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HomeMy WebLinkAboutWM0801235_Application_20231108NORTH 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: October 31, 2023 4 County: Pender FOR OFFICE USE ONLY PERMIT NO. ISSUED DATE 3. What type of well are you applying for? (monitoring or recovery): Monitoring 4. Applicant: The Chemours Company FC LLC Applicant's Mailing Address: 22828 NC Highway 87W, Fayetteville, NC 28306 5. H 7 A a Applicant's Email Address (if available): sathya.v.yalvigi@chemours.com Telephone: 302-773-4291 Contact Person (if different than Applicant): Savannah Volkoff Telephone: 919-424-1849 Contact Person's Mailing Address: 2501 Blue Ridge Rd, Suite 430, Raleigh, NC, 27607 Contact Person's Email Address (if available): svolkoff@geosyntec.com Property Owner (if different than Applicant): NCDOT ROW Enroachment Property Owner's Mailing Address: See attached Property Owner's Email Address (if available): NA Telephone: 877-368-4968 Property Physical Address (Including PIN Number) Multiple locations - See attached figures & approved DOT permit City See attached figures/DOT permit County See attached figures/DOT permit Zip Code See figs/permit Reason for Well(s): Groundwater Monitoring Wells (ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.) Type of facility or site for which the well(s) is(are) needed: NA (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). NA 11. Type of contaminants being monitored or recovered: PFAS (ex: organics, nutrients, heavy metals, etc.) 12 13 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).: NA Distance from proposed well(s) to nearest known waste or pollution source (in feet): None 14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Yes - one public supply; possible private If yes, give distance(s): Public supply well 140 ft NE of drilling location B-15 15. Well Contractor: SAEDACCO Certification No.: 4220 Well Contractor Address: 9088 Northfield Dr., Fort Mill, SC 29707 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 material: 6 3. Number of wells to be constructed in bedrock: a How will the well(s) be secured? Flush -mount well vault 6. Estimated beginning construction date: November 1, 2023 4. Total Number of wells to be constructed: 6 7. Estimated construction completion date: November 1, 2024 (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 assumes total responsibility for ensuring that the well(s) will be located, constructed, maintained, and abandoned in accordance with 15A NCAC 02C. Sathya Yalvigi 1ig41yaigne°1y Sathya Vaivigl DN. ­Sathya Va gi, -US, o= CM1emours Company, ou=Corporate Reme°iation Group, email-SatM1ya vyalvigi@cM1emours.com 4.11 Ofi fl]-3. 29-f15'Ofl' Signature of Applicant or *AgentDa1e 2 Sathya Valvigi Printed name of Applicant or *Agent Title of Applicant or *Agent * If signing as Agent, attach authorization agreement stating 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 well(s) as outlined in this Well Construction Permit application and acknowledges that it shall be the responsibility of the Applicant to ensure that the well(s) will be located, constructed, maintained, and abandoned in accordance with 15A NCAC 02C. Signature of Property Owner (if different than Applicant) NCDOT (See Attached Encroachment Agreement for Signature) 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 Raleigh Regional Office Wilmington Regional Office 2090 U.S. Highway 70 3800 Barrett Drive 127 Cardinal Drive Extension Swannanoa, NC 28778 Raleigh, NC 27609 Wilmington, NC 28405 Phone: (828) 296-4500 Phone: (919) 791-4200 Phone: (910) 796-7215 Fax: (828) 299-7043 Fax: (919) 571-4718 Fax: (910) 350-2004 Fayetteville Regional Office 225 Green Street, Suite 714 Fayetteville, NC 28301-5094 Phone: (910) 433-3300 Fax: (910) 486-0707 Mooresville Regional Office 610 East Center Avenue Mooresville, NC 28115 Phone: (704) 663-1699 Fax: (704) 663-6040 Washington Regional Office 943 Washington Square Mall Washington, NC 27889 Phone: (252) 946-6481 Fax: (252) 975-3716 Winston-Salem Regional Office 450 W. Hanes Mill Road Suite 300 Winston-Salem, NC 27105 Phone: (336) 776-9800 Fax: (336) 776-9797 GW-22M/R (Rev. 5-26-2022) STATEm STATE OF NORTH CAROLWA DEPARTMENT OF TRANSPORTATION Roy COOPER J.R. "JOEY" HOPKINs GOVERNOR SECRETARY October 27, 2023 The Chemours Company, FC LLC-Fayetteville Works 22828 NC Highway 87 W Fayetteville, NC 28306 SUBJECT: Encroachment Agreement on SR-1522, SR-1318, SR-1307, and SR-1205 Onslow/Pender County (E031-071-23-00332) Dear Michael Schott, Attached for your files is a copy of Right of Way Encroachment contract properly executed. This contract covers the following: Located in Pender County. (Monitoring Wells) With the construction and/or erection of 3 temporary environmental ground monitoring wells and 3 permanent environmental ground monitoring wells. This approval is subject to this work being done in accordance with the attached plan sheet and special provisions. • No lane closures shall be allowed between the hours of 6:00 am to 9:00 am, and 4:00 pm to 7:00 pm (peak hours restricted). Further restrictions do apply; see the attached Standard Provisions. No lane closures to be placed on the weekends. The Continuing Indemnity Bond (9422949) posted with the North Carolina Department of Transportation is hereby obligated to cover work under this encroachment agreement. The applicant shall notify NCDOT at 910-467-0500 upon completion of the work for a final inspection to be performed by NCDOT personnel. After the project has been completed for ONE YEAR, and upon request by the applicant, NCDOT personnel will conduct a final inspection. If found satisfactory, the bond will be released. Mailing Address: NC DEPARTMENT OF TRANSPORTATION DIVISION OF HIGHWAYS 295A WILMINGTON HIGHWAY JACKSONVILLE, NC 28540 Telephone: (910) 467-0500 Fax: (910) 346-8030 Customer Service: 1-877-368-4968 Website: www.ncdot.gov Location: 295 A WILMINGTON HIGHWAY JACKSONVILLE, NC 28540 Sincerely, EP DocuSigned by: b+S OJ ra6W- B0327AD7C80B486... Douglas W. Racine Deputy District Engineer For Chad Kimes, P.E. Division Engineer CK/DWR/gom Attachments cc: Jeff Garrett, Pender County Maintenance Engineer (Electronic File) ROUTE multiple (see attached) PROJECT STATE OF NORTH CAROLINA COUNTY OF Pender DEPARTMENT OF TRANSPORTATION RIGHT OF WAY ENCROACHMENT AGREEMENT FOR NON -UTILITY ENCROACHMENTS ON -AND- PRIMARY AND SECONDARY HIGHWAYS The Chemours Company, FC LLC- Fayetteville Works Michael Schott 22828 NC Highway 87 W 919-424-1824 Fayetteville, NC 28306 mschott@geosyntec.com THIS AGREEMENT, made and entered into this the day of 120 23 , by and between the Department of Transportation, party of the first part; and The Chemours Company, FC LLC - Fayetteville Works party of the second part, WITNESSETH THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as Route(s) multiple (see attached figures) , located in Pender County with the construction and/Or erection of: 3 temporary environmental ground monitoring wells and 3 permanent environmental ground monitoring wells WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the right of way as indicated, subject to the conditions of this agreement; NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are made a part hereof upon the following conditions, to wit: That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part shall require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the party of the first part. That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights, flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices for Streets and HighwaVs and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained from the Division Engineer of the party of the first part. That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and claims for damage that may arise by reason of the installation and maintenance of this encroachment. It is clearly understood by the party of the second part that the party of the first part will assume no responsibility for any damage that may be caused to such facilities, within the highway rights of way limits, in carrying out its construction and maintenance operations. That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the first part. That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the Division Engineer of the party of the first part. That the party of the second part agrees to have available at the encroaching site, at all times during construction, a copy of this agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless evidence of approval can be shown. Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed. Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will not be required. That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the first part. That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the second part from the party of the first part. FORM R/W 16.1A (Revised February 2021) R/W (161A) : Party of the Second Part certifies that this agreement is true and accurate copy of the form R/W (161A) incorporating all revisions to date. IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and year first above written. DEPARTMENT OF TRANSPORTATION Se�" for Chad Kimes, P.E. BY: Digitally signed DIVISION ENGINEER C h e ri I yn by Cheri lyn ATTEST OR WITNESS: Mertes Sthya DIptal1, 51g1 ed by Sa'hya Y111 i a Mertes Date:2023.08.27 DN:� F,.thyavam,9,­os,o=rhe Chemoura Company, ou=Co,po,ate 15:43:05 04'00' Ya I vi g i Remed thy Croup, a=sathya.o yaw 9 @ohemo :.00m Date: 2023.08.25 11'.51'.22-04'00' Cherilyn Mertes, Sr. Scientist Sathya Yalvigi, Sr. Remedial Project Manager Geosyntec Consultants 1007 Market Street, Wilmington, DE 19898 Second Party INSTRUCTIONS When the applicant is a corporation or a municipality, this agreement must have the corporate seal and be attested by the corporation secretary or by the empowered city official, unless a waiver of corporate seal and attestation by the secretary or by the empowered City official is on file in the Raleigh office of the State Utilities Manager. In the space provided in this agreement for execution, the name of the corporation or municipality shall be typed above the name, and title of all persons signing the agreement should be typed directly below their signature. When the applicant is not a corporation, then his signature must be witnessed by one person. The address should be included in this agreement and the names of all persons signing the agreement should be typed directly below their signature. This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the following applicable information: 1. All roadways and ramps. 2. Right of way lines and where applicable, the control of access lines. 3. Location of the proposed encroachment. 4. Length and type of encroachment. 5. Location by highway survey station number. If station number cannot be obtained, location should be shown by distance from some identifiable point, such as a bridge, road, intersection, etc. (To assist in preparation of the encroachment plan, the Department's roadway plans may be seen at the various Highway Division Offices, or at the Raleigh office.) 6. Drainage structures or bridges if affected by encroachment. 7. Typical section indicating the pavement design and width, and the slopes, widths and details for either a curb and gutter or a shoulder and ditch section, whichever is applicable. 