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Home My WebLink AboutWI0400534_DEEMED FILES_20191114Permit Number WI0400534 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 Kennedy's Komer Convenience Store Location Address 7000 Friendship Churc Rd Mc Leansville Owner Owner Name Huffman Oil Co Dates/Events NC Orig Issue 11/14/2019 App Received 10/28/2019 Regulated Activities Groundwater remediation Outfall Waterbody Name 27301 Draft Initiated Scheduled Issuance Public Notice Central Files: APS SWP 11/14/2019 Permit Tracking Slip Status Active Version 1.00 Project Type New Project Permit Classification Individual Permit Contact Affiliation Major/Minor Minor Region Winston-Salem Facility Contact Affiliation Owner Type Non-Government Owner Affiliation James A. Barnwell Jr. PO Box 730 Burlington County Guilford NC Issue 11/14/2019 Effective 11/14/2019 27216 Expiration Requested /Received Events Streamlndex Number Current Class Subbasin i North Carolina Department of Environmental Quality-Division of Water Resources NOTIFICATION OF INTENT (Non 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 injection) AQUIFER TEST WELLS C15A 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. Print Clearly or Type Information. Rlegible Submittals Will Be Returned As Incomplete. DATE: October 18 ,2019_ PERMIT NO. V'I/ ).-0 4-0 0 5D lf (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 Injection 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): Huffman Oil Company/Steve Barnwell Mailing Address: P.O. Box 730 City: Burlington State: ~ Zip Code:=2 ~72~1=5 ____ County: Alamance Day Tele No.: ---~3~3~6-~2=27~-~8~88~1 ___ _ Cell No.: __________ _ EMAIL Address: ___ ____,s=b=arn=-.,.w'----'e=ll""@""h=u=ffm=an=o=il=.n=e=t ___ _ Fax No.: ________ _ Deemed Permitted GW Remediation NOI Rev. 3-21-2018 Page 1 D. PROPERTY OWNER(S) (if different than well owner/applicant) Name and Title: -----'B~ill=--y'--T"".'""R=o=b~e=rt=s~------------------------ Company Name ___ K=enn=e~d""'y_'s~K=o=m=e=r~C~o=n~v~e=m=·e=n~ce~S=to-=-re~---------------- Mailing Address: __ ___,_70-=-4-=-4-'-F"-'n=·e=n=d=sh=i,.,p....::C=h=m=che:..=R=o=ad,e__ _________________ _ City: McLeansville State: _NC_ Zip Code: 27301 County: Guilford Day Tele No.: 910-323-1091 Cell No.: __________ _ EMAIL Address: _____________ _ Fax No.: ___________ _ E. PROJECT CONTACT (Typically Environmental Engineering Firm) Name and Title: ___ W..:..:....::a::.,.yn.:.:.e:::.....:.W.:...;a=tt=e~rs::..:o=n"'------------------------- Company Name ---=S&=M=E=-.,__c. In=c_,_. _________________________ _ Mailing Address: ----=-8-=-64-'---'6=----W--'---'---"e=st~M=ar=k=e"'-t =S ... tr .... ee=t....:.Su=i=te:...1::....:0=5 ________________ _ City: Greensboro State: _NC_ Zip Code:27409 County: Guilford Day Tele No.: ---=33~6~-2=8~8-~7~18~0~---Cell No.: 336-312-0276 EMAIL Address: ___ ww~~a=tt=ers~on=@ ........ s=m=e=in=-c=.c~o=m~--Fax No.: F. PHYSICAL LOCATION OF WELL SITE ( 1) Facility Name & Address: ____ .