WM-0100111_Complete - Historical File_20190326

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14C tqi Job No,6361•DI En,;,oninentaL Sciences Inc,
ViCiNiTi MAP ate; 3/27/97 AvE�f Coumr scwas

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FIELD MONITORING WELL INSTALLATION DIAGRAM FOR WELL NO. N4-4
MONITORING WELL 'DATA-,'
Flush Mounted Bolt Down
Steel Manhole Cover \ 1:: Watet Level Fom Top
of PVC
Date: Depth:(ft)
.Cement 7 ft.
Bentonite Grout �� \
Seal and Plug
PVC Pipe
Diameter=2 \
Schedule 40 `.
I
22 + 2. Well_ Developed by
Bentonite
Pellet Seal 1 ,
Date: Gallons:
Total.
Washe
d Gravel o- Depth
Coarse Sand =eft.
3. Elevations:
10 ft. Ground Surface= ft.
PVC Well Screen — Top of PVC ft.
Diameter=�2 —
Schedule 40 —
Slot Size=Q_010"
Suggested Warning Label
WARNING
For Monitoring Only
Not To Be Used For
Portable.-
..Water-Borehole
Diameter
= g .
Date Installed: Drill Rig: Crew:
Proposed monitoring wells to be constructed for AveryALPHA 400 DELLWOOD ROAD •BUILDING A.SUITE 2
County schools on the Underwood and Weld Property, Newland NC P.o.BOX 31. WAYNESVILLE.NC79766
ENVIRONMENTAL SCFN'CES LTC
SCALE Drawn: Job No.
A-5 Ct1kxed: G 361.01 .
5}{OWIJ Date: Dwr. No.

3. TNdTess of casing: Sch .40 inches :
7. How wrll the well(s) be4secured? bolt down well covers/lockiria plugs
B. Estimated begirining construction 'date: 'Wril' 10;- 1997 ;
9. Estimated completion date Abri 1 11, 1997 - -
ADDITIONAL- -INFORMATION _
1. ATTACH A SITE MAP .SHOWING THE LOCATIONS: OF THE FOLLOWING:
1 - PROPOSED MONITORING WELL(S)
2- ALL EXISTING MONITORING AND RECOVERY WELLS OR TEST BORINGS WITH THE PROPERTY
BOUNDARY
3 - ALL WATER SUPPLY WELLS WITHIN 500 FEET OF THE WASTE SOURCES
4 - AT LEAST TWO REFERENCE POINTS (NUMBERED ROADS, INTERSECTIONS, STREAMS, ETC.)
2. PROVIDE A WELL CONSTRUCTK)N DIAGRAM OF EACH WELL SHOWING DIAMETER, ESTIMATED DEPTH, SCREEN
INTERVALS, SANDIGRAVEL PACKS, TYPE OF CASING MATERIAL, CASING WALL THICKNESS, WELL HEAD COMPLE-
TION DETAILS, ETC.)
The Applicant hereby agrees the proposed well(s) -will be constructed in accordance with
approved specifications and conditions of the Well Construction Permit as regulated under the Well
Construction Standards (Title 15A North Carolina Administrative.-.Code, Subchapter .2C), and accepts
full responsibility for compliance with these rules.
JJ, I'140'u- — ��2v�'�yUtiQ��i""wt ���.C¢/L�¢o G�l1C�•
Signa re of Applicant or Agent
Title (a applicable)
If the property is owned by someone other than the applicant,. the property owner hereby
consents to allow the applicant to construct monitoring wells as-outlined in this application and that
it shall be the responsibility of the applicant'to, ensure that these monitoring wells conform to the Well
Construction Standards (Title 15A North Carolina Administrative Code, Subchapter 2C).
Ato-,_, ,,P— --30jf— 2k,
Signature of PPoperty Owner Of different from applicant)

