WI0700408_DEEMED FILES_20150819

Rogers, Michael
From: Cox, Ashley B
Sent:
To:
Wednesday, August 19, 2015 3:52 PM
Rogers, Michael
Subject:
Attachments:
FW: RE: Injection Well Notification WI0700408 (NOi)
creswell injection 8.19.15.pdf
PDF is now attached.
From: Cox, Ashley B
Sent: Wednesday, August 19, 2015 3:51 PM
To: Rogers, Michael
Subject: RE: RE: Injection Well Notification WI0700408 (NOI)
Michael,
Please find attached the Injection Event Record for the NCDOT Maintenance Yard in Creswell, Permit #WI0700408.
If you have any questions, please contact me.
Thanks,
)f.slifey <B Co~ Jr,£(]
f£nvironmenta[ f£ngineer
NCDOT -Fleet & Material Management Unit
1566 Mail Service Center
Raleigh, NC 27699
Phone: [phone]
Fax: [phone]
From: Palmer, Gwendolyn M
Sent: Thursday, July 23, 2015 9:38 AM
To: Cox, Ashley B
Cc: Rogers, Michael; May, David; Hart, William
Subject: RE: Injection Well Notification WI0700408 (NOI)
Thank you for submitting the Notice of Intent to Construct or Operate Injection Well? (NOi) for the NCDOT c/o Ashley
Cox located at 4809 Beryl Rd., Raleigh, NC 27606. The Central Office of the WQROS received your complete NOi on
July 22, 2015. Please note the following:
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/wq/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 ~ells (e.g., air flow 'continuous' for date or rate of injection, etc.).
1
You can scan and send these forms directly to me at michael.ro>±ersO'ncdenrov, send by fax to my attention at 919-
807-6406, orvia regular mail to address below. When submitting the above forms, you will need to enter the nine -digit
alpha -numeric number on the form (Le., WIOXXXXXX) that has been assigned to the injection activity at this site. This
notification has been given the deemed permit number WI0700408. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in reply to this email. as it will already have the
assigned deemed permit number in the subject line.
Thank you for your cooperation
Gwendolyn M. Palmer
Support Staff
NCDepartment of Environment & Natural Resources
Division of Water Resources
Animal Feeding Operations and Groundwater Protection Branch
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone]
Email: owendolynpalmer(a�ncdenr.gov
Email correspondence to anti from this sender is subject to the N.C. Public Records Law end may be disclosed to third parties.
2

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Permit Number OtDt & De
1. Permit Information
NY—berr
Permittee
IACbUt-- CI4art-4-*-4,1-41.— Ice< -
Facility Name
l�ktq' NC�►a►w' Stl tii. .,cs,,,,t.A,t-ZL
Facility Address
2. Injection Contractor Information
Injection Contractor / Company Name
Street Address
City State Zip Code
ANot `b3-- how
Area code — Phone number
3. Well Information
Number of wells used for injection _ L
Well names t•i\W`
Were any new wells installed during this injection
event?
❑ Yes RI No
If yes, please provide the following information:
Number of Monitoring Wells
Number of injection Wells
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 farm for each
well insulted.
Were any wells abandoned during this injection
event?
❑ Yes pq No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned.
Injectant Information
Re-D I SnK
Injectant Type
Concentration (- _'f 5 16S —
Lithe injectant is diluted please indicate the source
dilution fluid.
Total Volume Injected J. is -
Volume
Injected per well 1• 7S [Ls
Injection History
Injection dates) �� N 101S
Injection number (e.g. 3 of 5) e 5
Is this the last injection at this site?
❑ Yes A No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PE. _1RMED WITHIN THE
STANDARDS LAI - T IN THE �.RMIT.
SIG RE OF 1 :TOR DATE
AnCY 6%
PRINT NAME OF PI SON PERFORMrNG THE INJECTION
Submit the original of this farm to the Division of Water Resources within 30 days of injection.
Attn. UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form U]C-IER
Rev. 8/5/2013