-=-K=e=nn=e=d y.,_'-=-s-=-K=o=m=er:...C=-o=n=-v,..,e=n=ie=n=c-=-e-=S'-'-to=r=e __________ _ 7000 Friendshi p Church Road City: --~M=cL=e=an=sv-'--'i=ll~e _______ County: Guilford Zip Code: --~27~3~0~1 _ (2) Geographic Coordinates: Latitude**: --~3~6° __Q.2' ~"Nor _____ _ Longitude**: ___ -_7_9° ----18_' _j]_" W or _____ _ Reference Datum: __ ...:.7-"'8-=-7-=-fe=e=t ___ Accuracy: ________ _ Method of Collection:---'G=o::..:o=g=le:...E=arth=~------------ **FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COO RD INA TES . G. TREATMENT AREA Land surface area of contaminant plume: Estimated 3 .000 square feet Land surface area ofinj. well network: __ <_l0~00_0 ____ square feet ts 10,000 ft 2 for small-scale injections) Percent of contaminant plume area to be treated: Unknown (must be s 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 OCT 28 7019, 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, 4SitEd,Liaayduration of injection over time. ogioaei Operations Soctloa A release of gasoline from a former under round storage tank system located on the property impacted groundwater quality to Ievels greater than the 15A NCAC 2L :0202 groundwater quality standards. Five monitor wells have been installed on the site. including one vertical extent monitor well. Only source monitor wells MW-I and MW-2 were impacted by benzene only, at levels greater than the 2L Standards during January 2019. Nine potable water supply wells are located within 500 feet of the release. The use of Enviro-BAC using monitor well MW-1 is planned to enhance degradation of petroleum contaminant levels in the groundwater. Two kilograms of Enviro-BAC concentrated powder, mixed with five gallons of fresh water, provided by Progress Environmental, will be gravity -fed into MW-1 in approximate 1-gallon increments over a time interval of one hour, followed by 5 to 10 gallons of clean water. 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:/fdeLl.nc.,ov/aboutldivisions/water- resourceslwater-resourcesTen its/wastewater-branchhaound-water-protectionicround-water-approved-injectants. All other substances must be reviewed by the DES prior to use. Contact the UIC Program for more info (919- 807-6496). Injectant: Enviro-BAC _ Volume of injectant: 5 gallons with sucrose additive added immediatelvprior to injection Concentration at point of injection: 2 kg 10.4 kg: gallon _. 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: 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: Proposed 1 Existing (provide GW-1s) (2) For Proposed wells or Existing wells not having GW-ls, provide well construction details for each injection well in a diagratn 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) (b) (c) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery Depth below land surface of casing, each grout type and depth, screen, and sand pack Well contractor name and certification number Deemed Permitted GW Remediation NO1 Rev. 3-21-2018 Page 3 L. SCHEDULES — Briefly describe the schedule for well construction and injection activities. Enviro-BAC solution will be placed into existing. well MW-1 within one month of receipt of the notification permit number. 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 injection of Enviro-BAC solution is not expected to result in violations of the 2L Standards. Monitor well MW-1 will be sampled for analysis of volatile oreanic compounds approximately 2 months following injection. N. SIGNATURE OF APPLICANT AND PROPERTY OWNER Well Owner/Applicant: "I hereby certify, under penalty of law, that 1 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, 1 believe that the information is true, accurate and complete. 1 am aware that there are significant penalties, including the possibility of fines and imprisonment. for submitting false information. 