WI0800532_Permit (Issuance)_20191217

FeNorth Carolina Department of Environmental Quality — Division of Water Resources
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 MA NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to iniectLQAl
k QUIFER TEST WELLS r 15A NCAC 02C .02201
1 hese wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
1.% SITU REMEDIATION (15A NCAC 02C .022:) or TRACER WELLS 115A NCAC 02C .0229):
1) Passive Injection S-\ stems - 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).
') Small -Scale Inl eotion Operations — Injection wells located within a land surface area not to exceed 10,000 square feet
i or the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required for test or
r reatment areas exceeding 10,000 square feet.
Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a remediation strate
in order to develop a full scale remediation plan for future implementation, and where the surface area of the injection zone
;% ells are located within an area that does not exceed five percent of the land surface above the known extent of groundwater
contaminant plume.
4) Air Inj ection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be
Returned As Incomplete.
DATE: July 1. 2019_ PERMITNO. W Jbp ()0 5 3 2 (to be filled in by
DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well ............................
(2) Aquifer Test Well .............................
(3) Passive Injection System ....................
(4) X Small -Scale Injection Operation............
(5) Pilot Test .......................................
......... Complete sections B through F, K, N
..........Complete sections B through F, K, N
...........Complete sections B through F, H-N
..........Complete sections B through N
..........Complete sections B through N

(6) Tracer Injection Well...................................Complete sections B through N
B. STATUS OF WELL OWNER: Business/Organization
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): CBR Enterprises
Inc.
Mailing Address. 4709 Wedyefield
Drive
City: Wilmin on State: NC Zip Code:
28409 County: New Hanover
Day Tele No.: 910.367.3156 Cell No.:
EMAIL Address: tommy.ali@,me.com Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title:
Same
Company
Name
Mailing Address:
City: State: Zip Code: County -
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Engineering Finn)
Name and Title: 3ef my A. Ballsiener. Director of Environmental
Services
Company Name Prog.ivss Environmental Groin'.
Inc.
Mailing Address: 120 Fayette
Street
City: Winston-Salem State: NC Zip Code:
27101 County: Forsyth
Day Tele No.: 336.722.9999 Cell No.:
336.782.9725
EMAIL Address: jballsimeria oroaressenvironmental.com Fax NO.:
336.722.9998

F. PHYSICAL LOCATION OF WELL SITE
(I) Facility Name & Address:
Road
City: Wilmington
Code: 28401
(2) Geographic Coordinates:
34. 193741
Tommv's Quick Shop Site _
2461 Carolina Beach
County: New Hanover Zip
Latitude": 1" or
Longitude": � " or
-77 .935220
Reference
Datum: Accuracy:
Method of Collection: GooileEarth
FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAYBE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: 100 square feet
Land surface area of inj. well network: 100 square feet (< 10,000 d for small-scale
injections)
Percent of contaminant plume area to be treated:
injections)
1% (must be < 5% of plume for pilot test
H. INJECTION ZONE MAPS — Attach the following to the notification.
i
(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 — Provide a brief narrative regarding the purpose,
scope, and goals of the proposed injection activity. This should include the rate, volume, and duration of injection
over time.
Progrsss will inject approximatch 5 kilogsams of Enviro-BAC mixed with up to 55—allons of water into monitoring
well MW-1. The Enviro-BAC will be iniected into the aquifer through a PVC tremie E it a or During
directly into the monitoring well. The tremie pipe will extend to an amroximate do ith of ten feet into the
subsurface. Progress anticipates in'ec� tin_g Enviro-BAC into the shallow aquifer.
J. APPROVED INJECTANTS — Provide a MSDS for each injectant (attach additional sheets if necessary).
NOTE: Only iniectants approved by the NC Division of Public Health, Department of Health and Human Services
can be injected Approved injectants can be found online at
http://deq.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 DHHSprior to use. Contact the UIC Program for mom info (919-807-6496).
Injectant: Enviro-
BAC—
Volume of injectant: 5 kg mixed with up to fifty-five Gallons of water
Concentration at point of injection:
100%
Percent if in a mixture with other injectants:
N/A
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: N/A Proposed 1 Existing (provide GW-1s)
(2) 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
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities_
Planned iniection activities to occur in Jul,, 2019.
Subse: uent sanirling activities to occur approximately 30 and 60 days from iniection.
M. 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.
ProUess will collect a groundwater sample from each monitoring well approximately 30 days subsequent
tQ the injection event. The vroundwater samples will be analFzed for volatile gTanic compounds usin Standard

Method 6200B. The «roundwater saWle will also be anahzed for bacteria counts before and following, the
iniection.
4au, 0 AtLLL
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Ownerl&) 1p icant•. "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 15A JNrCAC 02C 0200 Rules. "
SignaturA.fApl,.(.�P)
Print or Type Fall Name and Title
Prop2qy Owner (if the property is not owned b, the Well Owner/ licant
"As owner of the property on which the injection wells) are to be constructed and operated 1 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 (I �A
NCAC 02C . 020. "
"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.
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. 3-21-2018 Page 3

