WI0700503_DEEMED FILES_20200706

Permit Number WI0700503
Program Category
Deemed Ground Water
Permit Type
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Former Phillips Store
Location Address
414 Snug Harbor Rd
Hertford
Owner
Owner Name
Ncdeq Ust Section
Dates/Events
NC 27944
Scheduled
Orig Issue
sn12020
App Received Draft Initiated Issuance
5/1/2020
Re g ulated Activities
Groundwater remediation
Outfall
Central Files: APS _ SWP __
7/6/2020
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Washington
County
Perquimans
Facility Contact Affiliation
Owner Type
Government -State
Owner Affiliation
Scott Ryals
1646 Mail Serivce Ctr
Raleigh
Public Notice Issue
sn,2020
Re q uested /Received Events
Effective
sn12020
NC 2769916·
Expiration
Waterbody Name Streamlndex Number Current Class Subbasin
NC Department of Environmental Quality -Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOi) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are ''permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200 (NOTE: This form must be received at least 14 DAYS p rior to injection)
AQUIFER TEST WELLS (1 5A NCAC 02c .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (I SA NCAC 02C .0225 ) or TRACER WELLS (15A NCAC 02C .0229 ):
1) Passive In jection S y stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small-Scale In jection 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 is located within an area that does not exceed five percent of the land surface
above the known extent of groundwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air In jection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
5) In-Situ Thermal Wells (I ST)-Used to 'heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: A pril 30 ,2020_ PERMIT NO. ________ (to be filled in by DWR)
NOTE-If this NOI is being submitted as notification of a modification of a previously issued NO! for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No. WI _____________ lssued Date: _________ _
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
(1) ___ .Air Injection Well ....................................... Complete sections B through F, J, M
(2) --~Aquifer Test Well ....................................... Complete sections B through F, J, M
(3) X __ Passive Injection System ............................... Complete sections B through F, H-M
( 4) ___ Small-Scale Injection Operation ...................... Complete sections B through M
(5) ___ .Pilot Test. ................................................ Complete sections B through M
(6) ___ Tracer Injection Well ................................... Complete sections B through M
(7) ___ .In-Situ Thermal (1ST) Well .................. ···REC~ete sectfons B through M
STATUS OF WELL OWNER: State Government MAY 15 202.0
NCOEOIDWR
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Central 0ftiC8 ~ Page I
C. WELL OWNER(S) -State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): NCDEO Division of Waste Management UST Section Trust Fund Branch : Scott R yals
Mailing Address: 1646 Mail Service Center
City: Ralei 0 h State: NC Zip Code: 27522 County:._W.:..:...=ak=e"-----
Day Tele No.: 919-707-8168 CellNo.: _________ _
EMAIL Address: scott.ryals @ncdenr.gov Fax No.: ___________ _
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: ___ W-'-'--'i.!.!11.!-"ia'-'-'m'-'----=L"----. -""S=im.o-'cm=o.o.cn"'--s ___________________ _
Company Name ____________________ _
Mailing Address: ___ 4,__,1_,4_,S=n=uccg._,H=a=r--=b-=-o=---r =R=o=ad=----------------------
City: Hertford State: _ NC Zip Code: __ 2_79_4_4 ____ County: Perquimans
Day Tele No.: 252-426-3063 Cell No.: 252-562-3278
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONT ACT (Typically Environmental Consulting/Engineering Firm)
F .
Name and Title: ___ M=a=tt=h=ew~G=1_·11~is=,~S~r~. P~r~o..,_je~c~t ~M=a=n=a=iz:=er~-----------
Company Name ----=E,__,,C=S<-=So=u=t=h""'ea=s""t '-'L=L=P,_ __________________ _
Mailing Address: __ ____,9'---'0=0:...:.1_:G=l=e=n-'--'w--=o--=o=d _,_A=v'----"e=n=u=e ---------------------
City: Ralei gh State: _NC_ Zip Code:_2_7_6_1_7 ____ County:_W'-'-=ak=e"-----
Day Tele No.: 919-215-6174 CellNo.: 919-215-6174
EMAIL Address: m gillis @ ecslimited.com Fax No.: ___________ _
PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Former Philli ps Store -414 Snul! Harbor Road
City: ---=B=e=th=e=l _______ County_: P_e_r~g_u_im_a_n_s ________ Zip Code: ____ _
