WI0700503_Permit (Issuance)_20200507

NC Department of Environmental Quality — Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to injection)
AQUIFER TEST WELLS (15A NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small -Scale Injection Operations — Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells is located within an area that does not exceed five percent of the land surface
above the known extent of groundwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
5) In -Situ Thermal Wells (IST) — Used to `heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: April 30 , 2020
PERMIT NO. W 10700503
(to be filled in by DWR)
NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No. WI
Issued Date:
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1)
Air Injection Well .......................................
Complete sections B through F, J, M
(2)
Aquifer Test Well .......................................
Complete sections B through F, J, M
(3) X
Passive Injection System ...............................
Complete sections B through F, H-M
(4)
Small -Scale Injection Operation ......................
Complete sections B through M
(5)
Pilot Test .................................................
Complete sections B through M
(6)
Tracer Injection Well ...................................
Complete sections B through M
(7)
In -Situ Thermal (IST) Well ...........................
Complete sections B through M
B. STATUS OF WELL OWNER: State Government
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 1

C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): NCDEQ Division of Waste Management UST Section Trust Fund Branch; Scott E3 als
Mailing Address: 1646 Mail Service Center
City: Raleigh State: NC Zip Code: 27522 County: Wake
Day Tele No.: 919-707-8168 Cell No.:
EMAIL Address: scott.r ls0bncdenr.gov Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: William L. Simmons
Company Name
Mailing Address: 414 Snug Harbor Road
City: Hertford State: NC Zip Code: 27944 County: Perquimans
Day Tele No.: 252-426-3063 Cell No.: 252-562-3278
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Matthew Gillis, Sr. Project Manager
Company Name ECS Southeast, LLP
Mailing Address: 9001 Glenwood Avenue
City: Raleigh State: NC_ Zip Code: 27617 County: Wake
Day Tele No.: 919-215-6174 Cell No.: 919-215-6174
EMAIL Address: m ig llis(c�r�,ecslimited.com Fax No.:
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Former Phillips Store — 414 Snug Harbor Road
City: Bethel County: Perquimans Zip Code.. 27944
(2) Geographic Coordinates: Latitude": " or 36 °. 113444
Longitude": " or 76 0. 481914
Reference Datum:Center of Former UST BasinAccuracy: +/- 3 meters
Method of Collection: Google Earth
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: square feet
Land surface area of inj. well network: square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: (must be < 5% of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 2

H. INJECTION ZONE MAPS — Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE — Provide a brief narrative
regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity:
Iniect 12 kiloerams of an approved remediation compound identified as EnviroBac blended with municipal water
across four injection points (3 kilo blend each). Injection points are identified as existing MW-1, MW-2, MW-
11 and proposed MW-12. Ratio of blend is to be 3 kilos of EnviroBac to approximatel0gallons of water at
each of the four proposed injection points. Each injection is estimated to be completed in approximate 2 to 2.5
hours. Goal is to reduce dissolved phase hydrocarbon plume concentrations that have been documented above
the Gross Contamination Levels (GCLs) at the site for over a decade.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 1 Proposed 3 Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS): 2 ft BLS
(3) For Proposed wells or Existing wells not having GW-Is, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as -built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
K. INJECTION SUMMARY
NOTE: Onlv iniectants anmroved by the emidemioloQv section of the NC Division ofPublic Health. Department
of Health and Human Services can be infected. Approved iniectants can be found online at
hgp:Hdeg.nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Proms for more info i1you wish to get approval for a different additive. However, please
note it may take 3 months or longer. If no iniectants are to be used use N/A.
Injectant:EnviroBac (formerly ProgressBlend)Total Amt. to be injected (gal)/event: 160 gal — 40gal/inj.point
Injectant: Total Amt. to be injected (gal)/event:
Injectant: Total Amt. to be injected (gal)/event:
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3

lnjectant: Total Amt. to be injected (gal)/event:
Injectant: Total Amt. to be injected (gal)/event:
Total Amt. to be injected (gal/event):
No. of separate injection events:0 Total Amt. to be injected (gal): 160
Source of Water (if applicable
160
L. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
Groundwater quality samples are to be collected for analysis EPA Method 6200B from existing MW-
1, MW-2, MW-3, MW-11, and proposed MW-12 prior to injection. Future quarterly monitoringof f the
groundwater quality by EPA Method 6200B will then be recommended to gauge the effectiveness of the
EnviroBac product.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "I hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the 1 SA NCAC 02C 0200 Rules. "
x4a&,6e Matthew Gillis, Sr. Project Manager (Agent for NCDEQ)
Signature of Applicant Print or Type Full Name and Title
Property Owner (if the property is not owned by the Well Owner/Applicant):
"As owner of the property on which the injection well(s) are to be constructed and operated, I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(I SA NCAC 02C C. 0200). "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
See Attached Access
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 4

