Air Injection UIC Deemed Permitted 2012-2013

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule"and do not require an individual permit when constructed in accordance
with the rules of ISA NCAC 02C.0200. This form shall be submitted at least 2 weeks prior to construction.
AQUIFER TEST WELLS(15A NCAC 02C.0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION(15A NCAC 02C.0225)or TRACER WELLS(15A NCAC 02C.0229):
1) Passive Injection Systems - In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks,iSOC systems,and other gas infusion methods.
2) Small-Scale Injection Operations - Contaminant plumes located entirely within a land surface area not to
exceed 10,000 square feet. For tracer tests in uncontaminated areas the area of influence of the injection well(s)shall
be entirely within a land surface area not to exceed 10,000 square feet. An individual permit shall be required for
test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation,and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: September 12 , 20 12 PERMIT NO. (to be filled in by DWQ)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) X Air Injection Well......................................Complete sections B-F,K,N
(2) Aquifer Test Well.......................................Complete sections B-F,K,N
(3) Passive Injection System...............................Complete sections B-F,H-N
(4) Small-Scale Injection Operation......................Complete sections B-N
(5) Pilot Test.................................................Complete sections B-N
(6) Tracer Injection Well...................................Complete sections B-N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER — State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: Petroleum World,Inc.
Mailing Address: P.O. Box 341
City: Mooresboro State: NC Zip Code: 28114 County: Cleveland
Day Tele No.: 828-453-2247 Cell No.:
EMAIL Address: dpotter�cchpw.com Fax No.: 828-453-2204
DWQ/UIC/In Situ Reined.Notification(Revised 4/26/2012) Page 1

D. PROPERTY OWNER(if different than well owner)
Name: Brian Kerr
Mailing Address: 6201 S NC 9 Hwy
City: Tryon State: NC Zip Code: 28782 County:Polk
Day Tele No.: Cell No.: 828-817-9856
EMAIL Address: Fax No.:
E. PROJECT CONTACT-Person who can answer technical questions about the proposed injection project.
Name: James Gamertsfelder
Mailing Address:4301 Taggart Creek Road
City: Charlotte State: NC Zip Code:28208 County:Mecklenburg
Day Tele No.: 704-394-6913 Cell No.: 704-266-2245
EMAIL Address:jgamertsfelder(2shielden ing eering.com Fax No.: 704-394-6968
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 6213 S NC 9 Hwy
County: Polk
City: Tryon State:NC Zip Code: 28782
(2) Geographic Coordinates: Latitude**: ° "or 350.245275
Longitude**: "or -820.089343
Reference Datum: Accuracy:
Method of Collection: Google Earth
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: square feet(< 10,000 ftZ for small-scale injections)
Land surface area of treatment area/radius of influence: square feet
Percent of contaminant plume area to be treated: (must be<5%of plume for pilot test injections)
H. INJECTION ZONE MAPS—Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells,and existing and
proposed injection wells;and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells,and existing and proposed injection wells.
DWQ/UIC/In Situ Reined.Notification(Revised 4/26/2012) Page 2

I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES — Provide a brief narrative regarding the
purpose,scope,and goals of the proposed injection activity.
J. INJECTANTS—Provide a MSDS and the following for each injectant.Attach additional sheets if necessary.
NOTE: Approved injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/web/wg/apslwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the UIC Program for more info(919-807-6496).
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Inj ectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: 1 Proposed 6 Existing
(2) Provide well construction details for each injection well in a diagram or table format. A single
diagram or line in a table can be used for multiple wells with the same construction details. Well
construction details shall include the following:
(a) well type as permanent,direct-push,or subsurface distribution system(infiltration gallery)
(b) depth below land surface of grout,screen,and casing intervals
(c) well contractor name and certification number
DWQ/UIC/In Situ Reined.Notification(Revised 4/26/2012) Page 3

L. SCHEDULES—Briefly describe the schedule for well construction and injection activities.
M. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
N. CERTIFICATION(to be signed as required below or by that person's authorized agent)
15A NCAC 02C.0211(e)requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3. for a municipality or a state,federal, or other public agency: by either a principal executive officer or
ranking publicly elected official;
4. for all others: by the well owner;
5. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
"I hereby cert fy, under penalty of law, that 1 have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, 1 believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon
the injection well and all related appurtenances in accordance with the 1 SA NCAC 02C 0200 Rules,"
�W71,&
hdklmr, 4dywlyk
j6u, & ;�61/u &
�Sinatu!r, oji�rty
Ap icant Print or Type Full Name
Owner(if different from applicant) Print or Type Full Name
Signature of Authorized Agent,if any Print or Type Full Name
Submit one copy of the completed notification package to:
DWQ-Aquifer Protection Section
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone: [phone] Fax:[phone]
DWQ/UIC/In Situ Remed.Notification(Revised 4/26/2012) Page 4

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NOTES: 1-SITE MAP BASED ON SURVEY BY HARRISBURG SURVEYING
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2-ALL LOCATIONS ARE APPROMMATE.
MW-13 �0.4 EPrt
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Amendment to Section K:Well Construction Data
Intervals(feet below rade) Well Contractor
Well Type Well Screen Well Casing Grout Name Certification Number
Permanent 68.5-70 0-68.5 0-64.5 Geologic Exploration, Inc. A2401

08-08-'12 12;36 FROM-N DENB I iQis �V E 0919715 684 T-654 P001/025 F-518
AUG 0 8 2612
Central Files: APS,__ SWP_
Asheville Regional C�ifice o8rori12
Permit Number WI0700220 lit Ifer Prgtection I�- rmit Tracking'Slip
Program Category Status Project Type
Deemed Ground Water Active New Project
Permit Type Version Permit Classification
Injection Deemed In-situ Groundwater Remediation Well 1.00 individual _
Primary Reviewer Permit Contact Affiiiotion
erio.g.smith Joe McKeon
Coastal SW Rule 980 Macintosh Dr
Rochester NY 14626
Permitted Flow
Facility
Facility Name Major/Minor Region
Former BASF Manufacturing Facility Minor Asheville
Location Address County
1110 Carbon City Rd Burke
Morganton NC 28165 7271 Facility Contact Affiliation
Owner
Owner Name Owner Type
BASF Corporation Non-Government
Owner Affiliation
Charles Waltz
100 Park Ave
Florham Park NJ 07932
DatestEvents
Scheduled
Orig Issue App Received Draft Initiated Issuance public Notice Issue Effectiva Expiration
08/07/12 08/03/12 08/07/12 08/07/12
Reyulated Activities
Groundwater remediation
Outfali NULL
waterbody Nama Stream Index Number Current Class Subbasin