NORTH CAROLINA
ENV NMENTAL MANAGEMENt COMMIS, d;DEPARIT,, NT 6, ENVIRONMENT, HEALTH, & NATUR'_ RESOURCES rn
R N U U
APPLICATION FOR PERMIT TO CONSTRUCT A. MONITORING, -FIFJ , SYSTEM
0 9
Date: March 27 1997. County Avery _
J jsro!urldwat'r
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina a_ri_d_irreg ilations"pursuant-
thereto, application is hereby made for a permit to monitoring wells.
1. Name of Applicant Avery County Schools (Telephone:(704) 733-W )
Applicant's Mailing Address: P.O. Box 1360 Newland, NC 28657
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2. Name of Property Owner (if different from applicant) l T e o 2 g e ��a�G c,2 Um 4k%no C%c+
Owner's Mailing Address: P.O. Box 669 Spruce Pine, NC 28777
3. Contact Person: Roger Moore - Alpha Envimrmental Sciences, Inc. (Telephon'.:(7n4) 4 3449 )
4. Location of Property: Newland, NC NC 194 North
5. Reason for Monitoring _Well(s):Carprehensive Site Assessment - AST Release
(ex: nordscharge permit requirements, suspected contamination, env'vormental assessmerd, etc.)
6. Type of facility or'site for which the monibcring well(s) is needed: Aboveground storage tank release
(ex: nordscharge faality, waste dsposal site, landfdl, underground storage tarn, etc.)
7. Type of contamination being monitored (if applicable); Petroleum— Diesel Fuel
(ex: mrtrients, orgarics, heavy metals, etc.)
B. Are any existing recovery wells associated with the monitoring well(s)? NO tf yes, how many?
Recovery Well'.Construction. Permit No.
9. Distance to a known waste or pollution source: 50 feet
10. Are any water supply wells located less than 50o _feet from the proposed monitoring wells? No
If yes, give ckstance: feet
11. Well Driller. Alpha Fnvimrrmntal SCiP_Lrpr,, Tnf
12. Registration #: (441
13. Drillers AddressP.O. Box 31, Waynesville, NC 28786
PROPOSED MONITORING WELL CONSTRUCTION INFORMATION
1. Total Number of Wells to be constructed: 5 ; (A) Number to.-be completed in bedrock? 5
(B) Number to be.completed in unconsolidated .material? 0
20 FOR FF10E USE ONLY
2. Estimated'depth of well(s): feet PERMITTED 4
— ACTIVITY
U.S.T. LEAK DETECTION
3. Gravel or sand pack interval Cr appropriate) _ GROUNDWATER: QUALfTY STANDARDS
From 9 feet To 2— feet VIOLATIONS SUSPECTED FROM UNPERMfTTED
ACTIVITIES _.. .
4. Type of using .used: _. PVC _ NOTICE OF NON-COMPLIANCE AT
(ex: PVC, stainless steel, galvanized steel, etc.) UNPERMrI7ED FACILITIES 19
PERMIT. NO. ISSUED
5. Diameter of casing: 2 inches INCIDENT #
CAW-22M M911

North Carolina -Department of Environment. Health, and Natural Resources " FOR 6FFiCt3 USE ONLY
Division of Environmental Management-Groundwater Section QUAD.NO, SERIAL N0. -
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone] Lat. Long `_b0�
Minor Basin
W,ELL CONSTRUCTION RECORD Basin Code -
DRILLING CONTRACTOR: #6- Header 1=nt. 1=nL`
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: fyr-// PERMIT NUMBER: W/t/t0/00///
1. WELL LOCATION: (Show sketch of the location below) /�
Nearest Town: A{w Arun .L County: Ay_e
(Road,Community,or Subdivision/and Lot No.) DEPTH DRILLING LOG
2. OWNER AVty &vn4v 5dwc15 From To Formation Description
ADDRESS PV, 40Z 1366
(Sheet or Route No.)
ONE COPY OF THIS FORM
City or Town State Zip Code SENT TO DRILLER
3. DATE DRILLED USE OF WELL
4. TOTAL DEPTH
5. CUTTINGS COLLECTED YES ❑ NO❑
6. DOES WELL REPLACE EXISTING WELL? YES F_� . NO[] _.
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use"+"it Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface'
•Casing Terminated at/or below land surface Is illegal unless a variance is Issued -'
In accordance with 15A NCAC 2C .0119
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (depth):
11. CHLORINATION: Type Amount If additional space is needed use back of form
12. CASING: --` '-
Wail Thickness LOCATION SKETCH
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From To Ft. Roads,or other map reference points)
From To Ft.
From To Ft.
13. GROUT:
Depth Material Method
From To Ft.
From To Ft.
14. SCREEN: ,
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. _ in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS: —
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL
CONSTRUCTION STANDARDS, AND,THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CONTRACTOR OR AGENT PATE
GW-I REV.9,91 Suhmit nrininni in ni Wnn nI F:rw4nn---1,1 lA� �+ - J---•••-.

