WI0400538_DEEMED FILES_20200213

2725 East Millbrook Road i~TC //'JM 1/06538
Suite 121
Raleigh, NC 27604
Tel : [phone]
Fax: [phone]
www.atcgroupservices.com
N.C. Eng ineering License No. C-1598
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES • MATERIALS TESTING
---------------------------------··
February 6, 2.020
Ms. Sbristi Shrestha
North Carolina Department of Environmental Quality
Division of Water Quality-Aquifer Protection Section, UIC Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Reference: Injection Event Record -WI0400538
United States Postal Service -Bulk Mail Center
3701 West Wendover Avenue
Greensboro, Guilford County, North Carolina
NCDEQ Incident No. 4013
Priority Site Ranking: 1180D
Dear Ms. Shrestha:
RF CElVE:DP-iCT.JEQJDWn
FEB 1 S zozo
W1 .torQ:J1Uly
Fleglonaf O~lt#Jli§n
ATC Associates of North Carolina, P.C. (ATC) is submitting an Injection Event Record for the
United States Postal Service (USPS) Bulk Mail Facility (BMC) on behalf of the Louis Berger
Group, Inc. The record documents the placement of Enviro-BAC in three monitoring wells (MW-
6, MW-13, and MW-14) associated with the above referenced site.
If you have questions or require additional information, please contact our office at [phone].
Sincerely,
ATC Associates of North Carolina, P.C.
Ashley M. Winkelman, P.G.
Senior Project Manager
cc: Shannon McKinney, Environmental Scientist for The Louis Berger Group, Inc.
Email: shannon.mckinney@wsp .com
Attachments
Injection Event Record
USPS BMC. Greensboro. North Carolina
INJECTION EVENT RECORD
.11.• 41,1,, J171:

North Carolina Department of Environmental Quality-Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WI0400538
1. Permit Information
USPS -Gardner Jones
Pennittee
USPS BMC
Facility Name
3701 W. Wendover Ave .• Greensboro , Guilford
County
Facility Address (include County)
2. Injection Contractor Information
ATC Associates of NC. P.C.
Injection Contractor I Company Name
Street Address 2725 E. Millbrook Road. Ste 121
Ralei gh NC 27604
City State Zip Code
[phone]
Area code -Phone number
3. Well Information
Number of wells used for injection.____,.3 ____ _
Well IDs MW-6. MW-13 , and MW-14
Were any new wells installed during this injection
event?
D Yes [8:1 No
If yes, please provide the following information:
Number of Monitoring Wells_. _N/ A ____ _
Number oflnjection Wells ____ N/A ____ _
Type of Well Installed (Check applicable type):
□ Bored □ Drilled O Direct-Push
D Hand-Augured D Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
D Yes [8:1 No
If yes, please provide the following information:
Number of Monitoring Wells __ NIA ____ _
Number oflnjection Wells __ N/A ____ _
Please include a copy of the GW-30 for each well
abandoned.
4. lnjectant Information
Enviro-BAC
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration _=20"'"'o/c"""o _________ _
If the injectant is diluted please indicate the source
dilution fluid. City of Greensboro Munici pal Water
Total Volume Injected (gal)~7:,.._5 ______ _
Volume Injected per well (ga1)_=25=--------
5. Injection History
Injection date(s) February 4 . 2020
Injection number (e.g. 3 of5),_:,.._1 =of,c___;_l ____ _
Is this the last injection at this site?
[8:1 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.
SIG~ OF INJEC~ON CONTRA~TOR
2 / u£f~
ATC Associates of North Carolina, P.C.
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days ofinjection.
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
Program Category
Deemed Ground Water
Permit Type
WI0400538
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
United States Postal Service-Bulk Mail Service Center
Location Address
3701 W Wendover Ave
Greensboro NC
Owner
Owner Name
United States Postal Service
Dates/Events
Orig Issue
1/31/2020
App Received
1/28/2020
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27495
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
1/31/2020
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
Government -Federal
Owner Affiliation
Gardner Jones
3701 W Wendover Ave
Greensboro
County
Guilford
NC
Issue
1/31/2020
Effective
1/31/2020
27495
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin

2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcgroupservices.com
N.C. Engineering License No. C-1598

December 30, 2019

Ms. Shristi Shrestha
North Carolina Department of Environmental Quality
Division of Water Quality - Aquifer Protection Section, UIC Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636

Reference: Notice of Intent to Construct or Operate Injection Wells
United States Postal Service - Bulk Mail Center
3701 West Wendover Avenue
Greensboro, Guilford County, North Carolina
NCDEQ Incident No. 4013
Priority Site Ranking: I180D

Dear Ms. Shrestha:

ATC Associates of North Carolina, P.C. (ATC) has prepared the enclosed Notice of Intent to
Construct or Operate Injection Wells on behalf of The Louis Berger Group, Inc. The permit
application covers the performance of passive remediation in three monitoring wells associated
with the above referenced site.

If you have questions or require additional information, please contact our office at [phone].

Sincerely,
ATC Associates of North Carolina, P.C.

Ashley M. Winkelman, P.G.
Senior Project Manager

cc: Shannon McKinney, Environmental Scientist for The Louis Berger Group, Inc.
Email: [e-mail]

Attachments
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES• MATERIALS TESTING
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

