WI0800469_DEEMED FILES_20170221

INJECTION EVENT RECORD
RECEIVED/NCDEO/DWR
FEB 21 2017
Water Quality Re .
North Carolina Department of Environment and Natural Resources -Division of Watet(!Jplsmr~ Sec~·ional
Permit Number w,oaoo469 ion
1. Permit Information
Carteret-Craven Electric Cooperative (attn.: Jake Joplin)
Permittee
Carteret-Craven Electric Cooperative
Facility Name
1300 HIGHWAY 24, Newport, NC 28570
Facility Address
2. Injection Contractor Information
Terraquest Environmental Consultants, P.C.
Injection Contractor/ Company Name
Street Address 100 E. Ruffin st
Mebane NC 27302
City State Zip Code
~ 563-9091
Area code -Phone number
3. Well Information
Number of wells used for injection 2
-----
Well names MW6 MW?
Were any new wells installed during this injection
event?
D Yes Iii o
If yes, please provide the following information:
Number of Monitoring Wells _____ _
Number of Injection Wells ______ _
Type of Well Installed (Check applicable type):
D Bored D Drilled D Direct-Push
D Hand-Augured D Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
D Yes Iii No
If yes, please provide the following information:
Number of Monitoring Wells _____ _
Number of Injection Wells -------
Please include a copy of the GW-30/or each well
abandoned.
4. Injectant Information
Oxygen BioChem
Injectant Type
Concentration =solubility=? weight %
If the injectant is diluted please indicate the source
dilution fluid. bottled water ------------
Total Volume Injected o.4 gallons
Volume Injected per well 0 -2 gallons/well
5. Injection History
Injection date(s) 11 /15/16 ------------
1 n j e ct ion number ( e.g. 3 of 5)_1_o_f_4 ___ _
Is this the last injection at this site?
D Yes Iii No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
tD/4 Digitally signed by Ryan D. Kerins
ON: cn='Ryan D. Karins, o, ou, emaiP"rdkerin..@temique5lpc:.~m,
c•US
Dale:2017.02.1709:57:37-05'00'
SIGNATURE OF INJECTION CONTRACTOR DATE
Michael J. Brown
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 8/5/2013
Duo( w.rc&OolyiG 9
RECEIVEDiNCQEWaWR
INJECTION EVENT RECORD
FEB 2 0 2017
North Carolina Department of Environment and Natural Resources — Division of Water Resouccgrbrouelity
Permit Number W1O8OO469 P190+0n6! C]
perarfa+ts Section
I. Permit Information
Carteret -Craven Electric Cooperative (attn.1 Jake Joplin)
Permittee
Carteret -Craven Electric Cooperative
Facility Name
1300 HIGHWAY 24, Newport, NC 28570
Facility Address
2. injection Contractor Information
Terraquest Environmental Consultants, P.C.
Injection Contractor / Company Name
Street Address 166 E. Ruffin St
Mebane NC 27302
City State Zip Code
919 563-9091
Area code — Phone number
3. Well Information
Number of wells used for injection 2
MW6 MW7
Well names
Were any new wells installed during this injection
event?
❑ Yes ElNo
If yes. please provide the following information:
Number of Monitoring Wells
Number of Injection Wells _
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy o f the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
❑ Yes 0 No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned.
4, Injectant information
Oxygen BioChem
Injectant Type
Concentration =solubility=7 weight %
If the injectant is diluted please indicate the source
dilution fluid. bottled water
Total Volume Injected °'4 gallons
Volume Injected per well 0'� gallons/well
5. Injection History
injection date(s) I 1 / 15/16
Injection number (e.g. 3 of5)1 of 4
Is this the last injection at this site?
❑ Yes 1■ No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT_
bJ
Zak.k wow oy Rymn C. I*.
• o,.nyd,.C1. Norm e.ent..,ti...1,..4,..,,, v,.
