WI0400616_Notification of Intent (NOI) – GW Remediation_20240221

NC Department of Environmental Quality (DEQ) —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 application to be submitted and an individual permit
be issued when constructed in accordance with the rules of I5A NCAC 02C.0200(NOTE: This form must be
received at least 14 DAYS prior to infection)
GROUNDWATER(GW)REMEDIATION INJECTION PERMIT TYPES:
(1)IN-SITU GW REMEDIATION PERMIT TYPE (15A NCAC 02C.0225)
• In-Situ 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).
• In-Situ Small-Scale Injection Operations—Injection wells located within a land surface area not to exceed 10,000
square feet(SF)for the purpose of soil or groundwater remediation or tracer tests.If area to be treated exceeds 10,000
SF do not use this NOI;an injection Permit application shall be submitted,and a Permit issued per 15A NCAC
02C.0225(f).
• In-Situ Pilot Tests-Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy 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. Also,if pilot test is going to be conducted on separate groundwater
contaminant plumes do not use this NOI; a Permit application shall be submitted,and a Permit issued as per
15A NCAC 02C.0225(f).
• In-Situ Thermal(IST)—IST wells `heat' contaminated groundwater in-situ to enhance remediation.
(2)AIR INJECTION PERMIT TYPE(15A NCAC 02C.0225)
These permit types are used to inject ambient air to enhance treatment of soil or groundwater.
(3)TRACER WELL PERMIT TYPE(15A NCAC 02C.0229)
These permit types are used to inject substances for determining hydrogeologic properties of aquifers.
(4)AQUIFER TEST PERMIT TYPE(15A NCAC 02C.0220)
These permit types are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
DATE: February 15 ,20 24 NOI TRACKING NO. WI0400616 (To be filled in by DWR)
DIRECTIONS- Submit this NOI only for(1)New deemed`permitted by rule' injection project or(2)If there is going
to be a different permit!ype(listed above)used for a previously issued NOI.
NOTE-After this NOI is processed and acknowledged,any supplemental or additional injections still meeting the
criteria referenced in Section G below shall be reported using Injection Event Records(IERs)and using the NOI
tracking number provided by DWR.
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) 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(IST)Well........................... Complete sections B through M
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 1

B. STATUS OF WELL OWNER: State Government
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-DWM,UST Section,Federal& 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.: 910-796-7401 Cell No.: NA
EMAIL Address: Liz.price(a)deq.nc.gov Fax No.: 910-350-2004
D. PROPERTY OWNER(S)(if different than well owner/applicant)
Name and Title: Gayle Myrick Smith,Property Owner
Company Name NA
Mailing Address: 1208 East Franklin Street
City: Monroe State: NC_Zip Code: 28112 County: Guilford
Day Tele No.: 336-669-9231 Cell No.: NA
EMAIL Address: Fax No.: NA
E. PROJECT CONTACT(Typically Environmental Consulting/Engineering Firm)
Name and Title: Flora D'Souza,Environmental Project Scientist II
Company Name WithersRavenel,Inc.
Mailing Address: 115 Mackenan Drive
City: Cary State: NC_Zip Code: 27511 County:Wake
Day Tele No.: 919-678-3830 Cell No.:
EMAIL Address: fdsouzagwithersravenel.com Fax No.: 919-467-6008
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name&Address: Foscoe Country Corner—8937 NC Highway 105,NCDEQ Incident#44948
City: Boone County:Watauga Zip Code: 28607
(2) Geographic Coordinates: Latitude": 36.1578800
Longitude": -81.770692'
Reference Datum: Google Earth Accuracy: +/-5m
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.
G. TREATMENT AREA
Land surface area of contaminant plume: square feet
Land surface area of inj.well network: square feet(< 10,000 ftz 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.3-1-2023 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:
Purpose:The purpose of the passive injection(installation of a Provect-OX2 In Situ Chemical Oxidation(ISCO)
sleeve)in MW-2,MW-3, and MW-7 is to further reduce dissolved phase contaminants(BTEX)concentrations
to values below the NC 2L Standard to reach site closure.
Scope: The scope of this passive injection event will be to install one 3-ft Provect-OX2 sleeve into MW-2,MW-
3, and MW-7. The sleeve will remain in place until the site is sampled in September 2024 (approximately6
months).
Goals: The goal of using the Provect-OX2 sleeves is to further reduce the BTEX concentrations in groundwater
in the vicinity of MW-2,MW-3,and MW-7 over an approximate 6-month period.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: Proposed 3 Existing(provide NC Well
Construction Record(GW-1)for each well)
(2) Appx. injection depths(BLS):_10-ft BGS
(3) For Proposed wells or Existing wells not having GW-1s,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: Only iniectants approved by the epidemiology section of the NC Division ofPublic Health.Department
of Health and Human Services can be infected. Approved iniectants can be found online at
http://deg.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-watgr-
protection/uround-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Program for more infoi if you wish to get approval for a different additive. However,please
note it may take 3 months or longer. If no iniectants are to be used use N/A.
Injectant: Provect-OX2 ISCO Sleeves Total Amt.to be injected(gal)/event: Three 3-ft sleeves
Injectant: Total Amt.to be injected(gal)/event:
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 3

