WI0400198_Complete File - Historical_20200724

ROY COOPER
Governar
MICHAEL S. REGAN
Secretory
S. DANIEL SMITH
Director
NORTH CAROLINA
Envbw mento[Quality
July 24, 2020
Mr. Hardik Patel, Project Manager
Atlantic Richfield Company / BP Products North America, Inc.
3711 Waldenbrook Road
Greensboro, NC 27407
Re: Injection Permit WI0400198
Former Knollwood Gulf Station Forsyth County, NC
Sent electronicalty and via TJ.S. Postal Service
Dear Mr. Patel:
In accordance with your permit renewal application received June 11, 2020, we are forwarding this permit for
continued monitoring only. This permit shall be effective, unless revoked, from the date of issuance until June
30, 2025, and shall be subject to the conditions and limitations stated therein, including the requirement to
submit a Final Project Evaluation (FPE) as stated in PART VI — MONITORING .AND REPORTING
REQUIREMENTS. Please read the entire permit to ensure that you are aware of all compliance requirements
of the permit.
Please note the foliGming:
Per pennit condition VI.2, sample results shall be submitted to the D W R U1C Program and Winston-
Salem Regional Office annually starting from date well construction and/or injection activities
commence. Monitoring reports shall include, a summary of injection activities and monitoring results,
historical analytical data presented in a tabular/spreadsheet format distinguishing between pre -
injection and post injection data, and an update on the status and location of monitoring and injection
wells.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this permit is
not transferable to any person without prior notice to, and approval by, the Director of the Division of Water
Resources (DWR). If you have any questions regarding your permit or the Underground Injection Control
Program, please call me at [phone].
Best Regards,
i
Michael Rogers, P.G. (NC & FL)
Underground Injection Control {UIC) Program Manager
Division of Water Resources - Ground Water Resources Section
cc: Winston-Salem Regional Office, WQROS (sent clr-ctronically)
W10400198 Permit File
D Q
� North Carolina Department of Environmental Qual tV I Division of Water Resources
_ Si2 Borth Salisbury Street 1 1636 Mail Service Center I Ratelgl, North Carding 27699.1636
919.707.9000

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY (DEQ)
RALEIGH, NORTH CAROLINA
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143; and other
applicable Laws, Rules, and Regulations
f 3�:i�ii•��Is]`l I•'1: i �1:1�1:�`ie#:��fl if �iti�Cs7
Atlantic Richfield Company (ARCO) 1 BP Products
Forsyth County
W10400198
FOR THE CONTINUED MONITORING OF IN SITU REMEDIATION, INJECTION WELL(S)
defined in Title 15A North Carolina Administrative Code 2C .0209(5)(b)(viii). These injection
points are located at the Former Knollwood Gulf Station, 381 Knollwood Street, Winston-Salem,
NC 27103, and will be operated in accordance with the permit renewal request received June 11,
2020, and in conformity with the specifications and supporting data submitted, all of which are
filed with the Department of Environmental Quality and are considered a part of this permit,
This permit is for Monitoring 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 issuance until June 30, 2025.
Permit issued the.84 day of [1 , 2020
for S. Daniel Smith, Director
Division of Water Resources
By Authority of the Environmental Management Commission.
Permit No. WI0400198 PAGE 1 OF 7
►+er. 114-2019 UIC-51/5T

PART I — PERMIT GENERAL CONDITIONS
The Permittee shall comply with all conditions ofthis 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 [ l 5A
NCAC 02C .0211 (k)].
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 [ 15A NCAC 02C .0211(o)].
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 [l5A NCAC 02C .0203].
PART I1- WELL CONSTRUCTION GENERAL CONDITIONS
Each injection well shall not hydraulically connect separate aquifers [15A NCAC 02C
.0211(b)].
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 [I5A
NCAC 02C .0225(h)(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 f 15A NCAC 02C .0225(h)(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(h)(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(h)(23)].
Permit No. W10400198 PAGE Z OF 7
ver. 11-4-2019 UIC-5I15T

6. Each injection well shall be afforded reasonable protection against damage during construction
and use [I 5A NCAC 02C .02250)(3)].
7. Each permanent injection well shall have a permanently affixed identification plate [ 15A
NCAC .0225(h)(20)].
8. If not previously submitted, a copy of the completed Well Construction Record (Form OW-1)
shall be submitted as described in Part VI.3 of this permit (the original document goes to the
address indicated on the form).
PART III - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing or operating any injection well, the
Permittee shall notify the Underground Injection Control (UIC) Central Office staff, telephone
number 919-707-9000, and the Winston-Salem Regional Office staff, telephone number 336-
776-9800.
PART IV - OPERATION AND USE CONDITIONS
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 [ 15A NCAC 02C
.0211(i)].
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface water or groundwater resulting from the operation of this facility [ i 5A 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 [ 15A NCAC 02C
.0211(i)].
4. In the event that the facility fails to perform satisfactorily resulting in the creation of nuisance
conditions, failure of the injection zone to adequately assimilate the injected fluid, or
daylighting, the Permittee shall take immediate corrective actions including, but not limited
to, repairs, modifications, or abandonment of the injection facility. The Permitee shall report
non-compliance according to Part VI.7 of this permit [I5A NCAC 02C .0206].
PART V - INSPECTIONS [ 15A NCAC 02C .02110)]
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.
Permit No. WI0400198 PAGE 3 OF 7
ver. 1 l 4-2019 UIC-5I15T

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
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 [I 5A NCAC 02C .0225(k)].
2_ An Annual Report with all historical monitoring results shall be submitted in hound hard copy
format with attached CD or flash drive to the UIC Program Central Office, and Winston-Salem
Regional Office starting within one year of the first injection event. Monitoring reports shall
include, a summary of injection activities and monitoring results, analytical data presented in
a spreadsheet distinguishing between pre -injection and post injection 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 [I5A NCAC 02C .0225(l)].
Records of well construction, repair, or abandonment shall be submitted within 30 days of
completion of such activities [I 5A NCAC 02C .0225(1)].
4. An Injection Event Record (IER) shall be submitted within 30 days of each individual injection
event, if applicable [ 15A NCAC 02C .0225(1)].
5. The Permittee shall submit a Final Project Evaluation (FPE) 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: Injectants and related reaction byproducts must
attenuate to re -injection concentrations or vundwater standards specified in rule 15A NCAC
02L .0202, whichever is greater, in order for this permit to be closed. Otherwise, corrective
action as described in Part VII may be required [I5A NCAC 02C .0225(1)].
6. All monitoring results, forms, and reports required in this Part shall be submitted to:
UIC Program Water Quality Regional Operations
NC Division of Water Resources and WQROS Winston-Salem Regional Office
1636 Mail Service Center 450 W. Haines Mill Road, Suite 300
Raleigh, NC 27699-1636 Winston-Salem, NC 27105
7. 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
groundwater quality standards, or that a malfunction of the injection system may cause the
injected fluids to migrate outside the approved injection zone or area. As specified in rule
15A NCAC 02C .0211(p), noncompliance notification shall be as follows:
Permit No. W10400198 PAGE 4 OF 7
per. 11-4-2019 UIC-5115T

(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 #6 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.
PART VII - CORRECTIVE ACTION [ 15A NCAC 02C .02061
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 greater. 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 may
warrant a corrective action plan as provided under rule 15A NCAC 02C .0206, depending
on the type, concentration, and distribution of the groundwater quality standards being
exceeded.
PART VIII - PERMIT RENEWAL [ 15A NCAC 02C. 0211 (h)]
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 [I 5A 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:
Permit No. WI0400198 PAGE 5 OF 7
ver. 11-4-2019 UIC 5I15T

(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(1) 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
DEQ-Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION [I 5A NCAC 02C
.0225(a)]
1. Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat, and lung irritation. If the product is released into the environment in 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.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. Face and body protection should be used for anticipated splashes or
sprays.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
Permit No. W10400198 PAGE b QF 7
per. 114-2019 UIC-5115T

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. WI0400198 PAGE 7 OF 7
per. 11 -4-2019 UIC-5115T

Rogers, Michael
From: Rogers, Michael
Sent: Tuesday, March 24, 2020 411 PM
To: Patel, Hardik
Cc: Shrestha, 5hristi R
Subject: RE: [External] Re: W10400198
Also, in future reporting note this change in sampling wells.
From: Rogers, Michael
Sent: Tuesday, March 24, 2020 4:01 PM
To: Patel, Hardik <Hardilk. [e-mail]>
Cc: Shrestha, 5hristi R <[e-mail]>
Subject: RE: [External] Re: W10400198
Based upon the fact that the area where MW-19 was located has been paved over and is now a mall parking
lot, your request to sample MW-6 in lieu of MW-19 is reasonable and approved.
From: Patel, Hardik[[e-mail]]
Sent: Tuesday, March 24, 2020 3.21 PM
To: Rogers, Michael <n itc l [e-mail]>
Subject: Re: [External] Re: W10400198
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
r_1..)1)r i..
Mr. Rogers,
This is a follow up to our phone conversation. It will be problematic and burdensome to install a replacement
well for the paved over MW-19. Let me know how Arcadis can move forward.
Thanks,
Hardik
Hardik Patel I AFS Project Managed [e-mail]
Arcadis I ARCADIS U.S- Inc.
5420 Wade Park Blvd, Suite 350 1 Raleigh, NC 1 276071 USA
T. [phone] M. [phone]
. nn+ectwith usi www.arcadis.co [arcadis.coml i ...iIlrul,;11 Ilinkedin.coml [twitter.coml I Facebook
ffacabook.coml
ARCADIS
for S Coi1auttPnr:,
farnaturalend
hunt assets
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From: Patel, Hardik <Hardik.Patel @ arca_dis.com>
Sent: Tuesday, March 24, 2020 9:43 AM
To: Rogers, Michael <michael.ro ers ncdenr. ova
Subject: Re: [External] Re: W10400198
Good Morning Mr. Rogers,
Arcadis went out this morning to conduct the 1H2O20 M&S sampling event. Upon arriving at the site (Former
BP station #24163, 381 Knollwood Street), the entire site has been paved recently. All the wells were fine,
except for MW-19.Our sampling plan at this site is MW-8R and MW-19 for analysis of sulfate.
What should Arcadis next step be? Conduct GW sampling of MW-8R only. Or, should we sample MW-6 to the
sampling plan, since it located close to MW-19.
Thank you for your help,
Hardik
Hardik Patel I AFS Project Managers hardik. p atel arcadis.com
Arcadis I ARCADIS U.S. Inc.
5420 Wade Park Blvd. Suite 350 1 Raleigh, NC 1 276071 USA
T. [phone] M. [phone]
Connect w4th usi www.arcadis.com larcadis.coml I �lnkedt�, flinkedin.coml I Twitter [twitter.coml 1 Facebook
Ifacebcok.coml
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From: Rogers, Michael <michael.rogers@ncden_r.gov>
Sent: Wednesday, March 11, 202012:45 PM
To: Patel, Hardik <[e-mail]>
Cc: Shrestha, Shristi R <shristi.shrestha ncdenr. ova
Subject: RE: [External] Re: W10400198
❑K, thanks.
From: Patel, Hardik fmailto:[e-mail]]
Sent: Tuesday, March 10, 2020 3:19 PM
To: Rogers, Michael Emichael.rogers@ncdenrgov>
Subject: )External] Re: W10400198

External email. Do not click links or open
i enort pa�gtpnt,gov
Thank you! I'll get the signatures and submit this paperwork!
Hardik Patel I AFS Project Manager I hardik. atel arcadis.corn
Arcadis f ARCADIS U.S. Inc.
542❑ Wade Park Blvd. Suite 350 1 Raleigh, NC j 276071 USA
T. [phone] M. [phone]
. [arcadis.coml Lnam02.safelinks.protection.outlook.com] } Ilinkedin.com]
[na 312. safe links.protection.outIook.com] I jtw's_tt_ e_r.coml nam02.safelinks. protection.outlook.com1 ' Facebook
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PARICADIS
far natural acid tincy
eultt cossets
From: Rogers, Michael [e-mail]>
Sent: Tuesday, March 10, 2020 2:33 PM
To: Patel, Hardik <[e-mail]>
Subject: W 10400198
Hardik-
This is a follow up to our phone conversation this afternoon.
We received the 2019 semiannual monitoring report for the above permit. Thank you. This permit expired on
7/31/18. This permit should be renewed since active monitoring has been on -going for the past 2 years and will be
continued to be monitored for several more years. Because of this, this permit should be renewed for 'Mon ito ring Only'
where future injections would not be included in the permit. Attached is a renewal application. Please have it
completed and submit. At tap of the form check the 'Renewal without modification', On the cover letter indicate you
are requesting it be renewed for `Monitoring Only'.
Thank you for your cooperation.
M ichael
This email and any files transmitted with it are the property of Arcadis and its affiliates. All rights, including without limitation copyright, are reserved. This
email contains information that may be confidential and may also be privileged. It is for the exclusive use of the intended recipient(s). If you are not an
intended recipient, please note that any form of distribution, copying or use of this communication or the information in it is striotly prohibited and may be
unlawful, tf you have received this communication in error, please return it to the sender and then delete the email and destroy any copies of it. While
reasonable precautions have been taken to ensure that no software or viruses are present in our emails, we cannot guarantee that this email or any
attachment is virus free or has not been intercepted or changed. Any opinions or other information in this email that do not relate to the official business
of Arcadis are neither given nor endorsed by it.
This email and any files transmitted with it are the property of Afcadis and its affiliates. All rights, including without limitation copyright, are reserved. This
email contains information that may be confidential and may also be privileged. It is for the exclusive use of the intended recipient(s). If you are not an
intended recipient, please note that any form of distribution, copying or use of this communication or the information in it is strictly prohibited and may be
unlawful. If you have received this communication in error, please return it to the sender and then delete the email and destroy any copies of it. While
reasonable precautions have been taken to ensure that no software or viruses are present in our emails, we cannot guarantee that this email or any
attachment is virus free or has not been intercepted or changed. Any opinions or other information in this email that do not relate to the official business
of Arcadis are neither given nor endorsed by it.

Table 6 (Revised 11-7-2018)
Injection Monitoring Plan
Andrex Industries
Asheville, North Carolina
NCDEQ Groundwater Incident Dumber 6586
BLE Project No. JIS-I022-50
Q
7
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ION -3 mud III-[
RW-3
X
X
X
X
X
M W-s
x
x
X
X
X
%1►►'-12
X
X
X
X
X
RW-1, IW-2. I►►-3 anWaI I IN' -1A
l -?
X
X
X
X
X
1OV-1
X
X
X
X
X
NINV-6
X
X
X
x
X
<IW-10>
MIN-44
X
X
X
X
X
None
<Nl % '-3 its
X
<l W-4>
III ►V-7
X
X
X
X
X
<IW-5>
SMW-SR>
X
X
X
X
X
M W-9
X
X
X
X
X
AWfi>
None
RW-5 or <iW-7>
RW-5
X
X
X
X
X
NI W-10
X
X
X
X
X
M W-13
X
X
x
X
x
MNV-14
X
X
x
x
X
RW-6
X
X
X
X
X
<IW-8>
RW-6
X
X
X
X
X
<IW-9>
RW-7
X
X
X
X
X
M W-I l
X
X
X
X
X
M W-23
X
X
X
<IW-il>
NINE'-24
X
X
X
X
X
<IW-12>
<MW-25R •
X
X
X
X
X
None
M W-15
X
M W-16
X
nI W-17
X
M W-18
X
M W-20
X
M W-21
X
M W-26
X
Surface Water
None
Smith Mill Creek I
X
Smith Mill Creek 2
X
Smith Mill Creek 3
X
Smith Mill Creek 4
X
Smith Mill Creek 5
X
Smith Mill Creek 6
X
Sear Creek i
X
X
Bear Creek 2
X
Bear Creek 3
X
Bear Creek 4
X
Bear Creek 5
X
Jehovah Witness 1
X
X
Cecil's Spring I
Cecil's Spring 2
X
Notes:
Wells located outside of the Injection Zone.
VOC• analyses perlbnned by EPA Method 8260 M S V Low l.cvel.
TOC analyses performed by SM Method 9064A.
It may not be possible to obtain samples at exact milestones (30, 90, and 150 days, etc)
due to weekends, holidays, inclement weather, or other delays beyond our control.
Samples will be collected as near the milestone dates as the schedule allows.
Monitoring is performed when injection is perforated in corresponding well.
eWell Name? = Well Planned for Possible Future Installation.
Prepared by: AWA
Table 6 Monitoring Plan (R) of Tables Permit Renewal 2018 And= 1022-54.xlsx Chocked by. TIB

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om�
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d LEGEND:
PROPERTY LINE
r t oNCREr ABANDONED GROUNDWATER MONITORING WELL
FORMER PRODUCT LINE
PARKING M TER IC ❑C.B. CATCH BASIN
Q M,H- MAN HOLE
M4 -17 I 0-F, AREA LIGHT
1
■ U.P. UTILITY POLE
-6 F H.
FIRE HYDRANT
r] TELEPHONE
ASPHALT TRASH LARGE MANHOLE COVER
PARKING ENCLOSURE
1 GROUNDWATER MONITORING WELL
METAL U
SHED �a
0
— ` METAL SHED
FORMER
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1
1
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a
PARKING
' I
FORMER PUMF
ISLAND(rYP.
II I
CONCR=TEz
FORMER
CANorr
I I
FORMER
VENT RISERS
NOTE-
1. MONITORING WELL LOCATIONS ARE APPROXIMATE.
2- THE SITE IS A VACANT PARKING LOT. ALL SITE FEATURES EXCEPT
PARKING LOT CURBS AND ROADWAYS REPRESENT FORMER SITE
CHARACTERISTICS-
0 30' 60'
GRAPHIC SCALE
r3
u bi

Rogers, Michael
From: Goodell, Paul <[e-mail]>
Sent: Tuesday, April 11, 2017 11:42 AM
To: Rogers, Michael
Subject: RE: UIC Permit #Wl0400198 - Sulfate
Thanks Mike!
I appreciate the quick response and thorough explanation. I was hopeful that the N 0 R P would be sufficient but I
understand that the permit is explicit in regards to the monitoring requirements. We will continue monitoring for
sulfate at the site and once below 2L standards submit the Final Project Evaluation.
Thank you again
Paul
From: Rogers, Michael[mailto:[e-mail]]
Sent: Tuesday, April 11, 2017 10:14 AM
To: Goodell, Paul <[e-mail]>
Cc: Buchanan, Ira <[e-mail]>; Simpson, Alex [e-mail]>; Bostian, Scott
<Curtis.Bostian@arcad is.com>
Subject: RE: UIC Permit #W10400198 - Sulfate
See corrected email below.
From: Rogers, Michael
Sent: Tuesday, April 11, 2017 9.14 AM
To:'Goodell, Paul' <Paul.Goodel[@ rcadis.com>
Cc: Buchanan, Ira <[e-mail]>; Simpson, [e-mail]>; Bostian, Scott
<Cu rtis.Bostian@arcad is.com>
Subject: RE: UIC Permit #W10400198 - Sulfate
If the elevated sulfate is from injection activities, the site will need to be continued to be monitored until the sulfate
meets pre -injection or 2L standards. Then a Final Project Evaluation (or equivalent) needs to be submitted and reviewed
before the permit can be closed out and a completion letter sent.
From: Goodell, Paul ][e-mail]]
Sent: Monday, April 10, 2017 2:49 PM
To: Rogers, Michael <[e-mail]>
Cc: Buchanan, Ira rlra.BuchananC2arcadis.com>; Simpson, Alex <Alexandra.Sim son arcadis.com>; Bostian, Scott
<Curtis.Bostian arcadis.com>
Subject: RE: UIC Permit #W10400198 - Sulfate
Good afternoon Mr. Rogers,
I've been working on this site for a few months now and have had some time to familiarize myself with the Site history
and conditions. I would like to revisit the UIC permit (W10400198) associated with the former BP Facility #24163 located
in Winston-Salem with you.

In August 2011, the UIC permit was issued for the injection of sodium persulfate to remediate the historic petroleum
release that occurred at the Site. Two sodium persulfate injections were completed at the Site in June 2012 and June
2013. The sodium persulfate injections were successful at remediating the petroleum impacts. The UST Section
reduced the risk classification for the Site and issued closure of the groundwater incident on April 28, 2015. However,
post -injection dissolved -phase sulfate concentrations on the Site property have remained above the 2L Standard. As a
result the UIC permit is still open.
I understand that the 2L Standard is in place in order to prevent any threats to human health and to keep groundwater
sources suitable for drinking water use. However, as part of the closure process the UST Section required that a Notice
of Residual Petroleum (NGRP) be completed for the site property. The NDRP was recorded with the Forsyth County
Register of Deeds on March 18, 2015 and is attached- The NGRP imposed the following perpetual restriction [Page #6]
on the site property:
■ Groundwater from the site is prohibited from use as a water supply. Water supply wells of any kind shall not be
installed or operated on the site.
As we have an institutional control in place for the site property that is both protective of human health and which
prevents groundwater at the site property from being utilized as a drinking water source in perpetuity would this satisfy
the UIC Program and allow far closure of this permit? All dissolved -phase sulfate concentrations above the 2L Standard
are limited to the site property itself,
Thank you
Paul
Paul Goodell, E.I. ! AFS Project Manager 5 1_.
Arcadis I ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300, Raleigh, NC 127607 1 USA
T. [phone] M. + 1 845 857 4270
:. : Y 5 C:ru'.r-
From: Rogers, Michael[maiIto. [e-mail]]
Sent: Thursday, July 7, 2016 9:56 AM
To: Goodrich, David <david•[e-mail]>; Goodell, Paul <[e-mail]>
Cc: Buchanan, Ira <Ira.Buchanan arcadis.com>
Subject: RE: UIC Permit #WI0400198 - Sulfate
If the residual elevated Sulfate is a result of the injection activities, then the site needs corrective action and/or
monitoring until the sulfate returns to pre -injection or 2L standards. We cannot close out our permit and issue a
completion letter until these conditions are met. Call if you have any questions.
Michael Rogers, P.G. (NC & FL)
Underground Injection Control (UIC) Program Manager - Hydrogeologist
NCDEQ - DWR

Water Quality Regional ❑{aerations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6412
htt de .nc. ov about divisions water -resources water -resources- ermits wastewater -branch round -water -
protect o n/g ro a n d-wate r-a ppl icat i on s
From: Goodrich, David
Sent: Thursday, July 07, 2016 7:49 AM
To: Rogers, Michael <michael.ro ers ncdenr. ova
Subject: FW: UIC Permit #WI0400198 - Sulfate
Mike,
I am forewarding this to you, since it concerns a UIC injection permit.
Regards,
David
David Goodrich
Hydrogeologist II
North Carolina Division of Water Resources
North Carolina Department of Environmental Quality
919 807 6352 office
[e-mail]
512 North Salisbury Street
1617 Mail Service Center
Raleigh, NC 27699-1617
= —lNotbing Compares
Ernail correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
From: Goodell, Paul [mailto:Paut.Goodetl arcadis.comj
Sent: Wednesday, July 06, 2016 5:01 PM
To: Goodrich, David <david.goodrichftncd_enr.gov>
Cc: Buchanan, Ira <[e-mail]>
Subject: UIC Permit #€W10400198 - Sulfate

Good afternoon Mr. Goodrich,
This email is regarding the Former 6P #24163 located at 381 Knollwood Street in Winston-Salem. This site has the active
UIC Permit #WI0400198. Arcadis is taking over as the new consultant for the Site and I've been reviewing the
environmental records. From the records it appears that the NCDEQ UST Section closed the groundwater incident
number associated with the site in 2015. The NCDEQ classified the Site as "Low" Risk and compared all groundwater
COCs at the Site to the GCL standards.
The records also indicate that the previous consultant completed two sodium persulfate injections at the Site in 2012
and 2013. The latest sampling data that I have is from April 2015 which indicated detections of sulfate concentrations in
four groundwater monitoring wells above the groundwater quality standard (2L) for sulfate (250 mg/L). My question is
regarding the groundwater quality (2L) standard for sulfate that has been applied at the Site.
There are no water -supply wells located within 1,500-feet of the site and municipal water is supplied to all nearby
properties. As the NCDEQ has previously indicated that the Site is "Low" Risk and that groundwater CCCs at the site
should be compared to GCL shouldn't sulfate also be compared to the GCL standard? There currently is no established
GCL standard for sulfate and therefore additional groundwater monitoring and sampling would not be required.
If this recommendation is acceptable, Arcadis will proceed with moving forward in closing out this U I C Permit. The
groundwater incident associated with the Site is closed and no further chemical injections will be necessary.
Thank you.
Paul
Paul Goodell, E.I. 1 AFS Project Manager 5 1 _- .,! Goodell [e-mail]
Arcadis ) ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300, Raleigh, NC 1 27607 1 USA
T. [phone] M. + 1 845 857 4270
This a -mail and any files transmitted with it are the property of Arcadis. All rights, including without limitation copyright, are reserved. This a -mail contains
information which may be confidential and may also be privileged. It is for the exclusive use of the intended recipient(s). If you are not the intended
recipients) please note that any form of distribution, copying or use of this communication or the information in it is strictly prohibited and may be
unlawful. If you have received this communication in error please return it to the sender and then delete the e-mail and destroy any copies of it. Whifst
reasonable precautions have been taken to ensure no software viruses are present in our emails we cannot guarantee that this e-mail or any attachment
is virus -free or has not been intercepted or changed. Any opinions or other information in this e-mail that do not relate to the official business of Arcadis
are neither given nor endorsed by it.
This email and any files transmitted with it are the property of Arcadis and its affiliates. All rights, including without limitation copyright, are reserved This
email contains information that may be confidential and may also be privileged. It is for the exclusive use of the intended recipient(s). If you are not an
intended recipient. please note that any form of distribution, copying or use of this communication or the information in it is strictly prohibited and may be
unlawful. If you have received this communication in error, please return it to the sender and then delete the email and destroy any copies of it. While
reasonable precautions have been taken to ensure that no software or viruses are present in our emails, we cannot guarantee that this email or any
attachment is virus free or has not been intercepted or changed Any opinions or other information in this email that do not relate to the official business
of Arcadis are neither given nor endorsed by it.
This email and any files transmitted with it are the property of Arcadis and its affiliates. All rights, including without limitation copyright, are reserved. This
email contains information that may be confidential and may also be privileged. It is for the exclusive use of the intended recipient(s) If you are not an
intended recipient, please note that any form of distribution, copying or use of this communication or the information in it is strictly prohibited and may be
unlawful. If you have received this communication in error, please return it to the sender and then delete the email and destroy any copies of it. While
reasonable precautions have been taken to ensure that no software or viruses are present in our emails, we cannot guarantee that this email or any

attachment is virus free or has not been intercepted or changed. Any opinions or other information in this email that do not relate to the official business
of Arcadis are neither given nor endorsed by it.

Rogers, Michael
From:
Rogers, Michael
Sent:
Tuesday, May 29, 2018 4:32 PM
To:
'Goodell, Paul'
Subject:
W10400198
Paul -
We received the monitoring report for the above permit dated May 2, 2018. Thank you.
However, you request that MW-5R no longer be sampled because of sulfate below 2L in the last sampling event. We
request that there be two consecutive sampling events with concentrations below 2L to drop from monitoring
plan. Therefore, please include this well in the next event. It can then be dropped if next event shows levels below
ZL. If you have any questions, please advise.
Thank you for your cooperation.

b._I Ot_in01g6
A lanfic Richfield Company
�Frbch
0Pff2fi"Pfl*CtMWQW
October 23, 2015
Mr. Michael Rogers
DWQ - Aquifer Protection Section
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Re: Notification of Change of Address
for SP Products of North America, NA
Dear Mr. Rogers:
RECEIVEDIDENRIDWR
OCT 2 6 2015
Wager Quality Regtonal
Operations Section
1114 North Court 5t #125
Medina. OH 44256
Phone: [phone]
E-Wail: greg.frisch®bp.cam
In a continuing effort to keep you informed, please be advised that BP Products of !North America,
Incorporated, {BP) has relocated their office from Cuyahoga Heights, ❑hio, to Medina, Ohio. We request
that all records under your supervision be updated to reflect the new contact information, which is
effective immediately.
New Address: 1114 North Court #125
Medina, ❑H 44256
Attn: Greg Frisch
Telephone: [phone] ' C�► l C� Q t �}
UST Facility ID
Site ID
Site Address
city
URS Project
Manager
PM Contact
No.
6400
24163
381 Knollwood St
Winston-Salem
Jasen Zinna
919.461.1285
If you have any questions or concerns, please contact me at 330.421.1100, or our consultant, UR5, at the
numbers shown above.
Sincerely,
��l
Greg Frisch
Operations Project Manager
BP Products of North America, NA
iJ)
A BP affilLated comparry

March 26, 2013
UIC Program Staff
DWQ - Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
DWQ - Aquifer Protection Section
Winston-Salem Regional Office
585 Waughton Street
Winston-Salem, NC 27107
RE: Injection Permit WI0400198 Renewal Application
Former Knollwood Gulf Station (BP 24163)
381 Knollwood Street, Winston-Salem, NC
[IRS Corporation - North Carolina (URS), on behalf of Atlantic Richfield Company (ARCO), a BP
Products North America, Inc. affiliated company, requests renewal of Injection Permit WI0400198
for the Former Knollwood Gulf Station (BP 24163) in Winston-Salem, North Carolina.
An initial injection of activated sodium persfulate was performed at BP 24163 in June 2012 as
indicated in the Injection Event Record submitted to NDCDENR DWQ by URS in duly 2012.
Injection monitoring performed through September 2012 was presented in the Activated Sodium
Injection Persuljate Completion Report (URS, December 2012). Quarterly performance monitoring
events are ongoing. Monitoring results for events performed through February 2013 are presented
on the attached Table 1 and Table 2. A more detailed Serni-Annual Data Package is currently
being developed for submission to the NCDENR DWM UST Section and the DWQ Aquifer
Protection Section Regional and Central offices. A follow-up injection event, in accordance with
Injection Permit WI0400198, is planned for approximately May 2013.
If you require additional information or have any questions regarding this submittal, please contact
me at (919)461-I595.
Sincerely,
[]RS C�rporatia =North Carolina
Krouse, PE
Project Manager
Attachments: Injection Permit WI0400198 Renewal Application Form
Table 1 - Summary of Groundwater Analytical Results
Table 2 - Groundwater Field Parameter Results
cc: ENFOS, BP (electronic)
Project File (electronic)
Mr. Charles Sherren, Thruway Shopping Center, LLC. (electronic)
UFiS Corporation — North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
Tel: [phone]
Fax: [phone]
RECEIVERENR Dwo
MAR 27103
AquiferProtectio€1 Secoorl

North Carolina Department of Environment and Natural Resources
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation i Tracer Injection
Do not use this form for the following:
■ in situ remediation, tracer, or aquifer test injection wells permitted by rule [ref. 15A NCAC 02AROVEDIDERDWO
remediation systems that reinject treated contaminated groundwater (ref. 15A NCAC 02T .16
Application Number (to be completed by DWQ): MAR 2 7 10+J
I. APPLICATION INFORMATION Aquifer protection Section
1. Project is. [ ] New [ ] Modification [X] Renewal without modification [ ] Renewal with modification
2. If this application is being submitted for renewal or modification to an existing permit, provide:
existing permit number WI0400198 and the issuance date August 9, 2011
For renewal k4thout modifications, fill out sections I & II only, sign the certification on the last page of this forni, and obtain
the property owner's signature to indicate consent (if the applicant is not the owner).
For all renewals, submit a status report including monitoring results of all injection activities to date.
IL WELL OWNER (generally the responsible party)
1. Name: Atlantic Richfield CompanvBP Products North America Inc.
2. Signing Official's Name*: Greg Frisch Title:_ FM Operations Manager
* Signing Official must be in accordance with instructions in Part IX on page 5.
3. Mailing address of applicant: 4850 E. 49"' Street, MBC-3 Room 155C
City: Cuyahoga Heights State: NC Zip: 44125
4. Telephone number: 216-271-8740 Email: [e-mail]
5. Status (choose one): Individual X Business/Org. Federal State County Municipality
III. PROPERTY OWNER (if different than well owner)
1. Name:
2. Physical address:_
City:
3. Mailing address: —
City:
4. Telephone number:
State: Zip:
State: Zip:
III/. PROJECT CONTACT — Person who can answer technical questions about the proposed injection project.
1. Name: Title:
2. Company:
3. Address:
4. City:
5. Telephone number:
Email:
State: Zip:
Revised 10/8/2012 UIC-5115T Page l of 5

