WM0701302_Application_20230421

GMA
April 21, 2023
Mr. Randy Sipe
Hydrogeologist
North Carolina Department of Environmental Quality
943 Washington Square Mall
Washington, NC 27889
Groundwater Management Associates, Inc.
4300 Sapphire Court, Suite 100
Greenville, North Carolina 27834
Telephone [phone]
www.cimo-nc.com
Re: Well Construction Permit Application for the Southern Site (Ward Property) Monitoring (Test)
Wells for the Chowan County Water System
Dear Randy,
Groundwater Management Associates, Inc. (GMA) is working as a subconsultant to Rivers and
Associates, Inc. (Rivers) for hydrogeological consulting services associated with the exploration of
the Castle Hayne and Upper Cape Fear Aquifers in eastern Chowan County, North Carolina. These
aquifers are potential sources of groundwater to supply a proposed Reverse Osmosis (RO) Water
Treatment Plant.
This letter includes an Application for Permit to Construct a Monitoring or Recovery Well(s) (Form
GW-22MR). The completed application form is attached along with figures and other supporting
documentation. Below, we provide details on the proposed wells that will withdraw from the Castle
Hayne and Upper Cape Fear Aquifers.
Background
In December of 2020, Rivers, with assistance from GMA, prepared a Preliminary Regionalization
Feasibility Study that presented a regional water -supply option based upon construction of a new RO
Water Treatment Plant and associated wellfield near the Yeopim community. The conceptual
wellfield includes three well sites (a western well site, an eastern well site, and a southern well site)
spread over a triangular area north of Poplar Neck Road, west of Naughton Road, and south of
Yeopim Road. Each planned well site includes a shallow well screened within the Castle Hayne
Aquifer and a deeper well screened within the Upper Cape Fear Aquifer. These three locations
should provide critical data on the depths, thicknesses, yield potential, and water quality of the
Castle Hayne and Upper Cape Fear Aquifers across the proposed wellfield so that the production
wells can be designed for the raw water system to feed to the RO plant. Rivers anticipates that
construction of the test wells to begin in late spring of 2023. Public bidding for the test well
construction has not occurred, but it will be conducted in the coming weeks.

Mr. Sipe
PAGE 2
Well Construction Permit Application Details
The completed GW-22W form (attached) provides details of the well owner, contact information,
intended use, and design capacity for the wells. The attached Figures 1 and 2 present the location
for the proposed test well sites in detail. The proposed "Southern Site" (Ward Property) test wells
are located at 36102'03.6"N, 76032'10.5"W.
The test wells will be constructed of SDR17 PVC and SCH 10 stainless -steel casing, stainless -steel
screens, and built according to the North Carolina Well Construction Standards (NCAC 02C). Casings
will be properly grouted to prevent interconnection of the aquifers. At this time, Rivers has not bid
the drilling exploration work. All well contractor work will be done by a NC Licensed Well Contractor,
and all well construction will be completed in accordance with the 15A NCAC 02C Well Construction
Standards. Rivers anticipates that construction of the test wells will occur late spring of 2023,
pending receipt of the well construction permit. Your help with meeting our proposed timetable
would be appreciated.
This Application for Permit to Construct a Monitoring or Recovery Well was prepared by
Groundwater Management Associates, Inc. on behalf of CCWS. GMA is a professional corporation
licensed to practice geology (#C-121) and engineering (#C-0854) in North Carolina. I, James K.
Holley, a North Carolina Licensed Geologist employed by GMA, do certify that the information
provided in this permit application package is accurate and correct to the best of my knowledge.
Please let me know if you have any questions or need additional information.
Sincerely,
Groundwater Management Associates, Inc.
James K. Holley, P.G.
Senior Hydrogeologist
Enclosures:
Application Form (GW-22M/R) With Property Owner Signature
Figure 1 — Wellfield Map
Figure 2 — Southern Site (Ward Prop.) Map
Figure 3 — Well Const. Diagram
CC: Scott Godefroy, P.E. — Rivers