NOTICE OF INTENT FORM
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NC Department of Environmental Quality-Division of Water Resources (DWR)
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 injection)
AQUIFER TEST WELLS (I SA NCAC 02c .0220)
These well s are u sed to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristic s.
IN SITU REMEDIATION (ISA NCAC 02C .0225) or TRACER WELLS (I SA NCAC 02C .0229):
1) Passive Injection Systems -In-well de li very systems to diffuse inj ectants into th e subsurface . Examp les include
ORC socks, iSOC systems, and other gas infus ion me thods (Note: Inj ection Event Records (IER) do not need to b e
submitted for replacement of each sock used in ORC systems).
2) Small-Scale Inj ection Operations -Injection well s located w ithin a land surface area not to exceed I 0 ,000
square feet for the purpose of soil or gro undwater r e mediation or tracer tests. An individual permit shaU be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for th e purpose of eva luating the techni ca l feas ibility of a
rem ediation strategy in order to develop a full scale rem ediation pla n for future impl e mentation, a nd where the
surface area of the inj ection zone well s is lo cated with in an area that does not exceed fi ve percent of th e lan d s urface
above the known extent of gro undwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air Inj e ction Wells -Used to inject ambient a ir to enhance in-situ treatment of soil or gro undwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: December 30 20 19 PERMIT NO. ________ (to be filled in by DWR)
NOTE-I f thi s NOi is be in g s ubmitted a s notification of a modificat ion of a previous ly issued NOi fo r this site ( e .g.,
different inj ection well s, plume, additives, etc.) and still meets the deemed permitted by rul e c rit eria, prov id e the
previous ly assigned permit tracking numbe r and any needed relevant in fo rm ation to assess and approve injection:
Permit No. WI _____________ Issued Date: _________ _
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(I )
(2)
(3)
(4)
(5)
(6)
___ Ai r Injection Well. ..................................... C omplete s ections B through F, J, M
___ Aquifer T est Well. ...................................... Complete sections B through F, J, M
___ Pass ive Inj ection System ............................... Complete sections B through F , H-M
~X~ __ Small-S cale Injec tion Operati on ...................... C omplete sections B through M
___ Pilot Test ................................................. Complete sections B through M
___ Tracer Inj ection W e ll. .................................. Complete sections B through M
B. STATUS OF WELL OWNER: Business/Organi zation
Deemed P ermitted GW Remediation NOI Rev. 10-14-2019 Page I
C. WELL OWNER(S) -State na me o f Business/ Agency, and Name a nd Title o f person deleg ated au tho rity to
s ign on behalf of th e bus iness or agency:
Name(s): US Postal Service -Gardner Jones, E nv ironme nta l Engineer -Facilities
Mailing Address: 3701 W. We ndover Avenue
C ity: Greensboro State: NC Z ip Code: 27495 County: Guil ford
Day Tele No.: 336-665-2885 C ell No.: ___ N'-'--"-o.C...t '-'Ac..cv=a1=·1a=b""l-=-e ___ _
EMAIL Address: gardner.jones@u s ps.gov Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
!Na me and Title:
Not Avail able
Company Name __________________________ _
Mailing Address: _______________________ _
C ity: ____ State: __ Z ip Code: _______ County: _____ _
IDay Tele No.: _________________ _ Cell No.:
MAIL Address:_______________ Fax No.: ___________ _
E. PROJECT CONTACT (Typically E nv ironmenta l Cons ulting/Engin eering Firm)
Name and Title: Ashley Winke lman, P.G., Senior Project Manager
Company Nam e ATC Associates of North Carolina P.C.
Mailing Address: 2725 E . Mi llbrook Road Suite 121
City: Ral eigh State: _NC_ Z ip Code: 27604 County:_W"--=ak=e=----------
D ay Te le No.: 919-87 1-0999 Cell No.: 9 19 -830-3576
E MAIL Address: ashl [e-mail] Fax No.: 9 19 -87 1-0 335
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: United States Postal Service -Bulk Mail Center
370 1 W. Wendover Avenue
C ity: ___ G~re~e_n~sb~o~r~o ________ County: Guilford Z ip Code: 27495
(2) Geographic Coordinates : Latitude**: ___ 0 ____ " or -~3~6_0 05863
Longitude**: 0 " or -~7~9_0 87357
Reference Datum: WGS84 Accuracy: I 0 -meter
M etho d of Co ll ec ti o n: DOO-Acme M appe r 2.2
**FOR AIR INJECTION AND AQUIFER TE ST WELLS O N LY: A FAC ILI TY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBM IT T ED IN LIEU OF GEOGRAPHIC COORDINATES .
G. TREATMENT AREA
L and s urface area of contaminant plume:~5~3~5~0 ____ square feet
L and surface area of inj . we ll network:_~! =5~8-=-0 ____ square feet(:'.:: I 0 ,000 ft2 for s ma ll-scale injec tion s)
Percent of contaminant plume area to be treated: 29 .5% (must be :S 5% of plume for pilot test inj ectio n s)
Deemed Permitted GW Remediation NOI Rev. 10-14-2019 Pag e 2
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 contamin ation 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 inj ection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, p lu s existing
and proposed wells .
The following figures are included in this NOi:
Figure 1 -Site Topographic Map
Figure 2 -Site Map
Figure 3 -Dissolved Benzene Isoconcentration Contour Map
Figure 4 -Dissolve d Naphthalene Isoconcentration Contour Map
Figure 5 -Geologic Transect Map
Figure 6 -Geologic Cross-Section A-A'
Figure 7-Geologic Cross Section B-B'
Figure 8 -Groundwater E levation Contour Map
Please note there are no comprehens ive soil maps prepared for this site; however, historical assessment activities
indicate there are no exceedances of the Industrial/Commercial Maximum Soil Contaminant Concentrations,
which are considered the applicable soil cleanup goal for this s ite .
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE -Provide a brief narrative
r egarding the cause of the contamination, and purpose, scope, goals of the proposed inj ection activity:
ATC will gravity feed four kilograms ofEnviro-BAC each into monitoring well s MW-6, MW-13 , and MW-14
in order to aide in natural attenuation and abate light non-aqueous phase liquid (LNAPL). Based on the most
recent sa mpling event performed in May 20 19, LNAPL was detected in monitoring wells MW-6, MW-13, and
MW-14 at a thickness of0.17 feet, 0.94 feet, and 1.27 feet, respective ly. The inj ectate, followed by 20 gallons
of municipal water, will be poured into each well over up to a 3 hour time period per well as to minimize
disruption to the water column. Following the injection event, ATC w ill install absorbent socks in each well to
facilitate free product recovery. The socks will be replaced on a weekly bas is for one month.
J. WELL CONSTRUCTION DATA
(I ) No. of injection wells : _______ Proposed __ __,3"--__ Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS): ____ ----=2~8~to~30~fe=e~t -'-'(d=e=p=th~o=f~i=n'-'je=c=tio=n~w=e=lls=) _____ _
(3) For Proposed wells or Existing wells not having GW-l s , provide well construction details for each
injection well in a diagram or table format. A s ing le diagram or line in a table can be u sed for
multipl e well s with the same construction details. W e ll construction detail s s ha ll include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or s ubsurface d istribution infi ltration 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. 10-14-2019 Page 3
A well construction record was not available for MW-6. Details for the well are prov ided below. A soil
boring log for MW-6 and well construction records for MW-13 and MW-14 are included as Appendix A.
MW-6 We ll Construction D etails:
(a) Permanent
(b) Depth -2 8 feet; Well Screen -18-2 8 feet; Well Riser -0-1 8 feet; Grout type, grout depth , and sand pack
depth are unknown .
( c) Well Contractor -Groundwater Protection; Driller -C. Aiken; Certification Number unknown.
K. INJECTION SUMMARY
NOTE: Only iniectants approved by th e epidemiology section o[the NC Division of Public Health, Department
of Health and Hum an Services can be injected. Approved iniectants can be found online at
http://deg.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All o ther substances must be reviewed by the DHHS prior to use.
Co ntact the UIC Program for more info i(you wish to get approval for a different additive. However, please
note it may take 3 months or longer.
Inj ectant~: --~E=nv~i=ro~-~B~A~C~_Total Amt. to be inj ected (ga l)/event: Approximately 15 gall ons (12 kilograms)
Amt. Water to be inj ecte d (gal/event):
Total Amt. to b e injected (gal/event):
60 gallons
75 gallons
No. of separate injection events.a..: .,;al ___ Est. Total Amt. to be injected (gal): __ 7.;..a5:a..ag.aaa;;.;;11.aa.o;:.:.ns"--____ _
Source of Water (if appli cab le): City of Greensboro Municipal W ate r
A Safety Data Sheet for Enviro-BAC is included in Appendix B .
L. MONITORING PLAN -D escribe be low or in separate attachment a monitoring plan to be used t o determine
if violations of groundwater quality st andards specified in Subchapter 02L re sult from the inj ection acti vity.
A TC will perfonn a groundwater monitorin g event thirty days after the inj ection event. Samples w ill be collected
from a total of s ix wells, including wells MW-6, MW-1 3, and MW-14. The samples w ill be ana lyze d for vo latil e
organic compounds by EPA Method 62 00B and semi-vo latil e organi c compounds by EPA M ethod 625 . The
sampl es w ill be shipped to SGS Accustest in Scott, Louisiana. ATC w ill a lso measure dissolved oxygen,
conductivity, temperature, pH, and oxygen reduction potential during the sampling event.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
We ll Owner/Applicant: "I hereby certify, under p enalty 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 th at ther e 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 NCA C 02C 0200 Rules. "
Digitally signed by Gardner Jones Ill
Ga rd n er JO n e S 111 DN: cn=Gardner Jones Ill, o, ou=Eastern FSO,
-------=='-'--'=-'--'-=-'---'<--=--'-'-='--'--'-~""a1t""-a""ar,.,_do...,.er..,.,o=ne .... s@,,.us ... os ... a""ov..,,c=-u..._s ________________ _
Signature of Applicant Date, 2020.01.02 10:54:35-os·oo· Print or Type Full Name and Title
Deemed Permitted GW Remediation NOI Rev. 10-14-2019 Page 4
P ro pe rty Owner (if th e property is not own ed by the Well Owner/Ap pli ca nt):
"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
(1 5A NCAC 02C .0200)."
"Owner" means any p erson w h o ho lds t he fee o r o ther p rop erty rights in the well be ing construc te d . A well
is real p roperty a nd its construction on land s ha ll be deemed to vest owne rs hip in th e land own er, in th e
absence o f contrary agreement in w ri t in g.
Sig na ture* of Pro pe rty Owne r (i f different from a ppli cant) Print o r Ty pe Full Name and T itle
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (on e) hard color copy o f this NOi along with a copy on an attached CD or Flash Drive at le ast
two (2) weeks prior to injection to:
DWR -UIC Program
1636 Ma il Servic e Center
R aleigh, NC 27699-1636
T elepho ne : (9 19) 707-9000
Dee med Permitted GW Remediation NOi R ev. 10 -14-20 19 Page 5
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

