WI0300372_DEEMED FILES_20180223

Ro g ers, Michael
From: Rogers, Michael
Sent: Friday, February 23, 2018 4:25 PM
To:
Cc:
Shrestha, Shristi R; '[e-mail]'; [e-mail]'
Pitner, Andrew; Watson, Edward M
Subject: WI0300372-RE: [External] Injection NOi -Fields Exxon, NCDEQ Incident No. 36303
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NO I) 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 (ori ginals 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 ://de q.nc.gov/about/ divisions /water-resources /water-resources-permits /wastewater-branch /ground-
water-protection/ground-water-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 these forms directly to [e-mail] 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., WIOXXXXXX) that has been assigned to the injection activity at this site. This notification has been given the
deemed permit number WI0300372. 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 ply to this email, as it will already have the assigned deemed permit
number in the subject line.
Thank you for your cooperation.
From: Shrestha, Shristi R
Sent: Friday, February 23, 2018 2:40 PM
To: Rogers, Michael <[e-mail]>
Subject: FW: [External] Injection NOi -Fields Exxon, NCDEQ Incident No. 36303
From: Frans Lowman [ mailto:Frans.Lowman @atcassociates.com]
Sent: Tuesday, February 13, 2018 4:4 7 PM
To: Shrestha, Shristi R <[e-mail]>
Cc: Jacob Lane <jacob.lane @atcassociates.com>
Subject: [External] Injection NOi -Fields Exxon, NCDEQ Incident No. 36303
~WLll~.a External email. Do not dick links or open .a~m~_11ts unless verified, S~nd aii. suspftj9us email as an attachment to1
1
Dear Shristi,
Attached please find a completed Notice of Intent form for the placement of oxygen releasing socks in select wells
at the subject site. Don't hesitate to contact me with any questions.
Thanks
Frans
Frans Lowman, P.G. I SENIOR GEOLOGIST I ATC Group Services LLC
[phone] I [phone] mobile I [phone] fax
/\TC
7606 Whitehall Executive Center Drive, Suite 800 I Charlotte, NC 28273
frans.lowman @atcassociates.com I www.atcq rou pservi ces .co m
This email and its attachments may contain confidential and/or privileged information for the sole use of the intended recipient(s). If you -e
not the intended recipient, any use, distribution or copying of the information contained in this email and its attachments is strictly prohibited.
If you have received this email in error, please notify the sender by replying to this message and immediately delete and destroy any copies
t this .I'· 11 and 1 ~ Jtt.:,cl .n~ 0 11r<; The views or opinions exnressed c1re the c111thor's own c1ncl mav not rPflect the views or opinions of ATC.
2
Rogers, Michael
From: Rogers, Michael
Sent: Friday, February 23, 2018 4.26 PM
To: Pitner, Andrew; Watson, Edward M
Subject: FW: [External] Injection NOI - Fields Exxon, NCDEQ Incident No. 36303
Attachments: MO-7626_36303_P_UIC_20180213.pdf
FYI.
From: Shrestha, Shristi R
Sent: Friday, February 23, 2018 2:40 PM
To: Rogers, Michael <[e-mail]>
Subject: FW: [External] Injection NOI - Fields Exxon, NCDEQ Incident No. 36303
From: Frans Lowman [mailto:[e-mail]]
Sent: Tuesday, February 13, 2018 4:47 PM
To: Shrestha, Shristi R [e-mail]>
Cc: Jacob Lane rjacob.lane@atcassociates,com>
Subject: [External] Injection NOI - Fields Exxon, NCDEQ Incident No. 36303
Extvrnai email. Do natciirk links or open attachments unless verified. Send all suspicious email as an attachment to,
iigIKELSMAIM
Dear Shristi,
Attached please find a completed Notice of Intent form for the placement of oxygen releasing socks in select wells
at the subject site. Don't hesitate to contact me with any questions.
Thanks
Frans
Frans Lowman, P.G. I SENIOR GEOLOGIST I ATC Group Services LLC
[phone] [phone] mobile I [phone] fax
ATC
7606 Whitehall Executive Center Drive, Suite 800 I Charlotte, NC 28273
frans,[e-mail] I www.atcgroupservices.com
This email and its attachments may contain confidential and/or privileged information for the sole use of the intended recipient(s). If you are
not the intended recipient, any use, distribution or copying of the information contained in this email and its attachments is strictly prohibited.