}If
X.
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Sitrt Groundwater Remediation I Tracer Injection
CERTIFICATION* (to be signed as required below or by that person's authorized agent*)
NCAC 15A 02C .021 I(e) requires that all permit applications shall be signed as follows:
1, for a corporation: by a responsible corporate officer
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or
ranking publicly elected official
4. for all others: by the well owner.
*If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant
that names and authorizes their agent.
"I hereby cerrify under penalty of' laiv that I have personally examined and am familiar with the information
submitted in this document and all attachments therein, and that, hared on my inquiry of those individuals
imrndiately responsible for ohlaining said information, I believe that the infnrutation is true, accurate, and
complete. 1 am aware that there are penalties, including the possibility of fines and imprisonment, for submitting
false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well(s)
and all related appurtenances in accordance with the approved specifications and conditions of the Permit- "
Printed Name Title: t -7Y=� [LS �� 4 Q�e-�Zf�nk o►-.3c,
Signature: Date: 2-6t 20rs
CONSENT OF PROPERTY OWNER (if the property is not owned by the permit applicant)
"Owner" means any person who Bolds the fee or other property rights in the well being constructed. A well is real
property and its construction on land shall be deemed to vest ownership in the land owner, in the absence of
contrary agreement in writing.
"fts owner of the property on which the injection well(s) are to he construcled and operated, 1 hereby consent to
allow the applicant to construct each injection well as oullined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection wells) conform to the Well Construction Standards
(Title 15A NCAC 02C . 0200). "
Printed Name and TitIe:(i0kA-4--r kv. S tIzE-V '1A. In x" BALL.. AA% !
so"-,Z CrA..rcA.
Signature: +—• Date!/lP�i Zir ZU%.?
Submit TWO copies of the completed application package, including all attachments, to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
RECEIVECICENRIDWO
MAR 2 7 2013
Aquifer Protection Section
Revised I018I2012 ujc-5It5,r Page 5 of 5

Table 1
Summary Groundwater Analytical Results
Former BP Service Station No. 24163
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
Well
Event
Sample Date
Benzene
Ethyl
benzene
MTBE
Toluene
xylenes
[Total]
Sulfate
Carboll
dioxide
NC GCL:
5.000
84.500
20.000
260.000
95.500
NE
NE
Units:
1
1
I
P g1l
MgfI
m
MW-03
6-months prior
10/31/2011
5.5
0.76
19.1
r 0.17 U
0.381
8.4
405
2-weeks prior
5/22/2012
E 0.43 U
E 0.2
4.6
< 0.2
< 0.52
15.3
378
1-week after
6/14/2012
12.1
6.7
15.4
0.72
4.7
6.6 J
344
1-month after
7/9/2012
2.2
1.6
14.7
2.6
3
9.9
393
2-months after
8/14/2012
2
2.1
17.9
E 0.13
0.4 J
3.6
303
3-months after
9/19/2012
2.7
0.66
19.8
< 0.13
0.33 J
2.8
459
6-months after
12/5/2012
11.3
1.2
19.3
0.431
L l J
t}.78 J
377
8-months after
2/26/2013
0.23 J
< 0.1
5.4
< 0.1
r 0.22
300
338
MW-05R
6-months prior
10/31/201 l
T960
2,660
3,830
28.000
13.800
< I
< 5
6-months prior
10/3112011 (1'
8,360
2,870
4.070
24.600
14,800
NR
NR
2-weeks prior
5/22/2012
7,980
3,470
3.820
32.200
19,200
< 5
179
1-week after
6/1512012 12)
244
227
36.9
1,190
I J 20
6.070
1.820
I -month after
7/9/2012
336 J
481 J
48.4 J
2.010 J
2.400 J
6.470
2.620
2-months after
8/14/2012
201
283
48.5
1.050
1.300
14.700
4,190
3-months after
9/19/2012
158
181
114
650
883
19,000
3,280
6-months after
12/5/2012
754
505
1.160
2.720
2.380
13.600
1.840
8-months after
2/26/2013
1.360
878
1,660
3.520
3,940
3.400
1.530
MW-08R
6-months prior
10/31/201 l
8,000
3,180
3.170
32,100
17,200
< 1
< 5
2-weeks Crior
5/22/2012
8,270
3,360
3.920
36,400 J
17.800
< 5
119
1-week after
611512012'`'
726
47 J
96.3 J
760
242 J
4,760
22.200
i-month after
7/9/2012
4,540 J
1,870 J
1.5301
17,1001
10.9001
6.570
1.500
2-months after
9/14/2012
4.370
1.610
1 2.000
193W)
8,780
7,010
1.560
3-months after
9/19/2012
4.780
1.800
2.600
20,900
10.400
6.700
1.100
6-months after
12/5/2012
7,760
2.440
4,560
31.900
13,800
2.110
635
8-months after
2/26/2013
7,310
2,480
4,530
30.500
13,400
883
590
MW-18
6-months prior
10131/2011
3,140
998
1,140
11.100
9.950
K2
446
2-weeks prior
5/22/2012
2.280
2.790
789
1 K '00
12,000
< 5
307
1-week after
6/15/2012 12'
373
910
114
4,800
3,910
10,600
3.410
]-month after
7/9/2012
1.7301
2.170 J
676 J
15,000 J
9,750 J
2,300
835
2-months after
8/14/2012
3.020
2,990
1,090
24.400
12.800
758
580
3-months after
9/19/2012
3,190
3,090
1,240
22,600
14.000
322
542
6-months after
12/5/2012
3,370
2.970
1380
20.100
12,800
32.2
436
8-months after
2/26/2013
2,510
2.970
1.140
10,100
8,690
3 l 1
500
NM -1y
6-months prior
10/31/2011
2,390
1.380
5.160
8.790
7.040
3.7
425
2 weeks rior
512J20121
2,700
1.560
4,880
14,200
7.940
5
310
1-week after
6/15/2012 ` '
4,020
1.440
3,290
18.200
7,940
1.090
6,520
l-month after
7/9/2012
2,910
5,330
30,400 J
16,300
232
991
2-months after
8/14/2012
2,420
1.650
4.090
14,200
8.370
469
1,080
3-months after
9/19/2012
1090
1.630
3.960
12.9[H]
8,640
260
690
6-months after
12/5/2012
1
2320
1.810
4.010
15,200
10,400
58.8
588
8-months after
2126/2013
2.210
1.110
3,890
1 10,600
6.990
590
503
Page l of 2

Table 1
Summary Groundwater Analytical Results
Former BP Service Station No. 24163
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
Notes:
Field duplicate
'' AIkaiinity_ sulfate, and carbon dioxide samples were collected 611412012 and volatile organic analysis sampics were collected W15112.
This table presents the results of all anal}tes. Sample results have been qualified by URS based on the results of the data review process. which is
modeled after the USEPA Contrart Laharatnrp Program (UP) National Fgamiarraf Gtrrdehnes (NFG) for Saperfiond Organic Merhadx Data
Review (EPA. June 2008) and USEPA CLP NFG frtr lm+rganie Superfund lktra Review (USEPA. Januan•2010).
Gross Contamination Levels, effective April t6. 2011 obtained From the NCDENR. Division of Waste Management. UST Section. A bold border
indicates the concentration is greater than the NC Gross Contamination Level.
<- Not detected at the specified detcci ion Iimlt GCL- Gros.~ Con1wnination Lercl
µgll - Micrograms per Liter MTB> - Methyl ten -Butyl Ether
mg/L - Milligrams per Liter NE - Not established
J - Estimated value NR - Not required
U - Not present above the associated Ievel; blank contamination exists
Page 2 of 2

Table 2
Groundwater Field Parameter Results
Former BP Service Station No. 24163
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
MW-3 (downgradient control)
Event
Description
Date
Sodium
Persulfate
DTW
pH
[?RI ,
Temp.
Specific
Cond.
DO
91L
feet
S.U.
mV
°C
mSlcm
mg1L
6-months prier
10/31/11
NM
I3.87
6.84
-72
22.04
1.171
3.2
2-weeks prior
05/22/12
0.07
13,55
7.13
-5.4
20.32
0.708
4.6
1-week after
06/ 14/ 12
ND
13.53
6.84
21.7
20.53
0.854
0.5
1-month after
07/09/12
ND
13.98
7.08
-7
21.42
0.753
3.6
2-month after
08/14/12
ND
14.24
7.02
-51.9
22.43
0.552
2.7
3-month after
09/19/12
0.07
14.08
7.00
-125.9
22.06
0.854
0.9
6-month after
12/05/12
NM
14.42
6.89
-66.6
2I.22
0.774
1.3
9-month after
02/26/12
NM
13.55
6.61
-72.5
16.30
0.573
1.3
MW-5R
Event
Description
l) Iti
Sodium
Persulfate
DTW
pH
ORP
Temp.
Specific
Cond.
DO
p(i.
feet
S.U.
mV
°C
mS1cm
mg/L
6-months prier
10/31/11
NM
13.97
4.89
185.6
22.00
0.123
1.7
2-weeks prior
05/22/12
ND
13.66
4.19
153.9
20.04
0.078
1.1
l-week after
06/14/12
ND
13.73
13.08
8.9
23.57
37.82
0.5
1-month after
07/09/12
ND
14.18
13.I0
39.9
22.42
35.02
7.2
2-month after
08/14/12
0.07
14.45
13.38
144.1
23.36
34.91
(),I
3-month after
09/19/12
ND
14.35
13.3+6
39.9
23.12
46.21
0.2
6-month after
12/05/12
NM
14.68
12.39
1.2
22.79
27.87
0.6
9-month after
02/26/ 12
NM
13.89
11.66
-44.7
1 15.14
1 16.44
l .2
MW-8R
Event
Description
Date
Sodium
Persulfate
DTW
pH
ORP
Temp.
Specific
Cond.
DO
9/L
Meet
S.U.
mV
°C
mSlcm
mg/L
6-months prior
10/31/11
NM
13.34
4.80
198.1
21.88
0.250
1.9
2-weeks prior
05/22/12
ND
13.69
4.59
250.4
19.80
0.158
0.8
1-week after
06114/ 12
32.18
14,94
13.32
17.2
22.80
194.5
17.16*
1-month after
07/09/12
8.4
14.08
13.38
116.7
21.56
68.5
32.85*
2-month after
08/14/12
3.64
14.29
13.09
171
21.75
20.15
42.28*
3-month after
09/19/12
0.665
14.08
12.74
123.9
21.92
19.1
13.97*
6-month after
12/05/12
ND
14.53
1 1 1.34
25.4
22.10
6.993
2.1
9-month after
02/26/12
NM
13.80
1 10.02
-59.2
15.35
2.298
0.7
P LSPV4hya WC'7.i1R i. Cif W $. �1{I KrxdM.J 5pa�tLS U Orl�wx�ksl 111yrt klenn lYfi.mNnM ]l V1C pam.1 RcrwA 14ryl-nn1T04n. lygavau.. mJ G"­ i
I of 2

Table 2
Groundwater Field Parameter Results
Former BP Service Station No. 24163
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
MW-18
Event
Description
Date
Sodium
Persulfate
DTW
pH
ORP
Temp.
Specific
Cond.
DO
g/-
feet
s.u,
my
°C
mSlcm
mglL
6-month prior
10/31/11
NM
13.95
6.86
12.9
22.47
0.117
2.4
2-weeks prior
05122/ 12
ND
14.10
6.20
30.7
21.43
0.001
3.0
1-week after
06/ 14/ 12
ND
13.61
13.12
5
21.06
54.11
0.3
I -month after
07/09/12
ND
14.05
11.92
40.4
21.29
10.05
1.2
2-month after
09/14/12
ND
14.43
10.89
- 35
22.59
2.533
0.2
3-month after
09/19/12
ND
] 4.34
11.09
-35
22.59
3.301
0.2
6-month after
12/05/12
NM
14.62
6,91
-68.1
22.85
0.859
0.7
9-month after
02/26/12
NM
14.07
6.11
-84.2
14.86
0.589
1.0
MW-19
Event
Description
hate
Sodium
Persulfate
DTW
PH
ORP
Temp.
Specific
Cond.
DO
g/L
feet
S.U.
mV
"C
m5/cm
ingfL
6-month prior
10/31/11
NM
13.75
5.37
190
21.81
0.193
3.9
2-weeks prior
05/22/12
ND
13.37
4.62
131.7
19.89
0.103
0.9
1-week after
06/14/12
6.615
13.39
13.30
-15.8
2I.57
117.8
22.38*
1-month after
07/09/12
ND
13.89
12.75
46.9
21.91
13.4
25.79*
2-month after
09/14/12
0.07
14.13
12.50
162
22.57
10.21
25.46*
3-month after
09/19/12
0.07
14.02
11.71
157
22.47
3.424
12.9*
6-month after
12105/12
NM
14.39
9.99
20.1
23.03
1.537
5.2
9-month after
02/26/12
NM
13.62
8.14
-41.9
16.85
1.511
0.8
Notes-
* Dissolved oxygen results above saturation (approximately 9.1 mgIL at 20°C) are considered to represent measurement
error and are not considered representative of actual dissolved oxygen concentration in groundwater. Error in
measurements for the sensor used. a steady-state polarographic sensor, can be caused membrane fouling and interference
gases, among other causes (YSI. 2009). The likelihood of measurement error from these sources may have been heightened
by the injection.
DTW - depth to water ND - Not Measured
ORP - oxidation reduction potential ND - Not Detected
DO - dissolved oxygen
g/L. - grams per liter
s.u. - standard units
my - millivolts
C - degrees Celsius
mSlcm - milIiSiemens per centimeter
mg1L - milligrams per liter
P'pP1?�yr.+.NY'L'il Ri CK W S.;91 1 D,4 k­04. hl-42I VVP~19­Amh­:T.hle Afrm" e. a.d SReph. rc+1 2 of 2

Lij
JUL 0 6 2011
July 5, 2011
UIC Program
Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
RE: Underground Injection Control (UIC) Permit Application
Former Knollwood Gulf Station (BP 24163)
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
NCDENR UST Section Groundwater Incident No. 6400
URS Project number: 38436651
UIC Program Manager:
Please find the enclosed two full copies of the completed UIC permit application for
injection of activated sodium persulfate to treat petroleum impacts within the subsurface
of the above referenced property. One of the two copies includes the original signatures
of both the applicant (Greg Frisch, Operations Manager for Atlantic Richfield
Company/BP Products North America, Inc. [ARCO]) and the property owner (Charles
Sherren Jr., Senior Vice President. and Manager for Thruway Shopping Centers, LLC.).
The application was completed by URS Corporation — North Carolina on behalf of
ARCO.
The Project Geologist's signature and seal below is included to confirm that the geologic
plans, reports, and documents included in this report were completed by or under the
direction of a licensed geologist.
If you have any questions regarding this submittal please do not hesitate to contact Caleb
Krouse at [phone].
Sincerely,
'o'�
UR Car ration — North C�=na ,�•►-�H CA y ••��
I-Er-AU
(?,t
El
Caleb Krouse, PE �: SEAL r : Paul Farris, PG � . S 10QR ; r
037432
Project Manager �� _�o�, Project Geologist p G+F���
Enclosures �i�"z .'�'Gtt1 y�.� ��''■p�frPE� sea4'-��.a
E�cc: Thomas Moore, l�L't� UST Section {hard copy}
ENFOS, BP (electronic)
Project File (electronic)
URS Corporation — North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NG 27560
Tel: [phone]
Fax: [phone]
P!1.B"r%ymANCt3143, CK, WS. 381 Knollwixid Siv=1J_0 Delivrrubk50:2 Final Deli vetab;oM,13 UIC%Copy of Cove; Leiter io BF Saul ku SilAoc

State of North Carolina
Department of Environment and Natural Resources JUL.D 6 2011
Division of Water Quality
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 5I Wells -- In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
• Do not use this form for rem ediation systems that extract contaminated groundwater, treat it, and reinject the treated groundwater.
• Submit TWO copies of the completed application and all attachments to the address on the last page of this fonn.
• Any changes made to this form will result in the application package being returned.
Application Number (to be completed by DWQ); L' C�4DO Iq'9
fill01001IMAalei 2Cf]N►►Ill1DNo
1. Applicant's Name (generally the responsible party):Atlantic Richfield Company/BP Products North America Inc.
2. Signing Official's Name*: Greg Frisch Title: RM Operations Manager* Signing Official must be in
accordance with instructions in part VI on page 7.
3. Mailing address of applicant: 4850 E. 49°s Street
MBC-3 Room 1 55C
City: Cuyahoga Heights State: OH Zip: 44125
Telephone number: 216-271-8740 Fax number: 216-271-8242
4. Property Owner's Name (if different from Applicant): Thruway Shopping Center, LLC
5. Property Owner's mailing address: 7501 Wisconsin Avenue. Suite 1500
City:
State: MD Zip: 20814-6522
6. Name and address of contact person who can answer questions about the proposed injection project:
Name: Caleb Krouse Title: Project Manager
Company: URS Corporation —North Carolina
Address: 1600 Perimeter Park Drive, Suite 400
City: Morrisville State: NC Zip: 27560
Telephone number: 919-461-1595 Fax number: 919-461-1415
Email Address: caleb.krouse (rr�,urs.com
IL PERMIT INFORMATION:
1. Project is: (New ( Modification of existing permit ( Renewal of existing permit without modification
( Renewal of existing permit with modification
2. If this application is being submitted for renewal or modification to an existing permit. provide:
existing permit number and the issuance date
For renewal without modifications, fill out sections I & If only, sign the certification on the last page of this
form, and obtain the property owner's signature to indicate consent (if the applicant is not the owner).
For all renewals, submit a status report including monitoring results of all injection activities to date.
Revised 6/09 UTC-5I/5T Page I of 7

n
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 51 Wells -- In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
INCIDENT & FACILITY DATA
FACILITY INFORMATION
1. Facility name: Former Knollwood Gulf Station BP 24163)
2. Complete physical address of the facility: 381 Knollwood Street
City: Winston-Salem County: Forsyth State; NC Zip: 27103
B. INCIDENT DESCRIPTION
1. Describe the source of the contamination: Subsurface release of gasoline on or before September 1983 from a
ruptured product line associated with the Site's UST system. The quantity of the release remains unknown. In
December 1990 four gasoIine USTs one 10.000 gal and three 6,000 ga1 and one 10.000 gal diesel UST were
closed_ Approximately 500 tans of soil containin -petroleum_hydrocarbons was removed from the Site during
UST closure. A second set of USTs, not believed to be associated with the contamination, were removed from the
Site in December 2004.
2. List all contaminants present in soils or groundwater at the site (contaminants may be listed in groups, e.g.,
gasoline, diesel, jet fuel, fuel oil, chlorinated ethenes, chlorinated ethenes, metals, pesticides/herbicides, etc):
Gasoline. diesel
3. Has LNAPL or DNAPL ever been observed at the site (even if outside the injection zone)?
{ Yes If yes, list maximum measured separate phase thickness
0.56
feet (MW-5&MW-8, 2001)
(No If no, list maximum concentration of total VOCs observed at site: ppb
4. Agency managing the contamination incident:
UST Section ( Superfund Section (including REC Program and DSCA sites)
[ DWQ Aquifer Protection Section ( Solid Waste Section
( Hazardous Waste Section ( Other:
Incident managers name Thomas Moore and phone number [phone]
5. Incident number or other site number assigned by the agency managing the contamination incident:
NCDENR Groundwater Incident Number 6400
C. PERMITS
List all permits or construction approvals that have been issued for the facility or incident. including those not
directly related to the proposed injection operation:
1. Hazardous Waste Management program permits under RCRA: NA
2. DWQ Non -Discharge or NPDES permits: NA
3. County or DEH subsurface wastewater disposal perm
IV. Other environmental permits required by state or federal law: NCDENR ❑WO Monitoring _ Well Permit
WM0400624
Revised 6/09 UIC-51/5T Page 2 of 7

APPLICATION FOR PERMIT TO CONSTRICT AND/OR USE A WELL(S) FOR INJECTION
Type 51 Wells — In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
INJECTION DATA
A. INJECTION FLUID DATA
1. List all proposed injectants.
NOTE: Any substance to he injected as a tracer or to promote in situ remediation must be reviewed by the
Occupational and Environmental Epidemiology Section (OEES) of'the Division oj'Public Health, Department of
Health and Human Services. Review the list of'aWroved ig ctants or contact the UIC Program to determine if
the injectants you are proposing have been reviewed by GEES.
Injectant: Sodium Persulfate (Na-)SOs]
Concentration at paint of injection: Approximately 40 e/L
Percent if in a mixture with other injectants: 15% Is wei ht = Na?S OS 1(H O + NaOH + Na-)S Og
Injectant: Sodium Hydroxide INa01.1)
Concentration at point of injection: Approximately t 7 IL
Percent if in a mixture with other injectants: 25% by weight = (NaOH) / (NaOH + H-)O)
Injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
2. Source of fluids used to dilute or chase the injectants listed above:
[ None
[ Municipal water supply
( Groundwater from private well or any well within 'IA mile of injection site
( Air
[ Other:
3. If any well within 'A mile of injection site, a private well, or surface water is to be used as the fluid source, supply
the following information:
a. Location/ID number of source: NA
b. Depth of source: NA
c. Formation: NA
d. Rock/Sediment type: NA
In Attachment C, provide a current, complete chemical analysis of the water from the source we11. including
analyses for all contaminants suspected or historically recognized in soil or groundwater on the site.
NOTE: If contaminated groundwater is to be used as the dilution or chase fluid. this is not the proper permit
application form. You must apply for a closed -loop groundwater remediation permit using y1mlication lbrin
G WRS.
Revised 6/09 U[C-5I/5T Page 3 of 7

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 5I Wells — lit Situ Groundwater Remediation 1 Type 5T Wells — Tracer Injection
B. PROPOSED OPERATING; PARAMETERS
1. Duration of Injection: 10 Days
2.
3.
4.
5.
6.
a. Maximum number of separate injection events: 3
b. Expected duration of each injection event:_ 10 Days
c. Expected duration between events (if more than one event): 90 Days
Injection rate per well: 1 gallons per minute (gpm)
Total Injection volume: 3.000 gallons per day (gpd); 30,000 gallons per event (if separate events)
Injection pressure: 0-50 pounds/square inch (psi)
Temperature at point of injection: 65 OF
Briefly describe how the above parameters will be measured and controlled:
The application apparatus will include a progressive cavity or air diaphragm pump with recirculating line to
moderate flow down below 5gpm. The injection manifold will also include a pressure gauge to monitor injection
pressure. It is possible that multiple points will be injected at any one time.
7. Estimated hydraulic capacity of the well: 10 gpm
C. INJECTION WELL CONSTRUCTION DATA
1. Injection will be via:
{ Existing well(s) proposed for use as an injection well. Provide the data in (2) through (6) below to the hest of
your knowledge.
{ X) Soil Borings (i.e. direct push) to be constructed for use as an injection well. Provide the data
in (2) through (6) below as proposed construction specifications.
2. Well Drilling Contractor's Name: Vironex
NC Well Contractor Certification number: 3027
3. Date to be constructed: Fall 2011 Number of borings: 40
Approximate depth of each boring (feet): 20
4. Screened interval/Injection interval of injection wells:
Depth: 10 to 20 feet below ground surface (il' i-nultiple intervals, indicate shallowest and deepest depth).
5. Well casing (NIA if injection is through direct push rods):
Type: ( PVC ( Stainless steel( Other: NA
Casing depth: to ft.
6. Grout (NIA if injection is through direct push rods):
Type: ( Cement
Grout depth:
( Bentonite ( Other: NA
to ft.
Revised 6109 UIC-5115'I Page 4 of 7

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 51 Wells — In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
V. ATTACHMENTS
Provide the following items as separate attachments with the given headings:
A. SITE ) IISTORY
Provide a brief description of the site history including:
(1 ) site usage historically and present.
(2) origin of the contamination,
(3) previous remedial action(s).
NOTE: G.S 89E-18 requiresv that any geologic plans, reports, or ducutrtenis in which the performance is related to the
public welfare or sajeguarding of the environment be prepared by a licensed geologist or subordinate tinder their
direction, G.S. 89E-13 requires that all drawings, reports, or documents involving geologic work prepared or approved
by a licensed geologist, or a subordinate tinder their direction. be signed and sealed by the licensed geologist.
B. ffYDROGEOLOGIC DESCRIPTION
Provide a hydrogeologic description, soils description, and cross section of the subsurface to a depth that includes the
known or projected depth of contamination. The hydrogeologic description shall include:
(1) the regional geologic setting;
(2) significant changes in lithology;
(3) the hydraulic conductivity, transm iss ivity, and specific yield of the aquifer to be used for injection. including a
description of the test(s) used to determine these parameters; and
(4) the depth to the mean seasonal high water table.
C. INJECTION FLUID COMPOSITION
Describe the chemical, physical, biological and radiological characteristics of each injectant. Attach the Material Safety
Data Sheet (MSDS) for each injectant. If a private well or a well within '/a mile of the injection site is used as the source
well, include chemical analysis of source fluid here.
D. INJECTION RATIONALE
Attach a brief description of the rationale for selecting the injectants and concentrations proposed for injection, including:
(1) goals of the injection project;
(2) explanation and/or calculations of how the proposed injectant volume and concentration were determined;
(3) a description of the reactions between the injectants and the contaminants present including specific breakdown
products or intermediate compounds that may be formed by the injection; and
(4) summary results of modeling or testing performed to investigate the injectant's potential or susceptibility to change
(biological, chemical or physical) in the subsurface.
E. INJECTION PROCEDURE AND EQUIPMENT
Provide a detailed description of all planned activities related to the proposed injection including but not limited to:
(1) construction plans and materials;
(2) operation procedures;
(3) a detailed diagram of the surface and subsurface portions of the system; and
(4) a planned injection schedule.
Revised 6/09 UIC-51/5T Page 5 of 7

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 51 Wells — In Situ Grots ndwater Remediation 1 Type 5T Wells — Tracer Injection
F. moNITORING PLAN
Provide a plan for monitoring the results of the injection, including:
(1) a list of existing and proposed monitoring wells to be used;
(2) a list of monitoring parameters and analytical methods to be used: and
(3) a schedule for sampling to monitor the proposed injection.
NOTE: The selected monitoring wells must be located so as to detect any movement of injection _ fluids, process hv-
products, or formation fluids outside the injection area or zone. The monitoring parameters should include the target
contaminants as well as secondary or intermediate contaminants which may result from the injection and other
parameters which mqv serve to indicate the progress of the intended reactions, such as pH. ORP, dissolved or}>gen, and
other electron acceptors and donors. The monitoring schedule should be consistent with the pace of the anticipated
reactions and rate of'transport ofthe irtfectants and contaminants.
G. WELL DATA
Provide a tabulation of data on all existing or abandoned wells within ''A mile of the injection well(s) which penetrate the
proposed injection zone, including, but not limited to, monitoring wells and wells proposed for use as injection wells,
Such data shall include a description of each well's use (water supply, monitoring, etc), total depth, screened or open
borehole depth interval. and well construction or abandonment record, if available.
H. MAPS
Attach the following scaled. site -specific maps:
(1) Area map based on the most recent USGS 7.5' topographic map of the area, at a scale of 1:24,000 and
showing the location of the proposed injection site.
(2) Site map including:
a. all property boundaries;
b. all buildings within the property boundary:
c. existing and proposed injection wells or well field(s)
d. any existing sources of potential or known groundwater contamination, including waste storage,
treatment or disposal systems within `'A mile of the injection well or well system:
e. all surface water bodies within `/a mile of the injection well or well system; and
f. all existing or abandoned wells within 'Amile of the injection well(s) which penetrate the proposed
injection zone, including, but not limited to, monitoring wells and wells proposed for use as injection
wells.
(3) Potentiometric surface map(s) including:
a. direction of groundwater movement
b. existing and proposed monitoring wells
c. existing and proposed injection wells
(4) Contaminant plume map(s) including:
a. the horizontal extent of the contaminant plume, including isoconcentration lines
b. existing and proposed monitoring wells
c. existing and proposed injection wells
(5) Cross -sections) to the known or projected depth of contamination, including:
a, horizontal and vertical extent afthe contaminant plume, including isoconcentration lines
b. major changes in lithology
c. existing and proposed monitoring wells
d. existing and proposed injection wells
Revised 5109 UIC-5115T Page 6 of 7

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 51 Wells — In Situ Groundwater Remediation 1 Type 5T Wells — Tracer Injection
VI. CERTIFICATION (to be signed as required below or by that person's authorized agent)
NCAC 15A 2C .0211(b) requires that all permit applications shall be signed as follows:
l . for a corporation: by a responsible corporate officer
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively
3, for a municipality or a state, federal, or other public agency: by either a principal executive officer or
ranking publicly elected official
4. for all others: by the well owner.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that
names and authorizes their agent.
I hereby certify under penalty of law that I have personally examined and am familiar with the information
submitted in this document and all attachments therein, and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate, and
complete. I am aware that there are penalties, including the possibility of fines and imprisonment, for submitting
false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well(s)
and all related appurtenances in accordance with the approved specifications and conditions of the Permit.
Printed Name "d Title; L�r —rrf f C� R*tt o � r��c,J�4� �ak," r�Cmmye-_
Signature:
Date:o�27'Zn! J ^
V11. CONSENT OF PROPERTY OWNER (if the property is not owned by the applicant)
("Owner " means any person who holds the fee or other property rights in the well being constructed. A well is
real property and its construction on land shall be deemed to vest ownership in the land owner, in the absence of
contrary agreement in writing.)
As owner of the property on which the injection well(s) are to be constructed and operated, 1 hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(Title 15A NCAC 2C .0200).'
� G A/ Vya A��
Printed Name and Title:
_ fin. ,1�j>9�v►����a�
r `1 S cNIC- 3") Ii1G-
Signature-, r— Date: A4/�Ge�'
S CM►� LJ .tiee� 7 S ►v��
CPiD,/ e,71 0,011
� �v Girl,
Submit TWO copies of the corr[pleted application package, including all attachments, to:
T
UIC Program
Aquifer Protection Section
North Carolina ❑ENR-DWQ �a�i
1636 Mail Service Center JUL
Raleigh, NC 27699-1636
Telephone [phone]
Revised 6/09 U[C-5115T Page 7 of 7

ATTACHMENT A — SITE HISTORY
1) Site Usage
The site is located on the eastern side of Knollwood Street, southeast of its intersection
with Interstate 40 Business in Winston-Salem, North Carolina. The site property is
approximately 0.5 acres, is covered by asphalt and concrete, and was formerly developed
as a retail fueling station/convenience store with gasoline, diesel, waste oil, and kerosene
underground storage tanks (USTs). One 10,000-gallon steel gasoline UST, three 6,000-
gallon steel gasoline USTs, and one 10,000-gallon steel diesel UST were removed from
the site in 1990. Three 10,000-gallon gasoline USTs, one 10,000-gallon diesel UST, and
one 550-gallon waste oil UST were subsequently installed at the site in approximately
January 1994 and continued operation until 2004. The remaining five USTs were
removed in 2004 and the site was razed. All UST systems have been removed from the
site and the property is currently used as a parking Iot for an adjacent shopping center.
Currently, eight Type II monitoring wells (MW-3, MW-5R, MW-6, MW-8R, and MW-
14 through N4W-17) and one Type III monitoring well (MW-6i) are located at the site.
2) Origin of the contamination
The North Carolina Department of Environment and Natural Resources (NCDENR)
issued groundwater incident number 6400 due to a subsurface release of gasoline that
occurred on or before September 1983 from a ruptured product line associated with the
site's UST system. The quantity of the release remains unknown. In December 1990, four
gasoline USTs {one 10,000-gallon and three 6,000-gallon} along with one 10,000-gallon
diesel UST were closed. Approximately 500 tons of soil containing petroleum
hydrocarbons was removed from the site during UST closure.
3) Previous Remedial Action(s)
The bulleted list below briefly summarizes remediation that has occurred onsite since
1985.
• July 1985: two monitoring wells installed and receptor survey conducted (no
receptors identified).
• 1985-1988: groundwater and light non -aqueous phase liquid (LNAPL)
recovery system installed between 1985 and 1988. This system recovered over
490,000 gallons of water and 308 gallons of LNAPL before it was deactivated
in 1991.
• January 1991: Soil sampling conducted around four underground storage
tanks. Four gasoline USTs (one I0,000-galIon and three 6,000-gallon) and one
TJRSP kOP1PlojecWNCT4163. CK. WS. 381 Knollwood Stseetl5.0 DellveiatAesi5.2 Fnal Dehver Nes14.12111C'Attachment A

diesel UST (10,000-gallon) were closed. Approximately 500 tons of soil
containing petroleum hydrocarbons was removed from the Site during UST
closure.
■ January 1992: a vacuum extraction system was installed and operated until
November 1994, when it was deactivated.
■ January 2005: Five USTs and two hydraulic lifts were removed from the site.
■ July 1985 — Present: Periodic groundwater monitoring has been performed at
the site by various environmental contractors. Most recently, URS has
performed groundwater monitoring and free LNAPL gauging events since
2003. LNAPL has not been detected at the site since 2004.
URSP 41PTrnlects+.MG124163. CIS. W-5, 381 KnoiNvoad Slreen5.0 Oel verables�5.2 Final Oeliyerable"-12 11IC1AttaCbmonl A 2