CPUS
DOW all/94]7'J7-Wee
SIGNATURE OF INJECTION CONTRACTOR
Michael J. Brown
DATE
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: U1C Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Forrn U1C-IER
Rev. 8/5/20 ! 3

Central Files: APS _ SWP _
8/11/2016
Penn ;dumber W10800469 Permit Tracking Slip
Program Category
Deemed Ground Water
Permit Type
injection Deemed In -situ Groundwater Remediation Well
Prlrnary Reviewer
shnsti.shrestha
Coastal SW Rute
Permitted Flow
Facility
Status Project Type
Active New Project
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Jake Joplin
PO Box 1490
Newport
NC 28570149C
Facility Name
Carteret- Craven Electirc Cooperative
Location Address
1300 Highway 24
Newport
Owner
NC 28570
Major/Minor Region
Minor Wilmington
County
Carteret
Facility Contact Affiliation
Owner Name
Carteret -Craven Electric Cooperative
❑-cos/E vents
Owner Type
Non -Government
Owner Affiliation
Craig Conrad
PO Box 1499
Morehead City
NC 28557
Scheduled
Orig issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
8/11/2016 8/10/2016 8/11/2016 8/11/2016
Re.ulated Activities Re9uested /Received Events
Groundwater remediation
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

Shrestha, 5hristi R
From: Shrestha, Shristi R
Sent: Thursday, August 11, 2016 10:11 AM
To: 'Ryan Kerins'
Cc: Rogers, Michael; Gregson, Jim; King, Morella s
Subject: WI0800469 NOI - Carteret -Craven Electric RE: Notice of Intent Submittal
Good morning,
Thank you For submitting the Notice of intent to Construct or Operate Injection Weils (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
htt:::/tdej nc,gov,'about/divisions/water-resources water-resources-»ermitsiwastewater-branch:ground-water-
arotectlon/ground-water-reporting,-forms
2) Injection Event Records (1ER). All injections, including air and passive systems require an IER. The IER can be
modified for air sparge wells (e.g., air flow 'continuous' for date or rate of injection, etc.).
You can scan and send these forms directly to me at Shristi.shresthaloncdenr.ov 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 W10800469. This number is olso referenced in the subject line of this email. You may if you
wish, scan and send back as attachments in reoly 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. Shresthe
Hydrogeologist
Water Quality Regional Operations Section
Animal Feeding Operations & Groundwater Protection Branch
North Carolina Department of Environmental quality
919 807-6406 office
shristi.shrestha: ncdenr.aov
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.
From: Ryan Kerins [mailto:[e-mail]]
Sent: Tuesday, August 09, 2016 10:37 AM
To: Shrestha, Shristi R <[e-mail]>
Cc: 'Ryan Kerins' <[e-mail]>
Subject: Notice of Intent Submittal
Please find the attached Notice of Intent for the Carteret Craven facility . Thanks very much!
Ryan Kerins
Terraquest Environmental Consultants, P.C.
100 E Ruffin St, Mebane, NC 27302
919.563.9091
Shrestha, Shristi R
From: Shrestha, Shristi R
Sent: Thursday, August 11, 2016 10:15 AM
To: Gregson, Jim; King, Morella s
Cc: Rogers, Michael
Subject: NOI WI0800469 Carteret -Craven Electric Cooperative
Attachments: WI0800469 NOI.pdf
Please find the attached NCI.
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.shresthaincdenr.aov
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.

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
Tl,efollowi11g are '~Jermitted by rule" rmd do 1101 require <111 imlivitllwl permit wlte11 co11structe,I 111 accordance
with the m/e.r of 15A NCAC 02C .0200. TIiis form sltn/1 be submitted lll least 2 weeks prior to h1 ieclio11.
AQUIFER TEST WELLS CI SA NCAC 02C .02201
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN S/TUREMEDIATlON (I SA NCAC 02C .0225) or TUACER WELLS (15A NCAC 02C .0229 ):
I) Passive Tn iection Sv stems ~ In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale In iection 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 1ic1·mit shall be required
for test or tt·eatment areas cxccccling 10,000 squai·e 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 implementat ion, 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 :my separate groundwater cont:1111h1ant plume.
