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HomeMy WebLinkAboutWI0500841_DEEMED FILES_20150529~ers, Michael From: Rogers, Michael Sent: To: Thursday, May 28, 2015 3:04 PM Shire, Ebonee Subject: FW: Submittal Letter for Notice of Intent Form (NOi) for L.C. Industries for the Blind WI0500841 This is the acknowledgement email we sent yesterday. Keep this and copy and paste for your use for the next NOi. Just be sure to make the necessary changes. Thanks. From: Rogers, Michael Sent: Wednesday, May 27, 2015 3:25 PM To: 'Sandy Miller' Cc: Joe Beaman; William Frederick; Eugene Roddy; Smith, Danny; Bolich, Rick Subject: RE: Submittal Letter for Notice of Intent Form (NOI) for LC. Industries for the Blind WI0500841 Thank you for submitting the Notke of Intent to Construct or Operate Injection Wells (NOi) at the L. C. Industries for the Blind. This facility is located at 4500 Emperor Blvd., Durham, Durham County, NC 27703. We received your complete NOi on May 18, 2015. Please remember to submit the following regarding this injection activity: 1) Well Construction Records (GW-1) and Abandonment Records (GW-30) when completed. Please provide copies of the GW-ls and GW-30s if not already submitted (originals go the address printed on the form). NOTE: Direct push or Geoprobe wells are considered wells and require construction (GW-1) and abandonment forms {GW-30). If well construction/abandonment information is the same for the wells, only one form needs to be completed-just indicate total number of injection points in the Comments/Remarks section of form. These forms can be found on our website at http://portal.ncdenr.org/web/wg/aps/gwpro/reporting-forms. 2) Injection Event Records (IER). All injections, including air and passive systems require an IER. The IER can be modified for air sparge wells (e.g., air flow 'continuous' for date or rate of injection, etc.). You can scan and send these forms directly to me at michael.rogers @ncdenr.gov, send by fax to my attention at 919- 807-6406, or via regular mail to address below. When submitting the above forms, you will need to enter the nine-digit alpha-numeric number on the form (i.e., WI0XXXXXX) that has been assigned to the injection activity at this site. This notification has been given the deemed permit number WI0500841. This number is also referenced in the subject line of this email. You may if you wish, scan and send back as attachments in re p ly to this email, as it will already have the assigned deemed permit number in the subject line. Thank you for your cooperation. Michael Rogers, P.G. (NC & FL) Hydrogeologist NCDENR -DWR Water Quality Regional Operations Section 1636 Mail Service Center Raleigh, NC 27699 Direct No. 919-807-6406 http://portal.ncdenr.org/web/wq/aps/gwpro/reporting-forms 1 NOTE: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North Carolina Public Records Law and may be disclosed to third parties. From: Sandy Miller [mailto:Smiller@hesnc.com] Sent: Monday, May 18, 2015 1:24 PM To: Rogers, Michael Cc: Joe Beaman; William Frederick; Eugene Roddy Subject: Submittal Letter for Notice of Intent Form (NOI) for LC. Industries for the Blind WI0500803 Good afternoon Michael, My apologies; I just noticed that I had omitted the submittal letter in my original email. I am sending out the hard copy and the submittal letter via U.S. Mail this afternoon to your attention. Thank you. Sandy Sandy Miller Project Scientist Highlands Environmental Solutions, Inc. 8410-D Falls of Neuse Road Raleigh, NC 27615 Office: 919-848-3155 Cell: 919-819-4312 Fax: 919-848-4265 email: www.smiller@hesnc.com website: www.hesnc.com Celebrating 10 years of Solutions! ~= From: Sandy Miller Sent: Monday, May 18, 2015 12:14 PM To: 'Rogers, Michael' Cc: Joe Beaman; William Frederick; 'Eugene Roddy' Subject: Notice of Intent Form NOi L.C. Industries for the Blind WI0500803 Good afternoon Michael, Attached is the Notification of Intent to Construct or Operate Injection Wells for the L.C. Industries site. I am putting the hard copy in the mail this afternoon to your attention. Please let us know if you have any questions or concerns. Thank you again for your assistance on this. Sandy Sandy Miller 2 Highlands Environmental �::, o l ut ions, Inc. 8410-D Falls of Neuse Road; Raleigh, NC 27615 Phone 91 "48-3 f 551 Fax: 91 "48-4265 / www.hesnacom May 18, 2015 Mr. Michael Rogers NCDENR — Department of Water ResourcesQROS rC 512 N. Salisbury Street RECEItt►►EDIDENRIDNN Raleigh, North Carolina 27604 MAY 2 9 2015 Subject- Submittal of Notification of Intent to Construct or Operate Injection Wells Wat9rQuauty L.C. Industries, Inc. - Diesel Fuel Release PermitUn j Section 4500 Emperor Boulevard, Durham, Durham County, NC NCDENR Incident No: 92274 HES Project #202003 Dear Mr. Rogers. - On behalf of L.C. Industries, Inc., please find enclosed an original copy of our Notification of Intent to Construct or Operate Injection Wells for the proposed in -situ remediation of petroleum -impacted soil activities at the subject site. The diesel fuel release resulted from the failure of an underground product line, and impacted an unpaved area immediately surrounding two aboveground storage tanks (ASTs), owned by LCI and located at the subject site. Additionally, the release impacted an underground electrical conduit housing three-phase power lines maintained by Duke Energy, an unpaved area near a light pole, and a paved parking lot located immediately southeast of the ASTs. The electrical conduit appears to have acted as a preferential pathway for product migration; allowing for the product to migrate to the second area southwest of the AST area, where the product surfaced adjacent to a light pole and concrete walkway. Emergency remediation activities and soil excavation activities have been performed, as well as performance and submittal of a Comprehensive Site Assessment (CSA) and a Corrective Action Plan (CAP), The CAP, which was approved on July 8, 2014, and proposed an in -situ remediation program for the remaining petroleum -impacted soils. This NOI is being submitted as fulfillment of the approval process. If there are any questions regarding this correspondence, or the project In general, please contact me at (919) 848-3155. Sincerely, Highlands Environmental Solutions, Inc- . Sandra Miller Project Scientist Enclosure cc, Mr- Eugene Roddy — L. C. Industries, Inc_ NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS The following are ''permitted by rule" and do not require an individual permit when constructed in accordance with the rules of 15A NCAC 02C .0200. This fo rm shall be submitted at least 2 weeks prior to iniection. AQUIFER TEST WELLS 0 5A NCAC 02c .0220 ) These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics. IN SITU REMEDIATION (1 5A NCAC 02C .0225 ) or TRACER WELLS (1 5A NCAC 02C .0229): 1) Passive Injection S y stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include ORC socks, iSOC systems, and other gas infusion methods. 2) Small-Scale Injection Operations -Injection wells located within a land surface area not to exceed 10,000 square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required for test or treatment areas exceeding 10,000 square feet. 3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a remediation strategy in order to develop a full scale remediation plan for future implementation, and where the surface area of the injection zone wells are located within an area that does not exceed five percent of the land surface above the known extent of groundwater contamination. An individual permit shall be required to conduct more than one pilot test on any separate groundwater contaminant plume. 4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater. Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete. DATE: --~M=a ..... v ~7 _, 201.L_ PERMIT NO. L,.J( ()';{ (X) g L/ \ (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-F, K, N ___ .Aquifer Test Well ....................................... Complete sections B-F, K, N ___ Passive Injection System ............................... Complete sections B-F, H-N =X~ __ Small-Scale Injection Operation ...................... Complete sections B-N ___ Pilot Test ................................................. Complete sections B-N ___ Tracer Injection Well ................................... Complete sections B-N B. STATUS OF WELL OWNER: Business/Organization C. WELL OWNER-State name of entity and name of person delegated authority to sign on behalf of the business or agency: Name: Mr. Eugene Roddy Mailing Address: 4500 Emperor Boulevard City: Durham State: NC Day Tele No.: 919-596-8277 ext. 2265 EMAIL Address: eugene.roddy@lc-ind.com UICI In Situ Remed. Notification (Revised 3/2/2015) Zip Code: 27703 County:_D~ur~h~am~--- Cell No.: 336-392-0715 Fax No.: Page 1 D. PROPERTY OWNER (if different than well owner) Name: -----=N""'A'--"--------------------------------- Mailing Address:--------------------------------- City: ____________ State: __ Zip Code: _______ County: _____ _ Day Tele No.: ___________ _ Cell No.: ------------ EMAIL Address: _____________ _ Fax No.: ------------ E. PROJECT CONT ACT -Person who can answer technical questions about the proposed injection project. Name: Sandra Miller Mailing Address: 8410-D Falls of Neuse Road City: Ralei gh State: NC Zip Code: 27615 County:_W~ak=e ___ _ DayTeleNo.: 919-848-3155 Cell No.: 919-819-4312 EMAIL Address: smiller@b esnc.com Fax No.: __ ....a.9-=19=------=84"""'8"-----4--"2=6=5 ___ _ F. PHYSICAL LOCATION OF WELL SITE (1) Physical Address: ___ L=·~C~·~In=d~u=s=tn=·e=s ~In~c.'------------------ ___ 4--=5~0~0_E_m_p_er~or_B_o~u~l~ev~ar~d ____________ County: Durham (2) City: ---~D=ur=h=a=m=------------State: NC Zip Code: ---=2"-'-7-"-70=3'----------- Geographic Coordinates: Latitude**: ___ 0 ____ " or --22_0 .=87"""3"'"4""'8 .... 4'------ Longitude**: 0 __ " or __ --"-7~8 °.838443 Reference Datum: ~37~8~'-_____ Accuracy: _______ _ Method of Collection:--'G=o=o=-<g=>=l=-e=M=a=-p=s ____________ _ **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:_<--=3~0~0~0~ ___ square feet Land surface area of inj. well network: __ <--=3-0~0~0'--__ square feet ts 10,000 ft2 for small-scale injections) Percent of contaminant plume area to be treated: 100 (must be~ 5% of plume for pilot test injections) H. INJECTION WNE 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. UIC/ln Situ Remed. Notification (Revised 3/2/2015) Page2 I. DESCRIPTION OF PROPOSED INJECTION ACTMTIES -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. See attached in fo rmation fi'om 3tier. J. INJECT ANTS -Provide a MSDS and the following for each injectant. Attach additional sheets if necessary. NOTE: Approved injectants (tracers and remediation additives) can be found online at http://portal.ncdenr.org/web/wq/aps/gwpro . All other substances must be reviewed by the Division of Public Health, Department of Health and Human Services. Contactthe UIC Program for more info (919-807-6496). Injectant: __ ....::S=e=e'--'a=t=ta=c=h=ed"'"""'"in ... fo""rm'-"""'a=t=io'"'"n._.fr .... o=m=-=3~ti=·e.,__,r.'