If you have received this email In error, please notify the sender by replying to this message and immediately delete and destroy any copies
of this email and any attachments. The views or opinions expressed are the author's awn and may not reflect the views or opinions of ATC.
1

North Carolina Department of Environmental Quality-Division of Water Resources
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. This fo rm shall be submitted at least 2 WEEKS prior to in iection.
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 O5A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229):
1) Passive Injection S , stems -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 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.
. '7 . "? '"2-RECEIVEDINCOEOJDWD , ~
DATE: February 13, 2018_ PERMIT NO. l,u,J;;:-Q J Q2 ..}-r;l.(to be filled m oyt:1-wK)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
FEB 14 2018
(1)
(2)
(3)
(4)
(5)
(6)
. Water Qualily
___ .Air Injection Well ...................................... Com~ftm9~~fi>~, K, N
___ Aquifer Test Well ....................................... Complete sections B through F, ~' N
"'"'X'--__ Passive Injection System ............................... Complete sections B through F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B through N
___ Pilot Test ................................................. Complete sections B through N
___ Tracer Injection Well ................................... Complete sections B through N
B. STATUS OF WELL OWNER: Choose an item.
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): __ .... N""'o""'rt"""h=-=C""a=--ro""'l=in=a""'D~e-=--p--'artm==e=n=t"""o=f~E=n~v=ir~o=nm=e=nt=a=--l~Q--'u=a=li.c..-t y~(~C=D~E~Q~)_-_S~t=a=--te~L=e~a=d~P~r~o .... gr~am~---
Mooresville Re oional Office
Mailing Address: 610 East Center Ave. Suite 301
City: Mooresville State:_ NC_ Zip Code: __ --=28""'1'-'1=5 ____ County:""'I"'-'re=d=-el=I ___ _
Day Tele No.: 704-663-1699 Cell No.: __________ _
Deemed Permitted GW Remediation NOi Rev. 8-28-2017 Page 1
EMAIL Address: _____________ _ Fax No.: ___________ _
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: --~F~i=e=ld=s~l=n ~ve=s=tm=en=t=s~I=nc=·----------------------
Mailing Address: --~1=2=0~3~O'-'l=d~D'-'a=l=la=s~H=i=l.!=hw~a .... v _________________ _
City: ---~D'-'a=ll=a~s ____ State: _NC_ Zip Code: 28034 County: Gaston
Day Tele No.: 704-922-0228 Cell No.:
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONT ACT (Typically Environmental Engineering Firm)
Name and Title: Frans Lowman. Pro ject Mananer
Company Name ---"-'A'""T""'C"-'-'A=s=so""'c"'"ia=t=es,.__ _______________________ _
Mailing Address: ___ 7_6_0_6_W_hi_te_h_a_ll_E_x_e_c_u_ti_ve~C_e_nt~e_r_D_r~. ~S~ui~te~80~0~-------------
City: Charlotte State: _NC_ Zip Code: 28273 County: Mecklenburg
Day Tele No.: 704-529-3200 Cell No.: ___________ _
EMAIL Address: ___ fr_a_n_s_.l_ow_m_an____,_@ ___ 1 a~t~cas~s~oc~i=at=e~s-=c~om~ Fax No.: ___________ _
F. PHYSICAL LOCATION OF WELL SITE
(!) Facility Name & Address: ---~F~ie=l=d .... s =E=x=xo=n~-------------------
1203 Old Dallas Highwav
City: ___ D_al_la_s _______ County: Gaston Zip Code: __ 2=8~0~34~
(2) Geographic Coordinates: Latitude**: ___ 0 --__ " or_~35~0 301501
Longitude**: 0 "or -81 ° 179510
Reference Datum: ________ Accuracy: ________ _
Method of Collection: __________________ _
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: Localized Im pact* square feet
Land surface area ofinj. well network: <10.000 ft2 __ square feet (::S 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: NIA (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
(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.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Deemed Permitted GW Remediation NOi Rev. 8-28-2017 Page 2
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.
Adventus dissolved oxvg en release sleeve (remedial socks ) will be installed in monitoring wells MW-I. MW-2 .
and MW-3 (2 OSOXS in each well-6 total). A pproximatel v 6 months after the remedial sleeve installations.
~roundwater at the site will be sam pled and anal vzed for VOC concentrations. A site map with monitoring well
locations is attached. Groundwater contaminant concentrations are summarized in the Groundwater
Anal yt ical Data Table. also attached.
