WI0700436_DEEMED FILES_20160721

Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0700433
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Fomier Phelps Amoco
Location Address
USHighway 64
Owner
Owner Name
Northeast Oil Company
Dates/Events
Orig Issue
6/2/2016
App Received
5/23/2016
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27928
Draft Initiated
Scheduled
Issuance Public Notice
Central Files : APS SWP
6/2/2016
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Washington
County
Washington
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Owner Owner
PO Box 1836
Ahoskie
Issue
6/2/2016
Effective
6/2/2016
NC 27910
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
Shrestha, Shristi R
From: Shrestha, Shristi R
Sent: Thursday, June 02, 2016 1:53 PM
To: May, David; Tankard, Robert
Cc: Rogers, Michael
Subject: WI0700433 NOI Former Phelps Amoco
Attachments: WI0700433 .NOL.pdf, PRP info.pdf
Please find the attached NOI and information about PRP which will be injected.
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
shristi.shresthaI;z;ncdenr. ov
512N. Salisbury Street
1636 Mail Service Center
Raleigh, NC 27699 1636
rta
"'�Notttsny Compares —
Ernaii correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

Shrestha, Shristi R
From: Shrestha, Shristi R
Sent Thursday, June 02, 2016 1:51 PM
To: '[e-mail]';'[e-mail]'
Cc: Rogers, Michael; May, David; Tankard, Robert
Subject WI0700433 NOI Former Phelps Amoco
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOI) 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 (originals go the address printed on the form). NOTE: Direct
push or Geoprobe wells are considered wells and require construction (GW-1) and abandonment forms (GW-
30). If well construction/abandonment information is the same for the wells, only one form needs to be
completed -just indicate total number of injection points in the Comments/Remarks section of form, These forms
can be found on our website at
htto://deilric.gov/about/divisions/water-resources/ water-resources-hermits/wastewater-branch/dround-water-
protectio n /g rou nd-water-rep o rti ng-forms
2) Injection Event Records (IER). All injections, including air and passive systems require an IER. The !ER 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 me at Shristi.shresthagncdenr,gov 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 WI0700433. This number is also referenced in the subject line of this email. You may if you
wish, scan and send back as attachments in reply to this email, as it will already have the assigned deemed permit
number in the subject line,
Thank you for your cooperation.
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
shristi.shresthatc-Ocdenr. gov
512N. Salisbury Street
1636 Mail Service Center
Raleigh, NC 27699 1636
rdin
-'-":-`'"Nc thirtg CoMpares --

Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
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 ISA 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 USA NCAC 02C .0229):
1) Passive Iniection Systems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale Injection Operations -Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells 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.
i--J .I-010 0 4'33
DATE: ~M=---ay~l 7~_, 20 _ 16_ PERMIT NO. RECE l'v'ED/~Ma}B~ by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED MAY 2 3 2016
(1) __ Air Injection Well ...................................... Comp~~t!i<tiils~W ~@i~, K, N
(2) ___ Aquifer Test Well ....................................... Complete sections B through F, K, N
(3) X __ Passive Injection System ............................... Complete sections B through F, H-N
(4) ___ Small-Scale Injection Operation ...................... Complete sections B through N
(5) ___ Pilot Test. ................................................ Complete sections B through N
(6) ___ Tracer Injection Well ................................... Complete sections B through N
B. STATUS OF WELL OWNER: Business/Organization
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): North East Oil Company. Inc.
Mailing Address: Post Office Box 1386
City: Ahoskie State: _ NC_ Zip Code: 27910 County:-=H=ert=fi=or=d~-----
Day Tele No.: 252-862-0236 Cell No.: _________ _
EMAIL Address: woodb3 @mindspring.com Fax No.: ___________ _
Deemed Permitted GW Remediation NOi Rev. 3-1-2016 Page I
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: __ __,N'----'--"'o,,__,rth=----"C=ar=o=l=in=a"---'D=ep""'a=rtm==en=t'--'o=f_,T,_,,r-=an=s""'p'""o'°"rt=a=ti=on=-----------------
Company Name ---------------------------------
Mailing Address: __ ____,1'""1=3~A~1=· rp-=-o=rt~D~n=·v~e~, =S=m=·te~l ~00=----------------------
City: Edenton State: _ NC_ Zip Code: __ ~2~7~9-=-3=2 ____ County: Chowan
Day Tele No.: ____________ Cell No.: __________ _
EMAIL Address:______________ Fax No.: __________ _
E. PROJECT CONT ACT (Typically Environmental Engineering Firm)
Name and Title: __ __,An~=ge=l=a~R=o=a=ch~, P~r=o.,.._je=-=c=t =M=an=a=g=er~------------------
Company Name ---~G~e~o=lo..._g~ic~a=l ~R=e=so~ur~ce~s-,=In~c~·---------------------
Mailing Address: --~3~50=2~H=a .... ve~s~R=o~a=d~----------------------
City: Monroe State: _NC_ Zip Code: ___ 2_8~0_2_3 ____ County:~U=n=i~on ___ _
Day Tele No.: 704-845-4010 Cell No.: 704-798-4490
EMAIL Address: adr@geologi calresourcesinc.com Fax No.: __ ....a.7-=-04-'---=-84~5~-4~0~1=2 ___ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: ~P=h=el .... o-=-s -=-Am=o~c~o ____________________ _
U.S. Hi ghway 64 West
City: ___ C=r=-=e=sw--'-'-"'e=ll _________ County: Washington Zip Code: ____ _
(2) Geographic Coordinates: Latitude**: ___ 0 ____ " or 35_0 .886833 ____ _
Longitude**: 0 __ " or lfl._0 ._42_4_9~7_2 _____ _
Reference Datum: _______ ~Accuracy: _______ _
Method of Collection:_T=o=-ip=o~M=a""p _____________ _
**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:~8~0=00~ ____ square feet
Land surface area of inj. well network: __ 1~3~0_0 ___ ~square feet (s 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: ~20% (must be::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Deemed Permitted GW Remediation NOi Rev. 3-1-2016 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.
