WS0801072_Application_20230414

Ms. Heidi Cox
Groundwater Management Associates, Inc.
GMA 4300 Sapphire Court, Suite 100
Greenville, North Carolina 27834
Telephone [phone]
www.qma-nc.com
May 3, 2023
Mr. Geoff Kegley
Environmental Program Consultant
Water Quality Regional Operations Section
NCDEQ-Division of Water Resources
127 Cardinal Drive Ext.
Wilmington, NC 28405
Re: Application for Permit to Construct Town of Surf City Water -Supply Well #6
Dear Mr. Kegley,
Groundwater Management Associates, Inc. (GMA) has been contracted by Highfill
Infrastructure Engineering, P.C. (Highfill), to assist their efforts to provide a water -supply well
for their client, the Town of Surf City. Surf City plans to construct an additional water -supply
well, known as Well #6, in the Town of Surf City in Pender County at the site of Well #2, which
is no longer in service. The water -supply well will be completed with 'open -hole" construction,
with casing installed to depth of approximately 108 feet below land surface. The well will
withdraw from the Castle Hayne Aquifer System.
The proposed Town of Surf City Well #6 site is at the location of Surf City Well #2. A map
showing the location of Well #2 and the proposed Well #6 is included with the enclosed permit
application. Well #2 was constructed in 1968, and was operated until 2008 when it was taken
out of service due to age and deterioration. GMA performed a video inspection and conducted
yield testing on Well #2. The casing integrity seemed to be reasonably good, and no obvious
holes were noted. We capped the well and included a water -level access drop tube so that the
well could be used as an observation well during the construction of the proposed Well #6.
GMA conducted a site reconnaissance in 2020 as part of a setback evaluation for the Well #6
site. During the reconnaissance GMA confirmed the location of a private, non -potable irrigation
well located on the adjacent property approximately 350 feet south-southeast of Well #2. The
location of the irrigation well is also shown on the map included with the enclosed permit
application.

Mr. Geoff Kegley
May 3, 2023
Page 2of2
We request approval of the well construction permit application. The completed application for
a permit to construct Well #6 along with construction details and applicable additional
information is enclosed for your review.
If you have any questions, please feel free to contact me.
Sincerely,
Groundwater Management Associates, Inc.
Amy W. Cressman, P.G.
Project Hydrogeologist
Enclosures: GW-22W form, Application for Permit to Construct a Water Supply Well or Well
System;
Preliminary Well Site Approval Letter;
Proposed Production Well Specifications;
Figure 1. Proposed Well Location.
Cc: ]ay Holley, P.G., GMA Greenville
Paul Shivers, P.E., Highfill Infrastructure Engineering, P.C.

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY — DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A WATER SUPPLY WELL OR WELL SYSTEM
(Wells or Well Systems with a Design Capacity of 100,000 Gallons Per Day or Greater)
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct water supply wells.
1. Date: 5/3/2023
2. County: Pender
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
3. Applicant: Town of Surf City Telephone: [phone] x 100
Applicant's Mailing Address: 201 Community Center Drive, Surf City, NC 28445
4.
5.
6.
7.
8.
Applicant's Email Address (if available): kbreuer(a)_surfcitync.gov
Contact Person (if different than Applicant): Amy W. Cressman, P.G. (GMA) Telephone: [phone]
Contact Person's Mailing Address: 4300 Sapphire Court Suite #100, Greenville, NC 27834
Contac Person's Email Address (if available): amyCogma-nc.com
Property Owner (if different than Applicant): Town of Surf City Telephone: [phone] x 100
Owner's Mailing Address: 201 Community Center Drive, Surf City, NC 28445
Owner's Email Address (if available): kbreuer(a)surfcitync.gov
Property Physical Address (including PIN Number): PO Box 2475 (PIN: 4235-45-4988-0000)
City: Town of Surf City County: Pender Zip Code: 28455
Intended use of Well or Well System: Public Supply Well
(examples: irrigation, consumption, etc.)
