WI0100202_Complete File - Historical_20120615

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C��J06/15/12
Permit Number W10100202
Permit Tracking Slip
Program Category
Status Project Type
Ground Water
Active New Project
Permit Type
Version Permit Classification
Injection In situ Groundwater Remediation Well
1.00 Individual
Primary Reviewer
Permit Contact Affiliation
michael.rogers
Scott Bostian
Engineer Environmental Sr
Coastal SW Rule
801 Corporate Center Dr
Raleigh NC 276075073
Permitted Flow
Facilit
Facility Name Major/Minor Region
Exxon Mobil Retail Facility #45552 (AKA Energy Minor Asheville
Mart)
Location Address County
1920 Four Seasons Blvd Henderson
Hendersonvlle NC 28792 Facility Contact Affiliation
Owner
Owner Name Owner Type
Exxon Mobil Corporation Non -Government
Owner Affiliation
Jewel Cox
Manager Project
1016 W Poplar Ave
Dates/Events Collierville TN 38017
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
05/24/12 02/28/12 05/24/12 05/24/12
Regulated Activities Requested/Received Events
Groundwater remediation RO staff report received
RO staff report requested
Additional information requested 03/13/12
Additional information received 05/22/12
Outfall NULL
Waterbody Name
Stream Index Number Current Class Subbasin

M
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Listed To Physical Addres Parcel Number PIN Qeed Property Descn City Fire District
DUA.NE & MARGA1920 FOUR SEA 9948236 9579259550 916/103 Lot # ENERGY HENDERSONVILL'
2001 2007 201
KNE
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M Latitude: 350 28' 22,01' Longitude: -821126 28.95'
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DUANI & MARGA 1920 FOUR SEA 9948256 :9579259550
916/103
Lot=
ENERGY HENDERS
1920 FOUR SEASONS BLVD
9948256
9579259550
916/103
01/3111997
HENDERSONVILLE
745 ASHE ST
HENDERSONVLLE
NC
28792
Lot = ENERGY MART =1
9579.10
4 SEASON BLVD
Hendersonville
0,71-00
s223,900.00
C99A.7nn.nn
: 350 20 22.11'
T
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Property Summary - Henderson County Real Property Data
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Property Summary Tax Bills
Data last updated on: 6/13/2012
Ownership current as of: 5/11/2012
Property
Parcel Number 9948256 PIN # 9579259550 Search
Location Address Property Description
1920 FOUR SEASONS BLVD Lot # ENERGY MART #1 Go
Search Results New Search
Parcel Buildings : Land , Deeds J, Notes I Sales I., Photos I Tax Bill Map
Property Owner:
DUANE & MARGARET MCKIBBIN FAM LTD
PRTNR
Owner's Mailing Address
745 ASHE ST
HENDERSONVLLE
NC 28792
Property Location Address
1920 FOUR SEASONS BLVD
Administrative Data
Transfer Information
Property Value
Old Map# 9579.10
Deed Date 01/31/1997
Total Appraised Land Value $556,700
VCS C101A
Deed Book 000916
Total Appraised Building $223,900
City HENDERSONVILLE
Deed Page 00103
Value
Fire District
Revenue Stamps 0.00
CITY OF
Package Sale Date
Total Appraised Value $780,600
Township
HENDERSONVILLE
Package Sale Price
Land Class COMMERCIAL
Land Sale Date
Spec District 1
Land Sale Price
Elderly Exclusion
Spec District 2
Other Exemptions
History Parcel
Improvement Summary
Number 1
Total Units 0
Use Value Deferred
History Parcel
Heated Area 2,416
Historic Value Deferred
Number 2
Total Deferred Value
Acreage 0.71
Permit Date
Permit #
Total Assessed Value $780,600
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Property Summary -.Henderson County Real Property Data Page 2 of 2
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http://taxinfo.hendersoncountync.org/propertysearchIPropertySusmnary.aspx?REID=9948256 6/13/2012 _

WT0 t 0o L-')�L
ARCADIS
Infrastructure Water • Environment - Buildings
Attn: Ms. Sherri Knight
C/O: Mr. Michael Rogers
NCDENR — Division of Water Quality
Aquifer Protection Section — UIC Program
585 Waughtown Street
Winston-Salem, NC 27107
Subject:
Injection Performance Record
Former ExxonMobil Facility #45552
1920 Chimney Rock Road
Hendersonville, NC 28792
Incident Number: 9644
Dear Ms. Knight:
RXENWROW0
DEC 2 0 2012
A01brProUectron Section
On behalf of ExxonMobil Environmental Services (EMES), ARCADIS G&M of North
Carolina, Inc. (ARCADIS) is submitting an Injection Performance Record to the North
Carolina Department of Environment and Natural Resources (NCDENR) Division of
Water Quality — Aquifer Protection Section Underground Injection Control (UIC) Program
for former ExxonMobil facility #45552 located in Hendersonville, Henderson County,
North Carolina.
On June 28, 2012, ARCADIS provided oversight of Geologic Exploration Inc. (GEX)
to install three injection wells, INJ-1, INJ-2, and INJ-3, to be utilized for the injection
sodium persulfate, as specified by the underground injection control (UIC) Permit
approved for the site dated February 27, 2012. Due to the location of underground
utilities in the vicinity of monitoring well MW-9, ARCADIS submitted a Notification of
Intent to Construct or Operate Injection Wells for review and approval on September
5, 2012 which revised the chemical injection well locations to monitoring wells MW-
2R, MW-9, and INJ-2. Injection wells INJ-1 and INJ-3 will be utilized as replacement
monitoring wells for monitoring wells MW-9 and MW-2R, respectively.
On the evenings of December 10 - 12, 2012, ARCADIS personnel completed a
sodium persulfate injection utilizing ferrous iron and citric acid as activators at the site
as follows:
ARCADIS G&M of North Carolina,
Inc.
801 Corporate Center Drive
Suite 300
Raleigh
North Carolina 27607
Tel [phone]
Fax [phone]
www.arcadis-us.com
Environment
Date:
December 17, 2012
Contact:
Scott Bostian
Phone:
919.415.2291
Email:
Scott.Bostian@arcadis-
us.com
Our ref:
130085851.0026
ARCADIS G&M of North Carolina,
Inc.
NC Engineering License # C-1869
NC Surveying License # C-1869
Imagine the result

ARCADIS
• Approximately 554 gallons of the sodium persulfate and 554 gallons of the
ferrous iron/citric acid mixture were injected in monitoring well MW-9.
• Approximately 393 gallons of the sodium persulfate and 391 gallons of the
ferrous iron/citric acid mixture were injected into monitoring well MW-2R.
• Approximately 300 gallons of the sodium persulfate and 305 gallons of the
ferrous iron/citric acid mixture were injected into injection well INJ-2.
An injection event record is included as Appendix A. Well construction records for
monitoring wells MW-2R and MW-9 and injection wells INJ-1, INJ-2, and INJ-3 are
included as Appendix B.
ARCADIS will conduct two monthly post -injection groundwater monitoring and
sampling events in January 2013 and February 2013 as specified in the approved
Notification of Intent to Construct or Operate Injection Wells dated September 5,
2012. A report detailing the findings of the January 2013 and February 2013
groundwater monitoring and sampling events will be submitted to both the NCDENR
Division of Water Quality — Aquifer Protection UIC Program and the NCDENR
Division of Waste Management — Underground Storage Tank (UST) Section for
review and approval within 45 days of receipt of the laboratory analytical report.
Semi -Annual groundwater sampling will resume following the February 2013
groundwater monitoring and sampling event. The next semi-annual groundwater
monitoring and sampling event is scheduled for September 2013. A semi-annual
groundwater monitoring and sampling report will be submitted to the NCDENR
Division of Water Quality — Aquifer Protection UIC Program and the NCDENR
Division of Waste Management — Underground Storage Tank (UST) Section for
review and approval within 45 days of receipt of the laboratory analytical report.
Sincerely,
;ARDIS G&M of North Carolina, Inc.
Bostian P.E. S)
Senior Engineer
Ms. Sherri Knight
December 17, 2012
Page:
2/3

r.
ARCADIS
Appendix A — Injection Event Record — December 10-12, 2012
Appendix B — GW 1 B Well Construction Records (Two Copies)
Copies:
Ms. Jewel Cox — EMES
Mr. Michael Streeter — NCDENR UST Section
File — EM 45552
Ms. Sherri Knight
December 17, 2012
Page:
3/3

0 ARCADIS
Appendix A

RECEIVEDIDENR/M
INJECTION EVENT RECORD DEC 2 0 202
if
North Carolina Department of Environment and Natural Resources — Division o aer Protction Section
Qsty
Permit Number Permitted by Rule ter Qua
1. Permit Information
ExxonMobil Corporation
Permittee
Former ExxonMobil Retail Facility #45552
Facility Name
1920 Chimney Rock Road, Hendersonville, NC
Facility Address
2. Injection Contractor Information
ARCADIS G&M of North Carolina, Inc.
Injection Contractor / Company Name
Street Address 801 Corporate Center Dr. #300
Raleigh NC 27607
City State Zip Code
( 919) 854-1282
Area code — Phone number
3. Well Information
Number of wells used for injection 3
Well names MW-2R, MW-9, and INJ-2
Were any new wells installed during this injection
event?
© Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells.
I
1
Type of Well Installed (Check applicable type):
❑ Bored ❑x Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Were any wells abandoned during this injection
event?
❑ Yes 0 No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include two copies of the GW-30 for each
well abandoned.
4. Injectant Information
Sodium Persulfate and Ferrous Sulfate / Citric Acid
Injectant Type
Sodium Persulfate (95@) - 50 9/L
Concentration Ferrous Sulfate / Citric Acid (5E) - 2.5 9/L
If the injectant is diluted please indicate the source
dilution fluid. water Tanker (HAZ-MAT)
Total Volume Injected 2, 497 gallons
Volume Injected per well From 605 to 1,108 gallons
5. Injection History
Injection date(s) December 10 - 12, 2012
Injection number (e.g. 3 of 5) 1 of 2 (estimated)
Is this the last injection at this site?
❑ Yes x❑ No
DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
TIE BE T OF MY KNOWLEDGE AND THAT THE
ICTI WAS PERFORMED WITHIN THE
SND $rL,11ID OUT IN THE PERMIT.
CONTRACTOR
Please include two copies ofform GW-Ib for each v
Robby Shealy nd Jeremy Franz
well installed. PRINTNA PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Quality within 30 days of injection. Form UIC-IER
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-733-3221 Rev. 07/09

0 ARCADIS
Appendix B

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3098
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
116 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED, PERMIT#(if applicable)
SITE WELL ID #of applicable) INJA
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Gommercial ❑ Agricultural ❑ Recovery ❑ Injection N(
Imgation❑ Other ❑ (list use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley itFiat ❑Ridge ❑Other
LATITUDE 35 0 20 1 14.4400 " DMS OR DD
LONGITUDE 82 1 26 ' 40.1600 " DMS OR DO
Latitude/longitude source: IMPS ❑topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
EXXONMOBIL - 45552
N/A
Facility Name
Facility ID# (if applicable)
1920 FOUR SEASONS ROAD
Street Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
EXXONMOBIL
Contact Name
1920 FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 22,0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS
0.0 FT. Above Land Surface
'Top of casing terminated atlor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
: 7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 20.0
R. 2 INCH SCH 40 PVC
Top Bottom
R.
Top Bottom
Ft: l
:8. GROUT:
Depth
Material Method
Top 0.0
Bottom 16.0
Ft porttywoeerrroMre SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
S. SCREEN:
Depth
Diameter Slot Size Material
Top 20.0
Bottom 30.0
Ft 2.0 in. .020 in. PVC.
Top
Bottom
Ft. in. in.
Top
Bottom
FL in. in.
- 10. SAND/GRAVEL PACK:
Depth
Size Material
Top 18.0
Bottom 30.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 1
0.5
ASPHALT
0.5 /
8.0
BACKFILL/TAN SILTY SANDY CLAY
8.0 /
30.0
TAN SILTY SANDY CLAY.
l
/
/
: 12. REMARKS:
BENTONITE
SEAL FROM 16.0
TO 18.0 FEET
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
R1 CA , C, LL CONST UCTION STA DS, AND THAT A COPY OF THIS
ZORR B N PROM D TO THE OWNER.
l+ 07/17/12
SI TU REOL&RTIFIED WELL CONTRTCOR DATE
JOHNNY BURR
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GWA b
cessing;. Rev. 2/09

5rArpo
NONRESIDENTIAL WELL'CONSTRUCTION RECORD
✓'' _� ' ..-� North Carolina Department of Environment and Natural Resources- Division of Water Quality
t,'a�"a,,",��a• r WELL CONTRACTOR CERTIFICATION # 3098
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) .872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(N applicable) INJ-2
3., WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
IndustriaYCommercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ .(list use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑Valley NiFlat ❑Ridge ❑Other
LATITUDE 35 ° 20 14.5000 " DMS OR DD
LONGITUDE 82 ° 26 • 40.2200 " DMS OR DD
Latitudellong'Itude source: WSPS Dropographic map
(location of well must be shown on a USGS tope map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
d. TOP OF CASING IS
0.0 FT. Above Land Surface*
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
NIA Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 20.0
FL 2 INCH SCH 40 PVC
Top Bottom
Ft'. -
Top Bottom
Ft.
8. GROUT: Depth
Material Method
: Top 0.0 Bottom 16.0
Ft. PORUMDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 20.0 Bottom 30.0
.Ft 2.0 in. .020 in. PVC
Top Bottom
Ft in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 18.0 Bottom 30.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
EXXONMOBIL - 45552 N/A 0.0 / 0.5
Facility Name Facility ID# (if applicable) 0.5 / 8.0
1920 FOUR SEASONS ROAD 8.0 / 30.0
Street Address /
HENDERSONVILLE NC 28792 /
City or Town State Zip Code /
EXXONMOBIL
Contact Name
1920.FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE NC 28792
City or Town State Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO p/
c. WATER LEVEL Below Top of Casing: 22.0 FT
(Use "+" If Above Top of Casing)
Formation Description
ASPHALT
BACKFILL/TAN SILTY SANDY CLAY
TAN SILTY SANDY CLAY
12. REMARKS:
BENTONITE SEAL FROM 16.0 TO 18.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
ISA NC�WELLTRICTION ST DS, AND THAT A COPY OF THIS
RECO0 TO THE OWNN�ER.
`[Jv� 07/17/12
SIOMRE OtARTIFIED WELL CONTRACTOR DATE
JOHNNY BURR
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GWAb
fy = ;;tnforrpa5tin Piacessiity, ; Rev. 2/69

? NONRESIDENTIAL WELL CONSTRUCTION RECORD
0; North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 3098
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
'City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(Napplicable) INJ-3
3. WELL USE (Check One Box) Monitoring ❑ Munlcipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection @(
Irrigation❑ Other ❑ Qist use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY. HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC I LAND SETTING: (check appropriate box)
❑Slope []Valley g(Flat []Ridge ❑Other
LATITUDE . 35 ° 20 14.3600 ^ DMS OR DD
LONGITUDE 82 ° 26 , 40.6200 ^ OMS OR DD
Latitude/longitude source: L43PS Oropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
S. FACILITY (Name of the business where the well is located.)
EXXONMOBIL - 45552
N/A
Facility Name
Facility ID# (if applicable)
1920 FOUR SEASONS ROAD
Street Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
EXXONMOBIL
Contact Name
1920 FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
U
Area code Phone number
S. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO q/
C. WATER LEVEL Below Top of Casing: 2-2.0 FT
(Use "+' tf Above Top of Casing)
d. TOP OF CASING IS
0.0 FT. Above Land Surface`
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
NIA Amount NIA
g. WATER ZONES (depth):
Top Bottom
Top Bottom
; Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 20.0
Ft. 2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 16.0
Ft. PMTuwoeexror+rrE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
: 9. SCREEN: Depth Diameter Slot Size Material
Top 20.0 Bottom 30.0 Ft. 2.0 in. .020. in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
• 10. SAND/GRAVEL PACK:
Depth Size Material
Top 18.0 Bottom 30.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
: Top
0.0
0.5
/
/
Bottom
0.5
8.0
Formation Description
ASPHALT
BACKFILL/TAN SILTY SANDY CLAY
8.0
/
30.0
TAN SILTY SANDY CLAY
/
1
12. REMARKS:
BENTONITE SEAL FROM 16.0 TO 18.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WA,51ONSTRUCTED IN ACCORDANCE WITH
• 15A NCApB;a
NS CTION STA ,AND THAT A COPY OF THIS
RECORDD TO TH
07/17/12
SI URE O RTIFIED WELL CONTRACTOR DATE
JOHNNY BURR
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

MW-2,9
MM�L CoN UUC N HE f.0
North Carolina - Dement of Endsronmentel end Natural Resonmcas - Division of Water Quality - Groundwater Sedum
WELL CM,tMCMR (I MPADUAL) NAME (Pdtit) mnm mcca my CE RTWICATMN d 24o2
WELL CONTRACTOR COMPANY NAME CsaLOGIC maq ORATMN, nva. ^PHONE 0 fI04) 872.7686
STATE WELL CONSTRLTCMN PERMfI'il ASSOCIATED WQ PEttlf'ili
Cd ) (if applicabl0)
L WELL USE (Check Applicable Box): Rakiernid ❑ NumielpdTablic ❑ Industeial ❑ Apioubmat O
mmtonue l@ Reaovay ❑ Hot Pump water Iajedlon ❑ OdwO If Odm list Use
2. WELL �,�hi�
TION: r
Nearest Town: HMaxwsoNynjB Couny gomm ON ❑ Ridp ❑ Slope ❑ Valley 0 Flat
IMC1i11►MYP=RD. (Gook appropriate box)
(8tmd Naoe. Numbms ConmmtW 8MNWWo, LotNo., Zip Code) of wall bewtion
3.OWNER: i31Moxwo.CORFORATION
AAetiees 2217 D MATPfilill/S TOWNSHIP PARKWAY PM 313
(Street oeRodo No.)_
NC 28103
Ana e6_Ptme NemLa
4. DATE DRILLED 11d1-02
S. TOTAL DEPTH: 4o c pt�T
6. DOES WELL REPLACE E asmo WEIL? YES ® NO (]
7. STATIC WATER LEVEL Below Top 0f Cosi0F 27.0 ' FT.
(Use 1-ifAbave Tap aft-
S. TOP OF CASING IS o o FT. Above Land Surhm*
'Pop ofcm ft a lmd re, I , s
adum in f - wiffi lSA MAC 2C.0118,
9. YIELD' (gpm): MA METHOD OF TEST MA
10. WATER ZONES (depth): MA
11. DISINFELMOM Type
ryA
Ammmt
12. CASING:
WAR Thidmeac
Dept
Diameter
or WeigtAft MatoW
From OA To 20.0
Ft
2INCH SCM40 PVC
Flom To
Ft.
From To
Ft.
13. Grout: Depth
Material Method
Flom 0.0 To 16.0
Ft,
PWIM"Memb shoy
From To
Ft.
14.SCREEN: DeA
Diaalater
Slat gin Miterld
From 20.0 To 40.0
Ft.
2.0 in. .010 In PVC
From To
Ft
ire. is
15. SAND/GRAVEL PACK:
Depth
size Material
Prom itt.0 To 40.0
Ft.
20-00 FM S11.ICA SAID
From To
Ft
(depeoelmte�a/epegads)
Latituddlomgitude sourem ❑ GPs ❑ Topographic map
(dm*b-)
DIM DRILLING LOt3
From To 170101102100 Description
0.0 1.0
1.8
13.0
13.0
15.0
15.0
27.0
27.0 40.0
CONCRETE
SOIUGROUT
SENTIGN1TE
SAND
BROWNIORANGBII'AN SILTY
CLAYEY SAND
CATION H
Show direction and distance in miles from at least
two Stow Roads or County Roads, mculed the road
numbers and common road namos.
16. REMARKS: MW 2R SEAL FROM MO TO 18.0 MMr
I DO -HEAR-By CERTI<tY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISANCAC 2C. VIRL
Submit the arl Md to the Division of Water Qs®1ity, Gsetmdwater Section, 16M Mall Savieo CcnW - Rateig% NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07i2001

M W r 1 WELL CONSTRUCTION RECORD
North Carolina - Department of Environmental and Natural Rawurces - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME (print) DANNY SUMMFaM
CERTIFICATION 0 25"
WELL CONTRACTOR COMPANY NAME GB0tA01C MWRATION. DiC_
PHONE 9 (704) M,76M
STATE WELL CONSTRUCTION PERM r# ASSOCIATED WQ PER1b M
(ifapplicabk)
(ifappliable)
1. WELL USE (Chock Applicable Box): Residential ❑ MmticiPalfi tic ❑ Industrial ❑ Agdcultmal ❑
M= Mnng ❑ Recovery ® Heat Pump Water' lgjaxtoa ❑
Other❑ If Other, list Use
2. WELL LOCATION:
TopographirlIand yeWng
,Nearest Town: HMERSONyuzE Coumrty HENDERSON
❑ Ridge [] Slope ❑ Valley ® Flat
1920 FOUR SEASON BLVD
(check appropriate box)
(Shod Name. Number% Community; Subdivida%IANo., Zip Case)
Lmhtudedmigtmda ofwell location
3.OWNER: moNMOBII.
Address
( )
I.atihmddlonglhlde source-❑ GPS [I Topographic map
2217-W HATTHEWS TOWNSHIP PARKWAY/PMB. 315
( �)
(Sta d-RnmNo.)
DEPTH G LOG
MtverTa S
From To FormationDasmiption
CdvaTown Score iinCade
SA 7%C
0.0 25.0 BROWN SILT
Ares Code-PhcwX=ber
25.0 40.0 BROWN/rAN SANDY CLAY
4. DATE DRILLED o9r1aro3
S. TOTAL DEPTH: 400 FEET
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 23.0 FT.
(UN , if)N TopoFCbw
9. TOP OF CASING IS o o FT. Abmm Land Surfer#
'Topofeadmgtamiodedatlorbelmwlmdsm1waregWm a
vrimmimsaoadmoowith ISANCAC2C.0118.
9. YIELD (&m): WA METHOD OF TEST WA
10. WATER ZONES (depth): N/A
SKETCH
11. D1SINFECITON. Type WA Amount
Show direction and distance in miles from at least
12. CASING: Wan Thkka m
two State Roads or Colulty Roads, incule d the toad
Depth Dkmeetcr or Weights Material
numbers and common road names.
From 0.0 To 13.0 Ft 41NCH SCH40 PVC
,
From To Ft
From To FL
13. Grout: Depth Materiel Method
From 0.0 To 11.0 Ft PortlmdBmtami6e Slow
From To FL
14. SCREEN: Depth Diameter Slot Sites Material
From 15.0 To 40.0 FL 4.0 in. MO in Pvc
Flom To Ft in. m
MO-1
15. SAND/GRAVELPACK:
Depth Sim Material
From 13.0 To 40.0 Ft, Z040 FINE SIUCA SAND
From To Ft
16. REMARKS: MW-9 SENTONUESBALFROM MOT013.0 FEET
I DO NEARBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRICTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
$IGATA7'illtF nF URRCCIAr rnuarrerrrTr*in rrrc urm r ...
Submit the origial to the Division of Water Quality, Groundwater SCdkz14 1636 Marl Service Center- Raleigh, NC
27699-1636 PhoneNo. [phone], within 30 days. OW-1 REV. 07/2001

NONRESIDENTTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3098
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
_GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED. PERMIT#(ir applicable)
SITE WELL ID ftf applicable) INJ-1
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ injection 6(
Irrigation❑ Other ❑ (list use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley jiFiat ❑Ridge []Other
LATITUDE 35 ° 20, , 14.4400 " DMS OR DID
LONGITUDE 82 , 26, 40.1600 " DMS OR DD
Latitude/longitude source: W3PS Oropographic map
(location of well must be shown on a USGS topo map andaftached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
EXXONMOBIL - 45552
N/A
Facility Name
Facility ID# (if
applicable)
1920 FOUR SEASONS ROAD
Street Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
EXXONMOBIL
Contact Name
1920 FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
U
Area code Phone number
S. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 22.0 FT,
(Use'+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface`
'Top of casing terminated atfor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e• YIELD (gpm): N/A
METHOD OF TEST NIA
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
: 7. CASING: Depth
Diameter Weight Material
: Top 0.0 Bottom 20.0
R. 2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
FL
: 8. GROUT: Depth
Material Method
Top 0.0 Bottom 16.0
FL PORTLMDBENTOMM SLURRY
Top Bottom
Ft:
Top Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 20.0 Bottom 30.0 FL 2.0 in. .020 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft - in. in.
= 10. SANDIGRAVEL PACK:
Depth Size Material
Top 18.0 Bottom 30.0 Ft. 20-40 FINE SILICA SAND
: Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 0.5
0.5 / 8.0
8.0 / 30.0
ASPHALT
BACKFILL/TAN SILTY SANDY CLAY
TAN SILTY SANDY CLAY
1Z. REMARKS:
BENTONITE SEAL FROM 16 0 TO J R n FEET
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
I NCA , C. LL CONST UCTION STA DS, AND THAT A COPY OF THIS
RECOR B N PROvI D TO THE valf.OWNER.
07/17/12
SIrTURE.CEZERTIFIED WELL CONTRACTOR DATE
JOHNNY BURR
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
w "":• Form GWAb
fonnatiori,P[ocesstng;i Rev. 2/09

5TATt-o
�� -- ']w -r••� NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
�` •��; ;gip• WELL CONTRACTOR CERTIFICATION # 3098
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(itapplicable)
SITE WELL ID #{it applicable) INJ-2
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection @r
Irrigation❑ Other ❑ (list use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑Valley IjFlat ❑Ridge ❑Other
LATITUDE 35 " 20 - 14,5000 " DMS OR DD
LONGITUDE 82 " 26 , 40.2200 " DMS OR DD
Latitude/longitude source: V3PS Elropographic map
(location of we# must be shown on a USGS topo map andattached to
this farm if not using GPS)
S. FACILITY (Name of the business where the Well is located.)
EXXONMOBIL - 45552
NIA
Facility Name
Facility ID# (if applicable)
1920 FOUR SEASONS ROAD
Street Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
EXXONMOBIL
Contact Name
1920 FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ei/
c. WATER LEVEL Below Top of Casing: 22.0
(Use "+' if Above Top of Casing)
d. TOP OF CASING IS
0.0 FT. Above Land Surface'
"Top. of casing terminated attor below land surface may require
a variance'in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top. Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thicknessf
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 20.0
Ft. 2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
: 8. GROUT: Depth
Material Method
Top 0.0 Bottom 16.0
Ft. PORT1ANDBeffONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 20.0 Bottom 30.0
Ft 2.0 in. .020 in. PVC
Top Bottom
Ft in. in.
Top Bottom
R. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 18.0 Bottom 30.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 0.5
ASPHALT
0.5 / 8.0
BACKFILUTAN SILTY SANDY CLAY
8.0 / 30.0
TAN SILTY SANDY CLAY
/
12. REMARKS:
BENTONITE SEAL FROM 16.0
TO 18.O FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC ; WELL CONSTRUCTION STANJOPIRDS, AND THAT A COPY OF THIS
RECOR N PROM D TO THE OWNER.
07/17/12
SI URE OtARTIFIED WELL CONTRACTOR DATE
JOHNNY BURR
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

