WI0800541_Permit (Issuance)_20201009

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 individual permit when constructed in accordance
with the rules of ISA NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to infection)
AQUIFER TEST WELLS (15A NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .02251 or TRACER WELLS (15A NCAC 02C .0229):
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: August 20 , 2020
PERMIT NO. W10800541 (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.
Issued Date:
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) X Small -Scale Injection Operation ......................Complete sections B through M
(5) Pilot Test.................................................Complete sections B through M
(6) In -Situ Thermal (IST) Well...........................Complete all sections except K
B. STATUS OF WELL OWNER: Federal Government
Deemed Permitted GW Remediation NOI Rev. 2-14-2020 Page 1

C.
la
E.
F.
G.
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): Robert Lowder, Director, MCB Camp Lejeune, Environmental Management Division
Mailing Address: 12 Post Lane
City: Camp Lejeune State: NC Zip Code: 28542 County: Onslow
Day Tele No.: 910-451-5003 Cell No.:
EMAIL Address: Robert.A.Lowdergusmc.mil Fax No.:
PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: Same as above
Company Name.
Mailing Address:
City:
Day Tele No.: —
EMAIL Address:
State: Zip Code: County:
Cell No.:
Fax No.:
PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Ben Grosser
Company Name Rhea Engineers and Consultants, Inc.
Mailing Address: 400 Carl Street Ste 202
City: Wilmington State: NC
Day Tele No.: 910-350-3156
EMAIL Address: ben. rog sser(a-)rhea.us
PHYSICAL LOCATION OF WELL SITE
Zip Code: 28403 County: New Hanover
Cell No.: 910-650-9677
Fax No.:
(1) Facility Name & Address: Site Building 645, Incident # 87556
City: Camp Lejeune County: Onslow Zip Code: 28542
(2) Geographic Coordinates: Latitude": ° " or °
Longitude*
Reference Datum:
Method of Collection:
o ,
" or °
Accuracy:
"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: Approximately 7,498 square feet
Land surface area of inj. well network: See below square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: Monitoring wells UST645-MW27, UST645-MW40, and
UST645-MW41 with an estimated 20-foot radius of influence for each well. This represents a small-scale
pocket of contamination (hot spot <1 %) of the actual area of the plume. (must be < 5% of plume for pilot test
injections
Deemed Permitted GW Remediation NOI Rev. 2-14-2020 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.
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:
Wells UST645-MW27. UST645-MW40. and UST645-MW41 will receive a total of 800 hounds of CBN®
mixed with 800 gallons of water and 20 izallons of Petrobac®. Each individual well will get an portion of
the CBN®, water, and Petrobac® mixture. The actual injected volume will vary based upon expansion of the
CBN® into the water solution but is expected to be less than 1,500 ,gallons. The injection rate is no more than
3 gallons her minute.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 0 Proposed 3 Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS): 75-80 ft
(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
K. INJECTION SUMMARY
NOTE: Onlv iniectants avvroved by the evidemioloov 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/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 avvroval for a different additive. However. vlease
note it may take 3 months or lonz
Injectant: CBN® Total Amt. to be injected (gal)/event: 800 lbs/800 galloon
Injectant: Petrobac®. Total Amt. to be injected (gal)/event: 20 gallons
Injectant: Total Amt. to be injected (gal)/event:
Injectant:
Total Amt. to be injected (gal)/event;
Injectant: Total Amt. to be injected (gal)/event:
Amt. Water to be injected (gal/event): expected to be less than 1,500 gallons
Deemed Permitted GW Remediation NOI Rev. 2-14-2020 Page 3

Total Amt. to be injected (gal: event): expected to be less than 1,500 gallons
No. of separate injection events:I Est. Total Amt. to be injected (gal): Less than 1,500 gal
Source of Water (if applicable): Portable Water Tank
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 Subcha ter 02L result from the injection activity.
Groundwater sampling at the proposed 3 monitoring wells for VOCs using United States Environmental
Protection Agency (USEPA) Method 6200 is scheduled to occur in July_2020 and January 2021 to track
performance.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner. -Applicant: "1 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 responsib aining said information, 1 believe that the information is true, accurate and
complete. I am aw a that there re significant penalties, including the possibility offnes and imprisonment,
forqubii(tingfalse information. 1 gree to construct, operate, maintain, repair, and ifapplicable, abandon the
in Il and l related avvu enances in accordance with the / iA NCAC D2C 02?) 0 Rules."
I,--] aw� A &-ft4cw. ),rm
Print or Type Full Name and Title
"As owner of the property on which the injection wells) 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
(15.4 NC.4C 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.
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 N01 Rev. 2-14-2020 PLIkx 4

L E G E N D
EXISTING
NEW
DESCRIPTION
®
BUILDING
ED
SHALLOW ZONE WELL
(DEPTH <40')
®
INTERMEDIATE ZONE WELL
(DEPTH >40' - <60')
O
DEEP ZONE WELL
(DEPTH >60' - <90')
O
DEEP ZONE WELL
(DEPTH >90')
®
PUMPING WELL
(
)
TOP OF CASING ELEVATION
IN FEET MSL I
ASPHALT DRIVE
I o I
I I TBM PI-4
I tWi �I EL 28.02 B _ _ _�•..
I � I
jW
n j ®645—MW5
I I (30.06) i �l
W 0 0 D S I < I
I � I
I I W O O D S
645-M WO4 _
(25.32)(4 \g II 6(29.59) 8
L �.
645 MW11
645—MW21 1 -)1(29.72) I 45-MW28
I 6454MW13 21.51)
I 1(29.81)
J I 645-MW29
I 1 (24.77)
II I
FORMER GASOLINE I I
AST 645-9.39
MV�
FORMER LOCATION (2
BUILDING 645 I
645-M W-
f 29.78
/� w o o D s 6 (2s`s01 ®r -Gi 645-M WO3 645-M 3 BRusH „
(29.78) (29.57) 645-MW31
L (29.10) 645-MW30
645-MW17 645-MW24 645-MW02 - 645-MW22 (2787)
(27.27) (26.78) \ (29.52) , (27.04) (28.51) 645-MW18 645-MWO
/ I (31.45) (31.26)
645-M 25* /j &%TB 2 PI-3
d_—==25.58
QVLYWL=_
BREWSTER BOULEVARD
(PAVED)
645-M W20
0 (28.34) 645-N
® 645-MW19 (27.09)
(28.34)
O 645-MW16
(28.26)
645-M W7
ASPHALT (27.81)
c
PARKING
645-M W1
(28.10) ,
645- M W1
(27.81
ASPHALT
BUILDING 40 PARKING
LOT
a
NOTES:
- ALL WELL IDENTIFICATIONS PREFIXED WITH "UST"
645-M W32
(29.68)
-w
645-MW27
(28.29)
-w
50 25 0 50
SCALE IN FEET
Q � d 0
PROM BUILDING 645
UPDATED RAO/RCAP
MARINE CORPS BASE
CAMP LEJEUNE, N.C.
ru
GEOLOGIC SECTION
PLAN VIEW
FIGURE
4
EN0NIEERSand 8C{ENTISTS
I�MINGTON, NORTH CAROUNA
Na 205-044 DATE' JUN 2006
9'AE: 1 "=50' MA'm e" LCJ *E'w �' SVH

