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HomeMy WebLinkAboutWI0800526_DEEMED FILES_20191025D~ North Carolina Department of Environmental Quality -Division of Water Resources INJECTION EVENT RECORD (IER ) Permit Number WIOS00 526 I. Permit Information GPM Southeast. LLC Pem,inee GPM 3016 Facility Name 201 East Church Street, Atkinson , Pender County Facility Address (include County) 2. Injection Contractor Information CES of NC, PLLC Injection Contractor/ Company Name Street Address 5104 Reagan Dr., Ste. 7 Charlotte NC 28206 City State Zip Code ~ 236-8143 Area code -Phone number 3. Well Information Ucr 2s zo Number of wells used for injecti9JJ 1 ~ ~ lffiiof'lel &f QtJeli Well IDs MW-15 OIJe~0118'1J, Were any new wells installed during this injection event? D Yes ~ No If yes, please provide the following information: Number of Monitoring Wells _____ _ Number of Injection Wells _______ _ Type of Well Installed (Check applicable type): D Bored O Drilled D Direct-Push D Hand-Augured O Other (specify) __ _ Please include a ctJpy 1,f t/1e GW-J ftm11/or eucl, well i11.,;tu/led. Were any wells abandoned during this injection event? 0 Yes (ZI 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 Carus Corporation RcrnOx SR+ (Passive Cylinder) Injectant(s) Type (can use separate additional sheets if necessary Concentration _1,._,0""'0;.:_o/c"'"o ________ _ If the injectant is diluted please indicate the source dilution fluid. ___________ _ Total Volume Injected (gal) Solid weight 52.8 lb Volume Injected per well (gal) Solid weight 52.8 lb 5. Injection History Injection date(s) 9111119 ------------ l n j e ct ion number (e.g. 3 of 5) ------- Is this the last injection at this site? D Yes Ix] 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. A.. la/_~/• s ~- SIGNATURE OF INJECTION CONTRACTOR Aaron Williamson 10-11-, DATE Submit the original of this form to the Division of Water Resources within 30 days of injection. Attn: VIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464 Forni UIC-lER Re,·. 3•1-2016 Permit Number WI0800526 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 GPM 3016 Location Address 201 E Church St Atkinson Owner Owner Name Gpm Southeast LLC Dates/Events NC Orig Issue 8/28/2019 App Received 8/22/2019 Regulated Activities Groundwater remediation Outfall Waterbody Name 28421 Draft Initiated Scheduled Issuance Public Notice Central Files: APS SWP 8/29/2019 Permit Tracking Slip Status Active Version 1.00 Project Type New Project Permit Classification Individual Permit Contact Affiliation Major/Minor Minor Facility Contact Affiliatlon Owner Type Non-Government Owner Affiliation Rolfe Lann 8565 Magellan Pkwy Richmond Region Wilmington County Pender VA Issue 8/28/2019 Effective 8/28/2019 23227 Expiration Requested /Received Events Streamlndex Number Current Class Subbasin CES@NC� August 21, 2019 Shristi R. Shrestha DWR — UIC Program 1636 Mail Service Center Raleigh, North Carolina 27699-1636 RE: Notification of Intent to Operate Injection Wells GPM 3016 (Former Scotchman #16) 201 East Church Street Atkinson, Pender County, North Carolina NCDEQ UST Incident No.: 23795 Dear Ms. Shrestha: On behalf of the responsible party GPM Southeast, LLC (GPM), CES of NC, PLLC (CES of NC) is submitting the enclosed Notification of Intent to Operate Injection Wells. Following review should you have any questions or require additional information, please do not hesitate to contact me by phone at (704) 909-291 1 or email at awilliamson, dcrawfordenvironmentaI.com. Sincerely, CES of NC, PLLC i1--triw, U'✓.cdia., Aaron Williamson Project Manager Enc Insure UI AUG $22 'g leeway NVQ„erQvas�x 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 (NOTE: This form must be received at least 14 DAYS p rior to injection ) AQUIFER TEST WELLS (1 5A 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: 1) Passive Injection S vstems -In-well delivery systems to diffuse injectants into the subsurface. Examples include ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be submitted for replacement of each sock used in ORC systems). 2) Small-Scale Injection O perations -Injection wells located within a land surface area not to exceed 10,000 square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required for test or treatment areas exceeding 10,000 square feet. 3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a remediation strategy in order to develop a full scale remediation plan for future implementation, and where the surface area of the injection zone wells are located within an area that does not exceed five percent of the land surface above the known extent of groundwater contamination. An individual permit shall be required to conduct more than one pilot test on any separate groundwater contaminant plume. 4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater. Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete. DATE: 08 /20 , 20_19 __ PERMIT NO. /\/ J 0 R { 0 52.Co(to be filled in by DWR) A. WELL TYPE TO BE CONSTRUCTED OR OPERA TED (I) (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 ~X~ __ Passive Injection System ............................... Complete sections B through F, H-N ___ Small-Scale Injection Operation ...................... Complete sections B through N ___ Pilot Test ................................................. Complete sections B through N ___ Tracer Injection Well ................................... Complete sections B through N B. ST A TUS 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): GPM Southeast-Rolfe Lann VP of Environmental Mailing Address: 8565 Ma gellan Parkway. Suite 400 City : Richmond State: YA.__ Zip Code: 23227 County: Richmond Day Tele No.: 910-796-2418 Cell No.: ;..91~0~-7~9~8~-2~0=2~5 _____ _ EMAIL Address: rlann@ gp minvestments.com Deemed Pennitted GW Remediation NOT Rev. 3-21-2018 FaxNo.: 910-798-2025 Page: I D. PROPERTY OWNER(S) (if different than well owner/applicant) Name and Title: =Ri=·c=k=i~L=-~C~u=ev~a=s'-------------------------- Company Name: Atkinson Ba ptist Church Mailing Address: 200 Church Street City: Atkinson State: NC._ Zip Code: 2=8~4=2~1 ___ County: P~e=n=d=e~r __ _ Day Tele No.: """9 _l0~-~33~7~-2~9~3~0 _____________ Cell No.: __________ _ EMAIL Address: rcue @aol.com Fax No.: ___________ _ E. PROJECT CONT ACT (Typically Environmental Engineering Firm) Name and Title: Aaron Williamson , Pro ject Manager Company Name Crawford Environmental Services of NC PLLC Mailing Address: 301 McCullough Drive . Suite 400 City: Charlotte State: NC Zip Code: 28262 County: Mecklenburg Day Tele No.: 704-909-2911 Cell No.: ~9 ~10~-2=8~0~-2=9~74~----- EMAIL Address: awilliamson@ crawfordenvironmental.com Fax No.: 540-343-6259 F. PHYSICAL LOCATION OF WELL SITE (I) Facility Name & Address: ~G~P~M~30~l~6 __________________ _ 20 l East Church Street City: Atkinson (2) Geographic Coordinates: Countv : Pender Latitude**: =-34-'--__ 0 _3_1 __ ' 44.50 _" or Longitude**: ~78~ __ 0 _10 __ ' 09.30 _" or Zip Code: 28421 0 0 Reference Datum:W -'-'-G=S-=-84-'-------·Accuracy: 2==m=e=te=r=s ____ _ Method of Collection: -"'G=o=o=iil=e~E=a=rt=h'---------------- **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: _______ .square feet Land surface area ofinj. well network: square feet(::: 10,000 tt2 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 notificatio!l. (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. 