WI0800531_DEEMED FILES_20191213

Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0800531
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
GPM 3066
Location Address
267 Western Blvd
Jacksonville
Owner
Owner Name
Gpm Southeast LLC
Dates/Events
NC
Orig Issue
12/13/2019
App Received
12/2/2019
Reg ulated Activities
Groundwater remediation
Outfall
Waterbody Name
28546
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
12/13/2019
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit. Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Rolfe Lann
8565 Magellan Pkwy
Richmond
Region
Wilmington
County
Onslow
VA
Issue
12/13/2019
Effective
12/13/2019
23227
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
CES NC
November 25, 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 3066 (Scotchman #66)
267 Western Boulevard
Jacksonville, Onslow County, North Carolina
NCDEQ UST Incident No.: 20072
Dear Ms_ Shrestha:
On behalf of the responsible party/applicant GPM Southeast, LLC, CES of NC, PLLC is submitting the
enclosed Notification of Intent to Operate Injection Wells. The document details "deemed permitted"
passive injection activities utilizing existing monitoring wells for the purpose of groundwater remediation
associated with the referenced incident number. Following review should you have any questions or require
additional information, please do not hesitate to contact me by phone at .[phone] or email al
awill iamson.ti: crawfordenvironrnental.com
Sincerely,
CES of NC, PLLC
Aaron Williamson
Project Manager
Enclosure
RECENECatieDIMIN
L ECO 2 2019
illetigloatlQC%

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 prior to in jection)
AQUIFER TEST WELLS 0 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 (ISA NCAC 02c .0229 ):
l) Passive Injection Sy stems -In-well delivery systems to diffuse injectants into the subsurface. Ex amples 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 : 11/22 ,20_19 __ PERMIT NO. V\) 2--o K 00 5 3 / (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERA TED
(l)
(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. 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): GPM Southeast, LLC-Rolfe Lann, VP ofEnvironmental
Mailing Address: 8565 Magellan Parkway, Suite 400
City: Richmond State: YA_ Zip Code: =23=2=2~7 ___ County: Richmond
Day Tele No .: 910-796-2418 Cell No.: __________ _
EMAIL Address: rlann@ gp minvestments.com
Deemed Permitted GW Rem ediation NOi Rev. 3-21-2018
FaxNo.: 910-798-2025
Page I
D. PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: --~S~am~e~as~A~b~ov~e~------------------
Company Name: _________________ _
Mailing Address: ______________________ _
City: __________ State:_ Zip Code: ____ County: __ _
Day Tele No.: ____________ Cell No.: __________ _
EMAIL Address: Fax No.: __________ _
E. PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title: Aaron Williamson, Pro ject Manager
Company Name Crawford Environmental Services ofNC. PLLC
Mailing Address: 5104 Reaoan Drive. Suite 7
City: Charlotte State: NC Zip Code: =28=2=0=6 ____ County: Mecklenburg
Day Tele No.: ~98~0~-8~1=9~-9~3~3~3 ______ _ Cell No.: __________ _
EMAIL Address: awilliamson@ crawfordenvironmental.com Fax No.: 540-343-6259
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: _G_P_M_30~6~6 __________________ _
267 Western Boulevard
City: Jacksonville County : Onslow Zip Code: 28546
(2) Geographic Coordinates: Latitude**: "or 34°.759181N -----------0
Longitude**: ___ 0 ______ " or __ ~7-'-7°.382395W ___ _
Reference Datum: -'-W'--'G=S=8"-'4'--------'Accuracy: 2=m=e=te=r=s ____ _
Method of Collection: ~G=o=o=gl=e~E=arth=~-------------