A
40
30
20
10
0
-10
-20
c
0
m -30
a�
w
-40
-50
-60
-70
-80
0 20 40 60 80 100 120
Distance
SOILS LEGEND WELL BACKFILL Along Baseline (ft)
(CH) High Plasticity (SC-CL) Clayey (GP) Poorly -graded Portland
Topsoll
®
Clay
Sand to Sandy
ILL2J
Sandy Gravel
L:i�g
Cement
(SP) Poorly -graded
Sand
EM
(SM) Silty Sand
�
(CH-SP) High Plast.
Clay & Sand
®
Limestone
Bentonite
Pellets
®(CL)
Low to Med.
Plasticity Clay
®
(CL-CH) Low to
High Plasticity Clay
�
(SW) Well -graded
Sand
®
(ML) Inorganic Silt
and v.f. Sands
#2 Medium
Sand
APPROXIMATE DEEP ZONE
140 160 180 200
30
20
10
0
-10
-20
-30
-40
-50
-60
-70
-80
PROJECT BUILDING 645
TITLE
FIGURE
CAELIF2
UPDATED RAOIRCAP
MARINE CORPS BASE
CAMP LEJEUNE, N.C.
GEOLOGIC SECTION
A - A
'
4A
ENGINEERSwdSCiENTISTS
WILMINGTON, NORTH CAROLINA
JOB NO.:
VERT:1"=15'
HORZ1 "=15'
1 DRAWN BY
SVH

-50
-701
e,
UST645-
MW26
0 40 80 120 160 200 240 Distance Alo280 ng 320
Baseline (ft)
SOILS LEGEND WELL BACKFILL
TM (CH-SP)
SM S'I S d (SP) Poorly -graded I b =-_ : Portland
( ) I ty an
Sand
nter edded Clay
and Sand.
®
Llmestone
L�
Cement
BE(CH)
High Plasticity
(SP-SC) Sand with
(SC) Clay Sand e
®
Weathered
Bentonite
Clay
Clay
Limestone
Pellets
(CH -SW)
Interbedded Clay
(SW) Well -graded
Sand
El
Low to Med.
Plasticity Clay
(SC-SM)
Sand
#2 Medium
and Sand.
Clayey/Silty
Sand
360
B'
UST645- . ....
MW32
®m
APPROXIMATE INTERMEDIATE ZO 0
-30
-4fl
APPROXIMATE DEEP ZONE.
-50
400 440 480
520 560
® .1
.I -701
® o
PROJECT BUILDING 645
TITLE
FIGURE
CA L-
UPDATED RAO/RCAP
MARINE CORPS BASE
GEOLOGIC CROSS SECTION
B - B'
EIrGINEERS�dSCIENnSTS
CAMP LEJEUNE, N.C.
B
205-044
VERT:1"=15'
HORZ:1 ^=a0
SVH
:
M EM
VALMINGTON, NORTH CAROLINA

cam -
WELL
ENGINEERS and SGFNnsis
205-0rt" Caroline n, North 1 OF 3
Wilmingto
PROJECT NO.: 205-044
STATE: N.C. I
COUNTY: ONSLOW
LOCATION: MCB Camp Le:eune
PROJECT NAME: Building 645 RAO & RCAP
LOGGED BY: Charles Ray
WELL ID:
Addendum
UST645-
DRILLER: Bobbie Fowler
NORTHING: 3844234.2
1 EASTING: 285370.6
CREW: John Wood
MW27
SYSTEM: U fM NAD83 m
BORING LOCATION:See Map
T.O.C. ELEV.: 30.29
DRILL MACHINE: Diedrich D-50
METHOD: MR
0 HOUR DTW: NA
BORING DEPTH: 81.5
START DATE: 12/29/05
FINISH DATE:
01 /04/06
124 HOUR DTW: NA
WELL DEPTH: 81.5
BLOW COUNT
OVA
S
o
SOIL AND ROCK
WELL
DEPTH
sin sin sin sin
(PPM)
LAB.
s
G
DEPTH DESCRIPTION ELEVATION
DETAIL
0.0 LAND SURFACE 30.3
0.0
0.0
3.0
3.0 27.3
SC/
SM
Tan, SILTY, v.f. to f., CLAYEY SAND. Moist.
5.0 25.3
8.0
8.0 22.3
CH
Light orange/brown, mottled CLAY with mod.
stiffness and high plasticity. Moist.
10.0 20.3
13.0
13.0 17.3
CH
Gray, S.A.A.
15.0 15.3
18 0
18.0 12.3
SC/
Light gray, interbedded, v.f. to f., SANDY CLAY
CL
to CLAYEY SAND. Wet. No HCO.
20.0 10.3
23.0
23.0 7.3
SM
Light gray, SILTY, v.f. to f. SAND with some
clay.
25.0 5.3
28.0
28.0 2.3
SP
Greenish gray, well sorted, v.f. to f. SAND.
Sat. No HCO.
30.0 0.3
® Bentonite Grout M Bentonite Pellets 13 #2 Medium Sand

