WI0300282_Complete File - Historical_20150323

Central Files:_ . APS _ SWP
- 3/23/2015
Permit Number . W10300282
Permit Tracking Slip
Program Category
Status Project Type
Ground Water
In review - New Project
Permit Type
Version - Permit Classification
Injection'In situ Groundwater. Remediation Well
Individual
Primary Reviewer
Permit Contact Affiliation
michael.rogers
Coastal SWRule .
Permitted flow .
Facility
Facility Name a
Major/Minor Region
Former Preslar's Exxon - NCDOT Hwy 24/27 R.O.W.
Minor. Mooresville
Location Address
County.
901. NC Hwy 24/27 ROW.
Cabarrus
• .
Facility Contact Affiliation.
Midland NC 28107
Owner
Owner Name Owner Type
NCDOT - Geotechnical Unit Government -State
Owner Affiliation
Nick Tennyson.
Chief Deputy Secretary_
1589 Mail Service Ctr
Dates/Events Raleigh NC 27699
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
2/2/2015
Regulated Activities 'Requested /Received Events
Groundwater remediatiori RO staff report requested 2/8/15
RO staff report received 2/19/15
Additional information requested - 2/26/15
Additional information received 3/12/15
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

North Carolina Department of Environment and Natural Resources
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation (15A NCAC o2C .02251 I Tracer Injection (15A NCAC o2C .0229)
Do not use this form for the following:
• in situ remediation, tracer, or aquifer test injection wells permitted by rule (ref. 15A NCAC 02C .0217)
• remediation systems that reinject treated contaminated groundwater (ref. 15A NCAC 02T .1600)
Application Number (to be completed by DWR): GJ 2�o 3 CCU �� 13 Z
I. APPLICATION INFORMATION
1. Project is: [ X ] New [ ] Modification [ ] Renewal without modification [ ] Renewal 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 1 & 11 only, sign the certification on the ljgEjW ! 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. RE 9 0 2 2 0 i 5
II. WELL OWNER (generally the responsible party) Water Quality Regional
1. Name: North Carolina Department of Transportation Operations Section
2. Signing Official's Name*: Nick Tennyson Title: Chief Deputy Secretary
* Signing Official must be in accordance with instructions in Part IX on page 5.
3. Mailing address of applicant: NCDOT: Geotechnical Unit: Geoenvironmental Section
1589 Mail Service Center
City: Raleigh State: NC Zip: 27699-1589
4. Telephone number: [phone] Email: cfparkerlAncdot.gov
5. Status (choose one): Individual Business/Org. Federal X State CountyMunicipality
III. PROPERTY OWNER (if different than well owner)
1. Name: Same as well owner
2. Physical address:
City: State: Zip:
3. Mailing address:
City: State: Zip:
4. Telephone number: Email:
IIII. PROJECT CONTACT — Person who can answer technical questions about the proposed injection project.
1. Name: Michael Branson Title: Senior Project Manager
2. Company: Solutions-IES
3. Address: 1101 Nowell Rd.
4. City: Raleigh State: NC Zip: 27607
5. Telephone number: [phone] ext. 134 Email: mbransonAsolutions-ies.com
Revised 11/19/2013 UIC-5I/5T Page 1 of 5

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
V. FACILITY INFORMATION
1. Facility name: NCDOT Right -of -Way Ph#: N/A
2. Mailing address: N/A, but adjacent to 830 NC 24/27
City: Midland County: Cabarrus State: NC Zip: 28107
3. Geographic Coordinates: Latitude: 35014'53.73" Longitude: 80033'31.17"
Reference Datum: WGS84 Accuracy: unknown
Method of Collection: Google Earth
4. Brief description of business: highway right-of-way
VI. INCIDENT DESCRIPTION
1. Source and date of contamination: The site is the former location of a convenience store and gasoline.
station in Midland, NC. Three gasoline USTs and one kerosene UST were removed from the site in
1995. Further investigation revealed petroleum hydrocarbons in the soil and groundwater in excess of
the applicable re ug latory standards.
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):
Petroleum hydrocarbons —gasoline and kerosene constituents and daughter products.
3. Has LNAPL or DNAPL ever been observed at the site (even if outside the injection zone)?
[ ] Yes If yes, list maximum measured separate phase thickness: feet
[X] No If no, list maximum concentration of total VOCs observed at site: 50,200 ppb
4. Agency managing the contamination incident:
[ X ] UST Section [ ] Superfund Section (including REC Program and DSCA sites)
[ ] DWR Aquifer Protection Section [ ] Solid Waste Section
[ ] Hazardous Waste Section [ ] Other:
5. Incident manager's name: Brett Morris Ph#: 704-663-1699
6. Incident number or other incident mgmt. agency tracking number: 13543
VII. PERMITS
List all applicable permits or construction approvals issued for the facility or incident:
1. Hazardous Waste Management program permits under RCRA: N/A
2. DWR Non -Discharge or NPDES permits: N/A
3. County or DEH subsurface wastewater disposal permits: N/A
4. Other environmental permits required by state or federal law: N/A
Revised 11/19/2013 UIC-5I/5T Page 2 of 5

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
VIII. ATTACHMENTS — provide the following information in separate attachments. The attachments should be
clearly identified and presented in the order below to expedite review of the permit application package.
1. INJECTION ZONE — Per 15A NCAC 02C .0225(e)(2) specify the horizontal and vertical portion of the subsurface within
which the proposed injection activity will take place and beyond which no violations of groundwater quality standards
shall result from the injection as determined by an approved monitoring plan. The determination shall be based on the
hydraulic properties of the specified zone. Provide any supporting documentation in a separate attachment.
2. HYDROGEOLOGIC EVALUATION — Per 15A NCAC 02C .0225(e)(3) provide a hydrogeologic evaluation of the
injection zone that includes all of the following:
(A) Regional and local geology and hydrology;
(B) Changes in lithology underlying the facility;
(C) Depth to bedrock;
(D) . Depth to the mean seasonal high water table;
(E) Hydraulic conductivity, transmissivity, and storativity, of the injection zone based on tests of site -specific
material, including a description of the test(s) used to determine these parameters;
(F) Rate and direction of groundwater flow as determined by predictive calculations or computer modeling; and
(G) Lithostratigraphic and hydrostratigraphic logs of any existing test and injection wells.
3. INJECTANT INFORMATION — Per 15A NCAC 02C .0225(e)(5) list each injectant in the space below and provide the
following information for each injectant. NOTE: Approved injectants can be found online at
http://portal ncdenr.or/web/wq/ems/gwpro. All other substances must be reviewed by the Division of Public Health,
Department of Health and Human Services. Contact the UIC Program for more information (Ph# 919-807-6496).
(A) MSDS, concentration at the point of injection, and percentage if present in a mixture with other injectants;
(B) The source of fluids used to dilute, carry, or otherwise distribute the injectant throughout the injection zone. If
any well within the area of review of the injection facility is to be used as the fluid source, then the following
information shall be submitted: location/ID number, depth of source, formation, rock/sediment type, and a
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;
(C) A description of the rationale for selecting the injectants and concentrations proposed for injection, including an
explanation or calculations of how the proposed injectant volumes and concentrations were determined;
(D) 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;
(E) A summary of results if modeling or testing was performed to investigate the injectant's potential or susceptibility
for biological, chemical, or physical change in the subsurface; and
(F) An evaluation concerning the development of byproducts of the injection process, including increases in the
concentrations of naturally occurring substances. Such an evaluation shall include the identification of the specific
byproducts of the injection process, projected concentrations of byproducts, and areas of migration as determined
through modeling or other predictive calculations.
4. INJECTION PROCEDURE — Per 15A NCAC 02C .0225(e)(6) submit a table with a detailed description of the proposed
injection procedure that includes the following:
(A) The proposed average and maximum daily rate and quantity of injectant;
(B) The average maximum injection pressure expressed in units of pounds per square inch (psi); and
(C) The total or estimated total volume to be injected.
Revised 11/19/2013 UIC-5I/5T Page 3 of 5

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
5. FRACTURING PLAN (if applicable) — Per 15A NCAC 02C .0225(e)(7) submit a detailed description of the fracturing plan
that includes the following:
(A) Material Safety Data Sheets of fracturing media including information on any proppants used;
(B) a map of fracturing well locations relative to the known extent of groundwater contamination plus all buildings,
wells, septic systems, underground storage tanks, and underground utilities located within the Area of Review;
(C) a demonstration that buildings, wells, septic systems, underground storage tanks, and underground utilities will
not be adversely affected by the fracturing process;
(D) injection rate and volume;
(E) orientation of bedding planes, joints, and fracture sets of the fracture zone;
(F) performance monitoring plan for determining the fracture well radius of influence; and
(G) if conducted, the results of geophysical testing or pilot test of fracture behavior conducted in an uncontaminated
area of the site.
6. WELL CONSTRUCTION DETAILS — Per 15A NCAC 02C .0225(e)(8) submit the following information in tabular or
schematic form as appropriate for each item:
(A) number and depth of injection wells;
(B) number and depth of borings if using multi -level or "nested" well systems;
(C) indication whether the injection wells are existing or proposed;
(D)' depth and type of casing;
(E) depth and type of screen material;
(F) depth and type of grout;
(G) indication whether the injection wells are permanent or temporary "direct push" points; and
(H) plans and specifications of the surface and subsurface construction details.
7. MONITORING PLAN — Per 15A NCAC 02C .0225(e)(9) submit a monitoring plan that includes the following:
(A) target contaminants plus secondary or intermediate contaminants that may result from the injection;
(B) other parameters that may serve to indicate the progress of the intended reactions;
(C) a list of existing and proposed monitoring wells to be used; and
(D) a sampling schedule to monitor the proposed injection.
Monitoring wells shall be of sufficient quantity and location to detect any movement of injection fluids, injection process byproducts,
or formation fluids outside the injection zone. The monitoring schedule shall be consistent with the proposed injection schedule, pace
of the anticipated reactions, and rate of transport of the injectants and contaminants.
8. WELL DATA TABULATION — Per 15A NCAC 02C .0225(e)(10) provide a tabulation of data on all existing or abandoned
wells within the area of review of the injection well(s) that penetrate the proposed injection zone, including monitoring
wells and wells proposed for use as injection wells. Such data shall include a description of each well's type, depth, and
record of construction or abandonment.
9. MAPS AND CROSS -SECTIONS — Per 15A NCAC 02C .0225(e)(11) provide scaled, site -specific site plans or maps
depicting the location; orientation, and relationship of facility components including the following:
(A) 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;
(B) topographic contour intervals showing all facility related structures, property boundaries, streams, springs, lakes,
ponds, and other surface drainage features;
(C) all existing or abandoned wells within the area of review of the wells listed in the well data tabulation that
penetrate the proposed injection zone;
(D) potentiometric surface map(s) that show the direction of groundwater movement, existing and proposed wells;
(E) contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the contaminant plume
in soil and groundwater, and existing and proposed wells;
(F) 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, major changes in lithology, and existing and proposed wells; and
(G) any existing sources of potential or known groundwater contamination, including waste storage, treatment, or
disposal systems within the area of review of the injection well or well system.
Revised 11/19/2013 UIC-5U5T Page 4 of 5

IX.
0
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
CERTIFICATION* (to be signed as required below or by that person's authorized agent*)
NCAC 15A 02C .0211(e) 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.
"1 hereby certify under penalty of law that 1 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 in accordance with the approved specifications and conditions of the Permit. "
Printed Name and Title: N ICY`, � � �%� �S� 1 V � �� �� p
Signature: Date:
(Z
CONSENT OF PROPERTY OWNER (if the property is not owned by the permit 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
(I5A NCAC 02C .0200). "
Printed Name and Title:
Signature:
Date:
Submit TWO copies of the completed application package, including all attachments, to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Revised 11/19/2013 UIC-5I/5T Page 5 of 5

APPLICATION FOR PEI<iv1JL`T TO CONSTRUCT AND/OR USE A ` --L(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
1. INJECTION ZONE
A release from a system of four underground storage tanks (USTs) located at the fueling station of the
Former Preslar's Exxon site resulted in petroleum impacts to groundwater. A Comprehensive Site
Assessment (CSA) was prepared by S&ME, Inc. (S&ME Project No. 1040.98.0113 dated August 27,
2001) and revised in 2001 and 2002 and identified petroleum contamination in soil and groundwater as a
result of suspected releases from the former UST system. Much of the information relating to site
geology and hydrogeology are summarized from these reports. Project location and site maps are
attached as Figures 1 and 2, respectively.
A contaminant concentration map and a benzene isoconcentration map taken from the report titled Former
Preslar's Exxon Transmittal for April 2011 prepared by SIES dated June 15, 2011 are attached as Figures
3 and 4, respectively. These drawings illustrate the lateral extent of contamination at the site. Because
the original USTs were stored in separate areas, and the area is transected by NC highway 24/27, the
underground injections will be performed in two separate areas, approximately 40 feet apart. The
proposed injection zone (Figure 5) is approximately 11,000 square feet and configured to allow the use of
MW-13 as a monitoring well outside the injection zone. .
The CSA report referenced above suggested that the vertical extent of contamination is identified as the
depth of the deepest shallow monitoring well with detected contamination, based on the data that no
impact was detected in the deep monitoring wells. The deepest shallow well is MW-1 at a depth of 24.5
feet below ground surface [ft bgs]. Based on this depth, and the understanding that petroleum compounds
tend to impact the upper portion of an aquifer, the target treatment zone will be between 10 and 20 ft bgs.
2. HYDROGEOLOGIC EVALUATION
The site is located within the Piedmont Physiographical Province, where soil and partially weathered rock
reside on igneous and metamorphic bedrock. Shallow depth -to -bedrock is common within the piedmont
area. In general, the geology of the site is described by the CSA as distinct layers of sands, and clays
above partially weathered rock: Well construction records submitted as part of the CSA are provided in
Appendix A.
Cross -sections of the lithology provided as part of the CSA are included as Figures 6-9. Based upon
information provided in the cross sections, as well as field observations from the pilot scale study, it
appears that bedrock is typically encountered between 5 and 10 ft bgs.

