WI0501065_Permit (Issuance)_20201211

North Carolina Department of Environmental Quality — Division of Water Resources
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of15A NCAC 02C.0200. This form shall be submitted at least 2 WEEKS prior to iniection.
AQUIFER TEST WELLS (15A NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .02251 or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small -Scale Injection Operations —Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: December 3, 2020 PERMIT NO. W10501065 (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well......................................Complete sections B through F, K, N
(2) Aquifer Test Well.......................................Complete sections B through F, K, N
(3) Passive Injection System...............................Complete sections B through F, H-N
(4) X Small -Scale Injection Operation ......................Complete sections B through N
(5) Pilot Test.................................................Complete sections B through N
(6) Tracer Injection Well...................................Complete sections B through N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Company Name Party Beverage, Ki pal Singh
Delegated Signatory Authority: Raymond S. Marchant, III, Mid -Atlantic Associates, Inc. (consultant)
Mailing Address: P.O. Box 4583
City: Cary State: NC Zip Code: 27519 County: Wake
Day Tele No.: 919-208-1572 Cell No.: [phone]
EMAIL Address: Kir39har(a)gmail.com Fax No.: none
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 1

D.
E.
F.
G.
PROPERTY OWNER(S) (if different than well owner)
Company Name
Same as Well Owner
Mailing Address:
City:
State: _ Zip Code:
County:
Day Tele No.:
Cell No.:
EMAIL Address:
Fax No.:
PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title:
Raymond S. "Trey" Marchant, III, Principal Geologist
Company Name
Mid -Atlantic Associates, Inc.
Mailing Address:
409 Rogers View Court
City: Raleigh State: NC Zip Code: 2761
County: Wake
Day Tele No.: (919)
250-9918 Cell No.:
[phone]
EMAIL Address:
tmarchant(a-)maaonline.com Fax No.:
[phone]
PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Party Beverage
5200 Western Boulevard
City: Raleigh County: Wake Zip Code: 27606
(2) Geographic Coordinates: Latitude": 35 ° 47 ' 12.57 " N or
Longitude": -78 °
Method of Collection:
42 ' 46.72" W or
Earth Pro Software
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
TREATMENT AREA
Note: There has been a release of gasoline from a UST at this site. The site is currently regulated by the North
Carolina Department of Environmental Quality (NCDEQ), Division of Waste Management (DWM),
Underground Storage Tank (UST) Section. Benzene concentrations detected in monitoring well MW-1 have
rebounded to above its Gross Contaminant Level (GCL) and reducing the concentration of Benzene in
groundwater is necessary to move the site towards closure. The remedial system is nearing the end of its
operational life and would require expensive repairs to continue operation. Together with the UST Section, we
have developed an approach to remediate this "hot spot" in the area of MW-1. The approach includes advancing
soil borings to determine the location of highly contaminated soil that may be causing the high groundwater
concentrations, surfactant injection, and aggressive fluid/vapor recovery (AFVR). As such, the "area of the
contaminant plume" indicated below refers to the approximate area of the soil boring and surfactant injection
locations.
Land surface area of contaminant plume: 400 square feet
Land surface area of inj. well network: 400 square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: 100% (must be < 5% of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 2

