WI0400091_Permit_20150516

DIVISION OF WATER RESOURCES
WATER QUALITY REGIONAL OPERATIONS SECTION
May 16, 2015
PERMIT ISSUANCE MEMO
TO: Debra Watts
FROM: Thomas Slusser l 5
RE: Permit To Inject Oxygen, Hydrogen, and HRC 3DMe
Gilbarco, Inc.
I recommend that Permit Number WI0400091 be reissued to Gilbarco, Inc. to continue injection for enhanced
bioremediation of groundwater contaminated with chlorinated solvents and petroleum hydrocarbons. On April 14,
2015, an application was submitted for renewal without modification. See previous permit issuance memos for details
of project site, how injectants work, etc. Staff from the Winston-Salem Regional Office recommend issuance of this
permit without condition.

4
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE USE OF A WELL FOR INJECTION
In accordance with the provisions of Article 7. Chapter 87: Article 21, Chapter 143: and other
applicable Laws. Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Gilbarco. Inc.
FOR THE CONTINUED OPERATION OF 36 IN SITU REMEDIATION INJECTION WELLS,
defined in Title 15A North Carolina Administrative Code 02C .0209(5)(b)(viii), to inject oxygen,
hydrogen, and HRC 3DMe for the enhanced bioremediation of chlorinated solvents and
petroleum hydrocarbons. These injection wells/points will be located at 7300 West Friendly
Avenue in Greensboro, Guilford County, and will be operated in accordance with the permit
renewal application received April 14, 2015, and in conformity with the specifications and
supporting data previously submitted, all of which are filed with the Department of Environment
and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws. Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 02C
.0100 and .0200, and any other Laws, Rules. and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until May 22, 2020.
and shall be subject to the specified conditions and limitations set forth in this permit.
Permit issued this the 22"d day of May_ 2015.
p S_ Jay Zimmerman- Director
Division of Water Resources
By Authority of the I moronmental lt-lanagement Commission.
Permit No. W10400091 PA(31= 1 (_-)F 8

PART I — PERMIT GENERAL CONDITIONS
1. The Permittee shall comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Noncompliance with conditions of this permit constitutes a violation of the North
Carolina Well Construction Act and is grounds for enforcement action as provided for in
N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data
[15A NCAC 02C .0211(1)].
3. This permit is valid only for construction or operation of the number of injection wells
described in the application and other supporting data. Construction of additional injection
wells must be approved in advance by the Division of Water Resources (DWR) [15A NCAC
.0211(a)].
4. This permit is not transferable without prior notice and approval. In the event there is a
desire for the facility to change ownership, or there is a name change of the Permittee, a
formal permit amendment request and any supporting materials must be submitted at least 30
days prior to the date of the change [I 5A NCAC 02C .0211(q)].
5. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances that may be imposed by other
local, state, and federal agencies having jurisdiction. Furthermore, the issuance of this permit
does not imply that all regulatory requirements have been met [15A NCAC 02C .0203].
PART II - WELL CONSTRUCTION GENERAL CONDITIONS
1. Each injection well shall not hydraulically connect separate aquifers [15A NCAC 02C
.0211(c)].
2. Multi -screened wells shall not hydraulically connect different aquifers or zones having
differences in water quality that would result in a degradation of any aquifer or zone [15A
NCAC 02C .0225(g)(17)].
3. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen [15A NCAC 02C .0225(g)(4)].
4. Bentonite grout shall not be used to seal any water -bearing zone with a chloride
concentration equal to or greater than 1,500 milligrams per liter. In areas where elevated
chloride levels are known to exist or are probable, such as coastal areas, chloride levels shall
be verified in the field to determine existing conditions. [15A NCAC .0225(g)(8)].
5. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well shall be secured with a locking cap as defined in G.S. 87-
85(16) [15A NCAC 02C .0225(g)(23)].
Permit No. WI0400091 PAGE 2 OF 8
ver. 1 / 15/2015 U 1 C-51!5T

6. Each injection well shall be afforded reasonable protection against damage during
construction and use [15A NCAC 02C .0225(i)(3)].
7. Each permanent injection well shall have a permanently affixed identification plate [15A
NCAC .0225(g)(201)].
8. A completed Well Construction Record (Form GW-1) shall be submitted as described in Part
VL4 of this permit.
PART III - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing or operating each injection well, the
Permittee shall notify the Underground Injection Control (UIC) Central Office staff, telephone
number 919-807-6496, and the Winston-Salem Regional Office staff, telephone number 336-
776-9800 [15A NCAC 02C .0211(k)].
PART IV - OPERATION AND USE CONDITIONS
1. The Pennittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity [15A
NCAC 02C .0211(j)].
2. The issuance of this pen -nit shall not relieve the Pennittee of the responsibility for damages
to surface water or groundwater resulting from the operation of this facility [15A NCAC
02C .0206].
3. The injection facility shall be properly maintained and operated at all times to achieve
compliance with the conditions of this permit and the rules of 15A NCAC 02C .0200, even
if compliance requires a reduction or elimination of the permitted activity [I 5A NCAC.
02C .0211(j)].
4. In the event that the facility fails to perform satisfactorily. including the creation of
nuisance conditions or failure of the injection zone to adequately assimilate the injected
fluid, the Pennittee shall take immediate corrective actions that may be required, such as
the repair, modification, or abandonment of the injection facility [15A NCAC 02C .0206].
11emw No. W104000y 1 N.AG OF 8
\'rr. 1 1 �'""_M � t i IC-- fJ 1

