WI0100522_DEEMED FILES_20190206

Permit Number WI0100522
Program Category
Deemed Ground Water
Permit Type
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Ralph Wilson Plastics Company
Location Address
80 LA White Dr
Fletcher
Owner
Owner Name
Illinois Tool Works
Dates/Events
Orig Issue
2/6/2019
NC
App Received
1/31/2019
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
28732
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
2/6/2019
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Asheville
County
Henderson
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Ken A. Brown
155 Harlem Ave
Glenview
Issue
2/6f?019
Effective
2/6/2019
IL 60025
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
MEMO ~ ARCADIS I Oesl &Co!!SUI" ncy ..... · ::i=:nd
To :
North Carolina Department of
Environmental Quality
From:
Arcadis G&M of North Carolina, Inc.
Coples:
Ken A. Brown-lTW
Arcadls G&M of North Carolina, Inc.
801 Corporate Center Drive
Suite 300
Raleigh
North Carolina 27607
Tel [phone]
Fax [phone]
ARCADIS G&M of North Carolina, Inc.
Date : Arcadis Project No.:
January 28, 2019 NC180001.2018 NC Engineering License# C-1869
NC Surveying License # C-1869
Subject:
Notification of Intent to Construct or Operate Injection Wells
Wilsonart International
Fletcher, NC Facility
Arcadis G&M of North Carolina, Inc . (Arcadis) is pleased to provide to the North Carolina Department of
Environmental Quality (NCDEQ) this Notification of Intent (NOi) to Construct or Operate Injection Wells. This package
includes the installation of four new injection wells located in the vicinity of MW-4, within the area of the suspected
former source wells, for the purpose of injecting activated sodium persulfate in the attempt to oxidize residual
chlorinated materials from the subsurface and expedite completion of the current groundwater capture remedy.
Please see a brief description below of the figures and attachments included with the Notification of Intent to Construct
or Operate Injection Wells. All figures are included in the January 2019 Remedial Action Plan Addendum report.
Figures:
•
•
•
•
•
Figure 1-Site Map. General layout of the facility showing the locations of existing wells and proposed
injection well. lil'c~IIA,._
Figure 2-Water Table Surface Map, Saprolite Aquifer (September 2018). Thi~ the most recent water
table direction. An overall northwestern flow direction at an average hydraulic gradie~.§IDfl MW-4 and
MW-6) of 0 .028 ft/ft was observed. A depression in the RWP-1 and ™ t, i~ present from groundwater
recovery operations. ./ 20;.9
lie ' 11,::tk
Figure 3-Volatile Organic Compounds in Groundwater Monitor W lfs?Bl\9 \o/APri.L.Qcations (September 2017-
September 2018). This figure provides the most recent groundwater sal~fiWg,iiQ~lts at the site.
Figure 4-MW-4 Groundwater Profile Results (July 2018). ¾io11
Figure 5-Injection System P&ID. The general process and instrumentation of the injection system is shown
on this figure.
Page:
1/2
MEMO
• Figure 6-Proposed Injection Well Construction Details. This figures depicts the well construction details. The
injection well will be installed by Geolab Drilling Services, Inc (NC Drilling License 4206B)
Attachments:
• Attachment 1 -Contaminate plume maps for TCE. These maps shown an approximate TCE plume area of
50,051 square feet.
• Attachment 2 -Historic Cross Sections. The A-A' shows the east-west cross section and the B-B' shown the
north-south cross section of the site.
a read is.com
Page:
2/2
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 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 .0225) or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection 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 Injection O perations -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. Rlegib/e Submittals Will Be Returned As Incomplete.
DATE: __ __, 2019 PERMIT NO. VV" 1-0 f O O !, 2 l-/ren m lil'fr,f;illed in by DWR)
0 E"o,o i,y.<?
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED JAN 3 J <OJg
(1) A . In' . W 11 ~e(Jio Walt•,-,·1-. BF K N ir ~ectton e ................................... 'IJa mp ~.sections - , ,
fflf'att t ·
(2) ____ Aquifer Test Well ....................................... Comp e , "·/9,ns B-F, K, N
(3) ___ .Passive Injection System ............................... Complete sections B-F, H-N
(4)
(5)
(6)
=x __ Small-Scale Injection Operation ...................... Complete sections B-N
__ __,cPilot Test. ................................................ Complete sections B-N
___ Tracer Injection Well ................................... Complete sections B-N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER -State name of entity and name of person delegated authority to sign on behalf of the business
or agency:
Name: Illinois Tool Works , Inc-Contact: Ken A. Brown
Mailing Address: 155 Harlem Avenue
City: Glenview State: IL Zip Code: 60025 County: Cook
