WI0400523_UIC Staff Report for the Former Salem Uniform Facility._20191024

Permit No. WI0400523
Date: 10/28/2019 County: Randolph
To: Shristi Shresta Permittee/Applicant: _Cintas Corporation.
Central Office Reviewer Facility Name: Former Salem Uniform Services Facility
L GENERAL INFORMATION
1. This application is (check an that apply)
a. Date of Inspection: 10/23/2019
® New ❑ Renewal
❑ Minor Modification ❑ Major Modification
b. Person contacted and contact information: Matt Allen, AECOM, [phone]
c. Site visit conducted by: Jim Gonsiewski
d. Inspection Report Printed from BIMS attached: ® Yes ❑ No.
e. Physical Address of Site including zip code: 4015 North Cherry Street Winston-Salem, NC 27105
£ Driving Directions if rural site and/or no physical address:
g. Latitude: 872746.00 (Northing) Longitude: 1626889.72 (Easting)
Source of Lat/Long & accuracy (i.e., Google Earth, GPS, etc.): Site Survey
II. DESCRIPTION OF INJECTION WELL AND FACILITY
1. Type of injection system:
❑ Geothermal Heating/Cooling Water Return
® In situ Groundwater Remediation
❑ Non -Discharge Groundwater Remediation
❑ Other (Specify:
2. For Geothermal Water Return Well(s) onl
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? ❑ Yes ❑ No.
Provide well construction information from well tag:
b. Does existing or proposed system use same well for water source and injection? ❑ Yes ❑ No
If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor,
etc.) and attached map and sketch location of supply well in relation to injection well and any other
features in Section IV of this Staff Report.
3. Are there any potential pollution sources that may affect injection? ® Yes ❑ No
What is/are the pollution source(s)? Industrial Cleaning and Laundry Service that was in operation from 1967
to 1986. Operated as Salem Uniform Services from 1967 to 1983 and Cintas from 1983 to 1986.
What is the distance of the injection well(s) from the pollution source(s)_
4. What is the minimum distance of proposed injection wells from the property boundary?
5. Quality of drainage at site: ❑ Good ® Adequate ❑ Poor
6. Flooding potential of site: ❑ Low ® Moderate ❑ High

7. For Groundwater Injection Remediation Systems only, is the proposed and/or existing groundwater monitoring
program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ® Yes ❑ No.
If No, attach map of existing monitoring well network if applicable and recommend any changes to the
groundwater -monitoring program.
8. Does the map included in the Application reasonably represent the actual site (property lines, wells, surface
drainage)? ® Yes ❑ No. If No, or no map, please attach a sketch of the site. Show property boundaries,
buildings, wells, potential pollution sources, roads, approximate scale, and north arrow.
9. For Non -Discharge Groundwater Remediation systems only (i.e., permits with WQ prefix):
a. Are the treatment facilities adequate for the type of waste and disposal system? ❑ Yes ❑ No ❑ N/A.
If No, please explain:
b. Are the site conditions (soils, topography, depth to water table, etc.) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A. If no, please explain:
III. EVALUATIONAND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain.
2. List any items that you would like WQROS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
3. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
4. Recommendation
❑ Deny. If Deny, please state reasons:
❑ Hold pending receipt and review of additional information by Regional Office
❑ Issue upon receipt of needed additional information
® Issue
5. Signature of Report Preparer(s):
Signature of WQROS Regional Supervisor: I L' & T 5'at,
145B49E225C94EA...
Date:

IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional/If Needed)
The buildings at the site were demolished 2 to 3 years ago. All utilities were removed from the site so there are
no underground utilities in the injection or surrounding area. The SVE unit is currently in operation but,
according to Matt Allen, Project Manager for AECOM, the unit is likely to be shut down in a year since the
effectiveness of the system has significantly decreased. The in situ injection will be conducted by Regenesis.