PART V -INSPECTIONS [ 15A NCAC 02C .0211(k)]
1. Any duly authorized officer, employee, or representative of the Division of Water Resources
(DWR) may, upon presentation of credentials, enter and inspect any property, premises, or
place on or related to the injection facility at any reasonable time for the purpose of
determining compliance with this permit, may inspect or copy any records that must be
maintained under the terms and conditions of this permit, and may obtain samples of
groundwater, surface water, or injection fluids.
2. DWR representatives shall have reasonable access for purposes of inspection, observation,
and sampling associated with injection and any related facilities as provided for in N.C.G.S.
87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VI - MONITORING AND REPORTING REQUIREMENTS
The monitoring plan will be quarterly sampling of wells MW-12, MW-13D, MW-33, MW-
34, MW-40, MW-48, MW-48, MW-51 and MW-52 for analysis of VOCs, Total Petroleum
Hydrocarbons, and Total Chlorinated Hydrocarbons. Field parameters shall also be measured
and will consist of water levels, oxidation-reduction potential (ORP), pH, conductivity,
dissolved oxygen (DO), and temperature.
2. Any additional monitoring, including groundwater, surface water, or soil sampling, deemed
necessary to ensure surface water and groundwater protection may be established and an
acceptable sampling reporting schedule shall be followed [15A NCAC 02C .02250)].
3. All sample results shall be submitted to the WQROS Central Office and Winston-Salem
Regional Office annually. Monitoring reports shall include, at a minimum, analytical data
and an update on the status and location of monitoring and injection wells. Well locations
may be given in a table with the name and geographic coordinates or shown on an updated
version of the site map [15A NCAC 02C .0225(k)(2)].
4. Records of well construction, repair, or abandonment shall be submitted within 30 days of
completion of such activities [15A NCAC 02C .0225(k)(1)(A)].
5. An Injection Event Record shall be submitted within 30 days of each injection event [15A
NCAC 02C .0225(k)(1)(B)].
6. The Permittee shall submit a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce an interim evaluation to be
submitted with a renewal application for this permit. Both the final project evaluation and
interim evaluation shall contain historical monitoring data and updated contaminant plume
and potentiometric surface maps. PLEASE NOTE: Iniectants and related reaction byproducts
must attenuate to pre -injection concentrations or groundwater standards specified in rule 15A
NCAC 02C .0202, whichever is greater, in order for this permit to be closed. Otherwise,
corrective action as described Part V11 shall be required [15A NCAC 02C .0225(k)(2)].
7. All monitoring results, forms, and reports required in this Part shall be submitted to:
Permit No. W10400091 PAGE 4 OF 8
ver. 1/15/2015 U1C-51/5T
1

UIC Program
NC Division of Water Resources and
1636 Mail Sen-ice Center
Raleiah. NC 27699-1636
Water Quality Regional Operations Section
DWR Winston-Salem Regional Office
450 W. Hanes Mills Rd.. Suite 300
Winston-Salem. NC 27105
8, The Permittee shall report any monitoring or other information that indicates noncompliance
with a specific permit condition, that a contaminant may cause a violation of applicable
ground,,eater quality standards, or that a malfunction oft he injection system may cause the
injected fluids to migrate outside the approved injection zone or area. As specified in rule
15A NCAC 02C .0211(r), noncompliance notification shall be as follows:
(A) Oral notification shall be given within 24 hours of the occurrence, or first
knowledge of the occurrence, to the Winston-Salem Regional Office, telephone
number 336-776-9800.
(B) Written notification shall be made within five days of the occurrence and submitted
to the addresses in Item 47 above.
(C) The written notification shall contain a description of the noncompliance and its
cause, the period of noncompliance, including dates and times; if the
noncompliance has not been corrected, the anticipated time it is expected to
continue; and any steps taken or planned to reduce. eliminate, and prevent
reoccurrence of the noncompliance.
9. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee [I 5A NCAC 02C .0211(b)].
PART VII - CORRECTIVE ACTION [15A NCAC 02C .0206]
1. Any injection well not constructed or operated in accordance with this permit. or the criteria
and standards specified in 15A NCAC 02C .0200, shall be subject to corrective action as
provided under rule 15A NCAC 02C .0206.
2. The following corrective actions shall apply to elevated concentrations of injectants or
reaction byproducts resulting from the permitted injection activity:
(A) Continued monitoring until concentrations return to pre -injection values or meet the
standards specified in 15A NCAC 02L .0202, whichever are Oreater. The frequency.
duration. and location of monitoring shall be appropriate for site specific conditions and
potential receptors.
(B) Groundwater quality parameters that do not attenuate as described in 2(A) above ma\
warrant a corrective action plan as provided under rule 15A NCAC 02C .0206.
depending on the type. concentration. and distribution of the ground«ater qualit%
standards being exceeded.
Permit No. AV10400091 PA(iF, � OF

PART VIII - PERMIT RENEWAL [ 15A NCAC 02C .0211(b)]
t
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee should submit an application to renew the permit 120 days prior to its expiration date.
PART IX -CHANGE OF WELL STATUS [15A NCAC 02C .0240]
1. The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0240, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0240, including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if WQROS staff determines
that failure to do so could lead to the contamination of an underground source of
drinking water.
(D) Drilled wells shall be completely filled with cement grout or bentonite grout, which
shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0225(k)(1)(A) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
UIC Program
DENR-Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
Permit No. W 10400091 PAGE 6 OF 8
ver. 1 /15/2015 UIC-5I/5'r

PART X — WORKER PRECAUTIONS DURING APPLICATION [1 5A NCAC 02C
.0211(b)]
Oxygen:
1. Some effects reported to be associated with pure oxygen are as follows: eye, nose, and throat
irritation, nausea, dizziness, pulmonary irritation leading to pulmonary edema and
pneumonitis. Intense and potentially fatal pulmonary edema may develop tracheal irritation.
fever, nausea, vomiting, acute bronchitis, sinusitis, malaise, paresthesias, and conjunctivitis.
2. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
I Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Hydrogen:
6. Some effects reported to be associated with pure hydrogen are as follows:
a. Skin contact with hydrogen can cause severe burns and frostbite to the skin.
b. Significant iiflialation exposure to hydrogen can cause severe suffocation from
lack of oxygen. Symptoms include dizziness, weakness, nausea, vomiting, loss of
coordination and judgment, increased breathing rate, and loss of consciousness
and death.
Hydrogen is highly flammable liquid or gas and a dangerous fire and explosion hazard.
Hydrogen must be stored to avoid contact with heat, flames, sparks, and oxidizing agents
(e.g.; perchlorates, peroxides, permanganates. chlorates. nitrates. and bromine). explosives_
liquid nitrogen, ozone. catalysts. lithium. strontium. barium. and cesium since violent
explosion may occur.
If the product is released into the environment_ the proper respiratory protection should be
worn. The application process should be reviewed by an industrial hygienist to ensure that
the most appropriate respiratory equipment is worn if needed.
9. Persons working with the product should wear goggles or a face shield_ doves, and protective
clothing. In order to prevent contamination of the worker's home and other work areas. the
(loves and protective clothing should only_ be worn in the application area and should never
be taken home.
PCrmlt No. W10400091 PA(;F 7 OF S
err. 1, 15/,(11 -� IiIC 1' I

10. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
11. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
12. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
13. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the application area.
HRC 3DMe:
14. Ingestion may result in burns to the lips, tongue, and mouth. Exposure to the eyes can cause
disorientation of cellular membranes, loss of corneal, conjunctival and lens epithelium and
loss of endothelium of the cornea and blood vessels. Inhalation may produce upper airway
edema, respiratory failure, wheezing, pulmonary edema, and pneumonitis. Skin exposure
may cause pain, redness, irritation, and severe burns.
15. If the products are released into the environment in such a way that could result in a
suspension of fine solid or liquid particles, (e.g., grinding, blending, vigorous shaking or
mixing), then proper personal protective equipment should be used. The application process
should be reviewed by an industrial hygienist to ensure that the most appropriate personal
protective equipment is used.
16. Persons working with this product should at least wear safety goggles or a face shield,
gloves, and protective clothing. Face and body protection should be used for anticipated
splashes or sprays. Consult with an industrial hygienist to ensure proper protection.
17. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should never be
permitted in the application area during or immediately following application. Safety controls
should be in place to ensure that the check valve and the pressure delivery systems are
working properly.
18. The Material Safety Data Sheets should be followed to prevent adverse reactions and
injuries.
19. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the area of application.
20. Violent reactions or ignition could occur under the appropriate conditions with acids,
alcohols, p-bis (1, 3-dibromoethyl) benzene, cyclopentadiene, germanium, hyponitrous acid,
malefic anhydride, nitroalkanes, 2-nitrophenol, potassium peroxodisul fate, sugars, 2, 2, 3, 3-
tetrafluoropropanol, and thorium dicabide. Measures should be taken to prevent such
reactions.
Permit No. W10400091 PAGE 8 OF 8
ver. 1 /15/2015 U I C-51/5T

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
August 30, 2012
PERMIT ISSUANCE MEMO
TO: Debra Watts
FROM: David Goodrich yl
RE: Permit To Inject Oxygen and Hydrogen, 3DMe (HRC Advanced)
Gilbarco Facility, Guilford County
I recommend that Permit Number W10400091 be modified and reissued to Gilbarco, Inc. to inject oxygen and
hydrogen, as well as 3DMe (HRC Advanced), to remediate groundwater contaminated with chlorinated solvents and
petroleum hydrocarbons. Operation of the hydrogen and oxygen systems is expected to continue for several more
years, which is why the permit is being issued until March 31, 2015. The injection of 3DMe is a one-time event into
16 new injection wells (IW-01 through IW-16) which is intended to enhance the remediation of the chlorinated
solvents and petroleum hydrocarbons by chemical dispersion. Staff from Winston-Salem Regional Office recommend
the modification of this permit. Wells which have been, or are going to be, used for the injection of oxygen gas
and/or hydrogen gas are wells MW-7, MW-10, MW-13, MW-14D, MW-15, MW-16, MW-23D, MW-24, MW-25,
MW-29, MW-31, MW-32, MW-34, MW-40, MW-41, MW-43D, MW-47, and MW-49.
The original monitoring plan was to obtain groundwater samples on a quarterly schedule from monitor wells MW-7,
MW-11, MW-13D, MW-14, MW-14D, MW-23D, MW-24, MW-25, MW-42, MW-43D, and MW-45 for analysis of
field parameters, VOCs, isopropyl ether, methyl tert-butyl ether, ethylene dibromide, and xylenes. Monitor wells
MW-40 and MW-41 were to be sampled for field parameters, VOCs, EDB, methyl tert-butyl ether, and lead. Field
parameters consisted of water levels, oxidation-reduction potential (ORP), pH, conductivity, dissolved oxygen (DO),
and temperature.
Over time, the wells on the sampling list were modified by the removal of some wells and the addition of others.
Monitoring for the permit consists of the quarterly groundwater sampling of wells MW-12, MW-13D, MW-33, MW-
34, MW-40, MW-48, MW-51, and MW-52 for analysis of VOCs, Total Petroleum Hydrocarbons, and Total
Chlorinated Hydrocarbons. The locations of these injection wells and monitor wells are presented on Figure 5.
Please let me know if you have any questions.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Gilbarco, Inc.
FOR THE OPERATION OF 18 TYPE 5I INJECTION WELLS, defined in Title 15A North Carolina
Administrative Code 2C .0209(e)(3)(C), to inject hydrogen and oxygen, to stimulate bioremediation
of chlorinated solvents and petroleum hydrocarbons. PERMISSION IS ALSO GRANTED FOR THE
INSTALLATION AND OPERATION OF 16 TYPE 5I INJECTION WELLS, defined in Title 15A
North Carolina Administrative Code 2C .0209(e)(3)(C), to inject 3DMe (HRC Advanced) to
stimulate the breakdown of chlorinated solvents and petroleum hydrocarbons. All of these injection
wells/points will be located at 7300 West Friendly Avenue, Greensboro, Guilford County, North
Carolina, and will be operated in accordance with the permit renewal application submitted February
25, 2010, additional information associated with this application submitted March 15, 2010, the
application for permit modification submitted August 6, 2012, additional information associated with
this application submitted August 8, 2012, and in conformity with the specifications and supporting
data previously submitted, all of which are filed with the Department of Environment and Natural
Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the Water
Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an injection well
shall be in compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and
any other Laws, Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until March 31, 2015,
and shall be subject to the specified conditions and limitations set forth in Parts I through X hereof.
Permit issued this the 4th day of September, 2012.
fior Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400091 PAGE 1 OF 8
ver. Jan.2010 AP/UIC-6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and criteria
specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any
noncompliance with conditions of this permit constitutes a violation of the North Carolina Well
Construction Act and is grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during construction
and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall notify the
Aquifer Protection Section -Underground Injection Control (UIC) Central Office staff, telephone
number 919-807-6352 and the Winston-Salem Regional Office Aquifer Protection Section Staff,
telephone number 336-771-5000.
Permit No. WI0400091 PAGE 2 OF 8
ver. Jan. 2010 APARC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
This permit is effective only with respect to the nature, volume of materials, rate of injection, and
number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request must
be submitted to the Director, including any supporting materials as may be appropriate, at least
30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with
any and all statutes, rules, regulations, or ordinances which may be imposed by other local, state,
and federal agencies which have jurisdiction. Furthermore, the issuance of this permit does not
imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater which will render it unsatisfactory for normal use. In the event
that the facility fails to perform satisfactorily, including the creation of nuisance conditions or
failure of the injection zone to adequately assimilate the injected fluid, the Permittee shall take
immediate corrective actions including those actions that may be required by the Division of
Water Quality such as the repair, modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of
any planned physical alterations or additions in the permitted facility or activity not specifically
authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection,
the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central Office staff,
telephone number 919-715-6164. Notification is required so that Division staff can inspect or
otherwise review the injection facility and determine if it is in compliance with permit
conditions.
Permit No. WI0400091 PAGE 3 OF 8
ver. Jan.2010 AP/UIC-6

