WI0600071_Contract_20130412

Barber, Jim
From: Smith, Eric w-TO � � ��.
Sent: Friday, April 12, 2013 3:28 PM
To: Barnhardt, Art; Barber, Jim
Subject: RE: NOI - One Hour Cleaners of Laurinburg, Inc.
Art and Jim:
It's up to the Region if you want to perform a site visit. We have them submit the Notifications two weeks prior to
injection so that we (Central and Regional Offices) have the chance to look over the Notification to see if there are any
issues. I just review the. Notification for completeness and to see if the injectants are approved.
I reviewed this particular Notification and was ok with the content and the proposed injectant.
-Eric G. Smith,
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Division of Water Quality
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
Phone: [phone]
Fax: [phone]
Website: http://portal.ncdenr.org/web/wq/apss
DISCLAIMER: Per Executive Order No. 150, all a -mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.
From: Barnhardt, Art
Sent: Friday, April 12, 2013 3:02 PM
To: Barber, Jim
Cc: Smith, Eric
Subject: FW: NOI - One Hour Cleaners of L.aurinburg, Inc.
Jim:
If I read the processing instructions correctly, we just need to let Eric know if a visit to the site is needed. I would think
we should have a view, of the site unless you are already familiar with the area. Either way, I'll leave that up to you and
Eric to determine.
Thanks
ArtB.
From: Godwin, Tonya
Sent: Thursday,:April 11; 2013 1:07 PM
To: Barnhardt, Art

Cc: Smith, Eric I I
Subject: NQI - One Hour Cleaners of Laurinburg, Inc.
Good afternoon'
Attached is an. N01: ; W10600117 for your review.
Thanks
Tonya Godwin` , i '•I 'i;
NC Dept of Enviroriment'and atural Resources
Aquifer Protection. Section;
1636 Mail Service Center.i.
Raleigh, NC :Z-7699-1636': - ;
919-807-6301(Office,) ,
919-80776496.(F6x) ! +•, is
Tonya.Godwin@ncdenr.1ov;
Email correspondence] to and from this address may be subject to the North Carolina Public Records Law and
may be disclosed to third parties.
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)AGREEMENT FOR ASSESSMENT AND REMEDIATION PURSUANT TO DSCA
t at i
ATTACHMENT 1
.'LIMITED POWER OF ATTORNEY
I I_ f;
I .. i ('Petitioner"), do hereby grant a
lmuted power of attorney to the Division and to the Division's independent contractors as follows.'
I;r r ,
Tlie Divisiond,the Division's independent contractors shall have the limited power of attorney for.
'the preparaho; stgmng filing and delivery of any permit application, hazardous waste manifest,:
.non hazardous waste manifest, National Pollution Discharge Elimination System (NPDES) permit, .
for complying with any reporting requirements and for any administrative activities that may be
necessary im Ithe course of assessment and remediation conducted pursuant to the Agreement into,
which -this Attachment I is incorporated.
I s�
This limited poweir o,'fi attorney shall terminate upon termination of the Agreement.
:: � ;� i l;;I• III"it �I -
Dahe
ii. j s i°•"'(Seal) ..
Signature of,Petitioner /��,n• �Q
STATOF I `0 Li O A COUNTY OF
• 'I i'� i I 'i �, i
On this ! I dais� of7 , personally appeared before me, the said namedIETr� '
r
0 to me known- and known to me to be the person described
in andiwho executedahe foregoing limited power,of attorney and he (or she) acknowledged that
. �', ` ' 1i�•�i" � ! Fill I I° ! 'I � •
he (or'she�� x -cuted the same and being duly sworn by me, made oath that the statements in the
foregoingllimited;po.wer of attorney are true.
11
My Commission Expires [3
At (Signature of Notary Public)
Notary Public Offic'al Seal) j
t � •I.l��„IA I � 'I r'jl I •
DSCA' l 1�,i4 05;! ; Attachment 1
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JAN-10-2008..THIJ,I 04:43PI1(i ID,I . , • FACE:1
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01/1f /2008 , ;15:46 ; {Si;I9197U34811 6UF'E12 UtJD SECTION PACE : 02/05
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Iea�lphr; .$eat -lard
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#�> ale ID No.:-
c Cwe��tYP�'dorp'd!nteci:om
Nsine,o Pm'peTty
�,11i,; c narY4e of Prol��Y
tf.ig �
I;. I'!ijl'-,�I LR r of a aroal ai' property Located
" OwnBr;� Chill Property wIn
nec ie the P
Cau '� Mont Caroline (prropett 1 are
s dora to the North Carolina'Departrwnt
w�l�t, '(try PUt�o�) i
bfl,ni~nWonment and Natural Rescurs�Q; piviston of Waste Mart
' tt'tIt'o IM Dry-CIMing W silt to uP
for. c:ertlfkati>an of the Prapgrt�l �e Act of
ro ram ursuant to th a Dry-Cloaning Solvent CIII
!oat; iP tdtr� ;(P chapter 1+4� N,D.G S § 1 0�-2%1D4A et
;,I i, I�9 t111 o, Pon
B,,Artif 21A,► I 1 ed
�'I. lj',',�{1I \ i�?;'� � �f �l �'"�' ... � � • went far .I
, p1'; I IIIjjLj{III IWHEREA$� the Petalorw .IntwAD to enter Into an Agree
1 1 I I I I i
rttiWi end Romedial '(AM) with the DIVISion concerning. the Dry
ohrenfcontefmination an the Froperty; d
jClarn I$
III IWHERFJ°�8, tfle irripkVientation of the ARA will mgtAre Opt the Division
;:f i�
and It
ilridepondent contradOm (vontrautl have ' and un4rl+ Cnbered
II[�"I ss; �taj "rie '�operty for 1he� purposes of investipaling, aseeseing and
I I
,.ftam9d atitigl DryrCteanng Sownt contaittination on artd ,round the Property,
,
WHEREAS, the parties to this . Fla�ss Agreerne+tt �fre they Dlvislotl and
ii�OW YHEREFQR>;, in conslderdon of the 'terms and condiflvrl$
.�I.I
I, + ' aCl7t�il 11h.I thie Moil Agroftent, and for 09W gaud and VMU8b1>9
I' 3 `''ooneii�fatio' I ttia• receipt and sulliclenot► of whirl hereby that
dd
,
IMl'8@ ens loUows: � � � i • � -
�;� nt-of Uaons2lMnd Petmi Property Owr�r W reb'y grants
�111/ W tii4, Division a license to access the Property fo Yhonitor and eftrca the
i e , ll�,++I,. ii� {i �.. ji:.'i•'. w/ A-1__/ A .l_—/_• — 0-- A— ------
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9197334a1i :' i SUPERF N D MCI L N
PAGE 03/65
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teke,dii'°work
to. be, Wormed at the Property; Inoludtr?g, taut not limil!ad too •
III
ffin
Ins peClglsiceWrig pnd phoidaraphing the Fr+apatiy;
Faking h galls water and air samples as may bo. ;.
.
other•ackne relged to the'bw1914etl0n of
i:
(+: surface or subsurfam, conditions, i11 o o instalia an of
it
rnonitoring Wells orexcavation of (me red sail;
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d.
I Transportation of equipment onto and around the
'
I
} Property us necessary to ec=npfieh ft investigation;
T;klong wponss actions necessary to mi lgets M
'l,:thmat to human health attd the.environment; . . •
;
'
Rsmedlating dry. -planning snlverd' cor1%mtnaWn et, the
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property as neede, dand
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UndertAi vxh YQ w actiVitles + w rAwssary to
:;�, ' . rig
,
complete the work to be peft meq as required or
' permitted under the ARA.
'
�ar�dilions 13recedmrtt. The llomm aroatsd In Paragraph 1 ahalt
rI�;
letfect
in �
'upop, the ..Gars eatlon of the property Into the Program and than
terminated punsuantta Peaagr+sph 12 kmtow au
as
eirtfrt,.unWav otherwise
a P r Y ►6=lne cerpfied under the Program.
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gip,: Upon the Property Owner's reasoa�bla rta and
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set, ;Ilia
property owner and its consultants shall h (M right to obsarvs
WIL4609 porivrrnad by or on behelt of ft Division at the Property. UpM tits
arty Owner's reasonable notice and raquest, the Dlvialon or Its amtmctors•.
ai
I the, Pra�wrill Owner to epik samples of any envirornnardal samples
,
of the Division, All oasts asserted with 0WOW1110 NXI
k s a samples shall be bon* aolely by the l'roper�► e?wrtsT.
`l
I , � ' ergare .' The CtivislOrt and tt& oontrnctors shall endaavdr to
,
activltles auttalmd hemunder at the i property in a manner that
; !
?
�rzgs InterFeronaa with the use of the Property. ih4 P ivlsion end it8
motors %,AII: ake reasonable attempts to notify the l�pstty Owner at least
i
ours
prior,.to' entering the Pmoorty-far the p mmms sWed in Paragraph 1. -
ll�'_'Ii._--
' 9>''BCtAt>3 ftBV9 �d 40 malrrtetn tf,a
HI The [3rvlsron a son s8r
nned In their agMarnent whirr the olvislan, provided however,
reomenr-dd+a�t6, 200G)
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FUND SECTIQq
iI alit ;�� I!II, :, I'
RM I: ion ihall bave no llab)rdy for its omtradees UUM to maintain such
The Widon or; Ro cont abWrA shall remove and shall
right is remove frog the Property all equipment sn'd Wher materials
lAo.':ffie.Vlvisson or its oontraoW.9 vAthin ark rya xn.a* period of *m
ldon of the art boas at MejPropwtyauUWzed harsunder. To the
Wllasble,­-ft Division's corftedots. shall M*we the P(60* to the
0041on; li was in Pdor W any -'acAlAes'auffiorizad hemurder at the'
alas othepMaB agreed,to by the parties, shall. properlyY. RIOnrno wageto amordance with' any applIcolawse Iend
:
-A IkAfAl A
r UMURRIU12uh 1TV0F1`iiJP'41LY9wttei9114111 not
r+srnove, . Aver or cover any monitoring at remediallon wells an the
li-The property Owner also phW1 " tamper with or Affed the oixMfion
:# Fitijor remadjallon equl ht lnsWkwby d on th2 Party the
Any notlos, reports, or other communkdfons required dr
! under this Aoxw Agmament shall be a4dressW to the representative
tarty as, set rant below!
ilai+a;. ,�party Owner.
011, 0 Y-Q--Ll
1)52�N. rl� 12M YWI, Y-1-4 Y�._ZYA-34 1*"_V_1_
I' i
I itatjans, AM obilgdons of tho Division pLeftuent taAhis Ac4ass
ritjil!shek, be wrlwnt upon th4 evailabirdy of morays In the North
UrpCleaning 801"nt Ad Fund.
.!1141
MoMina Lay, TWa Amass Nreemant shall be goveMed by and
OIW-Aivyl once
with to km* of the stme Qf NorthCOMIN, Wifi-lbut
'tot at i M., OP
I, ISAN PdMPWS.
lause, ''ThlaAmass Agreeilnent represents the entire,
Win 60*0 EW w*wsedeo Sny
. 9 and agreement bahween the partles .
66r;!a*6mIenta, whether written or. oral, that may.exlet between me
I .
egardrip same. No amendment or modiflastlan to this Aoms
it, -or e* waiver 91 ww provWns h6W shall be sit' Wve unless In
I IN.
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70:19197334811 P:2/2
PAGE 05/,05
1'hLb! Ifeeroes creMed in Parawaph
may be,:
'iltdollwy of =mniable written natJ66 to the UMBIOn, Which
411i�,be''Acllve upon rwelpt of ouch nollcep, Howevew, such
)n *lLiizu terminate the ARK I.Ond CAM thefolleitM of flaiYllity:
I JUOthe DSCA' I no cuqh nofice Is served and sU*d to provislems'
rapt !Z Me Illowee cra%ed herein shall* romelTv in effect until;
Adt4flas undw thi ftgrom have bein'c&nplkod at the
set nut in the first senWw of Pkepaph OLt
This A=M ftreaviml may
not be amdad excep(
by,
a partite 'each reprosiont and warrant that this Aawas Agreement Is
their dLdy authbdzed rep epentiWyes as of the date accepted and
qped', this lb day of JC�A 200
(inhh" of P"" Owner)
and ridfor, v I
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.DEPAI
VBER1
"RIE
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-reputatic
And
th6.6n"
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reta ed
NOW;
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LINA i CONTRACT NO.
21, V,
CONTRACTOR'S' FEDERAL
No.-.'-56--1941224
T")' is made and entered into by and between Hart &'Hickrnan,
j
in North Carolina with 'an ad&ess of 2923 South Tryon Street, Suite i
o ma, 28203, hereinafter referred to'as "CONTRACTOR," and the North
te{of
4 Environment'- and Natural ResOurc es hereinafter referred to as
W I T N E S E T H:
..
DEPARTMENT is charged with:the responsibility of controlling pollution of the :j
Will,
the: State; and ! {FIR. Is=iblefon r6inistering the Dry-CleaningSolvent Cleanup
grade d, Part 6, 21A, . Chapter 143, N.C.G.S. § 143-215.104A et seq.
:j
i, COCONTRACTOR has exhibited evidence
NTRACTOR of 'experience, ability, competence and
brin en*dnmental engineering services at contaminated dry-cleaning facility sites;
J.
flit.
CTOR entered a competition to perform certain investigative and/or
nation resulting from the,i release of dry�cleaning solvents into
v 0 "dry-cleaning facility sites (hereinafter "site(s)"). in the State of North,
DEPARTMENT recommended, and on. October 5, 2010, the State Building
dCONTRACTOR to perform certain investigative and/or remedial activities
cation resulting from such sites in the State of North Carolina.
�IRE,Iforand in consideration of the mutual promises to, each other, as hereinafter
I I ay dietq
do mutually agree as follows:
he
reby y agrees to provide,' to the satisfaction of the DEPARTMENT, and as i
a 1,,order/costs-not-to-exceed basis, professional services to assess and
ere -necessary, to provide pot
able water at various sites. Services may
r i ' f limnted to the following:,
gipf site -specific work plans (including technical proposals and cost estimates) for
110 cafiiisks.
V
flat :nle�s; background data collection, site recomaissance,- property,ownership,
o entryac surveys..
acquisition arid receptor
y,eponse activities (e.g., containment or recovery of spilled product, emergency.
F ,ery, pfpotable water, installation' of poini-of-entry treatment systems,
provision o
Ii e,hook-ups, boom maintenance for surface spiffis, etc.).
ion' dVersight of initial remedial actions such as the excavation and treatment
p�gsal of contaminated soil, tank cleaning/decontamination (including the removal
19 ank, contents and tanks), in' -situ tank closure, and the recovery and disposal
h
1 Page I of 10.
j