W ellBooms© will be placed in monitorin g wells as soon as possible. Every six months the well booms will be
replaced with new booms. The product degrades itself in approximately six months de pending on tem perature.
The product traps hvdrocarbons and does not release anyth ing into the ground water. Every six months the wells
be sampled for volatile organic com pounds. After samplin g, new wellbooms will be installed until gro und water
concentrations are below cleanup levels (2L ground water).
J. APPROVED INJECT ANTS -Provide a MSDS for each injectant. Attach additional sheets if necessary.
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 ht1u;//de q .nc.l!.ov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/gr ound-water-protection/1?round-water-a pp 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: --~P~RP~©=c ----'o=r----'O=i=l ~b~u=st=er~----------------------
Volume of injectant: -~12~o=z ..._p~er_fo~o~t ______________________ _
Concentration at point of injection: ------'3=---6=o=z=----------------------
Percent if in a mixture with other injectants: NIA
Injectant:
Volume of injectant: _____________________________ _
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
Injectant: ----------------------------------
Volume ofinjectant:
Concentration at point of injection:
Percent ifin a mixture with other injectants: ____________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: --~O ___ Proposed ___ 2 ___ Existing (provide GW-ls)
(2) For Proposed wells or Existing wells not having GW-1 s, 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 Permitted GW Remediation NOI Rev. 3-1-2016 Page3
04/11/2609 22:54 2527932211
D.S. LEE, HCi74T
PAGE 02102
L. SCHEDULES — Welk describe the sohodule for well construction and injection activities.
-14 Qud1++iW 2l
InoliteatIsrived tame Iodide= 9oncentraCtev.
1%'_D ackUtionsi lig will be instalie.i.fOr i}aisclissLacifivines.
M. MONITORING PI.,Alb/ —Describe below ar in separate attachment a monitoring plan to be used to determine
ilviolstiena ofgroundwater quality standards specified in jubrl pier p2 , reedit from the i jeation activity.
lit® r1]necdUnivental WAlboamae wtLaudj:W=m1Nje L
e to d
IrIonuitorinx we Umv_esssl W om wits tr ¢armed i>ar teeth so w v n
i 4 Pz i elmry six NOLWellbecius69 will be Waved in the welts rnbsecNent to aamvlinw_
The ground wet ern ids h ate I 's v a c o
En, Method-6200,E bead aoacredfd Iaboetnty,
N. SIGNATURE OF APPI]CANT AND minim OWNER
APPIXA IT: "'hereby c rttfy underpertaIty oflav, shad am familiar with the information submitted in this
doe:anent tend tdi altachrhanty Memo and the; based on my ingrdiy of those indMd is iinmediarrly responsible
for obtaintag said inrformawian, Fbelieve that the itex.madam is into, accurate and complete_ I am aware that
there are signtleant penalties including the pasalbility of finer and impthsonmen4 for subs false
ie fu notion. 1 wise m torso OPerak w aauvirt, repj and if uppllaable, .abandon the htilsetion well and
all related appurtenances in accordance with the t 5 4 N : C 02C 02001tuleo.,'
mn et Appilexnt Trict or Tyr Fyn Plates iced Mc
PROISI Y OWNER (if thaprovsart i is net ova* by the permit er>trHcsnt):
"As owner of fee property on which the infection wail(.) tins to he conrtructed and operated. I hereby consent to
aural Ike applicant to construct each Ind ection well as outlined in this application and agree that it shall be the
rsaponsibifihy of go applicant to ensure that the Infection wells) as font o the Well Constmetlon Standards
(15A NCa4C 02C .0200). "
"Oman" roses ray palm Who holds to fee cr other property rights is the w ell. being cdtettincted. A well
is teal property awl its construed= on hind shell be decco.ed to vest ownership in the land owner, to the
aE>s icr� of co rattly agreement in writing , 4/ fE►
‘4,14...- eleI./041,/V� 'T. L I L►��;A"--Ap9iRe+�* ar 1Pret Or fouca agptimaf) Plat er 'Type Slat me Ang t
edrr access ugrt:rmenrt between ilea applicant and properly owner may be submitted ire tint of a sig ur
e onSubmit the canaptetnd natifcatiora package to:
DM— UXC Program
16315 Malt Serriee Canter
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Arintsni OW EawedIraimt NOIRay. 3-1-2016
Page 4

Jan 13 US 03:31p Linda Hawaii
252 862 0312 p.2
• •NONRESTDEALea WELL CoNSraut,: rION RECORD
Worth Carolina Department ofEnviroriraeat andNatrcral Resources- Divisiart o Water quality
•
A WELL CONTRACTOR CERTIFICATioN # � al , .