Will the proposed water supply well or well system replace or be added to an existing well or well system? YES
(If yes, complete questions 7 and 8) (If no, complete question 7 and then skip to question 9)
9. Total design capacity of proposed well or well system in gallons per day (gpd): 1,440,000 GPD (1,000 GPM
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
The existing water supply well system includes Well #5 (1,000 GPM) and Well #3 (1,000 GPM)
11. Is this a public well or well system? Yes If yes, give Public Water ID Number: 0471015
If yes, give Project Engineer and contact information: Paul R. Shivers, [e-mail], [phone]
12. Well Contractor: Magette's Well & Pump Co. Well Contractor Certification No.: 2299
Well Contractor Address: 2342 US 13 S, Ahoskie, NC 27910
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
e. Type of casing material and thickness
f. Grout horizons
g. Well Head completion details
2. No. of wells to be constructed in unconsolidated
material: 1
3. No. of wells to be constructed in bedrock: 0
4. Total No. of wells to be constructed: 1
(add answers from 2 and 3)
5. Estimated beginning construction date: 5/16/2023
6. Estimated construction completion date: 6/15/2023
Continued on Reverse

ADDITIONAL INFORMATION
1. As required by 15A NCAC 02C .0105(0(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.
2. As required by 15A NCAC 02C .0105(g)(3), for wells screened in multiple zones or aquifers, provide representative data on the
static water level, pH, specific conductance, and concentrations of sodium, potassium, calcium, magnesium, sulfate, chloride,
and carbonates from each aquifer or zone from which water is proposed to be withdrawn.
3. Attach any water use permits (if required). [e.g. Central Coastal Plain Capacity Use Area Permit is required in 15 eastern NC
counties by NC Division of Water Resources, visit: http://www.ncwater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
the Water Supply Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina
dministrative Code, Subchapter 2C) and accepts full responsibility for compliance with these rules
IJ �V v
Project Hydrogeologist
Sign ure of Applicant or *Agent Title of Applicant or *Agent
Amy W. Cressman * 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
water supply wells as outlined in this Water Supply Well Construction Permit application and that it shall be the responsibility of the
applicant to ensure that the water supply well(s) conform to the Well Construction Standards (Title 15A of the North Carolina
Administrative Code, Subchapter 2C).
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office 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: [phone] Phone: [phone] Phone: [phone]
Fax: [phone] Fax: [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]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
GW-22W Rev. 3-1-2016

ROY COOPER
Governor
DIONNE DELLFGATTI
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
Preliminary Well Site Approval Letter
March 16, 2021
Town of Surf City
Attn: David Price, Public Utilities Director
P.O. Box 2475
Surf City, NC 28445
Re:
Dear Mr. Price:
Preliminary Well Site Approval
Town of Surf City
NC0471015
On March 9, 2021, I met with Mr. David Price, Town of Surf City, and Mr. Paul Shivers,
Highfill Infrastructure Engineering, to conduct a preliminary investigation of the proposed
well site listed below. The proposed well has been assigned a Water System Facility (WSF)
Identification Number and Sampling Point Code as indicated below. Attached is a copy of
the map provided by Mr. Shivers which depicts the location of the proposed well.
WSF ID
Sampling
Description of Well Site
Preliminary Latitude and
No.
Point Code
Longitude
W06
RW6
—100' from existing perimeter
34.444701,-77.558814
fence
—25' NE of existing brick
wellhouse for W02 inactive
This letter is provided by Public Water Supply (PWS) Section, in accordance with
rule .0305(b) of the Rules Governing Public Water Systems (15A NCAC 18 C), to provide
permission to drill a well at the listed site in order to establish water quality and quantity
and suitability of the well as a source for a public water system.
In addition, this "preliminary well site approval" is to acknowledge that according to the
information and documentation provided, we understand that the proposed well is located
on a lot so that the area within 100 feet of the well is owned or controlled by the person
supplying the water and that the supplier of water will protect the well lot from potential
sources of pollution and construct landscape features for drainage and diversion of
pollution as required in rule .0203 (1). In addition, we understand that you have
North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 11634 Mail Service Center Raleigh, North Carolina 27699-1634
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determined that the proposed well location satisfy the minimum horizontal separation
distances specified in rule .0203 (2) and summarized in the following table:
Distance (in
Potential Source of Pollution
feet
100
• From any sanitary sewage disposal system, sewer, or sewer pipe (unless sewer is
constructed of water main materials and joints, in which the sewer pipe shall be
at least 50 feet from the well.
• From buildings, mobile homes, permanent structures, animal houses or lots,
cultivated areas to which chemicals are applied.
• From surface water.