APPLICATION FOR PEkLvxiT TO CONSTRUCT AND/OR USE A V-_�_L(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
According to the CSA, hydraulic conductivity was calculated from information obtained from slug tests
on two monitoring wells at the site (1VIW-6 and MW-7. Calculated hydraulic conductivity values at the
site ranged from 6.17 x10-' cm/s to 1.72 x 10' cm/s. The CSA also indicated that shallow groundwater
flow velocity at the site is 0.005 ft/day and flows generally toward the southeast. A groundwater
potentiometric map from an SIES report dated June 15, 2011 is attached as Figure 10.
3. INJECTANT INFORMATION
3.A EASTM Overview
A CAP Addendum prepared by SIES dated May 31, 2012, concluded that the most cost-effective
groundwater remedy at the site would be sulfate -enhanced bioremediation. EOS Remediation's Electron
Acceptor Solution (EASTM) is composed of 25-percent magnesium sulfate, 5-percent nutrients and 70-
percent water in solution, and thus does not require dilution. Fifty-five gallons of EASTM will be injected
at each injection point during each event. EASTM is an approved injectant by the North Carolina
Underground Injection Control (UIC) program. A safety data sheet for EASTM is included as Appendix
B.
3.11 Dilution
No dilution is required or planned for the injection of EAST". EASTM will arrive on -site in 55-gallon
drums, ready for injection.
3.0 Injection Rationale
The goals of the site full scale injection are to promote anaerobic oxidation of the petroleum hydrocarbons
using sulfate enhancement, reducing the concentration of benzene and other petroleum constituents in
groundwater to below their applicable 15A NCAC 2L Standards. The injectant volume is based on a
stoichiometric relationship of 4.7 grams of sulfate necessary to degrade one gram of benzene, toluene,
ethylbenzene, and xylenes (BTEX) present in the groundwater. This volume was verified as appropriate
with the pilot test.
3.1) EAST" Technology
EASTM utilizes sulfate -enhanced technology for in situ remediation of contaminated groundwater and
stimulates biodegradation by providing a soluble, readily available electron acceptor. In the presence of
elevated sulfate, anaerobic groundwater bacteria use petroleum hydrocarbons for carbon and energy while

APPLICATION FOR PEh-'unT TO CONSTRUCT AND/OR USE A V:-,:;L(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
mineralizing the hydrocarbons to carbon dioxide and water. The following equation illustrates the
concept using toluene as the hydrocarbon:
C6H6 +3.75SO42- +7.5H+ —> 6CO2 +3.75H2S+3H2O '
The reaction results in the complete degradation of the petroleum hydrocarbon.
3.E Modeling and Testing
EAST' has been applied over 200 sites to date. Based on those pilot and full-scale applications, EAST'
can be expected to increase the sulfate concentration and sulfate reducing bacteria population in the
groundwater. Carbonate generated as a result of increased biological activity and contaminant
degradation will have a slight buffering effect further supporting biological activity. Additionally, free
sulfides present in the groundwater may combine and immobilize dissolved metals forming metal sulfides
including juvenile pyrite.
To evaluate the applicability of EAST' at the Preslar's Exxon site, SEES conducted a pilot test of the
injectant at the site. One injection well and three observation wells were installed in the area of highest
concentrations. One 55-gallon drum of the injectant was gravity -fed into the injection well. Groundwater
samples were collected periodically from the observation wells and analytical results indicated that BTEX
concentrations decreased significantly over time. Based on these results, the North Carolina Department
of Environment and Natural Resources, UST Section approved a full-scale injection program.
4. INJECTION PROCEDURE
EASTM will be gravity -fed into each injection point. As such, there will be no injection pressure.
Approximately 55 gallons of EASTM will be injected into 21 injection wells, equaling approximately1,155
total gallons of EASTM to be injected during each field event. Based upon field observations from the
pilot scale study, SIES anticipates injection rates of 0.6-0.7 gallons per minute (gpm). Due to the low
viscosity of EASTM, chase water is not required. The CAP Addendum concluded that site cleanup may be
accomplished with a series of injection events spaced at approximate 6-month intervals. SEES anticipates
' Formula cited from EOS Remediation website.

4
APPLICATION FOR PEIL ua TO CONSTRUCT AND/OR USE A VY t-i_,L(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
four injection events over an 18-month period, equaling a total injection volume of approximately 4,620
gallons of EASTM.
5. , FRACTURING PLAN
Not applicable
6. WELL CONSTRUCTION DETAILS
Proposed injection well construction details are provided'in Appendix C. Up to 21 permanent injection
wells will be installed and used for injection. Well construction forms will be completed.
7. MONITORING PLAN
7.A Groundwater Parameters
SIES will conduct a baseline -sampling event prior to the initial injection followed by sampling events at
one month, three months, and six months after injection to evaluate the effectiveness of the EASTM. In
the event the groundwater analyses show rebound of the BTEX compounds, additional injection will be
conducted. Groundwater sampling and analyses will be conducted at six-month intervals following
subsequent injections. Groundwater samples will be collected from thirteen existing site monitoring
wells (1VIW-1 through MW-13) and four water supply wells. Groundwater samples will be analyzed for
sulfate and VOCs by EPA Methods 601 and 602 (including 1,2-dichloroethane, naphthalene, isopropyl
ether (IPE), and methyl-tert-butyl ether (MTBE)). No additional groundwater parameters will be
required.
7.0 Monitoring Wells
The remediation progress will be evaluated by groundwater monitoring and analysis. Thirteen monitoring
wells and four water -supply wells exist at the site and vicinity. The monitoring plan includes depth -to -
water measurements and groundwater sample collection from the existing monitoring wells at the site and
water supply wells (Table 1). Wells will be purged using a peristaltic pump and disposable tubing until
readings of pH, temperature, dissolved oxygen (DO), Oxidation Reduction Potential (ORP), turbidity and
conductivity stabilize. Due to the groundwater elevation within the well, monitoring well MW-5 has
historically been purged using an electronic submersible pump. If the pumps within the water supply
wells are missing or inoperable, samples will be collected via electronic submersible pump. Samples will

APPLICATION FOR PEklvii T TO CONSTRUCT AND/OR USE A Nv �LL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
be collected in laboratory -supplied glassware, placed on ice, packaged and shipped or relinquished via
laboratory courier under chain -of -custody control to Pace Analytical Services in Huntersville, NC.
7.1) Schedule
To evaluate the effectiveness of the EASTM injection with respect to cleanup of the petroleum
contamination in groundwater, SIES will perform periodic groundwater monitoring using the existing
monitoring well and supply well network. Initial post -injection monitoring will occur at one-, three-, and
six-month intervals following completion of the injection activities. Upon approval of the subsequent
injections, post -injection monitoring will occur within six months of the actual injection. Sampling
protocols and analyses will be the same as indicated in 7A above.
8. WELL DATA TABULATION
A site well inventory is presented in Table 1. Available well construction records are provided in
Appendix A.
9. ADDITIONAL ATTACHMENTS
The following figures are attached.
Figure 1
Site Location Map
Figure 2
Site Map
Figure 3
Contaminant Concentration Map
Figure 4
Benzene Isoconcentration Contour Map
Figure 5
Preliminary Full Scale Injection Points for EASTM
Figure 6
Cross Section Location Map
Figure 7
Geologic .Cross Section A -A'
Figure 8
Geologic Cross Section B-B'
Figure 9
Geologic Cross Section C-C'
Figure 10
Shallow Groundwater Potentiometric Map
The following tables are attached.
Table 1 Well Inventory
The following appendices are attached.
Appendix A Soil Boring Logs and Well Construction Records
Appendix B EASTM Safety Data Sheet
Appendix C Injection Well Construction Design

TABLE 1
Well Inventory
Former Preslar's Exxon
Midland, Cabarrus County, North Carolina
Well ID
Well Type
Status
Total Depth (ft bgs)
Screened Interval (ft bgs)
Construction Date
MW-1
Monitoring Well
Active
24.5
9.5-24.5
7/16/1998
MW-2
Monitoring Well
Active
21.5
6-21.5
8/11/1998
MW-3
Monitoring Well
Active
25
5-25
8/11/1998
MW-4
Monitoring Well
Active
21.5
6.5-21.5
8/11/1998
MW-5
Monitoring Well
Active
60
50-60
8/17/1998
MW-6
Monitoring Well
Active
18
8-18
7/3/2001
MW-7
Monitoring Well
Active
18
8-18
7/2/2001
MW-8
Monitoring Well
Active
20
10-20
7/2/2001
MW-9
Monitoring Well
Active
25
10-25
10/22/2001
MW-10
Monitoring Well
Active
15
5-15
3/25/2009
MW-11
Monitoring Well
Active
16
4.5-16
3/25/2009
MW-12
Monitoring Well
Active
19
7-19
3/25/2009
MW-13
Monitoring Well
Active
19
9-19
3/25/2009
PMW-1
Monitoring Well
Active
20
10-20
3/19/2012
PMW-2
Monitoring Well
Active
20
10-20
3/19/2012
PMW-3
Monitoring Well
Active
20
10-20
3/19/2012
PIW-1
Injection Well
Active
20.8
10.8-20.8
3/19/2012
WSW-3
Water Supply Well
Active
NA
WSW-4
Water Supply Well
Abandoned
NA
WSW-5
Water Supply Well
Abandoned
NA
WSW-6
Water Supply Well
Abandoned
NA
WSW-8
Water Supply Well
Abandoned
NA
WSW-9
Water Supply Well
Active
NA
NA
NA
WSW-10
Water Supply Well
Active
NA
NA
NA
WSW- 11
Water Supply Well
Active
NA
NA
NA
WSW-12
Water Supply Well
Active
NA
NA
NA
Notes:
NA - Not Available

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
1. JECTION ZONE
A release fr a system of four underground storage tanks (USTs) located at t/natation the
Former Preslar Exxon site resulted in petroleum impacts to groundwater. A Csive rte
Assessment (CSA was prepared by S&ME, Inc. (S&ME Project No. 1040.98.gust 27,
2001) and revised in 001 and 2002 and identified petroleum contamination inoundwater as aresult of suspected relea s from the former UST system. Much of the informg tosite geology
and hydrogeology are s arized from these reports. Project location and sitattached as
Figures 1 and 2, respectively.
A contaminant concentration map anV
e isoconcentration map t en from the report titled Former
Preslar's Exxon Transmittal for Aprilpared by SIES dated J e 15, 2011 are attached as Figures
3 and 4, respectively. These drawinthe lateral extent o contamination at the site. The
estimated area covered by the 1 µg/socontour is app ximately 21,060 sq ft. Because the
original USTs were stored in separad a area is nsected by NC highway 24/27, the
undergroundinjections will be perfoo se ate reas, approximately 40 feet apart. Figure 5
illustrates the proposed injection lay
The CSA report referenced above suggested that a vertica\conn
depth of the deepest shallow monitoring well th detected
impact was detected in the deep monitorin ells. The deepest sh
feet below ground surface [ft bgs]. Base on this depth, and the w
tend to "float" within the aquifer, the rget treatment zone will be
2. - HYDROGEOLOGIC FdVALUATION
of contamination is identified as the
nation, based on the data that no
[low well is MW-1 at a depth of 24.5
\et
ding that petroleum compounds
n 10 and 20 ft bgs.
The site is located within th iedmont Physiographical Province, where soil and ially weathered rock
reside on igneous and m amorphic bedrock. Shallow depth -to -bedrock is common thin the piedmont
area. In general, the ology of the site is described by the CSA as distinct layers of san s, and clays
above partially we ered rock. Well construction records submitted as part of the CSA ar rovided in
Appendix A.
Ion
ns of the lithology provided as part of the CSA are included as Figures 6-9. Based ups
provided in the cross sections, as well as field observations from the pilot scale study, it
that bedrock is typically encountered between 5 and 10 ft bgs.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
According to the CSA, hydraulic conductivity was calculated from information obtained from slug tests
on two monitoring wells at the site (MW-6 ad MW-7. Calculated hydraulic conductivity values at the site
ranged from 6.17 x10-6 cm/s to 1.72 x 10.5 c e CSA also indicated that shallow groundwater flow
velocity at the site is 0.005 ft/day and flows ge f
y toward the southeast. A groundwater
potentiometric map from an SIES report dated June 15, 2011 is attached as Figure 10.
3. INJECTANT INFORMATION
3.A EASTM Overview
A CAP Addendum prepared by SIES dated May 31, 2012, concluded that the most cost-effective
groundwater remedy at the site would be sulfate -enhanced bioremediation. EOS Remediation's Electron
Acceptor Solution (EAST") is composed of 25-percent magnesium sulfate, 5-percent nutrients and 70-
percent water in solution, and thus does not require dilution. Fifty-five gallons of EAST" will be injected
at each injection point during each event. EAST" is an approved injectant by the North Carolina
Underground Injection Control (UIC) program. A safety data sheet for EAST" is included as Appendix
B.
3.13 Dilution
No dilution is required or planned for the injection of EAST". EAST" will arrive on -site in 55-gallon
drums, ready for injection.
3.0 Injection Rationale
The goals of the site full scale injection are to promote anaerobic oxidation of the petroleum hydrocarbons
using sulfate enhancement, reducing the concentration of benzene and other petroleum constituents in
groundwater to below their applicable 15A NCAC 2L Standards. The injectant volume is based on a
stoichiometric relationship of 4.7 grams of sulfate necessary to degrade one gram of benzene, toluene,
ethylbenzene, and xylenes (BTEX) present in the groundwater. This volume was verified as appropriate
with the pilot test.
3.1) EAST" Technology
tilizes sulfate -enhanced technology for in situ remediation of contaminated groundwater and
;s biodegradation by providing a soluble, readily available electron acceptor. In the presence of
sulfate, anaerobic groundwater bacteria use petroleum hydrocarbons for carbon and energy while

