WI0500615_GEO THERMAL_20140312

Smith, Eric
From:
Sent:
Mike Armour <[e-mail]>
Wednesday, March 12, 2014 9:14 AM
To: Smith, Eric
Cc: Thomas Witner
Subject: RE: Deemed GW Permit WI0S00615 (Eagle Transport Corp)
Eric,
We are still utilizing these wells in_ our air sparging remedial system at the subject site. Abandonment is not forthcoming
for the near future.
Regards,
fVl ~ D. Ar-VV\.Ov41"
Principal Geologist
Shield Engineering, Inc.
phone: [phone]
fax: [phone]
direct: 704.971.4143
www.shielden qineerin q.com
From: Smith, Eric [mailto:eric.g.smith @ncdenr.gov]
Sent: Tuesday, March 11, 2014 10:27 AM
To: Mike Armour
Subject: Deemed GW Permit WI0500615 (Eagle Transport Corp)
Mr. Armour:
I just wanted to check on the status of the air injection wells for the subject permit. Have these wells been
abandoned? If not, do you intend to abandon them?
Thank you,
Eric G. Smith, P.G.
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Division of Water Resources
Water Quality Regional Operations Section
Groundwater Protection Branch
1636 Mail Service Center
Raleigh, NC 27699-1636
Phone : [phone]
Fax: [phone]
Website: http://portal.ncdenr.org/web/wq/aps
1
Godwin, Ton ya
From: Smith, Eric
Sent:
To:
Thursday, February 28, 201311:59AM
Pitner, Andrew; Rice, Eric
Cc: Godwin, Tonya; Slusser, Thomas
Subject: RE: Deemed GW Remediation Permit WI0300198
Andrew & Eric:
See email below. The permit number was changed from WI0300198 to WI0500615 .
-Eric G. Smith
Eric G. Smith, P.G.
Hyd rogeologist
NCDENR
Division of Water Quality
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
Phone: [phone]
Fax: [phone]
Website: http://portal.ncdenr.org/web/wg/aps
DISCLAIMER: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.
From: Smith, Eric
Sent: Wednesday, February 27, 2013 12:06 PM
To: Pitner, Andrew; Rice, Eric
Cc: Godwin, Tonya; Slusser, Thomas
Subject: Deemed GW Remediation Permit WI0300198
Andrew and Eric:
Just as a heads up ...
It was brought to my attention that groundwater remediation permit WI0300198 was incorrectly assigned to the
Mooresville Region (Mecklenburg County). The permit was issued on May 4, 2012. The correct region is the Raleigh
Region and the correct county is Johnston. I have put in a DOTS ticket to make the corrections. The permit will probably
be assigned the newest WIOS ... number. I'll let you know the number once it gets fixed.
-Eric G. Smith
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Division of Water Quality
1
lAri (04 5
Central Files: APS SWP_
05/03/12
Permit Number Permit Tracking Slip
Program Category
Ground Water
Permit Type
'Injection Air Deemed permitted 5P Individual
Status Project Type
In review New Project
Version Permit Classification
Primary Reviewer Permit Contact Affiliation
eric.g.smith
Coastal SW Rule
Permitted Flow
Facility
Facility Narne Major/Minor Region
Eagle Transport Corporation NC Hwy 96N Minor
Location Address
6709 NC Hwy 96n
Selma NC 27576
Owner
County
Facility Contact Affiliation
Owner Name
Eagle Transport Corporation
Dates/Events
Owner Type
Non -Government
Owner Affiliation
Bob HeinisCh
300 S Wesleyan Blvd
Rocky Mount
NC 27603
Orig Issue
App Received Draft Initiated
05/01/12
Regulated Activities
Scheduled
Issuance
Outfall NULL
Public Notice Issue
Effective Expiration
Waterbody Name Stream Index Number Current Class Subbasin

TRANSMISSION REPORT
T377SYOU232 F562-A14
TIME :05-02-'12 15:18
FAX N0.1 :9197150684
NAME :NC DENR P&S
NO. FILE NO. DATE TIME DURATION POS TO DEPT MODE STATUS
628 473 05.02 15:11 05:47 6 f 99195714718 G3 100 OK
Qc'- L1Or
L 4Gu
4ldc4 +ti -�u

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are "permitted by ruk" and do not require an individual permit when constructed in accordance
with the rules of ISA NCAC 02C.0200 This form shall be submitted at least 2 weeks prior to construction.
