WI0300404_DEEMED FILES_20190506

])~
North Carolina Department of Environmental Quality -Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number \N I03ODI./O'-/
,---------------------.---------------------,
I . Permit Information
Permittee
Facility Name
Lllo£ A,,,.pcwt RA . 5'1\,sb"..-)· NC. fow,a,
Facility Address (include County) (O\Af\t~
2. Injection Contractor Information
Injection Contractor / Company Name
Street Address 20D Q"'olo D<
Nl 27513 CA.-~ c· State
~ &7E•QJl{O
Area code -Phone number
Zip Code
~,~
l>INcc&-Q,f:,~
3. Well Information .
3
O 6 20/9
Ftflg,· W.~ater
Number of wells used for inject~O ""I~
Well IDs f -+o IP-l't :,.
~"4'cD.
Were any new wells installed during this inlt;Jpn
event? OtJ '1n
~ Yes O No ,,_.,~ , . ~fli
If yes, please provide the following infonn ~
Number of Monitoring Wells _ ___,,.O'-----
Number of Injection Wells __ ..:..f 'i ___ _
Type of Well Installed (Check applicable type);
D Bored O Drilled (gJ Direct-Push
0 Hand-Augured O Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
lXI Yes O No
If yes, please provide the following information:
Number of Monitoring Wells _ _,.O:__ __ _
Number of Injection Wells _ __._q ___ _
Please include a copy of the GW-30 for tack well
abandoned.
4. lnjedant Information
lnjectan1(s) Type (can use se arate additional sheets
if necessary
Concentration__ 5 __ Dj;~------
lfthe injectant is diluted please indicate the source
dilutionfluid. tltfv:c;.o± wc:.±er
Total Volume Injected (gal) t.J OD
Volume Injected per well (gal) '-/OD,, (oQO
5. Injection History
Injection date(s) L )q J, -LI lq / Jq
",9 Injection number (e.g. 3 of 5)_-'-f_.q'----
ls this the last injection at this site?
D Yes @ No
I DO HER.EBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
lNJECTfON WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT. fl~ ~ s/2/-1q
SI ~T REOF TN CTlONCONTRACTOR DATE
Submit the original of this fonn to the Division of Water Resources within 30 days of injection~
Attn: UJC Program, J 636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Fonn UJC-IER
Rev. 3-1-2016
Redox Tech, LLC Field Injection Log Page No.1
location: S1li1bury, NC Chemic.I: Sodium Penn■nganate
Date: Concentntlon: 5%
Injection Trailer: water transport lbldox Tech Crew: Blair Mltch1II & Bnldford Balllff
Pump :ARO Note Taker: Bradford
Injection ScrNn/ Injection Flow Rite Planned Actual
Date Point Depth ft start Time Stop rm. Prnaure GPM Volume Volume
IPSII lnle ctad ln iected
419/2.019 IP-1 25 8:SO 9.()11 40 6.3 100 100
419/2019 IP·I 20 9.07 9,19 30 50 100 60 o,yHgllung dose 10 drainage d~c11e
4!912019 IP-2 2S 10.03 10.34 30 Jl 100 100 Dayt .... rv 20" NSI ol poilt
41';112019 IP-J 25 IN6 14;50 10 22 100 140 WeHC11>nol-,19
4J9nOl9 Jp.) 25 IS:20 17:24 IS 47 100 300
419/2019 IP-l 20 17:24 18.09 IS 2.2 100 100
4/1012019 IP-3 20 8:13 8·32 20 42 100 80 °'1tigh6ng "'°"nd building found ■lion
4i l0/2019 IP-4 25 9:20 9.45 40 88 100 220
4110/2019 IP-I 20 945 10:00 40 61 100 100
4/1012019 IP-I 20 10:19 10:JS so 6.3 100 100
4/10/2019 IP-I 15 10:412 II 07 )0 4.0 100 100
4/10/2019 IP-<I 10 11:07 11 .29 30 4.5 100 100
4/101;!019 IP-5 35 1248 13:00 50 8.3 100 100 verytightpo-.
4/IO/l0l9 IP-5 35 l ◄:25 14 39 so 71 100 100
4/IO/l0l9 IP-5 JO 14,)9 14.S2 40 77 100 100
4/11)12019 IP-S 25 14:58 15:10 45 83 100 100
4110!2019 IP-5 20 15:10 15:21 45 9.1 100 100
4.'10/2019 IP-6 JO 16:02 16.21 SD SJ 100 100
4,'10/2019 IP-6 2S 16 23 1640 40 59 100 100
4.'1012019 IP-6 20 16:50 17·03 40 7.7 100 100
4.'l0!2019 IP-6 15 17:04 1716 30 8.3 100 100
4/1112019 IP-7 2' 9.24 9:3$ so 9.1 100 100
4/1112019 IP-7 20 9:37 9.S2 30 6.7 100 100
411112019 IP-7 15 9.58 1010 )0 83 100 100
4/IU2019 IP-7 10 1014 10:27 20 77 100 100
4111/2019 IP-8 25 1103 !US 40 83 100 100
4/1112019 JP-8 20 II 18 II 31 40 77 100 100
4/11/2019 IP-8 15 11.JB 11:49 Jj 9.1 100 JOO
4111/2019 IP-8 10 11 -so 12:01 20 9 ,1 100· 100
4/11/2019 IP-10 25 1414 1434 40 7.5 150 ISO Ollllblned hlll volume ol cancelltd poinl Iola! ""'"''"""00
41I I/Z019 IP-10 20 14.]6 14·54 35 8.3 150 150
4/1112019 lP-10 15 14:58 15.12 so 71 150 100 lffllllY•••
411 l/2019 IP-10 15 15 24 15.31 so 7 I 150 so ,
4111/2019 IP-10 10 isn 15:SO 20 83 ll0 ISO
4111/2019 IP-I I 25 1609 16:22 40 II l 150 ISO combiMd hair volume or cancelled point. 1ot11 voklme-eoo
4/l lf.!019 JP-IJ 20 16:32 1638 35 83 150 50 omplylri
4/11;2019 IP-II 20 16·SS 1707 50 8.J 130 100
4111/2019 IP-I I 15 17:08 17 24 30 ~-' 150 150
411 t,:!019 IP-I I 10 17:29 1744 25 10.0 150 ISO
4.'I 112019 IP-9 25 8.07 819 so 8] 100 100
4/1112019 Jp.9 20 821 8.)8 35 59 100 100
4111/2019 IP-9 15 846 8 55 40 JI I 100 100
4/ll~0l9 IP-9 10 9 01 9 15 JO 71 100 100
4'll'Z0l9 IP-12 25 9:58 1015 40 59 100 100 I
4.'IF2019 IP-12 20 10 17 10 ·36 30 SJ 100 100
4!1 li2019 IP-12 15 1043 10 55 2~ 83 100 100
411112019 IP•l2 10 10·56 I 1.13 20 59 100 100
4,'J 1/2019 IP-13 25 12-29 1.2.47 50 5.6 100 100
4•'11 '2019 IP-13 20 1247 IJ 04 40 5.9 100 100
4111/2019 IP-13 15 130! I) 18 )0 100 100 100
41} 1'2019 11'·13 10 Jl 19 13 28 20 111 100 100
4!11/2019 IP-14 25 16·00 16.19 40 B 100 100 kM9r 181/el salll"ated relQcated to upper -
4;11 i2019 IP-14 20 1619 1630 I 35 91 100 100
4111 ."2019 IP-14 IS 16·34 16.45 30 91 100 100
4'11 .'2019 IP-14 IO 16:46 l&:59 25 11 100 100
4·121:019 IP-IS 25 7 58 a 16 40 H 100 100
4-.'12,'2019 IP-15 20 8 17 8 32 l5 67 100 100
4.'l2.'1019 IP-15 15 8 38 8 .50 )0 83 100 100
>t·l2,Z019 IP-I 5 10 8 52 9 0~ 20 77 100 100
-
4.'1212019 IP-16 25 11 17 II 38 45 71 150 ,~o ont ot lndoor-locat1ons to get 600G
4{12/2019 IP-16 2-0 1141 Ii.DO 35 79 ISO 150
4f!~:2019 IP-16 IS 12 OJ 12 18 JO 67 100 100 empty lank
4:'11.'201 Q lP -16 15 114] 1249 30 8] so__J so ---~ --~
WELL CONSTRUCTION RECORD [GW 1
For internal Use Only;
t. Weil Contractor Information:
Sla yr -kcne
well Contractor Name
NC Well Contractor CeniEe tion Number
Reno 1Tp c _ L L C
Company Home
2. Well Construction Permit #: W ID 300 04
Lisa all applicable well conciniciion pernrirs li e- WC. Ce.w j: Stine. *Hance etc)
3. WdI Use (check well use,:
Water Sap piy Well:
Agricultural DMuniaipatlPublic
]Geothermal (HcatingICooling Supply) OResidential Water Supply (single)
Industrial/Commercial QResiidential Water Supply (shared)
Irrfwtion
Non -Water Supply Well:
Monitoring ❑Recovery
njection Weil:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Iicatini /Coolinc Return)
4. Date Well(s) Completed:
Se. Well Location;
P ker fn4%41qA !
Groundwater Remedial on
DSatinity Barrier
DStorm water Drainage
Qsubsidence Control
EllTracer
Other (explain under #21 Remarks
1-061-41 ri"I.yell ZlA9 I P-1
Factory/Owner Name Faeillty Ina (if applicable)
L 5 Airpor+ Rfl 16r C. 2BJL 7
Physteal Address, City, and zip
Wan
County
Parcel Identification No. (PiN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one let/tong is sufttcieml
35.o;54176 N -S0. 5237'ro
6.1s(art) the we11(s)0Permaueat or aTemporary
7.1s this a repair to an existing well: QYes or S;f No
dllhlr is a repair, Jill our known well nRrirrrckon information and explain the nwure efthe
repair render 021 remarks scrawl or en the hark of Obis torn.
S. For Geoprohe/DFT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: tt i
9. Total well depth below land surface: 25
Far multiple wells disc all depdu iifd(eireer (example- 3@200' wad 2@I00')
10. Static water level below top of casing:
If%wrerlevel isabateeasing, use "+"
11. 8orebale diameter: L • 2�(In, I
12. Well construction method: Dire C4- PhkS h
(i.e. auger, rouuy. cable. direct push, Mc.)
iff.J
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14, WA7ERZONFS
FROM ' 1O
trLSCWrnUN
i1.
rt.
1L
15. OUTER CASING gar multi -cased vests OR LINER iif aoklieabk}
IaAmRG4
FROM
'm
!
DiAMl311R THICKH5S5
16. U'INER CASING OR TANG fithermal closed -haul
FROM TO - DIAMETER � Ti0C1CNESS j 1MATERs+L
R R. In.
ft.
it.
ia.
19. SCREEN
ERt/at i TO i IIM.MP rest
fi' it t z Ga
mars E _ TRIL1F.I.= J atATERZAL
relf
f.
ht.
19. GROUT
FROM TO
25 fit.
0.6 f
f:,
0.
MATEPIAL
No. 16 lelelAa
VIA Cr61s
EMPLACEMENT M!TROO *AMOUNT
ole fir [lead& packed
t;1lf.1 +, vbAce
29. SAND/GRAVEL mcx 9iappuerbtel
FROM
TO MATERIAL 1 5MNACEMENTME1ROC
n.
R.
n.
2& 1:1011.Lt4G LAG Wadi addltlmstl sheets 1f aeees:an t
FROM TO tft5CR1TT7U3rwlot,bantam. srveveatap•.rim viin eve.)
rt.
ft.
t<.
R.
ft.
R.
R.
�t.
21. REMARXS
fG
R.
22. Certification:
r Lure of Certified Nee$ Connector
/ain
Ask 12tvci_ -
B� rt;geing This form, 1 hereby strut Thar the .Welt{s) was (were) CntartrMefed in accordance
we;15A WAG 02C 0100 AIC or I SA IC 02C 0200 Ball G+asrrarrivrr Srnn half and char a
espy efrhfr record has been provider( the wall owner
23-Site diagram or additional well details:
You may use the back of this page so provide additional well site details or well
construction details. You may also attach additional pages tf necessary.
SUBMITTAL INSTRUCTION'S
fo
r or Ail Wells: Submit this forth within 30 days of completion of well
construction to the following:
Division. of Water Resources, information Processing Unit,
1617 Mail Stn. Ice Center, Raleigh, NC 27699.1617
24b. For lniection Wells: In addition to sending lire form to the address in 24a
above, also submit one copy or this form within 30 days of completion of well
construction to the following:
Division of Water Resources, underground injection Control Program,
1636 Mail Service Center, Raleigh, NC 17699-1636
24c, E..r N'ater Supp1t& injection Wells: In addition to sending the form to
the address(es) above, also submit cue copy of this Form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Fans OW -I
Noah Csrntina Dead morn' oiEnvironsernmi Qualrry • 0ivision cl J etcr Resources
Revised 2-22-2iI6

WELL ABANDONMENT RECORD
1, Weil Contractor information:
3lair- !] J-kke 11
Well Contractor Name or welt owner personally abandoning well on hislher property)
NC Well Cornrietor Certification Number
Reax Tech ,L1 C
Company Name
2. Weil Construction Permit #: dry .0 LD1!
Lis' all applrcahle well corrstracr/en permits (i.e (JIC Cowry. Snot Variance, eh.f rfknerwr
3. Well use (check well use):
Water Supply Well:
❑ Agricultural
❑Geothermal (Heating/Cooling Supply)
❑industna fCommercial
❑Lriaatioa
Plan -Water Supply Well:
▪ Monitoring
Injection Well:
°Aquifer Recharge
(°Aquifer Storage and Recovery
❑ Aquifer Test
°Experirrtental Technology
❑ Creothermal {Closed Loop}
❑ Geothermal (Heating Cooling Return)
0Municipa!(PubIir C] Neat Cement Grout
❑Residential Water Supply (single) 0 Sand Cement Grout
❑Residential Water Supply (shared) ¢)Concrete Grout
0 Specialty Grout
❑Recovery
iiGroundwater Remedial ion
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
°Tracer
❑Other (exi,lain under 7: )
4. Date wells) abandoned: 11 - `i 14 119
5a. Welt location:
PaYktif �nf�>t44riG {
racil:ty.Uwncr Name Facility MO (if appiicabte)
q ,5 PiYp(,r4 1151141elj 714.7
Physical Address. City. and Zip
County Fared rdentifscarion No (P1N)
Sb. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if welt Held, one lauleng t sur ieient)
.5.354151❑ N-80.52;7130
W
CONSTR['I"TiON DFT.III S (W WFL! es) BF1'9C M3&'t]DONFD
Attach wet cranv rucirna reeord(sl ifaaailcbir. For rnairlphinfec'irxr arnon-water supptj- wells
OA'LY wish the mme consrru n ain anonrfnnenem, +note can rabmer our form.
6a. Well [Dli: 1 p -1, 'E'p 1 ?' 0 1
6b. Total welt depth: __ 2 S (ILI
6c. Borehole diameter: I• 2 5 (In.j
6d. Water level below ground surfacer 6 _ (ft.)
be. Outer casing length (if known): NIA (ft.)
frf. inner castngttubing length (if known): )1 4B•i
6g. Screen length (if known): N JA (ft.,
For internal Use ONLY:
WEII.L .&BANDOiY_►4ENT DETAILS
70. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
well construction/depth, onl;. ' GW-30 is needed. Indicate TOTAL NUMBER of
wells abandoned: J q
lb, Approximate volume of water remaining in we'l(s): L'a ! A (gal.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d. Amount of disinfectant used:
7e- Sealing materials used (check all that apply):
$iL Bentonite Chips or Pellets
❑ Dry Clay
D Drill Cuttings
0 Gravel
❑ Bentonite Slurry 0 Other (explain under 70
71. For each material selected above, provide amount of materials used
Na- 1� before ago Ib4
i-ll t cA 9 fin (mere k 25 Ibs
J
1 7g. Provide a brief description of the abandonment procedure:
�,llerl l 1% C wig, Na- ben-n�#e�
wked anti fe;11 ca 40 4" be low
uwTui� - Fkile .. f.onco
4-0 s ►l,,rroiLe •
8. Certification:
2�—��-
Signature crCertified Well Cenvactar or Well Owner Date
illy string this form. 1 hereby certify rhar the well(.) was {were) ahandoned in
accordance with IJA IYCAC 02C 0100 or 2C .0200 Well Construction Standards
and that a copv of this record has been provided to the well owner.
9. Silt diagram or additional well details:
You may use the hack of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
SC'StiTIT7.�i tYSTRE'CTFO'
Hia. For MI tYeljs: Submit this form within 30 days of completion of well
3bandanmcnt to the following:
Divfsiou of Water Resources, Information Processing limit,
i617 Med Service Center, Raleigh, NC27699-I617
[Ob. 1.+1r tnjgct#on W Is: In addition to sending the form to the address in 10a
above. also submit one copy of this form within 3) days of completion of well
abandonment to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
lac. Eor Water Suailr & finjecrion Wells: In addition to sending the form to the
addresses) above. also submit one copy of this form within 30 days of completion
of well abandonment to the county health depanment of the courtly whom
abandoned,
lni lh Carolina PCWnnrerit *t Fnvrronrnental Qtral[t) . Dicipon of Wier RC%1ar-:ri
Rai tscd 2-12-20le