• From a chemical or petroleum fuel underground storage tank with secondary
containment
• From any other potential source of pollution not listed in this table.
200
From a subsurface sanitary sewage treatment and disposal system designed for
3,000 or more gallons of wastewater a day, unless your well water source is a
confined aquifer.
300
From any cemetery or burial ground.
500
• From a septage disposal site.
• From a chemical or petroleum fuel underground storage tank without secondary
containment
• From the boundary of a ground water contamination area.
• From a sanitary landfill or non -permitted non -hazardous solid waste disposal
site.
1,000
. From a hazardous waste disposal site or in any location which conflicts with the
North Carolina Hazardous Waste Management Rules cited in NCAC 13A.
We also understand that the owner will ensure that the lot is graded or sloped so that
surface water is diverted away from the wellhead and that the lot is not subject to flooding
in accordance with rule .0203(4).
PWS Section "Authorization to Construct" and "Final Approval"
Subsequent to well drilling and evaluating water quality and quantity (e.g., collecting and
analyzing samples and performing a 24-hour well drawdown test) the owner must submit
an "Application for Approval of Engineering Plans and Specifications for Water Supply
Systems" to document proposed well completion (e.g., selected pump, wellhead and well
house details) and associated transmission lines, treatment and/or storage facilities and
other critical information about the public water system. In accordance with rule .0305(a)
no construction shall be undertaken until the PWS Section issues an "Authorization to
Construct' letter. In addition, in accordance with .0309(a) the new well and all associated
treatment, storage or transmission/distributions lines shall not be placed into service until
the PWS Section has issued a "Final Approval." These steps are described in the
Engineering Planning and Development Guidance Document available at
https:/Ifiles.nc,gov/ncdeq/Watero/n20Resources/files/pws/planreview/EPD Guidance lul
y2019.pdf
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1634 Mail Service Center I Raleigh. North Carolina 27699-1634
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wxm.,n wuwoi...mxa.im 919.707.9100

Be aware that plans, specifications, and reports for the new well must be certified by a
Professional Engineer. Therefore, it is recommended that a Professional Engineer or
Licensed Geologist (or their designated representative) experienced in the construction of
water supply wells, conduct on -site monitoring of well construction. At a minimum, certain
critical phases of well construction such as installation and grouting of casing should be
monitored. In many situations it may be necessary to go beyond the minimum
requirements in order to protect the public health and ground water resources.
Other Agency Approvals Required
This PWS Section "preliminary well site approval" letter does not address other agency
applicable rules and requirements pertaining to well construction and registration.
Local county well construction rules and ordinances may include additional requirements.
Well construction must meet the standards specified in the Well Construction Standards
(15A NCAC 2C). Be aware that these rules require a permit to be obtained from the Water
Quality Regional Operations Section of the Division of Water Resources before the well is
constructed if it is anticipated that the new well will be part of a water system with a design
capacity of 100,000 gallons per day or greater. In addition, these rules require that wells
be constructed by a properly certified well driller. For more information contact the Water
Quality Regional Operations Section at 919-807-6300 or http://portal.nedenr.org/web/wq/aps
Sincerely,
�M
Jeannine Press
Engineer
Wilmington Regional Office
Cc: R.W. (Bob) Midgette, Chief, Public Water Supply Section
Heidi Lane Cox, Regional Engineering Supervisor, Public Water Supply Section
Pender County Health Department
Morella Sanchez -King, Regional Supervisor, Water Quality Regional Operations
Section
Nat Wilson, Chief, DWR-Groundwater Management Branch
Paul R. Shivers, P.E., Highfill Infrastructure Engineering, P.C., 3804 Park Avenue,
Unit A, Wilmington, NC 28403
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1634 Mail Service Center I Raleigh. North Carolina 27699-1634
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PREFERRED OPEN BORE
HOLE OPTION
PROVIDE TEMPORARY WELL SEAL
WITH 20" BOLTED BLIND FLANGE
(SEE NOTE 1)
020" SCH10S SS WELL CASING
° 030" STEEL SURFACE °
(PIT) CASING
0.375" MIN. WALL THK °
°
a
038" MIN. BORING °
°
NEAT CEMENT
GROUT AROUND
030" SURFACE CASING °
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STEEL CENTRALIZER
a
028" BORING °
°
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020" SCH10S SS °
WELL CASING
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GROUT AROUND o°
020" WELL CASING
°
°
018" BORING
OPEN
BOREHOLE
C/L
PROPOSED PRODUCTION
WELL SPECIFICATIONS
SURF CITY WELL #6 (2A)
LAND SURFACE
PROVIDE TEMPORARY WELL SEAL
WITH 20" BOLTED BLIND FLANGE
(SEE NOTE 1)
01.25" SS DROP TUBE-
(3.0' STICKUP)
LAND SURFACE
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01.25" SS ELBOW SCH 10S (MIN)
FOR WATER LEVEL
MEASUREMENTS
ALTERNATE SCREEN AND
GRAVEL PACK OPTION
a
TACK WELD THE BLIND FLANGE TO
CASING FOR LATER REMOVAL
020" SCH10S SS
030" STEEL SURFACE
° PIT CASING 0.375" MIN.