8. Horizontal alignment indicating general curve data, where applicable. 9. Vertical alignment indicated by percent grade, P.I. station and vertical curve length, where applicable. 10. Amount of material to be removed and/or placed on NCDOT right of way, if applicable. 11. Cross -sections of all grading operations, indicating slope ratio and reference by station where applicable. 12. All pertinent drainage structures proposed. Include all hydraulic data, pipe sizes, structure details and other related information. 13. Erosion and sediment control. 14. Any special provisions or specifications as to the performance of the work or the method of construction that may be required by the Department must be shown on a separate sheet attached to encroachment agreement provided that such information cannot be shown on plans or drawings. 15. The Department's Division Engineer should be given notice by the applicant prior to actual starting of installation included in this agreement. 16. Method of handling traffic during construction where applicable. 17. Scale of plans, north arrow, etc. Encroachment Agreement Standard Conditions District Office Contact Information: 295 Wilmington Hwy Jacksonville, NC 28540 (910) 467-0500 The Standard Conditions in this document apply to this and all encroachment agreements issued by District 1. Pre -Construction SC1 A Pre -Construction Meeting is required prior to beginning work. Contact the District Office to schedule. SC2 This permit along with all terms and agreements shall be incorporated into any lease or sales agreement. SC3 Approval may be rescinded upon failure to follow any of the provisions in this permit and may be considered a violation of the encroachment agreement. SC4 If the approved permit encroaches within the limits of an active construction project the Encroaching Party will be required to coordinate with the NCDOT contractor as well as secure a hold harmless agreement prior to commencing work. If the approved permit encroaches within the limits of a project in preconstruction, the Encroaching Party will be required to coordinate with the Department's Project Development Unit to ensure no conflicts are created with the installation. SCS The Encroaching party or their contractor shall provide the following notices prior to construction activity within the NCDOT Right of Way: a. Three (3) business days advance phone call at telephone (910) 467-0500 or email to div3distl @ncdot.gov to the District Engineer's office b. If the construction falls within the limits of an NCDOT managed construction project, five (5) business days advance phone call to the Resident Engineer, Daniel Waugh at (910) 467-0520 or email dqwaughl @ncdot.gov. Failure to provide these notifications prior to beginning construction is subject to the Division Engineer's discretion to cease construction activity for this encroachment. NCDOT reserves the right to cease any construction or maintenance work associated with this installation by the encroaching party until the construction or maintenance meets the satisfaction of the Division Engineer or their representative. SC6 Prior to beginning work, it is the requirement of the Encroaching Party to contact the appropriate Utility Companies involved and make arrangements to adjust or relocate any utilities that conflict with the proposed work. SC7 It shall be the responsibility of the encroaching party to determine the location of utilities within the encroachment area. NCGS § 87-115 through § 87-130 of the Underground Utility Safety and Damage Prevention Act requires underground utilities to be located by calling 811 prior to construction. The encroaching party shall be responsible for notifying other utility owners and providing protection and safeguards to prevent damage or interruption to existing facilities and maintain access to them. SC8 The encroaching party shall notify the appropriate municipal office prior to beginning any work within the municipality's limits of jurisdiction. SC9 NC 811 services DOES NOT provide locates of traffic signal cables. Excavation within 1000 feet of a signalized intersection will require notification by the encroaching party to the Division Traffic Engineer's Office at telephone number (910) 341-2200 no less than one week prior to beginning work. All traffic signal or detection cables must be located prior to excavation. Cost to replace or repair NCDOT signs, signals, pavement markings or associated equipment and facilities shall be the responsibility of the encroaching party. SC10 If modifications to a traffic signal are required under this encroachment agreement, a separate traffic agreement is required prior to work. Contact the Division Traffic Engineer or Deputy Division Traffic Engineer at (910) 341-2200. SC11 This agreement does not authorize installations within nor encroachment onto railroad rights of way. Permits for installations within railroad right of way must be obtained from the railroad and are the responsibility of the encroaching party. SC12 At the discretion of the District Engineer, a NOTIFICATION FOR UTILITY / NON -UTILITY ENCROACHMENT WITHIN NCDOT R/W form (See corresponding attachment) with the scheduled pre -construction meeting and associated Division 3, District 1 Updated 09/12/2022 construction schedule details must be completed and submitted to the District Engineer's office a minimum of one week prior to construction. SC13 At the discretion of the District Engineer, the encroaching party (not the utility contractor) shall make arrangements to have a qualified inspector, under the supervision of a Professional Engineer registered in North Carolina, on site at all times during construction. The registered Professional Engineer shall be required to submit a signed and PE sealed certification that the utility was installed in accordance with the encroachment agreement. Legal & Right -of -Way Issues SC14 This approval and associated plans and supporting documents shall not be interpreted to allow any design change or change in the intent of the design by the Owner, Design Engineer, or any of their representatives. Any revisions or changes to these approved plans or intent for construction must be obtained in writing from the Division Engineer's office or their representative prior to construction or during construction, if an issue arises during construction to warrant changes. No alteration of the approved plan will be allowed without written approval by NCDOT. All design plan changes proposed by the contractor shall be prepared by the Engineer of Record and submitted by the Owner/Permittee to NCDOT for review to ensure that the Engineer and Owner participate in all construction changes. Field changes constructed without prior written approval by NCDOT will not be accepted by NCDOT during the inspection process. SC15 NCDOT does not guarantee the right of way on this road, nor will it be responsible for any claim for damages brought about by any property owner by reason of this installation. It is the responsibility of the encroaching party to verify the right of way. SC16 Encroaching party shall be responsible for obtaining all necessary permanent and/or temporary construction, drainage, utility and/or sight distance easements. SC17 It shall be the responsibility of the property owner or local municipality to maintain any proposed sidewalk that will be placed within the NCDOT Right of Way. It is the responsibility of the Encroaching Party to place the sidewalk and wheelchair ramps per NCDOT standards and the latest edition of the Americans with Disabilities Act. This maintenance requires an encroachment agreement through the District Office. SC18 No commercial advertising shall be allowed within NCDOT Right of Way. SC19 The encroaching party shall obtain proper approval from all affected pole owners prior to attachment to any pole. SC20 The installation within the Control of Access fence shall not adversely affect the design, construction, maintenance, stability, traffic safety or operation of the controlled access highway, and the utility must be serviced without access from the through -traffic roadways or ramps. SC21 It shall be unlawful to place any highway obstruction, including a driveway headwall, fence, rural mailbox, newspaper delivery box, or other roadside obstruction, so as to interfere with the traffic or maintenance of the roads and highways of the state highway system. See North Carolina Administrative Code 19A NCAC 2E.0404. Bonds SC22 A Performance and Indemnity Bond posted with the North Carolina Department of Transportation is hereby obligated to cover work under this encroachment agreement. This bond is only for work within NCDOT Right of Way. SC23 An Initial Construction Inspection is required after the completion of the work. An Initial Inspection Report will be issued upon satisfactory completion of the work and begins the one year warranty period. Contact the District Office to schedule an inspection. SC24 A Final inspection is required after one year and prior to release of the bond. Contact the District Office three months prior to the end of the one year bonding period for final inspection and creation of a list of deficiencies; this should provide enough time for corrective action prior to the end of one year. A Final Inspection Acceptance will be issued once the work has been completed and any deficiencies addressed. SC25 All bonds will be held for a minimum of one year from the time of the Initial Construction Inspection Acceptance. At the end of that time period, the bond may be released at the request of the applicant pending Final Inspection Acceptance. Division 3, District 1 Updated 09/12/2022 Work Zone Traffic SC26 WORK ZONE TRAFFIC CONTROL QUALIFICATIONS AND TRAINING PROGRAM All personnel performing any activity inside the highway right of way are required to be familiar with the NCDOT Maintenance / Utility Traffic Control Guidelines (MUTCG). No specific training course or test is required for qualification in the Maintenance /Utility Traffic Control Guidelines (MUTCG). All flagging, spotting, or operating Automated Flagger Assist Devices (AFAD) inside the highway right of way requires qualified and trained Work Zone Flaggers. Training for this certification is provided by NCDOT approved training resources and by private entities that have been pre -approved to train themselves. All personnel involved with the installation of Work Zone Traffic Control devices inside the highway right of way are required to be qualified and trained Work Zone Installers. Training for this certification is provided by NCDOT approved training resources and by private entities that have been pre -approved to train themselves. All personnel in charge of overseeing work zone Temporary Traffic Control operations and installations inside the highway right of way are required to be qualified and trained Work Zone Supervisors. Training for this certification is provided by NCDOT approved training resources and by private entities that have been pre -approved to train themselves. For questions and/or additional information regarding this training program please refer to https://connect.ncdot.gov/projects/WZTC/Pages/Training.aspx or call the NCDOT Work Zone Traffic Control Section (919) 814-5000. SC27 The party of the second part shall employ traffic control measures that are in accordance with the prevailing federal, state, local, and NCDOT policies, standards, and procedures. These policies, standards, and procedures include, but are not limited to the following: a. Manual on Uniform Traffic Control Devices (MUTCD) — North Carolina has adopted the MUTCD to provide basic principles and guidelines for traffic control device design, application, installation, and maintenance. North Carolina uses the MUTCD as a minimum requirement where higher supplemental standards specific to North Carolina are not established. Use fundamental principles and best practices of MUTCD (Part 6, Temporary Traffic Control). b. NCDOT Maintenance / Utility Traffic Control Guidelines — This document enhances the fundamental principles and best practices established in MUTCD Part 6, Temporary Traffic Control, incorporating NCDOT-specific standards and details. It also covers important safety knowledge for a wide range of work zone job responsibilities. SC28 There shall be no lane closures, narrowing of lanes, detaining and/or altering the traffic flow on or during holidays, holiday weekends, special events or any other time when traffic is unusually heavy, including the following schedules: a. For unexpected occurrence that creates unusually high traffic volumes, as directed by the Engineer. b. For New Year's Day, between the hours of 6:00 AM December 3111 and 7:00 PM January 2nd. If New Year's Day is on a Friday, Saturday, Sunday, or Monday, then until 7:00 PM the following Tuesday. c. For Easter, between the hours of 6:00 AM Thursday and 7:00 PM Monday. d. For Memorial Day, between the hours of 6:00 AM Friday and 7:00 PM Tuesday. e. For Independence Day, between the hours of 6:00 AM the day before Independence Day and 7:00 PM the day after Independence Day. If Independence Day is on a Friday, Saturday, Sunday, or Monday, then between the hours of 6:00 AM the Thursday before Independence Day and 7:00 PM the Tuesday after Independence Day. f. For Labor Day, between the hours of 6:00 AM Friday and 7:00 PM Tuesday. g. For Thanksgiving, between the hours of 6:00 AM Tuesday and 7:00 PM Monday. h. For Christmas, between the hours of 6:00 AM the Friday before the week of Christmas Day and 7:00 PM the following Tuesday after the week of Christmas Day. These restrictions are in addition to any lane closure restrictions list in the Encroachment Special Provisions. SC29 If the Traffic Control Supervisor determines that portable concrete barrier (PCB) is required to shield a hazard within the clear zone, then PCB shall be designed and sealed by a licensed North Carolina Professional Engineer. PCB plans and design calculations shall be submitted to the District Engineer for review and approval prior to installation. Division 3, District 1 Updated 09/12/2022 SC30 Ingress and egress shall be maintained to all businesses and dwellings affected by the project. Special attention shall be paid to police, EMS and fire stations, fire hydrants, secondary schools, and hospitals. SC31 Two-way traffic shall be maintained at all times unless designated by the District Engineer. Traffic shall not be rerouted or detoured without the prior written approval from the District Engineer. No utility work will be allowed on state holidays from 7:00 PM the night before through 9:00 AM the day prior to, following or during local events without prior approval from the District Engineer. If the construction is within 1000 feet of a school location or on a designated bus route, the construction shall be coordinated with the school start and end times to avoid traffic delays. SC32 Work requiring lane or shoulder closures shall not be performed on both sides of the road simultaneously within the same area. SC33 Any work requiring equipment or personnel within 5 feet of the edge of any travel lane of an undivided facility and within 10 feet of the edge of any travel lane of a divided facility shall require a lane closure with appropriate tapers per current NCDOT Roadway Standard Drawings or MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES. SC34 At the discretion of the District Engineer, a traffic control plan shall be developed and submitted under the seal and signature of a Licensed North Carolina Professional Engineer prior to construction. The plan shall be specific to the site and adequately detailed. Issues such as the close proximity to intersections shall be addressed. SC35 If pavement markings are required under this encroachment agreement, the Encroaching Party shall have the pavement markings pre -marked, inspected, and approved by NCDOT personnel prior to the placement of final pavement markings. Contact Traffic Services at (910) 341-2200 for pre -marking inspections or field changes. SC36 All temporary and final pavement markings are the responsibility of the encroaching party. Centerline pavement markings shall be installed the same day resurfacing is accomplished. All other pavement markings shall be completed within five days of resurfacing. Final pavement markings and sign plans shall be submitted with the encroachment request to the Division Traffic Engineer prior to construction. Final pavement markings shall be thermoplastic unless otherwise directed by the Division Traffic Engineer or District Engineer. SC37 Any pavement markings that are damaged or obliterated shall be restored by the encroaching party at no expense to NCDOT. SC38 All concrete or paved channelization islands shall have a 12 inch diameter round or square smooth wall hole drilled, cored, formed, or air -hammered to the subgrade and backfilled with soil placed a minimum of 10 feet from the nose of each end of the island (see Roadway Standard Drawing 904.50), or as directed by the engineer. All sign supports that are to be erected in existing or proposed concrete or paved channelization islands shall meet the same requirements. If necessary, contact Traffic Services at (910) 341-2200 to mark core locations. SC39 Sidewalk closures shall be installed, as necessary. Pedestrian traffic shall be detoured around these closures and shall be signed appropriately and in accordance with The American with Disabilities Act Accessibility Guidelines. The encroaching party must adhere to the guidelines for accommodating pedestrians in encroachment work zones as described in the NCDOT Pedestrian Work Zone Accommodations Training found at https://www.youtube.com/watch?v=AOuYa5lW3dg&feature=youtu.be. Roadside Environmental SC40 The encroaching party shall comply with all applicable Federal, State and local environmental regulations and shall obtain all necessary Federal, State and local environmental permits, including but not limited to, those related to sediment control, stormwater, wetland, streams, endangered species and historical sites. Additional information can be obtained by contacting the NCDOT Division Environmental Office regarding the North Carolina Natural Heritage Program or the United States Fish and Wildlife Services. Contact the Division Environmental Office at (910) 341-2000. SC41 The Verification of Compliance with Environmental Regulations (VCER-1) form is required for all non -utility encroachment agreements or any utility encroachments. The VCER-1 form must be signed and/or sealed by a NC registered professional engineer (PE), registered land surveyor (RLS), or authorized personnel who has verified that all appropriate environmental permits (if applicable) have been obtained and all applicable environmental regulations have been followed. SC42 All erosion control devices and measures shall be constructed, installed, maintained, and removed by the Encroacher in accordance with all applicable Federal, State, and Local laws, regulations, ordinances, and policies. Permanent vegetation shall be established on all disturbed areas in accordance with the recommendations of the Division Roadside Environmental Engineer. All areas disturbed (shoulders, ditches, removed accesses, etc.) shall be graded and seeded in accordance with the latest NCDOT Standards Specifications for Roads and Structures and within 15 calendar days with an approved NCDOT seed mixture (all lawn type areas shall be maintained and reseeded as such). Seeding rates per acre shall be applied according to the Division Roadside Environmental Division 3, District 1 Updated 09/12/2022 Engineer. Any plants, vegetation or trees in the NCDOT planted sites that is destroyed or damaged as a result of this encroachment shall be replaced with plants, vegetation or trees of like kind or similar shape. Contact the Division Roadside Environmental Engineer at 910-259-4919. SC43 No trees within NCDOT shall be cut without authorization from the Division Roadside Environmental Engineer. An inventory of trees measuring greater than 4 caliper inches (measured 6" above the ground) is required when trees within C/A right of way will be impacted by the encroachment installation. Mitigation is required and will be determined by the Division Roadside Environmental Engineer's Office. SC44 The applicant is responsible for identifying project impacts to waters of the United States (wetlands, intermittent streams, perennial streams and ponds) located within the NCDOT right-of-way. The discharge of dredged or fill material into waters of the United States requires authorization from the United States Army Corps of Engineers (USACE) and certification from the North Carolina Division of Water Quality (NCDWQ). The applicant is required to obtain pertinent permits or certification from these regulatory agencies if construction of the project impacts waters of the United States within the NCDOT right-of-way. The applicant is responsible for complying with any river or stream Riparian Buffer Rule as regulated by the NCDWQ. The Rule regulates activity within a 50-foot buffer along perennial streams, intermittent streams and ponds. Additional information can be obtained by contacting the NCDWQ or the USACE. SC45 The contractor shall not begin the construction until after the traffic control and erosion control devices have been installed to the satisfaction of the Division Engineer or their agent. SC46 The contractor shall perform all monitoring and record keeping and any required maintenance of erosion and sediment control measures to maintain compliance with stormwater regulations. STIP (or Division Managed) Projects SC47 State Transportation Improvement Projects (STIP) — If encroachment falls within a STIP that is active or in design when installation takes place coordination with Division Utility Coordinator is required. If project is specifically within an active STIP then a hold harmless letter from NCDOT's contractor will be required. Any encroachment determined to be in conflict STIP construction shall be removed and/or relocated at the encroaching party's expense. Construction General SC48 An executed copy of the encroachment agreement, provisions and approved plans shall be present at the construction site at all times. NCDOT reserves the right to stop all work unless evidence of approval can be shown. Additionally, if safety or traffic conditions warrant such an action, NCDOT reserves the right to further limit, restrict or suspend operations within the right of way. SC49 