WI0400494_DEEMED FILES_20180716

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North Carolina Department of Environmental Quality-Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WI0400494
1. Permit Information
Py ramid Environmental & Engineering
Permittee
Pleasant Garden Curb Market
Facility Name
4 700 Pleasant Garden Rd., Pleasant Garden,
Guilford Co .. NC 27313
Facility Address (include County)
2. Injection Contractor Information
fl/a e Quality
1npr!:ltinn~
Mika Trifunovic / P yramid Environmental &
Engineering
Injection Contractor/ Company Name
Street Address 503 Industrial Avenue
Greensboro NC 27406
City State Zip Code
[phone]
Area code -Phone number
3 . Well Information
Number of wells used for injection ---'-3 __
======------------------,
Were any wells abandoned during this injection
event?
D Yes [j]No
If yes, please provide the following information:
Number of Monitoring Wells NA
ion Number oflnjection Wells NA
Please include a copy of the GW-30/or each well
abandoned.
4. Injectant Information
ORC Advanced socks produced by Re genes is
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration 100%
If the injectant is diluted please indicate the source
dilution fluid.NA
Total Volume Injected (gal) 20 ORC Adv. socks
Volume Injected per well (gal)8. 9. and 3 socks
5. Injection History
Well IDs: RW-1. MW-9. and MW-10 Injection date(s) Jul 5. 2018
Were any new wells installed during this injection
event?
0 Yes ~No
If yes, please provide the following information:
Number of Monitoring Wells NA
Number oflnjection Wells NA
Type of Well Installed (Check applicable type):
D Bored D Drilled D Direct~Push
D Hand-Augured D Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed.
Injection number ( e.g. 3 of 5) 1 of 1
Is this the last injection at this site?
[j] Yes D 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.
~??~ ~e~2P~
SIGNATURE OF INJECTION CONTRACTOR DATE
Danny Oldham / P vramid Environmental. & Eng.
PRINT NAME OF PERSON PERFORMING THE INJECTION
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. 3-1-2016
North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IERI
Permit Number WI0400494
1 Permit Information
Pyramid Environmental & Engineering
Permittee
Pleasant Garden Curb Market
Facility Name
4700 Pleasant Garden Rd., Pleasant Garden,
Guilford Co.. NC 27313
Facility Address (include County)
2. Injection Contractor Information
Mika Trifunovic / Pyramid Environmental &
Engineerine
Injection Contractor / Company Name
Street Address 503 Industrial Avenue
Greensboro
City
NC
State
1336035-3174
Area code — Phone number
3. Welt Information
27406
Zip Code
RECENEDINCDEQIDWR
Jut. 11 Z018
Water Duality
Number of wells used for injection Regl5nai Operations Ssc'�a
Well 1Ds: RW-1. 3i1W-9. and MW-10
Were any new wells installed during this injection
event?
❑ Yes I•1 No
If yes, please provide the following information:
Number of Monitoring Wells NA
Number of Injection Wells NA
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-.I form for each
well installed
Were any wells abandoned during this injection
event?
❑ Yes 0 NO
If yes, please provide the following information:
Number of Monitoring Wells NA
Number of Injection Wells NA
Please include a copy of the GW 30 for each well
abandoned
4. Injectant Information
ORC Advanced socks eroduced bt Reeenesis
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration 100%
Ifthe injectant is diluted please indicate the source
dilution fluid.NA
Total Volume Injected (gal) 20 ORC Adv. socks
Volume Injected per well (gal)$. 9. and 3 socks
5 Injection History
Injection date(s) Ju15, 2018
Injection number (e.g. 3 of51 1 of 1
is this the last injection at this site?
® Yes ❑ No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM I5 CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
of
SIGNATURE OF INJECTION CONTRACTOR DATE
Dann) Oldham / P‘ ramid Environmental. & Eng.
PRINT NAME OF PERSON PERFORMING TIIE INJECTION
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. 3-1-2016

Permit Number WI0400494
Program Category
Deemed Ground Water
Permit Type
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Pleasant Garden Curb Market
Location Address
4700 Pleasant Garden Rd
Pleasant Garden
Owner
Owner Name
Pleasant Garden Curb Market
Dates/Events
NC
Orig Issue
6/11/2018
App Received
6/4/2018
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27313
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
6/11/2018
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
, Carol Stout
PO Box 88
Pleasant Gdn NC 27313
Major/Minor
Minor
Region
Winston-Salem
County
Guilford
Facility Contact Affiliation
Owner Type
Non-Government
Owner Afflllatlon
CW. Kirkman
5803 Hagen Stone Park Rd
Pleasant Garden
Issue
6/11/2018
Effective
6/11/2018
NC 27313
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
PY RA M 1D
ENVIRONMENTAL & ENGINEERING, P.C.
May 30, 2018
NCDEQ DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone : [phone]
Re: NOI for ORC socks for:
Pleasant Garden Curb Market
4700 Pleasant Garden Rd, Pleasant Garden
Guilford County, North Carolina 27313
NCDEQ Groundwater Incident # 9151
Pyramid Project # 2018-085
To whom it may concern:
Pyramid Environmental & Engineering, PC would like to inform the NCDEQ DWR UIC
Program that the Oxygen Release Compound socks (ORC Advanced manufactured by
Regenesis) will be placed in three monitoring wells at the Pleasant Curb Market site
(NCDEQ Groundwater Incident # 9151).
The detailed information about the placement of the ORC socks is provided in the
enclosed Notice of intent (NOI) Package. An electronic copy of the NOI Package is
provided on the enclosed CD.
If you need any additional information or clarification, please contact Mike Jones or me
at 336-335-3174.
S incerely,
/0/.49Wew
Mika Trifunovic
Project Manager
Enclosure: NOT For ORC socks &. CD
P.O. Box 16265 • Greensboro, NC 27416
503 Industrial Ave • Greensboro. NC 27406
Phone [phone] • Fax [phone] • Toll Free [phone]
Email: Ir�fuL �ti�runsidel� vsm�ttiie:itsi.:ari;
www.zErui it le_n g9_ental enm

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. This form shall be submitted at least 2 WEEKS prior to iniection.
AQUIFER TEST WELLS (1 5A 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 O 5A NCAC 02C .0229 ):
1) Passive Injection S 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: ------=M=ay.._=25=-, 2018 __ PERMIT NO. W..:1-V ~0 0 4-'f'f-(to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
C.
(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 Injection System .. : ............................ Complete sections B through F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B through N
___ Pilot Test ................................................. Complete sections B through N
___ Tracer Injection Well ................................... Complete sections B through N Ql\)\N'
. ,t,Cc\\JEDINCDe
STATUS OF WELL OWNER: Single Family Residence \' ,1 ·1 G 13
J\JN O 't L
WELL OWNER(S) -State name of Business/ Agency, and Name and Title of perso d lega!eldJ authority to
sign on behalf of the business or agency: 1 ~p,r<'\ · on~
Name(s): Mr.C.W. Kirkman contact: Ms. Carol Stout
Mailing Address: =-P-'--'.O=.'-'BCC..o=x=-8=8~-------------------------
City: Pleasant Garden State: NC Zip Code: 27313 County: Guilford
DayTeleNo.: 336-674-6129 CellNo.: _________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
Deemed Permitted GW Remediation NOi Rev . 3-21-2018 Page I
Deemed Permitted GW Remediation NOI Rev. 3-21-2018 Page 1
North Carolina Department of Environmental Quality – Division of Water Resources

Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.