Injectant: 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):
No.of separate injection events: Total Amt. to be injected (gal):
Source of Water(if applicable):
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.
WR will advise the NCDEQ incident manager that the sleeves should be removed in September 2024 and the
site should be re-sampled following the removal of the sleeves.
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. 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�)�is��4o- Flora D'Souza,Environmental Project Scientist Il
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
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(1 SA NCAC 02C C.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
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.3-1-2023 Page 4

Herb Berger
Hydrogeologist
DWM UST Section
1646 Mail Service Ctr
Raleigh,NC 27699-1646
RE: Site Access Agreement
Foscoe Country Store
8937 NC Hwy 105 South
Boone,Watauga County,NC
Incident#44948
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 Environmental Quality(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
Type/Print Name of Owner or Agent
A C)U"1 (A-3-
Phone Number
-(� k-b(W)(A V (J
Address
City/State/Zip Code
Date

SUMMARY OF GROUNDWATER ANALYTICAL RESULTS
Analytical Method 6200B-Volatile Organic Compounds Calculated
v v
• c c
v v
N N
N C N at
C C N N d d
N N N C) C T T
Sample Sample v c v N o N L s -
r""~ at
ID Date c a E N a m E E o
a .T+ `o c �. o m F-
• o H ? m' `o a o o s o w Ft
c
00 o a c m
_ Q 00 c U w o v Z c 08 F-
� .� X
67-64-1 71-43-2 104-51-8 135-98-8 67-66-3 100 41-4 98-82-8 99-87-6 91-2P3 103-65-1 1 -88-3 95.-63-6 108-67-8 1330 20-7
MW-1 8/16/2023 Not Sampled
MW-2 8/16/2023 <100 <�.0 40A 10.3 <5.0 126 24.7 5.66 90.2 96.1 58 99.2 119
MW-3 8/16/2023 <10.0 1.18 2.38 0.769 <0.50 4.77 0.8 <0.50 2.98 14.3 3.2 6.4
MW-4 8/16/2023 <100 1 <5.0 1 29.7 7.33 <5.0 31.2 10.4 <5.0 <10.0 42A <5.0 162 35.7 46.4
MW-5 8/16/2023 Not Sampled
MW-6 8/16/2023 <10,0 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <1.0 <0.50 <0.50 <0.50 <0.50 <0.50
MW-7 MW-7 8/16/2023 123 2.20 2.62 2.51 1.25 65 8.32 1.8 27A 25.7 0.675 162 47.4 72.6
WSW-1 8/16/2023 <10.0 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <1.0 <0.50 <0.50 <0.50 <0.50 <0.50
WSW-2 8/16/2023 <10.0 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <1.0 <0.50 <0.50 <0.50 <0.50 <0.50
Field Blank 8/16/2023 <10.0 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <1.0 <0.50 <0.50 <0.50 <0.50 <0.50
M W-1 MW-3 GCNC 2L Standard 6,000 1 70 70 70 600 70 25 6 70 600 400 400 500
Ls for Groundwater 16,000,000 5,000 5,900 8,800 70,000 80,000 30,500 11,700 6,000 26,100 260,000 28,500 24,100 5000
Notes:
1)All results provided in ug/L(micrograms per liter)or parts per billion.
2)Compounds analyzed for by laboratory but not listed were not detected above laboratory detection limits.Seethe laboratory report included in the Appendix for a full list of constituen
3)NC 2L Standard-North Carolina Groundwater Quality Standard as per NC Administrative Code 15A NCAC 02L.
4)GCLs for Groundwater=NCDEQ UST Section Gross Contamination Levels for Groundwater.
Result =Result Exceeds Laboratory Detection Limits. Result =Result Exceeds 2L Standard. Result =Result Exceeds GCL Value.
WSW-1
M MW-4
W-2� -
MW-6
MW-5
LEGEND
TYPE II MONITORING WELL LOCATION
GRAPHIC SCALE
® WATER SUPPLY WELL LOCATION 0 25 50 100
NOTES:
1.)AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT.
inch=5
DRAWN BY: SCALE: FIGURE NO.:
1/
�0- Withers Rave n e l FOSCOE COUNTRY CORNER GROUNDWATER DCV 1"=50 4 TF#44984 ANALYTICAL RESULTS
Engineers I Planners I Surveyors 8937 NC HIGHWAY 105 APPROVED BY: DATE PROJECT NO.:
115 MacKenan Drive l Cary,NC 27511 It:919.469.3340 1 license#:F-1479 I www.withersravenel.com BOONE,WATAUGA COUNTY,NC MAP -AUGUST 2023 FD 10/25/2023 23-0307-FP
J 12310307-R-Foscoe Country ComeAlin mICAMBase Mapd'+0-October 27,2023-DVAIL