* *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 (:'.S 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 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
r
I. DESCRIPTION OF PROPOSED INJECTION ACTMTIES -Provide a brief narrative regarding the
pw-pose, 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 four im pacted monitoring wells
(MW-4. MW-9 , MW-1 1, MW-12 ). Socks will contain sodium persulfate and potassium perman ganate
combination cy linders, each 1.5-feet long. Each well is constructed with 10-feet of well screen. Six feet of
cylinders will be placed into each monitoring well within the saturated well screen.
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 hnp ://deq.nc.gov/about/divisions/water-
resources/water-resources-pennits/wastewater-branch/ground-water-protection/fil ound-water-a pproved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
lnjectant: Sodium Persulfate (CAS #7775-27-1)
Volume ofinjectant: 34 .5 pounds per in jection point
Concentration at point of injection: =1~00~0~1/o~---------------------
Percent if in a mixture with other injectants: --"'3"""8"'"'%,,__ _______________ _
Injectant: Potassium Permanganate {CAS #7722-64-7)
Volume ofinjectant: 34.5 pounds per injection point
Concentration at point of injection: =10=0~0~1/o~---------------------
Percent ifin a mixture with other injectants: =3=8°~1/o"------------------
Injectant:
Volume ofinjectant: _____________________________ _
Concentration at point of injection: _______________________ _
Percent ifin a mixture with other injectants: ____________________ _
K WELL CONSTRUCTION DATA
(1) Number of injection wells: _____ Proposed ___ 4 ___ Existing (provide GW-1 s)
(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 NOT Rev. 3-21-2018 Page3
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities.
ISCD c. tinders to be installed in existing monitorin wells .lanuai./Februw\ 2i+20. 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 specified in Subchapter 02L result from the injection activity.
A eroundwater monitorinr. event will be conducted prior to cylinder installation. Subsequent monitoring events
are proposed on a semi-annual basis concurrent with cylinder removaitrejslacement. Groundwater samples will
be submitted for iabaratojy analysis of volatile organic compounds b7 Standard Metjtods 62008 includin];
STEX. MTBE. IPE. EDS. and naphthalene. See NCDEQ UST Incident Number 20072._
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/APPClcent: "I hereby certify, sender penalty of law, that 1 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 true, accurate and
complete. 1 am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. 1 agree to construct, operate, maintain, repair, and ifapplicable, abandon the
injection well and all related appurtenances in accordance with the I- \VC OZC 0200 Rules."
Gr •
Print or Type Pull Name and Title
Signature of Applicant
Proiert► Owner (if the property is not owned by the Well Owner/ApOicanh
"As owner of the property on which the injection well(s) are to be constructed and operated, I 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 we(s) conform to the Well Construction Standards
(15,4 NVC4C 02C .0200)."
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absoc -u contrary agreement in writing.
• - denature* of Property Owner of different from applicant) Print or Type Full Name mink
*-4n access agreement between the applicant and 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 (2) weeks prior to injection to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: (919) 8O7-6464
Deemed Permitted GW Remediation NM Rev. 3-21-20] 8
Page 4

