WI0100709_Notification of Intent (NOI) – GW Remediation_20240219

AECOM AECOM Technical Services of North Carolina, Inc.
6000 Fairview Road, Suite 200
Charlotte, NC 28210
February 8, 2024
Division of Water Resources — Underground Injection Control Program
North Carolina Department of Environmental Quality
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
tel: [phone]
Subject: Notification of Intent (NOI) to Construct or Operate Injection Wells
TravelCenters of America
153 Wiggins Road
Candler, Buncombe County, North Carolina
NCDEQ Incident No. 16413
NCDEQ Risk Ranking: Intermediate
On behalf of TravelCenters of America (TA), AECOM is pleased to submit one hard copy and one
digital of the Notification of Intent (NOI) to Construct or Operate Injection Wells for the above -
referenced site in response to the October 16, 2023 Notice of Regulatory Requirements (NORR)
directing a Feasibility Study including a pilot study for chemical injection at MW-15. In response to
the NORR, AECOM is providing the attached NOI for a planned Mobile Multi -Phase Extraction event
with surfactant injection (MMPE/Injection) at monitoring well MW-15. Due to the limited scope of this
pilot study, AECOM is submitting the boring/well log for MW-15, which is the target well for injection.
in lieu of a cross section map for the site.
If you have any questions regarding this submittal, please contact either me at
shaun.beckera.aecom.com or [phone] or Jeffrey Hvozdik at ieff.hvozdikCcaaecom.com or
[phone].
Sincerely,
AECOM TECHNICAL SERVICES OF NORTH CAROLINA, INC.
Shaun R Becker, PG
Deputy Project Manager
cc: Rob Porges (TA)
Jeffrey T. Hvozdik, PG
Project Manager

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: February 8, 2024 PERMIT NO. W10100709 (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 W10100709 Issued Date: 02/19/2024
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) 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) X 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: Business/Organization
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): TA Operating LLC
Mailing Address: 24601 Center Ridge Rd
City: Westlake State: _OH_ Zip Code: 44145 County: Cuyahoga
Day Tele No.: 440-808-7368 Cell No.: 440-570-1395
EMAIL Address: [e-mail] Fax No.: N/A
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title:
Company Name
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Jeffrey Hvozdik
Company Name AECOM
Mailing Address: 6000 Fairview Rd, Ste 200
City: Charlotte State: NC_ Zip Code: 28210 County: Mecklenburg
Day Tele No.: 704-522-0330 Cell No.: 412-977-4074
EMAIL Address: jeff.hvozdikkaecom.com Fax No.: N/A
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: TravelCenters of America
City: Candler County: Buncombe Zip Code: 16413
(2) Geographic Coordinates: Latitude": " or °
Longitude": " or °
Reference Datum: Accuracy:
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: >2.000 square feet
Land surface area of inj. well network: >100 square feet (< 10,000 fe for small-scale injections)
Percent of contaminant plume area to be treated: Approx 5(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:
The Site, Travel Centers of America — Candler is currently an active commercial petroleum fueling facility.
Several documented releases of gasoline and diesel have occurred at the site over many years with free product
discovered in monitoring well MW-15. The purpose of this project is to perform a Mobile Multi -Phase Extraction
(MMPE) with Surfactant Injection on MW-15. The MMPE system will be set up for prior and post injection to
simultaneously remove vapors and liquids from the subsurface of the Site and convey the contaminants to a
designated container. The solution. Ivey -Sol 9103 will be injected at 2% with water to absorb the petroleum
hydrocarbons in the monitoring well and groundwater plume. Following this procedure, groundwater sampling
will take place 30 days after the event, aiming to remediate the level of petroleum hydrocarbon in the
groundwater.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 1 Proposed MW-15 Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS):_ 16 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
Well ID
Well Type
Well
Construction
Data
Contractor
Certification
Number
Notes
MW-15
Geoprobe
Boring — Depth:
NEO
N/A
See boring/well
19 ft
Corporation
log for existing
Casing — Length:
permanent MW-
8 ft
15
Screen — Length:
loft
Well —Depth: 18
ft
Diameter — 2 ft
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3

