WI0300303_DEEMED FILES_20150910

Permit Number WI0300303
Program Category
Deemed Ground Water
Permit Type
Injection Deemed Air Well
Primary Reviewer
michael.rogers
Coastal SWRule
Permitted Flow
Facility
Facility Name
Fast Fare #3993
Location Address
7020 Lawyers Rd
Charlotte
Owner
Owner Name
Mark Oil Company
Dates/Events
NC
Orig Issue
8/31/2015
App Received
8/27/2015
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
28227
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
9/10/2015
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Bill Tome
PO Box 32064
Charlotte
Region
Mooresville
County
Mecklenburg
NC 28232
Issue
8/31/2015
Effective
8/31/2015
Expiration
Req uested /Received Events
Streamlndex Number Current Class Subbasln
Rogers, Michael
From:
Sent:
To:
Cc:
Subject:
Rogers, Michael
Monday, August 31, 2015 4:43 PM
'David Loftis'
Pitner, Andrew; Watson, Edward M; '[e-mail]'
NOi WI0300303 RE: Fast Fare #3993, Incident No. 16124 -Notice of Intent to Construct
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOi) for the Fast Fare
#3993 located at 7020 Lawyers Road, Charlotte, Mecklenburg County, NC 28227. The Central Office of the WQROS
received your complete NOi electronically on August 27, 2015.
Please note the following:
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/wg/aps/gwpro/reporting-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.).
Also, Please let me know a few days in advance of the injection as I may want to come out and observe.
You can scan and send these forms directly to me at michael.rogers @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 WI0300303. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in re p ly to this email, as it will already have the
assigned deemed permit number in the subject line.
Thank you for your cooperation
From: David Loftis mailto:Dloftis a:smeinc.com]
Sent: Thursday, August 27, 2015 3:59 PM
To: Rogers, Michael
Subject: Fast Fare #3993, Incident No. 16124 -Notice of Intent to Construct
Good afternoon Michael,
Please find the attached Notice of Intent to Construct an air sparge well at the referenced site for the purposes of
conducting a pilot test for groundwater remediation. A paper copy was also mailed out to you today.
Please contact me with any questions:
Best regards,
1
David R. Loftis, P .E.
Senior Engineer
♦S&ME
S&ME, Inc.
44 Buck Shoals Road, Unit C-3
Arden, NC 28704 lia
Ph: 828-687-9080 (office)
828-483-3012 (direct office)
Fax: [phone]
Mobile: [phone]
[e-mail]
www.smeinc.com
This electronic message is subject to the terms of use set forth at www.smeinc.com/email. If you received this message in error please advise the
sender by reply and delete this electronic message and any attachments. Please consider the environment before printing this email
2
Rovers, Michael
From: Rogers, Michael
Sent Monday, August 31, 2015 4'38 PM
To: Pitner, Andrew; Watson, Edward M
Subject: NOI WI0300303 FW: Fast Fare #3993, Incident No. 16124 - Notice of Intent to Construct
Attachments: Fast Fare #3993 NOI (August 27, 2015).pdf
Please find attached a NOI.
From: David Loftis tmailto_DLoftis.usmeinc.com]
Sent: Thursday, August 27, 2015 3:59 PM
To: Rogers, Michael
Subject: Fast Fare #3993, Incident No. 16124 - Notice of Intent to Construct
Good afternoon Michael,
Please find the attached Notice of Intent to Construct an air sparge well at the referenced site for the purposes of
conducting a pilot test for groundwater remediation. A paper copy was also mailed out to you today.
Please contact me with any questions.
Best regards,
David R. Loftis, P.E.
Senior Engineer
S&ME
S&ME, Inc.
44 Buck Shoals Road unit C-3
Arden, NC 28704
Ph: 828-687-908a (office)
828-483-3012 (direct office)
Fax: [phone]
Mobile: [phone]
dloftis smeinc.cnm
www.smeinc.com
This electronic message is subject to the terms of use set forth at www.smeinc.comlemail. If you received this message in error please advise the
sender by reply and delete this electronic message and any attachments. Please consider the environment before printing this email
1