------------------ Vo1ume ofinjectant: ___________________________ _ 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: ___________________ _ 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: --=2=-5 -'---Proposed'---_____ Existing (2) Provide well construction details for each injection well in a diagram oi-table format. A single diagram or line in a table can be used for multiple wells with the same construction details. Well construction details shall include the following: (a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery) (b) depth below land surface of grout, screen, and casing intervals -see attached figure (c) well contractor name and certification number -Quantex, #3106 UIC/ln Situ Remed. Notification (Revised 3/2/2015) Page 3 L. SCHEDULES - Briefly describe the schedule for well construction and injection activities. Prior to the detailed activities. HESanticWates completion ol-threepreliminan, tasks: abandonmentol one damaged well. minor r Jairs to three other existin wells. and co )letion o -a baseline sampling session: Well construction of the injection wells can begin upon NCDENR's authorization to gnKeed. continUent on the time schedule of the drilling contractor and the availabilin of the Stier personnel beinvp for set--ulp o1 the 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 '�ulhchwipter Q2L result from the injection activity. See attached in ormation from Stier. N. SIGNATURE OF APPLICANT AND PROPERTY OWNER APPLICANT: "I hereby certify, underpenalty of law, that 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. I agree to construe; operate, maintain, repair, and ij'applicable, abandon the injection well and all relatd appurtenarteg-in—avrvrdance with the )JA NCAC 02C U2f/0 Rules. " Print or Type dull Name "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 b jection 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 "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. ement in 'writing. C4(5 en e- l eaeld Signsti-re,�rroperty Owner Off diii'ereny�ry applicant) Print or Type Fsa. ! meet between the applicant a d property owner may be submitted in lieu of a signature on thisform. Submit the completed noflfication package to: DWR - UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: (919) 807-6464 UI0A Shu Remed. Notification (Revised 312/2015) Page 4 CA% N, Ul 280 F592111 Eidt 292 29 ev Mperor IJ6d Approximate 'Olwa— Site Location`, .............. .. ........ ............ . .... ...... t4O Ut J 4vd ExA 2840 FAM4 ki CNY E)dt APPMXbMb fta% 0.45 0.90 miles Source: Microsoft Streets & Trip, 2002 Site Location Diagram Pfvjod Name Injection Permit Durham, North Carolina t Z: Highlands Chen! Environmental LC Industries, Inc. PnVOGI # Drawn by Solutions, Inc. 202002 SM Appvxkn9ft Scma Date Rg. # scale as Noted I December 2014 1 r, Ism r - - • !'''�" Z"16 'e. ! Site Location --TIF r '� s :Cem -- _re, � — ,t _.sir_ r • � � ` „� _ C_� . � off. r� -- .� �► ��� t �^ � i`• JV i r ApprmWmaft 5e a% 0 1500 3000 N 188t Base diagram from Cary, NC, 9:24000 7.5 Minute Topographic Quadrangle, 2002. Topographic Location Diagram Project Neme Injection Permit Highlands Durham, North Carolina C&M Environmental LC Industries, Inc. Solutions, Inc. A*d# 202002 ran by SM Scales I Date ft. # As Shown December 2014 2 to chemical storage vessel Flush Mount Casing COnCrete _ Schedule 40 PVC Casing (approximately 2 ft.) Meat Portland Cernent Grout Hydrated Bentonite p (1.0 feet) C ' jI ^C^, 111 cY7 ++� Clean sand o a F- C 0. rn - Schedule 40 PVC Manufactured Screen m(0,010 Slot) _ (5 ft.) m - Q Hlghlsnds Injection Well Ei Schematic Diagram Not to Scafa Environumfti LC Industries, Inc. 4500 Emporer Boulevard, Durham, NC ar...a. w, pr GwWMdI. 6Ya�M1h a,. — - � 4afnQ 8F J8 202002 November2014 12 *mifL1 V;WL TECHNOLOGIES Treatment Solutions for Soil Contamination Highlands Environmental Solutions - LC Industries / Durham, N.C. Site Description: The subject site, LC Industries Inc, is located in Durham North Carolina. The original impacted area was the result of storage tank release. The original work plan utilized the dig and haul method of remediation. Due to underground infrastructure, pipes and utility lines, the full scope of material removal was limited and the result was continued impact of the hydrocarbon contaminants. The next phase of remediation will require a technique that allows for remediation material to be added to site through in -situ methods and encouraged to travel multiple pathways around the pies and limited access areas to reach the target residual contaminants. The three original excavation locations are still exhibiting unacceptable levels of Naphthalene and Methylnaphthalene. It is not unusual in sites that are not able to fully excavate the target areas to exhibit a level of rebound or continued influence from the contamination outside the treatment areas. The following recommendations are based on the three target areas supplemental treatments of an in -situ remediation process. Technology Overview: 3 Tier Technologies LLC is a green science and technology company focused on developing innovative and sustainable materials, processes and applications to optimize in -situ bio-remediation of soils and water Contaminated by hydrocarbons and other various organic constituents. 3 Tier focuses our efforts on the use of "Green Technology' that uses significantly Iess equipment, labor, and fuel to execute while remediating harmful contaminates in -situ. "Green Technology'' is a solid movement to identify products and methods to clean up various contamination sites without extensive use of equipment that can emit harmful pollutants to perform the required task and establish systems that allow for material to be recycled and/or re -used after completing the projects. To achieve maximum performance in these various treatment processes, 3 Tier Technologies has discovered that current products offered in today's markets offer a single solution that only impacts either bio-augmentation or bio-stimulation. The development of a complete regeneration and cleaning solution would not only enhance the remediation of contaminates, it would also regenerate contaminated soils and groundwater to a healthy and active state for effective and safe re -use. 3 Tier achieves a complete regeneration/cleaning system with a suite of products that uses various recipes consisting of three distinct yet synergistic components, a blend of activated organic bio-polymers derived from very stable, organic compounds found in brown and oxidized black coal, a ultra high concentration of live synergistic bacteria, and a readily biodegradable natural enzyme product consisting of a nutrient -rich extract with a broad-spectrum package of identifiable enzymes, coenzymes, amino acids and other proteins. These multi -action products are able to degrade common organic constituents with minimal use of equipment, labor and cost co 250 National Place. Suite 142. Longwood FL, 32750 • www.3166dech.com • 877-226-70B Treatment Product Soll Rx -Soil Rx is the ultimate heavy lifter in hydrocarbon remediation and utilizes a new approach to solving soil and water hydrocarbon contamination problems. Specially formulated for safety, effectiveness and environmentally friendliness, Soil Rx utilizes a blend of Polyelectro]yte Enhanced Biopolymers (PEB), a ultra high concentration oflive synergistic bacteria, and a readily biodegradable natural enzyme product consisting of a nutrient-rich extract with a broad-spectrum package of identifiable enzymes, coenzymes, amino acids and other proteins. This triple action product is able to degrade hydrocarbons with minimal use of equipment, labor and cost Soil Rx's liquid form and low cost make this a.n easy to use cost effective means for industries to eliminate hydrocarbon contamination problems that consist of gasoline, jet fuels, diesel fuels, grease, tar, motor oils, crude oils, solvents, etc. Soil Rx is NCP Listed**. Disclalme,..* Soil RX is on the U.S. Environmental Protection Agency's NCP Product Schedule. This listing does NOT mean that EPA approves, recommends, licenses, certifies, or authorizes the use of Soil Rx on an oil discharge. This listing means only that data. have been submitted to EPA as required by subpart] of the National Contingency Plan, Sec. 300.915. Ireabnent Method & Rates; Due to the relative size of the area to be remediated, 3 Tier recommends applying Soil Rx using a modified bore-n-pour method of application. This method will provide maximum control and saturation of the soil that will ensure proper penetration of the product to come in contact with the contaminants while utilizing the established pathways that the current contaminants are currently using around the pipes and infrastructure. This method will require a minimal number of injection points per location that will remain in-place until the process is completed. 3 Tier recommends the use of a 2" GeoProbe direct push unit to establish the required injection points per location. The approximate depth of each hole will be 7.5' to 8'. These points will then receive one section of 1" slotted pipe (bottom section) and one section of solid riser. Each injection point is to be sand filled and capped with Bentonite. After initial injection process, pipes will trimmed flush with the ground and capped while remaining in-place until no further action notice is received. Established points may be re-used at a later date for spot treatments or removed after completion. No further equipment requirements will be needed after initial injection point establishment. Soil Rx is the remediation workhorse in our suite of hydrocarbon products and must be diluted with water prior to use. The target goal is to apply 20 ounce of Soil Rx concentrate per cubic yard of soil to be treated. As previously stated, the work will focus on three target areas that continue to exhibit hot spots after excavation. Target area One known as Area "C" measures 15' by 18' with approximately 60 cubic yards of material to treat. Target area Two lmown as Area "A" is approximately 28' by 20' with approximately 165 cubic yards of material. Target area Three known as Area "D" measures 48' by 20' and has approximately 275 cubic feet ofmaterial. Though the standard dilution rate is 10 to 1 with the standard application rate being 1 to 1.5 diluted gallons per cubic yard, for this application, 3 Tier recommends that the dilution rate be increased to 20 to 1 to ensure proper coverage and moisture content with the application rate being three gallons diluted material per cubic yard. Therefore, 75 gallons of Soil Rx concentrate will be diluted in 142 5 gallons of clean water for the previously described areas. Area "C" will require 180 gallons of diluted material, Area "A" will require 495 gallons of diluted material, and Area "D" will require 825 gallons of diluted material. Areas "A" and "C" will require 5 injection points each, and Area "D" will require approximately 15 injection points. As previously mentioned these injection points will remain avaHable for use until the project is completed thus saving potential additional costs for equipment usage. Injection point detail is available upon request or will be provided prior to work commencement. Areas "A" and "C" will can be plumbed to on 275 gallon IBC tote which would require Area "C" to be filled twice while Area "D" will use two separate totes for each half of the area requiring just one fill each. Tanks and plumbing will remain in-place until all material is absorbed into the injection points and removed and stored until areas are tested and the need for any additional treatments is determined. Due to the soil types, initial product application may require up to one week though our experience and past excavation has shown that material may only need a day or so. The target areas should be sampled 45 to 60 days after treatment. After the subject results are available, 3 Tier review progress and make further site recommendations. Should additional applications be required, they will be performed using existing injection points as determined by 3 Tier and HES personnel. 3 Tier recommends that the site work commence in the spring, once the soil temperatures begin to rise after the winter cool temperatures. 3 Tier will provide a technical support person for the initial work as technical support for this project The following application protocol has been provided by Daniel J Burdette, President, 3 Tier Technologies LLC. Please contact us for clarification, regulatory clarifications, or schedule technical support. 