AQUIFER TEST WELLS (15A NCAC 02C .0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection Systems - In -well delivery systems to diffuse injectanC.ih a=the subsUrfacc,: Examples include
ORC socks, iSOC systems, and other gas infusion methods,
Ii
2) Small-scale Injection Operations - Contaminant plumes located entirely within a ]and surface area not to
' exceed 10,000 square feet. For tracer tests in uncontaminated areas the area di l erid a1116 li p veli(s) shall
be entirely within a land surface area not to exceed 10,000 square feet. 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 Infection 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: May 1 , 2012 PERMIT NO.O ' 0 �3 (to be filled in by DWQ)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
C.
(1) X Air Injection Well .Complete sections l3-F, K, N
(2) Aquifer Test Wail Complete sections B-F, K, N
(3) Passive Injection System Complete sections B-F, H-N
(4) Small -Scale Injection Operation Complete sections B-N
(5) Pilot Test Complete sections B-N
(6) Tracer Injection Well. Complete sections B-N
STATUS OF WELL OWNER; Choose an item. Business/Organization
WELL OWNER — State name of entity and name of person delegated authority to sign on
business or agency:
Name: Eagle Transport Corporation
Mailing Address: 300 S. Wesleyan boulevard, Suite 202
City: Rocky Mount
behalf of the
State: _NCZip Code: 27084 County: Nash
Day Tele No.: 252-937-2464
EMAIL Address:_ bob,heinischri-4,eaeletransp_ortcmcom
Cell No.:
Fax No.: 252-397-2198
DWQII]IClln Situ Reined. Notification (Revised 4/26/2012) Page 1

D. PROPERTY OWNER (if different than well owner)
Name: NCDOT:Div of Hi ghway Division 4 District 3
Mailing Address: __ __::.2!>!..67L.JIL.:U~S..1..7:::t..0--'W:!..:e""s!..!:..t _____________________ _
City: Goldsboro State: _NC_ Zip Code: __ -'2=7'-=5=3--=-0 ____ County: Wa yne
Day Tele No.: 919-731-7938 Cell No.: __________ _
EMA IL Address: __ ____.,,m=l=m=c=la=m=b=@-..· =n=cd=o=t..,,,.g,__o~v ___ _ Fax No .: ---"9C.!.l-"-9-----'-7-"'--3 .!...l-=20=1'-"7 ___ _
E. PROJECT CONT ACT -Person who can answer technical questions about the proposed injection project.
Name: Michael Armour M.S. P.G.
Mailing Address: __ ___::i.4=.;30~1!....T~agg=>=art:!..!....'C""r'""e""'ek~R""o,.,ad,.__ __________________ _
City: Charlotte State: _NC_ Zip Code: 28208 County: Mecklenburg
Day Tele No.: 704-394-6913 Cell No.: __________ _
EMAIL Address: marmour @shielden gineerin g.com Fax No.: __ __,7""""0_,_4-....:::3..._94..,__--=-6"----'96=8'--__ _
F. PHYSICAL LOCATION OF WELL SITE
(I) Coun ty : Physical Address: ___ 6"---7,....,0=9....,N'-'-C=.....H=i.ogh=w,_,_a=-y._9""'6=N__,__ ___ ==-.,.:.,..· _ Johnston
City: Selma State: NC Zip Code: 27576
(2) Geographic Coordinates: Latitude**: 0 "or Q
----
0 "or 0 ----Longitude**:
Reference Datum: _______ -----'Accuracy: _______ _
Method of Collection: _________________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: ______ square feet(::: 10,000 ft 2 for small-scale injections)
Land surface area of treatment area/radius of influence: square feet
Percent of contaminant plume area to be treated: (must be::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(I) 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.
DWQ/UJC//n Situ Remed, Notification (Revised 4/26/2012) Page 2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity .
J. INJECTANTS-Provide a MSDS and the following for each injectant. Attach additional sheets if necessary.
NOTE: Approved }njectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/weblwq/aps/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 info (919-807-6496).