D'~
Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0700408
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
gwendolyn.palmer
Coastal SWRule
Permitted Flow
Facility
Facility Name
NCDOT Creswell Maintenance Facility
Location Address
14193 NC Hwy 94n
Creswell NC 27928
Owner
Owner Name
NCDOT -Fleet & Material Management Unit
Dates/Events
Orig Issue
7/23/2015
App Received
7/20/2015
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
Draft Initiated
Scheduled
Issuance Public Notice
Central Files : APS SWP
7/23/2015
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Government -State
Owner Affiliation
Ashley B. Cox
4809 Beryl Rd
Raleigh
Region
Washington
County
Washington
NC
Issue
7/23/2015
Effective
7/23/2015
27606
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
Palmer, Gwendolyn M
From:
Sent:
To:
Cc:
Subject:
Attachments:
Please find attached NOI.
".#i '. ':eklaar
Palmer, Gwendolyn M
Thursday, July 23, 2015 11:01 AM
May, David: Hart, William
Rogers, Michael
Injection Well Notification WI0740408 (N01)
201507231052.pdf
Gwendolyn M. Palmer
Support Staff
NCDepartment of Environment & Natural Resources
Division of Water Resources
Animal Feeding Operations and Groundwater Protection Branch
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone]
Email: gwendolyn.palmer ncdenr.gov

Palmer, Gwendolyn M
From: Palmer, Gwendolyn M
Sent Thursday, July 23, 2015 9:38 AM
To: Cox, Ashley B
Cc: Rogers, Michael; May, David; Hart, William
Subject: RE: Injection Well Notification WI0700408 (NOI)
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOI) for the NCDOT c/o Ashley
Cox located at 4809 Beryl Rd., Raleigh, NC 27606. The Central Office of the WORDS received your complete NOI on
July 22, 2015. Please note the following:
Please remember to submit the following regarding this injection activity:
1 j 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: 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:Jjportal.ncdenr.org/weblwpjaps/Rwprojreporting-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.rwersOncdenr.rov, send by fax to my attention at 919-
807-6406, or via regular mail to address below. When submitting the above forms, you wilt 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 W10700408. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in reply to this email, as it will already have the
assigned deemed permit number in the subject line_
Thank you for your cooperation
Gwendolyn M. Palmer
Support Staff
NCDepartment of Environment & Natural Resources
Division of Water Resources
Animal Feeding Operations and Groundwater Protection Branch
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone]
Email: gwendolyn.palmertaincdenr.,ov