FIGURES

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2725 E. Millbrook Road, Ste 121
Raleigh, NC 27604
[phone]
FIGURE 1: SITE TOPOGRAPHIC MAP
PROJECT NO: 45.07059.0001
JUNE 2014 PREPARED BY: GO
UNITED STATES POSTAL SERVICE –
BULK MAIL CENTER
3701 WEST WNDOVER AVENUE
GREENSBORO, NORTH CAROLINA
SOURCE: MSR MAPS. 1994 TOPOGRAPHIC MAP.
SCALE: 1” = 770’
SITE
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ASSOCIATES I NC .
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CAD FILEPREP. BYTYPE CODEREV. BYSCALEPROJECT NO.TITLEDATENOTES:DSCA ID# GEOTECHNICALENVIRONMENTAL MATERIALS TESTINGBUILDING SCIENCES2725 E. Millbrook Road, Suite 121(919) 871-0999 FAX [phone]Raleigh, North Carolina 27604INCIDENT #E
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- 6 -DISSOLVED NAPHTHALENE ISOCONCENTRATION CONTOUR ug/L
(137) DISSOLVED NAPHTHALENE CONCENTRATION ug/L
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Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

APPENDIX A

MONITORING WELL CONSTRUCTION DETAILS

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IUd.DI•' SCILllm · M.11UUU TUltHG
LOG OF TEST BORING BORING NO. MW-6
SHEET NO. 1 OF 1
PROJECT NAME USPS BULK MAIL CENTER PROJECT NO. 765.65
LOCATION GREENSBORO. NC INSTALLATION
CONTRACTOR GRNDWTR PROTECTION SURFACE ELEV. 845.4
DRILLING METHOD HOLLOW STEM AUGER BOREHOLE DIA. 8 IN.
SAMPLING NOTES
VISUAL CLASSIFICATION
AND GENERAL OBSERVATIONS
INTERVAL
RECOVERY
PID
NO.
TYPE
BLOWS
%
(ppm)
DEPTH
■
O
i
■
■
_
—'.':
�+
;
Asphalt /-
Gravel fill
1
2
3
4
SS
SS
SS
SS
5-6
7-11
5-7
11-15
8-8
10-13
5-7
8-9
0
63
100
0
ND
ND
5 ____,
r'✓/
10 �''/
%%
CLAY (CL) - slightly sandy; firm; slightly micaceous; moist;
brick red, some tan and gray. [Fill]
- as eve; gray in color.
- as above; brick red in color.
SILT (ML) - soft; micaceous; moist; orangish tan.
- as above; more tan, less orange.
5
6
7
8
9
10
11
f
12
SS
SS
SS
SS
SS
SS
SS
SS
5-5
5-8
4-5
7-8
5-6
7-10
4-6
7-9
5-7
9-10
2-4
9-17
3-5
10=12
6-7 ,
79
79
100
63
100
100
100
83
ND
ND
ND
ND
26
2
70
6 '
—
15 --
_
r
!
_
20 —
—'white.
—'
r —
—
25 .--,
'
SANDY SILT (ML) - slightly clayey; moist; mottled; tan and
[Saprolite] r
SILT (ML) - slightly sandy; firm; wet; grayish tan with some
orange banding.
9 12
■
s
■
■
■
•
it
■
■
■
■
■
■
■
or
■
•
■
■
■
■
■
■GENERAL
r
—
30 —
_.
35 —
—
SILT (ML) - slightly sandy; firm; wet; gray, tan and orange.
BORING TERMINATED AT 28.5 FEET
NOTES
DATE STARTED 6 JAN 93
WATER LEVEL OBSERVATIONS
WHILE DRILLING Q 22.0 FT:
AT COMPLETION 1 23.3 FT.
DATE COMPLETED 6 IAN 93
AFTER DRILLING
RIG DIEDRICH D-120
CAVE-IN: DATE/TIME DEPTH
CREW CHIEF C. AIKEN
WATER: DATE/TIME DEPTH
LOGGED LAM CHECKED