'�. 111,9 �r � f i +:I � ��I t t _•.. � '_ .: ... I a _.;' I 1 . ;
j.. r j; ;art $ydrogeologic assessment activities including well installation; groundwater and
f I r.
�ater;sampluig ;soiI sampling; aquifer testing; pilot testing;! expanded contaminant
Ynventones; Duman exposure assessments (evaluation of site -specific risks to potential„
or;'I )opula ons from site -related' contamination); and other . tasks I related to
I )�
I `p I iveassessment of soil and groundwater contamination at designated sites. i
la if , I Jt I� lff
i iIl t
'aii "oversight' of :various: alternate water su 1 stems and. deli and
t'G�o� r P I :...:.. PP Y sy, , . gn
5imle ;i�tat}jo�£rvarious.strategies for the provision,of long-term alternate water supplies `
�esidents at designated sites; evaluation of alternatives to include an assessment of : I
csleas bility and cost-effectiveness of preferred alternatives; said alternatives to
Iw wells, point -of -entry carbon treatment systems, and extension of public water, .
� I
" 1 F i+G r Management 'and: oversight of .' specialty and engineering subcontractors;, vendors or '
CTOR personnel involved in the installation, operation, and. maintenance of
1 al Systems at designated sues. '
f { i� I
' • H "Pr ' ar g't�Q"nj Id submittal of all required 6m t applications for the construction:of wells and
Iei��l-ITi11 TfTi �I. I ,,•jll: q P PP .I• ; � ,
t1ieP �o . MAI and operation of various remedial systems at designated sites as may be
'; i '` ! ` ;• ,I I, IY� 'I 'e DEPARTMENT or another governmental agency, including but not limited j i ; '' I • • .
I; { r 11171 III • > ;
le to .l o p g well .injection well NPDES non -discharge and air qualitypermit
' II I i
� hI,PRli
l I
qn of site -specific remedial action plans, providing an evaluation of various
�tternatives for soil and groundwater contaminated sites including an assessment of ;
tasipility and cost effectiveness of preferred alternatives and the preparation of I
documents for various remedial ystems.
,, 5.;�6'i ;����i� fit! i�ri �,.� ,'�+�;;�� � +;•',� I � s � I;. I, •:,
J Impel I t on,of site -specific remedial action plans,iincluding management and oversight ;
o es iof site remediation. i
. - ii , •IIC. I Prep }or};and implOnentation of site -specific health and safety plans including health and
11 5 I I tl ., � , I ,•.
5 �, nmg Ifor�hazardous wastes sites I under the' supervision of a qualified health and
cer, so' as to ensure compliance with all applicable OSHA regulations for worker
' {safe q a'o" xotect the health and safetylof nearby residential and business communities
q
'es;ll f site assessment and remediation. • '
i
of+l,�• { i ! t '•. � t '"' ..
+ L: IPrg I , I I Al''dl�;bn ittal .•of all required or requested reports or summaries, and any
' ` 'm s it dmentation as requested by the DEPARTMENT or Contract Administrator i
(;f ` 'a co; }ouschedule(s) agreed to by both parties.
I''�
I3{ I�:��., I,. :I II 1ii 11 •� IJ •� i ! I ' .
M Pro ;,upon request=,technical and administrative support to the DEPARTMENT in ;,
4i�nce; of its efforts to provide for public participation in remedial decisions at DSCA
c ''support: to include as -needed attendance of key CONTRACTOR personnel at
pubI �aEig�s 9r1 public meetings to discuss,elements of proposed remedial action plans. i
upon request technical support and, administrative support in meetings and ? ;
if ' sand technical su ort and,ex rt testimony in litigation related to
i 11 Pg PP Pe Y g r ; .
f tD c je �EP,ARTMENT is a party.to the litigation.
�II I j41[ t;, y3•„ } ;t , ! , I .I ' I
' I
rgndihons
r ,"H�I'i, II i
I I '
i e�ific i;CONTRACTOR tasks to bel performed under this AGREEMENT shall be
I tliorized oni a task order/costs-not-to-exceed basis followingsubmittal of sites ecific
iI '�taskl'specific work plans by the CONTRACTOR; not shall -be initiated by the
I
L T R until written authorization has been received from ; the
r 11 �_ I I ip] �� r� i � )I �il� Ilgt '; ,. � i' , �` t ;•—. '!� � 'i � I
I't lip j�� 13's si I�'il ' ��!�I�lt"��r,S}'� �' `.il � � i .II ', ; ,I j•i
{,IPage 2of10 I ;,
! i ! . li I # �� i� r I II fI; ill I S° ,I' .I I r I. •., I i [':, .
'r ' ' I � �l,I��;� I {;� I H II1,1;,61{.7("�� • I. � � I I., f. I I ;.

I
jt t w 1 4'
' i ICI Fb •�� F� ,- �i ( � �( .: I , 1 I 4 .. '. � :,!'
•' � � 1' ��� �Iu�Ji " �i;-' I • � ' �• 1 ' j, I
E�RTMENT's Contract Administrator (or his duly authorized staff). !The
A-'T MNT will only reimp ppburse re -a roved activities and costs.
�
DE .
,Fri �;11�•,�i �iTnleSs provided otherwise in -the DEPARTMENT's writtenguidelines: and related
i • ;,r sttructiopal'bulletins, workplans for: task andcoist approval must include a description
t l ,<<"' q�,jte secfic conditions and information relevant to the proposed activities, a..
proposed site actiyrties, a description of procedures which will be
waste generated as a result of the activities, a`proposed schedule for
au Areporting on site. activities,' the. estimated cost of conducting
14ppsed•� {;activities,° and , any other • relevant information requested by; 'the ;
I DE1.PRTMENT.
DEPARTMENT will determine bask-s ecific costs accordin to the Fee Schedule
I._ P g
5 I; ' ;7!, attached to this AGREEMENT as Attachment 1 and incorporated herein by reference.
The unit rices as shown in the Fee Schedule shall be fixed for period of 36 months
ti { t12' I r 11?
r << ' ; Krieg gffective date ofthis AGREEMENT and may be re -negotiated after this period
IFurtf
I Y:: I ,tc I
.{ . ase�d; For cost.items not shown on the Fee Schedulethe;CONTRACTOR will y i
' a A c NT tonsure se tandard industry atrovide su: es areunibeinrate g proposed. as equested by the
i{
iv T klautlionzations and pre -approved costs may be adjusted by the DEPARTMENT's
Administrator (or his duly authorized staff). Ifthe CONTRACTOR seeks an
, A' adjustment of a previously approved task order or pre -approved costs,the
; a
ONTRACTOR must make the request for adjustment prior to completion of the task
rhichjthe•adjustment is sought; requests for adjustment must be made in writing and
`Yf
d to a need for the adjustment: The CONTRACTOR may orally request the
a� 9 `` o ided the CONTRACTOR submits a written r
py, ; � equest and justification for
Centi:,within 24 hours of the DEPARTMENT'S oral approval. If i i.
TOR' S written • 'request and justification are . submitted• after' the
t `F�P'INT S oral approval of the request, the DEPARTMENT reserves the right
e;grqune; after review of the written request for adjushnent that the requested
tment was not -warranted and withdraw its approval of the, request. '.
11't
rlr
R " ! i providing' services to the DEPARTMENT under this AGREEMENT, the
i • 111 , CTOR is responsible for ensuring that only qualified and trained personnel '
le;llsssigned by the CON ' CTOR to perform tasks approved by; the '
Ad
escription of qualifications generally expected of particulaz levels '!
t, r iE;:ii .{ 141, III Irl I,,i r.. i
e�oel,l{,aiid• work tasks typically performed at each level, is attached to this
ij 4 E IT as Attachment, 2 and incorporated herein by reference.. 1
CIONTRACTOR shall not substitute key personnel assigned to the performance of •'
�rly„?tls AGREEMENT without prior approval by the Contract, Administrator or his ; !
a MI
designated agent. The individuals listed in Attachment 3 are designated key personnel
urp('oses of this AGREEMENT.
vie:; I; + QIi c 'i'services to the DEI ARTMENT under this, AGREEMENT,; the.,
! '�' ! 4 i'' C ' C'ORis responsible for complying with all applicable'local, State and federal
a .1 41. {� d 'g4l ations...:1
I ' ��11 � � �� p� �'I'I I�� 'If��Gl�f�. - �. I • ,I � ,I I i ! . ,
( '; a .l • O�, TRACTOR shall be responsible for securing a source of clean water for ? I I
Y I? :I;
�gciutne t decontamination, including steam cleaning and other equipment
I � ' I I'• ��. g
tagNiiation procedures associated with drilling andiother activities;
•''` � d 9., IF fl 1{{f{•'����I I�'1 !'i •'i `ly �'.i I� � i ' ' I
tx: •' _ e CON RACTOR shall be responsible for conducting an underground utilities search ,
1� g _ �'
at the site prior to initiating any intrusive investigations including
� I !
I j d tl d dnllmg activities•
I,. t IY ly � �r�� ;� I r � „I� � �� ��;.I ll��'+4{f' •`, iii' � •i �r��- � I�' � i� I + •1 I � I•� 1
Page 3of10 I i, i
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, t
i
.i i ,1F , I it t� ,: �} �,�;• ., ,: + + � '� � 1, .i �,. -. 1 , .
CONTRACTOR shall protect and prevent damage to the sites and surrounding'
7 ! ;; lends Toi `the extent practicable, the CONTRACTOR shall return the site and any .
i
,E'� �ctgd, surrounding lands, including,. any disturbed or damaged areas, to their original ;
ih ig i�l'he CONTRACTOR shall be responsible for, backfilling all borings and
ggbandoning wells at the site in accordance with all applicable local; State and:';
r 1 Ali j !•,la�s,ond'r'egulations and DEPARTMENT', guidance.
iV,
2 DEPARThereby agrees to compensate the CONTRACTOR for professional services
r�ndered.� r j this :AGREEMENT. ;The total compensation paid for :all work under this:
AGREEMB' shall"�not exceed six million dollars $6,000,000.00 The DEPARTMENT, however
d' esi rio I antee any 'minimum number of tasks to be performed under this AGREEMENT and'
P 1 :.;
! tI}erefoe, yes dot guarantee any amount of compensation. It is understood and agreed between the, .
ONT1tA.!;jt`�Q ;atl;tl}e DEPARTMENT thatj all payments to the CONTRACTOR under this
AGREE I ' 1 4 TT-�
�ssly contingent upon th'availabilityof monies in the,Dry-Cleaning Solvent C1eari
.3. The I DEP ' ;' will compensate the CONTRACTOR for work performed under this
Agreemd,I }i�' (
,� ,•I (1 ) CONTRACTOR has completed the work authorized by the DEPARTMENT,
provided �th�t CONTRACTOR may request partial payment as frequently as once a month for tasks
?'coinpleted�as!;flthe date,:of the request, if the total amount invoiced is greater than $1,000.00; (2) ;
C0 +OR! has requested payment and submitted an invoice and all required and requested;
u ` ' doe e to qn to' the'' DEPARTMENT; and ' (3) the DEPARTMENT deternunes that the
CONTI2iA ^� RI 4h ,completed the work to the satisfaction of the DEPARTMENT and all
necessary �o RA
tion, of the work performed and costs incurred have been received.: The
�,„
J DEP� R� 4 I compensate the CONTRACTOR as expeditiously as possible in an amount not;;
to i exceed p authorized in the approved work order.
�I�) I j
+ ; i, I'll
4. :Requests fob pa ; ' eni shall be in the form of an itemized invoice from the CONTRACTOR to the !
t DEPARTMENT wiih the, following document$ attached: '(1) a technical progress report, which
$hould:in"l de�'a' description of the work performed and all activities and costs covered by the
(' s Ii ,
1 ;invoice; ; 1 st of -any deliverables submitted to the DEPARTMENT during the period covered by,
the' invo}c�e���a}��ij a.idescription of any difficulties encountered and remedial actions taken; (2) if
+ ;'O�TTRfii�C� Q I ' req, estmg partial payment (�or tasks completed under an approved work order
;wher'e thel !� unt exceeds $1,000.00), the CONTRACTOR'should also include in the.
r ttechruc 1;�I . I ASS ,iep+ rt artist of work scheduled during the next period and any anticipated i
delrverab e, d i n ;he�ext period; (3) all receipts for costs covered by the invoice; (4) a copy of;
,the Worldu j���hori under which work was performed during the period covered by the invoice; ;
f I',I ,lu 4 ,�IIT: II IYI
I cop + any amendments) to the work authorization; and (6) any other documentation? ! .
requetedb ,bejDEPARTMENT. Payments may be delayed if the invoice or attachments to the
{{i voiceCc ntain� errors or inadequate back-up detail for individual cost items.
'• � � '� i�i` 1 1 _� � I` ••I I'� 1•ii' I � I 1 � i
i 5.tj- 'Tjhe C?Q TQR'Shall comply with all applicable local, State and federal laws and regulations,'
°arid EPu policies and guidance whn managing, either directly or through the use of
I; subcontrt companies, or individuals waste produced at a DSCA site. IThe duty to
properly } wsteashall°include all waste generated at a DSCA site, including both hazardous
waste';an "I dons waste, and shall further include but not be limited to investigation-
; den ed , d +remedial waste resulting from remediation activities. In addition to the!,
,.,,� ,
requnremen !;: contamed in applicablg .local, State and I federal laws and regulations, and ! .
DERAR policies !and guidance, the CONTRACTOR shall ensure compliance with the ; !
.: �'� I „ Ili ,i• I•. , „ 1 I-,
quilrIements';, j
`'�i�; �I � ; I��;� I ,�;I:�;, I" ,� 1�1�'RACTOR shall prepare all required hazardous and no . ! � ,• , � ; I ; d ,i ,Q:,� r n-hazardous waste
s dllabels.
r} k j j t �� �•a
l �I
Page 4 of 10
I�i 11{E„
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1�IIIIIIII' I