1C.
Water Resources
Environmental Quality•
August 2, 2017
RE: EnviroBac
To Whom It May Concern:
ROY COOPER
Gorernor
MICHAEL S. REGAN
S. JAY ZIMMERMAN
Director
The remediation compound EnviroBac (formerly ProgressBlend) made by Bio-Cat
Microbials is on the NC Division of Water Resources list of approved additives. If you have any
questions, please contact Michael Rogers at 919-807-6412 or [e-mail].
Best Regards,
.�L'�""`I F�
Michael Rogers, P.G. (NC & )
Underground Injection Control (UIC) Manager - Hydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
cc: File
77 Nothing Compares' ---
$Woe or Nunh Carolina i Envirwinvnial Quality I Division or Water Res* rm
Water Quality Regional operations section
1636 Moil senice Center I Raleigh, Nunh Carolina 27699-1636
9194t17-912Q

I.
B10-CAT
Microbials
Product Identifier.
Other Identifier.
Recommended Use:
Supplier Information:
Safety Data Sheet
Section 1:
NONE
See Product Literature
689 Canterbury Rd
Shakopee, MN 55379
(p)952-445-4251 (f) 952-445-7233
into@bio of coMw .bia-cat.com
434-589-4777 8am-4om EST
r Section 2: Hazard Identification )
Hazard Classification:
Eye Damage/Irritation Category 2B
Skin Corrosion/Irritation Category 2
Signal Word: Warning
Hazard Statements:
1­1315 Causes skin irritation.
H320 Causes eye irritation.
< >
1
•
Pictogram(s):
Precautionary Statement(s):
P264
wash face and hands thoroughly after handling.
P280
Wear protective gloves/protective clothing/eye protection/face protection.
Response Statement(s):
P302/352
IF ON SKIN: Wash with plenty of water.
P305/351 /338
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact
lenses, if present and easy to do. Continue rinsing. Immediately call a poison center/doctor.
P308/311
IF exposed or concerned: call a poison center/doctor.
P332/313
If irritation occurs: get medical advice/attention.
P337/313
If eye irritation persists: get medical advice/attention.
P362/364
Take off contaminated clothing and wash it before reuse.
Hazards Not Otherwise
Categorized:
Section 3: Composition/ Information on Ingredients
Name:
Proprietary bacterial blend CAS Number: WA
%by weight:
3.5-6%
Name:
Maltodextnn CAS Number: 9050-36-3
%by weight:
2-3.5%
Name:
Sodium chloride CAS Number: 7647-14-5
% by weight
Remainder %
Section 4: First -Aid Measures
Inhalation:
If inhaled remove from contaminated area to fresh air.
Report the situation. Seek
medical attention if allergic response is exhibited.
Page 1 of 3

i';O.
BI0-CAT
Microbials
Reactivity:
Chemical Stability:
Hazardous reactions:
Conditions to avoid:
Incompatible materials:
Routes of Exposure:
Symptoms:
Immediate:
Section 10: Stability and
Not available
Stable under normal storage conditions
Not available
Not available
Not available
Section 11: Toxicological Information
Eye contact, skin contact, ingestion, inhalation
Delayed:
Acute toxicity:
Eye Irritation:
Skin Irritation:
Respiratory Irritation:
Sensitization towards product:
Germ cell mutagenictty:
Reproductive toxicity:
May cause irritation to the eyes, skin, mucus membranes, and the
upper respiratory tract
Not available
Not available
May cause minor irritation
May cause minor irritation
May cause minor irritation
There is no evidence of sensitizing potential
Not available
Not expected to produce reproductive toxicity
F- Section 12: Ecological Information I
Ecotoxicity:
Not available
Persistence and degradability:
Product is readily biodegradable
filoaccumulative potential:
Not available
Mobility in soil:
Not available
nrhar nrrvena Pli t
Not available
I Section 13: Disposal Considerations I
No special disposal method
except that in accordance to all applicable federal, state, and
F—
Section 14: Transport Information
Harmonized Tart" Code:
3002.90.10 (for Microbials)
UN Number:
Not classified
UN Proper Shipping Name:
Not classified
Transportation Hazard Class:
Not classified
Packing Group:
Not classified
Transport Environmental Hazard:
Not classified
Transport Special Precautions:
Not classified
MARPOL:
Not classified
Section IS: Regulatory Information
All c_nmoonents of this Droduct are listed or exempt from listing on the TSCA Inventory.
Section 16: Other Information
Revision History: Effective Dale: 04/25/17 Supersedes: First issue GHS 2015 FORMAT
The information conioined in this Safety Data Sheet. as of the issue dole. is believed to be true and correct. However. the
accuracy or completeness of this information and any recommendations or suggestions are mode without warranty or
guarantee. Since the conditions of use are beyond the control of the company. it is the responsibility of the user to determine
the condtions of safe use of this product. The information does nor represent onotyticol specifications. END OF SDS
Page 3 of 3