(89.86) I
MW-
(NS) MW-1
MW-3
SW- (89.7 )/
MW- 4
(90.8-7) /
r
LEGEND
0
TYPE II MONITORING WELL LOCATION cn
® WATER SUPPLY WELL LOCATION 10
0 I e(Wf
N CID
I YYY
PA I
(90.75) GROUNDWATER ELEVATION � �
NGROUNDWATER ELEVATION CONTOUR00 OD
(DASHED WHERE INFERRED) I 03 � Lnn
GROUNDWATER FLOW DIRECTION N 00 GRAPHIC SCALE
'L cVn 0 25 50 100
NOTES:
L2.)NM=
1.)AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT.
NOT MEASURED
1 inch=50 ft.
FOSCOECOUNTRYCORNER GROUNDWATER DRAWN BY: SCALE: FIGURE NO.:
I/-40- WithersRavenel TF#44984 HYDRAULIC GRADIENT Dcv 1r=5or 3
Engineers I Planners I Surveyors 8937 NC HIGHWAY 105 APPROVED BY: DATE: PROJECT NO.:
115 MacKenan Drive I Cary,NC 27511 t 919.469.3340 1 license A:F-1479 I www.withersravenel.com BOONE,WATAUGA COUNTY,NC MAP -AUGUST 16,2023 FD 10/24/2023 23-0307-FP
J QM307 FP F—s Country Cv-,\E-,,,CADl6ase Wp_dwg Odber27,2023 DVAIL

ESTIMATEDEXTENTOF LL
B /GROUNDWATER IMP AT A A o r I o Cl
CONCENTRATIO z o
ESTIMATED EXTENT OF LL
EXCEEDING 2L N _ 41 105.00 ``� ``1A `g GROUNDWATER IMPACT AT t 105.00 O N
�v SURFACE GRADE AV J CONCENTRATIONS AY LL a
_ — — — — — — — — — — -" — — — — EXCEEDING 2L STANDARD Z w
//• 100.00 — — _ — — — —SURFACE GRADE — — — 100.00 � X
'� _7 ` �� ' GRAVEL FILL '' _ - O Li
X
95.00 _ ,, 1 95.00 N Q o X
SILT+
GROUNDWATER ELEVATION -. m
f• V�yYl� �j -�,., 90.00 _ _ _ — AUGUST 2023 90.00
z co
' 85.00 �I�I�I�I�I�IuD^ T IEiuii l Yu"Ii�_ jl..I I'I �j�jI q�jL
F
85.00
11,0111 I
80.00 ° a $
_ 80.00
W1/-
MW-2'® Q
4
!11r
"[ ti <
LEGEND
N S n W
TYPE II MONITORING WELL LOCATION Ln F_
f - Ln
D _
NOTES: m
1.)2022 AERIAL OBTAINED FROM NC ONE MAP. u
In
GRAPHIC SCALE HORIZONTAL SCALE
0 25 50 100 W_5 1inch=30ft GROUNDWATER CONTAMINANT
J CROSS-SECTION
1 inch=50 ft. 0 15 30 60 A-A'
Lu
- -� / r, 't - } _ 1 V.J / ESTIMATED EXTENT OF } �
\ / GROUNDWATER IMPACT AT Q
/
\ , Byrd Cet'Tl _ i 105.00 CONCENTRATIONS �, 105.00 Q
�/ - /�• _ _ _A� EXCEEDING 2L STANDARD
}, / 4% ,,`'•.,`\`,` \ SURFACEGRADE C = Q
3b '`� �- �, LL U F
Z >a
GRAVE FILL -u-� V
95.00 95.00 W u
SUB ECT SITE --= - _ _ _ — SILT s�LT` °
- 1r-� / - V1 m
Callowa Gem ^ GROUNDWATER ELEVATION 90.00 F0
3oa ± 0.5 ACRES C- Y V 9a.aa — _� — —
AUGUST 2023 LL
ROCK
-"_� r - TCITcllcllcllcl .
.- 85.00
�>�3 — - III �II�II�IRnanoioioioion- ---- -- —
- _ — _ - - - _
all�il�T,,• .
so.00 ROCK 80.00
Oro o
< i 2.
k�. Foscoe = - _ � s
m v
14
GRAPHIC SCALE _ - I I�` \\��•� _�._ ��--`~ -`\ l--- HORIZONTAL SCALE L" v
-~ '' "\ �\ "'� 1 inch=30ft GROUNDWATER CONTAMINANT
o soo 1000 2000 CROSS-SECTION
j 1
BB
\' I
\ _'\ - ' AFAW
1 inch=1000 ft. J �-�/ ` s �� \ - 3 L---\ 0 15 30 60, -