DayTeleNo.: 224-661-7784 CellNo.: 847-224-9003
EMAIL Address:[e-mail] FaxNo.: NA
UIC/Jn Situ Remed. Notification (Revised 3/2/2015) Page I
D. PROPERTY OWNER (if different than well owner)
Name: Wilsonart, LLC
Mailing Address: 80 L.A. White Drive, P.O. Box 249
City: Fletcher State: NC Zip Code: 28732 County: Henderson
Day Tele No.: ___________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: __________ _
E. PROJECT CONT ACT -Person who can answer technical questions about the proposed injection project.
Name: Timothy Hays
Mailing Address: 10 Patewood Drive Suite 375
City: Greenville State: SC Zip Code: 29615 County: Greenville
DayTeleNo.: 864-987-3905 Cell No.: 561-248-2169
EMAIL Address:[e-mail] Fax No.: 864-987-1609
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 80 L.A. White Drive County: Henderson
City: Fletcher State: NC Zip Code: 28732
(2) Geographic Coordinates: Latitude**: 35° 26' 13.56" or 35.4371000 °
Longitude**: 82° 28' 35.40" or 82.4765000 °
Reference Datum: ________ Accuracy: _______ _
Method of Collection: EDR Survey
**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: 50,051 square feet
Land surface area of inj. well network: <2,514 square feet (::: 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated:~ 5% (must be ::: 5% of plume for pilot test injections)
H. INJECTION WNE 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 Attachment 1-Figure 3
(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 Attachment 2 and Attachment 1-
Figure 4
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.-See Attachment 1-Figure 2
UIC/In Situ Rerned. 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.
The pro posed injection sys tem is intended to supp lement the current groundwater recovery remedy to reach
closure ob jectives described in the approved remedial action plan. The activated sodium persulfate injections
are pro posed to oxidize residual VOC materials from the subsurface. Four in jection wells are prop osed for this
activi tv for the purpose of mixing the injectate material with potable water. The injectant will be divided
among the 4 in jection wells d e pendin!! on anal ytical results followin g installation.
J. INJECT ANTS-Provide a MSDS and the following for each injectant. Attach additional sheets ifnecessary.
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: PeroxyC hem' K.lozur® SP (sodium persulfate)
Volume ofinjectant: U p to 18 ,800 gallons of50 grams per liter (g/L) sodium persuJfate activated
with 750 gallons of25% sodium h ydroxide (N aOH)
Concentration at point of injection: 50 g/L sodium persulfate
Percent if in a mixture with other injectants:
Injectant:
Volumeofinjectant: ____________________________ _
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 : ___________________ _
K. WELL CONSTRUCTION DATA
( 1) Number of injection wells: 1._Proposed
(2) 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 :-See Figure 6
(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
VIC/In Situ Remed. Notification (Revised 3/2/2015) Page 3
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities,
The ►yelj installation will be completed in a one -week time _Reim (4-5 days). The so4iutnpersulfatc injections
will be completed in an additional three-week time frame (14 days) for a total timeframe of 19 days.
Preliminary scheduk has well installation activities occurring in Febrgaa 2019 wish infection activities
Occurring. in the That quarter of 2019.
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 menitorinr: will Include two roundsofposl-inieclian manitarinb events completed approximately one- and three -
months post -infection. The nod -injection manitnrins is_pr„gposej to be completed in March and Mar 2019. The site
�v ll remain at an a sitaiai monitoring frequency (September) thereafter.
N. SIGNATURE OE APPLICANT AND PROPERTY OWNER
APPLICANT: `7 hereby certify, under penalty oflaw, that 1 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, 1 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 a , urtenances In ac - dance with the IS.4 NCAC 02C 0200 Rules."
Si store or Anoka 't
Print or Type Full Name
PROPERTY OWNER (if the nrunerty is not owned by the permit aaalicantl;
"As owner ofthe property on which the injection wells) 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 wells) conform to the Well Construction Standards
(MA NCAC 02C.0200), "
"Owner" means any person who holds the fee or otherproperty 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.
A.
tit yr
Signature of Property Owner (If ditf- ntrro pplicaot) Print or Type Full Na
* An access agreement between the appl ir_ - . property owner niay be submitted in lieu of a signature on this farm'.
Submit the completed notification package to:
DWR - UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1635
Telephone: [phone]
UICIJn Sthi Raratd. l4otificalion (Ftcyised 3/2/2015) Page4

