WI0100413_DEEMED FILES_20190301

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North Carolina Department of Environmental Quality-Division of Water Resources
INJECTION EVENT RECORD {IE R)
Permit Number W10100413 ~'-"'-==::::....,.:,.....=_-_-_-_-_-_-_-_-_-_-_-_-_-...::-_-_-___________ ~
1. Permit Information
Henderson County
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive, Hendersonville. NC
28791 <Henderson)
Facility Address (include County)
· 2. Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor/ Company Name
Street Address 5B Oak Branch Drive
Greensboro NC
City State
[phone]
Area code -Phone number
3. Well Information
27407
Zip Code
RECEIVED/NCDEQ/DWR
MARO 4 2019
Water Quality
Number of wells used for inj ~!NlaJDperatlgRs Seeti1>n
Well IDs IW-1 ·-=-~=------------
Were any new wells installed during this injection
event?
D Yes ~ No
If yes, please provide the following infonnation:
Number of Monitoring Wells _____ _
Number of Injection Wells ______ _
Type of Well Installed (Check applicable type):
0 Bored O Drilled O Direct-Push D Hand-Augured D Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
D Yes ~ No
If yes, please provide the following infonnation:
Number of Monitoring Wells _____ _
Number of Injection Wells. ______ _
Please include a copy of the GW-30 for each well
abandoned.
4. Injectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = I 0.6 mg/L
If the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 2000 gallons
Volume Injected per well (gal) 2000 gallons
5. Injection History
Injection date(s),~0=2=/0::....;4:.....:-2=6e....:/1=-9 ______ _
Injection number ( e.g. 3 of 5),---=-12"-'o=f,_,lS.!,2,..__ __ _
Is this the last injection at this site?
~ Yes D 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 WITIIlN THE
STAND,.n..n.~..n..JLLJ O IN THE PERMIT.
"'J-)-/7
DATE
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3~1-2016
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North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W10100413
1. Permit Information
Henderson County
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive, Hendersonville, NC
28791 (Henderson)
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC, Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
Greensboro_ _NC_ _ 27407
City State Zip Code
[phone]
Area code — Phone number
3. Weil Information
Number of wells used for injection 1
Well TDs IW-1
Were any new wells installed during this injection
event?
® Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells U
Number of Inj ection Wells 1
Type of Well Installed (Check applicable type);
❑ Bored ® Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include u copy of the GW-T foram for each
well installed.
Were any wells abandoned during this injection
event?
El Yes ®No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include a copy of the GW 30 for each well
abandoned
4. Injectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration AvLDO = 7.0 rn JI_
Lf the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 1650 gallons
Volume Injected per we11 (gal)_ 1650 gallons
5. Injection History
Injection date(s)_06/15-24/16
Injection number (e.g. 3 of 5) 1 of 12
Is this the last injection at this site?
❑ Yes ® No
1 DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON TIIIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
IN.TECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
_ #,r
SIGNATURE ( 3 CT1ON 04arricACTOR DATE
Rand Y. Rced,f 1i
PRINT NAME OF PERSON PFRFORMING3jJE FNJECTIO N
Submit the original of this form to the Division of Water Resources within 30 days of injection
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form [JIC-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD 1ER)
Permit Number W10100413
1. Permit Information
_Henderson County
Permittee
Henderson Conn:y Landfill
Facility Name
191 Transfer Station Drive Hendersonville. NC
28791 (Henderson1
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor 1 Company Name
Street Address 5B Oak Branch Drive
Greensboro
City
NC
State
[phone]
Area code — Phone number
27407
Zip Code
3. Well lnformation
Number of wells used for injection 1
Well IDs IW-1
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 a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Welts
Number of Injection Wells
Please include a copy of the GW 30 for each well
abandoned
4. Injectant Information
Aerated Water
Inj ectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 8.0 mg.L
If the injectant is diluted please indicate the source
dilution fluid. _Filtered County Public Water
Total Volume Injected (gal) 1510 eallons
Volume Injected per well (gal)-1510 gallons
5, Injection History
Injection date(s] 08/29/16 — 09/07/16
Injection number (e.g. 3 of 5) 2 of 12
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.
