WI0500989_DEEMED FILES_20180803

Permit Number WI0500989
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
IP-Spring Hope
Location Address
518 S Old Franklin
Nashville
Owner
Owner Name
International Paper Company
Dates/Events
NC
Orig Issue
7/17/2018
App Received
7/10/2018
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27856
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
8/3/2018
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Raleigh
County
Nash
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Mark S. Sutton
6400 Poplar Ave
Memphis
Issue
8/3/2018
Effective
8/3/2018
TN 38197
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
A:COM AECOM Technical Services of North Carolina, Inc.
1600 Perimeter Park Drive, Suite 400
Morrisville, North Carolina 27560
July 20, 2018
Shristi P. Shrestha, RPM
North Carolina Department of Environmental Quality
Water Quality Regional Operations Section
Underground Injection Control
13636 Mail Service Center
Raleigh NC 27699-1636
AUG O ~ 20i8
:1ter Q~ality €. )0~0·
·,r,Nat1 ons SP,. 10
919.461.1100 tel
919.461.1415 fax
RE: Re-Submittal of NOi Application for 518 S. Old Franklin Road, Spring Hope NC
Dear Ms. Shrestha:
Please find enclosed our re-submittal of the Notice of Intent (NOI) to Construct and Operate
Injection Wells. At your request, we have revised the tracer to a dye on the list of approved
injectants (Rhodamine WT). Please contact the either of the undersigned with any questions at
919 461-1100.
Sincerely,
AECOM Technical Services of North Carolina, Inc .
.,.,,-:7 ---
/ ~ ~,,.,/_ 4/)?
Conan Fitzg~d, PE, RSM
Engineering Manager II
C: Brent Sasser, International Paper
Brandon H. Turlington
Q:\DCS\Projects\L-URS\Jobs4\_Projects\lntemational Paper\lP -Spring Hope Fiber Pile\60546670 -Bench Scale Testing\3
Correspondence\3.2 Agency\UIC Req Resubmit.doc
ATTACHMENT 1
EMAIL CORRESPONDENCE DATED DULY 2017

From: Shrestha, Shristi R <[e-mail]>
Sent: Tuesday, July 17, 2018 3:14 PM
To: Zinna, Jasen <[e-mail]>; Brent Sasser <[e-mail]>
Cc: Bolich, Rick <[e-mail]>
Subject: [External] : NOi for tracer injection
Good afternoon,
We received a NOi application for a pilot test with tracer injection at the address 518 S. Old Franklin Rd.,
Nashville, NC 27856. The tracer dye in the application (Erioglaucine A) is not approved for injection.
Please find the following list for approved injectants https://deq.nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ground-water-protection/groundwater-
remediation .
Also, we no longer accept Notification Of Intent application by email . In future in you are submitting
NOi forms please submit 1 hard color copy along with a digital copy in a CD or flash drive at least two (2)
weeks prior to injection. The form can be found under the following
link https://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-
branch/ground-water-protection/ground-water-applications
Thank you,
Shristi
Thank you,
Shristi
Shristi R. Shrestha
Hydrogeologist
Water Quality Regional Operations Section
Animal Feeding Operations & Groundwater Protection Branch
North Carolina Department of Environmental Quality
919 807-6406 office
[e-mail]
512N. Salisbury Street
1636 Mail Service Center
Raleigh, NC 27699 1636
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
ATTACHMENT2
REVISEDNOI
518 S. OLD FRANKLIN ROAD
SPRING HOPE NC
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 jection.
AQUIFER TEST WELLS (15A NCAC 02c .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to detennine aquifer hy draulic characteristics.
IN SITU REMEDIATION (15A NCAC 02c .0225 ) or TRACER WELLS U SA 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 (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 are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE : Ju ly 2 0, 2018 __ PERMIT NO . ________ (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERA TED
B.
C.
(1)
(2)
(3)
(4)
(5)
(6)
___ .Air Injection Well ...................................... Complete sections B through F, K, N
---'Aquifer Test Well ....................................... Complete sections B through F, K, N
___ .Passive Injection System ............................... Complete sections B through F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B through N
___ Pilot Test. ................................................ Complete sections B throu ~ ~COEQ/DWI
x ___ Tracer Injection Well. .................................. Complete sections B thr~ugfi
AUG O 1
STATUS OF WELL OWNER: Business/Organization
'-::iter Qual:t,
--iprptjr,,
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): International Paper (Brent Sasser) _______________________ _
Mailing Address: 6400 Poplar Ave _________________________ _
City: Mem phis State : _TN_ Zip Code:..::;3=8 =19'-'7 ____ County:_S_h_el_by~---
Day Tele No.: 901 419-4447 Cell No.: _________ _
EMAIL Address: [e-mail] _____ _ FaxNo .: ___________ _
Deemed Permitted GW Remediation NOi Rev. 6/1/2017 Page I
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: --~B=ran=d=o=n~T~ur=l=in=g=t=on=-~O~wn~er~--------------------
Company Name ---=A_..g""'E""q""u=ip""m=en=t~D=-=ir~ec=t~L=L=C~--------------------
Mailing Address: ___ P=-O=--=Ba.ao=x'-'1=3-=-8-"-1 ______________________ _
City: Coats State:~ Zip Code:27521 County:-=H=arn=e=tt'-------
Day Tele No.: 910 230-0570 Cell No.: 910 916-0593
EMAIL Address: ___ a-g,._d=ir~e~c~tl=lc ... @ ......... &m~a1=·1 ~.c~o~m ___ _ Fax No.: --~9'-'1,...,,0....,8=3=9----'-9'---"0=5--=-8 ___ _
E. PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title: Jasen Zinna, Senior Engineer ______________________ _
Company Name AECOM Technical Services ______________________ _
Mailing Address: 1600 Perimeter Park Dr Suite 400 ____________________ _
City: Morrisville State: _NC_ Zip Code:=27-'-'5'""'6'"""0 ____ County:~W~ak=e ___ _
Day Tele No.: 919-461-1285 Cell No.: ___________ _
EMAIL Address: [e-mail] _____ _ FaxNo.: 919-461-1415
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: ----=IP=--..=cS'""pc:..:rin=g-=H=o,..p=e ____________________ _
518 S. Old Franklin Rd.
City: Nashville ___________ County _: N_a_s_h _______ Zip Code: 27856 __ _
(2) Geographic Coordinates: Latitude**: ___
0
--__ ,, or 35 _0
• 954169 ____ _
Longitude**: 0 "or-78 °.068133 _____ _
Reference Datum: ________ Accuracy: ________ _
Method of Collection:_G=o~o""'g=l~e ______________ _
**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:~l~.8~0~0~ ___ square feet
Land surface area ofinj. well network: __ 7~8~ _____ square feet(::: 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated:_~4 ___ (must be::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -The following is included as Attachment 1.
(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. 6/1/2017 Page2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and
duration of injection over time.
The pu rp ose of the pilot test is to veri fy the geolo g in the in jection interval. Water will be in jected along with
an environmentally friendl y d e (20 mL per point) to evaluate in jection rate , iniection pressure. and radius of
influence b y monitoring the presence of dy e in a nearbv existing downgr adient monitoring well. Additionally,
further assessment will be conducted to verify the horizontaVvertical extent across the proposed treatment area.
