The URL can be used to link to this page

Home My WebLink AboutRBPR-12-2022-43027.TIF • NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES VARIANCE APPLICATION FOR 2C.0100 WELL CONSTRUCTION STANDARDS: PRIVATE DRINKING WATER WELLS UNDER ISA NCAC 02C.0300 WATER SUPPLY WELLS UNDER ISA NCAC 02C.0107 All water supply wells not considered"Prirnte Drinking Water Wells"old including irrigation.urdustrial.and commercial wells. WELLS OTHER THAN WATER SUPPLY UNDER ISA NCAC 02C.0108 Including monitoring and reco.'ery wells. Print clearly or type information. Illegible submittals will be returned as incomplete. DATE: ��. 1'' , 20 )t 3 PERMIT NO.: (to be completed by DWQ/DPH) A. WELL OWNER -For single family residences list the propcny owncr(s). For all others, list name of the business, organization,or government agency gill person delegated signature authority: L.t.Y v1) w„J lJ lop>re.,-r Mailing Address: P615)(36S' City: - ' f(Q\I State: Ny Zip Code: t County: e ',Ag•w Day Tele No.: 7479- ZO) —1O f 5 Cell No.: 7011- c ) -(o'j EMAIL Address: St ;.rej g a y64,.(to'(.( Fax No.: B. PHYSICAL LOCATION OF WELL SITE (1) Parcel Identification Number(PIN)of well site: 146166q6370V3 County: (2) Physical Address(if different than mailing address): 9`cio i.,JCe /r-) City: le r reAl State: NC Zip Codc: 2,662- C. WELL DRILLER INFORMATION(if known) Well Drilling Contractor's Name: '41:. i0e. • (getkitleot NC Well Drilling Contractor Certification No.: Company Name: Contact Person: City: State: Zip Code: County: Day Tele No.: Cell No.: EMAIL Address: Fax No.: Form OW-22V Paso 1 Revised February 2013 U. REASON FOR VARIANCE REQUEST — Include type of well(s) to be constructed; rule for which the variance is being requested; description of how the alternate construction will not endanger human health and welfare and the environment;and reason why construction and/or operation in accordance with the standards is not technically feasible and/or Pt� provides equal lor Fetter protection of the groundwater. Y C ►'1��1 +vo 41we.- u J��']d��1�t3}ir1; lam/ j C46 f C f 1 . 4ke Kc BLiiref E. ATTACHMENTS—Provide the following information as attachments to this application: (1) A map showing general location of the property (including road names, NC State Route Number, distances, any kcy landmarks,etc.)sufficient for finding the well location. (2) Detailed site map with scale showing location of proposed well relevant to septic sys;em(s), building foundations,property lines,water bodies,potential sources of contamination,other wells,etc. (3) Submit a copy of the local well permit application and site evaluation map(if applicable). (4) Any other information relevant to the variance request such as a well construction diagram showing proposed well liner or atypical construction materials/methods. F. OTHER MINIMUM CONSTRUCTION REQUIREMENTS For water supply wells, approval of a variance will require that additional construction requirements beyond those specified in 1SA NCAC 02C .0107 be met. Minimum additional construction requirements for Coastal Plain and Piedmont and Mountain region wells are referenced on Attachments A and B on pages 4 and 5 of this application. Approval of a variance will not be considered in cases where the specified minimum additional construction requirements cannot be met. C. SIGNATURES l Signature of Person Respo antic for Well Construction(typicully the well drifter) Print or Type Full Name o Prrson Responsible for Wel]Construction (typically the)vell driller) le<51'd Signature of County Environmental Hearth Specialist JC1.11/ e fiSs Print or Type Full Name of Court nvtronmcntal Health Specialist Per 1SA NCAC 02C.0118 the Secretary of the Division of Water Quality or the Division of Public Health may require submittal of information deemed necessary to make a decision on the variance, may impose conditions as part of the decision, and shall respond in writing to the request within 30 days of receipt of the variance request. A variance applicant who is dissatisfied with the decision of the Director may commence a contested case by filing a petition as described in G.S. 150E-23 within 60 days after receipt of the decision. Form G IV-22V Past 2 \ Revised February 2013 I 2 p itdhJl co 1 j U ILI CD till . g / / I _ XM w ; • _ x a/ - z co % � 'ltll � . O tllli / `� OVll thC/ < * � w ` ,, ` U tl - ,. �\EA . ° / ON E r ' ill r chi - \\, u vir liji kii , 0 b. /ii AIL 14 1"fik‘` tutu „ iltlll / �' F4- z '9,e /' : o �5 .,,,,, / ?