ATTACHMENT 1

17 STEEL WELL VAULT
nitikot
26 ft.
TCE =104 ugR.
36 ft.
46 ft.
TCE=214ugIL
TCE =198 ugJL
56 ft. TCE 187 ug1L
66 ft.
NOT TO SCALE
TCE =187 ugIL
T.D.-70.Dit
4" V€ELL SEAL
2' N T CONCRETE WELL PAD
WOW*
EXISTING GRADE
4-INCH DIAMETER. THREADED SCHEDULE BO PVC CASING
1' OF FINE SAND OF CHOKER SAND
1' OF #1 SAND
MINIMUM 'PO -INCH DIAMETER DRILLED HOLE
CEMENT GROUT (PORTLAND TYPE I)
4 NCH DIAMETER, THREADED STAINLESS STEEL
SCREEN MOW -INCH SLOTS, 130-FF.LENOTH
(10-70 FT, HGS)
4-INCH DIAMETER, THREADED STAINLESS STEEL
SUMP 'AP/CAPPED BOTTOM
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
MW-4
GROUNDWATER PROFILE RESULTS
JULY 2018
ARCAD I5
FIGURE
4

ATTACHMENT 2

MEMO ARCADIS,
i
To:
North Carolina Depaltn-ient of
Environmental Quality
From:
Arcadis G&M of North Carolina, Inc.
Copley;
Ken A. Brown-ITW
Date: Arcadis Project No.:
November 2018 NC1 S0001.2018
Subject:
WI4100437 Modification
Notification of Intent to Construct or Operate Injection Wells
Wilsonart International
Fletcher, NC Facility
Iorneturatand
hulltassets
Arcadis G&M of North Carolina. Inc.
801 Corporate Center Drive
Suite 300
Raleigh
North Carolina 27607
Tel [phone]
Fax [phone]
ARCADIS G&M of North Carolina, Inc..
NC Engineering License # C-1869
NC Surveying License # C-1869
Arcadis G&M of North Carolina, Inc. (Arcadis) is pleased to provide to the North Carolina Department of
Environmental Quality (NCDEQ) this Notification of Intent (NOI) to Construct or Operate Injection Wells, This package
includes the installation of four new injection wells located in the vicinriy oP (i4M4-t q,the.area of the suspected
former source wells, for the purpose of injecting activated sodium persulfate in the attempt to oxidize residual
chlorinated materials from the subsurface and expedite completion of the current groundwater capture remedy.
Please see a brief description below of the figures and attachments included with the Notification of Intent to Construct
or Operate Injection Wells. All figures are included in the November 2018 Remedial Action Plan Addendum report.
Figures:
• Figure 1-Site Map. General layout of the facility showing the locations of existing wells and proposed
injection well.
• Figure 2-Water Table Surface Map. Saprolite Aquifer (September 2018). Tn,s shows the most recent water
table direction. An overall northwestern flow direction at an averaty i'rydraultc gradient (using MW-4 and
MW-6) of 0.028 ftlft was observed. A depression in the RWf -1 and EW-1 area is preAent from groundwater
recovery operations.
• Figure 3-Volatile Organic Compounds in Groundwater Monitor Wells and VAP Locations (September 2017-
September 2018), This figure provides the most recent groundwater sampfing.results a► the`site.
• Figure 4-MW-4 Groundwater Profile Results (July 2018).
Page:
1/2