MW-2 TO MW-4:0.012 FT/FT
MW-3 TO MW-7:0.026 FT/FT
r•
(89.86) I
MW-
�-
(NS) MW-1 .72
MW-3
� t
Y SW- (89.7 )/
MW- V'P-4
(90.87
LEGEND 11'
0KI
TYPE II MONITORING WELL LOCATION uVi
® WATER SUPPLY WELL LOCATION p I M I I W
IQ �4 I YYY
I
110
(90.75) GROUNDWATER ELEVATION Ln
N OD
GROUNDWATER ELEVATION CONTOUR I 9
(DASHED WHERE INFERRED) I 00 Pi tun
GROUNDWATER FLOW DIRECTION N 00 GRAPHIC SCALE
tVil 0 25 50 10
NOTES: -t
1.)AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT. -
2.)NM=NOT MEASURED
FOSCOE COUNTRY GROUNDWATER DRAWN BY: SCALE: FIGURE NO.:
t/-40- WithersRavenel TF#44984 HYDRAULIC GRADIENT Dcv 1"=50' 2
Engineers I Planners I Surveyors 8937 NC HIGHWAY 105 APPROVED BY: DATE: PROJECT NO.:
115 MacKenan Drive I Cary,NC 27531 t 919.469.3340 1 license#:F-1479 I www.withersraveneLcom BOONE,WATAUGA COUNTY,NC MAP -AUGUST 16,2023 FD 2/19/24 23-0307-FP
J0\0301-M-Famoe Country C0merlE1—\CAD\TF44948 X-SECT BASE 02-05-2024 ftg-February 19,2024-DVAIL

a
a
M -7 -
MW-1
�► MW-3 4 ,.
ESTIMATED MAXIMUM 9 _
RADIUS OF INFLUENCE
FOR PROVECTUS SLEEVES'
WSW-1
MW-2- ® MW-
MW-6
i MW-5
LEGEND
TYPE II MONITORING WELL LOCATION
GRAPHIC SCALE
® WATER SUPPLY WELL LOCATION 0 25 50 1
NOTES:
1.)AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT. _
FOSCOECOUNTRY CORNER DRAWN BY: SCALE: FIGURE NO.:
t/� W i t h e rs Ra ve n e l TF#44984 ESTIMATED RADIUS OF DCV 1"=50 r 1
Engineers I Planners I Surveyors 8937 NC HIGHWAY 105 INFLUENCE MAP APPROVED BY: DATE: PROJECT NO.:
115 MacKenan Drive I Cary,NC 27531 t 919.469.3340 1 license#:F-1479 I www.withersraveneLcom BOONE,WATAUGA COUNTY,NC FD 2/19/24 23-0307-FP
J0\0301-M-Famoe County C0merlE1—\CA0\TF44948 X-SECT BASE 02-05-2024 ftg-February 19,2024-DVAIL

Division of Environmental Health,Public Water Supply Section
SOURCE INFORMATION Date Form Completed
GROUND WATER 02/12/04 -� c
Assigned
Source Code Well Name__
W01-1 SWELL#1 o
Code Source Begin Date Availability C
G-Ground MM / YY P=Permanent
� Y=G w/direct influence 1 Il E=Emergency I=Interim
Gi (G WUDI) - J L i S=Seasonal O=Other
Location of well within the system
behind buildint!on right side
Latitude(N) Longitude(W) How Determined
Deg. Min See Deg Min Sec I G=GPS
36-09-27.43 81-46-14.19 i G` M=Map GPS File Name: B011316A(1999)
_ --1 -- S=Surveyed
n=n;t'e rPotial rvc
ENTRY POINT INFORMATION System Monitoring? Y (Y/N)
Assigned
Entry Point Code Entry Point Name
E01 kitchen sink
Use Code Availability Entry Point Begin Date Entry Point End Date
C=Ground/Permanent I P=Permanent S=Seasonal
C p E=Emergency I=Interim O=Other — MM Y MM/YY
(Ist Sample is Due)
Location: kitchen sink
Well Site:Owned or controlled? Y (YIN) Control Area(100'radius?) N (Y/N) If no,explain: building 511
Sources of pollution/distance:
1
Surface water within 200'? L 1(Y/N) If yes,actual distance L J If yes,bact.samples collected? L (Y/N)
Adequate slope? Y (Y/N) Flooding? N (Y/N) Site maintained? Y (Y/N)
Well House: Properly drained? Y (Y,N) Locked? -N —(Y,N) Free of stored material? Y (Y/N)
Condition of house: good tile/lid Type of freeze protection: insulation
Well:Diameter: 6 1/4 Type: drilled (Example:Drilled) Yield(gpm) 15 Properly sealed? Y (Y,N)
Properly vented? Y (Y,N) Casing Depth 53 - ift. (If unknown,put"unk")
Screened interval(s): Drilling Contractor: Dewey Wright Date Completed: 10/27/85
mmdd-vv
Concrete slab>=3 ft.radius? Y (Y/N) If no,explain: Concrete slab cracked? (Y,N)
Total depth(ft.) 124 Open interval: Sample tap?:Before treatment? (Y/N) After treatment? (Y/N)
Pumps:Capacity:GPM: HP: Height above floor(pump/casing): /
Ground:
Storage: Elevated: Hydro/bladder: 0,020 ] J
— -- - —
(gallons) (gallons) (gallons)
If hydro,pressure relief valves? (Y/N) Coded? (Y,N) Inspector tag? (Y/N)
TREATMENT INFORMATION
Is water treated? LN-_i (Y/N)
If other wells are treated here,which ones? If treated elsewhere,where?—
DISINFECTION: (Hypochlorination-post(D4210)): (Y/N)
Chlorinator Make: Condition? Capacity: --
Other type of disinfection:
Softening:(Ion Exchange(S4600)): (Y/N)
Other treatment:
Comments:
DEHR 3900B
Public Water Supply Section(Review"l)