1. WELL CONTRACTOR:
I
Well Contractor (Indlvld Name
CO f.e.r!.t't Lea O7 • �aL�?d YYlte 5
Well ConiractorCcmpany Name jj
STREET ADDRESS 1.; 3 k,; yid' ,
C_0 If t_co:P, ma(-. '
q. LI
. city or Town Bette ,
f 4A51)-_ 3 9 a-(, o2 z e
Zip Cbde
44
Area code- Phone number
2, WEU. INFORMATION:
SITEWELL tD#{dcpoloatie) fY1(A) - i
WELLCONSTR11CTION PERMITe(dapplfeaWe)
OTHER ASSOCIATED PERMIT Mt epplfaable)
3. WELL USE (Chock Applicable Box) Monitoringa
IndtrslrtaUCommerchel Aprlctt1WralD Recaveryll
hrtgatlorO Otlrerfl (Ilst use)
MunlcipaiiPublfd3
dnjedl:oal
DATE DRILLED_ i i f f D1 U $r
'
TIME COMPLETED 1110 • AMWWPNCI
4. WELL LQCATIOH: i - -
are: C- Y`-e. 1"{ COUNTY
{Street Hams Nuattes4Community, Sulxkitsmn, tat No., Parcel. Zip Code)
TOPOGRAPHIC/ LAND SETTING: •
. a Slope 0 Valley 0 Flat G Ridge DI other
•
(eixcie appropriate ban} ,..Lc.
1-fa s3
fATTTUDE 5
• may be to degrees.
rnmutes` seconds or
is n decimal format
.
LOHGITLIDE7 (..o Li ,.Lt' L. P
Latitudelongilude souarcc: 0 GPS 0 Topographic map
(location of we lmusthe shown on a USGS fop° map end
attached to drla 6111 ff naming OAS) •
6. FACILITY- a taw (woo is the awlmee rewrr the well le
FACILITY ID IV applicable) 0 " ON^ 3
NAME OF FACILITY '91-I12S ca_K.0
STREET ADDRESS e k.S LO'
C-1-eswe1l r*)C
City or Town Stale r� Zip Code
CONTACT PERSON! C,. • 1.0 OD _Loa 41- -Z
MAILING ADDRESS ? Q • eot% 3 R GI
i1r1AD.1 1 7 !1e
M yr Town Stela
{AIL t- tik7 -vz3&
zip
ff YESU NO tI
4-• 0 FT.
Armada - Phone number
6.WELL DETAILS: 1 . I -
a. TOTAL DEPTH: -
b. DOES WELL REPLACE EYJST1NG WELL?
c. WATER LEVEL Below Top of Cos1n f: �'
(Use'{-" If Allow Top of Casing)
d. TOP OF CASING IS 6. 0 FT. Above Land. Surface'
"Top of casing terminated at/or below land surface may require
a, variance In.syaCordanre with 18A NCAC 2C .0118.
e. YIELD Wpm): • METHOD OF TEST
f. DISINFECTION: Type Amount
it. WATER ZONES (depth-): '
From. . Co -To, l 2 - From To
From To From To
1ium To From To
I. CASING: Depth Diameter ThusimessrYvotpht MstSf1SI
From (3 To 2- FL 711 S�1n4D F' V
From To Ft
_
From To Ft.
9. GROUT: Depth Material j hrtathod
Foark_t r T , C Ft, �ITT.ICk 12S
From To Ft.
From_ To Ft.
,
9. SCREEN: Depth I Diameter Slot Sirs Material
From ?.r To, I �Fi 2- in() OW in. 0 VC -
From To Ft 1n. In.
Farm , To Ft, In. in.
10. SAND/GRAVEL PACK:
De f Size Material
Feecq To ! Ft 7*+1�-
From To Ft.
FromFt
__To_
I1.DR.ILUNG LOG .
From To Forma on n
p . ! C ra rttlrr S, i S
L. G Z G rr`..s-I �� SANS
•
12. REMARKS:
k-
l p0 HERESY i r1FY THAT Ti4SWE11 WAS CONSTRUCTED 1H ACCORDANCE watt
13ANCAC 20. WEL.00HSTIWCTiON STANDARDS, AND THAT ACOPY OF7H 5
RECORD HAS BEEN PROVCEDTO THEWELLOWNER
SZNKTURE OF ER7IFlE WECLCONT1 ACTOR DATE
s,`6►) a /cr I/r,r-d,/
PRINTED NAME OF PERSON CONS iRt1CTING THE WELL
Submit the original to the Division of Water Quality within 3Q days. Attn: infomiatlon Mgt,
1617 Mall Service Center- Raleigh, NC 27699-1617 Phone No. [phone] ext S58.
Fowl OW --lb
Rev.12107

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3270
i. WELL CONTRACTOR:
Justin Radford
Well Contractor (Individual) Name
Geological Resources, Inc.
