WI0100616_Permit (Issuance)_20210421

NC Department of Environmental Quality — Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) 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 (NOTE: This form must be received at least 14 DAYS prior to injection)
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 Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small -Scale Injection Operations — 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 is 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.
5) In -Situ Thermal Wells (IST) — Used to `heat' contaminated groundwater to enhance remediation.
Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete.
DATE: 3-26
, 2021
PERMIT NO. W10100616 (to be filled in by DWR)
NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
A.
B.
Permit No. WI
Issued Date:
WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well Complete sections B through F, J, M
(2) Aquifer Test Well Complete sections B through F, J, M
(3) Passive Injection System .. Complete sections B through F, H-M
(4) X Small -Scale Injection Operation Complete sections B through M
(5) Pilot Test Complete sections B through M
(6) Tracer Injection Well Complete sections B through M
(7) In -Situ Thermal (IST) Well Complete sections B through M
STATUS OF WELL OWNER: Single Family Residence
Deemed Permitted GW Remediation NOI Rev. 2-17-2020
Page 1

C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): Sarah Clement
Mailing Address: 149 Eliada Home Road
City: Asheville State: NC Zip Code: 28806 County: Buncombe
Day Tele No.: 678-451-7753 Cell No.: 678-451-7753
EMAIL Address: [e-mail] Fax No.:
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: Same -Sarah Clement
Company Name
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
Name and Title: Thomas Gladden Jr.
Company Name Shield Engineering, Inc.
Mailing Address: 4301 Taggart Creek Road
City: Charlotte State: NC_ Zip Code: 28208 County: Meckelnburg
Day Tele No.: 704-394-6913 Cell No.:
EMAIL Address: [e-mail] Fax No.: 704-394-6968
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: 149 Eliada Home
City: Asheville County: Buncombe Zip Code: 28806
(2) Geographic Coordinates: Latitude**: 35.602334°
Longitude**: -82.607378°
Reference Google Earth Accuracy: Uncertain
Method of Collection: Internet
**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: 6,118 square feet
Land surface area of inj. well network: 3474 square feet (< 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: 57% (must be < 5% of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 2

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; See Figure 4 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. See Figure 5
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells. See Figure 3
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE — Provide a brief narrative
regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity:
The cause of contamination was a leaking 270-gallon underground storage tank (UST) containing
heating oil found under the crawlspace of the residence shortly after the current owner Sarah
Clement bought the residence. See Figure 1 and 2. The scope of the proposed injection activity
is below:
The horizontal portion where the injection will occur is an approximate 50 foot radius
encompassing monitoring wells MW-1, -3, -7, -8 and remediation wells RW-1 and -2 which are
the impacted wells closest to the main source of contamination. See the attached figures.
Mobile multi -phase extraction events (MMPEs) are planned a short time after each injection event
to move and remove the injectant and the freed up or remediated petroleum hydrocarbons.
The purpose and goals are to remediate the soil and groundwater contamination so that the
receptors such as the house and the nearby surface water are not impacted.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 6 Existing (provide NC Well
Construction Record (GW-1) for each well) See Appendix 1
(3) Appx. injection depths (BLS):_
(3)
Vertically the injection will occur in the screened portion of the wells from approximately 2-
5 feet BLS to 10-20 feet BLS depending on the well.
For Proposed wells or Existing wells not having GW-ls, 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 (indicate if construction is proposed or as -built): See Appendix 1.
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3

K. INJECTION SUMMARY
NOTE: Only injectants approved by the epidemiology section of the NC Division of Public Health, Department
of Health and Human Services can be injected. Approved injectants can be found online at
http://deq.nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Program for more info if you wish to get approval for a different additive. However, please
note it may take 3 months or longer. If no injectants are to be used use N/A.
Injectant:Ivey-Sol 103 Total Amt. to be injected (gal)/event:25
Injectant:Ivey-Sol 106 Total Amt. to be injected (gal)/event:25
Injectant:Micro-Bac 1000H Total Amt. to be injected (gal)/event:130
Injectant:Micro-Bac Tri-Phasic Total Amt. to be injected (gal)/event:10
Total Amt. to be injected (gal/event): Ivey -Sol = 50, Micro-Bac = 140
No. of separate injection events:6 Total Amt. to be injected (gal): 1,140
Source of Water (if applicable): Pre -Diluted
L. 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.
Annual sampling following the injection and MMPEs will analyze for Massachusetts Department
of Environmental Protection (MADEP) Extractable Petroleum Hydrocarbons, MADEP Volatile
Petroleum Hydrocarbons, Semi -Volatile Organic Compounds, and Volatile Organic Compounds.
The annual sampling will include the abovementioned wells and downgradient monitoring wells
MW-4, -5, and -6, which are already impacted but to a lesser extent.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well 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 for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Signature of Applicant Print or Type Full Name and Title
Property Owner (if the property is not owned by the Well Owner/Applicant):
"As owner of the property on which the injection well(s) 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 well(s) conform to the Well Construction Standards
(15A NCAC 02C .0200)."
Deemed Permitted GW Remediation NOI Rev. 2-17-2020
Page 4