3tfer TECHkOL0411Eg MATERIAL SAFETY DATA OWEET PRODUCT: Sic -Regan Soil Rx Section 1— Chemical Product & Company Identification J Trade Name: Bia-Regen Soil Rx Chemical Family: Mbdure Product Description: A concentrated blend of organic biopolymers, bacterial cultures, and amino acids that is non -hazardous. Manufacturer: 3 Tier Technologies, LLC 260 National Place, Suite 142, Longwood, FL 32750 Technical Support: 877-226-7498 Chemical Emergency: 407-808-4653 Issue Date: 07/24/2012 Supersedes Date: 02J13=12 Section 2 -- Hazards Identification Emergency overview: Avoid contact with eyes. Mild skin irritation. Potential health effects: Eyes: Contact with eyes may cause severe irritation. Skin: May cause imitation upon prolonged contact. inhalation: None known Ingestion: May cause irritation/nausea if ingested in large quantities Section 3 — Composition I Information on Ingredients Components CAS # Percent Sol[ Rx is a blended composition "not considered hazardous" under the OSHA Hazard Communication Standard CFR Title 29 1910.1200. All ingredients appear on the EPA TSCA Inventory. All Bacillus Bacteria contained in this product are DSL Listed and Compliant. Organic Blopolyrner 141 "3-6 50% Amino Acids Various 10°% Bacillus Bacteria ATCC 18250-7 15% RO Water 7732-16-5 25% Ingredients of a1°% have been added to a non -hazardous liquid organic substrate. Active components <15°% are identified above Section 4 -- First Aid Measures J First aid procedures Eye contact: Immediately flush eyes with plenty of water for at least 15 minutes. Seek medical attention if irritation persists. Skin Contact: Flush skin with large amounts of water. Remove any contaminated clothing and wash before reuse. Seek medical attention if irritation occurs. O 2012 3 T of Teckndapiw. LLC. -Ph: 877-2241-74BB-wwW_UwNtech_wm- WDS BAD -Re rt Shc Rt Page 1 of 4 Inhalation: Ingestion: If symptoms are experienced, remove source of contamination and/or move victim to fresh air. If breathing is difficult, have trained personnel administer oxygen. If respiration stops, have trained personnel administer artificial respiration. Get medical attention immediately. Give large amounts of water. Do not induce vomiting. If vomiting occurs prevent aspiration by keeping victim's head below the knees . Get immediate medical attention. I Section 5 -Fire Fi g htin g Measures Flash Point: None Extinguishing Media: Water fog or fine spray, carbon dioxide, dry chemical or foam. No special requirements Fire fighting Protection: As in any fire, wear self-contained breathing apparatus pressure- demand, MSHA/NIOSH (approved or equivalent) and full protective gear. I Section 6 -Accidental Release Measures Personal Precautions: Isolate area. Keep unnecessary personnel away. Keep out of low areas. Ventilate closed spaces before entering. Use of safety glasses and impervious gloves recommended. Environmental Precautions: Prevent further leakage or spillage if safe to do so. Methods for Containment: Prevent entry into waterways, sewers, basements or confined areas. Methods for Clean-up: Wear appropriate protective equipment and clothing during clean-up. Large spill: Use a non-combustible material like venniculite, sand or earth to soak up the product and place into a container for later disposal. Dispose in accordance with all local, state and federal regulations. Small spill: Follow same procedure as above. I Section 7 -Handling and Stora ge Handling: Storage: Avoid contact with skin and eyes. Wash hands thoroughly after handling. Store this product below 120"F (49"C), preferably below 75"F (24"C), in a cool, dry, well ventilated area away from heat, sparks, flame, oxidizers and out of direct sunlight. For best results, use within 24 months. ~ 2012 3 Tier T echnologles, LLC. -Ph: 877-226-7498 -www.3tiertech .com -MSDS Bio-Regen Soll Rx Page 2 of 4 I Section 8 -Ex posure Controls, Personal Protection Personal Protection General: Eye wash fountain is recommended. Minimize exposure in accordance with good hygiene practices. Keep out of reach of children. Eyes: Wear chemical goggles. Skin: Suitable protective clothing is recommended but not required. Use impervious gloves. Respiratory: None required for recommended use. Avoid creating aerosols in poorly ventilated areas. I Section 9 -Ph ysical & Chemical Properties Vapor Pressure: Vapor Density (air = 1 ): Equivalent to Water Equivalent to Water 1.0 approx. Specific Gravity: Solubility in water: voe: Appearance: pH: Bolling Point: Flash Point: Freezing Point: Evaporation Rate: Weight: Odor: 99% Negligible Brown/Black Liquid 6.0 to 8.5 > 212" F (100° C) None < 32. F (O" C) Not Determined 8.7 -9.2 lbs. /gallon Mild citrus odor I Section 1 O -Stabillty & Reactivi ty Chemical Stability: Stable at normal conditions. Incompatible Materials: Strong oxidizing agents, alkalis Hazardous Decomposition Products: None known. Conditions to avoid: See Section 7. Hazardous Polymerization: Will not occur. I Section 11 -Toxicology Information Toxlcology data: Not available. I Section 12 -Ecolog ical Information Ecotoxicity: Readily biodegradable. [ Section 13 -Dis posal Considerations Disposal instructions: Dispose in accordance with all applicable regulations. All wastes must be handled in accordance with local, state and federal regulations. Regulations vary. C 2012 3 iler Technolog ies, UC. -Ph: en-226-7498 -www.3liertech.com-MSOS Blo~egen Soil Ric Page 3 of 4 I Section 14 -Trans p ortation Information General information: US DOT: Non-hazardous. Not regulated. Proper Shipping Description: Class 55 I Section 15 -Re gulato ry Information TSCA Inventory Status: This product and/or all of its components are either included on or exempt from the TSCA Inventory of Chemical Substances. DSL (Canada): This product and/or all of its components are either included on or exempt from the Domestic Substances List. I Section 16 -Other Information HMIS ratings: NFPA ratings: Disclaimer: Health: 1 Flammability: O Physical hazard: 0 Health: 1 Flammability: O Reactivity: 0 The data and recommendations presented herein are based upon research of others and are believed to be accurate. However, no warranty is expressed or implied regarding this data or the results to be obtained from the use thereof. The manufacturer assumes no responsibility for the injury to customers or third persons proximately caused by the material if reasonable safety procedures are not adhered to as stipulated in the data sheet. Additionally, sine actual use by others is beyond our control, no guarantee, expressed or implied, is made by the manufacturer as to the effect of such use, the results to be obtained or the safety and toxicity of the product nor does the manufacturer assume any liability arising out of use, misuse, by others, of the product herein. Information provided herein is provided solely for the customer's assistance in complying with the occupational safety and health act of 1970 and regulations there under. Any other use is prohibited. C 2012 3 Tier Technologies, LLC . -Ph: 877-226•7◄98-www.3tiertech.aim-MSDS Bio-Regen Soll Rx Page 4 of4 x* A UNM D STATES ENVIRONMENTAL PROTECTION AGENCY WASHINGTON. D.C. 20460 NOY 17 2010 Mr. Daniel J. Burdette 3 Tier Technologies, LLC OWCE of 2302 Mercator Drive soon WAM AND n3te 02 EME WENCY F ESMNSE Orlando, FL 32807 Dear Mr. Burdette, Thank you for providing the technical product data required by the National Oil and Hazardous Substances Pollution Contingency Plan (NCP), 40 CFR Part 300, on your product "Soil Rx (alb Bin-Regen Hydrocarbon)." Auer conducting our review, your data submissions have satisfied the requirements contained in Title 40 of the CFR section 300.915 of the NCP. "Soil Rx (aka, Bio-Regen Hydrocarbon)" will be listed on the NCP Product Schedule under the Bioremediation Agent category and may be authorized for use by Federal On -Scene Coordinators in accordance with 40 CFR section 300.910. The technical data for this product will be kept on file by the Of17ce of Emergency Management Regulation and Policy Division Oil Program Center pursuant to 40 CFR section 300.920. Enclosed are some of the relevant provisions in the NCP on restrictions regarding the listing of your product Please now, you are required to notify the Environmental Protection Agency (EPA) of any changes in composition, formulation, handling procedures, or application of your product. Based on this notice, EPA may require retesting of the product. Also, note that the listing of "Soil Rx (aka, Bio-Regen Hydrocarbon)" on the NCP Product Schedule does not constitute approval, certification, authorization, licensing or promotion of the product; not does it imply compliance with any criteria or minimum standards for such agents. Failure to comply with these restrictions or the making of any improper refemnee to EPA in an attempt to demonstrate approval or acceptance of the product will constitute grounds for removal of the product from the schedule. Please review the enclosed information and contact Ms. Leigh DeHaven in the Office of Emergency Management at (202) 554-1974 if you have any corrections or questions. Sincerely, . . 12. R. Craig Matthiessen, Director Regulation and Policy Development Division Office of Emergency Management Interw Address (URL) ■ tWJAmww,a &*w -lop CUKUPAPU 1abTQ • Prlr't9d W F1 VNpntsb4 Qi Based Inks on I OD% Poetcorvwner, P odM (>dcd sa Fm SacyaW Papa,- CERTIFICATE OF ANALYns 3 Tier Technologies, LLC Case Number: Reported To: 2302 Mercator Dr. Date Received: Suite 102 Date Reported: Orlando, FL 32807 Product: SOIL-RX Lot Number: 100501 ]9018 Overview: Triad Forensics IrldependfftSffvke I,abomw y 341 Technology Way Spite 167 Lab 1 Winston-Salem, North Carolina 27101 Tel 336-722-8963 Fax 866-571-8264 UH L- www.triaftrensic.com TFL-10-0721 7/21 /2010 08/25/2010 Test Method: U.S. EPA Appendix C to Part 300 Swirling Flask Dispersant Test Name: Effectiveness Test, Revised Standard Dispersant Test, and Bioremediation Agent Effectiveness Test In addition to gravimetric analysis, normal alkanes as well as the more highly resistant and toxic polynuclear aromatic hydrocarbons (PAHs), were monitored using High Resolution Gas Chromatography Mass Spectrometry (GC/MS) to quantify changes in the oil composition resulting from biodegradation during a 28-day effectiveness study for SO] L-Rx®i. The bioremediation effectiveness test was performed Using a Shimadzu GC-2010 with AOC-20i auto sampler. The GC/MS was operated in the selective ion -monitoring mode (SIM mode) at a scan rate greater than LS scans per second using Helium as the carrier gas. All other instrument settings and analytical procedures follow U.S. CPA Method 8270 and the configuratian and calibration section of reference text A; see below, Concurrent microbiological analyses were performed to determine and monitor the viability of the microbial cultures being studied. ASCLD-LAB International approved laboratory notebooks were maintained to document the chemicals, media, surrogates, stock solutions, standards, and reagents used to perform the 28-day effectiveness study. Effectiveness testing was conducted using triplicate samples of the following: controI2, nutrient3, and product? Control and treatment flasks were sampled three times over a 28-day period: day 0, day 7, and day 28. 3 Manufactured by 3 Tier 7bc:hnologies I Control samples contain approximately 0.5 grams of reference ail and brought to a final volume of 1000-mL with non -sterile seawater a Nutrient samples contain approximately 0.5 grams of reference oi1,10-mL of N&P Salt solution, 2 - m L solutions 2-5, and brought to a final volume of 1000-mL with non -sterile seawater. 