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 ISA NCAC 02C .0200. This form shall be submitted at least 2 weeks prior to iniection.
AQUIFER TEST WELLS (15A NCAC 02C .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (ISA NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229 >:
1) Passive In jection S ystems -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 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 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: ~Ju~l~Y~l3~--~ 20_15_ PERMIT NO. l,vI01O0£./09, (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
X __ Passive Injection System ............................... Complete sections B-.F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B-N
___ Pilot Test ................................................. Complete sections B-N
___ Tracer Injection Well ................................... Complete sections B-N
B. STATUS OF WELL OWNER: ' _i~
C. WELL OWNER -State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: North Carolina De partment of Trans portation c/o: Ashle Cox
Mailing Address: 4809 Berv l Rd
City: Ralei uh State: _NC_ Zip Code: 27606 County:_W~ak=e~---
Day Tele No.: 919-835-8020 ___________ _ Cell No.: ____ _
EMAIL Address: __ __,a=b=c-=-o=x ""'@""n=c=d=ot=.,,,.g""o=...cv'------------Fax No.:
,VIC/in Situ Rerned. Notification (Revised 3/2/2015) Page I
D. PROPERTY OWNER (if different than well owner)
Name: ------------------------------------
Mailing Address:---------------------------------
City: _____________ State: __ Zip Code: _______ County: _____ _
Day Tele No.: ____________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: Ashle v Co x. Environmental En gineer.L .G.
Mailing Address: 4809 Beryl Rd _________________________ _
City: Raleigh _________ State: _NC_Zip Code:_2~76~0~6 ____ County:~W_a=k=e ___ _
Day Tele No.: 919-835-8020 Cell No.: __________ _
EMAIL Address: [e-mail] Fax No.: 919-733-1192 ______ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 14193 NC HWY 94N. ___________________ _
(2)
________________________ County:_W~as=h=in=g__.L~o=n ____ _
City: Creswell ____________ State: NC Zip Code: ~2~79~2~8~------
Geographic Coordinates: Latitude**: ___
0
____ " or 35_0 .915696 ____ _
Longitude**: 0 11 or -76_0 .472246 ____ _
Reference Datum: ___ W~G=S=8~4 ___ Accuracy: __ -'8=·=2m=-------
Method of Collection: __________________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES .
G. TREATMENT AREA
Land surface area of contaminant plume:--=1=.8~7~5 ____ .square feet
Land surface area of inj . well network: __ 1~-~87~5~ ___ square feet (:S 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: ____ (must be :S 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus
existing and proposed wells.
UIC/Jn Situ Remed .. Notifieation (Revised 3/2/2015) ,Page.2•.
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.
The pmpose of this in jection event is to treat the source area of former tank pits (I ncident# 16928 ) for the
petroleum constituents benzene and na phthalene which continue to exceed 21 standards. The plan is to use the
existing monitoring well (MW-5 ) for EHC-O/O-SOX passive in jection with 1.75 pounds of product. Drilling a
new well in the source area is not feasible due to an existing cano py protectin g brine tanks for stormwater
pollution prevention. The site is sam pled semiannually for VOCs usin g SM 6200B anal ysis (June/December).
During the sam p lin g events the O-SOX product level will be checked and contamination levels sam pled for.
U pon com p lete dissolution of the O-SOX product, contaminant concentrations will be monitored for rebound
and a determination will be made to continue with passive in jection of O-SOX or to resume monitored natural
attenuation.
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/weblwq/aps/gwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the UIC Program/or more info (919-807-6496).
Injectant: EHC-O / 0-SOX. _______________________ _
Volume ofinjectant: l.75lb _________________________ _
Concentration at point of injection: Dry solid in stainless steel sleeve ___________ _
Percent if in a mixture with other injectants: ____________________ _
Injectant:
Volume ofinjectant: _____________________________ _
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume ofinjectant: _____________________________ _
Concentration at point of injection:
Percent ifin a mixture with other injectants:
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: _____ Proposed ___ l ___ Existing
UIC/Jn Situ Remed. Notification (Revi_sed3/2/2015) Page 3
false information.
(2) Provide well construction details for cacti injection well in a diagram or table format. A single
diagram or line in a table can be used for multiple wells with the same construction details. Well
construction details shall include the following:
(a)
(b)
(c)
well type as permanent, direct -push, or subsurface distribution system (infiltration gallery)
depth below land surface of grout, screen, and casing intervals
well contractor name and certification number
L. SU1 RULES — Briefly describe the schedule for well construction and injection activities.
Use of an existing monitorinL well (_MW-5_). Injection activities are planned within 60 da%s of successful
notification of intent to operate an injection well.
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
The site is subject to semiannual monitoring aune/Decembee for VOCs using SM 6200B anals sis. Incident#
1692E
N. SIGNATllRE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "I hereby certify, under penalty of law, that 1 am familiar with the information submitted in
this document and all attachments thereto and that, based on my inquiry of those individuals immediately
responsible for obtaining said information, 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, far submitting
I a gr . o construct, operate, maintain, repair, and if applicable, abandon the injection well
and all related—i-ienances in accordance with the 15A NCAC 02C 0200 Rules."
ature of Applicant
400 V Ioe
Pr' t or Type Full Name
PROPERTY OWNER (if the propene is not owned b% the permit applicant):
"As owner of the property on which the injection well(s) are to be constructed and operated, I hereby consent
to allow the applicant to construct each injection well cis outlined in this application and agree that it shall be
the responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction
Standards (15A NCAC 02C .0200). "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A
well is real property and its construction on land shall be deemed to vest ownership in the land owner, in
the absence of contrary agreement in writing.
Signature* of Property Owner (if different from applicant) Print or Type Full Name
* An access agreement between the applicant and property owner may be submitted in lieu of a signature on this for►n.
t;ICI1n Sire Reined. Notification (Revised 3/2/2015) Page el

GEOLOGIC CROSS SECTION
105'
95'
85'
75'
65'
MW-8
NCDOT MAINTENANCE YARD
CRESWELL.NC
DW-I
MW-5
BENZENE
BDL
NAPHTHALENE
fir/ NAPHTHALENE IOOug/L
Zug/L