411212019 lP-16 10 12:SO 13:IS 20 6.0 150 ISO --411212019 IP-17 25 13,27 13:45 4S 83 150 ISO one Ol indOor locations to get eocG
411212019 IP-17 20 U:48 13:Sl! 40 6.3 so so omp4yl•n<
4/1212019 IP-17 lO IS:26 IS:38 40 8.3 JOO 100
4/1212019 IP-17 IS 15;40 1':SS 30 1.3 ISO ISO
4112/2019 IP-17 10 16:00 16:19 3S 7.9 150 ISO
4/1212019 IP-18 2S 16:SS ·11:08 4S 10.0 100 100
4112/2019 IP-18 20 17:12 17:24 40 8.3 100 100
411212019 IP-18 15 17:29 17:40 JS 9.1 100 100
411212019 IP-18 10 17:41 17:54 20 7.7 100 100
4/13/2019 IP-19 25 7;44 7:56 so 8.3 100 100
411312019 IP-19 20 S;OO 8'12 40 8.3 100 100
4/13/2019 IP-19 IS 8:15 8:27 30 8.3 100 100
4/13/2019 IP-19 10 8:27 8:41 20 7.1 100 100
Tcial Volume 8400
REDOX TECH, LLC
''Providing Innovative In Situ Soil and Groundwater Treatment"
To whom it may concern,
Upon review errors were found in forms GW-1, GW-30 and the Injection Event Record that were previously submitted and signed on
4/22/19 pertaining to Permit Number Wl0300404.
Corrections/changes have been made to the following items:
1) GW-1
a. Item number 4: :Oate Well(s) Completed has been corrected to say "4/9-4/14/19"
2) GW-30
a. Item number 4: Date Well(s) Abandoned has been corrected to say "4/9 -4/14/19"
3) IER
a. Item number 4: The Concentration has been changed to say "5%"
b. Item number 5: Injection Date(s) has been corrected to say "4/9/19 -4/14/19"
The corrected forms GW-1, GW-30 and IER signed and dated 5/2/19 have been included with this letter. No other changes, updates or
corrections have been made to any form.
Thank you,
Blair Mitchell
4419-C
MAY O !J. 20
Water Quality
GQ1ona1 OP81at1oftaSecloll
Page 1
WELL CONSTRUCTION RECORD (GW-1,
1, Well Contractor Information;
For Internal Use Only:
Well Contractor Nate
NC We11 Contractor Certification Number
P tic»& "kp f".11_ L L C
Company Nana �y �]
3. Well Construction Permit Of;, VI ; 10 W V Li 04
List all applicable well cansrrvcrios permits. (l.e. U1C, County, Stale, Variance, ere)
3. Well Use (check well use);
Water Supply Well:
QAgricultural
°Geothermal (Heating/Cooling Supply)
dusn ialICenrmercia l
nlrrii!ation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
.Aquifer Test
pExperimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
d. Date Well(s) Completed:
5a. Well Location: I I
Pow ke,r l Y1� t Tlr c� 1
°1lunicipallPublic
°Residential Water Supply (single)
°Rcsidcatiat Water Supply (shared)
°Recovery
Crrourtdwater Remerhation
IQISalinity Barrier
°Stormwater Drainage
°Subsiderice Control
°Tracer
f'Other (explain under #2I Remarks)
"ditihiveft [D# 1P-1 l P'19
Facility/Owner Name Facility 113# (if applicable)
Lito,5 A -par+ its s'otiv C 281g47
Physical Address, City, and Zip
RC/Wan
County Parcel identification No. (PIN)
5b. Latitude and langiwde in degreeslmtnutealseconds or decimal degrees:
Orwell field, one lat./long is sufficient)
351ta54770 N 0 2374ro
6. ls(are) the well(e)QPermanent or BTemporary
7. Is this a repair to an existing well: °Yes or No
If this 1s a repair, fill out known well ane:ructlan information and explain the nature alike
repair raider 421 remarks :action or on the hack of tea form
S. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
cODsirueticn, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:_ iq
9. Total well depth below land surface: 25
For multiple weir lilt all depths tfdiferanl (example- 3 a 00' and 2@a lOrn
(it)
10. Static water level below tap of casing: (PL)
!f water level [s 01700e casing, use "+"
l I. Borehole diameter: : r.6. {in.)
12. Well construction method: Di r'O C+ PttS
(i.e, auger. rotary, cable. direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13e. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14, WATER ZONES
FROM
TO DESCRIPTION
it.
la
ft. tt.
15. OUTER CASLYG (For multi -cased wens) OR LINER Of afl [liable)
FROM TQ Dtn-oF.T!O Trltl'K't Ss ttATEAlAL
rt. (1. ht.
16, INNER CASING OR TUBING i¢eathermal closed -loop)
PROM
r--- EZ
TO
R.
➢tAMETER THroicnE56
la.
MAMMA
ff.
14
in. I
17. SCREEN
TO
DIAMETER
SLOT SIZE TEitcKNESS MATERIAL
IS. GROUT
PROM
2.5fl.
0.6
ft.
• y . x5 tit.
TO MATERIAL
Poi
n' No. 119 ,Cfl %
p fr.
pinto,
EMPLACEMZNT METHOD & AMOUNT
!k fiii�J pc.
;a ie.! +it leis.
19. SAND/GRAVEL PACK {if applicable)
L FROM I To
fit,
Pt
MATERIAL EMPLACEMENT METHOD
ft.
rt.
20. DRILLING LOG isnash additrnuai zeeel U neceasar?
FROM TO ctIPTr 1ir.Jnr suilricktspet rtik size, etc.
rL rt. ttAhin Cacti
ft,
ft.
Ft.
ft,
ft.
ft.
ft.
Z1. REMARKS
22. Certification:
-
5,ga'ature of Certified Weil Contractor
2' S I2M
Dat�
Ly signing this form, 1 hereby cerrity dial the well(4) was (were, trtnsmteted in accordance
wlrh 154 NCAC 02C .0100 or 13A NCAC 02C .0200 Weil Construction Standards and than a
copy glad! record has been provided to the well owner.
23. Sile diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary
SUBMITTAL INSTRUCTIONS
24a, For AB Wells: Submit This form within 30 days of completion or well
constmletian to the following:
Division of Water Resources, Information Processing Unit,
I617 Mail Service Center, Raleigh, NC 27699-1617
24b. For II,aie tion Wells: In addition to sending the Form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 17699-1636
24e. For Water Suppy & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Fon n G W. I
North, Carolina Department oiEnvironmental Quaiiry - Aiviamn or Welrr Resoersea Revised 2-22-2016

WELL ABANDONMENT RECORD
For internal !Jae ONLY.:
1, Well Contractor Information:
Blair 1)/44thne 1 l
Well Contractor Name (or well owner personally abandoeiag well on his/her property)
L.LICI —C
NC Well Contractor Certification Number
keciox Ce�.�n , L C
Company Name
�] �j
Z. Well Construction Permit iO 0Q'7 VL4
Lis, all applicable well ronstrnatron permits t3.e, WC, County, State, Variance, etc) if knorm
3. Well use (check well use):
Water Supply Well:
❑ Agricultural
['Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑irri-ation
❑MunicipaVPubiic
❑Residential Water Supply (single)
°Residential Water Supply (shared)
Non -Water Supply Weil:
❑ Monitoring
°Recovery
Injection Well;
❑ Aquifer Recharge
❑Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
°Geothermal (Closed Loop)
❑Geothermal (HearingfCooiing Return)
gGroundwater Remediation
°Salinity Harrier
OStormwater Drainage
°Subsidence Control
El Tracer
❑Other (explain under 7g)
d. Date well(,) abandoned: 14.j1 f 9
Ss- Well location:
& kir irldU54v-u61
Facility/Owner Name
Facility ID# (if applicable)
41(5 Arjh,fi Slitisbw-j,wc. 27)i7
Physical Address. City, and Zip
6SvV)�n
County Parcel identification No. (PIN)
Sb, Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Indians is sufficient)
S64 354 S1 D N 10.6 2_ 7 910
W
CONSTRUCTION DETAILS OF WELLS]. BEING ABANDONED
Attack welt runarr'etrtion record(s) ifuvailob/e. Formultiple injection or non-wa,ersupply wells
ONLY with the same con.oructianlrr6andonmeat, you can submit nnreInert.
ba. W elf LD#: r ' ¢U l ?' l 1
6b. Total wen depth: 26 (ft-)
6c. Borehole diameter: • 75 (in.)
6d. Water level below ground surface: (ft.)
6n. Outer casing length (if known): !Y JA CM)
6f. Inner mingltubing length (if known): f't IA (ft /
6g. Screen length (if known): N /A (ft.)
WELL ABANDONMENT DETAILS
7a. For Geaprobe/DPT or Closed -Loop Geothermal Wells having the same
well constrnctionldepth, onl , I GW-30 is needed. Indicate TOTAL iNUMBER of
wells abandoned:.
7b. Approximate volume of water remaining in well(s): Ai I (gal.]
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d, Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
0 Neat Cement Grout $ Bentonite Chips or Pellets
❑ Sand Cement Grout
Concrete Grout
° Specialty Grout
❑ Bentonite Slurry
0 Dry Cay
❑ Drill Cuttings
0 Grave!
❑ Other (explain under 78)
7f. For each material selected above, provide amount of materials aced:
lie. ber*unle 360 ibc
High s 4 cti n (olrlere M 25 1 �s
7g, Provide a brief description of the abandonment procedure:
F,lled bcvNa- (19 ben1fl th
xtc 1 Gun A. ire Aled -I0 be 1
c u•r e - F1 It ea ,11-1-h con ore it.4.e
S. Certification:
Sign of Certified Well Contractor or Well Owner pare q
8y signing this form. 1 hereby certifi, that the well(s) was (were) abandoned in
accordance with 15A NCAC 02C 0100 or 2C .0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
9, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
abandonment details. You naay also attach additional pages if necessary -
SUBMITTAL INSTRUCTIONS
10a. For All Wells: Submit this form within 30 days of completion of well
abandonment to the following-.
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-I6I7
10b. For falection Welts: In addition to sending the form la the address in I0a
above, also submit one copy of this form within 30 days of completion of well
abandonment to the fallowing:
Division of Water Resources, Underground Injection Control Program,
1636 h[ail Service Center, Raleigh, NC 27699.1636
Mc. For WaterSujrlilv & IniecI1on Wells: In addition to sending the form to the
address(es) above, also submit one copy of this form within 30 days of completion
of well abandonment to the county llrgl(1jpgtS m}eL pj_t17� canary where
abandoned. rr R1�}ilfR
9. 2139
Form G W.30
die rC148ti1X
Natili Caroline {7cpartmert or Environmental Quality - Division of Warr Re tonnes - ntn+titi, n onser...itLviscd 2.22.2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER1
Permit Number
Permit Information
ER NI
Permittee
Pii ker IfICII4AYA1
Facility Name
E-1(0.6 A P.A. 5611661,r l)C Row
Facility Address (include County) Iv Lato}�
2. Injection Contractor Information
krwciox lec+� PLC
Injection Contractor / Company Name
Street Address 2OD
ter NC 27 513
Cir? State Zip Code
(T!9 ) 01- OlgQ
Area code — Phone number
3. Well Information
Number of wells used for injection //
Well IDs _ tp j -Fv gp - t q
Were any new wells installed during this injection
event?
®Yes No
If yes, please provide the following information:
Number of Monitoring Wells _ 0
Number of Injection Wells 161
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ® Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 form for each
well installed.
f D 3001/011
Were any wells abandoned during this injection
event?
® Yes ❑ Na
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of injection Wells 1 9
Please include a copy of the GW-30 far each well
abandoned
4. Injectat Information
�cii�rrr- i edYv1Qnqcin4 fe
Injectant(s) Type (can use searate additional sheets
if necessary
Concentration — 50,_6
If the injectant is diluted please indicate the source
dilution fluid. Jilin,.ri 634+er
Total Volume Injected (gal) g,Y dO
Volume Injected per well (gal)qoo ADD
5. Injection History
Injectiondate(s)_ 1.11qhCi —4.1ligliq
Injection number (e.g. 3 of 5) / 7
Is this the last injection at this site?
❑ Yes IZI No
I DO HEREBY CERTIFY THAT ALL THE
INFORIUTATION ON THIS FORM IS CORRECT "r0
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
V 5/ [0.
SIG: ATURE OF fN f .CTION CONTRACTOR DATE
biC11r___WI-C,1111C11
N 1 f• f -ri. ! l• •i Ili- L1it_.. .
Submit the original of this form to the Division of Water Resources within 30 days of injection.`
Attn: WC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636. Phone No. 919-807-6464
Form LAC-IER
Rev. 3-1-2016