, ,, � � ,i S1 i11�1� ;k,�, � I I i - � �•11 il}' i l�f :{ •N r ! i i �I i '
j l lr 7f�lf lf'I �l`i' J11lI�'. s, ' � ! � i � � i •
l! i I
preparing a.manifest-for waste produced; of a`DSCA site that is sutijectao aii -
I it Is z` eementfr,, Assessment and Reme' cation between the DEPARTMENT and erson s
! `� I 4 (I� p ( )
;I'. vY ¢ ;We ;petitioned for certification of thesite into the DSCA program ("DSCA;
j,, ytiflner s)"), the CONTRACTOR shall identify the DSCA Petitioners) as the
g i�a�gi�;q�,'the waste: The CONTRACTOR .shall:, ate:si the manifest; with
l� I ,
CTjOR-representative's name:followed by the wording"on behalf of DSCA'
r,24 `(s);€,or DSCA' Site No. [insert assigned site number]."
zjrgparuig a manifest forte produced at a DSCA site for which there, is no.-
'
Petitioner -, the CONTRACTOR shall identify the DSCA Program as the generator,
'I; o 1.thei waste, and sign each manifest with CONTRACTOR representative's name;
ki ll Yved by..tfie'wording "on behalf o'f the DSCA Program."
Vi
transporting waste generated at a DSCA site, the CONTRACTOR shall use only
edd bonded transporters who! have all applicable permits, under local, state, and,
Yvslfafnd regulations, and who have an' EPA Identification No I
IONRACTOR shall offer waste generated at a DSCA site only to those facilities,
arerauthorized to accept, store, treat and/or dispose of such waste, and which have;
i,a�plicable, permits under local, state, and federal laws and regulations for such I.
rage, treatment or disposal.
,I� ! 7;�II�l Ij.
�; ,,��fllc
1 i e'CONTRACTOR shall include in each work plan for task authorization submitted to
-1��! I PI TiMENT. an estimate of the types and quantities of waste to be produced
ii , I, p ro se site activities, the types) of containers the CO CTORproposes to use
z ; �lt' I, : I �' ,� I NTR�, •i
F rie�the';waste and estimatesof the 'costs to properly containerize, label,
alyze manifest, transport, store, treat or dispose theiwastes. The work plan'
„ I r pq�s Imust present the names, locations, wasteprofiling requirements, and applicable
x� � ,� t ' of tlie! anticipated waste transportation and receiving facilities that will be used to'
ak ; II ,e the.,waste .
1 , { 4 }�'IIj3di I'il li I
�YI. 'lll Ui it ,UIF I t:r, ,
lie CONTRACTOR shall place waste generated during site investigation or monitoring
"investigation -derived waste") in appropriate containers as soon as the waste is l
I� •.. .. ; ,
Al
-.-r arrangements can be made by the CONTRACTOR that are approved by the
CONTRACTOR shall:) coordinate and meet with transporters on
e ;day that ,waste containerization activities are completed to verify that the
arei properly labeled,; identified on the waste manifests, and loaded by the
�appronate.waste transporters) prior to the containers being transported from the site to
,la 1they waste receiving facility; and 2) ensure that drums containing investigation -derived
I
teiare removed from the site and trans orted to a waste receiving facility as soon as
p. g tY
j� Yv. erization and sampling activities, are completed. The containers will be
>• '; ; ' +`li e w �e receiving facility pending receipt of waste sample laboratory analytical
I p i g facility decision on waste Vis osal., The waste recervin facili must bey
ji; �; IFfI � , q� T d � •r ;j �11, ... i ,
loljtgmporarily hold the containers for a minimum of ten (10) days from the
ie Econtainers were collected from the; site by the waste transporter. i The ;
r r E I 'TOR must notify the DEPARTMENT,prior to any transportation�of the waste
II
�
1; , el' eceiving facility until the waste is ultimately disposed. d
j.; ,, i
�� I;I � 'ONTRACTOR will ensure thdt each roll -off container used to containerize
.i estiation-derived waste is properly labeled and secured on the site
g P p Y � pending the ,
it I i Y•; I� ; ; ' TOR' S receipt of waste sample'Iaboratory analytical results and a final
i o�t ,' aste disposal. Within five (5) working days of receipt of laborato
.���I�I.t�.�'t',, g Y p r3' '
F , ;Isis r ults, the CONTRACTOR shall coordinate and meet with transporters on -site
appropriate labels have been placed on the roll -off container and the't, i
i r 11 I Page 5 of 10
- 1

• iti i� ��i��.r�`i
t A ,
it
identified- on a waste manifest, o confirm and tothe designation of waste.. b
�{ 1 I ty'prmitted to store, treat or dispose of the waste. The CONTRACTOR must
D PARTMENT . rior to ant rtation of the waste, from'the rece'ivin 'l p Y ranspo g
yv"W is ultimately disposed.'
rh ! Y;aNTRACTOR shall instruct facilities receiving any waste containers (drums br.
3 ff containers) from DS,CA sites that the information provided on container labels
I j� Iry c sQgiated manifests must not to;be altered *' ithout prior written authorization and
from prpvthe DEPARTMENT. '
;CONTRACTOR shall provide'a copy of all waste sample laboratory analytical
3 , r' s, ,z r� e DEPARTMENT and toeach facility receiving waste from the site, In each'
„ i��lf
C;. shall
�py, r „all :be provided (electronic transmission oi� facsimile':is permitted)
working days of CONTRACTOR'S receipt of .the results from the;
z a
1
i !' s tiff 141�,
CONTRACTOR shall provide to the DEPARTMENT copies of each completed '
a e' manifest; ' associated 'transport, storage, disposal or treatment weight tickets
1.
1''[ �Sposal certificati_ and associated] invoices and receipts for the waste listed on each
iI II1 onsI
1 a I Iianifest ;;The copies shall be provided to the DEPARTMENT within ten (10) working'
of the documentationcei t
z , _ p showing final disposition of the waste.
I I 5,1 I"IIie'I for the management
of remedial waste resulti
ngfrom'remediation; !'
I ,
I{ < IF �a .' e' tl`IaSCA' sites including treatment and disposal o bons will be developed!; 1 {:
,a� gp
�,� `' ` 'ado' on of risk -based rules establishing. cleanup. requirements at DSCA+ '
i c , ,E �•�. y � II III ' f�I � 'I; 'i .• '
CONTRACTOR subcontracts for any or all of the services or activities
covgr`.ed by Ithis(AGREEMENT, the CONTRACTOR AGREES that: (a) CONTRACTOR is not,
P I ,b
r,e i9 �ed f,�� l#y..ofl,'the duties and responsibilities provided in this AGREEMENT; (b)
TT I_��a' '�'I' E,.�� 11 require that the subcontractor abide by the standards contained herein or;
sproyide.s cgr}ation asto allow the CONTACTOR to comply with these standards; and (c) i
quire that the subcontractor agree to allow the DEPARTMENT access to; i
f y Irecor s t t41,the', subcontractor's work on the site. The DEPARTMENT will not be
rye poiisi 11 r °yg';p '�ts,or omissions:of any subcontractor.'
'A: h' !
AGREEMENT the CONTRACTOR at its sole cost and ex ease shall; !:
p
provide { xp}e�rcial insurance of such type and( with such terms and limiis as may be reasonably
(' sociate' th tlus'AGREEMENT. Providing
and maintaining the adequate insurance covera a is
I� !' I' i w., 1 I g g
a�ay material o ligation of the CONTRACTOR and is of the essence of this AGREEMENT. All such
..n4 ��rl I•I�lild�r 14-o�i'�•
I! It u I ��i�isu ance� I Imee[�iallllaws of the State of North Carolina. Such insurance coverage shall be,'
y'; I q'btainei �;� )anfes that are authorized jo provide such coveragel and authorized by the i
ttli 'I I tls �i I,,.�i �:, 1
l.; Qommiss o ff sur ce to. do business in North Carolina. The CONTRACTOR shall at all'
I 'i I.I?i(I if �'�r''I i O
times,coin I e;iternis of such insurance policies, and all requirements of the insurer under
II ,
ahy: such) i policies, except as they may conflict with existing North Carolina laws.' The!
lunitsi oflgo"erage,Iunder each insurance policy maintained by the CONTRACTOR shall not be I
interpretecias:, twig the CONTRACTOR'S liability and obligations under this AGREEMENT.
The Iiiisu I' (required iriiifiis paragraph shallf cover all losses incurred (during the ,term of this
irrespective of when a claim is made. As a minimum, the CONTRACTOR'shall
;I p ovide d auitain the following coverage and limits:
e i LIIo I`Ipe I ation - The CONTRACTOR !shall provide d, maintain: Worker's,a
�'ikl i bt lul r'uur ,
Cori o ' s ance,±.as required by the laws of North Carolinaas well as employer's
to er's
p Y
` $ 50,000.00, covering all of CONTRACTOR s
liapil� ',' ��e" e'; ,I 'th�minimum limits of 1 g �
{ e 1 I I lao are,engaged in an • work under this AGREEMENT. If an work is sublet the
Y, Y ,.
� �..��Il f� ;� �li ��� III I' i �I j I .I I ±I• -
F l� r
Page 6loflo
'
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L1 r�LIV-' -�y

1 j 3,. � � 1�t I t� � � i :• .,• it
1, y'
I I�f r
CQrl1'�'C�OR shall require the subcontractor to provide the same coverage for all;
z i sutr`ll o'}j�ttlrlF to , m loyees engaged in any work under this AGREE NT.
8 Ile ah�'Teneiral liability- General Liability Covera a on a Com rehensive Broad Form
oniazt " ce`abasis in;the minimum amour of.$1 000000.00 Combined Single Limit
A W,� e l 1 ' Qs tslall be in excess of the limit of liability.) III`
' C ;Pro essr jWt'i I-,iabili . rrors and . Omissions I CONTRACTOR shallobtain, at
ty '.(E )
CQI T CTORWexpense, and keep in effect, errors and omissions insurance covering any
da ages, ,caused'by an error, omission' or any negligent acts of CONTRACTOR, its
t�.it
s1b�co>�tratorst agents, officers, or employees under this AGREEMENT. Combined single,
f �taCeur{enee shall not be less than $1,000,000.00: Annual:aggregate.limit shall not be ,
0,900 00
H51
D } Au om� ile l i - 6tomobile,Liability,:Insurance; to ;include liability coverage,- covering all!. ,t
t • . Qwn ;;iu{gd, and1non-owned vehicles, used in connection with this AGREEMENT: The
in}nur}uinlcombined smgle.limit'shall be $150,000.00 bodily. injury and property damage, '
4.
usinsd/undand $1,000 medical payment.
preer insured motorist;
! i€l��j�"�� S '
8: rm this AGREEMENT shall be three years from its effective date. This AGREEMENT;
}nay{g, Q�ledI or a period of two years, if mutually agreeable to both parties and if the,
a;O, ,1 performance to date has been satisfactory to the DEPARTMENT, provided]
3 haisuffaxcl¢n f �imgi!exists. The sum of .payments made by the DEPARTMENT to the i
TRA Oor work"authorized by the DEPARTMENT on a task order/cost-not-to-exceed
lias}s`, f " . ' ; teed four million dollars ($4,000,000.00) for the 2-year agreement extension
eriod},Ii .j�yi ,! i
I,1 f
�i l��.r U.il I !I I-
i 9 ' ' CQN r I CTOR:Is I ensure ' that work, performed under this AGREEMENT shall be'
I' { ertak nand completed in such sequence -as to assure its, expeditious completion in light ofthe
purposes�o jt�us AGREEMENT. If completion of any portion of the work is delayed for causes':
peyond.tl}e `t}o}" f and without the fault of the CONTRACTOR, and for reasons which could
nof Ih'ayg` I' e' ° na 1 avoided or antici ated b the exercise of due care and prevention,the' t f
3i;t ltai� T I A; y' p y
I,; Ohl"o , x ar} qf�j the woik Will be extended fora period equal to the delay. Excusable delays J I i ' • - .
shalllir}cl . v 'tl}q t .limitation'acts of God or the, publicienemy; acts of federal, state, local, or "
forei o e is ;acts of DEPARTMENT's agents; fires, floods epidemics; .strikes; riots•' i i �
f I '��YF: IiIh, >, I:
i freight emllar�goes, and unusually severe weather affecting the progress of work at the site. Such 1
ell I 0' 'be the result of labor or equipment shortages.
1�i
j 10 a Ell ; I NT;may terminate this AGREEMENT at any time for any reason satisfactory to j
;f e,�E1' 't'�FrIT'by giving five days prior notice in -writing to the CONTRACTOR of such;
II .J N !I.
terra nr� I lSpeoifymg the reason(s) thereoF and the, effective date thereof. In that event, all
i rn r 1
ii s d , ocuments, data, studies surveys, drawings, maps, .models, photographs, I
repo4s'1.a 1 iq, y erials prepared by the CONTRACTOR shall, at the option of the
DE PAR ecome the DEPARTMENT's property. The CONTRACTOR shall be entitled
tQtreoeiYi t �a'�wnd!lequitable compensation for any satisfactory work completed on such documents'; . ; i f „ 1,,
acid other t I alb, l ]The CONTRACTORshall not be relieved of liability.to the DEPARTMENT i '
fpor cjam a s>�stamed by the DEPARTMENT by virtue of any,breach ofthis AGREEMENT, and ; i
;f �e I� T may withhold payment to t#e CONTRACTOR for the purpose of set offuntil
i' I ]the exact•I:amount of damages due the DEPARTMENT from such breach can be
:; i F • r Bete a f, cash of default by the . CONTRACTOR, the DEPARTMENT may procure the!
c esialr s from other sources and hold the CONTRACTOR responsible forany excess . f .�I• r I al, h u r
c b st :i The CONTRACTOR ma not terminate this AGREEMENT except in the ` ! '
I� i4 ,I Ilf I' lil 11�, y ep '•!, i
eve t of: b qq tlu�AGREEMENT by the DEPARTMENT.
is, terminated by the DEPARTMENT as provided herein; _the']
DE 1111 11 compensate the CONTRACTOR for work completed, subject to the'
Page 7.of'10 ! i.
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I
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:. :.�ri.'�5 i}I!�iW.:.����1 ,'I i. 41�: ,'}.I ,• II - I� �. �o
i� l 11 :� ��i�,