TRAVELED WAY
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GRASS
FORMER
KEROSENE
UST BASIN
ASPHALT
WET AREA
EPHEMERAL)
r
FORMER
KEROSENE
PROIDUCT LINE
DRAINAGE SWALt
WHITE STREET
UST VENT PIPES o
0
0
CURRE
UST B,
Legend
Otis-F is Monitoring Well (Type II)
r-i 4) Monitoring Well (Type III)
Utility/Power Pole
Light Pole
- — Overhead Electric Line
w — Water Line
Natural Gas Line
Sanitary Sewer Line
Communication Line
EOP End of Pavement
® Stormwater Inlet
j Sanitary Sewer Manhole
)4 Water Valve
• Fire Hydrant
Liquefied Petroleum Tank
Communication Pedestal
d Bollards
0
15'
30*
6o'
� F
1 inch equals 30 feet
CES
NC
n
CLIENT:
GPM Southeast. LLC
LOCATION: P571 stern Boulevard
Jadcaonvile. NM Carolina
Figure 2
GPM 3066
Site Map
Groundwater Monitoring Report

C
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 suppliers 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
[phone] - All other non -emergency inquiries about the product should be
directed to the company
[e-mail]
www.caruscorporation.com
Dr. Chithambarsthanu Piliai
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 (Toll -Free - must be dialed from within country)
01-800-681-9531
CHEMTREC®, Other countries: 001 [phone]
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 lasting effects.
RemOxx SR+ ISCO Reagent 808 US
923162cp Version#_ D1 Revision date:- Issue date: 04 -April-2015 1 i 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
treabnent 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
sos 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
Form
lnhalable fraction.
Respirable fraction.
Form
Fume.
Fume.
sos us
3/9
f
l
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
Respiratory protection
Thermal hazards
General hygiene
considerations
Use protective gloves made of: Rubber or plastic. Suitable gloves can be recommended by the
glove supplier.
Wear chemical-resistant, impervious gloves.
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.
When using, do not eat, drink or smoke. Keep from contact with 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
Physical state
Form
Color
Odor
Odor threshold
pH
Melting point/freezing point
Initial boiling point and boiling
range
Flash point
Evaporation rate
Flammability (solid, gas)
White solid.
Solid.
Solid.
White.
Paraffinic.
Not applicable.
Not applicable.
130 °F (54.44 °C)
Not applicable.
Not applicable.
Not applicable.
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
Explosiv~ 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.
10. 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
SDS 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 May cause irritation to the respiratory system.
Skin contact
Eye contact
Ingestion
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 Test Results
Potassium permanganate (CAS 7722-64-7)
Acute
Dermal
LD50
Oral
LD50
Skin corrosion/irritation
Serious eye damage/eye
irritation
Respiratory or skin sensitization
Respiratory sensitization
Skin sensitization
Germ cell mutagenicity
Rat
Rat
Causes severe skin bums.
Causes serious eye damage.
2000 mg/kg
2000 mg/kg
May cause allergy or asthma symptoms or breathing difficulties if inhaled.
May cause allergic skin reaction.
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
SDS US
5/9
r
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Components Species Test Results
Potassium permanganate (CAS 7722-64-7 )
Aquatic
Fish
Persistence and degradability
Bioaccumulative potential
Mobility in soil
Mobillty in general
Other adverse effects
LC50 Bluegill (Lepom is 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, SOS 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
Rem Ox® SR+ ISCO Reagent
92 3 162cp Version#: 01 Revision date:-Issue date: 04 -April-2015
sos us
6/9
l
Label(s) Packing 5 .1
group Environmental II
hazards ERG Code Yes
5L
Special precautions for user Read safety instructions, SOS 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, SOS 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
Potassium permanganate
Other federal regulations
CAS number
7722-64-7
Clean Air Act (CAA) Section 112 Hazardous Air Pollutants (HAPs) List
Potassium permanganate (CAS 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 California to cause cancer, birth
defects ar 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/no)'
Australia Australian Inventory of Chemical Substances (AICS) Yes
Canada domestic Substances List (DSL) Yes
Canada Non -Domestic Substances List (NDSL) No
China inventory of Existing Chemical Substances in China (IECSC) Yes
Europe European Inventory of Existing Commercial Chemical Yes
Substances (EINECS)
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 counlry(s).
A "No" indicates that one or more components of the product are not listed ar 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
NEPA ratings
List of abbreviations
References
0
ox
LD5Q: Lethal Dose, 50%
LC50 Lethal Concentration, 50%
Chemical safety report.
ECHA registered substances database
RemOxe SR* ISCO Reagent
9231e2cp Vers{on#7 01 Revision date:- Issue dater 04-Apnl-2015
SDS US
S/9