Redox Tech, LLC Field Injection Log ·Page No.1
Location: Salisbury, NC Chemical: Sodium Permanganate
Date: Concentration: 5%
Injection Trailer: water transport Redox Tech Crew: Blair Mitchell & Bradford Bailiff
Pump:ARO Note Taker: Bradford
Injection Screen/ I start Time
Injection Flow Rate Planned Actual
Date Po int Depth ft Stop Time Pressure GPM Volume Vo lume
IPS ll ln iected ln iected
4/912019 IP-I 25 8:50 9:06 40 6.3 JOO 100
4/912019 IP-I 20 9:07 9:19 30 5.0 100 60 Daylighting close to drainage dilch.
4/9/2019 IP-2 25 10:03 10:34 30 3.2 100 JOO Daylighting 20 ft east or point.
4/9/2019 IP-3 25 13 :46 14:50 10 2.2 JOO 140 Well cap not secure.
4/912019 IP-3 25 15:20 17:24 15 4 .7 100 JOO
4/912019 IP-3 20 17:24 18:09 15 2.2 100 JOO
4110/2019 IP-3 20 8:1 3 8:32 20 4.2 100 80 Daylightlng around building foundalion.
4110/2019 IP-4 25 9:20 9:45 40 8.8 JOO 220
4/10/2019 IP-4 20 9:45 10:00 40 6.7 I 100 100
4/1012019 IP-4 20 10:19 . 10:35 50 6.3 100 100
4/10/2019 IP-4 15 10:42 11 :07 30 4.0 100 100
4/10/2019 IP-4 JO I 1:07 11 :29 30 4.5 JOO JOO
4/1012019 IP-5 35 12:48 13:00 50 8.3 IOO 100 very tight packed.
4/J0/2019 IP-5 35 14:25 14:39 50 7.1 100 100
4/10/2019 IP-5 30 14:39 14:52 40 7.7 JOO 100
4/10/2019 IP -5 25 14:58 15 :10 45 8 .3 JOO JOO
4/J0/2019 IP-5 20 15:10 15:21 45 9.1 JOO 100
4/10/2019 IP-6 30 16:02 16:21 50 5.3 IOO 100
4/10/2019 IP-6 25 16:23 16:40 40 5.9 100 100
I 4/10/2019 IP-6 20 16:50 17:03 40 7.7 100 100
4/1012019 IP-6 15 17:04 17:16 30 8.3 100 100
4/1112019 IP-7 25 9:24 9:35 so 9.r 100 100
I 411112019 IP-7 20 9:37 9 :52 JO 6.7 100 100
4/1112019 IP-7 IS 9:58 10:10 JO 8.3 JOO 100
I 4/1112019 I IP-7 10 10:14 10:27 20 7.7 IOO 100
411112019 IP-8 25 11:03 11:15 40 8.3 100 100
4/1112019 IP-8 20 11:18 11 :31 40 7.7 100 100
4/11/2019 IP-8 IS 11 :38 11 :49 35 9.1 100 100
4/1112019 IP-8 JO 11:50 12:01 20 9.1 100 100
411112019 IP-10 25 14:14 14:34 40 7.5 150 ISO cr3tfltiln«! Pu.JI 'iolume -:i' i:.A.nc::ellro po,il total vol"rnw--600
4/1112019 IP-10 20 14:36 14:54 35 8.3 150 I SO
4/11 /2019 IP-10 15 14:58 15 :1 2 50 7.1 150 100 1mpty ranlli
4/11/2019 lP-10 15 15:24 15:JI 50 7.1 150 50 -
4/11 /2019 lP-10 10 15:32 I 15:50 20 8.3 150 1,0 ;j;
4/1112019 lP-11 25 16:09 16:22 40 11.S 150 l \.'.l eM1bIned f'l~lf °""olumo af r.anc1111~ DOin-1 t(n al ..,01um~ !ti
4/11/2019 !P-11 20 16:32 16:38 35 8.3 I 150 50 l!m~ylBnk l.,J ~ g
I 4/1112019 I lP-11 20 16:55 17:07 so 8.3 150 101) ,::S <'-i .¢~
411112019 IP-11 I 15 17:08 17:24 JO 9.4 150 150 .;_;.;' ~ ~~ -· 411 112019 IP-11 10 17:29 17:44 25 10.0 150 150 u -O'fi
4/11/2019 I IP-9 25 8:07 8:19 so 8.3 100 100 I it; ..... ~ _§. •·:..-·
4/11/2019 !P-9 20 8:21 8:38 JS 5,9 100 100 i;f "':"~-s ~
4111/2019 lP-9 15 8:46 8:55 40 II.I 100 !90 •r ir
4/ll/2019 ' IP-9 JO 9:01 9:15 JO 7.1 100 100 ii
4/11/2019 IP-12 I 25 9:58 10:15 40 5.9 100 100 ~
411112019 IP-12 20 10:17 10:3 6 JO 5.J 100 100
4/1112019 IP-12 I 15 10:43 10:5 5 25 8.3 100 100
4111/2019 lP-12 10 10:56 11:13 20 5.9 100 IOO
I 4/1112019 lP-13 25 12:29 12:47 ' 50 5.6 I 100 100
4111/2019 IP-13 20 12 :47 13:04 I 40 5.9 100 100
4111/2019 IP-13 15 13 :08 13:18 30 10.0 100 100 I
411112019 IP-13 10 13 :19 13:28 20 II.I 100 100
4/11120 19 IP-14 25 16:00 16:19 40 5.3 100 100 / lower level saturated. relocated 10 upper.
4/11/2019 lP-14 20 16:1 9 16:JO 35 9.1 IOO 100
4/11/2019 IP-14 15 16 :34 16:45 30 9.1 I 100 I 100
4/1112019 IP-14 10 16:46 16:59 I 25 7.7 100 100
4/1 212019 IP-15 25 7:58 8:16 40 5.6 100 100
4112/2019 IP-15 20 8:17 8:32 35 6 .7 100 100
4/1212019 IP-15 15 8:38 8:50 JO I 8.J 100 100
4/1212019 IP-15 10 8:52 9:05 20 7.7 I 100 100
4/1212019 lP-16 25 11 :17 I 11:38 45 7.1 ISO 150 one of indoor locations to get 6OOG
4/12/2019 IP-16 20 I 11 :41 12:00 JS 7.9 150 150
4/12/2019 IP-16 I 15 12 :03 12:18 JO 6.7 100 100 empty tank
4112/2019 IP-16 15 I 12:43 12:49 30 8.3 50 50 I --
4112/2019 IP-16 lO 12:50 13:15 20 6.0 150 150
4112/2019 IP-17 25 13 :27 13 :45 45 8,3 150 150 one of incloor locations lo get 600G
4/12/2019 IP-17 20 13 :48 13:56 40 6.3 50 50 empt~ lank
4/12/2019 lP-17 20 15:26 15:38 40 8.3 100 100
4112/2019 JP-17 15 15:40 15 :58 30 8.3 150 150
4/12/2019 JP-17 lO 16:00 16:19 35 7.9 150 150
4112/2019 IP-18 25 16:58 17:08 45 10.0 100 100
4/12/2019 IP-18 20 17:12 17:24 40 8,3 100 l00
4/12/2019 IP-18 15 17:29 17:40 35 9.1 100. 100
4112/2019 IP-18 lO 17:41 17:54 20 7.7 JOO 100
4/13/2019 !P-19 25 7:44 7:56 50 8.3 100 100
4/13/2019 IP-19 20 8:00 8:12 I 40 8.3 100 100
4/13/2019 JP-19 15 8:15 8:27 30 I 8.3 I 100 100
4/13/2019 IP-19 10 8:27 8:41 20 7.1 100 100
Total Volume 8400
D e ,sC
WELL CONSTRUCTION RECORD SGW I.)
1. Well Contractor Information:
A 6 4-0 5'
For Internal Use Only:
Weli Contractor Name
NC Well Contractor Certification Number
Neat 1��n LLC
Company Name //'yyn j�
2. Well Construction Permit 0: '+I1f 10 3004 Dy
List all tgvpficahle well construeli m penults (l.e UIC, Counll+, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (HeatingiCooling Supply)
Industrial/Commercial
Irrigation
°Municipal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
Non -Water Supply Well:
Monitoring
QRecavery
injection Well:
3Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technoiagy
]Geothermal (Closed Loop)
OlGroundwater Remediation
°Salinity Barrier
JStormwater Drainage
°Subsidence Control
°Tracer
Geothermal (ileatiag/Cooling Return) (Other (explain under 421 Remarks)
4. Date Well(s) Completed: 14'f ' 113 Well ID# I P-i t 1 P* { q
5a. Well location:
Parker inat4 Ytitia 1
Facility/Owner Name Facility 1134 (if applicable)
Li05 L 'pdr+ .a Sa11SNC 28147
Physical Address, City, and hip
Rowan
County Parcel Identification No. (PIN)
5b- Latitude and longitude in degrees/nunutes/seconds or decimal degrees:
(if well field, one tat/long is sufficient)
35,LIA54770 N —3.0,6237C170
6. is(are) the weil(s)4jPermanent or 'Temporary
7. Is this a repair to an existing well: DYes or No
ff this is a repair, fill out known well cons:meeti,n lrlrrmation and explain the nature of the
repair ander till remarks section or an the hank of this form,
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1�
9. Total well depth below land surface: 25 (ft.)
For multiple wells list all depths iifdi different (ewmple- 3 200' and
__ 2@i00')
10. Static water level below top of casing: V (ft.)
If .water level is above easing use "+"
11. Borehole diameter:
.277 fin.)
12. Well construction method: D I l'0 C ` Plts •'
(r.e auger, rotary, cable, direct push, etc.)
FOR WATER SiFPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM
TO
DESCRiPTION
ft.
ft,
V
ft.
tt.
15. OUTER CASING ( r uruN-eased weft OR LINER Sif applie:miei
FROMDIAMETER TIDCKNRSS MATERIAL
TO
ft.
R
in.
IA INNER CASING OR WRING (geothermal closed -low
DIAMETER I THICKNESS
FROM
MATERIAL
ft.
in.
ft.
17. SCREEN
ft.
in.
FROM
7-5it
TO
19
DIAMETER
1.2.5 ia.
SLOT SIZE
told,
THICKNESS
MATERIAL
ft.
ft.
in.
18. GROUT
FROM
TO MATERIAL
EmPLACEME.NT saTHOn & AMOUNT
ZO IL 665 ft.
0.6 ft. Q rr.
rt.
R.
NE. baba
(slhcTe
11. SAND/GRAVEL PACK of applicable] -
FROM
R.
TO
ft.
1k 4'1-tredtfackid
;Ala 4e, ru.orp,ce
iMATERIAL EMPLACEMENT METHOD
it.
ft.
-t
2.0. DRILLING LOG [attach additional sheets if w«cesar)1
DEr.C'RlPTION (color. hardness. solilroek tyee, I►ala size, etc.i
FROM
f.
TO
OA t chid
R.
ft.
ft.
ft.
rt.
ft.
ft.
11
rt.
11.
ft.
21. REMARKS
22. Certification:
��-
1 ,
of Cstt
q/2
zlif
g ifled Well Contactor Date
By signing this form, I hereby certif}+ that the wears) wee (were) coerrructed is accwrlancs
with iSA NCRC 02C .0/00 or ISA NCAC 02C .0200 Well Construction Staederds and that a
ropy of ihu record has been provided to the wed owner.
23. Site diagram or additional well details:
You may use the hack of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mall Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also Submit one copy of this form within 30 days of completion of well
construction to the following'
Division of Water Resources, Underground injection Control Program,
1 636 Mail Service Center, Raleigh, NC 27699-1636
24e- For Water SuppI & Tnlection Wells: In addition to sending the term to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
TO
Form GW-I
North Carolina Department of Environmental Quality ision of Water Resources Revised 2-22-2016

WELL ABANDONMENT RECORD
For Internal Use ONLY:
1. Well Contractor Information:
Blair Pork he I
Well Contractor Name (or well owner personally abandoning wall on his/her property)
NC Weil Contractor Certification Number
Redox Tec.t r1-L L
Company Name
2. Well Construction Permit#: �P!I 03o0 `4 04
Lest all applicable well cnr+sfrrtctlon petruits 11,e. UIC, Calmly. 3rare. Variance, Cit.) 7f/morr7t
3. Well use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
Q industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
EMonitoring
❑MunicipaVVPublic
DResidential Water Supply (single)
❑Residential Water Supply (shared)
GRecovery
Injection Well:
0Aquifer Recharge
LGAquifer Storage and Recovery
0Aquifcr Test
❑Experimental Technology
LlGeothermal (Closed Loop)
❑Geotberrnai (Heating/Cooling Return)
gGrouadwater Remediation
❑ Salinity Barrier
IaStormwater Drainage
❑ Subsidence Control
❑Tracer
Other (explain under 7g)
4. Date wcII(1) abandoned: — '"[ 1 i 3
5a. Well location:
Paykey rnd1151Y101
Facility/Owner Name
FacilitylDi (ifspillicabk)
145 Arp r'r kJ_ _c1(513i4 - ,NC, 27141
Physical Address, City, and Lip
Rowan
County Parcel identification Na. (PEN)
5b. Latitude pad longitude in degrees/minutes/seconds or decimal degrees:
(dwell Geld, one ladleng is sufficient)
35.E3591Z0 N -30-523700
WELL ABANDONMENT DETAILS
?a. For GeoproheJOPT or Closed -Loop Geothermal Wells having the same
well construction/depth, trnly.GW-30 is needed, Indicate TOTAL Nl]MBER of
wells abandoned: �� ++
7b. Approximate volume of water remaining in weil(s): 1 A (gal.)
FOR WATER SUPPLY WELLS ONLY:
7e. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used (check ail that apply):
O Neat Cement Grout
t Sand Cement Grout
gConcrcte Grout
O Specialty Grout
❑ 13entonite Slurry
Bentonite Chips or Pellets
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7L Far each material selected shove, provide amount of materials used:
No . I to bells-oni e ago 1b5�
Ai9 h s 4erty4, (oVlere 25 ! bs
7g. Provide a brief description of the abandonment procedure:
Pled btvt6.a1e wi;-4, Na. to bendnit ,
kefA ask ire -111 ed -4Q ,o" be law
Sty dace sr-LeFi tied. ,�►4'� concre
4-0
8. Certification:
73.Pav,. lject
022 )1R
Signature cif Certified Well Contractor or Weil Owner Date
By signing this -farm, I hereby certify that the weil(s) was (were) abandoned in
accordance with 15.4 ,YCAC 02C .0100 or 2C 0200 Welt Construction Standards
and that a copy of this record has been provided to the well owner.
w
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Antic); •.veil corxrtrrciion record(s) ifavnefable. For muhtple lnjectinn or non-watereupply welts
ONLY with rile sarnls cnnsteurlinrclabandonmen[r, tau Cali srrbrea one form.
6a. Well 100: 9 ~, 40 I' -
6b. Total well depth: 2 5 (ft.)
6c. Borehole diameter: f • 2 5 (In.)
6d. Water level below ground surface: v+ fft.)
Se. Outer casing length (if known): NIA (ft.)
6f. inner easing/tubing length {if known): M IA (ft,)
6g. Screen length (if known): 1 V IA {ft.)
9. Sire diagram or additional well details:
You may use the bask of this page to provide additional well site details or well
abandonment detail;:. You may also attach additional pages if necessary.
SUB,NIITTAL INSTRUCTIONS
Lila. For All Wells: Submit this farm within 30 days of completion of well
abandonment to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-16I7
IOh. For Infection Wells: In addition to sending the form to the address in lila
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Division of Water Resources, underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-I636
10c. For Water Supply & Infection Wens: In addition to sending the forth to the
address(es) above, also submit one co s,gwrtkia.r3 f completion
of well abandonment to the county ea`'[ti epartment o f aunty where
abandoned -
A► R 2 & ZU19
Form G W-36
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2.22.20I 6