PART VI - INSPECTIONS
Any duly authorized officer, employee, or representative of the Division of Water Quality may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related
to the injection facility at any reasonable time for the purpose of determining compliance with
this permit, may inspect or copy any records that must be maintained under the terms and
conditions of this permit, and may obtain samples of groundwater, surface water, or injection
fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation,
and sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-
90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with
the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
The monitoring plan will be quarterly sampling of wells MW-12, MW-13D, MW-33, MW-34,
MW-40, MW-48, MW-48, MW-51 and MW-52 for analysis of VOCs, Total Petroleum
Hydrocarbons, and Total Chlorinated Hydrocarbons. Field parameters shall also be measured and
will consist of water levels, oxidation-reduction potential (ORP), pH, conductivity, dissolved
oxygen (DO), and temperature.
2. All sample results shall be submitted to the Aquifer Protection Section's Winston-Salem
Regional Office and the Raleigh Central Office. Any monitoring (including groundwater,
surface water, or soil sampling) deemed necessary by the Division of Water Quality to ensure
surface and ground water protection, will be established and an acceptable sampling reporting
schedule shall be followed.
3. The Permittee shall submit an Injection Event Record within 30 days of completing each
injection.
4. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting a renewal application for this permit. This document shall assess the injection
projects findings in a written summary. The final project evaluation shall also contain
monitoring well sampling data, contaminant plume maps and potentiometric surface maps.
Permit No. WI0400091 PAGE 4 OF 8
ver. Jan.2010 AP/UIC-6

5. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
6. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of
the occurrence, to the Winston-Salem Regional Office, telephone number 336-771-5000, any of
the following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
7. Where the Permittee becomes aware of an omission of any relevant facts in a permit application,
or of any incorrect information submitted in said application or in any report to the Director, the
relevant and correct facts or information shall be promptly submitted to the Director by the
Permittee.
8. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal. If a
well is not to be used for any purpose that well must be permanently abandoned according to
15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose,
the Permittee shall abandon that injection well in accordance with the procedures specified in
15A NCAC 2C .0113(b), including but not limited to the following:
Permit No. WI0400091 PAGE 5 OF 8
ver. Jan.2010 APMC-6

(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to do so could lead to the contamination of an underground source of drinking
water.
(D) Drilled wells shall be completely filled with cement grout, or bentonite grout which shall
be introduced into the well through a pipe which extends to the bottom of the well and is
raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely filling
it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each well shall be abandoned in such a manner that will prevent the movement
of fluids into or between underground sources of drinking water and in accordance with
the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h) (1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
Oxygen:
1. Some effects reported to be associated with pure oxygen are as follows: eye, nose, and throat
irritation, nausea, dizziness, pulmonary irritation leading to pulmonary edema and
pneumonitis. Intense and potentially fatal pulmonary edema may develop tracheal irritation,
fever, nausea, vomiting, acute bronchitis, sinusitis, malaise, paresthesias, and conjunctivitis.
2. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
Permit No. W10400091 PAGE 6 OF 8
ver. Jan.2010 AP/U1C-6

4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Hydrogen:
6. Some effects reported to be associated with pure hydrogen are as follows:
a. Skin contact with hydrogen can cause severe burns and frostbite to the skin.
b. Significant inhalation exposure to hydrogen can cause severe suffocation from
lack of oxygen. Symptoms include dizziness, weakness, nausea, vomiting, loss of
coordination and judgment, increased breathing rate, and loss of consciousness
and death.
7. Hydrogen is highly flammable liquid or gas and a dangerous fire and explosion hazard.
Hydrogen must be stored to avoid contact with heat, flames, sparks, and oxidizing agents
(e.g., perchlorates, peroxides, permanganates, chlorates, nitrates, and bromine), explosives,
liquid nitrogen, ozone, catalysts, lithium, strontium, barium, and cesium since violent
explosion may occur.
8. If the product is released into the environment, the proper respiratory protection should be
worn. The application process should be reviewed by an industrial hygienist to ensure that
the most appropriate respiratory equipment is worn if needed.
9. Persons working with the product should wear goggles or a face shield, gloves, and protective
clothing. In order to prevent contamination of the worker's home and other work areas, the
gloves and protective clothing should only be worn in the application area and should never
be taken home.
10. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
11. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
12. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
13. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the application area.
3DMe (HRC Advanced):
14. Ingestion may result in burns to the lips, tongue, and mouth. Exposure to the eyes can cause
disorientation of cellular membranes, loss of corneal, conjunctival and lens epithelium and
Permit No. WI0400091 PAGE 7 OF 8
ver. Jan.2010 AP/UIC-6

