WM0100420_Other_20171106

State of North Carolina | Environmental Quality | Water Resources
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
828-296-4500

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director
Water Resources
Environmental Quality

November 6, 2017

Alan Chapman
NCDEQ-DSCA Program
1649 Mail Service Center
Raleigh, NC 27699

Re: Well Construction Permit WM0100420
DSCA Site 12-0003
NC Broughton Hospital Property
Burke County

Dear Mr. Chapman,

In accordance with the application submitted on your behalf by Shane Sisco on November 2, 2017, we are
forwarding well construction permit WM0100420 dated November 6, 2017. The permit is for the
construction of six monitoring wells on the State of North Carolina Broughton Hospital property as
described in the application and the attached permit.

The permit will be effective from the date of issuance for a period of one year and is subject to the
conditions and limitations as specified therein. A Well Construction Record shall be completed and
signed by the certified drilling contractor for each well. The forms shall be submitted to the Department
upon completion of the wells and shall reference the permit number. Please review the attached permit
conditions.

If you should have any questions or need additional information, contact Andrew Moore at 828-296-4500.

Sincerely,

G. Landon Davidson, P.G.
Regional Supervisor
Water Quality Regional Operations Section

cc: Shane Sisco – Hart & Hickman, P.C. (via email)
ARO file

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES
PERMIT FOR THE CONSTRUCTION OF 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
NCDEQ-DSCA Program
FOR THE CONSTRUCTION OF A MONITORING WELL SYSTEM consisting of six monitoring wells (four
traditional and one nested pair) owned by NCDEQ-DSCA, 1649 Mail Service Center, Raleigh, NC 27699-1646. The
wells will be located on property owned by the State of NC Broughton Hospital located in Burke County (PIN#
2703517663). This Permit is issued in accordance with the application received on November 2, 2017, in conformity
with specifications and supporting data, all of which are filed with the Department of Envir onmental 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 supersede any other agreement, permit, or requirement issued by
another agency.
2. The well(s) shall be located and constructed as shown on the attachments submitted as part of the
Permit application.
3. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C
.0108(O) where applicable.
4. The monitoring well shall be maintained in accordance with 15A NCAC 02C .0108.
5. A Well Construction Record (GW-1) for each well shall be submitted to the Division of Water
Resource’s Information Processing Unit within 30 days of the well completion in accordance with
15A NCAC 02C .0114.
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
Resource’s Information Processing Unit and the property owner within 30 days of the well
abandonment in accordance with 15A NCAC 2C .0114.

Permit issued the 6th day of November, 2017
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION

_______________________________________________
Landon Davidson, Regional Supervisor
Water Quality Regional Operations Section
By Authority of the Environmental Management Commission
Permit No. # WM0100420