Injectant:
Volume ofinjectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants: ___________________ _
Injectant: --------------------------------
Volume ofinjectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants:
Injectant: --------------------------------
Volume of injectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
(1)
(2)
Number of injection wells: ---=-3 ___ Proposed __ ~9 ___ Existing
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:
(a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery)
(b) depth below land surface of grout, screen, and casing intervals
(c) well contractor name and certification number
DWQ/UIC/ln Situ Remed . Notification (Revised 4/26/2012) Page 3
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities,
M. MONITORING PLAN -Describe below or in separate attachment a monitoring plan to be used to detennine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
N. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .021 l(e) requires that all pennit applications shall be signed as follows:
I. 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;
5. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
"I hereby certify, under penalty of law, that I have personally examined and 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 tf applicable, abandon
the injection well and all related appurtenances in accordance with the I 5A NCAC 02C 0200 Rules. "
l a& ~1£c \ / :bi ~u:/f.)()~1?t'f--Cotp . 1:>o~ lkt.~zJ •~~ ........ H--
sign111ure of Applicant ✓ Print or Type Full Name
Signature of Property Owner (if different from applicant)
Signature of Authol'ized Agent, if any
Submit one copy of the completed notification package to:
DWQ -Aquifer Protection Section
1636 Mall Service Center
Raleigh, NC 27699~1636
Telephone: {919) 807-6464 I _Fax: [phone]
DWQ/U[C/ln Situ Remcd. Notification (Revised 4/26/2012)
Print or Type Full Name
Print or Type Full N11me
Page4
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WATER SUPPLY WELL LOCATION AND 0 MASER
AIR SPARGF WkIL LOCATION AND ID MASER
SOIL VAPOR E CTRACnoN WELL LOCATION ATM ID WINDER
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PROPOSED 5TSTOW TRENCMII
HOTg:
SITE MAP USED ON RELD MEASOREmuNTS BY
SN,EED PERSO # L.
x- ALLLL LOCATIONS ARE APPRORVAATE
3. (?] PROPOSED SYSTEMLhHMAOMFNTS
AND M00IP,CATIONS.
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SITE MAP
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DATE : 03/30/12 DRAWN BY : RBS
SCALE : AS SHOWN FIGURE : 1

SEE WELL HEAD DETAIL
Y' SCH. 40 PVC
CASING
(PROVIDED BY OTHERS)
APPROXIMATE GROUNDWATER
DEPTH
IFREMDEYI BY OT1-FGRORUTS]
SENTON[TE SEAL.
[PROVIDED BY OTYpER6)
FILTER PAD%
(PROVIDED 8Y OTHERS)
0.010-MN SLOTTED
SCREEN
(PROVIDED BY OTHERS)
TOTAL DEPTH. 40' OR TO TOP OF BEDROCK
7
GROUND SUR FACE -
11COSTING)
8-INCH CONCRETS
2' CONCRETE SEAL
4'0 SCH 40 -
PVC CONDUIT
VS' AIR LINE ----
FROM AER
COMPRESSOR
GROUT
[PROVIDED SY OTHERS)
18
RI REAR
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18" m x 3O (DEEP)
AASHTO H-20 TRAFFIC RATED
WELL VAULT WITH LOCI404G
BOLT-DO104 WATER WONT
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IPROV[DED BY OTHERS)
AIR SIDARGE WELL HEAD SECTION DETAIL
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fTEU NIATER]AL
A T'a< 2'xY SCH 40 PVC TEE(SUP x SLP X$1,IP)
B 2' SCH 40 PVC ADAPTER {SLIP • NFT)
C 2' SCH 40 THREADED PVC PLUG (NAT)
D PRESSURE GAUGE (Cr - TOO" PSIO)
E 112-BALL vAL_VF
F 10 1rt'%1A"TEE
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TRANSMISSION REPORT T377SYOU232
TIME
FAX NO.l
NAME
F562-A14
: 05-03-'12 13:27
: 9197150684
: NC DENR P&S
_N_O_. __ F_IL_E_N_O_. __ D_k_TE_T_I_ME ___ D_URA_TI_ON __ P_GS __ T_O _________ DEPT MODE . ___ .,,'l._'A_TU_S ___ _
629 474 05.03 13:16 06:06 6 99195714718 G3 100 OK
Permit Number WI0300199
Program Category
Ground Water
Permit Type
Injection Air Deemed permitted 5P
Primary Reviewer
eric.g.smith
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
Eagle Transport Corporation NC Hwy 96N
Location Address
6709 NC Hwy 96n
Selma
Owner
Owner Name
NC
Eagle Transport Corporation
Dates/Events
27576
Scheduled
Central Files: APS_ SWP_
05/04/12
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
ML. Mclamb
2671 us 70 W
Goldsboro NC
Major/Minor
Minor
Region
Mooresville
County
Mecklenburg
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Bob Heinisch
300 S Wesleyan Blvd
Rocky Mount NC
27530
27803
Orig Issue
05/04/12
App Received Draft Initiated Issuance Public Notice Issue Effective
05/04/12
Expiration
05/03/12 05/04/12
Regulated Activities
Well Construction
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin
W:m ?a) l'f't -------NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are "permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200. This fo rm shall he submitted at least 2 weeks prior to construction.