H. INJECTION ZONE MAPS — Attach the following to the notification. Provided in Attachment A. Please
note that Mid -Atlantic took over this job in 2006. Cross sections were created in 2001 by Agra Environmental,
Inc. and were obtained during a file review in 2006. Documents were annotated at the time of the file review.
Copies are included in Attachment A.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES — Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and duration
of injection over time.
Benzene concentrations in excess of its GCL remains present in ,groundwater at the site in monitoring well MW-
1. We propose to inject surfactant prior to performing an Aggressive Fluid Vapor Recovery (AFVR) event. Mid -
Atlantic proposes to inject EnviroClean at the site to enhance free product recovery during the AFVR. Injection
will be performed at MW-1, multiple 2-inch diameter geoprobe borings (yet to be installed), and up to one
additional 4-inch diameter recovery well (yet to be installed). The geoprobe borings will be advanced to an
approximate depth of 25 feet in the locations shown on the attached drawing and the recovery well will be
installed if highly contaminated soils and/or evidence of free product is found during soil boring advancement
(up to a depth of 30 feet BLS). If highly contaminated soils or free product is not encountered, MW-1 may be
"overdrilled" and replaced with the 4-inch diameter recovery well. Injection will then be performed on the well(s)
and also into any_geoprobe boreholes that exhibit evidence of contamination/free product. EnviroClean (EC-
165) is a common cleanup/miti at�gent that can be applied as both an emulsifying_ agent for free product
recovery and biosurfactant for dissolved -phase groundwater remediation. It is estimated that up to 250 gallons
of 2% solution of EnviroClean will be gravity injected into the above -referenced wells and borings over an
estimated period of up to 8 hours on -site. An 8-hour AFVR event will then be conducted at the site approximately
one to two weeks following completion of the surfactant injection event, with post-AFVR free product gauging
activities conducted approximately two to four weeks following completion of the AFVR event.
J. APPROVED INJECTANTS — Provide a MSDS for each inj ectant. Attach additional sheets if necessary.
Provided in Attachment B
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be injected. Approved injectants can be found online at http://deq.nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ground-water-protection/ground-water-approved-inj ectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
Injectant: EnviroClean
Volume of injectant: 250 Gallons
Concentration at point of injection: 2%
Percent if in a mixture with other injectants:
K. WELL CONSTRUCTION DATA GW-1 for existing well MW-1 and a table summarizing proposed
injection points are provided in Attachment C.
(1) Number of injection wells: 1, plus up to 10 open holes Proposed 1 Existing
(provide GW-Is)
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 3

(2) For Proposed wells or Existing wells not having GW-1s, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as -built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities.
Proposed wells and borings are scheduled to be installed from Monday 12/28 through Wednesday 12/30/2020.
The injection event is currently scheduled for Wednesday 12/30/2020, and the AFVR is scheduled to be
conducted on Thursday January 7, 2020. It is anticipated that the surfactant injection will take approximately 8
hours for completion and the AFVR is expected to run for approximately 8 hours. Post-AFVR free product
gauging will be conducted approximately two to four weeks following completion of the AFVR event.
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
The site is currently regulated by the NCDEQ DWM UST Section. Sampling of site monitoring wells (not
containingfree ree product) will be performed approximately two months after completion of the surfactant injection
and AFVR event, with results reported to the UST Section. Please note that EnviroClean is a proprietary blend
of water -based, biodegradable surfactants that was specifically engineered as a cleanup/miti atg ion agent and
vapor suppressant for use on a wide range of hydrocarbon products. EnviroClean, in and of itself, does not cause
or catalyze specific chemical reactions, nor does it contain any bacteria cultures. The basic principle of
EnviroClean is to emulsify and encapsulate hydrocarbon particles. As such, the injection activi . is not
anticipated to result in violations of the NCGQS for additional compounds other than those already noted from
the previous gasoline release.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER Please note that Mid -Atlantic is signing
the application on behalf of the Applicant. Permission for Mid -Atlantic to sign is provided in Attachment
D.
APPLICANT: "I hereby certify, under penalty of law, that I am familiar with the information submitted in this
document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible
for obtaining said information, I believe that the information is true, accurate and complete. I am aware that
there are significant 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 and
all related anrnjrtenanr,,s in accnrdanre with the I5A NCAC 02C 0200 Rules. "
Su
Signature of Applicant Print or Type Full Name and Title
PROPERTY OWNER (if the property is not owned by the permit applicant):
"As owner of the property on which the injection well(s) are to be constructed and operated, I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(I5A NCAC 02C C. 0200). "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 4

Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Submit the completed notification package to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 5