ATTACHMENT B — HYDROGEOLOGIC DESCRIPTION
1] Regional Geologic Setting
The site lies at an elevation of approximately 870 feet above mean sea level (ft amsl) and
is situated on a northeast -southwest trending ridge, which forms the southeastern limit of
the Little Creek drainage area. According to the North Carolina Geological Survey's
1985 Geologic Map of North Carolina, the site is located in the Milton lithotectonic belt
of the Piedmont physiographic province. Bedrock beneath the site is mapped as a
strongly foliated biotite gneiss and schist. Based on a review of boring logs, the surficial
geology beneath the site consists of sandy silts that grade upward to clayey silts and silty
clays. The maximum depth of investigation at the site has been approximately 55 feet
below ground surface (ft bgs); bedrock has not been encountered during any site
investigation work.
2) Significant Changes in Lithology
Based on site boring logs, subsurface materials at the site consist of soil and saprolite
overburden, including silty/clayey sand, sandy clay/silt, and silt/clay. The maximum
depth of investigation at the site has been approximately 55 ft bgs; bedrock has not been
encountered during any site investigation work. No significant lithology changes have
been observed within the interval studied. Cross -sections are provided as Figure 5a and
Figure 5b of Attachment H.
Groundwater in the Piedmont province occurs in the overburden under unconfined (i.e.,
water table) conditions, and in the underlying bedrock under both unconfined and
confined conditions. Groundwater in the overburden occurs within pore spaces of the
unconsolidated medium, including relict bedrock structures (i.e., fractures, foliations,
etc.). Due to the typical fine-grained nature and low permeability of saprolite, the
formation is not usually utilized for groundwater production.
UMP?,8RPrajecfs%NC12at63. CK. W-S, 361 Knollwond Street15.0 6eliveraWes%5.2 Final Deli verablesA-12 UICWnachmens 6 - Hydrogeology I

3) Hydraulic Conductivity, etc.
The following is a summary of results of the most recent, October 2010, hydraulic
conductivity (K) tests completed in various monitoring wells located in the source area
where injection is proposed:
SLUG TEST RESULTS
Well No.
Total Depth
(feet below grade)
Screen Interval
(feet below grade)
Hydraulic Conductivity
(feet per day)
Rising Head
Falling Head
MW-3
10.0
NA -NA
0.28
0.18
MW-5R
20.0
10,0-20,0
0.053
0.14
MW-6
25.5
10.5-25.5
0,31
0.32
MW-8R
20.0
10.0-20.0
0.086
0.069
M W-8R
20.0
10.U-20.0
0.077
0.086
Geometric Mean:
0.13
Results from slug tests performed in October 2010 on monitoring wells MW-3, MW-5R,
MW-6, and MW-8R were used to calculate hydraulic conductivities ranging from 0.053
to 0.32 feet per day. Depth -to -water measurements from May 27, 2010 indicate that site
groundwater flow is to the northwest with an apparent horizontal gradient of 0.011 feet
per foot (ftlft) from MW-14 to MW-17 and 0.012 ftlft between MW-15 and MW-16.
Assuming a conservative soil porosity of 20%, an approximate conductivity of 0.13 feet
per day, and a gradient of 0.012 ft/ft, the calculated groundwater seepage velocity for
shallow groundwater beneath the site is 2.8 feet per year:
(0.13 feet per day x 0.012 ftlft x 365 days per year) 10.2 = 2.8 feet per year
Transmissivity (T) and specific yield have not been determined for this site as pumping
tests have not been conducted.
(4) Depth to Mean Seasonal High Water Table
Based on historical measurements, the water table beneath the site has ranged f1,0111
approximately 10 to 16 feet bgs and typically exists at between 11 and 14 feet bgs.
UMPIBMPrajec1MNC124183. CK, W-S. 381 KnalWrood Slraet15.0 Deliverables15.2 Final Deliverables14.12 UICL41tarhment B - Hydrogeology 2

ATTACHMENT C — INJECTION FLUID COMPOSITION
The proposed remedy consists of the injection of activated sodium persulfate (ASP)
within the area of exceedences of petroleum impacts in groundwater at the site_ Among
all the persulfate salts typically manufactured (sodium, potassium, and ammonium salts),
sodium persulfate (Na2S208) is generally preferred in environmental remediation
applications due its greater solubility in water when compared to potassium persulfate
and due to the potential formation of ammonia gas associated with ammonium persulfate.
Sodium persulfate degrades petroleum hydrocarbons through both direct oxidation and
free radical formation. Sodium persulfate salts dissociate into the persulfate anion
(S2082-), which is itself a strong oxidizer with an oxidation potential of 2.12 volts (V).
Oxidation by the persulfate ion is most effective for a limited number of contaminants,
including benzene, toluene, ethylbenzene, and xylenes (BTEX), and is typically
kinetically slow which results in further distribution prior to decomposition. In most
recent applications, sodium pesulfate is "activated" through addition of a catalyst
(activator) that results in the production of the sulfate radical (SO4-), which is a stronger
oxidant with an oxidation potential of 2_6 V. The most commonly applied activators
include heat, ferrous iron, chelated metals, hydrogen peroxide, and alkaline (high pH)
chemistry.
The proposed remedy includes alkaline activation of sodium persulfate through the
inixing of sodium hydroxide (NaOH) and sodium persulfate with water prior to injection
to maintain target area geochemistry above a pH of approximately 10.5 during and
following injection. Alkaline ASP is a proven method of remediating petroleum
hydrocarbons.
The material safety data sheets (MSDS') for the sodium persulfate powder and sodium
hydroxide solution (25%) are attached. The sodium persulfate powder will be mixed
with municipal water and the sodium hydroxide solution to create an estimated injected
mixture concentration of approximately 15% sodium persulfate by weight.
Attachments:
Sodium Persulfate MSDS
Sodium Hydroxide MSDS
TinsPABRPraJeCMNCW41B3. CK. WS.381 KniAvoad Srsee115.0 Delivsrahlesl52 Final Detivarablesu4.12 U CAhachment C

ATTACHMENT ❑ - INJECTION RATIONAL
1) Remedial Goals and Injection Rational
The remedy objective at the site is to reduce the mass of chemicals of concern (COCs) in
saturated soil and groundwater such that dissolved -phase COC concentrations in
groundwater are reduced to below the North Carolina Department of Environment and
Natural Resources Underground Storage Tank Section Gross Contaminant Levels
(NCDENR UST Section GCLs). The proposed remedy consists of the injection of
Activated Sodium Persulfate (ASP) within the area of exceedences of the GCL for
benzene in groundwater at the site.
Four remediation alternatives, air sparging and soil vapor extraction (ASISVE),
excavation, monitored natural attenuation (N NA), and chemical injection were evaluated
based on exposure risk, feasibility, stakeholder acceptance, progress towards site closure,
sustainability, and cost. Based on this comparison, chemical injection was chosen as the
remedy for the site (note that excavation is not feasible mostly due to the proximity of
Knollwood Street to the targeted area). Chemical injection is anticipated to reach the site
cleanup goals in the safest and most cost effective manner. Activated persulfate was
chosen as the treatment media to be injected based on previous experience, anticipated
cost, site cleanup goals, and previous regulatory acceptance.
2) Contaminant 1 Injectant Reactions
Determination of the quantity of ASP required to reach remedial objectives at a site can
be initially estimated stoichiometrically utilizing soil and groundwater CGC
concentrations, the estimated soil treatment volume, and porosity. A calculation of the
treatment media required for the site is presented on Table 1. Required ASP quantities
are based on the oxidation demand of not only the site contaminant mass, but also
oxidation of soil organics within the soil matrix. An industry standard of one gram of soil
oxidant demand (SOD) per kilogram of soil was utilized for the calculation presented on
Table 1.
Alkaline ASP oxidation is not just a matter of high pH, but also of the buffering capacity
(mole ratio of pH modifier to persulfate). Consequently, excess buffering capacity,
including analysis of soil acidity, is a necessary component of the injection design
calculations (as shown on Table 1, a soil buffering factor of 1.5 was utilized to develop a
preliminary estimate of the required quantity of NaOfl). As indicated on Table 1, an
estimate of between approximately 11,000 and 29,000 pounds of sodium persulfate will
be required to oxidize the petroleum hydrocarbon mass within the area targeted for
treatment. Tentatively, a conservative estimate of 30,000 pounds of sodium persulfate
RSP:%8PSPeojeclslNG%24163. CI, W•S. 381 KnolNunod Sireat15.0 Deliaerabl%Z.2 Final Duliverablesl4-12 UIC1Att8chmW D I

along with approximately 5,500 gallons of sodium hydroxide activator will be assumed
for planning purposes. Assumptions utilized to calculate these values are presented on
Table 1_ Additional field investigation performed during the injection event, including
SOD analysis, NaOH buffering analysis, and additional soil petroleum hydrocarbon
analysis will be utilized to refine this estimate.
Injection volume calculations are presented on Table 2. Injection is anticipated at a rate
of approximately one gallon per minute (gpm) per well (flow rate will be dependent on
aquifer acceptance but is estimated based on previous experience with similar geology).
Sodium persulfate will be diluted with water and the 25% sodium hydroxide solution
prior to injection. Based on preliminary values calculated from available data, the
required sodium persulfate mass should be diluted to 15% prior to injection resulting in a
total sodium persulfate mixture injection volume of approximately 18,700 gallons. This
design total mixture volume represents the approximate penetrable (mobile) pore space
within the targeted treatment area. The calculated mobile pore space is based on an
estimated mobile porosity of 10% and represents the interconnected pore space within the
treatment area anticipated to be filled with the ASP mixture during injection. Assuming
32 injection locations, approximately 580 gallons will be injected into each injection
location in one -foot intervals between 10 and 20 feet below ground surface (ft bgs)
(approximately 58 gallons per one -foot interval).
3) Summary of Modeling 1 Pilot Testing
A membrane interface probe (MIP) system will be utilized prior to the injection to
confine the treatment area and injection interval. The MIP is a direct push technology
(DPT) drill tool that heats the soil, water, and vapor inatrix as it is driven into the ground
in order to extract and analyze volatile organic compounds (VOCs) within the subsurface.
Subsurface VQCs are extracted across a permeable membrane and carried to the surface
by an inert purge gas through small diameter tubing within the drilling rods. The tubing
transports the VQCs into a mobile analyzer inclusive of a photo -ionization detector
(PID), [lame ionization detector (FID), and electron capture detector (ECD), allowing for
identification and relative quantification of a range of volatile compound categories. The
MIP tool also includes an integrated soil electrical conductivity (EC) probe to indicate
relative penmeability of soils in order to identify potential pathways for subsurface CRCs.
The MIP tool will be driven to approximately 25 feet bgs at approximately five locations
to develop a conceptual three-dimensional estimate of the extent of source area soil and
groundwater. The results will not likely effect the overall petroleum hydrocarbon mass
estimate but will help define the vertical interval targeted for treatment and will help
isolate potential areas of concentrated petroleum hydrocarbon mass. If identified, these
Uiw P �SFyWfo*NWCti24163, CK, W-S. 361 Knollwcwd &reet+5.0 DehverablaV5.2 Final DeliveraWar.%4.12 UCAttachment D 2

s
areas may warrant concentrated sodium persulfate injection (i.e. greater than 58 gallons
per foot).
A DPT rig will be utilized to install a temporary direct push one -foot well screen with
riser similar to the injection tool planned for sodium persulfate injection. The injection
tool will be utilized to inject clean water at approximately one -foot intervals between 10
and 20 feet bgs in order to evaluate the site aquifer characteristics relevant to chemical
injection. The achievable injection rate will be utilized to facilitate planning of the ASP
injection event. The water injection testing will be conducted at two locations. Injection
of water to determine aquifer characteristics is deemed permitted per North Carolina
Administrative Code (NCAC) Tide 15A Subchapter 2C .0211 (u) (3).
The reactive properties of sodium persulfate at petroleum impacted groundwater sites has
been studied extensively. Sodium persulfate degrades petroleum hydrocarbons through
both direct oxidation and free radical fonnation. Sodium persulfate salts dissociate into
the persulfate anion (S2Og2-), which is itself a strong oxidizer with an oxidation potential
of 2.12 volts (V). Oxidation by the persulfate ion is most effective for a limited number
of contaminants, including benzene, toluene, ethylbenzene, and xylenes (BTEX), and is
typically kinetically slow which results in further distribution prior to decomposition. In
most recent applications, sodium pesulfate is "activated" through addition of a catalyst
(activator) that results in the production of the sulfate radical (SO4"), which is a stronger
oxidant with an oxidation potential of 2.6 V. The proposed remedy includes alkaline
(base) activation of sodium persulfate through the incorporation of sodium hydroxide
(NaOH) prior to injection to maintain target area geochemistry above a pH of
approximately 10.5 during and following injection. Buffering capacity at the site will be
further analyzed by site specific NaOH buffering.
Oxidation of soil organics and site contaminant mass will produce carbon dioxide,
sulfate, and hydrochloric and sulfuric acids. In addition to oxidation of contaminant mass
by persulfate anions and the sulfate radical, the resulting increase in sulfate is anticipated
to enhance biodegradation of petroleum hydrocarbons in the subsurface by providing
electron acceptors for sulfate reducing znicrorganisms.
Attachments:
Table 1 Treatment Media Mass Calculation
Table 2 Injection Volume Calculations
XTRSP:%8RProjec1s%NCT4163, CK, WS. 381 KnoNwood Stree15.0 DOYerableM5.2 Final Delwerahles*12 VICWGachmant 0 3

Table 1
Treatment Media Mass Calculation
Activated Sodium Persulfate Injection
SP 24163, Winston-Salem, NC
Assumptions
Definition
Value
Units
Source
Treatment Area =
2,500
square feet
Attachment H
Treatment Interval =
10
feet
Attachment H
Soil Density =
50
kg/fe
typical
Effective porosity=
30%
conservative assumption
Sodium Persulfate SOD =
1
Ikg
www.envsolutions.fmc.com
NaOH Persulfate Demand =
0.1267
gal. 25% NaOH
per pound
ersultate
www.envsolutions.frnc.com
NaOH - Soil Buffering Factor =
1.5
preliminary assumption
Design Concentrations :
Groundwater
(ug1L)
Soil,
(mg/kg)
Benzene
8,570
0.42
Toluene
31,700
7
Eth Ibenzene
2,870
11
x lenes
15,700
35
methyl tert-bu I ether
6,260
0.17
1,2,4-trimeth Ibenzene
2,040
NA
Ali hatics C5•C8
67,200
NA
Ali phatics C9-C 12
24,400
NA
Aromatics C9-C10
1 6,440
1 NA
Page 1 of 3

Table 1
Treatment Media Mass Calculation
Activated Sodium Persulfate Injection
BP 24163, Winston-Salem, NC
Calculations
Definition
Value
Units
Treatment Area Volume =
25,000
cubic feet
Soil mass =
1,250.000
killa rams
Groundwater Volume =
212,325
liters
Persulfate SOD =
2,756
ounds
Groundwater Contaminant Mass and Associated Persulfate Oxidant Demand:
Petroleum
Hydrocarbon
Mass
(kg)
Petroleum
Hydrocarbon
Mass
(Ibs)
Persulfate
Oxidant Demand
(lb per lb)
Persulfate
Oxidant Demand
(Ibs)
Benzene
1.8
4.0
46
185
Toluene
6.7
14.8
41
608
Eth lbenzene
0.6
1.3
43
58
}[ lenes
13
7.3
47
345
methyl tert-butyl ether
1.3
2.9
41
120
1,2,4-trimeth lbenzene
0.4
1.0
36
34
Total
1 14.3
1 31.4
NA
1,351
Alternate Groundwater Contaminant Mass and Associated Persulfate Oxidant Demand':
Oxidant
Persulfate
Mass
Mass
Demand'
Oxidant Demand
(kg)
(Ibs)
(lb per lb)
(Ibs)
Ali hatics C5-C8
14.3
31.5
52
1636
Ali hatics C9-C12
5.2
11.4
52
594
Aromatics C9-C10
1.4
3.0
45
136
Soil Contaminant Mass and Associated Persulfate Oxidant Demand:
Mass
(kg)
Mass
(Ibs)
Persulfate
Oxidant Demand
(lb per lb)
Persulfate
Oxidant Demand
(Ibs)
Benzene
0.5
1.2
46
53
Toluene
8.8
19.3
41
791
Eth lbenzene
13.8
30.3
43
1303
X lenes
43.8
96.5
47
4533
methyl tert-butyl ether
0.2
6.5
41
19
Total
67.0
147.7
NA
6,700
Alternate Soil Contaminant Persulfate Oxidant Demand4:
Groundwater Oxidant Demand x 10 = 1 23,653 pounds
Total Persulfate Oxidant Demand
Total Persulfate Oxidant Demand =
1 10,806
pounds
Conservative Total Persulfate Oxidant Demand =
1 28,774
pounds
NaOH Demand (25% solution)
NaOH Persulfate Demand = 3,646 gallons
Total NaOH Demand = 5,468 gallons
Page 2of3

Table 1
Treatment Media Mass Calculation
Activated Sodium Persulfate Injection
SP 24163, Winston-Salem, NC
Notes
1.) Groundwater concentrations based on concentrations detected in a sample collected from MW-SR on May 27,
2010.
2.) Soil concentrations based on concentrations detected in a sample collected at SS-14 at an interval of 14 to 15
feet below ground surface on November 16, 2009 (highest concentrations historically detected in saturated sail).
3.) The alternate groundwater contamination persulfate oxidant demand utilizes Massachusetts Department of
Environmental Protection (MADEP) volatile petroleum hydrocarbons (VPH) and extractable petroleum
hydrocarbon (EPH) range concentrations to determine the petroleum contaminant mass. Persulfate oxidant
demands for aiiphatics CB-C8, aliphatics Cg-Cl2, and aromatics C9-C10 are based on stoichiometric analysis
using surrogate compounds octane, dodecane, and total 6TEX, respectively,
4.} Alternate soil contaminant persulfate oxidant demand utilizes the industry standard 'Yule of thumb" that soil
contaminant mass is approximately 10 times the dissolved phase groundwater contaminant mass (based loosely
on soil -water partitioning theory).
5.) The conservative total persulfate demand is the sum of the alternate soil contaminant persulfate oxidant
demand and alternate groundwater cantaminant persulfate oxidant demand and represents an estimate of the
persulfate demand based on the most conservative assumptions.
-NaOH persulfate demand is based on the conservative total persulfate demand.
-Because the remedial objective for the site does not require degradation of all of the contaminant mass and
because conservative assumptions were utilized throughout, a factor of safety was not added to the preliminary
calculated persulfate demand.
-SOD: Soil Oxidant Demand
-SOD is an industry standard preliminary assumption.
Page 3of3

Table 2
Injection Volume Calculations
Activated Sodium Persulfate Injection
BP 24163, Winston-Salem, NC
Assumptions
Definition
Value
Units
Source
Treatment Area Volume =
25,000
cubic feet
Attachment H
Mobile porosity =
10%
conservative assumption'
Number of Injection Locations =
32
Attachment H
Injection Location Vertical Interval Height =
10
feet
Attachment H
Total Persulfate Oxidant Demand =
28,774
pounds
Table 1
Total NaOH Solution 25% Quantity =
5,468
gallons
Table 1
Density of NaOH Solution 25% =
10.61
lbsl al
www.envsolutions.fmc.com
Density of Water =
8.345
lbsl al
Sodium Persulfate Crystal Specific Gravity =
2.59
www.envsolutions.fmc.corn
Calculations
Design Total Injection Mixture Volume = mobile porosity x treatment area volume =
18,700
gaflons
Sodium Persulfate 100% Mixed Volume =
1,331
gallorls
Calculated Design Persulfate Dilution Water Volume =
17,369
gallons
Calculated Design Persulfate Dilution Water Mass =
157,328
pounds
Design Mixture Dilution Percentage' =
15%
Injection Volume per In-ection Location = 1 584 gallons
Injection Volume per Injection location Vertical Foot = 1 58 gallons
1.) The mobile porosity is conservatively estimated to represent soil pare volume available for injection.
2.) Note that the dilution water includes the NaOH 25% sotution.
3.) Dilution percentage = persulfate mass 1 (persuifate mass + dilution water mass)
-A design total injection mixture volume equal to the estimated mobile pore volume is utilized to ensure that: 1.j enough pore
space is available tar injection (avoid daylighting of treatment material) and 2.) the treatment media is injected into and reacts
within the area targeted for treatment and is not pushed into pore space outside of the targeted area.
Page 1 of 1

ATTACHMENT E -- INJECTION PROCEDURE AND EQUIPMENT
1) Construction Plans & Materials
URS proposes to inject activated sodium persulfate (ASP) solution (see attached map in
Attachment H). The treatment area is approximately 2,500 square feet with the
advancement of an estimated 32 borings within the area. Spacing of the points will be in
grid pattern (i.e_ offset rows with approximately ten foot spacing between each point).
Borings are to be advanced between approximately 10 and 20 feet below ground surface
(ft bgs). A direct push technology (DPT) drill rig will be used as a delivery platform. A
"top down" injection method will be utilized in which ASP is injected one foot at a time
between approximately 10 feet bgs and 20 feet bgs (injection intervals may change based
on conditions observed in the field). An injection manifold inclusive of quick connect
couplings, a ball valve, and a pressure gauge will be attached to the top of the DPT rods.
Concurrent with the DPT advancement, a sodium persulfate and 25% sodium hydroxide
solution will be diluted and mixed with potable water to approximately 15% sodium
persulfate prior to injection.
2) Operation Procedures
The injection system will be a contractor supplied temporary mobile system. Chemically
compatible components (i.e. stainless steel or polyvinyl chloride (PVC)) consist of a
dilution tank with mechanical mixers, product pump, metering and measuring system and
affiliated conveyance hose. The application apparatus will include a progressive cavity
or air diaphragm injection pump with recirculation line to modulate flow to below five
gallons per minute (GPM). The injection pressure will be monitored at the injection
manifold through pressure gauges.
The mobile system will be equipped with tanks for mixing the injection solution.
Municipal water will be used for the solution mixing. The solution will be injected at
ambient temperatures. High pressure hose will extend from the mixing tank, to the
injection pump, to the injection. A pressure gauge, shut-off valves, and pressure bleed -
off will also be installed in -line. Injection will be performed using either a progressive
cavity or air diaphragm pump, injection pressures may range from 0 to 50 pounds per
square inch (psi) and injection flow rates are estimated to be approximately one GPM per
injection point. The injection pressure will be monitored continuously using a pressure
gauge and the injection rate will be adjusted using the injection pump and valves. After
injection, the injection pump will be turned off and the shut-off valve will be closed.
XTRSP %BMProjecN%NCQ4163, CK. W-S, 381 Knoihoaod SlreeM 0 Deilverabies15.2 Final DehveradlasA.12 UICIAtladirnent E I

3) Diagrams & Figures
See the attached figure in Attachment FI for the proposed area of injection. A diagram of
the mobile injection system is included in this attachment.
4) Planned Injection Schedule
It is anticipated that the injections will take place in Fall 2011, pending Underground
Injection Control (UIC) permit and Corrective Action Plan (CAP) approval by the North
Carolina Department of Environment and Natural Resources (NCDENR).
Approximately 94 days following the first injection event, groundwater samples will be
collected from MW-3, MW-SR, MW-8R, MW-18, and MW-19. Following receipt of the
first post -injection groundwater sampling results, the need for a second ASP injection
event will be evaluated. Should a second event be deemed necessary the event will be
performed as soon as is feasible following the determination. The second event will
include injection of approximately one-half of the ASP quantity injected during the first
event.
Following the second ASP injection event, if applicable, groundwater sampling will be
completed approximately every 90 days (quarterly) until all samples analyzed show
chemical of concern (CDC) concentrations below the gross contaminant levels (GCLs)
for three events in a row (including the initial post -implementation groundwater sampling
event, as applicable). Each of these events will include sample collection at MW-3, MW-
5 R, M W-8R, M W-18, and MW-19. Due to the remedial goals for the site, a third
injection event is not anticipated to be required. However, if further groundwater
monitoring indicates persistent contaminant concentrations such that additional injection
is warranted, a third injection event would be conducted.
Attachments:
Mobile Injection System Diagram
irRS PABRProjectMN024163, CK. WS.381 Knollwood Slreet15.0 DLHverables15.2 Final DallvevabVsA-12 UICWtlaOrnenl E 2

MOBILE INJECTION SYSTEM DIAGRAM
Flow Meter
Pressure Gauge [5x)
Flow Meter 5:x
Injection Manifold
Injection Pump (Moynoj
Pressure Gauge
Flnw Meter

ATTACHMENT F - MONITORING PLAN
1) Monitoring Well Installation and Baseline Groundwater Sampling Event
Two additional permanent monitoring wells, MW-18 and MW-19, are proposed for the
purposes of monitoring the performance of the activated sodium persulfate (ASP)
injection remedial action. Proposed well locations are shown on Figure 2b in Attachment
H. The wells are positioned to provide monitoring points near the boundary of gross
contaminant level (GCL) exceedences in groundwater and will be utilized in combination
with MW-5R and MW-8R to monitor the ASP injection effectiveness in achieving the
site remedial objectives. The wells will be installed by a North Carolina licensed driller
using a hollow stem auger (HSA) drill rig following receipt of an approved monitoring
well installation permit by the North Carolina Department of Environment and Natural
Resources' (NCDENR) Division of Water Quality (DWQ). The wells will be constructed
of two-inch diameter polyvinyl chloride (PVC) riser from 10 feet below ground surface
(ft bgs) to ground surface with 0.01-inch slotted PVC screen from 20 feet bgs to 10 feet
bgs.
Following well installation and development, a baseline groundwater sampling event will
be performed and will include sample collection at all site monitoring wells. Samples
will be submitted for analysis for benzene, toluene, ethylbenzene, and xylerles (BTEX)
and methyl tert-butyl ether (MTBE) by EPA Method 620013, sulfate by EPA Method 300,
and carbon dioxide by EPA Method 4500-CO2. The results of this analysis will provide a
baseline for site groundwater concentrations prior to ASP injection. Samples collected
from wells MW-5R, MW-8R, MW-18, and MW-19 will also be analyzed for total
petroleum hydrocarbons gasoline range organics (TPH-GRO) and total petroleum
hydrocarbons diesel range organics (TPH-DRO) by SW-846 Method 8015. This
additional analysis will be utilized to refine the groundwater contaminant mass and
associated persulfate oxidant demand estimates presented on Table 1 in Attachment D.
Field water quality parameters, including p1l, specific conductivity, oxidation-reduction
potential (ORP) and temperature, will be collected and recorded for each well sampled.
2) Post -Implementation Groundwater Monitoring
A groundwater sampling event will be performed approximately 90 days after the
completion of ASP injection and will include sample collection at MW-3, MW-5R, MW-
8R, MW-18, and MW-19. Samples will be submitted for analysis for BTEX and MTBE
by EPA Method 6200B, sulfate by EPA Method 300, and carbon dioxide by EPA Method
4500-001. Field water quality parameters will also be collected and recorded for each
well sampled. The results of this event will be used to determine if a second ASP
P.43P1ProjecWN024163, CK, WS, 3a1 Knoftood StreetZ-0 De7iverableMS-2 Final Deliverablesw 12 UCtAgllchment F

injection event is necessary at the site. if a second ASP injection event is determined to
be necessary, further groundwater sarnpling will be delayed until approximately 90 days
following the second injection event.
Following the initial past -implementation groundwater sampling event, or following the
second ASP injection event, groundwater sampling will be completed approximately
every 90 days (quarterly) until all samples analyzed show chemical of concern (COC)
concentrations below the GCLs for three events in a row (including the initial post -
implementation groundwater sampling event, as applicable). Each of these events will
include sample collection at MW-3, MW-5R, MW-8R, MW-18, and MW-19 with
analysis BTEX and MTBE by EPA Method 6200B, sulfate by EPA Method 300, and
carbon dioxide by EPA Method 4500-CO2. Field water quality parameters will be
collected and recorded for each well sampled. After three events are completed without
GCL exceedences, a final sampling event will be completed. The final sampling event
will include collection of samples at all site monitoring wells with analysis for the
NCDENR Underground Storage Tank (UST) Section Required Target Volatile Organic
Compound (VOC) Analytes by EPA Method 6200B, the NCDENR UST Section
Required Target Semi -Volatile Organic Compound (SVOC) Analytes by EPA Method
625, ethylene dibromide (EDB) by EPA Method 504.1, and aromatic and aliphatic
hydrocarbons by Massachusetts Department of Environmental Protection (MADEP)
volatile petroleum hydrocarbon (VPH) and extractable petroleum hydrocarbon (EPH)
analysis.
11 M P %BPWrojecWNM2d463. CIS W S. 381 KnalMrood StreeR5.0 QeWerables%5.2 Final DeliverMlesW.12 UICl Wdiment F 2

ATTACHMENT G — WELL DATA
As indicated in the Additional Investigative Activities Report completed by Conestoga -
Rovers and Associates (CRA) in 2000, based on agency records and field reconnaissance,
no private potable water wells were identified within a 1,500-foot radius of the Site.
During a visual inspection of area properties, CRA found no evidence (i.e., presence of a
well pump house, absence of a water meter, etc.) of private potable water wells. During
April 2011 visual inspection of area properties, URS also found no evidence of private
potable wells. According to the Forsyth County Health Department each resident and
business in the area is serviced with city -supplied potable water. The Winston-Salem
Utility Department supplies public potable water for the site and surrounding area.
Winston-Salem has three municipal water intakes, two located on the Yadkin River,
approximately 7.4 miles southwest of the site, and the other on Salem Lake,
approximately 5.1 miles east of the Site (as indicated by the Additional Investigative
Activities Report, CRA, 2000).
An email was sent by URS to the Forsyth County Health Department on June 13, 2011,
requesting verification that no water supply wells are located in close proximity to the
site. Mr. Heath Snow (336-703-3154) of the Forsyth County Health Department's
Environmental Health Division followed up with a telephone call on June 14, 2011
indicating that no water supply wells are located within 1,500 feet of the site according to
available Forsyth County Health Department Well Records.
Several monitoring wells have been installed at the site for the purposes of monitoring
petroleum hydrocarbon impacts. A list of available information for current and
abandoned wells is provided on Table 1. Available construction and abandonment logs
are also attached. The locations of current and known abandoned wells are illustrated on
Figure 2b of Attachment H.
Attachments:
Table 1: Well Construction Details
MW-5 and MW-8 Well Abandonment Records
MW-511 and MW-8R Well Construction Records
iJIMP:kBIVrajeds%NCl24163, CK W-S, 381 Knoftwood Sireo".0 Cloliverables152 Final 0e11verablesA.12 UICW UchmenlG 1

Table 1
Summary of Well Construction Data
Former BP Service Station No. 24163
381 Knollwood Street
Winston-Salem, Forsyth County, North Carolina
Well
Status
Well
Tyne
TUC
Elevation I2'
Total
Depot lu
Well
Diameter finches)
Screen
Interval nF
Avg Screen
Elevation `2'
MW- 3
In L "Ic
Type I1
99,03
20
2
CIA - NA
N A
MW-5
Abandoned
Type 11
99.39
25.5
4
10.5 25.5
81.4
MW-5R
In Use
Type II
NS
20
-
10 - 20
NA
MW-b
In Use
Type 11
98.58
25.5
-t
111.5 - 25.5
80.7
MW-6i
In Use
Type ill
99.26
55
2
7l1 ;5
46.8
MW-8
Abandoned
Type II
97.84
24
6
NA NA
NA
MW-8R
In Use
Type Il
NS
20
2
11) - 20
NA
MW-14
In Use
-type II
100.44
22 1
4
7 22
85.9
MW-15
In Usc
Type Il
99.91
72
4
7 22
85.4
MW-16
In Use
Type 11
97.42
25
2
10 25
79.9
MW-17
In Use
Type 1I
100,00
22
4
7 2-)
85.5
Notes:
I - Reported in feet below grade
2. Measured in feet relative to site datum
4. Conestoga Rover and Associates, a former supplier for this Site, previously reported that no reference was found to the following wells. MW-I, MW-9. MW-10, MW-1 I. MW-12 or MW-13.
These wells are presumed to be abandoned.
3. URS Corporation is not responsible for data generated by others. Data included on this table not generated by
or on behalf of URS Corporation - North Carolina (URS) has been taken from documents prepared and submitted to the NC ❑ENR by Others and
is included only for ease of reference; URS does not assume or accept any responsibility or liability for the quality, accuracy, or completeness of
the data included on this table that was not generated by or on behalf of URS.
4. Monitoring wells MW-5 and MW-8 were abandoned on 5119t2010 and replaced with monitoring wells MW-5R and MW-8R the same day.
NA = Not Applicable 1 Available
NS = Not Surveyed
TOC = Top of Casing
PABRPro)ft%WCl?d Ih3, K W-S. 3H i Knullwood StrecAA.0 RepnrL%W.12 t11CWuachm m G • We➢ DataUjhL- I WA% Ccmur [Table 1 W1312011 Io^9 AM

