WM0501349_Application_20190329

kTNAC
ENVIRONMENTAL• GEOTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
March 22, 2019
Mr. Rick Bolich, L.G.
North Carolina Department of Environmental Quality
Raleigh Regional Office
Division of Water Quality — Aquifer Protection
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Re: Permits to Construct Monitoring Wells
Eakes Cleaners - DSCA Site #DC320004
827 West Morgan Street
Durham, Durham County, North Carolina
ATC Project No. DC320004
DSCA Site No. DC320004
Dear Mr. Bolich:
2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcassociates.com
N.C. Engineering License No. C-1598
NC Dept of Environmental Quality
MAR 2 9 2019
Raleigh Regional Office
Enclosed please find an application for a permit to construct two temporary monitoring wells.
The monitoring wells will be located at 827 West Morgan Street in Durham, North Carolina.
The permit application, site map with the proposed locations of the monitoring wells, well
construction details and other relevant information are enclosed as attachments. Please review
this package and return the approved permits to this office.
If you have any questions or require additional information, please contact our office at (919)
871-0999.
Sincerely,
ATC Associates of North Carolina, P.C.
J
Staff Geologist

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: 03/22/2019
2. County: Durham
FOR OFFICE USE ONLY
PERMIT NO. _ ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: ATC Associates of NC, PC on Behalf of NCDEQ DWM DSCA Telephone: [phone]
Applicant's Mailing Address: 2725 E. Millbrook Road, Suite 121, Raleigh, NC 27604 / N.C. DEQ Waste Management 1646 Mail
Service Center, Raleigh, NC 27699
Applicant's Email Address (if available): kevin.sommers(a-)-atcgs.com / billy. meyer(a)ncdenr.gov
5. Contact Person (if different than Applicant): Jeremy Robbins, ATC Telephone: [phone]
Contact Person's Mailing Address: 2725 E. Millbrook Road, Suite 121, Raleigh, NC 27604
Contact Person's Email Address (if available): Jeremy. robbins(a)atcgs.com d
6. Property Owner (if different than Applicant): ROBERTS & CATES PROPERTIES LLC Telephone:
Property Owner's Mailing Address: 827 West Morgan Street, Durham, NC 27701 a-)
Property Owner's Email Address (if available): Unknown CC
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7. Property Physical Address (Including PIN Number) 827 West Morgan Street (PIN: 0821-07-69-7269)
City Durham County Durham Zip Code
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8. Reason for Well(s): Groundwater 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: Former Dry-cleaner (DSCA)
(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. Type of contaminants being monitored or recovered: Chlorinated Solvents
(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).: Unknown
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 75 feet / 75 feet
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s):
15. Well Contractor: Geologic Exploration, LLC Certification No.: 4252-A
Well Contractor Address: 176 Commerce Blvd., Statesville, NC 28677
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
0
ix

Continued on Reverse
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
Number of wells to be constructed in unconsolidated
material: 2
Number of wells to be constructed in bedrock: 0
Total Number of wells to be constructed: 2
(add answers from 2 and 3)
How will the well(s) be secured? Locking well cap
Estimated beginning construction date: TBD
Estimated construction completion date: TBD
ADDITIONAL INFORMATION
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 hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
2 President ATC Associates of NC. PC
Slgnature of Applicant or *Agent Title of Applicant or *Agent
v" 1V,, �-,` C:, * 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 Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
Court Order Court Order
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
Swannanoa, NC 28778
Phone: [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]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
GW-22MR Rev. 3-1-2016

LEGEND:
W-1 MONITORING WELL
4M"'� Well Identification
1B-1 SOIL BORING
T "-- Boring Identification
PROPOSED TEMPORARY
MONITORING WELL
-- SITE PROPERTY LINE
DURHAM COUNTRY PARCEL LINE
OTE: ALL LOCATIONS ARE APPROXIMATE
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A' C 2725 E. Millbrook Road, Suite 121
AFAkT
' Raleigh, NC 27604
ENVIRONMENTAL• OEOTECHNICAL [phone]
PROJECT NO: DC320004
DATE: 03/18/2019 1 REVIEWED BY: BB
Temporary well unfinished at surface.
,ocking well cap.
cite Seal
hedule 40 PVC Casing Extending
urface to Top of Screen (0-5 feet)
chedule 40 Well Screen (0.010" Slot)
Groundwater Table
Sack Extending 2 Feet Above Screen
WELL CONSTRUCTION DETAIL #1
Eakes Cleaners
827 West Morgan Street and 912 West
Main Street
Durham, Durham County, NC 27705
DSCA ID: DC320004