Rogers, Michael
From: David Loftis <[e-mail]>
Sent: Thursday, August 27, 2015 3:59 PM
To: Rogers, Michael
Subject: Fast Fare #3993, Incident No. 16124 - Notice of Intent to Construct
Attachments: Fast Fare #3993 NO (August 27, 2015).pdf
Good afternoon Michael,
Please find the attached Notice of Intent to Construct an air sparge well at the referenced site for the purposes of
conducting a pilot test for groundwater rernediation. A paper copy was also mailed out to you today.
Please contact me with any questions.
Best regards,
David R. Loftis, P.E.
Senior Engineer
*SLIME
S&ME, Inc.
44 Buck Shoals Road. Unit C-3
Arden, NC 28704 E;""•')
Ph 828-687-9080 4otfrce)
828-483-3012 (direct office)
Fax [phone]
Mobile: [phone]
d loftisCe sm a inc.corrn
www.smeinc.com
This electronic message is subject to the terrnS of use set forth at www_smeinc_comfernail. If you received this message in error please advise the
sender by reply and delete this electronic message and any attachments. Please consider the environment before printing this email

S&ME
August 27, 2015
NCDENR
DWQ — Aquifer Protection Service
1636 Mail Service Center
Raleigh, North Carolina 27699-1536
Attention: Mr. Michael Rogers
QFr;E!1/E.r /OENR/DV/1-
CEP - I L01
Water quality lianlonr.,
Reference: Notice of Intent to Construct or Operate Injection Wells
Air Injection Well
Fast Fare #3993, UST Incident # 16124
7020 Lawyers Road, Charlotte, Mecklenburg County, NC
5&ME Project No. 4335-15-160
Dear Mr. Rogers;
S&ME, Inc. (S&MEJ, on behalf of Mark Oil Company, submits the attached Notice of Intent to Construct
and/or Operate Injection Wells to the NCDENR, Division of Water Quality, Aquifer Protection Section. The
risk classification of the referenced UST Incident is Intermediate based on the groundwater quality and the
proximity of nearby water supply wells.
5&ME plans to install one air sparge test well (AS-1) to a depth of 60 feet below land surface for the
purposes of preparing a Corrective Action Plan. The well will be constructed with approximately four feet
of slotted screen and sufficient riser casing to bring the well to approximately ground surface.
If you have any questions concerning this Notice of Intent, feel free to contact us at 828-687-9080.
Sincerely,
S&ME, Inc.
Scott Younr9 f
Project Professional
0,41 C20k-
David Loftis, P.E,
Senior Engineer
MSY/DRL TN...VFast Fare 3993-DWQ APS Cover Letter August 2015.docx
Attachments:
Notice of Intent to Construct or Operate Injection Wells
Figure 1: Topographic Location Map
Figure 2: Proposed Well Location Map
S&ME, Inc. i 9751 Southern Pine Boulevard Charlotte, NC 28273 I p 704.523.4726 I f 704.525.3953 I www.smeinc.com