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
mineralizing the hydrocarbons to carbon dioxide and water. The following equation illustrates the
concept using toluene as the hydrocarbon:
C6H6 + 3.75SO42- + 7.5H+ —> 6CO2 + 3.75H2S + 3H2O '
The reaction results in the complete degradation of the petroleum hydrocarbon.
3.E Modeling and Testing
EAST" has been applied over 200 sites to date. Based on those pilot and full-scale applications, EASTM
can be expected to increase the sulfate concentration and sulfate reducing bacteria population in the
groundwater. Carbonate generated as a result of increased biological activity and contaminant
degradation will have a slight buffering effect further supporting biological activity. Additionally, free
sulfides present in the groundwater may combine and immobilize dissolved metals forming metal sulfides
and juvenile pyrite.
To evaluate the applicability of EAST" at the Preslar's Exxon site, SIES conducted a pilot test of the
injectant at the site. One injection well and three observation ells were installed in the area of highest
concentrations. One 55-gallon drum of the injectant was gravity -fed into the injection well. Groundwater
samples were collected periodically from the observation wells and analytical results indicated that BTEX
concentrations decreased significantly over time. Based on these results, the North Carolina Department
of Environment and Natural Resources, UST Section approved a full-scale injection program.
4. INJECTION PROCEDURE
EASTM will be gravity -fed into each injection point. As such, there will be no injection pressure.
Approximately 55 gallons of EASTM will be injected into 35 injection wells, equaling approximately1,925
total gallons of EASTM to be injected during each field event. Based upon field observations from the
pilot scale study, SIES anticipates injection rates of 0.6-0.7 gallons per minute (gpm). Due to the low
viscosity of EASTM, chase water is not required. The CAP Addendum concluded that site cleanup may be
accomplished th a series of injection events spaced at approximate 6-month intervals. SIES anticipates
four injecti events over an I8-month period, equaling a total injection volume of approximately 7,700
gallonsXf EASTM
' F96mula cited from EOS Remediation website.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
5. FRACTURING PLAN
Not applicable
6. WELL CONSTRUCTION DETAILS
Proposed injection well construction details are provided in Appendix
wells will be installed and used for injection. Well construction forms will be completed.
7. MONITORING PLAN
7.A Groundwater Parameters
SIES will conduct a baseline -sampling event prior to the initial injection followed by sampling events at
one month, three months, and six months after injection to evaluate the effectiveness of the EAST"' In
the event the groundwater analyses show rebound of the BTEX compounds, addit oni al injection will be
conducted. Groundwater sampling and analyses will be conducted at six-month intervals following
subsequent injections. Groundwater samples will be collected from thirtee"�ex`Ming-site$rnonitoririg+
wellss( lsthr-oughyl4 - 3 and"f wa er supp y we1 &--mmdwater samples will be analyzed for
sulfate and VOCs by EPA Methods 601 and 602 (including 1,2-dichloroethane, naphthalene, isopropyl
ether (IPE), and methyl-tert-butyl ether (MTBE)). No additional groundwater parameters will be
required.
7.0 Monitoring Wells
The remediation progress will be evaluated by groundwater monitoring and analysis. Thirteen monitoring
wells and four water -supply wells exist at the site and vicinity. The monitoring plan includes depth -to -
water measurements and groundwater sample collection from the existing monitoring wells at the site and
water supply wells (Table 1). Wells will be purged using a peristaltic pump and disposable tubing until
readings of pH, temperature, dissolved oxygen (DO), Oxidation Reduction Potential (ORP), turbidity and
conductivity stabilize. Due to the groundwater elevation within the well, monitoring well MW-5 has
historically been purged using an electronic submersible pump. If the pumps within the water supply
wells are missing or inoperable, samples will be collected via electronic submersible pump. Samples will
be collected in laboratory -supplied glassware, placed on ice, packaged and shipped or relinquished via
)urier under chain -of -custody control to Pace Analytical Services in Huntersville, NC.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
7.1) Schedule
To evaluate the effectiveness of the EASTM injection with respect to cleanup of the petroleum
contamination in groundwater, SIES will perform periodic groundwater monitoring using the existing
monitoring well and supply well network. Initial post -injection monitoring will occur at one-, three-, and
six-month intervals following completion of the injection activities. Upon approval of the subsequent
injections, post -injection monitoring will occur within six months of the actual injection. Sampling
protocols and analyses will be the same as indicated in 7A above.
8. WELL DATA TABULATION
A site well inventory is presented in Table 1. Available well construction records are provided in
Appendix A.
9. ADDITIONAL ATTACHMENTS
The following figures are attached.
Figure 1
Site Location Map
Figure 2
Site Map
Figure 3
Contaminant Concentration Map
Figure 4
Benzene Isoconcentration Contour Map
Figure 5
Preliminary Full Scale Injection Points for EASTM
Figure 6
Cross Section Location Map
Figure 7
Geologic Cross Section A -A'
Figure 8
Geologic Cross Section B-B'
Figure 9
Geologic Cross Section C-C'
Figure 10
Shallow Groundwater Potentiometric Map
The following tables are attached.
Table 1 - Well Inventory
The following appendices are attached.
Appendix A Soil Boring Logs and Well Construction Records
Appendix B EASTM Safety Data Sheet
Appendix C Injection Well Construction Design

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
FIGURES

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
APPENDIX A
WELL CONSTRUCTION RECORDS

COMPLETION REPORT OF WELL i m o. MW-1
PROJECT:
Preslar's Exon
WATER LEVEL TOB (Fr.): 11
PROJECT NO:
1040-98-091A
WATER LEVEL 24 HRS (FT.):
PROJECT LOCATION:
Midland, NC
TOP OF CASING ELEVATION (FT.): 93.92
DRILLING CONTRACTOR:
DRILLING METHOD:
S&ME
4'/4" H.S.A.
BORING DEPTH (FT.): 24.5
LOGGED BY: W.Johnson
DATE DRILLED:
7/16/1998
STRATA
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WELL CONSTRUCTION
Q
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DETAILS
w
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DETAILS
DESCRIPTION
y
a
PROTECTIVE CASING
Diameter: 2 in.
Ground Surface
0.0
Type: Flash -wonted
Interval: 0 - 0.3 ft.
To soil
Brown to orange, fine to medium
SAND
2.5
CG
3.5
BS
RISER CASING
Diameter. 2 in.
5 0
88.92
Type: Schedule 40 PVC
Interval: 0 - 0.3 ft.
28
40
GROUT
Type: Portland Cement
83 92
Interval: 0.3 - 2.5 ft.
Tan, silty fine to medium SAND
:
10.0
SEAL
Type: Bent. pellets
Interval: 2.5 - 3.5 ft.
15.0
.`-
78.92
FILTERPACK
Type: Filter Sand #2
Gray, sandy CLAY
Interval: 3.5 - 24.5 ft.
SCREEN
Diameter. 2 in.
20.0
; •
73.92
Type: Schedule 40 PVC
Interval• 10 - 24.5 ft.
24.5
FP
BSC
NOTES:
COMPLETION REPORT OF
SM3100 spring Forest Rd. WELL No. MW-1
E ��� Raleigh, NC 27616
B•IVIRO EWA�E 1fAl SE!KrEsES

COMPLETION REPORT OF WELL rio. MW-2
0
PROJECT:
-Preslar's Exon
WATER LEVEL TOB (Fr.): 9.25
PROTECT NO:
1040-98-091A
WATER LEVEL 24 HRS. ED: ,
PROJECT LOCATION:
DRILLING CONTRACTOR:
DRILLING METHOD:
Midland, NC
S&ME
4r/4" H.S.A.
TOP OF CASING ELEVATION (Fr.): 94.52
25
BORING DEPTH (FT.): W.Johnson
LOGGED BY:
DATE DRILLED:
8/7/1998
n
STRATA
WELL
Ex.
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3
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3
WELL CONSTRUCTION
DETAILS
0
x
DESCRIPTION
W w
DETAILSA
"
Aa
A
PROTECTIVE CASING
Diameter. 2 in.
Ground Surface
0.0
Type: Flush -mounted
Interval: 0 - 03 ft
To oil
Brown to orange, slightly clayey,
fine to mediumSAND
2.5
CG
3.5
BS
RISER CASING
Diameter. 2 in.
_M
5.0
89.52
Type' Schedule 40 PVC
Interval: 0 - 0.3 ft.
Tan, slightly clayey, fine to
mediumSAND
'=
GROUT
Type: Portland Cement
Interval: OA - 7-5 ft.
10.0
84.52
Tan to light brown, silty,
W.
coarseSAND
-
SEAL
Type: Bent pellets
Interval: 1.5 - 3.5 ft
15.0
79.52
FILTERPACK
Type: Filter Sand iI2
Gray, sandy CLAY=.'
Interval: 3.5 - 25.0 ft
SCREEN
Diameter. 2 in.
20.0
;'
74.52
Type: Schedule 40 PVC
Interval: 5 - 25.0 ft
25.0
25
FP
BSC
69.52
NOTES:
COMPLETION REPORT OF
Sam3100 Spring Forest Rd. WELL No. MW-2
Raleigh, NC 27616
ENVROATR
VICES

COMPLETION REPORT OF WELL n o. MW-3
0
PROJECT:
Preslar's Exon
WATER LEVEL TOB (FT.): 11
PROJECT NO:
1040-98-091A
WATER LEVEL 24 HRS (FT.):
PROJECT LOCATION:
DRILLING CONTRACTOR:
DRILLING METHOD:
Midland, NC
S&ME
41/41' H.S.A.
TOP OF CASING ELEVATION (FT.): 93.92
BORING DEPTH (FT.): 25
LOGGED BY: W.Jobnson
DATE DRILLED:
8/7/1998
STRATA
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DETAILS
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DESCRIPTION
p
j
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PROTECTIVE CASING
Diameter. 2 in.
Ground Surface
0.0
Type: Flash -mounted
93.92
,Toosoil
Interval: 0 - 0.3 ft.
Brown to orange, fine to
2
CG
mediumSAND
3
BS
RISER CASING
Diameter: 2 in.
White to tan, fine to medium
5.0
88.92
Type: Schedule 40 PVC
SAND
Interval: 0 _ 0.3 ft.
Brown, rtne to mediumSAND
GROUT
Type: Portland Cement
Interval: 0.3 - 2.0 ft.
f 0.0
83.92
Tan, silty, fine to mediumSAND
SEAL
Type: Bent. pellets
Interval: 2.0 - 3.0 ft.
15.0
-
78.92
FILTERPACK
Type: Filter Sand #2
Light gray, sandy CLAY
Interval: 3.0 - 25.0 ft.
SCREEN
Diameter: 2 in.
20.0
73.92
Type: Schedule 40 PVC
Interval: 5 - 25.0 ft.
Gray, sandy CLAY
25.0
25
FP BSC
68.92
NOTES:
COMPLETION REPORT OF
#S&ME3100 Spring Forest Rd. WELL No. MW-3
�1� �G77��ss��Raleigh, NC 27616
E�MRONh 4AI SEKVICN1

COMPLETION REPORT OF WELL isi'o. MW-4
Al
PROJECT:
P.reslar's Exon
WATER LEVEL TOB (FT.): 12A8
PROJECT NO:
1040-98-091A
WATER LEVEL 24 HRS (FT.):
PROJECT LOCATION:
Midland, NC
TOP OF CASING ELEVATION (FT.): 94.58
DRILLING CONTRACTOR:
S&ME
BORING DEPTH (FT.): 21.5
DRILLING METHOD:
4%11 H.S.A.
LOGGED BY: W.Johnson
DATR DRILLED:
8/7/1998
STRATA
WELL
,-.
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_
F
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WELL CONSTRUCTION
®
-
MAILS
p
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DETAILS
DESCRIP PION
z
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w
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A
PROTECTIVE CASING
Diameter. 2 in.
Ground Surface
0.094.58
3
Type: Flush -mounted
Interval: 0 - 0.3 ft.
CG
Topsoil
Brown to orange, fine to
mediumSAND
RISER CASING
4.5
BS
Diameter. 2 in.
5.0
89.59
TYPe: Schedule 40 PVC
Interval: 0 - 0.3 ft.
Brown, foe to mediumSAND
GROAT
Type: Portland Cement
Interval: 03 - 3.0 ft.
10.0
-
84.58
Tan, silty, fine w mediumSAND
--
SEAL
Type: Beat. pellets
_
Interval: 3.0 - 4.5 ft.
15.0
79.58
FILTERPACK
Type: Filter Sand #2
Light gray sandyCLAY
Interval: 4.5 - 21.5 ft.
SCREEN
Diameter: 2 in
20.0
74.58
Type: Schedule 40 PVC
21.5
FP
BSC
Interval: 6.5 - 21.5 ft.
NOTES:
COMPLETION REPORT OF
S&ME
3100 Spring Forest Rd. WELL No. MW4
Raleigh, NC 27616
INEEpNG • TE EN�S NG
W RONMENTALSE CES

