WI0300153_Permit_20130326

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Plantation Pipe Line Company
--FOR THE CONSTRUCTION AND/OR OPERATION OF ONE HUNDRED . SIXTY FOUR
(164) IN SITU REMEDIATION/TRACER INJECTION WELLS, defined in Title 15A North
Carolina Administrative Code 2C .0209(5)(b)(viii), to inject Micro-Bac M-100011, ORC-A,
RegenOx, Hydrogen Peroxide, Sodium Pursulfate, and TriPhasic 12 for the oxidation and
bioremediation of petroleum hydrocarbons. These well points will be located at the Plantation
Pipe Line Company Poplar Tent Road Site, located near the intersection of Poplar Tent Road and
Middlecrest Drive NW, Huntersville, Cabarrus County NC 28078, and will be operated in
accordance with the previous permit application received April 29, 2011, and in conformity with
the specifications and supporting data submitted July 15, 2011, and the renewal application
received March 12, 2013, all of which are filed with the Department of Environment and Natural
Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until February 28,
2018, and shall be subject to the specified conditions and limitations set forth in Parts I through
X hereof.
Permit issued this the 26th day of March 2013.
L�
Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. W10300153 PAGE 1 OF 6
ver. January 2013 UIC-51/5T

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during
construction and use.
8. Each injection well shall have permanently affixed an identification plate.
PART H - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Aquifer Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number 919-807-6406 and the Mooresville Regional Office Aquifer
Protection Section Staff, telephone number 704-663-1699
2. Bentonite grout shall not be used to seal any water -bearing zone with a chloride
concentration equal to or greater than 1,500 milligrams per liter. In areas where elevated
chloride levels are known to exist or are probable, such as coastal areas, chloride levels shall
be verified in the field to determine existing conditions.
Permit No. WI0300153 PAGE 2 OF 6
ver. January 2013 UIC-5I/5T

' PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances that may be imposed by other
local, state, and federal agencies having jurisdiction. Furthermore, the issuance of this permit
does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use.
2. In the event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
3. The Permittee shall be required to comply with the terms and conditions of this permit even
if compliance requires a reduction or elimination of the permitted activity.
4. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned alterations or additions in the permitted facility or activity not specifically
authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone number 919-807-6406 Notification is required so that Division staff
can inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
Permit No. WI0300153 PAGE 3 OF 6
ver. January 2013 UIC-51/5T

PART VI - INSPECTIONS
- 1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
- PART VII - MONITORING AND REPORTING REQUIREMENTS
1. The proposed monitoring plan included in the application shall be followed. Any additional
monitoring, including groundwater, surface water, or soil sampling, deemed necessary by the
Division of Water Quality to ensure surface water and groundwater protection may be
established and an acceptable sampling reporting schedule shall be followed.
2. All sample results shall be submitted to the Aquifer Protection Section's Mooresville
Regional Office and the Raleigh Central Office. Monitoring reports shall include, at a
minimum, analytical data and an update on the status and location of monitoring and
injection wells. Well locations may be given in a table with the name and geographic
coordinates or shown on an updated version of the surveyor's base map.
3. Within 30 days of completion of well construction, a complete Well Construction Record
(Form GW-1) shall be submitted to the addresses specified in Part VII.6 below.
4. The Permittee shall submit an Injection Event Record within 30 days of completing each
injection.
5. The Permittee shall submit a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce an interim evaluation while
submitting a renewal application ,for this permit. Both the final project evaluation and
interim evaluation shall contain historical monitoring data and updated contaminant plume
and potentiometric surface maps.
6. All monitoring results, forms, and reports required in this Part shall be submitted to:
UIC Program Staff
DWQ — Aquifer Protection Section and
1636 Mail Service Center
Raleigh, NC 27699-1636
DWQ - Aquifer Protection Section
Mooresville Regional Office
610 E. Center Avenue
Mooresville, NC 28115
Permit No. WI0300153 PAGE 4 OF 6
ver. January 2013 UIC-H15T

7. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Mooresville Regional Office, telephone number 704-663-1699 any
of the following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
8. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
9. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIH - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily,. the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0240, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0240, including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to do so could lead to the contamination of an underground source of
drinking water.
(D) Drilled wells shall be completely filled with cement grout or bentonite grout, which
shall be introduced into the well through a pipe which extends to the bottom of the
Permit No. WI0300153 PAGE 5 OF 6
ver. January 2013 UIC-5I/5T

well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0225(k)(1)(A) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X - WORKER PRECAUTIONS DURING APPLICATION
1. Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat, and lung irritation. If the product is released into the environment in a
way that could result in a suspension of fine solid or liquid particles (e.g., grinding, blending,
vigorous shaking or mixing), then proper personal protective equipment should be used. The
application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. Face and body protection should be used for anticipated splashes or
-sprays.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0300153 PAGE 6 OF 6
ver. January 2013 UIC-5I/5T