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
VINCE FEDERLE
\Veil Contractor Name
A-3552
NC \Veil Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
Ust all applicable ll'e!l cm1structio11 permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Waler Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
Ill Monitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquiler Storage and Recovery □Salinily Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Healing/Cooling Return) □Other (explain under #21 Remarks)
4. Date Well(s) Completed: 05/04/15 Well ID# MW-13
Sa. Well Location:
USPS
Facility/Owner Name Facility ID# (if applicable)
3701 WEST WENDOVER AVENUE GREENSBORO 27407
Physical Adclress, City, and Zip
GUILFORD
County Parcel Identification No. (PINJ
Sb. Lahtude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
36° 03' 26.24" 79° 52' 30.32" ____________ N _______________ W
6. Is (arc) the well(s): l2lPennanent or □Temporary
7. Is this a repair to an existing well: □Yes or 0No
((this is a repair,Jill ollf lmml'!I well co11structio11 i11Jhr111alio11 and explain the nature of the
repair under t!21 remarks section or on the back ofthisjbrm.
8. Number of wells constrncted: ___ 1 _________ _
For 11111/tiple injeclion or 11011-water supply wells ONLY 11·ith the same construction, you can
submit one .fhrm.
I For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING (for multi-casccl wells) OR LINER (ifannlicable)
FROM TO DIAMETER TIIICKNESS MATERIAL
ft. ft. in,
16. INNER CASING OR TUBING (ecothcrnrnl closccl-Ioonl
FROM TO DIAMETER TIIICKNESS MATEI!IAL
0.0 ft. 15.0 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
15.0 ft. 30.0 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 11.0 ft. PORTLAND OENTONlTE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK (if a1lf)licable}
FROM TO MATERIAL EMPLACEMENT METHOD
13.0 ft. 30.0 ft. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG (nttuch udditionul sheets if necessarv}
FRO~! TO DESCRIPTION (color, hardness, soil/rock tvoe, grnin size, elc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 5.0 ft. GRAVEL
5.0 ft. 30.0 ft. RED/BROWN SANDY CLAYEY SILT
ft. ft.
ft. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. Certification:
~~&it ;£. J;/4;1~
Signature of Certified \Veil Contractor 7:A -""
05/19/15
Date
I~v signing this .fOrm, I hereby certijj, that the well(.\) was (were) co11structed in accordance
u·ith 15A NCAC 02C .0/00 or 15A NCAC 02C .0200 Well Co11str11clio11 Sta11dar,l1· aml that a
copy (fthis record has been provided to the well owner.
23. Site dingrnm 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 INSTUCTIONS
9. Totnl well depth below land surface: --:---:-=c-:3 __ 0,...._o...,...,_:--,,.-----<ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple ll'ells list all depths !f'd!fferelll (example-3@200' and 2@100') construction to the following:
10. Static water level below top of casing: ___ 2_4_.0 _______ (ft.)
~/'ll'ater level is abtJ\'e ca.Ying, use "+"
11. Borehole diameter: ___ 8_.0 ____ (in.)
12. Well constrnction method: ___ A_LJ_G_E_R _________ _
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) ______ _ Methot! of test: _______ _
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Rnleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of complelion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For WnJcr Supplv & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construclion to the county health department of the county L::.::.::.:.:.:=:::.:.:..:::.:..:::...:::.~:...========-~:.::'..::.:.:.'..:..:=========J where constructed.
FormGW-1 North Carolina Department of Environment and Natural Resources Division of Water Qunlity Revised Jan. 2013
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
VINCE FEDERLE
Woll Contrnctor Name
A-3552
NC Well Contractor Certification Nnmber
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit II:
List all applicable well co11str11ctio11 permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
W,1tcr Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Waler Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
IZIMonitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquifer Storage and Recovery □Salinity Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Heating/Cooling Return) □Other (explain umler 1121 Remarks)
4. Date Well(s) Completed: 05/04/15 Well ID# MW-14
Sa. Well Location:
USPS
Facility/Owner Name Facility ID# (if applicable)
3701 WEST WENDOVER AVENUE GREENSBORO 27407
Physical Address, City, and Zip
GUILFORD
County Parcel Identification No. (PIN)
5b. Latitude nnd Longitude in degrees/minutes/seconds or dccimnl degrees:
(if well field, one lat/long is sufficient)
36° 03' 26.24" 79° 52' 30.32" ____________ N _______________ W
6. Is (arc) the well(s): !21Permanent or □Temporary
7. ls this n repair to an existing well: □Yes or li'JNo
{/ihis is a repair, Jill ollf lmoll'11 well co11struclio11 i11/0rmatio11 amt explain the nalure of the
repair under f/2 / remarks section or 011 the back rfthisfOrm,
8. Number of wells constrnctcd: ___ 1 _________ _
For multiple i1{iectio11 or 110,1-water supply wells ONLY with the same con.,·truction, you can
submit one Jhrm.
I For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING (for multi-casctl wells) OR LINER (ifannlicablcl
111\OM TO DIAMETER TIJICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING (ecothcrmal closed-loon)
FROM TO DIAMETER TIIICKNESS MATERIAL
0.0 ft. 15.0 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO IJIMIETER SLOT SIZE TIIICKNESS MATERIAL
15.0 ft. 30.0 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in,
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & A~IOUNT
0.0 ft. 11.0 ft. PORTLAND IJENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL !'ACK (if ap1ilicable)
FROM TO MATERIAL EMPLACEMENT METHOD
13.0 ft. 30.0 ft. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG (uttuch additional sheets if necessary)
FROM TO DESCRIPTION (color, hardness, soil/rock tvnc, Prain size, t•tc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 5.0 ft. GRAVEL
5.0 ft. 30.0 ft. RED/BROWN SANDY CLAYEY SILT
ft. ft.
ft. ft.
ft. ft.
ft. ft.
21.REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. Certification:
Sig>krr~fWell iD,;,ctor u~ 05/19/15
Date
J~v signing this Jhrm, I hereby certijj1 that the well(.\) was (were) constructed in accordance
ll'ith l5A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Co11str11ctio11 Sto11dard1· and that a
copy of this record has been proi·ided to the well owner.
23. Site dingram or ndditional well dctnils:
You may use the back of this page to provide additional well site details or we! I
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
9. Totnl well depth below land surface: ____ 3_0_._0 ________ (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple ll'ells list all depths ifd/[ferelll (example-3@200' and 2@/00'_) construction to the following:
10. Static water level below top of casing: ___ 2_4_._0 _______ (ft.)
If water level i.v abo1•e cming, use "+"
11. Borehole diameter: ___ 8_._0 ____ (in.)
12. Well construction method: ___ A_U_G_E_R _________ _
(i.e. nugcr, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) ______ _ Method of test: _______ _
13b. Disinfection type: Amount: ________ _
Division of Water Qunlity, Information Processing Unit,
1617 Mnil Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division ofWnter Quality, Underground Injection Control Program,
1636 Mnil Service Center, Raleigh, NC 27699-1636
24c. For Wnter Supply & Injection 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 lo the county health department of the county
where constructed.
FormGW-1 North Carolina Department of Environment and Natural Resources -Division of Water Quality Revised Jan. 2013
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

APPENDIX B

MSDS FORM

/\.TC
(fftl!U ■m-1•1umw1m
IUd.DI•' SCILllm · M.11UUU TUltHG

Page 1 of 3

Safety Data Sheet

Form: Powder (SZE)
Section 1: Identification
Product Identifier: EnviroBac
Other Identifier: NONE
Recommended Use: See Product Literature
Supplier Information: 689 Canterbury Rd
Shakopee, MN 55379
(p)952-445-4251 (f) 952-445-7233 [e-mail]
Emergency Phone: [phone] 8am – 4pm EST
Section 2: Hazard Identification
Hazard Classification:
Eye Damage/Irritation Category 2B
Skin Corrosion/Irritation Category 2
Signal Word: Warning
Hazard Statements:
H315 Causes skin irritation.
H320 Causes eye irritation.
Pictogram(s):
Precautionary Statement(s):
P264 Wash face and hands thoroughly after handling.
P280 Wear protective gloves/protective clothing/eye protection/face protection.
Response Statement(s):
P302/352 IF ON SKIN: Wash with plenty of water.
P305/351/338 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.
P308/311 IF exposed or concerned: call a poison center/doctor.
P332/313 If irritation occurs: get medical advice/attention.
P337/313 If eye irritation persists: get medical advice/attention.
P362/364 Take off contaminated clothing and wash it before reuse.
Hazards Not Otherwise Categorized:
Moderate Respiratory Irritant
Section 3: Composition/ Information on Ingredients
Name:Proprietary bacterial blend CAS Number: N/A % by weight: 3.5-6%
Name:Maltodextrin CAS Number: 9050-36-3 % by weight: 2-3.5%
Name:Sodium chloride CAS Number: 7647-14-5 % by weight: Remainder %
Section 4: First-Aid Measures
Inhalation: If inhaled remove from contaminated area to fresh air. Report the situation. Seek
medical attention if allergic response is exhibited.
BIO-CAT
Microb ials

