NC0038377_6- Offsite Well Permits from DENR March 2015 for Peed Property_20150902

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
March 23, 2015
John Toepher P.E., Lead Engineer
Environmental Services
Duke Energy Progress, Inc.
410 S. Wilmington Street
Raleigh, N.C. 27601
Subject: Monitoring Well Construction
Permit # WM0501072
Mayo Steam Electric Plant
10660 Boston Road
Roxboro, NC -Person County
Dear Mr. Toepher;
Donald R. van der Vaart
Secretary
In accordance with the application received on March 18, 2015, and the additional
information received on March 20, 2015, we are forwarding herewith Monitoring Well
Construction Permit No. WM0501072 dated March 23, 2015, issued for the construction of a
monitor well system (four wells) at the subject property (2815 Mayo Lake Road). Please be
aware that some counties have well construction programs, and you may be required to
obtain a well construction permit before installation.
This Permit shall be effective from the date of its issuance, and shall be subject to the
conditions and limitations as specified therein. Please note the addition of stipulation #3 to the
permit enclosed.
Sincerely,
4Rickolich, L.G.
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
Enclosure
cc: DWR-RRO Well Permit Files
DWR Central Office (w/originals)
Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section http://portal.ncdenr.org/web/wq/aps
1628 Mail Service Center, Raleigh, NC 27699-1628 Phone: [phone]
Location: 3800 Barrett Drive, Raleigh, NC 27609 Fax: [phone]
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION OF A WELL OR WELL SYSTEM
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes,
and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Duke Energy Progress, Inc.
FOR THE CONSTRUCTION OF four monitoring wells located on the property owned by Doyle & Durwood Peed at 2815 Mayo
Lake Road in Roxboro, NC -Person County, in accordance with the application received on March 18, 2015, and the additional
information received on March 20, 2015, in conformity with specifications and supporting data, all of which are filed with the
Department of Environment and Natural Resources and are considered part of the Permit. This Permit is for well construction only
and does not waive any provisions or requirements of the Water Use Act of 1967, or any other applicable laws and regulations.
Well construction shall be in compliance with the North Carolina Well Construction Regulations and Standards. This Permit
pertains to the jurisdictional authority of the Division of Water Resource and does not waive the requirements of other jurisdictions.
This Permit will be effective for one year from the date of its issuance and shall be subject to other specified conditions,
limitations, or exceptions as follows:
L The well(s) shall be located and constructed as shown on the attachments submitted as part of the permit application.
2.Well construction record (GW-1) for each well must be supplied to the Division of Water Resources' Information
Processing Unit within 30 days of well completion. Provide the well construction permit number on the GW-1 form.
3.Issuance of this Permit does not obligate reimbursement from State trust funds, if these wells are being installed as part of
an investigation for contamination from an underground storage tank or dry cleaner incident.
4.Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another agency.
5. The well(s) shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C.0108(o).
6. When the well(s) are discontinued or abandoned, they shall be abandoned in accordance with 15A NCAC 02C.0113 and a
well abandonment record (GW-30) shall be submitted to the Division of Water Resource's Information Processing Unit
within 30 days of well abandonment.
If any requirements or limitations of this Permit are unacceptable, you have the right to an adjudicatory hearing upon written
request within 30 days. The request must be in the form of a written petition conforming to Chapter 150B of the North Carolina
General Statutes and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, North Carolina
27699-6714. Unless such demand is made, this Permit is final and binding.
Permit issued the 23`d of March 2015
NORTH CAROLINA ENV N AL MANAGEMENT COMMISSION
Rick Bolich L.G., Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
Permit No. WM0501072

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER RESOURCES - AQUIFER PROTECTION SECTION
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 67, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: 03 /03 /15 FOR OFFICE USE ONLY
2. County: Person PERMIT NO. 4IOYO 107ZSUED DATE Mgvl 23 24
3. What type of well are you applying for? (monitoring or recovery): Monitoring Well
4. Applicant: Duke Energy Progress, Inc. (DEP) Telephone:
Applicant's Mailing Address: 410 S . Wilmington St . /NC14 , Raleigh, NC 27601 _
Applicant's Email Address (if available): ]ohn• toepfer®duke-energy, com
5. Contact Person Ofdifferent than Applicant): John Toepfer Telephone: [phone]
Contact Person's Mailing Address: same as applicant
Contact Person's Email Address (if available): _same as applicant
6. Property Owner Of different than Applicant): Doyle & Durwood Peed Telephone: [phone]
Property Owner's Mailing Address: 428 Bethel Hill Road, Roxboro, NC 27574
Property Owner's Email Address (if available):
7. Property Physical Address (including zip code) and PiN Number 2815 Ma o Lake Rd. Roxboro NC 27574 PIN# 003100256615)
8. Reason forWell(s): Assessment
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remedlation, etc.)
9. Type of facility or site for which the well(s) Is(are) needed: Power Plant
(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).
Yes, NPDES Permit #NC00038377
11. Type of contaminants being monitored or recovered: Metals
(e): organics, nutrients, heavy metals, etc.)
12, Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existaig Monitoring or Recovery Well Construction Permit No(s).: N/A
13. Distance from proposed well(s) to nearest known waste or pollution source On feet): 1,500
14, Are there any water supply wells located less than 500 feet from the proposed well(s)? NO
If yes, give distance(s): _
15. Well Contractor. Cascade Drilling CertlficatlonNo: NC #2980B
Well Contractor Address: 1585 Columbia_ Highway N. , Aiken, SC 29801
PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter
b. Estimated well depth
C. Screen intervals
d. Sand/gravel pack intervals
Continued on Reverse
Type of casing material and thickness
Grout horizons
Well head completion details

PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
Number of wells to be constructed In unconsolidated 5. How will the well(s) be secured? Docked wells
material: 2
Number of wells to be constructed In bedrock: 2
Total Number of wells to be constructed:
(add answers from 2 and 3)
Estimated beginning construction date: 0 3 / 2 5 / 15
Estimated construction completion date. 03 /2 7 / i 5
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:
All properly 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.
All odslinq wells, Identified by type of use, within 500 feet of the proposed well or well system.
The proposed well or well system.
Any test borings within 500 feet of proposed well or well system.
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. 143-215.1013(5), landfills, or other waste disposal areas) within 500 feel
of the proposed well or well system.
SIGNATURES
The Applicant hereby reel that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Constructs it u ed under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
b er 2C) and accepts full responsibility for compliance with these rules
Lead Engineer
Signature of App nt or *A9W Title of Applicant or
Appl Agent
John Toepf e r • tf signing as Agent, attach authorization agreement stating
Printed name of Applicant or *Agent that you have the Buthorrly to act as the Agent.
If the property Is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined In this Well Construction Permit application and that it shall be the responsiNtity of the applicant to ensure that the
well(s) conform to the Well Constru n Standards (Tice 15A of the North Carolina Administrative Code, Subchapter 2C).
I)yYL,�- T.
Signature o pe Owner (if different than Applicant} Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources's Aquifer Protection Section Regional Office:
Asheville Regional Office
2090 U.S. Mghway 70
Swannenoa, NC 28778
Phone: [phone]
Fax [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax [phone]
Mooresville Regional Office
610 East Carter Avenue
Mooresville, NC 28115
Phone: [phone]
Farc [phone]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mail
Washington, NC 27M
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
Fax: (336) T71-4630
GW-22MR (Rev. at13)

MONITORING WELL
GROUND SURFACE
MW-15S and MW-16S
LOCK
LOCKABLE
COMPRESSION CAP\
BOLT DOWN FLUSH MOUNT PROTECTION
2' x2' CONCRETE PAD SLOPED TO PREVENT
WATER AND MUD FROM COLLECTING
(MINIMUM 6" THICK)
` 4" MINIMUM DEPTH
NEAT CEMENT GROUT TO
NEAR GROUND SURFACE
� 6" BORE HOLE DIAMETER
J o 2" PVC WELL CASING
J J (SCHEDULE 40)
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F-
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04
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w ♦ WATER TABLE
SAPROLITE/TRANSTITION ZONE
NOT TO SCALE
148 RIVER STREET, SUITE 220
GREENVILLE, SOUTH CAROLINA 29601
PHONE [phone]
www.synterracorp.com
Tffra OBAWN C NEWEll DATE 02/18(2015
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PROTECT MANAGER KATHY WEBS
LAYOUT Z INCH SAPROLITE WELL FLUSH MOUNi(MW-]55 MW
SAND PACK -WASHED HIGH GRADE
NO. 1 OR 2 SILICA SAND
(MINIMUM 2' ABOVE TOP OF THE
PRE PACKED WELL SCREEN)
--BENTONITE PELLET SEAL
(2' MINIMUM THICKNESS)
PREPACKED WELL SCREEN
SCHEDULE 40
5' SCREEN SLOT SIZE 0.010"
=PWR / BEDROCK. I I I ,
MONITORING WELL SCHEMATIC
FLUSH MOUNT
MAYO STEAM ELECTRIC PLANT
ROXBORO, NORTH CAROLINA
If

MONITORING WELL
MW-15BR and MW-16BR
LOCK
BOLT DOWN FLUSH MOUNT PROTECTION
LOCKABLE
COMPRESSION CAP
2' x2' CONCRETE PAD SLOPED TO PREVENT
WATER AND MUD FROM COLLECTING
/(MINIMUM 6" THICK)
GROUND SURFACE
4" MINIMUM DEPTH
NEAT CEMENT GROUT INSIDE 6" PVC
SURFACE CASING (LET SIT A MINIMUM
OF 24 HOURS BEFORE DRILLING)
NEAT CEMENT GROUT IN BETWEEN
<`=
BOREHOLE AND 6" PVC SURFACE CASING
10" BORE HOLE DIAMETER
6" PVC SURFACE CASING
2" PVC WELL CASING
,z
(SCHEDULE 40)
,F
SAPROLITE/TRANSTITION ZONE
v WATER TABLE ABOVE BEDROCK
DRILL SOCKET A MINIMUM OF 2'
TOP OF COMPETENT BEDROCK
INTO COMPETENT BEDROCK
if.
BEDROCK
BENTONITE PELLET SEAL
(2' MINIMUM THICKNESS)
FIRST WATER BEARING FRACTURE A MINIMUM
OF 10' BELOW THE TOP OF COMPETENT ROCK
SAND PACK- WASHED HIGH GRADE
NO. 1 OR 2 SILICA SAND
{'
(MINIMUM 2' ABOVE TOP OF THE
PRE PACKED WELL SCREEN)
WATER BEARING FRACTURE
PREPACKED WELL SCREEN
SCHEDULE 40
5' SCREEN SLOT SIZE 0.010"
BEDROCK
NOT TO SCALE
MONITORING WELL SCHEMATIC
148 RIVER STREET, SUITE 220
FLUSH MOUNT
GREENPHONE 64-4 OUTH 19999 ROLINA29601
PHONE [phone]
MAYO STEAM ELECTRIC PLANT
www.syriterracorp.com
ROXBORO NORTH CAROLINA
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DRAWN BY NAG TDATE 02/18/2015
PROTECT MANAGER KANATHYHY WEBS
LAYOUT 21NCH BEDROCK WELL FLUSH MDDNT(MW-15BR MW-16
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02/18/2OL5202PM P D,keEne Pr aa.1026\105 M
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