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
June 30, 2011
PERMIT ISSUANCE MEMO
TO: Debra Watts
THROUGH: Thomas Slusseras
FROM: John McCray
RE: Permit To Inject sodium persulfate, and hydrogen peroxide across the site and RegenOx, ORC-
Advanced, and Micro-Bac M-1000H and Triphasic 12
Plantation Pipe Line Poplar Tent Road Site \�A-e con+pW'4 � s�Pd
a
I recommend that Permit Number WI0300153 be issued to Plantation Pipe Line Company to injecto-o""n to
remediate groundwater contaminated with hydrocarbons.
SITE DESCRIPTION Turbine fuel was released to the groundwater initially in 1976 through a leak in the pipe line.
The pipe line was cleaned and deactivated in 1977. Prior remedial activity at the facility recovered 1,050 gallons of
product. Further impacted soils were uncovered in 2007 during construction of a road crossing the former pipeline at
a location of 100 feet to the northeast (down -gradient) of the 1976 release location. During inspection and
maintenance of pipelines at the location, 200 tons of contaminated soil was removed, four large diameter recovery
wells were installed (May 2009), and fourteen separate Aggressive Fluid Vapor Recovery events have been
conducted. Contamination is located within the groundwater of the surficial aquifer, extending into the upper portion
of weathered bedrock. Groundwater flows across the site to the north-east.
HYDROGEOLOGIC DESCRIPTION The site is located within the inner Piedmont Physiographic Province and is
underlain primarily by saprolitic sand and silt derived from underlying bedrock. Within the constraints of the site, the
surficial aquifer is contained within the saprolite and extends down into the fractures of the bedrock. Depth to
groundwater ranges from 24 feet below ground surface (bgs) near the release location to 3 feet bgs adjacent to the
stream, and it flows to the northeast under a hydraulic gradient of .02 ft/ft through the saprolite aquifer that has an
average hydraulic conductivity of approximately 10.48 ft/day. The average velocity for groundwater under these
conditions is approximately 1.1 ft/day.
EXTENT OF CONTAMINATION Contaminant distribution of hydrocarbons for concentrations above the
NCGWQS is located within the surficial aquifer, based on the most recent sampling event, and has two components.
The main component is roughly elliptical in distribution, having a long axis of —335 ft. and an —125 ft. long short axis
(Figure 4-3), while the smaller disseminated zone occurs in the deeper, weathered bedrock zone, is ellipital in shape,
consists of Benzene and Naphthalene, and has a long axis of —135ft and a short axis of —56 ft (Figures 4-2 and 4-5).
The large contaminant plume extends to the northeast from a point near Edgepine Lane, and the smaller, deeper
plume, represents an extension of the main plume into the weathered bedrock and occurs in the vicinity of the
unnamed stream. The plume extends to an overall depth of —60 ft. below ground surface in the vicinity of monitoring
well MW-8.
PROPOSED INJECTION The applicant proposes an injection of sodium persulfate, and hydrogen peroxide
across the site and pilot test injections of RegenOx, ORC-Advanced, and Micro-Bac M-1000H and Triphasic 12
through a series of four injection events through V Direct Push Points per event. The total volume of injectant
r �" comprises —19.7 percent of the contaminated aquifeL

HOW IT WORKS The main remedial activity of the sodium persulfate and Hydrogen Peroxide solution as well
as RegenOx is through direct oxidation of contaminants. The ORC-Advanced and Micro-Bac solutions remediate
contaminants through enhanced biodegradation.
MONITORING All monitoring wells, monitoring event type, and parameters analyzed are listed in table form
in Attachment F. T=hir"ne-(34)existing-mar tring-wells-loea d-s the site�wiii' be sampled for a baseline
monitoring event. Injection perfomance monitoring for the events will be sampled daily during the injection events
and have differing wells based on which injection regime is being monitored, 6ighg8).z xisting­_m-onitoringwells
located at the site will be used to monitor the persulfate injections, three.-3)_existing monitonng--wellslocatedbat the
site will be used to monitor the persulfate injections facilitated by the PrimaWave Technology, four- 4) existing
monitoring wells located at the site will be used to monitor the RegenOx injections, six(---existing=m-onitoringwells
located at the site will be used to monitor the ORC-A/Micro-Bac injections. The consultant has proposed semi-annual
post-inj ection event monitoring utilizing lh -seve (3 )zxfsting munitoring:w lls, however, the frequency will need
to be changed to quarterly in order to comply with 15A NCAC 2C .0213(f)(2)(D). Parameters for post injection
`monitoring also need to be modified to include sulfate and sodium for all wells, alkalinity for those wells associated
with monitoring the RegenOx pilot test area, and Total Organic Carbon and biological oxygen demand (BOD) for
those wells associated with the ORC-A/Micro-Bac pilot test area. Monitoring will continue for three years
(Attachment F).
EPIDEMIOLOGY On April 2, 2002, the DHHS' Epidemiology Branch provided comments on the use of
hydrogen peroxide for the oxidation of petroleum groundwater contaminants. Dr. Luanne K. Williams did not present
any information that would preclude the use of these products for injection. On September 2, 2003, the DHHS'
Epidemiology Branch provided comments on the use of sodium persulfate for the oxidation of petroleum groundwater
contaminants. Dr. Luanne K. Williams did not present any information that would preclude the use of these products
for injection. On September 5, 2007, the DHHS' Epidemiology Branch provided comments on the use of RegenOx
to enhance bioremediation of petroleum groundwater contaminants. Dr. Luanne K. Williams did not present any
information that would preclude the use of these products for injection. On August 8, 2005, the DHHS'
Epidemiology Branch provided comments on the use of ORC-Advanced to enhance bioremediation of petroleum
groundwater contaminants. Dr. Luanne K. Williams did not present any information that would preclude the use of
these products for injection. On October 11, 2004, the DHHS' Epidemiology Branch provided comments on the use
of Micro-Bac biological and non -biological agents to enhance bioremediation of petroleum groundwater
contaminants. Dr. Luanne K. Williams did not present any information that would preclude the use of these products
for injection. A health risk analysis for each injectant and worker safety precautions, which are in Part X of the
attached permit.
REGIONAL OFFICE COMMENTS Maria Schulte of the Mooresville Regional Office recommended issuance of this
permit upon satisfactory response to required updates and modifications to the application.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Plantation Pipe Line Company
FOR THE CONSTRUCTION AND OPERATION OF 164 TYPE 5I INJECTION WELLS,
defined in/Title 15A North Carolina Administrative Code 2C . 209(e)Q)(C), to inject sodium
persulfate, hydrogen peroxide, RegenOx, ORC-A,' Micro-Bac-1000H!, and Tri-Phasic 12, for
the oxidation and bioremediation of petroleum hydrocarbons. These injection wells/point§ will
be ,located at latitude 35.43133 and longitude-80.7590.1. near the intersection of Poplar Tent
Road and Middlecrest Drive in Concord, Cabarrus County, North Carolina, and will be operated
in accordance with the revised application dated April 28, 2011, and in conformity with the
specifications and supporting data submitted July 15, 2011, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until June 30, 2013,
and shall be subject to the specified conditions and limitations set forth in Parts I through X
hereof.
Permit issued this the 22"d day of July, 2011.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0300153 PAGE 1 OF 6
ver. June 2011 UIC-5I/5T

