WI0800264_Staff Report_20111117

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: November 17, 2011
To: Aquifer Protection Section Central Office
Central Office Reviewer: Michael Rogers
Regional Login No: Geoff KeeleN
County: Carteret
Permittee: Tom Potter Oil Company
Project Name: Former Tee Pee #1 Store
Application No.: WI00800264
I. GENERAL INFORMATION
1. This application is (check all that apply): ® New ❑ Renewal
❑ Minor Modification ❑ Major Modification
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❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals
❑ Distribution of Residuals
E Attachment B included
❑ Surface Disposal
❑ 503 regulated ❑ 503 exempt
❑ Closed -loop Groundwater Remediation ® Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ❑ Yes or ® No.
a. Date of site visit:
b. Person contacted and contact information:
c. Site visit conducted by:
d. Inspection Report Attached: ❑ Yes or ❑ No.
2. Is the following information entered into the BIMS record for this application correct?
❑ Yes or ® No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and Injection Sites:
(If multiple sites either indicate which sites the information applies to. cop• and paste a new section into the
document for each site, or attach additional pages for each site)
a. Location(s):
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: 34 43 40.52 N Longitude: 76 38 27.54 W
H. NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals or minor
modifications, skip to next section)
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
FORM: WI0800264 staff report Nov 2011 1

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well( S) And Facilities — New, Renewal, And Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
In situ remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5L/"Non-Discharge")
❑ Other (Specify: )
2. Does system use same well for water source and injection? ❑ Yes El No
3. Are there any potential pollution sources that may affect injection? ® Yes ❑ No
What is/are the pollution source(s)? Facility is an existing groundwater contamination site, remediation for
pertroleum related contaminants is on -going and overseen by the Division of Waste Management. UST Section.
What is the distance of the injection well( s) from the pollution source(s)? 0 ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 0 ft.
5. Quality of drainage at site: ❑ Good
6. Flooding potential of site: ® Low
® Adequate ❑ Poor
❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ® Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal And Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No. If yes, explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If yes, explain:
3. For renewal or modification of groundwater remediation permits (of any type), will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If ves, explain:
FORM: WI0800264 staff report Nov 2011 4

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V. EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.: This review was conducted for a
new type 5I injection well permit. The permittee proposes to inject oxygen via an in -situ submerged oxygen
curtain (ISOC®) to enhance remediation of petroleum contamination resulting from leaking underground
storage tanks. After review of the permit application and supporting documents, the WiRO has no objections to
issuance of the permit.
2. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item
Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition
Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information; El
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report preparer(s):
Signature of APS regional supervisor:
Date:
7. 744
FORM: WI0800264 staff report Nov 2011 6

1

At,dIFER PROTECTION SECTI6,1
APPLICATION REVIEW REOUEST FORM
Date: November 4. 2011
To: ❑ Landon Davidson, ARO-APS
❑ Art Barnhardt, FRO-APS
❑ Andrew Pitner, MRO-APS
❑ Jay Zimmerman, RRO-APS
From: Michael Rogers Groundwater Protection Unit
Telephone: [phone]
E-Mail: Michael.RoQersrncmail.net
:1101"En b[�
NOV 0 B 2011
By
❑ David May, WaRO-APS
® Charlie Stehman, WiRO-APS
❑ Sherri Knight, W-SRO-APS
Fax: [phone]
RECEAD
A. Permit Number: WI 0800264
B. Owner: Tom Potter Oil Company
C. Facility/Operation:
❑ Proposed ® Existing
RECEIVED / DENR / DWQ
AOUIFPR'PF?(1TF'CT1fN SECTION
NOV y82011
❑ Facility ❑ Operation
D. Application:
1. PermitZype: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
..........
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
® UIC — 5I Groundwater Remediation Well
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project°_Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑
NOTE:
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within, please take the following actions:
® Return a Completed APSARR Form and attach laboratory analytical results, if applicable.
❑ Attach Well Construction Data Sheet.
E Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
r.,
RO-APS Reviewer:-£4..
Date:
FORM: APSARR 07/06 Page 1 of 1

