WQ0036881_Injection Event Record_20240516

North Carolina Department of Environmental Quality—Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WQ0036881
Were any wells abandoned during this injection
1. Permit Information event?
❑ Yes ® No
Northrop Grumman Guidance and Electronics Co., Inc.
Permittee If yes,please provide the following information:
Former Clifton Precision Site Number of Monitoring Wells
Facility Name
Number of Injection Wells
1995 NC Highway 141, Murphy, Cherokee County
Facility Address (include County) Please include a copy of the GW-30 for each well
abandoned
2. Injection Contractor Information
4. Injectant Information
Groundwater& Environmental Services, Inc.
Injection Contractor/Company Name see attached
Injectant(s)Type(can use separate additional sheets
Street Address 310 Maxwell Road, Suite 600E if necessary
Alpharetta, GA, 30009 Concentration see attached
City State Zip Code
If the injectant is diluted please indicate the source
8( 66 ) 435-4424 dilution fluid. see attached
Area code—Phone number
Total Volume Injected(gal) 234,823
3. Well Information
Volume Injected per well(gal) see attached
Number of wells used for injection see attached
5. Injection History
Well IDs see attached
Injection date(s) see attached
Were any new wells installed during this injection
event? Injection number(e.g. 3 of 5) 14 of 14
❑ Yes ® No
Is this the last injection at this site?
If yes,please provide the following information: ❑ Yes ® No
Number of Monitoring Wells
I DO HEREBY CERTIFY THAT ALL THE
Number of Injection Wells INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
Type of Well Installed(Check applicable type): INJECTION WAS PERFORMED WITHIN THE
❑ Bored ❑ Drilled ❑ Direct-Push STANDARDS LAID OUT IN THE PERMIT.
Hand-Au ed Other s ecif Digitally signed Brian P McCann
�' ( P Y) Brian P McCann Date:2024.06.05 1ss,:os-oa� 6/5/202400�
Please include a copy of the GW-1 form for each SIGNATURE OF INJECTION CONTRACTOR DATE
well installed. Brian P. McCann
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection. Form UIC-IER
Attn:UIC Program, 1636 Mail Service Center,Raleigh,NC 27699-1636,Phone No.919-807-6464 Rev.3-1-2016