SIGNATURi INJECTT�TRACTOR DATE
]L- Reedv tI
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (1ER)
Permit Number W10100413
1. Permit Information
Henderson County
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive, Hendersonville. NC
28791 (Henderson) _
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
Greensboro
City
NC
State
27407
Zip Code
[phone]
Area code— Phone number
Well Information
Number of wells used for injection - 1
Well 1Ds IW-1
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 a copy of the GW {form for each
well installed
Were any wells abandoned during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Welts
Number of injection Wells_
Please include a copy of the GW-_.30_ for each well
abandoned
l.Af ectant Information
Aerated Water
Irilectant(s) Type (can use separate additional sheets
if necessary
Concentration _Avg DO = 11.t7 mg 'L
If the injectam is diluted please indicate the source
dilution fluid. Filtered Count) Public Water
Total Volume Injected (gal) 1950 gallons
Volume Injected per well (gaI) 1950 gallons
Injection History
Injection date(s)_ 11/14-22/16
Injection number (e.g. 3 of 5)_3 of 12
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.
SIGNATURE
JECT1ON 0ISNTRACTOR
DATE
P vid Y. Rs u PRINT NAME NAME of PERSON PERFORMING THE IN IFCI ION
Submit the original of this form to the division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-ZFR
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (1 ER)
Permit Number WI0100413
1. Permit Information
Henderson Counts
Permittee
_Henderson County Landfill
Facility Name
_191 Transfer Station Drive Hendersonville, NC
28791 (Henderson)
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC. Inc,
Injection Contractor / Company Name
Street Address 5B Oak Branch Dive
Greensboro NC
City State
27407
Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection 1
Well 'Ds_ 1W-1
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
LI Hand -Augured ❑ Other (specify) _
Please include a copy of the GW-1 jorrn 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 a copy of the GW 30 for each well
abandoned.
4. lnjectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 11.3 mg/L
Lithe injectant is diluted please indicate the source
dilution fluid. filtered Count`. Public Water
Total Volume Injected (gal) 2000 gallons
Volume Injected per well (gal) 2000 gallons
5. Injection History
Injection date(s) 02/13-24/17
Injection number (c.g. 3 of 5) 4 of 12
Ls 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.
!. -7'
SIGNATURE 'IECII► f•NTRACTOR DATE
_David Y. Reedh n
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mad Service Center, Raleigh, NC 27699-1636_ Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W 10100413
1. Permit Information
Henderson County
Permittee
Hendersson County Landfill
Facility Name
191 Transfer Station Drive. Hendersonville. NC
28791 (Henderson)
Facility Address (include County)
?. Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
Greensboro NC 27407
City State Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection 1
Well 1DsIW-1
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):
E Bored ❑ 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?
E Yes ® No
If yes, please provide the following information:
Number of iVIonitoring Wells
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned.
4. Injeetant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 10.3 mg/1.
If the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal)_1975 gallons
Volume Injected per well (gal)_1975 gallons
5. Injection History
Injection date(s) 05/01-1VI 7
Injection number (e.g. 3 of 5) 5 of 12
Is this the last injection at this site?
❑Yes ®No
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.
-
SIGNATURE[ iNJECi't CONTRACTOR DATE
David Y.Reedti1
PR NTNAME of PERSON PERFORMINQ THE 1NJEC11ON
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality - Division of Water Resources
INJECTION EVENT RECORD ( IER )
Permit Number W10100413
I . Permit Information
Henderson Count•,
Pcrniittee
Henderson Count\ Landfill
Facility Name
_191 Transfer Station Drive, Hendersonville, NC
28791 (Henderson)
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC, Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
Greensboro
City
NC
State
W336.} 852-4903
Arca code — Phone number
3. Well information
Number of wells used for injection
Well1Ds IW-1
27407
Zip Code
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 a copy of the GW 1 form for each
well installed.
Were any wells abandoned during this injection
event?
El Yes ®No
If yes, please provide the following information:
Number of Monitoring Wells _
Number of Injection Wells
Please include a copy of the GW 30 for each well
abandoned.
4. Injectint Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg,DO = 7.8 mIL
If the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) _ 1900 gallons
Volume Injected per well (gal)_ 1900 gallons
5. injection History
Injection date(s) 08/21/17 - 09/01/17
Injection number (e.g. 3 of 5) 6 of 12
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 REST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
S1CNATURFri7F NJECI1 ONTRACTOR DATE
Dvid Y. iiesdv lj
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attu. UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form LT!C-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W101oo413
1. Permit Information
Henderson County
Permittee
Henderson Count LLand fiiii
Facility Name
191 Transfer Station Drive, Hendersonville, NC
28791 (Henderson)
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC, Inc,
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
_Greensboro NC 27407
City State Zip Code
[phone]
Area code - Phone number
3. Well Information
Number of wells used for injection l
Well IDsIW-1
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 E Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy tithe GW-1 form 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 a copy of the GW-30 for each well
abandoned.
4, Injectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 12.2 =IL
[f the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 1675 gallons
Volume Injected per well (gal) 1675 gallons
5. Injection History
Injection date(s) 11/06-17/17
Injection number (e.g. 3 of 5) 7 of 12
Is this the last injection at this site?
❑Yes ®No
l 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.
IZ-Y Ir
SIGNA IF INIECTI`ONTRACTOR DATE
David Y, Re;ec y [I.
j:$LN f NAM OF PERSON PFRFORM[NG THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attu' Lilo Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No_ 919-807-6464
Form UIC-IER
Rev. 3-1-1016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W10100413
1. Permit Information
Henderson County
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive, Hendersonville, NC
28791 (Henderson]
Facility Address (include County)
2. Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor / Company Name
Street Address 513 Oak Branch Drive
Greensboro
City
NC
State
(336} 852-4903
Area code — Phone number
27407_
Zip Code
3. Well Information
Number of wells used for injection 1
Well IDs IW-1
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 a copy of the GW--1 fordo 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 a copy of the GW- 30 for each well
abandoned.
4. Injectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration JALrg DO = 10.1 mi/L
If the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 1950 gallons
Volume injected per well (gal) 1950 gallons
5. Injection History
Injection date(s) 02l02-16/18
Injection number (e.g. 3 of 5)—S of 12
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.
SIGNATURE O1 INJECTION NTRACTOR DATE
_tlrn 1 Y. Ree 1v LI
PKINI NAME_QFPEPS?N PE$EQRMING ?HEIN jgC'110ri
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W10100413
! Permit Information
Henderson County
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive, Hendersonville. NC
287911Hend ersopL _
Facility Address (include County)
2, Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
Greensboro NC 27407
City State Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection I
Well Ds IW-1
Were any new welts 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 E Direct -Push
❑ Hand. -Augured ❑ Other (specify)
Please include a copy of the GW-I form for each
well installed
Were any wells abandoned during this injection
event?
❑ Yes No
If yes, please provide the following information:
Number of Monitoring Wens
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned
4, Injectsnt Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avt DO = 8.1 mgll_
lithe injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 215d gallons
Volume Injected per well (gal) 2150. �aiions� _
5. Injection History
Injection date(s) 05/04-21/18
Injection number (e.g. 3 of 5) 9 of 12
Is this the last injection at this site?
❑ Yes ® No
I DO HERESY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITIffN THE
STANDARDS LAID OUT IN THE PERMIT.
SIGNATURE Of INJECTION NTRACTOR DATE
DavidY. Reee}h_q
PRIYT y4yl F1uF PERSON PERFORATING THE INiECiION
Submit the original of this force to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919.807-6464
Form U1C-IER
Rev. 3-1-2016

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (LER)
Permit Number W10100413
. Permit Information
Henderson Count
Permittee
Henderson CounL', Landfill
Facility Name
191 Transfer Station Drive Hendersonville, NC
28791 fllendersonl
Facility Address (include County)
Injection Contractor Information
Golder Associates NC. Inc.
Injection Contractor / Company Name
Street Address 5B Oak Branch Drive
_Greensboro
City
NC
State
27407
[phone]
Area code — Phone number
Zip Code
Well Information
Number of wells used for injection 1
Well LDs IW-1
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 a copy of the G W-1 form 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 a copy of the GW 30 for each well
abandoned
Injectant Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 8.3 me1L
If the injectant is diluted please indicate the source
dilution fluid_ _Filtered County Public Water
Total Volume Injected (gal)_2100 gallons
Volume Injected per well (gal) 2000 gallons
Injection History
Injection date(s) 08/07-27/18
Injection number (e.g. 3 of 5) 10 of 12
Is this the last injection at this site?
❑ Yes ® No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM I5 CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED 'WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
SIGNA TURi��NTRACTOR
David Y. Reedy 1!
12 • t.1 •J
DATE
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-LER
Rev. 3-1-2016

D eeir,-.c( c, d0 ' 0 U 443
North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number W10100413
Permit Information
Henderson Count
Permittee
Henderson County Landfill
Facility Name
191 Transfer Station Drive. Hendersonville, NC
28791 (Henderson)
Facility Address (include County)
Injection Contractor Information
_Golder Associates NC, Inc.