J. APPROVED INJECTANTS -Provide a MSDS for each injectant. Attach additional sheets ifnecessary.
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be injected. Approved injectants can be found online at htt p://deg .nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ ground-water-protection/ groimd-water-a pp roved-in j ectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
Injectant: Adventus dissolved ox vc en release sleeve (remedial socks )
Volume ofinjectant: __ 6~re~m~ed~i~a_l ~so~c~k~s_r_ZiJ_2_0~·~8~6 _in_._3 _:_T~o_ta_l_V_ol~u_m_e~=_1_2~5_.1_6~in_.3 ___ _
Concentration at point of injection: --~9~0~3/c~o ___________________ _
Percent if in a mixture with other injectants: ___ N_/_A _________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: Q_Proposed 3 MWs (MW-1 through MW-3 ) Existing (provide GW-ls)
(2) 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):
(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 Pem1itted GW Remediation NOi Rev. 8-28-2017 Page3
L. SCHEDULES -Briefly describe the schedule for well constiuction and injection activities.
Approximately 2 weeks following the submittal of this NOL oxygen releasing socks will be installed in site
monitoring wells MW-1 through MW-3. It is anticipated that oxygen releasing sock replacement may occur on
a quarterly basis.
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 Subcha pter 02L result from the injection activity.
Site monitoring wells MW-1 through MW-3 will be sampled approximately 6-months following the placement
of the oxygen releasing socks. Groundwater samples will be collected from each site well and submitted to a
North Carolina certified analytical laboratory and analyzed for VOCs by EPA method No. 6200B
N. SIGNATURE OF APPLICANT AND PROPERTY 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 inquily of those individuals immediately responsible
for obtaining said information, I believe that the information is true, accurate and complete. I am aware that
the,·e are significant penalties, including the possibility of fines and imprisonment, for submitting false
informa!iJ,'n, I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and
all relfited appurtenances in accordance with the 15A NCAC 02C 0200 Rules." . /7 / ,,. --·<f >,, ·,:-· :y'f, , On behalf ofNCDEO Frans Lowman on behalf ofNCDEO
Signat~re of Applicant Print or Type Full Name and Title
PROPERTY OWNER if the property is not owned bv the permit applicant):
"As owner of the property on which the i11jection 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
CJ5A NC.AC 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
absence of contrary agreement in writing.
NCDEO UST State Lead Program -Scott Ryals
Signature* of Property Owner (if different from applicant) Print or Type Full Name.!!.!!!! Title
* An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
P]ease send this NOi electronically to Shristi.Shresthar@.ncdenr.gov AND one hard copy to:
DWR-UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Pennitted GW Remediation NOI Rev. 8-28-2017 Page4
0
15
30
60
APPROXIMATE SCALE IN FEET
EXPLANATION
PROPERTY BOUNDARY
MONITORING WELL LOCATION
TITLe FIGURE 2
SITE MAP
FIELD'S EXXON
1203 OLD DALLAS HIGHWAY
DALLAS, GASTON COUNTY, NORTH CAROLINA
ATC
ASSOCIATES OF NORTH CAROLINA, P.C.
Cheric4to, North Carolina 28270 (704) 52 -3200 FAX 004) 2
CAD FILE.
FE_36303SM
TYPE COD
PREP BY
AD
REV. BY
JL
SCALE
AS SHOWN
OAT_
12.22.17
PROJECT NO.
5LP3630302

ADVENTUS
sf Proven soil sedinen and Groundwater
4
Remediatien Technologies
Safety
Data
MATERIAL SAFETY DATA SHEET:
O.S�XTM
Page: 1 of 6
I. PRODUCT IDENTIFICATION:
PRODUCT USE:
MANUFACTURER:
Adventus Americas Inc.
2871 W. Forest Rd., Suite 2
Freeport, IL
61032
o-sO
Soil and water treatment.
EMERGENCY PHONE:
Office Hours: 815-235-3503
After Hours: 815-235-3506
TRANSPORTATION OF DANGEROUS GOOD CLASS1 ICATION:
Oxidizing Solid, n.o.s. (Calcium Peroxide), Class 5.1. PG II, UN1479
WIIMLS CLASSIIE'ICATION:
Oxidizer
2. COMPOSITION/INFORMATION ON INGREDIENTS
Ingredients
Calcium Peroxide
Calcium Hydroxide
3. PHYSICAL DATA
Chemical Formula
CaO,
Ca(OH)2
CAS No.
