WI0400403_DEEMED FILES_20150708

Permit Number WI0400403
Program Category
Deemed Ground Water
Permit Type
Injection Deemed Air Well
Primary Reviewer
ebonee.shire
Coastal SWRule
Permitted Flow
Facility
Facility Name
Former BP 1363
Location Ad.dress
1101 NC Hwy 61
Whitsett
Owner
Owner Name
BP Products of Na
Dates/Events
NC
Orig Issue
6/23/2015
App Received
6/18/2015
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27377
Draft Initiated
Scheduled
Issuance Public Notice
Central Files : APS SWP
7/8/2015
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Winston-Salem
County
Guilford
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Greg Frisch
Manager Operations Project
4850 E 49th St
Cleveland
Issue
6/23/2015
Effective
6/23/2015
OH 44125
Expiration
Requested /Received Events
Streamlndex Number cu·rrent Class Subbasin
RE: W10400403 - Former BP 1363 - Outlook Page 1 of 2
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Calendar RE: WI0400403 - Former BP 1363
Rogers, Michael
Contacts
Sent: Wednesday, July 8, 2015 2!47 PM
To: Palmer, Gwendolyn M
y'ge Deleted Items
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From: Palmer, Gwendolyn M
Sent: Wednesday, July 08, 2015 11:28 AM
To: Basinger, Corey
Cc: Knight, Sherri; Rogers, Nlichaet
Subject: WI0400403 - Former BP 1363
Good Morning Corey & Sherri,
I am the new temp assisting Mike, Eric and Steven here at the Central Office. Attached
you will find the NOI information for the above listed permit #. Mike informed me that
the time fine normally required for action has expired, however he was out of the office
and the other temp (Ebonee) was entering the information during his absence. From this
point forward I will be sending this information. We do not have the copies of the emails
sent/acknowledgment letters.
I look forward to working with you from this point on.
Thank you,
Gwendolyn
Gwendolyn M. Palmer
Support Staff
NCDepertment of Environment & Natural Resources
Division of Water Resources
Animal Feeding Operations and Groundwater Protection Branch
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone]
https://outlook.office365.comlowa/?ae 1tem&t=IPM.NoteB id=RgAAAABgI%2frrADg4S... 7/10/2015