Welt Contractor Company Name
STREETADDRES5 2301-F Crown Point Executive Drive
Charlotte NC 28227
City or Town State
{ 704 )_ $45--4d10
Zip Code
Area coda- Phone number
2. WELL INFORMATION:
SITE WELL I❑ #(if applicable) MW-21
WELL CONSTRUCTION PERMIT#(ifapplicable)
OTHER ASSOCIATED PERMIT #(if applicable)
3. WELL USE (Check Applicable Boxy MonItoringl5
Induslrfal/CommercialO Agricultural❑ Recovery0
Irrigator') Other('. (fist use)
WM0700950
N/A
Municipal/Public-0
Injectiortl
DATE DRILLED 4127110
PMO
Washington
TIME COMPLETED 0900 AMC
4. WELL LOCATION:
CITY: Creswell _ cauM-Y
US Highway 64 West
!Street Name, Numbers, Community, Subdivision, Lot No., Bartel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
$1Gpe 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE . 35.886833
May be in degret. ,
minutes, seconds Cr
in a decimal format
LONGITUDE 76.424972
Latitude/longitude source: 0 GPS I] Topographic map
Vacation of wall must be shown on a USGS topo map and
attached la this form if nal using CAPS)
5. FACILITY- IS the name or the business where the well ie located.
FACILITY ID Mil applicable) 0-006306
NAME OF FACILITY Phelps Amoco
STREET ADDRESS US Highway 64 West
Creswell NC
City or Town State . • Zlp Code
CONTACT PERSON William Regentbar
MAILING ADDRESS 2301 F-Cli3W11 Point Executive Dr
Charlotte NC 28227
City or Town State
( 704 ).845-4010
Zip Code
PESO NO0
FT.
Area code - Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12.0 feet
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: _3•5'
(Use'+' if Above Tap of Casing)
d. TOP,OF CASING 1S 0.0 FT. Above Land Surface'
'Tap of casing terminated al/or below rand surface may require
a variance In accordance with 15A NCAC 2C ,0118.
e. YIELD wpm): nla METHOD OF TEST
f. DISINFECTION: Type n/a Amount
g. WATER ZONES (depth):
From 3.5 To 12 From To
From To From To
From To From . To
T. CASING: Depth Diameter Thickness/Weight Material
From To 0 Ft 3 Sch 4C PVC
From To Ft
From To FL
8. GROUT: Depth Material Method
From 0 To 0.25 Ft Cement Pour
From 0.25 To 1 Ft Bentonite_ Pour
From To Ft.
9. SCREEN: Depth Diameter Slot Size Material
Frain 3 To 12 Ft. 2 in. 0.010 in. PVC
From To Ft. In. In.
From To FL in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
From 1 To 12 Ft. #2 Sand
From To Ft.
From To Ft.
11,DRILLING LOG
From To Formation Description
0 2 Black sandy topsoil
2 6 Gray and tan clay
6 12 Gray fuse sand
12. REMARKS:
I DO HERE BYCERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD', BEEN PROVIDED TO THE WELL NCR.
U
SIGNgGFURE OF CERTIFWEL TRACTOR DATE
Justin Radford, Geological Resources, Inc.
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Duality within 30 days. Attn: information Mgt.,
i817 Mali Service Center — Raleigh, NC 27699.1617 Phone No. 1919) 733-7015 ext 568.
Form GW-lb
Rev.12107

1
0000. W 076.44060V W 076.430006V° W
1 1 1 1 1 I 1 1 1 1 1 E i j 1 1 1 �}J 1 1 1 1 1 1 1 i
. , , i
�I
,e
Q
+a
cis
tegj
Mt Tabor,
Declination
MN 10.52' VV
11
1
ti- 4I
114'' ,J
Approximate
Site Location
•
Y
' Ifu` J
' r /
• i� - • _ _/`.
.1.1
• W a , _-
• f ti
Name: Site Location Map
Date: 10/02/14
Scale: 1 inch = 2,000 ft.
Figure 1
Former Phelps Amoco
U.S. Highway 64 West
Creswell, North Carolina
Incident* 12613
076.42147000" w
1 1 1 1 1
1
0
076.4400W W .L76.4000
!,
Y..
imi. _ r
_c_ .f.
=\ i 5�`
,BM
SCALE 1:24000
5 C-
-.z
8
r0�
- co
1000 2000 3000 4000 5000
- -1
FEET
Map Center Location: 035.8868333° N 076.4249722' W
Created by ECl- at Geological Resources, Inc.

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biodegrade that oil.
Utrirlerslll ~on,ln~-manu&m,,. andinwnatJonally
madteta unique oHbiodegtading products and support Ml'Vit:9$
that provide our·~ an NS,; otNHtep .method ol cleaning
up h,µ/rol:arbon spill•, retu.ming the sm, to its odginal state ..