,
{ 15 j yil�J 9 t i' -I I I II fI i?'�, i' Il - •! i 1 j r
f •�q� I. 1, , 4 � !. 1� I •• 1 •
(fin;'
• .,:,rI ��;,§;IICI 9{I�!°� �,, , ��;,4:= �,,'I
`qII a pI }
41= {
T.
to withhold payment ;for the purpose of set off.•. il,%ipal invoices shall be
b ICI 'RACTOR to the DEPARTMENT within 3 0 days or agreement termiriatton.
b
R'Shall repay to the DEPARTMENT any compensation the CONTRACTOR �.
of the payment'to which the CONTRACTOR, is entitled herein ' i
� ,�,. r.•,'f 1� t_�;fi .�l'A I, I Y i-. jtk � j i� I ,_� i � , I :'� I � I, I r' ,� .
F, r i j1
I ' 1~OR shall ensure that alli documents produced as a result of this AGREEMENT
re�prte�d) double Sided on recycled paper. Figures, maps, design drawings, colored prints and
`gl te{jdlI ' aly pruitimgs are excluded from this requirement.
I I I
13 iirifq r� �' f`4n (are„ data, documents, statistics, surveys, studies, reports, addresses of property
prepared or assembled py the CONTRACTOR under.this AGREEMENT:. ; r
rntia� and not divulged or made available to any individual or°oiganization . • .
nt}io i " tir tt n approval ofthe' DEPARTMENT. I No reports, maps;br other documents' i
produced wvpi ,,Qr impart under this 'AGREEMENT shall: be the subject of an application for
} { op >s I f 1 j� p behalf of the CONTRACTOR.
,
14 P vi imm{lo:.prQ�ded to, prepared or assembled by the CONTRACTOR under this AGREEMENT
I N ; `s shah nq e� ed to promote, market or offer the CONTRACTOR's services. The CONTRACTOR
!I a grgesa ,, a the existence of this AGREEMENT or the name of the State of North Carolina or.
aggT` jj�"j�' �I{`/ a `IeTI'otflEj (part of any commercial advertising. r
111.!I� I. � (�� � II'I�I III I��,' 1 }I i,. �I i ,1 • I I .. `
15.�� iCQI, T �R�I�nay: not'assign this AGREEMENT or its obligattons he except as;
fperm�tte, Ili ;' �1d1106&1003 and this paragraph. ;The CONTRACTOR shall- provide the'
j ]E i I I? f thwritten notice of not less than thirty (30) days prior to any consolida<tion,; I'I
��cgiusion Qerger:I Amy assign shall affirm this AGREEMENT according to the terms and';
j e�onditap i ` agrfed� and th6.,C0NTRACTOR shall a�rml that the assignee is fully capable of I t
i z I t
if CONS RACTOR' S obligations under the AGREEMENT.All assignments shall'
settingforth the obligations of the CONTRACTOR and of the assignee, signed by the;
j 1 i T the, CONTRACTOR and the'assignee. i
�'•: ;` ,� Wm!II ad.. e under shall beI116 ? i •
andgoverned and construed in accordance with they ' � I'
',.arolin No'I ` Ca. It is agreed between the parties hereto that the `place of this 1
itusl and forum, shall be Wake County, North Carolina, and in said County and'
;I SStatF�l 1 �te�s';whether sounding in contract or tort relating to the validity, construction,! ,
F1 dte r c �i a�d�' `nforcement of this AGREEMENT, be determined.
17: Ihe� I i .TOR ees that in all matters relating to thus AGREEMENT, it shall be,actin as'
t i g g
la i!i. de a `' enb'contractor and not as an employee of the DEPARTMENT. The CONTRACTOR;
;rlepr� sett I 4,has; or will secure at its own expense, all personnel required in performing the!
i; 'r¢ice S eement. The CONTRACTOR shall be wholly responsible for the work to be
f! f ,l
N� Leo {{II g ,,. Pl u� a supervision of its employees. Nothing in this AGREEMENT shall be;
icon$true ,, ,a 16.14 {venture : or partnership between •the •-CONTRACTOR andthey ,
:18. ; : e CQ. , I� ` I ypR agrees that the State has the right to audit the records ofthe CONTRACTOR ' .
e ' AGREEMENT both during performance'and for 36 months after completion or
'minate'�'he CONTRACTOR must retain 411 records relating to this AGREEMENT and shall r'
o ' e{I' 1y, s oi;agents of the DEPARTMENT to inspect suchrecords during the period of time
slet; {�t'l ;! State Auditor shall have access to persons and records as a result of all, j
'coon ac { I nt ied into by State agen ies or political subdivisi ns in accordance with
{ P
,`EMI 13 I { GI II ,�1)'I }I I�,st�• I, Irt ,, i 7 'i,� 1I �I.�fl j i,! ;� ' I
�;I��11Pllili��'" II
19 7�?he C�Qhl agrees that any and all non -expendable equipment that is purchased for a site l ; 1
't�ntl}'D�C � "' � � � PARTMENT funds v�nll be the property of the DEPARTMENT and will remain � I � : � • •
' ; •,H r l hl• � I I' III I � ,
n fat , {X�i. i e I 17the DEPARTMENT deems necessary Ito dispose, remove, or relocate the 1 ,
1 I,, Qtber site orholding facility.
I•� y , I:,
,
Page 8of10 I j
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h a,
:? p•jl ' it ^! > I� 1..I: Ij i. ��il � i� i; -- '--•-- .. _ .. - I i I..__...
o I, l� /t "r ��111,11 rl _' .. 'I• .�-
r C t(i'1h
20 �IC I I{ tt i
Rl green that,he•shall be responsible for the proper custody and care of any
E,,' _ K ` !"�iwried properfy'fiirnished him for use in connection with the performance oftlus
tG
at d will reimburse the State for its loss or jdamage, excluding normal wear. ; ; • ; '
21; !tea 1 1 T represents' the -entirety of the agreements. and covenants between the;
I E T and CONTRACTOR with respect to the;subject'matter hereof and accordingly; .
an 10,-
ll. (pendedforimodified except by written instrument executed by the parties hereto:.
:'I kYslr l} }t'�slYl ��I ���j '�I)1141 �I 1•, � �' �. ( .I•
,t 4 �,
1 22.,',ih <Q OR has no authority to act or make any representations on behalf of the '
�DEp , y' ;$ q1, .• r � i'I'61� 16 i.;,... .?.' � � ' �' � _•- - I . •• i r-
23 They R ' ' I warrants that its performance will not infringe the copyright, patent or, other
\'pToperly( t gf,4n*6ther.person.
lIj is If I' � I i� l i , I I' I I) :, � ' ' : '.�; I• . i � ; • 1 '• ' I
' 24 . GO TOR shall indemnify and save and hold harmless the DEPARTMENT its officers
age�its Iladt �i�iloyees ,, from liability of any kind, including all claims and losses accruing or;
i 5 ! iie it Ia iy person, firm or corporation furnishing or supplying work, services; materials or,
, up l gsit eclon with the performance of this AGREEMENT and from any and all claims'
lQss;'gpr,resulting to any person, firm or corporation that may be injured or damaged,
eC 1 q�;OR�iii its performance of this AGREEMENT. The CONTRACTOR represents'
sandwI '
t�it;pliall.riot make claims of any kind or nature against the DEPARTMENT or the'
DE AR „ j. I9fflsers, agents and,employees who are involved in the delivery or processing of I
O �R goods to the DEPARTMENT: The provisions of this paragraph shall survive the;,
terminat}ifor xpiration of this AGREEMENT. j
' ;.'I $ I� � �f �l'tl��Ll � �j �• ;II (I d) iI !. � I i.,r; � \'• . ! t'• i ;: I � � � a I , .
25.iD T oes not waive its sovereign immunity by entering into this AGREEMENT, ;
`I.,!.
end y, et all immunities and defenses provided by law with respect to any action based on;
;this AGNI
a•IZ��1��'��I'��,
26 i �a I I W, ,warrant that no gratuities; kickbacks or contingency fee(s) were paid ml ' j '
,, u' I
4 ec A �rREEMENT, nor were any fees, commissions, gifts or other considerations! F'
ej h � I " on the award of this AGREEMENT: l
� I I I
27 s CC� J TOR certifies that it (a) has neither used nor will use any funds or compensation
ed��rs AGREEMENT for payments to, lobbyists; (b) will disclose the name, address, j
' !' I '' i 'a a and pose of an a Bement th lobbyists whom CONTRACTOR or its subtier
11. , j. y I, . ' �v it$ 1? Y �'4'1 3'i I
on tp (gg)) r''subgrantee(s) will pay with profits or nonappropriated funds on or after December,
i I., Tt� ri'I .
,9819 'd ( r 11, file quarterly updates about the use of lobbyists if material changes occur in
ei lus
it
28. =The CoI ; T R, certifies that it is in co m Hance I with the Assurances -Non Construction
ro sj elto this Agreement as Attachment 4 and incorporated herein by reference
29 h 11 1 ACTOR will;.take ' affirmative action in ' complying with all Federal and' State;
, t 1 11,, 1.1 1, 111 11 I � I '
q�e concernilig fair employment and employment of people - with disabilities, and' !
d I i on el g I e treatment of all employees without regard to discrimination by reason ofrace, color,; ;
r♦y� e'itioorigin or disability. The'Americans with Disabilities Act (ADA) makes it Q
� 1.9 l'
nal
la Ill }pate in employment against'' a qualified individual with a disability and outlaws,
II .. I l' , lij:'1. II I III :,I i '.
' 's individuals with disabilities in State and local government services and;
s �,�'�'
? ?! ipub a o t ons1� The CONTRACTOR certifies that it and its principals and subcontractors
_:will c'o • 1gulahons in ADA Title I (Employment) l Title II (Public Services)' and Title III;
s i(�?u he '' 'od tions) in fulfilling the obligations under this' AGREEMENT.
' I � { 1 �:
I� I '
30 it et er o s;4 signatedt,as' the !Contra4 Administrator (project coordinator) for the: I
Ii E T ry'1Hovyever any changes in th scope of the AGREEMENT that will increase or Iqll
! l
Page 9 of 10 I
I I d' � { ' II ' � �71I jj "i iCl� ,;I i � •I, i l ' r II r d � s � !� I

� F•, {, p
try'
�%.il � I, I
f.
1�' a, E '•
{ti ,
�1 amountof compensation which tha' y be paid under this Agreement shall not be
he'changes have.been approved by the Secretary, of the DEPARTMENT or his.;;;
perform its servicgs;,using that degree of sk}ll:and
7. ,li�yvl�l care ordinarily ,
�l conditions by reputable members of�CONTRACTOR's profession
f this AGREEMENT s
shall be the date on which it iexecuted by'th
i �Depwment or his Authorized Agent.,
;;'•
Fi I
/CONTRACTOR
EREOF, the and the DEPARTMENT have executed this i
. icate originals, one of whi& is retained by each of the parties, the day and year
IIail; liy '�,� t •, +, � ) :,,. �
,
i
.
North p
h Carolina Department of Environment and
treet;iSuite 100 Natural ResourFes
:
Wil iam G. Ross Jr. Secretary
;Si nature) 'gnature of;Secretary or uthorized Agent) I !
aft, !•G;a J ���/;
Date: • (� 2 d �� i .
WITNESS: IAl,
n
t�
Pres., or V. Pres. only)
�71lid''
' 'Page 10 of 10

ttl
ATTACHMENT 1
t ,
FEE SCHEDULE.
1RersonneMevell
' F ' :IF` �.i� �,'.I'r ,Iilllyl,.,` I v ,•t:'':•� : 'I:,. ,
$ 122/hOUT . r
$ 101/liour
/y
ry. �) r7 1 .pppry� I`i la: i i. . $ 85/our
'�4iICItl' 1 $ 75//Hhour I < 1
� ,. �� ,
Il la J,''" a'� + ` I I, $ 60/hour
rson%CAD` � $ 5 Whour
I..
olcessor/Clerical $ 42.50/hour
.,:
contractor Mana ement Fees
10% '
• It � it �•il'.IC�'illltl. O'
{,, Gp q { I kW to ui and_Disposal. 10/o for costs less than $100,000;
I
i 5%for costs greater than or equal to
isi,Is it ,r, I
IJ y1j ij a �� :j I�i:f r $100,000
lling� jl 11 j.. 15% i
ai J.
ediatioin: 15% for costs less than $100,000;
{ I{ li" 10% for costs greater than orequal
' to $100,000 and less than $200,000; ,
1 5% for costs greater ithan or equal to ,
I� j l !1 li i; ;lf Ilk 3111 ;, $200,000
3
bids{!may be required by the DEPARTMENT's Contract Administrator
II�"�authorized staf) for subcontracted activities that exceed $3,000. ,
I dr I�lll� Ili 1 ,d
a orator. rdj,l
Ithod'8260'(soil) $93/sample
I{; L gtl}od 8260 (water) ! $93/sample
ij ; ethod 8270'- Base Neutral Extractables only (soil) $161/sample { ;
etliod 670 =Base Neutral Extractables only (water) p
a $161/sam le,
;i y Miscellaneous
' Jet, person for overnight travel only)' $110,
I IQ
ar,orltrudk) ; $0.50/mile,
:> f;I :(r I',Vapor•Analyzer $110/day.
u j'"ductivity.Meter. $25/day
("II iil ii 'T'l i{ ;Ii I' i. • II =Iir
4. • j ' ,1; k l
JJ I: Page 1 'of 2
' it ° � �k i ��I iili t i I.i•�' I' I llI I , ,i I
i Ili I I it �I li�'� I

l�fi
tti ii i I 1
t
I I r
ATTACEMENT 1
FEE SCHEDULE
!
laneous'(continued) !
Se,' ,robe
WNW, Indicator! ; '
i $30/day
+ ."•$25/day°;
-
�Na11er
$20/day .
Bailer.
$10
able
'
I
ss, S'teel Auger i
$10/day
`
os Pump !
d.. $50/day.
,Equipment
$30/day:
$40
lP otective Equipment
I.$30/day;
., � .. ° . :'+ is •:
��f
$20/day,._
'(include tape, gloves, ice) '
b1
$25/day
;
Photos`` . i
Cost
Not Reimbursable
Not Reimbursable
I
,1
i�
I
I
Page 2 of 2