PROJECT: FreslaW-Exxon WELMOG NW-5
Midland. NC
'pp,�CNp, ; 1040-98-091 ELEVAT101� 9•t.75 ft. N6VD N0 The elevations reported are relative..
OWED BY. NKJ BORING DEFM
60 FEET
OATS ORMLEM a-t7-99 . WATER LEM:
14.15
ORILLINB NETH017: Air Rotary DRILL RIa
CME-55
o Oescrlption &Remarks
Uj
o N
V
w
c�
Brown to orange, fine to medium. slightly
Clayey Sand
9t
5
Brown, fine to medium Sand
4�"
gl
to
Brown, fine to coarse, Silty Sand
Light gray, slightly Silty Sand .
Gray, Sandy Clay
Gray, Sandy Clay
Tan to medium brown, stiff, Sandy Clay
Tan to light brown, very stiff, Sandy Clay
r
Very light gray to medium gray, partially
weathered Saprolite
Rock
Termination Of Boring At 60.0 Feet
WELL DIAGRAM
f
�i
y11
page: 101 1
IS& ME
�.
Environmental Services
Engineering * Testing
I
c
E
U

COMPLETION REPORT OF WELL 1N o. MW-6
PROJECT:
Preslar's Exon
WATER LEVEL TOB (FT.):
PROJECT NO:
1040-98-091A
WATER LEVEL 24 FIRS (FT.): b.57
PROJECT LOCATION:
Midland, NC
TOP OF CASING ELEVATION (FT.): 86.83
DRILLING CONTRACTOR:
S&ME
BORING DEPTH (FT.): 18
DRILLING METHOD:
41/4" H.S.A.
LOGGED BY: E. Lane
DATE DRILLED:
7/3/2001
STRATA
WELL
3
a
WELL CONSTRUCTION
.a
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W
DETAILS
W
V
a
06 '
>
A
DETAILS
DESCRIPTION
a
PROTECTIVE CASING
Diameter: 2 bit.
Ground Surface
0.0
86.83
Type: Flush -mounted
Interval: 0 - 0.3 ft.
Town TOPSOIL.
Brown orange clayey SII,T, fine.
RISER CASING
Brown SAND whack fragments,
medium -coarse.
4
CG
Diameter: 2 in.
5.0
6
BS
81.83
Type: Schedule 40 PVC
Interval: 0 - 0.3 ft.
Soft weathered ROCK w/minor
sand, coarse -very coarse.
1 :. •. •
.
8
FP
GROUT
Type: Portland Cement
Hard weathered ROCK, very
coarse.
Interval: 0.3 - 4.0 f
ft.
10.0
SEAL
Type: Bent. pellets
Interval: 4.0 - 6.0 ft.
15.0
71.83
FILTERPACK
Type: Filter Sand #2
Interval: 6.0 - 8.0 ft.
18
BSC
SCREEN
Boring terminated Q 18.0 fL
Diameter. 2 In.
Type: Schedule 40 PVC
Interval: 8.0 -18.0 ft.
NOTES:
SM
ENG1IVO�I�rAL BERM 9
3100 Spring Forest Rd.
Ratelgh, NC 27616
COMPLL+ LIVI I KLrUx1 %Jr
WELL No. MW-6

COMPLETION REPORT OF WELL , . j. MW-7
PROJECT:
Preslar's Exon
WATER LEVEL TOB (FT.):
PROJECT NO:
1040-98-091A
WATER LEVEL 24 HRS (FT.): 10.56
PROJECT LOCATION:
Midland, NC
TOP OF CASING ELEVATION (FT.): 82.11
DRILLING CONTRACTOR:
S&ME
BORING DEPTH (FT.): 18
DRILLING METHOD:
4'/4" H.S.A.
LOGGED BY: E. Lane
DATE DRILLED:
7/3/2001
STRATA
WELL
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Q
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WELL CONSTRUCTION
DETAILS
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DETAILS
DESCRIPTION
�
PROTECTIVE CASING
Diameter: 2 in.
Ground Surface
0.0
Type: Flush -mounted
Interval: 0 - 0.3 ft.
RISER CASING
Brown TOPSOIL.
Brown SAND, medium -coarse.
Soft weathered ROCK, coarse.
4
CG
Diameter. 2 in.
5.0
6
BS
77.11
Type Schedule 40 PVC
Interval: 0 - 0.3 ft.
SAND w/soft weathered rock,
coarse.
8
FP
GROUT
Type: Portland Cement
Interval: 0.3 - 4.0 ft.
10.0
72.11
HARD WEATHERED ROCK
w/quartz and granite fragments,
SEAT,
very coarse.
Type: Bent pellets
interval. 4.0 - 6.0 ft.
15.0
:
67.11
FILTERPACK
Type: Filter Sand #2
Interval: 6.0 - 8.0 ft.
18
BSC
SCREEN
Boring terminated @ 18.0 ft.
Diameter: 2 in.
Type: Schedule 40 PVC
Interval: 8.0 - 18.0 ft.
(0m) NOTES:
#SME
ENGINEERING • TESTING
ENVIRONMENTAL SERVICES
3100 Spring Forest Rd,
Raleigh, NC 27616
COMPLETION REPORT OF
WELL No. MW-7

COMPLETION REPORT OF WELL no. MW-8
PROJECT:
Preslar's Eton
WATER LEVEL TOB (FT.):
PROJECT NO:
1040-98-091A
WATER LEVEL 24 HRS (FT.):
PROJECT LOCATION:
Midland, NC
TOP OF CASING ELEVATION (FT.): 90.89
DRILLING CONTRACTOR:
S&ME
BORING DEPTH (F-F.): 20
DRILLING METHOD:
4r/4" H.S.A.
LOGGED BY: E. Lane
DATE DRILLED:
7/2/2001
STRATA
WELL
a
AA
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3
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WELL CONSTRUCTION
DESCRIPTION
o
0.DETAILS
v
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DETAILS
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PROTECTIVE CASING
Diameter: 2 in.
Ground Surface
0.0
Tie Flush -mounted
Interval: 0 - 0.3 ft.
Dark brown TOPSOIL, organic.
Brown SAND, medium -coarse.
RISER CASING
Diameter: 2 in.
Light brown SAND,
medium -coarse.
5.0
6
CG
85.89
Type: Schedule 40 PVC
Interval: 0 - 0.3 ft.
Brown SAND w/ rock fragments,
oarse.
Light brown SAND w/weathered
rock, coarse.
8
BS
GROUT
Type: Portland Cement
Brown orange SAND w/
weathered rock, coarse.
10
FP
Interval: 0.3 - 6.0 ft.
I0.0
80.89
Soft weathered ROCK wisand,
coarse -very coarse.
SEAL
Type: Bent. pellets
Interval: 6.0 - 8.0 ft.
Hard weathered ROCK, very
coarse
1-20.0
15.0
'.
75.89
FILTERPACK
Type: Filter Sand #2
Interval: 8.0 -10.0 ft.
SCREEN
20
BSC
Diameter: 2 in.
70.89
Type: Schedule 40 PVC
Boring terminated at 20 feet.
Interval: 10.0 - 20.0 ft.
NOTES:
#S&ME
ENGINEERII� TESTING
ENVIRONMENTAL SERVICES
3100 Spring Forest Rd.
Raleigh, NC 27616
UUIV1YLE 11UIN IMrUI%1 yr
WELL No. MW-8

CO 'LETION REPORT OF WEL— No. MW-9
PROJECT: Preslar's Exxon
YKUJECT NO: 1040-98-091B
PROJECT LOCATION: Midland, NC
f DRILLING CONTRACTOR: S&ME, Inc.
DRILLING METHOD: 4%" H.S.A.
DATE DRILLED. 10/22/2001
WATER LEVEL TOB (FT.): 15.45
WATER LEVEL 24 HRS (FT.):
TOP OF CASING ELEVATION (FT.): 665.15
BORING DEPTH = X.
--
LOGGED BY:
K. Journigan
STRATA
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a DETAILS
n,
>DESCRIPTION
WELL CONSTRUCTIO
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DETAILS
�
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Ground Surface
PROTECTIVE CASING
TOPSOIL as brown to tan slightly
0.0
Diameter. 2.0 in.
�ilty fine to medium sand
-
Type: Flush -mounted
Light tan silty medium SAND
Interval: 0.0 - 0.3 ft
Tan brown fine sandy SILT
RISER CASING
5.0
5
CG
67
Diameter: 2.0 in.
660.15
Type: Schedule 40 PVC
Interval: 0.0 -10.0 ft.
8
BS
GROUT
-
Type: Neat Cement
10.0 :: -' ;
10
FP
76
655.15
Interval: 0.3 - 5.0 ft.
-
SEAL
_
Type: Bentouite Pellets
Interval: 5.0 - 8.0 ft
PARTIALLY WEATHERED
ROCK sampled as orange tan
15.0- .•-'•
-
86
650.15
clayey SILT w/manganese oxide
-
FILTERPACK
and rock fragments
-
Type: Filter Sand #2
Interval: &0 - 25.0 &
PARTIALLY WEATHERED
ROCK sampled as brown tan
_
SCREEN
Diameter. 2.0 in.
mottled silty fine SAND to silty
20.0 .
100
645.15
CLAY
_
Type: Schedule 40 PVC
Interval: 10.0 - 25.0 ft
Storing terminated at 25.0 R
25.0
25
BSC
100
640.15
LEGEND
-Water Level At Tertmnation of Boring (TOB)
1 - water Level AM 24 Houn
BS - Bectcnite- Seal
FP Filter Fa*
CG - Canent Grout
13SC- Bottom of Screen
NOTES:
3100 spring Forest Rd.
*S&ME
COMPLETION REPORT OF
WELL No. MW-9
Raleigh, NC 2761t3
ENGlNEERIN TE�7ING
ErMRONME SERVICES

"ALL k-VA,'S1'KUC:'110N R;C:OF7,
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONMACiOR(INDIVIDUAL)NAME, (print) `�At�1���L GA%CERTIFICATIO`# 33S5
DELL- COEVTRACTOR G01UPA.'V7i NAME _G WN&%. (, U X fZg W Ett �Ho. (i�). 6 7)• ZqZ 1
STATE BELL CONSTRUCTION PERMIT# ASSOCIATED NVQ PERMIT#
(if applicable) -mmmmm(if applicable)
1. WELL USE (gheck Applicable Box): Residential ❑ Municipal!Public ❑ Industrial ❑ Agdcultural ❑
Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: i 1^,*� County �.� � a rlr v
(S tmet Name, Numbers. CQommuait t Subdivision. Lot No.. Zap Code)
-3. OWNER:__t'¢vc�tS
Address 1101 %-Y Z
(Sheet of Route N
W— ) Z Fla Z
City or Town State Zip Code
(RIR)- a7-5 - 1U6C> 501�( e-5
Area code- Phone number
4. DATE DRILLED '32 S
5. TOTAL DEPTH:_ 1 15
6. DOES WELL REPLACE EXISTING WELL? YES 11 NO u
7. STATIC WATER LEVEL Below Top of Casing: —r" FT.
Wse u_.. if Above Top or Casing)
8. TOP OF CASING IS FT. Above Land Surface*
"Top or casing terminated at/or below land surface requires a
variance in accordance with [SA N-CAC 2C .0118.
9. YIELD (gpm): . - — METHOD OF TEST
10. WATER ZONES (depth):
11. DISINFECTION€: Type Amount
12. CASING: Wall Thicknew
Depth Diameter or Weight/Ft. Material
Froln a To 5 Ft. 2. " S tk &La -e%x-�
From To Ft.
From To FL
TopographiclLand setting
❑Ridge ❑Slope ❑Valleylat
(check appropriate box)
Latitude4ongitude of well location
(degrees,,minuteslsecoads)
Ladtude!longitade source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
© l Tod Soll`-
S i�F, lc.
ROt. - 14 otti C t-Y
LOCATION SKETCH
Show direction and distance in riles from at least
two, State Roads or County Roads. include the road
numbers and common road names.
13. GROUT: Depth Matetial Beth
Froru_ To 3 Ft. �-o �crtl �ov [��Fw �—
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To 16 Ft. Z i lL in. P��
From To Ft. in in.
15. SAND/GRAVEL PACK:
Depth Size Material
From�JToo Ft ,. A!4, 0 From To Ft. -----�
16. REMARKS: i -J F L C O
I DO HEREBY CERTIFY THAT THIS WELL Ii AS CONSTRUCTED IN ACCORDANCE WrW 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS—AbD-THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
z S/0
CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Attu: Information Nfanagement,1617 Mail Service Center -
RaIeigh, NC 27699-IG17, Phone No. [phone], within 30 days.
GW 1 REV. 0912004

