WI0400543_DEEMED FILES_20210219

Permit Number WI0400543
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
Former Chemcratt
Location Address
3950 New Walkertown Rd
Winston Salem
Owner
Owner Name
Akzo Nobel Coatings Inc
Dates/Events
NC 27105
Orig Issue
3/10/2020
Scheduled
App Received Draft Initiated Issuance
2/26/2020
Re g ulated Activities
Groundwater remediation
Outfall
Central Files: APS SWP
Permit Tracking Slip
Status
Active
Project Type
New Project
2/19/2021
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Winston-Salem
County
Forsyth
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Brett Whittleton
1 E Water St
Waukegan
Public Notice Issue
3/10/2020
Re q uested /Received Events
Effective
3/10/2020
IL 60085
Expiration
Waterbody Name Streamlndex Number Current Class Subbasin
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
wiO, the rules of 15A NCAC 02C .0200 (NOTE: This form must be received at least 14 DAYS p rior to iniection)
AQUIFER TEST WELLS ll5ANCAC 02c .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION Cl 5A NCAC 02C .0225) or TRACER WELLS C1 5ANCAC 02c .0229 ):
1) Passive Injection Sy stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (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 I 0,000
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 {I ST) -Used to 'heat' contaminated groundwater to enhance remediation.
Prtnt Clearly or Type Information. Illegible Submittals Wdl Be Returned as Incomplete.
DATE: October 16 , 2020_ PERMIT NO. rJ J..l> Lf 00 S'f-;3 (to be filled in by DWR)
NOTE-If this NOI is being submitted as notification of a modification ofa 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:
Permit No. WI0400543 ____________ Issued Date:~0=3~/1=0~/2=0 ________ _
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
(I)
(2)
(3)
(4)
(5)
(6)
(7)
--~Air Injection Well ....................................... Complete sections B through F, J, M
___ Aquifer Test Well ....................................... Complete sections B through F, J, M
___ Passive Injection System ............................... Complete sections B through F, H-M
x ___ Small-Scale Injection Operation ...................... Complete sections B through M
--~P.ilot Test ................................................. Complete sections B through M
___ Tracer Injection Well ................................... Complete sections B through M
___ In-Situ Thermal (IST) Well ........................... Complete sections B through M
STATUS OF WELL OWNER: Business/Organization RECEIVED
OCT 21 2020
Deemed Permitted GW Remediation NOi Rev. 2-17-2020 Page 1
NCDEO/DWR
Central Office
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): Akzo Nobel Coatings, Inc. (Brett Whittleton, Vice President, Director Legacy Assets &
Environmental Affairs)
Mailing Address: 1 East Water Street _______________________ _
City: Wauke gan State: _ IL_ Zip Code: 60085 County:.--=L=ak:=e ___ _
Day Tele No.: 312-613-8684 Cell No.: 312-613-8684
EMAIL Address: [e-mail]___ Fax No.: __________ _
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: ______________________________ _
Company Name ______________________________ _
Mailing Address: ______________________________ _
City: ____________ State: __ Zip Code: _______ County: _____ _
Day Tele No.:____________ Cell No.: __________ _
EMAILAddress:______________ FaxNo.: __________ _
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
F.
Name and Title: Jasen Zinn, PE. ___________________ _
Company Name: AECOM Technical Services _____________________ _
Mailing Address: 1600 Perimeter Park Dr. Suite 400 ___________________ _
City: Morrisville State: _NC_ Zip Code:._,2"-'7-=5-=6-=-0 ____ County:-'W'-'-=ak:=e'-----
Day Tele No.: 561-271-9662 Cell No.: _______ _
EMAIL Address: [e-mail]~----
PHYSICAL LOCATION OF WELL SITE
Fax No.: __________ _
(1) Facility Name & Address: Former Chemcraft. 3950 New Walkertown Rd.