Injection Contractor / Company Name
Street Address 58 Oak Branch Drive
Greensboro NC 27407
City State Zip Code
aye 0 5 470/8
Number of wells used for injectiotP a.0 pt�e41Ataratorisy.
ection
(336) 8524903
Area code - Phone number
Well Information
Wel11Ds IW-I
Were any new wells installed during this injection
event?
❑Yes ZN❑
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Type of Well Installed (Check applicable type):
El Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 fords for each
well installed
Were any wells abandoned during this injection
event?
El Yes ®No
If yes, please provide the following information;
Number of Monitoring Wells
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned.
Injectint Information
Aerated Water
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration Avg DO = 9.7 rng/L
If the injectant is diluted please indicate the source
dilution fluid. Filtered County Public Water
Total Volume Injected (gal) 2200 gallons
Volume Injected per well (gal) 2200 gallons
Injection History
Injection date(s) 11/02-26/18
Injection number (e.g. 3 of 5) 11 of 12
Is this the last injection at this site?
El Yes ® No
1 DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM I5 CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
2-if- I4.?'
SIGNATURE Ii5iF 1 SECTION 'TRACTOR DATE
David Y. ({red, [1
PR1NT NAME OE E1 eE1tf9RM 1NG THE INJECTLON
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: 1JIC Program, 1636 Mail Service Center, Raleigh, NC 77699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev, 3-1-2016

iermit Number
Program Category
Deemed Ground Water
Permit Type
WI0100413
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
michael.rogers
Coastal SWRule
Permitted Flow
Facility
Facility Name
Henderson County Closed MSW and C&D Landfill
Location Address
191 Transfer Station Dr
Hendersonvlle
Owner
Owner Name
Henderson County
Dates/Events
NC
Orig Issue
12/28/2015
App Received
12/18/2015
Reg ulated Activities
Groundwater remediation
Outfall
Waterbody Name
28792
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
12/28/2015
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Government -County
Owner Affiliation
Natalie J. Berry ·
asst county eng
100 N King St Ste 210
Hendersonvlle
Region
Asheville
County
Henderson
NC 28792
Issue
12/2812015
Effective
12/28/2015
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
f
,~ogers, Michael
From: Rogers, Michael
Sent: Monday, December 28, 2015 3:22 PM
To:
Cc:
'Reedy, David'; [e-mail]
Davidson, Landon; Moore, Andrew W
Subject: RE: WI0100413 Henderson County Landfill NOi
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOi} for the above referenced
site.
Please remember to submit the following regarding this injection activity:
1) Well Construction Records (GW-1) and Abandonment Records (GW-30) when completed. Please provide copies of
the GW-ls and GW-30s if not already submitted (originals go the address printed on the form). NOTE: Direct push
or Geoprobe wells are considered wells and require construction {GW-1) and abandonment forms (GW-30). If well
construction/abandonment information is the same for the wells, only one form needs to be completed-just
indicate total number of injection points in the Comments/Remarks section of form . These forms can be found on
our website at http ://portal.ncdenr.org/web /w g/aps/gw p ro /re portin g-forms.
2) Injection Event Records (IER). All injections, including air and passive systems require an IER. The IER can be
modified for air sparge wells (e.g., air flow 'continuous' for date or rate of injection, etc.).
You can scan and send thE'se forms directly to me at michael.ro gers (ai ncdenr.gov, send by fax to my attention at 919-
807-6406, or via regular mail to address below. When submitting the above forms, you will need to enter the nine-digit
alpha-numeric number on the form (i.e., WI0XXXXXX} that has been assigned to the injection activity at this site. This
notification has been given the deemed permit number WI0100413. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in reply to this email, as it will already have the
assigned deemed permit number in the subject line.
Thank you for your cooperation.
Michael Rogers, P.G. (NC & FL)
Underground Injection Control (UIC) Program Manager -Hydrogeologist
NCDEQ-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://portal.ncdenr.org/web/wq /aps/gwpro/reporting-forms
NOTE : Per Executive Order No. 150, all e-mails sent to and from this account ore subject to the North Carolina Public
Records Law and may be disclosed to third parties.