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. CARUS CORPORATION DISCLAIMS ALL LIABILITY FOR RELIANCE ON
THE COMPLETENESS OR ACCURACY OR THE INFORMATION INCLUDED HEREIN . CARUS
CORPORATION MAKES NO WARRANTY, EITHER EXPRESS OR IMPLIED, INCLUDING, BUT
NOT LIMITED TO, ANY WARRANTIES 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
Incident #: 20072
Boring
Well
Well No. Depth
Screen
Interval
(ft,bgs)
(ft, bgs)
MW-1 12 2 -12
MW-2 12 2 -12
MW-3 12 2 -12
MW-4 12 2 -12
MW-5 12 2 -12
MW-6 12 2-12
MW-7 12 2-12
MW-8 12 2-12
MW-9 12 2 -12
MW-10 12 2 -12
MW-11 12 2 -12
MW-12 12 2 -12
T-1 35 30-35
Notes:
-ft, bgs denotes feet below ground surfac e
-NA denotes data not available
Table4
Summary of Well Construction Data
Scotchman #3066
267 Western Boulevard, Jacksonville, NC
CES of NC Project Number 9.0464
Well
Top of
Diameter Casing Installation
Elevation Date (inches)
(ft)
2 98.73 1998
2 99.12 1998
2 98.68 1998
2 99.38 1998
2 98.67 1999
2 99.38 1999
2 99.32 1999
2 99.72 1999
2 99.37 06/2013
2 98.85 06/2013
2 99.45 06/2013
2 98.82 06/2013
2 98.72 1998
-MW-1, MW-5, MW-10, and T-1 manways reconstructed and TOC resurveyed on June 9, 2017
Facility ID: 0-020149
Well Status
Present
Present
Present
Present
Present
Present
Present
Present
Present
Present
Present
Present
Present
Revision Date: 8/29/19
NON ON RESIDENTIAL WELL. CONSTRUCTION RECORD
North Carolina Deparhnent of Environment and Natural Resources- Division of Water Qualify
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
Randy Uottmarl
Welt Contractor (individual) Name
SAEDACCO Ina
Weil Contractor Company Name
9088 North Tiald Dr
Street Address
Farb Mill
City or Town
{ _ } 17041 622-4750
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT$
8C 26707
State Zlp Code
OTHER ASSOCIATED PtRMIT#(!f appncebie)
SITE WELL ID#(iteppllcablei 9
3_ WELL USE (Cheat One Box) Monitoring al Municipal/Public 13
Industrial/Commercial p Agricultural 0 Recovery ❑ Injection p
Irrigallonp Other © (list use)
DATE DRILLED 6/13/13
4. WELL LOCATION:
267 Western Boulevard Jacksonville, NC
(Street Name, Nurnberg, Cvmmudty, Subdivision.Lc' No-. Perta41Ip Coda)
CITY: COUNTY
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
C1Slope LiVelley DFtat ❑Ridge ❑Other
LATITUDE 34.757805 " DMS OR 3X.XXXXXXXXX DO
LONGITUDE-77.381668 " DMS OR 7x.xxxxxxxxx ❑tS
Latitude/langlfude source, E 33PS IJropographic map
{location of wall mast be shown an a USGS lope map andattached fo
this form ifret using GAS)
5. FACILITY (Name of the business where the well is located.)
Facility Name Facility ID# (if applicable)
Street Address
City or Town Stale Zip Code
Znviraamanta1 Services and solutions
Contact Name
PO Box 12055
Mailing Address
Wilmington NC 28405
City or Town
State Zip Code
( 910 ) 470-7066
Area code Phone number
6. WELL DETAILS:
a. TOTAL OEM: 12
b. DOES WELL REPLACE EXISTING WELL? YES tj NON
c. WATER LEVEL Below Top of Casing: FT.
(Use'+' if Above Top of Casing)
Size
#2
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mall Service Center, Raleigh, NC 27699.161, Phone ,. [phone]
3476
S3g
d. TOP OF CASINO 1S 0 FT. Above Land Surface"
'Top of casing terminated etlor below lend surface may require
a variance In accordance with 15A NCAC 2C .0118.
a. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
g. WATER ZONES (depth):
Top 2 Bottom 12
Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Tap 2 Bottom !2 Ft.2" 40 Ova _
Top Bottom Ft.
Top - Bottom Ft.
8. GROtir: Depth Material Method
Top 0 Bottom 1 Ft, portiand pour
Top Bottom Ft.
Top Bottom FL
9. SCREEN: Depth Diameter Slot Size Materiel
Tap 2 Bottom 12 FI. 2 in 010 in. pvo
Top Bottom Ft, in in.
Tap Bottom FI, In. • In.
10. SAND/GRAVEL PACK:
Depth
Top 1.5 Bottom 12 FL
Top Bottom Ft.
Top Bottom Ft.
11. DRiLL1NG LOG
Top Bottom
0 1 12
1
1
1
1
1
1
1
Material
aand
Formation Description
sand
12. REMARKS:
shallots water tablis 2'
I00 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED iN ACCORDANCE WITH
3A NCAC C. WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
RECORD HAS BEEN oftovi}ED TO THE WELL OWNER
6/17/2013
SIrC-1rt OO CI:,RTIFTED WELL CONTRACT t DATE
Randy Hof !man
PRINTED NAME OF PERSON CONSTRICTING THE WELL
RECEMINCDEMer
Form OW -lb
Rev. 9
22019
oz91,c Quay
ripghonalOpe+rat f15