J. APPROVED INJECT ANTS -Information on the injectant is included in Attachment 2.
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 http ://deq .nc.gov/about/divisions/water-
resources/water-resources-pennits/wastewater-branch/ground-water-protection/eround-water-app roved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info
(919-807-6496).
Injectant: Rhodamine WT (tracer dye) mixed with water _______________ _
Volume of injectant: -~3~1=5'-----'g=al=lo=n=s'--'p""'e=r ... o=o=in=t~a=t~u=-p~t=o~fi=o~u=r .. p~o=in=t~s ____________ _
Concentration at point of injection: 20 mL of tracer per point ______________ _
Percent if in a mixture with other injectants: NA
lnjectant:
Volume ofinjectant: _____________________________ _
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:
K. WELL CONSTRUCTION DATA
(1)
(2)
Number of injection wells: u p to 4 Proposed _____ ~Existing (provide GW-ls)
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
Temporary geoprobe points
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
Not expected to exceed 38 feet below ground surface
Deemed Permitted GW Remediation NOi Rev. 6/1/2017 Page3
{c) Weli contractor name and certification number
Pm-ratt ,Volte 3367-A
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities.
This pilot test will take one dav to com plete __ _ ------·--·
------·~··-
l\f. MONITORING PLAN -Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in~-~·· · _ .: :_~0 result from the injection activity.
Not applicable since onh water and a tracer d\'e ,arc to be iniec,erl_into subsurface
N. SIGNATURE OF APPLICANT AND PROPERTY OW~ER
APPLICANT: ··1 harih;· ranify, under p,!nai~r a_f!mt. that I ,w;jamiliar with the il;fomwtion submitted in
rhis document and ali aUai.:hmems thereto ,:md tha~. ha.~ed on my inqui,y rf those individuah immediately
responsfbi.:._;o;-obtainmg said i11fbrmation, I bdf.,,,, !iwt tlw frtt~•rmmion is true. accurate and complete. I um
aware that there ar.: signijicalll penalties, including th£ possHulity ojjines and imprisonment, for submi((ing
false information. I agree to conslrucJ. operate. ma:ntcin, repair, and if applicable, abandon the injection well
and all related appurtenances in accordance with ;/;e . Rules."
~E-:2.~~-·1 ..... ,~. ,1 _-:r; ,-,~ j L ~l,,, ~~-U e;;:;::i::t :::. &re_/\+ °Sc; 5~ ~ r R,,,__,._:';t:•.t:::•p ;;;; :: Tit /;$ (
PR,_OPERTY OWNJ:R.(jf the propertv is not owned bv the permit apf;!)j.cam.D;
·'As owner uf the property 011 whi,.;h the itij(!Cfi011 wttllt.,J w::: to be constn1cted and operated. I hereby consent
w allow the appfit.:am to ~·onsrrnct each i1rieclion wet'! as outlined in this applic:arion and agree that it shall be
fhe rcspam'ir.iility rd· the applicant to ensure that the ir;fectfon wcll(sj COt!fimn to the Weil ConsrruNion
Standard:: ( :·_
"Ov.-11er" means any person who hold.s the fee or othe:-prop2rty rights in the well being constructed. A
well is real property and its construction 011 land st.ali be deemed to vest ownership in the land owner, in
the absence of contrary agreement in writing.
~~_,// ·-~ 1 .< l" lo -··--··'. -~-·.?'•'_: =-::. _____ . -·-... -A~!C?,~-ILJ0.('. L~~ _____ '."· -·· ---------
Signatu,I!• of P operty Owner {ifdiffc,er.t from appli,ar.t} P:;{f~, T;n,e. Full ~ame.a11.~ Title
*An access agreement between the applicant and property owner may be submitred in lieu of a signa/ure on 1his form.
Submit the completed notification package to:
[k-emd Perrniucd GW Remediati{ln 1':01 Rev. 6 I 2017
DWR .. rnc Pt'{;gr:un
1616 M~il .'iiien·ief f"'.1>nter
R:deigh, NC 27n99-163tl
Telephone: [phone]
Pnge4
ATTACHMENT 1
INJECTION ZONE MAPS
Pilot Test Area
L
a
G
LEGEND
- — APPROX. PROPERTY LINE
a 4-00
APPROX. SCALE, ft.
wu re wit MAYNE 1u. ea.�m �� Figure 2_ Site Map
11e"""' SH TSH Dirt Former Masonite Facility 13APR1• n armSpring Hope. North Carolina 13A P 9
WOP 13APR12 -a...+-T R u o .v•
W omsecd
CDF 13APR12 �` rt 31827527 FIGURE-2 0
L)
AS SHOWN
�rn.wlu .ons Mill-..swn .
EV.dM1 du.. J110

GW13.11•
ND
GWR-IO•
NV
UWD-I3•
CWB-12
'L) •
6L20
RL-30
[TEST LOCATION #1
OL-4O
[TEST LOCATION 11.1
Gw6-9•
•,u
CB Li
I; -OCB I-9
1.4-006 4.1
•
GWB-8
c s1 -2.4
MP-M W-D
CR I40
I.2-D03 140
1.3.0014 3.7
1.4-UCB 24
AII,n10.1 1
.GWD-1
yOWD-2
ODL•1
L W b-2
CB 34
1,2-DCB 6.4
1,4-fC8 fi.11ai
TEST LOCATION ,TI
TREATMENTAREA
{TEST LOCATION 01
GWB-4
CR 71r
1.2-UCO 77
1.3-UCR 2.1
I,4_DCB 11
• GVW6-5
CB 1.3
1.2fiCB 2A
1,4 DCB 0273
• O WB-6
CB O.26
DB•2
1 h.iHit II, 41
0
AB-1
APPROXIMATE SCALE
0
GO 120
LEGEND
EXISTING MONITORING WELL.