3-21-2018 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. A pp lication of sodium persulfate and potassium permanganate well socks within one im pacted monitorin g well (MW-15 ). Socks will contain sodium persulfate and potassium permanganate combination c ylinders . each 1.5- feet lon g. Each well is constructed with IO-feet of well screen. Six feet of cylinders will be placed into each monitorin g well within the saturated well screen. J. APPROVED INJECT ANTS-Provide a MSDS for each injectant (attach additional sheets if necessary). NOTE: Only iryectants approved by the NC Division of Public Health, Department of Health and Human Services can be injected. Approved iryectants can be found online at htt p://deg.nc.gov/about/divisions/water- resources/water-resources-permits/wastewater-branch/ground-water-protection/1!round-water-a pp roved-in jectants. All other substances must be reviewed by the DHHS prior to use. Contact the UJC Program for more info (919- 807-6496). lnjectant: Sodium Persulfate Volume ofinjectant: 52.8 pounds total weigh t Concentration at point of injection: _l 0~0~0~1/o _____________________ _ Percent if in a mixture with other injectants: ~3~8°~1/o'---------------------- Injectant: Potassium Permanganate Volume ofinjectant: 52.8 pounds total wei ght Concentration at point of injection: =-10=--0=--o/c"-'o'------------------------ Percent ifin a mixture with other injectants: =3=8~%~------------------- Injectant: Volume ofinjectant: _____________________________ _ Concentration at point of injection: Percent if in a mixture with other injectants: ____________________ _ K. WELL CONSTRUCTION DATA (1) Number of injection wells: _____ Proposed ___ l ___ Existing (provide GW-ls) (2) For Proposed wells or Existing wells not having GW-ls, provide well construction details for each injection well in a diagram or table format. A single diagram or line in a table can be used for multiple wells with the same construction details. Well construction details shall include the following (indicate if construction is proposed or as-built): (a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery (b) Depth below land surface of casing, each grout type and depth, screen, and sand pack (c) Well contractor name and certification number Deemed Permitted GW Remediation NOi Rev. 3-21-2018 Page3 L. SCHEDULES — Briefly describe the schedule for well construction and injection activities. Premanufactured c\ tinders to be installed in September 2019. Semi-annual maintenance will be performed to evaluate condition of the cylinders. M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine if violations of groundwater quality standards speciEted st3 Subcharter 02L result from the injection activity. A groundwater manitorinu event will be conducted prior to ciinder installation. Subsjuent monitornnu events are proposed on a semi-annual basis following, cylinder removal. Orundwater sarniles will be submitted for laboreton analrsis of volatile orpnik compounds U$EPA Method 6200E including MTBE. IPE. and naphthalene. N. SIGNATURE OF APPLICANT AND PROPERTY OWNER Well Owner/Apolieant: "I hereby certify, under penalty of law, that I am familiar with the information submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obtaining said information, 1 believe that the information is lase, accurate and complete. I am aware that there are significant penalties, including the possibility offines and imprisonment, for submitting false information. 1 agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance wjlkjthe I SA NC,4 C: 02C 0200 Rules." attire +if Applicant hI L Print or Type Full Name and Title Prop:rty Owner tifthe .aroperty is not owned bF the Well Owner/Applicant,: "As owner of the property on which the infection well(s) are to be constructed and operated, 1 hereby consent to allow the applicant to construct each injection well as outlined in this application and agree that it shall be the responsibility of the applicant to ensure that the injection wells} conform to the Well Construction Standards (15_4 NCAC 02C .0200h. " "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 theland owner, in the absence of contrary agreement in writing. See attached access agreement Signature" of Property Owner (if different from applicant) Print or Type Full Name and Title *yin access agreement between the applicant ooze/ property owner may be submitted in lieu of a signature an this form. Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or flash Drive at least two () weeks prior to injection to: DWR — UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: (919) 807-6464 Deemed Permitted GAY R.emediation NOI Rev. 3-21-20lS Page 4 1. Identification Product identifier Other means of identification Recommended use Recommended restrictions SAFETY DATA SHEET RemOx® SR+ ISCO Reagent None. In situ and ex situ chemical oxidation of contaminants and compounds of concern for environmental remediation applications. Use in accordance with supplier's recommendations. Manufacturer/Importer/Supplier/Distributor information Company name Address Telephone E-mail Website Contact person Emergency Telephone 2. Hazard(s) identification Physical hazards Health hazards Environmental hazards OSHA defined hazards Label elements Signal word Hazard statement CARUS CORPORATION 315 Fifth Street, Peru, IL 61354, USA +1 815 223-1500 - All other non -emergency inquiries about the product should be directed to the company salesmkt@caruscorporation.com www.caruscorporation.com Dr. Chithambarathanu Pillai For Hazardous Materials [or Dangerous Goods) Incidents ONLY (spill, leak, fire, exposure or accident), call CHEMTREC at CHEMTREC®, USA: 001 (800) 424-9300 CHEMTREC®: Mexico (Toil -Free - must be dialed from within country) 01-800-681-9531 CHEMTREC®. Other countries: 001 (703) 527-3887 Oxidizing solids Acute toxicity, oral Skin corrosion/irritation Sensitization, respiratory Sensitization, skin Specific target organ toxicity, single exposure Specific target organ toxicity, repeated exposure Hazardous to the aquatic environment, acute hazard Hazardous to the aquatic environment, long-term hazard Not classified. Category 3 Category 4 Category 1 B Category 1 Category 1 Category 1 (Respiratory system) Category 1 (Central Nervous System. Respiratory system Category 1 Category 1 Danger May intensify fire; oxidizer. Harmful if swallowed. Causes severe skin burns and eye damage. May cause allergy or asthma symptoms or breathing difficulties if inhaled. May cause an allergic skin reaction. Causes damage to organs (Respiratory system). Causes damage to organs (Central Nervous System, Respiratory system) through prolonged or repeated exposure. Very toxic to aquatic life with long fasting effects. RemOxe SR+ ISCO Reagent 923182cp Version#: 01 Revision date:- Issue date' 04 -April-2015 SDS US 1/9 Precautionary statement Prevention Response Storage Disposal Hazard(s) not otherwise classified (HNOC) Keep away from heat. Keep/Store away from clothing//combustible materials. Do not breathe dust. Wear protective gloves/protective clothing/eye protection/face protection . Do not eat, drink or smoke when using this product. Wash thoroughly after handling . Take any precaution to avoid mixing with combustibles. [In case of inadequate ventilation) wear respiratory protection. Contaminated work clothing must not be allowed out of the workplace. Avoid release to the environment. In case of fire: Use water for extinction. If swallowed: Rinse mouth . Do NOT induce vomiting. If on skin (or hair): Take off immediately all contaminated clothing. Rinse skin with water/shower. If inhaled: Remove person to fresh air and keep comfortable for breathing. If in eyes: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do . Continue rinsing. If experiencing respiratory symptoms : Call a poison center/doctor. Take off immediately all contaminated clothing and wash it before reuse. If exposed or concerned: Call a poison center/doctor. Immediately call a poison center/doctor. Collect spillage . Store locked up. Dispose of contents/container in accordance with local/regional/national/international regulations . None known. 