loss of endothelium of the cornea and blood vessels. Inhalation may produce upper airway
edema, respiratory failure, wheezing, pulmonary edema, and pneumonitis. Skin exposure may
cause pain, redness, irritation, and severe burns.
15. If the products are released into the environment in such a way that could result in a
suspension of fine solid or liquid particles, (e.g., grinding, blending, vigorous shaking or
mixing), then proper personal protective equipment should be used. The application process
should be reviewed by an industrial hygienist to ensure that the most appropriate personal
protective equipment is used.
16. Persons working with this product should at least wear safety goggles or a face shield, gloves,
and protective clothing. Face and body protection should be used for anticipated splashes or
sprays. Consult with an industrial hygienist to ensure proper protection.
17. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should never be
permitted in the application area during or immediately following application. Safety controls
should be in place to ensure that the check valve and the pressure delivery systems are
working properly.
18. The Material Safety Data Sheets should be followed to prevent adverse reactions and injuries.
19. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the area of application.
20. Violent reactions or ignition could occur under the appropriate conditions with acids,
alcohols, p-bis (1, 3-dibromoethyl) benzene, cyclopentadiene, germanium, hyponitrous acid,
maleic anhydride, nitroalkanes, 2-nitrophenol, potassium peroxodisulfate, sugars, 2, 2, 3, 3-
tetrafluoropropanol, and thorium dicabide. Measures should be taken to prevent such
reactions.
Permit No. WI0400091 PAGE 8 OF 8
ver. Jan.2010 AP/TJIC-6

SUPPORTING MATERIALS
PERMIT REISSUANCE
OF
APRIL 20, 2010

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
April 13, 2010
PERMIT ISSUANCE MEMO
TO:
Debra Watts
FROM:
Thomas Slusser -
RE: Permit To Inject Oxygen and Hydrogen
Gilbarco Facility, Guilford County
I recommend that Permit Number WI0400091 be reissued to Gilbarco, Inc. to inject oxygen and hydrogen to
remediate groundwater contaminated with chlorinated solvents and petroleum hydrocarbons. Operation of the
hydrogen and oxygen systems is expected to continue for several more years, which is why the permit is being issued
for the full 5 years allowed by Rule. Staff from Winston-Salem Regional Office recommend issuance of this permit.
Please let me know if you have any questions.

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
April 13, 2010
PERMIT ISSUANCE MEMO
TO: Debra Watts
FROM: Thomas Slusser
RE: Permit To Inject Oxygen and Hydrogen
Gilbarco Facility, Guilford County
I recommend that Permit Number WI0400091 be reissued to Gilbarco, Inc. to inject oxygen and hydrogen to
remediate groundwater contaminated with chlorinated solvents and petroleum hydrocarbons. Operation of the
hydrogen and oxygen systems is expected to continue for several more years, which is why the permit is being issued
for the full 5 years allowed by Rule. Staff from Winston-Salem Regional Office recommend issuance of this permit.
Please let me know if you have any questions.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87. Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Gilbarco, Inc.
FOR THE OPERATION OF 14 TYPE 5I INJECTION WELLS, defined in Title 15A North Carolina
Administrative Code 2C .0209(e)(3)(C). to inject hydrogen and oxygen, to stimulate bioremediation
of chlorinated solvents and petroleum hydrocarbons. These injection wells/points will be located at
7300 West Friendly Avenue, Greensboro, Guilford County, North Carolina, and will be operated in
accordance with the permit renewal application submitted February 25, 2010, additional information
submitted March 15, 2010, and in conformity with the specifications and supporting data previously
submitted, all of which are filed with the Department of Environment and Natural Resources and are
considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the Water
Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an injection well
shall be in compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and
any other Laws, Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until March 31, 2015, and
shall be subject to the specified conditions and limitations set forth in Parts 1 through X hereof.
Permit issued this the 20th day of April, 2010.
3�t � �-A�
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. W10400091 PAGE 1 OF 7
ver. Jan.2010 APIRC-6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and criteria
specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any
noncompliance with conditions of this permit constitutes a violation of the North Carolina Well
Construction Act and is grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during construction
and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall notify the
Aquifer Protection Section -Underground Injection Control (UIC) Central Office staff, telephone
number 919-715-6164 and the Winston-Salem Regional Office Aquifer Protection Section Staff,
telephone number 336-771-5000.
Permit No. WI0400091 PAGE 2 OF 7
ver. Jan.2010 AP/UIC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials, rate of injection. and
number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by. the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership. or there is a name change of the Permittee, a formal permit amendment request must
be submitted to the Director, including any supporting materials as may be appropriate. at least
30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with
any and all statutes, rules, regulations, or ordinances which may be imposed by other local. state.
and federal agencies which have jurisdiction. Furthermore. the issuance of this permit does not
imply that all regulatory requirements have been met.
PART IV- PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater which will render it unsatisfactory for normal use. In the event
that the facility fails to perform satisfactorily, including the creation of nuisance conditions or
failure of the injection zone to adequately assimilate the injected fluid, the Permittee shall take
immediate corrective actions including those actions that may be required by the Division of
Water Quality such as the repair, modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of
any planned physical alterations or additions in the permitted facility or activity not specifically
authorized by the permit.
At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection,
the Permittee must notify by telephone the Aquifer Protection Section-UIC. Central Office staff,
telephone number 919-71 5-6164. Notification is required so that Division staff can inspect or
otherwise review the injection facility and determine if it is in compliance with permit
conditions.
Permit No. WI0400091 PAGE 3 OF 7
ver. Jan.2010 AP/UIC-6