The Encroaching Party and/or their Contractor shall comply with all OSHA requirements and provide a competent person on site to supervise excavation at all times. If OSHA visits the work area associated with this encroachment, the District Office shall be notified by the encroaching party immediately if any violations are cited. SC50 The Encroaching Party shall follow any and all revisions shown in RED on attached plan(s). SC51 All disturbed areas are to be fully restored to current NCDOT minimum roadway standards or as directed by the Division Engineer or their representative. Disturbed areas within NCDOT Right -of -Way include, but not limited to, any excavation areas, pavement removal, drainage or other features. SC52 All drainage structures disturbed, damaged or blocked shall be restored to its original condition as directed by the Division Engineer or their representative. SC53 All pipes placed within the NCDOT Right of Way shall be NCDOT approved materials. All joints shall be sealed with mortar or other NCDOT approved material. Backfill compaction shall meet NCDOT Standardized Testing Method. SC54 Throughout the life of the project, the Encroaching Party shall maintain all drop-offs within the work zone such that they do not exceed the maximum of 2". SC55 All removed curb, driveways, and shoulder areas shall be backfilled at a 6:1 slope or flatter at the end of the days' production. SC56 Abandoned pipes 12" in diameter and larger in fills 20' or less shall be removed and backfilled, filled with grout, or plugged, as directed by the Manager of Right -of -Way, Division Engineer or State Design Services Engineer. There may be unusual circumstances where the same requirements will apply on pipes smaller than 12". Division 3, District 1 Updated 09/12/2022 SC57 For trenching excavations within the typical ditch cross-section, positive drainage shall be restored within the existing ditch by grading between driveway pipe invert elevations or by re-establishing the original hydraulic grade line. SC58 Material shall NOT be unloaded or stockpiled on the roadway at any time without proper lane closure during the project. Work is not permitted when the shoulder material is wet or during adverse weather conditions. SC59 The placement of curb and gutter is not allowed within shoulder sections of roadway. SC60 A minimum of 5 feet (10 feet desirable) clearance is required for utility installations beneath or near drainage pipes, headwalls, and a minimum of two -foot clearance below the flowline of streams. If directional drilling, a minimum ten -foot clearance distance is required from drainage structures and a minimum of 5 feet below flowline of streams. SC61 At points where the utility is placed under existing storm drainage, the trench will be backfilled with excavatable flowable fill up to the outside diameter of the existing pipe. SC62 Unless specified otherwise, during non -working hours, equipment shall be located away from thejob site or parked as close to the right of way line as possible and be properly barricaded in order not to have any equipment obstruction within the Clear Recovery Area. Also, during non -working hours, no parking or material storage shall be allowed along the shoulders of any state -maintained roadway. SC63 No access to thejob site, parking or material storage shall be allowed along or from the Control of Access Roadway. SC64 Guardrail removed or damaged during construction shall be replaced or repaired by an NCDOT approved guardrail contractor to its original condition, meeting current NCDOT standards or as directed by the Division Engineer or their representative. SC65 The resetting of the Control of Access fence shall be in accordance with the applicable NCDOT standard and as directed by the Division Engineer or their representative. SC66 Right of Way monuments disturbed during construction shall be referenced by a registered Land Surveyor and reset after construction. SC67 All Traffic signs moved during construction shall be reinstalled as soon as possible to the satisfaction of the Division Engineer or their representative. SC68 Any utility markers, cabinets, pedestals, meter bases and services for meter reading required shall be as close to the Right of Way line as possible. If it is not feasible to install at or near Right of Way line, then written approval shall be obtained from NCDOT prior to installation. SC69 Any sewer manholes, telephone vaults or valve vaults that are to be abandoned shall either be removed or broken down two (2) feet below subgrade, plugged and filled with suitable material. SC70 Detection tape, where required by NCGS § 87-115 through § 87-130 of the Underground Utility Safety and Damage Prevention Act, shall be buried in the trench approximately 1 foot above the installed facility. Where conduit is installed in the right of way and is not of ferrous material, locating tape or detection wire shall be installed with the conduit. SC71 All driveways disturbed during construction shall be returned to a state comparable with the condition of the driveways prior to construction. SC72 Conformance with driveway permit review should be required in conjunction with this encroachment agreement. In the event there is a conflict between the driveway permit and the encroachment agreement, the District Engineer should resolve the conflict and notify the parties involved. SC73 If the approved method of construction is unsuccessful and other means are required, prior approval must be obtained through the District Engineer before construction may continue. Engineering SC74 All traffic control, asphalt mixes, structures, construction, workmanship and construction methods, and materials shall be in compliance with the most -recent versions of the following resources: ASTM Standards, Manual on Uniform Traffic Control Devices, NCDOT Utilities Accommodations Manual, NCDOT Standard Specifications for Roads and Structures, NCDOT Roadway Standard Drawings, NCDOT Asphalt Quality Management System manual, and the approved plans. SC75 Prior approval for any blasting must be obtained from the Division Engineer or their representative. SC76 Regulator stations, metering stations, cathodic test stations, and anode beds are not permitted within NCDOT right of way. Header wires are permitted. SC77 Non -Utility Communication and Data Transmission installations (ground mounted type or Small Cell pole - mounted type) must adhere to guidelines in the Utilities Accommodations Manual and, when located within municipal jurisdictions, are subject to review and approval by municipal ordinances and any additional municipal Division 3, District 1 Updated 09/12/2022 approval for proximity to historic districts and landmarks. All wiring and related telecommunications work shall conform to the latest regulations by the Federal Communications Commission. SC78 All wiring and related electrical work shall conform to the latest edition of the National Electrical Safety Code. Location within R/W SC79 All utility access points, such as manholes, vaults, handholes, splice boxes and junction boxes shall be located as close to the right of way line as possible and shall not be placed in the ditch line, side slopes of the ditches or in the pavement. All manholes, handholes, splice boxes, junction boxes and vaults and covers shall be flush with the ground when located within the vehicle clear zone. Slack loops for telecommunications in industry standard housing units shall be buried a minimum of 18 inches when buried or meet minimum NCDOT vertical and horizontal clearances when installed aerially. SC80 Proposed manholes, handholes, valves or other appurtenances shall be installed flush to match the elevation of the existing ground and shall not be located in the existing ditch line, front slope of a ditch, or in a manner that would restrict the maintenance or flow of the existing ditch line. SC81 Fire Hydrants shall be of the breakaway type. Fire Hydrant(s) shall be placed a maximum of 1 foot from the right-of- way line. (STD. 1515.02 in the NCDOT Roadway Standard Drawings). SC82 Luminaire and/or utility poles and guy wires shall be set as close to the Right of Way line as practical and outside the Clear Zone in accordance with the latest version of the AASHTO Roadside Design Guide (See corresponding attachment) or made breakaway in accordance with the requirements of NCHRP Report 350. Any relocation of the utility poles from the original design due to Clear Zone requirements shall require a re -submittal for the utility design. SC83 Luminaire and/or utility poles shall be set a minimum of 5'-6" behind face of any guardrail or otherwise sufficiently protected. However, standard placement may be reduced to 3'-6" behind face of guardrail when posts are spaced 3'-1 1/2", or where speed limit is less than 55 MPH. SC84 Hot box (aka ASSE 1060) or Safe-T-Cover type enclosures covering utility main pipejoints, backflow preventers, valves, vent pipes, cross connections, pumps, grinders, irrigation assemblies, transformers, generators, and other similar large appurtenances shall be located outside sight distance triangles and off of the NCDOT Right -of -Way. SC85 Sprinkler heads shall be located a minimum of 10 feet from the edge of pavement, edge of shoulder, or back of curb whichever is greater and shall be directed so that water does not spray or drain on the roadway surface, sidewalk, or passing vehicles at any time. Upon completion of the installation and prior to activation of the system, the Encroacher shall contact the District Engineer to schedule a test of the system to verify the spray pattern. Sprinkler systems shall not be operated during periods of high wind or freezing weather, or to the extent that the subgrade adjacent to the pavement structure becomes saturated. NCDOT reserves the right to require immediate termination and removal of any sprinkler system which in itsjudgement and opinion adversely affects safety, maintenance, or operation of the roadway. Excavation SC86 Excavation material shall not be placed on pavement. SC87 It is the responsibility of the encroaching party or their contractor to prevent any mud/dirt from tracking onto the roadway. Any dirt which may collect on the roadway pavement from equipment and/or truck traffic on site shall be immediately removed to avoid any unsafe traffic conditions. SC88 The utility shall be installed within 5 feet of the right of way line and outside the 5-foot minimum from travel lane plus theoretical 2:1 slope from the edge of pavement to the bottom of the nearest excavation wall for temporary shoring. If the 2:1 slope plus 5 feet requirement above is met for traffic, then temporary shoring is typically only necessary to protect roadways from damage when a theoretical 1:1 slope from the edge of pavement intersects the nearest excavation wall. This rule of thumb should be used with caution and does not apply to all subsurface conditions, surcharge loadings and excavation geometries. Situations where this 1:1 slope is not recommended include groundwater depth is above bottom of excavation or excavation is deeper than 10 feet or in Type B or C soils as defined by OSHA Technical Manual. Temporary shoring may be avoided by locating trenches, bore pits, and other excavations far enough away from the open travel lane, edge of pavement and any existing structure, support, utility, property, etc. to be protected. Temporary shoring is required when a theoretical 2:1 slope from the bottom of excavation will intersect the existing ground line less than 5 feet from the outside edge of an open travel lane as shown in the figure below or when a theoretical 2:1 slope from the bottom of excavation will intersect any existing structure, support, utility, property, etc. to be protected. Division 3, District 1 Updated 09/12/2022 Traffic in Ouitside Lane Lane Open to Traffic 5 ft xisUng Ground rni n Line H ' ' Bottom of Excavation Edge of 2-1 (H:V) Slope Pavement Traffic Shifted (Outside Lane Closure) Lane Open to Lane Closed Traffc xistin� Ground _ Line rnn� -- 1f _ H� f3ot yn of Theoretical Excavation 2:1 (H:V)Slope 'If the 2:1 slope plus 5 reel requirement above is ma[ for traffio, [hen temporary shoring is typicaly only neoesr ary In pmrec[ raadways fram damage when a theorefical 1:1 slope from the edge of pavamant intersects the nearest excavation wall_ Thin Fule of thumb should be used with raudion and does not apply to all subsurface conditions, surcharge Ioadngs end excavation geome[ries Additional guidenca provided below. 