Page 2 of 3

Eye Contact: In case of contact with eyes, flush eyes with low pressure water for at least 15 minutes.
If irritation develops, seek medical attention.
Skin Contact: In case of contact with skin, wash skin with soap and cold water. Remove
contaminated clothing and wash.
Ingestion: If swallowed, rinse mouth and throat thoroughly with tap water. Drink water.
Section 5: Fire-Fighting Measures
Suitable Extinguishing Media: Standard procedure for chemical fires. Foam. Water.
Non-Suitable Extinguishing Media: None
Specific Exposure Hazards: None
Protective Equipment: No special requirements
Section 6: Accidental Release Measures
Personal precautions, Use only with adequate ventilation/personal protection. Avoid breathing
Emergency Procedures: dust or spray mist. Avoid formation of dust and aerosols. (See section 8).
Containment methods: Prevent further leakage or spillage if safe to do so.
Cleanup Procedures: Contain and remove spilled product by mechanical means or with a
vacuum cleaner equipped with a high efficiency filter. Avoid formation
of aerosol.
Section 7: Handling and Storage
Safe Handling: Never handle powder without appropriate personal protective
equipment in accordance with Section 8. Avoid formation of dust.
Avoid splashing and high pressure washing. Ensure good ventilation of
the room when handling this product.
Storage: Keep container tightly closed in a cool, dry, well ventilated place.
Section 8: Exposure Controls/Personal Protection
Appropriate engineering controls: Adequate ventilation required for dusty conditions
Eye/face protection: Wear protective glasses or eye shield
Skin protection: Impermeable gloves recommended
Respiratory Protection: Use NIOSH approved respiratory protection such as full face mask
Section 9: Physical and Chemical Properties
Appearance: Light to dark tan colored powder
Odor: Characteristic fermentation odor
Odor Threshold: Not available
pH: Not available
Melting point/freezing point: Not available
Initial boiling point and boiling range: Not available
Flash point: Not available
Evaporation rate: Not available
Flammability (solid, gas): Not available
Upper/lower flammability or explosive limits: Not available
Vapor Pressure: Not available
Vapor Density: Not available
Relative Density: Not available
Solubility: Soluble
Partition coefficient: n-octonol/water: Not available
Auto-ignition temperature: Not available
Decomposition temperature: Not available
Viscosity: Not available
BIO-CAT
Microb ials

Page 3 of 3

Section 10: Stability and Reactivity
Reactivity: Not available
Chemical Stability: Stable under normal storage conditions
Hazardous reactions: Not available
Conditions to avoid: Not available
Incompatible materials: Not available
Hazardous Decomposition Products: Not available
Section 11: Toxicological Information
Routes of Exposure: Eye contact, skin contact, ingestion, inhalation
Symptoms:
Immediate: May cause irritation to the eyes, skin, mucus membranes, and the
upper respiratory tract
Delayed: Not available
Acute toxicity: Not available
Eye Irritation: May cause minor irritation
Skin Irritation: May cause minor irritation
Respiratory Irritation: May cause minor irritation
Sensitization towards product: There is no evidence of sensitizing potential
Germ cell mutagenicity: Not available
Reproductive toxicity: Not expected to produce reproductive toxicity
Carcinogenicity: Not classified as a carcinogen by IARC, OSHA, or NTP
Section 12: Ecological Information
Ecotoxicity: Not available
Persistence and degradability: Product is readily biodegradable
Bioaccumulative potential: Not available
Mobility in soil: Not available
Other adverse effects: Not available
Section 13: Disposal Considerations
No special disposal method required, except that in accordance to all applicable federal, state, and
local regulations.
Section 14: Transport Information
Harmonized Tariff Code: 3002.90.10 (for Microbials)
UN Number: Not classified
UN Proper Shipping Name: Not classified
Transportation Hazard Class: Not classified
Packing Group: Not classified
Transport Environmental Hazard: Not classified
Transport Special Precautions: Not classified
MARPOL: Not classified
Section 15: Regulatory Information
All components of this product are listed or exempt from listing on the TSCA Inventory.
Section 16: Other Information
Revision History: Effective Date: 04/25/17 Supersedes: First Issue GHS 2015 FORMAT

The information contained in this Safety Data Sheet, as of the issue date, is believed to be true and correct. However, the
accuracy or completeness of this information and any recommendations or suggestions are made without warranty or
guarantee. Since the conditions of use are beyond the control of the company, it is the responsibility of the user to determine
the conditions of safe use of this product. The information does not represent analytical specifications. END OF SDS
BIO-CAT
Microb ials

2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcgroupservices.com
N.C. Engineering License No. C-1598

December 30, 2019

Ms. Shristi Shrestha
North Carolina Department of Environmental Quality
Division of Water Quality - Aquifer Protection Section, UIC Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636

Reference: Notice of Intent to Construct or Operate Injection Wells
United States Postal Service - Bulk Mail Center
3701 West Wendover Avenue
Greensboro, Guilford County, North Carolina
NCDEQ Incident No. 4013
Priority Site Ranking: I180D

Dear Ms. Shrestha:

ATC Associates of North Carolina, P.C. (ATC) has prepared the enclosed Notice of Intent to
Construct or Operate Injection Wells on behalf of The Louis Berger Group, Inc. The permit
application covers the performance of passive remediation in three monitoring wells associated
with the above referenced site.

If you have questions or require additional information, please contact our office at [phone].

Sincerely,
ATC Associates of North Carolina, P.C.

Ashley M. Winkelman, P.G.
Senior Project Manager

cc: Shannon McKinney, Environmental Scientist for The Louis Berger Group, Inc.
Email: [e-mail]

Attachments
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES• MATERIALS TESTING
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

NOTICE OF INTENT FORM
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Deemed Permitted GW Remediation NOI Rev. 10-14-2019 Page 1
NC Department of Environmental Quality – Division of Water Resources (DWR)

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

DATE: December 30 , 20_19___ PERMIT NO. (to be filled in by DWR)

NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:

Permit No. WI Issued Date:

A. WELL TYPE TO BE CONSTRUCTED OR OPERATED

(1) Air Injection Well……………………………..…Complete sections B through F, J, M
(2) Aquifer Test Well……………………….………..Complete sections B through F, J, M
(3) Passive Injection System…………………..……..Complete sections B through F, H-M
(4) X Small-Scale Injection Operation………………….Complete sections B through M
(5) Pilot Test………………………………………….Complete sections B through M
(6) Tracer Injection Well………………………….….Complete sections B through M

B. STATUS OF WELL OWNER: Business/Organization

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 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 is 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. 10-14-2019 Page 2
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): US Postal Service – Gardner Jones, Environmental Engineer - Facilities
Mailing Address: 3701 W. Wendover Avenue
City: Greensboro State: _NC_ Zip Code: 27495 County: Guilford
Day Tele No.: 336-665-2885 Cell No.: Not Available
EMAIL Address: [e-mail] Fax No.: Not Available

D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title:
Company Name
Mailing Address:
City: State: ____ Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Ashley Winkelman, P.G., Senior Project Manager
Company Name ATC Associates of North Carolina, P.C.
Mailing Address: 2725 E. Millbrook Road, Suite 121
City: Raleigh State: _NC___ Zip Code: 27604 County: Wake
Day Tele No.: 919-871-0999 Cell No.: 919-830-3576
EMAIL Address: [e-mail] Fax No.: 919-871-0335

F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: United States Postal Service – Bulk Mail Center
3701 W. Wendover Avenue
City: Greensboro County: Guilford Zip Code: 27495
(2) Geographic Coordinates: Latitude**: o ′ ″ or 36 o. 05863
Longitude**: o ′ ″ or 79 o. 87357
Reference Datum: WGS84 Accuracy: 10-meter
Method of Collection: DOQ-Acme Mapper 2.2
**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: 5,350 square feet
Land surface area of inj. well network: 1,580 square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: 29.5% (must be < 5% of plume for pilot test injections)

Deemed Permitted GW Remediation NOI Rev. 10-14-2019 Page 3

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.