PROJECT: Foscoe Country Store MONITORING WELL NOI MW-2 0
CLIENT: NCDEQ UST Section PROJECT NO. 49-5313B
LOCATION: ELEVATION:
8937 NC Hwy 105 South Foscoe Watauga County, NC
DRILLER: DATE DRILLED: LOGGED BY:
Quantex 11/2/17 Randy Cavallier
DRILL RIG: DEPTH TO WATER:
Geo robe 8.78'
v 0)
1 Elevation/ � 'D °� 0 �^ _3 m
v a E E E _ ° SOIL DESCRIPTION WELL
Depth(Ft) in z' U CONSTRUCTION
) a)
o U U
> 0
b dark gray/brown clayey silt
b
R 4
ML-CIL
.,, _ -
v =
A
y
b 5 4,380 dark gray rocky silt
v
v
u
v GM
t?
A
0 10 1,530
brown silt
v
0
x
N
r
ro
15 ML
10000
u
0
A
N
P
JJ
ri
0 20
0 refusal at 20'
r
ro
u
a
a
a
O
.�
P
fd
11
25
0
w
a
x
E
30
35
Figure
Page 1 of 1

PROJECT: Foscoe Country Store MONITORING WELL NOI MW-3 a
CLIENT: NCDEQ UST Section PROJECT NO. 49-5313B
LOCATION: ELEVATION:
8937 NC Hwy 105 South Foscoe Watauga County, NC
DRILLER: DATE DRILLED: LOGGED BY:
Quantex 11/2/17 Randy Cavallier
DRILL RIG: DEPTH TO WATER:
Geo robe 7.54'
v 0)
1 Elevation/ � 'D °� 0 �^ J m
v a E E E _ ° SOIL DESCRIPTION WELL
Depth(Ft) in z' U CONSTRUCTION
) a)
o U U
b gray clayey silt
b
R 4
ML-CIL
.,, _ -
v =
A
ro 5 1,540
b brown rocky silt
v
v
u
v GM
t?
A
0 10 10000 MW-3 brown silt
a
v
0
.0 ML
N
r
ro
15 962
u
0
A
41
4J
ri
a 20
a
-H
ro
u
a
a
a
0
.r,
P
fd
11
25
0
w
a
x
E
30
35
Figure
Page 1 of 1

Monitoring Well MW-7
Client: NCDEQ, UST Section Drill Rig: Geoprobe Top of Casing Elevation: NA
Project:Foscoe Country Store Driller: Carolina Soil Investigations Geographic Coords: 36.157855,-81.770727`3'
Location: 8937 NC Hwy 105 South,Foscoe,NC Logged By: DRM Initial Groundwater Depth: 7.97 Ft.BLS(')
Date: August 6,2020 Hole Diameter:8-inch Final Groundwater Depth: NA
m
N(n
Description U 2'x2'x6"Concrete Pad
5 0 E 8-inch-diameter Flushmount
a) � m
2"Locking Cap
Ground Surface
Concrete 0
Gravel Fill
1
2-Inch-Diameter
2 Sch.40 Blank Casing
Bentonite/Cement Grout
3 3'—
Bentonite Pellet Seal
4 4'—
5'
Inch-Diameter Borehole
5
6 =
10/30 Silica Sand
7 =
Brown Sandy Silt with cobble =_
8
2-Inch-Diameter Sch.40
9 = 0.010"Slotted PVC Screen
SM-ML =
10 =
11 =
Refusal at 12' 12 12'—
13
14
15
16
17
18
19
20
Notes: Project No.
1.USCS=Unified Soil Classification System
2.BGS=Below Ground Surface 49-05313-G
3.Geographic Coordinates obtained from Google Earth
Page 1 of 1
File name:G:\DWG\49-05313-G\We1l Log.dwg

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EN VIRONMENTAI PRODUCTS'
Page 1/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Product identifier
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
Application of the substance/the mixture
In situ and ex situ chemical oxidation of contaminants and compounds of concern for environmental
remediation applications.
Details of the supplier of the safety data sheet
Manufacturer/Supplier: Emergency Number.
Provectus Environmental Products, Inc. Call CHEMTREC
PO Box 358 Toll Free: 1-800-424-9300/[phone]
Freeport, IL 61032 CCN 1010557
Phone: [phone] For Hazardous Materials Incident (Spill, Leak,
Fax: [phone] Fire, Exposure, or Accident)
www.provectusenvironmental.com
Classification of the substance or mixture
Flame over circle
May intensify fire-, oxidizer.
- - - - - - - - - - - - - - - - - - - - - -
Health hazard
May cause allergy or asthma symptoms or breathing
difficulties if inhaled.
1
•
Harmful if swallowed.
Harmful if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause an allergic skin reaction.
May cause respiratory irritation.
Label elements
GHS label elements
The product is classified and labeled according to the Globally Harmonized System (GHS).
Hazard pictograms
<t< >< >
GHS03 GHS07 GHS08
(Contd.on page 2)

