WI0400609_Notification of Intent (NOI) – GW Remediation_20240108

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 individualpermit when constructed in accordance
with the rules of 15A NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to infection)
AQUIFER TEST WELLS (15A NCAC 02C .02201
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .02291:
1) Passive Injection Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small -Scale Injection Operations — Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells is located within an area that does not exceed five percent of the land surface
above the known extent of groundwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
5) In -Situ Thermal Wells (IST) — Used to `heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: January 5, 2023 PERMIT NO. W10400609 (to be filled in by DWR)
NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No. WI
Issued Date:
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) X
Air Injection Well .......................................
Complete sections B through F, J, M
(2)
Aquifer Test Well .......................................
Complete sections B through F, J, M
(3)
Passive Injection System ...............................
Complete sections B through F, H-M
(4)
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 (IST) Well ...........................
Complete sections B through M
B. STATUS OF WELL OWNER: State Government
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 1

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): NCDEQ Division of Waste Management, UST Section, State Lead Program, Attn: Liz Price
Mailing Address: 127 Cardinal Drive Ext.
City: Wilmington State: NC Zip Code:28405 County: New Hanover
Day Tele No.: 910-796-7215
Cell No.:
EMAIL Address: Liz.Price&deq.nc.gov Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: Matthew and Andrea Connell
Company Name
Mailing Address: 529 Tracy Circle
City: Boone State: NC Zip Code: 28607 County: Watauga
Day Tele No.: 804-938-8447 Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Al Quarles, Project Manager
Company Name: ATC Associates of North Carolina, PC
F.
G.
Mailing Address: 7606 Whitehall Executive Center Drive, Suite 800
City: Charlotte State: NC Zip Code: 28273 County: Mecklenburg
Day Tele No.: 704-529-3200 Cell No.: 803-984-6764
EMAIL Address:William.Quarlesgoneatlas.com Fax No.: 704-529-3272
PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Todd General Store (UST Incident #24093), 3866 Railroad Grade Rd.
City: Todd County: Ashe Zip Code: 28684
(2) Geographic Coordinates: Latitude**: " or 36.308473°
Longitude**: " or-81.595113'
Reference Datum: UST Basin Accuracy: f5 ft
Method of Collection: Google Earth
* *FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
TREATMENT AREA
Land surface area of contaminant plume: NA square feet
Land surface area of inj. well network: NA square feet L< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: NA (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.
L 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:
Air sparging to reduce petroleum VOCs in groundwater, using two wells (existing AS-1 and new AS-2)
combined with a 96-hour Multi -Phase Extraction Event (MMPE) using two wells MW-1 and MW-3.
Approximately 5 cfm per SPARGE well for approximately 96 hours (possible 12 hrs ON and 12 hrs OFF
schedule).
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 1 Proposed: 1 Existing (provide NC Well Construction
Record (GW-1) for each well)
(2) Appx. injection depths (BLS): 20-25 feet
(3) For Proposed wells or Existing wells not having GW-Is, 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
Planned injection well AS-2, installed using hollow -stem auger drilling, with a nominal 8-inch
diameter borehole: 2-in diam Sch 40 PVC well, 0.010-inch slotted screen (20 to 25 ft-bgs), PVC riser
to land surface, sand pack (18 to 25 ft-bgs), bentonite seal (16 to 18 ft-gbs) and cement grout (0.25 to
16 ft-bgs). Driller to be determined. AS-1 was constructed by others in similar fashion.
K. INJECTION SUMMARY
NOTE: Only injectants approved by the epidemioloy section of the NC Division ofPublic Health. Department
of Health and Human Services can be injected. Approved injectants can be found online at
hllp://deg.nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Program for more info if you wish to get approval for a different additive. However, please
note it may take 3 months or longer. If no injectants are to be used use N/A.
Injectant Air Total Amt. to be injected (gal)/event: —5 cfm/well (57,600 CF)
No. of separate injection events: up to 4 Total Amt. to be injected (gal): 230,400 CF
Source of Water (if applicable): N/A
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3

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.
Injection of air not anticipated to result in a violation of the 21, Standards. ATC plans to sample all accessible
wells approximately 3 to 4 weeks after each event, with analysis by SM 6200B
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "7 hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the I5A NCAC 02C 0200 Rules. "
Al Quarles, P.G. Senior Project Manage
ATC Associates of North Carolina. P.C., as aizent for and under contract with NCDEQ
Signature of Applicant Print or Type Full Name and Title
Property Owner (if the property is not owned by the Well Owner/Applicant):
"As owner of theproperty on which the injection well(s) are to be constructed and operated, I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(I5A 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.
See attached agreement by Joel Connell
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 4