The following figures are included in this NOI:
Figure 1 – Site Topographic Map
Figure 2 – Site Map
Figure 3 – Dissolved Benzene Isoconcentration Contour Map
Figure 4 – Dissolved Naphthalene Isoconcentration Contour Map
Figure 5 – Geologic Transect Map
Figure 6 – Geologic Cross-Section A-A’
Figure 7 – Geologic Cross Section B-B’
Figure 8 – Groundwater Elevation Contour Map

Please note there are no comprehensive soil maps prepared for this site; however, historical assessment activities
indicate there are no exceedances of the Industrial/Commercial Maximum Soil Contaminant Concentrations,
which are considered the applicable soil cleanup goal for this site.

I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE – Provide a brief narrative
regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity:
ATC will gravity feed four kilograms of Enviro-BAC each into monitoring wells MW-6, MW-13, and MW-14
in order to aide in natural attenuation and abate light non-aqueous phase liquid (LNAPL). Based on the most
recent sampling event performed in May 2019, LNAPL was detected in monitoring wells MW-6, MW-13, and
MW-14 at a thickness of 0.17 feet, 0.94 feet, and 1.27 feet, respectively. The injectate, followed by 20 gallons
of municipal water, will be poured into each well over up to a 3 hour time period per well as to minimize
disruption to the water column. Following the injection event, ATC will install absorbent socks in each well to
facilitate free product recovery. The socks will be replaced on a weekly basis for one month.

J. WELL CONSTRUCTION DATA

(1) No. of injection wells: Proposed 3 Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS):___________28 to 30 feet (depth of injection wells)_______________
(3) 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. 10-14-2019 Page 4
A well construction record was not available for MW-6. Details for the well are provided below. A soil
boring log for MW-6 and well construction records for MW-13 and MW-14 are included as Appendix A.

MW-6 Well Construction Details:
(a) Permanent
(b) Depth – 28 feet; Well Screen – 18-28 feet; Well Riser – 0-18 feet; Grout type, grout depth, and sand pack
depth are unknown.
(c) Well Contractor – Groundwater Protection; Driller – C. Aiken; Certification Number unknown.

K. INJECTION SUMMARY

NOTE: Only injectants approved by the epidemiology section of 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 if you wish to get approval for a different additive. However, please
note it may take 3 months or longer.

Injectant: Enviro-BAC Total Amt. to be injected (gal)/event: Approximately 15 gallons (12 kilograms)

Amt. Water to be injected (gal/event): 60 gallons

Total Amt. to be injected (gal/event): 75 gallons

No. of separate injection events: 1 Est. Total Amt. to be injected (gal): 75 gallons

Source of Water (if applicable): City of Greensboro Municipal Water

A Safety Data Sheet for Enviro-BAC is included in Appendix B.

L. 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.

ATC will perform a groundwater monitoring event thirty days after the injection event. Samples will be collected
from a total of six wells, including wells MW-6, MW-13, and MW-14. The samples will be analyzed for volatile
organic compounds by EPA Method 6200B and semi-volatile organic compounds by EPA Method 625. The
samples will be shipped to SGS Accustest in Scott, Louisiana. ATC will also measure dissolved oxygen,
conductivity, temperature, pH, and oxygen reduction potential during the sampling event.

M. 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. 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.”

Signature of Applicant Print or Type Full Name and Title
Deemed Permitted GW Remediation NOI Rev. 10-14-2019 Page 5
Property Owner (if 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 .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 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 this 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]
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

FIGURES

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PROJECT NO: 45.07059.0001
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90.00' —
/////
///////
// ///
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// /// ////
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// //
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// //
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// /// ///
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75.00'—%/////////
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85.00'
80.00'
65.00'
60.00'
5
0
NO COMPOUNDS DETECTED ABOVE
LABORATORY DETECTION LIMIT
NO COMPOUNDS DETECTED ABOVE
LABORATORY DETECTION LIMIT
SCALE IN FEET
I
15
30
60
MW-5
(97.25')
ma"//. ;•%/
WATER TABLE
WELL IDENTIFICATION
MW-4
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TOP OF CASING
WELL CASING
WELL SCREEN
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//// ./
// /
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MW-13
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SILTY —SAND / SILT
SANDY CLAY / CLAY
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MW-17
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/
NO COMPOUNDS DETECTED ABOVE
2L STANDARD
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95.00'
80.00'
05/05/2010
NO COMPOUNDS DETECTED ABOVE
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70.00'
65.00'
60.00'
E
0
00
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0
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MW-1 1
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WELL IDENTIFICATION
MW-1 1
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\ TOP OF CASING
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SCALE IN FEET
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VEHICLE MAINT.
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PAVED PAVIED
PARKIN PARKING
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0
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LEGEND:
• MONITORING WELL TYPE II
72 GROUNDWATER ELEVATION CONTOUR (ft.)
(73.16) GROUNDWATER ELEVATION (ft.)
(NM) NOT MEASURED
INFERRED GROUNDWATER FLOW DIRECTION
PROCESS
BUILDING
MW-4
(73.75)
MW-13
(NM)
MW-11
(73.16)
MW-6
(71.74)
MW-5
(71.64) DUKE
FORMER USTs AND/ PRODUCT LINES
MW-15
(NM)
/ MW-12
(67.57)
MW-2
(NM)
RELEASE SOURCE AREA BASED
ON UST CLOSURE SAMPLING AND
OBSERVATIONS DURING UST REMOVAL
MW-14
(NM)
GATE
/2 HOUSE
MW-16
(NM)
MW-10
MW-17 (70.6� .1O
4(NM)
-- 68
ENLARGED PLAN — BULK MAIL FACILITY
0
60' 120'
I
SCALE IN FEET
MW-1
(NM)
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GROUNDWATER ELEVATION CONTOUR MAP
TITLE FIGURE 8
UNITED STATES POSTAL SERVICE
MAIL FACILITY
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Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

APPENDIX A

MONITORING WELL CONSTRUCTION DETAILS

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IUd.DI•' SCILllm · M.11UUU TUltHG
LOG OF TEST BORING BORING NO. MW-6
SHEET NO. 1 OF 1
PROJECT NAME USPS BULK MAIL CENTER PROJECT NO. 765.65
LOCATION GREENSBORO. NC INSTALLATION
CONTRACTOR GRNDWTR PROTECTION SURFACE ELEV. 845.4
DRILLING METHOD HOLLOW STEM AUGER BOREHOLE DIA. 8 IN.
SAMPLING NOTES
VISUAL CLASSIFICATION
AND GENERAL OBSERVATIONS
INTERVAL
RECOVERY
PID
NO.
TYPE
BLOWS
%
(ppm)
DEPTH
■
O
i
■
■
_
—'.':
�+
;
Asphalt /-
Gravel fill
1
2
3
4
SS
SS
SS
SS
5-6
7-11
5-7
11-15
8-8
10-13
5-7
8-9
0
63
100
0
ND
ND
5 ____,
r'✓/
10 �''/
%%
CLAY (CL) - slightly sandy; firm; slightly micaceous; moist;
brick red, some tan and gray. [Fill]
- as eve; gray in color.
- as above; brick red in color.
SILT (ML) - soft; micaceous; moist; orangish tan.
- as above; more tan, less orange.
5
6
7
8
9
10
11
f
12
SS
SS
SS
SS
SS
SS
SS
SS
5-5
5-8
4-5
7-8
5-6
7-10
4-6
7-9
5-7
9-10
2-4
9-17
3-5
10=12
6-7 ,
79
79
100
63
100
100
100
83
ND
ND
ND
ND
26
2
70
6 '
—
15 --
_
r
!
_
20 —
—'white.
—'
r —
—
25 .--,
'
SANDY SILT (ML) - slightly clayey; moist; mottled; tan and
[Saprolite] r
SILT (ML) - slightly sandy; firm; wet; grayish tan with some
orange banding.
9 12
■
s
■
■
■
•
it
■
■
■
■
■
■
■
or
■
•
■
■
■
■
■
■GENERAL
r
—
30 —
_.
35 —
—
SILT (ML) - slightly sandy; firm; wet; gray, tan and orange.
BORING TERMINATED AT 28.5 FEET
NOTES
DATE STARTED 6 JAN 93
WATER LEVEL OBSERVATIONS
WHILE DRILLING Q 22.0 FT:
AT COMPLETION 1 23.3 FT.
DATE COMPLETED 6 IAN 93
AFTER DRILLING
RIG DIEDRICH D-120
CAVE-IN: DATE/TIME DEPTH
CREW CHIEF C. AIKEN
WATER: DATE/TIME DEPTH
LOGGED LAM CHECKED

