WS0801041_Application_20190725

July 8, 2019
NCDEQ
Division of Water Resources
Attn.: Dr. Morella Sanchez -King, PhD, PE
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Re.: INVISTA-Sarl
ARM
Geothermal, Environmental,
& Well Drilling
Application For Permit To Construct Two High Capacity Water Supply Wells
more] Ia. sanchez-kino(a ncdenr.gov
Dr. Sanchez -King,
Attached is a High Capacity Well Permit Application for the replacement of two industrial water
supply wells (AA and 62) located atthe referenced facility. Figure 1 depicts Proposed Water Well
Locations. Figure 2 is a Proposed Well Construction Diagram for replacement wells OA-3 and
OB-3.
If you have questions or require further information, do not hesitate to call.
;Sinc Zuncich
anager, CWD, Environmental Geologist
cc. Ms. Elizabeth Meyer, INVISTA-Sarl, w/enclosures
Applied Resource Management, P. C.
F. O. Box 882, 257 Transfer Station Road, Hampstead, NC 25445 910.270.2919 Fax [phone]

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY — DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A WATER SUPPLY WELL OR WELL SYSTEM
(Wells or Well Systems with a Design Capacity of 100,000 Gallons Per Day or Greater)
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 water supply wells.
1. Date: July S. 2019
2. County: New Hanover
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE:
3. Applicant INVISTA S.A r.l. Telephone: [phone]
Applicant's Mailing Address: 4600 Hwv 421 N. Wilmington, NC 28401
Applicant's Email Address (If available): Phillip.Cline(Minvista.com
4. Contact Person (if different than Applicant); Elizabeth Meyer Telephone: [phone]
Contact Person's Mailing Address (if different than Applicant):
Contac Person's Email Address (if available): Elizabeth.Mever(cainvista.com
5. Property Owner (if different than Applicant): Applicant Telephone: same as above
Owner's Mailing Address: Same
Owners Email Address (If available): Same as above
6. Property Physical Address (including PIN Number): _ 4600 Hwy 421 N. Ptn # R02400.001-001.000
City; Wilmington County: New Hanover Zip Code:28401
7. Intended use of Well or Well System: ProcesslProduction Water Supply.
(examples: irrigation, consumption, etc.)
8. Will the proposed water supply well or well system replace or be added to an existing well or well system? Yes
(Ityes, complete questions 7and 8) (If no, complete question 7and then skip to question 9)
9. Total design capacity of proposed well or well system in gallons per day (gpd): 869,400 GPD
10. If adding a well to an existing system, list the existing water supply wells in the existing system and their respective yields:
AA-0.5MGD 01-12-035MGD O 2-06MOD
11, Is this a public well or well system? No If yes, give Public Water ID Number:
If yes, give Project Engineer and contact information:
12. Well Contractor: ARM, Donald Cummings Well Contractor CertiBoation No.: 2412-A
Well Contractor Address: _E.0. Box 882 Hampstead NC 28443
PROPOSED WELL CONSTRUCTION INFORMATION
1, As required by 15A NCAC 020.0105(f)(7), attach a well C. Screen intervals
construction diagram of each well showing the following: d. Sandigravel pack intervals
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons

g. Well Head completion details 4. Total No. of wells to be constructed: 2
(add answers from 2 and 3)
2, No. of wells to be constructed In unconsolidated 5. Estimated beginning construction date: 7/29119
material: 2 6. Estimated construction completion date: 12/8/19
3. No, of wells to be constructed in bedrock: 0
Continued on Reverse
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 takes within 500 feet of the proposed well or well system.
b. All existing wells, Identified by type of use, within 500 feel of the proposed well or well system.
c. The proposed well or well system.
d. Any test borings within 5W 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.143-215.1013(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
2. As required by 15A NCAC 02C .0105(g)(3), for wells screened in multiple zones or aquifers, provide representative data on the
static water level, pH, specific conductance, and concentrations of sodium, potassium, calcium, magnesium, sulfate, chloride,
and carbonates from each aquifer or zone from which water is proposed to be withdrawn.
3. Attach any water use permits (if required). [e.g. Central Coastal Plain Capacity Use Area Permit is required in 15 eastern INC
counties by INC Division of Water Resources, visit: http://www.newater.org]
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
the Water Supply 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.s�
Sigriature dYApplicant or `Agent
Phillip Cline
Printed name of Applicant or "Agent
Site Manager
Title of Applicant or *Agent
"ffsigning 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
water supply wells as outlined in this Water Supply Well Construction Permit application and that It shall be the responsibility of the
applicant to ensure that the water supply well(s) conform to the Welt Construction Standards (Title 15A of the North Carolina
Administrative Code, Subchapter 2C).
WA
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
Mooresville Regional Office
2090 U.S. Highway 70
610 East Center Avenue
Raleigh Regional Office
Swannanoa, NC 28778
Mooresville, NC 28115
3800 Barrett Drive
Phone: [phone]
Phone: [phone]
Raleigh, INC 27609
Fax: [phone]
Fax: [phone]
Phone: [phone]
Fayetteville Regional Office
Fax: [phone]
225 Green Street, Suite 714
Washington Regional Office
Fayetteville, NC 28301-5094
943 Washington Square Mail
Phone: [phone]
Washington, NC 27889
Fax: [phone]
Phone: [phone]
Fax: [phone]

GW-22W Rev. 3-1-2016
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
Phone: [phone]
Fax: [phone]

FIGURES

ACTIVE
SAND MINE
LEGEND
® Former Production Well
E Active Production Well
® Proposed Production Well 1%NQ41A
Approximate Property Boundary
Note: 1. H2 and OG2 to be taken out of service by end of 2019
2016 and
INACTIVE
LANDFILL
VNED
BY
V
Pro osi
7 � •
TITLE: Proposed Water
Well Locations
INVISTA-Wilmin ton NC
JOB: SCALE: DATE: DRAWN BY:
10038 1 1" = 600' 1 6118119 1 EFC/JZ
Applied Reeouz e
Management,
H&Mpfftf.Jd /'V 6 8

1"X4o' P/C
Measuring Conduit
With Cap
26' Portland
Cement Grout
2' Bentonite
Grout
Well Vent 1.5' X 8" Riser With
Sanitary Well Seal
Ground Su
30' X 8"
Certo Lok SDR 17
PVC Casing
40' X 8" 8" X 16" Stainless Steel
42' #3 Well Screen Centralizers at 40' and 60'
Gravel Pack .030 Slot
i
i t
12" Borehole
i
Diameter � t
iJ.
i
Actual well depths will be determined
TD = 70' by well location geology and confining
layer depths.
TITLE: Proposed FIGURE:
App/iedReeouroe Well Construction Diagram
Management, P C. JOB: SCALE: DATE: DRAWN BY:
ACZ� 10038 NTS 6/18/2019 JLZ