4 Product samples contain approximately 0.5 grams of refe rence eil, 10-mL of N&P Salt solution, 2-mLof solutions 2.5, and brought to a final volume of 1000-mL with 1:10 diluted Soil- RxO/non-sterile seawater soIutian. Page 1 of 3 The effectiveness study was performed using the test methodologies described in the following texts: A EPA Appendix C to Part 300 -Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Test, and Bioremediation Agent Effectiveness Test B. 40 CFR part 300 -National Oil and Hazardous Substances Pollution Contingency Plan C. L.T. McCarthy, Jr., I. Wilder, and J.S. Dorrier. Standard Dispersant Effectiveness and Toxicity Tests. EPA Report EPA-RZ-73-201 (May 1973). Every attempt was made to comply with all requirements and quality guidelines for conducting effectiveness testing. In the referenced test methods, certain resources, chemicals, or equipment were no longer available. As a result, equivalent substitutes were used to facilitate rigorous testing and evaluation of the bioremediation product studied. The equivalency of substitute chemicals was cietermined by comparative assessment of the mass spectra data5 for both the original and all potential substitute chemicals. Substitutions of equipment mentioned in the reference texts were made after consulting with the device manufacturer and examining equipment and/or software manuals. Independent Laboratory Results: Data Table 1: Bioremediation Agent Effectiveness Test Data Sample Description CONTROL NUTRIENT SOIL-RX® PRODUCT Day of Collection DayO Day7 Day28 DayO Day7 Day 28 DayO Day7 Day28 Gravimetric Results (mg)* 496.20 458.24 456.24 491.03 487.03 454.52 497.65 482.93 347.64 IM krobial Viability ad Activity <3.0 <3.0 <3.0 <3.0 3.6 7.4 43 >1100 >1100 (MPN/g) GC/MS Results Total Mean 34908.9 35206.2 34287.8 34863.3 32894.1 32610.0 34993.0 24446.0 17597.0 Alkanes (oo m )*"' GC/MS Results Total Mean 6051.3 5720.9 5892.7 6047.4 5745.8 5205.1 6069.0 3219.2 1600.1 Aromatics (oom)** Percent Reduction in Total 1.779% 6.463% 49.713% !M ean Alkanes after 28 Days lP ercent Reduction in Total 2.621% 13.928% 73.635% Mean Aromatics after 28 Days • Gravimetric results are averages of the three replicate studies performed on each sample (ControL Nutrient, and Product) for each sample day (Day 0, Day 7, Day ZS). "GC/MS results of averaged total aromatic compounds of the three replicate studies performed on each sample (Control, Nutrient, and Product) for each sample day (Day 0, Day 7, Day ZS). Total of nine samples per day sampled (Three for Control, Nutrient. and Product on Day 0, three for Control, Nutrient, and Product on Day 7, and three for Control, Nutrient, and Product on Day ZS). 5 Obtained by a serial dilution and three point calibration curve PageZof3 Effectiveness testing for the control, nutrient, and product samples was conducted in triplicate. Minor qualitative changes were noted for the oil fraction in the nutrient and control sample flasks for bays 7 and 28. However, no observable changes in either color or turbidity were noted for the nutrient and control samples during the 28-day test period. For all three of the product flasks, significant qualitative changes in the sample solution's turbidity, coloration, and volume of the oil fraction were noted. The qualitative changes to the oil fraction layer in each of the samples were verified quantitatively using U.S. EPA Methods 1664 (gravimetric) and 8270 (Characterization of Volatile Organic Compounds). Upon termination of the effectiveness study, a significant reduction in hydrocarbons was documented for the product samples containing the bioremediation agent in Soil-Rxg. The microbial viability and activity was maximal for the Soil-Rx@ product samples assayed on day 7 and day 28. The data obtained from testing those samples indicates that a strong correlation exists between Soil-Rx§ microbial activity and hydrocarbon compound reduction. The product samples indicate that the microbes in the Soil-Rx® product are highly effective in reducing hydrocarbon compounds in a time period of less than 28 days. Laboratory Statement of Qualifications (SOQ): Triad Forensics Laboratory (TFL) is compliant with ISO/ IEC 17025:2005, EPA, FDA, NELAC, AOAC, and ASCLD•LAB International accreditation guidelines for independent testing laboratories. We are audited and conduct external proficiency tests at feast twice annually to maintain all accreditations and certifications. All laboratory equipment and instrumentation are calibrated in accordance with ISO/IEC 17025 guidelines. TFL is certified by, registered with, and operates in the State of North Carolina. END OF LABORATORY REPORT Reported By: Lauren A. Stainback Forensic Laboratory Director, Member AOAC, APHA, and NELAC ASCU? -LAB Legacy Auditor Date Signed. AuuguNj 25. 2010 Page 3 ar3 CERTIFICATE OF ANALYSIS 3 Tier Technologies, LLC Reported To: 2302 Mercator Dr. Suite 102 Orlando, FL 32807 Product: Soil Rx@) Lot Number: 10050119018 Methodology Overview: Triad Forensics independent 5ervive Laborauxy 391 Technology Way Suite 167 bah 1 Winston-Salem, North Carolina 27101 Tel 336-722-8963 Fax 866-571-8264 URL.- www.triadfbrensic.com Case Number- TFL-10-0913A Date Received: 6I5l2010 Date Reported: 6/7/2010 Test Name: 24 Hour Acute Toxicity The freshwater organisms, Pimephales promelas, selected for this study were purchased from a local fishery and were certified to be free of parasitic and bacterial pathogens. Approximately 160 live animals were purchased and transported 15 miles to the laboratory on 6/1/2010. Once the animals arrived at the laboratory, they were placed in a holding tank of simulated freshwater for observation. Their physical health and size were satisfactory according to EPA method 2000.0. The physical and chemical characteristics of the holding water tank were recorded at least once daily and the results are provided as attachments to this document. All aquarium tanks were cleaned using the procedure described in EPA 2000.0 Sections 5.2.2-5.2.3. All organisms were fed 0.007 grams Aqueon Tropical Flakes fish food one time per day. After a five-day observation period, approximately 20-24 healthy organisms were selected for each test of 0% (control), 12.5%, 18.75%, 25%, 50% and 100% dilute effluent toxicant. Dilute Soil RxO solution was prepared by the manufacturers instructions by diluting 1 part Soil Rx@ solution to 10 parts deionized water. 22 Selected organisms were then placed into aquarium tanks (including 1 bubble air hose, 1 filter, and 1 glass thermometer) that had been spiked with reagent grade chemicals to create simulated freshwater having the physical and chemical composition as described in EPA method 2000.0 section 7.2.3.1 and Table 7. Physical and chemical results for all pre- and post - toxicant water effluents were tested. The results are included as attachments. After the organisms acclimated to the new environment, the desired level of dilute toxicant was added to the water. The time was noted at the beginning of the study and each study had duration of 24 hours. Some tests were terminated before 24 hours of toxicant exposure time due to greater than 90% organism mortality. Studies in which all organisms expired were noted and all data have been tabulated and are provided as attachments. 'Affordable Excellence in Analytical Testing and Forensic Casework' Page 1 of 3 CERTIFICATE OF ANALYSIS Triad Forensics hxle�entSetvicelaboratmy 391 Technology Way Suite 167 Lab 1 Winston-Salem, North Carolina 27101 Tel 336-722-8963 Fax 866-5 7 2 -82 6 4 URL.- www,trladforenstc.com Starting Live Effluent Final Live Organism Organism Oty. Methodology Dilutions in Oty Past 24 Hour % Toxicant Exposure + Fathead minnow, Pimephales promelss, Acute Toxicity Tests with 22 Standard Synthetic Freshwater 12'S Effluents and Receiving Waters 22 Fathead minnow, Pimephates promelas, Acute Toxicity rests with Standard Synthetic Freshwater 22 Effluents and Receiving Waters 18.75 11 Fathead minnow, Pimephales promeles, Acute Toxicity Tests with Standard Synthetic Freshwater 22 Effluents and Receiving Waters 25 0 Fathead minnow, Pimephales promelas, Acute Toxicity Tests with Standard Synthe#c Freshwater 22 Effluents and Receiving Waters 50 0 Fathead minnow, Pimephales promeles, Acute Toxicity Tests with Standard Synthetic Freshwater 22 Effluents and Receiving Waters 100 0 "Affordable Excellence in Analytical Testfng and Forensic Casework" Page 2 of 3 CERTIFICATE OF ANALYSIS Independent Laboratory Results: Triad Forensics hxlTendentServiee L&)ora my 391 Technology Way Suite 167 Lab 1 Winston-Salem, North Carolina 27101 Tel 336-722-6963 Fax 866-571-6264 URL: www.tria4forensic.com Total organism survival was 100% after 24 hours of exposure at 12.5% dilute Soil Rx@i solution. LD50 was reached at 18.75% dilute Soil Rx9 solution after 24 hours of exposure. All organisms expired within 12 hours of exposure to 25%, 50%, and 100% dilute Soil RxV solutions. Laboratory Statement of Qualifications (SOD): Triad Forensics Laboratory (TFL) is compliant with 1SO11EC 17025:2005, EPA, FDA, NELAC, AOAC, and ASCLD-LAB International accreditation guidelines for independent testing laboratories. We are audited and conduct external proficiency tests at least twice annually. All laboratory equipment and instrumentation are calibrated in accordance with ISOIIEC 17025 guidelines. TFL is certified by, registered with, and operates in the State of North Carolina. Reported By Lauren A. Stainback, Forensic Laboratory Director Date Signed 06/07/2010 "Affordable Excellence in Analytical Testing and Forensic Casework" Page 3 of 3 Rogers, Michael From: Rogers, Michael Sent: Wednesday, May 27, 2015 3.25 PM To: 'Sandy Miller' Cc: Joe Beaman; William Frederick, Eugene Roddy; Smith, Danny; Bolich, Rick Subject: RF: Submittal Letter for Notice of Intent Form (NOI) far L.G. Industries for the Blind W10500841 Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOI) at the E. C. Industries for the Blind. This facility is located at 4500 Emperor Blvd., Durham, Durham County, NC 27703. We received your complete NOI on May 18, 2015. Please remember to submit the following regarding this injection activity: 1) Well Construction Records (GW-1) and Abandonment Records (GW-30) when completed. Please provide copies of the GW-1s and GW-30s if not already submitted (originals go the address printed on the form). NOTE: ❑irect push or Geoprobe wells are considered wells and require construction (GW-1) and abandonment forms (GW-30). if well construction/abandonment information is the same for the wells, only one form needs to be completed- just indicate total number of injection points in the Comments/Remarks section of form. These forms can be found on our website at http://portal.ncdenr.org/web/wa/aps/gwnro/reporting-forms. 