08-08-`12 12:36 FROM-NC DENS PAS 9197150684 T-654 P002/025 F-518 `
1 � ,
1
+Isrmy
Site Solutions,Inc.
ELM Site Solutions, Inc-
980 Macintosh Dr.
Rochester, NY 14626
2 August 2012
DWQ-Aquifer Protection Section
NC Department of Environment and Natural Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
Sent via FedEx
RE: Notification to Operate Injection Wells-Passive QRC Advanced Well Socks
Former BASF Plant, Morganton, North Carolina
Dear Sir or Madam:
ELM Site Solutions is submitting this Notification to Operate Injection Wells at the former BASF
Manufacturing Facility, Morganton, NC on behalf of our client. The material to be placed in the
wells is Regenesis ORC Advanced contained in socks for passive groundwater treatment. The
sock placement will be scheduled as soon as DENR-DWQ approval or acceptance is received.
Enclosed please find the following documents that complete the notification package:
• Completed Notification to Operate Injection Wells (please note that the current owner and
BASF signed on separate copies of the same page which are included along with BASF
Corporate Signature Authorization)
• Site Plan showing building and well locations, plume extent, injection and monitoring
locations
+ Geologic Reference Map
Geologic Cross Sections
• Well Construction Diagrams
• MSDS for Regenesis QRC Advanced
Please send a copy of the letter of acceptance or approval to me and also to:
Vernon Burrows
BASF Corporation
100 Park Ave.
Florham Park, NJ 07932
[phone]
A scanned copy of the letter sent by email will satisfy our documentation requirements.
RECEIVEDIDENRIMWQ
AUG a 3 2012
Aaifhr Protection Section

08-08-'12 12:37 FROM-NC DENR P&S 9197150684 T-654 P003/025 F-518
r
DWQ-Aquifer Protection Section
August 2, 2012
If you have any questions, concerns, or if further discussion is required, please call Vern Burrows
at(973)665-4829 or me at the number below.
Sincerely, -
ELM Site Solutions, Inc.
Joseph M. McKeon, EdM, MA, MS
Senior Scientist
JMcKeonaELMSiteSolutions.com
[phone]
cc w/o attachments: Vem Burrows, BASF
Charles Waltz, BASF
Mike Bail, LaGrace Properties, LLC
Rusty Norris, ELMSS
attachments
WCEIMIDESPOO
AUG a 3 2012
Page 2 of 2 Ag&r Protection Section

08-08-'12 12:37 FROM-NC DENR P&S 9197150684 T-654 P004/025 F-518
NORTI4 CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCRS
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are`permitted by rule"and do not require an individualpermit when constructed in accordance
with the rules of 15A NCAC 02C.0200. This form shall be submitted at least 2 weeks rior to construction.
AQUIFER TIEST WELLS(15A NCAC 02C.0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION(15A NCAC 02C.0225)or TRACER WELLS(15A NCAC 02C.0229):
1) Passive Injection Systems - In-well delivery systems to diffuse injectants into the subsurface_ Examples include
ORC socks,iSOC systems,and other gas infusion methods.
2) Small-Scale Injection Operations.- Contaminant plumes located entirely Within a land surface area not to
exceed 10,000 square feet. For tracer tests in uncontaminated areas the area of influence of the injection well(s)shall
be entirely within a land surface area not to exceed 10,000 square feet_ An individual Permit shall be required for
test or treatment areas exceeding 10,000 square feet.
3) pilot Tests-Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation,and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater,
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
GATE: May 21 , 2012 PERMIT NO. (to be filled in by DWQ)
A. WELL TYPE TO OE CONSTRUCTIED OR OPERATED
(1) Air Injection Well..................... ................Complete sections B-F,K,N
(2) Aquifer Test Well.......................................Complete sections B-F,K,N
(3) X Passive Injection System...............................complete sections B-F,H-N
(4) Small-Scale Injection Operation......................Complete sections B-N
(5) Pilot Test.................................................Complete sections B-N Q
(6) Tracer Injection Well...................................Complete sections B-TREGEIVC I
G�IDENRJDW
D. STATUS OF WELL OWNER: Choose an item.
AUG 0 3 2012
pquifet protectton Sed"11
C. WELL OWNER— State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: Charles Waltz
Mailing Address:BASF Corporation,100 Park Ave.
City: Florham Park State:—NJ—Zip Code: 07932 County:Morris
Day Tole No.: [phone] _ Cell No.:
EMAIL Address:charles.waltz@basfcom Pax No.: [phone]
GPUIUIC/GWR Notification(Revised 4/26/2012) Pago 1

08-08-'12 12:37 FROM-NC DENR P&S 9197150684 T-654 P005/025 F-518
)d. PROPERTY OWNER(if different than well owner)
Name: NB1te Ball
Mailing Address:LaGrace Properties,LLC,225 Sunny Way
City: Dandridge State: TN_Gip Code,37725 County:Jefferson
Day Tele No.; [phone] Cell No.: [phone]
EMAIL Address: mwballQComcast.net Fax No.: [phone]
E. PROJECT CONTACT-Person who can answer technical questions about the proposed injection project.
S
Name: .)toe M4) Keon
Mailing Address:ELM Site Solutions,980 Macintosh Dr.
City: Rochester State:NY�zip Code:14626_County:Monroe
Day Tele No.: 585 720-0362 Cell No.: [phone]
EMAIL Address:[e-mail] FaxNo.; 888-370-9057
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: Former BASF Manufacturing Facility,1110 Carbon City Road
County:Burke
City: Mor anton State:NC zip Code:_28655-7271
(2) Geographic Coordinates: Latitude*'": ° -` "or 3S_°.7328
Longitude": ° "or-81_0.748438
Reference Datum: Accuracy:
Method of Collection:
"FOR AIR INJECTION ANA AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIF-S MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TIRtAY'MENT AREA
Land surface area of contaminant plume: square feet(< 10,000 fe for small-scale
injections)
Land surface area of treatment area/radius of influence: square feet
Percent of contaminant plume area to be treated: (must be < 5% of plume for pilot test
injections)
H. INJECTION ZONE MAPS—Attach the following to the notification.
(1) Contaminant plume maps) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater,existing and proposed monitoring wells, and existing and
proposed injection wells;and
(2) Cross-section(s) to the known or projected depth of contamination that shove the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells,and existing and proposed injection wells.
GPU/UIC/GWRNotification(Revised 4/26/2012) Page 2