caEL0
WELL
LOGENGINEERS
and SCIENTISTS
205-044 SHEET 2 OF 3
Wilmingtoh, North CeioRne
PROJECT NO.: 205-044
STATE: N.C.
COUNTY: ONSLOW
LOCATION: MCB Cam Le"eune
PROJECT NAME: Building 645 RAO & RCAP
LOGGED BY: Charles Ray
WELL ID:
Addendum
UST645-
DRILLER: Bobbie Fowler
NORTHING: 3844234.2
EASTING: 285370.6
CREW: John Wood
MW27
SYSTEM: UTM NAD83 m
BORING LOCATION:See Map
T.O.C. ELEV.: 30.29
DRILL MACHINE: Diedrich D-50
METHOD: MR
0 HOUR DTW: NA
BORING DEPTH: 81.5
START DATE: 12/29/05
FINISH DATE:
01 /04/06
124 HOUR DTW: NA
WELL DEPTH: 81.5
BLOW COUNT
OVA
s
o
SOIL AND ROCK
WELL
DEPTH
sin sin sin sin
(PPm)
LAB
S
G
DEPTH DESCRIPTION ELEVATION
DETAIL
33.0
33.0 -2.7
SP
::
S.A.A. Sat.
-
a
35.0 -4.7
-
- U
-
to
38 0
38.0 7.7
a.
- 0
v
_ t
SP
:
S.A.A.
40.0 -9.7
(V
-r
r
43.0
43.0 -12.7
SP
::
S.A.A with trace white, highly weathered shell
fragments.
45.0 -14.7
48.0
48.0 -17.7
SP
::
S.A.A.
50.0 -19.7
53.0
53.0 -22.7
SP
::
S.A.A.
55.0 -24.7
58.0
58.0 -27.7
SP
S.A.A.
60.0 -29.7
63.0
63.0 -32.7
SIP
::
S.A.A.
65.0 -34.7
® Bentonite Grout M Bentonite Pellets El #2 Medium Sand

cam
WELL
LOGWilmington,
ENGINEERS and SCIENTUM
Nh Carolina SHEET 3 OF 3
PROJECT NO.: 205-044
STATE: N.C. I
COUNTY: ONSLOW
LOCATION: MCB Camp Lemeune
PROJECT NAME: Building 645 RAO & RCAP
LOGGED BY: Charles Ray
WELL ID:
DRILLER: Bobbie Fowler
Addendum
UST645-
NORTHING: 3844234.2
EASTING: 285370.6
CREW: John Wood
MW27
SYSTEM: UTM NAD83 m
BORING LOCATION:See Map
T.O.C. ELEV.: 30.29
DRILL MACHINE: Diedrich D-50
METHOD: MR
0 HOUR DTW: NA
BORING DEPTH: 81.5
START DATE: 12/29/05
FINISH DATE:
01/04/06
124 HOUR DTW: NA
WELL DEPTH: 81.5
BLOW COUNT
OVA
s
o
SOIL AND ROCK
WELL
DEPTH
sin sin sin sin
(PPm)
LAB
s
G
DEPTH DESCRIPTION ELEVATION
DETAIL
67.0
68.0
68.0 -37.7
SM
Olive, S.A.A. with white, highly weathered shell
frags.
70.0 39.7
70.0
73.0
73.0 -42.7
73.0
SM
Olive, S.A.A.
75.0 -44.7
76.5
78.0
78.0 47.7
U
ao
Q
L
SM
Olive, S.A.A.
U
0
80.0 -49.7
.6
(V
81.5
Boring Terminated at Elevation -51.2 ft
® Bentonite Grout M Bentonite Pellets Lj #2 Medium Sand

WELL LOG
'--- ' CATLIN
Engineers and Scientists
2 VVA"Von, SHEET 2 OF 2
PROJECT NO.: 209-094
STATE: NC I
COUNTY: ONSLOW
LOCATION: MCB Camp Lejeune
PROJECT NAME: BUILDING 645 - DEEP
LOGGED BY:
Tom Stetler
WELL ID:
DELINEATION
UST645-
DRILLER: John E. Wood III
NORTHING: 3844202.0
1 EASTING: 285369.6
CREW: Roger Caulder
MW40
SYSTEM: UTM NAD83 m
BORING LOCATION: -300ft S. of Brewster near fenced area in powerline
M.C. ELEV.: 30.37
DRILL MACHINE: Diedrich D-50
METHOD: Mud Rotary
10 HOUR DTW: NM
TOTAL DEPTH: 80.0
START DATE: 11 /24/09
FINISH DATE:
11 /30/09
24 HOUR DTW: 17.7
WELL DEPTH: 80.0
SLOW COUNT
OVA
o
L
SOIL AND ROCK
WELL
DEPTH
fin fin bin bin
(ppm)
LAB
s
G
DEPTH DESCRIPTION ELEVATION
DETAIL
(SP/SW) - F. SAND to Clayey SAND w/Shell
_
hash (continued)
J.
50.0 -19.3
'
(SP) - F. SAND w/some Clayey SAND and
=
trace shell hash
=
_= 64.0
65.0 -34.3
66.0
(SP) - Gray, f. to v.f. SAND w/few clay and tr.
white shell frags. No HCO
72.0
74.0 -43.3
75.0
o>
(SP/CL) - S.A.A. w/interlayered clay
oa
o�i
80.0 -49.3
5�
80.5
an n
Boring Terminated at Elev. -49.3 ft
EjPortland Cement MBentonite Pellets El#2 Medium Sand

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NONRESIDENTIAL ON RESIDENTIAL WELL CONSTRUCTION RECORD
��- North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #: 2799
1. WELL CONTRACTOR:
John E. Wood, III
Well Contractor (Individual) Name
CATLIN Engineers and Scientists
Well Contractor Company Name
STREET ADDRESS 220 Old Dairy Road
Wilmington North Carolina 28405
City or Town State Zip Code
( 910 ) - 452-5861
Area code - Phone number
2. WELL INFORMATION
SITE WELL ID #(if applicable): UST645-MW40
STATE WELL PERMIT #(if applicable): N/A
DWQ or OTHER PERMIT # (if applicable): N/A
WELL USE (Check Applicable Box): Monitoring ® MunicipauPubiic ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation ❑ Other ❑ (list use):
DATE DRILLED: 1 1/30/2009
TIME COMPLETED: 11:00 AM ® PM ❑
3. WELL LOCATION:
CITY: MCB, Camp Lejeune COUNTY: ONSLOW
Brewster Blvd.
(StreetName, um ers, ommun y. msion. Lot No, arcs, ip o e)
TOPOGRAPHIC / LAND SETTING
Slope❑ Valley❑ Flat® Ridge❑ Other:
LATITUDE: 34.71734064 May be in degrees,
tes, seconds,
LONGITUDE: 77.34380848 la decimal formatr
n
Latitude/longitude source: ® GPS ❑ Topo. map
(Location of well must be shown on a USGS topo map and
attached to this form if not using a GPS.)
4. FACILITY - is the name of the business where the wait is located
FACILITY ID #(if applicable) Building 645
NAME OF FACILITY: Building 645
STREET ADDRESS: Brewster Blvd.
MCB, Camp Lejeune NC
City or Town State Zip Code
CONTACT PERSON: Mr. Nick Schultz
STREET ADDRESS: Attn: I&E/ EMD/ EQB/ PSC Box 20004
Camp Lejeune NC 28542-0004
City or Town State Zip Code
9( 10)- 451-5068
Area code - Phone number
WELL DETAILS:
a. TOTAL DEPTH: 80
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing: 17.69 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING 15 0 FT. Above Land Surface"
Top of casino terminated suor below land surface requires
a variance In accordance with 16A NCAC 2C.0118
e. YIELD (gpm): NIA
f. DISINFECTION: Type
g. WATER ZONES (depth)
From To
From To
From To
METHOD OF TEST: NIA
N/A Amount: NIA
From —_To
From To
From To
6. CASING:
Thickness/
Depth
Diameter Weight
Material
From 0
To
75
ft.
2" Sch.40
PVC
From 0
To
66
ft.
6" Sch.40
PVC
From
To
ft.
"
7. GROUT:
Depth
Material
Method
From 1
To
64
Ft.
Portland Cement
Tremie
From 64
To
72
Ft.
Bent. Pellets Surface Pour
From
To
Ft,
8. SCREEN:
Depth
Diameter Slot Size
Material
From 75
To
79.5
Ft.
2 in. Slot .010in.
PVC
From
To
Ft,
in. in.
_
From
To
Ft,
in. in.
9. SAND/GRAVEL PACK:
Depth
Size
Material
From 72
To
80
Ft.
#2 Medium - Torpedo Sand
From
To
Ft.
From
To
Ft.
10. DRILLING LOG
From To Formation Description
SEE
_ATTACHE D
11. REMARKS:
DEEP ZONE
MONITORING WELL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEENPROVIDEDTO THE WELL OWNER
l�ia.,J
S NATURE OF CERTIFIED WELL CONTRACTOR DATE
J hn E. Wood, III
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days, Attn: Information Management,
1617 Mail Service Center - Raleigh, NC 27699167, Phone No. [phone] ext 568.
Modified from
Form GW-1b
Rev. 7/05