►_�ar_Taa,,IW
INJECTION ZONE MAPS
(SECTION H)

a
REFERENCES:
1. RALEIGH WEST, NC DIGITAL RASTER GRAPHIC, USGS, 2013. SCANNED
FROM 1:24,000-SCALE RALEIGH WEST, NC TOPOGRAPHIC MAP (PUBLISHED
2013), USGS.
2. INSET MAP DIGITAL DATA FROM 2002 NATIONAL TRANSPORTATION
ATLAS, BUREAU OF TRANSPORTATION STATISTICS, WASHINGTON, D.C.
Mid Atlantic
Engineering & Environmental Solutions
SCALE: 1:12,000
Feet
0 500 1,000 2,000
TOPOGRAPHIC SITE MAP
PARTY BEVERAGE SITE
5200 WESTERN BOULEVARD
RALEIGH, NORTH CAROLINA
DRAWN /
DATE:
BY:
FEBRUARY 2018
DRAFT sc.
JOB NO:
CHECK: t�
00OR1747.48
ENG.
2
GIS NO:
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CHECK:
04G-R1747.48-1.1
APPROVAL: 45W
DWG NO: 1.1

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Site Layout/ Soil Somple Locations Agra Environmental, Inc. —
Party Beverage
?I00 Western Boulevard
Raleigh, NC P.O. Box 5611 Cory, NC 27512
7igure

4j
L
-M
Monitoring Well Locations Agra Environmental, Inc.
Party Beverage
J200 Western Boulevard
Raleigh, NC P.O. Box 5611 Cary, NC 27512
Figure �
Drown By: Checked By: Date: Project

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NOTES:
* Sample Location
* Sample Cottected For Laboratory
Analysis at specified depth
Plume - any petroleum compound
detected above soil -groundwater MSCC
Soil Contaminant Plume 5' depth
party Beverage
-kO Western Boulevard
Raleigh, NC
7--
igure No: Scale: Drawn By:
B-12
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at specified depth
Fliligra 'Environmental, Inc.
I P.O. Box 5611 Cary, NC 27512
Checked By: Dote: Project No:

In
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NOTES:
* Sample Location
* Sample Collected For Laboratory
Analysis at specified depth
Plume - any petroleum compound
detected above soil -groundwater MSCC
Soil Contaminant Plume 10' depth
Party Beverage
POO Western Boulevard
Raleigh, NC
Figure No: Scale: Drawn By:
A I 1 $2 - I 1 r- I I I (I
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0
B-13
07 42
contaminated soil
at specified depth
C' C-
Agra Environmental, Inc.
I P.O. Box 5611 Cary, NC 27512
ecked By. Dote: Project -No.
r-. C- I 1n /n'l /n -i I

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NOTES:
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Analysis at specified depth
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detected above soil -groundwater MSCC
Soil Contaminant Plume 20' depth
Party Beverage
POO Western Boulevard
Raleigh, NC
figure No: Scole: DrownBy:
B-13
0
MW-4
0
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at specified depth
Agra Environmental, Inj
I P.O. Box 5611 Cory, NC 27512
Checked By: Dote: Project No:
DC I 1 n /n ') /n -I I

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Vertical Scale
7.5
10
NOTES:
D soil sample location — no compounds
detected above MSCCs
0 7�5 15
30 feet
u soil. sample location — one
or more
MA11:::AMMM=M
compounds detected above
MSCCs
Horizontal Scale
V water table
Soil Cross Section B—B'
Agra Environmental,
Inc.
Party Beverage
. POO Western Boulevard
Raleigh, NC
P.O. Box 5611 Cary, NC
27512
Figure No:
Scale:
Drown
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Checked By:
Dote:
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Project No:
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SAFETY DATA SHEET
(SECTION J)
M'd Atlantic

SAFETY DATA SHEET
SECTION 1 MATERIAL IDENTIFICATION
PRODUCT NAME / DESCRIPTION: EnviroClean
DISTRIBUTED / MANUFACTURED BY:
ENVIRO CLEAN PRODUCTS & SERVICES DATE: 05/18/2015
PO BOX 721090 PHONE: [phone]
OKLAHOMA CITY, OK 73172 EMERGENCY PHONE: [phone]
FUNCTION: Industrial Cleaner and Remediation Agent
SECTION 2 HAZARD IDENTIFICATION
CLASSIFICATION:
Acute Toxicity- Oral
Category 4
Skin Corrosion/Irritation
Category 3
Eye Damage/Irritation
Category 2B
Target Organ Specific Toxicity: Single
Category 3
Target Organ Specific Toxicity: Chronic
Category 2
SIGNAL WORD:
WARNING!
HAZARD STATEMENTS:
Harmful if swallowed
Causes mild skin irritation
Causes eye irritation
May cause respiratory irritation
May cause damage to organs through prolonged or repeated exposure
< I - ��
0 < - >
PRECAUTIONARY STATEMENTS:
Obtain special instructions before use
Do not handle until all safety precautions have been read and understood
Use personal protective equipment as required
Avoid breathing dust/fume/gas/mist/vapors/spray
Use only outdoors or in a well ventilated area
Wash all exposed skin thoroughly after handling
Avoid release to the environment