NONRESIDENTI4L WELL
North Caroline Department ofEnvlronment end Natural
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
Randy Hoffman
Well Contractor (Individual) Name
SAEDACCO Inc
Weil Contractor Company Name
9089 North Field Dr
Street Address
Fort Hill
City or Town
(7041 622-4750
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT*
SC 29707
State Zip Code
OTHER ASSOCIATED PERMIT#{li applicable)
SITE WELL ID #{Irappllcabty) 11
3. WELL USE (Check One Boxy Monitoring pp MunlcipatiPublic ❑
lnduetriallOommenial c) Agricultural p Recovery Ei Injection p
IrrI atfonl7 Other ❑ (list use)
DATE DRILLED 6113 / 13
4. WELL LOCATION:
267 Western Boulevard Jacksonville, NC
(Street Name. Numbers, Carrnnurety, SubtiNision, Lel No.. Parcel, rip Code)
CITY: COUNTY
TOPOGRAPHIC / AND SETTING: (check appropriate box) '
❑Slope ❑Valley ❑Flat aRidge ❑Other
LATITUDE 34.757805 " DMS OR 3x.xxxxxxxxx DD
LONGITUDE-77.381668 ' DMS OR 7x.xxxxxx}txcx Dt)
Latitude/longitude source: LOPS [)topographic map
{location of well must be shown on a USGS tapo map andattachad to
this form if nal using GPS)
5. FACILITY (Name of the business where the well Is located.)
Facility Name Facility ID# (if applicabia)
Street Address
City or Town State Zip Code
Environmental Services and solutions
Contact Name
PO Box 12055
Mailing Address
Wilmington NC 28405
City or Town Slate Zip Code
910 ) 470-7066
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO la
e. WATER LEVEL Below Top of Caelrsg: FT.
(Use"+' if Above Top of Casing)
CONSTRUCTION RECORD
esource,s- Division of Water Quality
3476
d. TOP F CASING IS 0 FT. Above Land Surface"
• op of casing terminated at/or below land surface may require
is variance In accordance with IBA NCAC 20.0118.
O. YIELq (gem):
METHOD OF TEST
I. DISINFECTION: Type Amount
g. WATkR ZONES (depth):
Tap Bottom 12
Top Bottom.
Top Bottom Top Bottom
Top Bottom Tap Bottom
Thickness/
T. CASI 0: Depth Diameter Weight Material
Tap 2 Bottom 12 FL2" 40 pee
TQp Bottom Ft,
Top Bottom Ft.
6. GROUT' Depth Material Method
Top 0 Bottom 1 Ft, ;Kirtland pour
Top Bottom Ft.
Top Bottom Ft.
9, SCREEN: Depth Diameter Slot Size Material
Top 2 Bottom 12 Ft. 2 in. _ 010 in. pviv __
Top Bottom Ft. 1n. in
Top Bottom Ft, in. In-
10. SAND/GRAVEL PACK:
Depth Size Materiel
Top 1.5 Bottom 12 Ft_ #2 sand
Top _Bottom FL
Top Bottom FL
11. DRILLING LOG
Top Bottom Formation Description
0 1 12 sand
1
1
12. FtE ARKS:
shallow water table 2`
I OD HERESY CERTIFY THAT MS WELL WAS CONSTRUCTED IN ACCORDANCE WRit
ISA NCAC 2C, WELL CONSTRUCTION STANDARDS. AND WAY A CtWY OFTH1S
RECORD i1As SEEN PROVIDED TO THE W ELL OWNER.
6/17/2013
SteNt IF BD WELL CONTRAC OORR DATE
Randy Roffman
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Subrnit within 30 days of completion to: Division of Water Quality - Infcrmatlon Probasaing.
1617.Mail Service Center, Rateigh,'NC 27699-161, Phone : [phone] •
Form GW-1 b
Rev. 2109