3. Composition/information on ingredients Substances Chemical name Potassium permanganate Sodium persulfate Composition comments 4. First-aid measures Inhalation Skin contact Eye contact Ingestion Most important symptoms/effects, acute and delayed Indication of immediate medical attention and special treatment needed General information 5. Fire-fighting measures Suitable extinguishing media Unsuitable extinguishing media Specific hazards arising from the chemical RemOx® SR+ ISCO Reagent Common name and synonyms CAS number 7722-64-7 7775-27-1 % 20-40 20-40 All concentrations are in percent by weight unless ingredient is a gas. Gas concentrations are in percent by volume. Remove victim to fresh air and keep at rest in a position comfortable for breathing. For breathing difficulties, oxygen may be necessary . Get medical attention immediately. Remove contaminated clothing and shoes. Wash contaminated clothing before reuse. Get medical attention immediately. Contact with skin may leave a brown stain of insoluble manganese dioxide . This can be easily removed by washing with a mixture of equal volume of household vinegar and 3% hydrogen peroxide, followed by washing with soap and water. Immediately flush with plenty of water for up to 15 minutes . Remove any contact lenses and open eyelids wide apart. Continue rinsing. Get medical attention immediately. Immediately rinse mouth and drink plenty of water. Never give anything by mouth to a victim who is unconscious or is having convulsions. Do not induce vomiting. If vomiting occurs, keep head low so that stomach content doesn't get into the lungs. Get medical attention immediately. Contact with this material will cause burns to the skin, eyes and mucous membranes. Permanent eye damage including blindness could result. Provide general supportive measures and treat symptomatically . Symptoms may be delayed. In the case of accident or if you feel unwell, seek medical advice immediately (show the label where possible). Ensure that medical personnel are aware of the material(s) involved, and take precautions to protect themselves. Flood with water from a distance, water spray or fog. Dry chemical. Foam . Carbon dioxide (CO2). Halogenated materials . Oxidizing agent, may cause spontaneous ignition of combustible materials . By heating and fire , corrosive vapors/gases may be formed . 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 SDS US 2/9 Special protective equipment and precautions for firefighters Fire fighting equipment/instructions General fire hazards Self-contained breathing apparatus and full protective clothing must be worn in case of fire. Selection of respiratory protection for firefighting: follow the general fire precautions indicated in the workplace. Move container from fire area if it can be done without risk. Cool containers exposed to flames with water until well after the fire is out. Prevent runoff from fire control or dilution from entering streams, sewers, or drinking water supply. Dike fire control water for later disposal. Water runoff can cause environmental damage. The product is not flammable. May intensify fire; oxidizer. 6. Accidental release measures Personal precautions, protective equipment and emergency procedures Methods and materials for containment and cleaning up Environmental precautions 7. Handling and storage Precautions for safe handling Conditions for safe storage, including any incompatibilities Keep unnecessary personnel away. Avoid inhalation of dust and contact with skin and eyes. Do not touch damaged containers or spilled material unless wearing appropriate protective clothing. Wear protective clothing as described in Section 8 of this safety data sheet. Local authorities should be advised if significant spillages cannot be contained. Keep combustibles (wood, paper, oil, etc.) away from spilled material. Should not be released into the environment. This product is miscible in water. Stop leak if possible without any risk. Dike the spilled material, where this is possible. Never return spills in original containers for re-use. For waste disposal, see Section 13 of the SDS. Do not allow to enter drains, sewers or watercourses. Contact local authorities in case of spillage to drain/aquatic environment. Take any precaution to avoid mixing with combustibles. Keep away from clothing and other combustible materials. Do not get this material in your eyes, on your skin, or on your clothing. Do not breathe dust or mist or vapor of the solution. If clothing becomes contaminated, remove and wash off immediately. When using, do not eat, drink or smoke. Good personal hygiene is necessary. Wash hands and contaminated areas with water and soap before leaving the work site. Avoid release to the environment. Do not expose to sparks, heat, open flames, or hot surfaces. It is important that smoking is not allowed in proximity to RemOx® SR. Do not cut RemOx® SR ISCO Reagent with any cutting tool which could produce friction (i.e. hand saws, circular saws, reciprocal saws, etc.) as it may cause ignition of the material. Store locked up. Keep container tightly closed and in a well-ventilated place. Store in a cool, dry place. Store away from incompatible materials (See Section 10). Follow applicable local/national/international recommendations on storage of oxidizers. 8. Exposure controls/personal protection Occupational exposure limits US. OSHA Table Z-1 Limits for Air Contaminants (29 CFR 1910.1000) Components Potassium permanganate (CAS 7722-64-7) US. ACGIH Threshold Limit Values Components Potassium permanganate (CAS 7722-64-7) Sodium persulfate (CAS 7775-27-1) Type Ceiling Type TWA TWA US. NIOSH: Pocket Guide to Chemical Hazards Components Potassium permanganate (CAS 7722-64-7) Type STEL TWA Value 5 mg/m3 Value 0.1 mg/m3 0.02 mg/m3 0.1 mg/m3 Value 3 mg/m3 1 mg/m3 Biological limit values Exposure guidelines No biological exposure limits noted for the ingredient(s). Follow standard monitoring procedures. RemOx® SR+ ISCO Reagent 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 Fonn lnhalable fraction. Respirable fraction. Fonn Fume. Fume. SDS US 3/9 Appropriate engineering controls Provide adequate general and local exhaust ventilation . An eye wash and safety shower must be available in the immediate work area . Individual protection measures, such as personal protective equipment Eye/face protection Wear safety glasses with side shields (or goggles). Wear face shield if there is risk of splashes . Skin protection Hand protection Other Use protective gloves made of: Rubber or plastic. Suitable gloves can be recommended by the glove supplier. Wear chemical-resistant, impervious gloves. Respiratory protection In case of inadequate ventilation or risk of inhalation of dust, use suitable respiratory equipment with particle filter. In the United States of America, if respirators are used, a program should be instituted to assure compliance with OSHA 29 CFR 1910.134. Wear appropriate thermal protective clothing , when necessary . Thermal hazards General hygiene considerations When using, do not eat, drink or smoke. Keep from contact w ith clothing and other combustible materials. Remove and wash contaminated clothing promptly . Wash hands before breaks and immediately after handling the product. Handle in accordance with good industrial hygiene and safety practice. 