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD {IER)
Permit Number ' O300L/D1/
l . Permit Information
ERN)
Permittee
iajc-er
Facility Name
4(0.5 A;,r + . Su41 b &n
Facility Address (include County) Lows*.1
2. Injection Contractor Information
Leda `Te c1� , L L C
Injection Contractor / Company Name
Street Address 20D Ci_,,,c1.41Q br
Car NG 27 613
Cire State Zip Code
(offq ) v$ - iio
Area code — Phone number
3. Well Information
Number of wells used for injection _ 1 q
Well Ws p - i -to IP - I q
Were any new wells installed during this injection
event?
j# Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells i
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled X Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-lJorm 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
Number of Injection Wells
0
Please include a copy of the GW-30 for each well
abandoned
Injectant Information
_�i►�.tim ?evr+nar c,n4 -e
Injectant(s) Type (can use serarate additional sheets
if necessary
Concentration
If the injectant is diluted please indicate the source
dilution fluid. w4 re4r_
Total Volume Injected (gal) g400
Volume Injected per well (gal) -l(p, (600
Injection History
Injection date(s) if 1C1 ` J/3ii'
Injection number (e.g. 3 of 5) C q
Is this the last injection at this site?
❑ Yes No
I 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
STANDARDS LAID OUT IN THE PERMIT.
r L /22/)q
Si RE OF INl-.CTION CONTRACTOR DATE
e1otir Atittle ,-.
PRLVZ':`,.1.\U 'J f'f I'FR7(R\tJNCi II -If I\IECIR \
Submit the original of this form to the Division of Water Resources within 30 days of injection.'
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-t -2016

Redox Tecll, LLC Field Injection Log . Pag . ~i:s~ lft '•,;~'"rr ··wr-. ~ ....,_,~iv~~.-·
Location: Salisbury, NC Chemical: Sodium Permanganate
Date: Concentration : 5%
Injection Trailer: water transport Redox Tech Crew: Blair Mitchell & Bradford Bailiff Ar-'f'( ~ 5 i'II IU
Pu mp:ARO Note Taker: Bradford -~
Injection Screen I Injection Flow Rate Planned Actual
I Date Point Depth ft Start Time Stop Time Pressure GPM Volume Volume
!PSII Inj ected Injected
4/912019 IP-I 25 8:50 9:06 40 6.3 100 100
4/9/20 19 IP-I 20 9:07 9:19 30 5.0 100 60 Daylfghting close to drainage ditch.
4/9/2019 IP-2 25 10:03 10:34 30 3.2 100 100 Oeyllghllng 20 fl east of point.
4/9/2019 IP-3 25 13:46 14 :50 10 2.2 100 140 wen cap not secure .
4/912019 IP-3 25 15:20 17:24 15 4.7 100 300
4/9/2019 IP-3 20 17:24 18:09 15 2.2 100 100
4/10/2019 IP-3 20 8:13 8:32 20 4.2 100 80 Daylighting around building foundation.
4/10/2019 IP-4 25 9:20 9:45 40 8.8 100 220
4110/2019 IP-4 20 9:45 10:00 40 6.7 100 100
4/10/2019 IP-4 20 10:19 .10:35 50 6.3 100 100
4/10/2019 IP-4 IS 10:42 11:07 30 4.0 100 100
4110/2019 IP-4 IO 11 :07 11:29 30 4.5 100 100
4/10/2019 IP-5 35 12:48 13:00 so 8.3 100 100 very tight packed.
4/10/2019 IP-5 35 14:25 14:39 50 7.1 100 100
4/10/2019 IP-5 30 14:39 14:52 40 7.7 100 100
4/1012019 IP-5 25 14:58 15:10 45 8.3 100 100
4/10/2019 IP-5 20 15:10 15:21 45 9.1 100 100
4/10/2019 IP-6 30 16:02 16:21 50 5.3 100 100
4/10/2019 IP-6 25 16:23 16:40 40 5.9 100 100 I
4/10/2019 IP-6 20 16:SO 17:03 40 7.7 100 100
4/10/2019 IP-6 15 17:04 17:16 30 8.3 100 100 I
4111/2019 IP-7 25 9:24 9:3S 50 9.11 100 :oo
4/11/2019 IP-7 20 9:37 9:52 30 6.7 100 100
4/11/2019 IP-7 15 9:58 10:10 30 8.3 100 100
4/11/2019 IP-7 10 10:14 10:27 20 7.7 100 100
4/11/2019 IP-8 25 11:03 11:15 40 8.3 100 100
4/11/2019 IP-8 20 11 :18 11 :31 40 7.7 100 100
4111/2019 IP-8 15 11:38 11:49 35 9.1 100 100
4/11/2019 IP-8 10 11:50 12:01 20 9.1 100 100
4/11/2019 IP-10 25 14:14 14:34 40 7.5 150 r5o eombl.ned hltr vWurn• or ncelteO pctn1 1ot1t vo1ume~OO
4111/2019 IP-10 20 14:36 14:54 35 8.3 150 150
4/11/2019 IP-10 15 14:58 15:12 50 7.1 150 100 11mp1~ 1an11,
4/11/2019 IP-10 15 15:24 15:31 50 7.1 150 so
4/11/2019 IP-I O 10 15:32 15:50 20 8.3 150 l!O
4/11/2019 IP-I I 25 16:09 16:22 40 I 1.5 150 150 ccmb1nt'd n1it vOfuf'r"-ti of cnic.eilWd po1n t. 1otat volW'tl.e:;::600
4/11/2019 IP-II 20 16:32 16:38 35 8.3 150 ;o empty tank
4/11/2019 IP-II 20 16:55 17:07 50 8.3 150 100
4/11/2019 IP-II 15 17:08 17:24 30 9.4 150 1•0
411 1/2019 IP-I I 10 17:29 17:44 25 10.0 150 150
4/11/2019 IP-9 25 8:07 8:19 50 8.3 100 !Oil
4/11/2019 IP-9 20 I 8:21 8:38 35 5.9 100 100
4/11/2019 IP-9 15 8:46 8:55 40 ILi 100 100
4111/2019 IP-9 10 9:01 9:15 30 7.1 100 100
4111/2019 IP-12 25 9:58 10:15 40 5.9 100 100 I
4/11120\ 9 IP-12 20 10:17 I 10:36 JO 5.] IOO 100 I
4/11/2019 IP-12 \5 I0:43 10:55 25 8.3 100 100
4111/2019 IP-12 10 10:56 11:13 20 5.9 100 100
4/11120\9 IP-13 25 12:29 12:47 50 5.6 100 100 I
4/11 /2019 IP-13 20 12:47 13 :04 40 5.9 100 100
4111/201 9 IP-13 15 13 :08 13 :18 JO 10.0 \00 \DO
411112019 IP-13 10 13 :19 13:28 20 I LI IOO 100 I
4/\ \/2019 IP-14 25 16:00 16:19 40 5.3 100 JOO lower level saturated. relocated to upper.
4/1112019 IP-14 20 16:19 16 :30 35 9.1 100 \00
4111/2019 IP-14 15 16:34 16:45 lO 9.1 100 100
4/1112019 IP-14 10 16:46 \6:59 25 7.7 100 100
4/12/2019 IP-15 25 7:58 8:16 40 5.6 100 100
4/12/2019 IP-15 20 8:17 8:32 35 6.7 100 100
4/12/2019 IP-15 IS 8:38 8:50 30 8.3 100 100
4/12/2019 IP-15 10 8:52 9:05 20 7.7 100 100
4112/2019 IP-16 25 11:17 11:38 45 7.1 150 150 ane of Indoor locations to gel 600G
4/1 2/2019 IP-16 20 11 :41 12:00 35 7.9 150 150
4112/201 9 IP-\6 \5 12:03 12:18 30 6.7 100 100 empty lank
4/12/2019 IP-16 [5 12:43 12 :49 I JO 8.3 lO 50
4/12/2019 IP-16 10 12:50 13 :IS 20 6.0 150 150
4/12/2019 IP-17 25 13 :27 13 :45 45 8.3 150 150 one or indoor locauons to gel 6000
4/12/2019 IP-17 20 13 :48 13 :56 40 6.3 50 50 empty tank
4/12/2019 IP-17 20 15:26 15 :38 40 8.3 100 100
4/12/2019 IP-17 IS 15:40 15 :58 30 8.3 150 150
4/12/2019 IP-17 10 16:00 16:19 35 7.9 150 ISO
4/12/2019 I IP-18 25 16:58 17:08 45 10.0 100 100
4/12/2019 IP-18 20 17:12 17:24 40 8.3 100 100
4/12/2019 lP-18 IS 17:29 17:40 35 9.1 100. 100
4/12/2019 lP-18 10 17:41 17:54 20 7.7 100 100
4/13/2019 lP-19 25 7:44 7:56 so 8.3 100 IOO
4/1312019 IP-19 20 8:00 8:12 40 8.3 100 IOO
4/13/2019 IP-19 15 8:15 8:27 30 8.3 100 100
4/13/2019 IP-19 10 8:27 8:41 20 7.1 100 100
Total Volume 8400
Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0300404
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Kem Polymeric
Location Address
465 Airport Rd
Salisbury
Owner
Owner Name
Pfs I Inc
Dates/Events
NC
Orig Issue
4/3/2019
App Received
3/27/2019
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
28147
Draft Initiated
Scheduled
Issuance Public Notice
Central Files : APS SWP
4/3/2019
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Stephanie Vincent
220 N Roemer Rd
Appleton
Region
Mooresville
County
Rowan
WI
Issue
4/3/2019
Effective
4/3/2019
54911
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
March 20, 2019
Underground Injection Control Program
NCDEQ -Division of Water Resources
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Phone: [phone]
Attention: Mr. Michael Rogers
MAR 27 ZIIJ
Subject: Notice of Intent to Construct or Operate Injection Wells
Former Kern Polymeric, Inc. Facility
465 Airport Road
Salisbury, North Carolina
Site ID NONCD0001951
Dear UIC Program Manager
On behalf of PFSI, Inc., ERM NC, Inc. (ERM) is submitting this Notice of
Intent (NOi) to Construct or Operate Injection Wells for a small-scale
injection operation for the purpose of groundwater remediation at the
referenced site. Site remediation activities are being conducted in
accordance with an Administrative Agreement (AA) between PFSI and
the NCDEQ for voluntary remedial action conducted under the
Registered Environmental Consultant (REC) program. The direct-push
borings and injection activities are scheduled to begin April 8, 2019.
An NOI was submitted to the UIC Program in June 2013 for a previous
full scale injection that was performed at the site in 2013 (Groundwater
Remediation Permit WI0300242). Based on the previous pilot-test and
full-scale injection, the shallow groundwater zone exhibited favorable
injection parameters (pressures, flow rates, radius of influence, etc.).
Post-injection groundwater performance monitoring conducted from
2013 to 2017 showed substantial reductions of PCE concentrations in
groundwater, indicating overall successful initial remediation, followed
by gradually increasing PCE concentrations in portions of the treatment
area. The monitoring results indicated that, as anticipated, a
supplemental injection of oxidant was needed to support continued
remediation of the residual PCE. This NOI is intended to cover the full-
scale activities for a second injection operation based on the findings of
the previous remedial activities.
ERMNC,lnc.
15720 Brixham Hill Avenue,
Suite120
01arlotte, NC 28277
T: [phone]
www.em1.com
ERM
Please contact me or Tom Wilson at [phone] if you have questions
or concerns.
Sincerely,
~~
Chris Means
Project Manager
cc: Ann Cleary, PFSI, Inc.
Project File
MAR 2 6 2019
North Carolina Department of Environmental Quality -Division of Water Resources
NOTIFICATION OF INTENT (NOi) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are ''permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200 (NOTE: This form must be received at least 14 DAYS prior to in jection)
AQUIFER TEST WELLS 05A NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (ISA NCAC 02c .0225 ) or TRACER WELLS C15A NCAC 02C .0229 ):
1) Passive Injection S ystems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small-Scale Injection O oerations -Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: March 11 .2019 PERMIT NO. IN l1J 3 0 0 Lf-04-(to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1)
(2)
(3)
(4)
(5)
(6)
__ ___,Air Injection Well ...................................... Complete sections B through F, K, N
___ Aquifer Test Well ....................................... Complete sections B through F, K, N
___ Passive Iajection System ............................... Complete sections B through F, H-N
X __ Small-Scale Injection Operation ...................... Complete sections B through N
___ Pilot Test ................................................. Complete sections B through N
___ Tracer Injection Well ................................... Complete sections B through N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER(S) -State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): ___ S_t ~e p~h_am_·e_V_1_·n_c_en_t_o_n_b_e_h _al_f _o_fP_F_S_I_._In_c_. ______________ _
Mailing Address: ___ 2_20_0_N_. _R_o_em_er_R_oa_d _____________________ _
City: A pp leton State: ..JYL_Zip Code:~5_49~1~1 ____ County: United States
Day Tele No.: 920-731-7724 Cell No.: __________ _
EMAIL Address: ___ ~St~e ... o=han=i~e ~.V~i=nc~e~n=t®._• ..... v~o~ith~.c~o=m=-FaxNo.: ___________ _
Deemed Permitted GW Remediation NOi Rev. 3-21-2018 Page I
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: ----=--Sam=~e ~as~w~e=ll~o~w~n=e=r ______________________ _
Company Name ________________________________ _
Mailing Address: _______________________ _
City: __________ State: ___ Zip Code:. _________ County: _____ _
Day Tele No.: ____________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title: ___ C~hr_i~s _M_e~a~n~s _(A~ss~o~c~ia~te~G~e~o~lo~g~is~t)~-----------------
Company Name ---=E=RM~~N~C~. I=n=c~. ________________________ _
Mailing Address: --~1~5~72=0~B=ri=xh=am=~H=i=ll~A=v~e=n=ue~S~u=it~e~1=2~0 _______________ _
City: Charlotte State: NC Zip Code:
Day Tele No.: 704-541-8345
29:-7:0it" U'2--*county: Mecklenburg
Cell No.: 336-406-7625
EMAIL Address: chris.means @erm.com Fax No.: ___________ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: _4~6_5 _A_i-rp_o_rt_R_o_a_d ___________________ _
City: ___ S=a=l=is=b~u_ry~ ________ County: Rowan
(2) Geographic Coordinates: Latitude**: -=--3~5 __ 0 ~• 6.4 N" or
Longitude**: ~8~0 __ 0 ]l___' 24.2 W" or
Zip Code: __ 2~8~1~47~
0
0
Reference Datum: ________ Accuracy:~--------
Method of Collection:_G=o-=--o=g=l-=--e =E=art=h~P~r~o ___________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: 292 .500 square feet
Land surface area ofinj. well network: __ 5=·=0-"-0-=--0 ____ square feet(;:: 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated: 1.7% (must be::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Deemed Permitted GW Remediation NOi Rev. 3-21-2018 Page2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and duration
of injection over time.
ERM. on behalf of PFSI, Inc .. will conduct a source area injection of sodium permanganate to treat a dissolved
contaminant plume containing prirnaril PCE and TCE. The treatment will involve in jecting a 5% sodium
permanganate solution through 20 borini:i:s to treat the source area of the dissolved contaminant plume. Each
point will receive a pp roximately 420 gallons of the 5% solution. The targeted injection zone is between 10 and
25 feet below gro und surface. The injection pressures in the treatment zone are expected to be between 20 and
30 psi. The antici pated injection rate is between 4 and 8 gallons per minute . although field conditions may vary .
The in jection event is antici pated to be completed in 8 days.
J. APPROVED INJECTANTS -Provide a MSDS for each injectant (attach additional sheets if necessary).
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be injected. Approved injectants can be found online at http://deg.nc.gov/about/divisions/water-
resources/water-resources-perrnits/wastewater-branch/e.round-water-protection/e.round-water-approved-injectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
Injectant: ---'R==em=-cO~x~L~S~o~d=ium=~P~e=rm=a=n=g=an=at=e_-~C~ar=u=s~C=orp'--"-"o=ra=t=io=n~-----------
Volume ofinjectant: 804 12allons of 40%
Concentration at point of injection: 5% bv weight (mixed with water)
Percent ifin a mixture with other injectants: ----=5c...c¾..,co _________________ _
lnjectant: ___ W-'--'---=a=te=r ___________________________ _
Volume ofinjectant: 7600-7800 gallons
Concentration at point of injection: --"'"'9"'"'5::...¾'-'o'----------------------
Percent if in a mixture with other injectants: --~9_5_¾_o ________________ _
K. WELL CONSTRUCTION DATA
(I) Number of injection wells: 20 Temporary Borings Proposed __ 0_Existing (provide GW-ls)
(2) For Proposed wells or Existing wells not having GW-ls, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
Deemed Permitted GW Remediation NOi Rev. 3-21-2018 Page3
L. SCHEDLtLES — Briefly describe the schedule for well construction and injection activities.
The injection is scheduled to occur starting on April 8, 2019. The work should take approximately 8 days to
complete. The temporary injection points will be advanced to a maximum depth of 25' below ground surface
using the DPT dril[ing method. Upon conviction ofeach infection point it will be abandoned per North Carolina
well elm rdon nxent s ridArds X 1la NC,AC 02c .0100)
M. MONITORING PLAIN -. Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
prior to and immediately following ISCO imikmentation, groundwater samples will be collected from nearby
existing monitoring and observation wells. Additional .-roundwater monitoring events will be cartJucted 1-
month. and 6 months following the injection. A summary of the scheduled performance monitoring. taken from
the 2018 Pre -construction R wort Addendum. is attached.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "I hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is trace, accurate and
complete. I am aware that there are significant penalties, including the possibility offines and imprisonment,
for submittingfalse information. I agree to construct, operate, maintain, repair, and ff applicable, abandon the
infer ' well and all related appurtenances in accordance with the I S.4 NCAC 02C 0200 Rules."
cw-
Signatu of Applicant
cu-tie $. V lctri+t Pas ►dcot- 6; 5t'ct y
Print or Type Full Name and Title
Property Owner (lithe property is not awned by the Well OwnerlApplicantl:
"As owner of the property on which the injection well(s) are to be constructed and operated I hereby consent ro
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 ayection well() conform ro the Well Construction Standards
(15.4 NCAC 02C .0200)."
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Signature* of Property Owner (if different from applicant) Print or Type Full Name ag_id Title
•An access agreement between the applicant dud property owner may be submitted in lieu of a signature an this farm.
Please send 1 (one) hard color copy of his NOI along with s copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR — UIC Program
1636 Mail Service Center
Lileigh, NC 27699-l636
Telephone: [phone]
Deemed PemtittiA OW 1%mediatioa NOI Rev. 3-21-2018
I'egc 4