2) Injection Event Records (IER). All injections, including air and passive systems require an IER. The IER can be modified for air sparge wells (e.g., air flow 'continuous' for date or rate of injection, etc.). You can scan and send these forms directly to me at michae1.rovers CED ncdenr.go_v, send by fax to my attention at 919- 807-6406, or via regular mail to address below. When submitting the above forms, you will need to enter the nine -digit alpha -numeric number on the form (i.e., WIOXXXXXX) that has been assigned to the injection activity at this site. This notification has been given the deemed permit number W10500841. This number is also referenced in the subject line of this email. You may if you wish, scan and send back as attachments in re assigned deemed permit number in the subject line. Thank you for your cooperation. Michael Rogers, P.G. (NC & FL) Hydrogeologist NCDENR - ❑WR Water Quality Regional Operations Section 1636 Mail Service Center Raleigh, NC 27699 Direct No. 919-807-6406 htt pJl po rta I. ncde n r, o rp/web/wry/a p slew pro/repo rr i ng-form to this email, as it will already have the NOTE: Per Executive Order No. 150, all e-malls sent to rind from this account ore subject to the North Corolin❑ Public Records Law and rnoy be disclosed to third parties. From: Sandy Miller [mailto:Smiller@hesnc.comj Sent: Monday, May 18, 2015 1:24 PM To: Rogers, Michael Cc: Joe Beaman; William Frederick; Eugene Roddy Subject: Submittal Letter for Notice of Intent Form (NOI) for L.C. Industries for the Blind WI0500803 Good afternoon Michael, My apologies; I just noticed that I had omitted the submittal letter in my original email. I am sending out the hard copy and the submittal letter via U.S. Mail this afternoon to your attention. Thank you. Sandy Sandy Miller Project Scientist Highlands Environmental Solutions, Inc. 8410-D Falls of Neuse Road Raleigh, NC 27615 Office: 919-848-3155 Cell: 919-819-4312 Fax: 919-848-4265 email: www.smiller@hesnc.com website: www.hesnc.com Celebrating 10 years of Solutions! ilt\ H1:'1tands ~~ From: Sandy Miller Sent: Monday, May 18, 2015 12:14 PM To: 'Rogers, Michael' Cc: Joe Beaman; William Frederick; 'Eugene Roddy' Subject: Notice of Intent Form NOi LC. Industries for the Blind WI0500803 Good afternoon Michael, Attached is the Notification of Intent to Construct or Operate Injection Wells for the L.C. Industries site. I am putting the hard copy in the mail this afternoon to your attention. Please let us know if you have any questions or concerns. Thank you again for your assistance on this. Sandy Sandy Miller Project Scientist Highlands Environmental Solutions, Inc. 8410-D Falls of Neuse Road Raleigh, NC 27615 Office: 919-848-3155 Cell: 919-819-4312 Fax: 919-848-4265 email: www.smiller@hesnc.com 2 Ro g ers, Michael From: Rogers, Michael Sent: To: Wednesday, May 27, 2015 2:19 PM ·Smith, Danny; Bolich, Rick Subject: Attachments: FW: WI0500297 Rescission Request 20150527131252545.pdf Please find attached a permit rescission request. Mr. Poole indicates he converted the open-loop to closed-loop system shortly after the permit was issued. I am not sure if he used the open-loop well to insert the loops or not. Please let me know if it is OK to rescind. You can conduct a site inspection prior to recommending rescission if you wish. Let me know. Thanks. -----Original Message----- From: Michael Rogers f mailto:michael.rogers @ncdenr.g ov] Sent: Wednesday, May 27, 2015 1:13 PM To: Rogers, Michael Subject: This E-mail was sent from "RNPAC7DDO" (Aficio 2075). Scan Date: 05.27.2015 13:12:52 (-0400) Queries to: robin.markham @ncdenr.gov 1 Ro gers, Michael From: Sent: To: Sandy Miller <Smiller@hesnc.com> Monday, May 18, 2015 1:24 PM Rogers, Michael Cc: Joe Beaman; William Frederick; Eugene Roddy Subject: Attachments: Submittal Letter for Notice of Intent Form (NOi) for LC. Industries for the Blind WI0500803 signed submittal letter.pdf Good afternoon Michael, My apologies; I just noticed that I had omitted the submittal letter in my original email. I am sending out the hard copy and the submittal letter via U.S. Mail this afternoon to your attention. Thank you. Sandy "--;J .e,.,.,,, (k;' f)., Sandy Miller Project Scientist Highlands Environmental Solutions, Inc. 8410-D Falls of Neuse Road Raleigh, NC 27615 Office: 919-848-3155 Cell: 919-819-4312 Fax: 919-848-4265 email: www.smiller@hesnc.com website: www.hesnc.com Celebrating 10 years of Solutions! !::x: From: Sandy Miller Sent: Monday, May 18, 2015 12:14 PM To: 'Rogers, Michael' Cc: Joe Beaman; William Frederick; 'Eugene Roddy' Subject: Notice of Intent Form NOi LC. Industries for the Blind WI0500803 Good afternoon Michael, Attached is the Notification of Intent to Construct or Operate Injection Wells for the L.C. Industries site. I am putting the hard copy in the mail this afternoon to your attention. Please let us know if you have any questions or concerns. Thank you again for your assistance on this. Sandy Sandy Miller Project Scientist 1 Roraers, Michael From: Sandy Miller <Smillera@hesnc.com> Sent: Monday, May 18, 2015 12:13 PM To: Rogers, Michael Cc: Joe Beaman; William Frederick; Eugene Roddy Subject: Notice of Intent Form NOI L.C. Industries for the Blind W10500803 Attachments: Text and all Attachments. pdf Good afternoon Michael, Attached is the Notification of Intent to Construct or Operate Injection Wells for the L.C. Industries site. I am putting the hard copy in the mail this afternoon to your attention. Please let us know if you have any questions or concerns. Thank you again for your assistance on this. Sandy Sandy Miller Project Scientist Highlands En viranmental Snlutians, Inc_ B410-0 Falls of Neuse Road Raleigh, NC 27615 Office: 919-848-3155 Cell: 919-819-4312 Fax: 919-848-4265 email: www.smi(ler@hesnc.corn website: w_ww.hesnc.com Celebrating 10 years of Solutions S. >=.rt�ronrrter�ii l �. �olvtions, Er►c. From: Rogers, Michael[mailto:michael.rogers@ncdenr.gov] Sent: Thursday, May 07, 2015 10:07 AM To: Sandy Miller Cc: Joe Beaman; William Frederick Subject: RE: notice of Intent Farm NO L.C. Industries far the Blind W10500803 Thank you and Your welcome. From: Sandy Miller [maitto Srniller uhesnc.corn] Sent: Thursday, May 07, 2015 10:02 AM To: Rogers, Michael Cc: Joe Beaman; William Frederick Subject: RE: Notice of Intent Form Good morning Michael, Highlands f. Environmental Solutions, Inc. 6410-d Falls of Neuse Road,RaFeigh, NC 27615 Phone: 919-W-3155I Far: 91"48-4265 /www,hesnc.com May 18, 2015 Mr. Michael Rogers NCDENR - Department of Water Resources WAROS 512 N. Salisbury Street Raleigh, North Carolina 27604 Subject: Submittal of Notification of Intent to Construct or Operate Injection Wells L.C, Industries, Inc. - Diesel Fuel Release 4500 Emperor Boulevard, Durham, Durham County, NC NCDENR Incident No: 92274 HES Project #202003 Dear Mr. Rogers On behaff of L.C. Industries, Inc., please find enclosed an original copy of our Notification of Intent to Construct or Operate Injection Wells for the proposed in -situ remediation of petroleum -impacted soil activities at the subject site. The diesel fuel release resulted from the failure of an underground product line, and impacted an unpaved area immediately surrounding two aboveground storage tanks (ASTs), owned by LCl and located at the subject site. Additionally, the release impacted an underground electrical conduit housing three-phase power lines maintained by Duke Energy, an unpaved area near a light pole, and a paved parking lot located immediately southeast of the ASTs. The electrical conduit appears to have acted as a preferential pathway for product migration; allowing for the product to migrate to the second area southwest of the AST area, where the product surfaced adjacent to a light pole and concrete walkway. Emergency remediation activities and soil excavation activities have been performed, as well as performance and submittal of a Comprehensive Site Assessment (CSA) and a Corrective Action Plan (CAP). The CAP, which was approved on July 8, 2014, and proposed an in -situ remediation program for the remaining petroleum -impacted soils. This NOI is being submitted as fulfillment of the approval process. If there are any questions regarding this correspondence, or the project in general, please contact me at (919) 848-3155_ Sincerely, Highlands Environmental Solutions, Inc. Sandra Miller Project Scientist Enclosure cc, Mr. Eugene Roddy - L. C. Industries, Inc. NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS The following are "permitted by rule" and do not require an indivi.dual permit when constructed in accordance with the rules of I 5A NCAC 02C. 0200. This form shall be submitted tit least2 weeks prior to iniection. AQUIFER TEST WELLS USA NCAC 02c .02201 These wells are used to inject uncontaminated fluid into an aquiferto determine aquifer hydraulic characteristics, IN S/1VREMEDIATION OSA NCAC 02c .0225) or TRACER WELLS USA NCAC 02c ;0229): 1) Passive Injection S y stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include ORC socks, iSOC systems~ and other gas infusion methods. · 2) Small.:Scale Infection O p erations -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 ofa remediation strategy 10 order to develop a full scale remediation plan for future implenientatiori, and where the surface area of the injection zone wells are located within an area that does notexceedfive percent of the land surface.above the known extent of groi.lndwater 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. DA TE: __ __,M=ay,_7...__,, 20li_ PERMIT NO. ~o < co @ Lj I (to be filled in by DWR) A. WELL TYPE TO BE CONSTRUCTED OR OPERATED (1) ---'Air Injection Well.., ..... ~ •... ,.; ... ; ....•. ; ....... ~ .. ,Complete sectionsB-F, K, N (2) ___ Aquifer Test Well .........................•............. Complete sections B-F, K, N (3) ___ Passive Injection System ............................... Complete sections B-:-F, H-N (4) X ~--Small-Scale Injection Operation, .............. , ...... Complete sections B-N (5) ___ .Pilot Test. .... , .. , ............ , ........................... Complete sections B-N (6) ___ T.racer Injection Well. ...........................•....... Complete sections B-N B. STATUS OF WELL OWNER: Business/Organization C. WELL OWNER-State name of entity and name of person delegated authority to sign on behalf of the business or agency: Name: Mr. Eugene Roddy Mailin:gAddress:.4500 Emperor Boulevard City: Durham State: NC DayTeleNo.: 919-596-8277 ext.2265 EMAIL Address: eugene.roddy@lc.,.ind.com UiCIInSitu Remed. Notification (Revised 3/2/2015) Zip Code: 27703 County:~D~u=rh-am=--- Cell No.: 336-392-0715 Fax No.: __________ _ Page I D. PROPERTY OWNER (if different than well owner) Name: NA Mailing Address: _____________________________ _ City: ____________ State: __ Zip Code: _______ County: _____ _ Day Tele No.: ___________ _ Cell No.: __________ _ EMAIL Address: _____________ _ Fax No.: __________ _ E. PROJECT CONT ACT -Person who can answer technical questions about the proposed injection project. Name: Sandra Miller Mailing Address: 8410-D Falls ofNeuse Road City: Ralei gh State: NC . Zip Code: 27615 County:~W ...... ak=e ___ _ Day Tele No.: 919-848-3155 Cell No.: __ _,9:;..:1=9-..,,,8=19"---4-"3=1=2'----- EMAIL Address: smiller@b esnc.com Fax No.: _____ 9=19--~84~8~-4=2~6~5 __ _ F. PHYSICAL LOCATION OF WELL SITE Physical Address: __ __,L=·-=C~. =In=d=u=stn=·=es=-=In=c'-'-. _______________ _ ___ 4~5~0~0~E=m=p=er=o'-=--r=B=o-=u=lec.c.v=~=d~ ___________ County: Durham (2) City: ---~D"""ur=ha=m~--------State: NC Zip Code: --=2'"""7 ...... 70=3~------ Geographic Coordinates: Latitude**: ___ 0 ____ " or ~0 -~87~3~4=8~4 ___ _ Longitude**: 0 __ " or __ -___ 78~0 .838443 Reference Datum: ~3 ...... 78~'-_____ Accuracy: _______ _ Method of Collection:.