9. Physical and chemical properties Appearance White solid. Physical state Solid . Form Solid. Color White. Odor Paraffinic. Odor threshold Not applicable . pH Not applicable . Melting point/freezing point 130 °F (54 .44 °C) Initial boiling point and boiling Not applicable. range Flash point Not applicable. Evaporation rate Not applicable. Flammability (solid, gas) Non flammable . Upper/lower flammability or explosive limits Flammability limit -lower Not applicable . (%) Flammability limit -upper (%) Explosive limit -lower(%) Explosive limit -upper(%) Vapor pressure Vapor density Relative density Solubility(ies) Solubility (water) Partition coefficient (n-octanol/water) Auto-ignition temperature Decomposition temperature Viscosity Other Information Explosive properties Oxidizing properties Not applicable . Not applicable. Not applicable. Not applicable. Not applicable . 1.18(25°C) Not available. Not applicable. Not available. Not available. Not applicable. Not explosive. Can explode in contact with sulfuric acid , peroxides and metal powders. Oxidizer. 1 O. Stability and reactivity Reactivity The product is stable and non-reactive under normal conditions of use , storage and transport . RemOx® SR+ ISCO Reagent 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 sos us 4 /9 Chemical stability Possibility of hazardous reactions Conditions to avoid Incompatible materials Hazardous decomposition products Stable at normal conditions. Contact with combustible material may cause fire. Contact with combustibles. Acids. Peroxides. Reducing agents. Combustible material. Metal powders. Contact with hydrochloric acid liberates chlorine gas. By heating and fire, corrosive vapors/gases may be formed. 11. Toxicological information Information on likely routes of exposure Inhalation Skin contact Eye contact Ingestion May cause irritation to the respiratory system. Causes severe skin bums. Causes serious eye damage. Harmful if swallowed. Symptoms related to the physical, chemical and toxicological characteristics Contact with this material will cause burns to the skin, eyes and mucous membranes. Permanent eye damage including blindness could result. Information on toxicological effects Acute toxicity Harmful if swallowed. Components Species Potassium permanganate (CAS 7722--64-7) Acute Dermal LOSO Oral LOSO Skin corrosion/irritation Serious eye damage/eye irritation Rat Rat Causes severe skin bums. Causes serious eye damage. Test Results 2000 mg/kg 2000 mg/kg Respiratory or skin sensitization Respiratory sensitization Skin sensitization May cause allergy or asthma symptoms or breathing difficulties if inhaled. May cause allergic skin reaction. Germ cell mutagenicity Test data conclusive but not sufficient for classification. Carcinogenicity Test data conclusive but not sufficient for classification. OSHA Specifically Regulated Substances (29 CFR 1910.1001-1050) Not listed. Reproductive toxicity Specific target organ toxicity - single exposure Test data conclusive but not sufficient for classification. Causes damage to organs (respiratory system). Specific target organ toxicity - repeated exposure Causes damage to organs (respiratory system, central nervous system) through prolonged or repeated exposure. Aspiration hazard Chronic effects Further information 12. Ecological information Ecotoxicity RemOx® SR+ ISCO Reagent Based on available data, the classification criteria are not met. May cause damage to respiratory system. Prolonged exposure, usually over many years, to manganese oxide fume/dust can lead to chronic manganese poisoning, chiefly affecting the central nervous system. No other specific acute or chronic health impact noted. Very toxic to aquatic life with long lasting effects. 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 sos us 5/9 Components Species Test Results Potassium permanganate (CAS 7722-64-7) Aquatic Fish Persistence and degradability Bioaccumulative potential Mobility in soil Moblllty in general other adverse effects LC50 Bluegill (Lepomis macrochirus) Carp (Cyprinus carpio) 2. 7 mg/I, 96 hours static 2.3 mg/I, 96 hours flow through 2.3 mg/I, 96 hours 1.8 - 5 .6 mg/I 3.16 -3.77 mg/I, 96 hours 2.97 -3.11 mg/I, 96 hours Goldfish (Carassius auratus) 3 .3 - 3 .93 mg/I, 96 hours static Milkfish, salmon-herring (Chanos > 1.4 mg/I, 96 hours chanos) Rainbow trout (Oncorhynchus mykiss) 1.8 mg/I, 96 hours 1.08 - 1.38 mg/I, 96 hours 0. 77 - 1.27 mg/I, 96 hours Expected to be readily converted by oxidizable materials to insoluble manganese oxide. Potential to bioaccumulate is low. Not available. The product is water soluble and may spread in water systems . None known . 13. Disposal considerations Disposal instructions Local disposal regulations Hazardous waste code Dispose of contents/container in accordance with local/regional/national/international regulations . Dispose in accordance with all applicable regulations. D001: Ignitable waste The Waste code should be assigned in discussion between the user, the producer and the waste disposal company. Waste from residues / unused products Do not allow this material to drain into sewers/water supplies. Dispose in accordance with all applicable regulations. Contaminated packaging Since emptied containers may retain product residue , follow label warnings even after container is emptied. Empty containers should be taken to an approved waste handling site for recycling or disposal. 