(2) Geographic Coordinates: Latitude**: ___ 0 __ __" or 36 ° 113444
Longitude**: ___ 0 ____ " or_~76~0 481914
Reference Datum:Center of Former UST BasinAccuracy: +/-3 meters
Method of Collection:------'G~o=oe:.:g:>!lc:::.e -=E::..:::a""rt~h'---___________ _
**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:. _______ square feet
Land surface area ofinj. well network: _______ square feet(:::: 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated: ____ (must be:::: 5% of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 2
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of 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.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE -Provide a brief narrative
regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity:
In ject 12 kilo grams of an a pproved remediation compound identified as EnviroBac blended with munici pal water
across four in jection points (3 kilo blend each ). In jection points are identified as existin g MW-I . MW-2 . MW-
11 and pro posed MW-12. Ratio of blend is to be 3 kilos ofEnviroBac to a pp roximatel y 40 g allons of water at
each of the four pro posed in jection points. Each in jection is estimated to be completed in a pproximate 2 to 2.5
hours. Goal is to reduce dissolved phase h ydrocarbon plume concentrations that have been documented above
the Gross Contamination Levels (GCLs) at the site for over a decade.
J. WELL CONSTRUCTION DAT A
(1) No. of injection wells: 1 Proposed. __ ~3 ___ Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS): __ 2 ft BLS _________________ _
(3) For Proposed wells or Existing wells not having GW-1 s, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
( c) Well contractor name and certification number
K. INJECTION SUMMARY
NOTE: Onlv in i ectants a pproved b v the ep idemiologv section o(the NC Division o(Public Health , Department
o( Health and Human Services can be in iected. A pproved ini ectants can be found online at
h rtp ://deg. nc. gov/about/ divisions/water-resources/water-resources-permits/wastewater-branch/ 1.,rround-water-
protection/ e:round-water-app roved-injectants. All other substances must be reviewed b v the DHHS p rior to use.
Contact the UJC Pro gram (or more in(o i[ vou wish to get a pproval (o r a di ffe rent additive. However, p lease
note it may take 3 months or lon g er. H no injectants are to be used use N/A.
Injectant:EnviroBac (formerl y ProgressBlend)Total Amt. to be injected (gal)/event: 160 gal -40gal/in j .point
Injectant.~: ____________ Total Amt. to be injected (gal)/event.~: __________ _
lnjectant.~: ____________ Total Amt. to be injected (gal)/event.~: __________ _
Deemed Permitted GW Remediation NOi Rev. 2-17-2020 Page 3
Injectant: Total Amt. to be injected (gal)levent:
Injectant- Total Amt. to be injected (gal)/event:
Total Amt. to be injected (gal/event): 160
No. of separate injection events:0 Total Anit. to he injected (gal): 160
Source of Water (if applicable): municipal
L. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
Groundwater quality samples are to be collected for analysis by EPA Method 6200E from existingMW-
1, MW-2. MW-3, MW-I 1, and proposed MW-12 prior to infection_ Future quarterly monitoring of the
groundwater quality by EPA Method 6200E will then be recommended to gauge the effectiveness of the
EnviroBac product.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "1 hereby certafy, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible. for obtaining said information, 1 believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility opines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Matthew Gillis: Sr. Pro iect Manauer (Aaent for NCI]EOj
Signature of Applicant Print or Type Full Name and Title
Property Owner tif the property is not owned by the Well Owner/Applicant):
"As owner of the property an 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 he the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(15A 1VCA C 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.
See Attached Access Agreement
Signature* of Property Owner {if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this farm_
Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR— WC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
'Telephone: [phone]
Dcemed Permitted GW Remediation NOT Rev. 2-17-2020
Page -�

Water Resources
EnviTonmcnral Qualify
August 2, 2017
RE: EnviroBac
To Whom It May Concern:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretory
S. JAY ZIMMERMAN
Dt ecfor
The rernediation compound EnviroBac (formerly ProwessBlend) made by Bio-Cat
Microbials is on the NC Division of Water Resources list of approved additives. If you have any
questions, please contact Michael Rogers at 919-807-6412 or [e-mail],
Best Regards,
-Michael Rogers, P.G- (NC & FL)
Underground Injection Control (tJ1C) Manager - Hydrngeoiogist
Division of Water Resources
Water Quality Regional Operations Section
cc- File
swathing Cnrrtpares7-
s4uic or North Caroling I I.nvirO,lmilllal Qualrly I Division iir Waivr Re.Tnura.Ys
\V,tlrr Qu, Iily riq;ieinnl Opre-HlinhI SCClinn
rh36Mnil SrrvitcCow j R-slcigh, M1'unhC rulinj 276W-ir,3h
V!N_707-9I2r%

BIB -CAT
Micrabials
Form: Powder (SZEI
Safety Data Sheet
Section 1: Identiftcotion
Product Identifier:
Other Identifier:
Recommended Use:
Supplier Information:
Emergency Phone:
EnviroBac
NONE
See Product Literature
689 Canterbury Rd
Shakopee. MN 55379
(p}952-445-4251 (f) 952-445-7233
in roO bio-cvt.co rnwmv.h*9.caf .corn
434-589-4777 Sam - 4pm EST
Section 2: Hazard identification
Hazard Classification:
Eye Damage/irritation Category 2B
Skin Corrosion/irritation Category 2
Signal Word: Warning
Hazard Statements:
H315
H320
Pictograms):
Precautionary Sfatement(s):
P264 Wosh face and honds thoroughly after handling,
P280 Wear protective gloves/protective clothing/eye protection/face protection.
Response Statemeni(s):
P302/352 IF ON SKIN: Wash with plenty of water.
P305/351 /338 IF 1N EYES. Rinse cautiously with water for several minutes. Remove contact
lenses. if present and easy to do. Continue rinsing. Immediately call a poison center/doctor.
P338/31 1 IF exposed or concerned: call o poison center/doctor.
P332/313 If imitation occurs: gel medico! advice/otter-ition.
P337/313 It eye irritation persists: get medical advice/attention.
P362/364 Toke ott contaminated clothing and wash it before reuse.
Hazards Not Otherwise Categorized:
Moderate Respiratory Irritont
Causes skin irritation.
Causes eye irritation.
Section 3: Composition/ Information on Ingredients
Name:
Name:
Name:
Proprietary bacterial blend
Maitodextrin
Sodium chloride
CAS Number: N/A
CAS Number_ 9050-36-3
CAS Number: 7647-14-5
% by weight: 3, 5--6%
% by weight: 2-3.5%
% by weight: Remainder %
Section 4: First -Aid measures
Inhalation: If inhaled remove from contaminated area to fresh air. Report the Situation. Seek
medical attention if ollergic response is exhibited.
Page ]af5