Herb Berger
Hydrogeologist
DWM UST Section
1646 Mail Service Center
Raleigh, NC 27699-1646
RE: Former Todd General Store
3866 Todd Railroad Grade Road
Todd, Ashe County, NC
Incident#24093
Dear Mr. Berger:
I am/We are the owner(s) of a parcel of property, located at or near the incident in question,
and hereby 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
groundwaters under the authority of G.S. 143-215.3(a)2.
I am/We 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 of the site and access shall be borne by the
Department or its contractor. The Department or its contractor shall protect and prevent
damage to the surrounding 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 full 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 of the 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 North Carolina G.S. 132-1.
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 land owner.
I/We agree not to interfere with, remove, or any way damage the Department's well(s) or its
contractor's well(s) and equipment during the investigation.
Sincerely,
Signature
Matthew Connell
Type/Print Name of Owner or Agent
804-938-8447
Phone Number
529 Tracy Circle
Address
Boone, NC, 28607
City/State/Zip Code
Sept. 30, 2019
Date
Herb Berger
UST Section
Division of Waste Management
1646 Mail Service Center
Raleigh, NC 27699-1646

TYPICAL TYPE II MONITORING WELL CONSTRUCTION DETAILS
FLUSH GRADE MANHOLE
CROSS SECTIONAL VIEW
NOT TO SCALE
LOCKABLE WELL C
L1
----------- .---..
L2
L3
a:%llIX0I1V/=Key_WIkglDT1►11Z6%7►[a]:7=1119=1111:7_1C7
CASING MATERIAL
steel
CASING DIAMETER
8 inches
CASING LENGTH
12 inches
PAD DIMENSIONS
2 feet x 2 feet
HEIGHT ABOVE GROUND
flush mounted
1Vi9=1ISayeF]I►10
MATERIAL
sch 40 PVC
DIAMETER
2 inches
JOINT TYPE
flush threaded
LENGTH
20 feet
BACKFILL AROUND CASING
MATERIAL cement -sand grout
THICKNESS 16 feet
SEAL
TYPE OF SEAL bentonite
THICKNESS 2 feet
FILTER PACK
TYPE OF FILTER #2 silica sand
DISTANCE ABOVE SCREEN 2 feet
1Vi9=1IW*61N=1 =1►
SCREEN MATERIAL Sch 40 PVC
DIAMETER 2 inches
LENGTH 5 feet
SLOT SIZE 0.010 inches
DEPTH TO BOTTOM OF
MONITORING WELL 25.0 feet
DEPTH TO BOTTOM OF
BOREHOLE 25.0 feet
L1 = 0.25 FT.
L2 = 20 FT. DIAMETER OF BOREHOLE 8.25 inches
L3 = 5 FT.
L4 = 25 FT.
nent Monitoring Well Diagram
Todd General Store 7606 Whitehall Executive Center Drive
3866 Todd Railroad Grade Road Charlotte, North Carolina 28273
Todd, Ashe County, NC 28684
FILE PREP. BY REV. BY DATE PROJECT NO.
SW I AQ 12/22/2023 STL2409301

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TOPOGRAPHIC MAP IMAGE COURTESY OF THE U.S. GEOLOGICAL SURVEY
QUADRANGLES INCLUDE: TODD, NC (1/1/1998).
Project Manager:
Project No.
TOPOGRAPHIC MAP
Exhibit
FCD
75207133
Drawn by: FCD
Sca—I e: 1"=2,000'
Irerracon
Todd General Store (incident No. 24093)
Checked by: NM
File Name: Todd
7327 W Friendly Ave Ste G
3866 Railroad Grade Road
Approved by: NM
Date: 3/1/2023
Greensboro, NC 27410-6253
Todd, Ashe County, North Carolina

Q Radius
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WSW
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Legend
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. Note:
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WSW-9
PM:
FCD
Project
07133
Irerracon
7327wFriend WAve Ste
Greensboro, NC27410-6253
Water Supply Well Map
EXHIBIT
No.
Drawn By:
FCD
Scale:
1 in = 330 ft
Todd General Store (Incident No. 24093)
3866 Railroad Grade Road
Todd, Ashe County, North Carolina
3
Checked By:
NM
File Path:
Todd General
Approved By:
NM
Date:
3/1/2023
7327-GW.M1riend1y Avenue Greensboro, NC 27410
Phone: [phone] Fax: [phone]

PM. FCD Proje�67133
Drawn By: Scale:
FCD 1 in = 50 ft
Checked By: File Path:
NM Todd General
Approved By: Date: NM 3/10/2023
Irerracon
7327 W Friendly Ave Ste G
Greensboro, NC 27470$253
West Friendly Avenue Greensboro, NC 27410
[phone] Fax: [phone]
Groundwater Elevation Ma EXHIBIT
p (Mar. 2023 ) No.
Todd General Store (Incident No. 24093)
3866 Railroad Grade Road 4
Todd, Ashe County, North Carolina