No117H CAROLINA DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPIuesT
DIVISION OF ENVIRONMENTAL MANAGEMENT - GROUNDWATER SECTION
P.O. SOX 21687 - RALEIGH,N.C. 27611. PHONE C919) 733-5083
WELL CONSTRUCTION RECORD
MW-5.
DRILLING CONTRACTOR Front Royal Environmental
DRILLER REGISTRATION NUMBER 1597
FOR OFFICE USE ONLY
Quad. NO. __ _ Serial Na.
Lat. Long. Pc
Minor Basin
• Basin Code
Header Ent. GW-1 Ent
STATE WELL CONSTRUCTION
PERMIT NUMBER-
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Creswell, North Carolina
Highway 64 East
(Road, Community, or Subdivision and Lot No.)
2. OWNER NCDOT
ADDRESS 4809 Beryl Road
(Street or Route No.)
Raleigh, North Carolina 27606
City or Town State Zip Code
3. DATE DRILLED 3/13/97 USE OF WELL, Monitoring
4. TOTAL DEPTH 8 • 5' CUTTINGS COLLECTED ® Yes ❑ No
5. COES WELL REPLACE EXISTING WELL? 0 Yes ® No
5. STATIC WATER LEVEL- 4.13
TOP OF CASING is 0.5
FT_ 0 above TOP OF CASING,
® below
FT.-0.138VE-LAND SURFACE
BELOW
7. `"'7L0 (gpm): METHOD OF TEST
5. , -. , rER ZONES {depth),
9. CHLORINATION: Type Amount
10. CASING:
From
From
From
11. GROUT:
Wall Thickness
Depth Diameter or Weight/FL
0.0 To 2.5 Ft Q.154"
From 0. 0
From 1. 0 To 2. 0 Ft. Bentonite Pellets
12. SCREEN:
To Ft
To Ft.
Depth
Material
PVC
Material Method
To 1.0 Ft. Cement Poured
Depth Diameter Slot Size Material
From 2.5 To 7.5 Ft 2 in, 0.01111. PVC
From To Ft. in. in.
From To Ft. in in.
13. GRAVEL PACK:
Depth Size Material
From 2.0 To 8.5 Ft. Torpedo San
From To Ft.
14. REMARKS:
County: Washington
Depth
From To
0.0
1.0'
2.0'
1.0'
2.0'
6.5'
6.58.5'
DRILLING LOG
Formation Description
Asphalt
Fill gravel
Gray silty clay and cla'
Gray clayey silty fine
sand
Boring terminated @ 8.5
If additional space Is needed use back of form.
LOCATION SKETCH
(Show direction and distance from at least two State Roads,
or other reap reference paints)
GARAGE
US 64
d s MW Mw-2
OFFICE
MW-3
Dw-1
Si
00
1.
O
aE9
v
U
STORAGE SHED
eio MW-4
FORMER TANK
GARAGE
FORMER UST% r
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECCE AS Bi=F,N P D111 Q THE WELL OWNER
74/97
SIGNATURE OF CONTRACTOR OR AGENT DATE

rA ADVENTUS
lyilhigSF Proven SoN Sediment, na 5er1 G and Gro+f teT
Rem diatron Technologies
Safety
Dat a
MATERIAL SAFETY DATA SHEET:
O-SOX Page: 1 of 6
1. PRODUCT IDENTIFICATION: O-SOXs24
PRODUCT USE: Sail and water treatment.
MANUFACTURER: EMERGENCY PHONE:
Adventus Americas Inc.
2871 W_ Forest Rd., Suite 2
Freeport, IL
s1o32
Office Hours: 815-235-3503
After Hours: 815-235-3506
TRANSPORTATION OF DANGEROUS GOOD CLASSIFICATION:
Oxidizing Solid, n.o.s. (Calcium Peroxide), Class 5.1, PG iI, UN1479
WHMIS CLASSIFICATION:
Oxidizer
2. COMPOSITION/INFORMATION ON INGREDIENTS
Ingredients
Calcium Peroxide
Calcium Hydroxide
3. PHYSICAL DATA
Chemical Formula
CaO
Ca(OH)2
CAS No.
1305-79-9
1305-62-0
Percentage
45%-70%
10%-20%
Appearance White & brown granules
Physical state Solid
Odor threshold None
Bulk Density 500-650g/I.
Solubility in Water .-----------•-•___ Insaluhle
pH —11 •
Decomposition Temperature —Self-accelerating decomposition with oxygen release starting from 275
degrees Celsius
4. HAZARDS IDENTIFICATION
Emergency overview
Oxidizing agent, contact with other material may cause fire. Under fire conditions this material may
decompose and release oxygen that intensifies fire. This product also contains crystalline silica. Long tern
exposure to hazardous levels of silica dusts can cause lung disease (silicosis), The World Health
Organization had indicated that there is limited evidence that crystalline silica is carcinogenic to humans,
but the NTP and OSHA have not classified this ingredient as carcinogenic.
Potential Health Effects:
General Irritating to mucous membrane and eyes.