08-08-'12 12:38 FROM-NC DENR P&S 9197150684 T-654 P006/025 F-518
I. DESCRWHON OF PROPOSED INJECTION ACTI,'V•ITIES -Provide a brief narrative regarding the
purpose,scope,and goals of the proposed injection activity.
Two minimal areas of contamination will be treated by plating Regenesis ORC :Extended Socks In the
indicated wells (MW-2. MW-15 (Benzene): and MW-14 and AM-1 (Nitrosamine. Nitrosomorpholine).
The areas to be treated are in highly developed areas of the site with buildings, paved areas and
unde round utilities. The socks will be replaced once after the original socks are deployed for one Yenr
providine a total treatment period of two years. The goal of the project is to reduce concentrations
below the 2L standards.
J. INJECTAN•TS-Provide a MSDS and the following for each injectant.Attach additional sheets if necessary.
NOTE. Approved injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/web/wa/aps/gwpro. All other substances must be reviewed by the Division of Public
Health,Department of Health and Human Services. Contact the UICProgram for more info(919-807-6496).
Injectant: Re enesis ORC Advanced
Volume of injectant: Socks-well placement
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
Injectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
K WELL CONSTRUCTION DATA
(1) Number of injection wells: Proposed 4 Existing
(2) Provide well construction details for each injection well in adiagram or table format. A single
diagram or line in a table can be used for multiple wells with the same construction details. Well
construction details shall include the following:
(a) well type as permanent,direct-push,or subsurface distribution system(infiltration gallery)
(b) depth below land surface of grout,screen,and casing intervals
(c) well contractor name and certification number
GPClfWC/GWR Notification(itcvised 4/26/2012) Page 3

08-08-'12 12:38 FROM-NC DENS P&S 9197150684 T-654 P007/025 F-518
L. SCHEDULES—Briefly describe the schedule for well construction and injection activities.
Sock Placement-May/June/luly 20M Sock Replacement-Ma /dunelJul 2013
Socks will be placed in Monitoring Wells 1,2.14,and 115.
M. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
One well for each of the two locations was placed downuradient of the wells that will contain socks.
MW-12 and MW-18 will be monitored semiannually for the in sihc parameters de th to water, li
tern erature turbidity, conductivity, DO and ORP and also for volatiles Method 9260 and
semivolatiles[Method_8270)with the top ten TICS. _
N. CERTIFICATION(to be signed as required below or by that person's authorized agent)
1SA NCAC 02C.0211(e)requires that all permit applications shall be sig}ted as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3_ for a municipality or a state, federal,or other public agency: by either a principal executive officer or
ranking publicly elected official;
4. for all others: by the well owner;
5. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants then, signature authority, and is signed
and dated by the applicant.
"I hereby cert fy, under•penalty of law. that I have personally examined and ani familiar with the information
submitted in this document and all attachments thersto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there art,sign(want penalties, including the possibility q ftnes and imprisonment,
for submitting false inft»7rtation. I agree 10 constMcl, operale, maintain, repair, and if applicable, abandon
the injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Signature of pplicant print or Type Full Name
m p Blau Michael Bali
Signature of Property Owner(if different from applicant) Print or Type Pull Nome
Signature of Authorized Agent,if any Print or Type Full Name
d notification package to: r V»����a
Submit one copy of the complete pa g VVEN
AWQ-Aquifer Protection Section Nvs 0 3 �01�.
1636 Mail Service Center - ��etp'���� A
Raleigh,NC 27699-1636
Telephone! [phone] 1 Pax: (919)9076496
P+Qu
GPU/UfC/GWR Notification(Revised 4126/2012) Pago4

08-08-'12 12:38 FROM-NC DENR P&S 9197150684 T-654 P008/025 F-518
L. SCHEDULES—Briefly describe the schedule for well construction and injection activities.
Sock Placement-Ma /JuneAfu1 2012• Sock Replacement-MAY/June/July MAY/June/July 2013
Socks will be placed in Monitoring Wells 1,2,14,and 15.
M. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
One well for each of the two locations was laced down radicnt of the wells that will contain socks.
M'W-12 and MW-18 will be monitored seniiannually for the in situ parameters (depth to water, H
temperature, turbidily, conductivity, DO and ORP and also for volatiles (Method 8260 and
semivolatiles(Method 8270)with the top ten TICS.
N, CERTIFICATION(to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211(e)requires that all permit applications shall be signed as follows:
1, for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3. for a municipality or a state,federal, or other public agency: by either a principal executive officer or
ranking publicly elected official;
4_ for all others: by the well owner;
5, for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
`11 hereby certify, under penalty of law, that I have personally examined and am famillar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. 1 am awate that there are significant penalties, including the possibility offines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon
the injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Signatu a of ApWant print or Type Full Name
Michael Ball
Signature of property Owner(if different from applicant) Print or Type Full Name
Signature of Autharized Agent,if any Print or Type Full Name
Submit one copy of the completed notification package to: nr-pMCEIVEDIDENRIDWO
DWQ-Aquifer Protection Section AUG 0 3 2012
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone:[phone] Fair: [phone] AquiferProte�ion Section
GPU/U1C/GWR Notification(Revised 4126/2012) Page 4

- .08-08-'12 12:39 FROM-NC DENR P&S 9197150684 T-654 P009/025 F-518
BASF
The Chemical Company
ENVIRONMENTAL. SIGNATURE AUTHORIZATION
WHEREAS certain federal and state environmental laws require certain
permit applications, reports or related documents to be executed on behalf of a
Corporation by a Principle Corporate Officer or by an official having significant
policy or decision-making responsibility.
And, WHEREAS the Inactive Sites Manager is responsible for all
Corporate Inactive Sites and is an official having significant policy and decision-
making responsibilities within the company.
Now, therefore`I, Fried-,Walter.-Muenstermann, Executive Vice President
and Chief Financial Officer of the Finance Division of BASF Corporation on the
_day of February, 2011 do hereby authorize the Inactive Sites Manager to
execute any such permit applications, reports and related documents on behalf
of BASF Corporation.
Fried Walter Muenstermann
Executive Vice President
Chief Financial Officer
BASF Corporation
Notary/01ness
CAROL A.DIAZ
A Notary Public of Now Jersey
My O*mMisslon Expires June 16,2013
�C�Iu�DIDENRlDWQ
BASF Corporation AUG 0 ZOl2
100 Campus Drive
Florham Park N.J.07932
w (Soo)bee-1072 Aquifer Pmte*n%cWn
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08-08-'12 12:39 FROM-NC DENS P&S 9197150684 T-654 P010/025 F-518
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"0PSCWM3,r FrsM
vcFmwm
SM PICK MATUNAL: PVC
BOTTOM CF ys Frn%
T TALMM YT' FrBGL
-DE6-$e:k42WW(T0A.:RMn)V*G �'aaWe,
TYPE It WELL DIAGRAM
RECEIVEDIDENPJDWQ -
. AUG 0 3 2012 � - .
rW4,F:WrT0,SrAL
Aquifer Protection Section

08-08-'12 12:39 FROM-NC DENR P&S 9197150684 T-654 PO11/O25 F-518
SOME-GASMSKUTCRMWELL
LOCHMOMW
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f W6R.7N111r�i
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TYPE 11 WELL DIAGRAM
SCALP-N6TM SCALE.