INJECTION POINT SUMMARY
Table 1
Former Kern Polymeric Facility -Source Area ISCO Treatment
Address: 465 Airport Road, Salisbury, North Carolina
No. of Injection
Descripion Points Construction
Injection Zone 20 Temporary DPT boring
Notes:
bgs = below ground surface
Depth of Grout,
Screen, and Casing
Not Applicable
The direct push activities will be completed by a certified North Carolina driller (to be determined).
Total Depth Injection Zone Diameter Injection
(ft bgs) {ft bgs) (inch) Method
Bottom-up,
direct push
25 10-25 2.25 injection
FIGURES
Legend
retmemoroethai a (PCE) {March2017)
— slrearn
©Site Properly Boundary
Partela
Figure 1
Site Layout
Map
Kem Polymetric Facility
Volth Holdings
Salisbury, North Carolina

Ell
140
Ci Site Propertyny
© Parcels
2013 Treavrene Zone
We II Location
Q Deep'AO
e. Monitor We
• Qhserea eon Wee
• DehraaticnSampklocstiar
PCE Concentration (uglL)
(9,500) August 2017
Notes:
Depicts data Iran groundwater 99 mp19:
col:ected • r- Ar4 trot 2017.
V=lues indi CAM PGE cancentremun ir
rnicrogr rrls p9r iter(ug!Ly.
Figure 2
Treatment Zone Delineation
PCE . Shallow Groundwater
Kern Polymetric Facility
Voith Holdings
Salisbury, North Carolina
ERM NC, Inc. ,�nn,,
Rro
9eumrnrx:50A

•
•
♦
•
"''tie it
{t,
10 20
Fos'
Smarr INYtirli
4.
••
1
•
Q Site Property Eatdndery
I= Parcels
2 D13 Treatment Zone
Well Location
O Deep Weil
• monitor'/ II
• Observation 'Nell
• C eli neatxn Samp!e Location
PCE Concentration (tlg/L)
(D,500 August 2017
Notes:
Deplete data from groundwater samples
collected In Ar g ust 2017.
VA hietindicele PCE concsniratian in
RYCr0g rams per ito (ug♦e),
Figure 3
Treatment Zone Delineation
PCE • Deep Groundwater
Kern Polymetric Facility
Voith Holdings
Salisbury, North Carolina
ERAS NC, Inc. :7+,=e•s.
www.rrur.com ERNI

Legend
Injection aunt
Area of Influence
O Deep'
Monitor Well
• Onset bon ryL'6[•
• Delineation Sarnp a Location
Proposed Treatment Zone
Sim Property Boundary
© Parrots
PCE Concentration (ug!L)
(9,500) August 2017
7oVCt6 dsFa 1Oom grmundwakir 9arrgms
7..ffwicet rrrearfpxst 2917
Values lnnlr$y P:F Coroy trolko yr
'ricrngro rr, pry her e.csn.r.
Figure 4
Proposed Injection Point
Layout
Kem Polymetric Facility
Voith Holdings
Salisbury, North Carolina
lit NE NC, Inc.
wnw.enn.rom :1,I
saw.

Legend
--- Seem
:OSxe Property Ba,ndary
L J PATOEIS
WeII Location
e Monitor Well
O Deep Wail
CI:amniion Wel
Figure 5
Monitor Well
Layout Map
Kem Poly metric Facility
Vaith Holdings
Salisbury, North Carolina
ERM NC, I nc
www,rrnLcom E1(M

A
770
700 2
740
730
710 -
700-
670
660
660
W
410
LEGEND
ASPH A T.T f A I.I.
CLAY
SILT
100
SAPROLTTE
200
PARTIALLY WEATHERED
ROCK
ORGANIC SOIL
300
400
EACOMPETENT ROCK
600
000
700
ERM NC, Inc.
ERM
d00
Q in
S6o
1000
A'
[0.22
1
1100
WATER LEVEL
707 PCE iI L}
CONCENTRATION
(M ARCH 2017)
PCE IN GROUNDWATER - CROSS SECTION A - A'
KERN POLYMERIC
SALISBURY, NORTH CAROLINA

LEGEND
ASPHALT/ALL
CLAY
SILT
E
Mill
B
770 -
N
Tao 1
760 -
777
750
700 -
890
660 -
670 -
660
830
SAPROLITE
100
PARTIALLY W EATFIERED
ROCK
ORGANIC SOIL
200
w0
COMPETENT ROCK
11
P0
600
co
a
2
sob
WATER LEVEL
700
B'
809
707 PCE CONCENTRATION
MARCH 2017
(PEILY
00
IsN6wf t M NB
11 s-I
0 76 WO
ERNI NC, Inc.
ERM
PCE IN GROUNDWATER - CROSS SECTION B - B`
KERN POLYMERIC
SALISBURY, NORTH CAROLINA
FIGURE
12

JOB NAME: Former Voith-Kern Facility
INJECTION POINT(S): IP-01 through IP-20
(Typical)
LOCATION: Salisbury, NC
GROUND SURFACE
INJECTION SCREEN
INTERVAL OF DIRECT
PUSH ROD
INJECTION SCREEN
INTERVAL OF DIRECT
PUSH ROD
DPT DRIVE POINT
TOTAL
DEPTH OF
BOREHOLE
25.0 FT
INJECTIONS CONDUCTED IN
5 FT. LIFT INTERVALS
it 't: Dr
* REFERENCED TO AN ASSUMED SITE
DATUM
NOT TO SCALE
Drilling Contractor Redox Tech
MINIM RIME EMI
t�4 iiu••i '. .
■ ►ortoraRIMmx.i! EA fi►�IM!
ERM
ERM NC, Inc.
DIRECT PUSH
INJECTION POINT
SCHEMATIC
13

MONITORING PLAN
The monitoring plan will include two components: 1) performance monitoring to evaluate the
efficacy of the ISeO treatment at the source area, and 2) site-wide groundwater and surface
water quality monitoring.
REMEDIATION PERFORMANCE MONITORING
Following the supplemental ISeO treatment, groundwater sampling will be conducted within
the ISeO treatment area to monitor the efficacy of the remedial action. Following the injection
event, performance monitoring will be conducted at 1-month, 6-month and 12-month intervals
for a period of approximately 12 months. The monitoring requirements will include sampling of
selected wells for analysis of voes and manganese. In addition to the laboratory analysis, water
levels will be gauged and field measurements will be collected for dissolved oxygen (DO),
oxidation reduction potential (ORP), pH, and temperature. Sample water will also be visually
inspected for the presence of permanganate (purple tinting).
The following table outlines a groundwater and performance effectiveness monitoring plan for
the remediation program:
R emediation Perf ormance Monitorin i Plan
Samp ling Event Wells Analy sis
Baseline samples
collected prior to
injection
1 month following • voes (EPA Method 8260) injection MW-4, MW-5, MW-6, Permanganate (visual) MW-7, DW-5, and .
6 months following OW-1 through OW-5 • Field parameters: ORP, pH, DO . Manganese injection
12-months following
injection (as part of the
site-wide monitoring
event).
The results of each event will be presented in the respective remedial performance monitoring
summary reports. .ERM will evaluate the performance monitoring results to assess the need for
modified performance monitoring, additional treatments and/ or technology transitioning.
SITE-WIDE GROUNDWATER AND SURFACE WATER MONITORING
A site-wide groundwater and surface water monitoring event will be conducted approximately
1 year after the ISCO injection. The site-wide monitoring event will also incorporate the 12-
month performance monitoring event. The site-wide monitoring event will consist of water
level gauging and groundwater sampling at thirty existing monitoring/ observation wells at the
site. In addition, samples will be collected at eight existing surface water sampling stations on
the unnamed tributary of Grant's Creek located west of the site. The groundwater and surface
water samples will be analyzed for VOCs by EPA Method 8260 by a North Carolina licensed
laboratory. In addition to the laboratory analyses, field measurements for dissolved oxygen
(DO), oxidation reduction potential (ORP), pH, and temperature will be collected for
groundwater. The following table presents a summary of the proposed monitoring plan.
Site-Wide Groundwater and Surface Water Qualit:11 Monitorinx Plan
Sampling Water Level
I Field Parameters voe Analysis
Location Gauging (EPA8260) -
Groundwater
MW-1 ✓ ✓ ✓
MW-2 ✓ ✓ ✓
DW-2 ✓ ✓ ✓
MW-3 ✓ ✓ ✓
MW-4 ✓ ✓ ✓
MW-5 ✓ ✓ ✓
DW-5 ✓ ✓ ✓
MW-6 ✓ ✓ ✓
MW-7 ✓ ✓ ✓
MW-8 ✓ ✓ ✓
MW-9 ✓ ✓ ✓
MW-10 ✓ ✓ ✓
MW-11 ✓ ✓ ✓
MW-12 ✓ ✓ ✓
MW-13 ✓ ✓ ✓
MW-13D ✓ ✓ ✓
MW-14 ✓ ✓ ✓
MW-15 ✓ ✓ ✓
MW-15D ✓ ✓ ✓
MW-16 ✓ ✓ ✓
MW-17 ✓ ✓ ✓
MW-19 ✓ ✓ ✓
MW-19D ✓ ✓ ✓
MW-20D ✓ ✓ ✓
MW-21D ✓ ✓ ✓
Sampling Water Level Field Parameters voe Analysis
Location Gauging (EPA8260)
OW-1 ✓ ✓ ✓
OW-2 ✓ ✓ ✓
OW-3 ✓ ✓ ✓
OW-4 ✓ ✓ ✓
OW-5 ✓ ✓ ✓
Total-GW 30 30 30
Surface Water
Creek 1 --✓ --
Creek2 --✓ --
Creek3 --✓ --
Creek4 --✓ --
Creek 7 --✓ --
Creek 8 --✓ --
Creek 9 --✓ --
Creek 10 ----✓
Total-SW ----8
The results of the site-wide monitoring will be summarized in an annual remedial progress
report to be submitted to NCDEQ. The remedial approach and site-wide monitoring program
will be evaluated annually and revised as appropriate. The plan for subsequent remedial
activities and site-wide monitoring events will be determined based on the combined
monitoring data.
Sodium Permanganate SDS
CARUS
INDUSTRIAL
AID
CAS Registry No,
10101-50-5
LIQUORSODIUM PERMANGANATE
DATA SHEET
UQUOXQ9 sodium permanganate Is a liquid oxidant recommended
for use in electronics and fine chemical synthesis, that require a
concentrated permanganate solution.
PRODUCT SPECIFICATIONS
Assay
pH
Specific Gravity
lnsolubles
40 - 41 % as NaM nO
5.0 - 8.0
1.37 - 1.40
5 0.005%
CHEMICAL/PHYSICAL DATA
Formula
Appearance
Shelf Life
NaMnO•
Deep purple solution
This product should be used within two years
of the date of production.
Decomposition may start at ! 50 `C 1 302 "F
APPLICATIONS
• DesmearingFEtchback - Printed circuit board desmearing
and etchback.
• Oxidation and Synthesis - Organic chemicals and
Intermediates manufacture. Oxidizes impurities in organic and
Inorganic chemicals.
BENEFITS
• Concentrated liquid oxidant
• More precise dosing of chemical
• Feed equipment is simplified
• Consistent concentration
• Dust problems are eliminated
• High solubility at room temperature
• Can be used whenever potassium ion cannot be tolerated
SHIPPING CONTAINERS
5-gallon pail (20-L) (UN Specification; UN3H I lY 1,81100) Made of
high -density polyethylene (HDPE), weighs 3,3 Ibs (I.5 kg). The net
weight is 57 lbs (25.9 kg). The pail stands approximately 14.8 in
(37.6 cm) tall, 10.6 in (26.9 cm) wide, and 11.0 in (27.9 cm) deep.
(Domestic and international)
SHIPPING CONTAINERS
55-gallon drum (208-L) (LIN Specification: LIN I H I/Y 1.91100)
Made of high -density polyethylene (HDPE). weighs 21 Ibs (9.5 kg).
The net weight is 550 lbs (250 kg). The drum stands approximately
34.8 in (88.3 cm) tali, has an outside diameter of 23.3 in (59.1 cm).
(Domestic and international)
275-gallon IBC (Intermediate Bulk Container) (1040-L)
(UN Specification: UN31 HAI /Y 1.9/ 100) They are also marked
"MX" for multi -trip. IBC weighs 123 Ibs (55.8 kg). The net weight
is 3000 Has (1360 kg). The IBC contains 263 gallons (1000 L) of
product The IBC dimensions are 45.3 in (114,9 cm) high, 47.3 in
(120.0 cm) long, and 39.4 in (100.0cm) wide. The !BC has a 2 in (5
cm) butterfly valve with NPT threads in bottom sump, (Domestic)
Packaging has a weight tolerance of +/- 3%.
Bulk Shipping Quantities from 3000-3800 gallons are available,
HANDLING, STORAGE, AND INCOMPATIBILITY
Like any strong oxidant. LtQLJOX sodium permanganate should be
handled with care. Protective equipment during handling should
include face shields andlor goggles, rubber or plastic gloves, rubber
or plastic apron. If clothing becomes spotted, wash off
immediately; spontaneous ignition can occur with cloth or paper.
In cases where significant exposure exists, use of the appropriate
NIOSH-MSHA dust or mist respirator or an air supplied respirator
is advised.
The product should be stored in a dry area in closed containers.
Product should be stored above 50°F. Concrete floors are
preferred. Avoid wooden decks. Spillage should be collected and
disposed of properly. Contain and dilute spillage to approximately
6% with water and reduce with sodium thiosulfate, a bisulfite, or
ferrous salt. The bisulfite or ferrous salt may require dilute sulfuric
acid to promote reduction, Neutralize any acid used with sodium
bicarbonate. Deposit sludge in an approved landfill or, where
permitted, drain into sewer with large quantities of water.
As an oxidant, the product itself is non-combustible, but will
accelerate the burning of combustible materials. Therefore,
convect with all combustible materials and/or chemicals must be
avoided. These include, but are not limited to: wood, cloth, organic
chemicals, and charcoal. Avoid contact with acids, peroxides,
sulfites, oxalates, and all other oxidizable inorganic chemicals.
With hydrochloric acid, chlorine is liberated.
CARUS CDRPORAl10H
IHE COMPANY. ENDLESS SOL11T1DiiS
CORPORATE HEAORUARTEBs T s15 Fi ti Street Aeru n 41254 1 Te! + 1915.223.1500 71-100-135-a5i i Fax+ 1115424.4697 I IBA! ww.anseorgoratlelicam I E-H7i1, salronklecaroorporationau
CARDS EUROPE I Porgy!! Empreearial de A$1130 I E35trundina Haas 3, Foos 1. 06ciaa 13.1i 18312I Cayes. LLeva Spain I Tel +3U85_78.55.121 Fu+3A.9l5.7335.1l
The inforrr'atlolr Canolned herein Is accunw w the best of our knoryiede, However, deti, areey siandanls and government regulations
re subject to change. end die candmons of handlleg, use or misuse of the product are beyond our control. Carus Cheninl Company
makes no wamnry, either eepressed or implled, including any warranLes of merchannbilky and frowss for i particular purpose- Cards
a!so dts=lams ell I abllq For rel.". on the romplekeness or confirming accuracy el any information induded herein. Jaen. should satisfy
Them terms that they tie aware of all current dam relevant co th efr particular use(s).
Cann and Clair 6 a regfoired serrfce toile a Care CO -WAS., UQt10X5 is a rrnwccd trae6tark of Caro Crvweur,. Re;amslh+e
Carr.1A is a rogistered service nark of the Amsr¢an Chrism -Ds Count
Copyright 2012
rev. 7:16
Form LX 1501
RESPONSIBLE CAR{