14. Transport information DOT UN number UN1479 UN proper shipping name Oxidizing solid, n.o.s. (Sodium persulfate, Potassium permanganate) Transport hazard class(es) Class 5 .1 Subsidiary risk Label(s) Packing 5 .1 group Environmental II hazards Marine pollutant Yes Special precautions for user Read safety instructions, SDS and emergency procedures before handling. Special provisions 62, 1B5, IP1 Packaging exceptions None Packaging non bulk 211 Packaging bulk 242 IATA UN number UN1479 UN proper shipping name Oxidizing solid , n.o.s. (Sodium persulfate, Potassium permanganate) Transport hazard class(es) Class 5.1 Subsidiary risk RemOx® SR+ ISCO Reagent 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 SDS US 6/9 Label(s) Packing group Environmental hazards ERG Code 5 .1 II Yes 5L Special precautions for user Read safety instructions, SDS and emergency procedures before handling . IMDG UN number UN1479 UN proper shipping name Transport hazard class(es) OXIDIZING SOLID, N.O .S . (Sodium persulfate, Potassium permanganate) Class Subsidiary risk Label(s) Packing group Environmental hazards Marine pollutant Ems 5.1 5.1 II Yes F-A, S-Q Special precautions for user Read safety instructions, SDS and emergency procedures before handling. Transport in bulk according to Not applicable. Annex II of MARPOL 73/78 and the IBC Code 15. Regulatory information US federal regulations This product is a "Hazardous Chemical" as defined by the OSHA Hazard Communication Standard , 29 CFR 1910.1200. All components are on the U .S. EPA TSCA Inventory List. TSCA Section 12(b) Export Notification (40 CFR 707, Subpt D) Not regulated. OSHA Specifically Regulated Substances (29 CFR 1910.1001-1050) Not listed. CERCLA Hazardous Substance List (40 CFR 302.4) Potassium permanganate (CAS 7722-64-7) LISTED Superfund Amendments and Reauthorization Act of 1986 (SARA) Hazard categories Immediate Hazard -Yes Delayed Hazard -Yes Fire Hazard -Yes Pressure Hazard -No Reactivity Hazard -No SARA 302 Extremely hazardous substance Not listed. SARA 311/312 Hazardous Yes chemical SARA 313 (TRI reporting) Chemical name CAS number Potassium permanganate 7722-64 -7 Other federal regulations Clean Air Act (CAA) Section 112 Hazardous Air Pollutants (HAPs) List Potassium permanganate (GAS 7722-64-7) % bywt. 20 -40 Clean Air Act (CAA) Section 112(r) Accidental Release Prevention (40 CFR 68.130) Not regulated. Safe Drinking Water Act (SOWA) Not regulated. Drug Enforcement Administration (DEA). List 2, Essential Chemicals (21 CFR 1310.02(b) and 1310.04(f)(2) and Chemical Code Number Potassium permanganate (CAS 7722-64-7) 6579 Drug Enforcement Administration (DEA). List 1 & 2 Exempt Chemical Mixtures (21 CFR 1310.12(c)) Potassium permanganate (CAS 7722-64-7) 15%WT RemOx® SR+ ISCO Reagent 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 sos us 7/9 DEA Exempt Chemical Mixtures Code Number Potassium permanganate (CAS 7722-64-7) 6579 US state regulations This product does not contain a chemical known to the State of Calitamia to cause cancer, birth defects or other reproductive harm. US. Massachusetts RTK - Substance List Potassium permanganate (CAS 7722-64-7) US. New Jersey Worker and Community Right -to -Know Act Potassium permanganate (CAS 7722.64-7) Sodium persulfate (CAS 7775-27-1) US. Pennsylvania Worker and Community Right -to -Know Law Potassium permanganate (CAS 7722-64-7) US. Rhode Island RTK Potassium permanganate (CAS 7722-64-7) US. California Proposition 65 Not Listed. International Inventories Country(s) or region Inventory name On inventory (yes/nor Australia Australian Inventory of Chemical Substances (AICS) Yes Canada Domestic Substances List (DSL) Yes Canada Nan -Domestic Substances List (NDSL) No China Inventory of Existing Chemical Substances in China (IECSC) Yes Europe European Inventory of Existing Commercial Chemical Yes Substances (ElNECS) Europe European List of Notified Chemical Substances (ELINCS) No Japan Inventory of Existing and New Chemical Substances (ENCS) No Korea Existing Chemicals List (ECL) Yes New Zealand New Zealand Inventory Yes Philippines Philippine Inventory of Chemicals and Chemical Substances Yes (PICCS) United States & Puerto Rico Toxic Substances Control Act (TSCA) Inventory Yes "A "Yes" indicates this product complies with the inventory requirements administered by the governing country{s). A No indicates that one or mare components of the product are not listed or exempt From listing on the inventory administered by the governing country(s). 16. Other information, including date of preparation or last revision Issue date 01-December-2014 Revision date Version # 01 NFPA ratings List of abbreviations References ox:: LDSO: Lethal Dose, 50°/n LC50: Lethal Concentration, 50%. Chemical safety report. ECHA registered substances database RemOx®15R+ i5C0 Reagent 9231e20p Version*: 01 Revision date:- Issue date' 04 -April-2015 SDS us 8/9 l l Disclaimer RemOx® SR+ ISCO Reagent The information contained herein is accurate to the best of our knowledge. However, data, safety standards and government regulations are subject to change and, therefore, holders and users should satisfy themselves that they are aware of all current data and regulations relevant to their particular use of product. CARLIS CORPORATION DISCLAIMS ALL LIABILITY FOR RELIANCE ON THE COMPLETENESS OR ACCURACY OR THE INFORMATION INCLUDED HEREIN. CAR US CORPORATION MAKES NO WARRANTY, EITHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, ANY WARRANT! ES OF MERCHANTIABILITY OR FITNESS FOR PARTICULAR USE OR PURPOSE OF THE PRODUCT DESCRIBED HEREIN. All conditions relating to storage, handling, and use of the product are beyond the control of Carus Corporation, and shall be the sole responsibility of the holder or user of the product. RemOx® is a registered trademark of Carus Corporation. 923162cp Version#: 01 Revision date:-Issue date: 04 -April-2015 SDS US 9/9 WELL CONSTRUCTION RECORD North Carolina — Department of Environmental and Natural Resources — Division of Water Quality — Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NAME. (print) STEPHEN SLOAN CERTIFICATION fl 2854 WELL COWTRACTOR COMPANY NAME GeoloecEenlmatitut, tnc. PHONE it (7041 S72-7686 STATE WELL CONSTRUCTION PERMITO (if appliutblel ASSOCIATED WQ PERMITH (if applicable) I. WELL USE (Chid: Applicable Box): Residential ❑ Monitoring LK Recovery ❑ Heat Pump Water Injection ❑ 2. WELL LOCATION: I3eatest Town: ATKTWSOH County FENDER 20I E. CHURCH STREET rSM # 1 D) (Screed Norte. Numbers, Community, Subdivision, La No. Zip Code) 3. ❑ WNER: W ORSLEV 01L Address P.O. BOX 3E17 Municipal/Public ❑ Industrial ❑ Agiculiutal ❑ Other❑ lfO her, list Use WILMINGTON I Str act w Reii r Nil.) NC ?_8406 Ck nxTnwn Suer 'Lin Code I. Area Code - Phone mien her 4. DATE DRILLED 0113.1'03 5. TOTAL DEPTH: 13.0 FEET 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El 7. STATIC WATER LEVEL Below Top of Casing: 4.0' FT. (Use `4' if Above Top of Casing) 8. TOP OF CASING IS o.0 FT. Above Land Surisre *Top of ung tduunated ails: be1o. land surface requires a vmiima in accordance with I SA Nt;AC 2C 0I 18. 9. YIELD (bpni): N/A METHOD OF TEST NIA I0. WATER ZONES {depth): NIA 11. DISJNEFf"TTON• Tyre NIA A -mum 12. CASING: Depth From 0.0 TO From To FL From To Ft- 13, Grout: Depth Wail Thickness Diameter or Weight/FL 3.0 Ft 2 INCH SCH dG Material PVC Maserial Method FLOM 0_0 To 1.0 Ft, Portland Bentonite Slurry From To Fi. I4. SCREEN: Depth Diameter Slot Size Mnterial From 3.0 To 13.0 Ft. ? 