NON ..RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3476
1. WELL CONTRACTOR:
Randy Hoffman
Weil Contractor (Individual) Name
SARDACCO Ina
Well Contractor Company Name
9088 North Field Dx
Street Address
Fort Hill.
City or Town
[ ) [phone]
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT*
SC 29707
State Zip Code
OTHER ASSOCIATED PERMIT#(if septrc:Ate)
SITE WELL ID#(Ifappllcable) 12
3. WELL USE (Check One Box) Monitoring Qt Municipal/Public p
Industrial/Commercial p Agricultural Recovery 0 Injection 0
Irrigations Other 0.61st use)
DATE DRILLED 6/13/13
4, WELL LOCATION:
267 Western Boulevard Jacksonville, NC
(Street Nerne, Numbers. Community. Subdwildon. Lot No.. Parcel, Zp Coda)
CITY: COUNTY
TOPOGRAPHIC / LAND SETTING; (check macerate box)
❑Slope °Valley ❑Flat °Ridge °Other
LATITUDE 34.757805 " DMS OR 3x.XXXXXXXXx DD
LONGITUDE-77.381668 " CMS OR 7_,X„xxxxxgxxx t1D
Latitudellongltude source: LIPS Gropographlc map
(location of wall mud be shown an a USGS logo map andaffeched to
this form If not using GPS)
5. FACILITY (Name of the business where the well is located.)
Facility Name Facility ID# (If applicable)
Street Address
City or Town State lip Code
Environmental Services and solutions
Contact Neme
PO Sox 12055
Mailing Address
Wilmington NC 28405
City or Taws Siete Zip Code
( 910 ) 470-7066
Ana code Phone number
6, WELLDETAILS:
a. TOTAL DEPTH: 12
b, DOES WELL REPLACE EXISTING WELL? YES q NO®
c. WATER LEVEL Below Top of Casing: FT.
(Use "+" 1f Above Top of Casing)
d. TOP OF CASING IS 0 FT. Above Land Surface'
'Top of casing terminated et/or below land surface may require
e variance In accordance with 16A NCAC 2C .0118_
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
0. WATER ZONES (depth);
Top 2 Bottom 12 Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight
Top 2 Bottom 12 Ft.2" 40
Top Bottom Ft.
Top • - Bottom Ft. -
6. GROUT: Depth Material
Tap 0 Bottom 1 Ft, portlaad
Top Bottom Ft.
Top Bottom Ft.
Material
pva
Method
pour
9. SCREEN: Depth Diameter Stot Size Material
Top 2 Bottom 12 Ft. 2 in. 010 in. pvo
Top Bottom Ft. In. in.
Top - Bottom
Ft. ln. M.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 1.5 Bottom 12 fit. #2 sand
Top Bottom Ft.
Top Bottom Ft.
T1. DRILLING LOG
Top Bottom
0 1 12
1
1_
/
1
1
1
1
1
Formation Description
sand
12. REMARKS:
shallow water table 2'
I Do HEREBY CER11FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
taA HCAC 2C. WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
REGARD HAS SEEN PROVIDED TO THE WELL OWNER.
6/17/2013
sl400 ERTIFIED WELL CONTRAC DATE
Randy HoUirman
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within. 30 days of completion to: Division of Water Quaflty - Information Processing,
1617 Mail Service Center, Raleigh, NO 27699.161, Phone : [phone]
Form GW-lb
Rev. 2109

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sUY WIRE (Gw)
e MONITORING WELL (WM)
tz PAY PRONE
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BENZENE CONCENTRATION CONTOUR
LB 51 BENZENE CONCENTRATION
ALL DATA PRESENTED IN ug/L
SAMPLED ON 1123/2019
(NS] NOT SAMPLED
25'
50'
100'
t ]t I
1 inch equals 50 feet
CES
NG
CLIENT GPM Invastments, LLC
LOCATION 201 East Church Street
Atkinson, North Carolina
Figure 4
GPM 3016
Estimated Horizontal Extent of
Benzene Above 2L Standards
Groundwater Monitoring Report