4
elm
01
IVl -
I(w• e Earth+ .
L
MW-1 IF APPROXIMATE EXISTING MONITORING WELL LOCATION
O APPROXIMATE INJECTION POINT MONITORING WELL LOCATION
DRAWN DATE
ANTICIPATED RADIUS OF INFLUENCE (15 FOOT) ceecKeo JSL JAIL APR 2020 Progress
JAB APR 202o FIGURE �
soA� ,ROB ENVIRONMENTAL GROUP, INC. PROPOSED INJECTION PLAN
SHOWN PHILLIPS STORE
FIE NA.E P. o. NA 27113 414 SNUG HARBOR ROAD
Figure 1.SKF WINSHONE 336.72.9999 AX 30.36.r72299998 BETHEL, NORTH CAROLINA

Table 1
Monitoring Well Construction and Groundwater Elevation Details
Former Phillips Store
414 Snug Harbor Road
Bethel, Perquimans County, North Carolina
NCDEQ Incident: TF-31005
ECS Project: 49:1991-C
Monitoring Well
ID
Date Measured
Casing Inner
Diameter (I.D. in.)
Depth to
Groundwater (ft.
btoc)
Date Installed
Total Well Depth
(ft. btoc)
Screen Interval
(ft. btoc)
TOC Elevation
Groundwater
Elevation (ft.)
10/25/2018
12/14/2002
3-13
100.00
91.72
[MW-L2
10/25/2018
12/14/2002
3-13
99.74
91.53
MW-3
10/25/2018
2
6.94
6/17/2003
33
28-33
99.65
92.71
MW-4
10/25/2018
2
7.08
6/16/2003
13
3-13
100.06
92.98
MW-5R
10/25/2018
2
7.37
11/19/2009
13
2.84-12.84
100.31
92.94
MW-6
10/25/2018
2
7.45
6/16/2003
13
3-13
99.22
91.77
MW-7
10/25/2018
2
5.31
May 2004
15
Unknown
Unknown
-
MW-8**
10/25/2018
2
5.49
May 2004
15
Unknown
Unknown
-
MW-9***
10/25/2018
2
6.63
May 2004
15
Unknown
Unknown
-
MW-10
MW-11
roposed MW-12
10/25/2018
N/A
2
6.70
May 2004
TBD
1 9.5
15Z-10
0 15
Unknown
2-13
Unknown
-
Notes:
I.D. in. = Inside Diameter in Inches
ft. btoc = Feet Below Top of Casing
TOC = Top of Casing
NM = Not Measured
* = Survey Data obtained from Groundwater Monitoring Report prepared by S&ME dated 9/26/2011
** = flush -mounted lid missing and casing severely to be damaged
*** = casing observed to be damaged
Data summarized above for MWA through MWA 1 includes all known "As Built' data. GWA forms are not available for these wells.

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SOURCE:
FIGURE 1
USGS
TOPOGRAPHIC MAP
SITE LOCATION MAP
YEOPIM RIVER NORTH CAROLINA
FORMER PHILLIPS STORE
QUADRANGLE
414 SNUG HARBOR ROAD
DATED 2013
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
SCALE: 1 : 24,000
NCDEQ INCIDENT: TF-31005
11
ECS PROJECT: 49:1991-B

AGRICULTURAL
1 inch = 128 feet
AGRICULTURAL
�4 f
SITE
SINGLE-FAMILY 4
RESIDENCES; k'
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
FIGURE 2
AERIAL SITE MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

f
MW-9
MW-4 O
Approximate Location
of Former Kerosene
UST
MW-5R MW-3
0 Approximate Location of
Former Dispenser
MW-1
MW-2 O
0
O MW-11 MW-10
Approximate Location
O of Former Gasoline
UST
M W-6 C)
■" M W-8
0 r
M W-7
LEGEND
MW-4 0 Approximate Location of
Monitoring Well
Approximate Location of Former
UST
Approximate Location of Former
Dispenser
1 inch = 65 feet
N
w * F
FIGURE 3
SOURCE:
MONITORING WELL LOCATION MAP
F
ERQUIMANS COUNTY GIS FORMER PHILLIPS STORE
DATED 2012 414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
SCALE AS SHOWN NORTH CAROLINA
M NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