08-08—'12 12:40 FROM—NC DENR P&S 9197150684 T-654 P012/025 F-518
SINGLE-CASED MONITOMNG ML.L
LOCIGNO WELL CAP
�- -- : Id*-- StEg.WUVAULT
MON I'MINGWELL W14
TOP OF CASING ELEVATION: IMAM
GROUT
i
CASING:
PVC
CASING MATERIAL SCI•IEDIS.E: 40
% INNER MANI f E-k-LO IN.
f
TOP OF SEN70NI'M 2 FT SOL
SENTONITE SEAL TOP OF SAND:-a,F7 DOL
TOP OF SCREEN: 2B' FT BGL
DEPTHTOVATEP-1 22.W
SCREEN TYPEi
dK SAND PACK MAT904 PVC
SCREDULE:�
� SLQTSI�E a,��o
---- SCREEN
.�.-. BOTTOM M SCREEN: ae FT BGL
TOTALVIELLDF.PTl1: 38 ET9GL
TYPE it V11ELL DIAGRAM
BASF INDUSTRIAL.COATINGS PLANT
+f=MFMT 1110 CARBON CITY ROAD
MORGAt`TON,NORTH CAROLINA
Site Solutions,Inc.
DATE.MAY 2011 SCALE:NOT TO SCALE

08-08-'12 12:40 FROM-NC DENR P&S 9197150684 T-654 P013/025 F-518
SINGLE-CASED MONITORING WELL
LOCI4NO WELLCAP
----91EaWF1LVAULT
f MONMR1NGWELL MVW-is
i
r 70P0rcM9QFIFVATION: 110092.
l
—GROUT ;
MA"I'EMAL• PVC
% CASING SCHEDULE 4040
INNERDIANIIETER: 20IN.
TOP OF BMMNCiE: 2 FT BGL
TOP OF SAW. 28 FT BGL
BE7Ct�FI'E SEAL
TOP OF SCREEN: 30 FT BGL
A h
IRPTFI TO WATER: 33655
scR�EN TYPE:
SAND PACK MATERIAL; PVC
SCHEDUM A
SLOTM 0.010
-- SCREEN
BOTTOM OF SCREEN: 40 FT BGL
TOTALWELLDEPTH:_.._.40 .F'PWL
TYPE !t WELL DIAGRAM
BASF INDUSTRIAL COATINGS PLANT
1110 CARMN CITY ROAD
+I=MrmT MORGANTON,NORTH CRROLINA
SII:ESolufiOns,Inc,
[SATE MAY 2011 SCALE:NOT TO SCALE

08-08-'12 12:40 FROM-NC DENS P&S 9197150684 T-654 P014/025 F-518
Oxygen Release Compound—Advanced(ORC Advanceiirm)
MATERIAL SAFETY DATA SHEET(MSDS)
Last Revised: March 13,2007
Section 1-Material Identification
Supplier:
REGENESIS
1011 Calle Sombra
San Clemente,CA 92673
Phone: [phone]
Fax: [phone]
E-mail: info@reg!enesis.com
Chemical A mixture of Calcium OxyHydroxide [CaO(OH)21 and
Description: Calcium Hydroxide[Ca(OH)21.
Chemical Family:- Inorganic Chemical
Advanced Formula Oxygen Release Compound
Trade Name:
(ORC AdvancedrIA)
Chemical Synonyms Calcium Hydroxide Oxide;Calcium Oxide Peroxide
Product Used to remediate contaminated soil and groundwater
Use: (environmental applications)
Section 2— Composition
CAS No. Chemical
682334-66-3 Calcium Hydroxide Oxide[CaO(0fl)z1
1305-62-0 Calcium Hydroxide [Ca(OH)21
7758-11-4 Dipotassium Phosphate(HK204P)
7778-77-0 Monopotassium Phosphate(H2K04P)
RECEIVED/DENRjDy j
AUG 0 3 2012
AquiferProte*n

08-08-'12 12:41 FROM-NC DENR P&S 9197150684 T-654 P015/025 F-518
Regenesis-ORC Advanced MSDS
Section 3—Physical Data
Form: Powder
Color: White to pale Yellow
Odor: Odorless
Melting Point: 527°F(275 °C)—Decomposes
Boiling Point: Not Applicable(NA)
Plammability/Plash NA
Point:
Auto-]Flammability: NA
Vapor Pressure: NA
Self-Ignition, NA
Temperature:
Thermal 527°F(275 °C)—Decomposes
Decomposition;
Bulk Density: 0.5—0.65 g/ml(Loose Method)
Solubility:'- 1.65 g/L @ 68-F(20°C)for calcium hydroAdc,
Viscosity: NA
PH: 11-13 (saturated solution)
Explosion Limits % Non-explosive
by Volume:
Hazardous
Decomposition Oxygen,Hydrogen Peroxide,Stearn,and Heat
Products;
Hazardous None
Reactions:

08-08-'12 12:41 FROM-NC DENS P&S 9197150684 T-654 P016/025 F-518
Regenesis-(SRC Advanced NBDS
Section 4-Reactivity Data
Stability: Stable under certain conditions(see below).
Conditions to Avoid: Heat and moisture.
Incompatibility: Acids, bases, salts of hearty metals, reducing agents, and
flammable substances,
Hazardous Does not occur.
Polymerization:
Section S--Regulations
TSCA. Inventory Listed
Dist:
CERCLA Hazardous Substance(40 CFR Part 302)
Listed Substance: No
Unlisted Substance: 'Yes
Reportable Quantity 100 pounds
(RQ):
Characteristic(s): Ignitibility
RCRA Waste D0a 1
Number:
SA.RA, Title III, Sections 302/303 (40 CFR Part 355 -Emergency Planning and
Notification)
Extremely
Hazardous No
Substance:
SARA, Title III, Sections 311/312 (40 CFR Part 370 -- Hazardous Chemical _ -
Reporting: Community Right-To-Know
Immediate Health Hazard
Hazard Category:
Fire Hazard
Threshold Planning 10,000 pounds
Quantity:

08-08-'12 12:41 FROM-NC DENR P&S 9197150684 T-654 P017/025 F-518
Regentesis-ORC Advanced MSDS
Section S—Regulations(cunt)
SARA, Title 111, Section 313 (40 C)E{R part 372 -- Toxic Chemical Release
Reporting: Community Right-To-Know
Extremely
Hazardous No
Substance:
WHMIS Oxidizing Material
Classification: C Poisonous and Infectious
Material
Material Causing Other Toxic
D Effects—
Eye and Skin Irritant
Canadian Domestic Not Listed
Substance List:
Section 6--Protective Measures,Storage and Handling
Technical protective
Measures
Storage: Keep in tightly closed container. Store in dry area, protected
from heat sources and direct sunlight.
Clean and dry processing pipes and equipment before
operation. Never return unused product to the storage
Handling: container. Keep away from incompatible products, Containers
.and equipment used to handle this product should be used
eXclasiveiy for this material., Avoid contact with water or
humidity.