K, INJECTION SUMMARY
NOTE: Only injectants approved by the gpidemio1w, section of the NC Division of Public Health. Department
of Health and Human Services can be injected. Approved injectants can be found online at
http://deg.nc. L=,ov/about/divisions/water-resources/water-resources-permits/wastewater-branch/g_round-water-
protection/ground-water-approved-injectants. AZl 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 ma►• take 3 months or lon er. If no injectants are to be used use N/A.
Injectant: Ivey -Sol #103 at 2% solution with water Total Amt. to be injected (gal)/event: 550
Injectant_
Injectant_
Total Amt. to be injected (gal)/event:
Total Amt. to be injected (gal)/event;
Injectant: Total Amt. to be injected (gal)/event:
Injectant: Total Amt. to be injected (gal)/event:
Total Amt. to be injected (gal/event): 550
No. of separate injection events: NA Total Amt. to be injected (gal): 550
Source of Water (if applicable): On -site potable water.
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.
Approximately 30 days after completion of the Limited Injection/NIMPE event, AECOM will mobilize to the site to
collect a confirmatga groundwater sample from monitoring well MW-15 to evaluate the effectiveness of the Limited
Jection/MMPE event. Prior to sampling, groundwater levels will be measured at all on -site monitoring wells. The
groundwater sample will be collected using a dedicated bailer and a minimum of three well volumes will be purged
prior to sampling. One duplicate sample will be collected during the sampling event for quality assurance purposes.
The groundwater samples will be shipped to a North Carolina certified laboratory via overnight courier and analyzed
by EPA Method SM6200 for a targeted list of anal qes including benzene, toluene, ethylbenzene, xylenes_(BTEX),
1.2-dichloroethane (1.2-DCA), ethylene dibromide (EDB), isopropyl ether (IPE), methyl tert-butyl ether (MTBE), and
naphthalene.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: `I 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. Iam aware that there are significant penalties, including the possibility offines 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 1 SA NCAC 02C 0200 Rules. "
�' Rob Porges, Sr. Director
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 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
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 4

responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(I M NCAC 02C . 0200j. "
"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.
SVC HYB Lease Pool 4 LLC K,
) L Todd HarL eaves. President
Signature* of Property Ow r 0 different from applicant) Print or Type Full Name and 1Stle
*An access agreement between the applicant andproperty 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 5

� /cs00010
�ti
0
44
M W-9
M W-20
.� �N S
- O MW.rfVS
�r -
MW-1
NS
MW-10 •
DNS 1
M W-5
NS
V-2' "
NS
MW-11
NS
�Z MW-6
ry_ NS
MW-16
NS
"�MW-7
NS
r
MW-15
..+ S Truck Stop
and
Restau rant
r
MW-15 (08/10/2023)
Benzene 8,230
Proposed MMPE/Injection
Point at MW-15
MW-12
NS MW-17
NS
MW-18
MW-18 (08/10/2023)
Benzene I
MW-13 `�
MW-13 (08/10/2023)
Benzene I 28.3
MW-14 OW
NS
LEGEND
iii� Monitoring Well Location
Proposed Area of
Influence for
MMPE/Injection
ND Not Detected
NS Not Sampled
NC GCL
Benzene
5,000
1,2-Dichloroethane
400
Ethylbenzene
84,500
m&p-Xylene
85,500
Methyl-tert-butyl ether
20,000
Naphthalene
6,000
o-Xylene
85,500
Toluene
260,000
Xylene (Total)
85,500
Ethylene dibromide
50
NOTES.
1. All results shown in ug/L.
2. Samples were collected
August 10, 2023.
3. NC GCL - North Carolina
Gross Contaminant Level.
N
0 25 50 100
Feet
DIRECTED MMPE/INJECTION EVENT
Benzene Results with Proposed MMPE/Injection Point AECOM
CANDLER TRAVEL CENTER
CANDLER, NORTH CAROLINA Figure 1