LL k-VIN6.1KUU ION REA C OR" -
North Carolina Department of Envirotlntent and Natural Resources - Division of Water Quality
N\'ELL CO\TRACTOR (L-'DI«DLiAL) N'-AAIE (p//rint)trtt `����� C ( t E'� `n CERTMCATIO` # 13 Ss
%VTLL CO:N'TR.4,CTOR COAIPA:.NY N&NIE V 6�� 4Nj. t (,t) & qC W F,<L" 6, PH0;.gE # (Ito). 61 '. 7qe t
STATE WELL CONSTRUCTION PERIAff9 ASSOCIATED WQ PERA3I7179
(if applicable) (if applicable)
1. WELL USE (,fleck Applicable Box): Residential 13MunicipaL/Public ❑ Industrial ❑ Agricultural 13Monitoring Ef Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: 1 r'-4 County C,.b -Irr v 5
`I . t Wwa 4 21 , Nt?.Al.t e N C
(Street Name, Numbers; dommunig- Subdivision. Lot No.. Zip Code)
3. OWNER__ tlr Cd'S E Y)CO s
Address _ 'lot 14 wv V
(Street orRoateN�
IN ; c�� mat N(_.. [
City or Town State Zip Code
° Ico- ;m - tor() --
Area code- Phone number
4. DATE DRILLED 3 2 6
5. TOTAL DEPTH: 16
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: -�" F E
(Use `-' if Above Top ofCasing)
8. TOP OF CASING IS 7. FT. Above Land Surface*
`Top of easing terminated at/or below land surface requires a
v-ariancein accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): .--• METHOD OF TEST
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or WeighdFt. Material
From D To �1 • $ Ft. 2 " 5 C_k LLa PJc_
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley fgFlat
(check appropriate box)
Latitude./longitude of well location
(degrees%minutes; seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Descripption
o l -Top SO)l
1.5 Bwk .(ttl
Clw / Sa-�-3c r)z,,c,t
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth- Material Me1hqA
'From • To q•5 Ft.Vvu.�(�r�..r),
From To Ft.
14. SCREEN: Depth Diameter Slot Sue Material
From (-! . 5 To Ft. Z iu. in. PAL
From To Ft. in. in.
15. SAND/GRAVEL PACE,
�i Depth Size Material
I From �l . 5 To b Ft._ _ _�A�nu 0
From To Ft.
16. REMARKS: WE LL i�-
. .. .... .. . ..
Lc I t
�o
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T CONSTRUCION ST.ArDARDS, AM THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
a s/01
CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Attn: Information Management, 1617 flail Serlice Center -
Raleigh, NC 27699-1617, Phone No. [phone], within 30 days.
GW-1 REV. 0912004

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_��--- --- — 07►fN �T(1T.T.1f1x.TC�In�'TrIMMA

North Carolina Departnleut of Environment and Natural Resources - Division of Water Quality
NVELL CONTRACTOR (ODWID(?AL) NMIE (print)
hh -TN t&I;- L(„ G 0 WA-CERTIIYC4TIO�i # 3 � �o�
IRTLL CONTRACTOR COMPANY NANM E ,• 7 qZ j
STATE WELL CONSTRUCTION PERAi1T9 ASSOCIATED WQ PERMIT9
(if applicable) (if applicable)
L WELL USE (gwcl; Applicable Box): Residential © MunicipalrTublic ❑ Industrial © Agricultural 11
Monitoring ig Recovery O Heat Pump IA'ater Injection ❑ Other © If Other, List Use
2. WEL-L LOCATION:
Nearest ToR°tl: i j ifedz County C.w b R revs
t Q l Ww t- 2� t Nt+, `", Ri C
(Street Name, Numbers, ommuniq-t Subdh ision. Lo[ No.. Zip Code)
-3. 0114'NER:�c4.�rt�S EYlta�t
Address _ i o t 14wy Z? .
"N� ttteN -) Z v i c I
City or Town State Zip Code
(Rtq)- ;z 73 — [o6b FS
Area code- Phone number
4. DATE DRILLED -3 2 S b 1
5. TOTAL DEPTH: l Q
6. DOES WELL REPLACE EXISTING WELL? YES C3 NO El
7. STATIC WATER LEVEL Below Top of Casing: --^ * FT.
(LFse "+" ifAbove Top of Casing)
8. TOP OF CASING IS 7- FT. Above Land Surface's
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NC.AC 2C Ong.
9. YIELD (epm): -- METHOD OF TEST
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: R'all Thickness
Depth Diameter or Weiht/Ft. Material
From 0 To `� Ft.
From To Ft.
Frotu To Ft.
Topograpbic/Land setting
[]Ridge OSlope ❑Valley ai
(check appropriate box)
Latitude%iongitude of *veil location
(degtemJ'zn nutes;seconds)
Latitude4ongitude source:110PSl7Topographic map
(check box)
DEPTH DRUJ ING LOG
From To Formation DescriQLion
0 1 Top Soil
-t 15 C1^
S 1 54V (tact C 1.&?e
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth
Material
M.ethqd
From To ? . 5
Ft.
C_oncNAic—
4vv.� (�rF��r
From To
Ft.
e L
14. SCREEN: Depth
Diameter Slot Size Material
FromT4
Ft.
2 in.
in. Voc—
,To
From To
Ft.
in.
in.
dP
15. SAND: GRAVEL PACE:
Depth
From 7. 5 To 1 `�
Ft.
Size,
15�7­
Material
S&AA,
From To
Ft.
_
16. REMARKS: VIE C U
R . 7 �
! tA � � ®���•
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WEIL
CONSTRUCTION STAND ARDS. ANDITHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ZS/0`7
CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Attn: Information Management,1617 Mail Setzice Center -
RaIelgh, NC 27699-1617, Phone No. [phone], within 30 dkvs.
GW I REV. 0912004

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
APPENDIX C
INJECTION WELL CONSTRUCTION DESIGN

F_
0
0
z
Cr O'
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zo
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Cr
Cr
a
�a
W V,
r
0
m
0
LU
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V
LU
1 ft
r
TYPE II FLUSH -MOUNT WELL
NOT TO SCALE
l
STEEL LID
1 " LOCKING WELL CAP
GROUND SURFACE
_1_" DIA. SCH._40_ PVC CASING
CONCRETE
CEMENT GROUT (AS NEEDED)
NOMINAL 6 " BOREHOLE
BENTONITE SEAL (AS NEEDED)
COARSE GRAINED QUARTZ SAND
WATER TABLE
0.0_10_ " SLOTTED PVC SCREEN
BOTTOM PLUG
EST. DEPTH 20 ' 4m
So U UMIN IEs INJECTION WELL CONSTRUCTION DESIGN
Industrial & Environmental Services
1101 NOWELL ROAD
RALEIGH, NORTH CAROLINA 27607
TEL.: [phone] FAX.. [phone]
PRESLAR'S EXXON
MIDLAND, NORTH CAROLINA

EAS
SAFETY DATA SHEET --
Disposal
Waste Disposal Methods: ? Dispose of according to Federal and local regulations for non -hazardous
j waste.
Date of Preparation: 129 May 2014
Last Modified Date: 15 September 2014
The information contained herein is based on available data and is believed to be correct. However, EOS
Remediation, LLC makes no warranty, expressed or implied, regarding the accuracy of this data or the results to
be obtained thereof. This information and product are furnished on the condition that the person receiving
I them shall make his/her own determination as to the suitability of the product for his/her particular purpose.
EOS Remediation, LLC 4

EAS
SAFETY DATA SHEET
Section 9: Physical and Chemical Properties
1 Hppearance:
I i ransparent iiquiu
txpiusive omits.
ivt
Odor:
None
Vapor Pressure:
NE
j Odor Threshold:
NE
Vapor Density:
1.37
PH:
j NE
Relative Density:
1.25
Melting Point/Freezing Point:
Liquid at room
temperature
Solubility:
Miscible
Boiling Point:
NE
( Partition coefficient:
NE
rlcnai ruim. IVC. HUI1- 1 MUlu-1rJ11llull ICIIIPCICILU1C. IVC
combustible I
I Evaporation Rate: NE I Decomposition Temperature: NE
Flammability (solid, gas): NE ; Viscosity: <50 cP j
NE — Not Established
N/A — Not Applicable
StabilitySection 10:
Stability:
( Stable
Incompatibility:
Metal hydrides and other water reactive materials.
Hazardous Decomposition
Products:
; Thermal decomposition may produce magnesium oxide, sulfur dioxide and
sulfur trioxide.
Hazardous
Reactions/Polymerization:
None known j
Conditions to Avoid:
; None known
Section 11: Toxicological Information Routes of Exposure:I Ingestion, dermal and eye contact {
Signs and Symptoms of Exposure: '': None known 1
Health Hazards:
_
Acute: Potential eye and skin irritant. Ingestion causes nausea, vomiting, .
gastrointestinal discomfort and diarrhea.
_
Chronic: if None known
Carcinogenicity: j
NTP: i No
IARC: No
OSHA: i No
There is no data on the
of this product.
EOS Remediation, LLC 3

EAS
SAFETY DATA SHEET
Extinguishing Media: j Compatible with all extinguishing media. j
Special Fire Fighting Procedures: j Wear self-contained breathing apparatus and chemical resistant clothing.
Use water spray to cool fire exposed containers.
Fire Hazard(s): None
j Personal Precautions: I Avoid contact with eyes and skin. Do not consume. j
Emergency Procedures: j N/A
Methods & Materials used for Compatible granular absorbent j
Containment:
Cleanup Procedures: i Spread compatible granular absorbent over spill area and sweep using I
broom and pan; dispose in appropriate receptacle. Clean area with water. I
Safe Handling & Storage: i Do not store near water reactive materials.
Other Precautions: Consumption of food and beverages should be prevented in work area
where product is being used. After handling product, always wash hands
and face thoroughly with soap and water before eating, drinking, or
smoking.
ection 8: Exposure Controls/Personal Protection ,
Exposure Limits
OSHA PEL:
NE NE _
ACGIH TLV:
NE NE
NIOSH REL•
I NE NE _
Personal Protective Measures
Respiratory Protection:
{ Not normally required. N95 respirator if aerosols might be generated.
Hand Protection:
Protective gloves are recommended
Eye Protection: _
_ Recommended
Engineering Measures:
Local exhaust ventilation if aerosols are generated _
Hygiene Measures:
Wash promptly with soap & water following skin contact
Other Protection:
Wear appropriate clothing to prevent skin contact
NE — Not Established
EOS Remediation, LLC 2

E6S FAS
EOS am,LLc SAFETY DATA SHEET
Identification
Name:
EAS
Chemical Description:
Mixture; clear liquid
Manufacturer:
EOS Remediation
1101 Nowell Road
Raleigh, NC 27607
(P): 919-873-2204
Recommended Use:
Groundwater Bioremediation (environmental applications)
Restricted Use:
Not for human consumption
24-Hour Emergency Contact:
ChemTel: United States
(P): 800-255-3924
ChemTel: International
(P):813-248-0585
Hazard Classification: Irritant (skin and eye)
Signal Word: Warning
Hazard Statement(s): Potential eye and skin irritant
Pictograms: ,
•
Precautionary Statement(s): Avoid contact with eyes and skin. Wear protective gloves and eye
protection.
Section 3: Composition/Information on Ingredients
Common Name(s)
CAS NO.
by Weight
Sulfate Salt
Proprietary 35 - 37
Trade Secrets
Nutrients
1.5
Trade Secrets Proprietary <_
Water 7732-18-5 61.5 - 63.5
1— The precise composition of this product is proprietary information. A more complete disclosure will be
provided to a physician in the event of a medical emergency.
Routes of Exposure Emergency First -Aid Procedures
Inhalation Remove to fresh air.
Eye Contact Flush with water for 15 minutes; if irritation persists see a physician.
Dermal Wash with mild soap and water.
Ingestion Seek medical advice.
EOS Remediation, LLC

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
IN SITU GROUNDWATER REMEDIATION
SECTION VII. ATTACHMENTS
APPENDIX B
EAS MSDS

�--{-
•
LLI 650
w
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OL—
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1127
CO F-
Lu
w'�.��
BM 58
i1v�= 0
22
®t�
700 tti Site
� �-''•, \ � \ _ � I �'"�. err � '� Q�
REFERENCE: L, r,�� - • /
t5 USGS 7.5 MINUTE TOPOGRAPHIC MAP
CZ MIDLAND, NC 1993
CONCORD SE, NC PHOTOREVISED 1987
2 (DRG DIGITAL MAP FROM GEOCOMM)
=3
O 0 1000 2000LL
SCALE IN FEET
FIGURE:
SITE LOCATION MAP
1,Solufions-ms FORMER PRESLAR'S EXXON
Industrial & Environmental Services 901 NC HWY 24/27 1
1101 NOWELL ROAD NCDOT PROJECT R-615B, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607 MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.: [phone] FAX.: [phone]

H
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LEGEND
WATER SUPPLY WELL
O
DEEP MONITORING WELL
O
SHALLOW MONITORING WELL
--
PROPERTY LINE
Indicates exceedance of 15A
NCAC 2L Standards
Notes:
Base map provided by S&ME, Inc. and
Cabarrus County GIS. Monitoring well locations are
approximate.
0
125 250
SCALE IN FEET
i
i
I � \
I 0\
I@ WSW ❑ \
IHOUSE I \
v ----� C3 03
WSW-3
30 FEET
INSET FROM
BLUE X
PIW-1 ABOVE IN
BETWEEN MWA
AND MW-13
PMW-1 `�"
PMW-2
m I WSW-5 I 0 5 10
m � L
r
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H USE
z I SCALE IN FEET
WSW-6 \ \
MW-2 APPROXIM E' OCAT!ON
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w
NC HIGHWAY 24/27 ( WEST BOUND LANE)
Q
� �
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MW
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---- ---� — MW-12
House — — — — — — — — — — — — — T — — — — —
o ❑I //
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\ I
� I
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\ /- — —
in
a WSW-9
0
rn
M 1
w
J_
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I 1
FIGURE:
SITE MAP
TiSolutions-IB FORMER PRESLAR'S EXXON
Industrial & Environmental Services 901 NC HWY 24/27 2
1101 NOWELL ROAD NCDOT PROJECT R-615, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607 MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.: [phone] FAX.: [phone]