x
Store in a well ventilated place
TOXICITY INFO:
See Section 11.
SECTION 3 HEALTH HAZARDS
CHEMICAL NAME %WIW CAS NUMBER
(Proprietary Formula)
Proprietary Blend of Ethoxylated Octylphenolic Surfactants
Non-ionic water based liquid blend, concentrate
This product does not contain any hazardous ingredients as defined by CERCLA and California's Prop. 65.
SECTION 4 FIRST AID
Potential acute health effects:
Eyes: May cause irritation with redness and pain.
Skin: May cause irritation with redness and pain.
Inhalation: Inhalation may cause irritation.
Ingestion: Ingestion may cause severe irritation, corrosion/ulceration, nausea, and vomiting.
Medical Conditions Aggravated by Exposure:
None known.
Eye Contact: In case of contact, immediately flush eyes with cool running water. Lift and
separate eyelids while flushing with plenty of water for at least 15 minutes. Get
medical attention.
Skin Contact: Wash with soap and water. Get medical attention if irritation occurs. Wash
clothing before reuse. Destroy contaminated shoes.
Inhalation: Remove victim to fresh air and keep at rest in a position confortable for breathing.
If not breathing, give artificial respiration. If breathing is difficult, give oxygen.
Seek medical attention if symptoms develop.
Ingestion: Do NOT induce vomiting unless directed to do so by medical personnel. Never
give anything by mouth to an unconscious person. If large quantities of this
material are swallowed, call a physician immediately. Give plenty of water.
SECTION 5 FIRE FIGHTING MEASURES
Fire Hazard Classification (OSHA/NFPA): 0
Extinguishing Media: As required for fire being fought.
Special Fire Fighting Procedures: Use self-contained breathing apparatus.
Hazardous combustion products: No known.

SECTION 6 ACCIDENTAL RELEASE MEASURES
Personal Precautions, PPE, and Emergency Procedures:
Wear protective clothing as described in Section 8 of this safety data sheet.
Containment Procedures: Stop the flow of material, if this is without risk. Wear appropriate protective
equipment and clothing during clean-up. Do not allow the spilled product to enter
public drainage system or open water courses.
Clean -Up Procedures: Sweep up or gather material and place in appropriate container for disposal.
Wash spill area thoroughly. Wear appropriate protective equipment during
cleanup. Dispose of collected material according to regulations.
SECTION 7 HANDLING AND STORAGE
Handling: Avoid contact with eyes, skin and clothing. Do not take internally. For industrial
use only. Wash after handling. Don't breathe dust, vapor, or gas. Keep this and
all chemicals out of reach of children.
Storage: Keep away from heat, sparks, and open flames. Prevent spills. Keep container
tightly closed and in a cool, well -ventilated place away from incompatible
materials. Empty product containers may contain product residue, do not reuse.
SECTION 8 PERSONAL PROTECTION / EXPOSURE CONTROLS
Ventilation System:
Always keep exposure below permissible exposure limits. In general, dilution
ventilation is a satisfactory health hazard control for this substance. However, if
conditions of use create discomfort to the worker, a local exhaust system should
be considered.
Airborne Exposure Limits: None Established.
Personal Protection:
As prescribed in the OSHA Standard for Personal Protective Equipment (29 CFR
1920.132), employers must perform a Hazard Assessment of all workplaces to
determine the need for, and selection of, proper protective equipment for each
task performed.
Eyes:
Wear face shield, safety glasses, or chemical goggles.
Hands & Skin:
For prolonged or repeated handling, use impervious gloves. Gloves should be
tested to determine suitability for prolonged contact. Use of impervious apron
and boots are recommended.
Respiratory:
If ventilation is not sufficient appropriate NIOSH/MSHA respiratory protection
must be provided.
Work Practices:
Eye wash fountain and emergency showers are recommended.
SECTION 9 TYPICAL PHYSICAL AND CHEMICAL PROPERTIES
Physical Form: Liquid
Color: Red