° 1.1' I..p.vi•1 . __ s. / i / , •��/ _i• \ r / \ 1� - ti . .• . / \ / • -GI. AP OS 16 . Q `A S �Pf 4 s .4ft x � rq ti ,Z54;--. N(.:; ' . cc rl i ili% . ----- o "K1 mgit , rvi' 15� ••tno $Y! Zi tl 1 bag p 4� �.144 g,.: � � • rt STATE '•, .6 �,�..,,> Nay,. ROY COOPER • Governor g , NC DEPARTMENT OF KODY H. KINSLEY• Secretary - f. �_ OA HEALTH AND 4, t1 •� HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health . ; ,.7" MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch March 10, 2023 Wind and Water Development PO Box 365 Terrell, NC 28682 Re: Approval No. JMB2934 Private Well Located Less than 50' from Surface Water [Rule 15A NCAC 2C .0107(a)(2)(Q)l Property location: 4980 Kiser Island Rd Terrell, NC 28682 To Whom It May Concern: On March 3, 2023,the On-site Water Protection Branch received your request for a variance from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The request for a variance concerns a proposed water supply well on the referenced property that will serve a single-family dwelling and part of a surface water body will be within fifty feet of the well. The home is on a lot with very difficult topography. Specifically, the variance request grants you permission to construct a water supply well at a distance closer than the fifty-foot setback to surface water. Achieving the fifty-foot setback would be difficult given the challenges of the property. Based upon information provided by the Catawba County Health Department, and the property owner, it is my finding that based upon current conditions as the site exist today (as well as the current proposal for use of the structure) you meet the conditions necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1)and (2). On that basis and if the following conditions are met,the requested variance is approved: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION 5605 Six Forks Road, Raleigh, NC 27609 MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL: 919-707-5874 • FAX.919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER 1) The new water supply well shall be constructed of either PVC, steel, or galvanized metal casing. 2) The well shall be located as far as possible from the structure where, depending upon where well rig can actually set up, will possibly encroach upon the 50foot setback, but not be closer than 25feet. 3) A preconstruction meeting shall be required with the Catawba County Health Department staff to ensure that the maximum possible distances are achieved. 4) The well will be required to have casing installed to a minimum of 50 feet below land surface or to bedrock, whichever is greater. 5) The casing shall extend at least ten feet into bedrock. 6) The well shall be at least fifty feet from any part of the septic system including repair area. 7) Grout will be required the entire length of the casing from land surface into bedrock. 8) A drill bit with a diameter of a least one third greater than the diameter of the casing must be used to drill the cased portion of the well. 9) Grout must be either pumped into place with the use of a tremmie pipe or pressure method. 10)If a full-length grout is not possible due to site conditions, then a packer-liner must be installed in the well. The liner must extend at least five feet beyond the end of the casing and grouted entirely with a neat cement grout. 11)The well must be constructed outside of any road right of way. The granting of this variance is for the well location only. It in no way relieves the owner or agent from other requirements of the North Carolina Well Construction Standards including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to abandon any well which acts as a source or channel for the migration of contamination. This approval does not imply sufficient water quality. Further, the approval does not relieve your responsibility to comply with any other applicable Federal, State, or local laws or regulations. If you have any questions regarding this variance, please contact me at (828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS 2