BID -CAT
Micrcbials
Section 1 D: Stability and Reactivity
Reactivity:
Chemical Stability:
Hazardous reactions:
Conditions to avoid:
Incompatible materials:
Hazardous Decomposition
Routes of Exposure:
Symptoms;
immediate:
Not available
Stable under normal storage conditions
Not available
Nat available
Not available
Products: Nal available
Section 11: Toxicological information
Delayed:
Acute toxicity:
Eye irritation:
Skin irritation:
Respiratory Irritation:
Sensitization towards product:
Germ cell mutogen€city:
Reproductive toxicity:
Carcinogenicity:
L
Ecotoxicity:
Persistence and degradability:
Sioaccumulative potential:
Mobility in soil:
Other adverse effects:
Eye contact, skin contact, ingestion, inhalation
May cause irritation to the eyes. skin, mucus membranes, ord the
upper respiratory tract
Not available
Not ❑vailr:able
May cause minor irritation
May cause rnir or irritation
May cause minor Irriialiorl
There is no evidence of sensitizing potential
Not available
Not expected to produce reproductive toxicity
Not classified as o carcinogen by IARC. OSHA, or NTP
Section 12: Ecological information
Not available
Product is readily biodegradable
Not available
Not available
Not available
Section 13: Disposal Considerations
No special disposal method required, except that in accordance to all applicable federct. state. and
local regulations.
Section 14: Transport Information
Harmonized Tariff Code:
UN Number:
UN Proper Shipping Name:
Transportation Hazard Class:
Packing Group:
Transport Environmental Hozard:
Transport Special Precautions:
MARPOL:
3002.90.10 tier Microbials)
Not classified
Not classified
Not classified
Nat classified
Nol classified
Not classified
Not classified
Section 1S: Regulatory Information
All components of this product ore listed or exempt from listing an llTe TSCA Inventor,
Section 16: ❑ther Information
Revision History: Effective Date: 04f25/17
Supersedes: First Issue
GHS 201S FORMAT
The inlorrnolion contained in this Solely Ooto Sheet, as of the issue dole, is believed to be Irue ond correct. However. the
accuracy cr completeness of this information and ony recommendations or suggestions are made without warranty or
guorantee_ Since the condil ens of use are beyond the control of the Company, if is the responsibility of the user fo delermine
the conditions of sole use of This product. The information does not represent onolylicol specifications. ENO OF SIDS
Page 3 of 3

..,
MW-1 APPROXIMATE EXISTING MONITORING WELL LOCATION
APPROXIMATE INJECTION POINT MONITORING WELL LOCATION
ANTICIPATED RADIUS OF INFLUENCE (15 FOOT)
JSL
JAB
SHOWN
rtl.f N IJ,I.[
APR 2020
APR2020
PROJECT
Progress
ENVIRONMENTAL GROUP, INC.
_I
P.O. Box 5884
WINSTON-SALEM. NORTH CAROLINA 27113
PHONE [phone] FAX [phone]
FIGURE 1
PROPOSED INJECTION PLAN
PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, NORTH CAROLINA
Table 1
Monitoring Well Construction and Groundwater Elevation Details
Former Pizillips Store
414 Snug Harbor Road
Bethel, Perquimans ':aunty, North Carolina
NCDEQ Incident: TF-31005
ECS Project: 49:1991-C
Monitoring Well
ID
MW-3
Date Measured
10/25/2018
Casing Inner
Diameter �1.D. in.)
2
Depth to
Groundwater (ft.
bloc)
6.94
Date nstalled
611 `r 12003
Total Well Depth
(ft. bloc)
33
Screen Interval
(ft. btoc}
28-33
TOC Elevation *
99.65
Groundwater
Elevation (ft.)
92.71
MW-4
10/25/2018
2
7.08
6/1E/2003
13
3-13
100.06
92.98
MW-5R
10/25/2018
2
7.37
11/1912009
13
2.84-12.84
100.31
92.94
MW-6
10/25/2018
2
7.45
611E/2003
13
3-13
99.22
91.77
MW-7
10/25/2018
2
5.31
May 2004
15
Unknown
Unknown
-
MW-8"*
10/25/2018
2
5.49
May 2004
15
Unknown
Unknown
-
MW-9""*
10/25/2018
2
6.63
May 2004
15
Unknown
Unknown
-
MW-10
10/25/2018
2
6.70
May 2004
9.5
Unknown
Unknown
-
Notes:
I.D. in. = inside Diameter in Inches
ft. btoc = Feet Below Top of Casing
TOC = Top of Casing
NM = Not Measured
= Survey Data obtained from Groundwater Monitoring Report prepared by S&ME dated 9/26/2011
= flush -mounted lid missing and casing severely to be damaged
***= casing observed to be damaged
Data summarized above for MW-1 through MW-11 includes all known "As Built" data. GW-1 forms are not available for these wells.