K
1. WELL CONTRACTOR:
JOHNNY BURR
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(lt applicable)
SITE WELL ID #(if applicable) INJ-3
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection s7
Irrigation❑ Other ❑ (list use)
DATE DRILLED 06/28/12
4. WELL LOCATION:
1920 FOUR SEASONS ROAD 28792
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY. HENDERSONVILLE COUNTY HENDERSON
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley &(Flat ❑Ridge []Other
LATITUDE 35 -20 - 14.3600 " DMS OR DID
LONGITUDE 82 " 26 - 40.6200 " DMS OR DD
Latitudeflongitude source: 03PS Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
S. FACILITY (Name of the business where the well is located.)
EXXONMOBIL - 45552
N/A
Facility Name
Facility ID# (if applicable)
1920 FOUR SEASON_ S ROAD
Street Address
HENDERSONVILLE
NC
28792
City or Town
State
Zip Code
EXXONMOBIL
Contact Name
1920 FOUR SEASONS ROAD
Mailing Address
HENDERSONVILLE
NC
28792 ,
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 30.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO G/
c. WATER LEVEL Below Top of Casing: 22.0 -FT,
(Use "+" If Above Top of Casing)
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3098
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
'Top of casing terminated atfor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Thicknessl
: 7. CASING: Depth
Diameter Weight Material
Top
0.0 Bottom 20.0
FL 2 INCH SCH 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT: Depth
Material Method
: Top
0.0 Bottom 16.0
Ft. aoannrroeerrroalrt: SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft
9. SCREEN: Depth Diameter Slot Sae Material
Top 20.0 Bottom 30.0 Ft. 2.0 in. .020 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. iri. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 18.0 BottomL 30.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
: Top Bottom Formation Description
0.0 / 0.5
0.6 / 8.0
8.0 / 30.0
/
1
ASPHALT
BACKFILUTAN SILTY SANDY CLAY
TAN SILTY SANDY CLAY
1Z REMARKS:
BENTONITE SEAL FROM 16.0 TO 18.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WA51ONSTRUCTED IN ACCORDANCE WITH
��D
CTION STA DS. AND THAT A COPY OF THIS
: TO TH � ,. 0 �
K��vv� 07/17/12
• SI URE O RTIFIED WELL CONTRACTOR DATE
JOHNNY BURR
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
il.tji;= .InforrraYionPiRev.2/09
i300

MW-2,9
_MME L CONSTItUcCTI N RECORD
North Carotin— Department ofEavironmental end Natural Resources — Division of Water Quality — Gmmdwster Section
WEI,I. (3Y3MTtACPOR (lAIDIVIDUAL) NAME (pft) mcoaNAiiEY CERT1F=TI0N N 24o2
WELL CONTRACTOR COMPANY NAME tI£01 OGlC IDtPLORATION:INC. ^PHONE 0 ON m76a
STATE WELL CONSTRUCTION PERM W ASSOCIATED WQ PEBMIN
CifspPlicable) fd appIicahio)
WELL USE (Check Applicable Box): PteAe vial ❑ Mrmi4dTabko ❑
Monitoring ® Recovery ❑ Heat Paaw water Injewon ❑ OthpO
2. WELL LOCATION:
NCA=Town iffiIDIDtSONVRIE Couay HENDMWON
1MCMRAWYR=R1)L
(91wet Name. Nmnbdm Commu iiy. 9*&vidca6 LetNo. rip Code)
3. OWNER: EXSCI MOM CORPORAMON
Addmss 2217 D HdATnMM TOWNSW PARKWAY PMB 315
(Steeor arRmft No.)
NC 29105
CSWorTawe swo zip Code
Moos Code —Etna Noa6a
4. DATE DRILLED 11-1I 02
S. TOTAL DEPTH: 4o n FtmT
6. DOES WELL REPLACE MUSTING WELL? YES ® NO j]
7. STATIC WATER LEVEL Below Top of C*d* 27o ' FT.
(Elea "+PWAbave Tap off)
S. TOP OF CASING IS 0.0 Fr Above Land Safi=*
'Top of or lfDd ieI I , a
weieme is eooaaLsoe wig 1sA wAc 2c A11t
9. YIELD (gpm): NIA METHOD OF TEST NIA
10. WATER ZONES (depth): WA
11. DISINF MOM Type wA Amount
12. CASING: Walt Thicime w
Depth Diemreter or WdgbM Material
From oA To 20.0 Ft 2 INCH SC140 PVC
Hoot To Ft
From To ��
Ft
13. Grout Depth Material Melhod
Fipm 0.0 To 16.0 Ft Pmtlmd Bmtmb Stony
Frets To Ft _
14. SCREEN: Depth Dlwder Slat Sin Materiel
From 20.0 To 40.0 Pt 2.0 #re. Ala in PVC
From To Ft in.in
15. SAND/(iRAVEL PACK:
Depth Size Material
From 18A To 40A Ft 20-40 FM S11= SAID
From To Ft
tend 9ft ❑ Agri�mcal C7
IfOthrr, list Use
❑ Topographic/Land � setting
(Oak appropriate bolt)
TFfifthawgilade of vmu Location
(deSoeea/m{mRae/yp)
I.atihide/h *tudo r 3GPS ❑ Topographic map
(CbmDEM DRILLING LQQ
From To Fomratinn Deseli0m
0.0 1.0 CONCRIM
1.0 110 SOIL I ROUT
13.0 15.0 SENT8NITE
15.0 27.0 SAND
27.0 40.0 BROWN/ORANQEIPAN Sim
CLAYEY SAND
Show direction end distance in miles from at lemst
two State Roads or County Roads, inculed the road
numbras and common road name.
16. REMARKS: _ MW-2R BM40NM SEALFROM 16.0 To 1t0 FMr
I DO HPARBY CERTIFY THAT THIS wELL WAS CONSTRUCTED IN ACCORDANCE W= ISA14CAC 2C, WELL
CONSTRUCMN STANDARDS, AND THAT A COPY OF TNS RE4ORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the orkmal to the Division of Water Quality, G wmdwaW Section' 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone NM [phone], within 30 days. GW-1 REV. 072001

W-1 WELL CONSTRUCTION RECORD
North Carolina - Department of Environmental and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME (print) DANNY sUmmms CERTIFICATION # 25n
WELL CONTRACTOR COMPANY NAME OEoLooiC E1o'toRATioN., INC. PHONE # (704) M76M
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERNUMV
(ifapplimble) (ifapplic")
1. WELL USE (Check Applicable Box): Residential ❑ MunicipaUPublia ❑ Industrial ❑ AFicvltand ❑
Monitoring ❑ Recovery® heat pump water Wectiou ❑ Omer❑ If Other, list Um
2-WELL LOCATION: Topo&,a*dLand sag
,Nearest Town: HMERSONVII m County HENDERSON ❑ Ridge ❑ Slope ❑ Valley ® Flat
1920 FOUR SEASON BLVD (checkqpqviate box)
" (Strad Name. NumheM Ccmm®ity, Subdiviaon, IAtNo., Zip Cade) Latituddlongitade ofwdl location
3.OWNER: ExxoNmoBIL {� )
Address 2217-MMATnMWSTOWNSHPPARKWAY/P.M.B.31$ Latiftd0longitudesource: ❑(IFS ❑Topographicmap
(Sheet or Rmft No.) (dt=k bcm)
DEPTH PRM&W LOG
MATMEwS NC 29105 From To Formation Dauiplion
CkvorTawn Slate ZinCade 0.0 25.0 BROWNSILT
L�
An*Co&-PhmeWkmber 25.0 r 40.0 BROWN1TAN SANDY CLAY
4. DATE DRILLED o4rl4m3
5. TOTAL DEPTH: 4o.o FEET
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Caqing: 23,0 FT.
(Uae "F ifAlrow Top ofCasm�
S. TOP OF CASING IS o o FT. Above Land surfed
*Top ofaasinommkodm/orbelow Imdamlioe reggaes a
wilam in sooavlmoe with 1SA Nt AC 2C 0118.
9. YIELD (Mm): WA METHOD OF TEST N/A
10. WATER ZONES (depth): —NIA
I I- DISINITZ TON: Type N/A Amount Shaw direction and distance in miles from at least
12. CASING: waRThicknew two State Roads or County, Roads, inculed the toad
Depth Diameter or WeWif t Material numbers and coninicn road names.
From 0.0 To 15.0 Ft 4INCH KH40 PVC _.�, 1 L _q
From To FL to
From To FL
13. Grout:- Depth Material Method Wrea
Frog 0.0 To 11.0 Ft. Portland livid foe Slury ra
RMIn To Ft
14. SCREEN: Depth Diameter Slot Sim MderW
From 15.0 To 40.0 Ft 4.0 is Ma in PVC
From To Pt ip m
15. SAND/GRAVEL PACK:
Depth She Material
From 13.0 To 40A Ft 20-40 FINSSIUCASAND
From To Ft
16. REMARKS: MW.9 BENTONIIE SEAT. FROM 1I.0 TO t3A FEET
I DO HEARBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
•
SIGNATURE OF PERSON CONSTRUCTING THE WELL DA
Sub-h the original to the Divi of Walla Quality. GmwW* tw Saflon, 1636 Mad Service Center — Raleigh, NC
276MI636 Phonewo. [phone], within 30 days. GW-1 REV. 07=1

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
Type 5I Wells —In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
• Do not use this form for remediation systems that extract contaminated groundwater, treat it, and reinject the heated groundwater.
• Submit TWO copies of the completed application and all attachments to the address on the last page of this forte. -
• Any changes made to this form will result in the application package. being returned. ' r'
A. Application Number (to be completed by DWQ): 1,�� 0 %;�,� cv '
I. GENERAL INFORMATION:
1. Applicant's Name (generally the responsible party): Jewel Cox (Exxon Mobil Corporation) c o;
2. Signing Official's Name*: Title:
* Signing Official must be in accordance with instructions in part VI on page 7.
3. Mailing address of applicant: 1016 W. Poplar Ave, Suite 106, Number 232
City: Collierville State: TN Zip: 38017
Telephone number: 901.233.4112 - Fax number: 262.313.1830
4. Property Owner's Name (if different from Applicant): Henderson Oil Company.
5. Property Owner's mailing address: 745 Ashe St
City: Hendersonville State: NC Zip: 28792
6. Name and address of contact person who can answer questions about the proposed injection project:
Name: Scott Bostian Title: Senior Environmental Engineer
Company: ARCADIS
Address: 801 Corporate Center Drive., Suite 300
City: Raleigh State: NC Zip: 27607
Telephone number: 919.854.1282 ext 222 Fax number: 919.854.5448
Email Address: Scott.Bostian(a,arcadis-us.com
II. PERMIT INFORMATION:
1. Project is: ew ( Modification of existing permit ( Renewal of existing permit without modification
( Renewal of existing permit with modification
2. If this application is being submitted for renewal or modification to an existing permit, provide:
existing permit number and the issuance date
For renewal without modifications, fill out sections I & H only, sign the certification on the last page of this
form, and obtain the property owner's signature to indicate consent (if the applicant is not the owner).
For all renewals, submit a status report including monitoring results of all injection activities to date.
1
Revised 6/09 UIC-5I/5T Page 1 of 8

APPLICATION FOR PEL_.— T TO CONSTRUCT AND/OR USE A ..,:LL(S) FOR INJECTION
Type 5I Wells — In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
III. INCIDENT & FACILITY DATA
B. FACILITY INFORMATION
1. Facility name: ExxonMobil Retail Facility #45552
2. Complete physical address of the facility: 1920 %Yt Si, h' Saws 'EW-0
City: Hendersonville County: Henderson State: NC Zip: 28792
C. INCIDENT DESCRIPTION
1. Describe the source of the contamination: Four Underground Storage Tanks (USTs) onsite stored unleaded
gasoline, and used motor oil at the above site. According to an Exxon representative a set of storage tanks were
removed and replaced with the current storage tanks in 1985. Whether release occurred from the current storage
tanks or the removed set is unknown but in 1992 a soil investigation was conducted that detected contaminants in
exceedances of the NCGCLs and remediation systems were installed.
2. List all contaminants present in soils or groundwater at the site (contaminants may be listed in groups, e.g.,
gasoline, diesel, jet fuel, fuel oil, chlorinated ethenes, chlorinated ethanes, metals, pesticides/herbicides, etc):
Soil: Petroleum Hydrocarbons
Groundwater: Petroleum Hydrocarbons
3. Has LNAPL or DNAPL ever been observed at the site (even if outside the injection zone)?
( es If yes, list maximum measured separate phase thickness Historical maximum thickness of 0.25 feet in
MW-9 on May 20,2009. This was the last time free product was observed in any monitoring
( No If no, list maximum concentration of total VOCs observed at site:
NAPL last observed on May 20, 2009. MW-9 and MW-2R contained benzene detections of 23,200 ug/L and 9,390
u and ethylene dichloride (EDC) detections of 1,660 ug_/L and 964 u respectively which exceed the applicable
North Carolina Gross Contamination Levels (GCLs). A detection of ethylene dibromide in MW-2R at 149.4 ug/L
also exceeds NCGCLs.
4. Agency managing the contamination incident:
(CgT Secti uperfund Section (including REC Program and DSCA sites)
( DWQ Aquifer Protection Section iesolid Waste Section
( Hazardous Waste Sectio, I ( Other:
5. Incident managers name: DauiE � ser—hone number: 94f" vn= ) 9 '?�6 -- V4 V 3
6. Incident number or other site number assigned by the agency managing the contamination incident:
Groundwater Incident #9644
Revised 6/09 UIC-5I/5T Page 2 of 8

APPLICATION FOR PEL'-; iT TO CONSTRUCT AND/OR USE A .. LLL(S) FOR INJECTION
Type 5I Wells — In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
D. PERMITS
List all permits or construction approvals that have been issued for the facility or incident, including those not
directly related to the proposed injection operation:
1. Hazardous Waste Management program permits under RCRA: NA
2. DWQ Non -Discharge or NPDES permits: NA
3. County or DEH subsurface wastewater disposal permits: NA
IV. Other environmental permits required by state or federal law: NA
Revised 6/09 UIC-5I/5T Page 3 of 8

APPLICATION FOR PEI T TO CONSTRUCT AND/OR USE A .. -�LL(S) FOR INJECTION
Type 5I Wells — In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
INJECTION DATA
A. INJECTION FLUID DATA
1. List all proposed injectants.
NOTE. Any substance to be injected as a tracer or to promote in situ remediation must be reviewed by the
Occupational and Environmental Epidemiology Section (OEES) of the Division of Public Health, Department of
Health and Human Services. Review the list of approved injectants or contact the UIC Program to determine if
the injectants you are proposing have been reviewed by OEES.
Injectant: sodium persulfate
Concentration at point of injection: 50 g/L as sodium persulfate
Percent if in a mixture with other injectants: 5 % (persulfate)
Injectant: ferrous sulfate with citric acid (persulfate activator)
Concentration at point of injection: 2.5 g/L as ferrous sulfate heptahydrate (0.5 gJL as ferrous iron)
Percent if in a mixture with other injectants: 0.05 % (ferrous iron)
Injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
2. Source of fluids used to dilute or chase the injectants listed above:
(
'ci al water su 1
( Groundwater from private well or any well within % mile of injection site
(Air
( Other: if no access to fire hydrant, will have water delivered by private vendors
3. If any well within'/ mile of injection site, a private well, or surface water is to be used as the fluid source, supply
the following information:
a. Location/ID number of source:
b. Depth of source:
c. Formation:
d. Rock/Sediment type:
e. In Attachment C, provide a current, complete chemical analysis of the water from the source well, including
analyses for all contaminants suspected or historically recognized in soil or groundwater on the site.
NOTE. If contaminated groundwater is to be used as the dilution or chase fluid, this is not the proper permit
application form. You must apply for a closed -loop groundwater remediation permit using application -form
GWRS.
Revised 6/09 UIC-5I/5T Page 4 of 8

RE
C.
APPLICATION FOR PEluviiT TO CONSTRUCT AND/OR USE A : ,=.LL(S) FOR INJECTION
Type 5I Wells —In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
PROPOSED OPERATING PARAMETERS
1. Duration of Injection: approximately 48 hours/event
a. Maximum number of separate injection events:
b. Expected duration of each injection event: 4 days (injecting 3 wells simultaneously)
c. Expected duration between events (if more than one event): approximately 6 months
2. Injection rate per well: 1.0 gallons per minute (gpm)
3. Total Injection volume: 1,764.75 (maximum) gallons per day (gpd); 7,059 (maximurn). gallons per event
(if separate events)
4. Injection pressure: gravily feed preferred. If necessarypressure maximum of 5 psi, will be applied
(pounds/square inch (psi))
5. Temperature at point of injection: dependant upon water source (fire hydrant) and weather conditions, no
heated water will be injected T
6. Briefly describe how the above parameters will be measured and controlled: pressure gauges, flow
meters/totalizers, field groundwater parameter meters (YSI, Horiba or similar)
7. Estimated hydraulic capacity of the well: 1.0 gpm
INJECTION WELL CONSTRUCTION DATA
1. Injection will be via:
( Existing well(s) proposed for use as an injection well. Provide the data in (2) through (6) below to the best of
your knowledge.
(<Eo osed s) to be constructed for use as an injection well. Provide the data in (2) through (6) below as
proposed construction specifications.
2. Well Drilling Contractor's Name: TBD (Geologic Exploration, Parratt Wolf or SAEDACCO)
NC Well Contractor Certification number: TBD (NC#2401, #2489, or #2332, respectively)
3. Date to be constructed: Subsequently upon permit approval Number of borings:
approximatel 3 (two 2-inch injection wells)
Approximate depth of each boring (feet): 22 below ,ground surface (bgs)
4. Screened interval/Injection interval of injection wells:
Depth: _12- 22 feet below ground surface (if multip mtervals, indicates llowest and deepest depth).
5. Well casing (N/A if injection is through direct push rods):
Type: PVC ( Stainless steel( Other:
Casing depth: 0 to 12 ft (22 ft well).
6. Grout (N/A if injection is through direct push rods):
Type: qlCeient ( Bentonite ( Other:
Grout depth: 0 to 10 ft (22 ft well)
Revised 6/09 UIC-5I/5T Page 5 of 8

APPLICATION FOR PEI T TO CONSTRUCT AND/OR USE A' ;LL(S) FOR INJECTION
Type 5I Wells —In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
V. ATTACHMENTS
Provide the following items as separate attachments with the given headings:
A. SITE HISTORY
Provide a brief description of the site history including:
(1) site usage historically and present,
(2) origin of the contamination,
(3) previous remedial action(s).
NOTE. G.S. 89E-18 requires that any geologic plans, reports, or documents in which the performance is related to the
public welfare or safeguarding of the environment be prepared by a licensed geologist or subordinate under their
direction. G.S. 89E-13 requires that all drawings, reports, or documents involving geologic workprepared or approved
by a licensed geologist, or a subordinate under their direction, be signed and sealed by the licensed geologist.
B. HYDROGEOLOGIC DESCRIPTION
Provide a hydrogeologic description, soils description, and cross section of the subsurface to a depth that includes the
known or projected depth of contamination. The hydrogeologic description shall include:
(1) the regional geologic setting;
(2) significant changes in lithology;
(3) the hydraulic conductivity, transmissivity, and specific yield of the aquifer to be used for injection, including a
description of the test(s) used to determine these parameters; and
(4) the depth to the mean seasonal high water table.
C. INJECTION FLUID COMPOSITION
Describe the chemical, physical, biological and radiological characteristics of each injectant. Attach the Material Safety
Data Sheet (MSDS) for each injectant. If a private well or a well within % mile of the injection site is used as the source
well, include chemical analysis of source fluid here.
D. INJECTION RATIONALE
Attach a brief description of the rationale for selecting the injectants and concentrations proposed for injection, including:
(1) goals of the injection project;
(2) explanation and/or calculations of how the proposed injectant volume and concentration were determined;
(3) a description of the reactions between the injectants and the contaminants present including specific breakdown
products or intermediate compounds that may be formed by the injection; and
(4) summary results of modeling or testing performed to investigate the injectant's potential or susceptibility to change
(biological, chemical or physical) in the subsurface.
E. INJECTION PROCEDURE AND EQUIPMENT
Provide a detailed description of all planned activities related to the proposed injection including but not limited to:
(1) construction plans and materials;
(2) operation procedures;
(3) a detailed diagram of the surface and subsurface portions of the system; and
(4) a planned injection schedule.
Revised 6/09 UIC-5I/5T Page 6 of 8

APPLICATION FOR PEIuvi T TO CONSTRUCT AND/OR USE A ;LL(S) FOR INJECTION
Type 5I Wells —In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
F. MONITORING PLAN
Provide a plan for monitoring the results of the injection, including:
(1) a list of existing and proposed monitoring wells to be used;
(2) a list of monitoring parameters and analytical methods to be used; and
(3) a schedule for sampling to monitor the proposed injection.
NOTE. The selected monitoring wells must be located so as to detect any movement of injection fluids, process by-
products, or formation fluids outside the injection area or zone. The monitoring parameters should include the target
contaminants as well as secondary or intermediate contaminants which may result from the injection and other
parameters which may serve to indicate the progress of the intended reactions, such as pH, ORP, dissolved oxygen, and
other electron acceptors and donors. The monitoring schedule should be consistent with the pace of the anticipated
reactions and rate of transport of the injectants and contaminants.
G. WELL DATA
Provide a tabulation of data on all existing or abandoned wells within % mile of the injection well(s) which penetrate the
proposed injection zone, including, but not limited to, monitoring wells and wells proposed for use as injection wells.
Such data shall include a description of each well's use (water supply, monitoring, etc), total depth, screened or open
borehole depth interval, and well construction or abandonment record, if available.
H. MAPS
Attach the following scaled, site -specific maps:
(1) Area map based on the most recent USGS 7.5' topographic map of the area, at a scale of 1:24,000 and
showing the location of the proposed injection site.
(2) Site map including:
a. all property boundaries;
b. all buildings within the property boundary;
c. existing and proposed injection wells or well field(s)
d. any existing sources of potential or known groundwater contamination, including waste storage,
treatment or disposal systems within % mile of the injection well or well system;
e. all surface water bodies within 1/ mile of the injection well or well system; and
f. all existing or abandoned wells within 1/a mile of the injection well(s) which penetrate the proposed
injection zone, including, but not limited to, monitoring wells and wells proposed for use as injection
wells.
(3) Potentiometric surface map(s) including:
a. direction of groundwater movement
b. existing and proposed monitoring wells
c. existing and proposed injection wells
(4) Contaminant plume map(s) including:
a. the horizontal extent of the contaminant plume, including isoconcentration lines
b. existing and proposed monitoring wells
c. existing and proposed injection wells
(5) Cross-section(s) to the known or projected depth of contamination, including:
a. horizontal and vertical extent of the contaminant plume, including isoconcentration lines
b. major changes in lithology
c. existing and proposed monitoring wells
d. existing and proposed injection wells
Revised 6/09 UIC-5I/5T Page 7 of 8

1'I
/mot
APPLICATION FOR PERvur TO CONSTRUCT AND/OR USE A-wr:LL(S) FOR INJECTION
Type 5I Wells —In Situ Groundwater Remediation / Type 5T Wells — Tracer Injection
CERTIFICATION (to be signed as required below or by that person's authorized agent)
NCAC 15A 2C .0211(b) requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or
ranking publicly elected official
4. for all others: by the well owner.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that
names and authorizes their agent.
I hereby certify under penalty of law that I have personally examined and am familiar with the information
submitted in this document and all attachments therein, 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 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(s)
and all related appurtenances m accordance with the ap ap o ed specifications and conditions of the Permit.
Printed F� e and Title:J�fuQ
Date: C2?'Cg
PROPERTY OWNER (if the property is not owned by the applicant)
("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.)
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
(Title 15A NCAC 2C .0200).
Printed Name and
r-
�1a
Signature: VkJ`%G� Date: LQ
T U31 r
co
Submit TWO copies of the completed application package, including all attachments -,,to: m T-'
UIC Program
Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Revised 6/09 UIC-SI/5T Page 8 of 8

ARCADIS
Infrastructure Water Environment Buildings
ExxonMobil Environmental Services
Corporation
Attachment to the
Application for Permit to
Use Wells for Injection
Former ExxonMobil Facility #45552
1920 Chimney Rock Road
Hendersonville, North Carolina
Groundwater Incident #9644
December 2011
Imagine the result

CA ARCADIS
Scott Bostian, PE
Senior EnvironmE
Attachment to the Application
for Permit to Use Wells for
Injection
Prepared for:
ExxonMobil Corporation
Exxon Mobil Environmental Services
Ms. Jewel Cox - Project Manager
1016 W. Poplar Avenue
Suite 106 #232
Collierville, Tennessee 38017
Prepared by:
ARCADIS G&M of North Carolina, Inc.
11000 Regency Parkway
West Tower
Suite 205
Cary, North Carolina 27518-8518
Tel [phone]
Fax [phone]
www.arcadis-us.com
Environmental
Our Ref.:
B0085851.0039
Date:
December 14, 2011
This document is intended only for the use
of the individual or entity for which it was
prepared and may contain information that
is privileged, confidential and exempt from
disclosure under applicable law. Any
dissemination, distribution or copying of
this document is strictly prohibited.

f2__ ARCADIS
ARCADIS ARCADIS, Inc.
bgs
below ground surface
BTEX
benzene, toluene, ethylbenzene, and xylenes (total)
COC
chemical of concern
DCE
dichloroethene
DO
dissolved oxygen
DRO
diesel range organics
ERD
enhanced reductive dechlorination
GIS
geological information system
GRO
gasoline range organics
IDW
investigative derived waste
ISCO
in -situ chemical oxidation
MCLGs
maximum contaminant level goals
MCLs
maximum contaminant levels
MDL
maximum detection limit
Mg/kg
milligrams per kilogram
Mg/L
milligrams per liter
MNA
monitored natural attenuation
MSCC
maximum soil contaminant concentration
NAPL
non -aqueous phase liquid
NCDENR
North Carolina Department of Environment and Natural Resources
O&M
operations and maintenance
ORP
oxidation reduction potential
PCE
tetrachloroethene
PID
photo -ionization detector
ppm
parts per millions
SVOC
semi -volatile organic compound
TCE
trichloroethene
TCLP
toxicity characteristic leaching procedure
TPH
total petroleum hydrocarbons
TOC
total organic carbon
pg/kg
micrograms per kilogram
pg/L
micrograms per liter
USEPA
U.S. Environmental Protection Agency
VOCs
volatile organic compounds
Attachment to the
Application for Permit to
Use Wells for Injection

Va ARCADIS
SITE INFORMATION SECTION
Attachment to the
Application for Permit to
Use Wells for Injection
SITE INFORMATION
Section 1: Site Identification
Date of Report:
—
December_14, 2011
Facility ID
Former ExxonMobil #45552 '—�
UST Incident Number: 9644
Site Risk:
Intermediate
Site Rank: Not Available
Land Use Classification: _
Industrial/Commercial
Site Name:
—
Former ExxonMobil #45552 —
Site Street Address:
1920 Chimney Rock Road
City/Town:
— —
He
Zip Code:
28792
County: —
Description of Geographical Data
Point:
Henderson
Former UST and dispensers located under current property's asphalt parking lot.
Location Method:
Map
Latitude/Longitude
350 21' 37.81" / 820 24' 58.43"
Section 2: Information About Contacts Associated with the Leaking UST System
UST Owner: ExxonMobil Corporation Phone: [phone]
ExxonMobil Environmental Services Corporation, 1016 W. Poplar Avenue, Suite 106 #232, Collierville, TN 38017
UST Operator: Former ExxonMobil #45552 Phone: Unavailable
Former ExxonMobil #45552, 1920 Chimney Rock Road, Hendersonville, North Carolina 28792
Property Owner: D. & M. McKibbin Family Limited Partnership Phone: [phone]
745 Ashe Street, Hendersonville, North Carolina, 28792
_
Property Occupant: Exxon Branded Retail & Gasoline Station Phone: Unavailable
1920 Chimney Rock Road, Hendersonville, North Carolina 28792
Consultant: ARCADIS G&M of North Carolina Phone: [phone]
801 Corporate Center Drive, Suite 300, Raleigh, North Carolina 28607
Analytical Laboratory:
Certification Number:
Test America Laboratories, Inc. Phone: [phone]
NC DWQ: 269, NC DHHS: 13701
Section 3: Information About Release
Date Discovered:
Quantity of Release:
Cause of Release:
Source of Release:
1992
Unknown
Product Line
Product Line
Size/Content of UST:
Criteria Used to Classify Release:
4 USTs; 1-12,000G gasoline, 1—10,000G gasoline, 1 — 8,000G gasoline, 1-1,000G
used oil
Dissolved -phase constituents exceed GCL standards

Q ARCADIS
TABLE OF CONTENTS
LIST OF ACRONYMS
SITE INFORMATION SECTION
1.0 Introduction
2.0 Site History
3.0 Hydrogeologic Description
3.1 Regional Geology and Hydrogeology
3.2 Site Geology and Hydrogeology
4.0 Injection Fluid Composition
5.0 Injection Rational
6.0 Injection Procedures and Equipment
7.0 Monitoring Plan
8.0 References
Tables
Table 1 Well Construction Data
Table 2 Groundwater Gauging Data
Table 3 Groundwater Analytical Data
Figures
Figure 1 Site Location Map
1
2
3
3
3
4
4
5
7
8
Attachment to the
Application for.Permit to
Use Wells for Injection