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
VINCE FEDERLE
\Veil Contractor Name
A-3552
NC \Veil Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
Ust all applicable ll'e!l cm1structio11 permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Waler Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
Ill Monitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquiler Storage and Recovery □Salinily Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Healing/Cooling Return) □Other (explain under #21 Remarks)
4. Date Well(s) Completed: 05/04/15 Well ID# MW-13
Sa. Well Location:
USPS
Facility/Owner Name Facility ID# (if applicable)
3701 WEST WENDOVER AVENUE GREENSBORO 27407
Physical Adclress, City, and Zip
GUILFORD
County Parcel Identification No. (PINJ
Sb. Lahtude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
36° 03' 26.24" 79° 52' 30.32" ____________ N _______________ W
6. Is (arc) the well(s): l2lPennanent or □Temporary
7. Is this a repair to an existing well: □Yes or 0No
((this is a repair,Jill ollf lmml'!I well co11structio11 i11Jhr111alio11 and explain the nature of the
repair under t!21 remarks section or on the back ofthisjbrm.
8. Number of wells constrncted: ___ 1 _________ _
For 11111/tiple injeclion or 11011-water supply wells ONLY 11·ith the same construction, you can
submit one .fhrm.
I For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING (for multi-casccl wells) OR LINER (ifannlicable)
FROM TO DIAMETER TIIICKNESS MATERIAL
ft. ft. in,
16. INNER CASING OR TUBING (ecothcrnrnl closccl-Ioonl
FROM TO DIAMETER TIIICKNESS MATEI!IAL
0.0 ft. 15.0 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
15.0 ft. 30.0 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 11.0 ft. PORTLAND OENTONlTE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK (if a1lf)licable}
FROM TO MATERIAL EMPLACEMENT METHOD
13.0 ft. 30.0 ft. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG (nttuch udditionul sheets if necessarv}
FRO~! TO DESCRIPTION (color, hardness, soil/rock tvoe, grnin size, elc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 5.0 ft. GRAVEL
5.0 ft. 30.0 ft. RED/BROWN SANDY CLAYEY SILT
ft. ft.
ft. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. Certification:
~~&it ;£. J;/4;1~
Signature of Certified \Veil Contractor 7:A -""
05/19/15
Date
I~v signing this .fOrm, I hereby certijj, that the well(.\) was (were) co11structed in accordance
u·ith 15A NCAC 02C .0/00 or 15A NCAC 02C .0200 Well Co11str11clio11 Sta11dar,l1· aml that a
copy (fthis record has been provided to the well owner.
23. Site dingrnm 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 INSTUCTIONS
9. Totnl well depth below land surface: --:---:-=c-:3 __ 0,...._o...,...,_:--,,.-----<ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple ll'ells list all depths !f'd!fferelll (example-3@200' and 2@100') construction to the following:
10. Static water level below top of casing: ___ 2_4_.0 _______ (ft.)
~/'ll'ater level is abtJ\'e ca.Ying, use "+"
11. Borehole diameter: ___ 8_.0 ____ (in.)
12. Well constrnction method: ___ A_LJ_G_E_R _________ _
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) ______ _ Methot! of test: _______ _
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Rnleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of complelion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For WnJcr Supplv & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construclion to the county health department of the county L::.::.::.:.:.:=:::.:.:..:::.:..:::...:::.~:...========-~:.::'..::.:.:.'..:..:=========J where constructed.
FormGW-1 North Carolina Department of Environment and Natural Resources Division of Water Qunlity Revised Jan. 2013
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
VINCE FEDERLE
Woll Contrnctor Name
A-3552
NC Well Contractor Certification Nnmber
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit II:
List all applicable well co11str11ctio11 permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
W,1tcr Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Waler Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
IZIMonitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquifer Storage and Recovery □Salinity Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Heating/Cooling Return) □Other (explain umler 1121 Remarks)
4. Date Well(s) Completed: 05/04/15 Well ID# MW-14
Sa. Well Location:
USPS
Facility/Owner Name Facility ID# (if applicable)
3701 WEST WENDOVER AVENUE GREENSBORO 27407
Physical Address, City, and Zip
GUILFORD
County Parcel Identification No. (PIN)
5b. Latitude nnd Longitude in degrees/minutes/seconds or dccimnl degrees:
(if well field, one lat/long is sufficient)
36° 03' 26.24" 79° 52' 30.32" ____________ N _______________ W
6. Is (arc) the well(s): !21Permanent or □Temporary
7. ls this n repair to an existing well: □Yes or li'JNo
{/ihis is a repair, Jill ollf lmoll'11 well co11struclio11 i11/0rmatio11 amt explain the nalure of the
repair under f/2 / remarks section or 011 the back rfthisfOrm,
8. Number of wells constrnctcd: ___ 1 _________ _
For multiple i1{iectio11 or 110,1-water supply wells ONLY with the same con.,·truction, you can
submit one Jhrm.
I For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING (for multi-casctl wells) OR LINER (ifannlicablcl
111\OM TO DIAMETER TIJICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING (ecothcrmal closed-loon)
FROM TO DIAMETER TIIICKNESS MATERIAL
0.0 ft. 15.0 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO IJIMIETER SLOT SIZE TIIICKNESS MATERIAL
15.0 ft. 30.0 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in,
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & A~IOUNT
0.0 ft. 11.0 ft. PORTLAND IJENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL !'ACK (if ap1ilicable)
FROM TO MATERIAL EMPLACEMENT METHOD
13.0 ft. 30.0 ft. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG (uttuch additional sheets if necessary)
FROM TO DESCRIPTION (color, hardness, soil/rock tvnc, Prain size, t•tc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 5.0 ft. GRAVEL
5.0 ft. 30.0 ft. RED/BROWN SANDY CLAYEY SILT
ft. ft.
ft. ft.
ft. ft.
ft. ft.
21.REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. Certification:
Sig>krr~fWell iD,;,ctor u~ 05/19/15
Date
J~v signing this Jhrm, I hereby certijj1 that the well(.\) was (were) constructed in accordance
ll'ith l5A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Co11str11ctio11 Sto11dard1· and that a
copy of this record has been proi·ided to the well owner.
23. Site dingram or ndditional well dctnils:
You may use the back of this page to provide additional well site details or we! I
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
9. Totnl well depth below land surface: ____ 3_0_._0 ________ (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple ll'ells list all depths ifd/[ferelll (example-3@200' and 2@/00'_) construction to the following:
10. Static water level below top of casing: ___ 2_4_._0 _______ (ft.)
If water level i.v abo1•e cming, use "+"
11. Borehole diameter: ___ 8_._0 ____ (in.)
12. Well construction method: ___ A_U_G_E_R _________ _
(i.e. nugcr, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) ______ _ Method of test: _______ _
13b. Disinfection type: Amount: ________ _
Division of Water Qunlity, Information Processing Unit,
1617 Mnil Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division ofWnter Quality, Underground Injection Control Program,
1636 Mnil Service Center, Raleigh, NC 27699-1636
24c. For Wnter Supply & Injection 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 lo the county health department of the county
where constructed.
FormGW-1 North Carolina Department of Environment and Natural Resources -Division of Water Quality Revised Jan. 2013
Notice of Intent to Construct or Operate Injection Wells
United States Postal Service – Bulk Mail Center, Greensboro, North Carolina