MEMO
• Figure 5-Injection System P&ID. The general process and instrumentation of the injection system is shown
on this figure.
• Figure 6-Proposed Injection Well Construction Details. This figures depicts the well construction details. The
injection well will be installed by Geolab Drilling Services, Inc (NC Drilling License 4206B)
Attachments:
• Attachment 1 -Contaminate plume maps for TCE. These maps shown an approximate TCE plume area of
50,051 square feet.
• Attachment 2 -Historic Cross Sections. The A-A' shows the east-west cross section and the B-B' shown the
north-south cross section of the site.
arcadis com
Page:
2/2
NORTH CAROLINA DEPAR1MENT 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 form shall be submitted at least 2 weeks prior to iniection.
AQUIFER TEST WELLS (1 5A NCAC 02C .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (ISA NCAC 02C .0225 1 or TRACER WELLS (1 5A NCAC 02C .0229):
I) Passive Injection S ystems -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 perations -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: November, 20ll PERMIT NO. ________ {to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(I)
(2)
(3)
(4)
(5)
(6)
----'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
=x __ Small-Scale Injection Operation ...................... Complete sections B-N
----'Pilot Test ................................................. Complete sections B-N
___ Tracer Injection Well ................................... Complete sections B-N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER-State name of entity and name of person delegated authority to sign on behalf of the business
or agency:
Name: Illinois Tool Works, Inc-Contact: Ken A . Brown
Mailing Address : 155 Harlem Avenue
City: Glenview State: IL Zip Code: 60025 County: Cook
Day Tele No.: 224-661-7784 Cell No.: 847-224-9003
EMAIL Address:[e-mail] FaxNo .: NA
UIC//n Situ Remed. Notification (Revised 3/2/2015) Page 1
D. PROPERTY OWNER (if different than well owner)
Name: Wilsonart . LLC
Mailing Address: 80 L.A. White Drive, P.O. Box 249
City: Fletcher State: NC Zip Code: 28732 County: Henderson
Day Tele No.: ___________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT-Person who can answer technical questions about the proposed injection project.
Name: Timothv Ha ys
Mailing Address: 10 Patewood Drive. Suite 375
City: Greenville State: SC Zip Code: 29615 County: Greenville
Day Tele No.: 864-987-3905 Cell No.: 561-248-2169
EMAIL Address:Timothy.Hays/@ arcadis.com Fax No.: 864-987-1609
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 80 L.A. White Drive County: Henderson
City: Fletcher State: NC Zip Code: 28732
(2) Geographic Coordinates: Latitude**: 35° 26' 13.56" or 35.4371000 °
Longitude**: 82° 28' 35.40" or 82.4765000 °
Reference Datum: ________ Accuracy: ________ _
Method of Collection: EDR Survey
**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: 50,051 square feet
Land surface area ofinj. well network: <2.514 square feet~ 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated:____::: 5% (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 Attachment 1-Figure 3
(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 Attachment 2 and Attachment I-
Figure 4
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.-See Attachment 1-Figure 2
UICI 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 .
The pro posed injection system is intended to su pp lement the current groundwater recove ry remedy to reach
closure ob jectives described in the a pproved remedial action plan. The activated sodium persulfate in jections
are pro posed to oxidize residual VOC materials from the subsurface. Four in jection wells are pro posed for this
activity with two for extraction of groundwater for the purpo se of mixing the in jectate material and two for
in jection we11s.
J. INJECTANTS-Provide a MSDS and the following for each injectant. Attach additional sheets ifnecessary.
NOTE: Approved injectants (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).
lnjectant: PeroxvChem' Klozur® SP (sodium persulfate )
Volume of ittjectant: U p to 18 ,800 gallons of50 grams per liter (g/L) sodium persulfate activated
with 750 gallons of25% sodium h ydroxide (N aO H)
Concentration at point of injection: 50 g/L sodium persulfate
Percent if in a mixture with other injectants :
lnjectant: --------------------------------
Volume ofinjectant: ____________________________ _
Concentration at point of injection: ______________________ _
Percent ifin a mixture with other injectants : ___________________ _
lnjectant: --------------------------------
Volume ofinjectant: ____________________________ _
Concentration at point of injection: ______________________ _
Percent ifin a mixture with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
(I) Number of injection wells: 1._Proposed
(2) 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:-See Figure 6
(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
UlC/ln Situ Remed. Notification (Revised 3/2/2015) Page3
L. SCHEDULES —Briefly describe the schedule for well construction and injection activities.
The well installation will be completed in a one -week time frame (4-5 days)_ The sodium persulfate in lections
will be completed in en additional three-week time fram (14 days) for a total timeframe of 19 days.
Preliminary schedule has well installation activities and injections occurring in the first quarter 2019.
M. MONITOR1NG 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 monitoring will include two romds ofpost iniection monitoring events completed appioxinnate]y one- and three -
months post injection. The post -injection mu nitarini is proposed to be completed in March and May 2019, the
exact timing of the monitoring will be adjusted based on the dates of the injection event. The site will remain at an
annual monitoring frequency (September) thereafter.
N, SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "I hereby cert5 under penalty of law, that tam familiar with the information subntflted in this
document and all attachments thereto and that, based on airy inquiry ofthose individuals immediately responsible
for obtaining said information, I believe that the information is true, accurate and complete. 1 am aware that
there are significant penalties, including the passibility of fines and ltnprisonrnent, for submitting false
information. Iagree to construct, operate, rrraintain, repair, and if applicable, abandon the injection well and
all related a trienances in accord ice with the 13A NCAC 02C 02M Rules."
�5igna�re aiA pliranr Print orType Full Name
j'ROPFJ3TY OWNER [if the _property is no; owned by the permit applicant):
"As owner of the property an which the injection well(s) are to be constructed and operated, l hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree Mat it shall be the
responsibility of the applicant to enserre that the injection well(. conform to the Well Construction Standards
(15A_1JCAC 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 shah he deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Signature* of Property Owner (if di rent om applicant) Print or•Type Full Nair
* ein access agreement between the app r and property owner may be submitted In lieu ofa sip velure va Mislay r
Subunit tite completed notification package to:
❑WR—UIC Program
1636 Mall Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
LW/in Siiu Remed. Nolifrcatron (Revised 31212015) Pegs 4