0 in 010 in _ PVC From To Ft. in 15. SAND/GRAVEL PACK: Depth From 2.0 To 13,0 Ft FrontTo FL 16. REMARKS: MW-15 Sire Material 2040 FINE SIUCASANt7 DEPTH From To 0.0 13.e Topographic/Land setting ❑ Ridge 0 Slope ❑ Valley ® Flat (chick appropriate box) Latitudelongitude of welt location tde}sa Jruuiutes/sewnds) Latitudellongitudc source: ❑ GPS ❑ Topographic mar (check hex) DRILLING LOG Formation Description GRAY SANDY CLAY LOCATION SKETCH Shaw direction and distance in miles from at [east two State Roads or County Roads, incuied the road numbers and common road names. BEN7ONITE SEAL FROM 1-0 TO 2.0 FEET ^7f� I DO HEAR,BY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C. WELL CONSTRUCTION STANDARDS. -AND THAT A COPY OF THIS -RECORD HAS BEEN PROVIDED TO THE'WELL OWNER SIGNATURE OF PERSON CONSTRUCTING THE WELL `DATE Submit thr original to the Division of Water Quality. Groundwater Section, 1636 Mail Service Center — Raleigh NC 27699-14)6 Phone No. (919) 733-3221, within 30 days- GW-1 REV.0712001 ri7 .t,,ol a t1 23.431 PAX 401112637341 ATKINSON O N H.AIA 11002.ruurla .Rt3MQFCOP / LICE MSEar1 pafarr1,€O T ithe "License') "Qweter(xr Property. Atkinson Baptist Church (21X1 Church Streit, At&irrson, North Carolina 734211 t>(tq u; z2-s .na.ra44-0001)-? Cb'asr.4r 13%:., A?ici7';ar+. No53h reV011rrja Dead Reference $l: x754/247 Prnperly'Cvsrncr(s)" Atk;nwn Baptist Church have tole right to powesston of the above Property and grams this +fght•af-entry request to allow cnvircnmentrt investigations as,grieed with the nefghbaring property to be rayrrductee: NZightrosini Property; GPM Sar:t r-ast. LLC { gal E Church St(eet, Atkinson North Carolina PIN q: 2.2;13p-o4-2.831•d00O- Former GPM Store rt3OIE Aced Reference P 465912C7 Planned ecrivftles IQ be Conductea un the Owner's• propertl, Include: • r-erio ie rnenitarroK„ranintenarrce, erxf same tYrk Of exist4ng mQ r Of rtg We tt rreniiy on the property (MW1O, MW-1$. Vi1f1-16, MW.17, M W-i , M' J-19, NSW -25, >W 3, and 10W-4). c, Actual s:!voting frequeruywill bedetermined by the stets regrlafor. nrreraiiy, monitoring vans are conducted semi-annually or annually, Periodic xlmtiriirg of any water suppiv w.11(s; un tire property (Including drinking anri/or irri tton wefis�_ • Groundarater remedijrthm activities utilizing OXisting monitoring welts currently on the prpper-ty. • rviorrltaring wets atianaonment after incident closure iy granted. t r Once the e NCD&U grant incident closure tor th e ' bjact Site, t*P rn vn its C, ng wells will be a b:t nd o n ed by a licensed well driller in accordance with re{Suir orn., The current -and .04 +'r:lurC vwuierf;,) of tire pivuerty grreit`61-'M 5out-heatst, s tG ants it> ennirtouicr,iai tvt,.tulsnnu I''Llren:4e`jtbe right to enter!ipon the Property. GR attiv,tlre will be p►,rrrtmud recturred by the NC6VC] untli k,tiettni c.rosure rs granted, Af� attjeitiex wiH be OedilAtil2 ejirnI+. tyke riJitrii�.E� rr fo tite.k!'Opff1Y. Work will cryir lr( be performed Monday through Friday, Oak) AM to S'Ori PM iexcluding nolid,r,s. Work related to wets nstailatlar., removal, and vepasr will be aancluc'ted during hears as egri.ed to by the Owurr(s). t1censre will nerdy the Ownerjsj ti minimum of24 haurfprfor to performing reirirnailydisruptive and shnrt•dutation wont loth 45 grpsmdwatee mot:rot ng. Wolf installation and Siroir..t activities wail be. coardiflute d with tttr_•Cmrser(:i) k„ wvdl ir, .dyeriw riCayolrrilik ahF.anxe exeunt yr'vvr i+iltr rruli,ir niir7,r wif tyk frihd@ tts Qwrrur4) should the ptunnest work or wirdi rtl►anyr_ This ijneesu rruy hP imrnediatnlp term'nated by the Ousee,h) [hrnugh wetter', not,re rntinwirie any brnxrN of this 1,rterr+St i1y i.ietnsee. t License is r.Rei.tive warm igr rig. Licensee agrcii! Id) repair any daFwag- tp tRtl Property r esuitiog from er try by lir,rnsee and aft111ates by reV:oring, Lathe extent reasonably possible. the Property to the Its condition lrrstneci aIery prior to entry, 07z 2S/2019 11 23A1 FAX y41102837341 ATK1NSON TOWN HALL 0003; 0003 :l nth DA __ .. _ _ _, 2O19 owri+rlal MEN* I.]_ u l , .. q C.7 Ye "Kp5 GPM Southeast, LLC J 1 S565 Magellan Parkway, Sulte 400 <a + 5 t C. lr.v r e iiichmand, Virginia Z32 x7 Signature j STinwturre ti seq. s Prim Name rerephnr !! c e,. ff 0 1- , CO Vr1 Email Raiff WgnVke Presi=ler,l arfnvioe;rurntfl Printed Harm 1 s { TRAVELED % ASPHALT�' .+s.ems r '*S ► GRASS P. t°1. ESW.0 / CRNNAG Ni 1 MW-6 0 o l (Na � t �` n WAY cuter I In V�H TE STREET ,•. WAY t TRAVE�D , FrA x SIGN =: + �i N + rn GRASS Legend MW-, 4, Monitoring Well (Type II) T-1 0 Monitoring Well (Type ill) rcv Utility/Power Pole 7 Light Pole — — Overhead Electric Line GRASS; I,{ji' MW-5 ASPHALTTe-1 ® N. Q5 MW-3 is WET AREA M�W-1 3.65i j - _r(93.86)--------- i (EPHEMERAL) O O l' l l + p `. GRASS r -- ; jc CURRENT ii 1 '. + C + __, UST BASI , --___ �, O ` FORMER UST • UST PORT e Water Ling Natural Gas Line Sanitary Sewer Line Communication Line FOP End of Pavement imp Stormwater inlet O Sanitary Sewer Manhole H Water Valve Fire Hydrant (T(P) tea .- UST BASIN 0 0 FORMER `sT 6ARSIN KEROSENE (94.09) PRODUCT LINE 0, MW-9 l l MW-8 W1 \ (NM) (93.96 r 3.20)• MW-4 \\ Liquefied Petroleum Tank Communication Pedestal a Bollards iyy I, e UST VENT PIPES co o (93 .1) \° f 0 —2 \ ° n l . vV r� / i GPM ti 10 rn MW-11i 5066 (94.16) l STORE " t i g CONC. I 0 l FoR E� x H Illl. DISPENSER ill' I ISLAND CONC. e ASPHALT MW-10 GRASS' (NM) • i� • DUMPSTER L — C�N9p Y — J 41110) DISPENSER (TYP.) CANOPY ASPHALT . SUPPORT (TYP.)gb ' GRASS Groundwater (93.66) Groundwater 4it Groundwater (NM) Not M 3 0 15' 30' Contour Line (feet) Elevation (feet) Flow Direction easured RIKENCIICIMPAMR A DEC-0.!t 2019 �iopeaniorvasgtoon . . 60' AIR MW-7 __ I 1 (NM) . 1 inch equals 30 feet ' r ---" ..,›...:,...., io • CESNC c.., _, a . 2.,,44, ,,,,7,vG, S4,,, ay 1 CLIENTGPM Southeast, LLC. �N FS � LOGATION: 267 Western Boulevard Jadcamrville, North Carolina Figure 3 4/`,pco GRASS GPM 3066 Water Table Elevation Map TRANSMISSION TOWER Groundwater Monitoring Report 5 7 ASPHALT .; `4 '' • `,- R r'-.: GRASS '�L. ' c�W�1..E Di�NMG w MW-6 e pop -} (NS) na } � ` Legend TRAVELED WAY i+a to WHITE STREW r ` TRAVELED WAY t rn x SIGN _ -1 E� (NS) (NS) c102}. i M GRASS mw-t a Monitoring Well (Type II) r-i Monitoring Well (Type III) Utility/Power Pole 3 Light Pole — — Overhead Electric Line MW-5 ASP T (220) 1 G Z e T-1 MW-3 r WET AREA MW-t -_ EPHEMERAL) 0 (140) { }r � C p O +++'� 1111 Water Line Natural Gas Line Sanitary Sewer Line Communication Line EOP End of Pariement Stormwater Inlet GRASS ; i CURRENT' _____$ • US BASI — — -11 p Y 1 r d FORMER KEROSENE /ST PORT (TYP)b / • l El UST BASIN Q 1 i MWMW B FORMER f3,800j y (2,900) p r 19.600) (NS) PRODUCT LONE - MYY-9 , MW-4 1 1 •.. Ifl` (� Sanitary Sewer Manhole ► I Water Valve Fire Hydrant 't Liquefied Petroleum Tank Communication Pedestal p Bollards UST VENT PIPES o 8 f 1 1 Uflj f i $ ° a $ MW-2 AMINO (140) Benzene Concentration -------- Benzene Concentration Contour OF! +lTilo r l 4 r--1(NS) o ii• 01 ; s 1 tv. Z -a#5066 MY� ' ��,400) (CONC. l STORE 1 " �1 ; 11 lnc 0 yI` c� '� R x i� 11}}. gib lid DISPENSER fit Not Sampled Units: micrograms per Liter (ug/L) Sampling Date: August 13, 2019 Benzene 2L Standard: 1 ugfL Benzene GCL: 5,000 ug/L ISLAND CONC. 1 0ASPHALT MW-1 D • GRASS (NS) 17 0 ❑(JMPSTER C�N4E�L-l . DISPENSER (TYP.) ASPHALT CANOPY SUPPORT (TYP.) GRASS 0 15' 30' 6a' AIR MW-7 1 f (x 1 inch equals 30 feet t. J S p, t 1 p kjNG CESNCL k) 11, CLIENT. GPM Southeast, LLC. 4�FS rMG LOCATION 287 Western 9oufeverd Jacksonville, North Carolina Figure 4 t'yjo,4J GRASS GPM 3066 Estimated Horizontal Extent of Benzene Above 2L Standards TRANSMISSION TOWER TOWER Groundwater9 Monitoring Report ASPHALT = � `• .■ '` GRASS r ❑RAMAGE SWALE to TRAVELED WAY WH1SE S7REEr TRAVE►_Ea WAY op (N S) (Ns.)(z2) • x M N- e n N!v. z ill. " auxe 0 % F a [ 1 \ ! ,cnx SIGN c WI -. In ` GRASS Legend kiw-i el Monitoring Well (Type II) ?