WELL LOG
CATLIN
Engineers and Selendsla
z1030 SHEET 1 OF 1
-PROJECT No.: 217030
STATE: NC
COUNTY: ONSLOW
LOCATION: Ca
I) Le'eune NC
PROJECT NAME:
Site 645 Type lil Well Installation
LOGGED BY: J. Liebi
WELL ID:
DRILLER: D.T. Chalmers Jr.
MW-41
NORTHING:
FASTING:
CREW: CATLIN
SYSTEM:
BORING LOCATION:
T.O.C. ELEV.:
DRILL MACHINE: CME 45B
METHOD: HSA
O HOUR DTW: 17.2
TOTAL DEPTH: 80.0
START DATE: 2/28/17
FINISH
DATE:
311117
24 HOUR DTW: NIA
WELL DEPTH: 80.0
DEPTH
BLOW COUNT
OVA
LAB
M
L
SOIL AND ROCK
WELL
o.sn 0.sft osn astt
(PPM)
s
G
DEPTH DESCRIPTION
DETAIL
10.0 LAND SURFACE
0.0
(CL) - Dark brown, Sandy CLAY
4.0
a.a
M
7.0 (ML ) - Lt. gray, Sandy SILT wlsome clay.
7.0
M
13.0
Sat.
u
(CL) - Lt. brown, Sandy CLAY.
se.a
70.0
79,60
(SP) - Gray, Poorly Graded SAND.
75.0a �
80.0
=:�
so.a
eo.gN� eoo
BORING TERMINATED AT DEPTH 80.0 It in Poorly
Graded SAND.
'Lithology provided by John Liebig of Consultech
Environmental, LLC.
MSentoNle Groui ® 8entonile Pellets El k2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single ar multipte wells
1. Well Contractor Information:
D.T. Chalmers, Jr.
Well Contractor Name
4146A
NC Well Contractor Cenification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit#: NIA
List all applicable well permits (i.e. CuuritY, Slate. Variance. Injeeriemr, etc.)
3. Well Use (check well use):
❑ Agricultural ❑ hiunicipaVPublic
❑Geothermal (Healing/Cooling Supply) ❑Residential Water Supply (single)
01ndustriallCommereial ❑ Residential Water Supply (shared)
Supply Well:
W htonitoring
❑Aquifer Recharge
C1Groundwater Remcdialiun
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑ Aquifer Tesl
❑ Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geuthermal (Heatmit/Cooline Return)
❑Other (explain under N21 1
4. Date Well(s) Completed: 03/01/17 Well 1D#: MW-41
5a. Well Location:
MCB, Camp Leieune
FacihtylOwner Name
Facility IDN Iitapp'¢ableI
MCG Camp Leieune, Camp Leieune, NC
Physical Address, City, and Tap
ONSLOW
County
Parcel Idemilicalion No. (PiN)
For Intemal Use ONLY
34. WATER
ZONES
Deer\I
To
F.-Ri smoN
ft
d
rL
It
rt
lS INNER CASING OR TUBViG
feeliodm7misill closed )
IiioM
Tel
nil%m n.R
T1IICKNuti
AMtLR %l
0 rL
75 rt.1I
PVC
I& OUTER CAS9%G for mdtitared
wellsi OR LiNER
rtracinlieith6l
MUM
I lu
I ntV imlt
I THICKNIUSti S�t.vn.RLV
0 ft.
70 tr
4 ire.
PVC PVC
ILI
ILI
4
17. SCREEN
1711%1
TO I
rnup-TIR
I Slursru. I
THICKNUs
I Nt%-LRIAL
75 R
80 rL
2 la
Slot .010
1 Sch. 40
PVC
R.
!t
Ea
IS GROUT
1110%1
ro
M,\TI:EM
I:AII'I AiMil TNR1nuxt&:wt0L'rrr
iL
a
68 ft.
70 rL
Gent. Pellets
Surface Pour
fL
fL
19.SANIVGAAVELPACK(Wainplidamble)
IR[Itit
To
I IAIATI:[tLVL IP RTN M tell. uU
70 rL
80 n.
h Medium 42 Medlu Surface Pour
a.
ft
20. DRILLING LOG (site&
addhinaal shells tfne®ry
Monk
I to
IMSUR11910N rknilw. kwdwlir. uxllRak n • ertin sire ex i
fL
rL
h. oft�1
rL % rjQ
rL
P
ft
h.
n
it.
21. REMARKS
5b. Latitude and Longitude in degreeslrWnutes/seconds or decimal degrees: 22. Certification:
(if well Geld one laftng is suffcieal)
N I W
6, Is (are) the well(s): MPermanent or OTemponary
7. is this a repair to an existing well: ❑Yes or MNo
If this is a repair. rill a;rr kmrttur u•eb1 carurnrcrhmr imfunnariau and explain file tratmrt of
rite repair under Mal rerrtarks setrhou irrrnr rite b u-,k ufth;s j:rn.
S. Number of wells constructed: 7
For nudrrple rrrjecrinn or+mm•uater supp(v trills ONLY with rite same construction. torn
ctrm xmbnrit urre /ern,
9. Total well depth below land surface: 80
Furnuilriple wells lar all depths in different (exutrgrle- 3(e 200'and I a100')
512X2017
Signature of CemGed Well Contractor Date
81 1ign ing tlria fora. I hereby cerrifi• Arai the uvil(tr uses f firm) cnnsrnrcred Indic vwxhim r uuh
15ANCACO2C.0100urIS.tNCACO2C.0200Well Crnutrrcrrun5rundunlrerrnithara p%.f
this re. unl lifts been prnlded err the wolf ntmer.
23. Site diagram or additional well details:
You may use die back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
(ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
10. Static water level below top of casing: 17.23 (rL) Division of Water Resources, Information Processing Unit,
Ifurrrer level is afketr casing, ,ue "+- 1617 Mail Service Center, Raleigh, NC 27699-1617
It. Borehole diameter: b an.)
24b. For Infection Wells ONLY: in addition to sending the fern to the
address In 24a above, also submit a copy of this form within 30 days of
12. Well construction method: HSA completion of well construction to the following:
fi a auger ri.lurs•, ruble. direct push. err.l Division or Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) 1lethod of test 24c. For Water Svpply- & Infectinn Wells:
Also submit one copy of this form within 30 days of completion of well
13b. Disinfection type: I Amount: construction to the county health department of the county where constructed.
Adapted from Form GW- I North Carolina Department of Environment and Natural Resources - bivisr it of Water Resources Revised 2-22-2016

