WI0400543_Permit (Issuance)_20201022

NC Department of Environmental Quality — Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of ISA NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to injection)
AQUIFER TEST WELLS (15A NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small -Scale Injection Operations —Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells is located within an area that does not exceed five percent of the land surface
above the known extent of groundwater contamination. An individual permit shall be required to conduct more
than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
5) In -Situ Thermal Wells (IST) — Used to `heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: October 16 , 2020 PERMIT NO. (to be filled in by DWR)
NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No. WI0400543
Issued Date: 03/10/20
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well ....................................... Complete sections B through F, J, M
(2) Aquifer Test Well ....................................... Complete sections B through F, J, M
(3) Passive Injection System ............................... Complete sections B through F, H-M
(4) x Small -Scale Injection Operation ...................... Complete sections B through M
(5) Pilot Test ................................................. Complete sections B through M
(6) Tracer Injection Well ................................... Complete sections B through M
(7) In -Situ Thermal (IST) Well ........................... Complete sections B through M
B. STATUS OF WELL OWNER: Business/Organization
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 1

C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): Akzo Nobel Coatings, Inc. (Brett Whittleton, Vice President, Director Legacy Assets &
Environmental Affairs)
Mailing Address: 1 East Water Street
City: Waukegan State: _IL Zip Code: 60085 County: Lake
Day Tele No.: 312-613-8684 Cell No.: 312-613-8684
EMAIL Address: [e-mail] Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title:
Company Name
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Jasen Zinn, PE
Company Name: AECOM Technical Services
Mailing Address: 1600 Perimeter Park Dr. Suite 400
City: Morrisville State: NC_ Zip Code: 27560 County: Wake
Day Tele No.: 561-271-9662 Cell No.:
EMAIL Address: [e-mail] Fax No.:
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Former Chemcraft, 3950 New Walkertown Rd.
City: Winston-Salem County. Forsyth Zip Code: 27105
(2) Geographic Coordinates: Latitude": 36 ° 8 44.0484" or °
Longitude": 800 11_' 14.316" or °
Reference Datum: Accuracy:
Method of Collection: Google Maps
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume:—10,000 square feet
Land surface area of inj. well network: —1,100 square feet (< 10,000 W for small-scale injections)
Percent of contaminant plume area to be treated: —11 % (must be < 5% of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 2

H. INJECTION ZONE MAPS — Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE — Provide a brief narrative
regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity:
The contamination Dresent in the eroundwater is a result of a historic release at a former coatings facilitv. An air
sparge/soil vapor extraction system is currently in operation; however, some additional injection is being
proposed downgradient. The goal of the injection is to prevent contamination from entering the creek utilizing
bioremediation. Fifteen injection locations are proposed, and each point will receive approximately 250 gallons
of 3 wt% hydrogen peroxide solution. The proposed injection interval is from 6 to 16 feet BLS through temporary
wells. The temporary wells will be constructed of 3/4" diatmeter PVC casing and screen.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 15 Proposed Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS): 6 - 16 feet
(3) For Proposed wells or Existing wells not having GW-Is, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as -built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
K. INJECTION SUMMARY
NOTE: Only iniectants annroved by the enidemiolo2v section ofthe NC Division ofPublic Health. Denartment
of Health and Human Services can be iniected. Approved iniectants can be found online at
http:Hdeg.nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Profor more info i�you wish to eft approval for a different additive. However, please
note it may take 3 months or lonzer. If no iniectants are to be used use N/A.
Injectant: Hydrogen Peroxide Total Amt. to be injected (gal)/event: 3,750
Injectant: Total Amt. to be injected (gal)/
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3

Injectant: Total Amt. to be injected (gal)/event:
Injectant: Total Amt. to be injected (gal)/event:
Injectant: Total Amt. to be injected (gal)/event:
Total Amt to be injected (gal/event): 3,750
No. of separate injection events: I Total Amt. to be injected (gall: 3,750
Source of Water (if applicable): fire hydrant
L. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subehapter 02L result from the injection activity.
Currently- annual groundwater sampling is performed around November/December of each year for volatile
organic compound utilizing EPA Method 8260D. Additionally, groundwater quality parameters are also
collected. This annual sampling plan will continue going forward at select site monitoring wells. The primary
sampling locations for monitoring this infection event are SW-1 (surface water) and TW-18 through TW-22.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "7 hereby certify, under penalty of law, that I am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. 1 am aware that there are significant penalties, including the possibility offines and imprisonment,
for submitting false information I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules. "
Brett Whittleton, VP, Director Legacy Assets & Environmental Affairs
Signature of Applicant Print or Type Full Name and Title
Property Owner (if the property is not owned by the Well Owner/Applicant):
"As owner of the property on which the injection well(s) are to be constructed and operated, I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(15A NCAC 02C .0200). "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
abser1ft&%VAry agreement in writing.
7414 oxerSPSlbsoT F#A I
SignMe* orProperiy Owner (if different fr&n applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send I (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR— UIC Program
1636 Mail Service Center.
Raleigh, NC 27699-1636
Deemed Permitted GW Remediation NOI Rev. 2.17-2020 Page 4

Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 5

Ir00aIs: ueslyrleC I on l [JeGKeU: CIVI
SW 1 -
- 876ATW-18
iq
� • '
STW-19 876
a�8 MW®15 878
OM W-16
55-GALLON
DRUM
REMOVAL
AREA
2 _f.�SW-3 �.
SW-4 CREEK
g80 ` 880/ ^ \MW-17,0 GRAsc _
6
88
TW-13®
TW-1
ANNUAL PROGRESS REPORT - 2019
AKZO NOBEL COATINGS INC.
WINSTON SALEM, NORTH CAROLINA
Project No.: 60618053 Date: 2020-02-04
886
TW ®
{ r�-� .
W®6 OMW-12
�....T4 88
.-_8
WATER TABLE CONTOUR MAP
DECEMBER 2019
0
WELL ID
DATE(FEET
DEPTH TO
WATER
BTOC
TOC ELEVATION
FTAMSL
GROUNDWATER
ELEVATION
FTAMSL
MW-2
12/3/19
18.22
907.08
888.86
MW-4
12/4/19
11.92
906.85
894.93
MW-6
12/4/19
35.08
922.51
887.43
MW-13
12/4/19
31.28
920.70
889.42
MW-14
12/4/19
DRY
919.74
DRY
MW-15
12/3/19
3.36
881.47
878.11
MW-24
12/4/19
14.20
906.74
892.54
TW-3
12/4/19
27.85
919.69
891.84
TW-4
12/4/19
31.14
919.59
888.45
TW-5
12/4/19
30.67
919.57
888.90
TW-7
12/4/19
30.22
921.51
891.29
TW-10
12/4/19
31.37
919.60
888.23
TW-11
12/4/19
31.27
920.13
888.86
TW-15
12/3/19
35.09
918.86
883.77
TW-17
12/3/19
24.32
905.27
880.95
TW-18
12/3/19
5.79
881.21
875.42
TW-19
12/3/19
5.33
881.53
876.20
NOTE: MW-14 NOT USED IN CONTOURING.
TW/M W
MW-9D
SW-5
0 100
APPROX. SCALE, ft.
LEGEND
MONITORING WELL
VERTICAL EXTENT MONITORING WELL
SURFACE WATER SAMPLE
GROUNDWATER CONTOUR
GROUNDWATER FLOW DIRECTION
Figure: 8

r IItlIItlIIIe. V.\UJCRJ\UAIVIr DCLLI.\VVUUIVI CIV I --VI VVURR—UIVUDCL\VRUU IN U VVA I CR RCr— I ODU IOUDO—V-1-1 RC J AUC I UIVC IJUrLC I M IV— LU I—V—-rofect management InmaIs. Uesgner. i J" uneoKea: CIVI Approvea: CIVI
OM 1W 5
\`
600 \T ®17 r
\ S
\ O
TW-16 ® �
55-GALLON
DRUM
REMOVAL
AREA \ TW-15�
TW-13®
TW-12
Mw-1
ANNUAL PROGRESS REPORT - 2019
AKZO NOBEL COATINGS INC.
WINSTON SALEM, NORTH CAROLINA
Project No.: 60618053 Date: 2020-02-04
SSW--3
SW-4
®M7MW-170
� GRASS
�N OL)s ®MW-1 WO
TW-8
MW-6
/ W-12
10 ® 600 �N-14
� T
®TW-4 v
9 �
1
MW®13
�600116,000
T 3
MI
�P
Q
Q
,5.0 JQ
,.
<5.0
1
°o MW-24
MW-23�
®MW-21
�2® 1
k s °O,
MW-70
OM W-8
MW-30
�o
9y
MW-19
MW-20 MW 0
ACETONE ISOPLETH MAP
DECEMBER 2019
0
ACETONE
SAMPLE NAME
SAMPLE DATE
CONCENTRATION
MW-2
12/3/19
<5.0
MW-4
12/4/19
5.7
MW-6
12/4/19
3.5 J
MW -13
12/4/19
6.2
MW-14
12/13/19
200,000
MW-15
12/3/19
<5.0
MW-24
12/4/19
80
TW-3
12/4/19
<500
TW-4
12/4/19
17
TW-5
12/4/19
43,000
TW-7
12/4/19
33
TW-10
12/4/19
210 E
TW-11
12/4/19
20
TW-15
12/3/19
7
TW-17
12/3/19
20
TW-18
12/3/19
980
TW-19
12/3/19
<5.0
2L STANDARD
6,000
NOTES:
1. BOLD CONCENTRATION INDICATES EXCEEDANCE OF
THE 2L STANDARD OF 6,000 ug/L.
2. ALL CONCENTRATIONS ON TABLE ARE IN MICROGRAMS
PER LITER (ug/L).
J
0 100
I APPROX. SCALE, ft.
LEGEND
TW/MW ®
MONITORING WELL
MW-9D ®
VERTICAL EXTENT MONITORING WELL
SW-5 a
SURFACE WATER SAMPLE
ACETONE ISOPLETH LINE ABOVE 2L STANDARDS
(DASHED WHERE INFERRED)
ACETONE ISOPLETH LINE BELOW 2L STANDARDS
(DASHED WHERE INFERRED)
<5.0
RESULT IS LESS THAN THE INDICATED VALUE
E
ESTIMATED CONCENTRATION GREATER THAN
THE INSTRUMENT CALIBRATION RANGE
J
ESTIMATED VALUE
�'wlqww w I
Figure: 3

=CaPeroxide inj 7' roi; 6'-16' bgs (15)
TW-190
-"*AMlk
3%-"W,A.G�3, W
lop
AS-3�4R
�34RR ♦ ��
%� �33

Well Construction Data - Former Chemcraft
Proposed Well ID
I Well Type
ITotal Depth
lWell Contractor Name
ICertification Number
IW-23 through IW-37
ITemporary 3/4" PVC
116 feet
I Redox Tech
4415-C