---'G=o=o=g=le=-=M=a=p=s ____________ _ **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:_<=3....aOO'--"-"'0 ____ s.quare feet Land surface area of inj. well network:. __ <~3~0~0'--"0'--__ .square feet (S 10,000 ft:2 for small-scale injections) Percent of contaminant plume area to be treated: 100 (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. UIC//n Situ Remed. Notification (Revised 3/2/2015) Page2 I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and duration of injection over time. See attached in fo rmation fr om 3tier. J. INJECTANTS -Provide a MSDS and the following for each injectant Attach additional sheets if necessary~ NOTE: Approved injectants (tracers and remediation additives) can be found online at http :l/portal.ncdenr.org/web/wq/apslgi·vpro ; All other substances must be reviewed by the Division of Public Health , Department of Health and Human Services. Contact the UIC Program for more info (919-807-6496). Injectant: ---=S=,e~e~a=tti=a~c~he=d~in_._fo~rm~a-ti~·o~n .... m_o~m~3~ti~·e~r, ________________ _ Volume ofinjectant: ____________________________ _ Concentration at point of injection: _______________________ _ Percent. if in a mixture with other injectants: ___________________ _ Injectan:t: ~------------------------------- Volume ofinjectant: ____________________________ _ Concentration at point of injection: ______________________ _ Percent if in a mixture with other injectants: ___________________ _ Irijectant: Volume of injectant: ____________________________ _ Concentration at point of injection: _______________________ _ Percent ifin a mixture. with other injectants: ___________________ _ K. WELL CONSTRUCTION DATA (1) (2) Number of injection wells: --=2;:a,.5 _--'Proposed _____ ~Existing Provide well construction details for each injection well in a diagram or table for:inat A single diagram or line in a table can be used. for multiple wens with the same construction details. Well construction details shall include the following: (a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery) (b) depth below land surface of grout, screen, and casing intervals -see att~ched figure (c) well contractorllame and certification number-Quantex, #3106 UIC/Jn Siiu Remed . Notification (Revised 3/2/2015) Page3 L. SCHEDULES — Briefly describe the schedule for well construction and injection activities. Prior to the detailed activities. TIES anticipates completion _of three preliminary tasks: abandonment of on_e_da_m_aged well. minor repairs to three other gxistinQ well.. and completion of a baseline Lam , in session. FfreIl construction of the injection wells can bggiLupon NCDENR's authorization to proceed contingent on the time schedule of the drillinz contractor and the availabiliti, of the 3tiergersonnel being uresent for set-up of the system, 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_ See attached information tom 3der_ N. SIGNATURE OF APPLICANT AND PROPERTY OWNER APPLICANT: .1 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 ofthose individuals immediately responsible for obtainhzg 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 cons operate, maintain, repair, and if applicable, abandon the injection well and all relat d appurte t s it y vrdance with the 1 SA MCA C 01 C 0200 Rules. " LGcgPrrt �adpt Print or Type lull Name "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 We11 Construction Standards (I SA NC.4C 02C .0200). " " Ownee' means any person who holds the fee or other property rigbts 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 cons ry,_agrcernf71 wn Mg, _ G� tit e- lzocld igm►1ureProperty owner (if differen ro i applicant) Print or Type F'uIl NAne * An accf4xa rt ment between the upplicRnt a d property owner may be submitted in lieu of a signature on this form. Submit the completed notification package to: DWR — UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone. (919) 807-6464 MUM Situ Remed. Notification (Revised 3I2I241 S) Page 4 Flush Mount Casing 'µ C6 k6 m 0 R 0 0 1- �---- 0— to chemical Storage vessel Concrete - 'Schedule 40 PVC Casing proximately 2 ft.) - Neat Portland Caxnent Grout Hydrated Bentonite i (1.0 feet) Clean sand Schedule 40 PVC Manufactured Screen - _ (O.010 slot) (5 ft.) Highlarsds Enviramriental Nod is Scene S01t�tians, or 4 —;-- y Injection Well Schematic Diaorar�1_ w",rrw.Wd LC Industries, Inc. 4500 Emporer Boulevard, Durham, NC 202002 November 2014 12 1a � O 3tier TECHNOLOGIES Treatment 5oiutions for Soil Contamination Highlands Environmental Solutions -- LC Industries / Durham, N.C. Site Description: The subject site, LC Industries Inc, is located in Durham North Carolina. The original impacted area was the result of storage tank release. The original work plan utilized the dig and haul method of remediation. Due to underground infrastructure, pipes and utility lines, the full scope of material removal was limited and the result was continued impact of the hydrocarbon contaminants. The next phase of remediation will require a technique that allows for remediation material to be added to site through in -situ methods and encouraged to travel multiple pathways around the pies and limited access areas to reach the target residual contaminants. The three original excavation locations are still exhibiting unacceptable levels of Naphthalene and Methylnaphthalene. it is not unusual in sites that are not able to fully excavate the target areas to exhibit a level of rebound or continued influence from the contamination outside the treatment areas. The following recommendations are based on the three target areas supplemental treatments of an in -situ remediation process. Technology Overview: 3 Tier Technologies LLC is a green science and technology company focused on developing innovative and sustainable materials, processes and applications to optimize in -situ hio-remediation of soils and water contaminated by hydrocarbons and other various organic constituents. 3 Tier focuses our efforts on the use of "Green TechnoloW that uses significantly less equipment, labor, and fuel to execute while remediating harmful contaminates in -situ. "Green Technology' is a solid movement to identify products and methods to clean up various contamination sites without extensive use of equipment that can emit harmful pollutants to perform the required task and establish systems that allow for material to be recycled and/or re -used after completing the projects. To achieve maximum performance in these various treatment processes, 3 Tier Technologies has discovered that current products offered in todays markets offer a single solution that only impacts either bia-augmentation or bio-stimulation. The development of a complete regeneration and cleaning solution would not only enhance the remediation of contaminates, it would also regenerate contaminated soils and groundwater to a healthy and active state for effective and safe re -use. 3 Tier achieves a complete regeneration/cleaning system with a suite of products that uses various recipes consisting of three distinct yet synergistic components, a blend of activated organic bio-polymers derived from very stable, organic compounds found in brown and oxidized black coal, a ultra high concentration of live synergistic bacteria, and a readily biodegradable natural enzyme product consisting of a nutrient -rich extract with a broad. -spectrum package of identifiable enzymes, coenzymes, amino acids and other proteins. These multi -action products are able to degrade common organic constituents with minimal use of equipment, labor and cost. 250 National Place. Suite 142, Longwood FL, 92750 • www,3tiertech.com • 877-226-7498 280 SA2BO a BA 2ff 1 1-40 EAM -low (§43 _T Ad Approximate , $dAW JO L Site Lomfion] .......... ........ ............. ...... 4k,Lb f. P40 rodt294 COP It Coy W r*d Appmzftsmfe Seale 0.45 0. 9WO My" Source. Mkrosoft Streets & Tdp, 2002 Site Lwation Diagram PMJ$d NVIM Injection Permit Highlands Durham, North Carolina Highlands LC Industries, Inc. Solutions, Inc. 202002 SM Scale APPmyinmfe pate Scale as Noted I December 2014 N T Treatment Product: Soil Rx -Soil Rx is the ultimate heavy lifter in hydrocarbon remediation and utilizes a new approach to solving soil and water hydrocarbon contamination problems, Speciallyformulatedfor safety, effectiveness and environmentally friendliness, Soil Rx utilizes a blend of Polyelectrolyte Enhanced Biopolymers (PEB), a ultra high concentration of live synergistic bacteria, and a readily biodegradable natural enzyme product consisting of a nutrient-rich extract with a broad..;spectrum package of identifiable enzymes~ coenzymes, amino acids and other proteins. This tpple action product is able to degrade hydrocarbons with minimal use of equipment, labor and cost. Soil Rx's liquid form and low cost make this an easy to use cost effective means for industries to eliminate hydrocarbon contamination problems that consist of gasoline, jet fuels, diesel fuels, grease, tar, motor oils, crude oils, solvents, etc. Soil Rx is NCP Llstedd:. Disclaim.e,-." Soil RX is on the U.£ Environmental Pro.tectfon Agency's NCP Product Schedule. This listing does NOT mean that EPA approves, recqmmends, licenses, certifies, or authorizes the use of Soil Rxon an oil discharge. This listing means only thatdata have been ~ . . submitted to EPA as required by subpart J of the National Contingency P/afl, Sec 300.915. TreatmentMethod & Rates: Due to the relative size ofthe area to be remediated, 3 Tier recommends applying Soil Rx using a modified bore-n~pour method of application; This 'method will provide maximum control and saturation ofthe soiJ that will ensure proper penetration ofthe product to come In contact with th.~ contaminants while utilizing the established pathways that the current contaminants are currently using around the pipes and infrastructure. This method will require a minimal number of injection points per location that will remain in.aplace until the proce~s is completed. 3 Tier recommends the use of a 2" GeoProbe direct push unit;to establish the required injection points per location. The approximate depth of each hole will be 7.5 1 to 8'. These points wm then receive orie section of 1•~ slotted pipe (bottom section) and one sectionofsolid riser .. Each injectionpointis to be sand filled and capped With Bentonite. After initial injection process, pipes will trimmed flush with the ground and capped while remaining in-place until no further action noticeis received. Established points may be re-used at a]ater date for spot treatments or removed after completion. No further equipment requirements will be needed· after initial injection.point establishment SQil Rx is the remediation workhorse in our suite of hydrocarbon products and must be diluted with water prior to use. The target goal is to apply 20 ounce of Soil Rx concentrate per cubit yard of soil to be treated. As previously stated,.the work will focus on three target areas that continue to _exhibit hot spots after excavation. Target area One known as Area ''C' measures 15' by 18' with approximately 60 cubic yards of material to treat. Target area Two known as Area ''A" is approximately 28' by 2 O' with approximately 165 cubic yards of material. Targetarea Three known as Area "D" measures 48' by 20' and has apptoximately27.5 cubicfeetofmaterial. Though the standard dilu.tion rate is 10 to 1 with the standard appUcation rate being 1 to 1.5 diluted gallons per cubic yard, for this application, 3 Tier recommends thatthe dilution rate be i,ncreased to 20 to 1 to ensure proper coverage and moisture content with the application rate being three gallons diluted materialper cubicyard. Therefore, 75 gallonsofSQil Rx concentrate will be di,luted in1425 gallons Mclean water-for thepreyiouslydescribed areas. Area "C" will require 180 galJons of diluted material, Area "A" will require 495 gallons of diluted material, and Area ;'D" will require 825 gallons of diluted material. Areas "A" and "C" will require 5 injection points each, and Area "D 11 will require approximately 15 injection points. As previously mentioned these injection points will remain available for use until the project is completed thus saving potential additional costs for equipment usage. Injection point detail is available upon request or will be provided prior to work commencement. Areas "A" and "C" will can be plum.bed to on 275 gallon IBC tote which would require Area "C" to be filled twice while Area "D" will use two separate totes for each half of the area requiring just one fill each. Tanks and plumbing will remain in-place until all material is absorbed into the injection points and removed and stored until areas are tested and the need for any additional treatments is determined. Due to the soil types> initial product application may require up to one week though our experience and past excavation has shown that material may only need a day or so. The target areas should be sampled 45 to 60 days after treatment. After the subject results are available, 3 Tier review progress and make further site recommendations. Should additional applications be required, they will be performed using existing injection points as determined by 3 Tier and HES personnel. 