WS0701168_Application_20220329

>, iutrien-
Feeding the Future -
March 28, 2022
Attn: Will Hart
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889-3314
Subject: Application For Permit To Construct
Temporary Water Supply Well
PCS Phosphate Company, Inc.' — Aurora Division
Beaufort County
Will,
Please see the attached application for well construction of six(6) temporary water
supply wells in the active mining area at the Nutrien — Aurora facility.
Well construction is estimated to begin April 8, 2022.
Please do not hesitate to contact me at [phone], if I can answer any questions or
provide any additional information concerning this application.
Jtifies Chandler Stroud
Supervisor, Environmental Affairs
Nutrien-Aurora
pc: 12-06-001-02 (w/attachment)
ec: Gabrielle Chianese (w/attachment)
Tyler Cvetan (w/attachment)
1530 NC Hwy 306 South, Aurora, NC USA 27806
1 Effective January 1, 2018, PCS Phosphate Company, Inc is an indirect subsidiary of Nutrien Ltd. PCS Phosphate Company, Inc.
remains the legal operating entity and permittee.

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY — DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A WATER SUPPLY WELL OR WELL SYSTEM
(Wells or Well Systems with a Design Capacity of 100,000 Gallons Per Day or Greater)
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 water supply wells.
1. Date: March 28rd 2022
2. County: Beaufort
3. Applicant: PCS Phosphate Company Inc. (Nutrien)
Applicant's Mailing Address: 1530 NC HWY 306 S Aurora, NC. 27806
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
Telephone: [phone]
Applicant's Email Address (if available): [e-mail]
4. Contact Person (if different than Applicant): James Chandler Stroud Telephone: [phone]
Contact Person's Mailing Address: 1530 NC HWY 306 S Aurora, NC, 27806
Contac Person's Email Address (if available): James.Stroudnutrien.com
5. Property Owner (if different than Applicant): Telephone:
Owner's Mailing Address:
Owner's Email Address (if available):
6. Property Physical Address (including PIN Number): 1530 NC HWY 306 S PIN #: 27806-9245
City: Aurora _ County:
7. Intended use of Well or Well System:
(examples: irrigation, consumption, etc.)
Temporar; Water Suooly Well
Beaufort Zip Code: 27806
8. Will the proposed water supply well or well system replace or be added to an existing well or well system? No
(If yes, complete questions 7 and 8) (If no, complete question 7 and then skip to question 9)
9. Total design capacity of proposed well or well system in gallons per day (gpd): 260 000
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
11. Is this a public well or well system? No If yes, give Public Water ID Number:
If yes, give Project Engineer and contact information:
12. Well Contractor: Roger Hudson Well Contractor Certification No.: 2399-A
Well Contractor Address: 2222 Swamp Road Panted°, NC. 27860
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
b. Estimated well depth
c. Screen intervals
d. Sand/gravel pack intervals
e. Type of casing material and thickness
f. Grout horizons
g. Well Head completion details
2. No. of wells to be constructed in unconsolidated
material: 0
3. No. of wells to be constructed in bedrock: 6
4. Total No. of wells to be constructed: 6
(add answers from 2 and 3)
5. Estimated beginning construction date: 4/8/2022
6. Estimated construction completion date: 7/31/2022
Continued on Reverse

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. 143-215.106(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
2. As required by 15A NCAC 02C .0105(g)(3), for wells screened in multiple zones or aquifers, provide representative data on the
static water level, pH, specific conductance, and concentrations of sodium, potassium, calcium, magnesium, sulfate, chloride,
and carbonates from each aquifer or zone from which water is proposed to be withdrawn.
3. Attach any water use permits (if required). [e.g. Central Coastal Plain Capacity Use Area Permit is required in 15 eastern NC
counties by NC Division of Water Resources, visit: http://www.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
the Water Supply 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
Superintendent. Mine Planning
Signaffe of Applicant or *Agent Title of Applicant or *Agent
171 ker GV If signing as Agent, attach authorization agreement stating
Print d 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
water supply wells as outlined in this Water Supply Well Construction Permit application and that it shall be the responsibility of the
applicant to ensure that the water supply well(s) conform to the Well Construction Standards (Title 15A of the North Carolina
Administrative Code, Subchapter 2C).
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]
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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-22W Rev. 3-1-2016

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STATE ROAD 1936
/MINE PERMIT
GLAND WATER WELL #20\
4.5 IN WELL - 80 GPM
LAT:35.324620
LON:76.849274
r
Iutr,enT
NUTRIEN - AURORA
1530 NC HWY 306S
AURORA NC, 27806
RICHLAND TOWNSHIP
BEAUFORT COUNTY
NORTH CAROLINA
TITLE
WELL PERMITTING
GLAND WATER WELLS - SITE 1
DATE
3/22/2022
SCALE
1"=500'
SIZE
B
DWG NO
DWG 1
REV
0
COORD SYSTEM
NAD 1983 NORTH CAROLINA STATE PLANE
DWG FILE
GLAND WATER WELL PERMITS 202203 V2.DWG

-GLAND WATER WELL #21
4.5 IN - 80 GPM
LAT:35.331606
LO N :76.832146
INE PERMIT
GLAND WATER WELL#22\
4.5 IN WELL - 80 GPM
LAT:35.345486
LON:76.807810
HIGHWAY 306S
144,
Iutr,enT
NUTRIEN - AURORA
1530 NC HWY 306S
AURORA NC, 27806
RICHLAND TOWNSHIP
BEAUFORT COUNTY
NORTH CAROLINA
TITLE
WELL PERMITTING
GLAND WATER WELLS - SITE 2 & 3
DATE
3/22/2022
SCALE
1" = 1,000'
SIZE
B
DWG NO
DWG 3
REV
0
COORD SYSTEM
NAD 1983 NORTH CAROLINA STATE PLANE
DWG FILE
GLAND WATER WELL PERMITS 202203 V2.DWG