City: Winston-Salem County: Forsyth Zip Code: 27105 __ _
(2) Geographic Coordinates: Latitude**: 36 __ 0 8 __ , 44.0484" or 0
Longitude**: 80 __ 0 11 ' 14.316" or 0
Reference Datum: _______ ~Accuracy: _______ _
Method of Collection: Goo gle Maps
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDJNATES.
G. TREATMENT AREA
Land surface area of contaminant plume: -10.000 square feet
Land surface area of inj. well network: -1 .100 square feet~ 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: -11 % (must be _:s 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; 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.
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 contamination present in the groundwater is a result of a historic release at a former coatings facili tv . An air
s parge/soil vapor extraction s vstem is currently in o peration : however, some additional injection is being
pro posed downgradient. The goal of the injection is to prevent contamination from entering the creek utilizin!!
bioremediation. Fifteen injection locations are pro posed, and each point will receive a p proximately 250 gallons
of 3 wt°/o h ydro gen peroxide solution. The pro posed in jection interval is from 6 to 16 feet BLS through temporary
wells. The tem porary wells will be constructed of ¾" diatmeter PVC casing and screen.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 15 Proposed ______ Existing (provide NC Well
Construction Record ( GW-1) for each well)
(2) Appx. injection depths (BLS):_6 -16 feet _________________ _
(3) 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
K. INJECTION SUMMARY
NOTE: Onlv in iectants approved bv the epidemiology section o f the NC Division o f Public Health , Department
o f Health and Human Services can be iniected A pproved iniectants can be found online at
h ttp ://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/eround-water-
r rotection/ground-water-a pproved-injectants . All other substances must be reviewed bi. the DHHS prior to use.
Contact the UIC Program fo r more in fo i f you wish to get a pproval fo r a di ffe rent additive. However , please
note it m ay take 3 months or longer. If no injectants are to be used use NI A.
Injectant-'--: ---'H=--"vdro=__,ge=n~P~er=o=xi=·d=e __ Total Amt. to be injected (gal)/event~: -~3~7~5"'"'0 ______ _
Injectant::....: ___________ Total Amt. to be injected (gal)/event._,__: __________ _
Deemed Permitted GW Remediation NOi Rev. 2-17-2020 Page 3
Injectant: Total Amt. to be injected (gal)levent:
Injectant: Total Amt to be injected (gap/evert:
Injectant: Total Amt. to be injected (gaijlevent:
Total Amt to be injected (galievent): 3,750
No. of separate injection events: I Total Amt. to be injected (gal): 3,750
Source of Water (if applicable): fire h► dratzt
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 fi?L result from the injection activity.
Currenth , ennutsl groundwater sarnnling is performed around November/December of each year for volatile
organic compound utilizing EPA Method 8260D. Additionalb., groundwater quality parameters are also
collected. This annual sampline plan will continue wing forward at select she monitorintiwells. The primary
sampling locations for monitoring this infection event are SW-1 (surface water) and TW-18 through TW-22.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: "I hereby cergifv. under penalty of law, that I am •familiar with the information
submitted in this document and all attachments thereto and than, based on my inquiry of those individuals
immediately responsible far obtaining said information, 1 believe that the information is true, accurate and
complete. I an aware that there are significant penalties, including the possibility of fines and imprisonment
for submittingfalse information. I agree to construct operate maintain, repair, and ifapplicable, abandon the
injection well and all related appurtenances in accordance with the NCAC' 02C O arse] Rules. ,.
Signature of Applicant
Brett Whittleton. VP. Director Legacy Assets &Environmental Affairs
Print or Type Full Name and Title
Property Owner o f the property is not owned b. the Well Owner/Appl icatitl:
"As owner of the properly on which the injection well(s) are to be constructed and operated, I hereby consent try
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 02L' . 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
abser agreement in writing.