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related
to the injection facility at any reasonable time for the purpose of determining compliance with
this permit, may inspect or copy any records that must be maintained under the terms and
conditions of this permit, and may obtain samples of groundwater, surface water, or injection
fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation,
and sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-
90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with
the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
The proposed monitoring plan included in the application shall be followed. All sample results
shall be submitted to the Aquifer Protection Section's Winston-Salem Regional Office and the
Raleigh Central Office. Any monitoring (including groundwater, surface water, or soil sampling)
deemed necessary by the Division of Water Quality to ensure surface and ground water
protection. will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall submit an Injection Event Record within 30 days of completing each
injection.
3. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting a renewal application for this permit. This document shall assess the injection
projects findings in a written summary. The final project evaluation shall also contain
monitoring well sampling data, contaminant plume maps and potentiometric surface maps.
4. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection_ Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Permit No. WI0400091 PAGE 4 OF 7
ver. Jan.2010 AP- UIC-6 -

5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of
the occurrence, to the Winston-Salem Regional Office, telephone number 336-771-5000, any of
the following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances,
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
6. Where the Permittee becomes aware of an omission of any relevant facts in a permit application,
or of any incorrect information submitted in said application or in any report to the Director, the
relevant and correct facts or information shall be promptly submitted to the Director by the
Permittee.
7. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal. If a
well is not to be used for any purpose that well must be permanently abandoned according to
15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose,
the Permittee shall abandon that injection well in accordance with the procedures specified in
15A NCAC 2C .0113(b), including but not limited to the following:
(A)All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to do so could lead to the contamination of an underground source of drinking
water.
Permit No. WI0400091 PAGE 5 OF 7
ver. Jan.2010 AP/UIC-6

(D) Drilled wells shall be completely filled with cement rout, or bentonite rout which shall
be introduced into the well through a pipe which extends to the bottom of the well and is
raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely filling
it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each well shall be abandoned in such a manner that will prevent the movement
of fluids into or between underground sources of drinking water and in accordance with
the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
Oxygen:
1. Some effects reported to be associated with pure oxygen are as follows: eye, nose, and throat
irritation, nausea, dizziness, pulmonary irritation leading to pulmonary edema and
pneumonitis. Intense and potentially fatal pulmonary edema may develop tracheal irritation,
fever, nausea, vomiting, acute bronchitis, sinusitis, malaise, paresthesias, and conjunctivitis.
?. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0400091 PAGE 6 OF 7
ver. Jan.2010 APTIC-6

Hydrogen:
6. Some effects reported to be associated with pure hydrogen are as follows:
a. Skin contact with hydrogen can cause severe burns and frostbite to the skin.
b. Significant inhalation exposure to hydrogen can cause severe suffocation from
lack of oxygen. Symptoms include dizziness, weakness, nausea, vomiting, loss of
coordination and judgment, increased breathing rate, and loss of consciousness
and death.
7. Hydrogen is highly flammable liquid or gas and a dangerous fire and explosion hazard.
Hydrogen must be stored to avoid contact with heat, flames, sparks. and oxidizing agents
(e.g.. perchlorates. peroxides, permanganates, chlorates. nitrates. and bromine), explosives,
liquid nitrogen, ozone. catalysts, lithium, strontium, barium, and cesium since violent
explosion may occur.
8. If the product is released into the environment, the proper respiratory protection should be
worn. The application process should be reviewed by an industrial hygienist to ensure that
the most appropriate respiratory equipment is worn if needed.
9. Persons working with the product should wear goggles or a face shield, gloves, and protective
clothing. In order to prevent contamination of the worker's home and other work areas, the
gloves and protective clothing should only be worn in the application area and should never
be taken home.
10. Eating, drinking, smoking, handling contact lenses. and applying cosmetics should not be
permitted in the application area during or immediately following application.
11. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
12. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
13. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the application area.
Permit No. W10400091 PAGE 7 OF 7
ver. Jan?010 AP, UIC-6

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
March 20, 2008
MEMORANDUM
TO: Debra Watts
FROM: Qu Qi
SUBJECT: 5I Injection well permit application
Gilbarco
Guilford County
WI0400091
The UIC Group has received a permit application for a type 5I permit for Gilbarco site. The
permit application has been reviewed and issuance of the permit is recommended. A summary
of the application follows.
Site Overview: Groundwater is contaminated by chlorinated solvents and petroleum
hydrocarbons. There is a pump and treat system operating at the site. This permit
application is for inject hydrogen gas into to the plume to treat chlorinated solvents (10
wells) and later oxygen gas to treat the petroleum products (10 wells). There are six
wells are used for both hydrogen and oxygen injection, so the total injection well number
is 14. The soil at the site is medium grained sandy silt. The water table is approximately
7 to 30 feet below the ground surface.
2. Injection: Gases will be delivered to the site in cylinders, and distributed into the
groundwater plume through HiSOC/iSOC units. HiSOC/iSOC Units improve the
efficiency of distributing the gas by diffusing it at a very small size, so the gas is readily
available to dissolve into groundwater. The gas will saturate the groundwater and flow
with the groundwater away from the injection points into the aquifer. One of the
proposed injectant is hydrogen, which is used for reductive biodegradation of chlorinated
solvents. The oxygen will be used later to treat petroleum contamination.
3. Monitoring: The proposed monitoring schedule: Ten monitoring wells will be sampled
for VOCs, and relevant geochemical parameters on a quarterly base after the system
starts.
4. Epidemiology: Dr. Luanne Williams provided a risk evaluation of oxygen and hydrogen
and did not identify any risks that would prevent injection.
5. RO Concerns: The WSRO did not provide any comments about the injection.
Based upon the remarks presented above, I recommend issuance of the permit. If you have any
questions, please let me know.