DATE: May 25, 2018____ 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) 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: Single Family Residence

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): Mr. C.W. Kirkman contact: Ms. Carol Stout
Mailing Address: P.O. Box 88
City: Pleasant Garden State: NC_ Zip Code: 27313 County: Guilford
Day Tele No.: 336-674-6129 Cell No.:
EMAIL Address: Fax No.:
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. This form shall be submitted at least 2 WEEKS prior 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 (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 (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).

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.
Deemed Permitted GW Remediation NOI Rev. 3-21-2018 Page 2
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: PG Market LLC
Company Name PG Market LLC
Mailing Address: PO BOX 88
City: PLEASANT GARDEN State: NC_ Zip Code:27313 County: GUILFORD
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:

E. PROJECT CONTACT (Typically Environmental Engineering Firm)

Name and Title: Mika Trifunovic / Project Manager
Company Name Pyramid Environmental & Engineering, P.C.
Mailing Address: P.O. Box 16265
City: Greensboro State: NC__ Zip Code:27416-0265 County: Guilford
Day Tele No.: 336-335-3174 Cell No.: 336-473-5098
EMAIL Address: [e-mail] Fax No.: 336-691-0648

F. PHYSICAL LOCATION OF WELL SITE

(1) Facility Name & Address: Pleasant Garden Curb Market
4700 Pleasant Garden Rd.
City: Pleasant Garden County: Guilford Zip Code: 27313
(2) Geographic Coordinates: Latitude**: o ′ ″ or 35o.968206
Longitude**: o ′ ″ or -79 o.764408
Reference Datum: Accuracy:
Method of Collection: Google Earth Pro
**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:3,560 square feet
Land surface area of inj. well network:1,520 square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated:42.7% (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 Page 3
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.
Twenty (20) 2-inch diameter ORC Advanced socks will be placed in monitoring wells RW-1, MW-9 and
MW-10. Eight (8) socks will be placed in RW-1, nine (9) socks will be placed in MW-9, and three (3) socks
will be placed in MW-10. The socks will be kept for nine months in the monitoring wells and after that
they will be removed and properly disposed of.

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://deq.nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ground-water-protection/ground-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: ORC Advanced by Regenesis
Volume of injectant: Twenty (20) 2-inch diameter and 1-foot long socks
Concentration at point of injection: 100%
Percent if in a mixture with other injectants: NA

Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:

K. WELL CONSTRUCTION DATA

(1) Number of injection wells: 3 Proposed Existing (provide GW-1s)
(2) For Proposed wells or Existing wells not having GW-1s, 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 Page 4
L. SCHEDULES – Briefly describe the schedule for well construction and injection activities.

The placement of ORC socks is planned to be completed during the week of June 11, 2018.
It will take approximately five (5) hours to complete the work.

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 02L result from the injection activity.

The pre-ORC-socks-placement groundwater monitoring event was completed on May 14, 2018. The
samples collected from monitoring wells RW-1, MW-9 and MW-10 were analyzed for VOCs using the
Standard 6200B method. In addition, field parameters such as DO, pH, ORP, conductivity, and
temperature were recorded during the monitoring event.
The post-ORC-socks-removal groundwater monitoring event is planned to be conducted in February
2019. The February groundwater event will include the same parameters as the May 2018 groundwater
monitoring event.

N. SIGNATURE OF APPLICANT AND PROPERTY 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. I am aware that
there are significant penalties, including the possibility of fines and imprisonment, for submitting false
information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and
all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules.”
Mika Trifunovic, Project Manager Pyramid Environmental
Signature of Applicant Print or Type Full Name and Title

PROPERTY OWNER (if the property is not owned by the permit applicant):
“As 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
(15A 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.

NA - The existing monitoring wells RW-1, MW-9, and MW-10 were installed between 1995 and 2014.
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.

Please send 1 (one) hard color copy of his NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:

DWR – UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
U S TCTPIjGRAP}IIC MAP
__
SITE:
4700 PLEASANT GARDEN RD.
LOCATION:
PLEASANT GARDEN, N.C.
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PHOTOREVISION
DATE:
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MONITORING WELL
L-
XXX
RECOVERY WELL
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(CONTOUR INTERVAL = 1 ft.)
STATIC WATER LEVEL AT MONITORING WELL
NG - NOT GAUGED
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MONITORING WELL
RECOVERY WELL
BENZENE ISOCONCENTRATION LINE
BENZENE CONCENTRATION LEVEL AT
MONITORING WELL (}rg/L)
NOTES;
ND — NOT DETECTED
NS — NOT SAMPLED
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1.1
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RECOVERY WELL
MTBE ISOCONCENTRATION LINE
MTBE CONCENTRATION LEVEL AT
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NOTES:
ND - NOT DETECTED
NS - NOT SAMPLED
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NS
LEGEND
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X X X
RECOVERY WELL
NAPHTHALENE ISOCONCENTRATION LINE
NAPHTHALENE CONCENTRATION LEVEL AT
MONITORING WELL (pg/L)
NOTES:
ND — NOT DETECTED
NS - NOT SAMPLED
MW-4
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TABLE 3 Monitoring/Remedial Well Construction Details Pleasant Garden Curb Market 4700 Pleasant Garden Road Pleasant Garden, Guilford County, North Carolina Monitoring Well Inst. Date Well Depth Depth to Bedrock Casing Type Riser Interval Screen Interval Grout Interval Bentonite Interval Sand Interval MW-1 4/7/1993 22’ NR 2-in. PVC 0-7 7-22 0-3 3-5 5-22 MW-2 6/16/1993 45.5’ NR 2-in. PVC 0-42 42-45 0-39 39-40 40-45 MW-3 6/17/1993 18’ NR 2-in. PVC 0-3 3-18 0-1 1-2 2-18 MW-4 6/17/1993 18’ NR 2-in. PVC 0-3 3-18 0-1 1-2 2-18 MW-5 6/17/1993 18’ NR 2-in. PVC 0-3 3-18 0-1 1-2 2-18 MW-6 10/15/1993 21’ NR 2-in. PVC 0-11 11-21 0-7 7-9 9-21 MW-7 10/15/1993 19’ NR 2-in. PVC 0-9 9-19 0-5 5-7 7-19 MW-8 4/15/1994 20’ NR 2-in. PVC 0-5’ 5-20’ 0-2 2-3 3-20’ MW-9 5/24/2012 25’ NR 2-in. PVC 0-10’ 10-25’ 0-6 6-8 8-25’ MW-10 1/3/2014 25’ NR 2-in. PVC 0-10’ 10-25’ 0-4 4-8 10-25’ RW-1 4/19/1995 46’ NR 4-in. PVC 0-11’ 11-46 0-9 9-10 10-46 AS-1 4/19/1995 36’ NR 1-in. PVC 0-31 31-36 0-29 29-30 30-36 VE-1 4/19/1995 13’ NR 2-in. PVC 0-6 6-13 0-2 2-3 3-13 NR – Not recorded, Available Well Records did not show the Geologic descriptions
Page 1 of 4
Depth Corrected
Monitoring Date TOC To Water
Well Gauged Elevation Groundwater Elevation
(feet)(feet)(feet)
MW-1 8/11/2011 100.46 16.00 84.46
5/16/2013 100.46 8.89 91.57
1/20/2013 NG NG NG
4/9/2014 100.46 6.64 93.82
9/2/2014 100.46 14.43 86.03
4/22/2015 100.46 7.69 92.77
9/10/2015 100.46 15.50 84.96
4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-2 8/11/2011 100.51 16.53 83.98
5/16/2013 100.51 11.84 88.67
1/20/2013 100.51 8.81 91.70
4/9/2014 100.51 9.93 90.58
9/2/2014 100.51 13.60 86.91
4/22/2015 100.51 8.43 92.08
9/10/2015 100.51 15.68 84.83
4/6/2016 NG NG NG
8/18/2016 100.51 11.20 89.31
11/22/2016 100.51 15.89 84.62
MW-3 8/11/2011 99.89 15.38 84.51
5/16/2013 NG NG NG
1/20/2013 NG NG NG
4/9/2014 99.89 6.56 93.33
9/2/2014 99.89 13.78 86.11
4/22/2015 99.89 7.81 92.08
9/10/2015 99.89 14.85 85.04
4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-4 8/11/2011 100.36 16.38 83.98
5/16/2013 100.36 9.05 91.31
1/20/2013 NG NG NG
4/9/2014 100.36 9.10 91.26
9/2/2014 100.36 14.79 85.57
4/22/2015 100.36 8.56 91.80
Table 4
Groundwater Elevation Data
Pleasant Garden Curb Market
Pleasant Garden, Guilford County, North Carolina
Page 2 of 4
Depth Corrected
Monitoring Date TOC To Water
Well Gauged Elevation Groundwater Elevation
(feet)(feet)(feet)
Table 4
Groundwater Elevation Data
Pleasant Garden Curb Market
Pleasant Garden, Guilford County, North Carolina
9/10/2015 100.36 15.78 84.58
MW-4 4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-5 8/11/2011 97.03 9.94 87.09
5/16/2013 NG NG NG
1/20/2013 NG NG NG
4/9/2014 97.03 NG NG
9/2/2014 97.03 NG NG
4/22/2015 97.03 NG NG
9/10/2015 97.03 NG NG
4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-6 8/11/2011 100.05 15.80 84.25
5/16/2013 100.05 9.65 90.40
1/20/2013 NG NG NG
4/9/2014 100.05 8.28 91.77
9/2/2014 100.05 14.18 85.87
4/22/2015 100.05 9.50 90.55
9/10/2015 100.05 15.19 84.86
4/6/2016 100.05 10.33 89.72
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-7 8/11/2011 101.79 18.20 83.59
5/16/2013 NG NG NG
1/20/2013 NG NG NG
4/9/2014 101.79 NG NG
9/2/2014 101.79 NG NG
4/22/2015 101.79 NG NG
9/10/2015 101.79 NG NG
4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
Page 3 of 4
Depth Corrected
Monitoring Date TOC To Water
Well Gauged Elevation Groundwater Elevation
(feet)(feet)(feet)
Table 4
Groundwater Elevation Data
Pleasant Garden Curb Market
Pleasant Garden, Guilford County, North Carolina
MW-8 8/11/2011 102.32 18.77 83.55
5/29/2012 102.32 13.86 88.46
5/16/2013 102.32 11.43 90.89
1/20/2013 102.32 10.59 91.73
MW-8 4/9/2014 102.32 9.33 92.99
9/2/2014 102.32 17.18 85.14
4/22/2015 102.32 10.63 91.69
9/10/2015 102.32 18.18 84.14
4/6/2016 NG NG NG
8/18/2016 NG NG NG
11/22/2016 NG NG NG
MW-9 5/29/2012 100.60 11.22 89.38
5/16/2013 100.60 9.51 91.09
1/20/2013 100.60 8.54 92.06
4/9/2014 100.60 7.38 93.22
9/2/2014 100.60 14.64 85.96
4/22/2015 100.60 8.72 91.88
9/10/2015 100.60 15.74 84.86
4/6/2016 100.60 9.25 91.35
8/18/2016 100.60 13.21 87.39
11/22/2016 100.60 15.76 84.84