From: Reedy, David [mailto:[e-mail])
Sent: Monday, December 28, 2015. 3:12 PM
To: Rogers, Michael <[e-mail]>; [e-mail]
1
Cc: Davidson, Landon <landon [e-mail]>; Moore, Andrew W <[e-mail]>
Subject: RE : WI0100413 Henderson County Landfill NOi
Mr. Rogers,
I have attached the electronic copy that you requested. Please let us know if you have any questions.
Dusty
David "Dusty" Y. Reedy 11, PG I Senior Hydrogeologist I Golder Associates NC , Inc.
58 Oak Branch Drive , Greensboro, North Caroiina, USA 27 407
T: [phone] F: [phone] IC: [phone] I
From: Rogers, Michael [mailto:michael.rogers (ru ncdenr.gov]
Sent: Monday, December 28, 2015 3:08 PM
To: nberry (ci)hendersoncoun ty nc.org ; Reedy, David
Cc: Davidson, Landon; Moore, Andrew W
Subject: WI0100413 Henderson County Landfill NOI
We received the NOi for the groundwater remediation well at the above site . Thank you. Please email an electronic
copy to me and the CC above . Thanks.
Michael Rogers, P.G . (NC & FL)
Underground Injection Control (UIC) Program Manager -Hydrogeologist
NCDEQ-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No . 919-807-6412
http ://portal.ricdenr.org/web /w o/aps/gwpro/re porting-forms
NOTE : Per Executi ve Order No. 150, all e-mails sent to and from this account are subje ct to the North Carolina Public
Records Low and may be disclosed to third parties.
2
NORTH CAROLJNA 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 be submitted at least 2 weeks prior to in iection.
AQUIFER TEST WELLS (ISA NCAC 02C .02201
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 Sy stems -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 O p erations -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. Rlegible Submittals Will Be Returned As Incomplete.
DATE: December 15 , 2012 PERMITNO. {/-..)f'D I ooy ,J (to be filled in by DWR)
A.
B.
c.
WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1)
(2)
(3)
(4)
Air Injection Well ...................................... Complet--.l\v~~o
-----'Aqu~fer T~st :"ell ....................................... Comple ~;itf!lfUlt:lrmtff l!)VVR":l
-----'Passive Injection System ............................... Complete se -¥J•l -N
Small-Scale Injection Operation ...................... Compl' -· s B-N -· Ii
(5) X Pilot Test. ................................................ Complefu · · '1;'$/J::fl/or,81 . . . . ectton
(6) -~-Tracer Injection Well ................................... Complete sections B-N
STATUS OF WELL OWNER: County Government ~\'{)~~~J~"
t\tCt.~\:,V
WELL OWNER -State name of entity and name of person delegatJcf' authority to sign on . be~lf of the
business or agency: .-1 •i>'::.,\l\~
. ·•.:.f;\\I\ ~-: . _ _;i\(.l\l
Name: Natalie Beny, Assistant County En!!ineer. Henderson County
,,., ._,J . ,.,
""'1'().\to ',.. ._,f' . ,.,.~ oov'<-
Mailing Address: 100 North Kin g Street, Suite 210
City: Hendersonville State: NC Zip Code: 28792 County: Henderson
Day Tele No.: 828-694-6521
EMAIL Address:[e-mail]
Cell No.: 828-691-5079
FaxNo.: NA
UIC!In Situ Remed. Notification (Revised 3/2/2015) Page 1
D. PROPERTY OWNER (if different than well owner)
Name:------------------------------------
Mailing Address:---------------------------------
City: _____________ State: __ Zip Code: _______ County: _____ _
Day Tele No.: ____________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: David Reedy, PG
Mailing Address: SB Oak Branch Drive
City: Greensboro State: NC Zip Code: 27407 County: Guilford
Day Tele No.: 336-852-4903
EMAIL Address: [e-mail]
F. PHYSICAL LOCATION OF WELL SITE
Cell No.: 336-465-0826
Fax No.: 336-852-4904
(1) Physical Address: 191 Transfer Station Drive County: Henderson
City: Hendersonville State: NC Zip Code: 28792
(2) Geographic Coordinates: Latitude**: 35° 21' 13.8139"
Longitude**: -082° 29' 58.7204"
Reference Datum: WGS 1984 Accuracy: ________ _
Method of Collection: Well will be located usin g GPS
**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: 899,000 square feet
Land surface area ofinj. well network: 2,000 square feet (S 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated: 0.2% (must be S 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 soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and See Drawing 1
(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. See Drawing 2
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus
existing and proposed wells. See Drawing 3 and Table 1
UlC/In Situ Remed. Notification (Revised 3/2/2015) Page2
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.