0 ARCADIS
Figure 2 Site Map
Figure 3 Potentiometric Surface Map - March 30, 2011
Figure 4 Benzene Isoconcentration Map - March 2011
Figure 5 EDB Isoconcentration Map - March 2011
Figure 6 Ethylene Dichloride Isoconcentration Map - March 2011
Figure 7 Chemical Injection Well Location Map
Figure 8 Typical Injection Well Construction Diagram
Appendix
A Material Data Safety Sheets
Attachment to the
Application for Permit to
Use Wells for Injection
iv

Q ARCADIS
1.0 Introduction
ARCADIS G&M of North Carolina (ARCADIS) has prepared this Attachment to the
Application for Permit to Use Wells for Injection on ExxonMobil Environmental
Services (EMES) for the former ExxonMobil Facility #45552 located in
Hendersonville, Henderson County, North Carolina. The purpose of this attachment
is to provide additional site data and remedial system details to facilitate evaluation of
the proposed injection plan. This attachment is organized into the following sections:
Section 1, Introduction — discusses the purpose and organization of the attachment;
Section 2, Site History — discusses the information relevant to the site history in
regards to site usage, origin of contamination, and previous remedial activities;
Section 3, Hydrogeologic Description — discuses the regional geologic setting,
lithology, and hydraulic conductivity;
Section 4, Injection Fluid Composition — describes the chemical and physical
characteristics of the injectant;
Section 5, Injection Rational — discusses rational for selection the injectants;
Section 6, Injection Procedure and Equipment — provides a detailed description of
the all planned activities related to the proposed injection;
Section 7, Monitoring Plan — describes the plan for monitoring the results of the
injection;
Section 8, References — provides references for site historical information and state
regulatory requirements;
Tables Section,_ Well data — provides tabulation of data on all existing or abandoned
wells; and
Figures Section — provides supporting figures.
Attachment to the
Application for Permit to
Use Wells for Injection

Attachment to the
Application for Permit to
%► ARCADIS Use Wells for Injection
2.0 Site History f nn
Former ExxonMobil (Exxon) facility #45552 is located at 1920 ,
Hendersonville, North Carolina and currently operates as a retail gas station owned
and operated by Henderson Oil Company, Inc. A soil investigation was conducted in
1992 by Delta Environmental Consultants as part of the property divestment which
identified adsorbed -phase and dissolved -phase petroleum impacts to soil and
groundwater on the site. A 12,000 gallon, 10,000 gallon, and 8,000 gallon fiberglass
underground storage tank (UST) containing regular unleaded gasoline and a 1,000
gallon fiberglass UST containing used oil were installed at the site in 1985. It is
unknown whether these USTs were removed or are still operational at this time.
Soil vapor extraction/air sparging (SVE/AS) remediation was initiated at the site in
January 1995 by ERM-Southeast. The remediation system was not operated during
the period of July 1996 through June 1998 as a result of the passage of Senate Bill
1317, which temporarily suspended remediation requirements for low priority sites.
The system was re -started in June 1998 and was operated by ERM-Southeast until
August of 2003 when it was permanently shutdown in response to the passage of
House Bill 897. This bill removed the requirement for environmental remediation at
sites classified as Intermediate risk by the North Carolina Department of Environment
and Natural Resources (NCDENR), where free product is absent or less than 1/4-inch
in thickness. The SVE/AS system and associated components were removed from the
site in August 2003.
Free product was observed in monitoring well MW-9 at a thickness of 0.25 feet during
a gauging event completed on May 20, 2009. Free product has not been observed at
the site since the May 2009 measurement.
The site is currently owned by the Henderson Oil Company Inc., and is operating as an
Exxon branded retail and gasoline service station. The land use surrounding the site is
mixed residential and commercial. Drinking water in the area is supplied by the City of
Hendersonville. Sensitive Receptor Surveys (SRSs) have not identified private or
public water wells within 1,500 feet of the property. No surface water bodies have
been identified within 500 feet of the site.
NCDENR Risk Classification for the site is "Intermediate" due to dissolved -phase
concentrations of chemicals of concern (COC) exceeding the North Carolina Gross
Contaminant Levels (GCLs). Therefore COC concentrations in groundwater are being
compared to the North Carolina GCL standards.

Q ARCADIS
A site location map is presented in Figure 1 and a site map is shown as Figure 2.
3.0 Hydrogeologic Description
The topographic gradient in the vicinity of the subject site is to the west and southwest.
Drinking water in the area is supplied by the City of Hendersonville. The water supply
is derived from the Branley Creek, Miles River and Northfork Reservoirs located
northwest of the site. Sensitive Receptor Surveys (SRSs) have not identified private
or public water wells within 1,500 feet of the property. No surface water bodies have
been identified within 500 feet of the site.
Well construction data is presented in Table 1. Current and historical groundwater
elevations measured in the site monitoring wells are presented on Table 2. A
potentiometric surface map from the March 30, 2011 groundwater gauging event is
provided as Figure 2. Groundwater elevation data obtained during previous
groundwater gauging events indicate the groundwater flows generally to the west.
Analytical data from groundwater collected in site monitoring wells from June 1992 to
March 2011 is presented in Table 3. Isoconcentration maps from the March 30, 2011
sampling event are illustrated in Figures through 6.
3.1 Regional Geology and Hydrogeology
Former ExxonMobil facility # 45552 in Hendersonville is situated within the Chauga
geologic belt of North Carolina which is composed of low to medium grade
metasedirnentary and metavolcanic rocks. and Henderson Gneiss. The Chauga belt is
bordered on the northwest by the Brevard Fault zone and on the. southeast by the
Inner Piedmont belt. Surficial rocks in the vicinity are part of the Henderson Gneiss.
The Henderson Gneiss is generally massive, homogeneous, well -foliated, and
inequigranular augen gneiss ranging in composition from quartz monzonite to
granodiorite. The overlying soil consists of reddish brown to tan, silty sandy clay with a
measured thickness of approximately from 15 feet to 37 feet.
3.2 Site Geology and Hydrogeology
The site is located within the Chauga geologic belt of North Carolina which is
composed of low to medium grade metasedimentary and metavolcanic rocks and the
Henderson Gneiss.
Attachment to the
Application for Permit to
Use Wells for Injection
3

0 ARCADIS
Soils at the site are comprised of reddish brown to tan, silty sandy clay with a
measured thickness of approximately 15 feet to 37 feet at the site.
Groundwater at the site occurs at a depth of 18.89 to 23.16 feet across the site.
Groundwater flow direction is indicated to be toward the west.
4.0 Injection Fluid Composition
The proposed injection fluid will be composed of potable water mixed with sodium
persulfate to a concentration of 5% weight of sodium persulfate/weight of water.
Additionally, ferrous sulfate heptahydrate and citric acid may be added to the solution
at concentrations of 0.25% weight/weight and 0.03% weight/weight of water,
respectively. Material Data Safety Sheets for these three chemicals are included in
Appendix A.
5.0 Injection Rational
The goal of the planned remediation injections is to chemically degrade target
constituents in saturated soil and groundwater at the site that are currently at levels
significantly above the North Carolina Gross Contaminant Levels (NC GCL standards).
The injections will not likely achieve all groundwater standards immediately, but the
intent is concentrations will be reduced significantly to levels that will allow natural
attenuation to achieve groundwater standards in a reasonable timeframe.
Injection volumes per well for the proposed events were determined by multiplying the
vertical height of the well screen by the radial surface area required to achieve
complete distribution within the treatment area. This value was converted from cubic
feet to gallons and then multiplied by the anticipated porosity of the subsurface that will
accept fluid during the injection (the mobile porosity). Based on ARCADIS' experience,
mobile porosities are less than 10% at sites with similar lithologies to that observed at
the former ExxonMobil #45552. Therefore the anticipated injection volume per well =
10 ft x 3.14 (7c) x (10 ft X 10 ft) x 10% x 7.481 gal.cf = 2,353 gallons. The maximum
injection volume would not exceed 7,059 gallons.
Prior to injection, solutions will be mixed on -site in separate small -volume high density
polyethylene (HDPE) tanks. These include dilute solutions of sodium persulfate (6%
wt/wt) and if an activator is utilized, a solution of ferrous sulfate (0.05% ferrous iron
wt/wt). Each tank will be subsequently mixed and injected. Between the mixing unit
and the subsurface, contact between the chelated iron and each persulfate anion will
split to generate two sulfate radicals. Sulfate radicals have similar oxidation potential to
Attachment to the
Application for Permit to
Use Wells for Injection
4

Va ARCADIS
hydroxyl radicals (2.6 millivolts (mV)), but do not result in the same quantity of heat and
gas generation as observed in Fenton's type approaches. The reaction kinetics are
slower and thus persulfate anion is available for treatment over longer durations (1 — 2
months). This allows for migration of the oxidant into the less mobile pore spaces for
treatment of hydrocarbons., Further consumption of the sulfate radical will result in
sulfate formation with the treatment area. In typical anaerobic systems (as observed at
most hydrocarbon sites), sulfate is preferentially consumed as an electron acceptor via
anaerobic biological oxidation mechanisms. Thus, while sulfate concentrations are
expected within the injection area, these concentrations are expected within the
injection area, these concentrations will be consumed as treated groundwater is diluted
with ambient groundwater outside of the injection area. Sulfate concentrations will also
provide further benefit with the approach, as existing hydrocarbon impacts outside of
the injection area will be degraded via the anaerobic oxidation pathway.
6.0 Injection Procedure and Equipment
The existing site maps and well locations as well as a conceptual process and
instrumentation diagram are attached in the Figures section of the report. Under the
proposed approach, active remediation would be conducted via in -situ chemical
injection to, the subsurface. These techniques represent aggressive strategies for the
rapid and effective destruction of organic contaminants in the subsurface. Compared to
other oxidants, sodium persulfate is slower -reacting with a long in -situ half-life that
enables effective distribution from the injection point throughout the subsurface
environment. Persulfate is either injected alone or with an activator (Fe(I1), heat,
caustic soda or hydrogen peroxide) which upon reaction results in the formation of
sulfate radicals. Both persulfate and activator will be delivered through an injection well
to the treatment area.
The primary advantage of persulfate is the in -situ stability of the sulfate radical
compared to other oxidants (USEPA, 2006). Upon formation, sulfate radicals are
extremely strong oxidizers. At an oxidation potential (Eo) of 2.6 volts, the sulfate radical
is only 0.2 Volts less than that observed with ozone or hydroxyl radicals (Fenton's
reagents). Due to the larger size of the sulfate radical compared to other oxidants,
sulfate radicals are more selective and have slower reaction kinetics. Accordingly,
these slower reaction rates result in long aquifer residence times (weeks to one month)
allowing for oxidant transport with ambient groundwater flow and treatment of difficult
to reach contaminants. The slower kinetics of persulfate also results in minimal gas
and heat formation that are observed with Fenton's chemistry. Thus, while the reactive
strength of the sulfate radical makes this technology effective for a wide range of
Attachment to the
Application for Permit to
Use Wells for Injection
5

0 ARCADIS
contaminants (including BTEX), the slower reaction rates allow for extended treatment
in -situ and fewer health and safety concerns.
Similar to other oxidants, care must be taken in direct handling and injection of
persulfate. During above -ground mixing of persulfate and activator, sufficient health
and safety precautions (personal protection equipment (PPE), secondary containment)
must be taken to prevent exposure. While persulfate is an effective oxidant, injection
will lead to increased sulfate concentrations that are higher than the background level.
Sulfate is not toxic, however, and current sulfate standards are based on preventing
taste and odor issues in drinking water as opposed to human health concerns. Sulfate
can be utilized as an electron acceptor in anaerobic biological oxidation of residual
petroleum hydrocarbons.
ARCADIS will inject the sodium persulfate using the following methodology:
• In each of the three injection wells, approximately 980 Ibs of sodium persulfate
will be combined with water and injected as a 50 g/L sodium persulfate
solution (40 g/L persulfate). After injection performance has been evaluated, a
ferrous sulfate heptahydrate activator may be utilized to optimize oxidant
performance. If employed, the activator concentration would be selected to
achieve 500 mg/L of iron in the injected solution. An estimated total of 2,353
gallons of solution will be injected into each well. The volume of injected
solution was determined assuming a migratory porosity of 0.10 (unitless) to
achieve an affected radius of 10 feet. The maximum injection volume would
be 7,059 gallons (based on 0.40 migratory porosity).
The solution will be delivered from poly tanks staged within secondary
containment on a truck. The solution will be mixed onsite while wearing the
proper protective equipment.
Injecting simultaneously in the three injection wells, approximately four, 12-hour
days will be required to complete the injections based on the estimated
injection flow rate of 1 gpm. ARCADIS will monitor the wellhead pressure via
a gauge at the top of each injection well. Gravity injection of the solution is
preferred but low pressures likely ranging up to 2 psi will be used if necessary.
Maximum injection pressure will not exceed 5 psi to prevent fracturing and
preferential pathways. ARCADIS will conduct a failing head test during the
well installation field event to evaluate achievable injection rates prior to
mobilizing for the injection event.
Attachment to the
Application for Permit to
Use Wells for Injection
0

0 ARCADIS
The proposed location of the direct push Geoprobe injection points represented in
Figure 7, will be biased around areas indicating the highest COC constituents and will
be adjusted based on field observations.
7.0 Monitoring Plan
During the injection, two samples per day will be collected via bailers from the dose -
response monitoring well locations within the injection ROI (MW-2R and MW-9) and
monitored for field parameters (pH, redox potential [ORP], conductivity, turbidity,
temperature, and dissolved oxygen). At the end of injection, groundwater samples will
be collected from MW-2R and MW-9 for laboratory analysis of volatile organic
compounds (VOCs), sulfate, and, if iron activation is selected, total and dissolved iron
and for field screening of persulfate using field test kits to confirm the, target injection
ROI has been achieved.
Following the injection event, ARCADIS will gauge all groundwater monitoring wells
associated with the site (MW-2R, MW-3R, MW-4, MW-5, MW-6, MW-7, MW-8, MW-
9, and DW-1) and sample monitoring wells MW-2R and MW-9 to determine the
effectiveness of the in -situ chemical injection monthly for two consecutive months.
Semi-annual groundwater sampling will resume after the second month of
groundwater sampling and monitoring. Each monitoring well will be gauged using an
oil -water interface probe (IP) prior to sampling to determine the depth to
groundwater. The IP and attached tape, marked in 0.01 foot increments, will be
properly decontaminated before each use with Alconox soap, and rinsed with distilled
water. The depth to water and/or any non -miscible liquids will be measured from the
marked survey point on the well casing. All measurements will be recorded to the
nearest 0.01-foot increment.
All monitoring wells to be sampled will be purged of three times the well volume so that
the water in the well after purging is representative of the water in the aquifer.
Monitoring wells that do not generate three well volumes of water will be bailed dry and
then given sufficient time to allow for recharging. Groundwater samples will be
collected from each monitoring well using a dedicated disposable polyethylene bailer.
The bailers will be of single check valve construction, and will be inserted into the
monitoring well using nylon rope of sufficient size and diameter so that the bailer will be
easily raised and lowered. All groundwater samples collected from the monitoring wells
will be placed in laboratory -supplied containers and shipped to TestAmerica, Inc. in
Nashville, Tennessee for laboratory analysis. In accordance with Table 5 — Approved
Methods for Groundwater Analyses at Petroleum UST Release Investigations of the
North Carolina Guidelines for Assessment and Corrective Action for Underground
Storage Tank (UST) Releases, July 15, 2008 edition, groundwater samples will be
Attachment to the
Application for Permit to
Use Wells for Injection

0 ARCADIS
submitted for analysis of Volatile Organic Compounds (VOCs) by Standard Method
(SM) 620013, ethylene dibromide (EDB) by Environmental Protection Agency (EPA)
Method 504.1.
Following the completion of the above proposed remedial actions, ARCADIS
recommends that semi-annual monitoring and sampling be conducted for one year.
The monitoring and sampling of the wells will be used to further evaluate the
effectiveness of the treatment.
8.0 References
ARCADIS. 2011. Work Plan — Chemical Oxidation Injection. Former Exxon Retail
Location #45552. 1920 Chimney Rock Road, Hendersonville, North Carolina.
July 14.
ARCADIS G&M of North Carolina, Inc. 2011. Semi -Annual Corrective Action Plan
Monitoring Report. Former Exxon Retail Location #4-5552. 1920 Chimney Rock
Road, Hendersonville, North Carolina. June 22.
Delta Environmental Consultants, Inc. 1993. Comprehensive Site Assessment
Report. Exxon Retail Location #4-5552. 1920 Chimney Rock Road,
Hendersonville, North Carolina. July 19.
NCDENR — Division of Waste Management, UST Section. Guidelines for Assessment
and Corrective Action for UST Releases, July 15, 2008 version. December 1,
2008.
Attachment to the
Application for Permit to
Use Wells for Injection
N

Tables

Table 1 - Well Construe" "M Data
Revision Date: 2/23/2012
Incident M 9644 Facility ID#. -,,)rmer ExxonMobil Facility #45552
Well
Designation
Well
Diameter
(inches)
Screen
Interval
(ft-bgs)
Total
Depth
(ft-bgs)
Top of Casing
Elevation
(ft-amsl)
Well Use
MW-1
2
15 - 20
25
97.50
Monitoring
MW-2R
2
20 - 40
40
97.68
Monitoring
MW-3R
2
20 - 40
40
98.96
Monitoring
MW-4
2
10 - 25
25
98.74
Monitoring
MW-5
2
10 -25
25
97.76
Monitoring
MW-6
2
10 - 25
25
98.53
Monitoring
MW-7
2
10 - 25
25
94.94
Monitoring
MW-8
2
12 - 27
27
98.16
Monitoring
MW-9 .
4
15 - 40
40
98.18
Monitoring
DW-1
2
32 - 37
37
98.07
Monitoring
Notes:
ft-bgs = Feet below ground surface.
ft-btoc = Feet below top of casing.
ft-msl = Feet above mean sea level.
NK = Not Known
Page 1 of 1

Table 2: Groundwater Gauging Data
Revision Date: 2/23/2012
Incident Number: 9644 Facility ID #: Former ExxonMobil Facility #45552
MonitorWelllD
Datelnstalled
Date Water
Level
Measured
Total Casing
Depth
(ft BGS)
Screened
Interval
(ft BGS)
Top of Casing
Elevation
(ft amsl)
Depth to
Water
(ft BTOC)
Depth to
Product
(ft BTOC)
Product
Thickness
(ft)
Ground
Water
Elevation '
ft amsl
Well
Diameter
MW-1
6/18/1992
5/2011993
25.00
15'-20'
97.50
14.46
-
83.04
2"
9/28/1993
97.50
16.55
-
80.95
2"
1/31/1994
97.50
17.98
79.52
2"
5/23/1994
97.50
17.24
-
80.26
2"
8/22/1994
97.50
17.10
-
80.40
2"
12/5/1994
97.50
16.47
-
81.03
2"
3/6/1995
97.50
15.65
-
81.85
2"
6/7/1995
97.50
16.26
-
81.24
2"
9/13/1995
97.50
16.74
80.76
2"
12/14/1995
97.50
17.47
-
80.03
2"
3/6/1996
97.50
16.98
-
80.52
2"
6/11/1996
97.50
17.11
80.39
2"
11M1997
97.50
19.16
78.34
2"
10/29/1998
97.50
18.79
78.71
2"
1/5/1999
97.50
19.77
-
77.73
2"
5/24/1999
97.50
19.69
-
77.81
2"
12/15/1999
97.50
20.83
-
76.67
2"
6/20/2000
97.50
20.54
76.96
2"
12/27/2000
97.50
22.71
-
-
74.79
2"
6/18/2001
97.50
22.21
75.29
2"
12/19/2001
97.50
22.98
74.52
2"
6/27/2002
97.50
22.73
74.77
2"
11/11/2002
97.50
23.40
-
74.10
2"
6/30/2003
97.50
19.83
77.67
2"
6/20/2007
97.50
19.29
-
78.21
2"
8/19/2008
97.50
22.35
75.15
2"
5/20/2009
97.50
22.58
74.92
2"
3/17/2010
97.50
17.58
79.92
2"
10/20/2010
97.50
18.72
-
78.78
2"
3130/2011
97.50
18.89
-
78.61
2"
MW-2
6/18/1992
5/20/1993
27.00
17'-27'
97.75
19.05
-
78.70
2"
9/28/1993
97.75
20.22
77.53
2"
1/31/1994
97.75
21.72
-
-
76.03
2"
5/23/1994
97.75
20.87
76.88
2"
8/22/1994
97.75
20.55
-
77.20
2"
12/5/1994
97.75
20.50
77.25
2"
3/6/1995
97.75
19.92
77.83
2"
6/7/1995
97.75
20.19
77.56
2"
9/13/1995
97.75
21.45
-
76.30
2"
12/14/1995
97.75
20.88
76.87
2"
3/6/1996
97.75
20.31
77.44
2"
6/11/1996
97.75
20.49
77.26
2"
11/7/1997
97.75
22.53
75.22
2"
10/29/1998
97.75
21.78
75.97
2"
1/5/1999
97.75
23.14
74.61
2"
5/24/1999
97.75
1 22.71
75.04
2"
12/15/1999
97.75
23.48
74.27
2"
6/20/2000
97.75
23.78
73.97
2"
12/27/2000
97.75
25.21
1
72.54
2"
6/18/2001
97.75
25.11
72.64
2"
12/19/2001
97.75
23.64
74.11
2"
6/27/2002
97.75
25.53
72.22
2"
11/11/2002
97.75
26.21
-
71.54
2"
6/30/2003
97.75
23.00
-
74.75
2"
6/10/2005
97.75
21.06
76.69
2"
9/20/2005
--?i7-.751
20.33
77.42
2"
MW-2
converted to MW-2R on 11/11/2002
MW-2R
11/11/2002
11/10/2006
40.00
20'-40'
97.68
22.39
75.29
.2"
6/20/2007
97.68
22.24
75.44
2"
8/19/2008
97.68
24.91
72.77
2"
5/20/2009
97.68
25.42
72.26
2"
3/17/2010
97.68
21.17
-
76.51
2"
4/28/2010
97.68
20.87
76.81
2"
6/17/2010
97.68
20.71
76.97
2"
8/11/2010
97.68
21.05
76.63 1
2"
10/6/2010
97.68
21.94
75.74
2"
10/20/2010
97.68
21.72
75.96
2"
3/30/2011
97.68
22.25
-
-
75.43 1
2"
Page 1 of4

Table 2: Groundwater Gauging Data
Revision Date: 2/23/2012
Incident Number: 9644 Facility ID #: Former ExxonMobil Facility #45552
Monitor Well ID
Date Installed
Date Water
Level
Measured
Total Casing
Depth
(ft BGS)
Screened
Interval
(ft BGS)
Top of Casing
Elevation
(ft amsl)
Depth to
Water
(ft BTOC)
Depth to
Product
(ft BTOC)
Product
Thickness
(ft)
Ground
Water
Elevation '
ft amsl
Well
Diameter
MW-3
6/18/1992
5/20/1993
27.00
17'-27'
98.96
19.61
-
79.35
2"
9/28/1993
98.96
20.94
78.02
2"
1/31/1994
98.96
22.39
-
76.57
2"
5/23/1994
98.96
21.55
-
77.41
2"
8/22/1994
98.96
21.16
-
77.80
2"
12/5/1994
98.96
21.09
77.87
2"
3/6/1995
98.96
20.40
-
78.56
2"
6/7/1995
98.96
21.74
-
77.22
2"
9/13/1995
98.96
21.06
-
77.90
2"
12/14/1995
98.96
21.61
77.35
2"
3/6/1996
98.96
21.10
-
-
77.86
1 2"
6/11/1996
98.96
21.45
-
77.51
2"
11/7/1997
98.96
23.22
75.74
2"
10/29/1998
98.96
21.36
77.60
2"
1/5/1999
98.96
22.96
-
-
76.00
2"
5/24/1999
98.96
23.33
75.63
2"
6/20/2000
98.96
24.51
74.45
2"
12/27/2000
98.96
25.82
73.14
2"
6/18/2001
98.96
25.69
73.27
2"
12/19/2001
98.96
26.13
-
72.83
2"
6/27/2002
98.96
25.95
73.01
2"
MW-3
converted to
MW-3R on 11/11/2002
MW-3R
11/11/2002
11/11/2002
40.00
20'-40'
98.96
26.67
72.29
2"
6/30/2003
98.96
23.32
-
75.64
2"
6/10/2005
98.96
21.18
77.78
2"
9/20/2005
98.96
20.43
-
78.53
2"
11/10/2006
98.41
22.55
75.86
2"
6/20/2007
98.41
22.56
75.85
2"
8/19/2006
98.41
25.13
-
73.28
2"
5/20/2009
98.96
25.63
-
73.33
2"
3/17/2010
98.96
21.35
-
77.61
2"
10/20/2010
98.96
21.92
-
77.04
2"
3/30/2011
98.96
22.48
-
-
76.48
2"
MW-4
6/30/1992
5/20/1993
25.00
10'-25'
98.74
17.88
-
80.86
2"
9/28/1993
98.74
21.49
77.25
2"
1/31/1994
98.74
22.84
75.90
2"
5/23/1994
98.74
22.06
76.68
2"
8/22/1994
98.74
21.83
-
76.91
2"
12/5/1994
98.74
21.74
77.00
2"
3/6/1995
98.74
21.23
-
77.51
2"
6/7/1995
98.74
21.52
-
77.22
2"
9/13/1995
98.74
21.75
76.99
2"
12/14/1995
98.74
22.26
76.48
2"
3/6/1996
98.74
21.69
77.05
2"
6/11/1996
98.74
21.85
76.89
2"
11/7/1997
98.74
23.60
75.14
2"
10/29/1998
98.74
23.06
75.68
2"
1/5/1999
98.74
23.78
-
74.96
2"
5/24/1999
98.74
23.71
75.03
2"
12/15/1999
12/27/2000
98.74
23.64
75.10
2"
98.74
23.69
75.05
2"
6/18/2001
98.74
23.92
-
74.82
2"
12/19/2001
98.74
23.47
75.27
2"
11/10/2006
98.74
23.60
-
75.14
2"
8/19/2008
98.74
23.00
75.74
2-
5/20/2009
98.74
24.06
74.68 1
2"
10/20/2010
98.74
22.93
75.81
2"
3/30/2011
98.74
23.16
-
-
75.58 1
2"
Page 2 of 4