1305-79-9
1305-62-0
Percentage
45%-70%
10%-20%
Appearance White & brown granules
Physical state Solid
Odor threshold None
Bulk Density..._ 500--550gfL
Solubility in Water Insoluble
pH —11
Decomposition Temperature Self -accelerating decomposition with oxygen release starting from 275
degrees Celsius
4. HAZARDS IDENTTFICATION
Emergency overview
Oxidizing agent, contact with other material may cause fire. Under fire conditions this material may
decompose and release oxygen that intensifies fire. This product also contains crystalline silica. Long tern
exposure to hazardous levels of silica dusts can cause lung disease (silicosis). The World Health
Organization had indicated that there is limited evidence that crystalline silica is carcinogenic to humans.
but the NIP and OSHA have not classified this ingredient as carcinogenic.
Potential Health Effects:
• General Irritating to mucous membrane and eyes.

@~~~~:~~
Remediation Technologies
Safety Data
MATERIAL SAFETY DATA SHEET: 0-SOX™ Page: 2 of6
• Inhalation ______________________ Irritating to respiratory tract. Long term inhalation of elevated levels
may cause lung disease (silicosis).
• Eye contact ___________________ May cause irritation to the eyes; Risks of serious or permanent eye
lesions.
• Skin contact ___________________ May cause skin irritation.
• Ingestion _______________________ _Irritation of the mouth and throat with nausea and vomiting.
5. FIRST AID MEASURES
• Inhalation ______________________ Remove affected person to fresh air. Seek medical attention if effects
persist.
• Eye contact ____________________ Flush eyes with running water for at least 15 minutes with eyelids
held open. Seek specialist advice.
• Skin contact ___________________ Wash affected skin with soap and mild detergent and large amounts of
water.
• Ingestion _____________________ _If the person is conscious and not convulsing, give 2-4 cupfuls of
water to dilute the chemical and seek medical attention immediately.
Do not induce vomiting.
6. FIRE FIGHTING MEASURE
Flash Point
• Not applicable
Flammability
• Not applicable
Ignition Temperature
• Not applicable
Danger of Explosion
• Non-explosive
Extinguishing Media
• Water
Fire Hazards
• Oxidizer. Storage vessels involved in a fire may vent gas or rupture due to internal pressure.
Damp material may decompose exothermically and ignite combustibles. Oxygen release due to
exothermic decomposition may support combustion. May ignite other combustible materials.
A void contact with incompatible materials such as heavy metals, reducing agents, acids, bases,
(I) ADVENTUS
e ��Proven Solt Sedan n4 and Groundwater
Remediatian Technologies
Safety Data
MATERIAL SAFETY DATA SHEET:
❑-SOKnd Page: 3 of 6
combustible (wood, papers, cloths etc,) Thermal decomposition releases oxygen and heat.
Pressure bursts may occur due to gas evolution. Pressurization if confined when heated or
decomposing. Containers may burst violently.
Fire Fighting Measures
• Evacuate all non -essential personnel
• Wear protective clothing and self-contained breathing apparatus.
• Remain upwind of fire to avoid hazardous vapors and decomposition products.
• Use water spray to cool fire- exposed containers.
7. ACCIDENTAL RELEASE MEASURES
Spill Clean-up Procedure
• Oxidizer_ Eliminate all sources of ignition. Evacuate unprotected personnel from equipment
recommendations found in Section 9. Never exceed any occupational exposure limit.
• ShoveI or sweep material into plastic bags or vented containers for disposal. Do not return spilled
or contaminated material to inventory. Avoid making dust.
• Flush remaining area with water to remove trace residue and dispose of properly. Avoid direct
discharge to sewers and surface waters. Notify authorities if entry occurs.
• Do not touch or walk through spilled material_ Keep away from combustibles (wood, paper, oils,
etc.). Do not return product to container because of risk of contamination.
8. HANDLING AND STORAGE
Storage
• Oxidizer. Store in a cool, well -ventilated area away from all source of ignition and out of direct
sunlight. Store in a dry location away from heat.
• Kccp away from incompatible materials. Keep containers tightly closed. Do not store in
unlabeled or mislabeled containers.
• Protect from moisture, Do not store near combustible materials. Keep containers well sealed.
Ensure pressure relief and adequate ventilation.
• Store separately from organics and reducing materials. Avoid contamination that may lead to
decomposition.