• GROUNDWATER BORING
O SOIL BORING
C8 CHLOROBENZENE
DC8 DICHLOROBENZENE
ND NOT DETECTED
* WELL HAS BEEN ABANDONED
Mai
AS SHOWN
mrm¢ark M11n wonoon r
•mv ar •n
Proposed Treatment Area
Efigirn MiTE Former Masonite Facility
TSH 29MAR I i Spring Hope. North Carotin°
DUN R •R
JZ 29MAR17 41—' ` `f►a
IPNIR1m Irt
CF
MaC
29MAR17 60518758 FIGURE-1 0

Project: ESI Sampling
Project Location:
Project Number:
Spring Hope, North Carolina
96R135
Log of Boring MF-MW-4
Sheet 1 of 2
Datelsl 3/24/97 Logged Gary MOier Checked Conan F'itzgerald Drilled Bv By
Drilling HoDow-Stem Auger Drill Bit 4-1/4-lnch-1D / 8-1/2-lnch-OD auger Surface 212.1 feet MSL Method Size(Type Elevation
Drill Rig
Type CME 76 Drilling
Contractor Bore and Core (Mark Back) Total Depth
Drilled lfeetl 38.5
Groundwater ! First ,completion· 24 Hours Number ' Sampler 2-lnch-0D x 24-inch-
Level !feet bgsl I -27 24.8 of Samples Disturbed: 11 Undisturbed: 0 Typelsl lo ng SPT split barrel
Diameter of 6-1/2 Diameter of 2 Type of Schedule 40 PVC Screen 0.010fflch slot Hole (inches) , Well (inches) Well Casing Perforation
Type of
Sand Pack #2 filter sand rype/Depth
o Seallsl Bentonlte 21-19 feet; cement grout 19 feet to surface
Comments Wal lnstaffed with riser 3 feet above ground surface
SAMPLES C PIO ( >D m)
c .g ,, cu 0 lii a. GI C .c · .. ~-u ::I m .. a.en-u MATERIAL DESCRIPTION =Ea al e REMARKS ~~ GI c.o.!Z GI a, D. >\j SJ > GI :c ~Oo II) CD
G) G) .!? G) GI E 3: u.., 0.C D. ~...I 'i .:,;: D. o.5a. uu me u c-w-> ::, iiiu,!2 CU C ".9 GI al ... z a::=. ::c m 0 -
// Slirtly moist, ray and brown, CLAYEY SILT i No odors or visible (M ), low plast city, contamination / observed during
--210 ~ 1A 2-4-4-5 13 Stiff, slif htly moist, reddish brown, SANDY 6.7 5.7 d rilling.
-(BJ SILT (M I, low plasticity. ~ -~ 2A 6-7-7-10 17 / Stiff to very stiff, sl~htly moist, reddish brown 7.2 5.7
5 -(141 / -with gray mottling, LA VEY SILT (Mll, low -g 0 V plasticity, trace send [Seprolite). -~ 3A 3-6-8-10 22 / 7.6 5.7
---205
(14) l-'1/
+Becomes non-plastic.
~ -~ 4A 6-11-13-22 V 6.5 5.6 V -15(24)
10-~ vv
-~ 5A .6,J 0,..16-. 22 V -.---wit_h !!ray and black mottlin!I: 7.9 5 .. 7
-16 (26) ~Y
-200 ~ V
/
. V i / -V
15-.I
~ 6A 34-50/3 9 ~:--.~ Hard, dry, greenish gray, MICACEOUS SCHIST, 6.7 5.7 Rock crumbles in
-~~ some silt. hand.
-~ 195 t~ ~ ~·~
~'-¼ 20-~ 35-50/3 9 -~· -- -~~· :'.~$•::+: •.:ti,
-.._ 190 ~'. ~ ~ ~:--. if,§· ~ -~ = :S::'.;f.::11'"-~ -~---~=~
~ =
25-~~ -.;.-~.-
~ 7A 34-50/5 11 ~ +With black mottling. -if: 7.5 5.6
-~ ·:S:--:!:•
~~ i -185 ~~ 11 Driller reports bein.p
:'\~ §:: ~hrough rock at 2 ft.
~ ~ 5::t:.
30-
Teml)l,te: 1 wt2A ProJ 10: ESINC Woodward Clyde Consultants (I -Printed: 9/10/97
Project: ESI Sampling
Project Location: Spring Hope, North Carolina
Project Number: 96R 135
Log of Boring MF-MW-4
Sheet 2 of 2
Elevation,
feet
SAMPLES
� ts
Type
Numbe►
Blows par
6 inches
iSPT N)
mG
c,
MATERIAL DESCRIPTION
C
0
al
moo
Headspece
Background
REMARKS
30-
t3A
5016
5
�-
Becomes uniformly gray Ina mottling).
=
5.5
1 5.6
'04
Hard, dry, gray, MICACEOUS SCHIST, wome
(continued).
=
180
N
silt
Steam from auger
due to haat and
moisture.
35-
4
9A
36-5013
14
)1
Hard, moist, greenish g . CLAYEY SILT (MU
7.6
5.7
Egtual proportions of
175
i�.
illiti
f`
+*
and MICACEOUS SCHIS non -plastic.
=
's1OA
SO/3
—_
-
-
40-
�-
45-
-
50-
l
55-
J
60
65
170
165
160
155
150
50
145
Bottom of boring at 38.5 feet.
`
- -
'
-
_ -
70-
tnl.,r.rhalftr.i-r vrick ( rtriel Eltan+ _. .-..-.__ '
Temp.Iata: Iwt.3A Pro! ID; ESINC

-'t.
'
s ~;~-01
II. L
-
' MF-MW-03**
221.32 S -,
(--\ ' \ I I
, ... ---,'I I
~ ' 0 I
"' ---('I
) 0
\ "' ; "' ('I ('I
/ I 1BER ?ILE \ ('I ~ )
\
'\,
il , . ~
~ 1---/
,ij MF-MW-04 N /
214.01 S
\
I
l r 0
;::l ' I
i --·~-\ . .... NM S / _. ,,,___...-'
....
LEGBN.D ~·MF-MW0 0SR••
;~ MW OI SRALu.'>WMONl'l'OR tl\"C. Wr;:Ll, 220.86'·~
APPROXIMATE SCALE
~l!IW .\IUNtl'Ll)UNU Wl!LL 0 200 400 FEET
~ll.ijb c;l l!IJ\mDWASll!ILl.1>-h71A"00N
-i'.iR.OUNl'>WA'IE!l,CQN'IOOI\ NOTE: ""-' JESDD :IT I IMT< Figure 3. Groundwater Contour
.~RflllNOWA'rall FtcOW-DIRECTJO:..~ ** INDICATES THE MONITORING AS SHOWN
Map, December 4, 2013 aN'llEJfTIAL....._lll&ffl~IF ,....,.-., '"'" WELL HAS BEEN ABANDONED. URS TSH 18FE814 Former Masonite Facility
~17'1!1· WFLL Rlll'AIRED {-VAL.JJF..E.'!nMNfJ;n ,_-., , .... Spring Hope, North Carolina
MM 18FEB14 """""'"· I ., __ ... Im. ·-•=" '"'" 31827527.00001 FIGURE-3 0
-• IIIIIBl ---••n,yo CF 18FEB14
ATTACHMENT 2
TRACER INFORMATION
Material Safety Data Sheet
Section 1: Chemical Product and Company Identification
Cat#: 19922
Part Name: RHODAMINE WT WATER TRACING DYE
Supplier: Polysciences, inc.
400 Valley Road
Warrington, PA 18976 USA
MSDS Telephone #[phone] Emergency only #215-378-4526
identified uses: Laboratory use, manufacture of substances
Section 2: Hazards identification
Hazard Overview
Causes eye irritation.
GHS Classification
Eye irritation Category 2A
Signal word: Warning
Hazard and Precautionary Statements
H319 Causes serious eye irritation.
P280 Wear protective gloves/protective clothing/eye protection/face protection.
P301A
Complies with EC no, 1907/2006
issue Date:11/1512013
Page 1 of 3
IF SWALLOWED do not induce vomiting. Do not give anything to drink. Obtain medical attention
without delay.
P301 D IF SWALLOWED, induce vomiting as directed by medical personnel.
P302+P352 IF ON SKIN: Wash with plenty of soap and water.