SITE
Yr i PO #1
wsw
J• F a
500 ft.{
Radius wsw-2
Radius
46 . r-1 fk. art � �.+t� l� ��• �^ _ ��, �f �r��'y
elp"
Jr
1 inch = 520 feet
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
LEGEND
WSW-1 0 Approximate Location
of Water Supply Well
TM
FIGURE 4
WATER SUPPLY WELL LOCATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDENR INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

5 '
MW-9
+ MW-4 NM
_ 92.98
40( 92.00
MW-5R MW-3 MW-1
92.94 92.71 91.72
,. MW-10
• NM
• MW-11 -
MW-2 NM
91.53
MW-6 •
91.77
NM
• r
MW-7
NM t
LEGEND
MW-4 Approximate Location of Monitoring Well
92.98 Groundwater Elevation
Groundwater Contour Line
Estimated Groundwater Contour Line
Estimated Direction of Groundwater Flow
1 inch = 65 feet NM Not Measured
FIGURE 5
SOURCE:
GROUNDWATER ELEVATION MAP
PERQUIMANS COUNTY GIS FORMER PHILLIPS STORE
DATED 2012 414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
SCALE AS SHOWN NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
TM ECS PROJECT: 49:1991-B

MW-5R
Benzene
14
Eth (benzene
3.0
lsopropylbenzene
0.27 J
Naphthalene
0.46 J
n-Propylbenzene
0.42 J
Toluene
1.6
1,2,4- Trimeth (benzene
0.96
1,3,5-Trimethyl benzene
0.24 J
Total X Ienes
5.6
MW-3
Acetone
16 J
Benzene
3,300
2-Butanone MEK
2.6 J
1,2-Dichloro ro ane
1.4
Diiso ro I ether DIPE
0.37 J
Eth (benzene
3.7
2-Hexaone MBK
7.7
1 sopropylbenzene
0.99
Toluene
18
1,2,4- Trimethyl benzene
1.2
1,3,5-Trimethyl benzene
0.31 J
Total X Ienes
152.4
M W-1
Benzene
1,700
n-But (benzene
30
sec -But (benzene
7.0 J
Eth (benzene
1,400
1 sopropylbenzene
36
Naphthalene
440
n-Propylbenzene
84
Toluene
1,2,4- Trimeth I
13,000
1 inch = 65 feet
x
MW-6
benzene 660
enzene 170
' •
M W-7
BRL
ti
M W-9
MW-4 gRL
BRL •
MW-11
MW-8
BRL
tsenzene si UUu
n-But (benzene 33 J
4 1,2-Dibromoethane EDB 41 J
Eth (benzene 2,000
I sopropylbenzene 61
Naphthalene 500
n-Propylbenzene 150
Toluene 19,000
OF 1,2,4-Trimeth (benzene 1,000
1,3,5-Trimethyl benzene 240
Total X Ienes 8 900
O
MW-10
Toluene 0.17 J
M W-2
Benzene 33,000
n-But (benzene 28
sec -But (benzene 7.0 J
Diiso ro I ether DIPE 5.2 J
Eth (benzene 1,700
I sopropylbenzene 48
p-isopropyltoluene 5.8 J
Naphthalene 380
n-Propylbenzene 110
Styrene 39
Toluene 7,700
1,2,4- Trimethyl benzene 800
1,3,5-Trimeth (benzene 200
Total X Ienes 6,800
LEGEND
MW-4 Approximate Location of Monitoring Well
30 Concentration Above Laboratory Reporting
Limit (fag/L)
1,700 Bold Concentration Above the NC2LGWQS (fag/L)
29,000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
BRL Below Reporting Limit
FIGURE 6
SOURCE:
GROUNDWATER CONCENTRATION MAP
PERQUIMANS COUNTY GIS FORMER PHILLIPS STORE
DATED 2012 414 SNUG HARBOR ROAD 1!10% BETHEL, PERQUIMANS COUNTY,
SCALE AS SHOWN NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
TM ECS PROJECT: 49:1991-B
M W-2
Benzene 33,000
n-But (benzene 28
sec -But (benzene 7.0 J
Diiso ro I ether DIPE 5.2 J
Eth (benzene 1,700
I sopropylbenzene 48
p-isopropyltoluene 5.8 J
Naphthalene 380
n-Propylbenzene 110
Styrene 39
Toluene 7,700
1,2,4- Trimethyl benzene 800
1,3,5-Trimeth (benzene 200
Total X Ienes 6,800
LEGEND
MW-4 Approximate Location of Monitoring Well
30 Concentration Above Laboratory Reporting
Limit (fag/L)
1,700 Bold Concentration Above the NC2LGWQS (fag/L)
29,000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
BRL Below Reporting Limit
FIGURE 6
SOURCE:
GROUNDWATER CONCENTRATION MAP
PERQUIMANS COUNTY GIS FORMER PHILLIPS STORE
DATED 2012 414 SNUG HARBOR ROAD 1!10% BETHEL, PERQUIMANS COUNTY,
SCALE AS SHOWN NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
TM ECS PROJECT: 49:1991-B
LEGEND
MW-4 Approximate Location of Monitoring Well
30 Concentration Above Laboratory Reporting
Limit (fag/L)
1,700 Bold Concentration Above the NC2LGWQS (fag/L)
29,000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
BRL Below Reporting Limit
FIGURE 6
SOURCE:
GROUNDWATER CONCENTRATION MAP
PERQUIMANS COUNTY GIS FORMER PHILLIPS STORE
DATED 2012 414 SNUG HARBOR ROAD 1!10% BETHEL, PERQUIMANS COUNTY,
SCALE AS SHOWN NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
TM ECS PROJECT: 49:1991-B