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--______
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[ SITE
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-� Lai
Bethel
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AL
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SOURCE:
USGS TOPOGRAPHIC MAP
YEOPIM RIVER NORTH CAROLINA
QUADRANGLE
DATED 2013
SCALE: 1 : 24,000
1
FIGURE 1
SITE LOCATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B
I -.
j

AGRICULTURAL
1 inch = 128 feet
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
AGRICULTURAL
SINGLE-FAMILY
RESIDENCES
FIGURE 2
AERIAL SITE MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL. PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

Approximate Location
of Former Kerosene
UST
LEGEND
MW-4 ■ Approximate Location of
Monitoring Well
1 inch = 65 feet
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
Approximate Location of Former
UST
Approximate Location of Former
❑ispenser
Approximate Location of
Former Dispenser
Approximate Location
of Former Gasoline
UST
FIGURE 3
MONITORING WELL LOCATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROA❑
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

1,000 ft.
Radius
1 inch = 520 feet
WSW-1
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
LEGEND
Approximate Location
of Water Supply Well
FIGURE 4
WATER SUPPLY WELL LOCATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDENR INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

1 inch = 65 feet
93.00
MW-4 •
92.98
111
ffilM
110.
NM
LEGEND
Approximate Location of Monitoring Well
Groundwater Elevation
Groundwater Contour Line
Estimated Groundwater Contour Line
Estimated Direction of Groundwater Flow
Not Measured
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
FIGURE 5
GROUNDWATER ELEVATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

MW-5R
Benzene
14
Ethylbenzene
3.0
Isopropylbenzene
0.27 J
Naphthalene
0.46 J
n-Propylbenzene
0.42 J
Toluene
1.6
1, 2 , 4- Trimethylbenzene
0.96
1,3,5-Trimethylbenzene
0.24 J
Total Xylenes
5.6
MW-3
Acetone
16 J
Benzene
3,300
2-Butanone (MEK)
2.6 J
1,2-Dichlorapropane
1.4
Diisopropyl ether (DIPS)
0.37 J
Ethy!benzene
3.7
2-Hexaone (MBK)
7.7
isopropyibenzene
0.99
Toluene
18
1,2,4- Trimethylbenzene
1.2
1,3,5-Trimethylbenzene
0.31 J
Total Xylenes
152.4
MW-1
Benzene
1,700
n-BLit yl benzene
30
sec-Butylbenzene
7.0 J
Ethylbenzene
1,400
Isopropvlbenzene
36
Naphthalene
440
n-Propylbenzene
84
Toluene
13,000
1,2,4- Trimethylbenzene
660
1,3,5-Trimethylbenzene
170
Total Xylenes
6,200 i
1 inch = 65 feet
•
MW-7
BRL
MW-9
BRL
MW-11
Benzene
n-Butylbenzene
1,2-D1bromoethane (EDB)
37,000
33 J
41 J
Ethylbenzene 2,000
Isopropylbenzene
Naphthalene
n-Propylbenzene
Toluene
1.2.4- Trimethylbenzene
1,3,5-Trimethylbenzene
Total Xylenes
MW-10
Toluene '0.17 J
MW-2
Benzene
n-Butvlbenzene
sec -But !benzene
Diisopropyl ether {RIPE]
Ethylbenzene
isopropylbenzene
-Isopropyltoluene
Naphthalene
n-Propylbenzene
Styrene
oluene
1,2,4- Trimethylbenzene
1,3,5-Trimethylbenzene
LEGEND
MW-4 * Approximate Location of Monitoring Well
30 Concentration Above Laboratory Reporting
Limit (pg/L)
1,700 Bold Concentration Above the NC2LGWQS (pgJL)
29.000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
BRL Below Reporting Limit
61
500
150
19,000
1,000
240
8,900
33,000
28
7.0 J
5.2 J
1,700
48
5.8 J
380
110
39
7,700
800
200
6.800
i
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
FIGURE 6
GROUNDWATER CONCENTRATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDEQ INCIDENT: TF-31005
ECS PROJECT: 49:1991-B