+MILL ABANDQ�1 CQRi
Barth Carolina Department of EnvironmenI and Natural Res urues. Division of Water Quality
WELL. CONTRACTOR CERTIFICATION # E. 5 5 [ n -
L WELL CONTRACTOR:
Mad Cawg, Inc. _
We [I Contractor (Individual) Name
Roland Dean 8 ant
Well Contrac tor Company Xame
sTREET ADDREss PO Box 398
iron Station NC 28080
City or Town Stare Zip Code
7[ 04 _) _ 732-02I 3
Area code - Phone number
Z. W19LI.INFORMATION-
SrrE WELL ID N (if applicable) Ao�-
STATE WELL PERFAR N (if applicable)t4l.1�4
COUNTY W ELL PERMIT Ir (if applicable)
DW Q or OTHER PERMrP 4 (ifapplicable) '6olk
WELL USE (Check applicable use): JB Monitoring ❑ Residential
❑ Muoklpol/Poblie ❑ ImdustriaYCnmmerela! © Agricultural
Pi Recovery [] injection ❑ Irriiadaa
❑ Other (lift use) —
3. WELL LOCATION:
COUNTYF�0'91j,[�� QUADRANGLE NAME ZVLlf
NEAREST TOW
rrN:• 4r Td A.) 51-, �Y°•'L
(StrewRoad None. Number, Com m niey, Suhdimiar4 Lae No., Parce4 lip Code]
TOPOGRAPHIC 1 LAND SETTING-
❑ slope ❑ valley PFlat ❑ liidge ❑ other
(Check appropnate setting)
L4TITIME 7 h b j may be io n
nwRKe4 seemob, or in ■
LONGITUDE L? I I. ❑t dedlyal tormet
LatitadbUngltude source: jdGPS ❑ Topographic map
(Locwton of well Wrest be shown an a USG3 iopo map and
arrached to rhtr form 1f riot re mV GPS)
41L FACILIT VY The name oftbe bos oms where the well n locahed Coaplete 4■ and4b
(Ifs reodm" well, skip 4a; vo"Im 4b, welt a nrr inks nhenon only-)
FACILrrY 10 M(ifapplicable) !% ) !2 A_
NAME OF FACILn Y -Ft � OP GAS AXTi;, J
STREET ADDRESS _yI(wdn J 5,
City or Town stare Zip Code
4b. CONTACT PERSONIWELI.OWNER:
NAME—C-AdEL �f KQ►ye _
STREET ADDRESS 1608 _ iCx""'TirA Q,'1-k 1)4
6. WELLDETAILS'
a'Fotal Depth: )-I- S R Diameter: CJ in.
b. Water Level (Below Mcasunng Point): 1 5- ft
Measuring point is 0 ft above land surface.
6. CASING:
a. Casing Depth (if known):
b. Casing Removed:
Length Diameter
�! A ft. in.
D ft in.
7. DISIN FECTION: [ G
(Amount of 650/0 75%calcium hypochlonte used)
L SEALING MATERIAL:
COiCYi
Cement lb.
Water_ +t ggl-
lolgil e
Bentonrle lb.
Type' ❑ Slurry XPellets
Water- gal.
QIlE
Type material A4 1f"
Amount
Cemcm lb.
water gal.
9. EXPf]L'AINb METHOD OF EMP�/CEMENT OF MATERIAL:
_ �h r.1) e01UCAc'�r- e-4R
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, grave] interval, intervals of casing perforatians, and depths and
types of rill materials used.
11. DATE WELL ABANDONED S 15 -/L-)
100 HEREBY CERTIFY THATTHiS WD-1 WAS ABANDONED IN ACCORDANCE
WITH t SA NCAC 2C, WELL C STANDARDS. AND THAT A COPY OF
THl5 RECORD BEEN P DF.I) TO THE WELL OWNER [` C
SIGNATURE CER LL CONTRACTOR DATE
SIGNATUR£OF PRIVATE WLLL OWNER ABANDONING THE WELL DATE:
(The private well aw= pf" bean wAmdad avbo ocuopaymbamdowstimba residential well
m accordo`�e4A) J c �Rv ,4 &) i
PRINTED NAM£ OF PERSON ABANODNING THE WELL
Submit a copy to the owner And the ori&*1 to tale Division of W ater Quality within 30 days. Form GW -30
Attn. lnformatloo Mltaagea tal, 1617 Mail Service Center - Raleigh. NC 37699-1611, Phone No. (9i9) 733-701S at 56& Rev. 5/06

WELL_ BANDONMENT RUORD
North Carolina Department of EnviranmenI and Natural Resources- Division o£ Water Q"ity
WELL CONTRACTOR CERTIFICA'
t. WELL CONTRACTOR:
Mad Dawg, Inc.
Well Connww (Individual) Name
Roland Deae Igant J _
Well Contractor Company Name
STREET ADDRESS Po Box 398
Iron Station NC 26080
City or Town State Zip Code
7�- 732-0213
Area code - Phone number
L WELL INFORMATION,
SITE WELL M 0 (if applicable) � e
STATE WELL PERMIT M (if applicable) I f
COUNTY WELL PERMIT p (if applicable}
DWQ or OTHER PERMIT p (if applicable)-646
WELL USE (Check applicable tizw) ❑ Monitoring ❑ Residential
Cl Maaielpal/Pablle ❑ InduutrillllCommiercial E] Agricultural
® Resowry ❑ laJecdon ❑ lrma(ion
❑ Cnher (list use)
3, WELL LOCATION:
COiRNTY C+�S QUADRASNGLE NAME — �
NEARESTTOWN: NS-70A)
(SbecMad Kane, Na 1w, Community, SWATvisiw>, let Na, Parcel, Tap Code)
TOPOGRAPHIC 1 LAND SETTING:
❑ Slope ❑ Valley ' gflat ❑ Ridge ❑ Dther_
(Check appropnak setting)
LATITUDE � S .� a{y • '$ 7 tire] be n dcgrcex
rrinwes, secntsds, a is a
LONGITUDE go 17 !I.20 dearml fbrmaz
Lalituddlongltudc source: 1APPS ❑ Topographic map
(Location of well must be sitonrr on a US(IS rnpn +nap and
arached ro ►his form rrf no► using GPS.1
4a. FACILITY- The name of the buaness where the well a located CcaVleie 4a and4b.
(ifa msidetatsl well, skip 4a cauiqikec 4b, welt ow`nna mfwnub at only y
FACILITY LDM(if applicable) .
NAME aF FACILI CY�9h" rl
STREET ADDRESS
w , .-JST90 57911r z W, c. .2 7)0 y
oily or Tovm state Zip Cade
4b. CONTACT PERSONIWEL.L OWNER:
NAME C MA _Aq0 $ E
STREET ADDRESS 1 d P x .nl OttP►4� k iY�
r1ON # Z55U —
IL W ELL DETAILS:
a Total Depth; ft. Diameter in.
b. Water Level (Below Measuring Point): �_ ft.
Measuring point is ❑ ift above lalsd surface.
6. CASU4G: Length Diameter
a Casing Depth (if kxwn): �'� & in.
b. Casing Removed: �� ft. in
7. DISINFECTION: ctyp
(Amount of 651Ar75%calcium hypochlorite used)
a SEALING MATERIAL.:
Dj " L, ')bumf $and fill
Cernent lb. Cement Ib
Water jIg A- gal, Water f gal
Benjonite
13tmanite 115.
Type [']Slum XPcHctS
Water _ ga!
7matenal
Amount
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL-
P�xl�t p�j1�rS
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing local depth, depth and diameter of screens (if any) retnalrnng
in the well, gravel interval, iniervais of casing perforations, and depths and
types of fill materials used.
11. DATE WELL ABANDONED 57—'7-140
I DO H£REBY CERTIFY THAT MS WELL WAS ABANDONED IN ACCORDANCE
WITH I5A NCAC , WELL CONSTRUCTION STANDARD& AND THAT A COPY OF
TFoS REC H PRO THE WELL OWNER
SIGNATURE OF Ct7tT11`1FD CONTRACTOR DATE
MCNAT UREOF PRIYATL W`LLLOWN1rk ABANDONING THE WELL DATE
([I* private well owner meet bit an mdividad *he Cm=dLx alwdms bWbirr residential well
in accordance with I5A NCAC 2C A 113.)
PRINTED NAME OF PERSON ASANDOMNG THE WELL
Submit it copy 10 the owner and the original to the Division of Water QuaMty witblo 30 days. Form GW -30
Altn: Information Managerwnt, 1611 M 20 Service Center — Raleigh, NC 27694-1617, Phone No. (919) 7JX7015 tit Ms. Rev. 5 06

NONRESIDENTIAL WELL, CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIF[CAT ION # 2556-A
1. WELL CONTRACTOR:
Roland Dean Bryant
Well Contractor (Individual) Name
Mad Dawa, Ind
Well Contractor Company Name
PO Box 398
Street Address
iron Station— NC -280BG
City or Town State Zip Code
LDS 732-0213
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# NIA
OTHER ASSOCIATED PERMIT#(rf applicaue) {VIA
SITE WELL ID cifvotcae{e} NIA
3. WELL USE (Check One Box) Monitoring V� MunicipaUPublic D
IndusWaVCommerclal •ID Agricultural LI Recovery ❑ Inject+on �:j
lmgaWnr--1 Other n (list use)
DATE DRILLED S 11 -r a
4. WELL LOCATION:
�L_
F&Wael Name, Numbers. Community, Subdivision, Lot No., Parcel. Zip C4del
CITY: wd�iv5Tc+ld - -5IF/ •t COUNTY c) k5
TOPOGRAPHIC I LAND SETTING- [deck appropriate boxy
E]Siope ❑Valley PtFIV Ridge F.lather
LATITUDE 36 'AL� 1C,kN DMS OR 3x-XXXXXXXXX DD
LONGITUDES f)C °-a' t l C5 " DMS OR 7X.XXAXXXXaUr_ DID
Latitudeliongitude source; BPS aopographic map
(location of well must Da shown on a USGS lopo map andattaChad to
this form if not using GPS)
b. FACILITY {Name of the business where the well is located.}
Fokloe t3 P �'rR14"Vd -2'1`I62
Facilime Faciiity ID# (if applicable)
N/ rCn]i flWtir,� �rJ
Strut Address
City or Town State Zip Cade
-
Contact Name
^Mailing Address ,, 1
IY42Kk.SV t1�56D
City or Town Stale Zip Code
[ ±5 Y -16I - 1 "S
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: I
b. DOES WELL REPLACE EXISTING WELL? YES :j NOW
c. WATER LEVEL Below Top of Casing- _ t 5 FT.
(Use "+' if Above Top of Casing)
d. TOP OF CASING IS -_ FT. Above Land Surface"
'Tap of casing terminated
allor betow land Surface may require
a variance in accordance
with I5A NCAC 2C .pi 18.
e. YIELD (gprn): _NLA__
METHOD OF TEST NIA
1. DISINFECTION: Type NIA _, Amount NIA
S. WATER ZONES {depth};
Top_ 1� * Bottom
Top Bottom_
Top Bottom
Tap Bottom
:Top Bottom _
Top Bottom
Thickneael
7. CASING: Depth
Diameter Weight Material
Top D Bottom_ 10
Ft. 1 soh 4Q PVC
Top Bottom
Ft. Sch 49 PVC
Top Bottom
Ft.
S. GROUT. Depth
Material Method
Top b Bottom 6
Ft, Portland- Tremmie
Top Bottom
Ft.
Tap Bottom
Ft. _
9. SCREEN: Depth
Dlarrmeter Slot Saxe Material
Top i J Bottom
Ft. z in. .10 in. _1(C _ J
Top Bottom
Ft. in. in. _
Top Bottom
Ft, in. in. _
10. SANDIGRAVEL PACK:
Depth
Size Material
:Top 4 eottom_26
Ft. 2 Silica _
Top Bottom
Ft.
Tap Bottom
Ft.
11, ORILL ING LOG
Top Bottom
0
1
I
1
I
Formation Description
I
1 r A 40/u}JAL., C A
12. REMARKS: �+
I DO HEREBY CERTIFY THAT THIS WELL WAS CONST RUCT EO IN ACCPRUANCE WITH
I SA NCAC 2C• wELL NSTRt1CTION STAN�AROS. ANp THAT A COPY OF T}tIS
RECORD eE R.
SIGNATURE aF CERWAD WELL CONTRACTOR DATE
- PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-I b
Submit within 30 days of completion to: Division of Water Quality - Inforrnatlon Processing, Rev. troy
1617 Mall Service Center, Raleigh, NC 27699-161, Phone., [phone]

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Depantrnent of Environment and Narund Resnuroes- Division of Water Quail}
WELL CONTRACTOR C'ERTIF'ICATION # 2556-A
I. WELL CONTRACTOR:
RdandDean Bryant
Well Contractor (Individual) Name
Dawa. Inc.
Well Contractor Company NamL-
P0 Box 39$
Street Address
im Station _ ,�..----NC 28080
City or Town State Zip Code
7�} 732-0213
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# NIA
OTHER ASSOCIATED PERMIT#(ir apprlrab[e) NIA
SITE WELL ID#(Mappw;able) NIA
3. WELL USE (Check One Box) Monitoring at MunielpaltPublic ❑
Industnal/Cornmeroal ❑ Agricultural ❑ Recovery ❑ Injection ❑
InigationEl Other ❑ (list use)
DATE DRILLED r -it)
4. WELL LOCATION: J
�L n4 -.� /
(Street Name, Numbers, Community, Subdirson, Lot No Parcd, Zip Code)
CITY: W ,'V:)V') - 2AIr el COUNTY ro A >!
TOPOGRAPHIC ! LAND SETTING: Seheck appropriate boxy
LISiope Walley Flat pRidge ociber
LATITUDE 36 °-.L-, 2L.$S - oms OR 3x.xxxxxxxxx DID
LONGITUDE 3 V °_Lj' i i .1 L_• DMS OR 7X.Xc QWXXXX DID
LaMudeAongitude source: MPS Ofopographir map
(location of well muss be shown on a 11SGS tops map andattaChed to
this form rtnot using GPS)
5. FACILITY (Name of the business whena the Weil is located.)
r 44*1e1? 3P :ram^�;a 21f1O
Fadir Name Facility ID# (if applicable)
�3,t rv�• r �1�ti� 5��
Street Address
City or Town State Zip Cade
— ICA.[,t6_A%L'
Contact Name
Mailing Address i
City or Town State Zip Cade
ir9 ' iki - i I—J
Area code Phone number
G. WELL DETAiLS: I
a. TOTAL DEPTH: -�? o
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ;V
C. WATER LEVEL Below Top of Casing: _ 1 FT.
(Use'+' if Above Top of Casing)
d- TOP OF CASING IS ... Q J FT. Above Land Surface,
'TOP of Casing terminated attar below land surface may require
a variance in accordance with 15A NCAC 2C .0118,
o. YIELD (gpm): NIA _. J METHOD OF TFST N/A
f. DISINFECTION: Type NIA _ Amount gLA _
g. WATER .ZONES (depth).
Top & a Bottom Top Bottom
Top
Bottom_
Top_
Bottom
Top
Bottam
Top
Bottom
Thickneasl
:7, CASING:
Depth
Diameter
Weight Material
Top 0
Bottom �U _ Ft.
Z
sch 40 PVC
Top
Bottom Ft"-
sch 4tl PVC _
Top
Bottom Ft.
8" GROUT. Depth
Materfal Method
`
a Top Bottom G
Ff. Portl f Ill le"
Top Bottom
Ft._
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slat Size Material
Topi N Bottom Z "
Ft. 2 in" in,
Top _ Bottom
Ft" in. in,
Top_ Bottom
Ft in. tit.
10. SANDIGRAVEL PACK:
Depth
Slxe Material
Tap g Bottom 26
Ft 2
Top Bottom
Ft. �.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
Oki
1 —7.:
it •�. :3 r-� u .IIW •Iy
1
1
1
I
1
12. REMAi4KS:
I DO HEREBY CERTIFY THAT TH 15 WELL WAS CONSTR UCT-50 I N ACCORDANCE WffH
SSA NCAC ELL NSrRUCT1�N STAN pARoS, AND THAT A CppY OF YHIS
RECORD EE R a TH£ WELL 9WNER
SIGNA UR 0 CE LL CONTRAC OR DATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
FormSubmit within 30 days of completion to: Division of Water Quality Infornnation Processing, Rev. GW 1b
Y P tY - 9, Rev. zms
1617 Mail Service Center, Raleigh, INC 27699-161, Phone: [phone]

ATTACHMENT H - MAPS
FIGURES
Figure 1:
Location Map
Figure 2a:
Vicinity Map
Figure 2b:
Site Map with Proposed Injection Area
Figure 3:
Groundwater Contour Map May 27, 2010
Figure 4:
Benzene Contours with Proposed Injection Area
Figure 5a:
Site Conceptual Model Cross Sections A -A' and B-B'
Figure 5b:
Site Conceptual Model Cross Section C-C'
Note: Benzene is the only compound that has been detected above the applicable
groundwater standard, the UST Section Gross Contaminant Levels (GCLs), at the site.
XYMPABRProOds%NC124163. M W-S.361 Knollwaad Street%5.0 Delivarables�5.2 Final Deliveraale"A2 UIClAttachmenl H

MATERIAL SAFETY DATA SHEET
MSDS Ref. No.: 7775-27-1-12
Date Approved: 02/22/2005 FNRevision No.: 1
This document has been prepared to meet the requirements of the U.S. OSHA Hazard Communication
Standard, 29 CFR 1910.1200; the Canada's Workplace Hazardous Materials Information System (WHMIS)
and, the EC Directive, 2001158/EC.
1. PRODUCT AND COMPANY IDENTIFICATION
PRODUCT NAME:
SYNONYMS:
GENERAL USE:
MANUFACTURER
FMC CORPORATION
Active Oxidants Division
1735 Market Street
Philadelphia, PA 19103
[phone] (General Information)
KlnxiirTM
Sodium Persulfate. Sodium Peroxydisulftte; Disodium
Peroxydisulfate
In situ and ex situ chemical oxidation of contaminants and
compounds of concern for environmental remediation applications.
EMERGENCY TELEPHONE NUMBERS
($00) 424-9300 (CHEMTREC - U.S.)
[phone] (Medical - Cali Collect)
2. HAZARDS IDENTIFICATION
EMERGENCY OVERVIEW:
White, odorless, crystals
Oxidizer.
■ Decomposes in storage under conditions of moisture (waterlwater vapor) and/or excessive heat causing
release of oxides of sulfur and oxygen that supports combustion. Decomposition could form a high
temperature melt. See Section 10 ("Stability and Reactivity"),
POTENTIAL HEALTH EFFECTS: Airborne persulfate dust may be irritating to eyes,
nose. lungs, throat and skin upon contact. Exposure to high levels of persulfate dust may cause difficulty in
breathing in sensitive persons.
Page 1 of 9

KlociirT" (7775-27-1-12)
Date: 02/22/2005
3. COMPOSITION 1 INFORMATION ON INGREDIENTS
Chemical Name
CAS#
Wt %
EC No.
EC Class
Sodium Persulfate
7775-27-1
1 >99
231-892-I
1 Not classified as hazardous
4. FIRST AID MEASURES
EYES: Flush with plenty of water. Get medical attention if irritation occurs and persists.
SKIN: Wash with plenty of soap and water. Get medical attention if irritation occurs and persists.
INGESTION: Rinse mouth with water. Dilute by giving i or 2 glasses of water. Do not induce
vomiting. Never give anything by mouth to an unconscious person. See a medical doctor immediately.
INHALATION: Remove to fresh air. If breathing difficulty or discomfort occurs and persists,
contact a medical doctor.
NOTES TO MEDICAL DOCTOR: This product has low oral toxicity and is not irritating to
the eyes and skin. Flooding of exposed areas with water is suggested, but gastric lavage or emesis
induction for ingestions must consider possible aggravation of esophageal injury and the expected absence
of system effects. Treatment is controlled removal of exposure followed by symptomatic and supportive
care.
5. FIRE FIGHTING MEASURES
EXTINGUISHING MEDIA: Deluge with water.
FIRE 1 EXPLOSION HAZARDS: Product is non-combustible. On decomposition releases
oxygen which may intensify fire. Presence of water accelerates decomposition.
FIRE FIGHTING PROCEDURES: Do not use carbon dioxide or other gas filled fire
extinguishers: they will have no effect on decomposing persulfates. Wear full protective clothing and self-
contained breathing apparatus.
FLAMMABLE LIMITS: Non-combustible
SENSITIVITY TO IMPACT: No data available
Page 2 of 9

Klocilri'l(7775-27-1-12)
Date: 02/22/2005
SENSITIVITY TO STATIC DISCHARGE: Not available
6. ACCIDENTAL RELEASE MEASURES
RELEASE NOTES: Spilled material should be collected and put in approved DOT container and
isolated for disposal. Isolated material should be monitored for -signs of decomposition (fuming/smoking).
If spilled material is wet, dissolve with large quantity of water and dispose as a hazardous waste. All
disposals should be carried out according to regulatory agencies procedures.
7. HANDLING AND STORAGE
HANDLING: Use adequate ventilation when transferring product from bags or drums. Wear
respiratory protection if ventilation is inadequate or not available. Use eye and skin protection. Use clean
plastic or stainless steel scoops only.
STORAGE: Store (unopened) in a cool, clean, dry place away from point sources of heat, e.g.
radiant heaters or steam pipes. Use first in, first out storage system. Avoid contamination of opened
product. In case of fire or decomposition (fuming/%making) deluge with plenty of water to control
decomposition. For storage, refer to NFPA Bulletin 430 on storage of liquid and solid oxidizing materials.
COMMENTS: VENTILATION: Provide mechanical general and/or local exhaust ventilation to
prevent release of dust into work environment. Spills should be collected into suitable containers to prevent
dispersion into the air.
8. EXPOSURE CONTROLS 1 PERSONAL PROTECTION
EXPOSURE LIMITS
Chemical Name
ACGIH
OSHA
Supplier
Sodium Persulfate
0.I mg/rr? (TWA)
ENGINEERING CONTROLS: Provide mechanical local general room ventilation. to
prevent release of dust into the work environment. Remove contaminated clothing immediately and wash
before reuse.
PERSONAL PROTECTIVE EQUIPMENT
EYES AND FACE: Use cup type chemical goggles. Full face shield may be used,
RESPIRATORY: Use approved dust respirator when airborne dust is expected.
Page 3 of 9

KlozilrTM (7775-27-1-12)
Date: 0212212(X)5
PROTECTIVE CLOTHING: Normal work clothes. Rubber or neoprene footwear.
GLOVES: Rubber or neoprene gloves. Thoroughly wash the outside of gloves with soap and
water prior to removal. Inspect regularly for leaks.
9. PHYSICAL AND CHEMICAL PROPERTIES
ODOR: None
APPEARANCE:
AUTOIGNITION TEMPERATURE:
BOILING POINT:
COEFFICIENT OF OIL 1 WATER:
DENSITY 1 WEIGHT PER VOLUME:
EVAPORATION RATE:
FLASH POINT:
MELTING POINT:
ODOR THRESHOLD:
OXIDIZING PROPERTIES:
PERCENT VOLATILE:
PH:
SOLUBILITY IN WATER:
SPECIFIC GRAVITY:
VAPOR DENSITY:
VAPOR PRESSURE:
White crystals
Not applicable. No evidence of combustion up to 800'C.
Decomposition will occur upon heating.
Not applicable
Not applicable
Not available
Not applicable (Butyl Acetate = 1)
Non-combustible
Decomposes
Not applicable
Oxidizer
Not applicable.
typically 5.0 - 7A @ 25 °C (1 % solution)
73 % @ 25 'C (by wt.)
2.6 (11,0=1)
Not applicable (Air = 1)
Not applicable
10. STABILITY AND REACTIVITY
CONDITIONS TO AVOID:
STABILITY:
POLYMERIZATION:
INCOMPATIBLE MATERIALS:
Heat, moisture and contamination.
Stable (becomes unstable in presence of heat,
moisture and/or contamination).
Will not occur
Acids, alkalis, halides (fluorides, chlorides,
bromides and iodides), combustible materials, most
metals and heavy metals, oxidizable materials,
other oxidizers, reducing agents, cleaners, and
organic or carbon containing compounds, Contact
Page 4 of 9

Kloziirr,%r (7775-27-1-12) Bate: 02/22/2005
with incompatible materials can result in a material
decomposition or other uncontrolled reactions.
HAZARDOUS DECOMPOSITION PRODUCTS: Oxygen that Supports comhustion and oxides of
sulfur.
COMMENTS: PRECAUTIONARY STATEMENT: Pumping and transport of Kloziir persulfate
requires appropriate precautions and design considerations for pressure and thermal relief_
Decomposing persuIfates will evolve large volumes of gas and/or vapor, can accelerate exponentially with
heat generation, and create significant and hazardous pressures if contained and not properly controlled or
mitigated.
Use with alcohols in the presence of water has been demonstrated to generate conditions that require
rigorous adherence to process safety methods and standards to prevent escalation to an uncontrolled
reaction.
11. TOXICOLOGICAL INFORMATION
EYE EFFECTS: Nan -irritating (rabbit) [FMC Study Number: ICGrr-79.0291
SKIN EFFECTS: Non -irritating (rabbit) [FMC Study Number: ICGIT-79.0291
DERMAL LD50: > 10 g/kg [FMC Study Number: ICGa-79.0291
ORAL LD50: 895 mg/kg [rat] [FMC Study Number: ICGIT-79.029]
INHALATION LC50: 5.1 me (rat) [FMC 195-2017]
SENSITIZATION: May be sensitizing to allergic persons. [FMC Study Number: ICGif-79.0291
TARGET ORGANS: Eyes, skin, respiratory passages
ACUTE EFFECTS FROM OVEREXPOSURE: Dust may be harmful and irritating.
May be harmful if swallowed.
CHRONIC EFFECTS FROM OVEREXPOSURE: Sensitive persons may develop
dermatitis and asthma [Respiration 38.144. 19791. Groups of male and female rats were fed 0, 300 or 3000
ppm sodium persulfate in the diet for 13 weeks, followed by 5000 ppm for 5 weeks. Microscopic
examination of tissues revealed some injury to the gastrointestinal tract at the high dose (3000 ppm) only.
This effect is not unexpected for an oxidizer at high concentrations. [Ref. FMC I90-1 I51, Toxicologist
1:149, 19911•
Page 5 of 9

Klociir-rm (7775-27-1-12)
Date: 02/22/2005
CARCINOGENICITY:
NTP:
Not listed
[ARC:
Not listed
OSHA:
Not listed
OTHER:
ACGIH: Not listed
12. ECOLOGICAL INFORMATION
ECOTOXICOLOGICAL INFORMATION:
BIuegill sunfish, 96-hour LC50 = 771 mg/L [FMC Study I92-12501
Rainbow trout, 96-hour LCSO = 163 mg/L [FMC Study I92-1251 ]
Daphnia, 48-hour LCi0 = 133 mgfL jFMC Study 192-12521
Grass shrimp, 96-hour LC50 = 519 mg/L [FMC Study I92-12531
CHEMICAL FATE INFORMATION: Biodegradability does not apply to inorganic
substances.
13. DISPOSAL CONSIDERATIONS
DISPOSAL METHOD: Dispose as a hazardous waste in accordance with local, state and federal
regulatory agencies.
14. TRANSPORT INFORMATION
U.S. ❑EPARTMENT OF TRANSPORTATION (DOT)
PROPER SHIPPING NAME:
PRIMARY HAZARD CLASS 1 DIVISION:
UNINA NUMBER:
PACKING GROUP:
LABEL(S):
PLACARD(S):
MARKING(S):
ADDITIONAL INFORMATION:
Sodium Persulfate
5.1 (Oxidizer)
UN 1505
III
5.1 (Oxidizer)
5.1 (Oxidizer)
Sodium Persulfate, UN 1505
Hazardous Substance/RQ: Not applicable
Page 6 of 9

KloziirT" (7775-27-1-12)
Date: 02/22/2005
49 STCC Number: 4918733
This material is shipped in 225 lb. fiber
drums, 55 lb. poly bags and 1000 - 2200 lb.
IBC's (supersacks).
INTERNATIONAL MARITIME DANGEROUS GOODS (IMDG)
PROPER SHIPPING NAME: Sodium Persulfate
INTERNATIONAL CIVIL AVIATION ORGANIZATION (ICAO)1
INTERNATIONAL AIR TRANSPORT ASSOCIATION (IATA)
PROPER SHIPPING NAME: Sodium Persulfate
OTHER INFORMATION:
Protect from physical damage. Do not store near acids, moisture or heat.
15. REGULATORY INFORMATION
UNITED STATES
SARA TITLE III (SUPERFUND AMENDMENTS AND REAUTHORIZATION ACT)
SECTION 302 EXTREMELY HAZARDOUS SUBSTANCES (40 CFR 355, APPENDIX A):
Not applicable
SECTION 311 HAZARD CATEGORIES (40 CFR 370):
Fire Hazard. Immediate (Acute) Health Hazard
SECTION 312 THRESHOLD PLANNING QUANTITY (40 CFR 370):
The Threshold Planning Quantity (TPQ) for this product, if treated as a mixture, is 10,000 lbs,
however, this product contains the following ingredients with a TPQ of less than 10.000 lbs.:
None
SECTION 313 REPORTABLE INGREDIENTS (40 CFR 372):
Not listed
CERCLA (COMPREHENSIVE ENVIRONMENTAL RESPONSE COMPENSATION AND
LIABILITY ACT)
CERCLA DESIGNATION & REPORTABLE QUANTITIES (RQ) (40 CFR 302.4):
Unlisted, RQ = 100 lbs., lgnitability
TSCA (TOXIC SUBSTANCE CONTROL ACT)
TSCA INVENTORY STATUS (40 CFR 710):
Page 7 of 9

Klo-ziir7N (7775-27-1-12) Date: 02/22/2005
Listed
RESOURCE CONSERVATION AND RECOVERY ACT (RCRA)
RCRA IDENTIFICATION OF HAZARDOUS WASTE (40 CFR 261):
Waste Number: D001
CANADA
WHMIS (WORKPLACE HAZARDOUS MATERIALS INFORMATION SYSTEM):
Product Identification Number: 1505
Hazard Classification 1 Division: Class C (Oxidizer), Class D. Div. 2, Subdiv. B. (Toxic)
Ingredient Disclosure List: Listed
INTERNATIONAL LISTINGS
Sodium persulfate:
Australia (AICS): Listed
China; Listed
Japan (ENCS): (1)-1 I31
Korea: KE-12369
Philippines (PICCS): Listed
HAZARD, RISK AND SAFETY PHRASE DESCRIPTIONS:
EC Symbols: (Not classified as hazardous)
EC Risk Phrases: (Not classified as hazardous)
EC Safety Phrases: (Not classified as hazardous)
16. OTHER INFORMATION
HMIS
Health 1
Flammability 0
Physical Hazard 1
Personal Protection (PPE) d
Protection = I (Safety goggles, gloves, apron & combination dust & vapor respirator)
HMIS = Hazardous Materials Identification System
Degree of Hazard Code:
4 = Severe
Page 8 of 9

KlozUrr"c(7775-27-1-12)
Date; 02/22/2005
3 = Serious
2 = Moderate
l = Slight
0 = Minimal
NFPA
Health
i
Flammability
0
Reactivity
I
Special
Ox
SPECIAL = OK (Oxidizer)
NFPA = National Fire Protection Association
Degree: of Hazard Code:
4 = Extreme
3 = High
2 = Moderate
i = Slight
0 = insignificant
REVISION SUMMARY:
New MSDS
KlozOr and FMC Logo - FMC Trademarks
a 2005 FMC Corporation. All Rights Reserved.
FMC Corporation believes that the information and recommendations contained herein (including data and
statements) are accurate as of the date hereof. NO WARRANTY OF FITNESS FOR ANY PARTICULAR
PURPOSE, WARRANTY OF MERCHANTABILITY, OR ANY OTHER WARRANTY. EXPRESSED
OR IMPLIED, IS MADE CONCERNING THE INFORMATION PROVIDED HEREIN. The information
provided herein relates only to the specific product designated and may not be applicable where such
product is used in combination with any other materials or in any process. It is a violation of Federal law to
use this product in a manner inconsistent with its labeling. Further, since the conditions and methods of use
are beyond the control of FMC Corporation, FMC Corporation expressly disclaims any and all liability as
to any results obtained or arising from any use of the product or reliance on such information.
Page 9 of 9

