WM0301023_Final Permit_20190718

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
Mr. Jamie Dillen (via email)
C4 CStore Holdings, LLC
121 W. Trade Street
Charlotte, NC 28202
Dear Mr. Dillen,
NORTH CAROLINA
Environmental Quality
July 18, 2019
RE: Monitoring Well Construction Permit
Permit #WM0301023
C4 CStore Holdings, LLC
815 S. New Hope Road, Gastonia
Gaston County
In accordance with your completed application received on July 18, 2019, we are forwarding
herewith Monitoring Well Construction Permit Numbered WM0301023 and issued for the
construction of three monitoring wells located near the subject site in Gastonia, Gaston County.
This Permit will be effective for one year from the date of issuance and shall be subject to the
conditions and limitations as specified therein.
Should you have any questions, please contact Edward Watson at [phone] ext. 2198,
or by email at [e-mail].
Sincerely,
DocuSigned by:
F161FB69A2D84A3...
Andrew H. Pitner, P.G., Assistant Regional Supervisor
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources
CC: WQROS, Central Office (via Laserfiche)
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
NORTH CAROHNA �
o.namremor �w.c�giuuei� /`� 704.663.1699

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT FOR THE CONSTRUCTION OF A 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
C4 CStore Holdings, LLC (ECS Limited, as Agents)
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of three monitoring wells owned by C4 CStore
Holdings, LLC at the subject site, Gastonia, Gaston County. This Permit is issued in accordance with the application
received on July 18, 2019, in conformity with specifications and supporting data, all of which are filed with the Department
of Environmental 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 obligate reimbursement from State trust funds, if these wells are being installed as
part of an investigation for contamination from an underground storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water Resources' Information
Processing Unit within 30 days of the well completion.
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 Resources' Information Processing
Unit within 30 days of the well abandonment.
7. Adequate permits shall be obtained from Gaston County Environmental Health.
Permit issued the 18th day of July, 2019
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
EA
DocuSigned by:
#-.� N P44�t4
F161FB69A2D84A3...
Andrew H. Pitner, P.G., Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
Permit No. # WM0301023