o�o� w A rFgQG Michael F. Easley, Governor
� William G. Ross Jr., Secretary
co r North Carolina Department of Environment and Natural Resources
>
Coleen Sullins, Director
Division of Water Quality
March 20, 2008
Mr. Paul Lemmers
Gilbarco, Inc.
7300 West Friendly Avenue
Greensboro, NC 27410
RE: Issuance of Injection Well Permit WI0400091
Dear Mr. Lemmers:
In accordance with the application submitted on August 29, 2007 and the supporting data
submitted February 29, 2008, we are forwarding permit number WI0400091. This permit is for
the injection of hydrogen and oxygen to remediate groundwater contaminated with chlorinated
solvents and petroleum hydrocarbons at the Gilbarco, 7300 West Friendly Avenue, Grreensboro,
Guilford County, North Carolina.
This permit shall be effective from the date of issuance until April 30, 2010, and shall be subject
to the conditions and limitations stated therein, including the requirement to submit a final
project evaluation as stated in PART VII — MONITORING AND REPORTING
REQUIREMENTS. Please read the entire permit to ensure that you are aware of all compliance
requirements of the permit. You will need to notify this office by telephone 48 hours prior to
initiation of operation of the facility. In order to continue uninterrupted legal use of the injection
facility for the stated purpose, you must submit an application to renew the permit 120 days prior
to its expiration date.
If you have any questions regarding your permit please feel free to contact me at [phone].
Sincerely,
u Qi, P.G.
Underground Injection Control
Program Manager
cc: Christopher Hay —Trigon
Winston-Salem Regional Office
Gene Mao — Guilford County
CO-UIC files
Enclosures
One NCarolina
�Naturallil
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Gilbarco, Inc.
FOR THE CONSTRUCTION AND OPERATION OF TYPE 5I INJECTION WELLS, defined
in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(C), to inject Hydrogen and then
Oxygen, to remediate groundwater contaminated with chlorinated solvents and petroleum
hydrocarbons. These injection wells/points will be located at 7300 West Friendly Avenue,
Greensboro, Guilford County, North Carolina, and will be operated in accordance with the
application submitted August 29, 2007, and in conformity with the specifications and supporting
data submitted February 28, 2008, all of which are filed with the Department of Environment and
Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until April 30, 2010,
and shall be subject to the specified conditions and limitations set forth in Parts I through X
hereof.
r
Permit issued this the �day of , 2008.
/2" J, uj-�'
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400091 PAGE 1
ver.8/07 AP/UIC-6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S.87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during
construction and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Aquifer Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number [phone] and the Winston-Salem Regional Office Aquifer
Protection Section Staff, telephone number [phone].
Permit No. WI04000Q I PAGE 2
ver.8/07 AP/UIC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances which may be imposed by other
local, state, and federal agencies which have jurisdiction. Furthermore, the issuance of this
permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned physical alterations or additions in the permitted facility or activity not
specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone number [phone]. Notification is required so that Division staff
can inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
Permit No. WI0400091 PAGE 3
ver.8/07 AP/UIC-6

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S. 87-90.
Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
The proposed monitoring plan included in the application shall be followed. All sample
results shall be submitted to the Aquifer Protection Section's Winston-Salem Regional Office
and the Raleigh Central Office. Any monitoring (including groundwater, surface water, or
soil sampling) deemed necessary by the Division of Water Quality to insure surface and
ground water protection, will be established and an acceptable sampling reporting schedule
shall be followed.
2. The Permittee shall submit an Injection Event Record within 30 days of initiation of the
injection.
3. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting a renewal application for this permit. This document shall assess the
injection projects findings in a written summary. The final project evaluation shall also
contain monitoring well sampling data, contaminant plume maps and potentiometric surface
maps.
4. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
Permit No. WI04000()l PAGE 4
ver.8/07 AP/UIC-6

58-, vv aughtown Street
Winston-Salem, NC 27107
5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Winston-Salem Regional Office, telephone number [phone],
any of the following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
6. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
7. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0113(b), including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to'do so could lead to the contamination of an underground source of
Permit No. WI040009 I PAGE 5
ver.8/07 AP/UIC-6

drinking water.
(D) Drilled wells shall be completely filled with cement grout, or bentonite grout which
shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G)The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
Oxygen:
1. Some effects reported to be associated with pure oxygen are as follows: eye, nose, and throat
irritation, nausea, dizziness, pulmonary irritation leading to pulmonary edema and
pneumonitis. Intense and potentially fatal pulmonary edema may develop tracheal irritation,
fever, nausea, vomiting, acute bronchitis, sinusitis, malaise, paresthesias, and conjunctivitis.
2. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WIO4000L) I PAGE 6
ver.8l07 APJAC-6

Hydrogen:
6. Some effects reported to be associated with pure hydrogen are as follows:
a. Skin contact with hydrogen can cause severe burns and frostbite to the skin.
b. Significant inhalation exposure to hydrogen can cause severe suffocation from
lack of oxygen. Symptoms include dizziness, weakness, nausea, vomiting, loss of
coordination and judgment, increased breathing rate, and loss of consciousness
and death.
7. Hydrogen is highly flammable liquid or gas and a dangerous fire and explosion hazard.
Hydrogen must be stored to avoid contact with heat, flames, sparks, and oxidizing agents
(e.g., perchlorates, peroxides, permanganates, chlorates, nitrates, and bromine), explosives,
liquid nitrogen, ozone, catalysts, lithium, strontium, barium, and cesium since violent
explosion may occur.
8. If the product is released into the environment, the proper respiratory protection should be
worn. The application process should be reviewed by an industrial hygienist to ensure that
the most appropriate respiratory equipment is worn if needed.
9. Persons working with the product should wear goggles or a face shield, gloves, and protective
clothing. In order to prevent contamination of the worker's home and other work areas, the
gloves and protective clothing should only be worn in the application area and should never
be taken home.
10. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
11. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
12. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
13. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the application area.
Permit No. WI040000 1 PAGE 7
ver.8/07 AP/UIC-6