CARUS
INDUSTRIAL
CAS Registry No.
i0101-50-5
COMPATIBILITY
LIQUOX3'sodium permanganate is compatible with many metals
and synthetic materials. Natural rubbers and fibers are often
incompatible, Solution pH and temperature are also important
factors. The material selected for use with sodium permanganate
must atso be compatible with any acid or alkali being used.
In neutral and alkaline solutions, sodium permanganate is not
corrosive to carbon steel and 316 stainless steel. However,
chloride corrosion of metals may be accelerated when an oxidant
such as sodium permanganate is present in solution. Plastics such
as teflon, polypropylene. HOPE and silicone are also compatible
with sodium permanganate,
Aluminum, zinc, copper, Iead, and alloys containing these metals
may be slightly affected by sodium permanganate solutions.
Actual corrosion or compatibility studies should be made under
the conditions in which the permanganate will be used prior co
use.
LIQUOX'SODIUM PERMANGANATE
DATA SHEET
SHIPPING
LIQUOX sodium permanganate is classified and listed as an
oxidizer by PHMSA (pipeline and Hazardous Materials Safety
Administration), Department of Transportation, in 49 CFR
Subchapter C. HMR (Hazardous Materials Regulation), Part
172_ 101 H1~IT (Hazardous Materials Table).
Proper Shipping Name:
Hazard Class:
Identification Number:
Packaging Group:
Label Requirements:
Packaging Requirements:
Sections:
Permanganates, inorganics,
aqueous solution n.o.s- (Contains
sodium permanganate).
5.1
UN 3214
11
Oxidizer, 5.1
49 CFR Parts 171 to 180
173.152, 173.202, 173.242
CARUS VALUE ADDED
LABORATORY SUPPORT
Carus Corporation has technical assistance available to answer questions, evaluate treatment alternatives, and perform laboratory
testing. Our laboratory capabilities include: consulting, treatablllty studies, feasibility studies, and analytical services.
FIELD SERVICES
As an integral part of our technical support, Carus provides extensive on -site treatment assistance. We offer full application services,
Including technical expertise, supervision, testing, and feed equipment design and installation In order to accomplish a successful
evaluation and/or application,
CARUS CORPORATION
During its I00-year history, Carus' ongoing emphasis on research and development, technical support, and customer service has enabled
the company to become the world leader in permanganate, manganese, oxidation, and base -metal catalyst technologies.
CAROS CORPORATION
ONE COMPANY. ENO1-ESS SOLOfIONS
'CORN RAEE REAOOII RATERS 1 315 fifth Strut Pert IL d1354 I TIE + 1.81S/2115BI f 1-iXo-L7r6A56 I Fax + 1.115-2/1,4897I Web- ww,taruxarporaGeacum 1 f-Mail adsamicienofcarporetlotram
CARUS EOROPE E Pirle§ Empruerisi de ASIPO I CfSetend ino Rocas ]. PLeeta 1. ORciai 13-15I 31821 Cayes. Llanan Spats I Toi +3AS85.7OS5.13 I fax[phone]p
Copyright 2012
rev. 7/16
Form LX 1501
are
The information contained herein is ccura1:4 m he best of our Imowleelte Hvwe.er, dab, safety sundurft and government regul accnt
subject to churg., and the condition, of handing, use or misuse of the product are beyond one control. Carus Chemical Ce paey
makes no warnety. sitter o'piessed or implied. inciudIng any warranties of morthanrtllay and fitness for a parutuCar puma Gres
also disclaims all eabt , for reliance on the ciamdlets lees or conAnning accuracy of any information mduded herein. Users should satisfy
di emcee. that they arc aware of all current data relevant co their pamtular use(s)-
Ce uaad ilesddi d a reek pared aervrce mar: d Caro CcrpenNsn LlQUOXQ. la a estrrened t adenv di of Cann Cruyprapon Raponable
Came is a raayfteed aarnte fr,irk prdre Anse -an Chemistry Cent+l.
L E5'QNS1eiE CAILE

March 20, 2019
Underground Injection Control Program
NCDEQ-Division of Water Resources
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Phone: [phone]
Attention: Mr. Michael Rogers
Subject: Notice of Intent to Construct or Operate Injection Wells
Former Kern Polymeric, Inc. Facility
465 Airport Road
Salisbury, North Carolina
Site ID NONCD0001951
Dear UIC Program Manager
On behalf of PFSI, Inc., ERM NC, Inc. (ERM) is submitting this Notice of
Intent (NOI) to Construct or Operate Injection Wells for a small-scale
injection operation for the purpose of groundwater remediation at the
referenced site. Site remediation activities are being conducted in
accordance with an Administrative Agreement (AA) between PFSI and
the NCDEQ for voluntary remedial action conducted under the
Registered Environmental Consultant (REC) program. The direct-push
borings and injection activities are scheduled to begin April 8, 2019.
An NOI was submitted to the UIC Program in June 2013 for a previous
full scale injection that was performed at the site in 2013 (Groundwater
Remediation Permit WI0300242). Based on the previous pilot-test and
full-scale injection, the shallow groundwater zone exhibited favorable
injection parameters (pressures, flow rates, radius of influence, etc.).
Post-injection groundwater performance monitoring conducted from
2013 to 2017 showed substantial reductions of PCE concentrations in
groundwater, indicating overall successful initial remediation, followed
by gradually increasing PCE concentrations in portions of the treatment
area. The monitoring results indicated that, as anticipated, a
supplemental injection of oxidant was needed to support continued
remediation of the residual PCE. This NOI is intended to cover the full-
scale activities for a second injection operation based on the findings of
the previous remedial activities.
ERMNC,Inc.
15720 Brixham Hill Avenue,
Suite120
Charlotte, NC 28277
T: [phone]
www.em1.com
ERM
Please contact me or Tom Wilson at'{704) 541-8345 if you have questions
or concerns.
Sincerely,
~~
Chris Means
Project Manager
cc: Ann Cleary, PFSI, Inc.
Project File
North Carolina Department of Environmental Quality-Division of Water Resources
NOTIFICATION OF INTENT (NOi) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are ''permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200 (NOTE: This form must be received at least 14 DAYS p rior to injection)
AQUIFER TEST WELLS (15A NCAC 02c .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS {ISA NCAC 02C .0229):
1) Passive Injection Sv stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small-Scale Injection O perations -Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: March 11 ,2019 __ PERMIT NO. --------'(to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) ___ Air Injection Well ...................................... Complete sections B through F, K, N
(2) ___ Aquifer Test Well ....................................... Complete sections B through F, K, N
(3) ___ Passive Injection System ............................... Complete sections B through F, H-N
(4) X __ Small-Scale Injection Operation ...................... Complete sections B through N
(5) ___ Pilot Test. ................................................ Complete sections B through N
(6) ___ Tracer Injection Well ................................... Complete sections B through N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER(S)-State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): --~S~t"""e p=h=am=·e_V~1=·n=c=en=t~o=n~b~e=hal=f ~o=-f P=-F=-S=I~. =In=c~. ______________ _
Mailing Address: ----=2=20~0~N~. =R=o=em=er~R=oad~---------------------
City: A ppleton State: WI Zip Code:.~5~4~9~1 =-1 ____ County: United States
Day Tele No.: 920-731-7724 Cell No.: __________ _
EMAIL Address:. ___ =St=e=p=h=aru=·=e'"""'.V~in=ce=n=t@'--'v'""o=it=h=.c~o=m=-FaxNo.: ___________ _
Deemed Permitted GW Remediation NOI Rev. 3-21-2018 Page 1
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: ---=Sam==e-=as"'----'-w'----=e=ll'-'o"--'wn=e=r ______________________ _
Company Name ---------------------------------
Mailing Address: _______________________ _
City: ________ _ State: ___ Zip Code: _________ County: _____ _
Day Tele No.: ____________ _ Cell No.: __________ _
EMAIL Address : _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title: ___ C=hri=·=-s =M=e=an=s -"(A~ss=o~c=ia=te~G~e=o=lo=g=is=t~) _________________ _
Company Name ---=E=RM=-"-N"'"'C"-'-'I=n=c·'--------------------------
Mailing Address: -----=-1=57.,_,2=0'-'B=r=ixh=am===H=il"'"l -=--A._.v=en=u=e=·-=S-=u=it=e """12=-0"-----------------
City: Charlotte State: NC Zip Code:_2=9'-'7"""0=8 ____ County: Mecklenburg
Day Tele No.: 704-541-8345 Cell No.: 336-406-7625
EMAIL Address: chris.means@ erm.com Fax No.: ___________ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: ~4..a.6.a..5 ~A=i'"""rp~o=rt~R=o=ad~--------------------
City: __ _,S=a=h=·s=b=urv'-'--________ County: Rowan
(2) Geographic Coordinates: Latitude**: =-3:::...5 __ 0 JL__' 6.4 N" or
Longitude**: =80-=----__ 0 _31 __ ' 24.2 W" or
Zip Code: ---=2=8.a..14"'"'7_
0
0
Reference Datum: ________ Accuracy: ________ _
Method of Collection:.----'G=o=o"""g..,le:::..=E=art=h==--=-P=ro.___ __________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume : 292.500 square feet
Land surface area ofinj. well network: __ 5~0~00~ ____ square feet (:s 10 ,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: 1.7% (must be _s: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(I) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map( s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Deemed Permitted GW Remediation NOI Rev. 3-21-2018 Page2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and duration
of injection over time.
ERM, on behalf of PFS I, Inc., will conduct a source area injection of sodium permanganate to treat a dissolved
contaminant plume containing primarily PCE and TCE. The treatment will involve iniectin!! a 5% sodium
perman2.anate solution throue.h 20 borings to treat the source area of the dissolved contaminant plume. Each
point will receive a pproximatel v 420 gallons of the 5% solution. The targeted in jection zone is between 10 and
25 feet below ground surface. The injection pressures in the treatment zone are ex pected to be between 20 and
30 psi. The antici pated injection rate is between 4 and 8 gallons per minute , although field conditions mav vary .
The injection event is antici pated to be completed in 8 days.
J. APPROVED INJECT ANTS -Provide a MSDS for each injectant (attach additional sheets if necessary).
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be injected. Approved injectants can be found online at hltp://deg.nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ground-water-protection/eround-water-approved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
Injectant: __ _.R=e=m=O=x-=L=-=So=d=i=um:::..,P,__e=rm=an=g=an=a=t=--e _-----'C=aru==--s --=C=o'-'--'rp"'"'o=r=at=io=n=------------
Volume of injectant: __ 8~0~4~g=a=l=lo=n=s ~o~f ~4~0°~1/o~--------------------
Concentration at point of injection: --~5~o/i~o~b_y_w~ei_.,_gh=· t~{_m1=·=x=e~d~w~i=th~w~at~e~r)~---------
Percent if in a mixture with other iajectants: --~5~o/i~o ________________ _
Injectant: ___ W~a~te=r ___________________________ _
Volume of injectant: -~7~6~0~0~-7~8~0~0 ... g=al=lo=ns~----------------
Concentration at point of injection: --~9~5~o/i~o __________________ _
Percent if in a mixture with other injectants : 95%
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: 20 Temporary Borings Proposed __ 0_Existing (provide GW-ls)
(2) For Proposed wells or Existing wells not having GW-ls, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
Deemed Permitted GW Remediation NOi Rev. 3-21-2018 Page3
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities.
The injection is scheduled to occur starting on April 8, 2019. The work should take approximately 8 days to
complete. The temporary injection points will be advanced to a maximum depth of 25` below around surface
using the DPT drilling method. Upon completion of each injection point it will be abandoned Der North Carolina
well abandonment standards 115a 02e .01001
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter On. result from the injection activity.
Prior to anti immediate'', foUcwine ISCO irrinletnentation, groundwater samples will be collected from nearby
existing monitori t and observation wells. Additional groundwater monitoring events will be coructed 1-
month. and 6 months following the iniection. A summary of the scheduled _performance roonitorina. taken from
the 201$ ere -cc instruction Report Addenthm . is attached.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "I hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete 1 am aware than Mere are significant penalties, including the possibility offrnes and imprisonment,
for subminingfalse information. Iagree to construct, operate, maintain, repair, and ifapplicable, abandon the
injecti well and all related appurtenances in accordance with the 154 NCAC 02C 0200 Rules."
Signatu of Applicant
c}(,ha.nie S. V;icerat Prstdan*-4 Yet/Vail/
Print or Type Full Name mg 'title
Property Owner Of the property is not owned by the Well Owner/Applicant):
".4s owner of the property on which the injection well(s) are to be constructed and operated I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
5.41VC4C 02C 0200)."
"Owner" recaps 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.
Signature' of Property Owner Cif different from applicant) Print or Type Full :lame And Title
*An access agreement between the applicant and properly owner may be submitted in lieu of a signature on this form.
Please send 1(one) hard color copy of his NOl along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DW R — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permuted cw Remehhalion NOI Rev. 3-21-201$ Page 4