PRP® OIL BUSTER
Hydrocarbon Spill Response Product
PRP°(OIL BUSTER') can be applied on most tracts of land and clings to most surfaces. It is
effective in fresh and salt water to control the spreading of oil spills in a one step application. It
significantly enhances the biodogration of the spilt. The product then ultimately biodegrades
itself.
All natural solid
absorbent r 1 •
N utrl entslmicro n ut rl a rats
within the
micrcei capsulation
100 Microns
Hydroplrobk and oleophillc
6 Nontoxic and nonhazardous
6 Stimulates indigenous microorganisms
B oaugmerrts the degradation of the spill
Mlnlmizes volatilization
Because it will not sink and repels water even after oil absorption, the benefits of PRP'
application are significant:
Rapid clean-up is facilitated.
Hard to reach areas such as sensitive marshlands can be treated remotely if left in place, the PRP'
and oil will biodegrade, minimizing arty toxic effects cf the oil.
6 PRP' reduces potential for the coating of mammals, wildlife, and plants which typically results in
severe damage.
6 Damage to beaches is minimized because the contamination is prevented from getting below
the surface.
6 If removal of the PRP7oil matrix is preferred, total recovered volumes are minimal, unlike vacuum
systems which generate large volumes cf contaminated water and minimal amounts of oil. The re-
covered matrix can then be landfarmed and bioremediated,
Apply PAP on transfer areas, marshlands, drainage ditches, wetlands, holding ponds, lagoons, shores, marinas.
and harbors. Reduce dysposal costs of oil contaminated water at irndustrial sites cr spill clean -bp operations by
using PRP to separate the oil from the water.

10
PRP® OIL BUSTER TM
Hydrocarbon Spill Response Product
These charts represen1: data from PAP" diesel fu~ spill fielcl test overseen and
evaluated by Nalional Environmental Technology Application Corporation (~ETAC).
CONTROL SPILL
• No biodegradalion
, Loss due to
vol:atillzatlon only
........_
1Q
!J,
~RP®TREATED SPILL
-----._ ~ &i> Within three weeks:
.. 97% decrease in
~ aHpha1ics
,.n • 76% decrease in
aromaUcs
PRP® OIL BUSTER''"'
Hydrocarbon Spill Response Product
P P' SPECIFICATIONS
BULK
1310.5010
B1O•ROOMe
50 lb. drums
8 oz. per SOK
12oz. per it
Do NOT use this product with any other bilge
cleaners or detergents as they prevent the oil/fuel
Crum being absorbed.
DIRECTIONS FOR USE
1
BULK
Apply dry by hand or dispense by agitation in water using
a hydroseederfire cannon or other venturi apparatus.
An application ratio of 1:2 by weight of PRP/ to oil is recom-
mend ed for CO r rrol and containment of the spill.
BlO-SDK
After rsmoving the Sok from the plastic bag, tie it securely
with the cord provided to a fixture in the bilge et the boat; Be
certain to place the Sok wh ere it wdl not g et caught up in
maveaele parts_ Then drop it into the water in the bilge tank
where it will float, absorbing and biodegrading the leaking
uilffuel.
8i4-ROOM
Remove plastic sleeve, position BioBooma, end tie securely
with the cords on each end. Do not stretch lightly. Leave
some slack. Should the area exceed the length of a single
BloBoomn, link as follows: Lay the BioBoamz end to srgd.
overlappng so that the and of each boom is adjacent to the
loop of the other [MOM i8" from end I. Draw cord around
opposite boom and tie to loop. Attach both overlapping ends.
BioBoornsr rnustfrt together snugly. Avoid indenting boom
with cord.
3
,na.cr doss rot mewl Atilt
'lanfmw uad r 40 CFR Of V,
b MTFO WY4ARr1N7Y, Sag
a lend
aunt Os/ tut Ott l 0
EXTWESSLYLWITS
PAffT1 L4A sata
Ingredients are 1CD% natural, nonhazardous.
nontoxic and biodegradable
• Naturally occurrirg raictoorgartlsms
Nutrients and micronulrients which
are requited for m:labvlic ac'lvily Of
microorganisms
ro r.�s reporTng wu{remprrs , S6cPen 3 t3 of SARA alt;ts regiku h"s a• any cafrpnnenr'>3uMve
azsurnoggayer Japkgsor. Amer re (fs orlu;ire oe uegradator Cr ce030 hyarucatoo . Seer
73.1Y ,� alrher. JI SOWS opkoo rg, acemof t ?I fre aei'eaqe goods 4 gr= trail) & t' vTE'U'J +f ,fie
o.. goAls !or went a wa airy Ga,'rrt 4 maw. ;O }e "Kemal sq &leer kartspatakli, arEAlia
SET FORn-' ABOVE' A,NO NEAEBY EXCL UCES OTTfER WARRANTIES EXPRESS OR iMPr.iEO IN
NT E5 MERCHAN7A8ILITY AND WARRANTIES OF FITNESS FOR ANY RART,Z'LCAP PURPOSE
Ar'tAeLf. T€I NOSE SET FORTN IN TNlNS LIMITED 'WARRANTY' IN NO EVENT SHALL SELLS SE
SS OrPilCFI TS C'R ANY OTHER FORM OF!_ni[F5E0UENTIAI OR JND RECT C,'IM4GE5 MA TSCE irER
AIL6 Petrol rem
Universal Remediation. Inc.