r + f�,�, ( t 1 tli ll,ia i ..i , I .. .i. -
iii Jill
ATTACHMENT
T CllkENt i;
NNEL --Q UA( IFICATIONS AND TASK DESCRIPTIONS fi�� ioiio'. mWDR And tas ',descriptions are Dry -Cleaning
k for those personnel who will be involved in activities for the Dzy
Solvent 11 ogram contracts.
QNNEL ;AND, QUALIFICkTIONS'
ASK DESCRIPTION S ,-:
Principal
. �ne ee
06L4 '.'�.drogeologist/Scientist ($122/hour)
Administ;atrve
add/or
si ii&ad' of the organization or contract. Responsible for conceiving ceiving
-.-Expert Testimony
and exec
IngP
I i; - organization. Directs the professional staff. Normally has a
Legal Strategies
financial
n r s t comp
ei
!ii"I"ip io owner-, major investor or stockholder, or officer. Chikges an
s
6f per,iteii,s, the, Principal. This position should never bill field or field
Depositions
Contract Oversight aimited)
supervisioni
Senior Engifiiid� .#Q!6g4toRydrogeologist/Scientist j ($101/hour).
.Typjc;ally,lre4iei-aa4iavanco.4,16ikee.iR4uires professional registration when applicable; 8 years of
experlencp"ih 610,
• Expert Tistimony
jtee'!_ a .and, compliance regulations. Se�vcs as senior technical
andtontract,bkcr�i qr �p I�q 'kafi6mediation projects of medium to large scope /or
Site stratelgy*a'nd planning j!
.leader .�tlfi
1,_ ­ . 'Y'ro -1
.h I ii � , I
complexity' and I'Vqopq sUb4#ntiil i., ox , iieitise in' the field of practice. Generally supervises
Project . Managers i' :! 11 -11 . .. .... .•I 's
anagers. severalprojects. Has limited involvement in projects. Duties typically
p
,Contract oversight
--Reviews technical reports
include reviewing repo Y dping'strateies, and attending client and/or DSCA Program meetings.-
Responsi ic for In' plans, and specifications before submittal to the DSCA ports, p,
- Reviews Corrective Action Plans
-Reviews Engineering/remedial system designi
Program. if 0 ifi1 0, d: 1 substantial technical
in e a highly technical project should haye subs
Health and safety coordinator
expertise Jire�tlyjrq project Ensures compliance of field service operations with OSHA
Reviews site safety plans
safety, siat dait,. public health coocems.
I.Project
management
Projedt Engiifieelr
J gis ydrogeologist/Scientist ($85/hour)
'11
Site strategy and planning '
Develop site health and safety plansI
rat,
Typically posisf,sicis I a
related fiqld. j Servii #
h ?1911 s9le, lc� ;&gree;in engineering, geology, hyqogeology, or a directly
eporli- and has least 5
age ,111 c
of experience in th
• Engineeringtremedial system design'
Data review and analysis
environmental field!:J�
.
(I� project years
ub t�pic I iiii �liidei preparing proposals, reviewing reports, developing
Report Preparation (limited)
. , I
--strategies,, and
" iint I DSCA Program meetings. Under general supervision, prepares
=Report review
environmental
qi I specifications for site remedial activities. Leads and supervises teams of
Site meetings and reconnaissance
staff and technician l",
I JqeI s leli but would have a limited -number of hours charged to each site,
'
On -site supervision (periodic)
and only a s '
'I 'site
n fi ['Bela hours. Serves as site technical expert or supervisor for
's'andirem
:-Work plan preparation
hy&ogeolo' Ic e
awr 16 i iadon activities and tests, and assembly of reports,
Site investigation planning
plans,jandspelol 'aii ki
Field work planning
��ia
�' I i" ''III„
Site Inspection (periodic)
Obtains permission for off -site access
Sfitff E i e
f
I g
s Ydfogeologist/Scientist ($75/hour)
Reqw*Fes g bac 6ior sidel
n ngind9ring, gco ogy, hydrogeology, or related science and I to 5 years
Report Preparation
of experic 'in n
I " I , .
routine 'Ciaeil
1111
Jr
at Perform
1,411"Tiq di,,)�prks under supervision of the project manager to
en investigation and remediation projects. Is the primary person
"J"&�s
Field work preparation/planning
Supervises site investigation and remediationt activities
responsible t: for f c
1' competent at data analysis. Must be able to conduct
Site reconnaissance and mapping
mvesugau ri asdje
pc
meslancluding drilling and monitoring well installation, samplin'g, site
Engineering/remedial system design and installation
layout an([ i ge ld
a in
(writing field notes, basic analysis and compiling data. Must have
7 Limited data review and analysis
I �dgc!d-
mowle�dg,!d,_? -V
hours bill( d iJ 0164i
r
d Oroto�col.-This position will normally be highest in the number of
However, 4r, technicians (see below) should conduct routine or on -going
-Obtains permission for off -site access
- On -site health and safety supervisor
n6nitoriiii&, I
Technician
an
1w
(560/hour)
Field work preparation
Typically vqutres:
Perso
a hi
� &.111
01 1"
ij!
nifi d Ii nsed trades -person, or an associate's degree.
1
'sl iiec' w'ithiless than I year of experience in the environmental
Operation and maintenance of equipment
- Well developing and sampling
field. Requlresl
f
supervision of
Mir
I
h�o!jj*
[I
I n
lil
f. 1.11 c en6c, in the environmental field. Responsible for general
n d repair, of on -site equipment. Routine monitoring and
� 11 J
- Soi I sampling
- Handling of investigation and remediation derived wastes
-Remedial system installation, operation, and maintenance
collection of samples
1 , .,
performs io)utinc;hit
I F i"i
I
tip ntenance/o ing logs. Under appropriate supervision.
1, . ;,
with on -site installation., maintenance, and repair of on -site
- Limited contractor supervision
Cquipmei
I dev,
Collects i0ii and groundwater samples.
Monitoring activities
Survey ing using OPS and standard methods
a P�
/Cl
($58/hour)
-Drafting
121p
;'!Typically-�qu
reA III
hi
M
h
c ODI'di !Requires 2 - 8 years of experience or 2 years of related
-CAD/CARD work
c6llegii, Eui I lMqr;
ibla
lye
of experience. Generally requires a Technical Drawing Certificate, and
"t
- Cartography
"advancedli'l
�I,
iiii
Ip, Computer Aided Drafting (CAD) & Design (CARD) operations.
-Plotting of GPS and standard survey data.
I
0 IT 11 1-
Spreadsheiets
-Report generation
Word P
-iiie§s61
a
11i 10, ($42.501bour)
-Wordprocessing
Operates c
ompu
er I
p
0 "Ing,
spreadsheets, and statistical typing, correspondence. report
-Typing
generation
pri eration
jen6i'i
mil andifiling, I
:Filing
i
General secretarial
Document reproduction
J

KEY PERSONNEL FOR THIS AGREEMENT
i Hart & Hickman, PC
I
Christie Zawtocki, PE
Matt Braniblett;.PE:.� . ` •
Steve Hart; PG •
Biuce Hickman;; PE
Shannon Cottrill, SEM
Barb Oslund,' PE
David;Graham
I Scott Drury; PE
KurtisBesheis, PG
Ed Stephens,;PG
i Mark Bascop'e; PG
Kevin Buchanan
I I
I :
!I
! •, !I Ili li
•. i i
! 'j Ali l �I iiil i;l 11 i '
Page 1 of 1

IN
1
0
K ; i
jl • j l ,!, ,
ATTACEN ENT 4
j ASSURANCES - NON CONSTRUCTION PROGRAMS
NR-ReACTOR certifies that with regard to:
)E 3ARMENl' AND SUSPENSION - To the best of its knowledge and belief
hat Ifand'its principals:
not ' presently debarred, suspended, proposed for debarment, declared
eligible,• or voluntarily excluded from covered transactions by any Federal
,pr-State ,department or agency;
b `l' e',not within a 3-year period preceding .this Agreement, been convicted of
i qr; had; a civil judgment rendered; against them for commission of fraud or a
'; r�rnn1naF:. offense inconnection with obtaining, attempting to obtain, or
perfornung a public (Federal, State, or local) transaction or contract under a
! publib, transaction; violation of • Federal or State antitrust statutes or
commission of 'embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
);are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of the
okffenses,enumerated in paragraph (1)(b) of this certification; and
i) baye�'i}pti.;witlun a 3-year period preceding this Agreement had one or more
public ;transactions (Federal; State, or local) terminated for cause of default.
BYING - To the best of its and its principals' knowledge and belief, that:
o Federal appropriated funds have been paid or will be paid, by or on behalf
F,the undersigned, to any person for influencing or attempting to influence an
Fficer; i or employee of any agency, a Member of Congress, 'an officer or
4l9y',eei1,of Congress, or an employee of a Member of Congress in
mnectson.,with the awarding of any Federal contract, the making of any
-deraf ! grant, the making of any Federalloan, loan, the entering into of any
I'� I ,,
)operative agreement, and the extension, continuation, renewal, amendment
modification of any Federal contract, grant; loan, or cooperative agreement;
any funds other than Federal appropriated funds have been paid or will be
Aid to, any person for influencing or attempting to influence an officer or
nployee of any agency, a Member of Congress, an officer or employee of
ongress, or an employee of a Member of Congress in connection with the
,&Xrq contract, grant, loan or cooperative agreement, the undersigned shall
)mplete ? and submit Standard Form-LLL, "Disclosure - Form to Report
5bbyi ig l'in accordance with its instructions.
- It and its principals will
y, py;, j
blishing;a'statement notifying employees that the unlawful manufacture,
>tribution, dispensing, possession or use of a controlled substance is
�lilited in the CONTRACTOR'S workplace and specifying the actions that
1 b' taken against employees for violation of such prohibition;
1 s g a drug -free awareness program to inform employees about
isli! I! i Page 1 of 2

I
• ii ¢lifi lf' • ' ,' �i LI' i I�i,i' f l a
J I J 'I __ ATTACHMENT 4
]th6j6e dangers of drug abuse in the workplace; ;
M
�CTOR'S policof maintaininga drug -free workplacea;ili��a
py!••available drug counseling, rehabilitation and employee assistance
rograms; and
the. penalties that may be imposed upon employees for drug' abuse
violations occurring in the workplace;
it a requirement that each employee to be engaged in the performance
greement be given a copy of the statement required, by paragraph (a)
11
aGl�e�'°I
' in `'the employee,in the statement required bparagraph a above that
j ,� •I' O ,oY. ;gq Y O
(condition of employment under the grant, the employee will - °
:'. i' i' l ' abide,b the terms of the statement; and
p7 ,11.� i
notify the employer of any criminal drug statute conviction . for a
i �Yiolation occurring in the workplace no later than five days after such '
fronviction; { I.
��lij
tto ! `the DEPARTMENT within ten da s after receivin notice under
's' bpaagraph (d)(2) above, from an employee or otherwise receiving actual
n"oticeof such conviction;
talang one. of the following actions within 30 days of receiving notice under
subparagraph (d)(2) above; with respect to any employee who is so convicted
I ,I ! li Iii �Il+d�aij;
ne�uag{n�!ppropriate personnel action against such an employee, up to -and.'
I Icl a 1g ,termination; or I
I; ,` i (i ',J ) Irelciuu7ng .such employee to participate satisfactorily in a drug abuse
;ss;<stance or rehabilitation program approved for such purposes by a !1
•; I IFederal, State or local health, law enforcement, or other appropriate
�! agency
I ii + a !' ood faith effort to continue to maintain a drug -free workplace
g implementation ofparagraphs a (b) (c) (d) (e) and (f) above.'
AND;1 ITh 0 CTOR and its principals further certify that they:
4. Will', coplyth the provisions of the Hatch Act which limit the political activities s
of;;en o, ees,whose nnci al employment activities are funded in whole or,in art
i P Y, P PP
with ederal funds; and
r ;, � 1
' Wily comply, as applicable, with the provisions of the Davis -Bacon Act, the Copeland
'•' i III i S ,, :1, 1 „ ,
Act, and •ithe ;Contract Work Hours and Safety Standards Act regarding labor
i ,, R st lard ;'r fe'derally assisted construction subagreements; and ;
t 6.'i 1Nilli f c p1y� 'th ii all! t applicable requirements of, all other federal laws, executive
ore ns' and-pohcies governing this program. i !
Page 2 of 2
p

"N
Central Flies: APS_ SWP
04/11/13 '
P.ermit`Nuhibei
l
°
;W1060011
r.
Permit Tracking Slip
Program Cat;egor�
�r i;l
' " i ,1;; Status Project Type
i
Deemed Ground�W
l
r, ft.l,
er
, t E ! .
i'i If r;j �„ `, I : . Active New Project;
PermitType';';';�fl;i+�al
Version Permit Classification
Injection Deemed
I
itu
r111'a�1i.i
Groundwater Remediation Well 1.0.0 Individual
SS
Primary Reviewgrll
Permit Contact Affiliation
eric g,..5mitj� I I1
1'�
�� f'
II i I , . Scott Drury
Coasta� 'Syr Rule{
2923 S Tryon St
�i
iz
II
Charlotte j NC : 282035449
PermittedfFlow
l
j I
�,yh
41;
1�. 'LJ�Ii
'11;f11: .•;• ,
FacilitV; "I'.:<;:: "r:`I
• I I is �I:a
Facility N me
I
W ,•.::i.,
'II
�`,'
1I''ll'' '
, „I I I .. i •,. Major/Minor Region
One otir�Clt3a
a
f'Laurinbtirg, Inc. Minor Fayetteville
Location Address
i!'
I County
1514 Maiq St�
li
`�i I 'j I Scotland
Laurinburg?;! `Ia
II.
�'';
!� NC ;;r. 28352 ! Facility Contact Affiliation
II ',15111 �J :I�
,';I JIIiI� li� i• I .. .� - �1 ' I
Owner
Owne
Name''lyOwner
'er'f
Type
Petitio
r
D
ca
Sitel 83; 0001 Govemrnent -State
..
Owner Affiliation
}
E
I i;;�
Teresa Lemmond
fill
Limited POA I
:15,14 S Main St
'1k
Laurinburg NC 28352
Dates/Events
•
I
.'hill
'I
I
I,I
� II
t' �, ,.
Scheduled
Ong Issue
l''
; I ••,
•Aopl
R�celved
Issuance
Draft Initiated Public Notice Issue � Effective Expiration I
�
:04/11/13
1 i�:�!
01
/
� /13
,I
�
04/11/13 04/11/13 ;
�:
Re tilated
AI tiities
III 'J;',i�
Ground
ate}'ree
Laund'ry,ope
l
)utfall
i
Waterbody
Stream Index Number I Current Class Subbasin
{,I ,r,'
Il
1�I;I;"�
I�l
•ICI: I•
! i I I}i � ,
�l!i�
11
� .
�
I;. � .i `�i 1�11 ,. �• � l i'
, iJ
i
,'•
j I .
I
I
I '� a
i
I
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i iP
i
y
I1
•