1
1gu e~
12" STEEL WELL VAULT '- 4' WELL SEAL
2' x 2' CONCRETE VvELL PAD
26 ft.
y /t`✓� f G Atlity.;:w
TCE = 104 u®IL
36 ft.
TCE =214ug/L
46 ft.
56 ft.
TCE •198ug1L
TCE =167 uglL
66 ft.
TCE 167 uglL J
T.D. = 70.0 ft
NOT TO SCALE
EXISTING GRADE
41NCH DIAMETER. THREADED SCHEDULE SO PVC CASING
1' OF FINE SAND OF CHOKER SAND
1' OF #1 SAND
MINIMUM 10-INCH DIAMETER DRILLED HOLE
CEMENT GROUT (PORTLAND TYPE I)
4-INCH DAMETER, THREADED STAINLESS STEEL
SCREEN WI0.020INCH SLOTS. 60-FT.LENGTH
( 10-70 FT- 13GS)
RECEIVED NCO( W
'JAN 042019
Water OWN
RegrOnot OpemuW % sthrTion
4-INCH DIAMETER, THREADED STAINLESS STEEL
SUMP WCAPPED BOTTOM
RALPH WILSON PLASTICS COMPANY
80 L-A- WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
MW-4
GROUNDWATER PROFILE RESULTS
JULY 2018
ARCADIS
FIGURE
4

T
H'storicaI Cross Section

di 9 t' \
`',��;�_ • �.' "+. k
1.
rl �_
Y1%`YXRk .II._
.i
4
0 (SO'
DETAIL GRAPHIC _SCALE
LEGEND
0
SHALLOW MONITOR WELL LOCATION
DEEP MONITOR WELL LOCATION
EXTRACTION WELL LOCATION
INJECTION WELL LOCATION (4/2016)
DESTROYEDIABANDONED WELL LOCATION
VERTICAL AQUIFER PROFILE LOCATION
PROPOSED INJECTION WELL LOCATION
PROPOSED VAPOR SAMPLE LOCATION
200'
4O
GRAPHIC SCALE
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
SITE LAYOUT
ARCADIS
F GU RE
1

