WM0401549_Application_20240823

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:
2. County: Guilford
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Temporary monitoring well
4. Applicant: Murphy Oil USA Telephone: [phone]
Applicant's Mailing Address: 9805 Katy Freeway Suite G-200 Houston, Texas 77024
Applicant's Email Address (if available): Caleb.Chambers6dWurphvUSA.com
5. Contact Person (if different than Applicant): Matthew Cowart Telephone: [phone]
Contact Person's Mailing Address: 625 Holcomb Bridge Road, Norcross, GA 30071
Contact Person's Email Address (if available): mcowart(aunitedconsulting.com
6. Property Owner (if different than Applicant): Brian Hunt Telephone: [phone]
Property Owner's Mailing Address: 34 Lata Palm Ct Blythewood, SC 29016
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 2403 Randleman Road
City Greensboro County Guilford Zip Code 27406
8. Reason for Well(s): Phase II assessment, suspect contamination
(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: On -site spills, adjoining fuel station, drycleaners, and auto store.
(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).
11
12
13
14
Spill of approximately 75-gallons non -PCB mineral Oil from failed utility pole transformer. Incident # 200604060
Type of contaminants being monitored or recovered: VOCs, lead, and PAHs
(ex: organics, nutrients, heavy metals, etc.)
Are there any existing wells associated with the proposed well(s)? If yes, how many? Not to my knowledge
Existing Monitoring or Recovery Well Construction Permit No(s).:
Distance from proposed well(s) to nearest known waste or pollution source (in feet): On -site (100 feet)
Are there any water supply wells located less than 500 feet from the proposed well(s)? Not to my knowledge
If yes, give distance(s):
15. Well Contractor: George Bridger Certification No.: 2393-A
Well Contractor Address: 609A Piner Road STE 607, Wilmington, NC 28409
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 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 5. How will the well(s) be secured?
material: 5 Temporary monitoring well
3. Number of wells to be constructed in bedrock: 0 6. Estimated beginning construction date: 8/27/24
4. Total Number of wells to be constructed: 5 7. Estimated construction completion date: 8/27/24
(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.
s Digitally signed by Caleb Chambers
Caleb Chamber
Date: 2024.08.1609:15:48-04'00' Project Manager
Signature of Applicant or *Agent
Caleb Chambers
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) wil�ocated, 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 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-22M/R (Rev. 5-26-2022)

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UNITED WELL/PIEZOMETER LOG ER�OPOSED ID: WELL
1 L ID:
CONSULTING"
CLIENT:
SITE LOCATION:
CONSTR. START:
Murphy Oil USA, Inc.
2403 Randleman Road, Greensboro, NC
8/27/2024
DRILLING METHOD:
CONSTR. COMP:
PROJECT NAME:
Greensboro, NC (Randleman & Meadowview)
Hollow Stem Auger
8/27/2024
PROJECT NUMBER:
DRILLING CONTRACTOR AND EQUIP:
DEVELOPMENT DATE:
MPOIL-24-NC-08518-02
Bridger Drilling
NA
LOGGED BY:
SAMPLING METHOD:
STATIC GROUNDWATER DEPTH:
Matthew Cowart
Peristaltic pump
Unknown
d
w
t
N
U
E LITHOLOGY
SAMPLES
SKETCH
NOTES
0
REC
Sample ID
OVM
0
2
-9
4
6
8
10
12
14
16
18
20
1::�
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.; ;,
; i
22
24
::•".•
:::
:�;; •
.
26
t�•
28
•::�
:1
30
NOTES
-
Surface Elev.:
Surface Completion:
Filter Pack Type:
Screen Length:
Time of Drilling
Stick-uD
#20 Well Slot Sand
10 Feet
Groundwater Level
TOC Elev.:
Riser Height (Surface):
Well Diameter:
Screen Slot Size:
11nch
0.001in
2a-Hour
Groundwater Level
Northing/Lat.:
Annular Fill Type:
Borehole Diameter:
Bottom of Screen:
Fill Soils
6.25Inches
30 Feet
C
Easting/Long.:
Annular Sealant Type:
Top of Screen:
Bottom of Well:
Development
Groundwater Level
Grout La er/Bentonite Seal
20 Feet
30 Feet

UNITED WELL/PIEZOMETER LOG TP 1 OSED ID: TPEL1 ID:
CONSULTING"
CLIENT:
SITE LOCATION:
CONSTR. START:
Murphy Oil USA, Inc.
2403 Randleman Road, Greensboro, NC
8/27/2024
DRILLING METHOD:
PROJECT NAME:
CONSTR. COMP:
Greensboro, NC (Randleman & Meadowview)
Hollow Stem Auger
8/27/2024
PROJECT NUMBER:
DRILLING CONTRACTOR AND EQUIP:
DEVELOPMENT DATE:
MPOIL-24-NC-08518-02
Bridger Drilling
NA
LOGGED BY:
SAMPLING METHOD:
STATIC GROUNDWATER DEPTH:
Matthew Cowart
Peristaltic pump
Unknown
d
w
t
N
U
E LITHOLOGY
SAMPLES
SKETCH
NOTES
0
REC
Sample ID
OVM
0
2
4
6
8
10
12
14
16
18
20
1::�
�•
22
24
::•".•
:::
:�;; •
.
26
t�•
28
30
�: �:.•.
c ;
NOTES
-
Surface Elev.:
Surface Completion:
Filter Pack Type:
Screen Length:
Time of Drilling
Stick-up
#20 Well Slot Sand
10 Feet
Groundwater Level
TOC Elev.:
Riser Height (Surface):
Well Diameter:
Screen Slot Size:
IInch
0.001in
2a-Hour
Groundwater Level
Northing/Lat.:
Annular Fill Type:
Borehole Diameter:
Bottom of Screen:
Fill Solis
6.25Inches
30 Feet
C
Easting/Long.:
Annular Sealant Type:
Top of Screen:
Bottom of Well:
Development
Groundwater Level
Grout La er/Bentonite Seal
20 Feet
30 Feet