o WALL THK
038" MIN. BORING
°
NEAT CEMENT
° ° GROUT AROUND
030" SURFACE CASING
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40'
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BLS
020" SCH10S SS
° WELL CASING
°
SS CENTRALIZERS
(AT 7', 57', 107' BLS)
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° 028" BORING
NEAT CEMENT
° GROUT
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° o BENTONITE (88'-98')
STEEL CENTRALIZER
— 10" x 12" SS REDUCER
018" BORING
#3 WELL GRAVEL
(100' — 176')
010" 50—SLOT
SS WELL SCREEN
MIN SCH 10S
SS CENTRALIZER
010" SS TAILPIECE
C/L
7.5 1012" SS CASING
DETAIL 1.0
10" x 12" SS REDUCER
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SS WELL SCREEN
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GEOPHYSICAL LOG FROM ON —SITE
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NOTES
1. OPEN BORE WELL DRILLING DETAIL WAS DEVELOPED BY
GROUNDWATER MONITORING ASSOCIATES (GMA)
2. CONTRACTOR SHALL PROVIDE A TEMPORARY LOCKING OR
BOLTED SANITARY SEAL ON THE TOP OF THE CASING IN BOTH
THE PREFERRED AND ALTERNATE CONSTRUCTION OPTIONS.
BOLTED BLIND FLANGES ARE SHOWN. HOWEVER, CONTRACTOR
MAY PROPOSE OTHER METHODS THAT ACCOMPLISH A SECURE
SANITARY SEAL.
3. FOR THE ALTERNATE SCREENED AND GRAVEL PACK OPTION,
CONTRACTOR SHALL PROVIDE AN ADDITIONAL PRICE ON THE
BID FORM (ADD/DEDUCT) FOR INSTALLING 014" SDR17 PVC
CASING (INSTEAD OF 12" SS) AND CONNECTING TO THE 10"
SS SCREENS. NOTE THAT THE 1.25" SS ELBOW FOR THE
DROP TUBE MUST BE ATTACHED TO SS CASING.
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HIGHFILL
INFRASTRUCTURE
ENGINEERING, P.C.
3804 Park Avenue, Unit A
Wilmington, NC 28403
Tel [phone]
www.hiepc.com
Firm License No. C-2586
Engineering is our profession.
Service is our passion.
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THIS PRODUCT IS FOR GENERAL REFERENCE PURPOSES ONLY AND SHOULD NOT BE USED,
AND IS NOT INTENDED FOR, SURVEY OR ENGINEERING PURPOSES. LOCATIONS ARE APPROXIMATE.
GIS SOURCE DATA:
1 PARCEL BOUNDARIES STREETS, AND HYDROGRAPHY OBTAINED FROM NC ONE MAP,
'e
LEGEND 0 150 300 600
PROPOSED WELL #6 0 500 FT RADIUS NOTEFeet
:
'TOWN
G MA
MONITORING WELL' STREAMS OF SURF CITY WELL#2 (OUT OF SERVICE)
WILL BE USED AS A MONITORING WELL-
® IRRIGATION WELL ROADS NO SOURCES OF KNOWN OR POTENTIAL GROUNDWATER
PARCELS CONTAMINATION EXIST WITHIN 500 FEET OF THE
PROPOSED WELL SITE.
File: DRAWINGS/132203
PERMIT MAP
APPROXIMATE PROPOSED WELL #6 LOCATION
Date: 12/6/2022
Project No.132203
TOWN OF SURF CITY, PENDER CO., NC
Figure 1