1405 Parkway View Drive ■ Pittsbu rg h. PA 15205
Ph: 412-710-2444 - IFax: 412-768-0111
www.bio-sok.com

MATERIAL SAFETY DATA SHEET
Oil Buster®/ PRP®
Effective Date:
Revised:
September 2004
January 2008
Product Names: Beeswax/ Soy Wax l Com Cob
Section 1: Manufacturer's Information
UNNERSAL REMEDIATION, INC.
1405 PARKWAY VIEW DRIVE
PITTSBURG~ PA 15205
TOLL FREE: [phone]
PHONE: [phone]
FAX: [phone]
Section 2: Composition/ Information on Ingredients
FOR EXPOSURE LIMITS SEE SECTION 8
FOR OTIIER TOXICOLOGICAL INFORMATION SEE SECTION 12
COMPONENT
NAME
Filtered Beeswax
Filtered Soy wax
Corncob Fractions
Section 3: Hazards Identification
Emergency Overview
%EXPOSURE
LIMITS
YES NO
X
X
X
SEC 12INFO
YES
X
X
X
This is a non-combustible, non-reactive, granular, solid material. It is supplied in the fonn of a
powder. Use methods suitable to fight surrounding fire. Exposure to dusts may be irritating to
eyes, nose and throat. At very high exposure levels, the dust may have an effect on the lungs.
Firefighters should wear self-contained breathing apparatus and full protective clothing. Use
extinguishing methods suitable for surrounding fire.
Potential Effects of Acute Exposure
Eye:
Skin Contact:
Powder may cause mechanical eye irritation.
May cause skin irritation. Long-term contact may cause de.pletion of natural skin
oils.
Page I of 4
Skin Absorption:
Ingestion:
Inhalation:
Possible Effects of
Chronic Exposure:
No components are known to be available for absorption through the skin.
May cause gastric disturbance if large amounts are swallowed.
Breathing large amounts may cause initation to the lungs. Treat as a nuisance
particulate.
None known for product.
Section 4: First Aid Measures
Eyes:
Skin:
Inhalation:
Ingestion:
Flush eyes immediately with plenty of water for at least 15 minutes. Consult a
physician if init.ation persists.
Wash skin thoroughly with mild soap and water.
Move person to non-contaminated air. Call a physician if irritation persists.
No need for fll'St aid is anticipated if material is swallowed.·
Section S: Fire Fighting Measures
General:
Flash Point:
Flammability
Limits:
Auto Ignition
Temperature:
Hazardous
Combustion
Products:
Fire Fighting
Instructions:
The wax will bum at high temperature. As with other organic material, any dust
that is generated may be explosive if mixed with air in critical proportions and in
the presence of a source ignition.
Greater than 2300 C / 400" F.
Not available.
Not applicable.
As Product is heated, it proceeds to a liquid form, and at higher temperatures, and
it forms combustion products that include oxides of carbon, sulfur and nitrogen.
Wear full protective clothing; including helmet, self-contained positive pressure
or pressure demand breathing apparatus, protective clothing and facemask.
Section 6: Accidental Spill / Release Measures
General:
Large/Small Spill:
Waste Disposal:
The Products are not considered hazardous material. The function of this product
is to aid in the spills / releases of oil-based products that may be regulated under
Federal, State and Local authority.
Collect spill using a vacuum cleaner with HEPA filter. Place in a closed
container. Do not dry sweep.
Products as produced do not contain any material regulated as hazardous. When
product is used to aid in clean up of oil-based product,, the treated oil product
must be tested to determine its status as a regulated waste and disposed of in
accordance with all applicable regulations.
Page2 of4
Section 7: Handling and Storage
General Handling
Precautions:
Storage Requirements:
Incompatibility:
Avoid inhalation of dusts. Avoid contact with skin and eyes. Wash thoroughly
after handling. Keep container c losed and dry.
Store in a dry, cool area. Avoid temperatures in excess of35° C / 95° F .
Detergents I Surfactants
Section 8: Exposure control/ Penonal Protection
Ventilation:
Exposun, Limits:
Chemical Name:
Particulates ( not
otherwise regulated):
NFP A Rating:
Whenever dusts are generated, use appropriate local exhaust ventilation to keep
exposures below the regulated limits.
OSHA: TWA-STEL ACGil:I: TWA-STEL ~ TW A-STEL
OSHA: total dust: 15 mg/m3
Respirable Fraction: 5 mg/m3
Health,.... 0, Flammability-I, Reactivity-0
Personal Protective Equipment
Eye Protection: Wear safety glasses with side shields.
Skin Protection: Wear cotto~ rubber or other appropriate work glove~ if necessazy for type of
operation.
Protective Clothing: Coveralls, apron.
Respiratory Protection: Not nonnally needed. If permissible, levels are exceeded use NIOSH approved
dust respirator.