\
LEGEND
i
WATER SUPPLY WELL
i
0
DEEP MONITORING WELL
/
Z
0 �SHALLOW MONITORING WELL
i
a
\
m o
--
LINEz
%OPEIRTY
0 exceedance of 15A
I
\
U N
w
NCAC 2L'Standards
I
❑\
O
cr
Notes: '-
---
\�
Q.
Base map provided by S&ME, Inc. nd
WSW-4
❑
Cabanus County GIS. Monitoring locations are
approximate.
❑
i \
0 125 250
\
LL
LuUw
I HousE
I \
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S
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a< Y
APPROXIMATE LOCATION
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MW-11
i
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0
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Ir
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— — —
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—
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FIGURE:
SITE MAP
s 0
Ut10ns
—1
T�� c
1 � 7
FORMER PRESLAR'S EXXON
Industrial & Environmental Services
901 NC HWY 24/27
2
1101 NOWELL ROAD
NCDOT PROJECT R-615, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607
MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.: [phone] FAX.: [phone]

i—
O
0
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w2
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a
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1,1
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LEGEND
0 WATER SUPPLY WELL
® DEEP MONITORING WELL
® SHALLOW MONITORING WELL
-- PROPERTY LINE
Notes:
Base map provided by S&I.E, Inc. and
Cabanus County GIS. Monitoring wed locations are
approximate.
Inckates exceedance of 15A 14CAC 2L
0 StandeMs.
0 125 250
SCALE IN FEET
i
i
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I 0\
I WSW-4 D \
t I\
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WSWW---10 I WSW-12
I Q M® /
----------
WSW-9 I 1
FIGURE:
TiSolutions —1ES CONTAMINANT CONCENTRATION MAP
FORMER PRESLAR'S EXXON
Industrial & Environmental Services 901 NC HWY 24/27
1101 NOWELL ROAD NCOOT PROJECT R-615, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607 MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.:[phone] FAX: [phone]
Iles\NCDOT\GeoEnvironmental\3940.07A3.NDOT Preslaes Sampling -Trust & Fund Reimb\CAD\Current Drawings\3940-PreslarsX.dwg, 2, 6/6/2011 9:15:40 AM,1:1

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L_ MW-2
NG HIGHWAY 24/27 ( WEST BOUND LANE)
'
FORMER UST BASIN ESTIMATED EXTENT OF
Llvi4
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(u9/L)
WW-1WAY ST BOUND LANE)
WSW-11
SHALLOW MONITORING WELL
DEEP MONITORING WELL
WATER SUPPLY WELL
PROPERTY LINE
BENZENE ISOCONCENTRATION LINE
Notes:
Base map provided by S&ME. Inc. and Cabanis Canty
GIS. Monitoring well locations are approximate.
MN-5 Is a deep well and ran -detect
Groundwater samples coNected on Apr# 25, 2011.
0 75 150
Injection Well Field with 3, 5,
10 ft spacing from injection
well
HOUSE
5a
FIGURE:
J
(�0�Ut10�� _1T� BENZENE ISOCONCENTRATION CONTOUR MAP
FORMER PRESLAR'S EXXON
Industrial & Environmental Services 901 NCHWY24/27 4
1101 NOWELL ROAD NCDOT PROJECT R-61513, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607 MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.: [phone] FAX.: [phone]

o
Proposed Injection Zone
0
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---------------
---- ----
----------—
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LEGEND
0 SHALLOW MONITORING WELL
DEEP MONITORING WELL
Q5 WATER SUPPLY WELL
— — PROPERTY LINE
BENZENE ISOCONCENTRATION LINE
PROPOSED MONITORING WELL AND ID
Pmwa
PROPOSED INJECTION WELL AND ID
PK '
3
O INJECTION POINT AND AREA OF INFLUENCE
HOUSE
X
i
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Notes:
Base map provided by S&ME, Inc. and Cabarrus County
GIS. Monitoring well locations are approximate.
ul
d
MW-5 is a deep well and non -detect.
a`
O
Groundwater samples collected on April 25, 2011.
w
0 30 60
J
w
SCALE IN FEET
FIGURE:
(�
Solutions-
FULL SCALE INJECTION POINTS FOR EAS
PRELIMINARY11T� FORMER PRESLAR'S EXXON
)
Industrial & Environmental Services
901 NC HWY 24/27
5
1101 NOWELL ROAD
NCDOT PROJECT R-61513, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607
TEL.: [phone] FAX.: [phone]
MIDLAND, CABARRUS COUNTY, NORTH CAROLINA

CD
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LEGEND
SHALLOW MONITORING WELL
DEEP MONITORING WELL
ESTI TED EXTENT OF
IMPAC D GROUNDWATER
WATER SUPPLY WELL
(p ) (�, v/L`
- - PROPERTY LINE
BENZENE ISOCONCENTRATION LINE
PROPOSED MONITORING WELL AND ID
PMW3
PROPOSED INJECTION WELL AND ID
P_
O INJECTION POINT AND AREA OF I LUENCE
HOUSE
Notes:
Base map provided by S&ME, Inc. and Ca rrus County
-�
a
GIS. Monitoring well locations are appr mate.
MW-5 is a deep well and non -detect
00
t—
Groundwater samples col cted o pril 25, 2011.
.
ILL
0 -'" 30 60
LL
SCALZIN FEET
FIGURE:
IS/Industrial
PRELIMINARY FULL SCALE INJECTION POINTS FOR EAS
_TPQ
FORMER PRESLAR'S EXXON
& Environmental Services
901 NC HWY 24/27
5
1101 NOWELL ROAD
NCDOT PROJECT R-6156, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607
TEL.: [phone] FAX.: [phone]
MIDLAND, CABARRUS COUNTY, NORTH CAROLINA

0
4
APPR
® OF DE
® APPF
OF 5i
erne
s"re'smuma
\A' wo
ROSS SECTION LOCATION MA Job No. 1040-98-091 B
PRESLAR'S EXXON Scale: NTS
MIDLAND, NORTH CAROLINA ENNRONMENTAL SERHCES 6
ENGINEERING •TESTING Fig No. _

MW-2
0
50
MW-5
MW-1
100
40 0 40
HORIZONTAL
GRAPHIC SCALE IN FEET
10 0 10
VERTICAL
GRAPHIC SCALE IN FEET
ILTZVA.
95
MW-7 -I-85
75
65
55
O
35
I
I A -A' I
I ' i i I i i
' i 1 1 1 1 1 1 1 1 1 1
150
200 250
300 350
400 450 500
GEOLOGIC CROSS-SECTION A -A'
LEGEND
CLAYEY SAND ❑ SAND
WEATHERED ROCK
'PRESLAR'S EXXON
MIDLAND, NORTH CAROLINA
SANDY CLAY go SILTY
SAN D
RSPRING3118
MONITOR WELL
SCREENED
_
ENVIRONMENTAL SERVICES
FOREST ROAD
P.O. BOX 58069
RALEIGN, N.C. 27658-8069
[phone]
TOPSOIL
INTERNE
ENGINEERING •TESTING
FAX: [phone]
SCALE: AS SHOWN
DRAWN BY: GLD
CHECKED BY:
JOB NO. 1040-98-091 B
DATE: AUG 2001
FIGURE 7

i
I
WA
Me
10 0 10
GRAPHIC SCALE IN FEET
5 0 5
GRAPHIC SCALE IN FEET
20
HORIZONTAL
VERTICAL
30
LEGEND
SAND
SILTY SAND
SANDY CLAY
95
or$
:s
75
70
NOTE: BLUE LINE REPRESENTS WATER TABLE (JULY 2001)
MONITOR WELL
SCREENED INTERVAL
GEOLOGIC CROSS-SECTION B-B'
;PRESLAR'S EXXON
MIDLAND, NORTH CAROLINA
1p Is RALEIGH .BRANCH
ImMIL sm 3118 SPRING FOREST ROAD
P.O. BOX 58069
RALEIGH, N.C. 2765E-8069
-- [phone]
ENVIRONMENTAL SERVICES FAX: [phone]
ENGINEERING - TESTING
SCALE: AS SHOWN DRAWN BY: GLD CHECKED BY: DTJ
1013 NO. 1040-98-0918 DATE: AUG 2001 FIGURE 8

��
6
if
MW- 8
All W- 6
50 100 C-C' 150 200
%_m
Vol
75
70
NOTE: BLUE LINE REPRESENTS WATER TABLE (JULY 2001)
LEGEND
CI SAND WEATHERED ROCK
20 0 20
GRAPHIC SCALE IN FEET HORIZONTAL SILT MONITOR WELL
® SCREENED INTERVAL
5 O 5 TOPSOIL
VERTICAL
GRAPHIC SCALE IN FEET
GEOLOGIC CROSS-SECTION C-C'
'PRESLAR'S EXXON
MIDLAND, NORTH CAROLINA
RALEIGH BRANCH
3118 SPRING FOREST ROAD
P.O. BOX 58069
RALEIGH, N.C. 27658-8069
ENNRONMENTAL SERVICES [phone]
FAX: [phone]
ENGINEERING • TESTING
SCALE: AS SHOWN DRAWN BY: GLD CHECKED BY: DTI
JOB NO. 1040-98-091 B DATE: AUG 2001 FIGURE 9

LEGEND 1 — — — — — — 0� ^
0 \
Q SHALLOW MONITORING WELL I I L� \
o ® CP
I W - I
DEEP MONITORING WELL \
Z. WATER SUPPLY WELL � HOUSE
c-- PROPERTY UNE D I H USE \
Z--650--- GROUNDWATER CONTOUR Z
1325
I
IMPLIED DIRECTION OF
a GROUNDWATER FLOW I ( WSW-6
655.21 GROUNDWATER ELEVATION (ft amsD /—��
Notes: -- �r47'---------------- --- —
Base map prov(ded by SSME. Inc. and Cabanas County W-2
wJ GIB. Monitoring well locatlousare appnmmnate. 657.00
I-
LL
Groundwater flow direction is assumed without
� Iddeerationofpreferentialpa8nvaysassociatedwlm BOUND LANE) .
Groundwater levels collected on Apra 25, 2011. 656.24 APPROXIMA
M -5 H
66 MW .,-"OF FORMER UST BASIN
0 75 150 MW-11
Y O O 654.78
ui SCALE IN FEET MW-10 IG AY 24/27 (EAST BOUND LANE)
U
655.79
MW-3 MWA s5a 1 MW 9
655.39 O 53:94 A
n 653.57
W 13 (NWW 12
w
IL
❑
s
I 653
N
N I HOUSE
W O I M6526
.76 O
I WSW-11
652.74 652
I �Os
WSW-10 I 651
649A965p /
I MW-7 /
LL I 1
FIGURE:
TISolutions—ILE-S
SHALLOW GROUNDWATER POTENTIOMETRIC MAP
FORMER PRESLAR'S EXXON
Industrial & Environmental Services 901 NC HWY24127 10
1101 NOWELL ROAD NCDOT PROJECT R-615B, WBS 34348.3.5
RALEIGH, NORTH CAROLINA 27607 MIDLAND, CABARRUS COUNTY, NORTH CAROLINA
TEL.: [phone] FAX.: [phone]

'. 74
41�?A*
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
March 30, 2015
Mr. Nick Tennyson, Chief Deputy Secretary
NC Department of Transportation
Geotechnical Unit
1589 Mail Service Center
Raleigh, NC 27699
Re: Issuance of Injection Permit WI0300282
NCDOT Geotechnical Unit
Cabarrus County, NC
Dear Mr. Tennyson:
Donald R. van der Vaart
Secretary
In accordance with the application received on February 2, 2015, and additional information received March 12,
2015, we are forwarding permit number WI0300282. This permit is to inject EAS to remediate groundwater
contaminated with petroleum products at the Former Preslar's Exxon Facility, 901 NC Hwy 24/27 (R.O.W.).
This permit shall be effective from date of issuance, until February 29, 2020, and shall be subject to the
conditions and limitations stated therein, including the requirement to submit a Final Project Evaluation (FPE)
as stated in PART VII — MONITORING AND REPORTING REQUIREMENTS. Please read the entire permit
to ensure that you are aware of all compliance requirements of the permit.
Please note the following:
0 Per permit condition Part VIA, field parameters shall be added to the monitoring plan
along with at least one additional monitoring event at 12 months after injection;
• Per permit condition Part VI.5, prior to closing this permit, the Permittee must meet
groundwater quality standards or pre -injection levels, whichever concentration is higher,
for all of the injection constituents; otherwise, continued monitoring as approved in the
monitoring plan will be required until such levels can be established;
Per permit conditions Part VI.3 &4, and IX.2(G), within 30 days after each injection event,
please provide the well construction (if not previously submitted) and injection information
on the applicable forms listed below. Note: if well construction/abandonment information
is essentially the same (e.g., direct push points or geo-probes), then only one GW-1 or GW-
30 form is needed. Just indicate in the comments section on the form the total number of
well points. These forms are available on the Division of Water Resources's website at
http://yortal.ncdenr.ory/web/wa/aps/Swp ro/reportinv-forms
➢ Injection Event Record (IER)
➢ Well Construction Record (GW-1)
➢ Well Abandonment Record (GW-30)
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone] Internet: http://www.ncwater.org
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

NCDOT — Geotechnical Unit
Page 2 of 2
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an application
to renew.the permit 120 days prior to its expiration date. As indicated in the permit, this permit is not -
transferable to any person without prior notice to, and approval by; the Director of the Division of Water
Resources. If you have any questions regarding your permit or the Underground Injection Control Program
please call me at [phone].
Best Regards,
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
cc: Michael Parker & Andrew Pitner, WQROS — Mooresville Regional Office
Central Office File, W10300282
Michael Branson, Solutions-IES, 1101 Nowell Road, Raleigh, NC 27607

kEGEIVE '::NRIDWR
%'Solutions-IES
Industrial & Environmental Services
MAR 12 Z015
Water Quality Regional
LiRT71Ms6V'TRANSMITTAL
1101 Nowell Road * Raleigh, North Carolina * 27607 * [phone] * Fax [phone]
TO: Michael Rogers DATE: March 11, 2015
NCDENR
Division of Water Resources ATTN:
ENCLOSED PLEASE FIND THE FOLLOWING ITEMS:
SHOP DRAWINGS
1-1 CHANGE ORDER
COPIES:
COPIES DATE
COPY OF LETTER
SPECIFICATIONS
1[0a
TRANSMITTED AS CHECKED BELOW:
FOR APPROVAL
0 FOR YOUR USE
0 AS REQUESTED
❑ FOR REVIEW & COMMENT
0 FORBIDS DUE
REMARKS:
RE:
El
PRINTS
PLANS
❑ APPROVED AS SUBMITTED RESUBMIT
❑ APPROVED AS NOTED SUBMIT
❑ RETURNED FOR CORRECTIONS RETURN
L
FOR FILE
SAMPLES
UIC Application Revisions
DESCRIPTION
COPIES FOR APPROVAL
COPIES FOR DISTRIBUTION
CORRECTED PRINTS
20 PRINTS RETURNED AFTER LOAN TO US
Attached are two copies of the revised UIC application attachments and figures for the NCDOT UIC
permit application at the former Preslar's Exxon in Midland, North Carolina.
CC:
SIGNED:
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE.