RE: WI0400403 -Former BP 1363 -Outlook Page 2 of2
Connected to Microsoft Exchange
https:// outlook.office3 65 .com/owa/?ae= Item&t= IPM. Note&id = RgAAAAB gI%2frr ADg4S;.. 7 /10/2015
URS
June 17, 2015
DWQ -Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
RE: Notification of Intent to Construct/Operate Air Injection Wells
Former BP 1363
1101 Ne Highway 61
Whitsett, NC 27377
Incident # 6133
To Whom It May Concern:
Attached is one copy of the completed notification package to install one air injection and one
soil vapor extraction well at the site for a pilot study. Included in the package is a site map
illustrating the locations of the proposed wells along with construction details of each well type.
If you have any questions regarding the reported information, or require additional information,
p l ase contact the undersigned at [e-mail] or 919-461-1285 .
Attachments: 1) Site Maps
2) Air Sparge/SVE Well Details
cc: Project File
URS Corporation -North Carolina
1600 Perimeter Park Drive, Suite 400
Morrisville, NC 27560
Tel: [phone]
Fax: [phone]
RECEIVED/DENR/DWR
JUN 18 2015
Water Q~allty Regional
Operations Section
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT 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. This form shall be submitted at least 2 weeks prior to construction.
AQUIFER TEST WELLS (15A NCAC 02C .0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02c .0225) or TRACER WELLS (15A NCAC 02c .0229):
1) Passive Injection Systems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale Injection Operations -Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells 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: _ __,-4e~47~·1:,~1~~e1~:, =-l,~--' 1 -l 5 PERMIT NO. W\D~OOjO 3 (to be filled in by DWQ)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1)
(2)
(3)
(4)
(5)
(6)
X __ Air Injection Well ...................................... Complete sections B-F, K, N
___ Aquifer Test Well ....................................... Complete sections B-F, K, N
___ Passive Injection System ............................... Complete sections B-F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B-N
___ Pilot Test. ................................................ Complete sections B-N
___ Tracer Injection Well ................................... Complete sections B-N
B. STATUS OF WELL OWNER: Choo-;,• an ii<'m.
C. WELL OWNER -State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: BP Products ofNA-Greg Frisch
Mailing Address: 4850 E. 49 th Street MBC-3 Room 155C
City: Cuvoga Heie:hts State: _OH_ Zip Code: 44125 County: _____ _
DayTeleNo.: 216-416-1232 CellNo.: 330-421-1100 ____ _
EMAlLAddress: [e-mail].______ FaxNo.: 216-416-1220 _____ _
DWQ/UIC//n Situ Remed. Notification (Revised 7/9/2012) Page I
D. PROPERTY OWNER (if different than well owner)
Name: Travel Centers of America
Mailing Address: 24601 Center Ridee Rd
City: Westlake State: ...QR_ Zip Code:_4,_,4-"-14..:..:5"'--___ County: Cuyaho e.a
Day Tele No.: 404-808-7368 Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: Jasen Zinna P.E.
Mailing Address: 1600 Perimeter Park Dr Suite 400
City: Morrisville State:_ NC_ Zip Code:-=2::...:.7-=-5.a:..60"--___ County:_W'-'---=ak=e=------
Day Tele No.: 919-461-1285 Cell No.: __________ _
EMAIL Address: [e-mail],__ _____ _ Fax No.: 919-461-1415 _____ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 1101 NC Highway 61 County:._G:=,.u=,ieeol6""'or,.,,d,....__ ___ _
(2)
City: Whitsett State: NC Zip Code: __ __,,2'--'-7=37-'---7_,____ _____ _
Geographic Coordinates: Latitude**: ___ 0 --__ " or 0
Longitude**: 0 __ "or 0
Reference Datum: ________ .Accuracy: _______ _
Method of Collection: __________________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume:. _______ square feet
Land surface area of inj. well network: square feet(::: 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: (must be::: 5% of plume for pilot test injections)
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.
DWQIUIC/ln Situ Rerned. Notification (Revised 7/9/2012) Page2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity.
J. INJECT ANTS -Provide a MSDS and the following for each injectant. Attach additional sheets if necessary.
NOTE: Approved injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/weblwqlapslgwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the UIC Program for more info (919-807-6496).
lnjectant:
Volume of injectant: ____________________________ _
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
lnjectant:
Volume of injectant: ____________________________ _
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
lnjectant: ---------------------------------
Volume of injectant: ____________________________ _
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
K. WELL CONSTRUCTION DATA
Number of injection wells: ___ l ___ Proposed ___ O ___ Existing
(2) 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:
(a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery)
(b) depth below land surface of grout, screen, and casing intervals
( c) well contractor name and certification number
DWQ/UIC/In Situ Remed. Notification (Revised 7/9/2012) Page3
1 SCHEDULES -Briefly describe the schedule tor weii construction and Injection activities.
M. MGN!TDRING PLAN - Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
ICI, CERTIFICATION (to be signed as required below or by that person's authorized agent)
1 SA NCAC 02C A211(c) requires that all permit applications shall be signed as follows:
for a corporation: by a responsible corporate officer,
2. for a partnership or solo proprictsarshiip: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or
ranking publicly elected official;
4. for all athers: by the well owner;
5. %r any other peraon authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly Identifies the person, grants them signature ;authority, and is signed
ar=d dated by the applicant.
"I hereby cert6under penalty of law, that I have personally examined and ant familiar with the irffrtrnration
submitted In this document and all attachments thereto and that, based on no, inquiry of those individuals
immediately responsible for obtaining said information. I believe that the information is tare, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprlsanmerrt,
far subrnllting false irrfornrutfo►t. 1' agree to .p. nslruct, rate, maintain, repair, and if applicable, abandon
the injection well and ail related appurterran, .t in ace d ce with the 114 NCAC 02C 0200 Rules."
r r
r ._ `_ laser' 7inna
PaZident-
Stg- adrure rrt nit TA p L� 4.Miltrayype Full Name
Signature ar; Property Owner (ildiftcrcnt ▪ [rem applicant] - Print or Type Full Name
Meantime of Authorized Agent, irany Print or'rype Furl Nam
Submit one copy of the completed notification package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1i36
Telephone: [phone] , Pax: [phone]
DWQttllCTtn Star Aemcd Noti6cetiurt (Itavisrd7/9/20l2)
Page 4