Super-aerated water (SAW) will be injected usin g a single injection well (IW-1 ) screened within the lower
partially-weathered rock (P WR) I fractured rock aquifer portion of the MW-6 area plume. To generate SAW. a
potable water sup pl y, available at the Facilitv. will be filtered for the removal of chlorine. An approximate
500-gallon tank will be filled with the filtered water. To generate the SAW, atmospheric air will be introduced
to the potable water within the holding tank using a compressor. The air supplied by the compressor will be
bubbled through the standing water column to facilitate the dissolution of atmospheric oxygen into the water,
producing SAW. A supplement. potassium bicarbonate, will be added to the SAW prior to injection.
Potassium bicarbonate will be added as a pH buffering agent. which will counteract the potential acidification
of the SAW (which mav occur via the introduction of atmospheric carbon dioxide). If an alternate pH-
buffering product is required, prior notification of this potential change will be provided to DENR for
approval. Prior to injection, the pH , temperature, oxidation-reduction potential (ORP), dissolved ox ygen
(DO), and turbidity of the SAW will be measured. A DO concentration equal to or exceeding 12 milli grams
per liter (m e:/L) is expected.
SAW will be introduced to the PWR / fractured bedrock aquifer via IW-1 under gravity flow. Because the
average potentiometric surface measured in performance monitoring well AMW-1 D is ap proximate 15 feet
BGS , a minimum injection pressure of 5 pounds per square inch (PSI) is expected durin g injection.
Approximately 500-gallon batches of SAW will be produced for individual injection events. The injection will
proceed until the batch of SAW has been introduced into the aquifer via gravi tv flow. The initial injection will
include four , 500-gallon batches, for a total proposed injection of 2.000 gallons of SAW to the PWR /
fractured rock aquifer during the pilot-scale test. Injections 2 - 4 will be implemented when field geochemical
conditions in the injection well and/or performance monitoring well indicate a decline in dissolved ox ygen
and/or aerobic conditions (to approximate baseline conditions) in the portion of the a quifer tanzeted during the
pilot test.
J. 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/web/wq/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: Super-aerated water (SAW)
Volume ofinjectant: 2000 gallons per injection
Concentration at point of injection: Approximately 12 mg/L of dissolved oxygen
Percent if in a mixture with other injectants: ____________________ _
Injectant: Potassium bicarbonate
Volume of injectant: Volume will be field determined based on a tare:et pH of 6.5
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: -=L=e=s=s -=th=a=n=--5=---0,_,1/o,....,('""e"'"st=im=a=teci) ___________ _
UIC /In Situ Remed. Notification (Revised 3/2/2015) Page3
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
K. WELL CONSTRUCTION DATA
Well
(1)
(2)
Number of injection wells: ------=-----Proposed. ___ O=----_-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)
Prop osed permanent injection well installed via air rotarv drillin g methods
(b) depth below land surface of grout, screen, and casing intervals
Casing Filter Pack Screened
Well Depth Diameter Riser Interval Grout Interval Bentonite Interval Interval
Identification (ft) (in) (ft BGS) (ft BGS) (ft BGS ) (ft BGS) CftBGS) Geology of Screened Interval
IW-1 65 2 0.5 -45 1 -41
Notes:
All depths are estimates and may have to be adjusted based on field conditions
ft=feet
in= inches
BGS = below ground surface
41 -43
( c) well contractor name and certi_fication number
Geolo gic Exp loration, Certification No.2581
UICI In Situ Remed. Notification (Revised 3/2/2015)
43-65 45-65 Partially Weathered Rock/ Bedrock
Page4
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities.
In jection well IW-1 is scheduled to be installed in December 2015 depending on subcontractor availability.
The first in jection event is scheduled for A pril 2016 with subsequent in jection events on an app roximatel y
guarterl v basis de pendent u pon dissolved ox yg en measurement measurements from injection well IW-1 and
performance monitorin g well AMW-lD.