Science Lah.com
Chemicals & Laboratory Equipment
Material Safety Data Sheet
Sodium Hydroxide, 25% MSDS
Section 1: Chemical Product and Company Identification
Product Name: Sodium Hydroxide, 25% Contact Information:
Catalog Codes: SLS4210
CAS#: Mixture.
RTECS: Not applicable.
TSCA: TSCA 8(b) inventory: Sodium hydroxide; Water
CI#: Not applicable.
Synonym:
Chemical Name: Not applicable.
Chemical Formula: Not applicable.
Sciencelab.com, Inc.
14025 Smith Rd.
Houston, Texas 77396
US Sales: 1-800-901-7247
International Sales: 1-281-441-4400
Order Online: ScienceLab.com
CHEMTREC (24HR Emergency Telephone), call:
1-800-424-9300
International CHEMTREC, call: 1-703-527-3887
For non -emergency assistance, call: 1-281-441-4400
Section 2: Composition and Information on Ingredients
Composition:
Name CAS # % by Weight
Sodium hydroxide 1310-73-2 25
Water 7732-18-5 75
Toxicological Data on Ingredients: Sodium hydroxide LD50: Not available, LC50: Not available.
1 Section 3: Hazards Identification 1
Potential Acute Health Effects:
Very hazardous in case of skin contact (corrosive, irritant), of eye contact (irritant), of ingestion. Hazardous in case of
inhalation. Liquid or spray mist may produce tissue damage particularly on mucous membranes of eyes, mouth and respiratory
tract. Skin contact may produce burns. Inhalation of the spray mist may produce severe irritation of respiratory tract,
characterized by coughing, choking, or shortness of breath. Inflammation of the eye is characterized by redness, watering, and
itching. Skin inflammation is characterized by itching, scaling, reddening, or, occasionally, blistering.
Potential Chronic Health Effects:
Non -corrosive for skin. Non-irritant for skin. Non -sensitizer for skin. Non-permeator by skin. Non -irritating to the eyes.
Non -hazardous in case of ingestion. Non -hazardous in case of inhalation. CARCINOGENIC EFFECTS: Not available.
MUTAGENIC EFFECTS: Not available. TERATOGENIC EFFECTS: Not available. DEVELOPMENTAL TOXICITY: Not
available. The substance is toxic to lungs, mucous membranes. Repeated or prolonged exposure to the substance can
produce target organs damage. Repeated or prolonged contact with spray mist may produce chronic eye irritation and severe

skin irritation. Repeated or prolonged exposure to spray mist may produce respiratory tract irritation leading to frequent attacks
of bronchial infection.
I Section 4: First Aid Measures
Eye Contact:
Check for and remove any contact lenses. Immediately flush eyes with running water for at least 15 minutes, keeping eyelids
open. Finish by rinsing thoroughly with running water to avoid a possible infection. Cold water may be used.
Skin Contact:
If the chemical got onto the clothed portion of the body, remove the contaminated clothes as quickly as possible, protecting
your own hands and body. Place the victim under a deluge shower. If the chemical got on the victim's expose4skin, such
as the hands : Gently and thoroughly wash the contaminated skin with running water and non-abrasive soap. Be particularly
careful to clean folds, crevices, creases and groin. Cold water may be used. If irritation persists, seek medical attention. Wash
contaminated clothing before reusing.
Serious Skin Contact:
Wash with a disinfectant soap and cover the contaminated skin with an anti -bacterial cream. Seek medical attention.
Inhalation: Allow the victim to rest in a well ventilated area. Seek immediate medical attention.
Serious Inhalation:
Evacuate the victim to a safe area as soon as possible. Loosen tight clothing such as a collar, tie, belt or waistband. If
breathing is difficult, administer oxygen. If the victim is not breathing, perform mouth-to-mouth resuscitation. WARNING: It may
be hazardous to the person providing aid to give mouth-to-mouth resuscitation when the inhaled material is toxic, infectious or
corrosive. Seek immediate medical attention.
Ingestion:
Do not induce vomiting. Loosen tight clothing such as a collar, tie, belt or waistband. If the victim is not breathing, perform
mouth-to-mouth resuscitation. Seek immediate medical attention.
Serious Ingestion: Not available.
Section 5: Fire and Explosion Data
Flammability of the Product: Non-flammable.
Auto -Ignition Temperature: Not applicable.
Flash Points: Not applicable.
Flammable Limits: Not applicable.
Products of Combustion: Not available.
Fire Hazards in Presence of Various Substances: Not applicable.
Explosion Hazards in Presence of Various Substances:
Risks of explosion of the product in presence of mechanical impact: Not available. Risks of explosion of the product in
presence of static discharge: Not available.
Fire Fighting Media and Instructions: Not applicable.
Special Remarks on Fire Hazards: Not available.
Special Remarks on Explosion Hazards: Not available.
Section 6: Accidental Release Measures
Small Spill:
p. 2

Dilute with water and mop up, or absorb with an inert dry material and place in an appropriate waste disposal container. If
necessary: Neutralize the residue with a dilute solution of acetic acid.
Large Spill:
Corrosive liquid. Stop leak if without risk. Absorb with DRY earth, sand or other non-combustible material. Do not get water
inside container. Do not touch spilled material. Use water spray curtain to divert vapor drift. Prevent entry into sewers,
basements or confined areas; dike if needed. Call for assistance on disposal. Neutralize the residue with a dilute solution of
acetic acid. Be careful that the product is not present at a concentration level above TLV. Check TLV on the MSDS and with
local authorities.
I Section 7: Handling and Storage I
Precautions:
Keep container dry. ❑o not breathe gas/fumes/ vapourlspray. Never add water to this product In case of insufficient ventilation,
wear suitable respiratory equipment If you feel unwell, seek medical attention and show the label when possible. Avoid contact
with skin and eyes Keep away from incompatibles such as acids.
Storage:
Alkalis may be stored in heavy duty gauge steel containers. Corrosive materials should be stored in a separate safety storage
cabinet or room.
I Section 8: Exposure Controls/Personal Protection !
Engineering Controls:
Provide exhaust ventilation or other engineering controls to keep the airborne concentrations of vapors below their respective
threshold limit value.
Personal Protection:
Face shield. Full suit. Vapor respirator. Be sure to use an approved/certified respirator or equivalent. Gloves. Boots.
Personal Protection in Case of a Large Spill:
Splash goggles. Full suit. Vapor respirator. Boots. Gloves. A self contained breathing apparatus should be used to avoid
inhalation of the product. Suggested protective clothing might not be sufficient; consult a specialist BEFORE handling this
product.
Exposure Limits:
Sodium hydroxide CEIL: 2 (mglm3) from ACGIH [1995] Consult local authorities for acceptable exposure limits.
Section 9: Physical and Chemical Properties
Physical state and appearance: Liquid.
Odor: Odorless.
Taste: Alkaline. Bitter. (Strong.)
Molecular Weight: Not applicable.
Color: Clear Colorless.
pH (1 % solnlwater): Basic.
Boiling Point: The lowest known value is 100°C (2127) (Water).
Melting Point: Not available.
Critical Temperature: Not available.
Specific Gravity: Weighted average: 1.15 (Water = 1)
Vapor Pressure: The highest known value is 17.535 mm of Hg (pia 20'C) (Water).
p. 3

Vapor Density: The highest known value is 0.62 (Air = 1) (Water).
Volatility: Not available.
Odor Threshold: Not available.
Water/Oil Dist. Coeff.: Not available.
lonicity tin Water]: Not available.
Dispersion Properties: See solubility in water,
Solubility: Easily soluble in cold water.
Section 10: Stability and Reactivity data
Stability: The product is stable.
Instability Temperature: Not available.
Conditions of Instability: Not available.
Incompatibility with various substances: Extremely reactive or incompatible with acids.
Corrosivity:
Highly corrosive in presence of aluminum. Slightly corrosive to corrosive in presence of glass.
Special Remarks on Reactivity: Not available.
Special Remarks on Corrosivity: Not available.
Polymerization: No.
I Section 11: Toxicoloaical Information
Routes of Entry: Eye contact. Inhalation. Ingestion.
Toxicity to Animals:
LD50: Not available. LC50: Not available.
Chronic Effects on Humans: The substance is toxic to lungs, mucous membranes.
Other Toxic Effects on Humans:
Very hazardous in case of skin contact (corrosive, irritant), of ingestion. Hazardous in case of inhalation.
Special Remarks on Toxicity to Animals: Not available.
Special Remarks on Chronic Effects on Humans: Not available.
Special Remarks on other Toxic Effects on Humans: Not available.
Section 1 2: Ecological Information
Ecotoxicity: Not available.
BOD5 and COD: Not available.
Products of Biodegradation:
Possibly hazardous short term degradation products are not likely. However, long term degradation products may arise.
Toxicity of the Products of Biodegradation: The product itself and its products of degradation are not toxic.
Special Remarks on the Products of Biodegradation: Not available.
p. 4

Section 13: Disposal Considerations
Waste Disposal:
I Section 14: Transport Information I
DOT Classification: CLASS 8: Corrosive liquid.
Identification:: Sodium hydroxide, solution (Sodium hydroxide) : UN1824 PG: II
Special Provisions for Transport: Not available.
Section 15: Other Regulatory Information
Federal and State Regulations:
Pennsylvania RTK: Sodium hydroxide Massachusetts RTK: Sodium hydroxide TSCA 8(b) inventory: Sodium hydroxide; Water
Other Regulations: OSHA. Hazardous by definition of Hazard Communication Standard (29 CFR 1910.1200).
Other Classifications:
WHMIS (Canada):
CLASS D-2A: Material causing other toxic effects (VERY TOXIC). CLASS E: Corrosive liquid.
DSCL (EEC): R35- Causes severe bums.
HMIS (U.S.A.):
Health Hazard: 2
Fire Hazard: 0
Reactivity: 0
Personal Protection:
National Fire Protection Association (U.S.A.):
Health: 2
Flammability: 0
Reactivity: 0
Specific hazard:
Protective Equipment:
Gloves. Full suit. Vapor respirator. Be sure to use an approved/certified respirator or equivalent. Wear appropriate respirator
when ventilation is inadequate. Face shield.
I Section 16: Other Information
References: Not available.
Other Special Considerations: Not available.
Created: 10/10/2005 12:05 PM
Last Updated: 11/01/2010 12:00 PM
The information above is believed to be accurate and represents the best information currently available to us. However, we
make no warranty of merchantability or any other warranty, express or implied, with respect to such information, and we assume
p. 5

no liability resulting from its use. Users should make their own investigations to determine the suitability of the information for
their particular purposes. In no event shall 5cienceZab.com be liable for any claims, losses, or damages of any third party or for
lost profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even if 5ciencet_ab.com
has been advised of the possibility of such damages.

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CREEK ENTERS SUBSURFACE
F
fl
LEGEND
FORMER BP STATION #24163
PROPERTY BOUNDARY
C] PARCEL BOUNDARY
PROPOSED INJECTION AREA
NOTES:
1. Monitoring wells within the
property boundary are shown
on Figure 2b.
2. No known water supply wells
exist within 1 /4 mile of the
site.
3. No known contamination
sources, other than former site
USTs, exist with 1 /4 mile of
site. O 200
APPROX. SCALE, ft.

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WITH BENZENE CONCENTRATION FROM
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PROPOSED MONITORING WELL
•
PROPOSED OPT INJECTION LOCATION
BENZENE ISOCONTOUR
(Dashed where Inferred)
PROPOSED INJECTION AREA
0 3❑
APPROX. SCALE, ft.
NOTES:
1, THE OPT INJECTION LOCATIONS ARE
CONCEPTUAL AND WILL VARY BASED ON
FIELD CONDITIONS.
aGwc AS SHOWN DESIGNED BY DATE Figure 2b. Site Map with
CM&-MTUL-ALL RSNn REXRVE, RTT or DRAWN By DATE Proposed Injection Area
TSH 30MAR1 1 Former BP Station No. 24163
CHECKED NY DATE Winston—Salem, North Carolina
CK 30MAR1 1 CONTRACT N6 VRA9M P11 REV.
in0 By °�T` 38436634 FIGURE-2B 0
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— - — • ---
PROPERTY LINE
GROUNDWATER MONITORING WELL
PROPOSED GROUNDWATER
MONITORING WELL
3.
ABANDONED GROUNDWATER
MONITORING WELL
VENT LINE
PRODUCT LINE
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a ""
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a UP,
UTILITY POLE
F•H•
FIRE HYDRANT
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85.E+6
GROUNDWATER
ELEVATION
(ft. Above Site
Datum)
(86.03)
GROUNDWATER
ELEVATION
(Not Used for
Contouring)
NM
NOT MEASURED
--�
GROUNDWATER
CONTOUR
(Dashed where
Inferred)
GROUNDWATER
FLOW DIRECTION
0 30
APPROX. SCALE, ft.

I cr`CAln
I 1 N ' - PROPERTY LINE
*MW--17 ABANDONED GROUNDWATER
5.7 MONITORING WELL
1 PROPOSED GROUNDWATER MONITORING
��1 1 WELL
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[ � WITH BENZEN
MW-E CONCENTRATION FROM
_ 4 62 1 E9�a MAY 2010 SAMPLING EVENT
tTyp
3' H.
11 FORMER DISCRETE GROUNDWATER SAMPLE POINT
M
i 4-._ CANOPY 2
WITH BENZENE CONCENTRATION FROM
1. PARKING OCTOBER 2010 SAMPLING EVENT
N 7 — BENZENE ISOCONTOUR
OR3T of (Dashed where Inferred)
_13 { UST �I
tFX
PROPOSED INJECTION AREA
i tin 2.290 1 1 1
0 30
APPROX. SCALE, ft.
p
IP

al
100
50 •
40
OFFSITE FFSITE ROADWAY SITE PROPERTY
ROPERTY
ABANDONED
SYSTEM CONDUIT ,
A ELECTRICAL AND ABANDONED SEWER A
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CONDUIT m a
i un � I i
3 KNOLLWOOD ST. a
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-T
PROPOSED
INJECTION AREA-,--,
DIRECTION OF FLOW (NW)
—Hydraulic Conductivity a 0.13 ft/day
—Porosity Assumed ;�4 20%
3 6 —Gradient a 0.012 ft/ft
—Seepage Velocity � 2.8 ft/yr
Receptor: Groundwater must
meet NCDENR UST Section
Gross Contamination Levels
(5,000 ug/L for Benzene)
K
100
90
m
70
6j
CROSS—SECTION A — A'
m
B �' I
WATER LINE
ELECTRICAL AND
COMMUNICATION
CONDUIT
ND
PROPOSED -
INJECTION AREA
,
r
CROSS --SECTION B - B'
W2.7 `-- -
r'
.62
RMER PRODUCT LINES
STALLED AFTER RELEASE)
LEGEND
ASPHALT
CONCRETE
FILL (CLAY AND
GRAVED
�?
SILTY CLAY
SILT
Imo'
SANDY SILT
SILTY SAND
WELL RISER/
SCREEN INTERVAL
APPROXIMATE
LIMIT OF GCL
EXCEEDANCES
6.610 BENZENE
CONCENTRATION
IN GROUNDWATER
(ug/L)
0 30
HORIZONTAL SCALE, ft.
VERTICAL
EXAGGERATION = 2X
NOTES:
1. Water table based on MW-5R, MW--8R, MW-14 and MW-16
measurements collected 5/27/10.
2. Boring logs for MW-6i, MW-14 and MW-16 (installed before 1996)
could not be located.
3. Bedrock was reportedly not encountered during MW-6i installation.
4. MW-5R, MW-6i, MW-8R, MW-14 and MW-16 Benzene concentrations
represent samples collected 5/27/10. TW-5, TW-9. TW-10, TW-12,
TW-15 and TW-17 samples were collected in October 2010.
5. Cross —sections d❑ not intersect former UST and piping suspected of
release (see Figure 5b). Release is of unknown quantity of gasoline
from UST or dispenser line prior to September 1983.
6. Nineteen soil samples were collected in November 2009 and nine
additional samples were collected in October 2010. No compounds
were detected above the applicable regulatory standard, the
Commerciol/Industrial MSCC, or more stringent Residential MSCC.
Several compounds were detected above the NC Soil —to —Groundwater
MSCC. No distinct spatial pattern to these detections was observed.
7. Depth and dimensions of utilities are unknown.
8. Water table gradient is based on MW-15 and MW-16 measurements
on 5/27/10. Hydraulic conductivity is based on geometric mean of
conductivities calculated from slug tests performed in October 2010.
9. GCL exceedance lateral extent is based on monitoring well Benzene
concentrations; vertical extent estimated from historical water table
measurements and PID soil screening. Benzene was the only
compound detected above the GCL in 2010.
MW-14
Tw-1a
q�
Biw-12
1W-5
PMW-19
MW
-15
PMW-1.- vW
1NI-17
B
IJ�
f
i
At
s
CROSS—SECTION LOCATION MAP (N.T.S.)

90
o
5o -
40 -
ELECTRICAL CONDUIT
C n SANITARY SEWER a3
ABANDONED
SYSTEM CONDUIT
rl
394 13
5.7 _
FORMER TANK
HOLD (INSTALLED
BEFORE RELEASE)
ASPHALT
CONCRETE
FILL (CLAY AND GRAVEL)
S I LTY C LAY
SILT
SANDY SILT
SILTY SAND
LEGEND
FORMER PRODUCT LINES
(INSTALLED AFTER RELEASE) 7
ABANDONED SEWER
SERVICE LATERAL
�a m
� I I
1� �, 11�)
PROPOSED
WJECTn■�
1.61
CROSS—SECTION C — C'
—,� APPROXIMATE LIMIT
OF GCL EXCEEDANCES
6,610 BENZENE CONCENTRATION (ug/L)
IN GROUNDWATER
0 30
WELL RISER/
SCREEN INTERVAL HORIZONTAL SCALE, ft.
VERTICAL EXAGGERATION = 2X
ELECTRICAL CONDUIT
STORM SEWER
FORMER TANK
HOLD (INSTALLEDI
i AFTER RELEASE)I
r I
D
ND
DIRECTION OF FLOW (NW)
—Hydraulic Conductivity ­�, 0.13 ft/day
—Porosity Assumed N 20%
—Gradient a 0.012 ft/ft
—Seepage Velocity a 2.8 ft/yr
Receptor: Groundwater must
meet NCDENR LIST Section
Gross Contamination Levels
(5,000 ug/L for Benzene)
ND
NOTES:
1. Water table based on MW-6, MW—SR, MW-15 and MW-17 measurements
collected 5/27/10.
2. Boring logs for MW-6 MW-67, MW-15 and MW-17 (installed before
1995) could not be located.
3. Bedrock was reportedly not encountered during MW-6i installation.
4. MW-6, MW-6% MW-8R, MW-15 and MW-17 Benzene concentrations
represent samples collected 5/27/10. TW-1, TW-2, TW-3, TW-16, and
TW-17 samples were collected in October 2010.
5. Release is of unknown quantity of gasoline from UST or dispenser line
prior to September 1983.
6. Nineteen soil samples were collected in November 2009 and nine
additional samples were collected in October 2010. No compounds were
detected above the applicable regulatory standard, the
Commercial/Industrial MSCC, or the more stringent Residential MSCC.
Several compounds were detected above the NC Soil —to —Groundwater
MSCC. No distinct spatial pattern to these detections was observed.
7. Depth and dimensions of utilities are unknown.
8. Water table gradient is based on MW-15 and MW-16 measurements on
5/27/10. Hydraulic conductivity is based geometric mean of
conductivities calculated from slug tests performed in October 2010.
9. GCL exceedonce ioteroi extent is based on monitoring well Benzene
concentrations; vertical extent estimated from historical water table
measurements and PID soil screening. Benzene was the only compound
detected above the GCL in 2010.
PMW-19
uW C'
Co:: 1' Tw-z TW- - T J
_
PMW-1
\V" _ -6i
w-6
CROSS—SECTION LOCATION MAP
(N.T.S.)

Rogers, Michael
From:
Rogers, Michael
Sent:
Tuesday, February 03, 2015 4:24 PM
To:
'[e-mail]'
Cc:
'Frisch, Greg (Ehs Support)'
Subject:
W10400198 ARCC/BP
Greetings -
We received the report titled Final Status Report Former Knollwood Gulf Station (BP #24163), 381 Knollwood Street,
Winston-Salem, North Carolina (dated December 15, 2014). In the Conclusions and Recommendations Section, sulfate
concentrations resulting from injection activities in MW-5R, MW-8R, MW-18, and MW-19 are still above the 15A NCAC
2L standard of 250 mg/L. One of the recommendations is to continue to collect samples from these wells until the
water quality meets the 2L standards. We concur with this recommendation and request these wells be monitored until
sulfate meets the 2L standard for 2 consecutive semiannual monitoring events. At that point, the Division will consider
closing the permit and issuing a Permit Completion Letter.
if you have any questions or comments, please advise. Thank you for your cooperation.
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
NCDENR - DWR
Water quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
h tto:lloo rta I. ncde n r.o[g/wWwglapslgwpro/reporting-forms
NOTE: Per Executive Order No. 150, all a -moils sent to and from this account are subject to the North Carolina Public
Records Low and may be disclosed to third parties.

AV;AV
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, Ili
Governor Secretary
September 15, 2014
Greg Frisch, RM. Operations Manager
Atlantic Richfield Company/ BP Products North America
4850 East 49th St., MBC-3 Room 155C
Cuyahoga Heights, OH 44125
Ref: Compliance Monitoring Required
Injection Well Permit WI0400198
Former Knollwood Gulf Station (BP 24163)
Winston-Salem, NC
Dear Mr. Frisch:
On September 8, 2014, the Division of Water Resources received the "Final Status Report"
document submitted by URS Corp. on behalf of Atlantic Richfield Company/BP Products
North America for the injection well permit and facility referenced above. This report
summarizes groundwater monitoring data following injection of sodium persulphate
activated with sodium hydroxide and was intended to satisfy the final project evaluation
requirement specified in Part V11.5 of the permit referenced above.
Review of this document indicated the following compliance issues_
1_ Groundwater samples were not analyzed for sulphate and carbon dioxide in June
2014 for monitoring wells MW-3, MW-5R, MW-8R, MW-18, and MW-19. Such
analyses were required as described in Part VII.1 of the permit.
2. Sulphate concentrations in monitoring wells MW-5R, MW-8R, MW-18, and MW-19
remain significantly higher than the groundwater quality standard of 2501mg/ L.
The Division of Water Resources is unable to close the permit as requested in Section Four
of the Final Status Report due to the high sulphate concentrations. As specified in Part
VI1.5 of the permit, continued monitoring of sulphate concentrations in wells specified in
the approved monitoring plan is required until concentrations decrease to pre -injection
concentrations or the groundwater quality standard of 250 mg/L, whichever value is
greater.
1636 Mail Service Center. Raleigh, !North Carolina 27699-1636
Phone. [phone]Internet: www,ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employe+ — Made in part by mn.ycfed paper

Greg Frisch
Permit W10400198
Sept. 15, 2014
Page 2 of 2.
The frequency of groundwater sampling from wells MW-3, MW-5R, MW-8R, MW-16,
MW-18, and MW-19 shall be at least semi-annually. An application for permit
modification may be submitted in order to conduct additional injections to hasten the
attenuation of sulphate, if desired.
Please contact me at thomas.slusser@ncdenr. gov or 919-807-6412 if you have any questions
or would like to discuss further.
Best Regards,
673—a �LAV"(.
Thomas Slusser, L.G.
Underground Injection Control Program Manager
Division of Water Resources.
cc: Sherri Knight, Winston-Salem Regional Office WQROS
Tom Moore, Winston-Salem Regionai Office LIST Section
]asen Zinna, URS Corp. (via email)

A. a jp
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P.E. Jahn E. Skvarla, III
Governor Director Secretary
May 24, 2013
Greg Frisch, RM Operations Manager
Atlantic Richfield Company/BP Products North America Inc.
4850 East 49" Street, MBC-3 Room 155C
Cuyahoga Heights, Ohio 44125
Ref: Renewal Issuance of Injection Permit WI0400198
Fortner l noilwood Gulf Station (BP 24163)
Winston-Salem, Forsyth County, North Carolina.
Dear Mr. Frisch:
In accordance with the application received on March 27, 2013, we are forwarding permit number WI0400198. This
permit is to inject sodium persulfate (tradename Klozur) and sodium hydroxide to remediate groundwater contaminated
with gasoline and diesel fuel at the facility referenced above. This permit shall be effective from August 31, 2013 until
July 31, 2018, and shall be subject to the conditions and limitations stated therein, including the requirement to submit a
final project evaluation as stated in PART V11— MONITORING AND REPORTING REQUIREMENTS. Please read the
entire permit to ensure that you are aware of all compliance requirements of the permit. Please note that Permit Condition
VII.5. requires the submission of a project summary report and a final project evaluation within nine months following the
conclusion of injection activity and completion of monitoring, as well as the attainment of certain standards.
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. Please.contact me at [phone] or at [e-mail] if
you have any questions about your permit.
` Best Regards, `
7U'11�1
David Goodrich
Hydrogeologist
cc: Sherri Knight, Winston-Salem Regional Office
Caleb Klouse, URS Corporation, 1600 Perimeter Park Drive, Suite 400, Morrisville, NC 27560
Thomas Moore, LIST Section, 1646 Mail Service Center, Raleigh, NC 27699-1646
W10400198 Permit File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 270-1636
Location: 512 N Salisbury St., Raleigh, North Carolina 27604
Phone: 919W-6464 I FAX: [phone]
Internet www.ncwa[erg ualitv.oro
One
NorthCarolina
An Equal Opportunity ) Affrrnalwe Artion Employer

ma fvw A
NCDENR
North Carolina Department of Environment and
Division of Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
April 4, 2013
Greg Frisch — RM Operations Manager
Atlantic Richfield Company/BP Products North America, Inc.
4850 E. 49" St., MBC-3 Room 155C
Cuyahoga Heights, OH 44125
Dear Mr. Frisch:
Natural Resources
John E. Skvarla, III
Secretary
Subject: Acknowledgement of
Application No. W10400198
Former KnolIwood Gulf Station
(BP 24163)
Injection In situ Groundwater
Remediation Well System
Forsyth County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on 03/27/2013. Your application package has been assigned the number listed
above, and the primary reviewer is David Goodrich.
Central and Winston-Salem Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application_ If you have any questions, please contact
David Goodrich at [phone] or [e-mail].
ncerely,
for Debr"atts
Groundwater Protection Unit Supervisor
cc: Winston-Salem Regional Office, Aquifer Protection Section
Caleb Krouse, PE — URS Corporation -North Carolina, 1600 Perimeter Park Dr., Ste, 400,
Morrisville, NC 27560
Permit File W 10400198
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, Nogh Carolina 27699.1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone]
NorthCafolitia
Internet: www.ncwater4uality orp ,y jY/ .�� I`t���sj `��
An Equal Opportunity 1 AfirrWve Aclion Employer �I/

-y 2013
Goodrich, David
From: Krouse, Caleb <[e-mail]>
Sent: Tuesday, May 28, 2013 11:26 AM
To: Goodrich, David; Wang, Shuying
Subject: RE: Additional information request for the former Knollwood Gulf Station Injection
Permit WI0400198
Attachments: FA2146.PDF
David and Shuying,
This emails serves as our greater than 48 hour notice of injection, which is scheduled to begin next Monday June 3`d at
the subject site.
Also, I noticed recently that in our previous report and permit renewal application, our table included incorrect Sulfate
concentrations for groundwater samples collected February 26, 2013. The correct results are reflected in the attached
Laboratory Analytical Report, which matches the laboratory report included in the previously submitted Semi -Annual
Data Report appendices. In summary, the correct results are as follows:
Sulfate
mgll
MW-3
2/26/2013
32.6
MW-5R
2/26/2013
8520
MW-8R
2/26/2013
959
MW-18
2/26/2013
13.8
MW-19
2/26/2013
169
Rega rds,
Caleb !Crouse, PE
URS Corporation
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
919-461-1595
[e-mail]
From: Goodrich, David mailto:david. oodrich ncdenr. ov
Sent, Friday, May 03, 2013 12:30 PM
To: Krouse, Caleb
Cc: Wang, Shuying
Subject: Additional information request for the former Knollwood Gulf Station Injection Permit WI0400198
Caleb,
Please send us an isopotential groundwater map for the subject facility, based on the most recent groundwater
elevation data.
Thank you.
Regards,

■ Southeast
E ACCLJTEE3T'
L A ❑❑ R AT Q R I E S
Technical Report for
Atlantic Richfield Company
URSNCM:S/S 24163: 381 Knollwood St, Winston-Salem, NC
38436760-104080
Accutest Job Number: FA2146
Sampling Date: 02/26/13
Report to:
URS Corporation
martha.meyers-lee@urs. com
ATTN: Martha Meyers
Total number of pages in report: 35
P �N ACCOR
Sti
r1 ,l
Q 2
Test resalts contained within this data package meet the requirements garryehzadi. Ph.D.
of the National Environmental Laboratory Accreditation Conference Laboratory Director
and/or state specific certification programs as applicable.
Client Service contact: Heather Wandrey 407-425-6700
Certifications: FL (E83510), LA (03051). KS (E-10327). IA (366J, IL (200063), NC (573), NJ (FL002j. SC (96038001)
DoD ELAP (L-A-$ L2229), CA (04226CA), TX (T104704404), AK, AR, GA, KY, MA, NV, OK, UT, VA, WA, WI
This report shall not be reproduced, except in its entirety, without the written approval of Accutest Laboratories.
Test insults relate only to samples analyzed.
Southeast • 4405 Vineland Road • Suite C-15 • orlando, FL 328I I • tel. [phone] • Fax: [phone]
Accutest Laboratories is the sole authority for authorizing edits or modi ficali on s to this
document. Unauthorized modification of this report is strictly prohibited.
• hitp://www.accutest.com
■! 1 of 35
AGCtJTESi:
rA2146 �.••�•••�"�••

Sections:
Table of Contents
9e
Section 1: Sample Summary................................................................................................... 3
Section 2: Case Narrative/Conformance Summary.............................................................. 4
Section 3: Summary of Hits.......................................................................... . 6
Section4: Sample Results........................................................................................................ 8
4.1: FA2146-1: TRIP BLANK............................................................................................
9
4.2: FA2146-2: MW-3.........................................................................................................
10
4.3: FA2146-3: MW-5R......................................................................................................
12
4.4: FA2146-4: MW-8R......................................................................................................
14
4.5: FA2146-5: MW-18.......................................................................................................
16
4.6: FA2146-6: MW-19.......................................................................................................
18
Section5: Misc. Forms............................................................................................................
20
5.1: Chain of Custody...........................................................................................................
21
Section 6: GC/MS Volatiles - QC Data Summaries..............................................................
24
6.1: Method Blank Summary................................................................................................
25
6.2: Blank Spike Summary ...................................................................................................
27
6.3: Matrix Spike/Matrix Spike Duplicate Summary ...........................................................
29
Section 7: General Chemistry - QC Data Summaries..........................................................
31
7.1: Method Blank and Spike Results Summary..................................................................
32
7.2: Duplicate Results Summary ..........................................................................................
33
7.3: Matrix Spike Results Summary .....................................................................................
34
7.4: Matrix Spike Duplicate Results Summary ....................................................................
35
■0 2 of 35
■,4,ccu-r��T
FA2145 ...u. �.a...