�rovectus
EN VIRONMENTAI PRODUCTS'
Page 219
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 1)
Signal word Danger
Hazard-determining components of labeling:
disodium peroxodisulphate; sodium persulfate
Hazard statements
May intensify fire; oxidizer.
Harmful if swallowed or if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause allergy or asthma symptoms or breathing difficulties if inhaled.
May cause an allergic skin reaction.
May cause respiratory irritation.
Precautionary statements
Take any precaution to avoid mixing with combustibles.
Keep away from heat/sparks/open flames/hot surfaces. - No smoking.
In case of inadequate ventilation wear respiratory protection.
Keep/Store away from clothing/combustible materials.
Avoid breathing dust/fume/gas/mist/vapors/spray.
Use only outdoors or in a well-ventilated area.
Wear protective gloves/protective clothing/eye protection/face protection.
Wash thoroughly after handling.
Do not eat, drink or smoke when using this product.
Contaminated work clothing should not be allowed out of the workplace.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to
do. Continue rinsing.
Specific treatment(see on this label).
Take off contaminated clothing and wash before reuse.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
Wash contaminated clothing before reuse.
IF INHALED: If breathing is difficult, remove victim to fresh air and keep at rest in a position comfortable for
breathing.
If skin irritation occurs: Get medical advice/attention.
If skin irritation or rash occurs: Get medical advice/attention.
If eye irritation persists: Get medical advice/attention.
Rinse mouth.
In case of fire: Use for extinction: CO2, powder or water spray.
IF SWALLOWED: Call a POISON CENTER/doctor if you feel unwell.
IF ON SKIN: Wash with plenty of water.
Call a POISON CENTER/doctor if you feel unwell.
If experiencing respiratory symptoms: Call a POISON CENTER/doctor.
Store locked up.
Store in a well-ventilated place. Keep container tightly closed.
Dispose of contents/container in accordance with local/regional/national/international regulations.
Classification system:
NFPA ratings (scale 0-4)
Health = 2
2 Fire = 3
Ox Reactivity= 2
The s bstance possesses oxidizing properties.
(Contd.on page 3)

�rovectus
EN VIRONMENTAI PRODUCTS'
Page 319
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name: Buffered Provect-OX211" Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 2)
HMIS-ratings (scale 0-4)
2 Health = *2
s Fire = 3
REACTIVITY Reactivity= 2
Chemical characterization: Mixtures
Description: Mixture of the substances listed below with nonhazardous additions.
Dangerous components:
7727-21-1 Potassium peroxodisulfate; potassium persulfate 50-70%
*Ox. Sol. 2, H272; 40 RResp. Sens. 1, H334; Acute Tox. 4, H302; Acute Tox. 4, H332;
Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
7775-27-1 Disodium peroxodisulphate; sodium persulfate 20-30%
©Ox. Sol. 2, H272; A-V Resp. Sens. 1, H334; 0 Acute Tox. 4, H302; Acute Tox. 4,
H332; Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
1309-37-1 Ferric oxide 1-20%
n.a. Terr-ORTm buffer and ferrate stabilizer(see associated SIDS) 0-5%
Description of first aid measures
General information:
Symptoms of poisoning may even occur after several hours; therefore medical observation for at least 48
hours after the accident.
After inhalation:
Supply fresh air and to be sure call for a doctor.
In case of unconsciousness, place patient securely on side position for transportation.
After skin contact: Immediately wash with water and soap and rinse thoroughly.
After eye contact: Rinse opened eye for several minutes under running water. Then consult a doctor.
After swallowing: Immediately call a doctor.
Most important symptoms and effects, both acute and delayed No further relevant information available.
Indication of any immediate medical attention and special treatment needed
No further relevant information available.
Extinguishing media
Suitable extinguishing agents:
CO2, extinguishing powder or water spray. Fight larger fires with water spray or alcohol resistant foam.
Special hazards arising from the substance or mixture No further relevant information available.
Advice for firefighters
Protective equipment: Mouth respiratory protective device.
Personal precautions,protective equipment and emergency procedures Not required.
Environmental precautions: Do not allow to enter sewers/surface or ground water.
Methods and material for containment and cleaning up:
Dispose contaminated material as waste according to section 13.
Ensure adequate ventilation.
Reference to other sections
See Section 7 for information on safe handling.
See Section 8 for information on personal protection equipment.
See Section 13 for disposal information.
(Contd.on page 4)

�rovectus
EN VIRONMENTAI PRODUCTS'
Page 419
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 3)
Precautions for safe handling
Thorough dedusting.
Ensure good ventilation/exhaustion at the workplace.
Prevent formation of dust.
Information about protection against explosions and fires: Protect from heat.
Conditions for safe storage, including any incompatibilities
Storage:
Requirements to be met by storerooms and receptacles: No special requirements.
Information about storage in one common storage facility: Not required.
Further information about storage conditions:
Keep receptacle tightly sealed.
Protect from heat and direct sunlight.
Specific end use(s) No further relevant information available.
Additional information about design of technical systems: No further data; see section 7.
Control parameters
Components with occupational exposure limits:
7727-21-1 Potassium peroxodisulfate
TLV Long-term value: 0.1 mg/m3
as Persulfates
7775-27-1 Disodium peroxodisulphate
TLV Long-term value: 0.1 mg/m3
as Persulfates
1309-37-1 Ferric oxide
PEL Long-term value: 10 mg/m3
Fume
REL Long-term value: 5 mg/m3
Dust&fume, as Fe
TLV Long-term value: 5* mg/m3
*as respirable fraction
Additional information:The lists that were valid during the creation were used as basis.
Exposure controls
Personal protective equipment:
General protective and hygienic measures: Keep
away from foodstuffs, beverages and feed. Immediately
remove all soiled and contaminated clothing. Wash hands
before breaks and at the end of work.
Breathing equipment: Not required.
Protection of hands:
(3
Protective gloves
The glove material has to be impermeable and resistant to the product/the substance/the preparation.
Due to missing tests no recommendation to the glove material can be given for the product/ the preparation/
the chemical mixture.
Select glove material based on penetration times, rates of diffusion and degradation.
(Contd.on page 5)