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: November 4. 2011
To: ❑ Landon Davidson, ARO-APS ❑ David May, WaRO-APS
❑ Art Barnhardt, FRO-APS ® Charlie Stehman, WiRO-APS
❑ Andrew Pitner, MRO-APS ❑ Sherri Knight, W-SRO-APS
El Jay Zimmerman, RRO-APS
From: Michael Rogers Groundwater Protection Unit
Telephone: [phone]
E-Mail: Michael.Rogers(a,ncmail.net
Fax: [phone]
A. Permit Number: WI 0800264
B. Owner: Tom Potter Oil Comna %
C. Facility/Operation:
❑ Proposed ® Existing
❑ Facility ❑ Operation
D. Application:
1. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
® UIC - 5I Gr-oundwaterRemediation Well
For Residuals: El Land App. ❑ D&M El Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ® New ❑ Major Mod. ❑ Minor Mod. El Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑
NOTE:
Attached, you will find all information submitted in support of the above -referenced application for your
review. comment. and/or action. Within, please take the following actions:
® Return a Completed APSARR Form and attach laboratory analytical results, if applicable.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer:
Date:
FORM: APSARR 07/06 .Page 1 of 1

Michael F. Easley, Governor Carmen Hooker Odom, Secretary .
North Carolina Department of Health and Human Services
Division of Public Health • Epidemiology Section
1912 Mail Service Center • Raleigh, North Carolina 27699-1912
Tel [phone] • Fax [phone]
May 21, 2002
MEMORANDUM
TO: Evan Kane
Groundwater Section
FROM: Luanne K. Williams, Pharm.D., Toxicologist tt'`
Medical Evaluation and Risk Assessment Unit
Occupational and Environmental Epidemiology Branch
North Carolina Department of Health and Human Services
SUBJECT: Use of Oxygen to Enhance Booremediation of Petroleum Groundwater Contaminants at a
Defense Department Facility in Hertford, North Carolina
I am writing in response to a request for a health risk evaluation regarding the use of oxygen to
enhance bioremediation of petroleum groundwater contaminants at a Defense Department facility in
Hertford, North Carolina. Based upon my review of the information submitted, I offer the following
health risk evaluation:
WORKER PRECAUTIONS DURING APPLICATION
Some effects reported to be associated with short-term exposure to 100%oxygen are as follows:
• Inhalation of 100% oxygen can result in nausea, dizziness, pulmonary irritation leading to
pulmonary edema, and pneumonitis (Meditext — Medical Management by Micromedex
TOMEs Plus System CD-ROM Database, Volume 52, 2002).
• Intense and potentially fatal pulmonary edema may develop tracheal irritation, fever, nausea,
vomiting, acute bronchitis, sinusitis, malaise, paresthesias and conjunctivitis (Meditext —
Medical Management by Micromedex TOMEs Plus System CD-ROM Database, Volume 52,
2002).
• Inhalation of 100% oxygen can cause eye, nose, and throat irritation (Meditext — Medical
Management by Micromedex TOMEs Plus System CD-ROM Database, Volume 52, 2002).
2. The application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
Location: 2728 Capital Boulevard • Parker Lincoln Building • Raleigh, N.C. 27604
An Equal Opportunity Employ.

Evan Kane Memo
May 21, 2002
Page Two
3. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should never be
permitted in the application area during or immediately following application.
4. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
5. The Material Safety Data Sheets should be followed to prevent adverse reactions and injuries.
OTHER PRECAUTIONS
1. Access to the area of application should be limited to the workers applying the product. In order
to minimize exposure to unprotected individuals, measures should be taken to prevent'access to
the area of application.
2. According to the information submitted by ATC Associates, the base operates their own public
water system. The active wells are located 1,250 to 1,800 feet northwest of the injection site.
Efforts should be made to prevent contamination of existing or future wells that may be located
near the application area.
3. According to the information submitted by ATC Associates, there is an unnamed swamp located
approximately 1,000 feet south of the injection site. Because of the proximity to this water body.
measures should be taken to prevent adverse impact to this surface water body.
Please do not hesitate to call me if you have any questions at [phone].
cc: Mr. Wade Jordan, Ph.D.
Harvey Point Defense Testing Activity
2835 Harvey Point Road
Hertford, North Carolina 27944
Mr. Joseph Olinger
ATC Associates of North Carolina, P.C.
6512 Falls of Neuse Road
Raleigh, North Carolina 27615
Air Products & Chemicals, Inc.
7201 Hamilton Boulevard
Allentown, PA 18195-1501