WM0501338_Application_20190117

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 : January 17 2019 FOR OFFICE USE ONLY
2 , County: Johnston PERMIT NO . ISSUED DATE _ .
3 . What type of well are you applying for? (monitoring or recovery) : Monitoring
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4, Applicant: Linamar Corporation Telephone : [phone] . 1 � r (L
Applicant's Mailing Address: 32233 West 8 Mile Road Livonia MI , USA 48152
Applicant's Email Address (if available): MikeManDieren(Kinamar com
5. Contact Person(if different than Applicant) : GHD - Matthew Talbert Telephone: [phone]
Contact Person's Mailing Address : 3075 Breckinridge Blvd Ste 470 Duluth GA 30096
Contact Person's Email Address (if available) : matthew.talbert onghd com
6. Property Owner (if different thanApplicant) : Selma Precision Technologies NC LLC Telephone :
Property Owner's Mailing Address : 500 Oak Tree Dr. , Selma NC
Property Owner's Email Address (if available) : _ viratCg),sptechnc.com
7 . Property Physical Address (IncludingPIN Number) 500 Oak Tree Dr. PIN : 260520-81 -0062
City Selma County Johnston Zip Code 27576
8 . Reason for Well (s) : Due diligence
(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 : Manufacturing
(ex: non-dischargefacility, wastedisposal 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) .
None known
11 . Type of contaminants being monitored or recovered : Volatile organics , petroleum hydrocarbons metals
(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) . : NA
13 . Distance from proposed well(s) to nearest known waste or pollution source (in feet) : No corfirmed impacts . Within 10 feet of
potential sources
14 , Are there any water supply wells located less than 500 feet from the proposed well (s)? Yes
If yes, give distance(s) : 300 ft
15. Well Contractor: Cascade Drilling Certification No . : NCWC 3221 -13
Well Contractor Address : 1020 S 82nd St. Tampa FL 33619
PROPOSED WELL CONSTRUCTION INFORMATION
1 . As required by 15A NCAC 02C . 0105(f)(7), attach a well construction diagram of each well showirg 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 completon 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? Locking well cao
material : 6 and protective cover
3 . Number of wells to be constructed in bedrock: 0 6 . Estimated beginning construction date : 2/4/2019
4 , Total Number of wells to be constructed : 6 T Estimated construction completion date: 2/8/2019
(add answers from 2 and 3)
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.
SIGNATURES
The Applicant hereby agrees that the proposed well (s) will be constructed in accordance with approved specifications and conditions of
this Well Construction PW it as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code ,
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Sub,chpppter ?,C) and accepts full responsibility for compliance with these rules
Sigature of Applicant or *Agent Title of Applicant or *Agent
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7 t C 4+?: {L � ' VAIJ i C � /J * 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
wells as outlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the W II Construction Standards (Title 15A of the North Carolina Administrative Code , Subchapter 2C) .
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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 Raleigh Regional Office
Swannanoa , NC 28778 3800 Barrett Drive Wilmington Regional Office
Phone : (828) 2964500 Raleigh , NC 27609 127 Cardinal Drive Extension
Fax : (828) 299-7043 Phone : (919) 791 -4200 Wilmington , NC 28405
Fax: (919) 571 -4718 Phone: (910) 796-7215
Fayetteville Regional Office Fax: (910) 350-2004
225 Green Street, Suite 714 Washington Regional Office
Fayetteville, NC 28301 -5094 943 Washington Square Mall Winston -Salem Regional Office
Phone: (910) 433-3300 Washington , NC 27889 450 W. Hanes Mill Road
Fax: (910) 486-0707 Phone : (252) 946-6481 Suite 300
Fax: (252) 975-3716 Winston - Salem , NC 27105
Mooresville Regional Office _
610 East Center Avenue win to al , 6-9800
797
Mooresville , NC 28115
Phone : (704) 663- 1699
Fax: (704) 663-6040
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CAP TYPE:LOCKING,WATER PROOF
PROTECTIVE CASING
STICK UP=3 ft
GROUND
SURFACE SEAL TYPE:CONCRETE
WELL CASING
ANNULUS BACKFILL TYPE:
NEAT CEMENT GROUT
TOP OF SEAL AT-5 ft.
SEAL TYPE; HYDRATED BENTONITE
BOTTOM OF SEAL AT-7 ft.
PACK TYPE:SAND
TOP OF SCREEN AT-9 ft. -
BOTTOM OF SCREEN AT-19 ft.
BOTTOM OF HOLE AT-20 R. NOTE:
ALL DIMENSIONS ARE BELOW
GROUND SURFACE(BGS)
SCREEN TYPE:CONTINUOUS SLOT
SCREEN MATERIAL: PLASTIC
SCREEN LENGTH:1 Oft SCREEN DIAMETER;2 IN, SCREEN SLOT SIZE:0.010 IN.
WELL CASING MATERIAL:PLASTIC WELL CASING DIAMETER: 2 IN.
HOLE DIAMETER:8 IN.
PROPOSED OVERBURDEN MONITORING WELL CONSTRUCTION DETAILS
STICK-UP
Sona Forgings
Selma, North Carolina

PHYSICAL SETTING SOURCE MAP - 5529986.2s
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SITE NAME: 11188712-Selma, NC CLIENT: GHD
ADDRESS: 500 Oak Tree Drive CONTACT: Laura Grana
Selma NC 27576 INQUIRY#: 5529986.2s
LAT/LONG: 35.537055/78.300324 DATE: January 09,2019 11:50 am
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