Handling
• Avoid contact with eyes, skin, and clothing. Use with adequate ventilation.
• Do not swallow. Avoid breathing vapors. mists, or dust. Do not eat, drink, or smoke in work
area.
• Prevent contact with combustible or organic materials.
• Label containers and keep them tightly closed when not in use.
• Wash thoroughly after handling,
9. EXPOSURE CONTROLS/PERSONAL PROTECTION

@ ~~~:~~~
Remediation Technologies
Safety Data
MATERIAL SAFETY DATA SHEET: 0-SOX™ Page: 4 of6
Engineering Controls
• General room ventilation is required. Local exhaust ventilation, process enclosures or other
engineers controls may be needed to maintain airborne levels below recommended exposure limits.
Avoid creating dust or mist. Maintain adequate ventilation. Do not use in closed or confined
spaces. Keep levels below exposure limits. To determine exposure limits, monitoring should be
performed regularly.
Respiratory Protection
• For many condition, no respiratory protection may be needed; however, in dusty or unknown
atmospheres or when exposures exceed limit values, wear a NIOSH approved respirator.
Eye/Face Protection
• Wear chemical safety goggles and a full face shield while handling this product.
Skin Protection
• Prevent contact with this product. Wear gloves and protective clothing depending on condition of
use. Protective gloves: Chemical-resistant (Recommended materials: PVC, neoprene or rubber)
Other Protective Equipment
• Eye-wash station
• Safety shower
• Impervious clothing
• Rubber boots
General Hygiene Considerations
• Wash with soap and water before meal times and at the end of each work shift. Good
manufacturing practices require gross amounts of any chemical removed from skin as soon as
practical, especially before eating or smoking.
10. STABILITY AND REACTIVITY
Stability
• Stable under normal conditions
Condition to A void
• Water
• Acids
• Bases
• Salts of heavy metals
• Reducing agents
• Organic materials
• Flammable substances
Hazardous Decomposition Products
• Oxygen which supports combustion
11. TOXICOLOGICAL INFORMATION
A_DVENTLUS
Proven Soil Sediment, � Pry 4 and Groundwater
Remortraitnn Technologies
Safety
Data
MATERIAL SAFETY DATA SHEET:
O-SOX
Page: 5 of 6
• LD50 Oral: Min,2000 mg/kg, rat
• LD5O Dermal: Min. 2000mglkg, rat
• LD5O Inhalation: Min. 4580 mg/kg, rat
12. ECOLOGICAL INFORMATION
Ecotoxicological Information
• Hazards for the environment is limited due to the product properties of no bioaccumulation, weak
solubility and precipitation in aquatic environment.
Chemical Fate Information
• As indicated by chemical properties oxygen is released into the environment.
13. DISPOSAL CONSIDERATIONS
Waste Treatment
• Dispose of in an approved waste facility operated by an authorized contractor in compliance with
local regulations.
Package Treatment
• The empty and dean containers are to be recycled or disposed of in conformity with local
regulations.
14. TRANSPORT INFORMATION
• Proper Shipping Name: EHC-O
• Hazard Class: 5.1
• Labels: 5.1 (Oxidizer)
• Packing Group: II
15. REGULATORY INFORMATION
• SARA Section Yes
• SARA (313) Chemicals No
• EPA TSCA Inventory Appears
• Canadian WHMIS Classification C, D2B
• Canadian DSL Appears
• EINECS Inventory Appears
16. PREPARATION INFORMATION
Prepared By: Kerry Bolanos-Shaw
Adventus Remediation Technologies
1345 Fewster Drive
Mississauga, Ontario
Low 2A5
Date Prep./Rev:
Print Date:
Phone:
Pax:
1I31O7
1/3107
905-273-5374
905-273-4367

Well ID Gauging Date
MW-I 7/14/2017
11/9/2017
MW-2 7/14/2017
11/9/2017
MW-3 11/9/2017
MW-4 11/9/2017
MW-5 11/9/2017
NM = Not Measured
TABLE2
GROUNDWATER ELEVATION DATA
Fields Exxon
1203 Old Dallas Highway
Dallas, North Carolina 28034
NCDEQ Incident #36303
Total Well Depth TOC Elevation
35 ---
35 100.00
35 99.53
35 97.54
35 99.60
Depth to Groundwater
Groundwater Elevation
28.06 ---
NM ---
29.31 ---
NM ---
31.05 68.48
28.73 68.81
30.16 69.44
.. = .. .. .. = = N .. .. = N = ..