Section 9: P .hysical and Chemical Properties
Physical State:
Odor and Appearance:
Specific Gravity:
Boiling Point:
Vapor Pressure:
Percent Volatile;
Vapor Density:
Softening Point:
pH:
Solubility 9in H20):
Freezing Point
Evaporation Rate:
Viscosity:
Melting Point:
Solid (particulate)
Yellow/ White/ Amber (Honey Odor)
0.97 gm/ cm1 (density)
Not applicable.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
Insoluble.
Not applicable.
Not applicable.
Not applicable.
130° F / 55° C
Section 10: Stability and Reactivity
Stability:
Conditions to Avoid:
Stable at temperatures below 230° C / 400° F.
Sparks~ flames and exposure to heat.
Page 3 of4
Hazardous
Polymeriz.ation:
Incompatibility:
Will not occw-.
Detergents and Surfactants.
Section 11: Transport Information
This product is not regulated as a rumu-dous material by the United States (DOT) or Canadian (TGD)
transportation regulations.
Section 12: To:sicological Information
Eye Effects:
Skin Effects:
Acute Oral:
Chronic Effects:
Particles may cause mechanical irritation. Symptoms can include irritation and
redness.
Particles may cause irritation.
No adverse health effects are known for this product. Ingestion may cause
transient irritation of throat, stomach and gastrointestinal tract.
Long-tenn skin contact with this product may lead to depletion of natural skin
oils.
Section 13: Regulatory Information
TSCA Status:
CERCLA/SARA:
RCRA:
All components are Jisted on the TSCA inventory.
This product does not contain any ingredient that is subject to the reporting
requirements of Section 313 of SARA and its associated regulations.
This product does not contain any component identified as hazardous under 40
CFR 261.24. Waste must be handled in accordance with all applicable
regulations. Purchaser is advised to review regulations referenced for
applicabi]ity as determined by purchaser~s use of product.
Section 14: Disclaimer of EXPRESSED aad Implied Warnmties
Seller warrants that the goods will, assuming proper application, enhance and stimulate the
biodegradation of certain hydrocarbons. Seller expressly limits its obligation and liability under this
limited warranty to either, at Seller's option, replacement of the defective goods or granting Buyer credit
in the amount pa.id for the defective goods. If requested by Seller, goods for which a warranty claim is
made will be returned to Seller, transportation prepaid.
SELLER EXPRESSLY LIMITS ITS W ARRANlY TO THE TERMS SET FORTH ABOVE AND
HEREBY EXCLUDES ALL OTHER WARRANTIES EXPRESSED OR 1MPLIED, IN PARTICULAR
EXCLUDING ANY AND ALL WARRANTIES OF MERCHANTABILITY AND WARRANTIES OF
FITNESS FOR ANY PARTICULAR PURPOSE. SELLER LIKEWISE LIMITS THE REMEDIES
AVAILABLE TO THOSE SET FORTII IN THIS LIMITED WARRANTY. IN NO EVENT SHALL
SELLER BE RESPONSIBLE FOR ANY LOSS OF INCO~ LOSS OF PROFITS OR ANY OTHER
FORM OF CONSEQUENTIAL OR INDIRECT DAMAGES WHATSOEVER
Page4of4
Z
+ D)
4
Q0
Cnra 5 i I sand
1,so}
Jo Type ins,
Was deS*otied 1i_-fie
Cor rtz-iic
o
11G IZ Co [3
101
} ¢
Q
-er jfC..

LEGEND
TYPE 11 MONITORING WELL
TYPE II MONITORING WELL
(DESTROYED/ABANDONED)
r� POWER POLE
WATER SUPPLY WELL
FENCE
HIGHWA Y MEDIAN
ou OVERHEAD UTILITY UNE
uT TELEPHONE LINE
Note.•
1. This Site mop is based on ❑ Site Plan doted May 4
2002 that was created by Coastal Environmental
Services Inc.
2. This Site was not professionally surveyec{• all
distonce.5 locations, and utilities are approximat8.
UT
UT UT
MW-6
{T
MW 23
UT
UT
UT JD' U _ UT
OLD HIGH WA Y 64 / NC HIGH WA Y 94
{ M O15
Du UJJ ■"CL., LIU
aLf
MW-24
MW-14
Gross Shoulder
1
M — 6
Former 1, 000-Gallon��
Diesel Fuel UST
l
¥2
Ma21
Former 4, 000-Gollon
Gasoline USTs (3)
Firmer Pump
,---Former
DITCH
Grass Shoulder
MW-18
Former Phelps
Amoco
US HASNWA Y 54 »EST WND LANE
Former Phelps
Residence
MW-20
MW 19
a
Gross Medion
US HIGHWAY 84 EASIBO)ND LANE
Geological Resource., Inc.