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Table 2: Groundwater Gauging Data
Revision Date: 2/23/2012
Incident Number: 9644 Facility ID #: Former ExxonMobil Facility #45552
Monitor Well ID
Date Installed
Date Water
Level
Measured
Total Casing
Depth
(ft BGS)
Screened
Interval
(ft BGS)
Top of Casing
Elevation
(ft amsl)
Depth to
Water
(ft BTOC)
Depth to
Product
(ft BTOC)
Product
Thickness
(ft)
Ground
Water
Elevation'
ft amsl
Well
Diameter
MW-8
5/20/1993
5/20/1993
27.00
12'-27'
98.16
12.03
86.13
2"
9/28/1993
98.16
22.13
76.03
2"
1/31/1994
98.16
23.79
74.37
2"
5/23/1994
98.16
22.85
75.31
2"
8/22/1994
98.16
22.70
75.46
2"
12/5/1994
98.16
22.61
75.55
2"
3/6/1995
98.16
22.26
75.90
2"
6/7/1995
98.16
22.41
-
75.75
2"
9/13/1995
98.16
22.57
-
-
75.59
2"
12/14/1995
98.16
23.17
74.99
2"
3/6/1996
98.16
22.76
75.40
2"
6/11/1996
98.16
22.92
-
75.24
2"
11/7/1997
98.16
24.42
-
-
73.74
2"
10/29/1998
98.16
24.02
-
74.14
2"
5/24/1999
98.16
24.84
-
73.32
2"
12/15/1999
98.16
26.13
-
72.03
2"
6/20/2000
98.16
26.09
-
72.07
2"
6/3012003
98.16
25.24
-
-
72.92
2"
MW-9
6/10/2005
6/10/2005
40.00
15'-40'
98.18
21.19
-
76.99
4"
9/20/2005
98.18
20.44
77.74
4"
11/10/2006
98.18
22.51
75.67
4"
6/20/2007
98.18
22.53
-
75.65
4"
8/19/2008
98.18
25.11
-
73.07
4"
5/20/2009
98.18
25.80
25.55
0.25
72.57
4"
3/17/2010
98.18
21.30
-
76.88
4"
4/28/2010
98.18
20.97
77.21
4"
6/17/2010
98.18
20.82
77.36
4"
8/11/2010
98.18
21.12
77.06
4"
10/6/2010
98.18
21.62
-
76.56
4"
10/20/2010
98.18
21.93
76.25
4"
3/30/2011
98.18
22.41
-
75.77
4"
DW-1
8/6/1992
5/20/1993
37.00
32'-37'
98.07
20.74
-
77.33
2"
9/28/1993
98.07
22.42
-
75.65
2"
1/31/1994
98.07
23.15
74.92
2"
5/23/1994
98.07
22.82
-
75.25
2"
8/22/1994
98.07
22.56
75.51
2"
12/5/1994
98.07
22.13
-
75.94
2"
3/6/1995
98.07
21.78
76.29
2"
6/7/1995
98.07
21.63
76.44
2"
9/13/1995
98.07
21.94
76.13
2"
12/14/1995
98.07
22.53
75.54
2"
3/6/1996
98.07
22.48
75.59
2"
6/11/1996
98.07
22.25
75.82
2"
11/7/1997
98.07
23.83
74.24
2"
10/29/1998
98.07
22.90
75.17
2"
5/24/1999
98.07
24.33
73.74
2"
12/15/1999
98.07
25.33
72.74
2"
6/20/2000
12/27/2000
98.07
25.42
72.65
2"
98.07
26.66
-
71.41
2"
6/18/2001
98.07
27.10
70.97
2"
12/19/2001
98.07
27.31
70.76
2"
11/11/2002
98.07
27.95
70.12
2"
6/30/2003
98.07
24.54
73.53
2"
11/10/2006
98.07
23.84
74.23
2"
Notes:
amsl = above mean sea level.
BGS = Below ground surface.
BTOC = Below top of well casing.
ft = feet.
NA = Not Available.
1 = Groundwater elevations that contain product have been corrected: [top of casing elevation - depth to water] + [free product thickness x 0.74]
Page 4 of 4

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Table 3: Groundwater Analytical Data i
Revision Date: 2/2312012 Incident Number. 9644 Facility ID W.,Fortner ExxonM1Aobil Facility #45552
SM62008 historical data used 602/6230D/6210D/8260B
'
EPA 504.1
6010C
MADEP VPH
II-
MADEP EPH
ID
Date
Incident Phase
x2m
m
m
m
ym
W
X
m
oW
m a
ma
mo
.2
$
LhE
`_'•'_
mLtIO.
r4
m
G
2
$
_
2
0'
-
L
t
m'
m
6
2
a
m
m
OUT0o
P
C)
i.2
_ _
v
m
Cj
N
,
U
dr
U
d,
d�a
_
U E
2
m
tWell
GCLs
NE
5,000
260.000
84,500
85,500
20.000
70000
400
NE
25,000
6900
8500
26000
NE
6000
30000
70000
3000
50
15,000
NE
NE
NE
NE
NE
NE
12,500
5
0.05
7/14/1992
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/21/1993
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
- -
-
-
-
-
9/2811993
4,530
1,300
1,500
230
1,500
NO
260
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1/31/1994
3344
2,400
310
34
600
NO
660
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/23/1994
896
667
85
8
136
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
8/2211994
375
306
10
NO
59
11
66
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/5/1994
61
55
NO
NO
6
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3/6/1995
940
840
30
NO
70
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6/7/1995
967
840
28
6
93
NO
197
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/13/1995
3,645
1,980
675
90
900
ND
2,490
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MW-0
12/14/1995
Monitoring
5775
5220
87
18
450
21
900
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3/6/1996
7,380
6,300
495
NO
585
ND
1,080
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6/11/1996
2,227
1,980
90
22
135
NO
1,240
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
11/7/1997
471
441
4
7
19
15.5
158
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
10/29/1998
4,790
300
226
665
3,600
NO
NO
-
-
-
-
-
-
-
-
-
-
2,940
3,370
6,090
-
-
-
-
-
-
1I5/1999
1,080
1010
21.7
3.4
45.3
53.2
152
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5I24/1999
14
14.1
NO
NO
NO
10.9
130
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/15/1999
1.2
NO
1.2
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
10120/2010
2.26
1.18
1.08
ND<1.00
ND<3.00
ND<1.00
ND<1.00
-
-
-
-
-
-
ND<0.0201
211
-
-
-
-
"- -
-
-
-
-
3130/2011
1.63
0.63
1
ND<0.50
ND<1.00
ND<0.50
ND<0.50
ND<0.50
ND<50
ND<0.50
ND<0.50
ND<0.50 ND<0.50
ND<0.50
ND<0.50
ND<5.0
ND<0.50
ND<0.50
ND<0.50
ND<0.02251
ND<50
-
-
-
-
-
-
-
-
-
7/14/1992
12,500
600
1,200
1,800
- 8,900
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/21/1993
12,310
470
940
1900
9000
170
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/28/1993
11,000
900
1,400
1,300
7,400
180
300
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- -
-
-
-
-
1/31/1994
8900
170
330
1400
7.000
110
220
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/23/1994
9,188
128
360
1,540
7160
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
8/22/1994
9,690
256
464
1,270
7,700
- 267
314
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/5/1994
55.790
1,300
3,020
7,470
44.000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3/6/1995
30,280
360
900
5,220
23,800
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6l7/1995
7,370
290
370
1,170
5,540
78
165
-
-
-
-
-
-
-
-
-
-
-
-
- -
-
-
-
-
9/1311995
3,600
270
360
1,170
1,800
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/14/1995
7,790
- 135
135
1,620
5,900
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3/6/1996
5360
158
112
1,600
3490
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6/11/1996
5,926
248
68
1,330
4,280
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MW-5
11f7/1997
Monitoring
4866
308
138
1.030
3390
34.5
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
10/29/1998
2,742
2,630
31.6
3.2
77
50.7
580
-
-
-
-
-
-
-
-
4,940
NO
370
-
-
-
-
-
-
1/511999
1675
176
75.2
394
1,030
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/24/1999
1346
82
102
383
779
435
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/15/1999
1.536
8.7
39.9
177
1310
53.4
34
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6120/2000
846
14.0
33.5
136
662
83.1
99
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
12/27/2000
238
2.0
6.9
38.8
190
6.3
6.6
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6118/2001
53
NO
1.5
7.8
44.1
5.4
2
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6127/2002
44
NO
1.1
3.9
39.2
ND
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6130/2003
ND
NO
NO
NO
NO
- - NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3117/2010
7.41
ND<1.00
ND<1.00
1.78
5.63
ND<1.00
ND<1.00
-
-
-
-
-
-
ND<0.0200
8.89
ND<100
ND<100
445
ND<102
ND4109
133
35.2
ND<9.8
ND<9.8
10/20/2010
BDL
ND<1.00
ND<1.00
ND<1.00
ND<3.00
ND<1.00
ND<1.00
-
-
-
-
-
-
-
ND<0.0201
6.8
-
-
-
-
-
-
-
-
-
3130/2011
BDL
ND<0.50
ND<0.50
ND<0.50
ND<1.00
ND<0.50
ND<0.50
ND<0.50
ND<50
40.7
26.6
32.1
1.05
ND<0.50
3.06
ND<5.0
2.34
ND<0.5021150ND<0.02011
ND<50
-
-
-
-
-
-
-
-
-
7114/1992
436
240
88
18
90
17
-------9/28/1993
-
-
-
-5121/1993
338
180
36
19
103
22
227
140
17
7.5
62
35
ND8122/1994
75
44
6
3
22
18
ND
-
-
-
-
-
-
-
-
-
-
-
-MW-6
9/13/1995
Monitoring
6
3
NO
ND
3
- 10
2512115/19
99
NO
NO
NO
NO
NO
NO
ND6130/2003
NO
NO
NO
NO
NO
NO
ND3/17/2010
BDL
ND<1.00
ND<1.00
ND<1.00
NDc3.00
ND<1.00
ND<1.00
-
-
-
-ND<0.0200
ND<5.00
ND<100
ND<100
ND<100
ND<102
ND<109
ND<98.0
ND<9.8
ND<9.8
ND<9.8
5/21/1993
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MW-7
9/28/1993
Monitoring
NO
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5121/1993
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/28/1993
20
2.4
5
1.7
11
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MW-8
8/22/1994
Monitoring
3
NO
NO
NO
3
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/13/1995
NO
NO
NO
NO
NO
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/24/2003
45,140
9,960
19,500
2.680
13,000
516
1 230
-
-
-
-
-
-
53.800
19,800
12,700
-
-
-
-
-
-
11/1912003
69,550
15,400
23,400
4,950
25,800
1 440
5 110
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1/10/2005
69,800
22,700
29,900
2,400
14 800
ND
4 100
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6/1012005
72,820
24,200
31,600
2,720
14,300
725
4130
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9/20/2005
60,890
18,000
27,600
2,290
13 000
679
2 840
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
MW-9
11/10/2006
Monitoring
68,090
19,600
36,100
2 09D
10 300
514
3 080
--
6/2012007
72,710
22,700
33100'
2,710
14,200
494
2,860
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
8/1912008
53,640
28,300
11,500
2,340
11,500
1,560
4,190
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3/17/2010
62490
18100
26,600
1 2590
15200
2380
2,620
-
-
-
-
-
-
-
-
573.1
1830
73600
ND000
14400
1100
ND009
848
237
ND<9.8
ND<9.8
10/20/2010
59,300
17,400
26 900
2,500
12,500
1,150
3,110
-
-
-
-
-
625
2,180
-
-
-
-
-
-
-
-
3/30/2011
67,170
23,200-
31,200
2,270
10,500
758
3,630
1,660
1,740
438
1,570
37.6
ND<10
66.4
ND<10
792
189
619
14.8
34.09
3.280
-
-
-
-
-
-
-
-
8/11/1992
8,140
1 3,600
3,100
240
1,200
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5/21/1993
408
230
62
3.3
113
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
DW-1
1 9/28/1993
Monitoring
3
1 0.8
0.9
NO
0.9
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
8/22/1994
42
1 18
NO
NO
24
NO
NO
-
-
-
-
-
-
-
-
-
-
-
-
-
9/13/1995
NO
I NO
NO
NO
NO
NO
I NO
-
-
-
-
-
-
-
-
-
-
Notes:
BDL - Below Detection Limit where detection limit not available from historical data.
GCL = Gross Contamination Level.
NO - Non -detect above laboratory reporting limit where laboratory reporting limit not available from historical data.
NE - Nan -existing.
NA - Not Analyzed.
Bold = Above applicable GCL standard.
BTEX = Benzene, Toluene, Ethylbenzene, Xylene.
MTBE = Methyl tert-Butyl Ether.
-= Not Analyzed for specific compound
< # = Non -detect above laboratory reporting limit
1 = Prior to March 2011 event, samples were analyzed via 8260E (historical data used 602162300162101)), March 2011 samples were analyzed via SM6200 B.
2 = Environmental Protection Agency 504.1
3 = Prior to March 2011 event, samples were analyzed via 3030C, March 2011. samples ewe analyzed via total characteristic leaching procedure (TCLP) SW846 1311/6010C.
2 of

-4-11- fl_ems
Rogers, Michael
From: Rogers, Michael
Sent: Wednesday, July 18, 2012 2:58 PM
To: 'Bostian, Scott'
Cc: Slusser, Thomas; Watts, Debra; Smith, Eric
Subject: RE: Exxon Mobil Hendersonville Site (WI 0100202)
Scott -
Per our discussion, submit the new notification form with the revised injection/monitoring plan. We will rescind the
previous permit number and assign another. Per the rule requirements, the notification form shall be submitted at least 2
weeks prior to injection. Please reference the presently assigned permit number in a cover letter.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal.ncdenr.org/web/wplaps/gwpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:[e-mail]]
Sent: Tuesday, July 17, 2012 10:55 AM
To: Rogers, Michael
Subject: RE: Exxon Mobil Hendersonville Site (WI 0100202)
This site was ultimately permitted by rule but we had originally submitted a permit application. For the modification,
should we submit the permitted by rule notification form?
From: Rogers, Michael [mailto:[e-mail]]
Sent: Tuesday, July 17, 2012 9:55 AM
To: Bostian, Scott
Subject: RE: Exxon Mobil Hendersonville Site (WI 0100202)
Hey Scott -
Complete a new application but check permit modification on the application. Most of the info will be the
same and you can use most of the same attachments. It should not take as much time as the initial permit for
the review.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal.ncdenr.o[gtweb/wq/aps/gwpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
1

From: Bostian, Scott [mailto:[e-mail]]
Sent: Monday, July 16, 2012 1:36 PM
To: Rogers, Michael
Subject: RE: Exxon Mobil Hendersonville Site (WI 0100202), and Raleigh Site (WI0500494)
Michael,
We installed the injection wells at the Hendersonville site (Exxon 45552). Because of a utility line (photo attached) and
the Exxon safety requirement that we can't drill within 10 feet of an underground utility, we had to move the injection
wells to the west. Because the source is likely around MW-9 and under the west edge of the dispenser islands, we would
like to switch INJ-2 and MW-9, that is, inject into MW-9 and use INJ-2 for monitoring. How should we proceed with
obtaining permission for this approach?
Thanks,
Scott
From: Rogers, Michael [mailto:[e-mail]]
Sent: Thursday, May 24, 2012 3:53 PM
To: Bostian, Scott
Cc: Zimmerman, Jay
Subject: Exxon Mobil.Hendersonville Site (WI 0100202),.and Raleigh Site (WI0500494)
Scott -
This e-mail is to follow up a voicemail I left on your phone at your office this afternoon. We have determined that based
.upon information in the applications and in the follow-up additional information packets we received May 21, 2012, the
two groundwater remediation permit applications referenced above qualify to be 'deemed permitted by rule'. The UIC
rule.15A NCAC .0200 was revised effective May 1, 2012.
Some- of -the - revisions :affect -groundwater remediation systems. One of the revisions is that if the size of the plume to be
remediated is less than 10,000 ft.2, it is eligible to be deemed permitted per Small Scale Injection Operations described in
15A NCAC 02C .0225(b)(2). Therefore, in accordance with the new rule requirements, the injection activities referenced
above are permitted by rule and do not require an individual permit. Refer to attached memo for additional information.
Future projects, which would qualify as deemed permitted, would need to be submitted on the new notification forms.
If you have any questions or comments, please advise.
Regards
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.org/web/wg/aps/awpro/permit-applications#geothermAi)ps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:[e-mail]]
Sent: Tuesday, May 22, 2012 11:35 AM
To: Rogers, Michael
Subject: RE: Exxon Mobil Charlotte Site AND Raleigh Site

Michael, r
Please send the mailing addresses so we can make sure they get to the correct person.
Thanks for your help,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]
From: Rogers, Michael [mailto:[e-mail]]
Sent: Monday, May 21, 2012 4:41 PM
To: Bostian, Scott
Subject: RE: Exxon Mobil Charlotte Site AND Raleigh Site
Scott -
I rec'd the Additional Info packet for the Raleigh and Charlotte Sites. Please send a duplicate copy to the
respective Regional Office so that they can insert into application and review also. This includes the two other
sites in Hendersonville and Greensboro. I will go ahead and forward the Original Application to the ROs for
th`e above sites so they can start their review (I won't wait for a second copy before sending). If you need
t - mailing address, let me know.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.o[g/web/wg/aps/gwpro/permit-applications#geothermAi)ps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:[e-mail]]
Sent: Friday, May 11, 2012 4:19 PM
To: Rogers, Michael
Subject: RE: WI0300194 Exxon Mobil Charlotte Site AND OTHER SITES
Michael,
I apologize for the delay. These have taken much longer than they should have. We're completing the
additions/responses to all four applications and will have them to you next week.
Thanks,
Scott

C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]
From: Rogers, Michael [mailto:[e-mail]]
Sent: Friday, May 11, 2012 4:03 PM
To: Bostian, Scott
Cc: Streeter, Mike
Subject: RE: WI0300194 Exxon Mobil Charlotte Site AND OTHER SITES
Brian -
What is the status on the referenced groundwater remediation site. It is coming up on 2 months, where we've not
received the additional information we requested. Please advise. Otherwise, we will return the applications.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality -.Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
_.___,http://portal ncdenrorg/web/wo/aps/gworolpermit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:Curtis.Bostian@arcadis=us.com]
Sent: Friday, March 16, 2012 2:19 PM
To: Rogers, Michael
Subject: RE: WI0300194 Exxon Mobil Charlotte Site
Thanks for the update
We're making the corrections now and will apply those same corrections to the other applications.
Best regards,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]

From: Rogers, Michael [mailto:[e-mail]]
Sent: Friday, March 16, 2012 2:09 PM
To: Bostian, Scott
Subject: FW: WI0300194 Exxon Mobil Charlotte Site
Scott -
I just did a preliminary review of the 5I groundwater remediation permit application for the former Exxon Mobil
Facility#40563 in Charlotte. Except for a geologic x-section, I see some of the same deficiencies in this application as I
indicated in the previous e-mail for the Hendersonville site application. In all likelihood, one or more of these deficiencies
are in all of the applications we received March 2.
Therefore, I will put on hold processing all these permit applications until they include the required information per 15A
NCAC 2C .0200.
If you any questions or comments, please advise.
Regards
NOTE: On January 6th, the Aquifer Protection Section (APS) is scheduled to move to
the 6th floor of the Archdale Building located at 512 N. Salisbury Street in
Raleigh. Our mailing address will remain the same (1636 Mail Service Center,
Raleigh, _NC 27699-1636). If you need to visit APS staff or, review files, please
call or email in advance to ensure availability. Please :Check the APS website
for updates on office numbers and phone numbers as they become available.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist -
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.o[g/web/wq/aps/gwpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Rogers, Michael
Sent: Tuesday, March 13, 2012 4:50 PM
To: '[e-mail]'
Cc: Bowser, Daniel P
Subject: WI0100202 Exxon Mobil Hendersonville Site
Scott -
We received the 5I groundwater remediation permit application for the above project. A preliminary review of the application indicates
some deficiencies.
1. One of the injectants, citric acid, an activator, is not on the pre -approved injectant list. In order for this injectant to be approved,
you would need to submit a request to use this compound, along with all supporting documentation (MSDS sheets, laboratory/human
health risk assessment studies, etc.). This package would then be forwarded by us to the Occupational and Environmental
Epidemiology Section of the NC Division of Public Health for review and approval. A link to the pre -approved injectant list is below.
When you open the page, click the link to the Excel spreadsheet in the paragraph labeled 'Injection of Remediation Compounds' near
the bottom of this page.
httR: //porta I. ncden r. oro/web/wq/a os/gwpro/u is
5

2. There were no geologic cross -sections included per the requirement of Section V.H(5).
3. There was no hydrogeologic information included indicating hydraulic conductivity, transmissivity, or specific yield/porosity as per
the requirement of Section V.13(3).
4. The application was not sealed by a North Carolina licensed geologist per the requirement of 15A NCAC 2C .0211(d)(3)(D).
Please address these comments/questions within 30 days of receipt of this e-mail. Please send revised site maps/text pages in the
same format and size as the original application for insertion/replacement.
If you have any questions or comments, please advise. Thank you for your cooperation.
Regards
NOTE: On January 6th, the Aquifer Protection Section (APS) is scheduled to move to
the 6th floor of the Archdale Building located at 512 N. Salisbury Street in
Raleigh. Our mailing address will remain the same (1636 Mail Service Center,
Raleigh, NC 27699-1636). If you need to visit APS staff or review files, please
call or email in advance to ensure availability. Please check the APS website
for updates on office numbers and phone numbers as they become available.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.org/web/wg/aps/gwpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
NOTICE: This e-mail and any files transmitted with it are the property of ARCADIS U.S., Inc. and its affiliates. All rights,
including without limitation copyright, are reserved. The proprietary information contained in this 6-mail message, and any
files transmitted with it, is intended for the use of the recipient(s) named above. If the reader of this e-mail is not the
intended recipient, you are hereby notified that you have received this e-mail in error and that any review, distribution or
copying of this e-mail or any files transmitted with it is strictly prohibited. If you have received this e-mail in error, please
notify the sender immediately and delete the original message and any files transmitted. The unauthorized use of this e-
mail or any files transmitted with it is prohibited and disclaimed by ARCADIS U.S., Inc. and its affiliates. Nothing herein is
intended to constitute the offering or performance of services where otherwise restricted by law.
6

CUM, GADOT BIOCHEMICAL NDUSTRIES LTD.
MATERIAL SAFETY DATA SHEET
1. Product Identification
Chemical Product name
Trade Name
Product Code (supplier)
Supplier
Telephone number emergencies
. Citric Acid
: Citric Acid
. 0901******
: Gadot Biochemical Industries Ltd.
117-119 Hahistadrut Rd., POB 10636
Haifa Bay 26118, Israel.
: 972 4 8461 555
2. Composition / Information about dangerous components
Substances / Preparation Substances.
Chemical Name CAS Number EG number E-No. R-sentences
2 Hydroxy Propane 77-92-9 201-069-1 E-330
Tricarboxylic Acid
3. Hazards Identification
Physical / Chemical Risks
Environmental Risks
Health Risks
4. First Aid Measures
Effects and Symntoms
After swallowing
After inhalation
After skin contact
After eye contact
General
None
. None/biologically degradable.
None known.
: Large quantities may cause nausea, vomiting,
cramps, and produce acidic irritation of mouth and
throat
Coughing, sneezing and labored breathing.
Irritation.
Irritation.
. Irritation. Some allergic reactions.
Print Date: 07/04/2008 Page i of 6

GADOT BIOCHEMICAL NDUSTRIES LTD.
MATERIAL SAFETY DATA SHEET
First Aid Measures
After swallowing
Inhalation
Skin contact
Eve contact
5. Fire Fighting Measures
Extinguishing agents
Suitable
Unsuitable
Specific measures
Unusual fire/explosion risks
Dangerous thermic
decomposition and
combustion products
Protection of fire fighting
crews
: Give 2-3 glasses of water or milk to drink Induce
vomiting. Get medical attention.
Remove to fresh air. If not breathing, administer
cardio-pulmonary resuscitation or artificial
respiration. Get medical attention
Rinse with water and soap.
Rinse with water. Get medical attention
Not combustible. Use appropriate
extinguishing media for material that is
supplying fuel.
Acidic product.
: Protective clothes.
6. Accidental Release Measures
Personal protection measures
Environmental protection measures
Cleaning methods
Protection of eyes.
Dike area to prevent run-off an contamination
of water sources.
With mechanical means and/or flush with
water.
Print Date: 07/04/2008 Page 2 of 6

I'm GADOT BIOCHEMICAL NDUSTRIES LTD.
ME
MATERIAL SAFETY DATA SHEET
7. Handling and Storage
Handling ; No specific requirements.
Storage Avoid humidity and high temperatures. Note
that material is slightly hygroscopic.
Packim- Measures
Suitable Polyethylene -lined bags. drums, big bags, etc.
8. Exposure Control and Personal Protection
Technical Exposure control
Hygienic measures
Dust masks.
Upper professional exposure limits
Chemical Name
"TLV" (USA)
"MAK"(Germany)
Personal protection measures
Breathing equipment
Dust masks.
Skin and body
Clothes.
Hands
Gloves.
Eyes
Safety glasses.
9. Physical and Chemical Properties:
Appearance
Colour
Smell
Boiling \ Melting point
pH
Solubility in water
Dry granulates.
White.
No unusual odour.
Solid.
(5% solution) - 1.8
162 gr./100 ml/ at 25' C
Print Date: 07/04/2008 Page 3 of 6

GADOT BIOCHEMICAL NDUSTRIES LTD.
MATERIAL SAFETY DATA SHEET
Vapor pressure (air = 1) : Practically zero
Vapor density (air = 1) : 6.8
Flash point Not combustible.
Ignition temperature 1011 degrees Celsius
Lower explosion limit -280
Upper explosion limit -2290
10. Stability and Reactivity
Stability : Stable.
Circumstances to be avoided -
Substances to be avoided May react vigorously with strong and
concentrated bases.
Dangerous decomposition products Not known.
11. Toxicological Information
Chemical Name
Acute to-vicitr IVN-RBT LD50 330 mg kg"'
Oral ORL-RAT LD50 11700 mg kg
ORL-MUS LD50 5040 mg kg
ORL-RBT LDLO 7000 mg kg '
Dermal : IPR-RAT LD50 883 mg kg "'
SCU-RAT LDLO 7000 mg kg
Breathing wise
Eye effects Causes irritation.
Skin effects May cause irritation.
Sensitivity
Chronic Toxicity
Carcinogenicity None known.
Print Date: o7/wnooa Page 4 of 6

Ga, GADOT BIOCHEMICAL NDUSTRIES LTD.
MATERIAL SAFETY DATA SHEET
12. Ecological Information
Ecological details of substance are not available.
Chemical Name
Ecotoxicity
Exotoxicity
13. Instructions for Disposal
Disposal methods
14. Transport Information
UN Number
Road & Rail Transport
ADR/RID Class
ADR/RID Class
Inland waterways
ADNR Class
Sea transport
IMDG Page number
Air Transport
IATA Class
National transport laws
Print Date: 07ro4'2008 Page 5 of 6

Loa ' GADOT BIOCHEMICAL NDUSTRIES LTD.
MATERIAL SAFETY DATA SHEET
15. Legally Required Information
Danger designation
Safety phrases
Risk phrases
*National Regulations
16. Other Information
History
Date of first issue
Date of last issue
Date of issue
MSDS composed by
On behalf of:
Warranty
10.03.96
June 5"', 2007
: Mr. Nissim Guigui
Quality Assurance Manager
Gadot Biochemical Industries Ltd
Haifa / Israel.
Gadot Biochemical Industries Ltd
This information herein given in good faith and to the best of our knowledge. Since we have no control
over the use of the product, we make no warrantee or representation, expressed or implied, other than that it
conforms to the chemical description on its label. No agent, representative or employee of Gadot
Biochemical Industries Ltd. is authorized to change any terms of this notice.
Print Date: 07/04/2008 Page 6 of 6

Please reduee your browser font slze for better vieMng and printing.
2A Hour ErnergencyTelephone: ON-859-2151
CHEWREC:1. *0.424.930D
SD5 Material Safe! Data Sheet CANOUTEC:51 onRosnada
fluisldo D.S. and Canada
Chemtree: 202 03-7616
From. Mallinekrodt Baker, Ino.
222 Red School Lano NALLINCKRODT J.T.Baker HOTS: so ConTREC, CANUTEc and National
tob
Rcs�onso Can;ar emotllanc) numbers to bo
Phillipsburg, NJ 0005 used onry In the mvntol chenirsr errergendes
invalving a spll, leak. rite, oxpowio or atcidenl
involving chsn•.cals.
All nod -emergency queslions should be directed to Customer Service (1.800-582-2537) for assistance.
FERROUS SULFATE
MSDS Number: F1802 --- Effective Date: 03101100
1. Product Identification
Synonyms: Iron (II) sulfate (1:1), heptahydrate; sulfuric acid, iron (2+) salt (1:1), heptahydrate
CAS No.: 7720-78-7
Molecular Weight: 278
Chemical Formula: FeSO4 71-12O
Product Codes:
J.T. Baker: 2070, 2074, 2075, 5830
Mallinckrodt: 5055, 5056, 5401, 5572
2. Composition/Information on Ingredients
Ingredient
---------------------------------------
CAS No
------------
Percent
-------
Hazardous
---------
Ferrous Sulfate
7720-78-7
99 — 100%
Yes
3. Hazards Identification
Emergency Overview
WARNING! HARMFUL IF SWALLOWED OR INHALED. CAUSES IRRITATION TO
SKIN, EYES AND RESPIRATORY TRACT. AFFECTS THE LIVER.
J.T. Baker SAF T-DATA(tn') Ratings (Provided here for your convenience)
Health Rating: 1- Slight
Flammability Rating: 0 - None
Reactivity Rating: 0 - None
Contact Rating: 0 - None
Lab Protective Equip: GOGGLES; LAB COAT

Storage Color Code: Orange (General Storage)
Potential Health Effects
Inhalation:
Causes irritation to the respiratory tract. Symptoms may include coughing, shortness of breath.
Ingestion:
Low toxicity in small quantities but larger dosages may cause nausea, vomiting, diarrhea, and
black stool. Pink urine discoloration is a strong indicator of iron poisoning. Liver damage, coma,
and death from iron poisoning has been recorded. Smaller doses are much more toxic to children.
Skin Contact:
Causes irritation to skin. Symptoms include redness, itching, and pain.
Eye Contact:
Causes irritation, redness, and pain.
Chronic Exposure:
Severe or chronic ferrous sulfate poisonings may damage blood vessels. Large chronic doses cause
rickets in infants. Chronic exposure may cause liver effects. Prolonged exposure of the eyes may
cause discoloration.
Aggravation of Pre-existing Conditions:
Persons with pre-existing skin disorders or eye problems, or impaired liver, kidney or respiratory
function may be more susceptible to the effects of the substance.
4. First Aid Measures
Inhalation:
Remove to fresh air. If not breathing, give artificial respiration. If breathing is difficult, give
oxygen. Get medical attention.
Ingestion:
Induce vomiting immediately as directed by medical personnel. Never give anything by mouth to
an unconscious person. Get medical attention.
Skin Contact:
Immediately flush skin with plenty of soap and water for at least 15 minutes. Remove
contaminated clothing and shoes. Get medical attention. Wash clothing before reuse. Thoroughly
clean shoes before reuse.
Eye Contact:
Immediately flush eyes with plenty of water for at least 15 minutes, lifting lower and upper eyelids
occasionally. Get medical attention immediately.
5. Fire Fighting Measures
Fire:
Not considered to be a fire hazard.
Explosion:
Not considered to be an explosion hazard.
Fire Extinguishing Media:
Use any means suitable for extinguishing surrounding fire.
Special Information:
Use protective clothing and breathing equipment appropriate for the surrounding fire.