t III [`^(x)
•
-hart %_ --hickman S :
{{ I f
!]�fiilR� �! `..
SMARTER ENVIRONMENTAL SOLUTIONS
Via Federal=E ress l f
1 J 4°°3 I� +- 1� �r� 3 p °!j •�lul I, + } J I
p 3, 20;'aJ
' S s,Jt �f�ii`}k,'1 �� :t. `�Illi ;, II tj.. {l '�•. •� ; , ' '�'
' UIC
DVVProtection-Section
t 163G Mqc �ener
` Ralei No'w 2,699 -163 I '
II6 .
s#,µi:� I s li yifF
t r A.
1
Atfenttontrki' .1; (' as:Slusser
Re t Notifiaato of Intent to Construct or Operate Injection Wells
�riej Cleaners
�J fa r
it ; ' i:ti : tug; North Carolina
1,961
'�0�70001 1
iDS0�21Z
I1!
Dear
- � t �. vy i � !r 9 •a � ; -f I i
Oii ; belialf 'do h; (North Carolina Department of Environment. and Natural Resources Dry.-'
Cle , Solvent Cleanup Act. Program, please find enclosed one copy of the Notification of:
li, I
!',fInten .to' tiq ct on Operate Injection wells. The project.involves injection of the chemicali.
oxida�t�otassi permanganate to remediate impacted groundwater at the One Hour Cleaners;
t .,u III p;
facili lo��ttedd� 1 1 am St in Laurinbur Scotland County, North Carolina.:: The project,
,',,° I! i1;9F l{!1 iilil I, f �� g�
has�ngtl ee tltlus tune.
i'
r II t !J.! ,,l.I�•i91 �I��i 11���!�t',:�li:. •� � ' I 4 ,.L•
.pf
If yo, h ve�Ja� Ikons or need additional information, please contact us at [phone].
II ;1
Hart ick an,`' C
Ti is IIII{ all ,
l !,
I, i-
e.lti°� J'I� v it I'�•I� 91��1t li .. (i+� ' J,� ' '-!'''
.'u r.'li �a .��aSl �
Christie, a, c li I �I E a , Scott Drury, PE
Program Project EnginelA
er
]i'I re ; ;•,� I i
Enclo
RECEIVEDIDENRIDWQ
If II
iRemediation Unit , "APR? !
0-4 2013.
! f II ,
r `• �3'3 ;! (�a I (; AquerProtection Section
2923 $ ut IT o f' tree' ulte 100 ! ,3334 Hillsborough Street
1,"�' I !! fll 'f 'I; www.harthickman.com
Charlotte;!2�p „' Raleigh, NC 27607
i. 70458 00 7 II j " . i a� i , s" 919.847.4241 rain '
I�r�I�,Ir' i�,!jI� I •,ill I�„. I ,
I I 1
I I
.�'
I � ��IL� i la'19I1��?'i�!la� �` � I�' �Ji � �I!f ���i� lit{ !iii�.. � I 1 •4 ! .� I .

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q a I{ I, }1+`,�'� I I,il�l ' � i� , 1 It' � i I •
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` `' '' ' NO C.kROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES ;
.i
it it
CATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
I r '
iI
IV-
k»
Th fo�{lo to kr ;.`per u'W.by:rule and do not require amindividual permit when constructed in accordance`
wuh 7l1Iihiije iu I IIS'I + C C 02C.0200. This form shall be submitted at least 2 weeks prior to construction.`
AQi71IFER ',ES'�Ir
I ELT. LS (15A NCac 02C .0227) I
These wells ale used to mject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics. '
INs,ITU RED�ATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229):
n,l)' Passive )infection Systems - In -well delivery systems,to diffuse injectants into the subsurface. Examples include ;
�� i t {s
OR so�1}S( ' Is s14IG r anti other gas infusion methods. 1
�`}I�fIflI''k+tl�'lIIIIII'11
:.:2)'; Small�Seal !'I niection!Operations = Injection wells located within a land surface area not to exceed 10;000. .I ` ,
.square f et+foratlie putpoSe;of so <l or groundwater remediation or tracer tests. An individual permit shall be requited ;
,fort�t.or tr a en reas exceeding 10,000 square feet.
:I• I ,I, 1 ��I IIII I INI II 'I � � !•�
1'•'f i` �;�� I`I.��L�II:!II4I I i I.s c"
!3),, PilotlTes'tsl Q111limiriary dieonducted for the purpose of evaluating the technical feasibility of a
.;;...,',{I Lure stu
creme a on strategy in• order to develop a full scale remediation plan for future implementation, and where the
,surface areal,of I e mjection zone wells are located within an area that does not exceed five percent of the land
Isurfa e',aboye,the �aiown'extent of groundwater contamination. An individual permit shall be required to conduct
.. I' .
�mor'elIthan!o{ne !iotIt It, any.,separate groundwater contaminant plume.
N� Ilril : Ilk,Ilhir In echo a sed to inject ambient air to enhance in -situ treatment of soil or groundwater.
i
j! ' . Ile arly; or:Type Information: Illegible Submittals Will Be Returned As Incomplete.
DATE Api 113 201r31 I''' PERMIT NO. (to be filled in by DWQ)
I
1 Ii
ONSTRUCTED OR OPERATED
�1I I I I r +
1 i 1 A#j I Lion Well......... ...................... Complete sections B-F, K; N ,
1(2 Test Well
u11. I
uifer ........'...........................I....Complete sections B-F, K', N' I I I
!.. � 1 �i1 ;',1 I I ; II,! I I I�t '' 31, , • I ! i ,, i �. NI: .
Passive Injection System .......................... ..Complete sections B-F, H-N
7,11
i y ! 4 ,X : I Small-Scale•Injection Operation..' .................Complete sections B-N
alL.�j4,1,( I
1 I if Z ij I;'I r• .', l of • �.. RECEIVED
Pilot Test.............................................Complete sections B-N IDEN DWQ
, !t(6 1'11 I, I' 1 ``� I Tia'cer : "ection Well .............. .................Complete sections B-N
Fi
;APR 0 4
Ili Ir ��I'u d I I Milli IIII ••i1 � q �• ''�
. B rI'' i�S AA I,U Fi' II 1 IjOWNER: Choose an item ; AgUif rP ectl S@
y'�� 1 e rot on cdon
C.;:IiWEILLI;R'i �-r, State name of entity and name of person delegated authority to sign on behalf oflthe'':' I'
, I
9 busmes of a I ency I
t1� Ii 1i III 11 f .
1.;� , I
ne Hour Cleaners of Laurinbure, Inc. (Petitioner for DSCA Site #83-6001)attn: Teresa Lemmond
1
I
"1Contact:ISCott Agent for Petitioner
Pro Mail Service Center 1646 I +
1 ` I •I
State: NC Zip C de: Wake I 1
0 27699-1646 County: I
jp 'iDay,�Tl' ll704-1586-0007 Cell No.: 919-414-0750 i lit '!
dre�s [e-mail] 1 Fax No.: 704-586-0373
DWQ/U CI {5r}! 1 e N0 Iii don evised 7/9/2012) i Pa
jut
i 1 ge 1
{ d
�!,I��l�lllal;�i�I�h� I I! ; Id�� �f►l� �. I ., � I I ..

>: sdiur
III,
I
if different than well. owner) ;
nd, LLC
Main St ;I
State: NC Zip Code: 28352 County,: Scotland'
)566 Cell No.: Not Available
rcleanersAbellsouth.net FaxNo.: 910-276-3566 '
- Person who can answer technical questions about the proposed injection project;,
PC, Scott Drury 1
"'Tryon St
State: NC Zip Code: 28203 County: Mecklenburg r
-0007 I Cell No.: 919-414-0750
11
51arthickman.com Fax No.: 704-586-0373
N OF WELL SITE I
hates: Latitude":
I
I i. b r4•. .I.' f
County: Scotland
I i
State: NC Zip Code: 28352
0. " or N367292°.
Longitude". _° " or E1858329°.
Reference Datum: NAD 83 (NSRS 2007)
I
Method of Collection: Survey by Registered PLS usingTrimble R8 GPS
I a
Unit in conjunction with the NC Geodetic Surveys Virtual
Reference System (VRS),which is based upon the CORS. I '
O ! I JECTION AND AQUIFER 7ST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY I ; 1 ' I :
i' I�III '• 'jil;+ �:! ! BOUNDARIES MAYBE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES. :
li III i1 'lY 4
I IARE�
ea of; contaminant plume: approx 1,650,000 square feet i
�j
arI�ea of lrij !`well network: agppprox 1,000 square feet (<10,000 ftZ for small-scale injections)
i t lume area to be treated: oprox 0.06 (must be < 5% of plume for pilot test injections)
�� II � �, I Ili �Il l i ., • ( � ' I � , I
l ��` Ali i li ,. I '. i ;i l !•I
ill LII _I , I I
! i
i
Jotification '(Rev►sed 7/9/2012) page 2
:. L II �ile��It•'j � II�'�I I �ii �I�II` I ! I

Piki i�i t+ !. � . I I i ' ,'
�{'l
i
, 1
�I
, I ..
�,
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l
,•I, � 1 I ,
I1�TJE
�T.ZOINE MAPS —Attach the following to the notification.
3.uaaf'lume
map(s)with isoconcentration lines that' show; the horizontal extent of, the
out
1p1}ime'in soil and groundwater, existing and proposed monitoring wells, and existing and
r .
0po1 ;election wells; andRI
�tl+!
;.Iments lA through 1D
(2
.
! Crosls=section(s)'to'
the known or projected depth of contamination 'that show the horizontal,' and
l
fveinal
extent. ;of the contaminant plume in soil and groundwater, changes in lithology, existing, and
I� r4
ed r>}oiutoring wells, and existing and proposed injection wells. f
ZI
JOIN
D
ri�Flli
OF'PROPOSED INJECTION ACTIVITIES — Provide a brief narrative regard °the
'I , g g
purpos�g,
scPpe
I and (goals of the proposed injection activity. 1
led project
`The'pl
opos
is "for a small-scale injection Hof potassium permanganate targeting an area of chlorinated
�.volatile.
rt
or
j•' •
I
anic coin ounds CVOCs in on -site groundwater that appears to be the 12rimM source of a
iiai
�j I,rljlli
l•. Iii
II P.l',il l'
�drssolved
G� OC
lumelassociated with the site. The project will include injection of approximately 39,000
!;
! i1i11I�'
lloiu
(�
i II "
!3
itV I,yl;llp;
b �we> t otassium erman anate solution.!' The solution will be mixed on=site usin
'a
roxnnat
li1pi! '
irl, l :�I'1 , !
0li 000 Ilbs , ob2otassium vermanganate powder and water from a municipal source. .The
:soluiion'
1', a
in ected through temporary direct -push injection wells targeting the 10 to 50 $•below ground
1yl.il'
surface:'. e
th
interval
within an'gpproximately 1,000 square ft area refer to attached ma s . The intended
'a i jl {JI •. j 1,
resulflo I'th'elmiection
,11'
.III! 11 111.1! 111
is'destruction of CVOCs by chemical oxidation to render non -hazardous less toxic
;COMD:Oig�d"§.[flier6bv'result*mg
in a significant decrease of CVOC concentrations in the area targeted by' the
ectilon
I"
�'
I,i�Illl
an
''
iiolii'
1
INJEC1�
I'I 15
T. Pi vide a MSDS and the following for each injectant. Attach additional sheets if necessary. .
1<
`
ant t s (acer tr s and I r emediahon additives) can be found online , at
http.//po
tal.'ncdenr.or/weAll other substances must be reviewed by the Division of Public
artrirent of Health and Human Services. Contact the UIC Program for more info (919-807-6496).
I Ik �'' tl i
kHl
k�'!
' 7rh;
�i'i�'<Cll�ll'IN'�•'I�IIi.i
De
1
Z
I
ect Potassium Dermanganate SDS included as Attachment 3
I t
,
I
f
o je ants Approx. 39,000 gallons of 3% b�potassium permanganate solution' '
e I atlon.at point of injection: 3% by wit solution = approximately 30,000 mgll
nt if in a mixture with other injectants:
1p 1gg
1�
I 1IY I
I{glctant
li
Ili
` I
I( IYl4 I I
t:(�
jj,�'�Il�V
uu}e'Ofiizijectant:
j
! '
ofinjection:
4,1
II
1a
1T ii
p;'tpoint
J. 9�llilV�e
with other ini ectants-
M1
1,06ation
`(Revised
7/9/2012) P4.3
ip I
t
ii
•,+

►n I ' '
t
, �
i
rl
� I
NSii
RUCTION DATA
�i
A
• � t
ction wells up to 15 Proposed ' 0 I Existing 1
O
�l�irt.jljG
construction details for each injection well ina diagram or table format., single
t
1 Nil{s
q
1;
i I
d
y �;
•; 11.• •. � .. �
pr hne m a{ p
I I table can be used for multiple wells with the same construction details. ;Well
>
��
cttori details shall include,the following:
'well type as permanent,'direct-push, or subsurface distribution system (infiltration gallery)
i
depth below land surface of grout; screen, and casing intervals
s
�
�
� t'
,;
e I. c ntract
{or name and certification number,
*
A
lc y
in�ct�on well diagram is included
as Attachment 4**
(
i J
(Nate,
we
contractor name is unknown at this time) ,
S
HEM
ES'=:
Briefly: describe the schedule for well construction and injection activities.,
e m
n` will
beerformed utilizing Up to 15 'tem or direct -push injection wells. It is anticil2ated,that
,eIcti
!i, IJ
;the
ro
ect .
ill b6 6erformed bv iniecting simultaneously into four wells. Uproximately 2 600 gallons of 3°/u
[ �' }r11'il I'!�i
Ib ! wei
S
't
I }1 i��'► i'I►' ►ii!'i!l,'
e an anateisolution will be injectedinto each. well at a rate of approximatelygpproximately fourizallons per
minute:>,
Base
on this ihection rate and the time re uired for direct -Rush well installation it is anticipated that
;.them
ection
activities will be completed during. a 8-dgy period.; j
ONITiORING
'I,IW.
PLAN Describe below or in separate attachment a monitoring plan to be used to determine
t
if
tt
tolatio
I li
$'of groundwater quality standards specified in Subchapter 02L result from the injection activity;
onitorm
wells)• the'in'ection area(including MW-1 MW-1 HIB MW-2 MW-3 MW-4 MW-4I MW-4
E
sand
!
ill''be sam led during four se arate'events conducted on the following schedule: one week
I t
riorR&'-
i,;;lll►�
►
� ;
ec
'.
io
! N �
'Zllirr ! �:I � II,
en one month three months and six months after the injection. Parameters to be collected
:ardl6ift
s
e
. durifia
the monitorin2 events include dissolved oLcygen, RH,oxidation-reduction potential..
'
conduch
i
t
total
dissolved solids chloride arsenic manganese. hexavaleni chromium and the Drimga,
!C �10Cs!
f
concern
at the site. It is antici ated' that these wells will continue to be monitored on a semi-
annual
bas
s'as
Dart
of routine monitoring currently. conducted at the site.
�!r
i
�
, �
I
k
: sal
11
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Re
dN{�•
tification'
14N �,1 :•:. .�
evised 7/912012) Page 4'
�,i�
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it �
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�ii�!!�i•. �_; _ �: •t I ;:,:r, , . ,:i - ..a , �i .