"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
absence of contrary agreement in writing.
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two (2) weeks prior to injection to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 5

FIGURES

ELIADA HOME ROAD, ASHEVILLE, NC\FIGURES\SITE LOCATION MAP.DWG
\\RDS\COMPANY\PROJECTS\2020\4200210-01 NATIONWIDE,
2300
Deaver View
DEAVERVIEW'RD
Sulphur
k4RD-RD
Wilshire, Park
Fore Cem-
0
EMMA.RD
Violet
Hill Cem
0 I
HAZE<
Green
HillsCem
GRAPHIC SCALE
0 1,000' 2,000'
SCALE: 1 in. = 2,000 ft.
SOURCE: NATIONAL GEOGRAPHIC USGSTOPO, 7.5 MINUTE MAP
SERIES, ASHEVILLE QUADRANGLE, NORTH CAROLINA.
Hazel -Green
SO,
MONTANA AVE
SHIELD
ENGINEERING, INC.
-Riverside Cem
Smith
Bride
SONG
4301 TAGGART CREEK ROAD
CHARLOTTE, NC 28208
704-394-6913
704-394-6968 fax
www.shieldengineering.com
SITE LOCATION MAP
149 ELIADA HOME ROAD
NATIONWIDE
ASHEVILLE, BUNCOMBE COUNTY, NORTH CAROLINA
SHIELD #4200210-01
DATE : 08/19/20 DRAWN BY : KJC
SCALE : AS SHOWN FIGURE : 1

0
z
NC\FIGURES\42
E ROAD, ASHEV
RING\PROJE
DETACHED
GARAGE
APPROX. LOCATION
OF FORMER FUEL OIL
LEGEND:
PROPERTY LINE
FORMER MOBILE HOME
(REMOVED -CONCRETE
PAD REMAINS)
MW-8
MW-4
® RW-2
MW-3
®MW-7
ELIADA HOME ROAD
MONITORING WELL (MW) LOCATION / SURFACE WATER SAMPLE LOCATION (SW) /
® RECOVERY WELL (RW) LOCATION
NOTES:
1- SITE MAP BASED ON MAP FROM APEX CO REPORT DATED 5/29/20, FIGURE 1.
2- ALL LOCATIONS ARE APPROXIMATE.
®MW-6
MW-5®
1 SW-2
/ SW-1
APPROX. AREA OF OBSERVED
FUEL IMPACTS IN STREAM AND
SEDIMENTS
STREAM____________
PROPERTY LIN,
GRAPHIC SCALE
0 10 20 30
SCALE: 1 in. = 30 ft.
SHIELD
ENGINEERING, INC.
4301 TAGGART CREEK ROAD
CHARLOTTE, NC 28208
704-394-6913
704-394-6968 fax
www.shieldengineering.com
SITE MAP
149 ELIADA HOME ROAD
NATIONWIDE
ASHEVILLE, BUNCOME COUNTY, NORTH CAROLINA
SHIELD # 4200210-01
SCALE : AS SHOWN I FIGURE :
DATE : 11 /11 /20 DRAWN BY : KJC
2

0
z
NC\FIGURES\42
E ROAD, ASHEV
RING\PROJE
APPROX. LOCATION
OF FORME1 FUEL OIL UST
LEGEND:
PROPERTY LINE
FORMER MOBILE HOME
(REMOVED -CONCRETE
PAD REMAINS)
MW-8
RW-1 (84.09)
d, (88.38) 86 86 8S 8v
s ���� MW-1 •� •� ��♦♦ •♦ •♦ MW-4
9��; • ry (88.69) ♦% ®RW-2 ♦� ! A (80.84)
MW-2®1♦ N.♦ \ HO`ISE 1 ,(85.62)�
(93.06),1 / , / • • ♦ ♦♦
L a / I I 1 1 / �# ♦♦•
aN / / / / ,• ♦ ♦
MW-3
co ��/ �i •
/ / (84.78) ♦♦♦ `%
N
MW-6 ®♦
/ (84.46) ,/ %
WMW-7 ... 00
(85.01) t‘'i
MW-5®
ELIADA HOME ROAD j
MONITORING WELL (MW) LOCATION / WATER SAMPLE LOCATION (SW) - S-
(ft) FEET
(88.69) GROUNDWATER ELEVATION (ft)
INFERRED GROUNDWATER ELEVATION CONTOUR LINE (ft)
GENERALIZED GROUNDWATER FLOW DIRECTION
NOTES:
1. SITE MAP BASED ON MAP FROM APEX CO REPORT DATED 5/29/20, FIGURE 1.
2. GROUNDWATER CONTOURS AND INFERRED FLOW BASED ON ELEVATION
MEASUREMENTS COLLECTED ON 11/5/20.
3. GROUNDWATER ELEVATION CONTOUR INTERVAL = 1 FOOT, BASED ON RELATIVE
ELEVATIONS.
4. ALL LOCATIONS ARE APPROXIMATE.
APPROX. AREA OF OBSERVED
FUEL IMPACTS IN STREAM AND
SEDIMENTS
GRAPHIC SCALE
0 10 20 30
SCALE: 1 in. = 30 ft.
SHIELD
ENGINEERING, INC.
4301 TAGGART CREEK ROAD
CHARLOTTE, NC 28208
704-394-6913
704-394-6968 fax
www.shieldengineering.com
GROUNDWATER ELEVATION CONTOUR MAP
149 ELIADA HOME ROAD
NATIONWIDE
ASHEVILLE, BUNCOME COUNTY, NORTH CAROLINA
SHIELD # 4200210-01
SCALE : AS SHOWN I FIGURE : 3
DATE : 11 /24/20 DRAWN BY : KJC