4) Air In jection Wells -Used to irtject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type /11/ormat/on. Jfleglble Suhmittals Will Be Returned As l11complete.
DATE: _____ , 20 __ PERMIT NO. Vv .:L O 8 0 0 q.. b q (to be filled in by DWR)
A, WELL TYPE TO BE CONSTRUCTED OR OPERATED
___ Air Injection Well ...................................... Complete sections B-F, K, N
___ Aquifer Test Well ............. ., ........................ Complete sections B-F, K, N
RECEIVED/NCDEQ/DWR
X __ Passive Injection System ............................... Complete sections B-F, H-N
___ Small-Scale lnjection Operation .... , ........... ,, .... Complete sections B-N AUG 0,'.9 2016
___ Pilot Test ........ , ........................................ Complete sections B-N
(1)
(2)
(3)
(4)
(5)
(6) ___ Tracer Injection Well ................................... Complete sections B-N Water Quality
Regional Operations Section
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER-State name of entity and name of person delegated authority to sign on behalf of the business
or agency:
Name; Carteret-Craven Electric Coo perative (attn.: Jake Jo plin)
Mailing Address: .,_P ,..,,.O,_,_ • .,,,,B=o=x...,.1-"49<..:!0'--------------------
City: New port State: ... N~C.....__ Zip Code: 28570-1490_County: Carteret
Day Tele No.: 252-727-2205 Cell No.: __________ _
EMAIL Address: [e-mail] Fax No.: ---=2=5=-2--=24-'-7'--=02=3=5 ___ _
UIC/Jn Situ Remed. Notification (Revised I 1/19/2013) Pago I
D. PROPERTY OWNER (if different than well owner)
Name: _________________ _
Mailing Address: _________________________ _
City: _______ State:_ Zip Code: ____ County:_
Day Tele No.: Cell No.: __________ _
EMAIL Address: Fax No.: __________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: ______ _,_R-".L-'a,,_,n_,_K'""'e""r-'-'in,.,,s'-----------------------------
Mailing Address: _____ __,_l""'0,,_0-=E'--'R..,.t,,.,1ffi'-'--1,,_,n'--'S,,_,t _____________________ _
City:_ _ __,_M,..e..,b,..aee.:n""e ______ State: NC Zip Code: 27302 County:_Alamance
Day Tele No.: ___ _.9"""1-"-9_.-5=6=3-"""9"""0"--9 "-I _____ _ Cell No.: 919-906-0960
EMAIL Address: __ __.1...,.·d.,,.,k,...er .... in...,s.,.0.,,u.,_,te""n""'·a.,.q""ue""s""tp"""c"'.c""'o""n:.:..1 __ Fax No,: 919-563-9095
F. PHYSICAL LOCATION OF WELL SITE
(I) Physical Address: __ _,1=3_,,_00"---=H=IG""He.e..,..,Wce.A~Ye....=24..,__ ________________ _
________________________ County: Caiteret
City: New port State: NC Zip Code: _..,,2=8~57,__,0'--------
(2) Geographic Coordinates: Latitude**: ___ 0 ______ " or 34 ° _7""'3..,6=8 ___ _
Longitude**: ___ 0 ______ "or-76 °. __ ~8=6_,,_68~----
Reference Datum: North American Datum of 1927 Accuracy: l/2 of
a contour interval from actual elevation . and/or more than 1/40 ofan inch (0 .6 mm ) horizontally from actual positi on
Method of Collection: USGS 7.5 minute to po
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARJES MAY BE SUBMITTED IN LIEU Of GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: _______ square feet
Land surface area of inj. well network: square feet~ 10,000 ft 2 for small-scale injections)
Percent of contaminant plume area to be treated: (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 ve1tical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
UIC/Jn Si111 Reined. Notification (Revised 11/19/2013) Page 2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief nan-ative regarding the
purpose, scope, and goals of the proposed injection activity.