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 monitorinq or recovery wells.
1. Date: 02/27/2023
2. County:
Chowan
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): monitoring
4. Applicant: Groundwater Management Associates Inc. Telephone: [phone]
Applicant's Mailing Address: 4300 Sapphire Court, Suite 100, Greenville, NC 27834
Applicant's Email Address (if available):
5. Contact Person (if different than Applicant): James Holley Telephone: [phone]
Contact Person's Mailing Address: 4300 Sapphire Court, Suite 100, Greenville, NC 27834
Contact Person's Email Address (if available): iay _qma-nc.com
6. Property Owner (if different than Applicant): Joyce A. Ward Telephone:
Property Owner's Mailing Address: 201 Nortwick Road, Rolesville, NC 27571
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 619 Poplar Neck Road PIN: 782400803333
City Edenton County Chowan Zip Code 27932
8. Reason for Well(s): assessment
(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: Water System Facility (WSF)
(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: Orqanic, Inorganic, Radioloqical
(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).:
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 9500
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: To Be Determined from Bidding Certification No.:
Well Contractor Address:
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? ocked cap
material: —2
3. Number of wells to be constructed in bedrock.- 0 6. i__stl mated beginning construction date -
Total Number of wells to ba. ---1*,nstrLJcte-,d- 7
Estimated construction completion date -
(add ans!Jile.,i-'s from 2 and 3)
ADDITIONAL INFORMATION
atiadh. ed map of the showing the locations of the following:
As required by 15A NCAC 02C.01(05(�(15� T �!; - scai1.
C-4. All property boundairies, at least one of which is referenced to a minimum of two landmarks-SUChE.S. 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_ 143-215-1 OB(5), landfills, or other waste disposal, areas; within 500 feet
of the proposed well or well system. I
SIGNATURES
The Applicant iai responsibility for ensuring that the well(s) will be located, constructed, maintained, and abandoned in
accordance with 15A NCAC 021%'-'*'.
Sig ture Yf 'Applicant or rAg lt;�_K-
Title of Applicant or q e
* Jg
J_a e7l� 65 0 Signing as Agent. attach authorization agreement stating
Printed name of Applicant or *Agent that Yo " u have the authority to act as the Agent.
-h
ft
the property owner hereby consen-L-S, "'.-DY allow the Applican"'t-o -onstruct
�
kj e propearty is owned by someone other than -the Applicant, t
well(s) as outlined in this `yell Construction Permit application and acknowledges that it shall be the respoi 'sibility of the Applicant to
1-minSiure that the well() will be located, constructed, maintained, and abandoned in accordance with 15A NCAC 02C_
§i4�re &,-Property Owner (if different, than Applicant,"',', Printe-`� .Tame of Property Owner(if different than Applicant)
Please send the completed application to th.- appropriate Division of Water RGs-c-lurces' Regional Office"
z
Asheville Regional Office
Raleigh Regional Office
':,"Mmington Regional Office
2090 U.S. Highway 70
3800 Barrett Drive
i
-"27 Cardinal Drive Extension
Swannanoa. NC 28778
Raleigh, NC 27609
Wilmington, NC 28405
Phone- [phone]
Phone: (9191, 791-4200
Phone- [phone]
Falx: [phone]
Fax: [phone]
77ax.- [phone]
Fayeftevill.e-) Regional Office
225 Green Street, Suite 714
1
Fayetteville, NC 28301-5094
Phone. (91M 433-3300
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue,
Mool-alsville, NC 28115
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone..- "252) 946-6481
Fax: [phone]
Winston-Salem Regional Office
450 �Nl. Hanes Mill Road
Suite 300
Winston-Salem, NC 2� -7
Phone- [phone]
Fax-- (336j � 776-9-,97
I i
GVV-22WR (Rev. .5-203-20221)