Igo ►1 tribtl s paw
Sign lld4e" of Property Ow er {iidii'Fereat helm applicant) Print or Type Full Name and Titic
'.sire access agreement between the applicant and property owner may be submitted in lieu ofa signature on this farm
Please send 1 (one) hard color copy of this NOI along with a copy on an attached CI) or Flash Drive al least
two (2) weeks prior to injection to:
DWR— VIC Program
1636 Mail Service Center -
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediatinn NOI Rev. 2-17-2020
Page 4

871.- •TW-19
55-GALLON
DRUM
REIAOVAL
AREA
dr9 -
a7w `Y M.0I5
IAIW -1B
Ga.G l TW-17W 880
a82
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1
h Two
TW 13T1M1�7 Mw�R
r~ 866
•0.4W-1211T)1-14
MW-1410
�W-4 ci6B
f510- TW-11■ 110M1W-13-
rTW-5
ago %7 04-3 - 1.102
fiTW-3
41,
11.
MNf 4 r W 2 .. %1*W-20
,,MW-21
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SW-4
CREEK
mw-4.
M*- uc
MW-7a
MIW-3.
MAW-19
f
RI4wrIa
1.11111.,11,
W ELL ID
DATE
DEPTH TO i
WATER
(FEET MCC)
TOC ELEVATION
(FTAMSLI
GROUNDWATER
ELEVATION
(FT AMSL)
888.86
MW-2
1213/19
18.22
907.09
MIN-4
1214N 8
11.92
900.85
994.93
MW$
12/4119
35.08
922.51
887.43
MYW-13
1214/19
3128
920.70
889.42
MW-14
1214119
DRY
919.74
DRY
MW-15
1213'19
3.36
881.47
878.11
M+W-24
1214119
1420
806.74
892.54
1W-3
1214119
27.85
919.69
891.84
1W-4
1214419
31.14
919.59
888.45
T W-5
121019
30.61
919.57
888.90
T W-7
12418
30.22
821.51
891.29
1W-10
1214/10
31.37
898.23
1W-11
12/4/19
31.21
_919.60
928.13
888.88
1W-15
12/3119
35.09
918.88
883.77
1W-17
12ri19
24.32
905.27
880.95
TN-18
1213119
5.79
881,21
875.42
T W 19
12/309
5.33
881.53
876.20
NOTE: 1A V-14 NOT USED N CONTOURING_
NAM ■
MW-90 0
5w- S
0 t❑❑
APPROX. SCALE. ft.
LEGEND
MONITORING WELL
VERTICAL EXTENT MONITORING WELL
SURFACE WATER SAMPLE
GROUNDWATER CONTOUR
GROUNDWATER FLOW DIRECTION
ANNUAL PROGRESS REPORT - 2019
AKZO NOBEL COATINGS INC,
WINSTON SALEM, NORTH CAROLINA
Project No.: 60618053 Date: 2020-02-04
WATER TABLE CONTOUR MAP
DECEMBER 2019
Aw0:611
Figure: $

rrw•••.e CVADREC5155laaoa MAC0 rwon5w20410b .1nmu4onu*xa RCPamy 111014MWMCIOwre f T mpalnl PAW UM aarw
11114.1 MemprwilM115 ammcesr. TE1H Ccecktd! tippoosee an
Injection Area
—TW-19S i 1W-18 —
t
TYVR2 j • + nine,
!lTYW2
— S` :17.'
TW-18 •
55—GALLON
DRUM
REMOVAL
AREA
•MW -15
TW-13T11
W-12O
MW-1
TW—t T
`-` — ~ SW-3
4
fiMW-18
MW-17. .amass. Oat -
SW-4
M11-3.
yi
-��IW-1B
r Ij
■NW-20'
MW-23 •MW-21
LAW-7•
SMWrlc
/
SAMPLE NAME
ACETONE
SAMPLE DATE
cONCENIRATION
MW-2 12/3/19
•5.0
MW-4
1214119
6.7
MW-0
_
12/4/19
3.5 J
111V-13
,2/4119
6.2
MW-14
12/13/19
2011000
MW-15
12/3/19
.5,0
MW24
12/4/19
80
1W-3
12/4119
<500
TW-4
12/4/19.