'Theoretical 1.1 (H:V) Slope (from Edge of Pavement) Temporary shoring shall be designed and constructed in accordance with current NCDOT Standard Temporary Shoring provisions (refer to httl2s://connect.ncdot.gov/resources/Specifications/Pages/2018-Specifications-and- Special- Provisions.aspx and see SP11 R002). a. Temporary excavation shoring, such as sheet piling, shall be installed. The design of the shoring shall include the effects of traffic loads. The shoring system shall be designed and sealed by a licensed North Carolina Professional Engineer. Shoring plans and design calculations shall be submitted to the Division Engineer for review and approval prior to construction. (See NCDOT Utilities Accommodations Manua( for more information on requirements for shoring plans and design calculations.) Trench boxes shall not be accepted as temporary shoring and will not be approved for use in instances where shoring is required to protect the highway, drainage structure, and/or supporting pavement or structure foundation. b. All trench excavation inside the limits of the theoretical one-to-one slope, as defined by the policy, shall be completely backfilled and compacted at the end of each construction day. No portion of the trench shall be left open overnight. Any excavation that is not backfilled by the end of the workday must address any safety and traveling public concerns including accommodations for bicycles, pedestrians and persons with disabilities. c. The trench backfill material shall meet the Statewide Borrow Criteria. The trench shall be backfilled in accordance with Section 300-7 of the latest NCDOT Standard Specifications for Roads and Structures, which basically requires the backfill material to be placed in layers not to exceed 6 inches loose and compacted to at least 95% of the density obtained by compacting a sample in accordance with AASHTO T99 as modified by DOT. Division 3, District 1 Updated 09/12/2022 d. At the discretion of the Division Engineer, a qualified NCDOT inspector shall be on the site at all times during construction. The encroaching party shall reimburse NCDOT for the cost of providing the inspector. If NCDOT cannot supply an inspector, the encroaching party (not the utility contractor) should make arrangements to have a qualified inspector, under the supervision of a licensed North Carolina Professional Engineer, on the site at all times. The Professional Registered Engineer shall certify that the utility was installed in accordance with the encroachment agreement and that the backfill material meets the Statewide Borrow Criteria. e. The length of parallel excavation shall be limited to the length necessary to install and backfill one joint of pipe at a time, not to exceed twenty-five (25) feet. SC89 All material to a depth of 8 inches below the finished surface of the subgrade shall be compacted to a density equal to at least 100% of that obtained by compacting a sample of the material in accordance with AASHTO T99 as modified by the Department. The subgrade shall be compacted at a moisture content which is approximately that required to produce the maximum density indicated by the above test method. The contractor shall dry or add moisture to the subgrade when required to provide a uniformly compacted and acceptable subgrade. The option to backfill any trenches with dirt or either #57 stone or #78 stone with consolidation with a plate tamp and without a conventional density test may be pursued with the written consent of the District Engineer. If this option is exercised, then roadway ABC stone and asphalt repair as required will also be specified by the District Engineer. Directional bore SC90 Boring equipment will be provided of a type and size to facilitate boring in the local geologic conditions and shall be able to facilitate the encroachment work. SC91 When Horizontal Directional Drilling (HDD) is used, the following stipulations apply: a. Use drilling fluids as appropriate for the type soils but use of water alone is prohibited. Pump drilling fluids only while drilling or reaming. Directional boring using jetting with a Bentonite (or equivalent material) slurry is recommended. Monitor flow rates to match the amount leaving the bore hole and do not increase pressure or flow to free stuck drill heads, reamers or piping. Open cutting to retrieve stuck drill heads is not allowed without prior permission from the District Engineer. b. The minimum depth shall adhere to the table below for transverse (under non -controlled access, partial controlled access, or limited controlled access roadway) installations and refers to maximum diameter of hole drilled and not the dimension of the carrier or encasement pipe. Diameter of Drilled Hole Minimum Depth of Cover (Backream) 2" to 10" 10 feet >10" to 15" 12 times hole diameter (e.g. 11-inch hole means 11 feet minimum depth) > 15" to 36" 15 feet or greater c. Under fully controlled access roadway installations, the minimum depth for transverse crossings shall be 15 feet under any pavement (ramps or thru lanes) d. An overbore (backream diameter) shall not be more than 1.5 times the outside diameter of the pipe or encasement under any highway for pipes 12 inches in diameter or less. For pipes with outer diameter larger than 12 inches, the overbore may be no larger than outer diameter of pipe plus 6 inches. An overbore exceeding 1.5 times greater than the outside diameter of the pipe or encasement may be considered if the encroachment agreement includes a statement signed and sealed by a licensed North Carolina Professional Engineer indicating that an overbore in excess of 1.5 times the outside diameter of the pipe or encasement will appropriately arch and no damage will be done to the pavement or sub -grade. e. Directional boring is allowed beneath embankment material in naturally occurring soil. f. Any parallel installation utilizing the directional boring method shall be made at a minimum depth of five (5') feet (cover) below the ground surface and outside the theoretical 1:1 slope from the existing edge of pavement except where the parallel installation crosses a paved roadway. g. All directional bores shall maintain ten (10) feet minimum (clear) distance from the nearest part of any structure, including but not limited to bridges, footings, pipe culverts or box culverts. Directional bores are not allowed beneath bridge footings, culvert wingwall footings, slope protection or retaining walls. h. The tip of the drill string shall have a cutter head. i. Detection wire shall be installed with non-ferrous material. j. HDPE pipe installed by directional boring shall not be connected to existing pipe or fittings for one (1) week from the time of installation to allow tensional stresses to relax. Division 3, District 1 Updated 09/12/2022 k. There shall be no bore pits within 20 feet of the signal pole foundation or the traffic control cabinet. There shall be no open cuts or trenching within 10 feet of the signal pole foundation and the traffic control cabinet. Aerial clearances SC92 Vertical clearance of overhead power and communication lines shall meet the National Electrical Safety Code requirements except the minimum vertical clearance shall be 18' for crossings over NCDOT roadways (24' over Fully Controlled Access roadways) and 16' for parallel installations. SC93 In relation to the bridge, the utility line shall be located with minimum clearances as indicated on the attachment for NCDOT Required Clearances for Aerial Installations by Encroachment Near Bridge Structures. Pavement Detail and Repair SC94 The paving of roadways shall be in accordance with the latest version of NCDOT Standard Specifications, Sections 610, 1012 and 1020. The Contractor shall follow all procedures of the Quality Management System (QMS) for asphalt pavement - Maintenance Version (see https://connect.ncdot.ciov/resources/Materials/MaterialsResources/2018%20QMS%20Asphalt%20Manual.r)df). The Contractor must adhere to all testing requirements and quality control requirements specified. The Contractor shall contact the NCDOT Division QA Supervisor prior to producing plant mix and make the Supervisor aware that the mix is being produced for a future NCDOT road. Only NCDOT approved mix designs will be acceptable. A Quality Control Plan shall be submitted (as Directed by the District Engineer) to the District Engineer's Office prior to asphalt production utilizing form QMS-MV1. Failing mixes and/or densities are subject to penalties including monetary payments or removal and replacement. To minimize traffic queuing in construction areas, the possibility of traffic detours may be considered when working on high traffic routes even if traffic control is used. The District Engineer may require traffic detours. SC95 When paving beyond utility installation is involved, a Roadway certification report sealed by a Professional Engineer shall be submitted to the District Engineer's office indicating the following: • Pavement thickness by type • Pavement density, core and/or test locations • Base thickness • Base density • Subgrade density Test frequency and method shall be in conformance with the NCDOT Materials and Tests Manual. Test must be performed by a Certified Technician including name and Certification number on report. SC96 "Potholing" pavement cores to expose existing utilities shall be made with an 18" diameter keyhole pavement core. Pavement core locations shall not be placed in the wheel path whenever possible. Vacuum excavation shall be utilized to expose underground utilities. Pavement cores shall be repaired within the same working day. The pavement core shall be retained and reused to fill the core hole. The excavation shall be backfilled and compacted with select material to the bottom of the existing pavement structure or as indicated by the District Engineer. The retained core shall be placed in the hole and secured with a waterproof, mechanical joint. If the pavement core is damaged and cannot be re -used, the core may be replaced with the surface mix, S9.513. The asphalt patch shall match