r:
"tec
Environmental Terhnologles
mm.etedir.tom
Safety Data Sheet
Section 1: Product and Company Identification
Product Name:
MSDS Number:
Chemical Name:
Chemical Family:
Recommended Use
Restrictions on Use
CBNTM Custom -Blend Nutrients
014
Inorganic Nutrient Mixture
Mixed Nutrient
Microbial Nutrient
No Data
Company: ETEC, LLC
3830 S. Truman St., Bldg. 12
Washougal, WA 98671
USA
Telephone: [phone]
Emergency Telephone: [phone]
Medical Emergencies: [phone]
U.S. Coast Guard National
Response Center: [phone]
Section 2: GHS Hazards Identification
3830 S. Truman St., Bldg 12
Washougal, WA 98671
[phone] Fax
www.etecllc.com
Revision Date: 05/12/2015
This chemical is considered hazardous by the 2012 OSHA Hazard Communication Standard (29 CFR
1910.1200)
Oxidizing solids
Category 3
Skin irritation
Category 2
Eye irritation
Category 2
Specific Target Organ Toxicity - single exposure (Respiratory system)
Category 3
Label Elements:
Signal Word: Warning
�jA4
,*1 :01
Revision Date: 05/12/2015 Page 1 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
Hazard Statements:
May intensify fire; oxidizer
Causes skin irritation.
Causes serious eye irritation.
May cause respiratory irritation.
Precautionary Statements:
Keep away from heat.
Keep/Store away from clothing/ other combustible materials.
Take any precaution to avoid mixing with combustibles.
Avoid breathing dust/ fume/ gas/ mist/ vapors/ spray.
Wash skin thoroughly after handling.
Use only outdoors or in a well -ventilated area.
Wear protective gloves/protective clothing/eye protection/face protection.
IF ON SKIN: Wash with plenty of soap and water.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present
and easy to do. Continue rinsing.
Call a POISON CENTER or doctor/ physician if you feel unwell.
Specific treatment (see supplemental first aid instructions on this label).
If skin irritation occurs: Get medical advice/ attention.
If eye irritation persists: Get medical advice/attention.
Take off contaminated clothing and wash before reuse.
In case of fire: Evacuate area. Fight fire remotely due to the risk of explosion.
Store in a well -ventilated place. Keep container tightly closed.
Store locked up.
Dispose of contents/container to an approved waste disposal plant
Hazards not otherwise classified (HNOC) or not covered by GHS - none
Section 3: Composition/Information on Ingredients
Ingredients as defined by 29 CFR 1910.1200:
Chemical Ingredients:
CAS Number:
Percent Range:
Trade Secret 1
-
60 — 80%
Trade Secret 2
-
20 — 30%
The specific chemical identity and/or exact percentage of the composition has been withheld as Trade
Secret in accordance with paragraph (i) of §1910.1200.
Section 4: First Aid Measures
Description of first aid measures:
Inhalation: Remove victim to fresh air and keep at rest in a position comfortable for breathing. If
not breathing, give artificial respiration. Call a poison center or doctor/physician if you feel unwell.
Skin Contact: Wash with plenty of soap and water. Take off contaminated clothing and wash
before reuse. If skin irritation occurs: Get medical advice/attention.
Revision Date: 05/12/2015 Page 2 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
Eye Contact: Rinse cautiously with water for several minutes. Remove contact lenses, if present
and easy to do. Continue rinsing. If eye irritation persists: Get medical advice/attention.
Ingestion: Never give anything by mouth to an unconscious person. Rinse mouth with water.
Most important symptoms and effects, both acute and delayed: See sections 2 and/or 11.
Indication of any immediate medical attention and special treatment needed: No data available.
Section 5: Fire Fighting Measures
Suitable Extinguishing Media: Use water spray, alcohol -resistant foam, dry chemical or carbon dioxide.
Unsuitable Extinguishing Media: No known information.
Specific Hazards Arising from the chemical/substance: Oxidizer - Contact with combustible/organic
material may cause fire. May decompose upon heating to produce corrosive and/or toxic fumes. Keep
product and empty container away from heat and sources of ignition. Sealed containers may rupture
when heated. Sensitive to mechanical impact. In case of major fire and large quantities: Evacuate area.
Fight fire remotely due to the risk of explosion.
Hazardous Combustion Products: Nitrogen oxides, phosphorous oxides, ammonia.
Protective Equipment and Precautions for Fire -Fighters: As in any fire, wear self-contained breathing
apparatus and full protective gear.
Section 6: Accidental Release Measures
Personal precautions, protective equipment and emergency procedures: Eliminate all ignition
sources and heat sources if safe to do so. Ensure adequate ventilation. Use personal protective
equipment. Avoid dust formation. Do not breathe dust/fume/gas/mist/vapors/spray.
Environmental Precautions: Do not flush to surface water. See section 12 for further environmental
data.
Methods for Containment/Cleaning Up: Collect spillage. Collected waste may be transferred to a
closed, preferably metal container and sent to a RCRA approved waste disposal facility. Alternatively,
pick up and place spill into noncombustible container and dissolve in large amount of water. Add soda
ash. Mix and neutralize with 6M-HCI. Neutralized sludge may be sent to an approved waste disposal
facility. Ventilate area and wash spill site after material pickup is complete.
Section 7: Handling and Storage
Precautions for Safe Handling: Avoid breathing dust. Use only outdoors or in a well -ventilated area.
Keep away from clothing and other combustible materials. Take any precaution to avoid mixing with
combustibles. Wash thoroughly after handling. Keep out of reach of children. Handle in accordance with
good industrial hygiene and safety practice.
Conditions for safe storage, including any incompatibilities:
Revision Date: 05/12/2015 Page 3 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
Storage: Hygroscopic — Protect from moisture. Store in a tightly closed container, store in a cool,
dry, ventilated place. Store locked up and away from clothing and other combustible materials.
Store at temperatures not exceeding 130°F (54°C), preferably not exceeding 86°F (30°C).
Section 8: Exposure Controls/Personal Protection
Exposure Limits: There are no OSHA PEL's, NIOSH REL's, or ACGIH TLV's applicable to this material.
Engineering Controls: Ensure adequate ventilation, especially in confined areas. Ensure that eyewash
stations and safety showers are close to the workstation location.
Personal Protective Equipment:
Eye Protection: Wear appropriate eye protection/face protection.
Hand Protection: Wear appropriate protective gloves.
Skin and Body Protection: Wear appropriate protective clothing to prevent skin exposure.
Take off contaminated clothing and wash before reuse.
Respiratory Protection: Use only in a well -ventilated area. Avoid breathing dust. Wear
appropriate NIOSH approved respirator if exposure limits are exceeded or irritation occurs.
Hygiene Measures: Keep away from clothing and other combustible materials. Use only outdoors or in
a well -ventilated area. Wash thoroughly after handling. Handle in accordance with good industrial hygiene
and safety practice.
Section 9: Physical and Chemical Properties
Appearance/Physical State:
Color:
Odor:
Odor Threshold:
pH:
Melting/Freezing Point:
Initial Boiling Point:
Flash Point:
Evaporation Rate:
Flammability (solid, gas):
Lower Explosive Limit:
Upper Explosive Limit:
Vapor Pressure:
Vapor Density:
Relative Density:
Solubility:
Partition Coefficient:
Autoignition Temperature:
Decomposition Temperature:
Crystals, granules
White
Odorless
Not Available
7.0
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
1.73 @ 77°F (23°C)
118 g/100 g water @ 32°F (0°C)
Not Available
Not Available
Not Available
Section 10: Stability and Reactivity
Reactivity: No information available.
Revision Date: 05/12/2015 Page 4 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
Stability: Hygroscopic. Stable under recommended storage conditions.
Possibility of hazardous reactions: Oxidizer: Contact with combustible/organic material may
cause fire. Liberates ammonia in reaction with strong alkalis.
Conditions to Avoid: Heat, flame, ignition sources, dusting and incompatibles. Moisture and
combustible materials. Shock sensitive.
Incompatible Materials: Reducing agents, powdered metals, strong acids, strong oxidizing
agents, strong bases, aluminum, antimony, chromium, copper, iron, lead, magnesium,
manganese, nickel, zinc, brass, oil, charcoal, organic material, acetic acid, ammonium chloride,
bismuth, cadmium, chlorides, cobalt, phosphorus, potassium and ammonium sulfate, sodium,
sodium hypochlorite, sodium perchlorate, sodium -potassium alloy, and sulfides.
Hazardous Decomposition Products: Other decomposition products — No data available. In
case of fire: see section 5.
Hazardous Polymerization: Will not occur.
Section 11: Toxicological Information
Information on Likely Routes of Exposure:
Inhalation: May cause respiratory irritation if inhaled. At high temperatures, exposure to toxic
nitrogen oxides decomposition products can quickly cause acute respiratory
problems. Inhalation of large amounts causes systemic acidosis and abnormal
hemoglobin.
Ingestion: Large oral doses of nitrates may cause dizziness, abdominal pain, vomiting,
bloody diarrhea, weakness, convulsions, and collapse. May cause
methemoglobinemia resulting in cyanosis.
Skin Contact: Causes skin irritation.
Eye Contact: Causes eye irritation.
Toxicity Data:
Chemical Name
LD50 ORAL
LD50 DERMAL
LC50 INHALATION
Trade Secret 1
2217 mg/kg
No data
No data
Trade Secret 2
6500 mg/kg ( Rat)
7950 mg/kg ( Rabbit)
No data
Symptoms: No information available.
Delayed and Immediate Effects, Chronic Effects from Short and Long Term Exposure:
Sensitization:
Mutagenic Effects:
Reproductive Toxicity:
STOT — Single Exposure:
STOT — Repeated Exposure:
Aspiration Hazard:
Chronic Exposure:
Aggravation of Pre-existing Conditions
No information available.
No information available.
No information available.
Respiratory system.
No information available.
No information available.
Small repeated oral doses of nitrates may cause
weakness, depression, headache, and mental
impairment.
No information available.
Revision Date: 05/12/2015 Page 5 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
Carcinogenicity:
Component
CAS
NTP
IARC
OSHA
Trade Secret 1
N/A
Not listed
Not listed
Not listed
Trade Secret 2
N/A
Not listed
Not listed
Not listed
Additional Information: To the best of our knowledge, the chemical, physical, and toxicological
properties have not been thoroughly investigated.
Section 12: Ecological Information
Ecotoxicity:
This product is safe for the environment at the concentrations predicted under normal use conditions.
Persistence and Degradability: When released into water, this material is expected to readily
biodegrade.
Bioaccumulative Potential: No information available.
Mobility in Soil: When released into soil, this material is expected to leach into groundwater. When
released into the soil, this material is not expected to evaporate significantly.
Other Adverse Effects: No information available.
Section 13: Disposal Considerations
Dispose of contents/container in accordance with all applicable local, state and federal regulations.
Section 14: Transport Information
For Transportation Emergencies Involving This Material, Call:
ChemTrec 1-800-424-9300 Company Code: E419
DOT (LAND):
Proper Shipping Name:
Hazard Class:
UN Number:
Packing Group:
Placards:
DOT Hazardous Substance RQ:
DOT Marine Pollutants:
AMMONIUM NITRATE BASED FERTILIZER
5.1
UN2067
Oxidizer
None/no reportable quantities
None/no reportable quantities
Section 15: Regulatory Information
SARA 302: No chemicals in this material are subject to the reporting requirements of SARA Title III,
Section 302.
Revision Date: 05/12/2015 Page 6 of 8