Permit issued this the 4th day of April, 1997.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Donald R. Link, L.G., Regional Groundwater Supervisor
Division of Environmental Management
By Authority of the Environmental Uana-gement Commission
PERMIT NO. WM0100111

This Permit will be effective for the construction of a monitor well from the date of its
issuance until the site assessment has been completed, and shall be subject to other specified
conditions, limitations, or exceptions as follows:
1. The well driller shall notify the Asheville Regional Office prior to actual
construction of the well.
2. The well shall be constructed with well casing and well screen that conform to
requirements of the "Criteria and Standards Applicable to Water Supply and
Certain Other Type Wells" (15A NCAC 2C .0100).
3. The well shall be afforded reasonable protection against damage during
construction and use.
4. The well screen shall be set at a depth where the anticipated high water table will
be below the top of the screen so that any floating petroleum products can enter the
monitor wells and of sufficient depth so there is water adequate for sampling
during the seasonally low water table.
5. Provisions shall be made on the well cover to prevent surface water with possible
contaminants from entering the well pit and contaminating the monitor well.
6. The well shall have permanently affixed an identification plate constructed of
durable material and shall contain the following information: drilling contractor's
name and registration number; date well completed; total depth of well; a warning
that the well is not for water supply and that the groundwater may contain
hazardous materials; and depth to screens.
7. Well completion, well abandonment, and water quality reports are to be submitted
to the Division of Environmental Management's Groundwater Section Central
Office in Raleigh.
8. When the well has served its purpose and is of no further use, it shall be
permanently abandoned by the applicant according to the requirements of.Section
.0113 of the "Criteria and Standards Applicable to Water Supply and Certain Other
Type Wells" (15A NCAC 2C).

NORTH CAROLINA
.ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
ASHEVILLE, NORTH CAROLINA
PERMIT FOR THE
CONSTRUCTION OF A WELL
OR WELL. SYSTEM
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
Avery County Schools
FOR THE CONSTRUCTION OF monitor wells for Groundwater Incident No. 15315 in the
residuum aquifer system of the Grandfather Mountain Window I-Iydrogeologic Unit, located at
George Badger Underwood III, Highway 194 next to Avery County Schools Building in Avery
County, in accordance with the application dated March 27, 1997, and in conformity with
specifications and supporting data, all of which are filed with the Department of Environment,
Health, and Natural Resources and are considered a part of this Permit.
This Permit is for well construction only, and does not waive any provisions or
requirements of any other applicable laws or regulations.
Construction of a well under this Permit shall he in compliance with the North Carolina
Well Construction Regulations and Standards, and any other State and local laws and regulations
pertaining to well construction.

VState of North Carolina-:-'
Department of Enyironment;
Health and Natural Resources "
Division of Water Quality
James B. Hunt,Jr:, Governor
Jonathan B. Howes,Secretary HNF::;Z
A. Preston Howard;Jr., P.E.; Director
Asheville Regional Office
GROUNDWATER SECTION
April 4, 1997
Avery County Schools
Attention: Dr. Phyllis Crain
P.O. Box 1360 Newland, NC 28657
SUBJECTS Well Construction Permit No. VM0100111
Avery County Schools
Groundwater Incident No. 15315
Avery County, North Carolina
Dear Dr. Crain:
In accordance with your application received April 2, 1997, we are forwarding herewith Well Construction
Permit No. WM0100111 dated April 4, 1997, issued to Avery County Schools for the construction of a
monitor well at George Badger Underwood III; Highway 194 next to Avery County Schools Building.
If any parts, requirements, or limitations contained in this Permit are unacceptable to you, you have the
right to an adjudicatory hearing before a hearing officer upon written demand to.the.Director within 30
days following receipt of this Permit, identifying the specific issues to be contended. Unless such demand
is made, this Permit shall be final and binding.
This Permit will be effective for the construction of a monitor well from the date of its issuance until the
site assessment has been completed, and shall be subject to the conditions and limitations as specified
therein. Attached a W is ell Construction Record to be completed and signed by the drilling contractor.
This form should be submitted to the Department upon completion of the well.
Sincerely,
- 1
Donald R. Link,.L.G.
Regional Groundwater Supervisor
DRL/sep
Attachment
cc: Arthur Mouberry
Roger Moore,- Alpha Environmental Sciences, Inc.
Interchange Building,59 Woodfin Place � � FAX [phone]
Asheville,North Carolina 28801 An Equal Opportunity/Affirmative Action Employer
Voice 704-251-6208 recycles/100%post-consumer paper ,
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