Accutest T abLink@15:05 13-Mar-2013
Sample Summary
Atlantic Richfield Company
Job No: FA2146
URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Project No: 38436760.104080
Sample Collected Matrix Client
Numbs Date Time By Received Code Type Sample ID
FA2146-1 02/26/13 00:00 SHJW 02/27/13 AQ Trip Blank Water TRIP BLANK
FA2146-2 02/26/13 09:50 SHJW 02/27/13 AQ Ground Water MW-3
FA2146-3 02/26/13 11:20 SHJW 02/27/13 AQ Ground Water MW-5R
FA2146-4 02/26/13 11:45 SHJW 02/27/13 AQ Ground Water MW-8R
FA2146-5 02/26/13 10:25 SHJW 02/27/13 AQ Ground Water MWAS
FAZ146-6 02/26/13 12:05 SHJW 02/27/13 AQ Ground Water MW-18
an 3 of 35
E ACCUTEST.
FA2146 •"•"•"•�'••�•

C
SAMPLE DELIVERY GROUP CASE NARRATIVE
Client: Atlantic Richfield Company Job No: FA2146
Site: URSNCM:S/S 24163: 381 Knollwood St, Winston-Salem, NC ReportGate 3/13/2013 3:OI A5 PM
5 Samples and I Trip Blank were collected on O2126l2013 and were received at Accutest on 02/27/2013 properly preserved, at 2.8 Deg. C
and intact. These Samples received an Aecutest job number of FA2146. A listing of the laboratory Sample ID, Client Sample 1D and
dates of collection are presented in the Results Summary Section of this report.
Except as noted below, all method specified calibrations and quality control performance criteria were met for this job. For more
information, please refer to QC summary pages.
Voiatiles by GCMS By Method SM 6200B
Matrix: AQ Batch ID: VE781
All samples were analyzed within the recommended method holding time.
All method blanks for this batch meet method specific criteria.
Sample(s) FA2146-6MS, FA2146-6MSD were used as the QC samples indicated
Matrix Spike / Matrix Spike Duplicate Recovery(s) for Toluene are outside control limits. Outside control limits due to high level in
sample relative to spike amount
FA.2146-3: Sample was not preserved to a pH < 2.
FA2146-4: Sample was not preserved to apH < 2.
Matrix: AQ Batch ID: VE782
All samples were analyzed within the recommended method holding time.
All method blanks for this batch meet method specific criteria
Sample(s) FA2146-2MS, FA2146-2MSD were used as the QC samples indicated.
Wet Chemistry By Method EPA 30+01SW846 9056A
Matrix: AQ Batch ID: GP21111
All samples were prepped within the recommended method holding time.
All samples were analyzed within the recommended method holding time.
All method blanks for this batch meet method specific criteria.
Sample(s) FA2319-1 MS, FA2319-1MSD were used as the QC samples for Sulfate.
Wet Chemistry By Method SM19 2320B
Matrix: AQ Batch ID: GN54459
All samples were analyzed within the recommended method holding time.
All method blanks for this batch meet method specific criteria.
Sample(s) FA2134-5DUP, FA2I34-SMS were used as the QC samples for Alkalinity, Total as CaCO3.
Matrix: AQ Batch ID: GN54503
All samples were analyzed within the recommended method holding time.
All method blanks for this batch meet method specific criteria.
Sample(s) FA21464DUP, FA21464MS were used as the QC samples for Alkalinity, Total as CaCO3.
Wednesday, March: 13, 2013 Page 1 of 2
Em 4 of 35
■.a,cmu-i-t=s-r.
FA2146 •••'••,"•••

Accutest Laboratories Southeast ALSE certifies that this report meets the ro'ect r uirements for anal ical data produced for the
(ALSE)P � a9 Yt
samples as received at ALSE and as stated on the COC. ALSE certifies that the data meets the Data Quality Objectives for precision,
accuracy and completeness as specified in the ALSE Quality Manual except as noted above. This report is to be used in its entirety.
ALSE is not responsible for any assumptions of data quality if partial data packages are used
Narrative prepared by:
Love]ie Metzgar, QA Officer (signature on file)
Wednesday, March 13, 2013
Date: March 13, 2013
Page 2 of 2
■� 5 of 35

Summary of Hits Page 1 of 2
Job Number: FA2146
Account: Atlantic Richfield Company
Project: URSNCM:S/S 24I63: 381 Knollwood St, Winston-Salem, NC
Collocted: 02/26/13
Lab Sample ID Client Sample ID Result)
Analyte Qual RL MDL Units Method
FA2146-1 TRIP BLANK
No hits reported in this sample.
FA2146-2 MW 3
Benzene
0.23 j
0.50
0.10
ugll
SM 6200B
Methyl Tert Butyl Ether
5.4
0.50
0.10
ugll
SM 6200B
Alkalinity, Total as CaCO3
300
5.0
0.60
mgll
SM19 2320E
Carbon Dioxide
338
5.0
5.0
rngll
SM19 4500002❑
Sulfate
32.6
2.0
0.60
mgll
EPA 3001SW846 9056A
FA2146-3 MW-SR
Benzene a
1360
25
5A
ugll
SM 6200B
Toluene
3520
50
10
ugll
SM 6200B
Ethylbenzene a
878
25
5.0
ugll
SM 6200E
Xylene (total) a
3940
75
11
ugll
SM 6200B
Methyl Ter[ Butyl Ether a
1660
25
5.0
ugll
SM 6200B
Alkalinity, Total as CaCO3
3400
25
13
mg/1
SM19 2320E
Carbon Dioxide
1530
5.0
5.0
mgll
SM19 4500002❑
Sulfate
8520
400
120
mg/1
EPA 3001SW846 9056A
FA2146-4 MW-SR
Benzene a
7310
250
50
ugll
SM 6200B
Toluene
30500
500
100
ugll
SM 6200B
Ethylbenzene a
2480
250
50
ugll
SM 6200B
Xylene (to(al) a
13400
750
110
ugll
SM 6200B
Methyl Ten Butyl Ether a
4530
250
50
ugll
SM 6200B
Alkalinity, Total as CaCO3
883
25
13
mgll
SM19 2320B
Carbon Dioxide
590
5.0
5.0
mgll
SM19 450OCO2D
Sulfate
959
20
6.0
mgll
EPA 3001SW846 9056A
FA2146-5 MW-18
Benzene
2510
50
10
ugll
SM 6200B
Toluene
10100
250
50
ugll
SM 6200B
Ethylbenzene
2970
50
10
ugll
SM 6200B
Xylene ((otal)
8690
ISO
22
ugll
SM 6200B
Methyl Ter[ Butyl Ether
1140
50
10
ugll
SM 6200B
Alkalinity, Total as CaCO3
311
5.0
0.60
mgll
SM19 2320E
Carbon Dioxide
500
5.0
5.0
:ngA
SM19 450OCO2D
Sulfate
13.8
2.0
0.60
mgll
EPA 3001SW846 9056A
Elm 6 of 35
ACCLiTf=ST.
FAZ746 �••""••'•�••

Summary of Hits Page 2 of 2
Job Number: FA2146
Account: Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Collected: 02/26/13
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL [hits Method
FA2146-6 MW-19
Benzene
2210
25
5.0
ug/l
SM 6200B
Toluene
10600
250
50
ug/l
SM 6200B
Ethylbenzene
1110
25
5.0
ug/l
SM 6200B
Xylene (total)
6990
75
11
ugll
SM 6200B
Methyl Teri Butyl Ether
3890
250
50
ug/l
SM 6200B
Alkalinity, Total as CaCO3
590
25
13
mgll
SM19 2329E
Carbon Dioxide
503
5.0
5.0
mgll
SM19 4500002❑
Sulfate
169
20
6.0
mgll
EPA 3001SW846 9056A
(a) Sample was not preserved to a pH < 2.
■o 7 of 35
�ACCLlTE�T.
FA2146

Section 4
WILD Southeast
m ACGUTEST
LABORATORIES
Sample Results
Report of Analysis
a
■■ 8 of 35
iiCCUTEBT.
FA2146 ..... -� .:

Accutest LabLink@15:05 13-Mar-2013
Report of Analysis
Client Sample III: TRIP BLANK
Lab Sample ID: FA2146-1 Date Sampled: 02/26/13
Matrix: AQ - Trip BIank Water Date Rowived: 02/27/13
Method: SM 6200B Percent Solids: nla
Project: URSNCM:SIS 24163: 381 Knollwood St. Winston-Salem, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Bate Analytical Batch
Run #1 E022730.❑ 1 03/06/13 TD nla nla VE782
Run #2
Purge Volume
Run # 1 10.0 ral
Run #2
Purgeable Aromatics, MTBE
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene (total)
1634-04-4
Methyl Tert Butyl Ether
CAS No.
Surrogate Recoveries
1868-53-7
❑ibromof]uoromethane
17060-07-0
1,2-Dichloroelhane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorobenzene
Result
RL
MDL Units Q
ND
0.50
0.10 ug11
ND
0.50
0.10 ug/1
ND
0.50
0.10 ugll
ND
1.5
0.22 ugll
ND
0.50
0.10 ug11
Run# 1
Run# 2
Limits
99%
70-130%
101 %
70-130%
101 %
70-130%
102%
70-130%
ND = Not detected MDL - Method Detection Limit
RL = Reporting Limit
E = Indicates value exceeds calibration range
j = Indicates an estimated value
B = Indicates analyle found in associated method blank
N = Indicates presumptive evidence of a compound
111112 9 of 35
� p.CCLJ-TEST.
FA2146 •'•,••,•.••••

Y
Accutest LabLink@ 15:05 13-Mar-2013
Report of Analysis
Client Sample ID: MW-3
Lab Sample ID: FA2146-2 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Mood: SM 6200B Percent Solids: n/a
Project: URSNCM:SIS 24163: 381 Knoilwood St, Winston-Salem, NC
Page 1 of I
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 E022723.D 1 03/06/13 TD nla nla VE782
Run #2
Purge Volume
Run # 1 10.0 mI
Run #2
Purgeable Aromatics, MTBE
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene (to(al)
1634-04-4
Methyl Tert Butyl Ether
CAS No.
Surrogate Recoveries
1868-53-7
Dibromofluoromethane
17060-07-0
1,2-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorohenxeue
Result
RL
MDL
Units Q
0.23
0.50
0.10
ugll
ND
0.50
0.10
ugll
ND
0.50
0.10
ugll
ND
1.5
0.22
ug1l
5.4
0.50
0.10
ugll
Run# 1 Ran# 2 Limits
104%
70-130%
110%
70-130%
99%
70-130%
103%
70-130%
ND = Not detected MDL - Method Detection Limit
RL = Reporting Limit
E = Indicates value exceeds calibration range
A
iv
j = Indicates an eslimaled value
B = Indicates analyze found in associated method blank
N = Indicates presumptive evidence of a compound
■n 10 of 35
■ .mac cU-ras-T;
FA2146 ••••••••",••

■
Accutest LabLinkLa 15:05 13-Mar-2013
Report of Analysis
Client Sample ID: MW-3
Lab Sample 1D: FA2146-2 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Percent Solids: nla
Project: URSNCM:SIS 24153: 381 Knollwood St; Winston-Salem, NC
General Chemistry
Analyte
Result
Alkalinity. Total as CaCO3
300
Carbon Dioxide
338
Sulfate
32.6
RL = Reporting Limit
MDL = Method Detection Limit
Page 1 of 1
RL
MDL
Unite
DF
Analyzed By Method
5.0
0.60
mg1l
1
03105113 13.45 AC SM 19 23211E
5.0
5.0
mg1l
1
03/05/13 AC SM19 4500002D
2.0
0.60
mgll
1
03/05/13 11:41 AA EPA 30111SW846 9056A
U = Indicates a result < MDL
B = Indicates a result > = MDL but < RL
■■ 11 of 35
■ accu-r�s�
FA2146 `••"•••°•�••

Accutest LahLink@15:05 13-Mar-Z013
Report of Analysis
Page 1 of 1
Client Sample ID:
MW-51Z
Lair Sample ID:
FA2146-3
Date Sampled:
02/26/13
A
Matrix
AQ - Ground Water
Date Received:
02/27/13
Method:
SM 6200B
Perowt Solids:
nla
Project:
URSNCM:SIS 24163: 381 Knoliwoed St, Winston-Salem, NC
File ID
DF
Analysed By Prep Date Prep Batch Analytical Batch
Run #1 a E022679.1) 50
03/05/13 TD nla nla
VE781
Run #2 E022697.1) 100
03/05/13 TD nla nla
VE781
Purge Volume
Run 01 10.0 ml
Run #2 10.0 ml
Purgeahle Aromatics, MTBE
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene {(otal)
1634-04-4
Methyl Teri Butyl Ether
CAS No.
Surrogate Recoveries
1868-53-7
Dibromolluoramethane
17060-07-0
1,2-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bramofluorobenzene
(a) Sample was not preserved to a pH < 2.
(h) Result is
from Run# 2
Result
RL
MDL
Units Q
1360
25
5.0
ugll
3520 b
50
10
ugll
878
25
5.0
ugll
3940
75
11
ugll
1660
25
5.0
ugll
Run# 1 Run# 2 Limits
99%
92%
70-130%
107%
89%
70-130%
100%
100%
70-130%
102%
100%
70-130%
ND = Not detected MDL - Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates anaiyte found in associated method blank
E = Indicates value exceeds calibration range N = indicates presumptive evidence of a compound
ma 12 of 35
ACCiJT�ST.
FA2146

Accutev LabLink@15:05 13-Mar-2013
Report of Analysis
Client Sample 11D: MW-5R
Lab Sample ID: FA2146-3 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Percent Solids: nla
Prujed: URSNCM:SIS 24163. 381 Knollwood St, Winston-Salem, NC
General Chemistry
Analyte
Result
Alkalinity, Total as CaCO3
3400
Carbon Dioxide
1530
Sulfate
8520
RL = Reporting Limit
MDL = Method Detection Limit
Page 1 of I
RL
MDL
Units
DF
Analysed By Method
25
13
mg/l
1
03/07/13 11:54 AC SM19 2320B
5.0
5.0
mg1l
I
03/07/13 11:54 AC SM19 45000O2D
400
120
mgll
200
03/05/13 11:56 AA EPA 3001SW846 9056A
U = Indicates a result < MDL
B = Indicates a result > = MDL but < RL
■■ 93 of 35
■ aGc�l��s�
FA274C `"•�•••'••••

Accutesi LabLink@ 15:05 13-Mar-2013
Report of Analysis
Page 1 of 1
Client Sample ID:
MW-8R
Lab Sample ID:
FA2146-4
hate Sampled:
02/26/13
A
Matrix:
AQ - Ground Water
Date Received:
OZ127113
Method:
SM 6200B
Percent Solids:
nla
Projed:
LIRSNCM:SIS 24163: 381 Itnollwood St, Winston-Salem, NC
File ID
DF Analyzed By
Prep Date Prep Batch Analytical Batch
Run #1 a E022680.D 500 03/05/13 TD
nla n/a
VE781
Run #2 E022693.D 1000 03/05/13 TD
n!a nla
VE781
Purge Volume
Run #1 10.0 ml
Run #2 10.0 ml
Purgeable Aromatics, MTBE
CAS No.
Compound
71-43-Z
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene ((otal]
1634-04-4
Methyl Tert Butyl Ether
CAS No.
Surrogate Recoveries
1868-53-7
Dibromofluoromethane
17060-07-0
1, Z-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorohenzene
(a) Sample was not preserved to a pH < 2.
(b) Result is
from Run# 2
Result
RL
MDL
Emits Q
7310
250
50
ugll
30500 b
500
100
ugll
Z480
250
50
ug11
13400
750
110
ugll
4530
250
50
ug1l
Run# 1 Run# 2 Limits
100%
99%
70-130%
108%
100%
70-130%
101%
101%
70-130%
103%
103%
70-130%
ND = Not detected MDL - Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = indicates analyze found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
■r_ 14 of 35
W ^r_=_ JTEST.
FA2146 —.... I - —

Accutest LabLink@15:05 13-Mar-2013
Report of Analysis
:Bent Sample ID: MW-8R
.ab Sample ID: FA2146-4 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Perecant Solids: n/a
'rojed: URSNCM:S/S 24163: 381 Knollwood St, Winston-Salem, NC
General Chemistry
Anaiyte
Result
Alkalinity, Total as CaCO3
883
Carbon Dioxide
590
Sulfate
959
RL = reporting Limit
MDL = Method Detection Limit
Page 1 of 1
RL
MDL
Units
DF
Analysed By Mdhod
25
13
mg/l
1
03/07/13 11:54 AC SM19 2320E
5.0
5.0
mg/l
I
03/07/13 11:54 AC SM19 450000ZD
2t}
6.0
mg/]
10.
03/05/13 12:12 AA EPA 300/SW846 9056A
U = Indicates a result r MDL
B = Indicates a result > = MDL but < RL
no 15 of 35
� .4CC1JTE8T.
FAa146 ...... ...

Accutest LabLink015:05 13-Mar-2013
Report of Analysis
Client Sample ID: MW-18
Lab Sample ID: FA2146-5 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Method: SM 6200B Percent Solids: nla
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Page 1 of 1
File 11D
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
Run #1 E022685.D
100
03/05/13
TD
nla
nla
VE781
Run #2 E022683.1)
500
03/05/13
TD
nla
nla
VE781
Purge Volume
Run #1 10.0 ml
Run #2 10.0 mi
Purgeable Aromatics, MTBE
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene (total)
1634-04-4
Methyl Teri Butyl Ether
CAS No.
Surrogate Recoveries
1868-53-7
Dibromolluoromethane
17060-07-0
1,2-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorobenzene
(a) Result is From Run# 2
Result
RL
MDL
Units Q
2510
50
10
ugll
101002
250
50
ugll
2970
50
10
ugll
8690
150
22
ugli
1140
50
10
ug11
Run# 1 Run# 2 Limits
103%
106%
70-130%
114%
113%
70-130%
101%
102%
70-130%
102%
105%
70-130%
ND = Not detected MDL - Method Detection Limit
RL = Reporting Limit
E = Indicates value exceeds calibration range
j = Indicates an estimated value
B = Indicates analyte found in associated method blank
N = Indicates presumptive evidence of a compound
■■ 16 of 35
a ACCUTEST.
FA2146 •••"•

Accutest LabLink@ 15:05 13-Mar-2013
Report of Analysis
Client Sample ID: MW-18
Lab Sample ID: FA2146-5 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Percent Solids: nla
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
General Chemistry
Analyte
Result
Alkalinity. Total as CaCO3
311
Carbon Dioxide
500
Sulfate
13.8
RL = Reporting Limit
MDL = Method Detection Limit
Page 1 of 1
RL
MDL
Units
DF
Analyzed By Method
5.0
0.60
mgll
I
o3105113 13:45 AC 5M19 2320E
5.0
5.0
mg1l
1
03/05/13 AC SM19 45DDCOZD
2.0
0.60
mg./l
I
0"5l13 13:32 AA EPA 3DO15W846 9056A
U = Indicates a result < MDL
B = Indicates a result > = MDL but < RL
on 17 of 35
ACCUTEST.
FA2146 " •

Accutest LabLink@15:05 13-Mar-2013
Report of Analysis Page 1 of 1
Client Sample ID: MW-19
Lab Sample ID: FA2146-6 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Method: SM 6200B Percent Solids: n/a
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
Run #1 E022689.1)
50
03/05/13
TD
n/a
nla
VE781
Run #2 E022684.1)
500
03/05/13
TD
nla
n/a
VE781
Purge Volume
Run # 1 10.0 nil
Run #2 10.0 ml
Purgeable Aromatics, MTBE
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene (total)
1634-04-4
Methyl Tert Butyl Ether
CAS No.
Surrogate Recowries
1868-53-7
Dibromofiuorumethane
17060-07-0
1,2-Dichloroethane-D4
2037-26-5
Toluene-138
460-00-4
4-Bromofluarobenzene
(a) Result is from Run# 2
Result
RL
MDL
Units Q
2210
25
5.0
ugll
10600 a
250
50
ugll
1110
25
5.0
ugll
6990
75
11
ugll
3890 a
250
50
ug11
Run# 1 Run# 2 Limits
104%
105%
70-130%
114%
116%
70-130%
101%
100%
70-130%
103%
105%
70-130%
ND = Nol defected MDL - Method Detection Limit
RL = Reporting Limit
E = Indicates value exceeds calibration range
J = Indicates an estimated value
B = Indicates anaiyle found in associated method blank
N = indicates presumptive evidence of a compound
NO 18 of 35
A C C IJTE ST.
FA2146

Accutest LabLink@ 15:05 13-Mar-2013
Report of Analysis
Client Sample ID: MW-19
Lab Sample ID: FA2146-6 Date Sampled: 02/26/13
Matrix: AQ - Ground Water Date Received: 02/27/13
Pert Solids: nla
Project: URSNCM:SIS 24163: 381 1Cnollwood St. Winston-Salem, NC
General Chemistry
Analyte
Alkalinity, Total as CaCO3
Carbon Dioxide
Sulfate
Page 1 of 1
Result
RL
MDL
Units
DF
Analyzed By Method
590
25
13
mgll
1
03/07/13 11:54 AC SM19 232U$
503
5.0
5.0
mgll
1
03/07/13 11:54 AC SM I9 45ODCO2D
169
20
6.0
mg11
10
03/05J13 13:49 AA EPA 3001SW846 9056A
RL = Reporting Limit
MDL = Method Detection Limit
U = indicates a result < MDL
B = indicates a result > = MDL but r RL
A
■■ 19 of 35
� ACCiJTEST.
FA2146 �••`•"•""�••

Section 5
Southeast
ACC UTE EB-r
L A B 0 R A T Q R I E S
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
■■ 20 of 35
FA2146 `"'""""""'

FA2146: Gain of Custody
Page 1 of 3
on 21 of 35
m .4CCLJTEST.
FA2146 "•:�•••

ACCUTEST LABORATORIES SAMPLE RECEIPT CONFIRMA'nON
ACCIrrESr'S JOB N UW93M Z / T CLIENT: 5 PROJECT: � [
T]ATFJrne •?- {hO�iIDDVYY 24:001 NS�R OF COOLERS RHC rVM
METHOD OF AFISVFRY: UPS ACCIITESJ COURREM GREYHOUM I7EI..IVElrY OTHER
AERBI L NUr►.tuFn s• G 5,
COOLER TNFORMATIQN
CUSTODY SEAL NOT PRESENT OR NOT INTACT
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ANALYSIS REQUEiSTW IS UNCLEAR OAI IMSING
SAMPLE DATES OR TES UNR3.EAR OR M]3MNC3
TEM7FVAYtM.E C21TRRiA NOT MET
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= BLATKINFORMATION
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BLANK NOT PROVIDED
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Page 2 of 3
No 22 of 35
a 4C0LJTES-r
FA2146 •,9•"•�••�•

Sahooaaact No. 27034,
work Otaft IBo
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ACCUTEST KIT REQUEST FORM
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Cl"t 8P__- - __ _ _ Cavral4ot: [JRS Corelion
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Fre)ert: BP 24163 Coarura at TL: Sanha[tig ficmoe[
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Section f
= .
Southeast
a AC;CLJTFST
L A B Q R A i O R I E 5
GUMS Volatiles
QC Data Summaries
Includes the following where applicable:
■ Method Blank Summaries
• Blank Spike Summaries
■ Matrix Spike and Duplicate Summaries
0
■ 24 of 35
M.4CCUTEST.
FA2146

Method Blank Summary Page 1 of 1
Job Number: FA2146
Account: BPAMSS Atlantic Richrield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Sample
File ID DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
VE781-MB
E022678.D 1
03/05/13
TD
nla
nla
VE781
The QC reported here applies to the following samples: Method: 5M 6200B
FA2146-3, FA2146-4, FA2146-5, FA2146-6
CAS No. Compound
71-43-2
Benzene
100-4I-4
Ethylbenzene
1634-04-4
Methyl Tert Butyl Ether
108-88-3
Toluene
1330-20-7
XyIene (total)
CAS No. Surrogate Recoveries
1868-53-7 Dibromofluoromethane
17060-07-0 I , 2-Dichloroethane-D4
2037-26-5 Toluene -DR
460-00-4 4-Bromofluorobenzene
Result
RL MDL
Units Q
ND
0.50 0.10
ugll
N❑
0.50 0.10
ugll
ND
0.50 0.10
ugll
ND
0.50 0.10
ugll
ND
1.5 0.22
ugll
Limits
100%
70-130%
104%
70-130%
102%
70-130%
103%
70-130%
Elm 25 of 35
■ ^ccuTt^s-r.
FA2146 `"•""•,�,•••

Mdhnd Blank Summary Page 1 of 1
Job Number: FA2146
Account: BPAMSS Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Sample
File ID DF
Analysed
By
Prep Date
Prep Batch
Analytical Batch
VE782-MB
E022715.D 1
03/06/13
TD
nla
n/a
VE782
The QC reported here applies to the following samples: Method: SM 6200B
FA2146-1. FAZ146-2
CAS No. Compound
71-43-2
Benzene
100-41-4
Ethylbenzene
1634-04-4
Methyl Tert Butyl Ether
108-88-3
Toluene
1330-20-7
Xylene ((otal]
CAS No. Surrogate Recoveries
1868-53-7 Dibromofluoromethane
17060-07-0 1, 2-Dichloroethane- D4
2037-26-5 Toluene-138
460-00-4 4-Bromofluorobenzene
Result
RL MDL
Units Q
ND
0.50 0.10
ugll
ND
0.50 0.10
ugll
ND
0.50 0.10
ugll
ND
0.50 0.10
ugll
ND
1.5 0.22
ugll
Limits
94%
70-130%
90%
70-130%
101%
70-130%
101%
70-130%
NU 26 of 35
NACCLJTES r
FA2146 `"....I "

Blank Spike Summary Page 1 of I
Job Number: FA2146
Account: BPAMSS Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
Samplc
File ID DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
VE781-BS
E022676.13 1
03/05/13
TD
nla
nla
VE781
The QC reported here applies to the following samples: Method: SM 6200B
FA2146-3. FA2146-4. FA2146-5, FA2146-6
CAS No. Compound
71-43-2
Benzene
100-41-4
Ethylhenzene
1634-04-4
Methyl Tert Butyl Ether
I08-88-3
Toluene
1330-20-7
Xylene [(otal)
CAS No. Surrogate Rcooveries
1868.53-7 Dibromofluoromethane
17060-07-0 1,2-Dichioroethane-D4
2037-26-5 Toluene-D8
460-00-4 4-Bromofluorobenzene
' = Outside of Central Lirnils.
Sprite BSP BSP
ugll ugll % Limits
10
9.3
93
70-130
10
9.3
93
70-130
10
9.4
94
70-130
10
9.2
92
70-130
30
25.7
86
70-130
BSP Limits
98%
70.130%
98%
70- i 30°%
100%
70-130%
101%
70-130%
M■ 27 of 35
■ ACCU-rE—=
FA2146 •"•�"•��•�••

Blank Spike Summary Page 1 of i
Job Number: FA2146
Account: BPAMSS Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Hnollwood St, Winston-Salem. NC
Sample
File ID OF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
VE782-BS
E022714.D 1
03/06/13
TD
nla
nla
VE782
The QC reported here applies to the following samples: Method: SM 62008
FA2146-1, FA2146-2
CAS No. Compound
71-43-2
Benzene
100-41-4
Ethylbenzene
1634-04-4
Methyl Tert Butyl Ether
108-88-3
Toluene
1330-20-7
Xylene (total)
CAS No. Surrogate Recoveries
1868-53-7 Dibromofluoromethane
17060-07-0 1,2-Dichloroethane-D4
2037-26-5 Toluene-138
460-00-4 4-Bromofluorobenzene
* = Outside of Control Limits.
Spice BSP BSP
ugll ugll % Limits
10
9.6
96
70-130
10
9.2
92
70-130
10
9.1
91
70-130
10
9.4
94
70-130
30
25.0
83
70-130
BSP Limits
92%
70-130%
89%
70-130%
101%
70-130%
101%
70-130%
■E 28 of 35
M.4CCUTEST.

Matrix Spike/Matrix Spike Duplicate Summary Page 1 of I
Job Number: FA2146
Account: BPAMSS Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwaad St, Winston-Salem, NC
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
FA2146-6MS
E022690.D
50
03/05/13
TD
nla
n/a
VE781
FA2146-6MSD
E022691.1)
50
03/05/13
TD
nla
nla
VE781
FA2146-6
E022689.1)
50
03/05/13
TD
nla
nla
VE781
FA2146-6
E022684.1)
500
03/05/13
TD
nla
nla
VE781
The QC reported here applies to the following samples:
FA2146-3, FA2146-4, FA2146-5, FA2146-6
Method: SM 6200B
FA2146-6
Spike
MS M5
MISD
MSD
Limits
CAS No.
Compound
ugll Q
UFA
ugn %
ugll
°%
RPD
RadRPD
71-43-2
Benzene
2210
500
2670 92
2610
80
2
70-130120
100-41-4
Ethylbenzene
1110
500
1620 102
1580
94
3
70-130120
1634-04-4
Methyl Tert Butyl Ether
3890 a
500
4460 114
4360
94
2
70-130120
108-88-3
Toluene
10600 a
500
10500 -20• b
10300
-60*
b 2
70-130/20
1330-20-7
Xylene (total)
6990
1500
8190 80
7900
61*
b 4
70-130120
CAS No.
Surrogate Reooveries
MS
MSD
FA2146-6
FA2146-6
Limits
1868-53-7
❑ibromofluoromethane
104%
101%
104%
105%
70-130%
17060-07-0
1,2-Dichloroethane-D4
114%
108%
114%
116%i
70-130%
2037-26-5
Toluene-D8
98%
100%
101%
100%
70-130%
460-00-4
4-Bromofluorobenzene
101%
103%
103%
105%
70-130%
(a) Result is
from Run #2.
(h) Outside
control limits due to high level in sample relative to spike amoun(.
* = Outside of Control Limits.
a)
■i 29 of 35
■ .o,ccu-rEE3T
FA2146

Matrix Spike/Matrix Spike Duplicate Summary Page 1 of 1
Job Number: FA2146
Account: BPAMSS Atlantic Richfield Company
Project: URSNCM:S/S 24163: 381 Knollwood St, Winston-Salem, NC
Sample
File ID
DF
Analymod
By
Prep Date
Prep Batch
Analytical Bath
FA2146-2MS
E022725.13
1
03/06/13
TD
nla
nla
VE782
FA2146-2MS❑
E022726.13
1
03/06/13
TD
nla
nla
VE782
FA2146-2
E022723.1)
1
03/06/13
TD
nla
nla
VE782
The QC reported here applies to the following samples: Method: SM 6200B
FA2146-1, FA2146-2
FA2146-2
Spike
MS MS
MSD
MSD
Limits
CAS No.
Compound
ugli Q
ugA
ugll %
ugll
%
RPD
Red"D
71-43-2
Benzene
0.23 J
10
8.9 87
8.7
85
2
70-130120
100-41-4
Ethylbenxene
ND
10
8.7 87
8.6
86
1
70-130120
1634-04-4
Methyl Tert Butyl Ether
5.4
10
14.3 89
14.0
86
2
70-130120
108-88-3
Toluene
ND
10
8.2 82
8.1
81
1
70-130120
1330-20-7
Xylene (total)
N❑
30
24.8 83
23.9
80
4
70-130120
CAS No.
Surrogate Recoveries
M5
MSD
FA214&•2
Limits
1868-53-7
Dibromofluoromethane
105%
104%
104°%
70-130%
17060-07-0
1,2-Dichloroethane-D4
110%
108%
110%
70-130%
2037-26-5
Toluene-138
98%
99%
99%
70-130°%
460-00-4
4-Bromofluorobenxene
103%
100%
103%
70-130%
* = Outside of Control Limits.
M
w
N
■■ 30 of 35
■ ^ccu--F_E3T
FA2146 �• •� �. �•

s Southeast
ACCLtTE-=ST
L A B❑ R A T b R 1 E S
General Chemistry
QC Data Summaries
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
N
31 of 35
FA2146

METHOD BLANK AND SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA2146
Account: BPAMSS - Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
HS Spike BSP BSP RC
Analyte Batch Ib RL Result Units Amount Result $Recov Limits
Alkalinity, Total as CaCO3 GN54459 5.0 0.70 mg/1 250 249 99.7 90-113%
Alkalinity, Total as CaCO3 GN54503 25 0.0 mg/1 250 253 101.0 90-1131
Chloride GP211111GN54476 2.0 0.0 mg/l 50 50.5 101.0 90-110%
Fluoride GP21111/GN54476 0.20 0.0 mg/l 2.5 2.61 104.4 90-110%
Nitrogen, Nitrate 43P211111GN54476 0.10 0.0 mg/1 2.5 2.48 99.2 90-110%
Nitrogen, Nitrite GP21111/GN54476 0.10 0.0 mg/1 2.5 2.52 100.8 90-1101
Sulfate GP21111/GN54476 2.0 0.0 mg/1 50 51.8 103.6 90-1101
Associated Samples: V
Batch GN54459; FA2146-2, FA2146-5 :-L
Batch GN54503: FA2146-3, FA2146-4, FA2146-6
Batch GP21111. FA2146-2, FA2146-3, FA2146-4. FA2146-5, FA2146-6
(1) Outside of ❑C limits
race 7
■e 32 of 35
FA2146

DUPLICATE RESULTS SUMMARY
GENERAL CNEMISTRY
Login Number: FA2146
Account: BPAMSS - Atlantic Richfield Company
Project: URSNCM:S/S 24163: 391 Knollwood St, Winston-Salem, NC
QC original DUP 4C
Analyte Batch ID Sample Units Result Result RPD Limits
Alkalinity, Total as CaCO3 GN54459 FA2134-5 mg/1 0.90 1.0 10.5 0-20%
Alkalinity, Total as CaCO3 GN54503 M146-4 mg/1 883 B88 0-6 0-20t
Associated Samples:
Batch GN54459: FA2146-2, FA.2146-5
Batch GN54503: FA2146-3, FA2146-4, FA2146-6
(1) outside of QC limits
Page 1
V
IV
■;� 33 of 35
■.o,ccu��s�
FA2148 `••`•••"»�••

MATRIX SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA2146
Account. RPAMSS - Atlantic Richfield Company
Project: URSNCM:SIS 24163: 381 Knollwood St, Winston-Salem, NC
or- original Spike MS QC
Analyte Batch ID Sample Units Result Amount Result %Rec Limits
Alkalinity, Total as CaCO3 GN54459 FA2134-5 mgll 0.90 250 252 100.0 90-113€
Alkalinity, Total as CaCo3 GN54503 FA2146-4 mgll 883 250 1160 109.0 90-113%
Chloride GP211IIIGN54476 FA2319-1 mg/l 2.6 50 51.4 97.6 90-110%
Fluoride GP21il11GN54476 FA2319-1 mg/1 0.0 2.5 2.2 88.ON(a) 90-110R
Nitrogen, Nitrate GP211111GN54476 FA2319-1 mgll 1.1 2.5 3.5 96.0 90-110%
Nitrogen, Nitrite GP211111GN54476 FA2319-1 mg/1 0.0 2.5 2.4 96.0 90-1101
Sulfate GP211111GN54476 FA2319-1 mg/l 0.0 50 47.1 94.2 90-110%
Associated samples: V
Batch GN54459: FA2146-2, FA2146-5
Batch GN54503: FA2146-3, FA2146-4, FA2146-6
Batch GP21111: FA2146-2, FA2146-3, FA2146-4, FA2146-5, FA2146-6
I'} Outside of 4C limits
M Matrix Spike Rec. outside of OC limits
(a) Spike recovery indicates possible matrix interference.
Palle ]
■■ 34 of 35
■ .acc�
FA2146 �.o,..,,...