:411
2084---
MW-1 26
(2083.12) MW-12
L----... 0
If
ti el,
a%b
.y 64.25
M W-74
076.3
(2080,10)MW1
Q
PLANT BUILDING
0.43jMw.5
8.07) Mw•3
41
ti
2077.7 • 'L4
cb
ryb
M W-6
(2095.96)
p
zr
MW-y
LEGEND
4t SHALLOW MONITOR WELL LOCATION
DEEP MONITOR WELL LOCATION
!") EXTRACTION WELL LOCATION
(I) INJECTION WELL LOCATION (4/2018)
DESTROYED/ABANDONED WELL LOCATION
■ VERTICAL AQUIFER PROFILE LOCATION
(2077.76) GROUNDWATER ELEVATION (ft N.G.V.O.)
(NM indicates Not Measured)
208a��
GROUNDWATER ELEVATION CONTOUR {ft N.G.V.D.}
INDICATES PREDOMINANT DIRECTION OF
GROUNDWATER FLOW
0
200'
400'
GRAPHIC SCALE
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
SHALLOW GROUNDWATER
ELEVATIONS
SEPTEMBER 2018
ARCADIS
FIGURE
2

aba
Depth
interval
as'
38'
46'
56'
66'
TCE
104
214
198
157
167
MW-4
9/2017
912018
TCE
189
158
1,1-DCE
1.8
1.4
Methylene Chloride
ND 1
ND
MW-4B
9/2017
1312018
TCE
0.59 J
ND
cis-1,2-DCE
ND
. ND
MW-14
9/2017
9l2018
i_TCE
35-6
24.2
1 bCA
1.8
1.0 J
1,1-DCE
14.7
9.9
Methylene Chloride
ND
ND
MW-13
912016
9I2017
Methylene Chloride
ND
ND
RWP-1
9/2017
912018
1.1",_CE
0.82 J
0.51 J
cis-1,2-DCE
0.49J
0.3J
Methylene Chloride
ND
ND
MW-7
9/2017
9/2018
cis-1,2-DCE
0.82 J
0.82 J
MTBE
0.25 J
0.56 J
EW-1
9/2017
9/2018
TCE
29.5
22,3
1.1-DCE
ND
ND
Methylene Chfofide
ND
ND
24-28' 24.7
33-36` 19.6
MW-19
9/2017-
912018
Methylene Chloride
ND
ND
MW-5
9I2017
9/2018
Benzene
ND
ND
Eth lbenzene
8.5
5.7
2-Hexanone
ND
1.7 J
p-Isapropyltoluene
ND
ND
MIBK
ND
ND
Vinyl Acetate
3.0 J
ND
AMP Xylene
4.0
2.3
o-Xylene
0.88 J
0.38 J
i
LEGEND
,8 SHALLOW MONITOR WELL LOCATION
DEEP MONITOR WELL LOCATION
EXTRACTION WELL LOCATION
NEW INJECTION WELL LOCATION (4/2018)
DESTROYED/ABANDONED WELL LOCATION
VERTICAL AQUIFER PROFILE LOCATION
PROPOSED INJECTION WELL LOCATION
PROPOSED VAPOR SAMPLE LOCATION
APPROXIMATE EXTENT OF VOCs IN
GROUNDWATER
NOTES:
1. All results in micrograms per liter (ug/L),
2. Blue results indicate North Carolina 2L exceedance.
3 "J" result qualifter Indicates laboratory estimated value.
4. "ND" indicates not detected.
JAN
201.9
wet
�tylo ti V1 7
Ck'Vrr,
1441
Sion 4'44*, P170' 400'
'GRAPHIC SCALE
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
VOLATILE ORGANIC COMPOUNDS
DETECTED IN GROUNDWATER
SEPTEMBER 2017 THROUGH SEPTEMBER 2018
ARCADIS
FIGURE
3

POTABLE WATER
9ALL
VALVE
p00STER PUMP
INJECT/MIXING IA K
500-CALLON
WTN BOOSTER PUMP FOR
MI XING/INJECTKQ.
SECONDARY CONTA4NMENT
VI1LL BE REWIRED
FOR THIS TANK
BALE
VALUE
CATE
VALVE
INJECTION SETUP:
1. (2) 1/2" GATE VALVES.
2. (1) 1` GATE VALVE
3. 1 1" BALL VALVE.
4. 1/2" 01A. TUBING t100 FT.)
GATE
VALVE
FM
b❑
CATE
VALVE
FM
LMUER QUALITY WEFFR
YsI wlnt 1G0' CORD
EE1!4.
(SCREENED
10'-701
DEEE
INJECTION
(SCRE kED
50'-70)
HJ.LLOW
RUCTION
WFIt
(SCREENED
25.-45.)
INJECTION WELL SETUP:
1. 4' OIA. SPIJT TOP WELL SEAL.
2 1/2" A1R VENT VALUE.
3. 0-15 PS! PRESSURE GAUGE.
AIR VENT
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
PROCESS FLOW DIAGRAM
ARCADIS
FIGURE
5