0� _
11010 s '�' LEGEND
r Go�� Monitoring Well Location
MW-9 /0�30
/ tiI Groundwater Contour
/� / /ti6!�, "�• (Dashed where Inferred)
zo
M� 9.61 Groundwater Elevation
` MW-4R / MW-10 (Ft. Above MSL)
0
/ / / �23.88
30.33e Groundwater Flow - s�
Direction
o
/i
MW-5 MW-11 NM Not Measured
2.68 20.82
MW-1� / �6 = Not Used in Contouring
28.75
MW-2 / MW_6 f ti
� �20.74 ► 91
~ 1 MW-12.��
f MW-16* I I ! I/ J
/110.61, MW-17
14.52 I / ii�9.39
MW-7� MW-18
r < 19.7 $*
SQ� I
Truck Stop MWA5
4 and I� 1
Restaurant IM-1f ,/.�•
• '�2"52 f � ��_
1 MW-14 f
. 9.31
N
0 25 50 100
Feet
DIRECTED MMPE/INJECTION EVENT
Groundwater Contour Map -August 10, 2023 AECOM
CANDLER TRAVEL CENTER
CANDLER, NORTH CAROLINA Figure 3

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GRAPHIC SCALE �F�FIGURE
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ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Mr. Rob Porges
Travel Centers of America
24601 Center Ridge Road, Suite 200
Westlake, OH 44145
NORTH CAROLINA
Environmental Quality
October 16, 2023
Re: Notice of Regulatory Requirements
15A NCAC 02L .0407(d) [Intennediate Risk]
Risk -based Assessment and Corrective Action
for Petroleum Underground Storage Tanks
Travel Ports of America
153 Wiggins Road, Candler
Buncombe County
Incident Number: 16413
Risk Classification: intermediate
Ranking: 145D
Dear Mr. Porges:
The Monitoring Report received on October 13, 2023 has been reviewed by the UST Section, Division of
Waste Management, Asheville Regional Office. The remedial strategy proposed in the Monitoring Report
has been reviewed and approved by the UST Section. Please proceed with the Feasibility Study which
includes a pilot study for chemical injection using BOS 200 or a similar approved product.
The review indicates that corrective action is necessary to remediate environmental contamination. Title
15A NCAC 02L .0407 (d) [Intermediate Risk] requires you to comply with the assessment and cleanup
requirements of Title 15A NCAC 2N .0707 and Title 15A NCAC 02L .0106(c) and 02L .01 11(c).
In accordance with 15A NCAC 02L .0111(a), a Corrective Action Plan shall be submitted to this office in
accordance with a schedule established by the Division of Waste Management Director. Because this
incident is eligible (or potentially eligible) for access to the Commercial Leaking Petroleum
Underground Storage Tank Cleanup Fund (State Trust Fund), a Feasibility Study in accordance with
the most recent version of the UST Section Corrective Action Guidelines, and the applicable State
Trust Fund Reasonable Rate Document must be submitted instead of a completed CAP. The Section
must approve the proposed remedial strategy prior to conducting a Feasibility Study.
In the CAP, natural attenuation of groundwater contamination must be used to the maximum extent
possible, plume stability should be evaluated, and efforts must be made to determine whether the
elimination of potential receptors, leading to risk reduction, is immediately practicable. A responsible party
who submits a Corrective Action Plan that proposes natural attenuation at any point in the process or
cleanup to alternate standards must provide public notice as specified in 15A NCAC 02L .0409(a).
D North Carolina Department of Environmental Quality I Division of Waste Management
Asheville Regional Office 12090 US Highway 70 1 Swannanoa, NC 28778 1 (828) 296-
NoaTK CArWNn ^ `Q� 4500
o.wmro,nw Emtr��e.r u�,r�

Page 2 of 2
Incident Number 16413
October 16, 2023
Because a release or discharge has been confirmed, a Licensed Geologist or a Professional Engineer,
certified by the State of North Carolina, is required to prepare and certify all reports submitted to the
Department in accordance with 15A NCAC 02L .0103(e) and 02L .01 I I(e).
The Department of Environmental Quality requires that all work not determined to be an emergency
response or associated with risk assessment (i.e., the Limited Site Assessment Report, per Title 15A NCAC
02L .0405) must be preapproved if State Trust Fund reimbursement is anticipated. To comply with this
requirement, a completed Preapproval/Claim Authorization Form, encompassing the scope of work
necessary to evaluate the feasibility of a proposed remediation strategy, must be received in this office
within 14 days of the date of this letter. Upon completion of preapproved activities that define an individual
step within the Corrective Action Plan process, you should submit your claim promptly. Reimbursement
funds are budgeted based on completed preapprovals, but delays in reimbursement or even denial due to a
failure to meet the statute of limitations on claiming a completed task can result if the work is not completed
in a timely fashion or of claims are not submitted immediately following work completion.
If you have any questions regarding trust fund eligibility or reimbursement from the Commercial Leaking
Petroleum Underground Storage Tank Cleanup Fund, please contact the UST Section Trust Fund Branch
at [phone]. If you have any questions regarding the actions that must betaken or the rules mentioned
in this letter, please contact me at the address or telephone number listed below.
Sincerely,
Maura Clark
Hydrogeologist
Asheville Regional Office
UST Section, Division of Waste Management, NCDEQ
cc: Buncombe County Health Department
AECOM; Jeff Hvozdik: [e-mail]
REQ North Carolina Department of Environmental Quality I Division of Waste Management
Asheville Regional Office 12090 US Highway 70 1 Swannanoa, NC 28778 1 (828) 296-
NF- caaou 4500
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Srmfactut Iechnalagy
www.iveyinternationaL cam
SAFETY DATA SHEET SDS # 231005-08
Ivey-sol Surfactant Remediation Technology
Ivey-sol Formulations: 103, 106, 106 Cl, and 108
1. Identification
Product identifier:
Other means of identification:
Recommended use:
Restriction on use:
Manufacturer/Supplier Address
Emergency telephone number:
2. Hazard Identification
Ivey-sol° 103, 106, 106 Cl, 108
Not applicable
Remediation surfactant
Not applicable
Ivey International Inc.
Unit 7, 19122-27 Avenue, Surrey, BC Canada V3Z 5T1
Tel: [phone] (Not available 24 hours)
Toll Free: [phone]
WHMIS 2015/OSHA Hazcom 2012/GHS Classification:
• Serious Eye Damage/Irritation Category 2
• Skin Corrosion/Irritation Category 3
Label elements:
Signal word: Warning Pictograms: Hazard statements:
H316 — May causes mild skin irritation. '
H319 — May causes eye irritation. •
Precautionary Statements:
P264 - Wash contacted areas thoroughly after handling.
P280 - Wear eye protection.
P305/P351/P338 - If In Eyes: Rinse cautiously with water for several minutes.
present and easy to do so. Continue rinsing.
P332/P313 - If skin irritation occurs: Get medical advice/attention.
P337/P313 - If eye irritation persists: Get medical advice/attention
3. Composition / Information on Ingredients
Remove contact lenses, if
Chemical Name
CAS No.
Concentration (v/v)
Other Identifiers
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 1
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 2
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 3
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 4
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 5
Biodegradable Non-ionic
Proprietary
1-10%
Not applicable
Surfactant 6
Page 1 of 5

