WS0801072_Application_20230414 (2)

Bill Magette President
Office: 252.332-2265
Cell: 252-209-4676
[e-mail]
Fax:[phone]
March 22, 2023
MAGETTE WELL
& PUMP COMPANY INC.
2342 US Hwy.13 S. Ahoskie NC 27910
Deep Well Drilling Water Guaranteed
North Carolina Department of Environment and Natural Resources
Division of Water Quality -Aquifer Protection Section
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington NC 28405
RE: Application Permit Town of Surf City
Proposed Well Construction Information
Jimmy Morris Supervisor
Office: 252-3324265
Cell: 252-799-8403
[e-mail]
Fax: [phone]
RECENEDINCDENPXVVR
1. a., b., c., d., e., f., & g. See drawing. APR ] 4 2023
2. 1
3. 0 watw ouaiity P491",
4. 1 opwatws sectlan
5. 4/10/2023 WAmagton Regional office
6. 6/5/2023
Additional Information
1. a., b., c., d. See site map.
e. There are no groundwater contamination problems within 500' to our knowledge
2. The well will produce water from the Castle Hayne aquifer which is the source of water for well
number 5 and well number 3 which are supplying the water for Surf City at this time. The water
quality should be very similar.

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: 3/al/23 FOR OFFICE USE ONLY
2. County: Pander PERMIT NO. ISSUED DATE:
3. Applicant {� 1e Iy,1 e Telephone: % S 2 a Dq q6,//-�
4,
Applicant's Mailing Address:
Applicant's Email Address (if available):
4. Contact Person (if different than Applicant):
Contact Person's Mailing Address:
Contac Person's Email Address (If available):
('e
Telephone:
5. Property Owner (if different than Applicant): Town of Surf City Telephone: [phone]x1g0
Owners Mailing Address: 214 W. Florence Way, Hampstead, NC 28443
Owner's Email Address (if available): kbreuer(d.surfcitvnc.gov
6. Property Physical Address (including PIN Number): PO Box 2475 (PIN: 423545-4988.0000)
City _Town of Surf Cilv County: Pender Zip Code: 28445
7. Intended use of Well or Well System: Public Supply Well
(examples: irrigation, consumption, etc.)
8. 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
EJngineeer and contact information: Paul R. Shivers. pshivers(c�hiepc.com (99110) 313.1516
12. Well Contractor: 1_" r ce e1' 9 (ei I+Lat'�4Al Well Contractor Certification No.: �I "/3 A
Well Contractor Address:
PROPOSED WELL CONSTRUCTION INFORMATION
1. As required by 15A NCAC 02C .0105(0(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. Sandtgravel pack intervals
e. Type of casing material and thickness
f. Grout horizons
g. Well Head completion details
2. Na. of wells to be construct �atep
material: p IL
3. No. of wells to be construct
n bedrock:
4. Total No. of wells to be con
cle�
(add answers from 2 and 3
5. Estimated beginning const
on date:
6. Estimated construction com
Continued on Reverse

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.
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.newater.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
ACe(-(,IPj(AII&Pxh jf 7 a2aq h
Si nature of Appli or *Agent Title of Applicant or *Agent
&I I Mal-e-He"ffsigning asAgent, attach authorization agreement stating
Printed name of Appli t 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).
Ky�% �4 ¢LLPiL Kyle M. Breuer, Town of Surf City
Signalur 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 Winston-Salem Regional Office
943 Washington Square Mall 450 W. Hanes Mill Road
Washington, NC 27889 Suite 300
Phone: [phone] Winston-Salem, NC 27105
Fax: [phone] Phone: [phone]
GW-22W Rev. 3-1-2016

PROPOSED PRODUCTION
WELL SPECIFICATIONS
SURF CITY WELL #6 (2A)
PPFfFPPEO OPEN Bg1E nL1FRNnlE SCRfFH I.Np
MqE Mfldl LRn`hL PRCK OPIIg1
ME TEMPORMY WELL Sf PRIME IEMPORWIY WELL SM
1 20' DtED BLIND MNGE WITH 20- SOLVED BUND fU4f M
(SEE NOTE 1) (LEE NONE 1)
0I.25- SS Of rvEE�
.zo' scWlos sz (Ba' sEWuo)
WELL GSINC WD SURFTCE UND SURFI
P50' STEEL WRfRCC
(PIfJ CASING
0.325' MIN. WALL MK (f I ^I• ,
WUL
NG-
f18-NEAT CEMEMAROUND�L'. - • I s� •IL
VI 1
GROUT ND
f6-
SURE GSINO 1
HEEL CEMP/L2ER
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020' SCN105 55
WELL CASINO
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