P340 Remove victim to fresh air and keep at rest in a position comfortable for breathing.
P351 Rinse cautiously with water for several minutes.
P361 Remove/Take off immediately all contaminated clothing.
P501 Dispose of contents/container 10 proper waste area in accordance with institutional practices and
local, state ❑r federal regualtlons.
NFPA Rating
Hazard Ratings:
These ratings are Polysciences' Inc. own assesments of the properties of the material using the ANSi1NFPA 704 Standard.
Additional information can be found by consulting in the NFPA published ratings lists (List 325 and List 49).
It no data is listed the information is not available.
Health Flammability Reactivity
2 0 1
Section 3: Composition/ Information on ingredients Note- Items listed with a CASRN.., number have no CAS# available.
Item# Name EINECS CAS# % in product
1 Rhodamine WT Unknown CASRNHX199 6 - 10
2 Water 231-791-2 0007732185 91 - 100
Section 4: First Aid Measures
Flush eyes with flowing water for at least 15 minutes.
if breathing is difficult, contact emergency personnel.
If swallowed, induce vomiting as directed by medical personnel.
Remove contaminated clothing.
Remove to fresh air.
Wash skin with deluge of water for al least 15 minutes.
Section 5: Fire Fighting Measures
Flash point, deg F.. no data
UEL: no data LEL: no data
Flammability Classification: no data
Hazardous Combustion Products. no data
Method: no data
Auloignition temperature, deg. F.: no data
Flame Propagation Rate: no data
Page 1 of 3

Section 6: Accidental Release Measures
Any information listed below is to be considered in addition to internal guidelines for isolation of spill , containment of spill, removal of ignition sources
from immediate area , and collection for disposal of spill by trained , proper1y protected clean up personnel.
Absorb liquids on absorbent material.
Contain spilled liquids.
Section 7: Handllng and Storage
Store at room temp
Section 8: Exposure Controls/ Personal Protection
OSHA (ACGIH) Exposure Limits
CAS#: 0007732185 IDLH: NE
OSHA
ACGIH
CAS#: CASRNHX1992 IDLH: NE
OSHA
ACGIH
TWA
ppm mg/
NE NE
NE NE
NE NE
NE NE
STEL CEILING
ppm mg/m3 ppm mg/m3
----------------
NE NE NE NE
NE NE NE NE
NE NE NE NE
NE NE NE NE
The use of eye protection in the form of safety glasses with side shields and the use of skin protection for hands in the form of gloves are
considered minimum and non-discretionary in work places and laboratories . Any recommended personal protection equipment or environmental
equipment is to be considered as additional to safety glasses and gloves .
Use chemical splash goggles and face shield .
Chemical-resistant gloves should be worn whenever this material is handled. The glove material has to be impermeable and resistant to the
product. Gloves should be removed and replaced immediately if there is any Indication of degradation or chemical breakthrough.
Rinse and remove gloves immediately after use. Wash hands with soap and water . All glove recommendations presume that the risk of
exposure Is through splash and not intentional Immersion of the hands into the product.
Since glove permeation data does not exist for this material, no recommendation for the glove material can be given for the product.
Permiation data must be obtained from the glove manufacturer to determine if the glove is suitable for the task.
Section 9: Physical and Chemical Properties
Formula:
Formula Weight:
boiling point:
melting point:
solubility:
no data
no data
no data
no data
miscible
Section 10: Stability and Reactivity
Chemical Stabilit no data
Conditions to Avoid: no data
Incompatibility with other materials: no data
Hazardous Decomposition Products: no data
Hazardous Polymerization: will not occur
Section 11 :Toxicological Information
Acute Data: no data
Subchronic data: no data
Section 12: Ecological Information
LC50: >320 mg/I rainbow trout (96 hour)
LC50: 170 mg/I daphnia magna
vapor pressure:
vapor density:
Specific gravity :
ph:
no data
heavier than air
1.01
10 .5@1.0 %
appearance: fluorescing red liquid
No developmental abnormalities or toxicity to oyster larvae at 100 mg/L.
Section 13: Disposal Considerations
The following chart lists the status of the chemical and its components in reference to 40 CFR Part 261.33. If the product is listed by code number
the substance may be subject to special federal and state disposal regulations. If no codes are listed the material must be disposed in compliance
with all Federal, State and Local Regulations .
CAS# Waste Code Regulated Name
0007732185 not listed not listed
CASRNHX19922 not listed not listed
Section 14: Transportation Data
Page 2 of 3
Proper Shipping Name
Chemical Name
UN
Class
PG
NOT REGULATED
Section 15: Regulatory Information
All components of this product are on the TSCA public inventory.
All components of this product are on the TSCA public inventory.
Prop 65 -Column A identifies those items which are known to the State of California to cause cancer. Column B identified items which are known
to the State of California to cause reproductive toxicity.
GAS# Column A Column B
0007732185 no no
CASRNHX19922 no no
State Regulatory Information :If a GAS# is listed below this material is subject to the listed state right-to-know requirements.
GAS#
0007732185 not listed
CASRNHX199 not listed
SARA Toxic Release Chemicals(as defined in Section 313 of SARA Tille Ill)
This list identifies the toxic chemicals, including their de minimis concentrations for which reporting is required under Section 313 of the Emergency
Planning and Community Right-to-Know Act (EPCRA). The list is also referred to as the Toxics Release Inventory (TRI) List.
CAS# Regulated name
0007732185 not listed
CASRNHX19922 not listed
SARA Extremely Hazardous Substances and TPOs
de minlmis cone. %
not listed
not listed
Rep . Tores .
not listed
not listed
This list includes hazardous chemicals as defined in 29 CFR 1910.1200(c): and extremely hazardous substances regulated under Section 302 of
SARA Title Ill with their TPOs (in pounds), as listed in 40 CFR 355, Appendices A and B.
GAS# Regulated name TPO (pounds) EHS-RO(pounds)
0007732185 not listed not listed not listed
CASRNHX19922 not listed not listed not listed
CERCLA
The hazardous substances, and their reportable quantities (ROs) are listed in the federal regulations at 40 CFR Part 302, Table 302.4. Release of a
CERCLA hazardous substance in an amount equal to or greater than its RO, in any 24-hour period, must be reported to the National Response
Center at [phone].
GAS# Regulated name
0007732185 Not listed
CASRNHX19922 Not listed
Section 16: Other Information
RO (pounds)
Not listed
Not listed
POL YSCIENCES, INC. provides the information contained herein in good faith but makes no representation as to its comprehensiveness or
accuracy . Individuals receiving this information must exercise their independent judgment in determining its appropriateness for a particular purpose.
POL YSCIENCES, INC. makes no representations or warranties, either expressed or implied of merchantability, fitness for particular purposes with
respect to the information set forth herein or to which the information refers. Accordingly, POL YSCIENCES, INC . will not be responsible for damages
resulting from the use of or reliance upon this information .
END OF MSDS
Page 3 of 3
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 form shall be submitted at least 2 WEEKS prior to iniection.