ENVIRCI
LEAN
C
Odor:
Wintergreen
Odor Threshold:
NE
pH:
8.5+/-0.5
Boiling Point:
NE
Melting Point:
N/A
Flash Point:
>200 deg F
Evaporation Rate (Butylacetate =1)
NE
Flammability:
Non -Flammable
UEL:
NE
LEL:
NE
Vapor Pressure:
NE
Vapor Density:
NE
Specific Gravity (Water = 1):
1.03 +/- .05
Solubility Water:
Complete
Partition Coefficient:
NE
Auto -ignition Temperature:
NE
Decomposition Temperature:
NE
Viscosity (CPS):
NE
SECTION 10 STABILITY AND REACTIVITY
Stability: This product is stable under normal temperatures and pressures.
Incompatibility: Strong Oxidizers and strong acids.
Decomposition Products: No Known hazardous products.
Conditions to Avoid: Sparks/flames/high heat.
SECTION 11 TOXICOLOGICAL PROPERTIES
Raw Material Test Result Route Species
N/A
See Section 4 for symptoms.
CARCINOGENICITY:
No known carcinogens, mutagens, or reproductively toxic ingredients
SECTION 12 ECOLOGICAL INFORMATION
Raw Material Test Result Time Species
N/A
PERSISTENCE & DEGRADABILITY:
NE

BIOACCUMULATION:
NE
MOBILITY
NE
SECTION 13 DISPOSAL CONSIDERATIONS
Whatever cannot be saved for recovery or recycling should be managed in an appropriate and approved
waste disposal facility. Processing, use, or contamination of this product may change the waste
management options. State and local disposal regulations may differ from federal disposal regulations.
Dispose container and unused contents in accordance with federal, state, and local requirements.
SECTION 14 TRANSPORT INFORMATION
Not Regulated by DOT or IATA.
SECTION 15 REGULATORY INFORMATION
US FEDERAL REGULATIONS
SARA (SUPERFUND AMENDMENTS AND REAUTHORIZATION ACT):
SARA 302 EXTREMELY HAZARDOUS SUBSTANCES LIST: NA
SARA 312 HAZARD CATEGORY:
SARA 313 TOXIC CHEMICALS LIST:
HWI
MM
CERCLA (COMPREHENSIVE ENVIRONMENTAL RESPONSE. COMPENSATION AND
LIABILITY ACT): NA
RCRA (RESOURCE CONSERVATION AND RECOVERY ACT) LISTED HAZARDOUS WASTES:
NA
CWA (CLEAN WATER ACT) LISTED SUBSTANCES: NA
FDA (FOOD AND DRUG ADMINISTRATION): NA
TOXIC SUBSTANCES CONTROL ACT (TSCA): NA

1013 6& ._EVA&AN M 10 IM RUTI IONO ►
101
4 - DEADLY
3 - EXTREME DANGER
2 - HAZARDOUS
1 - SLIGHTLY HAZARDOUS
0 - NORMAL MATERIAL
[0]
FLASH POINTS:
4
- BELOW 73 F
3 -BELOW
100 F
2
- BELOW 200 F
I -
ABOVE 200 F
0 -
WILL NOT BURN
101 REACTIVITY HAZARD (YELLOW DIAMOND)
4 - MAY DETONATE
3 - SHOCK AND HEAT MAY DETONATE
2 - VIOLENT CHEMICAL CHANGE
1 - UNSTABLE IF HEATED
0 - STABLE
p SPECIFIC HAZARD (WHITE DIAMOND)
OXY
OXIDIZER
ACID
ACID
ALK
ALKALI
COR
CORROSIVE
W
USE NO WATER
SECTION 16 OTHER INFORMATION
THIS INFORMATION IS OFFERED IN GOOD FAITH AS TYPICAL VALUES AND NOT AS A
PRODUCT SPECIFICATION. NO WARRANTY, EXPRESSED OR IMPLIED, IS HEREBY MADE. THE
RECOMMENDED INDUSTRIAL HYGIENE AND SAFE HANDLING PROCEDURES ARE BELIEVED
TO BE GENERALLY APPLICABLE. HOWEVER, EACH USER SHOULD REVIEW THESE
RECOMMENDATIONS IN THE SPECIFIC CONTEXT OF THE INTENDED USE AND DETERMINE
WHETHER THEY ARE APPROPRIATE.