1 POSED ID: WELL
UNITED WELL/PIEZOMETER LOG PROPOSED
� L ID:
CONSULTING"
CLIENT:
SITE LOCATION:
CONSTR. START:
Murphy Oil USA, Inc.
2403 Randleman Road, Greensboro, NC
8/27/2024
DRILLING METHOD:
CONSTR. COMP:
PROJECT NAME:
Greensboro, NC (Randleman & Meadowview)
Hollow Stem Auger
8/27/2024
PROJECT NUMBER:
DRILLING CONTRACTOR AND EQUIP:
DEVELOPMENT DATE:
MPOIL-24-NC-08518-02
Bridger Drilling
NA
LOGGED BY:
SAMPLING METHOD:
STATIC GROUNDWATER DEPTH:
Matthew Cowart
Peristaltic pump
Unknown
d
w
t
N
U
E LITHOLOGY
SAMPLES
SKETCH
NOTES
0
REC
Sample ID
OVM
0
2
4
6
8
10
12
14
16
18
20
i
�•
22
24
::•".•
:::
:�;; •
.
26
28
30
. :
NOTES
-
Surface Elev.:
Surface Completion:
Filter Pack Type:
Screen Length:
Time of Drilling
Stick-up
#20 Well Slot Sand
10 Feet
Groundwater Level
TOC Elev.:
Riser Height (Surface):
Well Diameter:
Screen Slot Size:
IInch
0.001in
2a-Hour
Groundwater Level
Northing/Lat.:
Annular Fill Type:
Borehole Diameter:
Bottom of Screen:
Fill Solis
6.25Inches
30 Feet
C
Easting/Long.:
Annular Sealant Type:
Top of Screen:
Bottom of Well:
Development
Groundwater Level
Grout La er/Bentonite Seal
20 Feet
30 Feet

UNITED WELL/PIEZOMETER LOG PROPOSED ID: WELL ID:
C-1 C-1
CONSULTING"
CLIENT:
SITE LOCATION:
CONSTR. START:
Murphy Oil USA, Inc.
2403 Randleman Road, Greensboro, NC
8/27/2024
DRILLING METHOD:
CONSTR. COMP:
PROJECT NAME:
Greensboro, NC (Randleman & Meadowview)
Hollow Stem Auger
8/27/2024
PROJECT NUMBER:
DRILLING CONTRACTOR AND EQUIP:
DEVELOPMENT DATE:
MPOIL-24-NC-08518-02
Bridger Drilling
NA
LOGGED BY:
SAMPLING METHOD:
STATIC GROUNDWATER DEPTH:
Matthew Cowart
Peristaltic pump
Unknown
d
w
t
N
U
E LITHOLOGY
SAMPLES
SKETCH
NOTES
0
REC
Sample ID
OVM
0
2
4
6
8
10
12
14
16
18
20
1::�
�•
22
24
::•".•
:::
:�;; •
.
26
t�•
28
30
NOTES
-
Surface Elev.:
Surface Completion:
Filter Pack Type:
Screen Length:
Time of Drilling
Stick-up
#20 Well Slot Sand
10 Feet
Groundwater Level
TOC Elev.:
Riser Height (Surface):
Well Diameter:
Screen Slot Size:
IInch
0.001in
2a-Hour
Groundwater Level
Northing/Lat.:
Annular Fill Type:
Borehole Diameter:
Bottom of Screen:
Fill Solis
6.25Inches
30 Feet
C
Easting/Long.:
Annular Sealant Type:
Top of Screen:
Bottom of Well:
Development
Groundwater Level
Grout La er/Bentonite Seal
20 Feet
30 Feet

UNITED WELL/PIEZOMETER LOG PROPOSED ID: PWE2LL ID:
CONSULTING"
CLIENT:
SITE LOCATION:
CONSTR. START:
Murphy Oil USA, Inc.
2403 Randleman Road, Greensboro, NC
8/27/2024
DRILLING METHOD:
CONSTR. COMP:
PROJECT NAME:
Greensboro, NC (Randleman & Meadowview)
Hollow Stem Auger
8/27/2024
PROJECT NUMBER:
DRILLING CONTRACTOR AND EQUIP:
DEVELOPMENT DATE:
MPOIL-24-NC-08518-02
Bridger Drilling
NA
LOGGED BY:
SAMPLING METHOD:
STATIC GROUNDWATER DEPTH:
Matthew Cowart
Peristaltic pump
Unknown
d
w
t
N
U
E LITHOLOGY
SAMPLES
SKETCH
NOTES
0
REC
Sample ID
OVM
0
2
4
6
8
10
12
14
16
18
20
1::�
�•
22
24
::•".•
:::
:�;; •
.
26
t�•
28
30
NOTES
-
Surface Elev.:
Surface Completion:
Filter Pack Type:
Screen Length:
Time of Drilling
Stick-up
#20 Well Slot Sand
10 Feet
Groundwater Level
TOC Elev.:
Riser Height (Surface):
Well Diameter:
Screen Slot Size:
IInch
0.001in
2a-Hour
Groundwater Level
Northing/Lat.:
Annular Fill Type:
Borehole Diameter:
Bottom of Screen:
Fill Solis
6.25Inches
30 Feet
C
Easting/Long.:
Annular Sealant Type:
Top of Screen:
Bottom of Well:
Development
Groundwater Level
Grout La er/Bentonite Seal
20 Feet
30 Feet