-1 ® Monitoring Well (Type Ill) Utility/Power Pole Light Pole — 'DK — Overhead Electric Line MW-5 ASPHALT T-} MW-3 WET AREA MW-1 e EPHEMERAL --- (11) ---------- i }- p i L ; -- CURRENT ; 1 _, Z UST BASIN r1-- ' - -- p / C i ~ ' ~ ` FORMER UST PORT {TYP} �� / KERBANE ..0 UST BASIN' FORMER 0 1 FORMER KEROSENE LEST BASIN (40) PRODUCT LINE i� ti MIN-9 1 -�-~ i 1 G, a ` `• __00 '1,1 r '. -� / 1 r 7°y c�r`1 ` G it MW+12 / it (25.000) (31,000) + MW-4 1 ' e y,ltt y 0 C.Communication C C) e MW-g (NS) Water Line Natural Gas Line Sanitary Sewer Line Line Eop End of PavementGRASS III! Stormwater Inlet Sanitary Sewer Manhole ►� Water Valve 4) Fire Hydrant 'D Liquefied Petroleum Tank Cvrrtmunication Pedestal c Bollards UST VENT PIPES q v (1.500) e MW-2 NM y ,, (co 1 'Y e rl~ 4 p t o (23,000J I: #5066 CONC. STORE ■ 1 Ilii ° t Z lc' 1 r`t 1 GPM - } �1 • g n f i t o x a 1 1 I 1 FORMER 1104 M (11) Toluene Concentration r`�.� Toluene Concentration Contour (NS) Not Sampled Units- micrograms per Liter (ug/L) Sampling Date: August 13, 2019 Toluene 2L Standard: 600 ug/L Toluene GCL: 260,000 ug/L 0 I DISPENSER 11 1 ISLAND CONC. I e ASPHALT MW-1O GRASS (NS) • DUMPSTER Y C Nd�PY- DISPENSER (TYP.) AP CANOPY ASPHALT . SUPPORT (TYP.) \GS 0 15' 30' 60' AIR MW-7 1 I (NS) 1 Inch equals 30 feet --- .„..-z..,,...,..z., 1 i.,, p ,,,, --v.,,,,, /4,,, C CEB@N Ca )04, CLIENT: GPM Southeast, LLC. 40.frFs ifrotirEa LOCATION: 267 Westem Boulevard Ja�� �G urtixP Figure 5 G‘�p. GRASS M 3066 Estimated Horizontal Extent of Toluene Above 2L Standards TISSION TOWER Groundwater MonitoringReport p Legend 10-1 0 Monitoring T-1 ' Monitoring Utility/Power >c Light Pole Overhead Water Line Natural - Sanitary Communication EOP End of Pavement rill Stormwater Sanitary N Water Valve Fire Hydrant CiT) Liquefied Communication Bollards (100) Ethylbenzene ��— Ethylbenzene (NS) Not Sampled Units: micrograms Sampling Date: August Ethylbenzene 2L Ethylbenzene GCL: 0 15' 30' Well (Type II) Well (Type III) Pole Electric Line Gas Line Sewer Line Line Inlet Sewer Manhole Petroleum Tank Pedestal Concentration Concentration Contour per Liter (ug/L) 13, 2019 Standard: 600 ug/L 84,500 uglL 60' I \\,....,,,.„.______ TRAVELED WAY GRASS FORMER KEROSENE UST BASIN ASPHALT .4° -,, -i GRASS WAB 55 flRAtit#AGE SWAB---- J i rn rn o r D MW-6 ,Ill' GRASS M 0 -8 (NS) •.. o 0 vs v yxeca GRASS } cuter t WNI�E STREW= iRA LEA wAY I.`� \ SIGN _ { S} , (NS'' MW-5 ASPHALT I;}, GRASS T-1 MW-3 MW-1 '. WETIEE a 0 p 1 , ' ' -+ ; i CURRENT t � r -- -, S. UST BA50 it I , 0 0 t UST (TYP) $� • NWt FORMER FORMER;1l i MW} KEROSENE -- 1 LUST BASIN (1,700) ;l (2,400) (2,800) PRODUCT UNE - l MW-9 j4 MW-4 I UST VENT PIPES o 8 (3,200) l F - ne MW-2 tr,,, i , �, in z I t n GPM 0l i 1�MW-11 # , (5,1aa) l STD l I t CONC. q 1 L1 ~ l DISPENSER .6 i ISLAND CONC. 0 ASPHALT MW-10 GRASS (NS) •` 1� DUMPSTER I___Y J . DISPENSER (TYP.) CANOPY ASPHALT ri SUPPORT (TYP.) • i AIR MW-7 (NS) _ 31. o "tN p4R*I ..,>,.....,..... 1 NG s,�/c /04f ZIMeS r�,�,�T�pl�JGPM GRASS TRANSMISSION TOWER - ] 11n equals 30 feet CESCNM, CLIENT. GPM Southeast. LLC. Figure 6 LOCATION.267Western Boulevard Jacksonville, Norm Carolina 3066 Estimated Horizontal Extent of Ethylbenzene Above 2L Standards Groundwater Monitoring Report Legend Mw-t a Monitoring T-1 0 Monitoring ea)UtilitylPower x i Light Pale — Overhead Line Natural Communication EOP End of Pavement IIII Storm water Sanitary ►� Water Valve ti Fire Hydrant CO Liquefied Communication O Bollards (33.4) Total Xylenes ---L� Total Xylenes (NS) Not Sampled Units: micrograms Sampling Date: August Total Xylenes 2L Total Xylenes GCL: 0 15' 30' Well (Type II) Well (Type III) Pole Electric Line Gas Line Sewer Line Line Inlet Sewer Manhole Petroleum Tank Pedestal Concentration Concentration Contour per Liter (ug/L) 13, 2019 Standard: 500 uglL 85,500 ug/L 60' ASPHALT "� Y+� Lt i �.. GRASSAg --a'---- i DRANAGE --sitVA a I v 5 it. TRAvELED wAY am "r WH(TE STREET r TRAUELE4 WAY I i SIGN " cop (NS) (N5) �y r v ;1i,i �: TT1 -I rn CO 0 C r'• Y D -; £ MW-S (NS) 141. GRASSWater MW-8 0 NS ( ) o z " `- GRASS MW-5 ASPHALT T-1 (65.91 ! GRASS' `-� MW-3 � • WET AREA MW-1 N `, fY _ ` •Sanitary (EPHEMERAL) O " LI o a ❑ i } ', GRASS i f ; .F CURRENT L ' ` " _l UST BAST 1 ___---- o — Y ~ i p 0I i FORMER UST UST ■ �V PORT (TYP) 01� ( KEUST BASIN 0 0 FORMER + FORMER n MWA-12 KEROSENE 1 LUST BASIN (145) it (13,100) 116,000) PRODUCT LINE , ; MW-9 I MW-4 � tt i UST VENT PIPES o a (5,800) t MW--2 dipn 1 Q i cn - el no i G M n -0 r�r 11 1 rn MW-11 x ; i I (11,300} 1 #5 66 * G.)1 + ti CONC. I ST, RE f 1 " . L. I 1 0 FORMER qui Avow'1 DISPENSER ,. 1 1}Si ISLAND CONC. 1e \ ASPHALT M (NS)0 GRASS IllI DUMPSTER i_ _ Q Qe — DISPENSER (TYP.) r CANOPY ASPHALT SUPPORT (TYP.) AIR MW-7 (NS) ` P _ Y p� � ��FS 61'1'4404o GRASS TRANSMISSION TOWER t — 1 1 1 inch equals 30feet CEBNC CLIENT GPM Southeast, LLC. Figure 7 LOCATION 267 Western Boulevard .7ac15801T, Ire. North Carolina GPM 3066 Estimated Horizontal Extent of Total Xylenes Above 2L Standards Groundwater Monitoring Report TRAVELED WAY GRASS FORMER KEROSENE .: UST BASIN ASPHALT WET AREA (EPHEMERAL) FORMER KEROSENE PRODUCT LINE - owatiAGE SWAB WHITE STREET S) MW-5 UST VENT PIPES TRAuELED WAY ASPHALT Mw-1 --- (8 0) ---------- 0 D GRASS ❑ 0 CURRENT UST BAS • o • o UST PORT f) 0 NC (lull CURB SIGN [C2 T-1 MW-3 ei • FORMER BUST BASIN (96) { MW-2 r OH MW-11 (2,600) ASPHALT DUMPSTER • AIR CONC. ,7 DISPENSER (TYP.) CANOPY ASPHALT SUPPORT (1YP,) (450) i{ MW-g MWi-12 (2.100) w (8,000) MW-4 e I I ' I � � I � k k Lk 0 FORMER DISPENSER ISLAND CONC. Ql Mw-)0 (NS) TRANSMISSION TOWER • MW-7 I PJ S'I GRASS 1 rn rn oD D r- rn GRASS Legend Mw-1 • Monitoring Well (Type II) T—t 0 Monitoring Well (Type III) cal Utility/Power Pole tz Light Pole — Overhead Electric Line Water Line Natural Gas Line Sanitary Sewer Line Communication Line EOP End of Pavement ill Stormwater Inlet • Sanitary Sewer Manhole H Water Valve Fire Hydrant CUD Liquefied Petroleum Tank Communication Pedestal Bollards (6.0) (N S) MTBE Concentration MTBE Concentration Contour Not Sampled Units: micrograms per Liter (uglL) Sampling Date: August 13, 2019 MTBE 2L Standard: 20 ug/L MTBE GCL: 20,000 ug/L 0 15' 30' 60' I♦ t 1 1 1 inch equals 30 feet N CLIENT: GPM Southeast LLC. LOCATION; 267 Western Boulevard Jacksonville. North Carolina Figure 8 GPM 3066 Estimated Horizontal Extent of MTBE Above 2L Standards Groundwater Monitoring Report TRAVELED WAY EOP GRASS FORMER KEROSENE UST BASIN ASPHALT Al all vT. IttZur y t gA 0E Sy4p,LE WET AREA (EPHEMERAL) WHITE STREET ,N MW-5 I9AvELED WAY ASPHALT 0 0 r —y ❑ ❑ CURRENT ' ____-I UST BA51l1 UST PORT (YP)) FORMER KEROSENE PRODUCT LINE UST VENT PIPES a 0- (1 s. ASPHALT DUMPSTER s AIR 11 CONC. MW-1 ---{z5.0'I---------- I (<5.0 • (FORMER 4 LUST BASIN (08) MW-9 00z 4 0 �4 CONC. • GRASS _ SIG (NS) T-1 © MW\3 GRASS', I [I }42, MW*-12 (100) i2801 MW-4 � o } FORMER DISPENSER ISLAND 12/ MW-10 DISPENSER (TYP.) CANOPY ASPHALT SUPPORT (TYP.) °N es ritzr'°i Fa TRANSMISSION TOWER Ng MW-7 (NS) GRASS { 4 4 0 0 GRASS Legend kw -a • Monitoring Well (Type 11) T-t Monitoring Well (Type III) col Utility/Power Pale Light Pole Overhead Electric Line Water Line Natural Gas Line Sanitary Sewer Line Communication Line End of Pavement Stormwater Inlet • Sanitary Sewer Manhole N Water Valve LF Fire Hydrant CID Liquefied Petroleum Tank Communication Pedestal a Bollards EOP IIII (<5.0) (NS) IPE Concentration IPE Concentration Contour Not Sampled Units: micrograms per Liter (ug/L) Sampling Date: August 13, 2019 IPE 2L Standard: 70 ug/L IPE GCL: 70,000 ug/L 0 15' 30' 60' — T 1 inch equals 30 feet CES N Ca CLIENT GPM Southeast, LLC. LOCATION 267 Western Boulevard Jacksonville, North Carolina Figure 9 GPM 3066 Estimated Horizontal Extent of IPE Above 2L Standards Groundwater Monitoring Report T LEa I ASPHALT ;w •�•,- •r GRASS l DROAAGE "ALEgr rrl N MW-6 us' I .0 2- '1 �, wA ` . VdH1i-E SYftEE� WAY . Legend �w 1 Monitoring Well {Type II) r-t 0 Monitoring Well (Type III) ��pVEIF� n x } . SIGN f ( i._�.,. (NS i rrt 73 GRASS co?UtilltyIPower Pole 0 Light Pole — cn Overhead Electric Line MW-5 ASPHALT -l7 ® (9.9) ', GRASS e MW-3 c WET AREA MW-1 0 _ EPHEMERAL) s `--{4$0) I _ O `. -, D GRASS r r-� - C RENT -+ _ ..