J i::::
WA
.1 t6 signed required below orbythit person's'authorizedagent)
Q
4"W*res•_ at all pe�mit applications sl�iidil be sigiied as fbllows
1,111:. v.,
c ation: or a responsiblevorporate officer
.a p ership or sole Proprietorship: by a general:partner or the proprietor, respectil veiy;
of ijil!"nicipality oi.a state, federal, or other public agency: 6 . either principal executive. office:r or
y
gpublicil d official;
Y,
4.1j 0 1 bt6rs: 1: by'the well owner; R
�p s g
1. AN� )`Aq
-person authorized to act on behalf of the appli t: documentation shall be submift
ot can
on that clearly identifies; the person, grants them signature authority, and. is signed,"
F 'W4pplicant,! - I.�
I'het'eb ,ccT y,jp penalty of law, •that I havepersonally examined and am familiar with the iqfiormailon:!
and 'all 'attachments thereto and that, based on my inquiry of, those ih. divida'als", 4.1
it
46hslblijbr:obtaining said information, I believe that the information is Iiiiie, accurate an
'co id*are that there are significant penalties, including the poss•ibility osslbi�lty of fines and impfisonm�nt,'
lie - infb,'rmadon. I'agree to construct, operate, maintain, repair, and if applicable, abandon -
ell and all related appurtenances in accordance with the 15.4 NCAC 02C 0200 Rules.
Limited
ed Teresa Lemmond:
Signature -,A" W .o
F P
*Iia D t
CA. COfi I dd inAttachinent5**
(if different from applicant)'
I. ! i . .! .. '.
if any
II Su 3mit one copy of the compl I eted notification package to:
DWQ -Aquifer Protection Section
1636. Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone] I .Fax: [phone]
II �i1lll �i�: �, it' . � , ' I
vised 7/9/2012)
Print or Type Full Name.! '
Teresa Lemmond
Print or Type Full Name
DSCA Site #83-0001)
Print or Type Full Name
RECCENEDIDENROWO
APR ;04 2013
Aquifer Protection Section
Page 5

LEGEND
SRE3_PROPERTY
...
NLIDNAER Y
RREPROERTY _ ice
...lAf SBUILDING.
__' _==i .-_+__'.�_.__:_.:.:. -.- .-__ ...�_�.....�___: ..._—_a:-_.--.�.._._— �.- __ _.__..._� -_s-_'- .t—�_t._"__ --:.:^� nc;_♦ \_ _ ->_._. ._..L_ _u____t_ -_��-�.- �"�-^__£+._._.Fs.�.-�_.'e._i_ •L._�:__— _�:__ z�^._�
-2
—7 '
"'OFP4IlE8U1CDING
-
- -
-
—
-
— . .- - - - - -
- - -__ _...__®'_DEEP MONIPORWG_WELL-- --. _
- DRDOGEOLOGICUNRI
DEEP troRt� WALL
:.
- ♦
-
--• ._
-� '-c' -:- ♦♦ .. .:
� :`�
-. ...•. '. —3.42—'SOIL PCE ISOQONTOURIN MGIKG (SEE
_
.__. ..__f_
.... .....".
NOTE BELOW)-.
-
ONE. HOUR CLEANERS =
',VAPOR
_-
- --
BUILDING - -_ •; _' -.- �Od4-.VAPOR
vEn• EXTRACTION WELL
VE-10 VE-6
EXTRACTION SYSTEM PIPING I
3.42
_ . \`_ _
. - ._ /� - . ® PROPOSED INJECTION AREA -
` VE-2
-E-11 °i��
-
VE-15 MW-4
9A- VE-8 VE-3
O�
VE-16
VE-12 VE_g VE-4
;
- ---
E-18
--.=
------NOTE: SOIL DATA WAS COLLECTED PRIORTO SOIL VAPOR:
/
,NIW 4 H1B
EXTRACTION (SVE) SYSTEM STARTUP IN OCTOBER 2010.
'
VE-17 VE-13 /
I/
VE-22 ��F�O L' Ar, VE-5
\\
y VE-19 VE-14 ;
MW-3
-
�\
VE-23
VE-20 VE-27
\
\
VE-24 /
VE-25 VE-21 SVE SYSTEM
BUILDING
— \\ - -" '--
VE-26
-- - - '- - -- —.
-- - - - /=-- - - -- APPNOXIYATE _..
MW-8 o 20 - 40
\
SCALE IN FEET
\
MW-1 /
". PROPOSED INJECTION AREA $ SOIL PCE
\
�4,�
MW-1 H1B y
0
ISOCONTOUR (PRE-SVE) OVERLAY MAP
- --
\\
MW-1 H2 Q / O�OG
/ \ ONE HOUR CLEANERS
\
DSCA ID. 83-0061
LAURINBURG, SCOTLAND COUNTY
°�'� \\
hart hkkman 2M3 °
(n�A
'
,
- -'\
Pam= \
_--. __ . . :. -__ � - _- _ _._ _ .
_ _. _ _._ _ 9M 1511AMDUNIN LLLWoM Lk- #C-1269/#C-2A5 Gmbh
DATE
03-12-13 REVISION. NO. 0
-
- -
JOB N0. D
-"
SO-21ATTACHMENT N0: 1B—�- -

_
-- - -
_ - -
. -... —� cam.. � - �i-�Y�, _ _ ...:�....• s � n_.D s i ._ +, v r.. - -
__ —_ — __ � _ � _ -�3� •�. _`.:, /._� ._ �-SHALtDW MONRORINGiNELt- _ — —
R2.r.,.. E DEEPJdON(TQRIN�SYELL._.
—
_—_
DEEP MONITORING WELC--::-
(HYD OGEOLOGICUNIT2,3)'
(17.5) OCTOBERINOVEMBER 20126CE----) —
_ - - _ \, •, - ``\ - \—0.07—Y- PCE ISOCONTOUR (mga, -
\ � � OUNDWATER (mg
1L),
PROPOSED INJECTION AREA
i Ion, jis
A NW-2 • \v'
Y(0.774) -NOTES
i 1. HYDROGEOLOGIC UNIT 1A MONITORING WELLS ARE
� /' �� � /' �' SCREENED ACROSS THE SHALLOW UNCONFINED
I
GROUNDWATER TABLE.
`�. ``�/ , 2. SAMPLE DATA FROM TEMPORARY WELLS (NOT SHOWN)
INSTALLED TO A DEPTH OF 30 FT BGS OR LESS WERE
t1 4(17 � � / ,UTILIZED TO AID IN CONTOURING.
A HIP
Q.0179) OZ_
-1 1B
i '< i '\
V APPROXIMATE
`,\ ��\ . ' �i `.\ . - SCALE IN FEET
-0 ' \ i / PROPOSED INJECTION AREA & GROUNDWATER
V `\ \ PCE ISOCONCENTRATION OVERLAY MAP
yy ` HYDROGEOLOGIC UNIT 1A (H1A)
ONE HOUR CLEANERS
/
1\ T ` \ DSCA ID: 83-0001
V, / LAURINBURG, SCOTLAND COUNTY
hart hkkman Y9USomhTryonSa Zai e100
- -
�d..e N..h fi�ohne28203
mnwo
DATE: 03/12/13 REVISION N0. 0
JOB NO.. DM-21 ATTACHMENT N0. 1C

zvm
-----------
a�A
F-f?ROPERTYBOUN
I
-113 HI N
vw(�o
_l
c_-j
S..,hTW.S--Si.IOD
hart—%-hlckman "23
� _­14
H2 704-(p) 7D448"373(o
kmw 4 C-1269 / #r,245 GwIW
14 HIoo
DATE. 03/12/13 :.REVISION. NO. 0
w
CrTYDFLAUMNS WS -7-:7- JOB N0.':DSO-21 ATTACHMENT NO.-ID
WATIER qPKY WELL PI H$
DEEP
MO
P
t.ROG
vy
_0 Q DEEP MONITORING WELL -,,.,-.---
ice`.;4 _(HYDROGEOLOGICUNITZS).-_
MUNICIPAL WATER SUPPLY WELL -
(1.43) OCTOBERINOVEMBER 2012 PCE
CONCENTRATION IN GROUNDWATER (ffKYL)
0.07 PCE ISOCONTOUR IN ffKYL
- (DASHING INDICATES INFERRED EXTENT)
Ns NOT SAMPLED
PROPOSED INJECTION AREA
1. HYDROGEOLOGIC UNIT 1 B MONITORING WELLS ARE
CONSTRUCTED WITH 5 OR 10 FT OF SCREEN SET AT THE
TOP OF A SEMI -CONFINING CLAY LAYER APPROXIMATELY
55-60 FT BGS WITH THE EXCEPTION OF MINA HIBWHICH IS
SET TOA DEPTH OF 35 FTBGSAND MW-13 HIS WHERE NO
CLAY LAYER WAS ENCOUNTERED).
CO 2. SAMPLE DATA FROM TEMPORARY WELLS (NOT SHOWN)
INSTALLED TOADEPTHOF30.ETBGS ORGREATERWERE.
UTILIZED TO AID IN CONTOURING.
`\ Oy O00249)' `\
17 0 HIS V APPROXIUATE 200 400
q (o
SCALE IN FEET
>' .� \ 1 / , PROPOSED INJECTION AREA & GROUNDWATER
PCE ISOCONCENTRATION OVERLAY MAP
HYDROGEOLOGIC UNIT 18
. .... ONE HOUR CLEANERS
DSCA ID: 83-0001
LAURINBURG, SCOTLAND COUNTY

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SHALLOW MONITORING WELL
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MUNICIPAL WATER SUPPLY WELL
DATE: 03/0/131�i-.I OEM
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OCTOBER 2012 PCE CONCENTRATION IN VERTICAL ACCERATION - 3X
GROUNDWATrR(.9A) CLAY CROSS-SECTION A-N
SANDY CLAY/ CLAYEY SAND
ONE HOUR CLEANERS ---
PROPOSED INJECTION AREA
DSCA ID: 83-0001
NOTES: LAURNBURG, SCOTLAND COUNTY
1. WELL CONSTRUCTION AND SOIL LITHOLOGY OF
LAURINBURG WATER SUPPLY WELL #2 WSW 1$2) OBTAINED
FROM FIELD NOTES AND CASING LOGS SUBMITTED BY hkknian
=W12HIAgROUNDWATERELEVATION CAROUNAWELL AND PUMP COMPANY, INC. (JUNE 1963� rt ha
2. SOIL LITHOLOGY SHOWN BETWEEN MINA I AND MW-14. . 704-58&W(p) 704-586-0373(0 - -
1V"12 HIBaQ GROUNDWATER ELEVATION WELL CLUSTERS IS BASED ON INFORMATION FROM DEEP. I km # r.1269 / OC-245 G-kV
SOIL BORING DB-1 AND MW-13H211ORING�-- v
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MONITORING WELL DEPICTING SCREEN INTERVAL - VERTICAL EXAGGERATION - 3X -
�OCTOBER 2012 PCE CONCENTRA71ON IN GROUNDWATER
to
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—OAT— PCElsocoNrouaw�L DSCAID:83-0001
(DASHED UNE INDICATED DIFERRED EXTENT)LAURINBURG, SCOTLAND COUNTY
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DATE:-03/12/13 REVISION N0.•0

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Attachment 3
Potassium Permanganate'MSDS
111l ,i�1 i '
�fl •' �I I I 1 ,
I
ui,,i al
�J II
I I+ fiii i�l•� ill I
�i �I•li�l l�!i + � .. I
1
i
I li tl I '

W NCOM
ratory EquipiTient
f
*e ria
,
1, Safety: Data' Sheet
illl,Vi6tasslum permanganate MSDS
Reactivity; . 0
Personal : " '' i I
Protection,
.4
Apiptioh,
fProduct
I.. Chemical an ornpany: Identification.'.
Product N mell,Ptas
wm permanganate
Contact Information:
Catalog C des SL
4911
$P3892,
SLP1075 Sciencelab.com, Inc.
,
14025 Smith Rd. .
'
CA§#:'JM
.1244,
Hou sk6h, Texas 77396I.
RTECS: SD64750001US
Sales: 1-800-901-7247
TSCA: TSCA 8(4)i In
Potassium
International Sales: 1-281-441-4400
permanganate
'
lailable,,:,(
Order Online: ScienceLab.com
Cl# Not
!,; I' III
!! I' i i
Synonym:;? Potassi
lis
M.Pqrmangahate,
CHEMTREC (24HR Emergency Telephone), call:
Biotech Grade 1-800-424-9300
>
i I: I I it l 111I
Chemical ame:j
ill h
Permanganate
International CHEMTREC, call: 1-703-527-3887
-Chemical Formula
dj,i�
0
For
1;:I non' -emergency assistance, calk, 1-281,-441-4400
ill
I I 1i `
H1
11:1,111
I't"pC..
ion 2: Composition and Information on Ingredients
Com
Name,
CAS # % by Weight
Pl6tais
u
per,"
71722-64-7, 100
Toxicological
Datai
N111,
ii llf
o
I
All
ri.
I t ;i
Potassium permanganate, Biotech:: ORAL (LD50): Acute: !'� : 1090 mg/kg [Rat]. 2157 mg/kg
[Mouse].,
...:,Section,3: Hazards Identification
'Hill 11] 11.4
Poientlail'Ac to Heat Effects
Hazardous i Ica i intact (irritant), of eye contact (irritant), of ingestion, of inhalation. Slightly hazardous in case of
r) os ibl co F skin contact 06 osive to eyes and skin The amount of tissue damage depends, on length of contact.
Eye .co contact n: r s i r a a.r blindness. Skin uce inflammation and blistering. Inhalation of
# pgp or contact can prod
dust will produ'' iiEr`i" 'Tt'lol t ps trp-Intestinal or respiratory tract, characterized by burning, 'sneezing. and coughing., Severe
over -exposure cans no u amdge,rlfli4'choking, unconsciousness or death. Prolonged exposure may result in skin burn
I j "I. r l- 1 11 1 :1 1 i i
and ulceratio & v x bs r blyllnh'alation may cause respiratory.irritation.
Potential Chronic q I hr 6ctj:.
CARCINOGENIC EFFECTS ot available. MUTAGENIC EFFECTS: Mutagenic for bacteria and/or yeast. TERATO ENiC!
EFFECTS; N vailabler I EL PMENTAL TOXICITY: Not available. The substance may be toxic to kidneys, liver skin
EP I Not jl" 1­41, ? .
central nervous, e� -,NS). Repeated or prolonged exposure to the substance can produce target organs damago.
�6��,slq a cal 1
Repeated-ek osprei f 1,6w level of dust can produce eye irritation' Repeated skin exposure can produce local
skin dOOT46tioni, I rted inhalation of dust can produce varying degree of respiratory irritation or lung damage.
P
13,