FIGURE 1
Folder: P:AMuni\ChowanCo-Rgnl_ROWTP-2022014\GIS\ChowanCo_Pro\

FIGURE 2
1/
NOW OR FORMERLY
\
BENJAMIN A. RICH
°�
AND SIMON B. RICH, III
I
i
1E0,
150,
I
i
I�
40't
+I TEST
WELL
13 q\ Q )
13 a LU
�1� �� / f
UPPER CAPE FEAR ( 1 J \
PRODUCTION
I / —14\ WELL LOCATION W
LU WI W \ } j:: )
d SPARE PRODUCTION LOWER CASTLE HAYNE 1 I w J_ W
II WELL LOCIL
ATION �o PRODUCTION \6 ` ¢ m
\ v WELL LOCATION i LL LU =
_ CC= d \
ILL 004
W = _ I 1� \ 1 W 40' W 100'/ �� \ / � Y =
L
cc 0
p Z Mn, LQL c
Q \ \� \ NOW OR FORMERLY
a �o \ — JOYCE A. WARD
a
PILOT RO WTP m��
I LOCATION
NOW OR FORMERLY I
TEST
BENJAMIN A. RICH L> WELL
AND SIMON B. RICH, III I CC I
I p UTILITY SERVICE a- �1
(480 3-PHASE) i
�100, 14 (1)-- 150' �58' J % Ww — — —
114 \,-14_i—� �I 01,3
—13- — — — — — -
- -74— — — — — 74
—75. — 15
15�- �— r�—>sV NOTES:
NC 32 - POPLAR NECK RD 1. PARCEL INFORMATION TAKEN FROM
50' 0 25' 50' 100' R/W - -; CHOWAN COUNTY GIS DATA.
13• 2. ELEVATION DATA TAKEN FROM NC ONE
MAP LIDAR DATA.
SCALE 1 inch = 50 ft WARD - WELILI Sll E
Engineers CHOWAN COUNTY
�107 East Second Street REGIONAL R O WT P
PlannersPlivers
CHOWAN COUNTY NORTH CAROLINA
` Greenville, NC 27858 PROJECT No. 2022014 SHEET No
Surveyors & ASSOCIATES, INC. DESIGNED BY SPMG
Since 1918 [phone] DRAWING No. ��
DRAWN BY JIM scaEE AS NOTED
Landscape Architects riversandassociates.com CHECKED BY: SPMG
DATE NOV 29, 2022

SOUTHERN WELL SITE
SOUTHERN WELL SITE
UPPER CAPE FEAR
CASTLE HAYNE
LAND SURFACE
LAND SURFACE
024" BOREHOLE N
024" BOREHOLE
16"0 PITT CASING ASTM
16"0 PITT CASING ASTM
A53, GRADE B STEEL OR
A53, GRADE B STEEL OR
SCH40 PVC I
100' SCH40 PVC
100'
CONCRETE GROUT
179 CONCRETE GROUT
I
179'
(0'-699') I
I
(0'-274')
I
6.9"0 UPPER
6.9"0 UPPER
WELL CASING
WELL CASING
SDR 17 PVC
SDR 17 PVC
I
319'
344'
6.9"X4.5" REDUCER
6.9"X4.5" REDUCER
369'
SDR 17 PVC
SDR 17 PVC
374'
I
I
380'
INTERMEDIATE
WELL CASING
04.5", SDR 17 PVC
I
013.69" BOREHOLE
I I
I
INTERMEDIATE
WELL CASING
04.5", SDR 17 PVC
BENTONITE GROUT
(274'-304')
I
I
4.5"X4" REDUCER
SDR 17 PVC
I
4.5"X4" REDUCER
I I
4"0 60—WIRE, 316 SS
SDR 17 PVC
WELL SCREEN, 50 SLOT
I
(319'-369')
I
I I
744' 04" TAIL PIECE
I
SCHEDULE 10, 316 SS
I
(369'-374')
794
799' #3 GRAVEL PACK
(304'-380')
850'
LOWER WELL CASING
04", 316 SCH10 SS
I
CONCRETE GROU
I
I
I
I
I
I
I
I
BENTONITE GROUT 1001
(699'-729')
#2 GRAVEL PACK I
(729'-850')
4"0 60—WIRE, 316 SS �►
WELL SCREEN, 30 SLOT
(744'-794')
I I
04" TAIL PIECE
SCHEDULE 10, 316 SS I
(794'-799')
VERTICAL
GMA
013.69" BOREHOLE —
SCALE IN FEET
0 3060'
_--
GROUNDWATER MANAGEMENT ASSOCIATES, INC.
File: DRAWINGS/21348
SOUTHERN WELL SITE
Date: 2/6/23
Project No. 21348
TEST WELL CONSTRUCTION DIAGRAM
Figure:3