AQUIFER TEST WELLS (15A NCAC 02c .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229 }:
1) Passive Injection 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 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 In jection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: June 12, 2018 __ PERMIT NO. VY 1 0 S' 0 0 q 8 CJ (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERA TED
B.
(1)
(2)
(3)
(4)
(5)
(6)
___ Air Injection Well ...................................... Complete sections B through F, K, N
___ Aquifer Test Well ....................................... Complete sections B through F, K, N
___ Passive Injection System ............................... Complete sections B through F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B through N
x ___ Pilot Test.. ............................................... Complete sections B through N
___ Tracer Injection Well ................................... Complete sections B through N . _
.c~E\\JFOINCDEQID~~ -
STATUS OF WELL OWNER: Business/Organization JUL : o 2urn
C. WELL OWNER(S) -State name of Business/Agency, and Name and Title of persomi:ieb'gal etil l~l!lthoriti )~
sign on behalf of the business or agency: · -. flr'3t· -" .. -·
Name(s): International Paper (Brent Sasser) ______________________ _
Mailing Address: 6400 Poplar Ave _________________________ _
City: Memphis State:_ TN_ Zip Code:_3_8 _19_7 ____ County:_S_h_el_b _y __ _
Day Tele No.: 901 419-4447 Cell No.: __________ _
EMAIL Address: [e-mail] _____ _ Fax No.: ___________ _
Deemed Permitted GW Remediation NOi Rev. 6/1/2017 Page I
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: ___ B_ra_n_d_o_n_T_u_rl_in_g~t_on_.~O_w_n_er ___________________ _
Company Name ___ A~g_E_q.,_u-.ip--m_en_t_D_i_re_c~t_L_L_C ____________________ _
Mailing Address: -----=-P"""'O'-'B==-o=x~13"""8"-'1'--------------------------
City: Coats State: NC Zip Code:27521 County:-=H-=ar=n=e"""tt.a,.._ ____ _
Day Tele No.: 910 230-0570 Cell No.: 910 916-0593
EMAIL Address: a gdirectllc @ em ail.com Fax No.: 910 839-9058
E. PROJECT CONT ACT (Typically Environmental Engineering Firm)
Name and Title: Jasen Zinna, Senior Engineer _____________________ _
Company Name AECOM Technical Services ______________________ _
Mailing Address: 1600 Perimeter Park Dr Suite 400 ____________________ _
City: Morrisville State:_ NC_ Zip Code:=2~75~6~0 ____ County:~W~ak=e ___ _
Day Tele No.: 919-461-1285 Cell No.: ------------
EMAIL Address: [e-mail] _____ _ Fax No.: 919-461-1415
F. PHYSICAL LOCATION OF WELL SITE
(I) Facility Name & Address: _IP_-_S...,.p_ri _n g....,__H_o..,_p_e ____________________ _
518 S. Old Franklin Rd.
City: Nashville ___________ County""": N'-'-=as=h'--______ Zip Code: 27856 __ _
(2) Geographic Coordinates: Latitude**: 0
____ "or35_0 .954169 ____ _
Longitude**: 0 11 or-78 °.068133 _____ _
Reference Datum: ________ Accuracy: _______ _
Method of Collection:_G=-o=-o""'g°""l=-e ______________ _
**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:_l~.8~0~0 ____ square feet
Land surface area of inj. well network: __ 7_8 ______ square feet(.::: 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated:_-"-4 ___ (must be~ 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -The following is included as Attachment 1.
(I) 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. 6/1/2017 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.
The pu rp ose of the pilot test is to veri fy the geolo gy in the in jection interval. Water will be in jected along with
an environmentall oint to evaluate in"ection rate in'ection ressure and radius of
influence b monitorin the resence of d e in a nearb existin down radient monitorin well. Additionall
further assessment will be conducted to veri the horizontal/vertical extent across the ro osed treatment area.
J. APPROVED INJECTANTS -Information on the injectant is included in Attachment 2.
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:!/deq .nc.goviabouUdivisions,water-
re sources/water-reso urces-ermits /wastewater-branch/0 round-water-rotection /,,round-water-a proved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info
(919-807-6496).
Injectant: Erioglaucine A (tracer dye) mixed with water _______________ _
Volume of injectant: 315 gallons per point at up to fo ur points
Concentration at point of injection: 20 mL of tracer per point _____________ _
Percent if in a mixture with other injectants: ----=-N=A-=-------------------
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: ___________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: u p to 4 Proposed _____ 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
Temporary geoprobe points
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
Not expected to exceed 38feet below ground surface
Deemed Permitted GW Remediation NOi Rev. 6/1/2017 Page3
tc) 1.'4'eli contractor name and certification number
Parroir Wolfe
I SCHEDULES — Briefly describe the schedule for well construction and iniection activities.
This pilot test will take one day to complete
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 _ _ - - _; result from the injection activity.
Not ag_pljcable Since Qtth water and a tracer fete are to be ir'r.z .Cil- into sUlqSllffaC.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "1 hereby rerrifr, tinder penalti. Brim%, that : ors familiar with tire itif,►rnaticn submitted hi
this- document Cur:i ail attachments thereto and that, based S1d c.n iv inquire (i those indiavidua1.% immediately
responsible for rrlrtainins%, sitid information, ion, I f'rfic ce rih7l the :ref nr'irr+71ion is tree. act -to -ate :;rid complete. 1 am
aware that there are significant penalties, including the passibility of fines and imprisonment, for submitting
false irfoo7rratirJn. 1 agree 10 CUrastrucl, operate. ma stain, repair, and if applicable, abandon the injection well
aid all related apprrrtena=Tees in accordance with the - -- _.. Rules."
_ Y
gnature if p Bat Print or Type Prfi Name and Title
a,+v, ArQ$4 S4sser A.-.-/Lt�cirw ►a„ N (4j61 �r
PROPERTY OWNEI&Jif the property is not owned b; permit 4pplicatit):
"As owner of the 1.►roErer:o, uu ,vbkh the injection trelttsj ar to l+c constructed and operated, I hereby consent
to allow the appli;;artt to e:;ns,'ruct each injection well as outlined in this application and agree that it .shall be
the respon5lhilil3v r;/ the applicant ra ensure that the iniection wends) co:frrr-rn io tin! !Veil Construction
randar'dv r . - _ .