Well socks will be hun g in twelve {1 2) monitorin g wells.
--------------------------------------
J. INJECT ANTS -Provide a MSDS and the following for each injectant. Attach additional sheets ifnecessaiy.
NOTE: Approved injectants (tracers and remediation additives) can b e found on/ine at
h1tp:llportal.11 cde11r.orglweblwqlapslgwpm All other substances mus/ be reviewed by the Division of Public
Health Department of Health and Human Services. Contact the UJC Program/or more info (919-807-6496).
lnj ectant: Ox yg en BioChem
Volume ofinjectant _The volume is 0.2 gallons of solid per point. ________ _
Concentration at point of injection: The solubilit y is approximatel y 7 wei ght percent . so that is the
concentration .
Percent if in a mixture with other injectants: I 00¾c.cC=n=o....,o=th=e=r_,_) __________ _
lnjectant: --------------------------------
Volume of injectant: ___________________________ _
Concentration at point of injection: ______________ _
Percent if in a mixture with other injectants: ___________________ _
lnjectant: --------------------------------
Volume of injectant: ___________________________ _
Concentration at point of injection: ______________________ _
Percent ifin a mixture with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
( l) Number of injection wells: --~O ___ Proposed _ -~1=2 __ Existing
(2) 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:
(a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery)
(b) depth below land surface of grout, screen, and casing intervals
(c) well contractor name and certification number
UIC/fnSitu Remed . Notification (Revised I 1/19/2013) Page3
L. SCHEDULES —Briefly describe the schedule for well construction and injection activities.
Wells are already installed. Socks will be hung in Setstember/Ocer 2016, Refili_of.the socks may occur
periodically as needed. _
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to he used to determine
if violations ofgroundwatcr quality standards specified in Subchapter Q2L result (ram the injection activity.
Site is currently sampled every tltree years as directed In, the NCDWM UST. Tittt will continue:
N. SIGNATURE OF APPGTCANT AND PROPERTY OWNER
APPLICANT:, "Thereby cerr jy, under penalty (Dent: that I ❑rya familiar riifth the information submitted in this
document and all attachments thereto and that, based on my inquiry+ of those indivviduals imnmediately responsible
At- obtaining said itfnrnration 1 believe that the it faruration is true, accurate and complete. 1 am aware that
there are significant penalties, including the possibility of fines and imprisonment, for submitlhrg false
it for►nation, I agree 10 construct, operate, maintain, t•epair, and if applicable, abandon the hetection well and
all related p ur ten ices in accordance with the 1511NCAC 02C 0200 Rules."
Signatur fApplIcarit
21474:9:ed
Print ar Type Full Name
PROPERTY OWNER. (if the pro erly is not owned by the permit applicant):
"As owner of thepr'operty an which the injection wells, are in he constructed and operated, 1 hereby consent to
allow the applicant to constrrtc1 each injection ivefl as outlined in this application and agree that it shall be the
responsibility of the applicant 1a ensure that the injection weals) conform to the Well Construction Standards
(15A NC4CO2C.020Ai. "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Signature* of Property Owner (if different from applicant) Print or Type Full Name
'" An access agreement between the applicant and property owner may be submitted in lieu of a signature an thisfonn.