a
back of curb
MW-2S
10.821
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CONCRETE (Conc.)
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FILL CAPS
❑ FUEL PUMP
—1 GUY WIRE (GW)
6 MONITORING WELL (WM)
PAY PHONE
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sE SIGN
VENT TUBE (VT)
TOLUENE CONCENTRATION CONTOUR
[30.5] TOLUENE CONCENTRATION
ALL DATA PRESENTED IN ug/L
SAMPLED ON 1/2312019
NOT SAMPLED
[NS]
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50'
100'
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CES
N C
CLIENT' GPM Investments, LLC
LOCATION 201 East Church Sbeel
Atkinson, Nortrl Carolina
Figure 5
GPM 3016
Estimated Horizontal Extent of
Toluene Above 2L Standards
Groundwater Monitoring Report

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Abandoned
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o ■
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Legend
ACCESS PANEL
BACK OF CURS (BC)
CGrICRETE (Conc.)
CATCH INLET (CI)
4 Lon EXIST. GROUND ELEVATION
�.
0 FILL CAPS
FUEL PUMP
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G , C� a
ay
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6crlc of taro 1
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bask a? curb Z
0
a
S cc
in
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Co cFt Inlet 1 a.
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Leitch Inlet f2 bock of curb Catch laic'
f46g] ETHYLBENZENE CONCENTRATION
ALL DATA PRESENTED IN ug/L
SAMPLED ON 1/2312019
h [751 7'16OpV
-- r a power _�- �
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/Allanson Lis As Clair ril
CLiENT- GPM InveslmenIS, LLC
201 Bast Church Streal
Figure 6
Gross
m
LOCATION: Atkinson, North Carolina
NW-25
D [NS] 1
stew churn
ell
a
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Arno
12
GPM 3016
Estimated Horizontal Extent of
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Groundwater Monitoring Report

v
Pipe A
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ill
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cc
S-1(SufiFACEWAT£R)
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x—x—x—x—x—r—x--x- z
,. oiirh
D Propane
SantiagoPumphpuse
Stan
IN
Abandoned
y Pum ph ou se
■
Legend
AI-G ss PANEL
BACK OF CURB (BC)
CONCRETE (Conc.)
- z CATCH INLET (c+)
*too EXIST. GRoutti[7 ELEVATION
❑ FILL CAPS
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r °
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fl1►t p
f ay [NS;
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,
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( !
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Sign (typ-)
TOTAL XYLENES CONCENTRATION
R
ail: LP. - [NS]
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be ! 1 zri. L ,� ., 1Y 23 W-1 tip s+r curb /
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back of curs
o
CZ
a
I
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Calch Inlet ►
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h
Catch fnlrt 12
! ]J TOTAL XYLENES CONCENTRATION
ALL DATA PRESENTED IN ug/L
SAMPLED ON 1/23/2019
back of curb bads of curb l PP Catt:h We'
500 ug(L back of .zurb
%h -_� y [i s.51
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-
f40
A:
201 East Cnurcn 3meel
Figure 7
Grass
up
Atkinson, Atkinson, Nonh Carolina
uw-zs
0 [NS] 1
NewChuron
3
site
Arco
12
GPM 3016
Estimated Horizontal Extent of
-�
Total Xylenes Above 2L Standards
Groundwater Monitoring Report

back of cub
Pipe A
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CC
i Auto Garage
(Bamhill
Crass Area
MW-21S
[9.2t 01,
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fib [Ns]
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W-7
[35.1]
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FORMER PRODUCT PIPJNQ
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[NS]
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(NS]
Tr
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4--d-c(Suari"rt Patin
Legend
ACCESS PANEL
BACK OF CURF1 (eC)
CONCRETE (Conc.)
CATCH INLET (CI)
EXIST. GROUND ELEVATION
FILL CAPS
FUEL PUMP
GUY WIRE (GW)
MONITORfNG WELL (V11,4)
PAY PHONE
POWER POLE (PP)
a SIGN
VENT TUBE (VT)
NAPHTHALENE CONCENTRATION
CONTOUR
130.E] NAPHTHALENE CONCENTRATION
ALL DATA PRESENTED IN ug//L
SAMPLED ON 1/23/2019
[NS] NOT SAMPLED
0
25'
50'
100'
li 1
1 inch equals 50 feet
CES
NC3
CLIENT:
GPM Investments. LLC
LOCATION205 East Church Street
Atkinson. North Carolina
Figure 8
GPM 3016
Estimated Horizontal Extent of
Naphthalene Above 2L Standards
Groundwater Monitoring Report