"Owner" means any person who holds the fee or other Ft:v.:sty rights in the well being constructed. A
well is real property and its construction oit land shall be deemed to vest ownership in the land owner, in
the absence of contrary agreement in writing.
je
Signature cf P Perty Owner Cif dit erect from applicant) Petit or Type run lame arse Title
",in access agreement between the applicant and properly owner may be submitted in lieu of a signature on this farm
Submit the completed notification package to:
t)W •- U1(: Program
Rill(, iMai1.Sen'ice Venter
Raleigh; N(- -6 4-I63i'
Telephone: [phone]
r)eenr_- d Perrrrit[ed GW Rcraed,s[ion NO1 Rev. 6 1 2017 Pig 4

ATTACHMENT 1
INJECTION ZONE MAPS
Project: ESI Sampling
Project Location: Spring Hope, North Carolina
Project Number: 96R135
Log of Boring MF-MW-4
Sheet 1 of 2
Datelsl 3/24/97 Logged Gary MIiier Checked Conan f"itzgarald ._D_n_·1 _le_d _______________ -+-B_y,___ _______________ 1-B_,y'--------------
~~!~:d HoDow-Stem Auger ~~~/}~pe 4-1/4-inch-1D / 6-1/2-lnch-OD auger ~~~=~~n 212.1 feet MSL
Drill Rig
Type CME75 &:~~~~ctor Bore and Core (Mark Beck) Total Depth
Drilled (feet) 38.5
Groundwater 'j First
Level (feet bgsl • -
,Completion 1· 24 Hours
27 24.8
Number
of Samples Disturbed: 11 Undisturbed: 0 Sampler 2-lnch-OD x 24-inch-
Type(sl long SPT spilt barrel
Diameter of
Hole (inches) 6 •112 Diameter of
Well (inches) 2 Type of
Well Casing Schedule 40 PVC Screen ch slo Perforation 0.010-in t
Type of
Sand Pack #2 flter sand Trpe/Depth o Seal(s) Bentonfte 21-19 feet; cement grout 19 feet to surface
Comments Wei Installed with riser 3 feet above ground surface
SAMPLES C PIO (11>om) 0 c I "0 .S! .. 15. CD C .s= &0-~-u tii .. MATERIAL DESCRIPTION = E CII CIII ::, REMARKS 12, ... Cl> rn!Z ., "' u a. e >t; .0 > GI :c ~Oo "' Cl Cl) Cl) .!! Cl) Cl> E ~u.-OJ: a. 0..J i ..lit OJ!? a. o.5:o. uu 19 Cl u w-~ ::,
iiico~ II C .. 0 1~• CD ID z a::::. C>...1 :I: m 0 -/ Slfhtly moist, ~ray and brown, CLAYEY SILT l/ ~ No odors or visible -(M I, low plast ity. contamination / observed during --210 ~ 1A 2-4-4-5 13 6.7 5.7 drilling. Stiff, sliehtly moist, reddish brown, SANDY -181 SILT IM I, low plasticity. ~ -~ 2A 6-7-7-10 17 /,/ Stiff to very stiff, sl~htly moist, reddish brown 7.2 5.7
5 -(14} ~-with gray mottling, LAVEY SILT (MLI, low -
~), ~ )/ plasticity, trace sand [SaproliteJ.
~ 3A 3-6-8-t0 22 +Becomes non-plastic. ~ 7.6 5.7 114) l/
-i-205 ~ /
-V ~ 4A 6-11-13-22 V 6.5 5.6 . 15(241
~ /
10-V
~ 5"' . 6.-:10:,1.6-.22 . -,r--with gray and black mottlln~. -7.9 5.7
-16 (261 l"
200 ~ / --V
/
l/
/
15 -/
:-..:. 6A 34-50/3 9 --s Hard, dry, greenish gray, MICACEOUS SCHIST, 6.7 5.7 Rock crumbles in . ~~ some silt . hand.
--195 ~~
l\~ -~ -~ 20-N
~ 35-50/3 9 ~~-- -
-2'~· ~~ ! -,_ 190 t ~-~-~ ~;
-~ : :5
~ ~:(
f ~ ,•,•,·.";:.", -.. = : ..
26 -~\~ -I :! ~ 7A 34-50/5 11 t ~ +With black mottling. -~ 7.5 5.6
]:~: = .::~:f
l\~ -;~;~ -•:::g:
~ E = -~ -185 -::❖'2 -.... ~ ..
1Driller reports bel'1 =· -,=
-l\~ -:ff4, hrough rock st 2 ft.
~ -.:;:.;::. ~ --~ ~:--., ~--....
30---......
Template: 1WL2A Proj ID: ESINC Woodward Clyde Consultants f, -Printed: 9/10/97
Project: ES1 Sampling
Project Location: Spring Hope, North Carolina
Project Number: 96R135
Log of Boring MF-MW-4
Sheet 2 of 2
0
w
0-
3
- 180
35---
175
— 185
50-
- 160
55-
- 155
60
150
65-
145
70-
SAMPLES
m N
o.c
m 0CC
$A 5p1$
U_
.0
C)
MATERIAL DESCRIPTION
Becomes uniformly gray (no mottling)
' Hard. dry. gray. MICACEOUS SCHIST. wome
' silt Icontinued.
9A 38 5a3
14
10A son
Hard. moist, greenish ray, CLAYEY SILT MUand MICACEOUS SCHIST. non -plastic.
Bottom of boring at 38.5 feet.
{
PID (pm)
R
D.
ea
ea
Z
6.5
7.8
C
0
n
CA
m
5.6
REMARKS
Steam from auger
!due to heat and
!moisture.
5.7 ,Equal proportions of
Isdt and rock.
Templale: 1WL2A Pro) IF?: ESINC
Woodward -Clyde Consultants
Printed: 9/10/97

ATTACHMENT 2
TRACER INFORMATION
Erioglaucine A
STRUCTURE VENDORS PHARMACOLOGY LITERATURE PATENTS 13IOACTIVtTiES
PubChem CID: 17559
Chemical Names: Erioglaucine A; Add Blue 9; Erioglaucine; Alphazurine FG; Erioglaucine E; C.l. Acid Blue 9 More...
Molecular Formula.: C37H4£N4.O9S3
Molecular Weight: 782.942 g/riniol
InChl Key: H M EKVHWROSNWPD-U HFF FAOYSA-N
Substance Registry: FDA UNiI

Safety Data Sheet
Issue Date: 01-Jan-2006 Revision Date: 24-Nov-2014 Version Number: 1
1. Identification
Product Identifiers
Product Name: Blue Tracing Dye Liquid
Product Number: 106502
Recommended Use & Restrictions on Use
Water tracing & leak detection dye
Manufacturer/Su pp lier
Cole Parmer
625 E. Bunker Ct.
Vernon Hills, IL 60061
U.S.A.
Emergen cy Telep hone Number
Company Telephone Number:
Emergency Telephone (24 hr):
Classification
[phone]
INFOTRAC [phone] (North America)
[phone] (International)
2. Hazards Identification
This chemical does not meet the hazardous criteria set forth by the 2012 OSHA Hazard Communication
Standard (29 CFR 1910.1200). However, this Safety Data Sheet (SOS) contains valuable information critical
to the safe handling and proper use of this product. This SOS should be retained and available for
employees and other users of this product.
3. Composition/Information on Ingredients
This product is not hazardous according to OSHA 29 CFR 1910.1200. Components not listed are not
hazardous or are below reportable limits.
First-Aid Measures
Eye Contact
Skin Contact
Inhalation
4. First-Aid Measures
Rinse immediately with plenty of water, also under the eyelids, for at least
15 minutes. If eye irritation persists: Get medical advice/attention.
Wash thoroughly with plenty of soap and water. If skin irritation occurs:
Get medical advice/attention.
Remove to fresh air. If breathing is difficult, administer oxygen; seek
medical attention immediately.
Page 1 of6
Blue Tracing Dye Li q uid
Ingestion
Revision Date: 24-Nov-2014
Rinse mouth. DO NOT induce vomiting. Drink plenty of water. Never give
anything by mouth to an unconscious person. Get medical attention if large
quantities were ingested or if nausea occurs.