ATTACHMENT 1
FLUSH LIouNTEO
R" 'MIN. 0
TRAFFIC REARING —
HOLE
N FT
26 FT
2i FT
2FT
2' LOCKING CAP
— J PLUG 0R EQUIVALENT
WATERTIGHT LOCH INC LID
-- CONCRETE COLLAR
FLUSH MOUNTED
12" MIN. u
TRAFFIC HEARING --��
MAN-TOL
WELL TYPE ATM SIZE 12 FT
2 IN. DIA. SCHEDULE 40 PVC PIPE
CEMENT GROUT (231
SIEKTONITE SEAL (1')
FILTER (3')
#1 SAND
WELL. SCREEN C21
3.0t0-INCH SLOTTED
SCH. 40 PVC
AIR SPARGE WELL DETAIL, AS-1
NOT TO SCALE
4" EXPANSION CAP
— J PLUG OR EQUIVALENT
} WATERTIGHT LACKING LID
1 IMP
SEAL 411
f I SANt7
WELL TYPE AND Sl2S
4 IN. DJ& SCHEDULE 40 PVC PPE
GRAVEL PACK 00.51
WELL SCREEN
4 IN. 0/A. SCHEDULE 40 PVC
0.020-INCH SLOTTED
SOIL VAPOR EXTRACTION WELL DETAIL, SVE-1
NOT TO SCALE
WELL CONTRACTOR:
GEOLOGIC EXPLORATION
CERTIFICATION No. NC Af25s0
AS SHOWN
r mrm1.l.,la mcrw m.ms.mnw
ammo tc Sic
�r r A r SporyeISVE Well Details
T i 15APR15 Farmer DP Station No, 1353
— Whitse1L. North Coralino
SF 15APR15.i mamae. qK
ax W 15APR 15 J3-000013G3.01 As -SUE 0

ATTACHMENT 2
10-18
DP-1
SOURCEWELL LOCATIONS/SITE FEATURES SURVEYED BY URS •• _ . ••I
UTILITIES SURVEYED BY TWT 12-13-13
LEGEND
1dWB 1AONH1R1NG WELL
LIMN, LIST FIELD MONITORING WELL
ABANDONED MONITORING WELL
• DUAL PRASE EXTRACTIDN WELL
SOL VAPOR IMPLANT
UNDERGROUND STORAGE TANA
OVERHEAD ELE{.1i11I, Lr E
SANITARY SEWER UNE
- 51QRAI SEWER LINE
STORM TRENCH LINE
PRODUCT DISPENSER LINE
DRAIN LINE
• PROPOSED AIR SPARSE WELL
• PROPOSED SOIL VAPOR EXTRACTION WELL
• PROPOSED OBSERVATON HELL
N[TTS
1. TANKS 3, 2, & 3 ARE GASOLINE UST's
2. TANKS 4, 5. 6. 7, & 6 ARE DEL FUEL UST's
1O'
SCALE 1N FLIT
= a r one
ra176n17-11.,
TSEi 01APR15
Melia W' —
SF O1APR15
N O NJ3-00001363.01
Proposed Well Location Mop
Former BP Station No. 1363
Whitsell, North Corolino
c+ K� DMA.n.a MY.
1363-2 D

Y1T-110"'
'CD,1
Ns
D➢Ytt- 2 9
NS 5
..�45THCQ.211-1
USTMW-4
-Q 1 .7
Dna-2 ---
X
eiDS1Y11-9
ns....
0,101-L5
<Di
Alit-1B
C0.I LAi
101-10 ,• -19
<O.l� 2"-5 ei•
9NS e
ti
SOURCE: WELL LOCATIDNS/S RE FEATURES SURVEYED BY URS 9-17-14
UDLi11ES SURVEYED BY TNT 12-13-13
,' B HCSAMW-4
017 e�
LEGEND
M1F6) MONRDRiNC NELL
LISTHWeit LIST FIELD MONITORING WELL
<0.1
UJ
NS
BOLD
ABANDONED MONITORING WELL
SWL PHASE DCTRACi1ON WELL
SOIL VAPOR IMPLANT
UNDERGROUND STORAGE TANK
OVERHEAD ELECTRIC UNE
SANITARY SEWER UNE
STORM SEWER LINE
STOW TRENCH LINE
PR.CDuCT DISPENSER UNE
DRAIN UNE
BENZENE CONCENTRATION [ug/L]
BENZENE ISGCOWCENTRATIGN
(Dashed where inferred)
ESTIMATED VALUE
NOT DETECTED AND
THE UNIT IS ESlWFED
NOT DETECTED AT
SPECIFIED DETECT%]N Law
NOT SAMPLED
INDICATES EOCCCEDANCE
OE NC 2L STANDARD
PRAT STUDY ARCA
NOTE:
NC 2L STANDARD FOR BENZENE=1A ug/L.
60' 0
SCALE 1H FEZ!'
AS SHOWN
m.mna-.smas1:11.6-r.uan
.- *rn+raw.I
1130.01
a'@Figure 5. Benzene ConcenbroUons
a�nr +Malt- In Groundwater, August and
TSH 200CT14 September 2014
J2OOCT14
OM= MY
—E4Lm $taiiarlN lw,r
MN 2L70CT1443--00001363.01 1363-5