6. Accidental Release Measures
Ventilate area of leak or spill. Wear appropriate personal protective equipment as specified in
Section 8. Spills: Pick up and place in a suitable container for reclamation or disposal, using a
method that does not generate dust. US Regulations (CERCLA) require reporting spills and
releases to soil, water and air in excess of reportable quantities. The toll free number for the US
Coast Guard National Response Center is [phone].
7. Handling and Storage
Keep in.a tightly closed container, stored in a cool, dry, ventilated area. Protect against physical
damage. Maintain a constant temperature not to exceed 24 degrees centigrade (75 degrees
fahrenheit). Fluctuating temperatures causes product oxidation. Do not use this product if coated
with brownish -yellow basic ferric sulfate. Isolate from incompatible substances. Containers of this
material may be hazardous when empty since they retain product residues (dust, solids); observe
all warnings and precautions listed for the product.
8. Exposure Controls/Personal Protection
Airborne Exposure Limits:
-ACGIH Threshold Limit Value (TLV):
1 mg/m3 (TWA) soluble iron salt as Fe
Ventilation System:
A system of local and/or general exhaust is recommended to keep employee exposures below the
Airborne Exposure Limits. Local exhaust ventilation is generally preferred because it can control
the emissions of the contaminant at its source, preventing dispersion of it into the general work
area. Please refer to the ACGIH document, Industrial Ventilation, A Manual of Recommended
Practices, most recent edition, for details.
Personal Respirators (NIOSH Approved):
If the exposure limit is exceeded, a half -face dust/mist respirator may be worn for up to ten times
the exposure limit or the maximum use concentration specified by the appropriate regulatory
agency or respirator supplier, whichever is lowest. A full -face piece dust/mist respirator may be
worn up to 50 times the exposure limit, or the maximum use concentration specified by the
appropriate regulatory agency, or respirator supplier, whichever is lowest. For emergencies or
instances where the exposure levels are not known, use a full-facepiece positive -pressure, air -
supplied respirator. WARNING: Air -purifying respirators do not protect workers in oxygen -
deficient atmospheres.
Skin Protection:
Wear impervious protective clothing, including boots, gloves, lab coat, apron or coveralls, as
appropriate, to prevent skin contact.
Eye Protection:
Use chemical safety goggles and/or full face shield where dusting or splashing of solutions is
possible. Maintain eye wash fountain and quick -drench facilities in work area.
9. Physical and Chemical Properties
Appearance:
Blue green crystals.
Odor:
Odorless.

Solubility:
48.6 g/100 g water @ 50C (122F)
Density:
1.90
pH:
No information found.
% Volatiles by volume @ 21C (70F):
0
Boiling Point:
> 300C (> 572F) Decomposes.
Melting Point:
57C (135F) Loses water
Vapor Density (Air=1):
No information found.
Vapor Pressure (mm Hg):
No information found.
Evaporation Rate (BuAc=1):
No information found.
10. Stability and Reactivity
Stability:
Stable under ordinary conditions of use and storage. Looses water in dry air and oxidizes upon
exposure to moisture, forming a brown coating of extremely corrosive basic ferric sulfate.
Hazardous Decomposition Products:
Burning may produce sulfur oxides.
Hazardous Polymerization:
This substance does not polymerize.
Incompatibilities:
Alkalis, soluble carbonates, and oxidizing materials. Reacts in moist air to form ferric sulfate.
Conditions to Avoid:
Moisture.
11. Toxicological Information
Oral rat LD50: 319 mg/kg. Investigated as a tumorigen and mutagen.
--------\Cancer Lists\ ------------------------------------------------------
Ingredient
------------------------------------
Ferrous Sulfate (7720-78-7)
12. Ecological Information
Environmental Fate:
No information found.
Environmental Toxicity:
No information found.
---NTP Carcinogen ---
Known Anticipated
----- -----------
No
No
IARC Category
-------------
None

13. Disposal Considerations
Whatever cannot be saved for recovery or recycling should be managed in an appropriate and
approved waste disposal facility. Processing, use or contamination of this product may change the
waste management options. State and local disposal regulations may differ from federal disposal
regulations. Dispose of container and unused contents in accordance with federal, state and local
requirements.
14. Transport Information
Not regulated.
15. Regulatory Information
--------\Chemical Inventory Status - Part 1\ --------------------------------
Ingredient
TSCA
EC Japan
Australia
-----------------------------------------------
Ferrous Sulfate (7720-78-7)
----
Yes
--- -----
Yes Yes
---------
Yes
--------\Chemical Inventory Status - Part 2\-=------------------------------
--Canada--
Ingredient
Korea
DSL NDSL
Phil.
-----------------------------------------------
Ferrous Sulfate (7720-78-7)
-----
Yes
--- ----
Yes No
-----
Yes
--------\Federal, State & International
Regulations -
Part 1\ ---------------
-SARA 302-
------SARA
313-----
Ingredient
RQ TPQ
List Chemical
Catg.
-----------------------------------------
--- -----
---- -------------
Ferrous Sulfate (7720-78-7)
No No No No
--------\Federal, State & International Regulations - Part 2\ ---------------
-RCRA- -TSCA-
Ingredient CERCLA 261.33 8(d)
----------------------------------------- ------ ------ ------
Ferrous Sulfate (7720-78-7) 1000 No No
Chemical Weapons Convention: No TSCA 12(b): No CDTA: No
SARA 311/312: Acute: Yes Chronic: Yes Fire: No Pressure: No
Reactivity: No (Mixture / Solid)_
Australian Hazchem Code: No information found.
Poison Schedule: No information found.
WHMIS:

This MSDS has been prepared according to the hazard criteria of the Controlled Products
Regulations (CPR) and the MSDS contains all of the information required by the CPR.
16. Other Information
NFPA Ratings: Health:1 Flammability: 0 Reactivity: 0
Label Hazard Warning:
WARNING! HARMFUL IF SWALLOWED OR INHALED. CAUSES IRRITATION TO SKIN,
EYES AND RESPIRATORY TRACT. AFFECTS THE LIVER.
Label Precautions:
Avoid contact with eyes, skin and clothing.
Wash thoroughly after handling.
Avoid breathing dust.
Keep container closed.
Use only with adequate ventilation.
Label First Aid:
If swallowed, induce vomiting immediately as directed by medical personnel. Never give anything
by mouth to an unconscious person. If inhaled, remove to fresh air. If not breathing, give artificial
respiration. If breathing is difficult, give oxygen. In case of contact, immediately flush eyes or skin
with plenty of water for at least 15 minutes. Remove contaminated clothing and shoes. Wash
clothing before reuse. In all cases, get medical attention.
Product Use:
Laboratory Reagent. Bulk pharmaceutical chemical.
Revision Information:
No changes.
Disclaimer:
*****************
Mallinckrodt Baker, Inc. provides the information contained.herein in good faith but makes
no representation as to its comprehensiveness or accuracy. This document is intended only
as a guide to the appropriate precautionary handling of the material by a properly trained
person using this product. Individuals receiving the information must exercise their
independent judgment in determining its appropriateness for a particular purpose.
MALLINCKRODT BAKER, INC. MAKES NO REPRESENTATIONS OR
WARRANTIES, EITHER EXPRESS OR IMPLIED, INCLUDING WITHOUT
LIMITATION ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A
PARTICULAR PURPOSE WITH RESPECT TO THE INFORMATION SET FORTH
HEREIN OR THE PRODUCT TO WHICH THE INFORMATION REFERS.
ACCORDINGLY, MALLINCKRODT BAKER, INC. WILL NOT BE RESPONSIBLE
FOR DAMAGES RESULTING FROM USE OF OR RELIANCE UPON THIS
INFORMATION.
*****************
Prepared by: Strategic Services Division
Phone Number: [phone] (U.S.A.)

MATERIAL SAFETY DATA SHEET
KlozurTM
MSDS Ref. No.: 7775-27-1-12
*MC Date Approved: 02/22/2005
Revision No.: 1
This document has been prepared to meet the requirements of the U.S. OSHA Hazard Communication
Standard, 29 CFR 1910.1200; the Canada's Workplace Hazardous Materials Information System (WHMIS)
and, the EC Directive, 2001/58/EC.
1. PRODUCT AND COMPANY IDENTIFICATION
PRODUCT NAME:
SYNONYMS:
GENERAL USE:
FMC CORPORATION
Active Oxidants Division
1735 Market Street
Philadelphia, PA 19103
[phone] (General Information)
KloziirTm
Sodium Persulfate, Sodium Peroxydisulfate; Disodium
Peroxydisulfate
In situ and ex situ chemical oxidation of contaminants and
compounds of concern for environmental remediation applications.
EMERGENCY TELEPHONE NUMBERS
[phone] (CHEMTREC - U.S.)
[phone] (Medical - Call Collect)
2. HAZARDS IDENTIFICATION
EMERGENCY OVERVIEW:
• White, odorless, crystals
• Oxidizer.
• Decomposes in storage under conditions of moisture (water/water vapor) and/or excessive heat causing
release of oxides of sulfur and oxygen that supports combustion. Decomposition could form a high
temperature melt. See Section 10 ("Stability and Reactivity").
POTENTIAL HEALTH EFFECTS: Airborne persulfate dust may be irritating to eyes,
nose, lungs, throat and skin upon contact. Exposure to high levels of persulfate dust may cause difficulty in
breathing in sensitive persons.
Page i of 9

KloziirTM (7775-27-1-12)
Date: 02/22/2005
3. COMPOSITION / INFORMATION ON INGREDIENTS
Chemical Name
CAS#
Wt.%
EC No.
EC Class
Sodium Persulfate
7775-27-1
1 >99
231-892-1
1 Not classified as hazardous
4. FIRST AID MEASURES
EYES: Flush with plenty of water. Get medical attention if irritation occurs and persists.
SKIN: Wash with plenty of soap and water. Get medical attention if irritation occurs and persists.
INGESTION: Rinse mouth with water. Dilute by giving 1 or 2 glasses of water. Do not induce
vomiting. Never give anything by mouth to an unconscious person. See a medical doctor immediately.
INHALATION: Remove to fresh air. If breathing difficulty or discomfort occurs and persists,
contact a medical doctor.
NOTES TO MEDICAL DOCTOR: This product has low oral toxicity and is not irritating to
the eyes and skin. Flooding of exposed areas with water is suggested, but gastric lavage or emesis
induction for ingestions must consider possible aggravation of esophageal injury and the expected absence
of system effects. Treatment is controlled removal of exposure followed by symptomatic and supportive
care.
5. FIRE FIGHTING MEASURES
EXTINGUISHING MEDIA: Deluge with water.
FIRE / EXPLOSION HAZARDS: Product is non-combustible. On decomposition releases
oxygen which may intensify fire. Presence of water accelerates decomposition.
FIRE FIGHTING PROCEDURES: Do not use carbon dioxide or other gas filled fire
extinguishers; they will have no effect on decomposing persulfates. Wear full protective clothing and self-
contained breathing apparatus.
FLAMMABLE LIMITS: Non-combustible
SENSITIVITY TO IMPACT: No data available
Page 2 of 9

KloziirTM (7775-27-1-12)
SENSITIVITY TO STATIC DISCHARGE: Not available
6. ACCIDENTAL RELEASE MEASURES
Date: 02/22/2005
RELEASE NOTES: Spilled material should be collected and put in approved DOT container and
isolated for disposal. Isolated material should be monitored for signs of decomposition (finning/smoking).
If spilled material is wet, dissolve with large quantity of water and dispose as a hazardous waste. All
disposals should be carried out according to regulatory agencies procedures.
7. HANDLING AND STORAGE
HANDLING: Use adequate ventilation when transferring product from bags or drums. Wear
respiratory protection if ventilation is inadequate or not available. Use eye and skin protection. Use clean
plastic or stainless steel scoops only.
STORAGE: Store (unopened) in a cool, clean, dry place away from point sources of heat, e.g.
radiant heaters or steam pipes. Use first in, first out storage system. Avoid contamination of opened
product. In case of fire or decomposition (fuming/smoking) deluge with plenty of water to control
decomposition. For storage, refer to NFPA Bulletin 430 on storage of liquid and solid oxidizing materials.
COMMENTS: VENTILATION: Provide mechanical general and/or local exhaust ventilation to
prevent release of dust into work environment. Spills should be collected into suitable containers to prevent
dispersion into the air.
8. EXPOSURE CONTROLS / PERSONAL PROTECTION
EXPOSURE LIMITS
Chemical Name
ACGIH
OSHA
Supplier
Sodium Persulfate
0.1 mg/m3 (TWA)
ENGINEERING CONTROLS: Provide mechanical local general room ventilation to
prevent release of dust into the work environment. Remove contaminated clothing immediately and wash
before reuse.
PERSONAL PROTECTIVE EQUIPMENT
EYES AND FACE: Use cup type chemical goggles. Full face shield may be used.
RESPIRATORY: Use approved dust respirator when airborne dust is expected.
Page 3 of 9

KloziirTM (7775-27-1-12)
Date: 02/22/2005
PROTECTIVE CLOTHING: Normal work clothes. Rubber or neoprene footwear.
GLOVES: Rubber or neoprene gloves. Thoroughly wash the outside of gloves with soap and
water prior to removal. Inspect regularly for leaks.
9. PHYSICAL AND CHEMICAL PROPERTIES
ODOR: None
APPEARANCE:
AUTOIGNITION TEMPERATURE:
BOILING POINT:
COEFFICIENT OF OIL / WATER:
DENSITY / WEIGHT PER VOLUME:
EVAPORATION RATE:
FLASH POINT:
MELTING POINT:
ODOR THRESHOLD:
OXIDIZING PROPERTIES:
PERCENT VOLATILE:.
PH:
SOLUBILITY IN WATER:
SPECIFIC GRAVITY:
VAPOR DENSITY:
VAPOR PRESSURE:
White crystals
Not applicable. No evidence of combustion up to 800°C.
Decomposition will occur upon heating.
Not applicable
Not applicable
Not available
Not applicable (Butyl Acetate = 1)
Non-combustible
Decomposes
Not applicable
Oxidizer
Not applicable
typically 5.0 - 7.0 @ 25 °C (1% solution)
73 % @ 25 °C (by wt.)
2.6 (H2O=1)
Not applicable (Air = 1)
Not applicable
10. STABILITY AND REACTIVITY
CONDITIONS TO AVOID:
STABILITY:
POLYMERIZATION:
INCOMPATIBLE MATERIALS:
Page 4 of 9
Heat, moisture and contamination.
Stable (becomes unstable in presence of heat,
moisture and/or contamination).
Will not occur
Acids, alkalis, halides (fluorides, chlorides,
bromides and iodides), combustible materials, most
metals and heavy metals, oxidizable materials,
other oxidizers, reducing agents, cleaners, and
organic or carbon containing compounds. Contact

KlozdrTM (7775-27-1-12) Date: 02/22/2005
with incompatible materials can result in a material
decomposition or other uncontrolled reactions.
HAZARDOUS DECOMPOSITION PRODUCTS: Oxygen that supports combustion and oxides of
sulfur.
COMMENTS: PRECAUTIONARY STATEMENT: Pumping and transport of Klozur persulfate
requires appropriate precautions and design considerations for pressure and thermal relief.
Decomposing persulfates will evolve large volumes of gas and/or vapor, can accelerate exponentially with
heat generation, and create significant and hazardous pressures if contained and not properly controlled or
mitigated.
Use with alcohols in the presence of water has been demonstrated to generate conditions that require
rigorous adherence to process safety methods and standards to prevent escalation to an uncontrolled
reaction.
11. TOXICOLOGICAL INFORMATION
EYE EFFECTS: Non -irritating (rabbit) [FMC Study Number: ICG/T-79.0291
SKIN EFFECTS: Non -irritating (rabbit) [FMC Study Number: ICG/T-79.029]
DERMAL LD50: > 10 g/kg [FMC Study Number: ICG/T-79.0291
ORAL LD50: 895 mg/kg (rat) [FMC Study Number: ICG/T-79.0291
INHALATION LC50: 5.1 mg/1(rat) [FMC 195-2017]
SENSITIZATION: May be sensitizing to allergic persons. [FMC Study Number: ICG/T-79.029]
TARGET ORGANS: Eyes, skin, respiratory passages
ACUTE EFFECTS FROM OVEREXPOSURE: Dust may be harmful and irritating.
May be harmful if swallowed.
CHRONIC EFFECTS FROM OVEREXPOSURE: Sensitive persons may develop
dermatitis and asthma [Respiration 38:144, 19791. Groups of male and female rats were fed 0, 300 or 3000
ppm sodium persulfate in the diet for 13 weeks, followed by 5000 ppm for 5 weeks. Microscopic
examination of tissues revealed some injury to the gastrointestinal tract at the high dose (3000 ppm) only.
This effect is not unexpected for an oxidizer at high concentrations. [Ref. FMC I90-1151, Toxicologist
1:149, 1981].
Page 5 of 9

Kloz&TM (7775-27-1-12) Date: 02/22/2005
CARCINOGENICITY:
NTP:
Not listed
IARC:
Not listed
OSHA:
Not listed
OTHER:
ACGIH: Not listed
12. ECOLOGICAL INFORMATION
ECOTOXICOLOGICAL INFORMATION:
Bluegill sunfish, 96-hour LC50 = 771 mg/L [FMC Study I92-12501
Rainbow trout, 96-hour LC50 = 163 mg/L [FMC Study I92-12511
Daphnia, 48-hour LC50 = 133 mg/L [FMC Study I92-12521
Grass shrimp, 96-hour LC50 = 519 mg/L [FMC Study I92-12531
CHEMICAL FATE INFORMATION: Biodegradability does not apply to inorganic
substances.
13. DISPOSAL CONSIDERATIONS
DISPOSAL METHOD: Dispose as a hazardous waste in accordance with local, state and federal
regulatory agencies.
14. TRANSPORT INFORMATION
U.S. DEPARTMENT OF TRANSPORTATION (DOT)
PROPER SHIPPING NAME:
PRIMARY HAZARD CLASS / DIVISION:
UN/NA NUMBER:
PACKING GROUP:
LABEL(S):
PLACARD(S):
MARKING(S):
ADDITIONAL INFORMATION:
Sodium Persulfate
5.1 (Oxidizer)
UN 1505
III
5.1 (Oxidizer)
5.1 (Oxidizer)
Sodium Persulfate, UN 1505
Hazardous Substance/RQ: Not applicable
Page 6 of 9

KlozurTm (7775-27-1-12)
Date: 02/22/2005
49 STCC Number: 4918733
This material is shipped in 225 lb. fiber
drums, 55 lb. poly bags and 1000 - 2200 lb.
IBC's (supersacks).
INTERNATIONAL MARITIME DANGEROUS GOODS (IMDG)
PROPER SHIPPING NAME: Sodium Persulfate
INTERNATIONAL CIVIL AVIATION ORGANIZATION (ICAO) /
INTERNATIONAL AIR TRANSPORT ASSOCIATION (IATA)
PROPER SHIPPING NAME: Sodium Persulfate
OTHER INFORMATION:
Protect from physical damage. Do not store near acids, moisture or heat.
15. REGULATORY INFORMATION
UNITED STATES
SARA TITLE III (SUPERFUND AMENDMENTS AND REAUTHORIZATION ACT)
SECTION 302 EXTREMELY HAZARDOUS SUBSTANCES (40 CFR 355, APPENDIX A):
Not applicable
SECTION 311 HAZARD CATEGORIES (40 CFR 370):
Fire Hazard, Immediate (Acute) Health Hazard
SECTION 312 THRESHOLD PLANNING QUANTITY (40 CFR 370):
The Threshold Planning Quantity (TPQ) for this product, if treated as a mixture, is 10,000 lbs;
however, this product contains the following ingredients with a TPQ of less than 10,000 lbs.:
None
SECTION 313 REPORTABLE INGREDIENTS (40 CFR 372):
Not listed
CERCLA (COMPREHENSIVE ENVIRONMENTAL RESPONSE COMPENSATION AND
LIABILITY ACT)
CERCLA DESIGNATION & REPORTABLE QUANTITIES (RQ) (40 CFR 302.4):
Unlisted, RQ = 100 lbs., Ignitability
TSCA (TOXIC SUBSTANCE CONTROL ACT)
TSCA INVENTORY STATUS (40 CFR 710):
Page 7 of 9

KloziirTM (7775-27-1-12) Date: 02/22/2005
Listed
RESOURCE CONSERVATION AND RECOVERY ACT (RCRA)
RCRA IDENTIFICATION OF HAZARDOUS WASTE (40 CFR 261):
Waste Number: D001
CANADA
WHMIS (WORKPLACE HAZARDOUS MATERIALS INFORMATION SYSTEM):
Product Identification Number: 1505
Hazard Classification / Division: Class C (Oxidizer), Class D, Div. 2, Subdiv. B. (Toxic)
Ingredient Disclosure List: Listed
INTERNATIONAL LISTINGS
Sodium persulfate:
Australia (AICS): Listed
China: Listed
Japan (ENCS): (1)-1131
Korea: KE-12369
Philippines (PICCS): Listed
HAZARD, RISK AND SAFETY PHRASE DESCRIPTIONS:
EC Symbols: (Not classified as hazardous)
EC Risk Phrases: (Not classified as hazardous)
EC Safety Phrases: (Not classified as hazardous)
16. OTHER INFORMATION
HMIS
Health
1
Flammability
0
Physical Hazard
1
Personal Protection (PPE)
J
Protection = J (Safety goggles, gloves, apron & combination dust & vapor respirator)
HMIS = Hazardous Materials Identification System
Degree of Hazard Code:
4 = Severe
Page 8 of 9

KloziirTM (7775-27-1-12)
3 = Serious
2 = Moderate
1 = Slight
0 = Minimal
NFPA
Health
1
Flammability
0
Reactivity
1
Special
OX
SPECIAL = OX (Oxidizer)
NFPA = National Fire Protection Association
Degree of Hazard Code:
4 = Extreme
3 = High
2 = Moderate
1 = Slight
0 = Insignificant
REVISION SUMMARY:
New MSDS
Klozur and FMC Logo - FMC Trademarks
© 2005 FMC Corporation. All Rights Reserved.
Date: 02/22/2005
FMC Corporation believes that the information and recommendations contained herein (including data and
statements) are accurate as of the date hereof. NO WARRANTY OF FITNESS FOR ANY PARTICULAR
PURPOSE, WARRANTY OF MERCHANTABILITY, OR ANY OTHER WARRANTY, EXPRESSED
OR IMPLIED, IS MADE CONCERNING THE INFORMATION PROVIDED HEREIN. The information
provided herein relates only to the specific product designated and may not be applicable where such
product is used in combination with any other materials or in any process. It is a violation of Federal law to
use this product in a manner inconsistent with its labeling. Further, since the conditions and methods of use
are beyond the control of FMC Corporation, FMC Corporation expressly disclaims any and all liability as
to any results obtained or arising from any use of the product or reliance on such information.
Page 9 of 9

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'Asl 'N `\
EXXON
STATION
MW3R 5�0�
(<0.50)
m
LEGEND
— -- — -- — PROPERTY BOUNDARY
1 UNDERGROUND STORAGE TANK
MONITORING WELL
SOIL VAPOR EXTRACTION WELL
m AIR SPARGE WELL
(<0.50) ETHYLENE DICHLORIDE CONCENTRATION IN GROUNDWATER (pg/1)
400 � ETHYLENE DICHLORIDE ISOCONCENTRATION
CONTOUR (pg/1) (400 MICROGRAMS PER
LITER (pug/1) = NORTH CAROLINA GROSS
CONTAMINATION LEVEL FOR GROUNDWATER)
< NON —DETECT (REPORTING LIMIT LISTED)
NOTE:
BASE MAP PREPARED FROM A DRAWING PROVIDED
BY GES; DATED APRIL 16, 2010; SCALE 1 "=40'
0 40' 80'
GRAPHIC SCALE
EXXONMOBIL ENVIRONMENTAL SERVICES
EXXONMOBIL SERVICE STATION #4-5552
1920 CHIMNEY ROCK ROAD, HENDERSONVILLE, NC
SEMI-ANNUAL CORRECTIVE ACTION PLAN MONITORING REPOR
ETHYLENE DICHLORIDE
ISOCONCENTRATION MAP
MARCH 2O11
ARCADIS � e`

404
sDW1
REALTY OFFICE
W-2R INJ-1 `�\\ �o�o 4MW6 /
EXXON
oFti MDPE STATION
\ T NKER G� /
-�
LEGEND
------- PROPERTY BOUNDARY
----- UNDERGROUND STORAGE TANK
MONITORING WELL
SOIL VAPOR EXTRACTION WELL
m AIR SPARGE WELL
QQ CHEMICAL INJECTION WELL
NOTE:
BASE MAP PREPARED FROM A DRAWING PROVIDED
BY GES; DATED APRIL 16, 2010; SCALE 1 "=40'
0 40' 80'
GRAPHIC SCALE

GROUND SURFACE: 50
TOP OF RISER PIPE: 49
TOP OF SEAL:
BOTTOM OF SEAL:
TOP OF SCREEN:
BOTTOM OF SCREEN:
BOTTOM OF WELL SUMP:
BOTTOM OF BOREHOLE:
LUSH MOUNTED COVER
OCKING CAP
ISER PIPE:
" Diameter Sch. 40 PVC
ROUT:
ement—Bentonite Mixture
(ELL SEAL:
OREHOLE DIAMETER:
.25"
RAIDED SAND PACK:
CREEN PIPE:
" Diameter Sch. 40 PVC
CREEN SLOT SIZE:
.02"
EXXONMOBIL ENVIRONMENTAL SERVICES
EXXONMOBIL SERVICE STATION #4-5552
1920 CHIMNEY ROCK ROAD, HENDERSONVILLE, NC
TYPICAL INJECTION WELL
CONSTRUCTION DIAGRAM
F? ARCADIS a

4MW8
\ cr MDPE
TANKER
I
BQ MW4/ /
WDW 1
REALTY OFFICE
wlimwi
1
W6 '
EXXON
A'
STATION
G
e3R y`p�
m /
�l
LEGEND
------- PROPERTY BOUNDARY
------ UNDERGROUND STORAGE TANK
19 MONITORING WELL
0 SOIL VAPOR EXTRACTION WELL
m AIR SPARGE WELL
Q CHEMICAL INJECTION WELL (PROPOSED)
NOTE:
BASE MAP PREPARED FROM A DRAWING PROVIDED
BY GES; DATED APRIL 16, 2010; SCALE 1"=40'
0 40' 80'
GRAPHIC SCALE