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 objectives of the enhanced bioremediation (EB) pilot-scale corrective action monitoring program are listed
as follows:
• Evaluate the physical distribution, transport, and longevity of SAW in the targeted aquifer
zone
• Measure temporal concentrations of dissolved oxygen and alkalinity in groundwater
samples
• Measure potential changes in potentiometric surface measurements in performance
monitoring well(s) during injection events
• Evaluate the conditioning of the aquifer for biodegradation of targeted COCs
• Measure the ORP, DO, specific conductance, temperature, and pH of the SAW
• Measure temporal changes in ORP, DO, specific conductance, temperature, and pH at the
injection well (post-injection) and performance monitoring well
• Evaluate the performance of the EB remedy with respect to the degradation of targeted COCs
■ Evaluate the protection of surface water quality and potential sensitive receptors
The specific components of the AMW-lD area pilot study monitoring program are presented in the following
table:
AMW-1D Area Pilot Study Monitoring Program
Monitoring Purpose Station Measurement Frequency Monitoring
Station T yp e Identification T yp e List
Single pre-injection pH, temperature, Background event; Post-specific Up gradient Data for MW-6 Field injeetion = conductance, Well(s) Remedy quarterly for 18 ORP,DO, Evaluation months, then semi-turbidity annually
Single pre-injection pH, temperature,
specific
Field event; Post-conductance, Injection Injection Site IW-1 injection= ORP,DO, Well(s) Monitoring quarterly for 18 turbidity months, then semi-COCs* and Laboratory annually Alkalinity
Single pre-injection pH, temperature,
specific
Field event; Post-conductance, Performance Performance AMW-lD injection= ORP,DO, Well(s) Monitoring quarterly for 18 turbidity months, then semi-COCs* and Laboratory annually Alkalinity
VIC/In Situ Rcmed. Notification (Revised 3/2/2015) Page5
L
Monitoring Purpose Statton Measurement Frequency Monitoring
Stat,i:Q~ l'YJ>e li,lentjficati9n Type L~t
PWR pH, temperature,
Mi:>nitoring Single pre-injection specific
MW~2and Field eve:nt; Post, co:Pcl.u..ctance, PWR Well(s) Before Full, AMW-2D injectim1 = semi, ORP,DO, Sc~e
Application annually tqtbidjtv
Laboratq ry COQs>t<
Single pre-injection pH, temperature,
specific event; Post-Sensitive Field conductance, Surface Water injection= Receptor BR-3 ORP,00, Statlon(s) Protection quartedy for 18 turbi<iity months, then, semi-COCsand Laboratory annually Alkalinity
Notes:
"' COCs =,constituents of concern
COCs include benzene; 1,4-dichloroben:zene; 1,1-dichloroelhane; methylene chloride; tetrachloroethene; tricb]oroethene; and vinyl chloride
Benzene and vinyl chloride are the only two VOCs currently detected in samples from AMW-1D above the NC 2L
Standards. Vinyl chloride will naturally degrade to ethene in an ru;J.aerobic envil:oi:nneiit with the right geochemical
conditions in the presence of the hl!C"teriUlll dehalococcoides (DHC). Benzene is readily susceptibie to natural
attenuation processes in the subsurface and abnospheric environments.
N. SIGNAt~ OF APPLICANT AND PROPEIUY OWNER
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 Jot obtaining said information, I believe that the infonnation is true, accurate and complete. I am
aw(n'e thqt there ate Significa.nt penalties, including the possibility of fines and imprisonm(#nt, for submitting
false i,iformation. ]agree to construct, operate, maintain, repair, and if.applicable, abandon the injection well
and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules. "
r/~ak., /J Vl/4v/ N,'J-rAUG' Be~y
Signatu_te (If Applic,mt Print or Type F'111 Name
PROPERTY OWNER{ifthe pro perty is not owned b y the permitap;plicant):
''As <n<,rnet of the property on which the infection well(s) are to be constructed r;ind operated, J hereby consent
to allow the applicant to construct each injedion well as oi/ilinf!li in this application and agree that it shall be
the responsibility of the applicant to ensure that the infection well(s) .conform to the Well CoTl$truction
Standards (.15A NCAC 02C .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 absenc_e of contrary agreement in writing.
Signature* ilf Property Owoer (ifdiffer.ent from ilpplic.nt) Print or Type F111l Niune
* An access agreement between the applicant and property owner may be submitted in lieu of a signature on this fotm.
Submit tb,e cmnpleted notification ()1lckage to:
VIC/In Situ Remed. Notification (Revised 3/2/2015)
DWR-UIC Prqgram
1636 Mail Service Center
R:aieigh, NC 27699-1636
Telephone: [phone]
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