F-11 I k f-,Tli 0 1 ITA I #',Nl I
WELL CONSTRUCTION INFORMATION
(SECTION K)

SUMMARY OF PROPOSED INJECTION POINTS
PARTY BEVERAGE SITE
RALEIGH, NORTH CAROLINA
MID -ATLANTIC JOB NO. R1747.59
PROPOSED
ANTICIPATED
ANTICIPATED
ANTICIPATED
PROPOSED
PROPOSED
SCREEN
BENTONITE
CEMENT GROUT
SAND PACK
INJECTION POINT ID
DEPTH
DIAMETER
(FEET BLS)
DEPTH
INTERVAL (FEET
INTERVAL (FEET
INTERVAL (FEET
(FEET BLS)
BLS)
BLS)
BLS)
MW-1 WELL (PERMANENT)*
4
30
15-30
12-14
1-12
14-30
UP TO 10 GEOPROBE
2
25
NA
NA
NA
NA
BOREHOLES (TEMPORARY)
Notes:
- existing monitoring well MW-1
may be "overdrilled" and replaced by a 4-inch diameter well with 0.020-inch
slotted screen
BLS - Below Land Surface
NA - Not Applicable
Wells and borings to be installed by Quantex, Inc. certification number 3106

ATTACHMENT D
SIGNATURE AUTHORITY EMAIL
(SECTION N)
MvidAtiantic

Trey Marchant
From: Par <[e-mail]>
Sent: Thursday, December 3, 2020 9:10 AM
To: Trey Marchant
Subject: Re: DRAFT of Notice of Intent for surfactant injection
Hi Trey,
Yes, please proceed by signature of you/Mid-Atlantic representing my Father.
Regarding contact information, if you can put my Father's-
919-208-1572
[e-mail]
If they get called, they'll tell me and then I can reach out in the unlikely scenario should it occur.
Kind regards,
Parminder
On Nov 20, 2020, at 9:39 AM, Trey Marchant <[e-mail]> wrote:
Hi Parminder-
I hope you are well and everyone is staying healthy. We are preparing the Notice of Intent, which is a
document that requests a permit from NCDEQ to "inject" or introduce a substance into the subsurface,
which is what we are going to do with the surfactant at this site. It's a pretty routine thing .... they just
want to know what's being done and make sure the injectant is on their approved list, etc. Someone
needs to sign the application (page ). It can either be the applicant or the consultant. We have done it in
the past for other clients. Would it be OK if I signed it instead of sending it to your father so we can get
the application submitted to NCDEQ? I have attached a draft in case you want to see what the
document looks like (it's not quite complete, but you'll get the idea). I put your cell number and email
address on the application because I don't know your father's. It's very unlikely they will try to contact
you anyway ... if they have questions, they will typically contact me.
Thank you,
Trey
<image00 I .png>
Raymond S. "Trey" Marchant, III, P.G.
Principal Geologist
MID -ATLANTIC ASSOCIATES, INC.
409 Rogers View Court I Raleigh, NC 27610
919-250-9918 1 919-250-9950 (Facsimile) 1 919-413-0868 (Mobile)
www.MAAONLINE.com I Outstanding Service Since 1993

Confidentiality Notice: The information contained in this e-mail is intended only for the individual or entity to whom it
is addressed.lts contents (including any attachments) may contain confidential and/or privileged information. If you
are not an intended recipient you must not use, disclose, disseminate, copy or print its contents. If you receive this e-
mail in error, please notify the sender by reply e-mail and delete and destroy the message.
<Notice of Intent DRAFT.pdf>
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