, �, t, j j q �? � jjjjjjJJJJJJ ij i, k� I i' I I' i t I ��� I (i'I G I I I' I .. i; I �, � I I
§3`111 11" MINE
111
""', MR.,
kM
MI, OIAHNA 017. FROM, M'DER"
M-1 IN All
ME'
Eye I:C6ntacI
N
Check for; and
rM9
M P
t lenses. In case of contact, immediately flush eyes with plenty of water for at least 115
...
minutesold
ter
I 'G t medical attention immediately.
4i 1i i�
Skin
siW'
In case�of 6`0611:6101,1
t I 1i i6H skin With plenty of water for at least:15, minutes while removing c6ntaminated'cI6th1n"g 1'::
and shoes.,
6v4rth
I
e I biwith an emollient. Cold water may be used.Wash clothing before reuse. Th6roughly.cle
shoes 6e'forT
reuse
,, 't
medical :pfteption immediately.
Serious Skim
il:64,
Washivyi6a
isi
it
V 8 . 0 C. Ver the contaminated skin1with an antil'bacterial cream. Seek immediate medical
m, ica j
nh Iiiil'o
Inhalation
If inhaled,re
rf'r
3 a hi give artificial respiration. If breathing Is difficult, Get medical!
;eat Ingi, give oxyben.,G1
atterit-
PRO
Serious nhalat
din", ++ry
i i' {,`:I
s'
Evacuate'
i
tim, i't,,
1
area !'soon as possible. Loosen tight clothing ;such as a collar, tie, belt or waistband. If
breathing'is
iv'
P.
I i
u t;
II II
11 ' '
i ni lar,oxygen. If the victim is not breathing, perform mouth-to-mouth resuscitation. WAR
WARNING: It may
be hazardob
corrosive +S
!�11:6
ek
t'e p,,e
Rif
Mei
roviding.aidAlo give mouth-to-mouth resuscitation when the inhaled material is toxic, infectious or
to medical66n'tion.
In6l;ispon'
"
I
., I q " ` 1
Do NOT 1 ind
4
't i�,
c6
ig
j re e o o so y medical personnel. evergive anything by mouth o an unconscious;
person ,Ii., f-l;@��r
1!
W
ua tit e
S maiTriatiare swallowed, call a 'physician Immediately. Loosen tight clothing such as a collan!",',
tie, belt, or. w
I
an
Serious Ing
C
hAN1 I
:W R
Flammabill' lof the P od It
1A
Auto- m All able.
i
Flash Points
Flammable lmltg! NQt1ir Idable.! W
'N .
0 1 i
�of i ion: f v
Productsi �,6. all6ble.
V,
Fire: kaiair& "in r ius".Substances: organic malterials, metals, combustible materials
Exlpiois6li H 'I S e of Various Substances:,
Riski;,6fi 6j' �11p�11;i` 16' 5' itI j esence of mechanical impact: Not available. Risks of explosion of the product 1 PD -
1 491 1 metals.
presence.bf tati d al,,a le, Explosive in presen�ce of organic materials, of M,
Fire Fightiri ions:
,Not applicable.
Special
iFy,H �
I
Ilk
4' 1-I.l'I �i
SpontapepuI am b20 col G.witethylene glycol; Potassium Permanganate being conveyed through prop�lne iu
1,!1II,I ignited the to e. s?liy yd -oxylamine is brought 'into contact with solid potassium permanganate, there is produced,
t "I t, immediately w liberated
ey ,e- assium,permanganate decomposes hydrogen trisulfide so rapidly that sufficient heat is ,
to ignite, theit isU fl e ntl ony or arsenic and solid potassium permanganate are ground together, the metals.'ignite."
1101 � iii i I I,,
Spe6ijEll Kernar s+®iik I sj I Hazards:
Take. CaFqi I! nay occur if It is brought 19 contact with. organic or other readily oxIdizabIe!substance�,IJr;jj'
r djjq D pp,ir
'ImIj F 1.. 9 Jr.
`n with sulfuric'acid or hydrogen p
i.
either in, solu'«cplc�siveI contact w peroxide. Potassium permanganate explode if permanganate is not kept cold. Explosions can occur when permanganates, acetic �'CO o' y 11
come on, con ,carbon disulfide, diethyl ether, ethyl alcohol,, petroleum, or oganic matter. Contact with glycerol
2
1`0

J
1, 1., Valsbf potassium permang
may producE anate.explode vigorously when. ground with phosphorous. A'mixtOre
of .5-/p:P,o`tds "I U!, 3W+."6riorii6m nitrate explosIv6 caused an explosion 7 hrsj later. Addition of Potassium.;! 1P I
ari a a e,,. I
p 'a; I e.
erM ;a �18 ;give a `20% -solution led !to an explosion after 5 min.'Dudng a preparation of chlorine
b 6dd y it'L, 0 ' j '0 th I ki6'�Hydrochloric acid) to solid: potassium permanganate, a sharp explosion occurred 6rione
ion,
occasion
If 1 0
#
IN NN NOR W *W�1� Aill, HUM, I n R
;NR U00.0 RMIAA
Small. tpllf.;
I! ttb' 106put the spilled solid in a convenient waste disposal container.
Large
11!.�j
OxIdi41rnrgp
, , r �
ri
4.
Ii..;
without risk. Donot solid. ..Stop leak if wi :not get water inside container. Avoid contact with a
I . I
b-O.-
con'
m
co sti I
Jeri.
r. oil, clothing...). Keep substance damp using water spray. Do not touch spilled material.
s
Use'' r.,r
LoUn
�o
Y.!
ws basements
event entry intosewers, or confined areas; dike if needed. Call for assistance
on 1
c 61P
1
C n a
d a concentration
1 is not present t level above TLV check TLV on the MSDS and;
local
I fli oca
I
-Or-1 1, - _� . — I -I' - - _'g, 5 �,!Y 42 r N N
Precautions
re aui ion's
Keep 6Way,f
pim
heat:from
I I sources of ignition. Keep away from combustible material. Do not ingest. Do 6ot'-:
breatH6� dUdt.
;Jn
I 0,il.1
iase
f,
[tit I—
ci dventilation, wear suitable respiratory equipment. If ingested, seek medical advice:
immediately
.'j.riiaterial
p
hqw
ttAvoid
contact.with skin and eyes. Keep away from incompatbles such as
organic ,f
is,
tora �j;
1
l',!7
:)lilyl� Js,i. ! �, i I . I I , I
Keep nt
.1g,
h
Y.
16
I IC
ee ntainer in a cool, well -ventilated areaj'Separate from acids, alkalies, reducing agents: 1!,;
ai
and combust
bles.'�S
I
1
a
1. ,
I
I)
43A,Codefor the Storage of Liquid and Solid Oxidizers. .!I, . j! j4
. � !, , ,,, ":P 6.Rg 1p 11*1NOU 6i'11110 ;1:; 1; ;;." i.,:_ i I ! , *.. I :..
i
WT
_Wqli�;k
My
i.
�La.l d8q­.'0
'. tftkawp&omfp� n$ t6did' 23, Ph
0
Engine466
Inslro
. bill
1A " �IUse:p'r'locles"s;
�41'1�,entilation,
,
1, 1
el
"
11VO
1901
I
A
;-
I au., or other engineering controls to keep airborne levels: below recommended
1911� ill, :.'111 i I 1 .1 ed'
expdsU1:ri!q'- I
'Im
S."
f us
-a:
1011 1 i Ili
gei i6rate. dust,. fume or mist, use ventilation to keep exposure to airborne contaminants:
below, the ',ex
os
i;
jrej
�11i:_
1
it, i
.
1 !III
;j
l
.;:. I 1!�
Personal ;'P�r
to "
ti onll
!
II,,
1j
lii JJ;
I tl�li �r j I` I' li'
Splash 99991
S
S,
t
it
ipr'n.
I
Vapor and. dust respirator. Be sure to use an approved/certified respirator or equivalent.
Gloves.-Ii
I
Pers�qnal*4
�t6
tLr
pis6!'6f
a; Large Spill:
Splaish!goggi
s,
It
dust respirator. Boots. Gloves. A self contained breathing apparatus should be Used,to
avoid in,halat-
n'
e
(isted protective clothing might not be sufficient; consult a specialist BEFORE handling
this peodd'6t!
W
Exposued,Li,nit
TWA: 5 Con
11j!
111�
�'C`11
�',
f6f,'acceptable limits., J,
j
ult
U
exposure
'N
I
111-11
'Jill
ol
Hill
A
R'If
1
w
P"RhYj
TV —
!�'!!
.;,fi$ 1,11;!
J 11
il
ill;
I
T..
1 1,1,;V,
vnysi s
ell',
na
17
11
S
id.
0 E
�l���IIr,11
ss.
(j,lit.
�.�IIli'
I
t';"d
i �{i111J�,Ii
f,
Taste:. Weia
ish
as
I
i,
V.
Molecular* Weight,
9�(Ij';`,
I
If},'I��'l:l:i
;;',;i�
1;1,�i
I�IIIu;Ijgs!Ixll
it ;l
�Mli
'i
II
MO.
'Kk;
4
n 3

A
, 41,
� it t, l:j
r
0,41
fIS"'MAN"
ty
Midi T 1?,Ri Vi NKNWW4_]*_k i,_1 WE �,�M
- V1,1114,
Stability:ffh
po
u
s
le'
lnstabiii!t
Conditions
rn
i
or
iii
CIO I
materials
lncompatibll
Highly ri
W
a'
Will
ti�l0
Ic4p
J§ 1: stances:
a with reducin agents, combustible material
rtem is, metals, acids. Reactive wi S.
l4i
Corrosivity'.,
S
46
irl,
av
b
j
etialjRiffi
0 1
io I
ift
aQt1VI
It? Is p6w6ifff
et
o
Iji
;d'!
pal
1g
t. Incompatible with reducing agents, acids, formaldehyde, ammonium nitrate,
(I ill
dim hylfotm
ferrousiori:m
mile
c
C
bus ible materials, alcohols, a senites, bromides, iodides, charcoal, organic substances,
losphites, hyposulfites, sulfites, peroxides, oxalates, ethylene Manganese silts ,
oxidj7'e`:t'he"t`b'
is
I
I
glycol; in,air
t oxic's ulfur trioxide. Can react violently with most metal powders, ammonia, ammonium
salts, pnp§ n
ro
s,l
n,
liTin
organic compounds (materials), flammable liquids, acids, sulfur.
I
Special,116mar
I 6t available.
'Polyindtliatl
In
Wil;
ur
i6li ! i I . . !II II 1 1 1 1 . . , : , . !. ,
Rou r 1:i,.Sc kin.Relcontact. Inhalation; Ingestiorill
ril
Toxicit t aH: .
Acute oralito i6i C53: I1�(90r at]. Lowest PLIblis6ed Lethal Dose-LDL[Wornan] -Route: Oral; Dose:-100 mg/kg'': I
nj/kg[R
LDL[Huinin]' mg/kg. t i�19
1,
rl s
4 4i
Chronic JI
MUTTAAGE IC EFF u �;g nic;for bacteria and/or yeast. May cause damage to the following organs: kidneys,, liver, skin,
i! I'll, 15 11
centralservo
JIT�ri 1
it
OtherToxic ff q�s II
'j. P 4

g
a 1#1
z 0
Ha ard' us 1 pal a tact!(!' tact (corrosive), of ingestion, of inhalation. Slight) hazardous' in ca§e:'bf
1 j(!, ant);ofeyecon
skin contact Oe e i of
-0
n;;
Special Re ar x city, t Animals: Not available.
rM
10
I
Special Re t ronic Effects on'Humans:
4i
May�,cause b V6rii6lier' effects (Male and Female fertility) based on animal data. May affect genetic material
a
pr?ductive el
(mutagenetic, b se't urnal data.'
al Sped .,66 Effects on Humans:
1,
g
M
.RM
U M 07
Ecotoxicity':
I961
dviiiiI
b
B D 0 .0and COD
Products..0f,
Possibly h*
S!bly az'
1,
't
d
"Forp'd
Us!!!!!
V
J.
j
j;;
rm degradation. products are not lik6ly. However', long term degradation products may adse.:i
Toxicity of t
61
d"
t
A
6,11,degradation: The products of degradation are less toxic than'the product itself.
Special Re
hrks
16filt
0
126 ductslof Biodegradation: Not available.
a
%
m,011) t MEN,
P A
Waste,
:!
hI16I
I!: il''!
Waste -must.;
e d
s', , o'
s,�ja
It fl 11;
accordance with federal, state and local environmental control regulations.
1; i l,,, I I U11JI Ml 1.1,11111 k.11 llWIN ill; III; , I I 1 .1 . .,; I ,
"d 0",
4
"TIAN
1, r A SQggai
DOT Classifi
a
C
51-.,Oxldizing material.
Identificatig'r
I.M.
I
n per angarfate UNNA: 1490 PG: 11
Specii iavvil rov
isl
di�;
ranspo, 6 available.
N ji
jns;
i
I�j i1l''.
1
1 i"j: 14-
�=Mwlgjllllmmm
lit, I
I :
I and ta a . ?S I
and
Connecticut, rp pq 1�1 m permanganate Illinois toxic substances disclosure to employee act: .1
T ,g,. 5
Feder'
Potassium]I �oisl'� 11i.
riganat llrii c6 safety act: Potassium permangarliate New York release reporting list- Potassium
perm
id RTKhazardous substances: Potassium permanganate Pennsylvania RTK: Potassium
permapga6`4t is Massa hi et s' iktk- Potassium permanganate Yassachusetts spill list: Potassium permanganate New Jersey:
Potatislu.mIp-s np it iN1,eW, 'Jersey"spill list: Potassium permaInganate Louisiana spill reporting: Potassium permangan ate
California DI I rd6us Substances: Potassium permanganate
Other Regultw
OSHA:a all S. ardlcommunication Standard (29 CFR 1910.1200) rodu6t is on th4
European Inventory' fi ist n -nmeecial Chemical Substances.
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