08-08-'12 12:41 FROM-% DENS P&S 9197150684 T-654 P018/025 F-518
Regenesis-ORC Advanced MSDS
Section 6—Protective Measures, Storage and handling(cant)
Personal Protective Equipment(PPE)
Calcium Hydroxide
ACGITP TLV'(2000)
5 mg/m3 TWA
OSHA PEL
Engineering 'total dust-15 mg/m3 TWA
Controls:
Respirable fraction-
5 mg/m3 TWA
NIOSH REL(1994)
5 mg/m3
Respiratory For many conditions, no respiratory protection may be needed;
Protection: however, in dusty or unknown atmospheres use a NIOSH
approved dust respirator.
Hand Protection: Impervious protective gloves made of nitrile, natural rubbber
or neoprene.
Eye Protection: Use chemical safety goggles(dust proof).
For brief contact, fear precautions other than clean clothing are
Skin Protection: needed. Full body clothing impervious to this material should
be used during prolonged exposure.
Safety shower and eyewash stations should be present.
Other: Consultation with an industrial hygienist or safety manager for
the selection of PPE suitable for, working conditions is
suggested.
Industrial Hygiene: Avoid contact with skin and eyes.
Protection Against NA
Fire&Explosion:
Section 7—Hazards Identification
Emergency Oxidizer — Contact with combustibles may cause a tire, This
material decomposes and releases oxygen in a fire. The
Overview: additional oxygen may intensify the line,
Potential Health Irritating to the mucous membrane and eyes, If the product
Effects: splashes in ones face and eyes, treat the eyes first. Do not dry
soiled clothing close to an open flame or heat source. Any

08-08-'12 12:42 FROM-NC DENS P&5 9197150684 T-654 P019/025 F-518
Regenesis-ORC Advanced MSDS
clothing that has been contaminated with this product should
be submerged in water prior to drying.
High concentrations may cause slight nose and throat irritation
Inhalation: with a cough. There is risk of sore throat and nose bleeds if
one is exposed to this material for an extended period of time.
Eye Contact: Severe eye irritation with watering and redness. There is also
the risk of serious and/or permanent eye lesions.
Skin Contact: Irritation may occur if one is exposed to this material for
extended periods.
Ingestion: irritation of the mouth and throat with nausea and vomiting.
Section 8--Measures in Case of Accidents and Fire
After Collect in suitable containers. Wash remainder with copious
Spillage/Lealcagc/Gas Leakage: quantities of water.
Extinguishing
Media., See next.
Suitable: •barge quantities of water or water spray. In case of fire in
close proximity,all means of extinguishing are acceptable.
Self containedbreathing apparatus or approved gas mask
should be worn due to small particle size. Use extinguishing
Further Information: media appropriate for surrounding fire. Apply cooling water to
sides of transport or storage vessels that are exposed to flames
until the fire is extinguished. Do not approach hot vessels that
contain this product.
After contact with skin,wash immediately with plenty of water
)First Aid: and soap. In case of contact with eyes, rinse immediately with
plenty of water and seek medical attention. Consult an
opthalmologist in all cases.
Section S•-Measures in Case of Accidents and]Fire
Flush eyes with running water for 15 minutes, while keeping
Eye Contact: the eyelids wide open. Consult with an ophthalmologist in all
cases.
Inhalation: Remove. subject from dusty environment, Consult with a
physician in case of respiratory symptoms.

08-08-'12 12:42 FROM-NC DENR P&S 9197150684 T-654 P020/025 F-518
Regenesis-ORC Advanced MSDS
If the victim is conscious, rinse mouth and admnister fresh
Ingestion: water. DO NOT induce vomiting. Consult a physician in all
cases.
Wash affected skin with running water. Remove and clean
Skin Contact: clothing. Consult with a physician in case of persistent pain or
redness.
Evacuate all non-essential personnel. Intervention should only
Special Precautions: be done by capable personnel that are trained and aware of the
hazards associated with this product. When it is safe,
unaffected product should be moved to safe area.
Oxidizing substance. Oxygen released on exothermic
decomposition may support combustion. Confined spaces
Specific Hazards: and/or Containers may be subject to increased pressure. If
product comes into contact with flammables, fire or explosion
may occur.
Section 9—Accidental Release Measures
Observe the protection methods cited in Section 3. Avoid
Precautions: materials and products that are incompatible with product.
Immediately notify the appropriate authorities in case of
reportable discharge(> 100 lbs).
Collect the product with a suitable means of avoiding dust
formation. All receiving equipment should be clean; vented,
dry, labeled and made of material that this product is
Cleanup Methods: compatible with. Because of the contamination risk, the
collected material should be kept in a safe isolated place. Use
large quantities of water to clean the impacted aiea. See
Section 12 for disposal methods.
Section 10—Information on Toxicology
Toxicity Data
Oral Route,LD50, rat, >2,000 mg/kg(powder 50%)
Acute Toxicity: Dermal Route,LDso,rat,>2,000 mg/kg(powder 50%)
Inhalation,LD5o,rat,>5,000 mghn3(powder 35%)
Irritation: Rabbit(eyes),severe irritant