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 he submitted at least 2 weeks prior to injection.
AQUIFER TEST WELLS (ISA NCAC 02C .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (1 5A NCAC 02C .0225 ) or TRACER WELLS O5A NCAC 02c .0229 ):
1) 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 In jection 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-,e"RI et rned As Incomplete.
r"<t t:. V DIDENRIDWR
DATE: August27 , 2015_ PERMIT NO. w f OJdQ J u} (tooefilledinbyDWR)
V f -1 2015
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED Water Quality Region;::il
0 on ron
(1) X Air Injection Well ...................................... Complete sections B-F, K, N
(2)
(3)
(4)
(5)
(6)
-----'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
___ Tracer Injection Well ................................... Complete sections B-N
B. STATUS OF WELL OWNER: Federal Government
C. WELL OWNER -State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: ---=M=a=r=k-"O=i.:...l C=om=pan=y'--'(""B=il=l-=T'-"o=m=e=) ____________________ _
Mailing Address: ------=P-"O'--'B=o=xc:.=32=0~6::....:4'---______________________ _
City: Charlotte State: NC Zip Code: =28=2=3=2'--__ County: Mecklenburg
Day Tele No.: 704-375-4249 Cell No.: __________ _
EMAIL Address: billtome@markoilcom pany.com Fax No.: __________ _
UIC/Jn Situ Remed. Notification (Revised 11/19/2013) Page I
D. PROPERTY OWNER (if different than well owner)
Name: Grou p Four Investment, Co. c/o Mr. George J. Couchell
Mailing Address: --~1~3~17~A~lfi~re~d~S=t~re~e~t ______________________ _
City: Charlotte State: NC Zip Code: 28211 County: Mecklenburg
Day Tele No.: 704-364-7691 Cell No.: 704-562-1824
EMAIL Address:. ______________ _ Fax No.: __________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: David Loftis
Mailing Address: ___ 44---=B~u~ck~S=h~oal~s ~R=o=ad~S~u=it=e~C~-~3 _________________ _
City: Arden State: NC Zip Code:_2~87~0~4 ____ County: Buncombe
Day Tele No.: 828-687-9080 Cell No.: __________ _
EMAIL Address: dloftis@ smeinc.com Fax No.: ----"8=28"---=68=7._-8-=0=0-=-3 ___ _
F. PHYSICAL LOCATION OF WELL SITE
(1)
(2)
Physical Address: ___ 7~0~2~0~L=a~wy-'---~e=rs~R~o=a=d~------------------
_______________________ County: Mecklenburg
City: Charlotte State: NC Zip Code: ---=2~82_2~7 ______ _
Geographic Coordinates: Latitude**: ___ 0 __ __" or ~0 ._20_1_2~0_2 ____ _
Longitude**: ___ 0 ____ " or ~0 • .,_72=3"-'5=-=2=-=8'-------
Reference Datum: Former USTs Accuracy: _______ _
Method of Collection:_G~o~o'""g-le~E=arth~-------------
**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
Land surface area of inj. well network: square feet (:s 10,000 ft2 for small-scale injections)
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.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells, and existing and proposed injection wells.
UIC/In Situ Remed. Notification (Revised 11/19/2013) Page2
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 injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.orz!weblwqlaps/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 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: ___________________ _
Injectant: --------------------------------
Volume ofinjectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percel)t if in a mixture with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: --~l __ ~Proposed _____ __:Existing
(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:
(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
Grout Screen Casing
Well ID Type Driller#
(ft-bis) (ft-bis) (ft-bis)
AS-1 Permanent 2" Sch 40 PVC 0 -52 56-60 0 -60 TBD
UIC/ln S it u Remed . Notification (Revised 11/19/2013) Page3
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities,
NI. MONITORING PLAIT — 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 #faro the injection activity.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "1' hereby certify, under penalty of law, that I am familiar with the infnmrattnn 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 infonnation is true, accurate and complete. I aril
aware that there are sigrnfrcant penalties, including the passibility offrnes and intprisormte g for submitting
false information. 1 agree to construct, operate. maintain, repair, and if applicable, abandon the injection well
and pll fated gppurtenances in accordance with the 15A NCAC 02C 0200 Rules."
�-t
Signature of Appticani Print or Type Fall Name
rROPJRTY OWNER (if the property is not ows ed by the permit applicant):
"As owner of the property on which the arxjecrian wefl(s) are to be constructed and operated I hereby consent
to allow the applicant to construct each bgection well as outlined in this application and agree that it shall be
the responsibility of the applicant w ensr►re that the injection well(s) conform to the Weil Construction
Standards (I SA NCAC Q 2r . 0200). "
"Owner" means any person. who holds the fee er other property rights in the well being constructed. A
well is real property and its construction on. land shall be deemed to vest ownership in the land owner, in
the absence of contrary agreement in writing.
Signature* of Property Owner (if different .from applicant) Print or Tope Pell Nxmc
access agreement between the applicant and property owner may be submitted in lieu fa signature on this form.
Submit one copy of the completed notification paclmge to:
DWR— U[C Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
UIGfn Situ Remed. Natiition (Revised 11/19/2013) Page 4
L'd

Fast Fare #3993, Inc. # 16124
7020 Lawyers Road
Charintte. Mecklenbura County. NC

SITE
PARKING LOT
@MW-SR SVE-1
MW-6 AS-1 DAM
LEGEND
4, EXISTING MONITORING WELL (TYPE 11)
PROPOSED AIR SPARGE/SOIL VAPOR EXTRACTION WELL (TYPE II)
® DEEP WELL (TYPE III)
g PROPOSED DEEP WELL (TYPE III)
MW-2R
® MW-2
MW-9
GRAPHIC SCALE
40 4 20 40 BO
{INFEST)
SCALE:
AS SHOWN
CHECKED BY:
DRL
DRAWN BY:
MSY
Dart=: 08-18-2015
SIIIIIIE
PROPOSED WELL LOCATION MAP
FAST FARE 43993
7020 Lawyers Road
CHARLOTTE, NORTH CAROLINA
FIGURE NO.
ENGINEERING TESTING
ENVIRONMENTAL SERVICES
JOB NO:
4335-15-160