MW-10 1/20/2013 101.82 10.11 91.71
4/9/2014 101.82 8.79 93.03
9/2/2014 101.82 16.54 85.28
4/22/2015 101.82 10.09 91.73
9/10/2015 101.82 17.55 84.27
4/6/2016 101.82 11.14 90.68
8/18/2016 101.82 15.35 86.47
11/22/2016 101.82 17.40 84.42
Page 4 of 4
Depth Corrected
Monitoring Date TOC To Water
Well Gauged Elevation Groundwater Elevation
(feet)(feet)(feet)
Table 4
Groundwater Elevation Data
Pleasant Garden Curb Market
Pleasant Garden, Guilford County, North Carolina
RW-1 8/11/2011 99.86 15.80 84.06
5/29/2012 99.86 10.60 89.26
1/20/2013 99.86 7.91 91.95
4/9/2014 99.86 6.59 93.27
9/2/2014 99.86 14.08 85.78
4/22/2015 99.86 7.61 92.25
9/10/2015 99.86 15.17 84.69
4/6/2016 99.86 9.88 89.98
8/18/2016 99.86 12.59 87.27
11/22/2016 99.86 15.13 84.73
NI = Not Installed NG = Not Gauged
Page 1 of 4
Gross
PARAMETER UNITS DATE NCAC 15A:2L Contamination
MW-1 MW-2 MW-3 MW-4 MW-5 MW-6 MW-7 MW-8 MW-9 MW-10 RW-1 VE-1 VE-2 VE-3 AS-1 AS-7 Standard Levels
(GCL)
6200B
Benzene ug/l 8/11/2011 <0.34 <0.34 <0.34 <0.34 <0.34 <0.34 <0.34 <0.34 NI NS 290 NS NS NS <0.34 <0.34 1 5000
5/29/2012 NS NS NS NS NS NS NS <0.5 50.6 NS 269 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 52.8 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND ND ND 38.9 NS ND ND NS NS
4/10/2014 ND ND ND ND NS 0.13 NS ND 52 0.4 180 ND ND ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND 90 1.4 250 NS NS NS NS NS
4/23/2015 ND ND ND ND NS 0.16 NS ND 55 0.62 140 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 9.5 1.2 150 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 11.2 ND 46 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 25.9 0.58 87.7 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 12.9 1.1 51.5 NS NS NS NS NS
Toluene ug/l 8/11/2011 <0.7 <0.7 <0.7 <0.7 <0.7 <0.7 <0.7 <0.7 NI NS 25 NS NS NS <0.7 <0.7 600 260000
5/29/2012 NS NS NS NS NS NS NS <0.5 153 NS 82.5 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 167 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 89.9 ND ND NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND 180 ND 55 ND 0.22 ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND 160 ND 10 NS NS NS NS NS
4/23/2015 ND ND ND ND NS 0.13 NS ND 310 ND 210 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 64.2 ND 157 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 294 ND 22.9 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 325 ND 589 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 64.2 ND 0 NS NS NS NS NS
Ethylbenzene ug/l 8/11/2011 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 NI NS 210 NS NS NS <0.5 <0.5 600 84500
5/29/2012 NS NS NS NS NS NS NS <0.5 656 NS 386 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 959 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 813 ND 58.9 NS 1.5 ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND 1200 ND 310 ND 1.6 ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND 1900 ND 520 NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND 1600 ND 140 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 223 ND 175 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 878 ND 126 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 1380 ND 321 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 865 ND 149 NS NS NS NS NS
Total Xylenes ug/l 8/11/2011 <3.2 <3.2 <3.2 <3.2 <3.2 <3.2 <3.2 <3.2 NI NS 570 NS NS NS <3.2 <3.2 500 85500
5/29/2012 NS NS NS NS NS NS NS <1.5 5360 NS 954 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 5100 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 4140 ND 111.8 NS 10.4 0.53 NS NS
4/10/2014 ND ND ND ND NS ND NS ND 5400 ND 378 ND 13.9 0.72 NS NS
9/2/2014 ND ND ND ND ND ND ND ND 8400 ND 920 NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND 7400 ND 620 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 926 ND 281 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 4350 ND 86.5 NS 3.3 NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 6620 ND 1082 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 3710 ND 37.4 NS NS NS NS NS
Pleasant Garden Curb Market
4700 Pleasant Garden Road
Pleasant Garden, Guilford County, North Carolina
MONITORING WELLS
Table 5
Monitoring Well Analytical Results
Monitoring Wells
Page 2 of 4
Gross
PARAMETER UNITS DATE NCAC 15A:2L Contamination
MW-1 MW-2 MW-3 MW-4 MW-5 MW-6 MW-7 MW-8 MW-9 MW-10 RW-1 VE-1 VE-2 VE-3 AS-1 AS-7 Standard Levels
(GCL)
6200B
Pleasant Garden Curb Market
4700 Pleasant Garden Road
Pleasant Garden, Guilford County, North Carolina
MONITORING WELLS
Table 5
Monitoring Well Analytical Results
Monitoring Wells
Total BTEX ug/l 8/11/2011 ND ND ND ND ND ND ND ND NI NS 5620.4 NS NS NS ND ND No No
5/29/2012 NS NS NS NS NS NS NS ND 6219.6 NS 1691.5 NS NS NS NS NS Standard Standard
5/15/2013 ND ND NS ND NS ND NS ND 6278.8 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 5042.9 ND 5791.1 NS ND ND NS NS
4/10/2014 ND ND ND ND NS 0.13 NS ND 6832 0.4 923 ND 15.72 0.72 NS NS
9/2/2014 ND ND ND ND ND ND ND ND 10550 1.4 1700 NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND 9365 0.62 1110 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 1222.7 1.2 763 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 5533.2 ND 281 NS NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 8350.9 0.58 2079.7 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 4652.1 1.58 237.9 NS NS NS NS NS