08-08-'12 12:42 FROM-NC DENR P&S 9197150684 T-654 P021/025 F-518
Regenesis ORC Advanced MSDS
Sensitization: No data
Chronic Toxicity: In vitro,no mutagenic effect(Powder 50%)
Target Organ Eyes and respiratory passages.
Effects:
Section II—Information on Ecology
Ecology Data
10 mg Ca(OH)2/L: pH=9.0
100 crag Ca(OH)2/L: pH= 10.6
Acute Exotoxicity: Fishes,Cyprinus carpio,LCso,48 hrs., 160 ing/L
Crustaceans,Daphnia sp.,EC50,24 hours, 25.6 mg/L
(Powder 16%)
Mobility: Low Solubility and Mobility
Water—Slow Hydrolysis.
Degradation products: Calcium Hydroxide
Abiotic Degradation: Water/soil W complexation/precipitation. Carbonates/sulfates
present at environmental concentrations.
Degradation products: carbonates/sulfates sparingly soluble
Biotic Degradation: NA(inorganic compound)
Potential for NA(ionizable inorganic compound)
Bioaccumulation:
Section 11—Information on Ecology(cant)
Observed effects are related to alkaline properties of the
product. Hazard for the environment is limited due to the
product properties of-
Comments: * No bioaccuznulation
Weak solubility and precipatation as carbonate or
sulfate in an aquatic environment.
Diluted product is rapidly neutralized at environmental pH.
)Further Information: NA

08-08-`12 12:43 FROM-NC DENS P&S 9197150684 T-654 P022/025 F-518
Regenesis-OHC Advanced MSDS
Section 12-Disposal Considerations
Waste Disposal Consult current federal, state and local regulations regarding
Method: the proper disposal of this material and its emptied containers.
Section 13--Shipping/Transport Information
D.O.T Shipping Oxidizing Solid,N.O.S [A mixture of Calcium OxyHydroxide
Name: [CaO(OH)2] and Calcium Hydroxide[C$(OH)Z].
UN lumber: 1479
Hazard Class: 5.1
Label(s): 5.1 (Oxidizer)
Packaging Group: 1I
STCC Number: 4918717
Section 14-Other Information
Hmle Rating Health-2 Reactivity- 1
Flammability-0 PPE-Required
HMISO is a registered trademark of the National painting and Coating Association.
NFPA®Rating Health-2 Reactivity- 1
Flammability 0 Ox
NFPA®is a registered trademark of the National Fire protection Association.
Reason for Issue: Update toxicological and ecological data
Section 15-Further)information
The information contained in this document is the best available to the supplier at
the time of writing, but is provided without warranty of any kind. Some possible
hazards have been determined by analogy to similar classes of material. The items in this document are subject to change and clarification as more information
become available.

08-08-'12 12:43 FROM-NC DENR P&S 9197150684 T-654 P023/025 F-518
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08-08-'12 12:43 FROM-NC DENR P&S 9197150684 T-654 P024/025 F-518
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08-08-'12 12;44 FROM-NC DENR P&S 9197150684 T-654 P025/025 F-518
ELEVATION(FEET ABOVE MSL)
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06-22-'12 11:39 FROM-NC D N3 P&S - 31 S'Z1.5 - 4 T-634 P001/007 F-487
iI eN 2 2�1 612 Centmi Files: APS,,,�, SWP
��
06/22/12
Permit Number W10100212 r{� - Rpninnni ngiclPer it Tracking Slip
Program Category L._._....'.rS�i�l -PPoke— -cti—On---,,it s Project Type
Deemed Ground Water Active New Project
Permit Type Version Permit Classification
Injection Deemed Air Wall 1.00 Individual
Primary Reviewer Permit Contact Affiliation
eric.g.smith Thomas W,Garrison III
Coastal SW Rule 625 Huntsman Ct
Gastonia NC 28054
Permitted Flow
Facility
Facility Name Major/Minor Region
Former Servco Facility No.01112 Minor Asheville
Location Address County
527 W Main St Rutherford
Forest City NC 28043 Facility Contact Affiliation
Owner
Owner Name Owner Type
Wilcohess LLC Non-Government
Owner Affiliation
Stephen T. Williams
5446 University Pkwy
Dates/Events Winston Salem NC 27105
Scheduled
Orig Issue App Received not Initiated Issuance Public Notice I ssua Effective Expiration
06/22/12 08/19/12 06/22/12 06/22/12
Regulated Activities
Groundwater rernedistion
Outfal€ NULL
Waterbody Name Stream Index Number Current Close Subbasin

06-22-'12 11:39 FROM-NC DENS P&S 9197150684 T-634 P002/007 F-487
VAL)I Uod ( J
NORTH CAROLIN'A VEPAXTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTINCATION OF WMNT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are"permitted by rule"and do not require an individual permit when consdructed in accordance
with the rules of I SA NC4C 02C_02aQ This form shall be submitted at least 2 weeks prior to construction.
AQUDZk TEST WELLS(15A NCAC 02C.0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
INSITU REN"IATION(isA NCAC o2C.o2n)or TRACER WELLS(15A N'CAC 02C.0229):
1) Passive Injection Systems-In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks,iSOC systems,and other gas infusion methods.
2) Small-� lea a Injection operations-Contaminant plumes located entirely within a land surface area not to
exceed 10,000 square feet. For tracer tests in uncontaminated areas the area of influence of the injection well(s)shall _
be entirely within a land surface area not to exceed 10,000 square feet. An individual permit shall be required for
test or treatment areas exceeding 10,000 square feet.
3) Pilot T . -�Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation,and where the
surface area of the injection zone wells are located within an area that does not exceed five,percent of the land
surface above the known extent of groundwater contamination- An individual permit shall W required to conduct
more than one pilot test on any separate groundwater contaminant plame.
4) Air Injection Wells-Used to inject ambient air to enhance in-situ treatment of soil or groundw'at r.
PrW Clearly or Type Information. Illegible Submittals Will Be RdurnedAs Incomplete. �„
DATE:May 29,2012 PERMTP NO. (to be filled in by DWQ) Z� a
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED n �? c�
(1) X Air Injection Well.............................
.........Complete sections B-F,IC,N �
(2} Aquifer Test Well.......................................Complete sections 13-F,IC,N
(3) Passive Injection System....................... .Complete sections B-F,H-N
(4) bull-Scale Injection Operation......................Complete sections B-N
(5) Pilot Test...................... . ....Complete sections 11 N
(6) Tracer Iti ection We ................ ..Complete sections B-NMCEilli� ! #U '}
�N 19
B. STATUS OF WELL OWNER: Choose an item.
Aquifer Protection Sectio17
C. WELL OWNER, State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name:WilcoHess, LLC
Mailing Address:5446 University Parkway
City:Winston-Salem State. NG Zip Code: 27105 County.Forsyth
Day Tele No.:[phone] Cell No.:
EMAIL Address:[e-mail] Fax No.: (336)767-628$
DWQ/UIC/In Situ Remcd.NoGfioation(Raviged 4/26/2012) Page 1