A
NORTHWEST
10(
95
F-
W
W
L�
Z
Z
O
H
Q
>
W
J
W
70
55
WATER
MW-5
TOC: 97.76'
TD: 25.0'
BE: 72.76'
ALT
MW-1
TOC: 97.50'
TD: 25.0'
BE: 72.50'
MW-6
TOC: 98.53'
TD: 25.0'
BE: 73.53'
r.
TANK PIT f
(UNKNOWN DEPTH)
f
f0j5jj
. .
. .
.
.
. .
. .
. .
so
:
1111.00
y3
MW-5
MW-1
MW-6
3-30-11
3-30-11
0
<0.50
6.53B
<1.00
<1.00
<0.50
rB
<0.50
T
<1.00
<0.50
rE
<0.50
E
<1.00
<1.00
<1.00X
<3.00
M <0.50
<0.50
M
I <1.00
LEGEND:
CASING
EN INTERVAL
limSILTY SAND
NOTES
TOC
TOP OF CASING
TD
TOTAL DEPTH
BE
BOTTEM ELEVATION
B
BENZENE
T
TOLUENE
E
ETHYLBENZENE
X
I TOTAL XYLENES
M
METHYL TERTIARY —BUTYL ETHER
A'
SOUTHEAST
00
95
70
55
GCLs
B
5,000
T
260,000
E
84,500
X
85,500
M
20,000
GCL: GROSS CONTAMINATION LEVELS
CONCENTRATIONS ARE REPORTED IN
MICROGRAMS PER LITER (ug/L)
ESTIMATED GROUNDWATER
ELEVATION CONTOUR
NOTES:
1. MW-6 DISCONTINUED FROM GROUNDWATER SAMPLING
SCHEDULE IN 2011 AS DISSOLVED —PHASE CHEMICALS
OF CONCERN WERE HISTORICALLY BELOW THE GCL
STANDARD AND/OR NOT DETECTED.
2. WATER LEVELS MEASURED 3-30-2011.
0 30' 60'
GRAPHIC SCALE

H
w
W
w
z
z
0
F-
W
J
W
i
B
SOUTHWEST
95
9
55
MW-4
DW-1
TOC: 98.74'
TOC:98.07'
TD: 25.0'
TD: 37.0'
BE: 73.74'
BE: 61.07'
I
I��J
I
I
0 0 0 �!
0 0 0 NORTHEAST
0 0 0
MW-2R a v MW-9 v MW-1 MW-7
TOC:97.68' n 4 TOC:98.18' TOC: 97.50' TOC: 94.94'
TD: 40.0' -13 TD: 40.0' TD: 25.0' TD: 25.0'
BE: 57.68' z z BE: 58.18' z_ BE: 72.50' BE: 69.94'
ASPHALT I I
100
95
TANK
PIT*
90
U�W­11
ENCOUNTERED
AT 37.0' BELOW
LAND SURFACE
AT DW-1
LEGEND:
WELL CASING
SCREEN INTERVAL
WATER LEVEL
SILTY SAND
*: UNKNOWN DEPTH
NOTES
TOC
TOP OF CASING
TO
TOTAL DEPTH
BE
BOTTOM ELEVATION
B
BENZENE
T
TOLUENE
E
I ETHYLBENZENE
X
TOTAL XYLENES
M
METHYL TERTIARY -BUTYL ETHER
NO
NOT DETECTED
GCLs
B
5,000
T
260,000
E
84,500
X
85,500
M 20,000
GCL: GROSS CONTAMINATION LEVELS
ND: NOT DETECTED
CONCENTRATIONS ARE REPORTED IN
MICROGRAMS PER LITER (ug/L)
5,000 ESTIMATED EXTENT OF
BENZENE GCL EXCEEDANCE
ESTIMATED GROUNDWATER
ELEVATION CONTOUR
NL NOT LOCATED
BOLD = GCL EXCEEDANCE
w
w
w
30 z
z
0
75
w
ui
W
70
65
55
NOTES:
1. MW-7 LAST LOCATED IN SEPTEMBER 1993.
HISTORICALLY DISSOLVED -PHASE CHEMICALS OF
CONCERN WERE NOT DETECTED AT MW-7.
2. DW-1 LAST SAMPLED IN 1995. HISTORICALLY
DISSOLVED -PHASE CHEMICALS OF CONCERN WERE
BELOW GCLs OR NOT DETECTED AT DW-1.
3. WATER LEVELS MEASURED 3-30-2011.
4. LITHOLOGY FOR MW-2R AND MW-9 ESTIMATED BASED
ON BORING LOGS FROM MW-2.
5. ACTUAL INJECTION WELL SCREENED INTERVALS WILL
BE ADJUSTED BASED ON WATER LEVELS.
0 30' 60'
GRAPHIC SCALE

ARCADIS
RECEiVEDIDENRIDWC,
JUN 15 2012
ARCADIS G&M of North Carolina,
Infrastructure Water Environment • Buildings
Aquifer Protection Section
Inc.
801 Corporate Center Drive
Suite 300
Raleigh
Mr. Michael Rogers
North Carolina 27607
Tel [phone]
North Carolina Department of Environment and Natural Resources
Fax [phone]
Division of Water Quality
www.arcadis-us.com
Aquifer Protection Section
1636 Mail Service Center
Raleigh, North Carolina, 27699
ENVRIONMENT
Subject: — ''016 d
Additional Information Request Date:
Former Exxon Facility #45552 June 14, 2012
1920 Chimney Rock Road
Hendersonville, North Carolina
Contact:
Groundwater Incident #9644 Scott Bostian
Phone:
Dear Mr. Rogers: 919-854-1282 x 52291
On behalf of ExxonMobil Environmental Services (EMES), ARCADIS G&M of North
Email:
Carolina (ARCADIS), is submitting a revised Site Location Map for former
Scott. Bostian@arcadis-
ExxonMobil Facility #45552 located at 1920 4 Seasons Road in Hendersonville,
us.com
Henderson County, North Carolina. The site address was formerly 1920 Chimney
our ref:
Rock Road and is the address referenced for the site in the NCDENR groundwater
60085851.0039
incident database. The revised Site Location Map depicting the location of the
subject property is attached as Figure 1.
ARCADIS G&M of North Carolina,
If you any questions regarding the injection permit response to the request for
Inc.
additional information or the proposed environmental investigation please contact me
NC Engineering License # C-1869
NC Surveying License # C-1869
at 919.854.1282 extension 52291.
Imagine the result
\\arcadis-us\officedata\bluefield-wv\projects\exxonmobil\mid-atlantic ctc portfolio\north carolina\nc-retail-(45552)\chemical injection\requested
figure edits\45552 - revised figure request letter.doc

ARCADIS
Sincerely,
ARCADIS G&M of North Carolina, Inc.
Scott Bostian, PE
Senior Environmental Engineer
Attachments:
Figure 1 — Site Location Map
Copies:
Ms. Jewel Cox — EMES
File — EM 45552
Jon Farley, EIT
Certified Project Manager I
J
Mr. Michael Rogers
June 14, 2012
Page:
IWcads-uslofricedataSluefield-NMPgKtsTmonMobilWid-Man6c CTC PortfolioWoM CardinaINC-Retal{45552)ICheniwI lnjectionlRequested Figure EdtsW5552- Revised Figure Request Letterdoc 2/2

Rogers, Michael
From: Rogers, Michael
Sent: Thursday, May 24, 2012 3:53 PM
To: 'Bostian, Scott'
Cc: Zimmerman, Jay
Subject: Exxon Mobil Hendersonville Site (WI 0100202), and Raleigh Site (W10500494)
Attachments: Memo to groundwater remediation Applicants.pdf
Scott -
This e-mail is to follow up a voicemail I left on your phone at your office this afternoon. We have determined that based
upon information in the applications and in the follow-up additional information packets we received May 21, 2012, the
two groundwater remediation permit applications referenced above qualify to be 'deemed permitted by rule'. The UIC
rule 15A NCAC .0200 was revised effective May 1, 2012.
Some of the revisions affect groundwater remediation systems. One of the revisions is that if the size of the plume to be
remediated is less than 10,000 ft.2, it is eligible to be deemed permitted per Small Scale Injection Operations described in
15A NCAC 02C .0225(b)(2). Therefore, in accordance with the new rule requirements, the injection activities referenced
above are permitted by rule and do not require an individual permit. Refer to attached memo for additional information.
Future projects, which would qualify as deemed permitted, would need to be submitted on the new notification forms.
If you have any questions or comments, please advise.
Regards
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncden r. org/web/wq/aps/gwpro/perm it-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:[e-mail]]
Sent: Tuesday, May 22, 2012 11:35 AM
To: Rogers, Michael
Subject: RE: Exxon Mobil Charlotte Site AND Raleigh Site
Michael,
Please send the mailing addresses so we can make sure they get to the correct person.
Thanks for your help,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]

Cell: [phone]
Email: [e-mail]
From: Rogers, Michael [mailto:[e-mail]]
Sent: Monday, May 21, 2012 4:41 PM
To: Bostian, Scott
Subject: RE: Exxon Mobil Charlotte Site AND Raleigh Site
Scott -
I rec'd the Additional Info packet for the Raleigh and Charlotte Sites. Please send a duplicate copy to the
respective Regional Office so that they can insert into application and review also. This includes the two other
sites in Hendersonville and Greensboro. I will go ahead and forward the Original Application to the ROs for
the above sites so they can start their review (I won't wait for a second copy before sending). If you need
mailing address, let me know.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.oro/web/wq/ar)s/g_wpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:[e-mail]]
Sent: Friday, May 11, 2012 4:19 PM
To: Rogers, Michael
Subject: RE: WI0300194 Exxon Mobil Charlotte Site AND OTHER SITES
Michael,
I apologize for the delay. These have taken much longer than they should have. We're completing the
additions/responses to all four applications and will have them to you next week.
Thanks,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]
From: Rogers, Michael [mailto:[e-mail]]
Sent: Friday, May 11, 2012 4:03 PM
To: Bostian, Scott
0

Rogers, Michael
From: Bostian, Scott [[e-mail]]
Sent: Friday, May 11, 2012 4:19 PM
To: Rogers, Michael
Subject: RE: W10300194 Exxon Mobil Charlotte Site ANC TH'ERISITES
Michael,
I apologize for the delay. These have taken much longer than they should have. We're completing the
additions/responses to all four applications and will have them to you next week.
Thanks,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]_
From: Rogers, Michael [mailto:[e-mail]]
Sent: Friday, May 11, 2012 4:03 PM
To: Bostian, Scott
Cc: Streeter, Mike
Subject: RE: WI0300194 Exxon Mobil Charlotte Site AND OTHER SITES
Brian -
What is the status on the referenced groundwater remediation site. It is coming up on 2 months, where we've not
received the additional information we requested. Please advise. Otherwise, we will return the applications.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal ncdenr org/web/wq/aps/gwpro/permit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Bostian, Scott [mailto:Curtis. [e-mail]]
Sent: Friday, March 16, 2012 2:19 PM
To: Rogers, Michael
Subject: RE: WI0300194 Exxon, Mobil Charlotte Site
Thanks for the update.

We're making the corrections now and will apply those same corrections to the other applications.
Best regards,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]
From: Rogers, Michael[mailto:[e-mail]]
Sent: Friday, March 16, 2012 2:09 PM
To: Bostian, Scott
Subject: FW: WI0300194 Exxon Mobil Charlotte Site
Scott -
I just did a preliminary review of the 5I groundwater remediation permit application for the former Exxon Mobil
Facility#40563 in Charlotte. Except for a geologic x-section, I see some of the same deficiencies in this application as I
indicated in the previous e-mail for the Hendersonville site application. In all likelihood, one or more of these deficiencies
are in all of the applications we received March 2.
Therefore, I will put on hold processing all these permit applications until they include the required information per 15A
NCAC 2C .0200.
If you any questions or comments, please advise.
Regards
NOTE: On January 6th, the Aquifer Protection Section (APS) is scheduled to move to
the 6th floor of the Archdale Building located at 512 N. Salisbury Street in
Raleigh. Our mailing address will remain the same (1636 Dail Service Center,
Raleigh, NC 27699-1636). If you need to visit APS staff or review files, please
call or email in advance to ensure availability. Please check the APS website
for updates on office numbers and phone numbers as they become available.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncdenr.org/weblwglapslgwi)rolpermit-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
2

Rogers, Michael
From: Bostian, Scott [[e-mail]]
Sent: Friday, March 16, 2012 2:19 PM
To: Rogers, Michael
Subject: RE: W10300194 Exxon Mobil Charlotte Site
Thanks for the update.
We're making the corrections now and will apply those same corrections to the other applications.
Best regards,
Scott
C. Scott Bostian, P.E.
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel: [phone]
Fax: [phone]
Cell: [phone]
Email: [e-mail]
From: Rogers, Michael[mailto:[e-mail]]
Sent: Friday, March 16, 2012 2:09 PM
To: Bostian, Scott
Subject: FW: WI0300194 Exxon Mobil Charlotte Site
Scott -
I just did a preliminary review of the 5I groundwater remediation permit application for the former Exxon Mobil
Facility#40563 in Charlotte. Except for a geologic x-section, I see some of the same deficiencies in this application as I
indicated in the previous e-mail for the Hendersonville site application. In all likelihood, one or more of these deficiencies
are in all of the applications we received March 2.
Therefore, I will put on hold processing all these permit applications until they include the required information per 15A
NCAC 2C .0200.
If you any questions or comments, please advise.
Regards
_ r
..t,"tt,..-_ ...'Y ,°4i l'"... Y. C...1 •r ��y .+ 'y _ .4. ) rt `�. }N. `.1C`,"i _
tiYe €ii:ii floor of the Lrc:hctale Building located ---at 512 N.--Salishui:y Street _Ln_
Raleigh. our mailing address will remain the same (1636 Mail Service Center,
Raleigh, NC 27699-1636). If you need to visit APS staff or review files, please
call or email in advance to ensure availability. Please check the A.PS website
for unda,tes or office nurnbers and phone numbers as they become avas la?'le.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
i

NC Div of Water Quality- Aquifer Prot(., - Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http•//portal ncdenr org/web/wg/aps/gwpro/permit-applicationskgeothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Rogers, Michael
Sent: Tuesday, March 13, 2012 4:50 PM
To: '[e-mail]'
Cc: Bowser, Daniel P
Subject: WI0100202 Exxon Mobil Hendersonville Site
Scott -
We received the 5I groundwater remediation permit application for the above project. A preliminary review of the application indicates
some deficiencies.
1. One of the injectants, citric acid, an activator, is not on the pre -approved injectant list. In order for this injectant to be approved,
you would need to submit a request to use this compound, along with all supporting documentation (MSDS sheets, laboratory/human
health risk assessment studies, etc.). This package would then be forwarded by us to the Occupational and Environmental
Epidemiology Section of the NC. Division of Public Health for review and approval. A link to the pre -approved injectarit.list is below.
When you open the page, click the link to the Excel spreadsheet in the paragraph labeled 'Injection of Remediation Compounds' near
the bottom of this page.
http•//portal. ncdenr oro/web/wq/aDs/gwpro/uic
2. There were no geologic cross -sections included per the requirement of Section V.H(5).
3. There was no hydrogeologic information included indicating hydraulic conductivity, transmissivity, or specific yield/porosity as per
the requirement of Section V.13(3).
4. The application was not sealed by a North Carolina licensed geologist per the requirement of 15A NCAC 2C .0211(d)(3)(D).
Please address these comments/questions within 30 days of receipt of this e-mail. Please send revised site maps/text pages in the
same format and size as the original application for insertion/replacement.
If you have any questions or comments, please advise. Thank you for your cooperation.
Regards
NOTE: On January 6th, the Aquifer Protection Section (APS) is scheduled to move to
the 6th floor of the Archdale Building located at 512 N. Salisbury Street in
Raleigh. -Our mailing address will remain the same (1636 Mail Service Center,
Raleigh, NC 27699-1636). If you need to visit APS staff or review files,, please,
call or email in advance to ensure availability. Please check the APS website
for updates on office numbers and phone numbers as they become available.
i`JI?ail:'? (�(is �,.,.. i1j, a [-o •, . .
NC Div_ -Water_Quality-.Aquifer_Protection.Section- (APS)----------
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
n�_:%%jiJCi2l.fiC(�c;i�'.J:l'iVr'ct:i?i`JUrapSr'1� !Ci' 'Ci�i�i'l-u•� «:ciiiiiiui.0 Gt 1Lii''i%ti S
E-mail correspondence to and from this address maybe subject to the North Carolina Public Records Law and maybe disclosed to third parties
PA

NOTICE: This e-mail and any files transmitted with it are the property of ARCADIS U.S., Inc. and its affiliates. All rights,
including without limitation copyright, are reserved. The proprietary information contained in this e-mail message, and any
files transmitted with it, is intended for the use of the recipient(s) named above. If the reader of this e-mail is not the
intended recipient, you are' hereby notified that you have received this e-mail in error and that any review, distribution or
copying of this e-mail or any files transmitted with it is strictly prohibited. If you have received this e-mail in error, please
notify the sender immediately and delete the original message and any files transmitted. The unauthorized use of this e-
mail or any files transmitted with it is prohibited and disclaimed by ARCADIS U.S., Inc. and its affiliates. Nothing herein is
intended to constitute the offering or performance of services where otherwise restricted by law.
3

Rogers, Michael
From: Rogers, Michael
Sent: Tuesday, March 13, 2012 4:50 PM
To: 'Scott. [e-mail]'
Cc: Bowser, Daniel P
Subject: -V�GI.'�' r on Mobil Hendersonville Site
Scott -
We received the 5I groundwater remediation permit application for the above project. A preliminary review of the application indicates
some deficiencies.
1. One of the injectants, citric acid, an activator, is not on the pre -approved injectant list. In order for this injectant to be approved,
you would need to submit a request to use this compound, along with all supporting documentation (MSDS sheets, laboratory/human
health risk assessment studies, etc.). This package would then be forwarded by us to the Occupational and Environmental
Epidemiology Section of the NC Division of Public Health for review and approval. A link to the pre -approved injectant list is below.
When you open the page, click the link to the Excel spreadsheet in the paragraph labeled 'Injection of Remediation Compounds' near
the bottom of this page.
http: //portal. ncdenr.orci/web/wq(aps/gwpro/uic
2. There were no geologic cross -sections included per the requirement of Section V.H(5).
3. There was no hydrogeologic information included indicating hydraulic conductivity, transmissivity, or specific yield/porosity as per
the requirement of Section V.13(3).
4. The application was not sealed by a North Carolina licensed geologist per the requirement of 15A NCAC 2C..0211(d)(3)(D).
Please address these comments/questions within 30 days of receipt of this e-mail. Please send revised site maps/text pages in the
same format and size as the original application for insertion/replacement.
If you have any questions or comments, please advise. Thank you for your cooperation.
Regards
NOTE: On January 6th,-the Aquifer Protection Section (APS) is scheduled to move to
the 6th floor of the Archdale Building located at 512 N. Salisbury Street in
Raleigh. Our mailing address will remain the,same (1636 Mail Service Center,
Raleigh, NC 27699-1636). If you need to visit APS staff or review files, please
-call or email in advance to ensure availability. Please check the APS website
for updates on office numbers and phone numbers as they become available.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist,
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line 919-807-6406
http://portal. ncden r. org/web/wg/aps/gwpro/perm it-applications#geothermApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
1

Rogers; Michael
From: Justin Ballard [[e-mail]]
Sent: Tuesday, March 13, 2012 5:06 PM
To: Rogers, Michael
Subject: FW: Injection Permit W10500273
Attachments: DC320008_20120227_SiteMap.pdf; DC320008_20120227_WelllnjectionTable.xls
From: Justin Ballard
Sent: Monday, February 27, 2012 1:48 PM
To: 'Rogers, Michael'
Cc: 'Slusser, Thomas'
Subject: Injection Permit WI0500273
Mr. Rogers,
Please accept this email as notification that ATC is proceeding with full-scale injection implementation at the above
referenced site in Durham, NC. The initial pilot phase was conducted in April 2011 and consisted of injecting a mixture
created by Innovative Environmental Technologies, Inc. (IET) containing blue green algae, sodium sulfite, calcium
propionate, zero valent iron, and soluble kelp extract into three injection wells. Prior to the injection event,
groundwater.sampiing was conducted with subsequent post -injection sampling events completed in July and October
2011 and January 2012. ATC will complete the final pilot phase post -injection sampling event in April 2012. The results
of the pre and post -injection groundwater sampling suggest that the pilot phase injection activities have successfully
reduced contaminant concentrations within the injection area. Attached in this email are a site map with the well
locations and an injection table that includes details regarding sampling results.
As per ATC's original permit application submitted on June 30, 2010 and the Additional Information Request submitted
on December.30, 2010, ATC plans to conduct full-scale remedial activities at the Former W.P. Ballard Facility. This
includes injection in the source area and along three permeable reactive barriers (PRBs). Please let me know if there are
any questions or concerns with the proposed injection implementation. Thank you.
Justin C. Ballard, P.G. I Project Geologist I ATC Associates of North Carolina, P.C.
[phone] direct 1 [phone] mobile
2725 E. Millbrook Road I Suite 121 1 Raleigh, North Carolina 27604
[phone] 1 [phone] fax I -www.atcassociates.com
ATC is a leader in developing innovative Environmental, Geotechnical/CMT/Special Inspections and Health & Safety solutions.
PLEASE NOTE: This message, including any attachme nts, may include privileged, confidential and/o inside informlation. Any
distribution or use ciF this communication by anyone other than the intended recipient is strictly pro`r.ibii:ed and may be unlawful. If
you are not the intended recipient, please notify the sender by replying to this message and then delete it from your computer.

NC®EN
North Carolina Department of Environment and
Beverly Eaves Perdue
Governor
Jewel Cox — Project Manager
Exxon Mobil Corporation
1016 W. Pop lar)Avenue
Suite 106 - Number 232
Collierville, TN 38017
Dear Ms. Cox:
Division of Water Quality
Charles Wakild, P.E.
Director
March 12, 2012
Natural Resources
Dee Freeman
Secretary
Subject: Acknowledgement of
Application No. WI0100202
Former ExxonMobil Retail
Facility #45552
Injection In situ Groundwater
Remediation Well (5I) System
Henderson County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on March 2, 2012. Your application package has been assigned the number
listed above, and the primary reviewer is Michael Rogers.
Central and Asheville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Michael Rogers at [phone] or [e-mail].
Sincerely, �Q
O ,f
for Debra J. Watts
Groundwater Protection Unit Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Scot-Bostian.—.ARCADIS
Cie 'nit-Pile-WI0-100202.-=
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwaterouality.oro
An Equal Opportunity1 Affirmative Action Employer
No thCarolina
Aahll ail'ff

ARCADIS
Infrastructure Water Environment Buildings
Mr. Michael Rogers
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Aquifer Protection Section
1636 Mail Service Center
Raleigh, North Carolina, 27699
Subject:
Additional Information Request
Former Exxon Facility #45552
1920 Chimney Rock Road
Hendersonville, North Carolina
Groundwater Incident #9644
Dear Mr. Rogers:
On behalf of ExxonMobil Environmental Services (EMES), ARCADIS G&M of North
Carolina (ARCADIS), is submitting this Response to an Additional Information
Request from the North Carolina Department of Environment and Natural Resources
(NCDENR) requesting additional information for an injection permit at the above
referenced site for your review. Inquiries from correspondence dated March 13, 2012
and their respective responses are listed below.
1. "One of the injectants, citric acid, an activator, is not on the pre -approved
injectant list. In order for this injectant to be approved, you would need to submit a
request to use this compound, along with all supporting documentation (MSDS
sheets, laboratory/human health risk assessment studies, etc.). This package would
then be forwarded by us to the Occupational and Environmental Epidemiology
Section of the NC Division of Public Health for review and approval. A link to the pre -
approved injectant list is below. "
Citric Acid is not necessary for the effectiveness of these injections and will not be
utilized. As noted in the Work Plan, the activation of the persulfate is accomplished
with ferrous iron in the form of ferrous sulfate. Divalent iron activated persulfate
effectively oxidizes the target compounds at this site. The chelating agent, citric acid,
was included as a method of enhancing iron availability. However, based on the
Imagine the result
g:\env\exxonmobil\north Carolina injection sites\45552\response to comments\text\45552 - response to ncdenr.doc
ARCADIS G&M of North Carolina,
Inc.
801 Corporate Center Drive
Suite 300
Raleigh
North Carolina 27607
Tel [phone]
Fax [phone]
www.arcadis-us.com
ENVIRONMENT
Date:
May 21, 2012
Contact:
Scott Bostian
Phone:
919-854-1282 x 52291
Email:
Scott. Bostian@arcadis-
us.com
Our ref:
B0085851.0039
ARCADIS G&M of North Carolina,
Inc.
NC Engineering License # C-1869
NC Surveying License # C-1869
RECEIVED/DENROWQ
MAY 2 2 2012
Aquifer Protection Section

ARCADES Mr. Michael Rogers
May 21, 2012
aquifer chemistry at this site, this enhancement is not necessary for the effective
activation of the persulfate and oxidation of the target compounds. If post -injection
data indicate the need for modifying the activation strategy, all required
documentation will be submitted in a revised application.
2. "There were no geologic cross -sections included per the requirement of
Section V.H(5)."
A cross-section location map is included as Figure 1 and cross -sections of the site
are included as are included as Figures 2 and 3.
3. "There was no hydrogeologic information included indicating hydraulic
conductivity, transmissivity, or specific yield/porosity as per the requirement of
Section V.8(3)."
Aquifer tests to measure hydraulic conductivity were performed in monitoring wells
MWA and MW-6. The test consisted of a sudden removal of water from the well and
the subsequent measuring of water recovery verses time using a pressure
transducer and data logger. Analysis of the data was conducted using the methods
of Bouwer and Rice (1976). The results revealed hydraulic conductivity values for
monitoring wells MWA and MW-6 were 0.152 feet per day (ft/day) and 0.703 ft/day,
respectively. Average hydraulic conductivity, 0.428 ft/day was calculated for the site
based on the aquifer test results. Aquifer test data and calculations can be found in
Attachment 1. The thickness of the surficial aquifer was found to be 22 feet (Delta
Environmental Consultants, Comprehensive Site Assessment, July 1993)..
Transmissivity is calculated by multiplying the hydraulic conductivity (K) and the
saturated thickness of the aquifer. The hydraulic conductivity values were previously
calculated from monitoring wells MW-1 (0.152 ft/day) and MW-6 (0.703 ft/day).
These hydraulic conductivity values, multiplied by the aquifer thickness of 22 feet,
yield transmissivity values of 3.34 square feet per day (ft2/day) (MW-1) and 15.47
ft2/day (MW-6).
Specific yield and porosity are estimated for the type of material present. Soil at the
site is composed of silt to silty sand yielding a specific yield of 18-21 % (Fetter, 1994).
The porosity ranges for silt and fine sand are 34-61 % and 26-53%; respectively
(Domenico and Schwartz, 1990). Boring logs are included as Attachment 2.
Page:
GAENV1EnonMohihNorth Carolina injection sites1455OResponse to CowentATezt145552 - Response to NCDENRdoc 2/3

ARCADIS
4. "The application was not sealed by a North Carolina licensed geologist per
the requirement of 15A NCAC 2C .0211(d)(3)(D)."
A North Carolina licensed geologist reviewed the original application and associated
attachments. An additional page for the Attachment to the Application for Permit to
Use Wells for Injection identifying the site has been sealed by a North Carolina
licensed geologist and is included with this Response to an Additional Information
Request.
If you any questions regarding the injection permit response to the request for
additional information or the proposed environmental investigation please contact me
at 304.325.3614, extension 17. "IttttM111"',
Sincerely,
North Carolina, Inc
Sb S�
Engineer
Attachments:
Figure 1 — Cross -Section Location Map
Figure 2 — Cross -Section A -A'
Figure 3 — Cross -Section B-B'
z
2293
Joshua Frizzell, L.G.
Geologist
Attachment 1 — Hydrogeological Calculations
Attachment 2 — Boring Logs and Monitoring Well Construction Diagrams
Copies:
Ms. Jewel Cox — EMES
File — EM 45552
Mr. Michael Rogers
May 21, 2012
RECEIVED/DENR/DW
Q
MAY
2 2 zo12
Aquifer Protection Section
Page:
G1ENVfmwMobiANoM Cadim irje bm sdesW5552ftspo to CormientsNKM5552 - Respo to NCDENR.doc 3/3

0 ARCADIS
9 It I
a V /1rrRe�O�O i
SEAL I
�� agues e
RECEIVEDIDENRIM
MAY 22 ML
Aquifer Protection Section
Attachment to the Application
for Permit to Use Wells for
Injection
Former ExxonMobil Facility
#45552
1920 Chimney Rock Road
Hendersonville, North Carolina
Groundwater Incident #9644
Prepared for:
ExxonMobil Corporation
ExxonMobil Environmental Services
Ms. Jewel Cox _ Project Manager
1016 W. Poplar Avenue
Suite 106 #232
Collierville, Tennessee 38017
Prepared by:
ARCADIS G&M of North Carolina, Inc.
801 Corporate Center Drive, Suite 300
Raleigh, North Carolina 27607
Tel [phone]
Fax [phone]
www.arcadis-us.com
Environmental
Our Ref.:
B0085851.0039
This document is intended only for the use
of the individual or entity for which it was
prepared and may contain information that
is privileged, confidential and exempt from
disclosure under applicable law. Any
dissemination, distribution or copying of
this document is strictly prohibited.