the thickness of the existing asphalt or four inches, whichever is greater. All materials must be listed on the NCDOT Approved Products List (APL) found at: https://apps.ncdot.gov/vendor/approvedproducts/. SC97 The minimum pavement design for pavement repair shall be according to NCDOT Standard Drawing 654.01 (https://connect.ncdot.gov/resources/Specifications/2018StandardRdwyDrawings/Division%2006%20Asphalt%20B ases%20and%20Pavements. pdfl and shall include a mechanical overlay extent to be a minimum of 25 feet each side of the pavement repair area OR as directed by the District Engineer. Any open cutting of pavement shall be repaired using the following method: • Pavements shall be cut full depth and removed. • After trench work is complete, the edges of the existing pavement along the trench shall be recut a minimum of 1' wider on each side of the trench. If the pavement is undermined, the edges of the existing pavement along the trench shall be recut to 1' beyond the undermined portion and the pavement removed. The design section stated below is to be placed in those areas. • The pavement repair shall be performed using the following method and pavement design section: Division 3, District 1 Updated 09/12/2022 0 11.0" B25.00 Asphalt Concrete Base Course (accomplished in 2 lifts minimum) according to NCDOT Standard 654.01. o Mill the entire area a depth of 2.0", starting from 15' in front of the edge of the final pavement cut. o Overlay entire area (a minimum 50' length mechanical overlay) with 2.0" S9.5C or S9.513 Asphalt Concrete Surface Course for a total asphalt depth of 13". Butt joints are required with no feathering of joints. All open cuts shall be backfilled, paved and traversable prior to removing lane closure. SC98 Pavement cuts shall be repaired the same day the cuts are made. SC99 Any pavement damaged because of settlement of the pavement or damaged by equipment used to perform encroachment work, shall be re -surfaced to the satisfaction of the District Engineer. This may include the removal of pavement and a 50' mechanical overlay. All pavement work and pavement markings (temporary and final) are the responsibility of the Encroaching Party. Centerline pavement markings shall be installed the same day resurfacing is accomplished. All other pavement markings shall be completed within five days of resurfacing. SC100 For projects with open cuts and roadway improvements, a PE certification may be required. When applicable, upon completion of construction, a certification memo that has been signed and sealed as appropriate under General Statute 89C-16 by a North Carolina Professional Engineer or Registered Land Surveyor shall be submitted to the District Engineer prior to opening the access connection for public use. Supporting documentation shall be attached certifying that improvements for the driveway access(s) meet the approved plan and NCDOT standards. All documentation shall be dated and initialed by the contractor. Verification will include inspection reports, testing reports, or any supporting documentation and calculations. Verification will cover, but is not limited to, subgrade, pavement structure, drainage, and traffic control items. Post Construction Close out/ Inspection SC101 The Encroaching party shall notify the District Engineer's office within 2 business days after construction is complete. The District Engineer may perform a construction inspection. Any deficiencies may be noted and reported to the encroaching party to make immediate repairs or resolve any issues to restore the right-of-way to a similar condition prior to construction, including pavement, signage, traffic signals, pavement markings, drainage, structures/pipes, or other highway design features. SC102 At the discretion of the District Engineer, a final inspection report may be provided to the encroaching party upon satisfactory completion of the work. SC103 A written acknowledgement of the completed work by the District Engineer's office begins the one-year warranty period associated with the performance bond. SC104 If the actual construction differs from the approved plans associated with this encroachment, a copy of "as -built" plans shall be submitted to the District Engineer's office in a PDF format and in a current ESRI GIS format within 4 weeks of construction. SC105 The encroaching party shall provide the North Carolina Turnpike Authority (NCTA) with an electronic copy of coordinate correct as -built plans within two weeks of installation completion. Failure to provide the as -built plans may jeopardize future approvals within NCTA right of way. SC106 A copy (in PDF format) of the completed ground water analysis shall be given to the District Engineer, including detailed drawings of the "as -built" wells showing location, depth and water level in well. Division 3, District 1 Updated 09/12/2022 ATTACHMENT FORM NOTIFICATION FOR UTILITY NON-UTII.ITY ENCROACHMENT WITHIN NCDDT R- Imhu.ctions for use: This form must be completed in its entirety and submitted direcftto the designated personnel m' the District En_iueer's office via email~ fax or hand delivery a minimum of one week prior to ocnstructim for the encroachment_ Ifthe designated NCDOT personnel names ue uahmo%.n by the person completing this farm, please contact the District E,uginecr's office to determine that contact info. Date: Submitted by Name: To: District Personnel Natue: District Personnel Email: District Fax No.: This notification is to infxm you that -%-e (encroa-ching party cr their contractor) mill begin construction irk on the fb1lon;ing project in a rninimum of one week - Encroachment number {assigned b}- NCI T) far the project: Construction start date: Approximate eading date: Crrntact NCDOT iflspector a minimum of 72 hrs. in advance to set-up Pre=structicm meeting in the District Engineer's office or -other location as directed by the District Engineer Preconstruction meeting date & time: Preconstmc.tion meeting address: Type of project: { 5ra fes: � err lelecommunieafr-on, -water, 5awer, gz, petroleum, other (describe)] Contact Info for this project: GzNntractor Company Facie: Contractor Contact Marne: Contractor Plione Dumber: contractor Email: NCDGT Utility Inspector Name: NCDOT Utiilitv Inspector Fbore: NCDOT Utility inspector Email: NCDGT Utilit+r Project hLmagerName: NCDOT Utility Project Manager Phone: NCDOT Utility Project Manager Email: Division 3, District 1 Updated 09/12/2022 Table 4-5 6i,ggoatad Clear-Zam bletancae from Edlgo of Throi,gh Trawolod Larnin fedige Foreslopes Bachaiopaa Speed D�rxlgn ADT 1 V:6H 1V:6H to IV:6H to I V, 8H r dater iVAH i V..3H MSH iV:+lH or Saf r Under750c 7-10 7-10 7-10 7-10 7- 10 756-1500 10-12 12-14 10-12 110-12 10-12 40 Sec Note b _ 15M-6000 12- 14 14-16 12-14 112-14 12-14 Over6000 14- 16 16-15 14-16 14-16 14-16 Under7%: 10- 12 12-14 6-10 6-10 10-12 750-1500 14- 16 16-210 10-12 12-14 14-16 45 - 50 SE* Note b 1506-6000 16- 1B 20-26 12-14 14-16 16-18 Ovar 6000 20 - 22 24 - 26 14 -16 18 - 20 20 - 22 UndeIr750�: 12- 14l 14-18 6-10 10-12 10-12 756-1541) 1a- 1B 20-24 10-12 14-16 15-18 55 6ee Nw* b 1500-6000 20-22 24-so 14-16 16-16 20-22 Over 6000 22 - 24 26 - 32' 16 -15 20 - 22 22 - 24 Under750: 16- 16 20-24 10-12 12-14 14-16 750-15b0 20-24 26-322 12-14 16-18 20-22 60 See flute b 1500 - 6000 26 - 30 32 - 409 14 - 1 B 16 - 22 24 - 26 Over 6000 30 - 32' 36 - 44° 20 - 22 24 - 26 26 - 28 Under 750{ 16 - 20 26 - 26 10-12 14 -16 14 - y6 756-1500 24-26 28-36,1 12-15 18-20 20-22 65 - TOJ see Note b 15 0 - 6000 26 - 32i 34 - 42-1 16 - 20 22 - 24 26 - 28 Over 6DDO 30 -:W 38 - 462 22 - 24 26 - 30 26 - 30 Notas: a. When a srie-apeciirr, investigation indicatea s high probabdity of continuing crashes or when such ooarirences are indicated by crash hiritoryr, me designer may prflvide dear-znrre distsnoe5 greater than the dear zone shown in Table 4-& Clear zones may be limilsd to 30 feet for practicaity and to pruwide a consistent roadway template if previous experienca with similar projecII& or desiign& indicates &atislaotnry pmfomnan+ce_ b. Bemuse recovery is leas iicalk on the unshielded, traversable 1 VAH fill alopert, fixed objects shed not be present in the vicinity of Ihs toe of Ihsse slope's Recovery of high-speed vehicles that encroach beyond Ihs edge of the shoulder may be eapecled to float beyond the Ioe of slope- Determinaion of the width of the recovery area al the toe of slope should consider Fight of way availability, envirormentsl aonaerns. eD3nomic factors, safety needs, and crash hialories. Also, Ihs dimence between the edge of the through [reveled lane end the beg*ning of Ihs I V:3H slope should influence the reemary area provided at the tie of slops. While the application may be limited by several factors, the forealope parameters that may enter iffb deler fining a maximum desirable recovery area are ihurrtrsted in Figure 4-:5. A 1 0-foot recovery area at the toe of slope should be provided for all trsvarsable, nar�rac rersblefid slopes. c, For ruadwayrr with low volumes, it may not be practical to apW raven the minimum values found in Table 4-5. Refer to RDG Chapter 12 far addrdcnal csansiderations for low -column roadways and RDG Chapter 10 for additional guidance for urban applications. d. When design speeds are greener then the values prcuidsd, the wri finer may pro -Ada clear -zone distances greater men thflae shown in Table 4�5. Soures: RD-G Chapler3 Section 3.1 Table 3-1 The above Clear -Zone table is from the Roadway Design Manual, November 2021. Division 3, District 1 Updated 09/12/2022 NCDOT Required Clearances for Aerial InstaHatiuns Near Bridge Structures NOT TO SC ski _F Amy -vmriatrontD this detail mintbe approved by the Di-visionEnginr+ar and. or State Utilities R{amger. Publishedby NCDOTUtihbes Unit June 2020 x x� iL1717]ti1IDti Sae elearanAm hit (See Note 2) Bridge Rail (design -v) Enid Ee Horizontal C lea ran ce to -wire nearest �I1il�exxx hfinimum = 8 Feet — Table' A: foT p im OR tehKo=nniraftol a _4my a wffptimi mwt be cowdiurted nith Di%!:!!mi BT die Pffson al Puiw to Uti&ty Pale (Ty pical-P-Dr an&.DrTic.Dmm1X1- atiDns) Varies **Sea Note r a b le A- Mi n im u m H ur iaontal C lemance Distances to POWER L ines from QSHA VOLTAGE MINIMUM CLEARANCE {nominal, W, alternating j f eel) Mont)- Cu Mont)- 10 Up to 50 Up o+e( 50 to 200 1 15 Over 200 to 350 20 Over 35+0 to 500 25 Over 500 to 750 35 Over 75+0 to 1000 45 Over 1000 As established by the utility ownc4operator or registered pr0feS3kmA6G englneef ++moo r$ a q Ual Ified person with respect to electrical power Iraimamisslon and distribulion E ngr Elzed FLme Conductor Pmti�er T .inaa M-Picel)* Neutral Con(1ue Dr (% eries im locum 9ched to Pam)* Teleaommnnirous lim(s) mounted belawany poorer lime OR ondedimiedi leo�nimnmczimn pals without pow line; * *Note 1: _ o ial lines ceding to nest pole %nth 1mi-est eles"= m at sag poi-mt. Aerial tines dmim as 3-D effect torepmemait t}picalminim,im pzaM imstallatiam to bmdgZ stmctwe- Top of bridge deek emended Distance Tories tD ground where pole is installed * *Note 2- IXIK TI�IUJN &JiG CLEARANCE HEIGHT is'A feet (apphim to tel mmunic on3 AND power. * * *Note 3: HORIZONTAL CLEAR.ANCEEXCEPTION.lf-v tieal sag clearame heiebf £Drpoiver above bridge deekis fieet AIdI? G�Dltage 13 35OkV, then hExi mom HonzDntalClmrame may be reducedtD 3 feet. Any telem=imimtioms attachment to pm erpoleallowedin this exoTtiommust haw a mininnn„ 2 5 feet sag clearame het ht abovebridge deck Division 3, District 1 Updated 09/12/2022 VERIFICATION OF COMPLIANCE WITH ENVIRONMENTAL REGULATIONS (Check Appropriate Box) Permits from the N.C. Department of Environmental Quality and the U.S. Army Corp of Engineers are not required for this project. However, all applicable federal and state regulations have been followed. ❑ The required permits from the N.C. Department of Environmental Quality and the U.S. Army Corp of Engineers have been obtained for this project. Copies of the permits are attached. V/All applicable NPDES Stormwater Permit requirements have been or will be met for this project. The project is in compliance with all applicable sedimentation and erosion control laws and regulations. Project Name: Township: Project Engineer: Project Contact: Applicant's Name: Date Submitted: Form VCER-1 June 2016 FW 4C Assessment Michael Schott Michael Schott County: Phone Number The Chemours Company, FC LLC Pender 5 ( I yZy - t4r,24 P.E. Seal c AR 0 fi a SEAL r• 040356 '�'l���iti ,wi�``. N B-14 SAMPSON B- 55 BLADEN COLUMBUS BRUNSWICK 11111»1\ ►1XhUa_10411111ILT51:11C7 1*10690U►Jt Legend Proposed Permanent Well Proposed Temporary Well Cape Fear River QFayetteville Works Site Boundary Four Counties Boundary Surrounding North Carolina County Notes: NCDOT - North Carolina Department of Transportation 1. County boundaries and major hydrography waterbodies were downloaded from NC OneMap site (https://www.nconemap.gov). 