WI0400599_Injection Well Permit Staff Report_20230531

Permit No. WI0400599
Date: _05/16/2023 County: Fors h
To: Michael Ro ers Permittee/Applicant: Illinois Tool Works
Central Office Reviewer: Michael Rogers Facility Name: ITW/CCI Fleet Suppl
L GENERAL INFORMATION
1. This application is (check an that apply): ❑ New ❑ Renewal
❑ Minor Modification ® Major Modification
a. Date of Inspection: 05/12/2023
b. Person contacted and contact information: Derick Haydin PG WSP Environment and Infrastructure 410-
474-8306 derick.haydin(&wsp.com
c. Site visit conducted by: Jim Gonsiewski.
d. Inspection Report Printed from BIMS attached: ® Yes ❑ No.
e. Physical Address of Site including zip code: 2737 West Mountain Street Kernersville, NC 27284
f. Driving Directions if rural site and/or no physical address:
g. Latitude: 36°06'50.30"N Longitude: 80'09'45.11"W
Source of Lat/Long & accuracy (i.e., Google Earth, GPS, etc.): Goo le Earth
II. DESCRIPTION OF INJECTION WELL(S) AND FACILITY
1. Type of injection system:
❑ Geothermal Heating/Cooling Water Return
® In situ Groundwater Remediation
❑ Non -Discharge Groundwater Remediation
❑ Other (Specify:
2. For Geothermal Water Return Well(s) only
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? ❑ Yes ❑ No.
Provide well construction information from well tag:
b. Does existing or proposed system use same well for water source and injection? ❑ Yes ❑ No
If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor,
etc.) and attached map and sketch location of supply well in relation to injection well and any other
features in Section IV of this Staff Report.
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)?
What is the distance of the injection well(s) from the pollution source(s) 250 to 600 feet
4. What is the minimum distance of proposed injection wells from the property boundary? _ 30 ft
5. Quality of drainage at site: ❑ Good ® Adequate ❑ Poor
6. Flooding potential of site: ❑ Low ® Moderate ❑ High

7. For Groundwater Injection Remediation Systems only, is the proposed and/or existing groundwater monitoring
program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ® Yes ❑ No.
If No, attach map of existing monitoring well network if applicable and recommend any changes to the
groundwater -monitoring program.
8. Does the map included in the Application reasonably represent the actual site (property lines, wells, surface
drainage)? ® Yes ❑ No. If No, or no map, please attach a sketch of the site. Show property boundaries,
buildings, wells, potential pollution sources, roads, approximate scale, and north arrow.
9. For Non -Discharge Groundwater Remediation systems only (i.e., permits with WQ prefix):
a. Are the treatment facilities adequate for the type of waste and disposal system? ❑ Yes ❑ No ❑ N/A.
If No, please explain:
b. Are the site conditions (soils, topography, depth to water table, etc.) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A. If no, please explain:
III. EVALUATIONAND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain.
2. List any items that you would like WQROS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item
Reason
MSDS sheets for the proposed injectants.
No MSDS sheets were provided with the
application.
Tabulation of data on all existing or abandoned
No well data table was provided.
wells within the area of review of the injection
wells that penetrate the proposed injection
zone.
3. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
4. Recommendation
❑ Deny. If Deny, please state reasons:
❑ Hold pending receipt and review of additional information by Regional Office

® Issue upon receipt of needed additional information
❑ Issue
D1ocu Signed by:
5. Signature of Report Preparer(s): !!//
DocuSigned by:
Signature of WQROS Regional Supervisor: 4. Ju
5/15/202 3 OMXE3HB7456...
Date:
IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional /If Needed)
The area of the proposed injection wells was inspected on May 12, 2023. It is located across from the former
ITW/CCI Fleet Supply Company site at 2737 West Mountain Street in Kernersville, NC. The area of the
injection is wooded and generally flat. Access to the injection site appears to be good. There were no potential
problems observed during the site visit. A pilot test conducted in 2021 indicated that the proposed system was
effective in remediating the contaminants of concern at the site.

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Compliance Inspection Report
Permit: W10400599 Effective: Expiration: Owner: Illinois Tool Works
SOC: Effective: Expiration: Facility: Former CCI National Fleet Supply Facility
County: Forsyth 2744 W Mountain St
Region: Winston-Salem
Kernersville NC 27284
Contact Person: Andrew Dorn Title: Phone:[phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
W10400567 Illinois Tool Works - Former CCI National Fleet Supply Facility
Inspection Date: 05/12/2023 Entry Time 10:37AM Exit Time: 11:25AM
Primary Inspector: Jim J Gonsiewski Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Reconnaissance
Permit Inspection Type: Injection In situ Groundwater Remediation Well
Facility Status: Compliant ❑ Not Compliant
Question Areas:
Wells System Operations
(See attachment summary)
Page 1 of 3

Permit: W10400599 Owner - Facility: Illinois Tool Works
Inspection Date: 05/12/2023 Inspection Type : Reconnaissance Reason for Visit: Routine
Inspection Summary:
The inspection was conducted to assist in the review of the injection well permit application. Nineteen (19) injection wells
will be installed. Two (2) performance monitoring wells will be be installed under permit WM0401452. The area where the
injection wells will be installed has been cleared of trees. There should be no problem installing the wells and operating the
system.
Page 2 of 3

Permit: W10400599 Owner - Facility: Illinois Tool Works
Inspection Date: 05/12/2023 Inspection Type : Reconnaissance
System Operation
Is same well used as source well and injection well?
Is injection well capable of assimilating injected fluid?
Reason for Visit: Routine
Injection flow rate at time of inspection (gpm)
Has system owner/operator noticed any abnormalities (turbidity, air in system, poor heating/cooling, etc) in
system operation?
Comment on system operation
Is system operation and construction consistent with that described in application?
Describe inconsistencies between application and observed operation/construction
Comment: The system has not been constructed.
Yes No NA NE
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