3 Tier recommends that the site work commence in the spring, once the soil temperatures begin to rise after the winter cool temperatures. 3 Tier will provide a technical support person for the initial work as technical support for this project The fol1owing application protocol has been provided by Daniel J Burdette, President, 3 Tier Technologies LLC. Please contact us for clarification, regulatory clarifications, or schedule technical support. Stier TEC"N0lD@IES MATERIAL SAFETY DATA SHEET PRODUCT: Bio-Regen Soil Rx Section I — Chemical Product & Company identification Trade Name: Blo-Regen Soil Rx Chemical Family: Mixture Product Description: A concentrated blend of organic biopolymers, bacterial cultures, and amino acids that is non -hazardous. Manufacturer: 3 Tier Technologies, LLC 250 National Place, Suite 142, Longwood, FL 32750 Technical Support: 877-226-7498 Chemical Emergency: 407--808-4553 Issue Date: 0712412012 Supersedes Date: 02l13/2012 Section 2 — Hazards Identification Emergency overview: Avoid contact with eyes. Mild skin irritation. Potential health effects: Eyes: Contact with eyes may cause severe irritation. Skin: May cause irritation upon prolonged contact. Inhalation: None known Ingestion: May cause irrhationlnausea it ingested in large quantifies Section 3 — Composition ! information on Ingredients Components _ CAS # Percent Soli Rx is a blended composition 'not considered hazardous' under the OSHA Hazard Communication Standard CFR Title 29 1910,1200. All ingredients appear on the EPA TSCA Inventory. All Bacillus Bacteria contained in this product are DSL Listed and Compliant; organic Blopolymer •1415-93-6 55% Amino Acids various 10% Bacillus Bacteria ATCC 18250-7 15% RO Water 7732-18-5 25% Ingredients of E1 % have been added to a non -hazardous liquid organic substrate. Active components <15% are identified above Section 4 -- First Aid Measures First aid procedures Eye contact: Immediately Mush eyes with plenty of water for at least 15 minutes. Seep medical attention if irritation persists. Skin Contact: Flush skin with large amounts of water. Remove any contaminated clothing and wash before reuse. Seek medical attention if irritation occurs- 0 2012 3 TFer'r0d1ndD9'es, ltC. -?n: 377-226-7496-www3aldeah.onm- MWS Bb-F e m Sd! Pc Pape 1 of 4 Inhalation: Ingestion: If symptoms are experienced, remove source of contamination and/or move victim to fresh air. If breathing is difficult,. have trained personnel administer oxygen. If respiration stops, have trained personnel administer artificial respiration. Get medical attention immediately. Give large amounts of water. Do not induce vomiting. If vomiting occurs prevent aspiration by keeping victim's head below the knees. Get immediate medical attention. I Section 5 -Fire Fi ghtin g Measures Flash Point: None Extinguishing Media: Water fog or fine spray, carbon dioxide, dry chemical or foam. No special requirements Fire fighting Protection: As in any fire, wear self-contained breathing apparatus pressure- demand, MSHA/NIOSH (approved or equivalent) and full protective gear. [ Section 6 -Accidental Release Measures Personal Precautions: Isolate area. Keep unnecessary personnel away. Keep out of low areas. Ventilate closed spaces before entering. Use of safety glasses and impervious gloves recommended. Environ mental Precautions: Prevent further leakage or spillage if safe to do so. Methods for Containment: Prevent entry into waterways, sewers, basements or confined areas. Methods for Clean-up: Wear appropriate protective equipment and clothing during clean-up. Large spill: Use a non-combustible material like venniculite, sand or earth to soak up the product and place into a container for later disposal. Dispose in accordance with all local, state and federal regulations. Small spill: Follow same procedure as above. I Section 7 -Handling and Storage Handling: Storage: Avoid contact with skin and eyes. Wash hands thoroughly after handling . Store this product below 120"F (49.C), preferably below 75"F (24'C), in a cool, dry, well ventilated area away from heat, sparks, flame, oxidizers and out of direct sunlight. For best results, use within 24 months. C> 2012 3 Tier T edmol:,gies. llC. -Ph: 377-226-7 498 -www .3tiarteeh.com -MSDS Bio-Regan Soil Rx Page 2 of 4 J Section 8 -Exposure Controls, Personal Protection Personal Protection General: Eye wash fountain Is recommended. Minimize exposure in accortlance with good hygiene practices; Keep out of teach ofchildren. Eyes: Wear chemical goggles. Skin: Suitable protective clothing is recommended but not required. Use impervious gloves. Respiratory: None required for recommended use. Avoid creating aerosols in poorly ventilated areas: j Section 9 -Physical & Chemical Properties Vapor Pressure: Vapor Density (air= 1): Equivalent to Water Equivalent to Water 1.0approx; Specific Gravity: Solubility in water: voe: Appearance: pH: Bolling Point: Flash Point: Freezing Point: Evaporation Rate: Weight: Odor: 99% Negligible Brown/Black Liquid 6.0to a.s > 212• F (100" C) None < 32 • F (o• C) Not Detennined 8.7 ..... 9.2 lbs. /gallon Mild citrus odor I Section• 10 -Stability & Reactivity Chemical St.ability: Stable at normal conditions. Incompatible Materials: Strong oxidizing agents, alkalis HazardQus Decomposition Products: None known. Conditions to avoid: See Section 7. Hazardous Polymerization: Will hot occur. I Section 11 -Toxicology Information Toxicology data: Not available. I Section 12-Ecological Information Ecotoxicify: Readily biodeQradable . I Section 13 -Disposal Considerations Disposal instructions: Dispose in accordance With all applicable regulations, All wastes must be handled in accordance with local, state and federal regulations. Regulations vary. · © 2012 3 Tier Technolog!es, LlC. -Ph: 877 •226-7498 -www.3liertec:h.com '-MSOS Bio-Regen Soll Rx Page 3of4 I Section 14-Transportation Information General information: US DOT: Non--hazardous. Not regulated. Proper Shipping Description: Class 55 I Section 15 -Regulato ry Information TSCA Inventory Status: This product and/or all of its components are either included on or exempt from the TSCA Inventory of Chemical Substances. DSL (Canada): This product and/or all of its components are either included on or exempt from the Domestic Substances List. I Section 16 -Other Information HMIS ratings: NFPA ratings; Disclaimer: Health: 1 Flammability: 0 Physical hazard: 0 Health: 1 Flammability: 0 Reactivity: 0 The data and recommendations presented herein are based upon research of others and are believed to be accurate. However, no warranty is expressed or implied regarding this data or the results to be obtained from the use thereof. The manufacturer assumes no responsibility for the injury to customers or third persons proximately caused by the material if reasonable safety procedures are not adhered to as stipulated in the data sheet. Additionally, sine actual use by others is beyond our control, no guarantee, expressed or implied, is made by the manufacturer as to the effect of such use, the results to be obtained or the safety and toxicity of the product nor does the manufacturer assume any liability arising out of use, misuse, by others, of the product herein. Information provided herein is provided solely for the customer's assistance in complying with the occupational safety and health act of 1970 and regulations there under. Any other use is prohibited. Cl 2012 S 11er Technologies, LLC . -Ph: 877-226-7498-www.3~ertech.airn-MSDS Bio-Regen Soil Rx Page 4 of4 . ,ISD t' UNITED STATES ENVIRONMENTAL PROTECTION AGENCY Uj Y WASHINGTON, D.C. 20460 NOV 17 2010 Mr. Daniel J. $urdette 3 Tier Technologies, LLC OFFICE OF 2302 Mercator Drive SOLID WASTE AND Suite 102 EMEROENCY RESPONSE Orlando, FL 32807 Dear Mr. Burdette, Thank you for providing the technical product data required by the National Oil and Hazardous Substances Pollution Contingency Plan (NCP), 40 CFR Part 300, on your product "Soil Rx (aka, Bio-Regen Hydrocarbon)." After conducting our review, your data submissions have satisfied the requirements contained in Title 44 of the CFR section 300.915 of the NCP. "Soil Rx (aka, Bio-Regen Hydrocarbon)" will be listed on the NCP Product Schedule under the Bioremediation. Agent category and may be authorized for use by Federal On -Scene Coordinators in accordance with 40 CFR section 300.910. The technical data for this product will be kept on file by the Office of Emergency Management Regulation and Policy Division Oil Program Center pursoant to 40 CFR section 300.920. Enclosed aye some ofthe relevant provisions in the NCP on restrictions regarding the listing of your product. Please note, you are required to notify the Environmental Protection Agency (EPA) of any changes in composition, formulation, handling Procedures, or application of your product. Based on this notice, EPA may require retesting of the product. Also, note that the listing of "Soil Rx (aka, Bio-Regen Hydrocarbon)" on the NCP Product Schedule does not constitute approval, certification, authorization, licensing or promotion of the product; nor does it imply compliance with any criteria or minimum standards for such agents. Failure to comply with these restrictions or the making of any improper reference to EPA in an attempt to demonstrate approval or acceptance of the product will constitute grounds for removal of the product from the schedule. Please review the enclosed information and contact Ms. Leigh DeHaven in the Office of Emergency Management at (202) 564-I974 if you have any corrections or questions. Sincerely, 12. R Craig Matthiessen, Director Regulation and Policy Development Division Office of Emergency Management In'WnWT AddMss {URQ a trt>pJAY waeps.gav R oc 6drAecyclebla 0 Priafad w fe Vegetable D7 Bawd Inks on 1W% Postcomumar, Process ChImfne Fran Rocyded raper i CERTIFICATE OF ANALYSIS 3 71cr Technologies, LLC Reported To: 2302 Mercator Dr, Suitt 102 Orlando, FL 32807 Product: SOrL-RX Lot Number: 10050119018 Overview: Case Number. Date Received: Date Repotted: Triad Forensics independa tService Lkm-abxy 391 Technology Way Suite 167 Lab 1 'i+lWinstoo•Salem, North Carolina 27101 Tel 336.722-8963 Fax 866-571-6264 URL. wwwsriadforensic.rsrm TFL-10-0721 7121120l 0 OnS/2010 Test Method: U.S. EPA Appendix C to Part 300 Swirling Flask Dispersant Test Name: Effectiveness T ast, Revised Standard Dispersant Test, and Sivremediation Agent Effectiveness Test In addition to gravimetric analysis, normal alkanes as well as the more highly resistant and toxic polynuclear aromatic hydrocarbons (PAHs), were monitored using }sigh Resolution Gas Chromatography Mass Spectrometry (GCIMS) to quantify changes in the oil composition resulting from biodegradation during a 28-day effectiveness study for SOIL-Itx@'. The bioremediadon effectiveness test was performed using a Shimadxu GC-2010 with AOC-201 auto sampler. The GC/MS was operated in the selective ion -monitoring mode (SIM mode) at a scan rate greater than 1.5 scans per second using Helium as the carrier gas. All other instrument settings and analytical procedures follow U.S. EPA Method 8270 and the configuration and calibration section of reference teat A; see below Concurrent microbiological analyses were performed to determine and monitor the viability of the microbial cultures being studied. ASCLD-LAB International approved laboratory notebooks were maintained to document the chemicals, media, surrogates, stock