MTBE ug/l 8/11/2011 11 9.2 6.2 <0.74 <0.74 <0.74 <0.74 20 NI NS 63 NS NS NS 1.7 <0.74 20 20000
5/29/2012 NS NS NS NS NS NS NS 18.9 1.1 NS 86.6 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS 16.9 ND NS NS NS NS NS NS NS
1/20/2014 NS 1.2 NS NS NS NS NS 16.9 ND 56.3 33.4 NS ND ND NS NS
4/10/2014 0.18 0.13 5.2 ND NS ND NS 11 ND 25 46 0.18 ND ND NS NS
9/2/2014 0.65 0.93 6 ND NS ND ND 3.5 ND 34 26 NS NS NS NS NS
4/23/2015 0.28 0.26 6.7 ND NS ND NS 8.2 ND 50 30 ND ND NS NS NS
9/10/2015 1.3 0.66 6.3 ND NS ND NS 4.9 2.6 49.4 12.3 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND 24.9 24.5 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND 37.8 6.1 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND 52.1 27.2 NS NS NS NS NS
Isopropyl Ether ug/l 8/11/2011 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 2.8 NI NS 9.4 NS NS NS <0.5 <0.5 70 70000
5/29/2012 NS NS NS NS NS NS NS 2 <0.5 NS 12.5 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND ND NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND ND 15.6 5.9 NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND ND 11 7.5 ND ND ND NS NS
4/23/2015 ND ND ND ND NS ND NS ND ND 11 4.8 ND ND NS NS NS
9/10/2015 0.53 ND ND ND NS ND NS ND ND 10 1.9 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND 6.7 4.5 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND 9.5 ND NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND 11.5 5.3 NS NS NS NS NS
Naphthalene ug/l 8/11/2011 <1 <1 <1 <1 <1 <1 <1 <1 NI NS 65 NS NS NS <1 <1 6 6000
5/29/2012 NS NS NS NS NS NS NS <2 1120 NS 178 NS NS NS NS NS
5/15/2013 ND ND NS ND NS 16.4 NS ND 1240 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 821 ND 19.2 NS 7.7 23.1 NS NS
4/10/2014 ND ND ND ND NS 4 NS ND 250 ND 70 ND 5.8 12 NS NS
9/2/2014 ND ND ND ND ND ND ND ND 1500 ND 330 NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND 390 ND 51 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 363 ND 85.6 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 872 ND 55.6 NS 6.1 NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 1090 ND 101 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 838 ND 53.2 NS NS NS NS NS
Page 3 of 4
Gross
PARAMETER UNITS DATE NCAC 15A:2L Contamination
MW-1 MW-2 MW-3 MW-4 MW-5 MW-6 MW-7 MW-8 MW-9 MW-10 RW-1 VE-1 VE-2 VE-3 AS-1 AS-7 Standard Levels
(GCL)
6200B
Pleasant Garden Curb Market
4700 Pleasant Garden Road
Pleasant Garden, Guilford County, North Carolina
MONITORING WELLS
Table 5
Monitoring Well Analytical Results
Monitoring Wells
1,2,4-Trimethylbenzene ug/l 8/11/2011 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 NI NS 220 NS NS NS <0.82 <0.82 400 28500
5/29/2012 NS NS NS NS NS NS NS <0.5 2820 NS 366 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 2740 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 1940 ND 63.9 NS 12 1.9 NS NS
4/10/2014 ND ND ND ND NS 0.25 NS ND 2200 ND 220 ND 21 1.8 NS NS
4/23/2015 ND ND ND ND NS ND NS ND 3300 ND 210 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 562 ND 91.6 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 1960 ND 47.3 NS 6 NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 2610 ND 297 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 1740 ND 49.5 NS NS NS NS NS
1,3,5-Trimethylbenzene ug/l 8/11/2011 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 <0.82 NI NS 65 NS NS NS <0.82 <0.82 400 25000
5/29/2012 NS NS NS NS NS NS NS <0.5 702 NS 92.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 658 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 456 ND 16.1 NS 1.5 ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND 640 ND 56 ND 2.1 0.41 NS NS
4/23/2015 ND ND ND ND NS ND NS ND 770 ND 56 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 149 ND 33.9 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 463 ND 10.8 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 649 ND 62.5 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 428 ND 9.5 NS NS NS NS NS
n-Propylbenzene ug/l 8/11/2011 <0.69 <0.69 <0.69 <0.69 <0.69 <0.69 <0.69 <0.69 NI NS 28 NS NS NS <0.69 <0.69 70 30000
5/29/2012 NS NS NS NS NS NS NS <0.5 176 NS 54.4 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 169 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 123 ND 5.8 NS 0.61 ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND 160 ND 37 ND 0.92 ND NS NS
4/23/2015 ND ND ND ND NS ND NS ND 210 ND 20 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 43.6 ND 23.7 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 138 ND 18.6 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 220 ND 40.7 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 138 ND 20.9 NS NS NS NS NS
Tetrachloroethene ug/l 8/11/2011 <0.58 <0.58 <0.58 <0.58 <0.58 <0.58 <0.58 <0.58 NI NS <1.2 NS NS NS <0.58 <0.58 0.7 700
5/29/2012 NS NS NS NS NS NS NS <0.5 <0.5 NS <1.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND ND NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND ND ND ND NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND ND ND ND ND ND ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND ND ND ND NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS 0.1 ND ND ND ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND ND ND ND NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND ND ND NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