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Gilbarco, Inc.
FOR THE CONSTRUCTION AND OPERATION OF TYPE 5I INJECTION WELLS, defined
in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(C), to inject Hydrogen and then
Oxygen, to remediate groundwater contaminated with chlorinated solvents and petroleum
hydrocarbons. These injection wells/points will be located at 7300 West Friendly Avenue,
Greensboro, Guilford County, North Carolina, and will be operated in accordance with the
application submitted August 29, 2007, and in conformity with the specifications and supporting
data submitted February 28, 2008, all of which are filed with the Department of Environment and
Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until April 30, 2010,
and shall be subject to the specified conditions and limitations set forth in Parts I through X
hereof.
Permit issued this the .2day of , 2008.
— ":�" a uj76
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400091 PAGE 1
ver.8/07 APAJIC-6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during
construction and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Aquifer Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number [phone] and the Winston-Salem Regional Office Aquifer
Protection Section Staff, telephone number [phone].
Permit No. WI040009I PAGE 2
ver.8/07 AP/UIC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances which may be imposed by other
local, state, and federal agencies which have jurisdiction. Furthermore, the issuance of this
permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned physical alterations or additions in the permitted facility or activity not
specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone number [phone]. Notification is required so that Division staff
can inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
Permit No. WI0400091 PAGE 3
ver.8/07 AP/UIC-6

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S. 87-90.
Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. The proposed monitoring plan included in the application shall be followed. All sample
results shall be submitted to the Aquifer Protection Section's Winston-Salem Regional Office
and the Raleigh Central Office. Any monitoring (including groundwater, surface water, or
soil sampling) deemed necessary by the Division of Water Quality to insure surface and
ground water protection, will be established and an acceptable sampling reporting schedule
shall be followed.
2. The Permittee shall submit an Injection Event Record within 30 days of initiation of the
injection.
3. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting a renewal application for this permit. This document shall assess the
injection projects findings in a written summary. The final project evaluation shall also
contain monitoring well sampling data, contaminant plume maps and potentiometric surface
maps.
4. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
Permit No. WI0400091 PAGE 4
ver.8/07 APIUIC-6

585 Waughtown Street
Winston-Salem, NC 27107
5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Winston-Salem Regional Office, telephone number [phone],
any of the following:
(A) Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
6. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
7. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0113(b), including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to do so could lead to the contamination of an underground source of
Permit No. WI0400091 PAGE 5
ver.8/07 AP/UIC-6

drinking water.
(D) Drilled wells shall be completely filled with cement grout, or bentonite grout which
shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G)The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
Oxygen:
1. Some effects reported to be associated with pure oxygen are as follows: eye, nose, and throat
irritation, nausea, dizziness, pulmonary irritation leading to pulmonary edema and
pneumonitis. Intense and potentially fatal pulmonary edema may develop tracheal irritation,
fever, nausea, vomiting, acute bronchitis, sinusitis, malaise, paresthesias, and conjunctivitis.
2. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI04000()1 PAGE 6
ver.8/07 AP/1AC-6

Hydrogen:
6. Some effects reported to be associated with pure hydrogen are as follows:
a. Skin contact with hydrogen can cause severe burns and frostbite to the skin.
b. Significant inhalation exposure to hydrogen can cause severe suffocation from
lack of oxygen. Symptoms include dizziness, weakness, nausea, vomiting, loss of
coordination and judgment, increased breathing rate, and loss of consciousness
and death.
7. Hydrogen is highly flammable liquid or gas and a dangerous fire and explosion hazard.
Hydrogen must be stored to avoid contact with heat, flames, sparks, and oxidizing agents
(e.g., perchlorates, peroxides, permanganates, chlorates, nitrates, and bromine), explosives,
liquid nitrogen, ozone, catalysts, lithium, strontium, barium, and cesium since violent
explosion may occur.
8. If the product is released into the environment, the proper respiratory protection should be
worn. The application process should be reviewed by an industrial hygienist to ensure that
the most appropriate respiratory equipment is worn if needed.
9. Persons working with the product should wear goggles or a face shield, gloves, and protective
clothing. In order to prevent contamination of the worker's home and other work areas, the
gloves and protective clothing should only be worn in the application area and should never
be taken home.
10. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
11. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
12. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
13. Access to the area of application should be limited to the workers applying the product. In
order to minimize exposure to unprotected individuals, measures should be taken to prevent
access to the application area.
Permit No. WI040000 1 PAGE 7
ver.8/07 AP/UIC-6

O�0F W A TF9PG Michael F. Easley, Governor
William G. Ross Jr., Secretary
fNorth Carolina Department of Environment and Natural Resources
>
Coleen Sullins, Director
O Division of Water Quality
March 20, 2008
Mr. Paul Lemmers
Gilbarco, Inc.
7300 West Friendly Avenue
Greensboro, NC 27410
RE: Issuance of Injection Well Permit WI0400091
Dear Mr. Lemmers:
In accordance with the application submitted on August 29, 2007 and the supporting data
submitted February 29, 2008, we are forwarding permit number WI0400091. This permit is for
the injection of hydrogen and oxygen to remediate groundwater contaminated with chlorinated
solvents and petroleum hydrocarbons at the Gilbarco, 7300 West Friendly Avenue, Grreensboro,
Guilford County, North Carolina.
This permit shall be effective from the date of issuance until April 30, 2010, and shall be subject
to the conditions and limitations stated therein, including the requirement to submit a final
project evaluation as stated in PART VII — MONITORING AND REPORTING
REQUIREMENTS. Please read the entire permit to ensure that you are aware of all compliance
requirements of the permit. You will need to notify this office by telephone 48 hours prior to
initiation of operation of the facility. In order to continue uninterrupted legal use of the injection
facility for the stated purpose, you must submit an application to renew the permit 120 days prior
to its expiration date.
If you have any questions regarding your permit please feel free to contact me at [phone].
Sincerely,
PuQ i, P.G,
Underground Injection Control
Program Manager
cc: Christopher Hay —Trigon
Winston-Salem Regional Office
Gene Mao — Guilford County
CO-UIC files
Enclosures
o `
NCarolina
'Vatura!!y
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
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