{J ADVENTUS Safety Data
~ Proven Soil, Sediment, and Groundwater
• Remediation Technologies
MATERIAL SAFETY DATA SHEET: 0-SOX™ Page: 2 of6
• Inhalation ______________________ Irritating to respiratory tract. Long term inhalation of elevated levels
may cause lung disease (silicosis).
• Eye contact ____________________ May cause irritation to the eyes; Risks of serious or permanent eye
lesions.
• Skin contact ___________________ May cause skin irritation.
• Ingestion _______________________ Irritation of the mouth and throat with nausea and vomiting.
5. FIRST AID MEASURES
• Inhalation _____________________ Remove affected person to fresh air. Seek medical attention if effects
persist.
• Eye contact ____________________ Flush eyes with running water for at least 15 minutes with eyelids
held open. Seek specialist advice.
• Skin contact __________________ Wash affected skin with soap and mild detergent and large amounts of
water.
• Ingestion _____________________ _If the person is conscious and not convulsing, give 2-4 cupfuls of
water to dilute the chemical and seek medical attention immediately.
Do not induce vomiting.
6. FIRE FIGHTING MEASURE
Flash Point
• Not applicable
Flammability
• Not applicable
Ignition Temperature
• Not applicable
Danger of Explosion
• Non-explosive
Extinguishing Media
• Water
Fire Hazards
• Oxidizer. Storage vessels involved in a fire may vent gas or rupture due to internal pressure.
Damp material may decompose exothermically and ignite combustibles. Oxygen release due to
exothermic decomposition may support combustion. May ignite other combustible materials.
A void contact with incompatible materials such as heavy metals, reducing agents, acids, bases,
te4) ADVENTUS
Proven Soil, Sediment, and CRwndwater
Remediation Technologies
Safety Data
MATERIAL SAFETY DATA S$MT:
Q-Sarm Page: 3 of 6
combustible (wood, papers, cloths etc.) Thermal decomposition releases oxygen and heat.
Pressure bursts may occur due to gas evolution. Pressurization if confined when heated or
decomposing. Containers may burst violently.
Fire Fighting Measures
• Evacuate all non -essential personnel
• Wear protective clothing and self-contained breathing apparatus.
• Remain upwind of fire to avoid hazardous vapors and decomposition products.
• Use water spray to cool fire- exposed containers.
7. ACCIDENTAL RELEASE MEASURES
Spill Clean-up Procedure
• Oxidizer. Eliminate all sources of ignition. Evacuate unprotected personnel from equipment
recommendations found in Section 9. Never exceed any occupational exposure limit.
• Shovel or sweep material into plastic bags or vented containers for disposal. Do not return spilled
or contaminated material to inventory. Avoid making dust.
• Flush remaining arca with water to remove trace residue and dispose of properly. Avoid direct
discharge to sewers and surface waters. Notify authorities if entry occurs.
• Do not touch or walk through spilled material. Keep away from combustibles (wood, paper, oils,
etc,). Do not return product to container because of risk of contamination.
8. HANDLING AND STORAGE
Storage
• Oxidizer. Store in a cool, well -ventilated area away from all source of ignition and out of direct
sunlight. Store in a dry location away from heat.
• Keep away fzuin incompatible materials. Keep containers tightly closed. Do not store in
Unlabeled or mis]abeled containers.
• Protect from moisture. Do not store near combustible materials_ Keep containers well sealed.
Ensure pressure relief and adequate ventilation.
• Store separately from organics and reducing materials. Avoid contamination that may lead to
decomposition.
Handling
a Avoid contact with eyes, skin, and clothing. Use with adequate ventilation.
• Do not swallow. Avoid breathing vapors, mists, or dust. Do not eat, drink, or smoke in work
area.
• Prevent contact with combustible or organic materials.
• LabeI containers and keep them tightly closed when not in use..
• Wash thoroughly after handling.
9. EXPOSURE CONTROLS/PERSONAL PROTECTION

2,- ADVENTUS
Proven Sall Sadiment. and Gmundwater
Remedfauvn Technologies
Safety Data
MATERIAL SAFETY DATA SHEET:
O-SOXTM Page: 4 of 6
Engineering Controls
■ General room ventilation is required. Local exhaust ventilation, process enclosures or other
engineers controls may be needed to maintain airborne levels below recommended exposure limits.
Avoid creating dust or mist. Maintain adequate ventilation. Do not use in closed or confined
spaces. Keep levels below exposure limits. To determine exposure limits, monitoring should be
performed regularIy.
Respiratory Protection
• For many condition, no respiratory protection may be needed; however, in dusty or unknown
atmospheres or when exposures exceed limit values, wear a NIOSH approved respirator.
Eye/Face Protection
■ Wear chemical safety goggles and a full face shield while handling this product.
Skin Protection
■ Prevent contact with this product. Wear gloves and protective clothing depending on condition of
use. Protective gloves: Chemical -resistant (Recommended materials: PVC, neoprene or rubber)
Other Protective Equipment
• Eye -wash station
▪ Safety shower
• Impervious clothing
• Rubber boots
General Hygiene Considerations
• Wash with soap and water before meal times and at the end of each work shift. Good
manufacturing practices require gross amounts of any chemical removed from skin as soon as
practical, especially before eating or smoking.
10. STABILITY AND REACTIVITY
Stability
• Stable under normal conditions
Condition to Avoid
• Water
• Acids
• Rases
• Salts of heavy metals
• Reducing agents
• Organic materials
• Flammable substances
Hazardous Decomposition Products
• Oxygen which supports combustion
11. TOXICOLOGICAL INFORMATION