INJECTION POINT SUMMARY
Table 1
Former Kern Polymeric Facility -Source Area ISCO Treatment
Address: 465 Airport Road, Salisbury, North Carolina
No. of Injection
Descripion Points Construction
Injection Zone 20 Temporary DPT boring
Notes:
bgs = below ground surface
Depth of Grout,
Screen, and Casing
Not Applicable
The direct push activities will be completed by a certified North Carolina driller (to be determined).
Total Depth Injection Zone Diameter Injection
(ft bgs) (ft bgs) (inch) Method
Bottom-up,
direct push
25 10-25 2.25 injection
FIGURES
Legend
Tetra ahloroelhene LPCE1 (Wre) 2017)
-- Slre'n
QSHe Property &Emdery
Q Parcels
Figure 1
Site Layout
Map
Kem Polymetric Facility
Voith Holdings
Salisbury, North Carolina
rAlhi NC, Inc
nn.nr.enn.crmr EIRM
eew». WC GA

J.
w r
y�1
r
No. 11101 111111M, 414, 44Z445
3
•
•
•
�� 4
r ., !-0,t
•
•
{
• •
•
A-toCir,
=Site Properly Boundary
Parcels
2013 Treatment Zone
Well Location
O Deep MR
`.t. Honda Wer
• Observation Wet
▪ Delineatio7 Sarr pie Location
PCE Concentration {ugJL]
(9,500) August2017
Notes
Depicts data from g roti adwb er samples
co, !ache! In FlugizZ 21717.
Values Indicate PCE concentrxion it
micrograms per Ear (ug&).
Figure 2
Treatment Zone Delineation
PCE - Shallow Groundwater
Kern Polymetric Facility
Voith Holdings
Salisbury, North Carolina
r_RM NC, Inc.
54 W W. Hmt.COM Erodyi

OW-7
INS!
0 9
GP-TZDPry-
-
• F ■
•
•
r
•
4305.,
•
•
1•
=Silo Property Boundary
© Parcels
2013 Tomiroent Zone
Well Location
0 Deep Well
QJ Marc[or WlX
• DOSaNaleen woo
a De ineauan Semple Location
PCE Concentration tug/L)
(9,5D0) August2017
N sten
Depicts data from proe+rdwaar samples
co 4sWidInfpgAt2017
Values in1m[e PCE comsat-gen Si
ml eograms par OW.
Figure 3
Treatment Zone Delineation
PCE - Deep Groundwater
Kem PcIymetric Facility
Voith Holdings
Salisbury, North Carolina
'..n".rr.m ERNI
2wne NCCCX

--
Legend
Injection Point
Area of Influence
opp�� Deep We
NI on Rol Well
Odservaim N'eL
• Delineation Semple Loceaion
Pm pa sad Ira a anent Zone
= Site Property 9aundery
© Pmce s
PCE Concentration (ugfL)
I9,54"i August 2D17
Hiles:
data from groundwater samples
colteclad i n August 2C17,
Values Indlcele PCE concenraticn in
roi angle ms per tier Sugrl]-
Figure 4
Proposed Injection Point
Layout
Kern Pofymetric Facility
Voith Holdings
Salisbury, North Carolina
LEIM NC, Inc,
+, ltw.cnn.com ERNI

Legend
— Stream
QSi'u aroparTy Boundary
Q Pgrca's
well LO Cation
yZ Monitor We4
O Deep Wei
OhservaEar, Wei
Figure 5
Monitor Well
Layout Map
Kem Polymetric Facility
Voith Holdings
Salisbury, North Carolina
ERM NC,3rte [JLF
uo.er.enttrf,l, LHh4

A
770
740J
B
760 +�
770
710 -
700 -
630
LEGEND
ASPHALT/FILL
CLAY
SILT
r •
{
4+4•4
4 r 4 ♦++
t y:,:ytttii4 tt+ ♦+ ttit4♦ f 4:4{a
44r4+++♦ 4tao vok..•v.... 44.4
10
., • •
7,000 r
7.
i+49pi�44 S
a.'4♦4a4844 44 t
e < i } . ¢ ♦+ Ot ai+�
a44 ♦♦♦ +t ++4+t+ r. t4�
4 ♦ ► 4 a t'+s 4 ► •i s + 4+415 tam•♦4'+ +*ia+'i+i.�r +•*� 4+itiy 4#i'��sr♦+�+�+i+ ai+�%'a f+*++t+ �..
•
4 ++4 A5.544 1 4*• 4 f ♦�a44 T +'v} ♦ i* 4 t a•4 4 ++ p►
a♦•
♦ s44�F
P YI
. + • +*
• 4♦**
• +
9.0
•♦o
Qa
7:
A'
(0.22
•
• WA'LF.L0 LEVEL
707 PCE (µg/L)
CONCENTRATION
{MARCH 2017}
E
Ell
100
SAPROLITE
200
PARTIALLY WEATHERED
r.00K
ORGANIC SOIL
am
COMPETENT ROCK
d00
n00
700
eon
two
100❑
1
1100
so
10
1. aI 0313
4d.11
4 50 100
ERM NC, Inc.
ERM
FCE IN GROUNDWATER - CROSS SECTION A — A' "
KERN POLYMERIC
SALISBURY, NORTH CAROLINA 11

B
770
Y6o -
700 -
4.
740 -
730
720 —
710 -
700
680
660
670 -
660
630
610 -
630
LEGEND
ASPHALT/FILL SAPROLIIE
CLAY
SILT
!Hill
[V
1023
Lo
iy#.ta eeisa •;a*';:::4 rrr:`.4 •* a'�t Ott+ t i
t t :a +a 4►r+:r:t
afit a atiia� 4+a#+t ►►`+ta+�+aairar a s ♦ * •* a �i
i rf•*a+a :may}i►*�/:++4 i`+ +F1. a .4 Y 44,Ya
t{�ta t ark t+ a +iaa++itt+►i ark+1•� •a f R i * f PY,a�♦
▪ •a Maf�++t+tttat • :
t'tt•+a wiaaa+aa►af:aiR+grata:*t a'�r ;a r � + r a� +f• �+
a►ta+� :�aa :a :tt *4:++chat oo # a •t# **.e a •
, 4artA.
'*at•4'i*++al')�� + a` a►'t allo. ia� • 74.44 r a it tt
100
PARTIALLY WEATHERED
ROCK
ORGANIC SOIL
r
too
B'
300
COMPETENT ROCK
400
e6o
WATERI.FVEI.
•
760
000
707 PCE CONCENTRATION
MARCH 2017
[µg/L)
00
so11ME IN REF
1R-e
0 00 1 0
ERM NC, Inc.
Eke!
PCE IN GROUNDWATER - CROSS SECTION B - B'
KERN POLYMERIC
SALISBURY, NORTH CAROLINA
12

JOB NAME: Former Voith-Kem Facility
INJECTION POINT(S): IP-01 through IP-20
(Typical)
LOCATION: Salisbury, NC
GROUND SURFACE
INJECTION SCREEN
INTERVAL OF DIRECT
PUSH ROD
INJECTION SCREEN
INTERVAL OF DIRECT
PUSH ROD
DPT DRIVE POINT
* REFERENCED TO AN ASSUMED SITE
DATUM
NOT TO SCALE
Drilling Contractor Relax Tech
INJECTIONS CONDUCTED IN
5 FT, LIFT INTERVALS
bi1c,d cc
I.
al I
iag
ERM
ERM NC, Inc.
TOTAL
DEPTH OF
BOREHOLE
25.0 FT
DIRECT PUSH
INJECTION POINT
SCHEMATIC
13

INJECTION PERFORMANCE MONITORING SUMMARY
MONITORING PLAN
The monitoring plan will include two components: 1) performance monitoring to evaluate the
efficacy of the ISeO treatment at the source area, and 2) site-wide groundwater and surface
water quality monitoring.
REMEDIATION PERFORMANCE MONITORING
Following the supplemental ISeO treatment, groundwater sampling will be conducted within
the ISeO treatment area to monitor the efficacy of the remedial action. Following the injection
event, performance monitoring will be conducted at 1-month, 6-month and 12-month intervals
for a period of approximately 12 months. The monitoring requirements will include sampling of
selected wells for analysis of voes and manganese. In addition to the laboratory analysis, water
levels will be gauged and field measurements will be collected for dissolved oxygen (DO),
oxidation reduction potential (ORP), pH, and temperature. Sample water will also be visually
inspected for the presence of permanganate (purple tinting).
The following table outlines a groundwater and performance effectiveness monitoring plan for
the remediation program:
R emediation Performance Monitorin g Plan
Sampling Event Wells Analysis
Baseline samples
collected prior to
injection
1 month following • voes (EPA Method 8260)
injection MW-4, MW-5, MW-6, Permanganate (visual) MW-7, DW-5, and
.
6 months following OW-1 through OW-5 • Field parameters: ORP, pH, DO . Manganese injection
12-months following
injection (as part of the
site-wide monitoring
event).
The results of each event will be presented in the respective remedial performance monitoring
summary reports. .ERM will evaluate the performance monitoring results to assess the need for
modified performance monitoring, additional treatments and/ or technology transitioning.
SITE-WIDE GROUNDWATER AND SURFACE WATER MONITORING
A site-wide groundwater and surface water monitoring event will be conducted approximately
1 year after the ISCO injection. The site-wide monitoring event will also incorporate the 12-
month performance monitoring event. The site-wide monitoring event will consist of water
level gauging and groundwater sampling at thirty existing monitoring/ observation wells at the
site. In addition, samples will be collected at eight existing surface water sampling stations on
the unnamed tributary of Grant's Creek located west of the site. The groundwater and surface
water samples will be analyzed for VOCs by EPA Method 8260 by a North Carolina licensed
laboratory. In addition to the laboratory analyses, field measurements for dissolved oxygen
(DO), oxidation reduction potential (ORP), pH, and temperature will be collected for
groundwater. The following table presents a summary of the proposed monitoring plan.
Site-Wide Groundwater and Surface Water Qualitt, Monitorinx Plan
Sampling Water Level Field Parameters VOC Analysis
Location Gauging (EPA8260)
Groundwater
MW-1 ✓ ✓ ✓
MW-2 ✓ ✓ ✓
DW-2 ✓ ✓ ✓
MW-3 ✓ ✓ ✓
MW-4 ✓ ✓ ✓
MW-5 ✓ ✓ ✓
DW-5 ✓ ✓ ✓
MW-6 ✓ ✓ ✓
MW-7 ✓ ✓ ✓
MW-8 ✓ ✓ ✓
MW-9 ✓ ✓ ✓
MW-10 ✓ ✓ ✓
MW-11 ✓ ✓ ✓
MW-12 ✓ ✓ ✓
MW-13 ✓ ✓ ✓
MW-13D ✓ ✓ ✓
MW-14 ✓ ✓ ✓
MW-15 ✓ ✓ ✓
MW-15D ✓ ✓ ✓
MW-16 ✓ ✓ ✓
MW-17 ✓ ✓ ✓
MW-19 ✓ ✓ ✓
MW-19D ✓ ✓ ✓
MW-20D ✓ ✓ ✓
MW-21D ✓ ✓ ✓
Sampling Water Level Field Parameters VOC Analysis
Location Gauging (EPA8260)
OW-1 ✓ ✓ ✓
OW-2 ✓ ✓ ✓
OW-3 ✓ ✓ ✓
OW-4 ✓ ✓ ✓
OW-5 ✓ ✓ ✓
Total-GW 30 30 30
Surface Water
Creek 1 --✓ --
Creek 2 --✓ --
Creek 3 --✓ --
Creek 4 --✓ --
Creek 7 --✓ --
Creek 8 --✓ --
Creek 9 --✓ --
Creek 10 --✓ --
Total-SW ----8
The results of the site-wide monitoring will be summarized in an annual remedial progress
report to be submitted to NCDEQ. The remedial approach and site-wide monitoring program
will be evaluated annually and revised as appropriate. The plan for subsequent remedial
activities and site-wide monitoring events will be determined based on the combined
monitoring data.
Sodium Permanganate SDS
CARUS
INDUSTRIAL
CAS Registry No_
1010E-50-5
LIQUOX sodium permanganate is a liquid oxidant recommended
for use in electronics and fine chemical synthesis, that require a
concentrated permanganate solution.
PRODUCT SPECIFICATIONS
Assay 40 - 41% as NaMnOa
pH 5.0 - 8.0
Specific Gravity 1.37 - 1.40
Insolubles S 0.005%
CHEMICAL/PHYSICAL DATA
Formula
Appearance
Shelf Life
NaMnO.
Deep purple solution
This product should be used within two years
of the date of production.
Decomposition may start at 150 °C / 302 °F
APPLICATIONS
• DesmearinglEtchback - Printed circuit board desmearing
and etchback.
• Oxidation and Synthesis - Organic chemicals and
intermediates manufacture. Oxidizes impurities in organic and
inorganic chemicals.
BENEFITS
• Concentrated liquid oxidant
• More precise dosing of chemical
• Feed equipment is simplified
Consistent concentration
• Dust problems are eliminated
High solubility at room temperature
Can be used whenever potassium ion cannot be tolerated
SHIPPING CONTAINERS
5-gallon pail (20-L} (UN Specification: UN3Hl/Y1.8/100) Made of
high -density polyethylene (HDPE). weighs 3.3 lbs (1 .5 kg). The net
weight is 57 Ibs (25.9 kg). The pail stands approximately 14.8 in
(37.6 cm) tall, 10.6 in (26.9 cm) wide, and 1 1 .0 in (27.9 cm) deep.
(Domestic and international)
LiQUOX- SODIUM PERMANGANATE
DATA SHEET
SHIPPING CONTAINERS
55-gallon drum (268-L) (UN Specification; UN I H 1 /Y 1.9/100)
Made of high -density polyethylene (HOPE), weighs 21 Ibs (9.5 kg).
The net weight is 550 Ibs (250 kg). The drum stands approximately
34.8 in (88.3 cm) tall, has an outside diameter of 23.3 in (59.1 cm).
(Domestic and international)
275-gallon IBC (Intermediate Bulk Container) (1040-L)
(UN Specification: UN3LHA1/Y1.9/100) They are also marked
"MX" for mufti -trip. IBC weighs 123 Ibs (55.8 kg). The net weight
is 3000 Ibs (1360 kg). The IBC contains 263 gallons (1000 L) of
product. The IBC dimensions are 45.3 in (1 14.9 cm) high, 47.3 in
(120.0 cm) long, and 39.4 in (I00,0cm) wide. The IBC has a 2 in (5
cm) butterfly valve with NPT threads in bottom sump. (Domestic)
Packaging has a weight tolerance of +/- 3%.
Bulk Shipping Quantities from 3000-3800 gallons are available.
1HAN0LING, STORAGE, AND INCOMPATIBILITY
Like any strong oxidant, LIQUOX sodium permanganate should be
handled with care. Protective equipment during handling should
include face shields and/or goggles, rubber or plastic gloves, rubber
or plastic apron. If clothing becomes spotted. wash off
Immediately: spontaneous ignition can occur with cloth or paper.
In cases where significant exposure exists. use of the appropriate
NIOSH-MSHA dust or mist respirator or an air supplied respirator
is advised.
The product should be stored in a dry area in closed containers.
Product should be stored above 50°F. Concrete floors are
preferred. Avoid wooden decks. Spillage should be collected and
disposed of properly. Contain and dilute spillage to approximately
6% with water and reduce with sodium thiosulfate, a bisulfrte. or
ferrous salt. The bisulfite or ferrous salt may require dilute sulfuric
acid to promote reduction. Neutralize any acid used with sodium
bicarbonate. Deposit sludge in an approved landfill or. where
permitted, drain into sewer with large quantities of water,
As an oxidant, the product itself is non-combustible, but will
accelerate the burning of combustible materials. Therefore,
contact with all combustible materials and/or chemicals must be
avoided. These include. but are not limited to: wood, cloth. organic
chemicals. and charcoal. Avoid contact with acids, peroxides.
sulfites, oxalates, and all other oxidizable inorganic chemicals.
With hydrochloric acid, chlorine is liberated.
CARUS CORPORATION
ONE COMPANY ENILLESS SOLUTiONNS
tOlPORME REApaUARTERS 1315 Fin Sfieei. Peru IL 31952 I Tel + 1.Et5.223.150011-500-335-6O52 I Fac+ 1.315.22.I.8697 I Well: vwr. aestorpo rAlinrcam i E-MAIL• calesmktt&aruscnrporation.com
CARUS EUROPE 1 Parque Empresariel de A5IP0 I t75ccdedioo Rotes 3, Plante 1, Cfficina 13-15 13342A Cayes, LLaera Spaia I Tel [phone] t Fax+3i.415.78.55.10
Copyright 2012
rev. 7/16
Form LX 1501
the inf°rmavon col named h.ereir n accurate m Thy bean or our knowledge_ However. dm, savory standards and government reguladorn
are sublecc ee change. and the vondldons of hangling. use or misuec of d+e product are bsyorrd our aonvo1 Carers Chemical Company
makes no warranq, ewer expressed or impred. incudiny any warnnaes of merchanabihry and gmess for a pardwl,. purpose Carus
also disclaims a!r kabll:sy for rerlan ce on dre con pknenera on confirming accuracy of .ry Inrormado° Included herein. Users should satisfy
themsef ua chat rtley are aware of a1P current dad relevant co died pardcular uses)
Canis aid Dann s a regnercd service made or Cana Corporation. 11QVC]x2S la a reps -erred oads•mr;s of Cann C°rpendnn. Remens5:e
Carr" • s • reginncd s®rtirra mark el the erldn Qner ashy Ceane L
PIS mik5p0N5w

