WM0501614_Permit Application_20240111

North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center Raleigh, North Carolina 27699-1611
919.707.9000

January 11, 2024 Mr. Samuel Kramer Speedway, LLC PO Box 1500 Springfield, OH 45501 Sent Via Email Subject: Monitoring Well Construction Permit # WM0501614 Speedway 2256 North Main Street Taboro, NC 27886 – Edgecombe County Mr. Kramer: In accordance with the application received on January 11, 2024, we are forwarding herewith Monitoring Well Construction Permit No. WM0501514 dated January 11, 2024, issued for the construction of a monitoring well system (installation of nine wells). 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 will 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. If you have any questions about this permit, please contact Michael Hall at [phone] or via email at [e-mail]. Sincerely,
Vanessa E. Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ Enclosure -Permit -Application Package Ec: Nathan Pinsker, AECOM Laserfiche

DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center Raleigh, North Carolina 27699-1611
919.707.9000
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
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 Speedway, LLC FOR THE CONSTRUCTION OF A MONITORING WELL SYSTEM consisting of six monitoring wells owned by Speedway, LLC at mailing address PO Box 1500, Springfield, OH 45501. The wells will be located on the property owned by BCS NC Fund Propco16, LLC at 2256 North Main Street, Tarboro, NC 27886. This Permit is issued in accordance with the application received on January 11, 2024, in conformity with specifications and supporting data, all of which are filed with the Department of Environmental Quality and are considered integral parts of this Permit.
This Permit is for well construction only and does not waive any provision or requirement of any other applicable law or
regulation. Construction of any well under this Permit shall be in strict compliance with the North Carolina Well
Construction Regulations and Standards (15A NCAC 02C .0100), and other State and Local Laws and regulations pertaining
to well construction.

If any requirements or limitations specified in this Permit are unacceptable, you have a right to an adjudicatory hearing
upon written request within 30 days of receipt of this Permit. 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 a demand is made, this Permit is final and
binding.
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:
1. 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.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by
another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the Permit
application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water Quality’s
Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it 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 Quality’s
Information Processing Unit within 30 days of the well abandonment.
7. If the well penetrates any water-bearing zone that contains contaminated waters, the upper three feet of
the well shall be grouted within one day after the casing is set or the well abandoned.

____________________________________
Vanessa E. Manuel, Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission

Permit Number: WM0501614
Permit Issued: January 11, 2024
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
FOR OFFICE USE ONLY
PERMIT NO.ISSUED DATE
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: 1/11/2024
2. County: Edgecombe
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: Speedway, LLC Telephone: [phone]
Applicant’s Mailing Address: PO Box 1500, Springfield, OH 45501
Applicant’s Email Address (if available): Samuel Kramer
5. Contact Person (if different than Applicant): Nathan Pinsker Telephone: [phone]
Contact Person’s Mailing Address: 5438 Wade Park Boulevard, Suite 200, Raleigh, NC 27607
Contact Person’s Email Address (if available): [e-mail]
6. Property Owner (if different than Applicant): BCS NC Fund Propco 16, LLC Telephone: Unknown
Property Owner’s Mailing Address: 1000 Forest Park Avenue Suite 401 Fort Worth, TX 76110
Property Owner’s Email Address (if available):
7. Property Physical Address (Including PIN Number) 2256 North Main Street (4739-01-1576-00)
City Tarboro County Edgecombe Zip Code 27886
8.Reason for Well(s):Assessment
(ex: non-discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9.Type of facility or site for which the well(s) is(are) needed:Gasoline station
(ex: non-discharge facility, waste disposal site, landfill, UST, etc.)
10. Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
No
11. Type of contaminants being monitored or recovered: Organics
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existing Monitoring or Recovery Well Construction Permit No(s).:
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet):50
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: Regional Probing Services Certification No.:3322-A
Well Contractor Address: P.O. Box 1161, Wake Forest, NC 27588
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
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
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:
4.Total Number of wells to be constructed: 6
(add answers from 2 and 3)
5.How will the well(s) be secured?NA
6. Estimated beginning construction date: 1/22/24
7. Estimated construction completion date: 1/22/24
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.
Manager, Environmental Services
Signature of Applicant or *Agent Title of Applicant or *Agent
Samuel Kramer * If signing as Agent, attach authorization agreement stating
Printed name of Applicant or *Agent that you have the authority to act as the Agent.
If the property is owned by someone other than the Applicant, the property owner hereby consents to allow the Applicant to construct
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)Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources’ Regional Office:
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22M/R (Rev. 5-26-2022)
Luke Stone - Manager
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
Client:
Project Number:
Site Location:Date Installed:
Well Location:Coords:Inspector:
Method:Contractor:
Proposed Monitoring Well Construction Log
Depth from G.S. (feet)Elevation (feet)
Datum
Top of Riser Pipe
Ground Surface (G.S.)
Length
Diameter (ID)
Type of Material
Thickness
Top of Sand
Top of Screen
Stabilized Water Level TBD
Screen:
Length
Diameter (ID)
Slot Size
Type of Material
Type/Size of Sand
Sand Pack Thickness
Bottom of Screen
Bottom of Tail Pipe:
Bottom of Borehole
Borehole Diameter
Describe Measuring Point:
Signature Date
#2
PVC
10 slot
1"
Thickness Sch 40
Sch 40
PVC
2.5"
25 ft bgs
25 ft bgs
12'
25 ft bgs
15
Speedway 8663
2256 North Main Street Tarboro NC 27886
Direct Push Technology (geoprobe)
1"
Regional Probing Services
0.0
5'
0.0
WELL ID: Temporary Well
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586
SB-6
SB-5
SB-4
SB-3
SB-2
SB-1
DocuSign Envelope ID: 3FECD905-D7A4-4A6E-8DCB-5758068F7586