AQUIFER TEST WELLS (15A NCAC 02c .0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (ISA NCAC 02C .0225) or TRACER WELLS (lSA NCAC 02C .0229):
I) Passive In jection Svstems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale In jection O perations -Contaminant plumes located entirely within a land surface area not to
exceed 10,000 square feet. For tracer tests in uncontaminated areas the area of influence of the injection well(s) shall
be entirely within a land surface area not to exceed 10,000 square feet. 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 In jection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Suhmittals Will Be Returned As Incomplete.
DATE: =M=a"'""y~l ___ _,, 2012 __ PERMIT NO. ________ (to be filled in by DWQ)
A. WELL TYPE TO BECONSTRUCTED OR OPERATED
B.
c.
X __ Air injection Well ...................................... Complete sections B-F, K, N
___ Aquifer Test Well ........................................ Complete sections B-F, K, N
---. Passive Injection System ............................... Complete sections B-F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B-N
___ Pilot Test. ..... :' .......................................... Complete sections B-N
(1)
(2)
(3)
(4)
(5)
(6) __ Tracer Injection Well ................................... Complete sections B-N RECEIVEO/DENR/OWQ
STATUS OF WELL OWNER: Choose an item. Business/Organization MAYO 3 2012
Aquifer Protection Section
WELL OWNER -State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: Eagle Trans port Co rp oration
Mailing Address: 300 S. Wesle yan boulevard. Suite 202
City: Roc ky Mount State: _NC_ Zip Code: 27084 County: ___ N_as~h-
Day Tele No.: 252-93-7-2464 Cell No.: _________ _
EMAIL Address:. ___ b=o=b"-'-.h=e=i=ni=s=ch~®=ea::.:g~le=t=ran=si,:.;po=rt=c=o'"'"rpic.:·=co=m"" Fax No.: __ __,,2=5=-2-=3=--97,_-=-21~9:.,::8c.__ __ _
DWQ!UlC/Jn Situ Remed. Notification (Revised 4/26/2012) Pagel
D. PROPERTY OWNER (if different than well owner)
Name: NCDOT:Div of Highway Division 4 District 3
Mailing Address: 2671 US 70 West
City:. Goldsboro State:_ NC_ Zip Code: ___ 2~7~5~3~0 ____ County:_,W'-'-ae::Jy'-"n=e __ _
DayTeleNo.: 919-731-7938 Cell No.: _________ _
EMAIL Address: mlmclamb@ ncdot.gov Fax No.: ---'9c...,1~9--7'-=3'--'l_,-2=0:_ol_,_7 ___ _
E. PROJECT CONTACT-Person who can answer technical questions about the proposed injection project.
Name: Michael Annour M.S. P.G.