�rovectus
EN ViRON MENTAI FRODVCTS'
Page 5/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 4)
Material of gloves
The selection of the suitable gloves does not only depend on the material, but also on further marks of quality
and varies from manufacturer to manufacturer. As the product is a preparation of several substances, the
resistance of the glove material cannot be calculated in advance and has therefore to be checked prior to the
application.
Penetration time of glove material
The exact break-through time has to be determined and observed by the manufacturer of the protective
gloves.
. . . -
Information on basic physical and chemical properties
General Information
Appearance:
Form: Powder
Color: Red
Odor: Odorless
Odor threshold: Not determined.
pH-value @ 20 °C(68 °F): 6
Change in condition
Melting point/Melting range: Not determined.
Boiling point/Boiling range: Undetermined.
Flash point: Not applicable.
Flammability(solid, gaseous): Contact with combustible material may cause fire.
Ignition temperature:
Decomposition temperature: Not determined.
Auto igniting: Product is not self-igniting.
Danger of explosion: Not determined.
Explosion limits:
Lower: Not determined.
Upper. Not determined.
Vapor pressure: Not applicable.
Density: Not determined.
Relative density Not determined.
Vapour density Not applicable.
Evaporation rate Not applicable.
Solubility in/Miscibility with
Water: Soluble.
Partition coefficient(n-octanol/water): Not determined.
Viscosity:
Dynamic: Not applicable.
Kinematic: Not applicable.
Solvent content:
Organic solvents: 0.0 %
Solids content: 99.5 %
(Contd.on page 6)

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EN VtRON MENTAI FRODVCTS'
Page 6/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 5)
Other information No further relevant information available.
Reactivity No further relevant information available.
Chemical stability
Thermal decomposition/conditions to be avoided: No decomposition if used according to specifications.
Possibility of hazardous reactions No dangerous reactions known.
Conditions to avoid No further relevant information available.
Incompatible materials: No further relevant information available.
Hazardous decomposition products: No dangerous decomposition products known.
Information on toxicological effects
Acute toxicity:
LD/LC50 values that are relevant for classification:
Oral LD50 1130 mg/kg (rate)
7775-27-1 disodium peroxodisulphate
Oral LD50 925 mg/kg (rat)
Primary irritant effect:
on the skin: No irritant effect.
on the eye: No irritating effect.
Sensitization:
Sensitization possible through inhalation.
Sensitization possible through skin contact.
Additional toxicological information:
The product shows the following dangers according to internally approved calculation methods for
preparations:
Harmful
Irritant
Carcinogenic categories
/ARC(International Agency for Research on Cancer)
1309-37-1 Ferric oxide 3
NTP(National Toxicology Program)
None of the ingredients is listed.
OSHA-Ca (Occupational Safety& Health Administration)
None of the ingredients is listed.
Toxicity
Aquatic toxicity: No further relevant information available.
Persistence and degradability No further relevant information available.
Bioaccumulative potential No further relevant information available.
Mobility in soil No further relevant information available.
Additional ecological information:
General notes:Water hazard class 1 (Self-assessment): slightly hazardous for water
Results of PBT and vPvB assessment
PBT: Not applicable.
vPvB: Not applicable.
(Contd.on page 7)

�rovectus
EN ViRON MENTAI FRODVCTS'
Page 719
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 6)
Other adverse effects No further relevant information available.
yj
Waste treatment methods
Recommendation:
Must not be disposed of together with household garbage. Do not allow product to reach sewage system.
Uncleaned packaging:
Recommendation: Disposal must be made according to official regulations.
Recommended cleansing agent:Water, if necessary with cleansing agents.
UN-Number 1505 and 1492
UN proper shipping name Sodium Persulfate and Potassium Persulfate
Transport hazard class(es) 5.1 (Oxidizer)
Packing group III
Environmental hazards:
Marine pollutant: No
Special precautions for user Not applicable.
Transport in bulk according to Annex 11 of
MARPOL73178 and the IBC Code Not applicable.
UN "Model Regulation": UN1505, Sodium persulfate and UN1492, Potassium persulfate
Safety, health and environmental regulations/legislation specific for the substance or mixture
Sara
Section 355(extremely hazardous substances):
None of the ingredients is listed.
Section 313(Specific toxic chemical listings):
None of the ingredients is listed.
TSCA (Toxic Substances Control Act):
All ingredients are listed.
Proposition 65
Chemicals known to cause cancer:
None of the ingredients is listed.
Chemicals known to cause reproductive toxicity for females:
None of the ingredients is listed.
Chemicals known to cause reproductive toxicity for males:
None of the ingredients is listed.
Chemicals known to cause developmental toxicity:
None of the ingredients is listed.
Carcinogenic categories
EPA (Environmental Protection Agency)
None of the ingredients is listed.
(Contd.on page 8)