17
1W-5
12/4/19
43,000
7W-7
12/4/19
33
1W-10
1214/19
210 E
TW11
1214/19
20
TN-15
12/310
7
1W-17
123119
20
7W-18
12/3119_
980
7W-19
12/3119
<5.0
2L STANDARD
6,000
NOTES:
1. SOLD CONCENTRATION INDICATES EXCEEDANCE OF
THE 2L STANDARD OF 6.000 ug/L
2. ALL CONCENTRATIONS ON TABLE ARE IN MICROGRAMS
PER LITER (ug1Lj.
4 100
APPROX. SCALE, ft.
TW/MW
µW-90
5ft-5 •
LEGEND
MONITORING WELL
VERTICAL EXTENT HIONITOR!NG WELL
SURFACE WATER SAMPLE
ACETONE 1SOPLFrH LINE ABOVE 2L STANDARDS
(DASHED WHERE INFERRED)
ACETONE ISOPLETH LINE BELOW 2L STANDARDS
(DASHED WHERE INFERRED)
45,0 RESULT 15 LESS THAN THE INDICATED VALUE
E ESTIMATED CONCENTRATION GREATER THAN
THE INSTRUMENT CALIBRATION RANGE
J ES -MATED VALUE
ANNUAL PROGRESS REPORT • 2019
AKZO NOBEL COATINGS INC.
WINSTON SALEM, NORTH CAROLINA
Project No.: 50518053 Date: 2020.02-04
ACETONE 1SOPLETH MAP
DECEMBER 2019
AECOM
Figure: 3

=CaPeroxide inj 7' roi; 6'-16' bgs (15)
1W-190 As-asigl
\-
As-3'MX AS --
34RR�\
� 33

Well Construction Data -Former Chemcraft
Proposed Well ID Well Type Total Depth Well Contractor Name Certification Number
IW-23 through IW-37 Temporary 3/4" PVC 16 feet Redox Tech 4415-C
Permit Number WI0400543
Program Category
Deemed Ground Water
Permit Type
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
sh risti.sh res th a
Coastal SWRule
Permitted Flow
Facility
Facility Name
Former Chemcraft
Location Address
3950 New Walkertown Rd
Winston Salem
Owner
Owner Name
Akzo Nobel Coatings Inc
Dates/Events
NC 27105
Central Files: APS _ SWP __
3/10/2020
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Winston-Salem
County
Forsyth
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Brett Whittleton
1 E Water St
Waukegan IL 60085
Scheduled
Orig Issue
3/10/2020
App Received Draft Initiated Issuance
2/26/2020
Re g ulated Activities
Groundwater remediation
Outfall
Waterbody Name
Public Notice Issue
3/10/2020
Requested /Received Events
Streamlndex Number Current Class
Effective
3/10/2020
Expiration
Subbasin
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
w~th the rules of ISA NCAC 02C .0200 (NOTE: This form must be received at least 14 DAYS p rior 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 1 or TRACER WELLS (15A NCAC 02c .0229):
1) Passive Injection S v 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 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 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 In jection 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: February 24 , 2020_ PERMIT NO. VV 1.iJ 4-0 0 5 4-3 (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:
Permit No. WI _____________ Issued Date: _________ _
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1)
(2)
(3)
(4)
(5)
(6)
: 'it);: ~?) ~.
___ Air Injection Well ....................................... Complete sections B through F, J, M
___ Aquifer Test Well ....................................... Complete sections B through F, J, M
___ Passive Injection System ............................... Complete sections B through F, H-M
x ___ Srnall-Scale Injection Operation ...................... Complete sections B through M
___ Pilot Test ................................................. Complete sections B through M
___ Tracer Injection Well ................................... Complete sections B through M
-:j,,J!-l In-Situ Thermal (1ST) Well ........................... Complete sections B through M
B. p·~_g'ji~6>F WELL OWNER: Business/Organization
.Jit•'t ~ ~•,. , • .;.-•tf.. ••~• • •),-,.-,A•• <J
Deemed Perirutted G~diation 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): Akzo Nobel Coatings, Inc. (Brett Whittleton, Vice President, Director Legacy Assets &
Environmental Affairs) ___________ _
Mailing Address: 1 East Water Street ________________________ _
City: Waukegan State: _IL_ Zip Code: 60085 County:~L=ak=e ___ _
Day Tele No.: 312-613-8684 Cell No.: 312-613-8684
EMAIL Address: [e-mail]___ Fax No.: __________ _
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: --------------------------------
Company Name --------------------------------
Mailing Address:--------------------------------
City : ____________ State: __ Zip Code: _______ County: _____ _
Day Tele No.: ___________ _ Cell No.: __________ _
EMAIL Address: _____________ _ FaxNo.: __________ _
E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm)
F.