0
15
30
60
( IN FEET )
finch -,30fe
51 TE MAP
Farmer Phelps Amoco
Creswell, Washington County, NC
U..5 Highway 64 West
Incident AO 12673
Date: 12/03%15 I Drawn bj ECH ` Figure: 2

LEGENQ
TYPE 11 MONITORING WELL
TYPE 11 MONITORING HELL
(DESTROYED/ABANDONED)
via.) POWER POLE
WATER SUPPLY Fff71
>e w FENCE
HIGHWAY MEDIAN
au OVERHEAD 1177LITY LINE
UT TELEPHONE LINE
- - - - 9 8. 0 - — — - WA7E"R TABLE SURFACE CONTOUR
(97.97) GROUND WA TER ELEVA770N (Fr)
(NM) NOr MEASURED
UT U7
1 M 6
1 22 (9z9i)
a
0)
1
1
UT
MW-23
(9v2) r UT
s
UT
OLD HIGHWAY 64 / NC HIGHWAY 94
I
1
M v15
it(9600)
I
A
r
r
14 X K x X x x K K
..0 Mi1�22
do*r9a.0- (974%
I -
MW -76
v
(97&)
riu
' MW -24
lW-74 , Iv
a v7J
(9 &2) Gil �ti`
11 11 It 17 M 74 7/ 17 it I. Pt if 41- —M-.iF -44 M IC • M - lF
MW-21
(9764)
MW-17
(97..87)
DI rcH
Former Phelps
Amoco
LIS MUMMY 64 NE57H (ND LANE
Former Phelps
Residence
Mii'-11
(9725)
1
M1Y-20 .0 Mile 19
r9v7) (9 76)
'-'98
LIS I#CHA4 Y 84 EAs78O1AAV LANE
0 15 JO
60
1-
Geological Resources. Inc.
( IN FEET )
1 inch 30 ft
WATER TABLE SURFACE MAP (17/11/75)
Former Phelps Amoco
GYeswell. Washington County. NC
U.S. Highway 64 West
Incident Or 12613
Dots- 12/03/15
Drawn by ECH
Figure' 3

LEGEND
TYPE 11 MONITORING WELL
TYPE 11 MONITORING WELL
(DESTRD YED/ASANDONED)
rQ POWER POLE
WATER SUPPLY WELL
FENCE
HIGHWAY MEDIAN
ou OVERHEAD U77LITY LINE
UT TELEPHONE LINE
- - - 97.50 - WA7ER TABLE SURFACE CONTOUR
(9735) GROUND WATER ELEVA 770N (FT.)
(NM) NOT MEASURED
LIT UT
1
MW 6 1
Go MW-23%
E (97.35) Q
T (97.48,.
OLD H1G'HWA Y 64 / NC HIGH WA Y 94
MW-16
(NM)
MW- IS
(97.43)
ou'�'m.�
Ru
x M M BAL
MW-22
(9�52)._ ~\
\
MW- 78
(NM)
r
�D
Former Phelps
Amoco
MW-14
(9Z.55)
M -21
(9732)
US HIGHWAY 64 $$ES7SOUND LANE
MW-24
► (97554.
MW-17
(NM)
9750
Former Phelps
Residence
MW-20
: i1TMl
M-19
(NM)
US rVGHWA Y 64 EASTBOUND LANE
Geological Resources, Inc.
0 15 30 50
(INFEET)
I inch a. J0 ft
WATER TABLE SURFACE MAP (04/01/15)
Former Phelps Amoco U.S. Highway 64 West
Creswell, Washington County. NC Incident # 12613
Date:: 04/24/15
Drawn by.
Eat
Figure:

0u
UT
<0.17
<0.17
<0.15.
<0.43
<0.18
<0.12
CONCEN7RA TONS IN ftg/C
,LEGEND
TYPE 11 MONITORING WELL
TYPE 11 MCWITQRING HE'LL
(DESTROYED/ABANDONED)
POWER POLE
WATER SUPPLY WELL
FENCE
HIGHWAY MEDIAN
OVERHEAD 6171LITY LINE
TELEPHONE LINE
BENZENE
TOLUENE
ETHYLBENIENE
X# ONES
NAPHTHALENE
sQ 17 LESS THAN IHE METHOD DE7ECnON LIMIT
SPEC/RED IN 7HE LABORATORY REPORT
J" ES77MA IEO VALUE
(NS) NOT SAMPLED
UT
<0.17
<0.17
<0.15
ca.a3
<0.1 E
®.12
MW-6
<0.17
"40.17
UT UT [0.43
MW-23
<4.18
<0.12
SIT UT UT UT UT UT
OLD HIGHWAY 54 / NC' HIGHWAY 94
• x \ x
I
MW"-16'
(Ns)
<0.17
<0.15
<0.43
<0.12
of a1
m tc K M x $ x
MWL22
MW-24
337
1.3116
C8.2
115
OU
$ K K 14 x
MW-21
its
MW=14
<0.17
m,17
<0.15
<0.43
<0.16
<0.12
x M X Y K X x x $ $ ii K r x M ).
MW 17
Cio
(NS)
x }c $
DITCH
MW 18
(NS)
Former Phelps
Amoco
US H1CWWA Y 64 ifES FECUND LANE
Former Phelps
Residence
MW-2D
M-79
(NS)
US HIGH 14.14 Y 64 EAS78 kIND LANE
Geological Resourcesy Inc.
0 75 30 60
( IN FEET )
1inch30ft
GROUND W'A1ER QUALITY MAP (11/71/15)
Former Phelps Amoco
Creswell, Washington County, NC
U.S Highway 64 West
Incident / 72613
Dote: 12/03115
Drawn by.
ECH
Figure