Mailing Address: --~4~3~0~12T~a:5,g~gart~~C:!..:re~e~k~R~o~a~d'---------------------
City: Charlotte State: _NC_ Zip Code: 28208 County: Mecklenburg
Day Tele No.: __,_70=-4'-'-3=9'-'4'-'-6=9-=-1-=-J ______ Cell No.:. __________ _
EMAIL Address:. __ --'m=arm=o"-'u=r_....@~s~h=ie=ld=e~nc<;g=in=e~e~ri~ng._..~co~m= Fax No.: ---=7-=-0_,_4--=3"'--94-'--~69~6=8 ___ _
F. PHYSICAL LOCATION OF WELL SITE
(1)
(2)
Physical Address: ___ 6~7~0~9~N~C_H~i.._,gh~w~ay-'-'-9~6N~---~C_o~u~nty~:. ___ =J=ohn=s=to=n=--------
City: Selma State: NC Zip Code: -==2:..:..7=-57"""6"--------
Geographic Coordinates: Latitude**: ___ 0 ____ " or 0
Longitude**: 0 __ "or 0
Reference Datum: ________ Accuracy: _______ _
Method of Collection:. _________________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY : A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES .
!
G. TREATMENT AREA
Land surface area of contaminant plume: _______ .square feet~ 10,000 tl2 for small-scale injections)
Land surface area of treatment area/radius of influence: square feet
Percent of contaminant plume area to be treated: (must be ,:5 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soH and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wellsi-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.
DWQ/UIC/In Situ Remed. Notification (Revised 4/26/2012) Page2
I.
J.
DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity.
INJECT ANTS -Provide a MSDS and the following for each injectant. Attach additional sheets if necessary.
NOTE: Approved _injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/weblwqla ps/gwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the U/C Program for more info (919-807-6496).
Injectant: --------------------------------
Volume of injectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants: ___________________ _
lnjectant: ---------------------------------
Volume of injectant: ____________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants: ___________________ _
Injectant: ---------------------------------
Volume of injectant: ____________________________ _
Concentration at point of injection: ______________________ _
Percent if in a mixture with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
(1)
(2)
Number of injection wells: ----=3'-__ Proposed. __ ---"9 ___ Existing
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:
(a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery)
(b) depth below land surface of grout, screen, and casing intervals
(c) well contractor name and certification number
DWQ/UIC//n Situ Remed. Notification (Revised 4/26/2012) Page3
L.
M.
N.
SCHEDULES -Briefly describe the schedule for well construction and injection activities.
MONITORING PLAN -Describe below or in separate attachment a monitoring plan to be used to detennine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
CERTIFICATION (to be signed as required below or by that person's authorized agent)
I SA NCAC 02C .02 i l(e) requires that all permit applications shall be signed as follows:
l. 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;
5. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
"i hereby certify, under penalty of law, that I have personally examined and am familiar with the information
silbmjtted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible/or 'obtaining said information, I believe that the information is true, accurate and
