WM0100455_Application_20190802

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: 8/2/2019
2. County: Buncombe
FOR OFFICE USE ONLY
PERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): Monitoring
4. Applicant: Red Rock Island LLC Telephone: [phone]
Applicant's Mailing Address: PO Box 621808, Orlando, FL 32862
Applicant's Email Address (if available): Colby Kiene Colby.kiene(cDcitybeverages.com
5. Contact Person (if different than Applicant): James C. Bevers, P.E., ECS Southeast, LLP Telephone: [phone]
Contact Person's Mailing Address: 1900 Hendersonville Road, Suite 10, Asheville, NC 28803
Contact Person's Email Address (if available): jbevers(a)ecslimited.com
6. Property Owner (if different than Applicant): J and J Holdings of Western Carolina LLC Telephone: [phone]
Property Owner's Mailing Address: 123 Coachmans Trl, Asheville, NC 28803
Property Owner's Email Address (if available): John Squires [e-mail]
7. Property Physical Address (Including PIN Number) 99999 Charlotte Hwy PIN 9667-36-6062
City Asheville County Buncombe Zip Code 28803
8. Reason for Well(s): assessment of suspected contamination of the groundwater
(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 automotive repair
(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).
No
11. Type of contaminants being monitored or recovered: solvents, gasoline
(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).: No
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): 0
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: TBD — Potentially CSI
Well Contractor Address:
Certification No.: TBD

PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(0(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
G. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals
00f%0f%QCr%MCI 1 t%AL1011`0Ilt%'rl 1A1 IL1CA0&AAT1/1A1
Number of wells to be constructed in unconsolidated
material: 1
Number of wells to be constructed in bedrock: 0
Total Number of wells to be constructed: 1
(add answers from 2 and 3)
5. How will the well(s) be secured? Temp
expansion cap
6. Estimated beginning construction date: TBD
7. Estimated construction completion date: TBD
(within 96 hours of installation)
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. 143-215.106(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
Signature of pplan or `Agent
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Printed name of Applicant or *Agent
U
Title of Applicant or *Agent
If signing as Agent, attach authorization agreement stating
that you have the authority to act as the Agent.
If the p p rty is owned by someone other than the aonlir_ant, the nronerty owner herehv consents to allow the annlirant to constnirt
wells o tlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
w II() conform to the Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
Signatu# of Property Owner (if different than Applicant)
-')D� n � (7 �- " ('e S
Printed name of Pr perty Owner (if different than Applicant)

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,�", FIGURE 1
SITE TOPOGRAPHIC MAP
S CHARLOTTE HIGHWAY SUB LOT 3
SOURCE: CHARLOTTE HIGHWAY, ASHEVILLE,
USGS TOPOGRAPHIC MAP BUNCOMBE COUNTY,
NORTH CAROLINA
FB-
^ ECS PROJECT NO. 49-9720-A

30 FEET
GROUND
SURFACE
EXPANSION CAP
WITH LOCK
BENTONITE PLUG
MINIMUM 2 FEET
SAND SCREEN
MINIMUM 1 FOOT ABOVE THE
SLOTTED PVC SCREEN
GROUNDWATER
NOT TO SCALE
2-INCH PVC CASING
SCHEDULE40
4-INCH BORE
HOLE
SLOTTED PVC SCREEN
0.01-INCH SLOT WIDTHS
SET TO INTERSECT GROUNDWATER
ESTIMATED 10 FEET IN LENGTH
WELLS ARE INTENDED TO BE INSTALLED USING DIRECT
PUSH DRILLING OR AIR ROTARY, GROUNDWATER
SAMPLED, & ABANDONED ON THE SAME DAY.
FIGURE 3
PROPOSED WELL CONSTRUCTION
DIAGRAM
CHARLOTTE HIGHWAY SUB LOT 3
CHARLOTTE HIGHWAY, ASHEVILLE,
BUNCOMBE COUNTY,
NORTH CAROLINA
ECS PROJECT NO. 49-9720-A