solutions, standards, and reagents used to perform the 28-day effectiveness study. Effectiveness testing was conducted using triplicate samples of the following: control, nutrient', and produce a Control and treatment flasks were sampled three times over a 28-day period: clay 0, day 7, and day 28. ` Manufactured by 3 Tier Technologies Control samples contain approximately 0.5 grams of reference oil and brought to a Finial volume of 1000-mL with non -sterile seawater a N u went s amples contain approximately 0.5 grams of reference vA,10-mL of N&P Sal tselution, 2-mL solutions 2-5, and brought to a final volume of 1000-mL with non -sterile sp. awarr, 4 Product samples ccomin approximately 0.5 grains of reference oil, 10-mL of N&P Salt solution, 2-mL of Sol utlons 2-5, and brought to a Gnat wIume of 1000-mL with 1.10 diluted Soil-Rxg/non sterile seawater solution. Page Iof3 The .effectiveness study was performed using the test methodologies described in the following texts: A. EPA Appendix Cto Part 300 -Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Test; andBioremediation Agent Effectiveness Test B. 40 CFRpar;t 300 * National Oil and HazardousSubstances Pollution Contingency Plan C. L.T. McCarthy; Jr., I. Wilder, and J.S. Dorrier, Standard Dispersant Effectiveness and Toxicity Tests. EPA Report EPA-:RZ-73-201 (May 1973). Every attempt was made to coinplywith all requireme'nts and quality guidelines for conducting effectiveness testing. ln the referenced test methods, certain resources, chemicals, or equipment were no longer available . As a result, equivalentsubstitutes were used to facilitate rigorous testing and evaluation ofthebioremediation product studied. The equivalency of substitute themicals was determined by comparative assessment of the mass spectra data5 for both the original and all potential substitute chemicals. Substitutions of equipment mentioned in the reference texts were made after consulting with the device manufacturer and examining equipment and/ or software manuals. Independent Laboratory Results: Data Table 1: Bioremediatjon Agent Effectiveness Test Data ~ample Description CONTROL NUTRIENT SOIL-RX® PRODUCT Day of Collection · DayO Day7 Day 28 DayO Day7 Day28 DayO Day7 Day28 Gravimetric Results (mg)"' 496.20 .458.24 456.24. 49i.03 487.03 454.52 497.65 482.93 347.64 M icrobfalViabllity ad Activity <3.0 <3.0 <3.0 <3.0 3.6 7.4 43 >1100 >1100 (MPN/g) :;C/MS Results Total Mean 34908.9 35206.2 34287.8 34863.3 32894.1 3.2610.0 34993;0 24446.0 17597.0 Alkanes loom)*"' G.C/MS Results Total Mean 6051;3 5720.9 5892.7 6047.4 5745.8 5205.1 6069.0 3219.2 1600.1 Aromatics foom)"'* Percent Reduction in Total 1.779% 6.463% 49;7l3%. Mean Alkanes after 28 Days Perteht Reduction in Total 2.621% 13.928% 73;635% Mean Aromatics after 28Days • Gravimetric results are averages of the three replicate studies perfonned on each sample (Control, Nutrient,, and Product) for each sample day (Day 0, Day 7, Day 28). . "'GC/MS results of averaged total aromatic compounds of the three replicate studies performed on ~ach sample (Ccintro~ Nutrient, and Product) for each .sarriple day (Day o, Day 7, Day 28). Total of nine samples per day sampled (Three for Controi, Nutrient, and Product on Day O; three for CQntrol; Nutrient. and Product on Day 7, and three for Control, Nutrient, and Product on Day 28). s Obtained by a serial dilution and three point callbration curve Page2of3 Effectiveness testing for the control, nutrient, and product samples was conducted in triplicate, Minor qualitative changes were noted for the oil fraction in the nutrient and control sample flasks for days 7 and 28. However, no observable changes in either color or turbidity were noted for the nutrient and control samples during the 28-day test period. For all three of the product flasks, significant qualitative changes in the sample solution's turbidity, coloration, and volume of the oil fraction were noted. The qualitative changes to the oil fraction layer in each of the samples were verified quantitatively using U.S. EPA Methods 1664 (gravimetric) and 8270 (Characterization of Volatile Organic Compounds). Upon termination of the effectiveness study, a significant reduction in hydrocarbons was documented for the product samples containing the bioremediation agent in Soil-Rx®. The microbial viability and activity was maximal for the Soil-Rx® product samples assayed on day 7 and day 28. The data obtained from testing those samples indicates that a strong correlation exists between Soil-Rx® microbial activity and hydrocarbon compound reduction. The product samples indicate that the microbes in the Soil-Rx® product are highly effective in reducing hydrocarbon compounds in a time period ofless than 28 days. Laboratory Statement of Qualifications {SOQ): Triad Forensics Laboratory (TFL) is compliant with ISO/IEC 17025:2005, EPA, FDA, NELAC, AOAC, and ASCLD-LAB International accreditation guidelines for independent testing laboratories. We are audited and conduct external proficiency tests at least twice annually to maintain all accreditations and certifications. All laboratory equipment and instrumentation are calibrated in accordance with ISO/IEC 17025 guidelines. TFL is certified by, registered with, and operates in the State of North Carolina. END OF LABORATORY REPORT ReportedBy, ~ Lauren A. Stainback Forensic Laboratory Director, Member AOAC, APHA, and NELAC ASCLD-LAB Legacy Auditor Date Signed: August 25, 2010 Page 3 of 3 CIItTIFICATE OF ANALYSIS 3 Tier Technologies, LLC Reported To: 2302 Mercator Dr. Suite 102 Orlando, FL 32807 Product: Soil Rx@ Lot Number: 10050119018 Methodology Overview: Triad Forensics tndeperidem--�avicelahora xy 391 Technology Way Suite 167 Lab I Winston-Salem, North Carolina 27101 Tel 336.722-6963 Fax 866-571•9264 UiiL: www.triadforensir.com Case Number; TFL-10-0913A Date -Received: 6/5/2010 Date Reported: 6/7/2010 Test Method: EPA 2000.E Test Name: 24 Hour Acute Toxicity The freshwater organisms, Pialephales prornelas, selected for this study were purchased from a local fishery and were certified to be free of parasitic and bacterial pathogens. Approximately 160 live animals were purchased and transported 15 miles to the laboratory on 61112010. Once the animals arrived at the laboratory, they were placed in a holding tank of simulated freshwater for observation. Their physical health and size were satisfactory according to EPA method 2000_0. The physical and chemical characteristics of the holding water tank were recorded at least once daily and the results are provided as attachments to this document. All aquarium tanks were cleaned using the procedure described in EPA 2000.0 Sections 5.2.2-5.2.3. All organisms were fed 0.007 grams Aqueon Tropical Flakes fish food one time per day. After a five-day observation period, approximately 20-24 healthy organisms were selected for each test of 0% (control), 12.5%, 18.75%. 25%, 50% and 100% dilute effluent toxicant. Dilute Soil Rx9 solution was prepared by the manufacturers instructions by diluting 1 part Soil RxG) solution to 10 parts deionized water. 22 Selected organisms were then placed into aquarium tanks (including 1 bubble air hose, 1 filter, and 1 glass thermometer) that had been spiked with reagent grade chemicals to create simulated freshwater having the physical and chemical composition as described in EPA method 2000.0 section 7.2.3.1 and Table 7. Physical and chemical results for all pre- and post - toxicant water effluents were tested. The results are included as attachments. After the organisms acclimated to the new environment, the desired level of dilute toxicant was added to the water. The time was noted at the beginning of the study and each study had duration of 24 hours. Some tests were terminated before 24 hours of toxicant exposure time due to greater than 90% organism mortality. Studies in which all organisms expired were noted and all data have been tabulated and are provided as attachments. "AFfordabie Excel]once in Analytical Testing and Forensic Casework' Page I of 3 Triad Forensics CERTIFICATE OF �AL!'SiS �>�i�tserv�e �� 391 Technology Way Suite 167 Lab 1 Wins-ton-SalertL North Carolina 27101 Tel 336.722-8963 Fax 866-571-8264 URL.- www.triadforemsiccom Starting Live Effluent Finai live Organism Organism Qty. Methodology ❑]lutions in aty Post 24 Hour % Toxicant Exposure Fathead minnow, Pimephales promelas, Acute Toxicity Tests With 22 Standard Synthetic Freshwater 12'S Effluents and Deceiving Waters 22 Fathead minnow, Pimephales promelas, Acute Toxicity Tests with Standard Synthetic Freshwater 22 Effluents and Receiving Waters 1 & 75 11 Fathead minnow, Pimephales promelas, Acute Toxicity Tests with Standard Synthetic Freshwater 22 Effluents and Recelving Waters 25 0 Fathead minnow, Pimephales promelas, Acute Toxicity Tests with Standard Synthetic Freshwater 22 Effluents and Receiving Waters 50 0 Fathead minnow, Pimephales promelas, Acute Toxicity Tests with Standard Synthefic Freshwater 22 Effluents and Receiving Waters 100 0 "Affordable Excellence in Analytical 'resting and Forensic Caseworle' Page 2 of 3 CERTIFICATE OF ANALYSIS Independent Laboratory Results: Triad Forsnsits ttdes�t Service l a�aralnry 391 Technology Way Suite 167 Lab 1 Winston-Salem, North Carolina 27101 TO 336-722-8963 Fax 866-571-8264 URL: www.triadforensic.com Total organism survival was 100% after 24 hours of exposure at 12.5% dilute Soil RxS solution. LD50 was reached at 18.75% dilute Soil RxO solution after 24 hours of exposure. All organisms expired within 12 hours of exposure to 25%, 50%, and 100% dilute Soil Rx@ solutions. Laboratory Statement of Qualiftcations (SOO). Triad Forensics Laboratory (TFL) is compliant with iSD1lEC 17025:2005, EPA, FDA, NELAC, ADAC, and ASCLD-LAB international accreditation guidelines for independent testing laboratories. We are audited and conduct external proficiency tests at least twice annually. All laboratory equipment and instrumentation are calibrated in accordance with ISQIIEC 17025 guidelines. TFL is certified by, registered with, and operates in the State of North Carolina. Reported By Lauren A. Stainback, Forensic Laboratory Director Date Signed 06107/2010 'Affordable Excellence in Analytical Testing and Forensic Casework' Page 3 of 3 ZAsphatt Perking APPROXIMATE SCALE 0 Z JL w Z �L� 1 HW-3 Grounding Point FfW-4 Product Reca�ery n Anse -B" 4p f �� ApprC*dmatA Extent of Con m ♦ , i Sall Exoe�tion �+Oftlad - f� 'elw /f FancyNil •..\ f r Asphalt Parking Ares -o- ;1 •, Emergency Generator ' 3-Phose Electric. Line •' HfW-2 .r Call Towar Approximate Extent of SonExCavaffon ' HW-9 - Aaphait Parking 1 ` Area 'A- tan rd ;yr T$l i Mrro l 1 re rw. asp Highlands Gedo0�TlaIKM 1a sM- Environmental 202 3"�`"'�"' AQP►BW&Eftof A -A APPROXIMATE SCALE � � LCbdlgMWolaeetWifflt C-C Solutions Inc. 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December 2014 LC lffthes, Im- Salutions, Inc. .., auftRNo* Camrre ASSHOWN FJp 10 so# &ample Looffm f 0 l4fa tOq Well toollon Areas of Sod JnvesUpOon AAprw#wtPExkdof Soil EExcavalion Areas of Resrd+W Pelydlaum lmpaded Sad LIUFreatmerrt Area IS Injection Point -r4iO .3enerawr Product Recovery Trenc Gel Controls erg for ti0 Area "B" @aL o�Gtd Area "EE" E_3 G motor - 1 rea - Fence Treatment Area C Ohi'i 1% A-6 ' Emergency Geryerator 3-Phase Electric Line ` A~4'0 Approximate Extent of \... Sail Excavation 41V a� Cell Tower Approximate Extent of - Soil Excavation Area of Residuel Petroleum Impacted Soil __ -- Treatment Area D ?#} l7- Injection Points 0-� Asphalt Parking �� Area "D" X H W-2 �A-2 HW-gAspt7alt Parking X I-W hU Stan s � APPROXIMATE SCALE 0' r5' 3o' Area "A" Area of Residuel Petroleum Impacted Soil Treatment Area A Fence Highlands IZ Environmental Solutions, Inc. 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