Isopropylbenzene ug/l 8/11/2011 <0.53 <0.53 <0.53 <0.53 <0.53 <0.53 <0.53 <0.53 NI NS 16 NS NS NS <0.53 <0.53 70 25000
5/29/2012 NS NS NS NS NS NS NS <0.5 74.9 NS 28.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND 65.4 NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND 52.4 ND 4.1 NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND 62 ND 18 ND 0.48 ND NS NS
4/23/2015 ND ND ND ND NS ND NS ND 88 0.16 13 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND 22.3 ND 13 NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS 58.4 ND 11.8 NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS 88.7 ND 19.8 NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS 58.2 ND 11.4 NS NS NS NS NS
Page 4 of 4
Gross
PARAMETER UNITS DATE NCAC 15A:2L Contamination
MW-1 MW-2 MW-3 MW-4 MW-5 MW-6 MW-7 MW-8 MW-9 MW-10 RW-1 VE-1 VE-2 VE-3 AS-1 AS-7 Standard Levels
(GCL)
6200B
Pleasant Garden Curb Market
4700 Pleasant Garden Road
Pleasant Garden, Guilford County, North Carolina
MONITORING WELLS
Table 5
Monitoring Well Analytical Results
Monitoring Wells
1,2-Dichloroethane ug/l 8/11/2011 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 NI NS <1 NS NS NS <0.5 <0.5 0.4 400
5/29/2012 NS NS NS NS NS NS NS <0.5 <0.5 NS <1.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND ND NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND ND 1.1 ND NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND ND 0.3 ND ND ND ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND ND 1 ND NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND ND 0.68 ND ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND ND 0.81 ND NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND ND ND NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND 0.69 ND NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND 0.96 ND NS NS NS NS NS
EDB ug/l 8/11/2011 <0.59 <0.59 <0.59 <0.59 <0.59 <0.59 <0.59 <0.59 NI NS <1.2 NS NS NS <0.59 <0.59 0.02 50
5/29/2012 NS NS NS NS NS NS NS <0.5 3.1 NS <1.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS ND ND NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS ND ND ND ND NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS ND ND ND ND ND ND ND NS NS
9/2/2014 ND ND ND ND ND ND ND ND ND ND ND NS NS NS NS NS
4/23/2015 ND ND ND ND NS ND NS ND ND ND 0.2 ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS ND ND ND ND NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND ND ND NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
Chloroform ug/l 8/11/2011 <0.6 <0.6 <0.6 <0.6 <0.6 <0.6 <0.6 5.6 NI NS <1.2 NS NS NS <0.6 <0.6 70 70000
5/29/2012 NS NS NS NS NS NS NS <0.5 <0.5 NS <1.2 NS NS NS NS NS
5/15/2013 ND ND NS ND NS ND NS 11.6 ND NS NS NS NS NS NS NS
1/20/2014 NS ND NS NS NS NS NS 13.3 ND ND ND NS ND ND NS NS
4/10/2014 ND ND ND ND NS ND NS 11 ND ND ND ND ND ND NS NS
4/23/2015 ND ND ND ND NS 0.16 NS 5.6 ND ND ND ND ND NS NS NS
9/10/2015 ND ND ND ND NS ND NS 2.3 ND ND ND NS NS NS NS NS
4/6/2016 NS NS NS NS NS ND NS NS ND ND ND NS ND NS NS NS
8/18/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
11/22/2016 NS ND NS NS NS NS NS NS ND ND ND NS NS NS NS NS
ND: Below Detection Limit.NA: Not analyzed for this parameter.NS = Not Sampled
GCL: Gross Contaminant Level.---: Well not sampled this date.Bold Values exceed the NCAC 2L Standard
REGENESIS
I. Identification
Product identifier
Other means of identification
Recommended use
Recommended restrictions
SAFETY DATA SHEET
Oxygen Release Compound Advanced (ORC Advanced®)
None.
Soil and Groundwater Remediatron.
None known.
Manufacturer/Importer/Supplier/Distributor information
Company Name Regenesis
Address 1011 Calle Sombre
San Clemente, CA 92673 USA
General information 949-366-8000
E-mail CustomerService@regenesis,com
Emergency phone number
USA, Canada, Mexico
International
2. Hazard(s) identification
Physical hazards
Health hazards
OSHA defined hazards
Label elements
Signal word
Hazard statement
Precautionary statement
Prevention
Response
Storage
Disposal
Hazard(s) not otherwise
classified (HNOC)
Supplemental information None
3. Composition/information on ingredients
Mixtures
For Hazardous Materials Incidents ONLY (spilt; leak, fire, exposure or accident), call
CHEMTREC 24/7 at
1-800-424-9300
1-703-527-3867
Oxidizing solids
Skin corrosion/irritation
Serious eye damage/eye irritation
Not classified.
Category 2
Category 2
Category 1
Danger
May intensify fire; oxidizer. Causes skin irritation. Causes serious eye damage.
Keep away from heat. Keep/Store away from clothing/combustible materials. Take any precaution
to avoid mixing with combustibles. Wash thoroughly after handling. Wear protective gloves/eye
protection/face protection,
If on skin: Wash with plenty of water. If in eyes: Rinse cautiously with water for several minutes.
Remove contact lenses, if present and easy to do. Continue rinsing. Immediately call a poison
center/doctor. If skin irritation occurs: Get medical advice/attention. Take off contaminated
clothing and wash before reuse. In case of fire Use appropriate media to extinguish.
Store away from incompatible materials.
Dispose of contents/container in accordance with local/regional/nationailinternational regulations.
None known.
Chemical name CAS number
Calcium hydroxide oxide
682334-66-3 ?85
Calcium hydroxide
1305-62-0 515
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SDS US
118