complete. 1 am aware . that there are significant penalti¢s, ·. including the possibility of fines and imprisonment,
for submitting false information.· I agree to construct, operate, maintain, repair, and if applicable, abandon
the injecllon well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rule$."
l dt-;;b;.,lsc ':>. L -6: ~l,;fw,~-t &p. Dp1!;, J..ka1 ,xH
Signature of Applicant Print or Type Full Name
Signature of Proper()' Owner (if different from applicant)
Signature of Authorized Agent, if any
Submit one copy of the completed notification package to:
D'WQ -Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone] I .Fax: [phone]
DWQ/UlC!lnSitu Remed. Notification (Revised 4/26/2012)
Print or Type Full Na me
Print or Type Full Name
RECE\VED/DENRJOWQ
t.1AY O 3 7012
Aquifer Protection Section
Page4
A MW-8
APPROXIMATE EXTENT
OF E SCAVATION
60' RIGHT OF WAY
_ �J
MW-9
MW-16 A
MW 18 it
MW-7_ -- - —= = _ -_
REME0IATION SYSTFM
i ^I- A PRO](IMATE EXTETrf
OF EXCAVATION
..• 5VE 61MW-6 .� �0 BT ;i2
�"'A5 SVE411NW154 AS_3 A5-8
MW-17 '0
SVE-2
JUNCTION 000( —
MW-1O £
A5-9 SVE-1 �{
$MW-14
+ZMW-1
60' RIGHT OF WAY
-- AS-11�
ENE OF PAVEMENT
MW-1I
1C0' RIGHT
— J Ili AY — —
2 UNDERGROUND FIBER OPTICS CABLES
2 UNDERGROUND TELEPHONE CABLES
tMW-12
CENTER LINE
Er1Gi OAVf.N1ENT
HIGHWAY 96
HIGHWAY 96
CENTER LINE
LEGEND:
OF PAVEMENT
60 RIGHT OF WAY
MW-4
*WHITLEY WELL
WSW-1
I MW-3 SHALLOW MONITORING WELL LOCATION AND ID NUMBER
-- WSW-1 WATER SUPPLY WELL LOCATION AND ID NUMBER
B AS-2 AIR SPARGE WELL LOCATION AND ID NUMBER
SVE-5 SOIL VAPOR EXTRACTION WELL LOCATION AND ID NUMBER
APPROXIMATE EXTENT OF EXCAVATION
-- UNDERGROUND FIBER OPTICS CABLE
UNDERGROUND TELEPHONE CABLE
— — SYSTEM TRENCHING
0
.1_ ADP ROXIMATE EXTENT
OF EXCAVATION
MW-3
H PROPOSED AIR SPARGE WELL LOCATION
PROPOSED MONITORING WELL LOCATION
PROPOSED SYSTEM TRENCHING
NOTES:
1- SITE MAP BASED ON FIELD MEASUREMENTS BY
SHIELD PERSONNEL,
2- ALL LOCATIONS ARE APPROXIMATE.
3- © PROPOSED SYSTEM ENHANCEMENTS
AND MODIFICATIONS.
WATSON WELL
WSW-3
—APPROXIMATE EXTENT
OF EXCAVATION
RECE1VED►DENRIDWQ
Aquifer Protection Section
EDGE OFaAVEMENr
Mw-2A4 MW-2
60' RIGHT OF WAY
64
e�O
GRAPHIC SCALE
fa tO 30 40
SCALE: I In. - 40ft
S00 RIGHT
OF WAY
WSW-3
SHIELD
ENGINEERING, INC.
4131 TAGGART CREEK ROAD
CRARLOTTE. NC 78238
IOGaa.-eaka
SITE MAP
EAGLE TRANSPORT
HIGHWAY 96
SELMA, NORTH CAROLINA
SHIELD it 1020134
DATE: 03/30/12
SCALE : AS SHOWN
DRAWN BY : RBS
FIGURE :

SEE WELL HEAD DETAIL
2" SCH. 40 PVC
CASING
(PROVIDED BY OTHERS)
APPROXIMATE GROUNDWATER
DEPTH
(PROVIDED BY OTHERGROUTS)
BENTONITE SEAL
(PROVIDED BY OTHERS)
FILTER PACK
(PROVIDED BY OTHERS)
0.010-INCH SLOTTED
SCREEN
(PROVIDED BY OTHERS)
TOTAL DEPTH = 40' OR TO TOP OF BEDROCK
2'
SCREEN INTERVAL
= 2.5
RECEWWEDIDENRIDWO
Aquifer Protection Section
GROUND SURFACE
(EXISTING)
8-INCH CONCRETE
2" CONCRETE SEAL
4" 0 SCH 40
PVC CONDUIT
•
1/2" AIR LINE �r
FROM AIR
COMPRESSOR
GROUT
(PROVIDED BY OTHERS)
1 #3 REBAR
r•
DFA
18"0x30"(DEEP)
AASHTO I-H-20 TRAFFIC RATED
WELL VAULT WITH LOCKING
BOLT -DOWN WATER TIGHT
LID
WEEP HOLE
2"0 SCH 40 PVC WELL CASING
(PROVIDED BY OTHERS)
AIR SPARGE WELL HEAD SECTION DETAIL
SGALE= N-T-S.
ITEM
A
S
C
0
E
F
MATERIAL
1" x 2" x 2" SCH 40 PVC TEE (SLIP x SLIP x SLIP)
2" SCH 40 PVC ADAPTER (SLIP x NPT)
2" SCH 40 THREADED PVC PLUG (NPT)
PRESSURE GAUGE [0" -100" PSIG)
1/2" BALL VALVE
1/2" x 1/2" X 112" TEE
L,3 ELL. Co NT`P C"To C. E \ w l N+ ENTA-L
� r l cA�-r1or 2 a 5 A