicant’s Mailing Address: 3021 E. Dublin-Granville Road, Suite 200

Applicant’s Email Address (if available): Mr. Steve Sceranka [e-mail]

5. Contact Person (if different than Applicant): Don R. Marlor, P.G., ECS Southeast, LLP Telephone: [phone]

Contact Person’s Mailing Address: 1900 Hendersonville Road, Suite 10, Asheville, NC 28803

Contact Person’s Email Address (if available): [e-mail]

6. Property Owner (if different than Applicant): Realty Company II, LLC Telephone: NA

Property Owner’s Mailing Address: PO BOX 15881, Asheville, North Carolina 28813

Property Owner’s Email Address (if available):

7. Property Physical Address (Including PIN Number) 99999 Governors View Road (965853892200000)
City Asheville County Buncombe Zip Code 28805
8. Reason for Well(s): assessment of former on-site fuel distribution facility, dispensers, and off-site petroleum facility
(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: assessment of former on-site fuel distribution facility, dispensers,
and off-site petroleum facility
(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 wells associated with the proposed well(s)? If yes, how many? No

Existing Monitoring or Recovery Well Construction Permit No(s).: Not Applicable

13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): On-site

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: Carolina Soil Investigations, LLC Certification No.: 2579-A

Well Contractor Address: 132 Gurney Road, Olin, NC 28660

Director of Real Estate Development - SE
Steven Sceranka
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-22MR Rev. 3-1-2016
SOURCE:
USGS TOPOGRAPHIC MAP
ASHEVILLE OTEEN, NORTH CAROLINA
QUADRANGLE DATED 2019
SCALE: 1:24,000
FIGURE 1
SITE LOCATION MAP
SWANNANOA RIVER ROAD PROPERTY
ASHEVILLE, BUNCOMBE COUNTY,
NORTH CAROLINA
ECS PROJECT NO. 49:13699-D
SITE
FIGURE 2
PROPOSED SAMPLE LOCATION MAP
SWANNANOA RIVER ROAD PROPERTY
ASHEVILLE, BUNCOMBE COUNTY,
NORTH CAROLINA
ECS PROJECT NO. 49:13699-D
SOURCE:
GOOGLE EARTH, DATED 2020
SCALE:
PROPOSED GROUNDWATER SAMPLE LOCATION
APPROXIMATE SITE BOUNDARY
= 100 FEET
LEGEND
PROPOSED SOIL SAMPLE LOCATION
FORMER USTs
(previously assessed)
FORMER
BUILDINGS
FORMER
4,000-GALLON
ASTs
FORMER
20,000-GALLON
ASTs
FORMER
GASOLINE
DISPENSERS
FORMER
LOADING
AREA
NOT TO SCALE
FIGURE 3
PROPOSED WELL CONSTRUCTION
DIAGRAM
SWANNANOA RIVER ROAD PROPERTY
ASHEVILLE, BUNCOMBE COUNTY,
NORTH CAROLINA
ECS PROJECT NO. 49:13699-D
EXPANSION CAP
WITH LOCK
6-INCH
BORE HOLE
1-INCH PVC CASING
SCHEDULE 40
GROUND
SURFACE
GROUNDWATER SLOTTED PVC SCREEN
0.01-INCH SLOT WIDTHS
SET TO INTERSECT GROUNDWATER
ESTIMATED 10 FEET IN LENGTH
SAND SCREEN
MINIMUM 1 FOOT ABOVE
THE SLOTTED PVC SCREEN
BENTONITE PLUG
MINIMUM 2 FEET
20 FEET
WELL CONTRUCTION DIAGRAM IS
REPRESENTATIVE OF ALL PROPOSED
MONITORING WELLS