Dipotassium Phosphate
Monopotassium Phosphate
Composition comments
4. First-aid measures
Inhalation
Skin contact
Eye contact
Ingestion
Most important
symptoms/effects, acute and
delayed
Indication of immediate
medical attention and special
treatment needed
General information
5. Fire-fighting measures
Suitable extinguishing media
Unsultable extinguishing
media
Specific hazards arising from
the chemical
Special protective equipment
and precautions for firefighters
Fire fighting
equipment/instructions
Specific methods
General fire hazards
7758-11-4 <5
7778-77-0 <5
All concentrations are in percent by weight unless otherwise indicated.
Move to fresh air. Call a physician if symptoms develop or persist.
IF ON CLOTHING: rinse immediately contaminated clothing and skin with plenty of water before
removing clothes. Rinse skin with water/shower. If skin irritation occurs: Get medical
advice/attention. Wash contaminated clothing before reuse.
Do not rub eyes. Immediately flush eyes with plenty of water for at least 15 minutes. Remove
contact lenses, if present and easy to do. Continue rinsing. Get medical attention immediately.
Never give anything by mouth to a victim who is unconscious or is having convulsions. Rinse
mouth. Do not induce vomiting. If vomiting occurs, keep head low so that stomach content doesn't
get into the lungs. Get medical attention if symptoms occur.
Severe eye irritation. Symptoms may include stinging, tearing, redness, swelling, and blurred
vision. Permanent eye damage including blindness could result. Dusts may irritate the respiratory
tract, skin and eyes. Skin irritation. May cause redness and pain.
Provide general supportive measures and treat symptomatically. Keep victim under observation.
Symptoms may be delayed.
Take off all contaminated clothing immediately. Contact with combustible material may cause fire.
Ensure that medical personnel are aware of the material(s) involved, and take precautions to
protect themselves. Wash contaminated clothing before reuse.
Water spray, fog (flooding amounts). Foam. Dry chemical powder. Carbon dioxide (CO2).
None known.
Greatly increases the burning rate of combustible materials. Containers may explode when
heated. During fire, gases hazardous to health may be formed. Combustion products may include:
metal oxides.
Self-contained breathing apparatus and full protective clothing must be worn in case of fire.
In case of fire and/or explosion do not breathe fumes. Move containers from fire area if you can do
so without risk. Use water spray to cool unopened containers.
Cool containers exposed to flames with water until well after the fire is out.
May intensify fire; oxidizer. Contact with combustible material may cause fire.
6. Accidental release measures
Personal precautions,
protective equipment and
emergency procedures
Methods and materials for
containment and cleaning up
Keep unnecessary personnel away. Keep people away from and upwind of spill/leak. Keep away
from clothing and other combustible materials. Wear appropriate protective equipment and
clothing during clean-up. Use a NIOSH/MSHA approved respirator if there is a risk of exposure to
dust/fume at levels exceeding the exposure limits. Do not touch damaged containers or spilled
material unless wearing appropriate protective clothing. Ensure adequate ventilation. Local
authorities should be advised if significant spillages cannot be contained. For personal protection,
see section 8 of the SDS.
Eliminate all ignition sources (no smoking, flares, sparks, or flames in immediate area). Collect
dust using a vacuum cleaner equipped with HEPA filter. Keep combustibles (wood, paper, oil, etc.)
away from spilled material. Ventilate the contaminated area. Stop the flow of material, if this is
without risk. Absorb in vermiculite, dry sand or earth and place into containers.
Large Spills: Sweep up or vacuum up spillage and collect in suitable container for disposal. Shovel
the material into waste container. Minimize dust generation and accumulation. Avoid the
generation of dusts during clean-up. Following product recovery, flush area with water.
Small Spills: Wipe up with absorbent material (e.g. cloth, fleece). Clean surface thoroughly to
remove residual contamination.
Never return spills to original containers for re-use. Place all material into loosely covered plastic
containers for later disposal. For waste disposal, see section 13 of the SDS. Wear appropriate
protective equipment and clothing during clean-up.
Environmental precautions Avoid discharge into drains, water courses or onto the ground.
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7. Handling and storage
Precautions for safe handling
Conditions for safe storage,
including any incompatibilities
Minimize dust generation and accumulation. Routine housekeeping should be instituted to ensure
that dusts do not accumulate on surfaces. Keep away from heat. Provide appropriate exhaust
ventilation at places where dust is formed. Keep away from clothing and other combustible
materials. Take any precaution to avoid mixing with combustibles. Avoid contact with water and
moisture. Do not get this material in contact with eyes. Avoid contact with eyes, skin, and clothing.
Avoid prolonged exposure. Wear appropriate personal protective equipment. Observe good
industrial hygiene practices.
Keep away from heat. Store in a cool, dry place out of direct sunlight. Store in original tightly
closed container. Store in a well-ventilated place. Do not store near combustible materials. Store
away from incompatible materials (see Section 10 of the SDS).
8. Exposure controls/personal protection
Occupational exposure limits
US. OSHA Table Z-1 Limits for Air Contaminants (29 CFR 1910.1000)
Components Type Value Form
Calcium hydroxide (CAS
1305-62-0)
PEL 5 mg/m3
15 mg/m3
Respirable fraction.
Total dust.
US. ACGIH Threshold Limit Values
Components Type Value
Calcium hydroxide (CAS
1305-62-0)
TWA 5 mg/m3
US. NIOSH: Pocket Guide to Chemical Hazards
Components Type Value
Calcium hydroxide (CAS
1305-62-0)
Biological limit values
Appropriate engineering
controls
TWA 5 mg/m3
No biological exposure limits noted for the ingredient(s).
Good general ventilation (typically 10 air changes per hour) should be used. Ventilation rates
should be matched to conditions. If applicable, use process enclosures, local exhaust ventilation,
or other engineering controls to maintain airborne levels below recommended exposure limits. If
exposure limits have not been established, maintain airborne levels to an acceptable level. If
engineering measures are not sufficient to maintain concentrations of dust particulates below the
Occupational Exposure Limit (OEL), suitable respiratory protection must be worn. If material is
ground, cut, or used in any operation which may generate dusts, use appropriate local exhaust
ventilation to keep exposures below the recommended exposure limits. Eye wash facilities and
emergency shower must be available when handling this product.
Individual protection measures, such as personal protective equipment
Eye/face protection Use dust-tight, unvented chemical safety goggles when there is potential for eye contact.
Skin protection
Hand protection
Skin protection
Other
Respiratory protection
Thermal hazards
General hygiene
considerations
Wear appropriate chemical resistant gloves. Frequent change is advisable. Recommended gloves
include rubber, neoprene, nitrite or viton.
Wear appropriate chemical resistant clothing.
If engineering controls do not maintain airborne concentrations below recommended exposure
limits (where applicable) or to an acceptable level (in countries where exposure limits have not
been established), an approved respirator must be worn. Recommended use:
Wear appropriate thermal protective clothing, when necessary.
Keep from contact with clothing and other combustible materials. Remove and wash contaminated
clothing promptly. Always observe good personal hygiene measures, such as washing after
handling the material and before eating, drinking, and/or smoking. Routinely wash work clothing
and protective equipment to remove contaminants.
9. Physical and chemical properties
Appearance
Physical state
Form
Color
Solid.
Powder.
White to pale yellow.
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Odor Odorless.
Odor threshold Not available.
pH 12.5 (3% suspension/water)
Melting point/freezing point Not available.
Initial boiling point and boiling Not available.
range
Flash point Not available.
Evaporation rate Not available.
Flammability (solid, gas) Oxidizer.
Upper/lower flammability or explosive limits
Flammability limit -lower Not available.
(%)
Flammability limit -upper Not available.
(%)
Explosive limit-lower(%) Not available.
Explosive limit-upper(%) Not available.
Vapor pressure Not available.
Vapor density Not available.
Relative density Not available.
Solubility(ies)
Solubility (water) Slightly soluble
Partition coefficient Not available.
(n-octanol/water)
Auto-ignition temperature Not available.
Decomposition temperature 527 °F (275 °C)
Viscosity Not available.
Other information
Bulk density 0.5 -0.9 g/ml
Explosive limit Non-explosive.
10. Stability and reactivity
Reactivity
Chemical stability
Possibility of hazardous
reactions
Greatly increases the burning rate of combustible materials.