(A) ADVENTUS
�.,,;_1 Proven Salt Sediment and Gr0Undwater
RemedetlonTecrrnoiogies
Safety Data
MATERIAL SAFETY DATA SIFT:
�SOXTM
Page: 5 of 6
• LD50 Oral: Min.2000 mg/kg, rat
• LD50 Dermal: Min. 2000mglkg, rat
• LD50 Inhalation: Min. 4580 mg,/kg, rat
12. ECOLOGICAL INFORMATION
Ecotoxicological Information
• Hazards for the environment is limited due to the product properties of no bioaccumulation, weak
solubility and precipitation in aquatic environment.
Chemical Fate Information
• As indicated by chemical properties oxygen is released into the environment.
13. DISPOSAL CONSIDERATIONS
Waste Treatment
• Dispose of in an approved waste facility operated by an authorized contractor in compliance with
local regulations.
Package Treatment
• The empty and clean containers are to be recycled or disposed of in conformity with local
regulations.
14. TRANSPORT INFORMATION
• Proper Shipping Name: EHC-O
• Hazard Class: 5.1
• Labels: 5.1 (Oxidizer)
• Packing Group: 11
15. REGITLATORY INFORMATION
• SARA Section Yes
• SARA (313) Chcmicalls No
• EPA TSCA Inventory Appears
• Canadian WHMIS Classification C. D213
• Canadian DSL Appears
• EINECS Inventory Appears
16. PREPARATION INFORMATION
Prepared By: Kerry Bolanos-Shaw
Adventus Remediation Technologies
1345 Fewster Drive
Mississauga, Ontario
L4W 2A5
Date Prep./Rev:
Print Date:
Phone:
Fax:
1l3107
1/3107
905-273.5374
905-273-4367

N
Fuel Canopy
POTENTIOMETRIC MAP - JUNE 8, 2015 ❑
McNair Residence
Jackson Residence
-4131-95.
MW-2
95.64
MW-3A
ED 95.66
MW-6
1E1)95_56
MW-B
�fl
5.57-%
DW-1
ED 94.87
FORMER UST
� I
� 1
96.05
INSET
5 MW-7
DORMER DISPENSER
ISLAND
MW-3A MW
Et9 65D -
1 8
(iliED
W-6 M
95.56
Brine Tank
96.05 Warehouse
MW-7
Oil & Grease House
Groundwater flow rate was determined by Front Royal
Environmental at 0.007 ft/day with a rate of 0.044 ft/day
used as a conservative estimate for the Corrective Action Plan
r
1=1
NCDOT Bridge Yard
Asphalt Plant & Yard
4
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
D1VISiON OF IIIGHWAYS
FLEET AND MATERI AI.S MANAGEMENT UNIT
NCDOT MAINTENANCE FACILITY
CRESWELL, WASHINGTON COUNTY
1 inch = 100 feet Drawn By: DAH Date: 06/30/2015
Nous

NAPHTHALENE PLUME - JUNE 8, 2015
McNair Residence
HWY 94
Jackson Residence
Fuel Canopy
MW-7
MW-2
MW3A
MW-8 2.7uai'
MW-6
FORMER UST
i
155ugt
MW-5 any. 82rzene
3i iug/L MW-7
MUv-4
e
_ MW111A
-- - Brine Tank
i
INSET
FORMER DISPENSER
ISLAND
Warehouse
C=3
Oil & Grease House
0
NCDOT Bridge Yard
Asphalt Plant & Yard
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DIVISION OF I TIGI I WAYS
FLEET AND MATERIALS MANAGEMENT UNIT
1 inch — 100 feet
NCDOT MAINTENANCE FACILITY
CRESWELL; WASHINGTON COUNTY
Drawn I3y; DA-I
Date: 06/30/2015
Notes