Most Im portant Sym ptoms and Effects
Symptoms Will cause staining of the skin on contact. May cause eye irritation.
Inhalation of dust may cause respiratory irritation. Ingestion may cause
urine to be a blue color until the dye has been washed through the system.
Indication of An y Immediate Medical Attention and Special Treatment Needed
Notes to Physician Treat symptomatically.
5. Fire-Fighting Measures
Suitable Extinguishing Media
Water spray (fog). Carbon dioxide (CO2). Dry chemical.
Unsuitable Extin guishing Media
Not determined
Specific Hazards Arising from the Chemical
Product is not flammable. Burning/combustion may produce oxides of carbon and nitrogen (NOx).
Protective Equi pment and Precautions for Firefighters
Wear self-contained breathing apparatus pressure-demand, MSHA/NIOSH (approved or equivalent) and full
protective gear.
6. Accidental Release Measures
Personal Precautions . Protective Eq ui pment and Emergency Procedures
Personal Precautions Use personal protective equipment as recommended in Section 8.
Environmental Precautions Prevent from entering into soil, ditches, sewers, waterways and/or
groundwater. See Section 12 and Section 13.
Methods and Material for Containment and Cleanin g U p
Methods for Containment
Methods for Cleaning Up
Precautions for Safe Handling
Advice on Safe Handling
Prevent further leakage or spillage if safe to do so.
Sweep up and collect into suitable containers for disposal. Flush area
with water.
7. Handling and Storage
Handle in accordance with good industrial hygiene and safety practices.
Use personal protection recommended in Section 8. Avoid contact with
skin, eyes, or clothing. Avoid breathing dusts. Contaminated clothing
should not be allowed out of the workplace.
Page 2 of 6
Blue Tracin D e Li uid Revision Date: 24-Nov-2014
Conditions for Safe Stora ge , Including Incom patibilities
Storage Conditions Keep container tightly closed and store in a cool, dry, and well-
ventilated area. Keep from freezing.
Incompatible Materials Acids.
8. Exposure Controls/ Personal Protection
Ex posure Guidelines
This product, as supplied, does not contain any hazardous materials with occupational exposure limits
established by the region specific regulatory bodies.
En gineering Controls
Ensure adequate ventilation, especially in confined areas. Eyewash stations. Showers.
Individual Protection Measures, Such as Personal Protective Eq ui p ment:
Goggles.
Rubber gloves. Suitable protective clothing.
Eye/Face Protection
Skin & Body Protection
Respiratory Protection No protection is ordinarily required under normal conditions of use.
Hygiene Measures Handle in accordance with good industrial hygiene and safety practices.
9. Physical and Chemical Properties
Information on Basic Ph ysical and Chemical Pro perties
Physical State Liquid
Appearance Dark blue liquid
Color Dark blue
Property
pH
Melting/Freezing Point
Boiling Point/Range
Flash Point
Evaporation Rate
Flammability (solid, gas)
Upper Flammability Limits
Lower Flammability Limits
Vapor Pressure
Vapor Density
Relative Density
Specific Gravity
Solubility
Partition Coefficient
Auto-ignition Temperature
Decomposition Temperature
Viscosity
Values
5.1-5.3
~32° F
~212° F
Not applicable
Not applicable
Liquid -not applicable
Not applicable
Not applicable
Not applicable
Not applicable
Not applicable
1.02
Highly soluble in water
Not determined
Not determined
Not determined
Not determined
Page 3 of 6
Odor
Odor Threshold
None apparent
Not determined
Blue Tracin D e Li uid
10. Stability and Reactivity
Reactivity
Not reactive under normal conditions.
Chemical Stability
Stable under recommended storage conditions.
Possibility of Hazardous Reactions
None under normal processing.
Conditions to Avoid
Keep separated from incompatible substances. Keep out of reach of children.
Incom patible Materials
Acids.
Hazardous Decom position Products
Oxides of carbon and nitrogen (NOx).
11: Toxicological Information
Information on Likel y Routes of Ex posure
Inhalation
Ingestion
Skin Contact
Eye Contact
Avoid breathing vapors or mists.
Do not ingest.
May cause an allergic skin reaction.
Avoid contact with eyes.
Revision Date: 24-Nov-2014
Dela yed , Immediate. and Chronic Effects from Short-and Lon g-Term Ex posure
May cause an allergic skin reaction.
Numerical Measures of Toxicity
Not determined
Sym ptoms Associated with Ex posure
See Section 4 of this SOS for symptoms.
Carcinogenicity
NTP
IARC
OSHA
None
None
None
Page 4 of 6
Blue Tracing Dye Liquid
Revision Date: 24-Nov _2014
12. Ecological Information
Ecotoxicity
This product is not classified as environmentally hazardous. However, this does not exclude the possibility
that large or frequent spills can have a harmful or damaging effect on the environment.
Component Information
Not available
Persistence/Degradability
Not determined
Bioaccumulation
Not determined
Mobility
Not determined
Other Adverse Effects
Not determined
13. Disposal Considerations
Waste Disposal Methods
Dispose of in accordance with federal, state, and local regulations.
Contaminated Packaging
Do not re -use empty containers. Dispose of containers in accordance with federal, state, and local
regulations.
14. Transport Information
Note
See current shipping paper for most up-to-date shipping information, including exemptions and special
circumstances.
DOT
IATA
OM DG
Not regulated
Not regulated
Not regulated
15: Regulatory Information J
International Inventories
TSCA Listed
U.S. Federal Regulations
CERCLA This material, as supplied, does not contain any substances regulated as
hazardous substances under the Comprehensive Environmental Response
Compensation and Liability Act (CERCLA) t40 CFR 302) or the Superfund
Page 5of6

Blue Tracing Dye Li q uid
SARA313
CWA (Clean Water Act)
U.S. State Re gulations
Revision Date: 24-Nov-2014
Amendments and Reauthorization Act (SARA) (40 CFR 355).
Section 313 of Title Ill of the Superfund Amendments and Reauthorization
Act of 1986 (SARA). This product does not contain any chemicals which are
subject to the reporting requirements of the Act and Title 40 of the Code of
Federal Regulations, Part 372.
This product does not contain any substances regulated as pollutants
pursuant to the Clean Water Act (40 CFR 122.21 and 40 CFR 122.42).
California Proposition 65 This product does not contain any Proposition 65 chemicals.
U.S. State Right-to-Know This product does not contain any substances regulated under applicable
state right-to-know regulations.
HMIS
Health Hazards
1
NFPA
Health Hazards
1
Issue Date
Revision Date
Revision Note
Disclaimer
16: Other Information
Flammability
0
Flammability
0
01-Jan-2006
19-Nov-2014
New format
Instability
0
Physical Hazards
0
Special Hazards
Not determined
Personal Protection
B
The information provided in this Safety Data Sheet is correct to the best of our knowledge, information and
belief at the date of its publication. The information given is designed only as a guidance for safe handling,
use, processing, storage, transportation, disposal and release and is not to be considered a warranty or
quality specification. The information relates only to the specific material designated and may not be valid
for such material used in combination with any other materials or in any process, unless specified in the
text.