Safety Data Sheet
CBNTM Custom -Blend Nutrients
SARA 311/312 Hazard Categories:
Acute Health Hazard Yes
Chronic Health Hazard No
Fire Hazard No
Sudden Release of Pressure Hazard No
Reactive Hazard Yes
SARA 313: The Trade Secret 1 component is subject to reporting levels (>1.0%) established by SARA
Title III, Section 313. Additionally, water dissociable ammonia salts are subject to the reporting
requirements of SARA 313 when placed in water.
State Right -to -Know:
Component
Massachusetts
New Jersey
Pennsylvania
Illinois
Rhode Island
Trade Secret 1
X
X
X
X
X
TSCA: Not Applicable
California Prop. 65 Components: This product does not contain any chemicals known to State of
California to cause cancer, birth defects, or any other reproductive harm.
Section 16: Other Information
NFPA Rating:
Health Hazard: 0
Fire: 0
Reactivity Hazard: 3
Other: Oxidizer
Legend:
ACGIH: American Conference of Governmental & Industrial Hygienists
CAS: Chemical Abstract Service
CFR: Code of Federal Regulations
DOT: Department of Transportation
DSL/NDSL: Domestic Substances List/Non-Domestic Substances List
IARC: International Agency for the Research of Cancer
IATA: International Air Traffic Association
ICAO: International Civil Aviation Organization
IMDG: International Maritime Dangerous Goods
IMO: International Maritime Organizations
NFPA: National Fire Protection Association Health, Flammability & Reactivity; Hazard Scale 0
=minimal/none 4= significant
NTP: National Toxicology Program
OSHA: Occupational Safety & Health Administration
PEL: Permissible Exposure Limits
RCRA: Resource Conservation & Recovery Act
RQ: Reportable Quantity
RTK: Right -To -Know
SARA: Superfund Amendments & Reauthorization Act
STEL: Short Term Exposure Limit
TLV: Threshold Limit Value
TSCA: Toxic Substances Control Act
Revision Date: 05/12/2015 Page 7 of 8