8
8
a
17'STEEL WELL VAULT -,
T.D.=45.0ft-
•
4" WELL SEAL
- 2' x 7 CONCRETE WELL PAD
�\f�rl�iti�i��r ff4rgy i�i
•
•
EXISTING GRADE
4-INCH DIAMETER, THREADED SCHEDULE SO PVC CASING
MINIMUM 1C-INCH DIAMETER DRILLED HOLE
5' OF FINE SAND OF CHOKER SAND
1' OF #+ SAND
CEMENT GROUT {PORTLAND TYPE I)
4 INCH DIAMETER, THREADED STAINLESS STEEL
SCREEN WIO.O20-INCH SLOTS, 20-FT,LENGTH
(2S-45 FT. BGS)
4 INCH DIAMETER, THREADED STAINLESS STEEL
SUMP W/CAPPED BOTTOM
IW-2 & IW-4 CONSTRUCTION DETAILS
12" STEEL WELL VAULT
Vems.•- ,.....-..
T-D. = 70.0 ft
r 4" WELL SEAL
r 7 x7 CONCRETE WELL PAD
E7fISTINC GRADE
4 INCH DIAMETER, THREADED SCHEDULE BD PVC CASING
MINIMUM 10-INCH DIAMETER DRILLED HOLE
---- 1' OF FINE SAND OF CHOKER SAND
7' OF4(1 SAND
CEMENT GROUT (PORTLAND TYPE 1)
4 INCH °!AMETEK, THREADED STAINLESS STEEL
SCREEN W10.020-INCH SLOTS, 20-FT-LENGTH
(50.70 FT. BGS)
44NCH DIAMETER, THREADED STAINLESS STEEL
SUMP W/CAPPED BOTTOM
IW-3 & IW-5 CONSTRUCTION DETAILS
RALPH WILSON PLASTICS COMPANY
80 L.A. WHITE DRIVE
FLETCHER, HENDERSON COUNTY, NORTH CAROLINA
TYPICAL INJECTION WELL
CONSTRUCTION DETAILS
ARCADIS
FIGURE
6

NOTE:
5193
2734
THIS FIGURE WAS COMPILED FROM MAPS OBTAINED
FROM THE HENDERSON COUNTY TAX ASSESSORS
OFFICE. MAP NO. 9663.04 AND 9663. THE LOCATIONS
ARE BASED UPON TELEPHONE INTERVIEWS, AND
DRIVE —BY WINDOW SURVEY, THERFORE, THESE
LOCATIONS ARE APPROXIMATED. A DETAILED LISTING
OF PROPERTY OWNERS AND WELL DETAILS ARE
PRESENTED IN TABLE 3-1.
•
7946
cr
•907
Ralph Wilson Plastics
Company
(Approx. Location)
9731
1470
„o
6770
2578
2466_
F571
5438
51
7325
9219
1227
-IA:.__• 1
9907
7804
4569
0329
6315r I
:Lp
3128
0779 • J
2507
0589
. 389
1341 9211
r-- 9130
—el — 9930
3235
NORTH
ri
LEGEND
PROPERTY UNE
SECONDARY ROAD
2625
•
PARCEL IDENTIFIER
(LAST FOUR DIGITS)
APPROXIMATE LOCATION
OF PRIVATE WATER WELL
SCALE
600 1200
1800
FEET
flIIfIIVPRASTRUG"fUR��
FIGURE 3-4
PRIVATE WATER WELL LOCATIONS
COMPREHENSIVE SITE ASSESSMENT
RALPH WILSON PLASTICS COMPANY
FIETCHER, NORTH CAROLINA
N:Ma1 a39\ 1 .39Ra01.DWC

IJ
LEGEND
MW —4 it SAPROLITE MONITORING WELL LOCATION
MW-9B qb BEDROCK MONITORING WELL LOCATION
6-8 CI SOIL BORING/TEMPORARY MONITORING WELL LOCATION
PWIEW-1 ED PUMPING/EXTRACTION WELL LOCATION
CROSS—SECTION LOCATION
0
100
200
400
&00
SCALE IN FEET
RUSTENVIRONMENT tic
INFRASTRUCTURE
FIGURE 4-1
LOCATIONS OF GEOLOGIC CROSS-5ECT1ONS
COMPREHENSIVE SITE ASSESSMENT
RALPH WLSON PLASTICS COMPANY
FLETCHER, NORTH CAROLINA
Nio'81639,16.39HC1ILOGN