CARUS
INDUSTRIAL
CAS Registry No.
10101-50-5
COMPATIBILITY
LUQUOXe'sodium permanganate is compatible with many metals
and synthetic materials. Natural rubbers and fibers are often
incompatible. Solution pH and temperature are also important
factors. The material selected for use with sodium permanganate
must also be compatible with any acid or alkali being used.
In neutral and alkaline solutions, sodium permanganate is not
corrosive to carbon steel and 316 stainless steel. However,
chloride corrosion of metals may be accelerated when an oxidant
such as sodium permanganate is present in solution. Plastics such
as teflon, polypropylene. HDPE and silicone are also compatible
with sodium permanganate.
Aluminum. zinc, copper, lead, and alloys containing these metals
may be slightly affected by sodium permanganate solutions.
Actual corrosion or compatibility studies should be made under
the conditions in which the permanganate will be used prior to
use.
LIQUOX" SODIUM PERMANGANATE
DATA SHEET
SHIPPING
LIQLIOX sodium permanganate is classified and listed as an
oxidizer by PHMSA (Pipeline and Hazardous Materials Safety
Administration), Department of Transportation, in 49 CFR
Subchapter C, HMR (Hazardous Materials Regulation), Part
172,101 HMT (Hazardous Materials Table).
Proper Shipping Name:
Hazard Class:
Identification Number_
Packaging Group:
Label Requirements:
Packaging Requirements:
Sections:
Permanganates, inorganics.
aqueous solution n.o s. (Contains
sodium permanganate).
5.1
LJN 3214
If
Oxidizer, 5.1
49 CFR Parts 171 to 180
173.152, 173.202, 173.242
CARUS VALUE ADDED
LABORATORY SUPPORT
Carus Corporation has technical assistance available to answer questions, evaluate treatment alternatives, and perform laboratory
testing. Our laboratory capabilities include: consulting, treatablllty studies. feasibility studies, and analytical services.
FIELD SERVICES
As an integral part of our technical suppoi t, Carus provides extensive on -site treatment assistance. We offer full application services,
Including technical expertise, supervision, testing, and feed equipment design and installation in order to accomplish a successful
evacuation and/or application.
CARUS CORPORATION
During its 100-year history, Carus' ongoing emphasis on research and development, technical support, and customer service has enabled
the company to become the world leader In permanganate. manganese, oxidation, and base -metal catalyst technologies.
CARDS CORPORATION
UNE COMPANY ENDLESS SOLUTIONS
CORPORATE HEAR88ARTER51315 Rth Strait Paru It 813511 Tal + 1.815313.138811-188,135-6856 I Fax + 1.815.224.664? 1 Welt. wrw.nrustar peraiarrsom 1 E-Niit salaamktalnruscorpera tIon.com
CAR85 EUROPE 1 Pargua Empresarlai da ASIPO 1 Mackin,' Races 3, Planta 1, 05cina 13-14133428 Cayes. Llanen Spain 1 Tel[phone] Fax—34315.79.55.11
The information cooay.ed herein Is ateurine to the best of our knowledge. However. data mealy standards and government rueulenons
ars subiecs to change and tie conditions of handling. use or Misuse of the pnteducc are be -ratio our control. Gros Cherrk4I Company
makea nc warranty. eider espreated o^ Implied, irdu.I ng any warranC. of ever hat abIII{Y and Omer kr a paralNlar purposa. Caron
dso lIdL ,s at ka!>•T•ry for reglanca on the completer -am or eon6na'n5 accura y a any item Harlon induced nereln. Users should mosey
Her msekes drat shay arm swan of all corm( dam raievan, to'chair particular saris}
Carus and timign is a regpteree serene perk cr Carus Corporation. uc UOXIIP n a registered trademark er Cana Corporadon. ReepondMe
Crae® Is a raginrced serrltc mirk of the American Ch rriory Council.
11110
sill s'
copyright 204 2
rev. 7/16
Form LX 15O1
C A ►4 L! S °

A.LIVIR MaI4 r
T 00 when printed . 11: 1
MW-06
�(739.75) DW-3;- ;
(7743176) � r
1'08-4T aW 1 '_QW
(730.6) ❑W'QS MW-05. (744-57]
[T35.85 ate (744.2)
pW-2
(738T92)
(736.88)
Source: NCCGIA
Legend
Stream
©Site Property
I' -I Parcels
Well Location
1' Monitor Well
D Deep Well
• Observation Well
Potentiometric Surface
Groundwater Elevation Contours
Approximate Groundwater Flow
Direction
Notes:
Depicts data from groundwater elevations
from March 2017.
Figure 6
Shallow Groundwater
Elevation Contours
March 2017
Kern Polymetric Facility
Voith Holdings
Salisbury, North Carolina

. PA VEMEN T
(BROKEN)
rn
E
PERMA--FLEX
MANUFACTURING
FACILITY
FFE--761.73'
DP-14 DP=10
OW-1 DP-2
$ MONITOR WELL L OCA RON
Gi DIRECT PUSH BORING LOCATION
WOODS-
„des—
.�.• ERMNC,Inc.
ERM
4 d
ELEVATED
LOADING,
DOCK
4
HYDROGEOLOGIC TRANSECT MAP
2013 TREATMENT ZONE DELINEATION
KERN POLYMERIC, INC. FACILITY
SALISBURY, NORTH CAROLINA
s
N C Grid • NAD 83
(NSRSPO11)
HORIZONTAL
F 1R
7

U
O
0
O
LSCO Treatmen
0
a
a
7M5 - A
(West)
760 -
755
750 -1-
745
740 -
735
730 --
725 -
720 -
715
710 -
705 -
T00 -
695 -
690
685
680
ci
I.,..
o 0
"
r—
, 12,000
a.�tra!!y rWi♦� ��4,f4V 4+e444eat{�er d RocF
# e
1—
0
10
20
30
515 PCE Concentration (pg/L)
I Water Table Surface Elevation
Approximate Groundwater Surface
40
50
70 80 90 100
NC 2L standard for PCE is 0.7 Pg/L
VE = Vertical Exaggeration
PCE concentrations based on mobile lab data collected 5/29.31/2013,
except OW-5, collected 3/22/2017
110
120
130
140
ct
..000
150
60
01.
170
eL
180
190
200
ERM NC, Inc.
210
`' A'
q
❑ (East)
- IncyV t�_.�____I
-1
A& -Z,1/4:&N. :414\-1/4
220
230
240
250
260
270
280
Notes
Outer Casing (Type III Wells Only)
Monitor Wall Riser
Monitor Well Screened Interval
Direct Push Point
101
Inieaion Points
Shallow
(-25')
Clayey Silt
Sandy Silt
Partially Weathered Rock
PCE Concentration 400 Pga'L
PCE Concentration a700 PglL
PCE Concentration P-70 kgWL
PCE Concentrate(' -7 NgIL
1� ?; 1
0 10.
HORIZONTAL
FULL SCALE ISCO TREATMENT ZONE CROSS SECTION
KERN
POLYMERIC, INC. FACILITY
SALISBURY, NORTH CAROLINA
FIGURE

765
760
755
750
745
740
735
730
725
720
715
710
705
i00
695
690
685
B
(North)
ti
Facility
680 —
B'
(South)
Tram
Tracks
C
CM=
.
'‘‘-
Z
ZOOM
1
1.
‘‘
19,000 _< .
35.000 24,000
r,i
— 4h.:-.'
'..
1
i\- .\-\:- ... 4- \
‘Il\ \
Clayey silt, „ \ .. \ . , ,, , , ‘h,
, : : , i . , \\. . \1
,,
~`ti 180
„11/4.. \\
. .tip � a\\\.\\ \\\
Bedrock
3.1
0 10
20
PCE Concentration (pg1L)
Y Water Table Surface Elevation
25
Approximate Groundwater Surface
30
40
50
60
70
80
NC 21. standard for PCE is 0.7 ugfL
90 100 110
VE = Vertical Exaggeration
PCE concentrations based on mobile lab data collected 5/29-31/2013,
except DW-5, collected 3122/2017.
120
130
1
Notes
sa
Cuter Casing (Type Ili Wel.s Only)
Monitor Well Riser
Monitor Well Screened !Ale real
Cired Push Point
Clayey Silt
Sandy Sill
Bedrock
PCE Concentration r7.000 NgIL
PCE Concanlralion'T00 Pg/L
PCE Concentration e70 µ97L
PCE Cancanvalion
vE. 2:1
0' 20'
1OR NTAL
ERM
ERM NC, Inc.
CROSS SECTION B-Bt
2019 TREATMENT ZONE DELINEATION
KERN POLYMERIC, INC. FACILITY
SALISBURY, NORTH CAROLINA
FIGURE

Figure.
1,E(:WNI)
# Monitoring Well
4- Deep Well
KPI_Transects Aug2D112
KPI_Transects Aug2O12
-- Streams
—� Railroad Tracks
=Kern Polymeric Property Boundary
=Parcel Boundary
ERM NC, INC
ERM
Kern Polymeric
Salisbury, North Carolina
Hydrogeologic Transect Map
FIGURE
75 150 Fer-.i
10

MW-4
DP-13
PA .DEMENT
(BROKEN)
4■
DP-7
MIW 6
•
MONI TOR WELL L OCA 77ON
al DIRECT PUSH BORING LOCA 77ON
M/

0
w
765 -
760 -
755 -
750
745
740
735
730 --
725 -
720 -
715 -
710 -
705 -
700 --
695 -
690
685
680
A
(West)
4
cla
yey Silt
•
++ 40 # # r♦ • Partially weathered Rork
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0 10 20 30 40 50 60 70 80 90 100
915 PCE Concentration (pg/L)
Y Water Table Surface Elevation
Approximate Groundwater SWAM
NC 2L standard for PCE is 0.7 pg/L
0
N4X\
0,40,044,4t4:•14.Sre4V
110
120
VE = Vertical Exaggeration
PCE concentrations based on mobile lab data collected 5/29-31/2013,
except DW-5, collected 3/22/2017,
130
r �7
140 15

765 - B
(North)
760 — Facility
755
750
Q.
B'
(South)
Li
Train
Tracks
745 -
740 --
735 ----- 19,000
710 —
705 -i
700 —
695 -
690 --
685
680
- 24,000
U
Bedrock
2
•
3.1
0 10 20 25 30 40 50 60 70 80
91; PCE Concentration (tog/L]
x Water Table Surface Elevation
Approximate Groundwater Surface
h1C 2L standard for PCE Is 0.7 pg/L
100 110 120 130
VE = Vertical Exaggeration
PCE concentrations based on mobile lab data collected 5r29-31/2013,
except DW-5, collected 3/22/2017.
Notes
Outer Casing (Type III Welts Orly)
Monitor Weal meet
MonilarWel Screened interval
Dared Push Pant
Clayey SIII
Sandy SUE
Bedrock
PCE conceraalion a7,O)0 ug7L
PCE Cancemration a700 yrgfL
PCE Cencennalion a70 pg/L
PCE Cmrenlradan 571ig7L
ERM
ERM NC, Inc.
CROSS SECTION B-B`
2019 TREATMENT ZONE DELINEATION
KERN POLYMERIC, INC. FACILITY
SALI58URY, NORTH CAROLINA
FIGURE

LEGEND
4- Monitoring Well
41 Deep Well
KPI_Transects Aug2012
KP I_Tran sects_Aug2012
— Streams
t Railroad Tracks
= Kern Polymeric Property Boundary
0 Parcei Boundary
l.. .• 1
alb ...
trikiligarwA
ERM
FIGURE
'50 Feet
ERM NC, INC
Kern Polymeric
Salisbury, North Carolina
t.(44434 C G �` "r P�� Ae�og d LC4 , GP s i o9g7 :Ea Ell` iropW' !
Hydrogeologic Transect Map
10

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SOIL x—SEW1CNs
5
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10 7.5 5
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ENVIRONMENTAL & ENGINEERING, P.C.
-11 SOIL CROSS SECTIONS A —A & B—B' R112011-039
6