WI0700208_INJECTION EVENT RECORD_20140312

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Quality
Permit Number WI0700208
1. Permit Information
Marine Corps Air Station, Cherry Point, NC
Perrnittee
Building 121
Facility Name
Near Intersection of 6th Ave. and H St., MCAS-CP
Facility Address
2. Injection Contractor Information
CATLIN Engineers and Scientists
Injection Contractor / Company Name
Street Address 220 Old Dairy Road
Wilmington, NC 28405
City State Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection 6
Well names 99GW0I, 99GW05, 99GW07,
99RW01, 99RW02, and 99RW03
Were any new wells installed during this injection
event?
❑Yes No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include two copies effort?: GW-Ib for each
well installed.
Were any wells abandoned during this injection event?
❑ Yes ®No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include two copies of the GW-30 for each well
abandoned.
4. Injectant Information
Injectant Type CBN (nutrients) and EZT-A2 (bacteria)
Concentration approx. 335 lbs CBN and 12.5 gals
EZT-A2 mixed with 1,500 gals potable
water
If the injectant is diluted please indicate the source
dilution fluid. potable water
Total Volume Injected approx. 1,500 gallons
Volume Injected per well 250 gals per well
5. Injection History
Injection date(s) March 12, 2014
Injection number (e.g. 3 of 5) 5 of 5
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
STA►tSARDS LAID O IT IN T E PERMIT_
SW
,%f•
TURE OF INJECTION CONTRACTOR
7 /
ATE.
Jacob C. Wessell. P.E.
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Quality within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-733-3221
Form UIC-IER
Rev. 07/09