L7
IONS+MMPE\FIGUR
HOME RD- INJ
J
w
0
RING\PROJE
0
w
ce
RW-1
CONSTITUENT
ug/L
Benzene
ND
Naphthalene
4.0/ND
1,2,4-Trimethylbenzene
5.1
Xylene
2.29
Aliphatic (C09-C18)
128
Aromatic (C11-C22)
187
Aliphatic (C05-008)
ND
Aliphatic (C09-C12)
ND
Aromatic (C09-C10)
ND
MW-1
Free Product
0.3 ft
CONSTITUENT
ug/L
Benzene
NA
Naphthalene
NA
1,2,4-Trimethylbenzen
NA
Xylene
NA
Aliphatic (C09-C18)
NA
Aromatic (C11-C22)
NA
Aliphatic (C05-008)
NA
Aliphatic (C09-C12)
NA
OX.
DRME
MW-2
CONSTITUENT
ug/L
Benzene
ND
Naphthalene
ND
1,2,4-Trimethylbenzene
ND
Xylene
ND
Aliphatic (C09-C18)
ND
Aromatic (C11-C22)
ND
Aliphatic (C05-008)
ND
Aliphatic (C09-C12)
ND
Aromatic (C09-C10)
ND
LEGEND:
Aromatic (C09-C10)
DETACHED
GARAGE
OCATION
FUEL OIL
CONSTITUENT
Benzene 1 ND
Naphthalene
162/6.2
1,2,4-Trimethylbenzene
Xylene
Aliphatic (C09-C18)
Aromatic (C11-C22)
Aliphatic (C05-008)
Aliphatic (C09-C12)
Aromatic (C09-C10)
(ug/L)
ND
NS
NA
A
25.1
17.4
269
ND
242
246
NA
MW-8
CONSTITUENT
ug/L
Benzene
41.5
Naphthalene 232
/ 109
1,2,4-Trimethylbenzene
489
Xylene
754
Aliphatic (C09-C18)
ND
Aromatic (C11-C22)
681
Aliphatic (C05-008)
607
Aliphatic (C09-C12)
1,400
Aromatic (C09-C10)
1,700
CARPORT
A'
MW-1
HOUSE
Free Product
RW-2
MW-3
0.01 ft
CONSTITUENT ug/L
Benzene
Naphthalene
1,2,4-Trimethylbenzene
Xylene
Aliphatic (C09-C18)
Aromatic (C11-C22)
Aliphatic (C05-008)
Aliphatic (C09-C12)
NA
NA
NA
Aromatic (C09-C10) NA
MONITORING WELL (MW) LOCATION / SURFACE WATER SAMPLE LOCATION (SW)
MICROGRAMS PER LITER
NOT DETECTED AT OR ABOVE THE LABORATORY METHOD DE FEETl&t1 IMIT
NOT SAMPLED ON 11 /5/2020
NOT ANALYZED ON 11 /5/2020
APPROXIMATE EXTENT OF GROUNDWATER CONTAMINATION EXCEEDING THE 15A NCAC 2L
GROUNDWATER STANDARDS
A INDICATES LINE OF CROSS SECTION VIEW
NOTES:
1. SITE MAP BASED ON MAP FROM APEX CO REPORT DATED 5/29/20, FIGURE 1.
2. GROUNDWATER SAMPLES COLLECTED ON 11 /5/20.
3. BOLDED VALUES EXCEED THE NC 2L STANDARDS.
4. ALL LOCATIONS ARE APPROXIMATE.
MW-6
RW-2
Free Product
0.3 ft
CONSTITUENT
ug/L
Benzene
NA
Naphthalene
NA
1,2,4-Trimethylbenzene
NA
Xylene
NA
Aliphatic (C09-C18)
NA
Aromatic (C11-C22)
NA
Aliphatic (C05-008)
NA
Aliphatic (C09-C12)
NA
Aromatic (C09-C10)
NA
MW- 5
1
SW-2
SW-1
SW-1
CONSTITUENT
ug/L
Benzene
NS
Naphthalene
NS
1,2,4-Trimethylbenzene
NS
Xylene
NS
Aliphatic (C09-C18)
NS
Aromatic (C11-C22)
NS
Aliphatic (C05-008)
NS
Aliphatic (C09-C12)
NS
Aromatic (C09-C10)
NS
MW-4
CONSTITUENT
ug/L
Benzene
3.4
Naphthalene
15.6/ND
1,2,4-Trimethylbenzene
15.8
Xylene
10.3
Aliphatic (C09-C18)
113,000
Aromatic (C11-C22)
19,900
Aliphatic (C05-008)
ND
Aliphatic (C09-C12)
1,120
Aromatic (C09-C10)
827
APPROX. AREA • _ ' D
FUEL I ?.o.-- STREAM AND
MW-6
Free Product
0.3 ft
CONSTITUENT
ug/L
Benzene
NA
Naphthalene
NA
1,2,4-Trimethylbenzene
NA
Xylene
NA
Aliphatic (C09-C18)
NA
Aromatic (C11-C22)
NA
Aliphatic (C05-008)
NA
Aliphatic (C09-C12)
NA
Aromatic (C09-C10)
NA
STREAM____
SW-2
CONSTITUENT
ug/L
Benzene
NS
Naphthalene
NS
1,2,4-Trimethylbenzene
NS
Xylene
NS
Aliphatic (C09-C18)
NS
Aromatic (C11-C22)
NS
Aliphatic (C05-008)
NS
Aliphatic (C09-C12)
NS
Aromatic (C09-C10)
NS
\�
MW-5
CONSTITUENT
ug/L
Benzene
ND
Naphthalene
2.2 / ND
1,2,4-Trimethylbenzene
0.96
Xylene
ND
Aliphatic (C09-C18)
350
Aromatic (C11-C22)
174
Aliphatic (C05-008)
ND
Aliphatic (C09-C12)
401
Aromatic (C09-C10)
226
GRAPHIC SCALE
0 10 20 30
SCALE: 1 in. = 30 ft.
SHIELD
ENGINEERING, INC.
4301 TAGGART CREEK ROAD
CHARLOTTE, NC 28208
704-394-6913
704-394-6968 fax
www.shieldengineeringvm
GROUNDWATER AND SURFACE WATER COC MAF
149 ELIADA HOME ROAD
NATIONWIDE
ASHEVILLE, BUNCOME COUNTY, NORTH CAROLINA
SHIELD # 4200210-01
DATE : 03/26/21 DRAWN BY : KJC
SCALE : AS SHOWN FIGURE : 4