--' ST r- J O ~ ~ FORMER PORT • • (=0Y a l�1fi. CO C Qi r0 Water Line Natural Gas Line Sanitary Sewer Line Communication Line EGP End of Pavement flli 5tormwater Inlet ® Sanitary Sewer Manhole IN Water Valve ER05ENE kJST (TYP) KUST BASIN �RMER I FORMER 0 1 POI- 12 q KEROSENE 1 '-' 7 BASIN (630) ,1 (380) t1,7001 PRODUCT LINE ---- , MW-9 MW-4 MW-8 (NS) �. Fire Hydrant CD Liquefied Petroleum Tank q Communication Pedestal O Bollards UST VENT PIPES } I o (620) I = I la MW-2 } C' .1 --. 'ram' 1 �o HI ` � (480) Naphthalene Concentration �- Naphthalene Concentration Contour (NS) Not Sampled xn �{~ I GPM `-' 1 #5066 x CONC. 1 STOI = -- )1 1 1 1 /r 1 = " �� { ❑ t_ -. I E� ~ 1 FORMER �e DISPENSER Y 1.4 ,SZII 11111 Units: micrograms per Liter (ug/L) Sampling Date: August 13, 2019 Naphthalene 2L Standard: 6 ug/L Naphthalene GCL: 6,000 ug/L { ISLAND CONC. { e ASPHALT MW-10 GRASS (NS) .7 * DUMPSTER 1, � �N4P�Cf- J . DISPENSER (TYP.) CANOPY ASPHALT . SUPPORT (TYP.) AIR ch GRASS 0 15' 30' 60' 7 Iti I I (NS) x ea' 1 inch equals 30 feet CESNCa o/� ��'wc row 1 CLIENT: GPM Southeast, s_LC. 1.1 4FS r �&02p40 LOCATION 267 Western Boulevard Jacksonville. North Carolina FI ure 10 GRASS GPM 3066 Estimated Horizontal Extent of Naphthalene Above 2L Standards TRANSMISSION TOWER Groundwater Monitoring Report Sidra lely of Kes:P ci1 Analypcy[ Reaula Icr Sod FORMER PROCUCT LINE GRA55 WHITE STR EET FORMER KEROSENE UST BASIN HA— I9L---- HA-2 galls N o~tiv HA-3 m 14W-5 ✓ C)T-1 I MW-1 si ACTivE 1 ;r_ — — GASOLIN�y ` UST EAS t I}I ■■■! III I1 rI I II Sc' IL N. S5 . S4 • S3 • FORMER GASOLINE LIST BASIN SCOTC$MAN #56 � I DISPENSER ISLAND (TYP ) 0 •51 MW-4 �/ / MW-7 MW-6 m MW-8 nomcmd C'• ri•.'+-i.' >m .paNMI GrM'Jedwrer 1_ _ Reslder•I.11 e. a 11M E lIIIKIME®�- .r' ... _70.:+.a •� I um, 12141A9 ]214 5a liE=1=7_ ryr� MS Link t2r4r98 M-����w�r�- Ben2elw =a NA NA NA �© 7fA 7,000 3.2Da W0 MiMWEEISMOIMEMES=1 NA NA lIA NA lee 92G 1M, NA NA NA NA NA NA NA u\ege•rPN Mi CS.ca 12 C00 935,000 NA NA z5aP NA NA NA NA ALA NA C5 C12 3255.X2 9 =B Cda IIIEMEMMINEZIN NA 1 Az AA IEME MA Cfl•G10 34 coo as9.000©© iim ��II - ouherroo AGM _ '�©a N1.070 i0p00 1'. rr. m T7.=W NA 1.72A000 ,.5,2 - pnaal .$ 4 40070 MEM= 7 0. On 77. PPP riA 247,000 BOIL- 5 . flat. nee — NO, M•1•101e6 PATIMC `, Mo YI144 C.Clegr.9. Sollia,ulorRl11771/151•71[11111 Aa wncurnlrxu are saluss ed as PL'b Per Munn iPFp3- 1: Ganane an d ID, 174a112 am PI01 owel.d tinder atm darn. VA me an 0=5 laveI r aya'Mart rsud a Not Altaymd 3: Balow❑uanina loll Jnel SL.lvr.y el An177: al R71n1c5 !or S14- Cam P.onerclhe Ene A,eeyv .nl a 1L7: r{F-I KA-2 KA-3 P1RN•5 PMW MW-7 P cael.d Ca -wound Sal -to- GrlwrCavor MSC* Ramdanld M5CCr D'.aroge tlauar 2 ram 2 lac 2 feel 1.10,Aniern unknown UrArte AnT Lklknarn PIQ 1�xn1: 95 2 115 NA NA NA NA 51,m:4O Cale. 10115WW •¢n ;SS 111/15199 9129199 4/297199 912999 9PdWWg3 %PA ar ilos ono' 0-1ke5.cryxomsr. •9L1 9a1 sot Al2 1 HAL KN. ECL SADEP•EPH C9:15 446,7994:00 4,31800 BCI. EOL 105.000 POL SOL S. BOL *ISt36 a 93.74•001 844. 311320 94.400 SQL ' SQL BC"- SQL asIz22 atom 169,000 PCY epl. 279,000 30L SOL SOL et_ Nola 71g2Ir40ed PairT`"Wn axe Nonr samearslp5ui-W:'Nwdwvlor SIpadaw A4 unmeant/Wm. ercressed as iskns Par Moon IPA 17 Na enel xed 2: P040w 0lanoieaarr •5ri1 .: CWGldersw uunot I. 0 a0 SCALE IN 'FEET LEGENQQ MW-1 m MONITORING WELL TELESCOPING WELL SANITARY SEWER MANHOLE ® STORM DRAIN - 11 FIRE HYDRANT ❑C TELEPHONE SOOTH SI • SOIL BORINGS INSTALLED ON 12 / 419E HA-1 O HAND AUGERS INSTALLED ON 10115 / 99 1 � _ t • •• • • • • ESTIMATED EXTENT OF TPH IN Self_ ESTIMATED EXTENT OF EPH IN SOIL Ea''11 2 2019 VOrer(}11El1H 1 $.:110fai Opp S Delta AEnvironmental Consultants, Inc- 1201 South i61h Street M, Valmington, North Carofino 28401 P4G.ECT NaL FIGURE WEN SACCASlCN xONC-110 SCCTCHMAN #66 6 most; umiAGER 267 WESTERN BOULEVARD J. STLITS JACKSCNVIL_E, NORTH CAROLJNA pcsoi : Br WANING 0CSCRIPTILW ESTIMATED HORIZONTAL ECTENT OF PETROLEUM ""9f er HYDROCARBONS IN UNSATURATED SOIL DO 03/21/00 1"=d4' I XONC— 1 10 FORMER UST BASIN KEROSENE \ I I FORMER PRODUCT LINE GRASS WHITE STREET A Mw--5 1 ACTIVE GASOLINE UST BASIN -III I 111 �Tr1 mw-1 -- FORME .. • E • i : IN SCOTCHMAN #66 l DISPENSER ISLAND (TIP.) W-3 MW-4 MW--7 -j N 11S3M 1Il 0 0 B' MW-6 MW-5 A' 0 40 SCALE IN FEET LEGEND MONITORING WELL TELESCOPING WELL SANITARY SEWER MANHOLE STORM DRAIN FIRE HYDRANT TELEPHONE BOOTH 1Delta Environmental Consulton ts, Inc. 201 South 16th Street A Wilmington, North Carolina 2BA01 PR0.ECT A4 rIom XONC-110 PRO,LCT YAMAGCR 1 4 J.STUTTS C1.Hf toCATKei SCOTCHMAN #66 267 WESTERN BOULEVARD JACKSONVILLE, NORTH CARQLI NA OE9pIEn BY MAW 81 I0 DAAMb[G oESCAUPACk SITE MAP DEPICTING CROSS-SECT1ONS A -A' AND B-B' SCA12 AESAEWER Br GA 03/21 /00 1 "aAO. , CAD HQ. X0NC-11 Q '°' MW—B A NMW-5 100' 95 -1 90 -r 85 80 - 75 - 70- 65 - 60 - !OW--4 l • 1 1 1 I 1 1 1 f I I , I 1 1 I 1 1 I ` 1 1 1 ! 1 ,15,000 ppb' I - ' r \ 10,000 ppb f • 5,000 ppb / '1,000 ppb-- 1 ppb I y HORIZONTAL: 1" = 30' VERTICAL: 1" = 5' WELL CASING DIAMETERS ARE N0T TO SCALE Z WATER TABLE 100' V /c Man -Made Materials SP = Poorly -Graded Sand (little or no fines) CL = Silty Clay SM = Silty Sand BENZENE CQNCEHTRATIONS WELL ID BENZENE (ppb) MW-2 141 MW--5 BOL MW-7 SQL MW-1 1,820 T-1 BOL MW-4 19,100 MW-3 813 MW-8 BOL MW-6 SOL SOL = BELOW 0L ANTrrAT10N LIMIT (0.5 pp5) Delta Environmental Consultants, Inc. 1201 South 161h Street AA Wilmington, North Corolino 28401 pwp,ECT Ma flQ „ XONC-110 il wan' icuut it 1 5 JS cLi TAcCAi1Gn SC0TCHMAN #65 267 WESTERN BOULEVARD JACKSONVILLE. NORTH CAROLINA mama o[saaascim A —A* ESTIMATED VERTICAL EXTENT OF BENZENE IN GROUNDWATER (OCTOBER 14, 1999 ANALYTICAL DATA) Mat-11WD WI OMF 9 G4.E I AD NO. 03/2a/00 AS SHOWN I 110—AA 3 100' 95 90 85 - 80 75 - 70 -- 65 - 60 -� MW -- 2 gr, 27 • -1 ppb— MW-3 140RIZONTAL 1 = 30. VERTICAL: 1" = 5' WELL CASING D AMETERS ARE NOT TO SCALE WATER TABLE Man -Made Materials SP = Poorly -Graded Sand (little or no tines) �� CL = Silty Clay 1111111111111111111 SM = Silly Sand ML = Clayey Slit BENZENE llQNCENMATIONS WELL ID BENZENE (ppb) MW-2 141 MW-5 BOL MW-7 BQL MW-1 T-1 1,820 BOL MW-4 19,100 MW-3 813 MW-8 MW--6 BQL BQL Eta BELOW QUANTTTATION LIMIT (0.5 ppb) JDelta Environmental Consultants, Mc.. �/ 1201 South 16th Street !A. Wilmington. North Carolina 25401 yrroxir T XONC--110 rpeo€c7 v.:rr .1S 16 wp+T WC.+rICw SCOTCHMAN #66 257 WESTERN BOULEVARD JACKSONVILLE. NORTH CAROLINA ctpo+ED og rn 9Y 00 DIMING DOCRIP71p+ B--B' ESTIMATED VERTICAL EXTENT OF BENZENE IN GROUNDWATER (OCTOBER 14, 1999 ANALYTICAL DATA) r ee uar[ . ub ma. 03/23/00 AS SHOWN I10—GB