WEST
A
2120
2100
> 2080
0
z
1 2060
z
0 2040
I —
a
w 2020
2000
NOTE! HOLLOW- STEM- AUGER REFUSAL WAS
USED FOR THE TOP )F BEDROCK AT LOCATIONS
WHERE ROCK CORING WAS NOT PERFORMED.
EAST
A'
t;LLJ
MAIN MANUFACTURING ciP
2120
[i 33 BUILDING MM 1
2100
2080
- 2060
2040
2020
2000
NORTH
2120
2100
2080
z
2060
Q 2040
2020
2000
0 100 200 400 600
HORIZONTAL SCALE IN FEET
B
b7
ma, Tr.ct
- -1
SOUTH
Br
./„,/\\ />;\ k/,,/ (,„(,.;,
.<.\\
/X/A/0,\ s<../ /-
\ \\ >
\/\/\<. /< (\/ \/
,LEGEND
I INDICATES SCREEN/OPEN HOLE PORTION
OF MONITORING WELL
SAPROLITE
r.'lg BEDROCK (PORPHYROCLASTIC MYLONITE)
9R SAPROLITE WATER TABLE CONTOUR (2/10/94)
2120
2100
2080
2060
2040
2020
2000
ENVIRONMENT INFRASTRUCTURE
FIGURE 4-2
GEOLOGIC CROSS -SECTIONS A -A' AND B-8'
COMPREHENSIVE SITE ASSESSMENT
RALPH WILSON PLASTICS COMPANY
FLETCHER, NORTH CAROLINA
T ! ►51639►1639HC MOON

LEGEND
MW`9 0 SAPROLITE MONITORING WELL LOCATION
MW—'9B if, BEDROCK MON I TOR I NG WELL LOCATION
B-8 1 SOIL BORING/TEMPORARY mONITORING WELL LOCATION
PN/E}p-1tle7 PUMP1NG/EXTRACTION WELL LOCATION
[2082.91 SAPROLITE WATER TABLE ELEVATION (FT. MSL.)
2096
SAPROLITE WATER TABLE CONTOURS (FT. I L.)
(DASHED WHERE INFERRED)
GROUNDWATER FLOW DIRECTION
I = HYDRAULIC GRADIENT (FT/FT)
NOTE:
WATER LEVELS USED TO CONSTRUCT THIS MAP WERE COLLECTED
ON FEBRUARY 10. 1994.
0
100
'00
400
600
SCALE. IN FLET
RusTENVIRONMENT &
INFRASTRUCTURE
FIGURE 4-3
SAPROLITE AQUIFER WATER TABLE MAP
COMPREHENSIVE SITE ASSESSMENT
RALPH WILSON PLASTICS COMPANY
FLETCHER, NORTH CAROLINA
m/E16391163914CO6.DGN

LEGEND
MW-9 Q SAPROLITE MONITORING WELL LOCATION
MW-9B lit BEDROCK MONITORING WELL LOCATION
B-8 3 SOIL BORING/TE PORARY MONITORING WELL LOCATION
PW/EW-1 -
6) PtJIiFING/ExTRACT ION WELL LOCATION
[2082.671 BEDROCK WATER TABLE ELEVATION IFT. MSL.J
2083-
BEDROCK WATER TABLE CONTOURS t FT. MSL.
(DASHED WHERE INFERRED)
GROUNDWATER FLOW DIRECTION
1 = HYDRAULIC GRADIENT (FT/FT).
NOTE:
WATER LEVELS USED TO CONSTRUCT THIS MAP WERE COLLECTED
ON FEBRUARY 10. 1994.
0
100
200
400
600
SCALE IN FEET
RuffENVIRONMENT tic
INFRASTRUCTURE
FIGURE 4-4
BEDROCK AQUIFER POTENTIOMETRIC MAP
COMPREHENSIVE SITE ASSESSMENT
RALPH WILSON PLASTICS COMPANY
FLETCHER. NORTH CAROLINA
tNt181639/1639H007.DGM