C:\USERS\KCLARK\SHIELD ENGINEERING\PROJECTS - 4200210-05 NATIONWIDE - 149 ELIADA HOME RD- INJECTIONS+MMPE\FIGURES\4200210-01 NOV 2020.DWG
95
90
85
80
75
70
LEGEND
CLAYEY SILT
SANDY SILT
2OCK SEAM
SILTY SAND W/ROCK FRAGMENTS
MICACEOUS SILT
MICACEOUS Tl`
SAND
CLAY W/ROCK
/jAD/Y/si / j////
\ \ \\\\ \\
SILTY SAND I /
\\ \ C E \ \
GROUNDWATER ELEVATION YIL \\\\
EASURED 11/5/20) _ /
SILTY SAND
ROCK SEAM
MICACEOUS SILTY SANfl
10 15 20 25 30 35 40 45 50 55
CROSS-SECTION A A'
MW-7
B-4
RW-2
MONITORING WELL
SOIL BORING
RECOVERY WELL
APPROXIMATE EXTENT OF FREE PRODUCT HEATING OIL
APPROXIMATE HORIZONTAL AND VERTICAL EXTENT OF SOIL AND GROUNDWATER CONTAMINATION
EXCEEDING NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY ACTION LEVELS
VERTICAL SCALE
HORIZONTAL SCALE
0
I I
5
/ -
SILTY SAND
60 65 70
4301 TAGGART CREEK ROAD
CHARLOTTE, NC 28208
704-394-6913
704-394-6968 fax
www.shieldeng Ineenng.com
CROSS-SECTION A -A'
149 ELIADA HOME ROAD
NATIONWIDE
ASHEVILLE, BUNCOME COUNTY, NORTH CAROLINA
SHIELD # 4200210-05
DATE : 03/26/21 DRAWN BY : KJC
SCALE : AS SHOWN FIGURE : 5
SHIELD
ENGINEERING, INC.