Safety Data Sheet CBNTM Custom -Blend Nutrients
TWA: Time Weighted Average
TCLP: Toxicity Characteristic Leaching Procedure
VOC: Volatile Organic Compounds
Disclaimer: The information contained in this SIDS is presented in good faith and believed to be accurate
based on the information provided. The SIDS does not purport to be all inclusive, and shall be used only
as a guide. While ETEC, LLC believes that the data contained herein comply with 29 CFR 1910.1200,
they are not to be taken as a warranty or representation for which ETEC, LLC assumes legal
responsibility. ETEC, LLC shall not be held liable or accountable for any loss or damage associated with
the use of this material and information. The recommended industrial hygiene and safe use, handling,
storage, and disposal procedures are believed to be generally applicable. However, since the use,
handling, storage, and disposal are beyond ETEC, LLC control, it is the responsibility of the user both to
determine safe conditions for use of this product and to assume liability of loss, damage, or expense
arising out of the material's improper use.
Revision Date: 05/12/2015 Page 8 of 8

Etec
Environmental TeEnnologies
m%w.etedir.tom
Safety Data Sheet
Section 1: Product and Company Identification
Product Name:
MSDS Number:
Chemical Name:
Chemical Family:
Recommended Use
Restrictions on Use
EZT-A2
010
Not Applicable — Biological Material
Not Applicable — Biological Material
Petroleum Hydrocarbon Degradation
No Data
Company: ETEC, LLC
3830 S Truman Rd. Bldg. 12
Washougal, WA 98671
USA
Telephone: [phone]
Emergency Telephone: [phone]
Medical Emergencies: [phone]
U.S. Coast Guard National
Response Center: [phone]
3830 S Truman Rd. Bldg. 12
Washougal, WA 98671
[phone] Fax
www.etecllc.com
Revision Date: 05/19/2015
Section 2: GHS Hazards Identification
This chemical is not considered hazardous by the 2012 OSHA Hazard Communication Standard (29 CFR
1910.1200)
Label Elements: Not a hazardous substance or mixture.
Hazards not otherwise classified (HNOC) or not covered by GHS - none
Section 3: Composition/Information on Ingredients
No ingredients are hazardous according to OSHA criteria.
No components need to be disclosed according to the applicable regulations.
Section 4: First Aid Measures
Description of first aid measures:
Revision Date: 05/19/2015 Page 1 of 6

Safety Data Sheet
EZT-A2
Inhalation: Remove victim to fresh air and keep at rest in a position comfortable for breathing. If
not breathing, give artificial respiration. Call a poison center or doctor/physician if victim feels
unwell.
Skin Contact: Wash skin with plenty of water.
Eye Contact: Rinse cautiously with water for several minutes. Remove contact lenses, if
present and easy to do. Continue rinsing.
Ingestion: Never give anything by mouth to an unconscious person. Rinse mouth with water.
Most important symptoms and effects, both acute and delayed: See sections 2 and/or 11.
Indication of any immediate medical attention and special treatment needed: No data available.
Section 5: Fire Fighting Measures
Suitable Extinguishing Media: Use extinguishing medium suitable for surrounding material.
Unsuitable Extinguishing Media: No known information.
Specific Hazards Arising from the chemical/substance: None known.
Hazardous Combustion Products: None known.
Protective Equipment and Precautions for Fire -Fighters: As in any fire, wear self-contained breathing
apparatus and full protective gear.
Section 6: Accidental Release Measures
Personal precautions, protective equipment and emergency procedures: Ensure adequate
ventilation. Use personal protective equipment. Avoid dust formation. Do not breathe
dust/fume/gas/m ist/va pors/s pray.
Environmental Precautions: Do not flush into surface water. See section 12 for further environmental
data.
Methods for Containment/Cleaning Up: Contain spillage and collect with non-combustible absorbent
material. Pick up and transfer to properly labeled containers. Ventilate area and wash spill site after
material pickup is complete.
Section 7: Handling and Storage
Precautions for Safe Handling: Do not breathe vapors/dust. Handle in accordance with good industrial
hygiene and safety practice. Use only outdoors or in a well -ventilated area. Wash thoroughly after
handling. Keep out of reach of children.
Conditions for safe storage, including any incompatibilities:
Storage: Keep containers tightly closed in a dry, cool and well -ventilated place. Store at
temperatures not exceeding 70°F (20°C).
Revision Date: 05/19/2015 Page 2 of 6

