WI0300409_Injection Event Record_20230908

North Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WI0300409
1. Permit Information
Marathon Petroleum_ComRM. LP
Permittee
Marathon Charlotte East Terminal
Facility Name
7401 Old Mount Holly Rd, Charlotte, Mecklenburg_
Facility Address (include County)
2. Injection Contractor Information
Geologic Exploration Inc.
Injection Contractor / Company Name
Street Address: 176 Commerce Blvd.
StatesvilleNC 28625
City State Zip Code
[phone]
Area code — Phone number
3. Well Information
Number of wells used for injection:
Well IDs: MW-21, MW-47, MW-48
Were any new wells installed during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 form for each
well installed.
Were any wells abandoned during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include a copy of the GW-30 for each well
abandoned.
4. Injectant Information
&egenOx Part A and Part B
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration: 6%
If the injectant is diluted please indicate the source
dilution fluid. Hydrant
Total Volume Injected (gal) 573
Volume Injected per well (gal)_ 365, 175 and 33
5. Injection History
Injection date(s)
Injection number (e.g. 3 of 5) 1 of 3
Is this the last injection at this site?
❑ Yes ® No
I DO HEREBY CERTIFY THAT ALL THI
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
TURF 2F WFXTION CONCRACI"OR DA] h
Stephen Sloan
Submit the original of this form to the Division of Water Resources within 30 days of injection. Form UIC-IER
Attn. UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464 Rev. 3-1-2016