MATRIX SPIKE DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA2146
Account: BPAMSS - Atlantic Richfield Company
Project. URSNCM:S/S 24163: 381 Knollwood St, Winston-Salem, NC
QC Original spike MSD QC
Analyte Batch ID Sample Units Result Amount Re"It RPD Limit
Chloride
GP21111/GN54476
FA2319-1
mg/1
2.6
50
51.3
0.2
Fluoride
GP21111/GN54476
FA2319-1
mg/l
0.0
2.5
2.2
O.aN(a)
Nitrogen, Nitrate
GP211111GN54476
FA2319-1
mg/1
1.1
2,5
3.5
0.0
Nitrogen, Nitrite
GP2IIII/GN54476
FA2319-1
mg/1
0.0
2.5
2.4
0.0
Sulfate
GP21III/GN54476
FA.2319•-1
mg/1
0.0
50
47.0
0.2
Associated Samples:
Batch GP21111: FA2146-2,
FA2146-3, FA2146-4, FA2146-5, FA2146-6
(*I Outside of QC limits
(N) Matrix Spike Rec. outside of RC limits
(a} Spike recovery indicates possible matrix interference.
Page 1
y
,A
Ell 35 of 35
P.CCLJT'FEST.
FA2145 "•••

Goodrich, David
From: Krouse, Caleb [caleb.krouse [e-mail]]
Sent: Friday, May 03, 2013 1:29 PM
To: Wang, Shuying; Goodrich, David
Subject: RE: Additional information request for the former Knoilwood Gulf Station Injection Permit
W10400198
Attachments: BP 24163 GW Contour.pdf
❑ops- David has sent me emails with similar titles for a different site recently. Attached are the last two maps based on
full scale gauging. ❑uring more recent events, per the CAP and UIC permit monitoring plan, we have not gauged site -
wide water levels.
Regards,
Caleb Krouse, PE
URS Corporation
1600 Perimeter Park Drive, Suite 400
Morrisville, INC 27560
919-461-1S95
[e-mail]
From: Wang, Shuying mailto:shu in .wan ncdenr, ov]
Sent: Friday, May 03, 2013 1:21 PM
To: Krouse, Caleb; Goodrich, David
Cc: Fitzgerald, Conan
Subject: RE: Additional information request for the former Knollwood Gulf Station Injection Permit WI0400198
Maps are not for the subject site!
Shuying Wang
Hydrogeologist
NC DENR Winston-Salem Regional Office
Division of Water Quality, Aquifer Protection Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice: (336) 771-S000
FAX: [phone] or 771-4632
[e-mail]
http://Portal.ncdenr.org/web/wq/aps
E-mail correspondence to and from this address may be subject to
the North Carolina Public Records Law and may be disclosed to third parties.
From: Krouse, Caleb fmailto:[e-mail]]
Sent: Friday, May 03, 2013 1:01 PM
To: Goodrich, David
Cc: Wang, Shuying; Fitzgerald, Conan
Subject: RE: Additional information request for the former Knoliwood Gulf Station Injection Permit W10400198

David,
The last two side -wide groundwater elevation gauging events were performed in January 2012 and August 2012.
Isopotential groundwater maps based on these measurements were included in Appendix 9 of our application (attached
for your convenience), Figure 9-D1 through Figure 9-134.
Regards,
Caleb Krouse, PE
URS Corporation
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
919-461-1595
ca le b. kro use (? urs. co m
From: Goodrich, David mailto:david. oodrich ncdenr. ov
Sent: Friday, May 03, 2013 12:30 PM
To: Krouse, Caleb
Cc: Wang, Shuying
Subject: Additional information request for the former Knollwood Gulf Station Injection Permit WI0400198
Caleb,
Please send us an isopotential groundwater map for the subject facility, based on the most recent groundwater
elevation data.
Thank you.
Regards,
David Goodrich
Office Telphone Number: [phone]
Aquifer Protection Section Main Number: [phone]
Fax Number: [phone]
This e-mail and any attachments contain URS Corporation confidential information that may be proprietary or privileged. If you
receive this message in error or are not the intended recipient. you should not retain, distribute, disclose or use any of this
information and you should destroy the e-mail and any attachments or copies.

LEGEND
PROPERTY LINE �•
GROUNDWATER MONITORING WELL
h
ABANDONED GROUNDWATER
+MW-17
MONITORING WELL
85.28
CATCH BASIN � j
MAN HOLE
AREA LIGHT
i
•
unurY POLE
Mri-34
85.15
FIRE HYDRANT
TELEPHONE
h
LARGE MANHOLE COVER
FORMER PRODUCT LINE
FORMER VENT OR FORMER
REMEDIATION SYSTEM LINE
86.30
GROUNDWATER ELEVATION
Mw-SR +
N M Mw-1 4
Y+MW-ISR
(ft. Above Site Datum)
86.30
(85.36)
GROUNDWATER ELEVATION
-+6 NM(Hot
Used for Contouring)
NM
NOT MEASURED
}
"w
GROUNDWATER CONTOUR
Inferred)
5T R'A
:i AR'hMWNM
V
(Dashed where
GROUNDWATER FLOW DIRECTION
&5.75
�r
NOTE: MONITORING WELL LOCATIONS ARE APPROXIMATE-
0 30
APPROX SCALE, It-
Mw-15+5

+MW-17
68.10
h
IAW-3 m47
55.96¢
PMW-leg 01
w 5R MW-14
-eNA4 87,44+
Mw-18
85.73 4� N V 1
�W �
8 .OS)M —8R
— r IrriT AoFslA UST Ri:
Mw— ,gl
9A4h
37.66
M*—t5—t5
LEGEND
PROPERTY LINE
'F
GROUNDWATER MONI7ORING WELL
ABANDONED GROUNDWATER
MONITORING WELL
s
PROPOSED GROUNDWATER MONITORING WELL
CATCH BASIN
MAN HOLE
AREA LIGHT
UTILITY POLE
FIRE HYDRANT
TELEPHONE
D
LARGE MANHOLE COVER
FORMER PRMUCT UNE
FORMER VENT OR FORMER
REMEOIATIGN SYSTEM UHE
B5.46
GROUNDWATER ELEVATION
(ft. Above Site Datum)
(86,03)
GROUNDWATER ELEVATION
(Not Used For Contouring)
NM
N07 MEASURED
GROUNDWATER CONTOUR
(Dpehed where inferred)
�r
GROUNDWATER FLOW DIRECTION
0 30
APPROX. SCALE, ft.

Goodrich, David
From: Krouse, Caleb [[e-mail]]
Sent: Tuesday, May 01, 2012 8:44 AM
To: Goodrich. David
Subject: Scheduled Injection Events and Reinjection Scenario
David,
Per our telephone conversation last week, the following permitted injections are scheduled:
Permit W10500448 Phase 2 ABC+ Injection in Wilson, NC Scheduled for May 17 through June 1.
Permit W10400198 Activated Persulfate Injection in Winston-Salem, NC scheduled for June 4 through June 13.
The phone call and this email are meant to fulfill the permit requirement for notification of the planned injection 48
hours prior to the injection date, If the injection start dates are changed from the above, you will be notified via email.
During our phone conversation it was also clarified that reinjection of a small amount of daylighted/resurfaced injection
material would be permitted. It was discussed that daylighting would be avoided by the means available, including
stopping injection at the subject injection point, such that reinjection of very large amounts of material would not be
applicable.
Regards,
Caleb !Crouse, PE
URS Corporation - North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
Tel: 919.461,1100
Direct: 919.461.1595
Fax: 919,461.1415
[e-mail]
This e-mail and any attachments contain URS Corporation confidential information that may 4e proprietary or privileged. If you
iaceive this message in error or are not the intended recipient, you should not retain, distribute. disclose or use any of this
information and you should destroy the e-mail and any attachments or copies.

Goodrich, David
From:
Goodrich, David
Sent:
Friday, April 27, 2012 9:42 AM
To:
Wang, Shuying
Cc:
Knight, Sherri
Subject:
Injection Schedule at the Former Knollwood Gulf Station in Winston-Salem WI0400198
Shuying,
Caleb Crouse with URS has just informed me that they intend to begin injection activities at the subject site on June 4,
2012.
Regards,
David
❑ffice Telphone Number: [phone]
Aquifer Protection Section Main Number: [phone]
Fax Number: [phone]

Goodrich, David
From:
Wang, Shuying
Sent:
Tuesday, October 04, 2011 5:57 PM
To:
Goodrich, David
Cc:
Knight, Sherri
Subject:
RE: Injection Permit W 10400198
Hi David,
I have no problem with the variation. Shuying
From: Goodrich, David
Sent: Monday, October 03, 2011 11:48 AM
To: Wang, Shuying
Subject: FW: Injection Permit WI0400198
Shuying,
I am inclined to grant their request for this proposed variation from their original plan. If you and Sherri are OK with it,
we can go ahead and allow them to do so. I cannot think of any danger or other reason why this would not be
acceptable.
David
From: Krouse, Caleb [mailto:caieb.krouseCcburs.coml
Sent: Monday, October 03, 2011 10:28 AM
To: Goodrich, David
Subject: Injection Permit WI0400198
Mr. Goodrich,
We will be performing the pre -injection investigation and baseline monitoring, as described in the permit application,
between October 20, 2011 and November 1, 2011 at the site.
in the application we had indicated that -pre -injection investigation would include aquifer testing, which would be
accomplished by injecting water in two locations to help plan for subsequently injecting NaOH and persulfate, and
would include laboratory testing to determine site soil NaOH buffering capacity. We would like to instead combine these
tests by injecting the 25% NaOH solution during testing and monitoring surrounding pH to test soil buffering capacity in -
situ. This will allow us to more accurately determine the amount of NaOH activator needed for persulfate injection to
support a more effective remediation event. We will be sampling all site groundwater monitoring wells and measuring
pH in all monitoring wells the week following the injection testing.
Please indicate approval of this small adjustment to the application information.
Regards,
Caleb Krouse, PE
URS Corporation - North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
Tel: [phone]

Direct: 919.461.1595
Fax: [phone]
[e-mail]
This e-mail and any attachments contain URS Corporation confidential information that may be proprietary or prwileged. If you
receive this message in error or are not the intended recipient, you should not retain, distribute. disclose or use any of this
information and you should destroy the a -mail and any attachments or copies.

MCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Govemor Director
August 9.2011
Greg Frisch, RM. Operations Manager
Atlantic Richfield Company/BP Products North America Inc.
4850 East 49u' Street. MBC-3 Room 155C
Cuvahoga Heights, Ohio 44125
Ref: Issuance of Injection Permit W10400198
Former Knollwood Gulf Station (BP 24163)
Winston-Salem, Forsyth County, North Carolina.
Dear Mr. Frisch:
Dee Freeman
Secretaru
In accordance with the application received on July 6, 2011. and the supporting data received July 121, 2011. we are
forwarding permit number W10400198. This permit is to inject sodium persulfate (tradename Klozur) and sodium
hydroxide to remediate groundwater contaminated with gasoline and diesel fuel at the facility referenced above. This
permit shall be effective from the date of issuance until July 31, 2013, and shall be subject to the conditions and
limitations stated therein, including the requirement to submit a final project evaluation as stated in PART V11 —
MONTTORING AND REPORTING REQUIREMENTS. Please read the entire permit to ensure that you are aware of all
compliance requirements of the permit. Please note that Permit Condition VII.3. requires the submission of a project
summary report and a final project evaluation within nine months following the conclusion of injection activity and
completion of monitoring.
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. Please contact me at [phone] or at [e-mail]�, if
you have any questions about your permit.
Best Regards,
David Goodrich
Hydrogeolo=ist
M Sherri knight. Winston-Salem Regional Office
Caleb Klouse. URS Corporation. 1600 Perimeter Park Drive, Suite 400_ Morrisville. NC 27560
Thomas Moore, UST Section, 1646 Mail Service Center. Raleigh. NC 27699-1646
W 10400198 Permit File
A3JF7_P PROiTE70N SECTION
1636 Mad aEt ar rBfirBr, Raiegrii, NO* ,810I1n6:
-m*n 2'2b ; apltaI 5aulavatc, r aoaldt,. Noah ',aroma 2160
0m
�'1rJ�: r11C -�.,_^ti7- *++�' 1 gt� -"rrn58:; *k}•' i 9t5-'i5-£{]4E :.�sSEa�` �N�v�Cs - _ "-;,::-�'�� hl.]1��� �[11�C�;�. �-li�.
m;�m:vrwx.n�wateroualitv.vm '!

Goodrich, David
From:
Wang, Shuying
Sent:
Monday, August 01. 2011 9:03 AM
To:
Goodrich. David
Subject:
RE: Permit W 10400198 for Atlantic Richfield/BP Products
A final project evaluation from them within 9 months of completion would be fine, but make sure WSRO get a copy,
Thank you!
Shuying Wang
Hydrogeologist
NC DENR Winston-Salem Regional Office
Division of Water Quality, Aquifer Protection Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone] or 771-46a2
shuving.wang(&ncdenr.gov
http:] portal.ncdenr.orLweb/wq/aps
E-mail correspondence to and from this address may be subject to
the North Carolina Public Records Law and may be disclosed to third parties.
From: Goodrich, David
Sent: Friday, 3uly 29, 2011 1:47 PM
To: Wang, Shuying
Subject: Permit WI0400198 for Atlantic Richfield/BP Products
Shuying,
Your report for this facility indicated that you wanted a project summary report to be submitted 60 days after the
completion of injection and monitoring/sampling. We also require a final project evaluation from them within 9 months
of completion. These two documents would contain essentially the same information.
Should we require, then, only one document from them at 60 days that will combine the requirements of the project
summary report and the final project evaluation? This would avoid redundancy.
Thank you.
David Goodrich

ad,:::;f Z-o. Fen, .
Goodrich, David
From: [e-mail]
Sent: Tuesday, July 12, 2011 10:27 AM
To: Goodrich, David
Subject: UIC Permit Question Response: 381 Knollwood Street, Winston-Salem, NC (BP 24163)
David
Per our telephone conversation today, all Direct Push Technology borings installed at 381 Knollwood Street, Winston-
Salem, NC (BP 24163) will be abandoned with bentonite plug following injection activities. In addition, the abandonment
will take place before demobilization of each injection event so that boreholes are not left open between injection events,
as applicable.
Regards,
Caleb Krouse, PE
URS Corporation - North Carolina
1600 Perimeter Park Drive. Suite 400
Morrisville, NC 27560
Tel: [phone]
Direct: 919.461.1595
fax: [phone]
caleb krouse(b),urscorp.com
jf»s e-mail and any attachments contain UPS Corporation confidential information that may be proprietary or privileged. ff you receive this message in error or are
not the intended recipient, you should not retain. distribute, disclose or use any of this information and you should destroy the e-mail and any attachments or
copies.

AI
ZA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H, Sullins
Governor Director
July 11, 2011
Greg Frisch — RM Operations Manager
4850 East 49"' Street
MBC-3 Room 135C
Cuyahoga Heights, OH 44125
Dear Mr. Frisch:
Dee Freeman
Secretary
Subject: Acknowledgement of
Application No. W10400198
Former Knollwood Gulf Station
(BP 24163)
Injection In situ Groundwater
Remediation Well (51) System
Forsyth County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on July 6, 2011. Your application package has been assigned the number listed
above, and the primary reviewer is David Goodrich.
Central and Winston-Salem Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions. please contact
David Goodrich at [phone] or [e-mail].
Sincerely,
for Debra J. Wa s
Groundwater Protection Unit Supervisor
cc: Winston-Salem Regional Office, Aquifer Protection Section
Caleb Krouse — URS Corporation 1600 Perimeter Park- Drive, Suite 400, Morrisville, NC 27560
Permit File WI0400198
AQUIFER PROTECTION SECTION
1636 Mail Service center, Ralagh, Nortn Carolina 27699-169
Locauon. 272E Gannal Boulevard. RatergM..North Carolina 276D4
Pnone 91y_731=1 I } FA 1 915.71.5-058E FAY. P'.91�-'15.5448 Custorne-5ervrce 1.87-345 74E
nterns? www.ncwaterouaky.oro
On
N❑ir hCciro na
-r, F-Un, iD nu pow � arfrmMvs Arlwr;=rnv1wi •

AQUIFER PROTECTION SECTION RECEIVED
N C.Qept. of ENR
APPLICATION REVIEW REQUEST FORM Vp n 2i'2
Date: April 4, 2013
To., ❑
Landon Davidson, ARO-APS
❑
Art Barnhardt, FRO-APS
❑
Andrew Pitner, MRO-APS
❑
Rick Bolich, RRO-APS
Winston-Sa!sm
Regfanai Office
❑ David May, WaRO-APS
❑ Morelia Sanchez King, WiRO-APS
X Sherri Knight, WSRO-APS
i
(David Goodrich, Land Application Unit
Telephone: [phone] Fax: [phone]
E Mail: dayid. oodrichiaia nedenngov
A. Permit Number: W10400198
B. Owner: Atlantic Richfield Company / BP
C. Facility/Operation: Former Knollwood Gulf Station
❑ Proposed X Existing X. Facility X Operation
l). Application:
1. Permit Type: ❑ Animal ❑ Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon X GW Remediation (ND)or5I Injection
❑ UIC - (W) open loop geothermal
For Residuals: ❑ Land App. ❑ D&.M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: []New ❑ Major Mod. ❑ Minor Mod. X Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
PLEASE SEE THE ATTACHED NOTES.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please take the foil PMtME `RCi►tfU/DWQ
X Return a Completed APSARR Form. - Please comment i1
❑ Attach Well Construction Data Sheet. WAY 0 8 2013
❑ Attach Attachment B for Certification by the LAPCU.
Sect -
El Issue an Attachment B Certification from the RO.*
Aquifer Protection iarl
* [remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SDP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer:
Date:
FORM: APSARR 07/06 Page 1 of I

AQUIFER PROTECTION SECTION — GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: May 3, 2013 Permittee(s): Atlantic Richfield Co./PB Products North America
Permit No.: WI0400198
To: APS Central Office County: Forsyth
Central Office Reviewer: D. Goodrich Project Name: Former Knollwood Gulf Station (BP 241 d3)
Regional Login No:
L GENERAL INFORMATION
1. This application is (check, all that apply): ❑ SFR Waste Irrigation System ® UIC Well(s)
❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ® Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit. May 3, 2a13_
b. Person contacted and contact information:
c. Site visit conducted by: Shuying Wang
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If no. please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, GoogleTM, etc.);
e, Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For UIC Injection Sites:
(If multiple sites either indicate which sites the information aoplies to. copv and paste a new section into the
document for each site. or attach additional panes for each site
a. Location(s):
b. Driving Directions: the site is right located at the southeastern corner of the intersection of Business I-40
and Knollwood St.
c. USGS Quadrangle Map name and number: RECEIVEDIDENRIDWO
d. Latitude: Longitude: Method Used (GPS, GoogleTM, etc.):
Aquifer Protection Section
APS-GPU Regional Staff Report (Sept 09) Page 1 of 6 Pages

AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IV. INJECTION WELL PERMITAPPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities— New, Renewal, and Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QMI5QW)
® In sidu remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5L1"Non-Discharge")
❑ Other {Specify:
2. Does system use same well for water source and injection? ❑ Yes ® No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)? What is the distance of the injection weil(s) from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? < 5 ft.
5. Quality of drainage at site: ® Good ❑ Adequate ❑ Poor
b. Flooding potential of site: ® Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ® Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow,
Injection Well Permit Renewal and Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heat inglcooling)?
❑ Yes ❑ No. If ,yes, explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If yes, explain:
3. For renewal or modification of groundwater remediation permits (of any type), will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ® No. If yes, explain:
APS-GPU Regional Staff Report (Sept 09) Page 4 of 6 Pages

< .f
AQUIFER PROTECTION SECTION — GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
4. Drilling Contractor: Name:
Address:
NC Certification number:
5. Complete and attach NEW injection Facility Inspection Report, if applicable
V. EVAL UATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application: The site is part of the parking lot of
a shopping center and the injection area is right beside Knollwood Street, a very heavy traffic road, so safety
should be addressed and the time for injection may be limited.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would Iike APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed froin the permit when issued. Make sure
that you provide a reason for each condition:
Condition
Reason RECP
,, .
'DENRIDWO
ction Section
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
MW-16 should be also sampled for sodium
Based on the groundwater contour map, MW-3
persulfate, pH, sulfate, and carbon dioxide, at
is not in directly downgradient direction from
least once, before the project or permit is closed.
the injection area. Both MW-3 and MW-16 are
The result should be included in the final project
sort of side-downgradient of wells, but located
evaluation report.
in different sides of the injection area. To make
APS-UPU Regional Staff Report (Sept 09) Page 5 of 6 Pages

AQUIFER PROTECTION SECTION -- GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
sure that the injectant does not have any adverse
impact on the quality of groundwater in
downgradient of the injection area, MW-16
should be also sampled.
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report Preparers):
Signature of APS regional supervisor: + yr L z
Date: l�
V1. ADDITIONAL INFORMATIONAND SITE MAP Sketch of site showing house and waste irri atian
system_, spray or drip field, location of wellfsl, andlor other relevant information- SHOW NORTH ARROW)
The site condition is as in the following picture:

AQUIFER PROTECTION SECTION GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: July 222011 Permittee(s): Atlantic Richfield Co.IPB Products North America
Permit No.: WI0400198
To: APS Central Office County: Forsyth
Central Office Reviewer: D. Goodrich Project Name: Former Knollwood Gulf Station (BP 24163)
Regional Login No:
L GENERAL INFORMATION
1. This application is (check all that apply): ❑ SFR Waste Irrigation System ® UIC Well(s)
® New ❑ Renewal
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ® Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: July 22, 2011
b. Person contacted and contact information: Caleb Krouse, Project Manager, URS Corporation. 919-461-
1100
c. Site visit conducted by: Shuying Wang
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the RIMS record for this application correct?
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, GoogWrm, etc.);
e. Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For UIC Injection Sites:
(If multivle sites either indicate which sites the information applies to, cot)v and paste a new section into the
document for each site, or attach additional paizes for each site)
a. Location(s):
b. Driving Directions: From WSRO: Take US 52 N;_then exit to Business 1-40 Ws then exit at Knollwood St.
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, Google'rm, etc.): RECEIVED I DENR 10VVQ
Aquifer :�rnfr•I-t''in Stzrtiprt
JUL 28 no
APS-GPU Regional Staff Report (Scpt 09) Page l of 6 Pages

AQUIFER PROTECTION SECTION — GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IY. INJECTION WELL PERMIT APPLICATIONS {Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities — New, Renewal, and Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
® In situ remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5LP Non -Discharge")
❑ Other (Specify:
2. Does system use same well for water source and injection? ❑ Yes ® No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)? . What is the distance of the injection well(s) from the pollution
source(s)? ft.
4, What is the minimum distance of proposed injection wells from the property boundary? r ft.
5. Quality of drainage at site: ®Good ❑ Adequate ❑ Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ® Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
S. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal and Modification Only:
1. For treat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No. If yes, explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No, If yes, explain:
3. For renewal or modification of groundwater remediation permits (of any type), will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. Ifyes, _explain:
APS-GPU Regional Staff Report (Sept 09) Page 4 of 6 Pages

0 40
AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
4, Drilling Contractor: Name:
Address:
NC Certification number:
5. Complete and attach NEW Injection Facility Inspection Report, if applicable
V EVALUATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application: The site is part of the parking lot of
a shopping center and the injection area is right beside Knollwood Street a ve heavy traffic road so safely
should be addressed and the time for injection may be limited.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
Within 60 days of the completion of injection
WSRO plans to evaluate if the injection has any
and monitoring/sampling, please submit a
adverse impacts on the quality of groundwater
project summary report, documenting injection
or aquifer,
activities and groundwater sampling results to
WSRO.
APS-GPU Regionat Staff Report (Sept 09) Page 5 of 6 rages

AQUIFER PROTECT N SECTION — GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report Preparer(s):
Signature of APS regional super
Date: 7 5
VI. ADDITIONAL INFORMATION AND SITE MAP CSketch of site showing house and waste kE ation
system, spray or drip feld� location of well(s), and/or other relevant information- SHOW NORTH ARROM
APS-GPLI Regional Staff Report (Sept 09) Page 6 of 6 Pages

FER PROTECTION SE RF=T: EC
APPLICATION REVIEW RE UE O M't D'lYT. n+ Ek�� _
JUL 12 2011
Date: duly 11, 2011 W nis r." I-SaIy"-
o: ❑ Landon Davidson, ARO-APS ❑ David May, WaRO-APS
CV ❑ Art Barnhardt, FRO-AP5 ❑ Charlie Stehman, WiRO-APS
❑ Andrew Pitner, MRO-APS X Sherri Knight, WSRO-APS
Jay Zimmerman, RRO-APS
F m: David Goodrich, Land Application Unit RECEIVE!)/ DENR 1 OM
U Telephone: (912)_715-6162 Fax: [phone] AgUhr Protection
E-Mail: david.goodrichAticdenr.UUL 2 0 2011
A. Permit Number: WI0400198
B. Owner: Atlantic Richfield Comoanv/ BP Products North America
C. FacilitviOperation: Former Knollwood Gulf Station (BP 24163)
❑ Proposed X Existing X Facility X Operation
D. Application:
1. Permit Type: ❑ Animal ❑ Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ IIE Lagoon X GW Remediation (ND)5I Injection
❑ UIC - (5A7) open loop geothermal
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
Z. Project Type: X New fl Major Mod. II Minor Mod. ❑ Renewal n Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please take the following actions:
X Return a Completed APSARR Form. - Please comment
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
R0- APS Reviewer.
FORM: APSARR 07/06 Page 1 of 1
Date:
0

RECEIVED i DENR) DWQ
• AQUIFF PPnTFrT1rW *=N
North Carolina Department of Health and Human ServiceMAY d 5 2009
Division of Public Health • Epidemiology Section
Occupational and Environmental Epidemiology Branch
1912 Mail Service Center ■ Raleigh, North Carolina 27699-1912
Tel [phone] • Fax 919-87" 10
Beverly Eaves Ptrduc. Govcrnor
Lstruer ,M. Cansler, ;ccretan-
April 30, 2009
MEMORANDUM
TO: Thomas Slusser
Aquifer Protection Section
Division of Water Quality
FROM: Kenneth Rudo, Ph.D, Toxicologist �(V"
MERAIDEEB
Division of Public Health
THROUGH: Mina Shehee, Ph.D, Supervisor
MERAIOEEB
Division of Public Health
Jcffrey P. Engcl, T LLD.
State Health Director
SUBJECT: Health Risk Evaluation
Groundwater Remediation Using -Hydroxide -and Calcium Chloride
This review is provided in response to a request for a health risk evaluation
regarding the use of sodium hydroxide and calcium chloride. These compounds are to be used to
enhance the remediation of groundwater contaminated with hydrofluorosilicic acid. The
following information is provided regarding precautions during use:
1) Sodium Hydroxide — chemical is hazardous in cases of ingestion, inhalation, skin and eye
contact and may be an irritant or corrosive. The amount of damage depends on length of
contact. Skin contact can produce inflammation and blistering characterized by scaling,
redness, itching and occasionally, blistering. Eye contact may produce inflammation
characterized by redness, watering and itching and severe contact may result in blindness
or corneal damage_ Inhalation may produce irritation to the respiratory and GI tract and
severe exposure may result in lung damage, choking or death. Please see the instructions
in the MSDS sheet for this chemical in regards to first aid treatment if exposed and the
exposure controls and personal protection when using sodium hydroxide.
2) Calcium Chloride — chemical may cause irritation from eye contact, may be a skin irritant
characterized by scaling, itching, reddening and occasionally blistering, May be hazardous
upon ingestion and inhalation exposure. Please see the instructions in the MSDS sheet for
this chemical in regards to exposure controls and personal protection when using calcium
chloride.
North Carolina Nblie Health
wo :I9fm ■ he rdiry. Ord sakr Barth CarWina A
Erc�ywherc EveryAyy. Ererybedy
Location. 5505 Sex Forks Road, 'j Floor, Roont D-1 a Raleigh, N,C. 27609

RECEIVED I Al NR r DWO
AQUiFr-R-aRnTFrTinN WrITION
MAY 4 5 2009
3) For both chemicals store and use in well ventilated areas. Do not store near heat, spark, or
flame. To minimize exposure access to the area of mixing and application should be
limited to those required to work with the 2 chemicals. All persons involved in the
handling and use of these 2 chemicals should be familiar with the MSDS infonmation and
the information in this memo. Please see the MSDS sheet for both chemicals in regards to
first aid measures to take upon exposure.
4) Eating, drinking, smoking, handling contact lenses, and applying cosmetics should never
be permitted in the application area during or immediately following application. After
handling, wash hands and face thoroughly with soap and water before eating, drinking or
smoking.
5) Based on the information provided by Mr. Slusser on the use of these chemicals in the
remediation process, well water contamination should not be expected in a manner that
would pose an increased health risk upon personal well water use. However, measures
should be taken to better identify any nearby private drinking water wells based on the
incomplete information provided to DEEB. In the event that wells are found within 500
feet of the remediation area, steps should be taken to prevent contamination of these nearby
wells.

9nrl
3
t-
North Carolina Department of Health and Human Services
Division of Public Health — Epidemiology Section
Occupational and Environmental Epidemiology Branch
1912 Mail Service Center • Raleigh, North Carolina 27699-1912
Telephone; 919-707-5900 Fax: [phone]
Michael F. Easley, Governor Leah Deviin, DDS, NTH
Dempsev Benton, Secretary State Health D'rcctor
A�[I8 EC�EI�UED I DEIJRI DINp
August 25, 2008 Rn�c�T1nN gFrTr0N
MEMORANDUM AUG 2 7 2008
To: Qu Qi — UIC Program
Aquifer Protection System
Division of Water Quality
Department of Environment and Natural Resources
From: Sandy Mort Afj--Pik
Epidemiology Section
Division of Public Health
Department of Health and Human Services
Subject: Health Risk Assessment
Use of calcium peroxide or sodium hydroxide as activator for
groundwater/soil remediation with sodium persulfate
The following information is provided in response to Aquifer Protection Section's (APS)
request for a health risk evaluation regarding the use of sodium persulfate with calcium
peroxide or sodium hydroxide as activators for groundwater or soil remediation. These
chemicals are proposed for use at a Duracell battery manufacturing site contaminated
with chlorinated hydrocarbons, petroleum hydrocarbons, acetone, and carbon
tetrachloride. This review is provided as supplemental information to that provided to
APS in September 2003 by DPH regarding the use of hydrogen peroxide and iron-EDTA
activators with sodium persulfate.
The information provided to ❑PH indicates that calcium peroxide will be used at a
proportion of 20% calcium peroxide and 80% sodium persulfate_ This mixture is diluted
to 30%. resulting in approximately 6% calcium peroxide and 24% sodium persulfate in
70% water. The information also states that sodium hydroxide will be used at 1 to 5%
with 30% sodium persulfate.
North Carehna Public Health
work. -a ic. a hral. h.er and safer Nonh Ca -boa
Lve.wherc Ever day to "b dF
Location: 5505 Six Forlcr Rd, ?" r Floor, Room l -?-DI • Raleigh, NC 274509
A fi E qnd Qyu-baxh E rr

Page Z of 9
NC DPH recommends that all persons that will come into contact with the above
chemicals review the MSDS and other appropriate health and safety documents and have
undergone appropriate health and safety training. NC DPH also recommends that.
transport of these chemicals off -site be controlled to prevent potential human or
ecological impacts. Access to the area of application should be limited to workers
applying the product. In order to minimize exposure to unprotected individuals,
measures should be taken to prevent access to the area of application.
SODIUM PERSULFATE HEALTH RISK INFORMATION:
Formula: Na2S203
CASN: 7775-27-1
Synonyms: Sodium peroxydisulfate. Sodium persulfate
Classification: strong oxidant
Sodium persulfate is a strong oxidant and reacts with combustible and reducing
materials. Sodium persulfate decomposes on heating producing toxic and corrosive fumes
including sulfur oxides. It reacts violently with powdered metals and strong bases. In
solution in water it is a weals acid. Sodium persulfate becomes unstable when exposed to
heat, moisture and/or contamination. It is incompatible with acids, alkalis, halides
(fluorides, chlorides, bromides and iodides), combustible materials, most metals and
hearty metals, oxidizable materials, other oxidizers, reducing agents, cleaners, and
organic or carbon containing compounds. Oxidizing chemicals, including sodium
persulfate, should not be stored or directly mixed with combustible material (such as
fuels, papers or solvents) or reducing agents (such as metals or sulfites). Contact with
incompatible materials can result in a material decomposition or other uncontrolled
reactions. Oxidizing chemicals may react energetically with combustible materials or
reducing agents and also release oxygen and heat during decomposition that could help
support a fire. Some oxidizing agents are incompatible with one another. Decomposing
persulfates will evolve large volumes of gas and/or vapor, can accelerate exponentially
with heat generation, and create significant and hazardous pressures if contained and not
properly controlled or mitigated. Use with alcohols in the presence of water has been
demonstrated to generate conditions that require rigorous adherence to process safety
methods and standards to prevent escalation to an uncontrolled reaction.
Potential health effects: The primary route of toxicity is through direct inhalation of
airborne dust or mist, or direct contact. Airborne persulfate dust may be irritating to eyes,
nose, lungs, throat and skin upon contact. Dust dispersion should be controlled. Sodium
persulfate in identified as a strong oxidizer and an irritant. Inhalation of dust may cause
asthma -like reactions. Acute (short-term) health effects that may occur immediately or
shortly after exposure include severe skin and eye irritation and bums. Breathing sodium
persulfate can irritate the nose, throat and lungs, causing coughing, wheezing and/or
shortness of breath. Long-term (chronic) or repeated exposure may cause a skin
allergy or dermatitis. if allergy develops, very low future exposure can cause itching and
a skin rash. An asthma -like allergy may also result from long-term or repeated inhalation
exposures with future exposure potentially causing asthma attacks with shortness of
x Location. 550j Sk Forks Rd.. ?""'Floor, Room 1 -DI •Rulerxh. N.0 2760Q
''• 1 n Equal Dppnrnuarr Ernplacer