�rovectus
EN VIRONMENTAI PRODUCTS'
Page 819
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 7)
TLV(Threshold Limit Value established by ACGIH)
1309-37-1 Ferric oxide A4
NIOSH-Ca (National Institute for Occupational Safety and Health)
None of the ingredients is listed.
GHS label elements
The product is classified and labeled according to the Globally Harmonized System (GHS).
Hazard pictograms
<t< >+
GHS03 GHS07 GHS08
Signal word Danger
Hazard-determining components of labeling:
Potassium peroxodisulfate, disodium peroxodisulphate
Hazard statements
May intensify fire; oxidizer.
Harmful if swallowed or if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause allergy or asthma symptoms or breathing difficulties if inhaled.
May cause an allergic skin reaction.
May cause respiratory irritation.
Precautionary statements
Take any precaution to avoid mixing with combustibles.
Keep away from heat/sparks/open flames/hot surfaces. - No smoking.
In case of inadequate ventilation wear respiratory protection.
Keep/Store away from clothing/combustible materials.
Avoid breathing dust/fume/gas/mist/vapors/spray.
Use only outdoors or in a well-ventilated area.
Wear protective gloves/protective clothing/eye protection/face protection.
Wash thoroughly after handling.
Do not eat, drink or smoke when using this product.
Contaminated work clothing should not be allowed out of the workplace.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to
do. Continue rinsing.
Specific treatment(see on this label).
Take off contaminated clothing and wash before reuse.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
Wash contaminated clothing before reuse.
IF INHALED: If breathing is difficult, remove victim to fresh air and keep at rest in a position comfortable for
breathing.
If skin irritation occurs: Get medical advice/attention.
If skin irritation or rash occurs: Get medical advice/attention.
If eye irritation persists: Get medical advice/attention.
Rinse mouth.
In case of fire: Use for extinction: CO2, powder or water spray.
IF SWALLOWED: Call a POISON CENTER/doctor if you feel unwell.
IF ON SKIN: Wash with plenty of water.
Call a POISON CENTER/doctor if you feel unwell.
(Contd.on page 9)

�rovectus
EN ViRON MENTAI FRODVCTS'
Page 9/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 8)
If experiencing respiratory symptoms: Call a POISON CENTER/doctor.
Store locked up.
Store in a well-ventilated place. Keep container tightly closed.
Dispose of contents/container in accordance with local/regional/national/international regulations.
National regulations:
The product is subject to be labeled according with the prevailing version of the regulations on hazardous
substances.
State Right to Know
7727-21-1 Potassium peroxodisulfate 50-70%
*Ox. Sol. 2, H272; ®Resp. Sens. 1, H334; U Acute Tox. 4, H302; Acute Tox. 4, H332;
Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
20-30%
Disodium peroxodisulphate
7775-27-1 Ox. Sol. 2, H272; Resp. Sens. 1, H334; `•'?Acute Tox. 4, H302; Acute Tox. 4,
H332; Skin Irrit. 2, H315; Eye Irrit. 2A, H319; Skin Sens. 1, H317; STOT SE 3, H335
1309-37-1 Ferric oxide 1-20%
-na- Terr-OR buffer and ferrate stabilizer(see associated SDS) 0—5%
All ingredients are listed.
Chemical safety assessment:A Chemical Safety Assessment has not been carried out.
This information is based on our present knowledge. However, this shall not constitute a guarantee for any
specific product features and shall not establish a legally valid contractual relationship.
Date of preparation/last revision 06/02/2014/3
Abbreviations and acronyms:
ACGIH:American Conference of Governmental Industrial Hygienists
EINECS:European Inventory of Existing Commercial Chemical Substances
ELINCS:European List of Notified Chemical Substances
CAS:Chemical Abstracts Service(division of the American Chemical Society)
NFPA:National Fire Protection Association(USA)
HMIS:Hazardous Materials Identification System(USA)
LC50:Lethal concentration,50 percent
LD50:Lethal dose,50 percent
Ox.Sol.2:Oxidizing Solids, Hazard Category 2
Acute Tox.4:Acute toxicity,Hazard Category 4
Skin Irrit.2:Skin corrosion/irritation,Hazard Category 2
Eye Irrit.2A:Serious eye damage/eye irritation,Hazard Category 2A
Resp.Sens. 1:Sensitization-Respirat.,Hazard Category 1
Skin Sens. 1:Sensitization-Skin,Hazard Category 1
STOT SE 3:Specific target organ toxicity-Single exposure,Hazard Category 3
*Data compared to the previous version altered.
SDS/MSDS Created by MSDS Authoring Services (www.MSDSAuthoring.com)