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VIVIrtactut Iechnalagy
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Preservative— DOWICIL 75
4080-31-3
<1%
Food Grade (Optional)
Scent — Pink Grapefruit 100%
Natural
8016
<1 %
Optional
Water
7732-18-5
<90%
Not applicable
Regulatory Note: Chemical names, CAS numbers and actual concentrations have been withheld as part of
a confidential business information claim with HMIRA Registry #11724 filed on 2017-07-17
4. First -aid Measures
Inhalation: No adverse effects anticipated by this route when handled according to section 7 of
document. However, if necessary, move person to fresh air.
Skin contact: Generally will not irritate skin. Wash contact areas with soap and water. If irritation
persist, seek medical attention.
Eye contact: May cause eye irritation. Flush eyes with plenty of water for at least 15 minutes, remove
contact lenses if present and easy to do so. If irritation persists, seek medical attention.
Ingestion: Do NOT induce vomiting. Never give anything by mouth to an unconscious person. Rinse
mouth with water. If necessary, seek medical attention.
Most Important Symptoms and Effects, Acute and Delayed
Acute Symptoms:
Eye Contact: May be irritating to the eyes. Occasional contact through splashing is not expected to affect
the eyes. If irritation occurs, effect will be transient.
Chronic Symptoms: Not Applicable
Immediate Medical Attention and Special Treatment: Not Applicable
5. Fire -Fighting Measures
Suitable extinguishing media: Not flammable. Use extinguishing media for surrounding fire.
Unsuitable extinguishing media: Not applicable
Specific hazards arising from the hazardous product: Not available
Special protective equipment for fire-fighters: Not available
6. Accidental release measures
Personal Precautions, Protective Equipment:
Observe good industrial hygiene practices. Use personal protective equipment as recommended in Section
8. Avoid breathing vapours, mist or gas. Ensure adequate ventilation. Emergency Procedures: Eliminate
and/or contain source with inert material (sand, earth, absorbent pads, etc.). Wear basic eye and skin
protection. Floor may be slightly slippery; so use care to avoid falling. Avoid discharge to natural waters,
and/or dilute with water. Transfer liquids to suitable containers for recovery, re -use or disposal. Contact
Ivey for technical assistance if required.
7. Handling and Storage
Precautions for Safe Handling:
Practice good housekeeping. Avoid breathing excessive vapours. Ensure adequate
ventilation. Avoid contact with skin and eyes. Wear protective gloves. Wash thoroughly after handling.
Conditions for Safe Storaae: Keep closed or sealed when not in use. Do not allow to freeze. keep >0°C.
Page 2 of 5

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8. Exposure Controls / Personal Protection
Control parameters: Not available
Appropriate Engineering Controls: General mechanical room ventilation is expected to be satisfactory.
Individual Protections Measures: Eye/face protection: Mono goggles or similar.
Skin protection: Latex gloves, or similar, would be sufficient. Normal work clothes.
Respiratory Protection: None expected to be needed. However, if an engineered / industrial application
where vapours and/or misting may occur, wear MSHA/NIOSH approved half mask
air purifying respirator
9. Physical and Chemical Properties
Appearance:
Liquid, cloudy
Odour:
Mild
Odour threshold:
Not available
pH:
7 (+/- 0.5) (1 % solution)
Melting Point:
_0°C
Freezing point:
_0°C
Boiling Point:
Not available
Flash Point:
Not applicable
Evaporation Rate:
<0.01
Flammability:
Not applicable
Lower flammable/ explosive limit: Not applicable
Upper flammable/Explosive
Limit: Not applicable
Vapour Pressure:
<0.01 mm Hg
Vapour Density:
>1
Relative Density:
0.99-1.04
Solubility:
100% (Completely miscible in water)
Partition Coefficient:
Not available (n-octanol / water)
Auto -Ignition Temperature: Not applicable
Decomposition Temperature:
Not available
Viscosity:
Not available
10. Stability and Reactivity
Reactivity:
Not reactive.
Chemical Stability:
Stable.
Possibility of Hazardous Reactions: Not applicable
Conditions to Avoid:
Prolonged excessive heat may cause product decomposition. Freezing
should also be avoided as it may cause product decomposition. In some
cases freezing may cause irreversible changes.
Incompatible Materials:
Normally un-reactive; however avoid strong bases at high temperatures,
strong acids, strong oxidizing agents, and materials with reactive hydroxyl
compounds. These compounds would damage the mixture and reduce its
effectiveness during application.
Hazardous Decomposition
products: Not applicable
11. Toxicological Information
Likely Routes of Exposure
Inhalation: No
Skin contact: No
Eye contact: Yes
Page 3 of 5