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S.87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by -the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Aquifer Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number 919-715-6164 and the Mooresville Regional Office Aquifer
Protection Section Staff, telephone number 704-663-1699.
2. Bentonite grout shall not be . used to seal any water -bearing zone with a chloride
concentration equal to or greater than 1,500 milligrams per liter. In areas where elevated
chloride levels are known to exist or are probable, such as coastal areas, chloride levels shall
be verified in the field to determine existing conditions.
PART III - OPERATION AND USE GENERAL CONDITIONS
1. ' This permit is effective only with respect to the nature, volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances that may be imposed by other
local, state, and federal agencies having jurisdiction. Furthermore, the issuance of this permit
does not imply that all regulatory requirements have been met.
Permit No. WI0300153 PAGE 2 OF 6
ver. June 2011 UIC-5I/5T

PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use.
2. In the event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure . of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
3.. The Permittee shall be required to comply with the terms and conditions of this permit even
if compliance requires a reduction or elimination of the permitted activity.
4. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned alterations or additions in the permitted facility or activity not specifically
authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone. number 919-715-6164. Notification is required so that Division staff
can inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
Permit No. WI0300153 PAGE 3 OF 6
ver. June 2011 UIC-5I/5T

PART VII - MONITORING AND REPORTING REQUIREMENTS
1. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
2. The proposed monitoring plan included in the application shall be followed. All sample
results shall be submitted to the Aquifer Protection Section's Mooresville Regional Office
and the Raleigh Central Office. Any monitoring (including groundwater, surface water, or
soil sampling) deemed necessary by the Division of Water Quality to ensure surface and
ground water protection, will be established and an acceptable sampling reporting schedule
shall be followed.
3. The Permittee shall submit an Injection Event Record within 30 days of completing each
injection.
4. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting .a renewal application for this permit. This document shall assess the
injection projects findings in a written summary. The final project evaluation shall also
contain monitoring well sampling data, contaminant plume maps and potentiometric surface
maps.
5. The monitoring results and the final project evaluation shall be submitted to:
UIC Program Staff DWQ - Aquifer Protection Section
DWQ — Aquifer Protection Section and Mooresville Regional Office
1636 Mail Service Center 610 East Center Aveune, Suite 301
Raleigh, NC 27699-1636 Mooresville, NC 28115
6. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Mooresville Regional Office, telephone number 704-663-1699, any
of the' following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
7. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
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ver. June 2011 UIC-5I/5T

8. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0214, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of .each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to do so could lead to the contamination of an underground source of
drinking water.
(D) Drilled wells shall be completely filled with cement grout or bentonite grout, which
shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
Permit No. WI0300153 PAGE 5 OF 6
ver. June 2011 UIC-5I/5T

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3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X - WORKER PRECAUTIONS DURING APPLICATION
1. Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat, and lung irritation. If the product is released into the environment in a
way that could result in a suspension of fine solid or liquid particles (e.g., grinding, blending,
vigorous shaking or mixing), then proper personal protective equipment should be used. The
application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. .Face and body protection should be used for anticipated splashes or
sprays.
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0300153 PAGE 6 OF 6
ver. June 2011 UIC-5I/5T