Telephone Record/Log

Rogers, Michael
From: Rogers, Michael
Sent: Wednesday, February 25, 2015 1:13 PM
To: '[e-mail]'
Subject: W10300282 NCDOT
I left a message on your VM, but it cut me off before I could finish (time limit on the recording evidently). Looking
further at the proposed inj plan, to pass the review process, there would need to be 2 more MWs installed if using the
current configuration. One well on the west side of the driveway, and another on the east side at a distance that would
intercept any movement of the injectant outside the IZ within a reasonable amount of time.
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
NCDENR - DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://Porta1.ncdenr.org/web/­wq/aps/gwpro/reporting-forms
NOTE: Per Executive Order No. 150, all a -mails sent to and from this account are subject to the North Carolina Public
Records Law and may be disclosed to third parties.
_ 1,

IKWA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van. der Vaart
Governor Secretary
February 8, 2015
Nick Tennyson, Chief Deputy Secretary
NCDOT Geotechnical Unit, Geoenvironmental Section
1589 Mail Service Center
Raleigh, NC 27699
RE: Acknowledgement of Application No. WI0300282
NCDOT Geotechnical Unit
In Situ Groundwater Remediation Well System
Cabarrus County
Dear Mr. Tennyson:
The Water Quality Regional Operations Section (WQROS) acknowledges receipt of your
permit application and supporting documentation received on February 2, 2015. Your application
package has been assigned the number listed above, and the primary reviewer is Michael Rogers.
Central and Mooresville 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 Water Quality Regional Operations
Section (WQROS) 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,
Debra J. Watts, Supervisor
Animal Feeding Operations & Groundwater
Protection Branch
Division of Water Resources
cc: Mooresville Regional Office, WQROS
Cyrus Parker, NCDOT Geotechnical Unit-Geoenvironmental Section,1589 Mail Service
Center, Raleigh, NC 27699
Permit file W10300282 .
1636..Mai�ervice.Center, Raleigh, North Carolina 27699-1636
ne:4 PhoJAJ�.64641 Internet: http://ww.w.ncwater.org
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
PAT MCCRORY
GOVERNOR
Thomas Slusser
DWR- UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
TIP:
County:
Description:
Incident:
January 29, 2015
R-0615B
Cabarrus
Former Preslar's Exxon
13543
ANTHONY J. TATA
SECRETARY
RECEIVED/DE1VR/DVVR
FF, -�U1,205
Water Quality Regional
Operations Section
SUBJECT: Application for Permit for In Situ Groundwater Remediation
Dear Mr. Slusser:
Enclosed for your review are 2 copies of an Application for Permit for In Situ Groundwater
Remediation for the former Preslar's Exxon located at the intersection of NC24/27 and Preslar
Lane in Midland, Cabarrus County. Please contact me at 919-707-6868 or Gordon Box at 919-
707-6859 for questions or comments regarding this application.
Sincere ,
Cy . P er, LG, PE
GeoEnvironmental Supervisor
Geotechnical Engineering Unit
Enclosures
MAILING ADDRESS: TELEPHONE: [phone] LOCATION:
NC DEPARTMENT OF TRANSPORTATION FAX: [phone] CENTURY CENTER COMPLEX
GEOTECHNICAL ENGINEERING UNIT BUILDING B
GEOENVIRONMENTAL SECTION www.ncdot.gov/doh/preconstruct/highway/geotech 1020 BIRCH RIDGE DRIVE
1589 MAIL SERVICE CENTER RALEIGH NC 27610
RALEIGH NC 27699-1589

Rogers, Michael
From:. - Pitner; Andrew
Sent: Monday, March 23,. 2015 12:13 PM
To: Rogers, Michael; Parker, Michael
Cc:Watson, Edward M
Subject: RE: W10300282 NCDOT
Seems reasonable. We're ok with the changes and issuance of the permit for this one..
Andrew
-----Original Message ----=
From.:.Rogers, Michael_
Sent: Friday,, March.20, 2015 11.:03 AM
To: Pitner, Andrew.; :Parker, Michael
Subject: FW: WI0300282.NCDOT
Attached is some revised.pages to replace in .for, the.permit application for the.above
project. They have made.some changes is the :proposed injection based upon input from your
staff :report and comments from me. In regards to the:setback of 150 feet:the DWM had
suggested, the.DWM is, OK with.our requirements (see. email from Brett Morris).
Please:review as soon as:possible:let me:know if you are -OK -with the issuing permit aswe
have had this for awhile.
Thanks
-----Original Message-_ --
From: Michael Rogers[mailto:michael.roeers(ncdenr.eov]
Sent: -Friday, March 20,:2015 10:30 AM'_.
To: Rogers, Michael:
Subject:
This E-:mail was sent:from_"RNPAUDDO (Aficio 2075)..
Scan Date: 03.20.2015 09:30:09 (-0500)
Queries to: robin.markham(@ncdenr..gov -
1

Rogers, Michael
From: Morris, Brett
Sent: Monday, February 23, 2015 3:49 PM
To: Rogers, Michael
Cc: Pitner, Andrew
Subject: Preslar's Exxon, Incident: 13543
Michael,
Regarding the UIC permitting questions for the proposed Corrective Action at 901 NC highway 24/27 the 150 foot
setback was originally based on recommendations of our ITC group. However, after speaking to my supervisor we felt
the setback isn't needed since the injections would require UIC permit approval. Let me know if I can help with further
questions.
Thanks,
Brett Morris - Brett. [e-mail]
NC DENR - UST Section
610 E. Center Ave., Suite 301
Mooresville, NC 28115
Phone:[phone] Fax:[phone]
*********************************************************************
Email correspondence to and from this address is subject to the North Carolina Public
Records Law and may be disclosed to third parties unless the content is exempt by statute
or other regulation.
*********************************************************************

c
(&C 1) 4/1 /15,
�
WQROS REGIONAL STAFF REPORT
Date: 02/19/2015 County: Cabarrus
To: WOROS Central Office Permittee: NCDOT Geotechnical Unit
Central Office Reviewer: Michael Rogers Project Name: Former Presslar's UST #13543
Regional Login No: Application No.: WI0300282
L GENERAL INFORMATION
1. This application is (check all that apply): M New ❑ Renewal
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation M Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ❑ Yes or M No.
a. Date of site visit: not applicable — offce review conducted;WOROS staff discussed site with DWM-UST
sta and preformed a desktop analysis of the site.
b. Person contacted and contact information: Brett Morris MRO- UST is the proiect manager for DWM (704-
663-1699
c. Site visit conducted by:
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If.no,`please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location (s): OK
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and Injection -Sites:
(If multiple sites either indicate which sites the information applies to copy and paste a new section into the
document for each site or attach -additional pages for each site)
a. Location(s): ".see above:,.,
b. Driving Nf(;ciions:
c. USGS Quadrangle 1VIap name and number:
d. Latitude: - Longitude:
F.
formes -Presslar UST Cabarrus Co Feb 2015

V
WQROS REGIONAL STAFF REPORT
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
❑ Yes ❑ No ® N/A. If no, please explain:
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? ® Yes ❑ No ❑ N/A. If no, please explain:
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)?
Yes ❑ No ❑ N/A. If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division. ❑ Yes ❑ No
N/A. If no, please explain:
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
❑ Yes ❑ No ® N/A. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
❑ Yes ❑ No ® N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? ❑ Yes or ® No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit:
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? ❑ Yes ® No ❑ N/A. Attach map of, existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program: Monitoring plan refers to MW4 through MW-13, vet table 1
includes other wells that are not shown on the site map (i.e. PMW-1 through PMW-3); additionally it
references four water supply wells but those are not specified. Recommendations are noted below addressing
these matters..
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑ No ® N/A. If yes, attach list of sites
with restrictions. (Certification B?)
III RENEWAL AND MODIFICATIONAPPLICATIONS (use previous section for new or major modification
stems '
+= Description Of Waste(S) And -Facilities (THIS SECTION MODIFIED .To INCLUDE APPLICABLE OTNS)
L- Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters,. etc.) adequaf?-El: Yes: {4' ❑ N/A:: -Attach- map -of existing monitoring well network if
FORM: Staff Report WQROSSR-WI0300282 former Presslar UST Cabarrus Co Feb 2015 2

WQROS REGIONAL STAFF REPORT
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program:- See #10 above needs more specifics.
2. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit correct?
Yes or ❑ No. If no, please explain:
3. Were monitoring wells properly constructed and located? ® Yes or ❑ No ❑ N/A. If no, please explain:
4. Has a review of all self -monitoring data been conducted (GW, NDMR, and NDAR as applicable)? ❑ Yes or
® No ❑ N/A. Please summarize any findings resulting from this review: MRO has reviewed the data
provided with the application which is limited in scope Tgures 3&4) ; figure 4 indicates that data was
collected in April 2011 • historical analytical data was not provided Discussions with UST staff indicated that
the nearby water supply wells have not historically shown detections of petroleum compounds.
5. Check all that apply: ❑ No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under JOC; ❑ Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc):
6. Have all compliance dates/conditions in the existing permit, (SOC, JOC, etc.) been complied with? ❑ Yes
❑ No ❑ Not Determined ® N/A.. If no, please explain:
7. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or ® No ❑ N/A. If yes, please explain:
IV. INJECTION WELL PERMITAPPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well(S) And Facilities — New, Renewal, And Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
® In situ remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5LP'Non-Discharge")
❑ Other (Specify:
2. "Does system use same well for water source and injection? - ❑ Yes ®No
3. Are there any potential pollution sources that may affect injection? [K Yes ❑ No
What.is/are the pollution source(s)? This is a UST incident -site = iniection is into source area and plume; the
original source is gone and the "er tank basin is now a median on a divided h htigy. What is the distance
of the iniection well(s) from the pollution source(s)? 0 ft.
FORM: Staff -Report WQROSSR-WI0300282 former Press]ar UST Cabarrus Co Feb 2015 3

WQROS REGIONAL STAFF REPORT
4. What is the minimum distance of proposed injection wells from the property boundary? —1 ft. Injection wells
are proposed at locations that appear to be immediately adjacent to 12roper1y lines.
5. Quality of drainage at site: ❑ Good ® Adequate ❑ Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
T- For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ® No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater -monitoring program: Needs more specifics — see recommendations below.
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow. Maps appear to show site reasonably well, however, there
may be other monitoring wells that are not shown on submitted maps -EMW--1 through PMW-3)with this
application.
Iniection Well Permit Renewal And Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No. If yes, explain: -
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If yes, explain:
3. For renewal or modification of groundwater remediation permits (of any —type), will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If yes, explain:
4. Drilling contractor: Name: Not specified in application for proposed wells; well logs for most existing MWs
do- not note contractor, but do show construction.
Address: .
Cer€if Cation-tl!iiber:
Complete and attach Well Construction Data Sheet.
- V. EVALUATIONAND.RECOMMENDATIONS
1. Provide'any additional narrative regarding your review of the application: Per discussion with UST site
manager, their conditional approval of the CAP for this site included a statement requiring that injection
activities be 150-feet from the nearest water supply well, which is WSW-11. This well is apparently used for
FORM: Staff Report WQROSSR-WI0300282 former Presslar US 1~Cabarrus Co Feb 2015 4

-J
WQROS REGIONAL STAFF REPORT
irrigation only and the owner's decision to keep this well is part of what is driving site remediation activities.
Apparently they have attempted to drill an alternate irrigation well at greater distance on the property, but
cannot get sufficient yield and the owner wants to keep the well, which is within 250 of the source, which is
primarily what is prompting UST to require remediation efforts at the site. Apparently UST put the 150'
separation between sulfate injectants and a water supply well qualifier based on recommendations from UST's
Innovative Technologies Group; 2C does not appear to have a similar setback, but this guidance does not seem
unreasonable.
Site drainage & well location potential concern — As the location of the source area is in the median of a
divided highway, it is understandable that flush mount well completions are proposed. However, it also
appears from aerial photos that the median serves as a storm drainage feature and the wells should be
adequately constructed to avoid standing water covering them up when the median contains stormwater. The
nearest surface water feature appears to be a pond to the south of the site, roughly 350 feet away, -which is the
headwaters of a UT to Muddy Creek a class C stream in the Yadkin basin
This proposal appears to be a follow up on W10300200 a deemed pilot injection. MRO has very limited
information on file regarding this activity, which appears to be the source of PMWs1-3. No data regarding the
installation of those wells or the results of that pilot test are referenced in the application.
Overall, MRO is likely to be supportive of this injection for remediation, however additional information
should be submitted and considered first.
2. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ❑ No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item
Reason
More specifics are needed about the
Specific monitoring and supply -wells should be
monitoring plan
listed in the sampling plan. WSW uses
(potable/irrigation) should be noted and WSWs
10, 11, and 12 should .be apart' of -the plan when
specifics are submitted. Where are PMW-1
through PMW-3 located and are they available
for monitoring2.The proposed analyses for VOCs
= and;s�� seem reasonable. -
FORM: Staff Reporf WQROSSR-WI0300282 former Presslar UST Cabarrus Co Feb 2015 5