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Ingestion:
No
Acute Toxicity:
LD50 - Oral (Rat): _
>43.00Omg/kg (rat) mg/kg
LD50 - Dermal (Rabbit):
>58.00Omg/kg (rabbit) mg/kg
Inhalation:
Not available
Skin corrosion/irritation:
Mild irritation
Serious eye damage/irritation:
Eye irritation
Respiratory or skin sensitization: No
Germ cell mutagenicity:
No
Carcinogenicity:
None known or expected
Reproductive toxicity:
No
12. Ecological Information
Toxicity: Low potential to affect aquatic organisms when used in accordance with Ivey
International Inc. In -situ and Ex -situ Remediation Application Guidelines.
Acute toxicitv Time Species I Method Evaluation I Remarks
LC/50 = 0.07695%
96h
Rainbow
trout
OECD 203
Not
applicable
Not
applicable
LC/50 = 0.11%
48h Daphnia
OECD 202 Not Not
Magna
applicable applicable
OECD 201 Not Not
EC/50 = Not applicable
72h Algae
applicable applicable
Persistence and degradability: >90% biodegradable in < 28 days.*
Bio-accumulative potential: Not available
Mobility in soil: Completely miscible with water.
Other adverse effects: Not available
Based on actual testing or on data for similar material(s). Degradation Biodegradation reached in Modified
OECD Screening Test (OECD Test No.301 E) after 28 days: 90 %. Biodegradation reached in CO2
Evolution Test (Modified Sturm Test, (OECD Test No. 301 B) after 28 days: 70 %.
13. Disposal Considerations
Product/Packaging:
For aqueous mixture solutions; aerobic biological wastewater treatment systems are effective in treating
said mixtures. Ivey-sol does not have any known negative affect on coagulant or flocculent water treatment
processes.
14. Transport Information
UN Number:
Not applicable
Proper Shipping Name:
Not applicable
Technical Name:
Not applicable
Transport Hazard Class:
Not applicable
Packing Group:
Not applicable
Environmental Hazards:
Not applicable
Notes: Not Regulated for Transport
HS Code: 3402.42.00.00
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9 ah 1VIY-SSl®
Srmfactut Iechnalagy
www.iveyinternationaL cam
15. Regulatory Information
UN GHS Classification: Classified in accordance with GHS 5th revised edition.
WHMIS Classification: Classified in accordance with HPR August 29, 2016 revised edition.
CPR Compliance: This product has been classified in accordance with the hazard criteria of the CPR,
and the SIDS contains all the information required by the CPR.
CEPA Compliance: All ingredients of this product are listed on the DSL.
16. Other Information
Creation Date: July 5, 2017
Revision Date: Updated October 2, 2017, October 18, 2018, November 4, 2022, October 6, 2023
Disclaimer: This Safety Data Sheet (SDS) was prepared by iHazmat Regulatory Ltd.,
(www.iHazmat.com) using information provided by Ivey International Inc. The
information in this SIDS is offered for your consideration and guidance when
working with this product. As per usual practice, accuracy of the information
included is based on what was provided by the manufacturer and sole liability for
the accuracy of these documents falls to Ivey International Inc.
This Safety Data Sheet may not be changed, or altered in any way without the expressed knowledge and
permission of Ivey International Inc.
SIDS Created By: iHazmat Regulatory Ltd.
www.iHazmat.com
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