2. Basemap source: Esri, HERE, Garmin, (c) OpenStreetMap contributors, and the GIs user community. F",Itr.c: l ,� 1, PENDER li�m 4 2 0 4 Miles Proposed Groundwater Well Locations In Pender County Four Counties Assessment North Carolina Geosyntec" Geosyntec Consultants of NC, PC. Figure consultants NC License No.: C 3500 and C 295 1 Raleigh September 2023 DRAFT; Privileged and Confidential; Attorney Client Work Product; For Discussion Purposes Only. 3 2 t CO N h CO 200 ft. to A ~ � Lodge Rd AM 1 J `. -77.811184, 34.552591 —15 ft from edge of pavement -77.811217, 34.552527 —15 ft from edge of `/mm not -77.81122' —15 ft from edge -%M Lodge Rd Legend $ Proposed Well Location = Tax Parcel Boundary Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 200 100 0 200 Feet Proposed B-12 Sampling Location Geosyntec'- Geosyntec, Consultants of NC, P.C. Figure consultants NC License No.: C 3500 and C 295 la Raleigh, North Carolina September 2023 N Legend Proposed Well Location Tax Parcel Boundary -77.9032, 34.6435 -5 ft from edge of pavement 1,405 ft. to Mallard Roost Dr SR-1318 Croo msbridge Rd Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 5. Pender County. i� 200 100 0 200 Feet Proposed B-13 Sampling Location Geosyntec'- Geosyntec Consultants of NC, PC. Figure consultants NC License No.: C 3500 and C 295 _ 1b �. Raleigh, North Carolina September 2023 2394-37-4899-0000 PZ M M WZ-M f'Tbalililill -78.0227, 34.7005 —8 ft from edge of pavement 171 ft to rd Rd 1001), Willard Rd (SR100I) Legend -o�- Proposed Well Location = Tax Parcel Boundary Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 5. Pender County. 50 25 0 50 Feet Proposed B-14 Sampling Location GeosyntecO Geosyntec Consultants of NC, P.C. Figure consultants NC License No.: C-3500 and C-295 1c Raleigh, North Carolina I August 2023 N Legend $ Proposed Well Location Tax Parcel Boundary 2 -78.1749, 34.5281 sm� —5 ft from edge of pavement s� .N 0 5V e�o 0 m s� 163 fVto W \Henry St Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 5. Pender County. 100 50 0 100 Feet Proposed B-15 Sampling Location Geosyntec'- Geosyntec Consultants of NC, PC. consultants Figure FI NC License No.: C 3500 and C 295 g 1d Raleigh, North Carolina August 2023 xenxronwwsu rxa�Emm n.xnxoaua s��res xe�arrsa rnocanM TYPICAL FLUSH -MOUNT GROUNDWATER MONITORING WELL CONSTRUCTION DIAGRAM BOLTED MANHOLE COVER CONCRETE PAA MANHOLESLEEVE LOCKING WELL CAP 2" SCH EDUL E 40 PVC PIPE BENTONME GROUT BENTONITE SEAL TYPE SAND PACK GRAIN SIZE T SLOTTED SCHEDULE aU PVC SCREEN BOTTOM GAP BOTTOM OF BO RIN G ANNULUS Figure 1: Typical Well Construction Figure 2: Typical Appearance of a Completed Well at Grade Geosyntec consultants Geosyntec Consultants of NC, PC Geosyntec Consultants of NC, PC 2501 Blue Ridge Road, Suite 430 Raleigh, North Carolina 27607 PH 919.870.0576 FAX 919.870.0578 www.geosyntec.com August 22, 2023 Ms. Kristen Spirakis, PE District Engineer NCDOT 295-A Wilmington Highway Jacksonville, NC 28540 Subject: Request for Right of Way Encroachments in Pender County Dear Ms. Spirakis, On behalf of our client, The Chemours Company FC, LLC, (Chemours), Geosyntec Consultants of NC, P.C. (Geosyntec) has prepared this request for Right of Way (ROW) encroachments at multiple locations in Pender County. Installation of environmental groundwater monitoring wells along with soil and groundwater sampling is proposed as directed by the North Carolina Department of Environmental Quality (NCDEQ). Specifically, Chemours is requesting encroachment agreements to install the monitoring wells at the following approximate locations listed below and shown in Figures 1 a-b of Attachment 1. Locations shown on figures may be moved up to 10 feet during drilling to accommodate conflicts with existing utilities and/or access issues with the drill rig. Figure la — 1 temporary well on Wallace Airport Rd, Pender County, NC 28478 Figure lb — 1 temporary well on N Sunset Rd, Pender County, NC 28421 A completed Standard Encroachment Plan Checklist, typical well plans and construction details, a completed VCER-1, and a signed Encroachment Agreement Form are attached to this application (Attachments 2-5). The proposed temporary monitoring wells will be installed by a North Carolina -licensed driller under the direction of Geosyntec. Wells will generally be constructed as shown in the schematics and plans in Attachment 3 and in accordance with applicable well construction regulations. The final well locations depend on the presence of existing utilities and other possible obstacles to the safety of drilling activities and field crew members. Temporary monitoring wells will be abandoned in accordance with well abandonment regulations. Your cooperation in this matter is appreciated. Please contact me at (919) 424-1824 or mschottggeosyntec.com if you need any additional information or have any questions. Sincerely, Michael Schott, PE, PMP Attachments Attachment 1 Proposed Monitoring Well Installation Locations (Figures I a and lb) Attachment 2 NCDOT Checklist Attachment 3 Plans & Details Attachment 4 VCER-1 Form Attachment 5 Encroachment Agreement Form Attachment I Proposed Monitoring Well Installation Locations (Figures la and lb) Request for Right of Way Encroachments in Pender County 2394-37-4899-0000 2394-36-4882-0000 -78.0227, 34.7005 —8 ft from edge of pavement 2394-37-6126-0000 2394-47-1692-0000 (5) 171 ft to rd Rd 1001) Willard Rd (SR1001) 2394-37-8195-0000 2394-47-1692-0000 Legend Proposed Well Location Tax Parcel Boundary Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 5. Pender County. 50 25 0 50 Feet Proposed B-14 Sampling Location Geosyntec V Geosyntec Consultants of NC, PC. Figure consultants NC License No.: C 3500 and C 295 1a Raleigh, North Carolina August 2023 N Legend $ Proposed Well Location Tax Parcel Boundary 3 Z -78.1749, 34.5281 —5 ft from edge of pavement s� �cP 0 00 s� 163 fVto Vl.\Henry St Notes: 1. Investigative locations are approximate and may be adjusted based on accessibility and on decision authority of Geosyntec field personnel. 2. County Boundaries were downloaded from OneMap site (https://www.nconemap.gov). 3. The well location may be adjusted slightly due to conflicts with existing utilities and / or access issues with the drill rig. 4. Basemap provided by the ESRI community 2023. 5. Pender County. 100 50 0 100 Feet Proposed B-15 Sampling Location Ge o syn to ct'- Geosyntec Consuitants of NC, P.C. Figure consultants F I U re NC License No.: C 3500 and C 295 g 1b Raleigh, North Carolina August 2023 Attachment 2 NCDOT Checklist Request for Right of Way Encroachments in Pender County North Carolina Department of Transportation Standard Encroachment Plan Checklist Intent This checklist is not all inclusive of the requirement for other agencies. The Applicant shall comply with all applicable local, state, and federal environmental regulations, and shall obtain all necessary local, state, and federal environmental permits associated with this installation. This checklist aids in promoting consistency in submittals and reviews and in expediting the process by understanding the requirements and providing sufficient information. The highlighted items on the checklist are provided for Utility Encroachments only. Please complete the full checklist for Utility Encroachments and disregard the highlighted items for Non -Utility Encroachments. General Submit only properly formatted, complete drawings with sufficient, applicable information with encroachment requests. If proper plans are not submitted, encroachment requests may be returned to the Applicant and encroachment review will not begin until proper plans are resubmitted. Large encroachments which span multiple Districts shall be separated by County and by Encroachment Agreement Type. Professional Engineer Seals and Other Information Certain utility encroachment requests require plans to be sealed by a licensed North Carolina Professional Engineer. Guidance on what requests have this requirement can be found in the NCDOT Utilities Accommodations Manual. For more information on Utility Encroachment Plan requirements, click here. Certain non -utility encroachment requests require plans to be sealed by a licensed North Carolina Professional Engineer. Specific instances include when a retaining wall is associated with sidewalk installation as well as a Gateway Sign standard practice that requires an encroachment agreement and may require PE Seal for a traffic safety analysis. Cover Letter EX Contact Person / Engineering Firm E)� Phone Number with Area Code K] Email Address EX Applicant Project Name / Information / Number IN County ❑ Proposed Schedule Not Applicable - less than 1 acre 77:7on ro Plan approved by NC DEQ (if 1 acre or more is disturbed) OR install proper erosion control measures (if less than 1 acre is disturbed) Plan Format EX Plans should be legible IX Plans should show the entire project limits EX Plan sheet size to engineering scale of 11"x17" or 8.5"x11" is preferred. Submit full size plan sheets only if requested IX Submit only applicable plan and detail sheets. Remove plan sheets and details forwork outside of NCDOT right of way, including work on city and non-NCDOT maintained roadways from the submittal Continued Page 1 of 3 April 2021 Plan Title Sheet ( Location / Vicinity Map: Include a vicinity map in the submittal to provide a quick and easy reference to the location of the proposed work. Include the following aspects in the vicinity map: ■ North arrow ■ Label roads ■ Label proposed work area L County name lX Contact information: This information should consist of names, telephone numbers, and email addresses of key people involved in encroachment plan development and encroachment construction and should, whenever possible, include