1 agree to construct, operate, maintain, repair, and if applicable, abandon the injecfion-1.14 and € l related appurtenances in accordance with the 15A NCAC 02C 0200 Rules." no 're of A. leant avne H. Watterson; Senior Engineer. S&ME Inc. (Agent for Responsible Party) Print or 1'ype Full Name and Title Property Owner Iif the property is not owned by the Well Owner/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 . 0200i. " "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. dated /i -d5 - i g Signature* of Pr err, Owner ( f i - erect from applii iw Print or Type Fall Name and Title '`An access agrees ent 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: (919) 807-6464 OCT 2 i 2019 W atai Quat4 Ragionnt O,per l+nna Sectiuti Deemed Permitted GW Remediation NO1 Rev. 3-21-2OI8 Page 5 ❑rawing path: Q:143581Z015115.018 - SA%1 S S10P & 5H0P 2019N2-19\Sams Stop & Shop Plans.dwg KEY O - SOIL VAPOR EXTRACTION WELL LOCATION ▪ - AIR SPARGE WELL LOCATION DEEP AIR SPARGE WELL LOCATION (65' - 70') - MONITOR WELL LOCATION C - VERTICAL EXTENT MONITOR WELL LOCATION CZ; - LIST LOCATION AND IDENTIFICATION UST - UNDERGROUND STORAGE TANK o - GASOLINE DISPENSER a - KEROSENE DISPENSER PRODUCT LINE — — — — - RIGHT-OF-WAY ELECTRICAL CONDUIT — — SURFACE DITCH - -• UNDERGROUND PHONE LINE OVERHEAD UTILITY LINE •p FIBER OPTIC LINE WATERLINE FENCE REMEDIATION TRENCH REMEDIATION COMPOUND NOTES: SAMPLES COLLECTED ON 5/18/18. MW-4 ug/L All Below 2L Standard I r t na 1 1 • MW-3 LASPHALT/ CONCRETE PAVEMENT 1 EXISTING - PAY PHONE CONCRETE CANOPY — PUMP ISLAND C GRASS AAMI-4 rso DW-1 ug/L All Below 2L Standard fie rei -::::: MW-3 ug1L All Below 2L Standard GRASS EXISTING WELL PI • • • n� Y ,, �r+, �h)` ,> � r � � . r' -U-• 2, ▪ r' .-Aa,MW 1 q't HICONE ROAD —Flo fl.0 pia � . r • = COILoo.&-Ora. � f are . r T1:14-".:.- war lVI. .� J� ral . —0�0/4 MW-2 Benzene ug/L 35 ▪ VENT LINES PRODUCT LINE EXISTING SEPTIC TANK NOTE MONITOR WELL LOCATIONS AND UTILITY LOCATIONS SHOWN ARE APPROXIMATE or MW-I ug/L S.R 25� Benzene 31 foci ,.a 0 10 20 GRAPHIC SCALE (IN FEET) rr a III S.:w SCALE: AS SHOWN DATE: FEB. 2019 PROJECT NUMBER 4358-15-018 FIGURE NO. 3 J Drawing path: Qh435612015MS-018 - SAM'S STOP & SHOP120141Z 191Sams Stop & Shop Plarts.dwg t 1 I ("ASP ALT/ GRASS \ O EXISTING 67 WELL MW-3 (74.12) CO CRETE Q 15. PA EMENT") P�,I �66\ 4?r / 165 N ti PUMP - 1011. / AQ� S ISLAND C•l► E-3 Th a. A. EXISTING 1 PAY PHONE — j CONCRETE 'L'' Q 4.1 GRASS MW-4 SPG-5 (77.53) � k /l- „ 4 5PG-4 1f 1 0 MW-1 i N ow-1 ® (79.9 • — (7937)— 5 1 KEY O - SOIL VAPOR EXTRACTION WELL LOCATION • - AIR SPARGE WELL LOCATION I_• - DEEP AIR SPARGE WELL LOCATION (65' - 70') MONITOR WELL LOCATION • - VERTICAL EXTENT MONITOR WELL LOCATION 72.5 — — — - PROJECTED GROUNDWATER ELEVATION CONTOUR LINE (77.53) - MEASURED GROUNDWATER ELEVATION IN MONITOR WELL - GROUNDWATER FLOW DIRECTION UST - UNDERGROUND STORAGE TANK o - GASOLINE DISPENSER ▪ - KEROSENE DISPENSER - - - - RIGHT-OF-WAY - ELECTRICAL CONDUIT - — — - SURFACE DITCH FENCE Ht''NE ROAD (.R.2565) VENT LINES PRODUCT LINE EXISTING SEPTIC TANK • NOTES MONITOR WELL LOCATIONS AND UTILITY LOCATIONS SHOWN ARE APPROXIMATE DATA FOR VERTICAL EXTENT WELL DW-1 NOT USED DURING GROUNDWATER FLOW CALCULATION DEPTH -TO -WATER MEASUREMENTS PERFORMED ON 5/18/18. 0 10 20 GRAPHIC SCALE (IN FEET) GROUNDWATER CONTOUR MAP SCALE: AS SHOWN DATE: FEB. 2019 PROJECT NUMBER 4358-15-018 FIGURE NO. 4