1 inch = 65 feet
MW-9
BRL
O
K\4
0 /
/ MW-11
37,000
0
O MW-10
O BRL
10
MW-8 1,000 f
BRL
30,000
r .
M W-7
BRL +
LEGEND
MW-4 Approximate Location of Monitoring Well
Benzene Isoconcentration Contour (pg/L)
1,700 Bold Concentration Above the NC2LGWQS
37,000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
BRL Below Laboratory Reporting Limit
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
+1
FIGURE 7
BENZENE ISOCONCENTRATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDENR INCIDENT:TF-31005
ECS PROJECT: 49:1991-B

NORTH.. CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES. &
DIVISION OF WASTE MANAGEMENT . .
�
MICHAEL F. EASLEY, GOVERNOR NCDENR
William G. Ross Jr., SECRETARY ""�°`o'""°�P"RntoF
rNVIRnNMFNT nNn NaTf icxai RFsni
Dexter R. Matthews, DIRECTOR
UNDERGROUND STORAGE TANK SECTION
April 15, 2008
Mr. Scott C. Ryals, P.E.
Environmental Engineer
=«
DWM UST Section.
1637 Mail Service Center
Raleigh, NC 27699-1637
RE: Former Phillips Store
414 Snug Harbor Road
Hertford, Perquimans County, NC
Incident Number 31005
Dear Mr. Ryals:
I am/We are the owner(s) of a parcel of property, located at or near the incident in question, and hereby
permit the Department of Environment and Natural Resources (Department) or its contractor to enter upon said
property for the purpose of conducting an investigation of the groundwater under the authority of G.S. 143-
215.3(a)2.
I am/We are granting permission with the understanding that:
The investigation shall be conducted by the UST Section of the Department's Division of Waste
Management or its contractor.
2. The costs of construction and maintenance of the site and access shall be borne by the Department or its
contractor. The Department or its contractor shall protect and prevent damage to the surrounding lands.
3 _ Unless otherwise agreed, the Department or its contractor shall have access to the site by the shortest
feasible route to the nearest public road. ;;ie Department or its cortractar.may enter upon. the land at
reasonable times and have full right of access during the period of the investigation.
4. Airy claims which may arise against the Department or its contractor shall be governed by Article 31. of
Chapter 143 of the North Carolina General Statutes, Tort Claims Against State Departments and Agencies,
and as otherwise provided by law.
5. The information derived from the investigation shall be made available to the owner upon request and is
a public record, in accordance with G.S. 1..32-1.
DIVISION OF WASTE MANAGEMENTIUST SECTION
1637 MAIL SERVICE CENTER, RALEICH, NORTH CAROLINA 27699-1637
PHONE: [phone] FAX: [phone]
INTERNET'. http://www.wastenot.enr.state.ne.us
AN EQUAL OPPORTUNITYIAFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/I0% POST -CONSUMER PAPER.

6. The activities to be carried out by the Department or its contractor are for the primary benefit of the
Department and of the State of North Carolina. Any benefits accruing to the owner are incidental.
The Department or its contractor is not and shall not be construed to be an agent, employee, or
contractor of the landowner.
TJWe agree not to interfere with, remove or any ways damage the Department's well(s) or its
contractor's well(s) and equipment during the investigation.
Sincerely,
Signature
Type/Print Name. of Owner or Agent
-5�lze, - 0 6
Phone NLunber
_y .7
Address
.� C-
City/State/Zip Code
Date