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TABLE 2
Monitoring Well Construction Information and Historical Groundwater Measurements
Todd General Store
3866 Railroad Grade Road
Todd, Ashe County, North Carolina
NCDEQ Incident No. 24093
Terracon Project No. 75207133
Well ID
Date
Installed
(m/ddyyyy)
Well
Casing
Dep
Screen
Interval
(ft. BGS)
Depth of
Well
(ft. BGS)
Top of
Casing
Elevation
Date Water
Level
Measured
Depth to
Water
from Top
of Casing
ft.)
LNAPL
Thickness
(ft.)
Groundwater
Elevation
Comments
MW-1
12/9/2002
6
6-21
21
100.00
12/8/2003
10.00
--
90.00
Type II
2/21/2007
9.99
0.55
90.48
11/6/2019
Not Measured- Inaccessible
5/19/2020
5.83
1 0.02
1 94.19
6/2/2020
5.78
1 -
1 94.22
11/24/2020
Not Measured- Inaccessible
4/4/2022
8.38
-
91.62
10/12/2022
9.8
-
90.20
3/1/2023
8.73
-
91.27
MW-2
3/11/2003
5
5-15
15
96.38
3/11/2003
7.20
-
89.18
Type II
11/6/2019
6.61
-
89.77
11/24/2020
5.21
-
91.17
4/4/2022
8.86
-
87.52
10/12/2022
7.76
-
88.62
3/1/2023
6.52
-
89.86
MW-3
3/11/2003
8
8-18
18
102.35
12/8/2003
14.01
Film
88.34
Type II
2/21/2007
14.12
1.20
89.26
11/6/2019
10.75
0.78
92.27
5/19/2020
9.22
0.78
93.80
6/2/2020
9.22
0.78
93.58
11/24/2020
9.68
0.30
92.67
4/5/2022
11.34
-
91.01
10/12/2022
12.44
-
89- 1
3/1/2023
11.13
-
91.22
MW-4
3/11/2003
10
10-20
20
103.90
10/15/2003
3.10
-
100.80
Type II
11/6/2019
Not Measured- Inaccessible
11/24/2020
4/5/2022
Not Measured - Not Found
MW-5
3/11/2003
2
2-5
5
89.43
12/8/2003
2.40
-
87.03
Type II
2/21/2007
2.06
-
87.37
11/6/2019
1.97
-
87.46
11/24/2020
1.80
-
87.63
4/5/2022
1.81
--
87.62
3/1/2023
1.57
87.86
MW-6
4/2/2003
35
35-40
40
99.14
12/8/2003
8.80
--
90.34
Type II
11/6/2019
7.50
-
91.64
11/24/2020
6.41
-
92.73
4/4/2022
8.62
-
90.52
10/12/2022
9.00
-
90.14
MW-7
9/25/2003
1.9
1.9-6.9
6.9
94.94
12/8/2003
2.45
-
92.49
Type II
2/21/2007
2.13
-
92.81
11/6/2019
Not Measured - Not Found
11/24/2020
Not Measured - Not Found
4/4/2022
2.24
-
92.7
3/1/2023
2.42
-
92.52
MW-8
9/25/2003
5.7
5.7-15.7
15.7
94.77
12/8/2003
6.35
-
88.42
Type 11
2/21/2007
6.30
-
88.47
11/6/2019
Not Measured - Not Found
11/24/2020
Not Measured - Not Found
4/4/2022
5.49
-
89.28
10/12/2022
6.02
-
88.75
3/1/2023
5.41
-
89.36
MW-9
9/25/2003
4.2
4.2-14.2
14.2
93.75
9/25/2003
6.45
-
87.30
Type 11
2/21/2007
6.33
-
87.42
11/6/2019
Not Measured - Not Found
11/24/2020
Not Measured - Not Found
4/4/2022
6.05
-
87.7
10/12/2022
6.29
-
87.46
3/1/2023
1 5.92
-
87.83
MW-10
9/25/2003
1.7
1.7-11.7
11.7
86.49
12/8/2003
1.90
-
84.59
Type 11
11/6/2019
1.79
-
84.70
11/24/2020
1.46
-
85.03
4/5/2022
2.07
-
84.42
3/1/2023
1.92
-
84.57
AS-1
4/4/2022
23
18-23
23
NM
4/4/2022
NM
NM
NM
Type 11
EX-1
4/4/2022
20
5-20
20
102,36
4/4/2022
NM
NM
NM
Type 11 - 4" Diameter
9/26/2022
12.10
-
90.26
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