ARCADIS
Attachment 1

�1
HORIZONTAL GROUND WATER FLOW VELOCITY CALCULATION
EXXON RAS 4- 4552
HENDERSO 3 F NORTH CAROLiNA
DELTA NO.50-92-021
EQUATION:
V=
V -
Velocity = K dh
ne dl
where K = average hydraulic conductivity
Ne = effective porosity
dh/dl = hydraulic gradient
and assuming an effective porosity of:
35% or .34 for clayey silt;
and assuming an average hydraulic conductivity of:
0.428 ft/day;
and a calculated hydraulic gradient of:
0.024;
(0.428 ft/day)/(0.34) * 0.024
0.030 ft/day

DELTA ENVIRONMENTAL CONSULTANTS, 64L.
SLUG TEST DATA ANALYSIS - BOUWER AND RICE METHOD
for an Unconfined Aquifer with a Partially Penetrating Welt
;OJECT DATA INPUT
'oject: EXXON CO.,USA
bite Name: EXXON CO.,USA
Location: HENDERSONVILLE,NC
' Ata No: 50-92-021
ita Collected By: L.Gross Date:
05/20/93
fta Analyzed By: L.Gross Date:
06/28/93
Analysis Reviewed By: D.Curtis Date:
G7/02/93
EST WELL DATA INPUT
a t No: 14W-1, Slug Out
method: Pressure Transducer and Datalogger
Total Depth Of Well From Measuring Point:
25.000
ft
Static Depth To Water From Measuring Point:
14.460
ft
ppth To Top Of Screen From Measuring Point:
15.000
ft
Length of Screen:
10.000
ft
Radius Of Note:
0.260
ft
Radius of Casing:
0.083
ft
Porosity Of Sandpack:
0.350
as a decimal
CALCULATED TEST WELL PARAMETERS
Le = 10.000 ft (effective screen length of well)
Lw = 10.540 ft (saturated thickness penetrated by well)
Rw = 0.260 ft (radius of borehole)
Rc = 0.083 ft (radius of casing)
Re = G.D83 ft (effective radial distance over which drawdown is dissipated)
Le/Rw = 38.462 dimensionless
A = 2.706 dimensionless
B = 0.443 dimensionless
in(Re/Rw) = 2.430 dimensionless
'�UIFER (SATURATED ZONE) PARAMETERS INPUT
H = 22.54 ft (aquifer thickness - estimate
to be 2 x
Lw if unknown)
SLUG TEST DATA INPUT, DRAWDOUN, AND BEST FIT LINE FROM REGRESSION ANALYSIS
Time
Depth be-
Drawdown
Drawdown
(min.)
low MP(ft)
(ft)
Log(y)
(Best Fit Line)
---------- ----
----------
0.0000
----------
15.06
--------------------
0,600
-0.22185
0.141
0.0033
15.05
0.590
-0.22915
0.141
0.0066
15.05
0.590
-0.22915
0.141
0.0099
15.03
0.570
-0.24413
0.141
0.0133
15.02
0.560
-0.25181
0.141
0.0166
15.02
0.560
-0.25181
0.141
0.0200
15.00
0.540
-0.26761
0.141
Logger
Field Data
16.59
16.6
16.6
16.62
16.63
16.63
16.65
EXX
MW-
Peg

0.0300
14.97
0.51G�
-0.29243
0.141
�.68
0.0333
14.97
0.510
-0.29243
0.141
'1o.68
0.0500
14.94
0.480
-0.31876
0.140
16.71
0.0666
14.91
0.450
-0.34679
0.140
16.74
0.0833
14.87
0.410
-0.38722
0.140
16.78
0.1000
14.84
0.380
-0.42022
0.140
16.81
0.1166
14.83
0.370
-0.43180
0.139
16.82
6.1333
14.81
0.350
-0.45593
0.139
16.84
0.1500
14.79
0.330
-0.48149
0.139
16.86
0.1666
14.78
0.320
-0.49485
0.138
16.87
0.1833
14.76
0.300
-0.52288
0.138
16.89
0.2000
14.76
0.300
-0.52288
0.138
16.89
0.2116
14.75
0.290
-0.53760
0.138
16.9
0.2333
14.73
0.270
-0.56864
0.137
16.92
0.2500
14.73
0.270
-0.56864
0.137
16.92
0.2666
14.72
0.260
-0,58503
0-137
16.93
0.2833
14.72
0.260
-0.58503
0.136
16.93
0.3000
14.72
0.260
-0.58503
0.136
16.93
0.3166
14.70
0.240
-0.61979
0.136
16.95
0.3333
14.70
0.240
-0.61979
0.136
16.95
0.4167
14.68
0-220
-0.65758
0.134
16.97
0.5000
14.67
0.210
-0.67778
0.133
16.98
0.5833
14.65
0.190
-0.72125
0.131
17
0.6667
14.64
0.180
-0.74473
0.130
17.01
0.7500
14.64
0.180
-0.74473
0.129
17.01
0.8333
14.62
0.160
-0.79588
0.127
17.03
0.9167
14.62
0.160
-0.79588
0.126
17.03
1.0000
14.62
0.160
-0.79588
0.125
17.03
1.0833
14.60
0.140
-0.85387
0.124
17.05
1.1667
14.60
0.140
-0.85387
0.122
17.05
1.2500
14.60
0.140
-0.85387
0.121
17.05
1.3333
14.59
0.130
-0.88606
0.120
17.06
1.4166
14.59
0.133
-0.88606
0.119
17.06
1.5000
14.59
0.130
-0.88606
0.117
17.06
1.5833
14.59
0.130
-0.88606
0.116
17.06
1.6667
14.59
0.130
-0.88606
0.115
17.06
1.7500
14.59
0.130
-0.88606
0.114
17.06
1.8333
14.59
0.130
-0.88606
0.113
17.06
1.9167
14.57
0.110
-0.95861
0.112
17.08
2.0000
14.57
0.110
-0.95861
0.110
17.08
2.5000
14.56
0.100
-1.00000
0.104
17.09
3.0000
14.56
0.100
-1.00000
0.098
17.09
3.5000
14.56
0.100
-1.00000
0.092
17.09
4.0000
14.54
0.080
-1.09691
0.086
17.11
4.5000
14.54
0.080
-1.09691
0.081
17.11
5.0000
14.54
0.080
-1.09691
0.076
17.11
5.5000
14.53
0.070
-1.15490
0.072
17.12
6.0000
14.53
0.070
-1.15490
0.067
17.12
6.5000
14.53
0.070
-1.15490
0.063
17.12
7.0000
14.51
0.050
-1.30103
0.060
17.14
7.5000
14.51
0.050
-1.30103
0.056
17.14
8.0000
14.51
0.050
-1-30103
0.053
17.14
8.5000
14.51
0.050
-1.30103
0.050
17.14
9.0000
14.51
0.050
-1.30103
0.047
17.14
9.5000
14.51
0.050
-t.30103
0.044
17.14
10.0000
14.49
0.030
-1.52288
0.041
17.16
12.0000
14.49
0.030
-1.52288
0.032
.17.16
14.0000
14.49
0.030
-1.52288
0.025
17.16
16.0000
14.48
0.020
-1.69897
0.020
17.17
18.0000
14.48
0.020
-1.69897
0.015
17.17
20.0000 .
14.48
0.020
-1.69897
0.012
17-17
22.0000
14.48
0.020
-1.69897
0.009
17.17
24.0000
14.46
0.000
ERR
0.007
17.19
26.0000
14.46
0.000
ERR
0.006
17.19
28.0000
14.46
0.000
ERR
0.004
17.19
30.0000
14.46
0.000
ERR
0.004
17.19

REGRESSION ANALYSIS INPUT EXX
[me T1 = 2.0000 min (time that regression analysis starts) Mw-
me T2 = 5.5000 min (time that regression analysis ends) Peg
REGRESSION ANALYSIS OUTPUT
Regression Output:
`Instant-0.84997164342071
..d Err of Y Est 0.023884476611891
R Squared 0,89769357512472
No. of Observations 8
::grees of Freedom 6
x'Coefficient(s)-0.0534822
Std Err of Coef. 0.00737091
11TPUT FROM BEST FIT LINE
Y(0) = 0.141 ft (= drawdown y a t=0, derived from y intercept of best fit line on y/t plot)
14PUT FROM BEST FIT LINE
t = 2..0000 min (= time t, where t>O, at which Yt will be selected)
Y(t) = 0.110 ft (= drawdown y 8 time t, derived from best fit line of y/t plot)
CALCULATED HYDRAULIC CONDUCTIVITY
K = 1.76E-06 ft/sec
K = 1.06E-04 ft/min
K = 1.52E-01 ft/day
K = 1.14E+00 gpd/ft"2
K = 5.36E-05 cm/sec
K = 5.36E-07 m/sec
K = 4.63E-02 m/day
REFERENCES
Bouwer, H. and Rice, R. C., 1976, A Slug Test for Determining
Hydraulic Conductivity of Unconfined Aquifers with Completely
or Fully Penetrating Wells, Water Resources -Research, v. 12,
pp. 423-428.
Bouwer, H.. 1989, The Bouwer and Rice Slug Test - An Update,
Groundwater, Vol. 27, No. 3. pp. 304-309.
Bouwer, H., 1989, DISCUSSION OF: The Bouwer and Rice Slug Test -
An Update, Groundwater, Vol. 27, No. 5, p. 715.

1.00
GAO
0.01
SLUG TEST DATA (Drawdown vs Thne)
Exxon Co., USA, MW-1 Slug Out
0.0 2.0 4.0 6.0 8.0 10.0 1 Z.0 14.0
3.0 5.0 7.0 9.0 11.0 13.0
Time (min)
i
Data
Best Fit

DELTA ENVIRONMENTAL CONSULTANTS,
SLUG TEST DATA ANALYSIS - BOUWER AND RICE METHOD
For an Unconfined Aquifer with a Partially Penetrating Yell
iOJECT DATA INPUT
'olect: EXXON CO.,USA
oite Name: EXXON CO.,USA
Location: HENDERSONVILLE,NC
"etta No: 50-92-021
ata Collected By: L.Gross Date: 05/20/93
•eta Analyzed By: L.Gross Date: 06/28/93
Analysis Reviewed By: D.Curlis Date: 07/02/93
':ST WELL DATA INPUT
'At No: NY-6, Slug Out
"=thod: Pressure Transducer and Datalogger
Total Depth Of Yell From Measuring Point: 25.000 ft
Static Depth To Water From Measuring Point: 16.810 ft
pth To Top Of Screen From Measuring Point: 10.000 ft
Length of Screen: 15.060 ft
Radius Of Hole: 0.260 ft
Radius Of Casing: 0.D83 ft
Porosity Of Sandpack: 0.350 as a decimal
-.ALCULATED TEST WELL PARAMETERS
Le = 8.190 ft (effective screen Length of well)
Lw = 8.190 ft (saturated thickness penetrated by welt)
Rw = 0.260 ft Cradius of borehole)
Rc = 0.083 ft (radius of casing)
Re = 0.168 ft (effective radial distance over which drawdown is dissipated)
Le/Rw - 31.500 dimensionless
A = 2.497 dimensionless
B = 0.408 dimensionless
ui(Re/Rw) = 2.222 dimensionless
AIUIFER (SATURATED ZONE) PARAMETERS INPUT
H = 22.54. ft (aquifer thickness - estimate to be 2 x Lw if unknown)
o�UG TEST DATA
INPUT, DRAWDOWN,
AND BEST FIT
LINE FROM REGRESSION ANALYSIS
EXX
----------
--------
------• -------------
..........
-------------------- MW-
Time
Depth be-
Drawdown
Drawdown
Logger Peg
(min.)
low MP(ft)
(ft)
Log(y)
(Best Fit Line)
Field Data
-----__--
0.0000
----------
17.93
---------- ----------
1.120
0.04922
----------
0.189
---------- ----------
13.9
0.0033
17.92
1.110
0.04532
0.189
13.91
O.DD66
17.90
1.090
0.03743
0.189
13.93
0.0099
17.88
1.070
0.02938
0.189
13.95
0.0133
17.87
1.060
0.02531
0.189
13.96
0.0166
17.85
1.040
0.01703
0.189
13.98
0.0200
17.84
1.030
0-01284
0.189
13.99

N N r allr r r r
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0 0 0 0 0 0 0 0 0 0 0 0 0 O O O O O O O O O O O O O O O O O O O O P O O O O p O 0 O 0 0 0 0 0 0 0 0 0 0 0 0.O 0 0 0 0 0 6 0
• _ _ _ _ _ _ _
O C OOOOO b 00000 000 r+++•-+rr�..r..+• • -.. N iN_ NN NN N W W W W W F F F F!/ Ul V10, 0+0�VVW O'O10
G O O N W VI Vl N W P P 61 00 03 .0 0- +++ W F P P P O� P V V V V �O �O -+ N i. Vi 11 07 N QQ.. 01 00 ��pp F pp�� V J F V O W Of W HO SR O pp��
O O b O b 0 0 0 0 0 0 0 0 O O P p 0 0 0 0 0 0 b 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1• I 1 1 1 1 1 1 1 1 1• 1• I I l I l l • I 1 I I I 1 I I 1• I
0 0 0 0 0 1616 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 1616 0 0 0 0 0 0 0 P 0 0 0 0 0 0 0 0
P ut W W W W N Np Jp p Jp pppO •O .O .p �D pppp OD N.I V'V y V P P P P PP%n LRF FF FF W W W W N N NN N-+• +O O btl
ONOOOON NCO .O •ORr. L" to t/1 unW Vi�.p .OPPPPni fV ut+O u,•O S. SF N O w VI W N.Oa r N O U W OV F+O
mmm0opNprrr�rr0.0 O•C7�V�papap7p7Q0�.WpVp7pVpltpop«p!l�77llphh7ZR-0�0,O�J VDN NAWW000 P yNVA_ +OOVpp.�7�Vf�N�V1�W1
AA A.00 W W W Wa V<�� `0a�rrO+�Or�O�V W W 07 OO Oo Ln Lnn Ut VNf L"%A wm.p 0, 9Oni OCNFN IA WO W� Wubl O��00 V NawV
mm7oV
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0000000000000 000 �+—--++J•.+.. —J-. �.• • � • • • • •p. �•1 _•�1+ •P _._•�1— j— —WJpppp ppJpp ��Jpp JJrJrsrr rpp—pp pprpp Jppppr
.0+WFpVVroNNA.NpN N FuOn O0OV OV+VFNP in O N9VPW-ONNOoW1nPwaPWtn tntn OD 4o W
tntn to A A AA A A a�F A r FF rr fl FF F A A. A AA AA F A A F F F-+FAAA .i�A AA oN oN NoVrI ��pp0 V V V P P •AAAA. .
OV Z. Z. Z00 OW:OZO o o OOnW400W&Spg�gf3.o�i
F F FW-4rr- 0 V< uV
UJ r W P V1 r M VI W !o A �0 00 N 0• F

REGRESSION ANALYSIS INPUT EXX
1me T1 = 2.5000 min (time that regression analysis starts) Mw-
;me T2 = 8.0000 min (time that regression analysis ends) Pag
REGRESSION ANALYSIS OUTPUT
Regression output:
nstant -0.72286604326691
id Err of Y Est 0.030853828688325
R Squared 0.92074617132146
No. of observations 12
:green of Freedom 10
x'Coefficient(s)-0.05562
Std Err of Coef. 0.00516025
1TPUT FROM BEST FIT LINE
Y(0) = 0.189 ft (= drawdown y a t=O, derived from y intercept of best fit line on y/t plot)
INPUT FROM BEST FIT LINE
t = 3.0000 min (= time t, where t>O, at which Yt will be selected)
Y(t) = 0,129 ft (= drawdown y a time t, derived from best fit tine of y/t plot)
CALCULATED HYDRAULIC CONDUCTIVITY
K = 8.14E-06 ft/sec
K = 4.89E-04 ft/min
K = 7.03E-01 ft/day
K = 5.26E+00 gpd/ft^2
K = 2.48E-04 cm/sec
K = 2.48E-06 m/sec
K = 2.15E-01 m/day
REFERENCES
Bouwer, H. and Rice, R. C., 1976, A Slug Test for Determining
Hydraulic Conductivity of Unconfined Aquifers with Completely
or Fully Penetrating watts, Water Resources Research, v. 12,
pp. 423-428.
Bouwer, H., 1989, The Bouwer and Rice Slug Test - An Update,
Groundwater, Vol. 27, No. 3, pp. 304-309.
Bouwer, H., 1989, DISCUSSION OF: The Bouwer and Rice Slug Test -
An Update, Groundwater, Vol. 27, No, 5, p. 715.

I . 00
0.01 i i
0.0 2.0
1.0 3.0
SLUG TEST DATA (Drawdown vs Time)
Exxon Co., USA, MW—G Slug Out
4.0 6.0 8.0 10.0 12.0 14.0
5.0 7.0 9.0 11.9 13.0
Hme (Mila)
i
Data
Best Fit

ARCADIS
Figures

I
Attachment 2

h _ CCMFLZTION LCG
LC=ICJ' Exxon #45552 Hendersonville
irDRK ORDER a D-19 7
` ADD 1920 Chimney Rock Rd. Hwy 164
` C'ICLIM: Delta Environmental L1AZ'E
6-30-92
j MW #6 CLAM
� Luba Gross -
INSTA= BY: Roy, Chris, Jim
GI'f�R S>=RiiIC�S Pam:
---�— _ xusx
.T'
+
F
F
F ,
10.
RISER - TYPE SCH 40 PVC
RISER -SIZE 2"
BENICNITE 50 lbs of 3/8 pellets
SCREEN - TYPE ' SCH 40 PVC
SCREEN - SIZE 2" .010 slot
FILTER Tylm_
20/60 Med/fine silica sand
DE�rOTfi 7P: &irLLE � FWD AIR LIFT SURGE -SWAB
-N_ DDFz TOTAL Tr : TOTAL GALLONS:
k-AkTEP, APPEARANCE: START Fes---'-----.-
f4

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section FOR OFFICE USE ONLY
P.O. Box 29535 - Raleigh. N.C. 27626-0535 QUAD. NO. SERIAL NO.
Phone [phone] Lat Lang `. Ro
WELL CONSTRUCTION RECORD JUL 2 9 ig92 min" Basin
Sarin Cade
DRILLING CONTRACTOR: Performance DeSijzn Syctoms Header Ent GW t Ent i
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER:_ 1337 PERMIT NUMBER: 10-0299-WM-0100
1. WELL LOCATION: (Show Sketch of the location below)
Nearest Town: County:
1920 Chimney -Rock Rd. Hwy 64
(loes, community, or Subdivision and Lot No.) - DEPTH
OWNER Exxon Com an , U.S.A. From To
ADDRESS P.O. Box 30451 0.0 - 25.0
(Street or Route No.)
Charlotte, N.C. 28230
DRILLING LOG
Fomtadon Description
Brownish silty sand
crty or i own Slate Zip Cade
3. DATE DRILLED 6-18-92 4. TOTAL DEPTH 25.0 USE OF WELL Monitoring
5. CUTTINGS COLLECTED YES XQ NO❑
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO®
7. STATIC WATER LEVEL Below Top of Casing: 20.0 FT.
(Use •.r' if Above Top of Casing)
8. TOP OF CASING IS 0.0 FT. Above Land Surface --------
Casing Casing Tsrmtnatsd avor below land surface Is illegal unless a variance is Issued
In accordance with 15A j4CAC ZC .0118
9. YIELD (gpm)• N/A METHOD OF TEST N/A
10. WATER ZONES (depth): N/A
11. CHLORINATION: Type N/A Amount NIA,._ If additional space is needed use back of form
12. CASING:
0.0 Depth 15.0 0�jneter
From To Ft.
From- To Ft.
From -To FL
. GROUT:
Wall Thickness LOCATION SKETCH
aryVP,,ighVFt. Material ( how direction and distance from at least two State
55CCt1 44 Roads, or other map reference points)
Depth Material
From _o-n To 1 1 _ f} Ft. Paxt I anti/Rant
From -To Ft.
SCREEN:
Depth Diameter Slot Size
From 15.0 To 25. 0 Ft Z_'_ in. _.010 in.
From To Ft in. in,
From To Ft in, in.
SAND/GRAVEL PACK:
Depth Size
From 13.0 To 25.0 Ft 20/60
From To - Ft
REMARKS: MW f>tl BENTONTTR SFA
Method k STortE
C1 _
� M�Material OI
V Q
PV w
Material
Med/fine s
0 to
e
L
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL * 1/ 5 5 -
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
REV. 9 s t
SIGNATURE OF CONTAACTOR OR AGENT
Submit orioinal to Division of t •- ,.. .. -
12-8— FZ
DATE

I
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section FOR OFFICE USE ONLY
P.O. Box 29535 - Raleigh, N.C. 27626-0535 QUAD. NO. SERIAL NO.
Phone [phone] Lai Long RO
WELL CONSTRUCTION RECORD Minor Basin
Basin Code
DRILLING CONTRACTOR: Performance Desiltn S st ms Header Ent GW-1 Ent
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 1337 PERMIT NUMBER:
WELL LOCATION: (Show sketch of the location below)
Nearest Town:- Bend_ erunvi11e.• N. .� County:
1920 Chimney Rock Rd.
(Road. Community, or Subdivision and Lot No.)
t2 OWNER Exxon Company, U..S.A. _
ADDRESS P.O. Box 304SI
(Street or Route No.) _
Charlotte, N.C. 28230
City or Town State Zip Code
3. DATE DRILLED 6-1_ 8-92 USE OF WELL Monitor'
ng
4. TOTAL DEPTH 27.0
RS. CUTTINGS COLLECTED YES NO[]
6. DOES WELL REPLACE EXISTING WELL? YES 0 NOr7X
7. STATIC WATER LEVEL Below Top of Casing: 20,0 FT.
(Use 'i if Above Top of Casing)
t8. TOP OF CASING 1S. 0_0 FT. Above Land Surface'
A•Casing Terminated at/or below land surface Is illegal unless a variance Is Issued
lnsocordamce with 15A NCAC2C ciis
79. YIELD (gpm):__N/AMETHOD OFTEST _ NIA
r10. WATER ZONES (depth): N/A '
11. CHLORINATION: Type N A „ Amount N/A
12. CASING:
DEPTH
From To
0.0 - 27.0
DRILLING LOG
Formation Description
Brownish silty sand
If additional space is needed use back of form
Wag Thickness I LOCATION SKETCH
Depth Diameter or Weight/FL Material rShow direction and distance from at least two State
From 0.0 TO —17.0 Ft. ___2 ' �0 Pyr II Roads, or other map reference points)
From To FL
From To FL
GROUT:
Depth Material Method f
From 0.0 To 1 3 - n FL
From To FL
SCREEN: C
Depth Diameter Slot Size Material oc
From 17.OTo 27.0 Ft 2" in.
.010 in. �1
�tr, Pore►s
From To FL in. in. 3
From -To-Ft- in. in. MWOZ
SAID/GRAVEL PACK:
Depth Size Material
From 15.0 To 27.0 Ft 20/60
From To spia
- FL _
REMARKS:_ MW #2 ,gMDNTTR 97A1TROm 11 n L_
t o 1S t) [ H Zr►�N Iv R >_ Rd H W Y U !t
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 BEEN PROVIDED TO THE WELL OWNER.
7-8-92-
REv. 9/9t
SIGNATURE OF CONTRACTOR OR AGENT
DATE