Suhrnit one copy of the completed notification package to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
MUM Stitt Reined. Notification (Revised i 1 /19/203) Page 4

Table 1 MONITORING WELL CONSTRUCTION INFORMATION
Date : 8/4/16 Incident Name: Carteret-Craven Electric Cooperative Incident No . 5835 Facility ID No : 0-001077
Well Casing Screened In te rval Bottom of Top of Depth to Free
Date Water Depth (xtoyfee t Well (feet Casing Water from Product Groundwater
Level (feet below below ground below ground Elevation Top of Casing Thickness Elevation
Well ID Date Installed Measured ground surfacE!) surface) surface) (feet) (feet) (feet) (feet) Comments
MW1 9/20/90 10/20/15 2.5' 2.S'-12 .5' 12.5' 100.00 3.72 NP 96.28 2" Diameter Type II monitoring well
MW2 9/20/90 2.5' 2.5'-12 .S' 12.5' 99.88 -NP -2" Diameter Type II monitoring well
MW3 9/20/90 2.5' 2.5'-12.5' 12.5' --NP -2" Diamet er Type II monitoring well
MW4 9/20/90 -2.5' 2.5'-12 .5' 12.5' 99.00 --2" Diameter Type II monitoring well
MW5 U/30/91 OC:20 I IC: 25 25'-30' 30' 99.55 --2" Diameter Tvoe Ill monitoring well
MW6 U/26/91 10/20/15 2.5' 2.5'-15' 15' 99.72 3.58 NP 96.14 2" Diameter Type II monitoring well
MW7. U/26/91 10/20/15 2.5' 2.5'-15 ' 15' 99 .16 3.13 NP 96.03 2" Diameter Type II monitoring well
MW8 U/18/91 2.5' 2.5'-15' 15' -- -
-2" Diameter Type II monitoring well
MW9 5/20/92 -2.5° 2.5'-15' 15' 99.79 --2" Diameter Type II monitoring well
MWlO 10/28/92 10/20/15 2.5' 2.5'-15' 15' 99.63 3.80 NP 95 .83 2" Diameter Type II monitoring well
MW11 10/29/92 -ABANDONED 2" Diameter Type II monitoring well
MW12 10/30/92 -OC:20 ( IC: 23.5 23 .5'-26' 26' ----2" Diameter Type Ill monitori ng well
MW13 10/29/92 . 2.5' 2.5'-15 ' 15' 99.51 --2" Diameter Type II monitoring well
MW14 3/21/95 NOT LOCATED 2" Diameter Type I! monitoring well
Notes:
1. All units In feet.
2. -Information not available.
3. OC = outer casing, IC= inner casing, NP= no free product detected.
4. MWll has been abandoned .
MAINTENANCE
BLDc.
ESTIMATED EXTENT OF MAINTENANCE]2L STANDARD
VIOLATIONS NA5Y2 ELEC.
4MW3''' �.ArWe +Nw
�Fw ygq
IrW44
kcw7+
.. +MW13
kiwi1� Nwg1W12
WAREHOUSE AND
LOADING DOCKS
CARTERET-CRAVEN
ELECTRIC COOPERATIVE
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LEGEND
'. TYPE li GROUNDWATER MONITORING WELL
TYPE III GROUNDWATER MONFfWRIt1G WELL
-0- WELL HAS SEEN ABANDONED
UNABLE TG LOCATE
Analytical results for the 10/20/15
sampling event are provided in
ug/L.
Monitoring walls MW1. MWS, MW7,
and ittW10 were the only wells
sampled an this dote.
Analytical results are summarized
in Table 3. The full analytical
report is provided in Appendix B.
r,..w
a r z
r.r
CHECKED BY;

WATER TABLE
IRW10 MW9 MW7I /elf
ESTIMATED EXTENT
Or 2L STANDARD
VIOLATION
MW4 MW5 MW5
MW1
/ •
OUTER CASING
(TYPE III)
y
WELL SCREEN
WELL SCREEN
(TYPE III)
20'
10'
VERTICAL SCALE 1 "-10'
HORIZONTAL SCALE 1"=30'
VERTICAL EXAGGERATION x 3
20.
40'
CCEMC
CROSS SECTIONAL VIEW
CARTERET CRAVEN ELECTRIC COOPERATIVE
NEWPORT FACILITY
CARTERET COUNTY. NC
NEWPORT. NC
Ell at kpest
ENVIRONMENTAL CONSULTANTS, P.C.
PROJECT NO. 05105
DATE: 8/4/16
CHECKED BY: MJB
SCALE: AS NOTED
DRAWN BY: ROK
FIGURE NO. 2