Name and Title: Thomas Marr, Vice President _____________________ _
Company Name: AECOM Technical Services _____________________ _
Mailing Address: 1600 Perimeter Park Dr. Suite 400 ___________________ _
City: Morrisville State: _NC_ Zip Code: 27560 County:_W_ak_e ___ _
Day Tele No .: 704-499-8014 Cell No .:_7~0'-'4'-'-9'---'0'""'"7---=-9--=2c.c.49"-------
EMAIL Address: [e-mail] ____ _ Fax No.: __________ _
PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Former Chemcraft . 3950 New Walkertown Rd.
City: Winston-Salem County: Fors th Zip Code: 27105 __ _
(2) Geographic Coordinates: Latitude**: 36 __ 0 8 ' 44 .0484" or 0
Longitude**: 80 __ 0 11 ' 14.316" or 0
Reference Datum: _______ -'Accuracy : _______ _
Method of Collection: Goo gle Ma ps
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY : A FACILITY SITE MAP WITH PROPERTY
BOUNDARIE S MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES .
G. TREATMENT AREA
Land surface area of contaminant plume: ~10 .000 square feet
Land surface area of inj. well network: ~ 1.100 square feet (:S 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated: ~ 11 % (must be :S 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; 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.
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 contamination present in the groundwater is a result of a historic release at a former coatings manufacturing
facility . An air sparge/soil vapor extraction s ystem is currently in operation: however, some additional injection
is being proposed downgradient. The goal of the injection is to prevent contamination from entering the creek
utilizing bioremediation. Fifteen injection locations are proposed. and each point will receive approximately 250
pounds of calcium peroxide in a 300-gallon slurry mi . Th e proposed injection interval is from 6 to 16 feet BLS
through direct push rods.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 15 Proposed. __ ~0 __ __,Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx. injection depths (BLS):_6 -16 feet __________________ _
(3) 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
K. INJECTION SUMMARY
NOTE: Onlr iniectants approved hi-the epidemiologv section of the NC Division of Public Health. Department
o f Health and Human Services can be injected. Approved iniectants can be found online at
htt p://dey .nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
protection/ground-water-a pp roved-in jectants . All other substances must be reviewed b the DHHS prior to use.
Contact the UJC Program for more info if vou wish to get approval for a different additive. However. please
note it mav take 3 months or longer. H no injectants are to be used use N/A.
Injectant.:....: ___ C=al=c=iu=m=-=-P-=-er=-=o=x=id=e'--__ Total Amt. to be injected (gal)/event.:....: -----'4"'"5:;..;0:;..;0'---------
Injectant,_: ___________ Total Amt. to be injected (gal)/event . .,_: __________ _
Injectant.,__: ___________ Total Amt. to be injected (gal)/event . .,_: __________ _
Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3
lnjectant: Total Amt. to be injected (gal)Icvent
lnjectent: Total Amt. to be injected (gal)Jcvent.
Total Amt. to be injected (gallcvent):
No. cif separate injection events:1 Total Amt. to be injected (gal): 4.500
Source of Water (if applicable): fire in drant
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 Sotlich pjet +:,ZI, result from the injection activity.