Page 3 01-9
breath, wheezing, cough, and/or chest tightness_ General allergic reactions, Iike urticaria
(hives) or shock, may occur. Sodium persulfate has not been tested for its ability to cause
cancer or reproductive effects.
Evidence of exposure includes:
Inhalation: cough, labored breathing, sore throat, wheezing
Skin: redness, pain
Eyes: redness, pain
Ingestion: diarrhea, nausea, sore throat, vomiting
Recommended personal protective equipment (PPE): Prevent release of dust into the
work environment with room ventilation. All persons working with sodium persulfate
should use appropriate PPE, including:
Eves and face: Use cup type chemical goggles. Full face shield may be used.
Respiratory: Use approved dust respirator when airborne dust is expected. A NIGSH 100
HEPA tight -fitting half -face unit is recommended (with fit testing).
Protective clothing: Normal work clothes. Rubber or neoprene footwear.
Gloves: Rubber or neoprene gloves. Thoroughly wash the outside of gloves with soap
and water prior to removal. Inspect regularly for leaks.
First Aid:
Eye contact: Immediately flush with large amounts of water for at least 15 minutes,
occasionally lifting upper and lower lids. Seek medical attention immediately.
Skin Contact: Quickly remove contaminated clothing. Immediately wash contaminated
skin with large amounts of soap and water.
Breathing: Remove the person from exposure. Begin rescue breathing {using universal
precautions} if breathing has stopped and CPR if heart action has stopped. Transfer
promptly to a medical facility.
Additional safety recommendations: Prevent release of dust into the work environment
with room ventilation. Workers whose clothing has been contaminated with sodium
persulfate should change into clean clothing promptly. On skin contact immediately
wash or shower to remove the chemical. Remove contaminated clothing immediately
and wash before reuse. At the end of the work shift, wash any areas of the body that may
have contacted sodium persulfate. whether or not known skin contact has occurred, Do
not take contaminated work clothes home to prevent exposure of family members.
Contaminated work clothes should be laundered by individuals who have been informed
of the hazards of exposure to sodium persulfate.
Eye wash fountains should be provided in the immediate work area for emergency use. if
there is the possibility of skin exposure, emergency shower facilities should be provided.
Do not eat, smoke, or drink where sodium persulfate is handled, processed, or stored,
since the chemical can be swallowed. Wash hands carefully before eating, drinking,
stroking, or using the toilet.
Handling and. storage: Use adequate ventilation when transferring product from bags or
drums. Provide mechanical general and/or local exhaust ventilation to prevent release of
Ltwation: 550i Sir Forks Rd, 2'0 Floor, Rom 1-2-DI • Raleigh, N.C. 2 760 9
A- An Equal Oppomgnitr Emp1gver•

Page 4 of 9
dust into work environment. Spills should be collected into suitable containers to prevent
dispersion into the air. Wear respiratory protection if ventilation is inadequate or not
available. Use eye and skin protection. Use clean plastic or stainless steel scoops only.
Store (unopened) in a cool, clean, dry place away from point sources of heat, e.g. radiant
heaters or steam pipes. In case of fire or decomposition (fuming/smoking) deluge with
plenty of water to control decomposition. Use a vacuum or a wet method to reduce dust
during clean-up. DO NOT DRY SWEEP.
CALCIUM PEROXIDE HEALTH RISK INFORMATION:
Formula:
CaO,
CASN:
1305-79-9
Synonyms:
calcium dioxide, calcium superoxide, Calper. Calper G
Classification:
oxidizer
Calcium peroxide is an oxidizer, thus contact with combustible materials (paper, cotton,
organics, leather, reducing agents, and other oxidizers) should be avoided. Calcium
peroxide is not flammable but will contribute oxygen to feed a fire. Contamination, heat,
and humid conditions will enhance and accelerate decomposition. Decomposition is
endothermic, unlike most oxidizers. Store calcium peroxide in a clean, dry place. Do not
expose to heat sources or high humidity. Store away from combustible materials, Keep
containers closed when not in use. Dilute spills with water.
Potential health effects: Contact can severely irritate and burn the skin and eyes with
possible eye damage. Breathing calcium peroxide can irritate the nose, throat and lungs
causing coughing, wheezing and/or shortness of breath. Harmful if swallowed. The
following acute (short-term) health effects may occur immediately or shortly after
exposure. Contact can severely irritate and burn the skin and eyes with possible eye
damage. Breathing calcium peroxide can irritate the nose, throat and lungs causing
coughing, wheezing and/or shortness of breath. Chronic (long-term) health effects can
occur at some time after exposure and can last for months or years and include lung
irritation. Repeated exposure may cause bronchitis with cough, phlegm, and/or shortness
of breadth. Calcium peroxide has not been tested for its ability to cause cancer or
reproductive effects. Calcium peroxide should be handled in well ventilated, dust
controlled areas. When handling large quantities, use a dust mask, goggles, and gloves.
Evidence of exposure includes:
Inhalation: nose and throat irritation
Skin: irritation
Eyes: irritation
Ingestion: irritation of mouth and stomach
Recommended personal protective equipment (PPE): Avoid skin contact with
calcium peroxide.
Eves and face: Wear chemical safety goggles. Wear a face shield along with goggles
when working with corrosive, highly irritating or toxic substances.
' Location: 5505 Sir Forkv Rd.. Z"d Floor, Roam 1-2-DI • Raleigh. N.C. 27609
An Equal Opporainirr Employer

page 5 of 1)
Respiratory: Use NIOSH certified toxic dust respirator. A NIOSH 100 HEPA tight-
fitting half -face unit is recommended (with fit testing).
Protective clothing: Wear protective gloves and full cover clothing
All protective clothing (suits, gloves, footwear, headgear) should be clean, available each
day, and put on before work.
First Aid:
Eves: Immediately flush with water for at least 15-30 minutes, lifting the upper and lower
eyelids intermittently. See a medical doctor or ophthalmologist immediately.
Skin: Remove contaminated clothing. Wash with plenty of soap and water. Get medical
attention if irritation occurs and persists.
Ingestion: if conscious rinse mouth with water. Dilute by giving I or 2 glasses of water or
milk. Do not induce vomiting. See a medical doctor immediately.
Inhalation: Remove to fresh air. If breathing difficulty or discomfort occurs and persists,
obtain medical attention.
Additional safety recommendations: Workers whose clothing has been contaminated
by calcium peroxide should change into clean clothing promptly. ❑o not take
contaminated work clothes home. Family members could be exposed.
Contaminated work clothes should be laundered by individuals who have been informed
of the hazards of exposure to calcium peroxide,
Eve wash fountains should be provided in the immediate work area for emergency use. If
there is the possibility of skin exposure, emergency shower facilities should be provided.
On skin contact with calcium peroxide, immediately wash or shower to remove the
chemical.
Do not eat, smoke, or drink where calcium peroxide is handled, processed, or stored,
since the chemical can be swallowed. Wash hands carefully before eating, drinking,
smoking, or using the toilet.
Use a vacuum or a wet method to reduce dust during clean-up. DO NOT DRY" SWEEP.
Handling and storage: Calcium peroxide must be stored to avoid contact with
combustibles; hydrocarbons; fuels; cellulose; hydrogen peroxide; and organic materials
since fires may occur. Store in tightly closed containers in a cool. well -ventilated area.
SODIUM HYDROXIDE HEALTH RISK INFORAMTION:
Formula: NaOH
CASH: 131 a-73-2
Synonyms: Caustic soda, Lye, Soda lye, Sodium hydrate
Classification: alkaline, corrosive
Location: 5545 Sir Forkv Rel., `nd Floor, Roam 1-2-D1 s kaleigh, N.C. 17609
'� An Equal Opportzatiti Emplovnr

Page 6 of 9
Sodium hydroxide is classified as a corrosive material. Sodium hydroxide is
incompatible with water, acids, flammable liquids, organic halogens, organic peroxides,
metals such as aluminum, tin, zinc, or nitromethane. It is corrosive to metals. Keep this
compound separated from acids, easily ignitable materials, explosives, metals, organic
peroxides, and water or any moisture. Sodium hydroxide will react with water to release
heat and contact with aluminum, tin, lead and zinc will release flammable and explosive
hydrogen gas. Contact with nitromethane and other nitro compounds may result in the
formation of Shock -sensitive or explosive salts. Contact with moisture or water may generate
sufficient heat to ignite combustible substances.
Potential health effects: Sodium hydroxide is a corrosive irritant of the skin, eyes, and
mucous membranes. Sodium hydroxide both in solid and in solution has a markedly
corrosive action upon all body tissues causing burns and frequently deep maceration,
with ultimate scarring. Inhalation of the dust or concentrated mist can cause damage to
the upper respiratory tract and to lung tissue, depending upon the severity of the
exposure. Effects of inhalation may vary from mild irritation of the mucous membranes
at 2 in to severe pneumonitis at higher airborne concentrations. Inhalation of
alkaline vapors can produce upper airway edema, respiratory failure, wheezing,
pulmonary edema, and pneumonitis. Exposure to the dust or mist may cause pain,
redness, irritation or full thickness bums. Contact with the eyes causes disintegration and
sioughing of conjunctival and corneal epithelium, corneal opacification (renders the
cornea opaque), marked edema, and ulceration. Permanent visual loss may occur. After 7
to 13 days, either gradual recovery begins, or there is progression of ulceration and
corneal opacification. On the skin, solutions of 25 to 50% sodium hydroxide cause a
sensation of irritation within about 3 minutes; with 4% solutions, irritation does not
develop for several hours. If it is not removed from the skin, severe burns with deep
ulceration may occur. Produces severe abdominal pain, Corrosion of the lips, mouth,
tongue, esophagus, and pharynx, and the vomiting of large pieces of mucosa. It can cause
perforation and scarring. Glottic edema and upper airway obstruction may occur
following ingestion. Cases of squatnous cell carcinoma of the esophagus have occurred
with latent periods of 12 to 42 years after ingestion. These cancers were the sequelae of
tissue destruction and possible scar formation, rather than due to a direct carcinogenic
action of sodium hydroxide itself. The greatest industrial hazard is rapid tissue
destruction of eyes or skin upon contact with either the solid or concentrated solutions.
Acute (short-term exposure) health effects which may occur immediately or shortly
after exposure include with contact severe irritation and burning the skin and eyes with
possible eye damage or clouding of the eves with loss of vision. Breathing sodium
hydroxide can irritate the mouth, nose and throat. Breathing can also irritate the lungs
causing coughing and/or shortness of breath. Higher exposures can cause a build-up of
fluid in the lungs (pulmonary edema), a medical emergency, with severe shortness of
breath. Chronic (long-term exposure) health effects can occur at some time after
exposure to and can last for months or years. Very high chronic exposure may cause lung
damage. Sodium hydroxide has not been tested for ability to cause cancer in animals.
There is no evidence it effects reproduction.
pr•ry
a.i
3 Location: 5505 Six Forks Rd„ :"'Flour. Roonr 1-2-DI ■Raleigh, N.C. 27609
An Equal Dpponvpiry Emplo.ver

Page 7 o1 9
Evidence of exposure includes:
Inhalation: irritation of mucous membranes, pneumonitis
Skin: irritation, bums, temporary loss of hair
Eyes: irritation, corneal damage
Ingestion: irritation of mucous membranes, severe abdominal pain, corrosion of
the lips, mouth, tongue, and pharynx, and the vomiting of large pieces
of mucoua, upper airway obstruction may occur
Workplace exposure limits:
These exposure limits are for air levels only.
OSHA: The legal airborne permissible exposure limit (PEL) is 2 mglm3 averaged over
an 8-hour work shift.
NIOSH: The recommended airborne exposure limit is 2 m�m3, which should not be
exceeded at any time. The N1OSH IDLH value is 10 mglm .
ACGIH: The recommended airborne exposure limit is 2 mglm3, which should not be
exceeded at any time.
Recommended personal protective equipment (PPE): Appropriate, impervious,
protective clothing (including gloves) should be worn to prevent skin contact. Protective
equipment should not be made of aluminum, copper, soft iron, tin, or zinc (or alloys
made of these metals.
Eves and face: For solid sodium hydroxide wear impact resistant eye protection with side
shields or goggles. For liquids wear indirect -vent, impact and splash resistant goggles. A
face shield along with goggles is recommended when working with corrosive, highly
irritating or toxic substances. Contact lenses should not be worts when working with this
substance. Eyewash fountains should be provided.
Respiratory: Use NIOSH certified toxic dust respirator. A NIOSH 100 HEPA tight-
fitting half -face unit is recommended (with fit testing). Where the potential exists for
exposure over 2 mg/mn , use a MSHAINIOSH approved supplied -air respirator with a Ball
face piece operated in a pressure -demand or other positive -pressure mode. For increased
protection use in combination with an auxiliary self-contained breathing apparatus
operated in a pressure -demand or other positive -pressure mode. Exposure to 10 mglm3 is
immediately dangerous to life and health. If the possibility of exposure above 10 mglm3
exists, use a MSHAINIOSH approved self-contained breathing apparatus with a full face
piece operated in a pressure -demand or other positive -pressure mode.
Gloves: Impervious. ACGIH recommends polyvinyl chloride, butyl, butyllneoprene,
natural rubber, neoprene, polyethylene, Saranex. Teflon and Vitonlneoprene as protective
materials.
First Aid:
Eves: Irrigate immediately
Skin: Water flush immediately. Clothing which becomes significantly contaminated, or
wet, should be removed as quickly as possible.
Breathing: Respiratory support
Ingestion: Medical attention immediately
Loctaiori: 53D5 Sr.r Forb- Rd- 2"`' Flunr. Ruuoi 1-'-DI • Rulei�;h. A! C_ 27609
�. An Equal Dpportutrm- Empki-ver

Page 8 of 9
Handling and storage: Store in tightly closed containers in a cool, dry, well -ventilated
area away from moisture. Wherever sodium hydroxide is used, handled, manufactured,
or stored, use explosion -proof electrical equipment and fittings. Keep sodium hydroxide
separated from acids, easily ignitable materials, explosives, metals, organic peroxides,
and water for any moisture).
Additional safety recommendations: Workers whose clothing has been contaminated
by sodium hydroxide should change into clean clothing promptly, Do not take
contaminated work clothes home. Family members could be exposed.
Contaminated work clothes should be laundered by individuals who have been informed
of the hazards of exposure to sodium hydroxide.
Eye wash fountains should be provided in the immediate work area for emergency use.
If there is the possibility of skin exposure, emergency shower facilities should be
provided. On skin contact sodium hydroxide, immediately wash or shower to remove the
chemical. At the end of the work shift, wash any areas of the body that may have
contacted sodium hydroxide, whether or not known skin contact has occurred.
Do not eat, smoke, or drink where sodium hydroxide is handled, processed, or stored,
since the chemical can be swallowed. Wash hands carefully before eating, drinking,
smoking, or using the toilet.
For solid sodium hydroxide use a vacuum to reduce dust during clean-up. DO NOT DRY
SWEEP.
Location: 5505 Sa Fork+ Rd., '0 Floor, Room 1-?-DI • Ruleigk N.C. 77609
�� ,_ An Equal Oppornudh Employer

Page 9 of 9
References:
1. International Chemical Safety Cards (ICSCs): International Programme on Chemical
Safety. CDC, NIOSH. http-./iwww.cdc.gov/nioshJipcs/lcstarLhtmi
2. New Jersey Department of Health and Senior Services Hazardous Substances Fact
Sheets_
3. Sodium Persulfate MSDS. FMC MSDS no.. 7775-27-4, April 30, 2006, revision no. 12.
FMC Corporation.
4. Calcium Peroxide Technical Data Sheet. FMC Corporation.
5. TOXNET Toxicology Data Network. US National Library of Medicine.
http: //to xnet. nlm.nih. govl
b. Calcium Peroxide MSDS. FMC MSDS no.: 1305-79-9-1, April 30, 2005, revision no. 9,
FMC Corporation.
7. Thomson MICROMEDEX.
8, NIOSH Pocket Guide to Chemical Hazards, CDC_
9. Technical and Regulatory Guidance for In Situ Chemical Oxidation of Contaminated Soil
and Groundwater, Second Edition. The interstate technology & Regulatory Council In
Situ Chemical Oxidation Team. January 2005. http://www.itrcweb.org/Documents/ISCO-
2-22H
Location: 5505 Six Forks Rd.. Floor, Room 1-2-D1 • Raleigh. 'V.C. - filly
Aak,. An Equal Oppormutr Emplover

�1J�J
June 26, 2013
UIC Program Staff
DWQ - Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
DWQ - Aquifer Protection Section
Winston-Salem Regional Office
585 Waughton Street
Winston-Salem, NC 27107
RE: Injection Event Record
Injection Completed Under Injection Permit WI0400198
Former Knollwood Gulf Station (BP 24163)
381 Knollwood Street, Winston-Salem, NC
URS Corporation — North Carolina (URS) and Vironex, Inc., on behalf of Atlantic Richfield
Company (ARCO), a BP Products North America, Inc. affiliated company, have prepared the
attached Injection Event Record, Well Construction Record, and Well Abandonment Record
for injection of sodium persulfate (Kloaur@) activated with sodium hydroxide (NaOH) at the
Former Knollwood Gulf Station (BP 24163) in Winston-Salem, North Carolina. URS will
continue quarterly groundwater sampling and reporting per the Injection Permit and will
submit the results for 2013 Q2 groundwater samples, collected on May 31, 2013, in
approximately August 2013.
If you require further information or have any questions regarding this submittal, please
contact me at [phone].
Sincerely,
URS orporgtion — tiorth Carolina
aleb Krouse, PE
Project Manager
Enclosures: Injection Event Record
Well Construction Record
Well Abandonment Record
cc: Thomas Moore, NCDENR DWM UST Section (hard copy);
Charles Sherren and Zane Zynda, Thruway Shopping Center (email);
ENF'OS, BP (electronic); RECE4V�]�DFNRI
Project File (electronic) owo
URS Corporation — North Carolina
1600 Perimeter Park Drive, Suite 400 Aquifer NO(ection Se cWn
Morrisville, NC 27560
Tel: [phone]
Fax: [phone]

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Quality
Permit Number W 10400198
1. Permit Information
Atlantic Richfield Company/BP Products
Permittee
Former Knollwood Gulf Station_LBP 24163)
Facility Name
381 Knollwood Street, Winston-Salem, Forsyth County
Facility Address
2. Injection Contractor Information
URS Corporation - North Carolina
Injection Contractor 1 Company Name
Street Address 1600 Perimeter Park Drive, Ste 400
Morrisville NC 27560
City State Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection 23
Well names IP2-1 through IP2-23
Were any new wells installed during this injection
event?
Q Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells 23
Type of Well Installed {Check applicable type}:
❑ Bored ❑ Drilled 0 Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include two copies of form GW-1 b for each
well installed
Were any wells abandoned during this injection
event?
® Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells 23
Please include two copies of the GW-30 for each
well abandoned.
4. Injectant Information
Sodium Persuifate (SP) & Sodium Hydroxide (NaOH}
Injectint Type
Concentration 6.726 lbs SP / 855 gal 25°/oNaOH 15.590 gal water
If the injectant is diluted please indicate the source
dilution fluid City of Winston-Salem Fire Hydrant
Total Volume Injected 6,826 gallons of solution
Volume Injected per well Approx. 300 gallons
5. Injection History
Injection date(s) __June 4. 2013 to June 6, 2013
Injection number (e.g. 3 of 5)
1of1
Is this the last injection at this site?
❑ Yes g] No (pending monitoring results)
1 DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STA4ARDS AID OUT IN THE PERMIT,
6/25/2013
URS Corporation Project Manager - Caleb Krouse
PRINT NAME OF PERSON PERFORMING T11E INJECTION
Submit the original of this form to the Division of Water Quality within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-733-3221
Form UIC-IER
Rev. 07/09

WELL CONSTRUCTION REC[
this limn can be u%d Iorsirrgle or multiple welis
I. Well Contractor Information_
Charles Terry
Nell Cwvracior Name
NCWC 4182-B
NC Well Ccrclnclor Certification Number
Vironex, Inc
Company Name
2. Well Construction Permit #: WI0400198 (Injection)
Lia all ❑ppheable %wil consowlion permily li.r. C t"in•. Sale. I inrurrrr. rk•. r
3. Well Use (check well use) -
Water Supply Well:
❑Agricultural
OlVlunicipallPublic
❑GcotlierataI (IILai inglCooling Supply)
0Rtsidt:tnial Water Supply (single)
Olndustriai,Cornmercial
❑ Res idential Water Supply (shared}
❑ irrigation
Ran -Water Supply Well:
❑ %lonitoriug
C Rceovvy
Injection Well:
❑Aquifer Recharge
00roundwater Rerriediation
❑Aquiter Storage and Recovery
❑salinity Barrier
:]Aquifer Test
Cstormwater Drainage
❑Experimental Technology
CSubsidence Control
CGeothenTW (Closed Loop)
CT'raca
❑Geothermal (Iicatinl+lCooling Retum)
COther (explain under #21 KLmatks)
4. Date Well(s) Compieled : 6/6/2013 Well TD# I P2-1 to IP2-23
5a. Well Location:
BP 24163 NA
F'xihnrOwner Name 1`36 ilyiD: (ifapphcahlel
381 Knollwood Street, Winston Salem, 27103
Physical Address. City. and ?Pp
Forsyth
C ouniv
6825048855
Parcel idsnt 16cation No. (PIN)
51b. Latitude and Longitude in degreeslminoreslseconds or decimal degrees:
Sif r+eII field. one Iavlong is sutficient)
36.090783 N-80.286412 W
6, is (are) the weli(s): OPermanent Or 71remporary
7. Is this a repair to an existing well: ❑Yes or -FItio
11 this is a repair. fill onr knaun rwd , ansrrwrion Inlornrar-on find a -,wain the r+arare urfhe
rcywir• under tell rcmurkc seclude fir wr 1hr harrk eif this loam.
H. Number of wells coastruetedr 23
Fr,r nridople +njecomi or non -water s+rppN %oils OYLY with The some eon"struciian, uw raft
.uGmil oar famr"
9. Total well depth below land surface: 17 (ft.)
Fnr multiple wok lim rill deprlis if dr(lrrrnr (eaampts- t;d•'&V' and 2qy 1W)
10. Static water level below top ofcaiing: 13.5 (ft.)
11 onler 4nVI is above. firing, cue -+"
11. Barchole diameter, 2
12. Well construction method: Direct Push
l "c. auger, troarv, cable, dlr�cz push. otc. I
Fos Internal Use iINLY'
14. WATER ZONES
FROM Tn nrsr R1Pn[!x
13.5 Iz 17 n. surficial aquifer
It. rL
15. OUTER CASING for multi cued welks OR LLYER if a ticable
FROM Toul,l►PETER Tri1CK�F:55 H.t FFRI.U.
NA R. ft. I
16. INNER CASING OR TUHLYG rural dosed-t
FROM TO DIAMETER THICKNF&S %VOPFR1AL
NA r" tr. la.
ft. R. in.
17. SCREEN
FROM to I)MMETER SLOT SUEE THICKN S NLAMIUAL
12 r` 17 ft- 2 In. NA NA steel rr>d
R. R. in.
I& GROUT
FROM 1"0 MATERIAL EN P1 AC!.XlE%'1' %lE1 HOD & AMOt;v1
NA rt. Ft.
rt. rt.
rt. R.
19. SAN DIG RAVEL PAC [C ifs Iicrblc
FROM FO %tATERLAL l:strL%TEKt:tiT M1--e unD
NA
R. n.
2& DR111.LLNG LOG (Attach addineaal sheets If eleres
FROM to nl-SCR IPTIDM1 enlur, hardnnr,+uiliTX n pe. KFARI >tse. ere,
n rt i7 rr. Soil Not logged
r1, rt.
f1. It.
fL ft.
fr, tr.
21. REMARKS
Direct push to 17 ft with steel rod fitted with 5 ft screen. Injection
performed through rod. rod removed, and points were abandoned.
22. Certifieation:
1/3
tiitenalurr ul Cetiificd we t'ontractor Pace
By .signing lhir form. I herehv rcrah, that the Kt1 urns {+.ere} ew+asniefed is accordance
rich f5 1 y'C.�C D?C "111tlR fir 1 S t 4[.f[ ❑'C 020Wf Corr.urarrial Sir+++rlarrra u1+d rhrlr a
ajn• of this retard hue Bern pmi ided in dip cell mviw.
23. Site diagram or additional well details:
You may use the bark of this page to provide additional well site details or well
eanstnlction details- You may also attach additional pages i€neeess;uy.
SUBMITTAL INSTUMONS
24a. For :UI Wells: Submit this form within 10 days of completion of well
construction to the following:
Division of Water Quality. Infortnation Processing Unit,
1617 Mail Service Center, Raleigh. \C 27699-1617
24b. For Injection Wells: In addition to sending the Form to the acidntss 1n 24a
above. also submit a copy of this form within 31) days Df completion of well
ConsrrucUon 10 the following
Division of Water Quality, Underground injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigb, NC 27699-1636
Method of test: 23c. For Water Supply & Inieemast Wells: in addition to sending the form to
132. Yield (gpm) the addressfi�sl above, also submit one copy of this form within 30 days of
13h. disinfection type: Amount: completion of will construction to the t:ounty health department of the county
where constmcicd.
Form G W. I North Carolina Pcpann=L of L•nvrronlnrm and Nzktuizl R notirecr, Dit lsion of Waler Quality Retiucd Jan. 2013

WELL A$ ANDONMENI
I -his form can be used tot single or midtiple svells
I. Well Contractor Information:
Charles Terry
a'COP
D For kmental U-sc UNL1 :
wEL ,►HA\DONMENFDETAIL
S
W,:il Conrraerc+r Nsme tnr n•eil pWFWr pcsa:sany aWdonrng "Cll on hishcT prapWVl
NCWC 4182-8
NC Well Can miur Ceriirkwion Number
Vironex, Inc.
Conlrany Nano
2. Well Construction Permit #: W10400198 (injection)
List all applicubte well canururnan prrnrirs ti.r- Covurv. Stare, I arianre, cra:l if known
3. Well use (check well asel:
Water Supply Well:
CALtncukardf
OCreothermal (IlcatingtCaoling 5uppiy)
7 Industrial"Commcruiui
❑Aquifer Recharge
❑Aqui ter Storage and Recovery
❑Aquifer Test
❑Experimental Technology
ElGensherrisal IClosed Loop)
❑G.other-nai (HLai ingiCooiing RclumI
4. date svell(s) abandoned: 6/6/2013
52. Well location:
BP 24163
©.Mun:cipaVPubiic
3Res idential Water Supply fsingle)
❑ Residential W atcr Supply (shared)
C
ElCrroundwalcr Remediation
❑Sshinty harrier
ostormwater Drainage
oSub&idence Control
OTracer
NA
1 wility Ow ncr Namr FH:ility 1DjO Iifapplicabtel
381 Knollwood Street, Winston Salem, 27103
PhypicaI Address. City. arrti Zip
Forsyth
County
6825048855
Parcel Idwiiication No. WIN)
5b. Latitude and it) agitude in degreeslminutes/secands or decimal degrees:
iifwcll ticld. vac iarlong is 5wlTwicnt1
36.090783 N-80.286412
7a, \umber of wells being abandoned: 23
Fnr �udkillle injlrriun or rrnn•wwrer srrppls• mils ONLY stub the r�rarr,
t- msiou fruit- uhuadt mew+ � vrr •an srrwwo uae rurrn,
7b. Approximate volume of water remaining In tvell(a): 1 (gt l.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
❑ Neal Cemcm Grout E Bcntonite Chips or Pcllcts
i! Sand Cement Grout
CI Concrete Grout
iI specialty Grout
CI Bcntonitc Slurry
� Dry clay
❑ Drill Cuttings
* Gravel
3 Other (cxplain under 7g)
7C For each material aelected above, provide amount of materials used:
13 bags (5o}breach)
7g. Provide a brief description of the abandonment procedure:
Slowly pour bentonite pellets into borehole void left
from removed DPT injection rods in accordance
with manufacturer recommendations.
-
T---
l5r�turc ofC �-rtifed Wrll.Carttnotoror-ttdLtt[riTnc7020Well
13a1a
Rs, .signing this form, I herrbv corn& that the rti ere) abandwtrd in
ac+cordaace nsrh 15A NCA C 62C .0100 or 3C anstruciion Standards
and that a copy arthis rerord he been provided to lire sur11 awner-
9. Site diagram or additional well details:
You may use the back of this page to provide additional well site: dew iIs or well
abandonment details. You may also attach addinemal pages if necessary.
CONSTRUCTION DFTA[LS OF WELLS) BEING ARAiNSUBMITTAL INURUCTION,
lftach strtl cu+Iwrmlion rerord(s) if alwdahle. for nniNple irvecanrr or wen -wafer r+rpryle
wulty ONL V u frh the sums, s`arrsrr:rrrrrin rrhrrndarerexr. Vote ran sahma orre jarnr. Na For All Wells' Submit this form within 30 da s of coo lelion of well
62. Well 117#: IP2-1 to IP2-23
6b. Total well depth: 17 (ft.)
fie. Be re hole diameler: 2 (in.)
hd. Heater 14:%0 below ,round surface: 13.5 (ft.)
tic. Outer casing length of knnwnl: NA (ft_)
bf. Inner casinWtubing length (if known); NA (ft-)
bg. Screen length (if kno+wr0' 5 (R•)
Y P
abandonment to the following:
Divisioa of Water Quality. Information Pracessing 1: nit,
1617 Mail Service Center, Raleigh, NC 27699-1617
lab. For Infection Wells: In addition to sending the Form to the address in IOa
above, also submit one copy of this term within 30 days of completion of well
ebandonmcnt to the following:
Division of Water Quality, Uadergrouad Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
IOc. For Water SupplyS'upp!y & In ection Wells: to addition to sending the form to
the uddrn.,(Ls) above, also submit ono copy of this form within 30 days of
cum pletion of well abandonment to the county health department of the county
where abandoned.
t;nnn [ ; W - i(n ti.jr, h Car�pline DcWffwnt of Fni itanmcni ami Manna! A sourccs Dk isron of Waler 0mbry Rcviscd March 2013

1 p�00 tJ8
July 2, 2012
UIC Program Staff
DWQ - Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
DWQ - Aquifer Protection Section
Winston-Salem Regional Office
585 Waughton Street
Winston-Salem, NC 27147
RECEivE01DENR10WQ
JUL 0 3 20iz
Act"Ffer Protectan Section
RE: Injection Event Record
Injection Completed Under Injection Permit WI0400198
Farmer Knollwood Gulf Station (BP 24163)
381 Knollwood Street, Winston-Salem, NC
URS Corporation — North Carolina, on behalf of Atlantic Richfield Company (ARCO). a BP
Products North America, Inc. affiliated company, has prepared the attached Injection Event
Record for injection of sodium persulfate (Klozur®) activated with sodium hydroxide (NaOH)
at the Former Knollwood Gulf Station (BP 24163) in Winston-Salem, North Carolina.
If you require further information or have any questions regarding this submittal, please
contact me at [phone].
Sincerely,
URS Corporation — North Carolina
Caleb Krouse, PE
Project Manager
Attachments: Injection Event Record
CC" ENFOS, BP (electronic)
Project File (electronic)
URS Corporation -- North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
Tel: [phone]
Fax: [phone]

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Quality
Permit Number W10400198
1. Permit Information
Atlantic Richfield Company/BP Products
North America, Inc.
Permittee
Former Knollwood Gulf Station (BP 24163)
Facility blame
381 ICnollwood Street, Winston-Salem, Forsyth, 27103
Facility Address
2. Injection Contractor Information
Caleb Krouse 1 URS Corporation
Injection Contractor/ Company Name
Street Address 1600 Perimeter Park Drive, Suite 400
Morrisville NC 27560
City State Zip Code
919) 461 - 1595
Area code — Phone number
3. Well Information
Number of wells used for injection 33 DPT Pushes
Well names IP-1 through IP-33
Were any new wells installed during this injection
event?
❑ Yes [x I No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Inj ection Wells 33 DPT Pushes
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled N Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include two copies ofform GW-Ih for each
well installed.
Were any wells abandoned during this injection
event?
[XI Yes ❑ No
33 DPT borings
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells
33 DPT Pushes
Please include two copies of the GW-30 for each
well abandoned.
4. Injectant Information
Sodium Persulfate (Klozur) and Sodium Hydroxide (NaOH)
inj ectant
Concentration
If the injectant is diluted please indicate the source
dilution fluid. City of Winston-Salem Water Supply
Total Volume Injected
Volume Injected per well
5. Injection History
10,560 gallons
230 gallons at 19 points and 442
gallons at 14 points
Injection date(s) 6/4/2012 to 6/9/2012
Injection number (e.g. 3 of 5)
I of I
Is this the last injection at this site?
❑ Yes [x—] No
More injections may or may not be performed, as indicated in
the UIC permit application, based on performance monitoring
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
IN3EC WAS PERFORMED WITHIN THE
ST S L OUT IN THE PERMIT.
6/29/20I 2
ggwaMB 6KINjEcTioN CONTRACTOR DATE
Caleb Krouse 1 URS Corporation
PRINT NAME OF PERSON PERFORMING THE 1NJEMON
Submit the original of this form to the Division of Water Quality within 34 days of injection. Form UIC-IER
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No, 919-733-3221 Rev. 07/09