06-22-'12 11:39 FROM-11C DENS P&S 9197150684 T-634 P003/007 F-487
D. PROPERTY OWNER(if different than well owner)
Name:Wilcol-less, LLC
Mailing Address:544E University Parkway
City:Winston-Salem State: NC Zip Code:27105 County:Forsyth
Day Tele No.:[phone] Cell No.:
EMAIL Address:[e-mail] Fax No.;[phone]
E. PROJECT CONTACT-Person who can answer tccbnieal questions about the proposed injection project.
Name:Thomas W. Garrison, ill
Mailing Address:625 Huntsman Court
City;Gastonia State: NC Zip Code:28054 County:Gaston
Day Tele No.:[phone] Cell No.:[phone]
EMAIL Address:[e-mail] Fax No.:[phone]
V. POYSICA1C LOCATION OF WELL SITE
(1) Physical Address:527 West Main Street County:Rutherford
City:Forest City State: NC Zip Code:28043
(2) Geographic Coordinates_ Latitude**, 35.3398059"
Longitude": -81.87581516
Reference Datum: (Map Attached) Accuracy:-
Method of Collection:www.findlafftudeandiongitude.com
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY; A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY 138 SLMMIT rED 7N LIEU OF GEOGRAPHIC COORDINATES,
G. TREATMENT AW&A
Land surface area of contaminant plume: square feet(<10,000 fe for small-scale injections)
Land surface area of treatment area/radius of influence: square feet
Percent of contaminant plume area to be treated: —(must be<5%of plume for pilot test injections)
H. INJECTION ZONE MAPS-Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells,and existing and
proposed injection wells;and
(2) Cross-sections) to the known or projected depth of contarnination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells,and existing and proposed injection wells.
DWQiUlC//n Situ Remed.Notifieadon(Revised 4/26/2012) Page 2

06-22-'12 11:40 FROM-NC DENR P&S 9197150684 T-634 P004/007 F-487
1. DESCRIPTION OF PIROPOSED INUC'TION ACTIV7,TMS —Provide a brief narrative regarding the
purpose,scope,and goals of the proposed injection activity.
J. IN:IECTANTS—Provide a MS)3S and the following for each injectant.Attach additional sheets if necessary.
NOTE: Approved injectants (tracers and remediation additives) can be found online at
ho.,11 rtal.ncdenr.org/weh1wq/ans1 ro. All other substances must be reviewed by the Division of Public
Health,Department of Health and Human Services. Contact the VIC Program for more info(919-807-6496).
Tnjectant: _
Volume of injectant:
Concmtration at point of injection:
Percent if in a mixture with other injectants:
lnjectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
lnjectant:
Volume of injectant:
Concentration at point of injection:
Percent if in a mixture with other injectants:
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: Proposed:7 Existing:0
(2) Provide well construction details for each injection well in a diagram or table format. A single
diagram or line in a table can be used for multiple wells With the same construction details. Well
construction details shall include the following:
(a) well type as permanent; direct-push,or subsurface distribution system(infiltration gallery)
Well'Type: Permanent(Rotary Air)
(b) depth below land surface of grout,screen,and casing intervals
Total Depth- 45' bgl(Detail Attached)
Grout:0'-36' Screen:40'-45' Casing:0'410'
(c) well contractor name and certification number
Contractor: Rangier Environmental Drilling, Incorporated
Certification No.: 2501
DWQ/01Cdn SYtu Remd.Nodfication(keviscd 4/26/2012) Pap 3

06-22-'12 11:40 FROM-NC DENS P&S 9197150684 T-634 P005/007 F-487
L. SCIRXDY1LES—Briefly describe the schedule for well construction and injection activities.
M. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
N. C1LRTMCATION(to be signed as required below or by that person's authorized agem)
15A NCAC 02C.0211(e)requites that all permit applications shall be signed as follows:
I. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3. for a municipality or a state,federal,or other public agency: by either a principal executive officer or
ranking publicly elected official;
4. for all others: by the well owner;
S. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
"I hereby certify, under perWty of law, that I have personally examined and am familiar with the information
submitted in this docmnent and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility offrnes and imprisonment,
for submitting false information_ I agree to construct, operate. maintain, repair, and if applicable, abandon
t je n weJt,gnd re t w tenances in accordance with the ISr1 NCAC 02C 0200 Rules."
�9 Ao-- T lMwow s
Signature of Applicant fPrint or Typo Pull Name
Signature of property Owner(if different from applicant) print or Type Pull Name
Signature of Authorized Agent,if any Print or'Type pull Name
Submit one copy of the completed notification package to:
X]WQ-Aquifer Protection Section
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone: [phone] i Fax;[phone] Aquifer Protection section
DWQ/UIGIn Sion Remed.Notification(Revised 4/2612012) Page 4

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Central Files: APS SWP
07/03/13
Permit Number W10100253 Permit Tracking Slip
Program Category Status Project Type
Deemed Ground Water Active New Project
Permit Type Version Permit Classification
Injection Deemed Air Well 1.00 Individual
Primary Reviewer Permit Contact Affiliation
eric.g.smith Michael Gragg
Engineer
Coastal SW Rule 231 Haywood St
Asheville NC 28801
Permitted Flow
Facility
Facility Name Major/Minor Region
Smith's BP (Brush Creek)Site Minor Asheville
Location Address County
9222 US Hwy 25/70 Madison
Marshall NC 28753 Facility Contact Affiliation
Owner
Owner Name Owner Type
O A Gregory Inc Non-Government
Owner Affiliation
R J Plemmons
PO Box 158
Marshall NC 28753
Dates/Events
` % ,
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective .Expiration
07/03/13 07/01/13 07103/13 07/03/13
Regulated Activities
Groundwater remediation
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin

231 HAYWOOD STREET, ASHEVILLE, NC 28.801
TEL.[phone] FAC.828.281.3351
W WW.ALTAMONTKNV1RONMZNTAL.COM
June 25, 2013
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Aquifer Protection Section
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Subject: Notification of Intent to Construct or Operate Injection Wells
Smith's BP(Brush Creek)Site
Incident Number 28370
Dear Sir or Madam,
On behalf of 0.A. Gregory, Inc.,Altamont Environmental, Inc. (Altamont) is submitting a Notification of Intent
to Construct or Operate Injection Wells for the above mentioned property. The injection wells are being used
as part of an air sparge/soil vapor extraction system in accordance with the Corrective Action Plan for the
Smith's BP(Brush Creek)site(Incident number 28730),submitted by Christopher Gilbert on August 2, 2011
and approved by Dan Murphy of the North Carolina Department of Environment and Natural Resources
(DENR), Underground Storage Tank(UST)Section on August 25, 2011.
Thank you for your time and consideration on this project. Please feel free to call or respond with any
questions or comments.
Sincerely,
ALTAMONT ENVIRONMEN AL, INC.
Christ pher Gilbert, P.E.
Attachments: Notification of Intent to Construct or Operate Injection Wells
Table 1:Air Sparge Construction Details
cc: Mr. R.J. Plemmons,0.A.Gregory, Inc. RECEIVED IDEN O
Mr. Dan Murphy, DENR UST Section
Agder Protection Sewn
P:\Oagregory\Smith's BP\Correspondence\Ltr-NOI To Operate Injection Wells Cover Letter.Docx