APPENDIX B

MSDS FORM

/\.TC
(fftl!U ■m-1•1umw1m
IUd.DI•' SCILllm · M.11UUU TUltHG

Page 1 of 3

Safety Data Sheet

Form: Powder (SZE)
Section 1: Identification
Product Identifier: EnviroBac
Other Identifier: NONE
Recommended Use: See Product Literature
Supplier Information: 689 Canterbury Rd
Shakopee, MN 55379
(p)952-445-4251 (f) 952-445-7233 [e-mail]
Emergency Phone: [phone] 8am – 4pm EST
Section 2: Hazard Identification
Hazard Classification:
Eye Damage/Irritation Category 2B
Skin Corrosion/Irritation Category 2
Signal Word: Warning
Hazard Statements:
H315 Causes skin irritation.
H320 Causes eye irritation.
Pictogram(s):
Precautionary Statement(s):
P264 Wash face and hands thoroughly after handling.
P280 Wear protective gloves/protective clothing/eye protection/face protection.
Response Statement(s):
P302/352 IF ON SKIN: Wash with plenty of water.
P305/351/338 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.
P308/311 IF exposed or concerned: call a poison center/doctor.
P332/313 If irritation occurs: get medical advice/attention.
P337/313 If eye irritation persists: get medical advice/attention.
P362/364 Take off contaminated clothing and wash it before reuse.
Hazards Not Otherwise Categorized:
Moderate Respiratory Irritant
Section 3: Composition/ Information on Ingredients
Name:Proprietary bacterial blend CAS Number: N/A % by weight: 3.5-6%
Name:Maltodextrin CAS Number: 9050-36-3 % by weight: 2-3.5%
Name:Sodium chloride CAS Number: 7647-14-5 % by weight: Remainder %
Section 4: First-Aid Measures
Inhalation: If inhaled remove from contaminated area to fresh air. Report the situation. Seek
medical attention if allergic response is exhibited.
BIO-CAT
Microb ials

Page 2 of 3

Eye Contact: In case of contact with eyes, flush eyes with low pressure water for at least 15 minutes.
If irritation develops, seek medical attention.
Skin Contact: In case of contact with skin, wash skin with soap and cold water. Remove
contaminated clothing and wash.
Ingestion: If swallowed, rinse mouth and throat thoroughly with tap water. Drink water.
Section 5: Fire-Fighting Measures
Suitable Extinguishing Media: Standard procedure for chemical fires. Foam. Water.
Non-Suitable Extinguishing Media: None
Specific Exposure Hazards: None
Protective Equipment: No special requirements
Section 6: Accidental Release Measures
Personal precautions, Use only with adequate ventilation/personal protection. Avoid breathing
Emergency Procedures: dust or spray mist. Avoid formation of dust and aerosols. (See section 8).
Containment methods: Prevent further leakage or spillage if safe to do so.
Cleanup Procedures: Contain and remove spilled product by mechanical means or with a
vacuum cleaner equipped with a high efficiency filter. Avoid formation
of aerosol.
Section 7: Handling and Storage
Safe Handling: Never handle powder without appropriate personal protective
equipment in accordance with Section 8. Avoid formation of dust.
Avoid splashing and high pressure washing. Ensure good ventilation of
the room when handling this product.
Storage: Keep container tightly closed in a cool, dry, well ventilated place.
Section 8: Exposure Controls/Personal Protection
Appropriate engineering controls: Adequate ventilation required for dusty conditions
Eye/face protection: Wear protective glasses or eye shield
Skin protection: Impermeable gloves recommended
Respiratory Protection: Use NIOSH approved respiratory protection such as full face mask
Section 9: Physical and Chemical Properties
Appearance: Light to dark tan colored powder
Odor: Characteristic fermentation odor
Odor Threshold: Not available
pH: Not available
Melting point/freezing point: Not available
Initial boiling point and boiling range: Not available
Flash point: Not available
Evaporation rate: Not available
Flammability (solid, gas): Not available
Upper/lower flammability or explosive limits: Not available
Vapor Pressure: Not available
Vapor Density: Not available
Relative Density: Not available
Solubility: Soluble
Partition coefficient: n-octonol/water: Not available
Auto-ignition temperature: Not available
Decomposition temperature: Not available
Viscosity: Not available
BIO-CAT
Microb ials

Page 3 of 3

Section 10: Stability and Reactivity
Reactivity: Not available
Chemical Stability: Stable under normal storage conditions
Hazardous reactions: Not available
Conditions to avoid: Not available
Incompatible materials: Not available
Hazardous Decomposition Products: Not available
Section 11: Toxicological Information
Routes of Exposure: Eye contact, skin contact, ingestion, inhalation
Symptoms:
Immediate: May cause irritation to the eyes, skin, mucus membranes, and the
upper respiratory tract
Delayed: Not available
Acute toxicity: Not available
Eye Irritation: May cause minor irritation
Skin Irritation: May cause minor irritation
Respiratory Irritation: May cause minor irritation
Sensitization towards product: There is no evidence of sensitizing potential
Germ cell mutagenicity: Not available
Reproductive toxicity: Not expected to produce reproductive toxicity
Carcinogenicity: Not classified as a carcinogen by IARC, OSHA, or NTP
Section 12: Ecological Information
Ecotoxicity: Not available
Persistence and degradability: Product is readily biodegradable
Bioaccumulative potential: Not available
Mobility in soil: Not available
Other adverse effects: Not available
Section 13: Disposal Considerations
No special disposal method required, except that in accordance to all applicable federal, state, and
local regulations.
Section 14: Transport Information
Harmonized Tariff Code: 3002.90.10 (for Microbials)
UN Number: Not classified
UN Proper Shipping Name: Not classified
Transportation Hazard Class: Not classified
Packing Group: Not classified
Transport Environmental Hazard: Not classified
Transport Special Precautions: Not classified
MARPOL: Not classified
Section 15: Regulatory Information
All components of this product are listed or exempt from listing on the TSCA Inventory.
Section 16: Other Information
Revision History: Effective Date: 04/25/17 Supersedes: First Issue GHS 2015 FORMAT

The information contained in this Safety Data Sheet, as of the issue date, is believed to be true and correct. However, the
accuracy or completeness of this information and any recommendations or suggestions are made without warranty or
guarantee. Since the conditions of use are beyond the control of the company, it is the responsibility of the user to determine
the conditions of safe use of this product. The information does not represent analytical specifications. END OF SDS
BIO-CAT
Microb ials