Figure 1
Topographic Site Map
Tommy's Quick Shop Site
2461 Carolina Beach Road
'~ Wilmington, New Hanover County, North Carolina
6
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ppFEAR BLW o j[�
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Ap
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�`� BRYr1N RA�vy[f ram. T �l �Ga'b� r l `, l' 5
P.O. Box 5884 Project: Tommy's Quick Shop
Winston-Salem, NC 27113 Wilmington, N.C.
Telephone: [phone] Date: 2016
Fax: [phone] United States Department of the Interior Client: CBR Enterprises
;cw. fro °ressemironmenrae.com United States Geological Survey r t�
7.5 Minute Series Topographic Map Progress Job #: 1018085-001 I
Contour Interval: 10 feet ++
Approximate Scale: 1:24,000 Date: August 2018 f

Jr
ell
IAj
■
0000-
MW-5
4.21
Al
:F
LEGEND
Appwim pmpmylim
W.-
A[Ir SIR
DRAWINOTTUE Site Nbp
Progress Tornolys Q-ck Shop Site
Environmental Group, Inc. 2461 Carolina Beach Road
120 Fayette Street Wirringtom North Carolina
Win,Aon-Salerri. North Carolina 27101
[phone]
FIGURE 2 0

2
v j:40
V
89
91
AWL
92
41:
k.
421
�jw' -.NA
LEGEND
AST( 201R
FMAi.sG—d—w-
11 I �� iWith
rz -, �--+ v*FIti,. Progress
C—mid�t� L%Wlcdi SCAT--:: SHOWN FnviromwnW Group, hic.
Cj1cuL=dC—nd—r1,w 120 Fayette Street
Winston-Salem North Carolina 27101
—proqresse mmnnvntal.c [phone]
j
Groundwater Flow Map
Tummy's Quick Shop Site
2461 Carolina Beach Road
Wilmington, North Carolina
-ix Edulk
FIGURE 4

10
10, ?
91
L
MAO
t
421 A411
41 777V
LEGEND
wm
M=WnDg %tu L—lion
400
AITG 2018
Cross -Section Locations Map
ftogress Tonirny's Qinck Shop Site
SCAI.F.'S"C3%VN Fnvironmental Group, hic. 2461 Carolina -Beach Road
120 Fayette Street WhTtington, North Carolina
Winston-Salem, 19ortli Carolina 27101 RI:v
(336)722-WW FIGURE 8 0

A MW-5
M1 D1
100 I101.09 1aQaoW F —W�__
MW-4
V W34
90
K'
80���✓
70
55
Fill Material/Gravel
Fine Grained Sand
Sand
Gay
Gayey Sand/Sandy Clay
1 I Estimated area of groundwater impacted above the NC 2L Groundwater Quality Standards.
165
MW 7
— — 91.82
88.40
A'
220
VERTICAL SCALE: As shown in feet
HORIZONTAL SCALE: As shown in feet
,1A9 `AUG 16 Progress FIGURE 9
°EO® SOIL CROSS-SECTION ATO R
e& �AAuuc 18 ENVIRONMENTAL GROUP, INC. TOMMYS QUICK SHOP
s. 1 AUG 18 P-O, e,,, 6884 2461 CAROLINA BEACH ROAD
11" WINSTONSALEM,NORTH CAROLINAM13 WILMINGTON, NORTH CAROLINA
Rp. 9.SKF PHONE [phone] FAX [phone]

100 BIMW 2
MW,4
97.94.
-r °6.54
I
90 91,88
I
9
Fill Material/Gravel
Fine Grained Sand
❑ Estimated area of groundwalar impacted above the NC 2L Groundwater Quality Standards.
WN
1 D.SKF
Bf
MW 6
.c
VERTICAL SCALE: As shown in feet
HORIZONTAL SCALE: As shown in feet
ROOM — — — —
— — FIGURE 10 —
SOIL CROSS-SECTION B TO IT
ENVIRONMENTAL GROUP, INC.
TOMMY'SQUICK SHOP
P.O. Box 5De4
2461 CAROLINA BEACH ROAD
WINSTONSALEM, NORTH CAROLINA 27113
WLMINGTON, NORTH CAROLINA
PHONE [phone] FAX [phone]

TABLE B-7
WELL CONSTRUCTION INFORMATION
GROUNDWATER MONITORING REPORT
TOMMY'S QUICK SHOP SITE
2461 CAROLINA BEACH ROAD
WILMINGTON, NEW HANOVER COUNTY, NORTH CAROLINA
NCDEQ INCIDENT NO.: 43081
Monitoring Well
I I1
Illation
Date
Well
Diameter
(inches)
Screened
Interval
(feet)
Total
Depth
(feet)
Depth to
to Water
(fit TOC)
913W2019
Relative
Elevation
(feet TOC }*
Groundwater
Elevation
(feet)
MW-1
11/29/2017
2
5-15
15
8.00
100.00
92.00
MW-2
11/29/2017
2
5-15
15
6.51
97.91
91.40
MW-3
11/29/2017
2
5-15
15
8.23
100.62
92.39
MW-4
11/29/2017
2
5-15
15
6.61
96.34
89.73
MW-5
7/12/2018
2
3.5-13.5
13.5
8.40
101.09
92.69
MW-6
7/13/2018
2
5-15
15
6.58
97.97
91.39
MW-7
7/13/2018
2
5-15
15
1 3.36
91.82
88.46
DW-1
7/12 & 13/2018
2
30-35
35
1 7.65
98.96
91.31