Ciirrent15. annual t;rowdyvater sampling is performed around November of each year for volatile o gamic
compound utilizing EPA Method 826d0. Additionally. groundwater quality parameters are also collected. This
annualsampiine plan will continue.going forward at select site monitoring wells. The primary sampling locations
kr monitoring this injection event are SW -I t iirface water). TW-18. and TW-19.
M. SIGNATURE OFAPPLICANT AND PROPERTY OWNER
Well Owner/Applicant, "I hereby eery+, under penalty of' law, that I am familiar with the information
submitted in this documerrr 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 signijrcant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and f applicable, abandon the
inject` rr well and ; l related appurtenances in accordance with the i 5.4 liCAt: 02C r?.?lot Rules. '.
SO* 7 f A. p a
Brett Whlttleton, VP. Director Leegacy Assets &environmental Affairs
Print or Type Full Name and Title
Property Owner Of the pmj ens is not owned by the Well Owner/Applicant):
"As owner ref the properly on which the injection weillsj are to be constructed and operated, l hereby consent to
allow the applicant to construct each irliectiotr 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
"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* or Property Owner (if different from applicant) Print or Type Fail Name and Title
*Ana access agreement between the applicant and properly owner ;nay be submitted in lieu of a signature on this forme,
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]
ll ernd Permitted OW Rcme4 iation NO) Rev. 2-17.2020 Page

=CaPeroxide inj 7' roi; 6'-16' bgs (15)
■ 111111111

Well Construction Data -Former Chemcraft
Proposed Well ID Well Type Total Depth Well Contractor Name Certification Number
IW-1 through IW-15 DPT 16 feet RedoxTech 4415-C
Filename: C:1USERSICAMPBELLODOCUMENTSL4ECOM WORKLAKZONOBELIGROUNDWATER REPORT 606180531DWGLFIGURE 8 - WATER TABLE CONTOUR MAP 2019.DWG
SW-11j
•TW-18 `t
876 TW
l
MW-15 878 ~�
SW-3
B
•MW-ifi
r� MW-17• CRASS
AR
W'ar? A W-18y
gad
TW-17•
=TW-16`
Be'
$ TW-13•
980
882
TW-15 $ark
•
TW-8
I1W46
TW-1 P
ago
MW-5•
ANNUAL PROGRESS REPORT - 2019
AKZO NOBEL COATINGS INC.
WINSTON SALEM, NORTH CAROLINA
Project No.: 60618053 Date: 2020-02-04
8�B
•MW-12 •YW-14
MW-14� 10 4
TW..4 6168
TW-110 •MWip S W-5
A
MW-1
IOW--2
csy
O
MW-23
AREA S
M W-- 220
mot 0
off,
SW-4
•
ti
CREEK
00MW-9D
lAW-9
1 W-20
ti •MW-21
•
•
~�9
MW-7•
a
SAW--8
MW-3•
•MW-19
(
■MW-10
WATER TABLE CONTOUR MAP
DECEMBER 2019
I
Project Management Initials: Designer. TSH Checked: EM Apprayd: EM
WELL ID
DATE
DEPTH TO
WATER
(FEET BTOC)
TOC ELEVATION
(FTAMSL)
GROUNDWATER
ELEVATION
(FTAMSL)
MW-2
12/3119
18.22
907.08
888.86
M W -4
12/4/19
11.92
906.85
894.93
MW-6
12/4/19
35.08
922.51
887.43
MW-13
12/4/19
31.28
920.70
889.42
MW-14
12/4/19
DRY
919.74
DRY
MW-15
12/3/19
3.36
881.47
878.11
MW-24
12/4/19
_ 14.20
906.74
892.54
1W-3
12/4/19
27.85
919.69
891.84
TW-4
12/4/19
31.14
919.59
888.45
TW-5
12/4/19
30.67
919.57
888.90
TW -7
12/4/19
30.22
921.51
891.29
TW-10
12/4/19
31.37
919.60
888.23
TW-11
12/4/19
31.27
920.13
888.86
TW-15
12/3/19
35.09
918.86
883.77
1W-17
12/3/19
24.32
905.27
880.95
1IN-18
12/3/19
5.79
881.21
875.42
TN-19
12/3/19
5.33
881.53
876.20
NOTE: MW-14 NOT USED IN CONTOURING.