End of Safety Data Sheet
Page 6 of 6
\\ //
BmGitiT
DYES
Division of Kingscotc Chemicals Q
WATER TRACING DYE
STANDARD BLUE PRODUCTS
TECHNICAL DATA BULLETIN
Bright Dyes Standard Blue products are specially formulated versions of the dye Acid Blue 9. This
dye is used for visual detection only and cannot be seen under ultraviolet light or detected by
fluorometry. However, when used visually, its color is often thought to be more acceptable to
public view than the fluorescing red or yellow green Bright Dyes products. In this respect, it is
sometimes used in fountains, ponds and streams for decorative effect. Visually, the dye appears as
aqua to royal blue depending on its concentration and activity of the water.
Based on biochemical oxygen demand (1BQD) studies, the dye is biodegradable with 77% of the
available oxygen consumed in 7 days. Bright Dyes Standard Blue products have been certified by
NSF International to the ANSI/NSF Standard 60 for use in drinking water at specific levels. As
always the suitability of these products for any specific application should be evaluated by a
qualified hydrologist or other industry professional.
General Properties
Tablets
Liquids
Powders
Detectability of active ingredient '
Visual <100 ppb
Visual <100 ppb
Visual <100 ppb
Maximum absorbance wavelength 7
630 nm
630 nm
630 nm
Appearance
Lt. Blue speckled
1.6cur diameter
Clear, dark blue
aqueous solution
Dark blue fine
powder
NSF, max use levels in potable water
2000 ppb
1200 ppb
100 ppb
Weight
1.25 gms ± 0.05
Dissolution Time '
50% < 3 minutes
95% < 6 minutes
50% < 3 minutes
95% < 6 minutes
Specific Gravity
1.04 ± 0.03 , ii 25° C
Viscosity i
1.8 cps
PH
5.2+1.0 i'25°C
Coverage of Products
One Tablet
One Pint Liquid
One Pound
Powder
Light Visual
200 gallons
125,000 gallons
1,200,000 gallons
Strong Visual
20 �allnns
12,500 gallons
120,000 gallons
Caution: These products may cause irritation andlnr staining if allowed to come in contact wit the skin, The use of gloves and goggles is
recommended when handling this product, as with any other dye or chemical.
To our best knowledge the information and recommendations contained herein are accurate and reliable. However, this information and
ow recommendations are furnished without warranty, representation, inducement, or license of any kind, including, but not limited to
the implied warranties and fitness for a particular use or purpose. Customers are encouraged to conduct their own tests and to read the
material safety data sheet carefully before using.
2
Smaller peak at405 am_
In deionized water itt 100 ml flask. Actual deteciability and coverage in the field will vary with specific water conditions.
a (One tablet, 1 gram of powder), in flowing deionized water in a l0 gallon tank_
4 Measured on a Brookfield viscometer, Model LV, UL adapter, 60 rpm @ 25° C.
Kingscote Chemicals, 3334 S. Tech Blvd., Miamisburg, Ohio 45324
Telephone: [phone] Fax [phone] Web: www.brightdyes.com

Re ort\5
0
rIS
. � -CaLS
Pilot Test Area
r '�' f-1 ii'l •�,E € �-) 1 `�
.� — - r
`
1 • f•H ti
1
1
1
1
n `T
:r- -
•
-ti
LEGEND
— APPROX. PROPERTY LINE
0 400
APPROX. SCALE, ft.
SCALE
AS SHOWN
DESK !Y
DATE
Cai:lwENTIAL-M.L RWl1S FETERVE7-PROPERIT EF'
URS
. MORiI 4AR3.11A Y75BG
IRAVM ar
T5H
DATE
13APR12
CMECO !Y
WDP
DA'C
13APR12
DRAVMG TITLE
Figure 2. Site Map
Former Mosonite Facility
Spring Hope, North Carolina
APPROVED /T
CDF
DATE
13APR 12
CONTRACT M6.
31827527
LRAWING NO.
FIGURE-2

GWB-11 •
NI)
GWB-10•
ND
GWB-13
ND •
BL-20
BL-30
TEST LOCATION #
BL-4°
TEST LOCATION #
GWB-9•
ND
IS MP-NEW-06*
CB 2.5
1,2-DCB 1.9
1,4-DCB 4.4
GWB-12
ND •
•
GWB-8
CB 2.6
MF-MW-04
CB 140 1 TEST LOCATION #3
1,2-DCB 140
1.3-DCB 3.7
1,4-DCB 24 • GWB-4 0
DB-2
CB 240
I ,2-DCB 77
1,3-DCB 2.1
1.4-DCB 11
GWB-1-
ND
• GWB-2
ND
vBL-1
• GWB-3
CB 3.4
1,2-DCB 6.4
1,4-DCB 0.841
TEST LOCATION #
Abandoned
TREATMENT AREA
• GWB-5
CB 1.5
1,2-DCB 2.4
1,4 DCB 0.27J
• GWB-6
CB U.26
0PB-1
Abandoned
0
DB- I
APPROXIMATE SCALE
0
60
120
FI PILE
LEGEND
• EXISTING MONITORING WELL
• GROUNDWATER BORING
❑ SOIL BORING
CB CHLOROBENZENE
DCB DICHLOROBENZENE
ND NOT DETECTED
* WELL HAS BEEN ABANDONED
AS SHOWN
aastore a sr RATE
CCWH ] TIRL-ALL RIGHTS RESERvo-Fxrery
ROIL NORM UROINI 275VO
*AWN re BATE
TSH 29MAR17
cccaccD By
JZ
BATE
29MAR17
Proposed Treatment Area
Farmer Masonite Facility
Spring Hope, North Carolina
APpIa v n IT
CF
RATE
29MAR17
CONTRACT NO-
60518756
oRAAmid ra
FIGURE-1
REV.
0

MF-MW-04
214.01 (19
MF-MW-06*
NM S
1
EGEND
MF-MW Q1 SHALLOW MONITORING WELL
DEEP MONITORING WELL
220.86 GROUNDWATER EI .FVATION
�1 GROUNDWATER CONTOUR
GROUNDWATER FLOW DIRECTION
217.38* WELL REPAIRED / VALUE ESTIMATED
L
MF-MW-03**
221.32 (50
61) MF-MW-05R**
220.86'
NOTE:
** INDICATES THE MONITORING
WELL HAS BEEN ABANDONED.
.,,
MF'-MW-Q1.
- �•232.66
APPROXIMATE SCALE
0
200
400 FEET
AS SHOWN
DEVGIED sr
DATE
CRf IlTTAL-AU. ODDS RESERVED -PROPERTY EF
Fe% RORTH COMMA 27510
DPAVN 1,r
TS H
DATE
18FEB 14
CHECKED EY
MM
DATE
18FEB14
Figure 3. Groundwater Contour
Map, December 4, 2013
Former Masonite Facility
Spring Hope, North Carolina
APPRDVER PT
CF
DATE
18FEB14
CENTRACT NO.
31827527.00001
DRAWING PC.
FIGURE-3
REV.