a 24-hour contact to address issues during construction ❑ Utility owner project number ❑ Engineering firm information General Notes If applicable, general notes should reflect NCDOT requirements. Legend / Symbology All features shown within the plan set should have a corresponding symbol. The legend should include all applicable symbols and line styles. Detail Sheets Include NCDOT standard details, if applicable. If no standard details are applicable, provide site- specific details. ❑ Aerial detail with minimum vertical clearance: Include this aerial detail even if the proposed work is an overlash of an existing crossing ❑ Minimum bury depth ❑ Road crossing detail for controlled access and/or non -controlled access roadways, depending on which is applicable ❑ Culvert crossing detail ❑ Utility Structures — NCDOT product number: ■ Provide applicable details for handholes, vaults, manholes and other utility structures proposed ■ Use of a structure included on the NCDOT Approved Products List is preferred. When using a structure from the NCDOT Approved Products List, include the NCDOT Product number with the structure detail ■ If proposing to use a utility structure that is not included on the NCDOT Approved Not Aple posed structure must be approved by NCDOT prior to use in the right of way ■ u i i YE ures are proposed to be installed within the sidewalk, include an /' installadewalk repair detail ❑ Bore pit detail: This detail should note the standard size and depth of proposed bore pits ❑ Bore detail: This detail should show maximum proposed bore diameter [X Other utility details as applicable Continued Page 2 of 3 April 2021 General Plan View L North arrow 4C State routes labeled EC Scale / Dimension. All plans should either be to engineering scale or properly and accurately dimensioned: ■ Scale should be shown ■ Scale should be no greater than 1" = 100' ❑ ils: See Attachment 3 for typical construction ■ Length, size, material, type o details. See Attachment 3 for typical post - Installation method Installation appearance. ■ Utility structures with dimensions, if applicable ■ Bore diameter ■ Bore pit locations, including dimensions of bore pit and offsets from all roadway features ❑ < Existing Roadway Details with proposed facility offsets (provide dimensions): See Attachment 1 for ■ Edge of pavement and/or back of curb, with roadway width Existing Roadway ■ Right of way line and/or control of access line, with right of way width Details ■ Guardrail ■ Storm drainage features (e.g. drainage pipes and structures), with culvert diameters ■ Ditch line and/or toe of fill ■ Structure Existing Utilities. Show and dimension all existing utility features near to or impacted bythe proposed enc t Existing utilities will be General Profile View located by NC 811 A profile view is required when crossing a roadway or other NCD public utility locator. Wells will be moved up ❑ Installation method to 10 feet with the ROW ❑ Prominent features to avoid any identified utilities. ❑ Roadway ❑ Right of way limits ❑ The entire crossing section through the right of way ❑ Minimum vertical dimensions ❑ Bore pit locations ❑ Elevations, sizes and materials for potential utility conflicts ❑ Grade and/or cover on proposed utilities ❑ Scale of profile view ❑ Rim and invert elevations for proposed utility structures ❑ 1:1 slope from the edge of pavement ❑ Maximum bore diameter Submittal Acknowledgement X I have reviewed all policies and guidelines and this submittal package is in compliance. Page 3 of 3 April 2021 Attachment 3 Plans & Details Request for Right of Way Encroachments in Pender County xaUMM 5 BRE rn nF FR ntxu�om�s srreana�o�e rnoaxAM TYPICAL FLUSH -MOUNT GROUNDWATER MONITORING WELL CONSTRUCTION DIAGRAM Nwoms¢�aa ow u�u oe� BOLTED MANHOLE COVER CONCRETE PRO MANHOLE SLEEVE LOCKING WELL CAP L' SCHEDULE 4U PVC PIPE BENTON TE GROUT BENTONITE SEAL TYPE SAND PACK GRAIN SIZE L' SLOTTED SCHEDULE 96 PVC SCREEN BOTTOM CAP BOTTOM OF BORING ANNULUS Figure 1: Typical Well Construction Figure 2: Typical Appearance of a Completed Well at Grade Attachment 4 VCER-1 Form Request for Right of Way Encroachments in Pender County VERIFICATION OF COMPLIANCE WITH ENVIRONMENTAL REGULATIONS (Check Appropriate Box) Permits from the N.C. Department of Environmental Quality and the U.S. Army Corp of Engineers are not required for this project. However, all applicable federal and state regulations have been followed. ❑ The required permits from the N.C. Department of Environmental Quality and the U.S. Army Corp of Engineers have been obtained for this project. Copies of the permits are attached. V/All applicable NPDES Stormwater Permit requirements have been or will be met for this project. The project is in compliance with all applicable sedimentation and erosion control laws and regulations. Project Name: Township: Project Engineer: Project Contact: Applicant's Name: Date Submitted: Form VCER-1 June 2016 FW 4C Assessment Michael Schott Michael Schott County: Phone Number The Chemours Company, FC LLC Pender 5 ( I yZy - t4r,24 P.E. Seal c AR 0 fi a SEAL r• 040356 '�'l���iti ,wi�``. Attachment 5 Encroachment Agreement Form Request for Right of Way Encroachments in Pender County ROUTE multiple (see attached) PROJECT STATE OF NORTH CAROLINA COUNTY OF Pender DEPARTMENT OF TRANSPORTATION -AND- The Chemours Company, FC LLC- Fayetteville Works 22828 NC Highway 87 W Fayetteville, NC 28306 THIS AGREEMENT, made and entered into this the RIGHT OF WAY ENCROACHMENT AGREEMENT FOR NON -UTILITY ENCROACHMENTS ON PRIMARY AND SECONDARY HIGHWAYS day of 120 23 , by and between the Department of Transportation, party of the first part; and The Chemours Company, FC LLC - Fayetteville Works party of the second part, WITNESSETH THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as Route(s) multiple (see attached figures) , located in Pender County with the construction and/or erection of: environmental, groundwater monitoring wells WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the right of way as indicated, subject to the conditions of this agreement; NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are made a part hereof upon the following conditions, to wit: That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part shall require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the party of the first part. That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights, flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices for Streets and HighwaVs and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained from the Division Engineer of the party of the first part. That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and claims for damage that may arise by reason of the installation and maintenance of this encroachment. It is clearly understood by the party of the second part that the party of the first part will assume no responsibility for any damage that may be caused to such facilities, within the highway rights of way limits, in carrying out its construction and maintenance operations. That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the first part. That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the Division Engineer of the party of the first part. That the party of the second part agrees to have available at the encroaching site, at all times during construction, a copy of this agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless evidence of approval can be shown. Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed. Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will not be required. That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the first part. That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the second part from the party of the first part. FORM R/W 16.1A (Revised February 2021) R/W (161A) : Party of the Second Part certifies that this agreement is true and accurate copy of the form R/W (161A) incorporating all revisions to date. IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and year first above written. ATTEST OR WITNESS Digitally signed C h e ri I yn by Cheri lyn Mertes Mertes Date:2023.08.27 15:43:05-04'00' Cherilyn Mertes, Sr. Scientist Geosyntec Consultants DEPARTMENT OF TRANSPORTATION ,01 DIVISION ENGINEER S at h ya DN: lly signed by Salhya Y111ill DN: cn=Salhya 11Y.1yg,S11, -US, ­Th. Chemoura Company, ou=Corporate emmediation Group, Ya l v i d Datell 023 0825a11 511 22 ep4'00f' Sathya Yalvigi, Sr. Remedial Project Manager 1007 Market Street, Wilmington, DE 19898 INSTRUCTIONS Second Party When the applicant is a corporation or a municipality, this agreement must have the corporate seal and be attested by the corporation secretary or by the empowered city official, unless a waiver of corporate seal and attestation by the secretary or by the empowered City official is on file in the Raleigh office of the State Utilities Manager. In the space provided in this agreement for execution, the name of the corporation or municipality shall be typed above the name, and title of all persons signing the agreement should be typed directly below their signature. When the applicant is not a corporation, then his signature must be witnessed by one person. The address should be included in this agreement and the names of all persons signing the agreement should be typed directly below their signature. This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the following applicable information: 1. All roadways and ramps. 2. Right of way lines and where applicable, the control of access lines. 3. Location of the proposed encroachment. 4. Length and type of encroachment. 5. Location by highway survey station number. If station number cannot be obtained, location should be shown by distance from some identifiable point, such as a bridge, road, intersection, etc. (To assist in preparation of the encroachment plan, the Department's roadway plans may be seen at the various Highway Division Offices, or at the Raleigh office.) 6. Drainage structures or bridges if affected by encroachment. 7. Typical section indicating the pavement design and width, and the slopes, widths and details for either a curb and gutter or a shoulder and ditch section, whichever is applicable. 8. Horizontal alignment indicating general curve data, where applicable. 9. Vertical alignment indicated by percent grade, P.I. station and vertical curve length, where applicable. 10. Amount of material to be removed and/or placed on NCDOT right of way, if applicable. 11. Cross -sections of all grading operations, indicating slope ratio and reference by station where applicable. 12. All pertinent drainage structures proposed. Include all hydraulic data, pipe sizes, structure details and other related information. 13. Erosion and sediment control. 14. Any special provisions or specifications as to the performance of the work or the method of construction that may be required by the Department must be shown on a separate sheet attached to encroachment agreement provided that such information cannot be shown on plans or drawings. 15. The Department's Division Engineer should be given notice by the applicant prior to actual starting of installation included in this agreement. 16. Method of handling traffic during construction where applicable. 17. Scale of plans, north arrow, etc.