TW/MW
MW-9D 0
SW-5•
0 100
APPROX. SCALE, ft.
LEGEND
MONITORING WELL
VERTICAL EXTENT MONITORING WELL
SURFACE WATER SAMPLE
GROUNDWATER CONTOUR
GROUNDWATER FLOW DIRECTION
Az-com
Figure: 8

Filename: C:IUSERSICAMPEELLCIOOCUMENTS\AECOM WORK JCZONOBELIGROUNDWATER REPORT 60816053IOWDIM URE 3_ACETONE ISOPLETH MAP_2019.DWO
Proiecl Management Ini11a15: designer. TSH Checked: EM Approved: EM
sed In ection Area
SW-1
TW-19i —18`
`1
11
11 % •MW-18
S
•\ �• MW-17i GNAW4 �REa mow_
18
\♦ ♦♦ �5.
TW-16 i_ ♦ •
r f __
♦ ♦
♦ ♦
\♦ i ,
♦• TW-15
I
---2
ANNUAL PROGRESS REPORT - 2019
AKZO NOBEL COATINGS INC.
WINSTON SALEM, NORTH CAROLINA
Project No.: 60618053 Date: 2020-02-04
ti
11
1%
iMW-15
TW-8
�l��__1
_.s i�W12 -—i���yyyy-1 4
TW-13i— ' —10-` .. —.-
TW-12 -rY
MW-14 � r •TW-4 >� TW-5`a.
SW-3
•--
SW-4
r
6.000 7 1
MW=13 1. �6.000 wa
MW-6
M W-5i
TW-11 1 1 Y,j'
TW-7�4 :/ yi -600I
_ ‘�,,�' TW--3 MW-2•
•
fig` +`♦ i—_—►L5Q, Asw _ ,,,,
J
— CS,0
MW-22,Q
Ma O
APE. I
MIA .
MW-24
MW-23
MW-7i
iMW-8
• MW-20
iMW-21
MW-3i
•MW-19
ACETONE ISOPLETH MAP
DECEMBER 2019
iMW-1❑
ACETONE J
SAMPLE NAME
SAMPLE DATE
CONCENTRATION
MW-2
1213119
<5.0
MW-4
12/4/19
5.7
MW-6
12/4/19
3.5 J
MW-13
1214119
6.2
MW-14
12/ 13/ 19
200,000
MW-15
1213/19
<5.0
MW -24
12/4119
80
1W-3
12/4/19
<500
TW -4
12/4/19
17
TW-5
12/4/19
43,000
TW-7
1214119
33
TW-10
12/4/19
,
210 E
TW -11
12/4/19
20
TW-15
1213/19
7
TW-17
1213119
20
1W-18
12/3/19
980
TW-19
12/3/19
<5.0
2L STANDARD
6,000
NOTES:
1. BOLD CONCENTRATION INDICATES EXCEEDANCE OF
THE 2L STANDARD OF 6,000 ug/L.
2. ALL CONCENTRATIONS ON TABLE ARE IN MICROGRAMS
PER LITER (ug1L).
0 100
APPROX. SCALE, ft.
TW/MW
MW-90
SW-5
LEGEND
MONITORING WELL
VERTICAL EXTENT MONITORING WELL
SURFACE WATER SAMPLE
ACETONE ISOPLETH LINE ABOVE 2L STANDARDS
(DASHED WHERE INFERRED)
ACETONE ISOPLETH LINE BELOW 2L STANDARDS
(DASHED WHERE INFERRED)
<5.0 RESULT IS LESS THAN THE INDICATED VALUE
E ESTIMATED CONCENTRATION GREATER THAN
THE INSTRUMENT CALIBRATION RANGE
1 ESTIMATED VALUE
AECOM
Figure: 3
0MW-9D
t W-9