WQROS REGIONAL STAFF REPORT
MRO would like to discuss setbacks from
It's not clear how the proposed layout of
WSWs with CO before requesting of applicant
injection points meets UST's conditional
approval that specifies a 150 setback between
injection points and WSW -I I as several points
appear to be within that radius in the SW corner
of the injection diagram
Info on pilot test
What were the results of W10300200 that led to
this proposal?
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason -
7. Recommendation: ❑ Hold, pending -receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ® Issue upon receipt of needed additional information; ❑
Issue; ❑ Deny. If deny, please state reasons:
S. Signature of report preparer(s): Andrew Pitner
Andrew H. DgilaN=9 per �� H.A,
DN: cn=AMrew H.Pitnx,¢NlDENR
Signature ofAPS regional supervisor: p„or [e-mail], ¢i15
�DLc3015D219163)HS OSVP .
Date: February 19: 2015
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
FORM: Staff Report WQRO.SSR-WI0300282 forniff Pn t_UST Cabarrvs CQ Feb 2015 6

Rogers, Michael
From: Pitner, Andrew
Sent: Thursday, February 19, 2015 4:32 PM
To: Rogers, Michael
Subject: W10300282 Former Presslar UST staff report
Attachments: Staff Report WQROSSR-WI0300282 former Presslar UST Cabarrus Co - ahp signed.pdf
Hi Mike,
Attaching my staff report to this. When you have a chance to review, please give me a call so we can discuss our
Section's position on setbacks between injection and supply wells.
Andrew
Andrew Pitner, P.G. - [e-mail]
Division of Water Resources - Water Quality Regional Operations Section
Mooresville Regional Office (MRO)
North Carolina Department of Environment & Natural Resources
610 East Center Avenue, Suite 301, Mooresville, NC 28115
MRO Main Phone: [phone]
Direct Office Phone: [phone]
MRO Fax: [phone]
DWR website: http://www.ncwater.or
NOTICE: Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.

WATER QtiALITY REGIONAL OPERATIONS SECTION
APPLICATION REVIEW REQUEST FORM
Date February 8 2015
To: MRO-WQROS: Michael Parker / Andrew Pitner
From: Michael Rogers, WQROS — Animal Feeding Operations and Groundwater Protection Branch
Telephone: [phone] Fax. [phone] E Mail. [e-mail]
A. Permit Number: WI0300282
B. Applicant: NCDOT Geotechnical Unit
C. Facility Name: Former Preslar's Exxon -Intersection of NC24/27
D. Application:
Permit Type: Groundwater Remediation Well
Project Type: New Project
E. Comments/Other Information:
❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please return a completed WOROS Staff
Report.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office Groundwater Protection Branch contact
person listed above.
RO-WOROS Reviewer:
COMIVVIENTS:
NOTES:
Date:

i
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SEC
TION
June 4, 2010
MEMORANDUM
TO: UIC Permit Reviewers
FROM: Thomas Slusser, UIC Program Manager
RE: Bioremediation Additive EASTM
EOS Remediation, LLC's bioremediation product Electron Acceptor Solution (EASTm) has been
added to our list of approved injectants. EOS submitted documentation that demonstrates that the
ingredients in.EASTM consist of the following substances that have been evaluated by DHHS .
Epidemiology:
Sulfuric Acid evaluation dated September 30, 2008
Magnesium Sulfate (Epsom Salt): evaluation dated November 13, 2006
• Vitamin B 12 evaluation dated April 27, 2009
• Yeast Extract evaluation dated August 7, 2000

I .
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Kelly Grant
Well Contractor Name
2730 A
NC Well Contractor Certification Number
American Environmental Drilling, Inc.
Company Name
2. Well Construction Permit #:
List all applicable well permits (f.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating(Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑ Irrigation
Non -Water Supply Well:
MMonitorine ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
El Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
Gm dwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
under #21
4. Date Well(s) Completed: 4-26-15 Well ID# 1 W 1 to I W 19
5a. Well Location:
FORMER PRESLAR EXXON
Facility/Owner Name Facility ID# (if applicable)
830 HWY 24
Physical Address, City, and Zip
CABARUS
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees
(if well field, one lat/long is sufficient)
35.249221 N-80.59491
6. Is (are) the well(s): ©Permanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or EJNo
If this is a repair, fill out known well construction information and explain the nature of the
repair under #21 remarks section or on the back of this form.
8. Number of wells constructed: 19
For multiple injection or non -water supply wells ONLY with the same construction, you can
submit one form.
9. Total well depth below land surface: 20, (ft.)
For multiple wells list all depths if different (example- 3@200' and 2@100�
10. Static water level below top of casing: 15 (ft.)
If water level is above casing, use "+"
For Internal Use ONLY:
`14r WATER ZONES: '
FROM
TO
DESCRIPTION
15 ft.
20 ft.
ft.
ft.
:15.OUTER CASING for
multi -cased wells OR LINER if a licable) `:
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
It.
I in.
16. INNER CASING OR TUBING.(geothermal closed-loo
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft'
5 ft.
1 in-
SCH40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
5 ft
15 ft.
1 in.
.010
SCH40
PVC
,ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
3 fit.
CEMENT BEP
POUR
3 ft
4 ft.
BENTONITE
I POUR
fL
ft.
19.SAND/GPAVEL:PACK(itappliiableI
FROM
TO
MATERIAL
EMPLACEMENT METHOD
4 ft
20 ft.
#2 SAND
POUR
ft.
ft.
20.DRILLING LOG' attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, wWrock type, grain size, eta
0 fL
5 ft.
BROWN SANDY CLAY
5 ft'
7 ft.
ROCK
7 f"
16 ft.
BROWN GRAY SANDY -CLAY
16 fit•
20 fit•
GRAY ROCK
ft.
ft.
fL
ft.
ft.
ft.
2f. RENfARKS
22. Certification:
5-4-15
Signature of Cyr cd Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or'15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 6 (in.) 24b. For Iniection Wells ONLY: In addition to sending the form to the address in
Al R ROTARY 24a above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test 24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
13b. Disinfection type: Amount: well construction to the county health department of the county where
constructed.
Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised August 2013

T&Solutions-IES
Industrial & Environmental Services
LETTER OF TRANSMITTAL
1101 Nowell Road * Raleigh, North Carolina * 27607 * [phone] * Fax [phone]
TO: NCDENR
Division of Water Resources
Underground Injection Control Program
1636 Mail Service Center
Raleigh, NC 27699-1636
ENCLOSED PLEASE FIND THE FOLLOWING ITEMS:
DATE: May 5, 2015
ATTN:
RE:
SHOP DRAWINGS
COPY OF LETTER
PRINTS
CHANGE ORDER
SPECIFICATIONS
PLANS
COPIES:
COPIES DATE
NO.
TRANSMITTED AS CHECKED BELOW:
SAMPLES
E
fiT�Yy�l�irl•I�I
Well Construction Records
❑ FOR APPROVAL ❑ APPROVED AS SUBMITTED ❑ RESUBMIT COPIES FOR APPROVAL
0 FOR YOUR USE ❑ APPROVED AS NOTED ❑ SUBMIT COPIES FOR DISTRIBUTION
F71 AS REQUESTED ❑ RETURNED FOR CORRECTIONS RETURN CORRECTED PRINTS
❑ FOR REVIEW & COMMENT ❑ FOR FILE
FORBIDS DUE 20 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS:
Attached is one copy of the Well Construction Record for installation of 19 injection wells under permit
#W10300282. The wells are part of the remediation effort for Incident #13543 at the former Preslar's
Exxon at 901 Hwy 24/27 in Midland, NC. Contact me at 919-873-1060 if you have any questions.
CC: SIGNED:
R
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE. MAY 0 7 2015
'Water Quality Regional
Operations Section

%Solutions-IES
' M5
Industrial & Environmental Services LETTER OF TRANSMITTAL
1101 Nowell Road * Raleigh, North Carolina * 27607 * [phone] * Fax [phone]
TO: NCDENR
Division of Water Resources
Underground Injection Control Program
1636 Mail Service Center
Raleigh, NC 27699-1636
ENCLOSED PLEASE FIND THE FOLLOWING ITEMS:
DATE: May 21, 2015
ATTN:
RE:
SHOP DRAWINGS 1:1COPY OF LETTER PRINTS
SAMPLES
CHANGE ORDER
SPECIFICATIONS
PLANS
❑x Injection Event Records
COPIES:
COPIES DATE
NO.
TRANSMITTED AS CHECKED BELOW:
DESCRIPTION
❑ FOR APPROVAL ❑ APPROVED AS SUBMITTED ❑ RESUBMIT COPIES FOR APPROVAL
0 FOR YOUR USE ❑ APPROVED AS NOTED ❑ SUBMIT COPIES FOR DISTRIBUTION
F7x AS REQUESTED ❑ RETURNED FOR CORRECTIONS F7RETURN CORRECTED PRINTS
❑ FOR REVIEW & COMMENT ❑
FOR BIDS DUE
REMARKS:
FOR FILE
20 0 PRINTS RETURNED AFTER LOAN TO US
Attached is one copy of the Injection Event Record for the initial injection under permit #W10300282.
The injection is part of the remediation effort for Incident #13543 at the former Preslar's Exxon at 901
Hwy 24/27 in Midland, NC. Contact me at 919-873-1060 if you have any questions.
CC:
SIGNED:
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE.

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Permit Number WI 0 3 0 0 2 8 2
1. Permit Information
NC Dept. of Transportation (NCDOT)
Permittee
NCDOT Right -of -Way
Facility Name
901 Hwy 24/27, Midland NC 27699
Facility Address
2. Injection Contractor Information
Solutions-IES
Injection Contractor / Company Name
Street Address 1101 Nowell Rd .
Raleigh NC 27607
City State Zip Code
9( 19) 873-1060
Area code — Phone number
3. Well Information
Number of wells used for injection 21
WellnameslW-1 - IW-19, PIW-1, PMW-2
Were any new wells installed during this injection
event?
X❑ Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells 19
Type of Well Installed (Check applicable type):
❑ Bored ❑X Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
❑ Yes N No
If yes, please provide the following information:
Number of Monitoring Wells N/A
Number of Injection Wells
N/A
Please include a copy of the GW-30 for each well
abandoned.
4. In ectant Information
EOS Remediation's
Electron Acceptor Solution (EAS)
Injectant Type
Concentration 1 : 1
If the injectant is diluted please indicate the source
dilution fluid. N/A
Total Volume InjectedApprox . 1,113 gallons
Volume Injected per well Approx. 53 gallons
5. Injection History
Injection date(s) 5 / 18 / 2 015 - 5 / 2 0 / 2 015
Injection number (e.g. 3 of 5) 1 of 4
Is this the last injection at this site?
❑ Yes ® No
I, DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
J
5/21/2015
SIGNATURE OF INJECTION CONTRACTOR DATE
Samuel McIntyre
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection. Form UIC-IER
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464 Rev. 8/5/2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Kelly Grant
Well Contractor Name
2730 A
NC Well Contractor Certification Number
American Environmental Drilling, Inc.
Company Name
2. Well Construction Permit #: W 10300282
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatine/Cooline
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑ Other (exDlain under #21
4. Date Well(s) Completed: 4-26-15 Well ID# 1 W 1 to I W 19
5a. Well Location:
FORMER PRESLAR EXXON
Facility/Owner Name
830 HWY 24
Physical Address, City, and Zip
CABARUS
County
Facility ID# (if applicable)
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat(long is sufficient)
35.249221 N-80.59491
6. Is (are) the well(s): [OPermanent or ❑Temporary
w
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction information and explain the narure of the
repair under #21 remarks section or on the back of this form.
S. Number of wells constructed: 19
For multiple injection or non -water supply wells ONLY with the same construction, you can
submit one form.
9. Total well depth below land surface: 20' (ft.)
For multiple wells list all depths ifdifferent (example- 3@200' and 2@100)
10. Static water level below top of casing:
Ifwater level is above casing, use
6
15
11. Borehole diameter: (in.)
12. Well construction method: AIR ROTARY
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14.'WATER ZONES'.-,---'
FROM
TO
I DESCRIPTION
15 ft.
20
ft.
fit
15. OUTER CASING for multi cased•wells OR INNER if a licable' =':. _-' "
FROM
TO
DIAMETER
THICKNESS
MATERIAL
fit,
in.
-16. INNER CASING ORTUBING eothermal closed-loo
FROM
I TO
I DIAMETER I
THICKNESS
MATERIAL
0 ft
5 ft'
1 in.
SCH40
PVC
ft.
I ft.
in.
17. SCREEN --
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
5 ft-
15 ft.
1 in.
.010
SCH40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 fL
3 1'
CEMENT BE
POUR
3 ft.
4 ft.
BENTONITE
I POUR
fit
ft.
19..SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL.
EMPLACEMENT METHOD
4- fL
20 ft.
#2 SAND
POUR
ft.
ft.
20. DRILLING
LOG attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION color, hardness, soillrock e,g rain size, etc
0 ft
5 ft
BROWN SANDY CLAY
5 ft.
7 ft.
ROCK
7 ft
16 ft.
BROWN GRAY SANDY CLAY
16 ft'
20 %
GRAY ROCK
fL
ft.
fit.
fit.
ft.
fit.
.. _
22. Certification:
5-4-15
Signature ofC�fed Well Contractor Date
By signing this form, I hereby certify that the wells) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test:
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
13b. Disinfection type: Amount: well construction to the county health department of the county where
constructed.
Form GW-1 North Carolina Department of Environment and Natural Resources — Division of Water Resources Revised August 2013