▪ N N - +r7
MW-26 MW-6 MW-3 MW-5 3 3 MW-13 MW-14 3 3 1-1A '
� [] � ❑
•WaHrer prnpest9'
A
•
x`.
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's.c
rp.o
tki
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t
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PC
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MW-6
MW-3
MW-5
.MW-23
DW-2
MW-13
MW-14
MW-27
DW-5
Dissolved Benzene
Conceotratiatl (uglL)
6.6
<0.5
19.1
304
19.1
<-0.5
<0.5
<0_5
<0.5
<0.5
• Well Screen Interval
SM: Silty Sand
SC: Clayey Sand
• CL: Clay to Sandy Clay
v Groundwater Elevation (ft)
Horizontal 1 inch = 50 feet
Vertical 1 inch = l0 feet
Delta
Delta Environmental Consultants, Inc.
3205 Randall Parkway Suite 104
Wilmington, North Carolina 28403
NCAC 2L Groundwater Quality Standard for Benzene is 1 ug/L
PROJECT NO.
XONC-036 —
PROJECT MANAGER
A. Lord
CLIENT/LOCATION
-- Worsley-Companies; Inc.
Former Scatchman #] 6
Atkinson, North Carolina
DATE
5/31l04
FIGURE NO.
14
DRAWING DESCRIPTION
A -A' Estimated Vertical Extent of
Dissolved Benzene Concentrations

100
90
80
70
60
40
30
MW-22 MW-13
"Walker preacr1Y
A
.ar-VA-1
if.2.1:1707
T
PO
ra+
"4,
•
Mw-16
• ,� P
r' rS
pamn+notl
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r W. Church SL
Win
,s-e
n
ado ION IN
NCAC 2L Groundwater Quality Standard for Benzene is I ug/L,
Well
M W-22.
MW-13
MW-23
DW-2
MW-15
DW-3
MW-16
DW-4
MW-17
Dissolved Benzene
Concentration (uglL)
<0.5
<0.5
19.1
<0.5
<500
<0.5
<0_5
<0.5
<0.5
riWell Screen Interval
SM: Silty Sand
SC Clayey Sand
sy to any ay
7 Groundwater Elevation (ft.)
Horizontal 1 inch 50 feet
Vertical 1 inch s 10 feet
Detta
7 [»y1ro..w. at.
ggtimol 5,irte•.
Delta Environmental Consultants, Inc.
3205 Randall Parkway Suite 104
Wilmington, North Carolina 28403
PROJECT NO,
_ x0NC-036
PROJECT MANAGER
A. Lord
CLIENT/LOCATION
- -—Worsley-Companies, Inc:
Former Scotchman #16
Atkinson, North Carolina
DATE
5/31/04
FIGURE NO.
15
DRAWING DESCRIPTION
B-B' Estimated Vertical Extent of
Dissolved Benzene Concentrations

-crc
.,
Pipe A
Grove( Arley In Zi
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■
c Abandoned
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■
Legend
ACCESS PANEL
SACK OF CURB (BC)
CONCRETE (Conic.)
;� CATCH INLET (CI)
+s.00 EXIST. GROUND ELEVATION
FILL CAPS
D FUEL PUMP
Pc' Pr'
Tank
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0
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MEASURED ON 1/23/2019
GROUNDWATER FLOW DIRECTION
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se rr
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Catch Inlet 2 P Catch Snlet
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hack of curt
7 . _ (96-29)
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d o aI p•°'p'w oe PP Z [a7-t3} 4 i.
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CEBvI\IC4
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dd
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CLIENT; GPM investments, LLC
Gross
1/1
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207 East Church Street
LOCATION: Atkinson, North Carolina
Figure 3
W--25
�(NMr 1
yew ,,,,
ra
i
,
Septic
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GPM 3016
Patentiometric Map (1/23/201 g)
Groundwater Monitoring Report