HomeMy WebLinkAboutWI0300409_Injection Event Record_20191230North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WI0300409
1. Permit Information
Mark W. Ehrman, P.E.
Permittee
Marathon Charlotte East Terminal
Facility Name
7401 Old Mount Holly Road, Mecklenburg
County, Charlotte, NC 28214
Facility Address (include County)
2. Injection Contractor Information
Margaret Ness / AECOM
Injection Contractor / Company Name
Street Address1600 Perimeter Park Dr., #400
Morrisville NC
City State
(_919) _461-1423
Area code — Phone number
27560
Zip Code
3. Well Information
Number of wells used for injection 4
Well IDsMW21, MW5I, MW65, and MW48
Were any new wells installed during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Wells NA
Number of Injection Wells NA
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
E Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
❑Yes ®No
If yes, please provide the following information:
Number of Monitoring Wells NA
Number of Injection Wells NA
Please include a copy of the GW-30 for each well
abandoned.
4. Injectant Information
0-Sox "socks"
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration —15 lbs/100 lb 0-Sox
If the injectant is diluted please indicate the source
dilution fluid.
Total Volume Injected (gal)_3 0-Sox socks /well_
Volume Injected per well (gal)_1.75 lb
material/sock 3 socks = 5.25 lb/well (4 wells)
5. Injection History
Injection date(s)_December 30, 2019
Injection number (e.g. 3 of 5) 2nd of TBD
Is this the last injection at this site?
❑ Yes ®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.
1Z111626
SIGNATURE OF INJECTION CONTRACTOR DATE
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016