Decomposes on heating. Product may be unstable at temperatures above: 275°C/527°F.
Reacts slowly with water.
Conditions to avoid Heat. Moisture. Avoid temperatures exceeding the decomposition temperature. Contact with
incompatible materials.
Incompatible materials
Hazardous decomposition
products
Acids. Bases. Salts of heavy metals. Reducing agents. Combustible material.
Oxygen. Hydrogen peroxide (H2O2). Steam. Heat.
11. Toxicological information
Information on likely routes of exposure
Inhalation Dust may irritate respiratory system. Prolonged inhalation may be harmful.
Skin contact
Eye contact
Ingestion
Causes skin irritation.
Causes serious eye damage.
Ingestion may cause irritation and malaise.
Symptoms related to the
physical, chemical and
toxicological characteristics
Severe eye irritation. Symptoms may include stinging, tearing, redness, swelling, and blurred
vision. Permanent eye damage including blindness could result. Dusts may irritate the respiratory
tract, skin and eyes. Skin irritation. May cause redness and pain.
Information on toxicological effects
Acute toxicity
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Components Species
Calcium hydroxide (CAS 1305-62-0)
Acute
Oral
LD50 Rat
Dipotassium Phosphate (CAS 7758-11-4)
Acute
Oral
LD50 Rat
Skin corrosion/irritation Causes skin irritation.
Serious eye damage/eye Causes serious eye damage.
irritation
Respiratory or skin sensitization
Respiratory sensitization Not a respiratory sensitizer.
Test Results
7340 mg/kg
> 2000 mg/kg
Skin sensitization
Germ cell mutagenicity
This product is not expected to cause skin sensitization.
No data available to indicate product or any components present at greater than 0.1 % are
mutagenic or genotoxic.
Carcinogenicity This product is not considered to be a carcinogen by IARC, ACGIH, NTP, or OSHA.
IARC Monographs. Overall Evaluation of Carcinogenicity
Not listed.
NTP Report on Carcinogens
Not listed.
OSHA Specifically Regulated Substances (29 CFR 1910.1001-1053)
Not regulated.
Reproductive toxicity This product is not expected to cause reproductive or developmental effects.
Specific target organ toxicity -Not classified.
single exposure
Specific target organ toxicity -Not classified.
repeated exposure
Aspiration hazard Due to the physical form of the product it is not expected to be an aspiration hazard.
Chronic effects Prolonged inhalation may be harmful.
12. Ecological information
Ecotoxicity The product is not classified as environmentally hazardous. However, this does not exclude the
possibility that large or frequent spills can have a harmful or damaging effect on the environment.
Components Species Test Results
Dipotassium Phosphate (CAS 7758-11-4)
Aquatic
Acute
Algae
Crustacea
Fish
Persistence and degradability
Bioaccumulative potential
Mobility in soil
Other adverse effects
EC50
EC50
LC50
Pseudokirchneriella subcapitata
Daphnia magna
Oryzias latipes
> 100 mg/I, 72 Hours
118.9 mg/I, 48 Hours
> 100 mg/I, 96 Hours
Decomposes in the presence of water. The product contains inorganic compounds which are not
biodegradable.
The product does not contain any substances expected to be bioaccumulating.
This substance has very low solubility in water and low mobility in the environment.
None known.
13. Disposal considerations
Disposal instructions
Local disposal regulations
Hazardous waste code
Collect and reclaim or dispose in sealed containers at licensed waste disposal site. Dispose of
contents/container in accordance with local/regional/national/international regulations.
Dispose in accordance with all applicable regulations.
The waste code should be assigned in discussion between the user, the producer and the waste
disposal company.
Oxygen Release Compound Advanced (ORC Advanced®) SDSUS
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Waste from residues/ unused
products
Dispose of in accordance with local regulations. Empty containers or liners may retain some
product residues. This material and its container must be disposed of in a safe manner (see:
Disposal instructions).
Contaminated packaging Empty containers should be taken to an approved waste handling site for recycling or disposal.
Since emptied containers may retain product residue, follow label warnings even after container is
emptied.
14. Transport information
DOT
UN number UN1479
UN proper shipping name Oxidizing solid, n.o.s. (Calcium hydroxide oxide)
Transport hazard class(es)
Class 5.1
Subsidiary risk
Label(s) 5.1
Packing group II
Environmental hazards
Marine pollutant No
Special precautions for user Read safety instructions, SOS and emergency procedures before handling.
Special provisions 62, 188, IP2, IP4, T3, TP33
Packaging exceptions 152
Packaging non bulk 212
Packaging bulk 240
IATA
UN number UN1479
UN proper shipping name Oxidizing solid, n.o.s. (Calcium hydroxide oxide)
Transport hazard class(es)
Class 5.1
Subsidiary risk
Packing group II
Environmental hazards No
ERG Code 5L
Special precautions for user Read safety instructions, SOS and emergency procedures before handling.
IMDG
UN number
UN proper shipping name
Transport hazard class(es)
Class
Subsidiary risk
Packing group
Environmental hazards
Marine pollutant
EmS
UN1479
OXIDIZING SOLID, N.O.S. (Calcium hydroxide oxide)
5.1
II
No
F-A, S-Q
Special precautions for user Read safety instructions, SOS and emergency procedures before handling.
Transport in bulk according to Not applicable.
Annex II of MARPOL 73n8 and
the IBC Code
15. Regulatory information
US federal regulations This product is a "Hazardous Chemical'' as defined by the OSHA Hazard Communication
Standard, 29 CFR 1910.1200.
All components are on the U.S. EPA TSCA Inventory List.
TSCA Section 12(b) Export Notification (40 CFR 707, Subpt. D)
Not regulated.
CERCLA Hazardous Substance List (40 CFR 302,4)
Not listed.
SARA 304 Emergency release notification
Not regulated.
OSHA Specifically Regulated Substances (29 CFR 1910.1001-1053)
Not regulated.
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Superfund Amendments and Reauthorization Act of 1986 (SARA)
SARA 302 Extremely hazardous substance
Not listed.
SARA 311/312 Hazardous
chemical
Classified hazard
categories
SARA 313 (TRI reporting)
Not regulated.
Other federal regulations
Yes
Oxidizer (liquid, solid, or gas)
Skin corrosion or irritation
Serious eye damage or eye irritation
Clean Air Act (CAA) Section 112 Hazardous Air Pollutants (HAPs) List
Not regulated.
Clean Air Act (CAA) Section 112(r) Accidental Release Prevention (40 CFR 68.130)
Not regulated.
Safe Drinking Water Act
(SOWA)
US state regulations
Not regulated.
US. Massachusetts RTK -Substance List
Calcium hydroxide (CAS 1305-62-0)
US. New Jersey Worker and Community Right-to-Know Act
Calcium hydroxide (CAS 1305-62-0)
Calcium hydroxide oxide (CAS 682334-66-3)
US. Pennsylvania Worker and Community Right-to-Know Law
Calcium hydroxide (CAS 1305-62-0)
US. Rhode Island RTK
Calcium hydroxide (CAS 1305-62-0)
California Proposition 65
California Safe Drinking Water and Toxic Enforcement Act of 2016 (Proposition 65): This material
is not known to contain any chemicals currently listed as carcinogens or reproductive toxins. For
more information go to www.P65Wamings.ca.gov.
International Inventories
Country(s) or region
Australia
Canada
Canada
China
Europe
Europe
Japan
Korea
New Zealand
Philippines
Taiwan
United States & Puerto Rico
Inventory name
Australian Inventory of Chemical Substances (AICS)
Domestic Substances List (DSL)
Non-Domestic Substances List (NDSL)
Inventory of Existing Chemical Substances in China (IECSC)
European Inventory of Existing Commercial Chemical
Substances (EINECS)
European List of Notified Chemical Substances (ELINCS)
Inventory of Existing and New Chemical Substances (ENCS)
Existing Chemicals List (ECL)
New Zealand Inventory
Philippine Inventory of Chemicals and Chemical Substances
(PICCS)
Taiwan Chemical Substance Inventory (TCSI)
Toxic Substances Control Act (TSCA) Inventory
*A "Yes" indicates this product complies with the inventory requirements administered by the governing country(s).
On inventory (yes/no)*
Yes
Yes
No
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
A "No" indicates that one or more components of the product are not listed or exempt from listing on the inventory administered by the governing
country(s).
16. Other information, including date of preparation or last revision
Issue date
Revision date
Version#
02-April-2015
19-November-2017
03
Further information HMIS® is a registered trade and service mark of the American Coatings Association (ACA).
Oxygen Release Compound Advanced (ORC Advanced®) SDS US
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HMIS® ratings
NFPA ratings
Disclaimer
Health: 3
Flammability: 0
Physical hazard: 2
Regenesis cannot anticipate all conditions under which this information and its product, or the
products of other manufacturers in combination with its product, may be used. It is the user's
responsibility to ensure safe conditions for handling. storage and disposal of the product, and to
assume liability for loss, injury, damage or expense due to improper use. The information in the
sheet was written based on the best knowledge and experience currently available.
Oxygen Release Compound Advanced (ORC Advanced®}
925597 Version #: 03 Revision date: 19-November-2017 Issue date: 02-April-2015
SOS us
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