Safety Data Sheet
EZT-A2
Section 8: Exposure Controls/Personal Protection
Exposure Limits: There are no OSHA PEL's, NIOSH REL's, or ACGIH TLV's applicable to this material.
Engineering Controls: Ensure adequate ventilation, especially in confined areas. Ensure that eyewash
stations and safety showers are close to the workstation location.
Personal Protective Equipment:
Eye Protection: Wear appropriate eye protection/face protection.
Hand Protection: Wear appropriate protective gloves.
Skin and Body Protection: Wear appropriate protective clothing to prevent skin exposure.
Take off contaminated clothing and wash before reuse.
Respiratory Protection: Use only in a well -ventilated area. Avoid breathing dust. Wear
appropriate NIOSH approved respirator if exposure limits are exceeded or irritation occurs.
Hygiene Measures: Wash thoroughly after handling. Handle in accordance with good industrial hygiene
and safety practice.
Section 9: Physical and Chemical Properties
Appearance/Physical State:
Color:
Odor:
Odor Threshold:
pH:
Melting/Freezing Point:
Initial Boiling Point:
Flash Point:
Evaporation Rate:
Flammability (solid, gas):
Lower Explosive Limit:
Upper Explosive Limit:
Vapor Pressure:
Vapor Density:
Relative Density:
Solubility:
Partition Coefficient:
Autoignition Temperature:
Decomposition Temperature:
Liquid
Brown/Tan
Slightly Sour Odor
Not Available
Not Available
Not Available
212°F (100°C)
Not Available
1.00
Not Applicable
Not Available
Not Available
18 mm Hg at 75°F (24°C)
Not Available
1.00
Completely soluble in water
Not Available
Not Available
Not Available
Section 10: Stability and Reactivity
Reactivity: No information available.
Stability: Stable under ordinary conditions of use and storage.
Conditions to Avoid: None identified.
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Safety Data Sheet
EZT-A2
Incompatible Materials: None identified.
Hazardous Decomposition Products: Other decomposition products — No data available. In
case of fire: see section 5.
Hazardous Polymerization: Will Not Occur
Section 11: Toxicological Information
Information on Likely Routes of Exposure:
Inhalation:
Ingestion:
Skin Contact
Eye Contact:
Toxicity Data:
No information available.
No information available.
No information available.
No information available.
Chemical Name
LD50 ORAL
LD50 DERMAL
LC50 INHALATION
Non -hazardous
component
No data
:j
No data
No data
Symptoms: No information available.
Delayed and Immediate Effects, Chronic Effects from Short and Long Term Exposure:
Sensitization:
Mutagenic Effects:
Reproductive Toxicity:
STOT — Single Exposure:
STOT — Repeated Exposure:
Aspiration Hazard:
Chronic Exposure:
Aggravation of Pre-existing Conditions:
Carcinogenicity:
No information available.
No information available.
No information available.
No information available.
No information available.
No information available.
No information available.
No information available.
Component
CAS
NTP
IARC
OSHA
Non -hazardous
component
N/A
Not listed
Not listed
Not listed
Additional Information: To the best of our knowledge, the chemical, physical, and toxicological
properties have not been thoroughly investigated.
Section 12: Ecological Information
Ecotoxicity:
This product is safe for the environment at the concentrations predicted under normal use conditions.
Persistence and Degradability: No information available.
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Safety Data Sheet EZT-A2
Bioaccumulative Potential: No information available.
Mobility in Soil: No information available.
Other Adverse Effects: No information available.
Section 13: Disposal Considerations
Dispose of contents/container in accordance with all applicable local, state and federal regulations.
Section 14: Transport Information
For Transportation Emergencies Involving This Material, Call:
ChemTrec 1-800-424-9300 Company Code: E419
DOT (LAND):
Section 15: Regulatory Information
Not regulated
SARA 302: No chemicals in this material are subject to the reporting requirements of SARA Title III,
Section 302.
SARA 311/312 Hazard Categories:
Acute Health Hazard No
Chronic Health Hazard No
Fire Hazard No
Sudden Release of Pressure Hazard No
Reactive Hazard No
SARA 313: This material does not contain any chemical components with known CAS numbers that
exceed the threshold (De Minimis) reporting levels established by SARA Title III, Section 313.
State Riaht-to-Know:
Component
Massachusetts
New Jersey
Pennsylvania
Illinois
Rhode Island
Non-
-
-
-
-
-
hazardous
Component
TSCA: Not Applicable
California Prop. 65 Components: This product does not contain any chemicals known to State of
California to cause cancer, birth defects, or any other reproductive harm.
Section 16: Other Information
NFPA Rating:
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Safety Data Sheet
EZT-A2
Health Hazard: 1
Fire: 0
Reactivity Hazard: 0
Legend:
ACGIH: American Conference of Governmental & Industrial Hygienists
CAS: Chemical Abstract Service
CFR: Code of Federal Regulations
DOT: Department of Transportation
DSL/NDSL: Domestic Substances List/Non-Domestic Substances List
IARC: International Agency for the Research of Cancer
IATA: International Air Traffic Association
ICAO: International Civil Aviation Organization
IMDG: International Maritime Dangerous Goods
IMO: International Maritime Organizations
NFPA: National Fire Protection Association Health, Flammability & Reactivity; Hazard Scale 0
=minimal/none 4= significant
NTP: National Toxicology Program
OSHA: Occupational Safety & Health Administration
PEL: Permissible Exposure Limits
RCRA: Resource Conservation & Recovery Act
RQ: Reportable Quantity
RTK: Right -To -Know
SARA: Superfund Amendments & Reauthorization Act
STEL: Short Term Exposure Limit
TLV: Threshold Limit Value
TSCA: Toxic Substances Control Act
TWA: Time Weighted Average
TCLP: Toxicity Characteristic Leaching Procedure
VOC: Volatile Organic Compounds
Disclaimer: The information contained in this SDS is presented in good faith and believed to be accurate
based on the information provided. The SDS does not purport to be all inclusive, and shall be used only
as a guide. While ETEC, LLC believes that the data contained herein comply with 29 CFR 1910.1200,
they are not to be taken as a warranty or representation for which ETEC, LLC assumes legal
responsibility. ETEC, LLC shall not be held liable or accountable for any loss or damage associated with
the use of this material and information. The recommended industrial hygiene and safe use, handling,
storage, and disposal procedures are believed to be generally applicable. However, since the use,
handling, storage, and disposal are beyond ETEC, LLC control, it is the responsibility of the user both to
determine safe conditions for use of this product and to assume liability of loss, damage, or expense
arising out of the material's improper use.
Revision Date: 05/19/2015 Page 6 of 6