.. y
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule"and do not require an individual permit when constructed in accordance
with the rules of.15A NCAC 02C.0200. This form shall be submitted at least 2 weeks prior to construction.
AQUIFER TEST WELLS(15A NCAC 02C,0227)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITUREMEDIATION(15A NCAC 02C.0225)or TRACER WELLS(15A NCAC 02C.0229):
1) Passive Injection Systems - In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems,and other gas infusion methods.
2) Small-Scale Injection Operations—Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation,and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: June 20, 2013 PERMIT NO. (to be filled in by DWQ)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) X Air Injection Well......................................Complete sections B-F,K,N
(2) Aquifer Test Well.......................................Complete sections B-F,K,N
(3) Passive Injection System...............................Complete sections B-F,H-N
(4) Small-Scale Injection Operation.......................Complete sections B-N
(5) Pilot Test.................................................Complete sections B-N
(6) Tracer Injection Well...................................Complete sections B-N
B. STATUS OF WELL OWNER: Business/Organization
C. WELL OWNER — State name of entity and name of person delegated authority to sign on behalf of the
business or agency:
Name: O.A.Gregory, Inc.,R.J.Plemmons
Mailing Address: P.O.Box 158
City: Marshall State: NC Zip Code: 28753 County: Madison
Day Tele No.: [phone] Cell No.:
EMAIL Address:greeoryoilna.charter.net Fax No.: [phone]
DWQ/UIC/In Situ Remed.Notification(Revised 7/9/2012) Page 1

D. PROPERTY OWNER(if different than well owner)
Name: Same as applicant
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT-Person who can answer technical questions about the proposed injection project.
Name: Michael Gragg
Mailing Address: 231 Haywood St
City: Asheville State: NC Zip Code: 28801 County: Buncombe
Day Tele No.: _828-281-3350 Cell No.: 615-521-1504
EMAIL Address: [e-mail] Fax No.: 828-28.1-3351
F. PHYSICAL LOCATION OF WELL SITE
(1) Physical Address: 9222 US Highway 25/70
County: Madison
City: Marshall State:NC Zip Code: 287 3
(2) Geographic Coordinates: Latitude": N350 50' 19"or_°.
Longitude": W820 42' 58"or_0.
Reference Datum: NAD83 Accuracy: +/-9.8 feet
Method of Collection: Trimble GeoHX 2005 series
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: NA square feet
Land surface area of inj.well network: NA square feet L 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: NA (must be< 5%of plume for pilot test injections)
H. INJECTION ZONE MAPS—Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells,and existing and
proposed injection wells;and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells,and existing and proposed injection wells.
DWQ/UIC/In Situ Remed.Notification(Revised 7/9/2012) Page 2

I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES —Provide a brief narrative regarding the
purpose,scope,and goals of the proposed injection activity.
NA
J. INJECTANTS—Provide a MSDS and the following for each injectant.Attach additional sheets if necessary.
NOTE: Approved injectants (tracers and remediation additives) can be found online at
httn•//portal ncdenr.org/web/wg/aps/gwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the UIC Program for more info(919-807-6496).
Injectant: NA
Volume of injectant: NA
Concentration at point of injection: NA
Percent if in a mixture with other injectants: NA
Injectant: NA
Volume of injectant: NA
Concentration at point of injection: NA
Percent if in a mixture with other injectants: NA
Injectant: NA
Volume of injectant: NA
Concentration at point of injection: NA
Percent if in a mixture with other injectants: NA
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: Proposed 7 Existing
(2) Provide well construction details for each injection well in a diagram or table format. A single
diagram or line in a table can be used for multiple wells with the same construction details. Well
construction details shall include the following:
(a) well type as permanent,direct-push,or subsurface distribution system(infiltration gallery)
(b) depth below land surface of grout,screen,and casing intervals
(c) well contractor name and certification number
DWQ/UIC/In Situ Remed.Notification(Revised 7/9/2012) Page 3

L. SCHEDULES—Briefly describe the schedule for well construction and injection activities.
NA
M. MONITORING PLAN—Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
NA
N. CERTIFICATION(to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211(e)requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or
ranking publicly elected official;
4. for all others: by the well owner;
5. for any other person authorized to act on behalf of the applicant: documentation shall be submitted
with the notification that clearly identifies the person, grants them signature authority, and is signed
and dated by the applicant.
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. 1 am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon
the injection well and all related appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Signature of A icant Print or Type Full Name
!e n1 tyy ,Js
Signature of Property Owner(iftliffeveirt fient applien ) Print or Type Full Name
Signature of Authorized Agent,if any Print or Type Full Name
Submit one copy of the completed notification package to:
DWQ-Aquifer Protection Section
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone: [phone] Fax: [phone]
DWQ/UIC/In Situ Remed.Notification(Revised 7/9/2012) Page 4

Table 1
Air Sparge Construction Details
Smith's BP(Brush Creek)
Marshall, North Carolina
Well ID Date Drilled Well Type Casing Total Depth Casing Screened Sand Filter BentoniteGrout
Interval Interval Pack Seal
AS-1 2/6/2012 . Permanent PVC Schedule 40 23 0-18 18-23 17-23 13-17 2-13
AS-2 2/6/2012 Permanent PVC Schedule 40 35 0-30 30-35 29-35 27-29 2-27
AS-3 2/7/2012 Permanent PVC Schedule 40 24 0-19 19-24 18-24 16-18 2-16
AS-4 2/7/2012 Permanent PVC Schedule 40 33 0-28 28-33 27-33 23-27 2-23
AS-5 2/7/2012 Permanent PVC Schedule 40 25 0-20 20-25 19-25 17-19 0-17
AS-6 2/7/2012 Permanent PVC Schedule 40 28 0-23 23-28 22-28 18-22 2-18
AS-7 1 2/6/2012 1 Permanent I PVC Schedule 40 25 0-20 20-25 19-25 15-19 2-15
Notes
1. All measurements are in feet below ground surface(ft-bgs).
2. All well screens contstructed of.010-inch slotted PVC.
3. All sand filter packs composed of 20-40 fine silica sand.
4. Wells constructed by Geologic Exploration, Inc.,certification number 2581.
P:\OAGregory\Smith's BP\CAP\AS-SVE System Design\AS SVE Construction Details.xls