North Carolina - Department of Environ , Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
FOR OFFICE USE ONLY
QUAD. NO. SERIAL NO.
Lat Long. RO
Minor Basin
Basin Code
ING CONTRACTOR: Performance Design Systems 1 Header Ent GW 1 Ent
STATE WELL CONSTRUCTION
REGISTRATION NUMBER: 1337 PERMIT NUMBER: 44-0299-WM-01 n0
LOCATION: (Show sketch of the location below)
t Town: Hendersonville, N.C. County: Henderson
1920 Chimney Rock Rd. HWY 64
(Road. Cornrnuntty. or 5ubdwwon and Lot No.)
VVNER Exxon Company, U.S.A.
voRESS P.O. Box 30451
(Street or Route No.)
Charlotte, N.C. 28230
Gty or Town State Zip Code
TE DRILLED 6-18-92 USE OF WELL Monitoring
TAL DEPTH 27.0
TTINGS COLLECTED YES ® NO❑
ES WELL REPLACE EXISTING WELL? YES [] NO®
ATIC WATER LEVEL Below Top of Casing: 20.0 FT.
(Use *+ if Above Top of Casing)
P OF CASING 1S 0.0 FT. Above Land Surface*
Terminated at/or Glow land surface Is Illegal unless a variance In Issued
trdance with 15A NCAC 2C .0118
:LD (gpm)•._l11 , METHOD OF TEST
LTER ZONES (depth): N/A
DEPTH
From To
0.0 - 27.0
DRILLING LOG
Formation Description
Brownish silty sand
3RINATION: Type NSA Amount NSA If additional space is needed use back of form
NG:
WagThickness LOCATION SKETCH
Depth Diameter or WeighVFL Material Show direction and distance from at least two State
0.0 To 17.0 FL 2" SCH 40 PVC Roads, or other map reference points)
To Ft.
To Ft. —
Depth Material Method
0.0 To 13.0 FL Portland/Bent S111r
To Ft
Depth Diameter Slot Size Material
17.07o 27.OFt 2" in. • 010in, PVC
To Ft. in, in.
To Ft._ in, in.
/GRAVEL PACK:
Depth Size
—15.0 To 27-0 FL 20160
.,_ To Ft.
,RKS: MW #3 BENTONITE
Material
1
q + S rmc_
�e
a MvrFAt3
1
1
HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C. WELL
STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
/.,.� %-8 —92-
9/9t SIGNATURE OF CONTRACTOR OR AGENT DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
FOR OFFICE USE ONLY
QUAD. NO. _ SERIAL NO. -----------�
Lat. Long. RO1_
Minor Basin
Basin Code
DRILLING CONTRACTOR: _Performance Design Svstws Header EnL Gw 1 Ent.
STATE WELL CONSTRUCTION �
DRILLER REGISTRATION NUMBER: 1337 PERMIT NUMBER: 44-0299-WM-01 o
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: ''Hendersonvi 11 e . I- camCounty:
1920 Ch mney Rock Rd. Hwy 64
(Road. Community, or Subdivision and Lot No.) DEPTH
2 OWNER From To
ADDRESS- P.O. Box 30451 0.0 - 25.0
(Street or Routs No.) --
Charlotte N.C. 28230
City or Town State Zp Code
3. DATEDRILLED 6-30-92 USEOFWELL M-4 .orinQ
DRILLING LOG
Formation Description
Brownish silty sand
4. TOTAL DEPTH 25.0 _ y
5. CUTTINGS COLLECTED YES Q NOE]
6. DOES WELL REPLACE EXISTING WELL? YES 0 NOD
7. STATIC WATER LEVEL Below Top of Casing: _20.0 FT,
(Us
S. TOP OF CASING 1S ° '+' if Above Top of casing)
��0— FT. Above Land Surface*
• Casing Terminated at/or below farad surface Is Illegal unless a variance is Issued
1n aecordsna with 15A NCAC 2C ,0118
9. YIELD (gpm): N/� METHOD OF TEST N/A
10. WATER ZONES (depth): N/A
11. CHLORINATION: Type N/A Amount N/A If additional space is needed use back of form
12. CASING:
Walt Thickness
Depth Diameter or Weight(Ft. Material
From 0.0 To _-10 - n Ft _._2= .fix AQ, Vyr
From To Ft
From To FL
13. GROUT:
Depth Material . Method
From 0.0 To 6.0 FLo is d-/Rent Slum
From —To FL
4. SCREEN:
Depth Diameter Slot Size Material
From _1 n _ o To ,)4 n Ft _ 2r' in. _ n i a in. ' MM___.
From To Ft in. in.
From To Ft in, in.
SAND/GRAVEL PACK:
Size ateria(
rom a•0 D � 25.0 FL 20/60 Med/ Fofine
From _ To. FL
REMARKS: MW #4 BENTONITE
1 LOCATION SKETCH
{Show direction and distance from at least two State
1 Roads, or other map reference points)
1Ft)JC716_
tsMwvs
—NT5
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
j'GW--1 REV. 9f91
"'&� -$ -Az-
SIGNATURE OF CONTRACTOR 6R AGENT DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment. Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626.0535
Phone [phone]
WELL CONSTRUCTION RECORD
i CONTRACTOR: Performance Design Systems
FOR OFFICE USE ONLY
OUAD. NO. SERIAL NO. ------,�
Lat Long. RO
Min" Basin
Basin Code
STATE WELL CONSTRUCTION
)BILLER REGISTRATION NUMBER: 1337 PERMIT NUMBER: 44-0299-WM-0100
WELL LOCATION: (Show sketch of the location below)
Nearest Town: Hendersonville County: Henderson
1920 Chimney Rock Rd.. Hwy 164
(Road, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG
OWNER Exxon Company U.S.A. From To Formation Description
ADDRESS-P.O. Box 30451 0.0 - 25.0 Brownish silty sand
(Street or Route No.)
Charlotte, N.C. 28230
City or Town State Zip Code
DATE DRILLED 6-30-92 USE OF WELL Monitoring
TOTAL DEPTH _ 25.0
L CUTTINGS COLLECTED YES 0 NO❑
i. DOES WELL REPLACE EXISTING WELL? YES [D NO®
STATIC WATER LEVEL Below Top of Casing: 20. 0 FT.
(Use '+' N Above Top of Casing)
6. TOP OF CASING (S 0.0 FT. Above Land Surface`
Casing Terminated aVor below land surface Is illegal unless s variance is Issued
In accordance with 15A N AC 2C .M 1 a
YIELD (gpm)' N/A •METHN/AFTEST N/A
0. WATER ZONES (depth):
CHLORINATION: Type A Amount N/A If additional space is needed use back of form
Z CASING:
_ Wall Thickness LOCATION SKETCH
Depth Diameter or WeightlFt. Material how direction and distance ? from at least two State _From 0.0 To 10.0 FL 2" SCH 40 PVC Roads, or other map reference points)
From To FL
From To FL
GROUT:
Depth Material Method
From 0.0 To 6.0 FL Portland/Bent Slurry
From To FL F ff
SCREEN: f� 1
Depth Diameter Slot Size Material 0
!From -10.0 To 2? 2 Ft _211 in. _- 010 in. PVC R� S
atom To Ft. in. in. 11C0
From -To Ft in. in.�
D/GRAVEL PACK: i Mw`�t5
Depth Size Material
m 8.0 To 25.0 FL •20/60 Med/fine silica saald
m To FL
RKS: Mid fly BENTONITE SEAL FROM 6.0 to -To Crl� MrUYc RecK 2i3 Nws1 t'_
00 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL .-
COiUSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
/ - r 8 /
REV. sni
SIGNATURE OF
OR AGENT
DATE

IC
I
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
FOR OFFICE uSE ONLY
QUAD. NO. _ SERIAL NO. ­­­�
Lu Long. RO —�
Minor Basin
Basin Code
DRILLING CONTRACTOR: Performance Design Systems ' Header Ent. GW-1 Ent
STATE WELL CONSTRUCTION—�
DRILLER REGISTRATION NUMBER. 1337 PERMIT NUMBER: 44-0299-Ulm-0100
WELL LOCATION: (Show sketch of the location below)
Nearest Town: Hendersonville, N.C. County: Henderson
1920 Chimney Rock Rd. Hwy 164
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNER Exxon Com an U.S.A.
From To
ADDRESS P.O. Box 30451
Fom,adon Description(Street
0.0 - 25.0 Brown silty sand
or Route No.)
Charlotte, N.C. 28230
City or Town State Zip Code
9. DATE DRILLED 6-30-92 USE OF WELL Monitoring
4. TOTAL DEPTH 25.0
6. CUTTINGS COLLECTED YES © NOO
E. DOES WELL REPLACE EXISTING WELL? YES F7 NO XQ
7. STATIC WATER LEVEL Below Top of Casing: 20 , 0 Fi-
.• (Use ': if Above Top of Casing)
1. TOP OF CASING IS � . n. n FT. Above Land Surface*
Icssing Terminated at/or below land surface is Illeflal unless a variance is Issued
Fti accordance with 15A NCAC 2C .MIS
i. YIELD (gpm): N/A METHOD OF TEST N/A
10. WATER ZONES (depth): N/A
11. CHLORINATION: Type At/AAmount g,tA—
If additional space is needed use back of form
l2 CASING.
b
1 S
Wan Thickness
Depth Diameter or Weight/Ft. Material
From 0. 0 To —10-0 Ft 2ft 40 _ PVC
FrOm— To Ft.
From----_.To Ft
GROUT:
Depth Material Method
From 0.0 To 6.0 Ft __Portland/Bent_ Slurry
From To Ft.
SCREEN:
Depth Diameter Slot Size Material
10.OTo 25.OFt 2" in .010 in. PVC
To FL in, in.
To Ft. in. in.
/GRAVEL PACK:
8.0 Depth Size Material
To 25.0 Ft 20/60 Med/fine silica
To Ft
a
�Ic
c
u
LOCATION SKETCH
direction and distance from at least two State
)ads, or other map reference points)
Mv�1dr►
SToitE
1
ROe.J: lzn t n.rV Leif
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
*NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
kv. 9,91
1 S fi
SIGNATURE OF CONTRA TOR OR AGENT DATE
Submit original to Division of Environmental Management and cow to well owner

FOR OFFICE USE ONLY
QUAD. NO. SERIAL NO. _---_�
Let Long. RO
Minor Basin
Basin Code
DRILLING CONTRACTOR: Performance Design Systems ) 1'1eaderEnc Gw t Ent
STATE WELL CONSTRUCTION --~�
DRILLER REGISTRATION NUMBER: 1337 PERMIT NUMBER: 44-0299-WM-0100
WELL LOCATION: (Show sketch of the location below)
NaarestTown:- Hendersonyi11e. N. C. County.- _
Henderson
1920 Chimney Rock Rd. Hwy 64
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
OWNER —Exxon C m
P.O. BOC 30451
From To
Formation DescriptionADDRESS
0.0 37.0 Brownish silty sand
(Street or Route No.)
Charlotte N.C. 28230
_ City or Town State Zip Code
37.0 Bed Rock
L DATE DRILLED 8-6-42 USE OF WELL Monitoring
i. TOTAL DEPTH 37.0
L CUTTINGS COLLECTED YES ❑ NO[XQ
L DOES WELL REPLACE EXISTING WELL? YES 0 NO
STATIC WATER LEVEL Below Top of Casing: 20.0 FT.
(Use': if Above Top of Casing)
TOP OF CASING IS 0.0 FT. Above Land Surface"
Casing Terminated st/or below land surface Is illegal unless a variance is Issued
Jn accordance with 15A NCAC 2C .0118
. YIELD (gpm)- N A METHOD OF TEST NIA
0. WATER ZONES (depth): N/A
1. CHLORINATION: Type NSA Amount N/A
If additional space is needed use back of form
2. CASING:
Wail Thickness
_LOCATION SKETCH
Jhow
r Depth Diameter or Weight/FL Material
r
direction and distance from at least two State
From 0.0 To ^32-0 Ft. —2"— SCH 40 PVC
From To Ft
From To FL
GROUT:
Depth Material Method
From 0.0 To 29.0 Ft. Portland/Bent Pumped
From To Ft. {
SCREEN: _y
Depth Diameter Slot Size Material
From 32.0 To 37.0 Ft 2�� in. .010 in. PVC
From To Ft in. in.
From To Ft in. in. i
SAND/GRAVEL PACK:
31.Depe
0 Toth
37.0 FL 20t� 60
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
Material
Med/fine silica s nd
From To----;-- FL ( ll%4,7e �+� lu t4wy L''f
REMARKS: MW #7 BENTONiTE SEAL FROM 29.0 to .0
dew- r
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF TkIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Roads, or other map reference points)
8 -1)4 %
SIGNATURE W CONTRACTOR OR AGENT DATE
Rom. 9�1 Submit original to Division of Environmental Management and ccov to well owner.

JUN
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Gro xitabex Fnobechian Irr-.
?
:QUAD: NO. +�-'QQin
.
...,.. �{ .:cif '_` ..4e. •__
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STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 1105 PERMIT NUMBER:
1. WELL LOCATI N: (Show sketch of the location below)
Nearest County:LQ
��Q�
i
(Road, Co u , or Subdivision and Lot Na_)
7y�
DEPTH
DRILLING LOG
2. OWNER .&n j
From To
Formation Description
ADDRESS �q as `
O, o•tJr,
(Street or Route No.)
` City or Town State 1 rp Code
3. DATE DRILLED USE OF WELL��
4. TOTAL DEPTH aS I
5_ CUTTINGS COLLECTED YES ❑ NOE]
6. DOES WELL REPLACE EXISTING WELL? YES [] NO®
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use '+" it Above Top of Casing)
8. TOP OF CASING IS Q . 6 FT. Above Land Surface'
Casing Terminated attar below land surface is illegal unless a variance is issued
in accordance with 15A NCAC 2C .0118
9. YIELD (gpm): Nk METHOD OF TEST NA
10. WATER ZONES (depth): NA
11. CHLORINATION: Type Amount Nk
If additional space is needed use back of form
12. CASING:
Depth Diameter
From m To 12' o FL a''
From To Ft.
From To Ft.
13. GROUT:
Wall Thickness LOCATION SKETCH
or WeighVFL Material (Show direction and distance from at least two State
Sd7. 40 pvc Roads, or other map reference points)
Depth n Material
From To "\' 0 Ft.
From To Ft.
14. SCREEN:
��
�viethod
�� ,.�1�� ✓ to ��
Depth Diameter Slot Size Material
From \O- o To Ft " in. • O p - in. EC t
From To Ft in. in....�_
From To Ft. in. in. i
15. SAND/GRAVEL PACK:
Depth Size Material 1
From 5. 0 To a 5 0 Ft. 20- M Fim S11-ica _1_ __ _ _
From To Ft
16. REMARKS: fir` �Gboa Bmtatibe PeUefs fmn 'l• O f:O�• d feet::
`mow -� --
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 BEEN PROVIDED TO THE WELL OWNER.
SIG
GW-1 REV.9I91 Submit
OF CONTRACTOR OR AGENT
al to Division of Environmental Management and copy to weft owner.

North Carolina - Department of Environment. Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, .N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: GraXlhiater PrOteCtiM Inc.
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 1105 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town-. County:
i (Road, Community, or bdivision and Lot No.) DEPTH DRILLING LOG
2. OWNER From To Formation Description
ADDRESS ao
(_Street or Route No) LN e)'
C Ira
City or Town State Zip Code
3. DATE DRILLED - ao • 3 tJSE OF WELL
4. TOTAL DEPTH a1
5. CUTTINGS COLLECTED YES ❑ NOtK
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO�
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'+' if Above Top of Casing.)
8. TOP OF CASING IS O , O FT. Above Land Surface`
• Casing Terminated atlor below land surface Is illegal unless a variance Is Issued
in accordance with 15A NCAC 2C .0118
9. YIELD (gpm): .NN METHOD OF TEST I&
10. WATER ZONES (depth):
11. CHLORINATION: Type -
12. CASING:
Depth Diameter
From D ' To Ft. r,
From To Ft.
From To Ft.
13. GROUT:
Amount Na If additional space is needed use back of form
WallThickness LOCATION SKETCH
or WeightfFt. Material (Show direction and distance from at least two State
Sch. 40 PVC Roads, or other map reference points)
Depth Material Method
From L •C*) To q. d F(. '
4
From To Ft.
14. SCREEN:
Depth Diameter Slot Size . Material
From 1a-0 To al O Ft Ait in. -6V`) in. PM
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From Tomb Ft. M-f Fire cA1icn Slmd
From To Ft. --
16. REMARKS: C'�).0 Q lattmite -Pe11.et^s fmn °1 to ft�
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND, THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNAE OF COWRAdOR OR AGENT
GWA B/91 ` Submit orhlnal to Division of Environmental Management and copy to well owner.
.�'R('TS

r WELL CCMFi.EI.ZON LOG
LOCATION: —Exxon #45552 Hendersonville ;C?-K ORDE #
E ------ N. C • _.._._ D-_1_9_7 _
AXRESS' 1920.Chimney Rock Rd, Hwy 164 --�'
E CL=: Delta Environmental 6-18-92
it V= NUMBER: mw #1 CON=:
Luba Gross
nZTA= BY:
Roy, Chris, Jim
C111ER SERVICES PERF'ORt=:
1 0
25.0 I
u-1
10.0I
NOW
C�I�RE1'E 2 BAGS
C EM= GRWr 4 BAGS
RISER - BCH 40 PVC
RISC — SiZE 21
1
BEM'CNI'I'E 50 lbs 3/8 pellets
SOZEEN - T� SCH 40 PVC w--
SCREEN - SIZE 2" .010
FILTER T pE 2-0/60 Med/fine silica sand
DEV=RO m7ci T: 3r�c^i RD r1r m
AIR LIFT Sum Svc lzI z. x
T=L Tom' TOIAL GALLONS:
TER APB: START FINISH - _.�--
----------
25.0 I
u-1
10.0I
NOW
C�I�RE1'E 2 BAGS
C EM= GRWr 4 BAGS
RISER - BCH 40 PVC
RISC — SiZE 21
1
BEM'CNI'I'E 50 lbs 3/8 pellets
SOZEEN - T� SCH 40 PVC w--
SCREEN - SIZE 2" .010
FILTER T pE 2-0/60 Med/fine silica sand
DEV=RO m7ci T: 3r�c^i RD r1r m
AIR LIFT Sum Svc lzI z. x
T=L Tom' TOIAL GALLONS:
TER APB: START FINISH - _.�--
----------

I wZU CCF11 'r-T0N LOG 1
I _-- --
WOR:{ ORDER Ia ,OCATION'� Exxon #45552 Hendersonville_ N.C. D-197_ -
S' 1920 Chimney Rock Rd.
Ts Delta Environmental DATE 6-18-92
"MIL Mw #2 Luba Gross
I J2ZIALLED SY: Roy, Chris, Jim
7ZHER SERVICES PEO7 CMM):
t
27.0
u-1
110.0 I
VA
,=
im.
X F LM MADE
ABOVE GRADE PROZE3271OR
WNE
C7OU' ETE 2 BAGS
CEMENT GROW 4 BAGS
RlRISER - TfpE Sch 40 PVC
EEN!'ONITE 50 lbs 3/8 pelletg
SCOZEMN - TYP-= SCH 40 PVC
SCREEN - SZ2E 2" .010
FILTER Tye 20/60 Med/fine silica sand
I%EVFLOFi'TrVI': BASLc'D� Fur Ir'-.jJ Art LIFT-- SJRC;"
TOTAL TImx--: TOTAL GALLONS:
k.TER APPEARANCE: START FZNISf
------ --------------__—

Pups VOTITTs OUT;/Pax 09/0Z
36nz IM'II3
O T O' u Z �SZI$ -- NZMW
0Ad Obi HOS SE7,1 — !�S
sIaTTad 8/E sqT 05 - ..-rnrpu�IIH
ilz 3ZIS — 2s 22i
0Ad 0*I HOS � _ =Id
soya 17 =ED aqmm
SvJM Z 3S3ld=N
29CH
arloEmmu X
CaMe'}i M TC.�11 �SiT 3Orl31f.'ia
+
+
+
+'
+
+
{
0
1
act C . w .1Ci. .� a
stsq,a uFAax 'dog :fig �5� -
i
ssozq eqnj Ell Mid
Z6-8T-9 3 Ts-4uatauosTAUZ s4Taa
179T AAH 'PX wog 18=TqD OUT =SS QCid
LST-Q J „s ZSSSh l uoxxg-�
-------------------- - --

WELL C "a E -Obt LOG
u
LOCATION: Exxon IM 5552 Hendersonville �� Ogg fur
`ADDRESS: 1920 Chimney Rock Rd. Hwy 1,64
Delta Environmental DATE 6-30-92
�=L P: MW q{4 COX=' Luba Gross
' BY: Roy, Chris, Jim
0
- 25.0
1 15.0 f
I /
0
Im
X FLUSH 2"Y'J1VC7.rLE
R�
RZ—CTR - TYLB SCH 40 PVC
RIS'R - Sim 211
HF�dT M-1 50 lbs 318 pellets
Sa -`N - =- SCH 40 PVC
SC= - SIZE 2" .010 slot
FILTER TYPE 20/60 med/fine silica sand
DEVEi4Pi=: Bo-i= Fries AM LIFT Sv'FM SKAB MNE X
TOTAL TIlVE: TGTAL GALLONS:
WATM APPEARANCE: STAPT__���—

WEr-L CU-ZL,f.TION LCG
ION'.._ Exxon #45552 Hendersonville_
PLDRESS' 1920 Chimney Rock Rd. T
SCR:{ ORDER A
D-197
crj=: Delta Environmental DATA
6-30-92
UELZ Imo: M4+t !i5 Ct,Pi!'ACT:
Laba Gross
INSTALLED BY:
Roy, Chris, Jim
OII-E:R SERVICES PERFpRMM:
f0�
10.0
25.0
t
t
F
i
i
i
t
t
e
X FVJSH NAMME
MNE
a�NME= 2 BAGS
(:E� G'ZZ 2 BAGS
TYM SCH 40 PVC
RIMM SIZE 2"
BENMNITE 50 lbs of 3/8 pellets
SCREEN - TYPE SCH 40 PVC
SCRE N - SIZE 2" .010
F'TER TYP-' 20/60 Med/fine silica sand
I)VELO -VT: Au`Z LIFT
SvnG'c SWAB NGIZ }{
TOTAL TIlYr-.: ----- ------ --__ -----
TVrAL GALLONS:
KkTER A.PPF-A : STARr -- ��_---�- -
FL*7IS'ri

� � OQi�3ZTION i,(]G
LCgATION: 5552 Hendersonville
---_---- Exxon 4E4hURM ORDER rYr D- 197
ADDRESS: 1920 Chimney Rock Rd. Hwy 164 �~
Q'IEW' Delta Environmental DATE
. b-30-92
Luba Gross -
INSTMJM BY: Roy, Chris, Jim
MM SERVICES FERF1QF M:
I'li-I ! ! + i ! i ! ,
110.01
s
25. 0
/
/
15.0
i--- ---- t
X FWSH MANE=
ABOVE GcWE pR=S=0R
ICNE
CONMEM
QUv 2 BAGS
SCH 40 PVC
RISER — SIZE
BENICNITE 50 lbs of 318 pellets
SCREEN - TYPE— SCH 40 PVC
SCREEN - SIZE 2" .010 slot
Fes'TER 7YPE 20/60 Hed/fine silica sand
DfiVELOPt�=: GAMED MGM . AIR.L-*EFr - �� SWAB, NODE X
Tai'AL TIl TOTAL GM DONS.
MATAPPEARANCE: START
FINiSri

WELL C ad:LL ION LOG
LccATICN:— Exxon #45552 w VJDFK ORDE<t # D214
X)DRE.SS: 1920 Chimney Rock Rd. Hwy 64 Hendersonville, N.C.
tZImr: Delta Environmental Consultants DATE 8-6-92
,WELL N[.MER= MW #7 (D(cl-r� _ � Doug
T
114S�� L' Roy, Chris, Jim -_
7vR SERVICE'S PE REMM :
~0
I
32.0
37.0
/I
+
t
5.0 I
+
+
+
+
+
+
4,
+
•
+
K FLUSH MkNHME
ABOVE GRADE PROTECIOR
MNE
CONCRETE 2 BAGS
CE U GR,OCTT 10 BAGS
R= -TYPE SCH 40 PVC
RISER - 211
BENMNITE 50 lbs of 3/8 oellets
SCREEN - TYM SCH 40 PVC
SCREEN - SIZE 211
FILTER TYPE 20/60 Med/fine silica sand
DEVELOPMENT: BA = PM 2ED AIR LIFT SJRG'• SWAB Me g
TOTAL MS.- T(7I'AL GALLONS:
WATER APPEARANCE: START FINISH
-------�_------------------
- --------- --------------

Performance
DESIGN SYSTEMS
P.O. BOX 26413 - CHAR► OtTc. N.C. 28221 (704) 33-9-8845
Location
Exxon #45552 Hendersonville,
N.C.Driller Roy Wilcox
1920 Chimney Rock Rd.
Drill Crest Kevin, Chris
Client
Delta ENvir onmenta3
Boring Date 6-1$-92
Projectj.
D-197
Boring Q Mw #1
Method:
8amae: adv.--, Thru auger
�, Rotary �. Split Spoon x
Shelby Tube �.
Static vater.level 20.0
I
a=ple Sample N Value Sample Water - Description
Depth Type Presence' Remarks
0.0 - 3.0 Post hole No Asphalt Tah silty sand
l
2
5.0 - 7.0
10.0-12.0
2,2,1,1
2,3,3,3
SS
SS
Tan silty sand
Tan silty sand '
3
4
115.0-17.0
120.0-22.0
2,1,2,2
1,2,2,4
SS
SS
,
Tan silty sand
Tan silty sand
125.0-27.0
T
I
Auger
�
�
I Tan silty sand
I
- 1
BORMG TERMINATED AT 22.0
I
I

PerfoYmance
DESIGN SYSTEMS
P.O. BOX 26413 - CHAALO1 i c, N.C. 25221 - [phone]
Location Exxon #45552 Driller Roy Wilcox
Drill Crew ,-,ir- rrt,,;
Client Delti Environmental Baring Date, 6-1R-Q?
Projectf. -D-197 Boring 9 ttW #2
Kethod: aaer adv._, Thru auger X Rotary • Split Spoon .X ,
Shelby Tube -
Static vater.level 20.0
arple Sample ' H Value Saaple water Description
Depth Type Presence' Reaatk3
.
0.0-3.4
Post hole
No
Asphalt
Tan sandv silt
1
10.0-12.0
7,12,6,7
SS I
No
Tan sandy silt
2
15.0-17.0
2,4,5,5
SS 7—No
Tan sandy silt
3
20.0-22.0
4,3,3,4
SS
Yes
Tan sandy silt
22.0-27.0
Anger
Yes
Tan sandy silt
BORING TERMINATED AT 22.0
I
I
I
i
1 4
I
I
1
I

j
Performance
DESIGN SYSTEMS '
P.O. BOX 26413 - CHARLOI ic, N.G 28221 • (704) 335-884.5
1
Location Exxon IM5552 Hendersonville Driller Rohr Wilcox
1920 Chimney Rock Rd. Drill Crev_ Kevin. .Chris _
Client Delta Environmental Boring Date 6-18-92 ~r
Projectf. D-197 Boring a MW #3
Method: Haarser atdv.`_, Thru auger X Rotary �. Split Spoon X�, :
Shelby Tube
a Static Water level 20.0
�K
7
a=ple Sample N Value Sample Water Description
Depth Type Presence' Remarks
0.0 --3.0
Post Hole
No
Brownish silty sand
3.0 - 10.0
Auger
No
Brownish silty sand
1
10.0-12.0
4,4,4,4
SS
No
Brownish silty sand
2 �15.0-17.0
13,3,4,4•
SS
Moist
Brownish silty sand
�17.0-27.0
Auger
Yes
Brownish silty sand
BORING TERMINATED AT•17.0
'
i
t
I
�
I
I
1
1

1.
Performance
DESIGN SYSTEMS
P.O. BOX Z6413 - CHA.RLO 11 E, N.C. ZSZZ i • [phone]
Location Exxoendersonville Driller Roy Wilcox
1920 Chimney Rock Rd Drill Crew Chris, Jim
Client Delta En�rironmental ��� � Boring Date 6- 0-92
Project, - ont... Baring f
Method-. Hamer Adv. �Thru auger ``, Rota. X
Shelby Tube �• 'Y ��• Split Spoon
Static vater.level 20.0
a=ple
Sample
Depth
X Value
Saaple
Watez
Description
Type
Presence'
Remarks
0.0 -'3.0
Post Hole
No
Blown Gray silt -
1
5.0-7.0
7,2,2,2
SS
No
Brown Gray silt
2
10.0-12.0
2,2,1,2
SS
No
Brown Gray Silt
3
15.0-17.0
3,2,1,4
SS
No
I Brown Gray silt
17.0-25.0
Auger
Yes
Brown Gray silt
.
.
I
f
i
f
�
�
f
BORING TERMINATED AT 17.0
i

Performance
DESIGN SYSTEMS
P.O. BOX 26413 - CIARL01ME. N.C. 28221 - [phone]
Location Exxon 1145552 Hendersonville
1920 Chimney Rodk Rd.
Client Delta Environmental
Project; D-197
Driller Roy Wilcox _
Drill Crev Chris, Jim
Baring Date 6-30-92
Baring 9 MW #5
Method: $am:ser adv. , Thru auger X , Rotary Split Spoon X`,
Shelby Tube.
Static eater,level 20.0
Sample Sample N Value Sample Water - Description
Depth Type Presence' Remarks
0.0 . 3.0
Post Hole
No
Brownish silty sand
1
5.0-7.0
1,1,1,1
SS
No.
Brownish silty sand
2
10.0-12.0
2,4,3,3
SS
No
Brownish silty sand
3
15.0-17.0
1,3,3,4•
SS
( Moist
Brownish silty sand
117.0-25.0
Auger
Yes
Brownish silty sand
IBORING TERMINATED AT r7.0 .
-
i
I
I
�
I
I
I
I !
I
I
I

Performance
DESIGN SYSTEMS
P.O. BOX26413 • CHARi-OTIc, N.C. 28221 - [phone]
Location Exxon #45552 Hendersonville Driller Roy Wilcox
1920 Chimney Rock Rd. Hwy 164 . Drill.Crev Chris Jim
Client Delta Environmental Boring Date 6-30-92
Projectf. D-197 Boring 0 MW #6
Method: Rammer adv.^-, Thru auger � X , Rotary . Split Spoon � X ,
Shelby Tube`.
Static vatar.level 20.0 '
Sample Sample N Value Simple Water - Description
Depth Type Presence' Remarks
�0- - 0 -•3.0 Post Half No Asphalt
Brbwn Gray Silt -
1 5.0-7.0 4,4,5,5 SS No- Brown Gray silt
2
10.0-12.D
2,3,3,5
SS
No
Brown Gray silt
3
115.0-17.0
117.0-25.0
1,2,2,4
SS
Auger
Moist
Yes
Brown Gray silt
Brown Gray silt
BORING TERMINATED AT -17.0
I
1
I
•

aq;
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
June 15, 2012
MEMORANDUM
TO: Landon Davidson, Asheville Regional Office
FROM: Michael Rogers, Central Office ,/!/
RE: In Situ Remediation Application/Notification (Permit 4WI0100202)
Attached is a duplicate copy of a former 51 Groundwater Remediation Permit Application for your file. Based upon
information in the application and follow-up additional information received by ARCADIS on May 22, 2012, we
concluded it met the criteria for being `deemed permitted by rule' according to the newly revised 2C .0200. Per my
request, you should have received a duplicate copy of the additional information packet dated May 21, 2012. If you did not
receive this, request a packet directly from Scott as the additional information has attached maps and figures.