1 inch = 65 feet
3,300
MW-11
37,000
MW-6
BRL
33,000
MW-7
BRL
MW-4
BRL
MW-8
BRL
MW-4 •
1,700
37,000 Underline Concentration Above the NC2LGWQS
(pg/L) and GCL
LEGEND
Approximate Location of Monitoring Well
Benzene Isoconcentration Contour (pgfL)
Bold Concentration Above the NC2LGWQS
BRL Below Laboratory Reporting Limit
MW-10
BRL
N
SOURCE:
PERQUIMANS COUNTY GIS
DATED 2012
SCALE AS SHOWN
FIGURE 7
BENZENE ISOCONCENTRATION MAP
FORMER PHILLIPS STORE
414 SNUG HARBOR ROAD
BETHEL, PERQUIMANS COUNTY,
NORTH CAROLINA
NCDENR INCIDENT:TF-31005
ECS PROJECT: 49:1991-B

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WASTE MANAGEMENT
MICHAEL F. EASLEY, GOVERNOR
William G. Ross Jr., SECRETARY
Dexter R. Matthews, DIRECTOR
NCDENR
Norm-. CAPo betxuatr.ffarr or
F.evu+nxMFM ...in Man Ina! Rctin Irrr.
UNDERGROUND STORAGE TANK SECTION
April 15, 2008
Mr. Scott C. Ryals, P.E.
Envimninental Engineer
DWM UST Section
1637 Mail Service Center
Raleigh, NC 27699-1637
RE: Former Philips Store
414 Snug Harbor Road
Hertford, Perquitnans County, NC
Incident Number 31005
Dear Mr. Ryals:
1 ani/We are the owner(s) of a parcel of property, located at or near the incident in question, and herby
permit the Department of Environment and Natural Resources (Department) or its contractor to enter upon said
property for the purpose of conducting an investigation of the groundwater under the authority of G.S _ 143-
215.3 (a}2.
1 amlWe are granting permission with the understanding that:
1. The investigation shall be conducted by the UST Section of the Department's Division of Waste
Management or its contractor.
2. The costs of construction and maintenance gibe site and access shall be borne by the Department or its
contractor. The Department or its contractor sba,I1 protect and prevent damage to the surrbianding lands.
3. Unless otherwise agreed, the Department or its contractor shall have access to the site by the shortest
feasible route To the nearest public road. The Department or its contractor may enter upon the land at
reasonable times and have fuii right of access during the period of the investigation.
4. Any claims which may arise against the Department or its contractor shall be governed by Article 31 of
Chapter 143 ofthe North Carolina General Statutes, Tort Claims Against State Departments and Agencies,
and as otherwise provided by law_
5. The information derived from the investigation shall be made available to the owner upon request and is
a public record, in accordance with G_S. 132-1.
DIVISION OF WASTE MANAGEMENT/UST SECTION
1637 MAIL. SERVICE CENTER, RALEIGH, NORTh CAROLINA 27699-1637
PHONE: [phone] FAX: [phone]
INTERNEr: http:f/WWW.wastenot.enr.state.ne.us
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/1 O% POST CONSUMER PAPER

6. The activities to be carried out by the Department or its contractor are for the primary benefit of the
Department and of the State of North Carolina. Any benefits accruing to the owner are incidental.
The Department or its contractor is not and shall, not be construed to be an agent, employee, or
contractor of the landowner.
I/We agree not to interfere with, remove or any ways damage the Department's well(s) or its
contractor's well(s) and equipment during the investigation.
Sincerely,
'ems
Type/Print Name. of Owner or Ageirt
P ane Numb,ang Ce 11
//fif _SA/u: /444
Ai dress
,4r7F-14-e A7Tvy
City/StatelZip Code
Date