= e ,Cl Well ID Sample Date .. ~ = E---= ....
i:-1
611912008 798 334 152
MW-1 7114120 17 6,200 34,400 5,080
11/912017
6/1912008 987 319 177
MW-2 7/14/2017 3,310 6,560 543
11/9/2017
MW-3 11/912017 2,930 13,400 1,400
MW-4 111912017 0.16 J 0.64 <0.13
MW-5 11/9/2017 0.14 J 0.44 J <0.13
2L Standard (ug/1) 1 600 600
GCL (ugll) 5,000 260,000 84,500
Notes:
Concentrations are reported in micrograms per liter (µg/1) or parts per billion.
"<" = Not detected at or above the laboratory detection limit
GCL = Gross Contamination Level
"' I
~ )<_
-; ....
C
!--<
473
27,700
658
4,710
8,870
0.56 J
<0.25
500
85,500
J = Estimated value above or equal to Method Detection Limit and less than Quantification Limit.
NIA= Data Not Available
NA = Not Analyzed
Underlined values indicate detection limit is above 2L Standard due to dilution.
Values in BOLD print indicate levels above 2L Standards
... ..
-= i:-1
E, I .. = = a = .. -; t-..
-= ,Cl :a E, -= =-... ... = ..
E--z ~
I =
~
196 128 NIA
90.1 1,280 95.5
257 267 NIA
133 739 14.8
1,240 1,810 7.6
0.27 J <0.13 <0.13
<0.13 <0.13 <0.13
20 6 70
20,000 6,000 6,900
TABLES
HISTORICAL GROUNDWATER ANALYTICAL RESULTS
Field's Exxon
.. .. = = .. .. !:I :::! .. ..
,Cl :S E, c = = = = I ..!, u I,,, .. .. "' -
NIA NIA
40.4 <25
NIA NIA
6.8 <5.0
4.1 <0.13
<0.13 <0.13
<0.13 <0.13
70 70
6,900 15,000
1203 Old Dallas Highway
Dallas, NC 28034
NCDEQ Incident #36303
.. .. = = .. .. ... .. N N .. = = = 8 -= .. .. .. .... N ,Cl ,Cl ... fl ~ ], .s i:-1
~ i -= C .... "ti ... =-.. .s C e .§ I,,, 0 -= ·;: Cl, ... ... u 0 ,:,., ~. E--.. I I ... = Ill
~ "'1-... ...
Concentrations in ug/L
NIA 286 NIA NIA NIA
<2 5 1,070 630 6,570 1,370
Well Not Sampled
NIA 476 NIA NIA NIA
<5.0 1,710 73.1 1,380 395
Well Not Sampled
<0.13 1,870 79.0 J 1,020 285
<0.13 0.27 J <0.13 <0.13 <0.13
<0.13 <0.13 <0.13 <0.13 <0.13
70 70 70 400 400
70,000 7,000 30,000 28,500 25,000
.. = ..
N = ..
,Cl
~ =-C
I,,,
Cl,
0 .. ...
NIA
192
NIA
23.2
50.3
<0.13
<0.13
70
25,000
= ~ = ,= ... .. ~ .. e ~ = .. ; .. = .. .. i = .. -= = :5! ] 3 C .. .. .. ,s e 0 = = = -= ~ 0 ... .a .. C e Cl, C ... :a = .... OI
I,,, :a = Q .. c .. e .s .. = u .,J .. =-< (I} Cl, -= ~ I OI -0 u .. N = "' I = I ~ ""i" 0 i N • ~
Cl, ... -= N .... ..
i:-1 ~
~
NIA NIA 48 12 NIA NIA NIA NIA 30
30.3 189 <25 15.9 J <130 <130 <500 315 NA
NIA NIA 290 41 NIA NIA NIA NIA <10
6.1 55.6 198 123 88.9 249 <100 50.8 NA
4.4 43.3 73.5J 90.4 J 28.8 63.5 <2 .0 124J NA
<0.13 <0.13 <0.13 <0.13 <1.3 <1.3 <2 .0 <0.13 NA
<0.13 <0.13 <0.13 <0 .13 <1.3 <1.3 <2 .0 <0.13 NA
25 100 0.02 0.4 100 4,000 6,000 70 15
Jl,700 NE 50 400 100,000 4,000,000 6,000,000 70,000 15,000