WI0400615_Notification of Intent (NOI) – GW Remediation_20240221

NC Department of Environmental Quality (DEQ) —Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are `permitted by rule"and do not require an application to be submitted and an individual permit
be issued when constructed in accordance with the rules of I5A NCAC 02C.0200(NOTE: This form must be
received at least 14 DAYS prior to infection)
GROUNDWATER(GW)REMEDIATION INJECTION PERMIT TYPES:
(1)IN-SITU GW REMEDIATION PERMIT TYPE (15A NCAC 02C.0225)
• In-Situ Passive Injection Systems-In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks,iSOC systems,and other gas infusion methods(Note:Injection Event Records(IER)do not need to be
submitted for replacement of each sock used in ORC systems).
• In-Situ Small-Scale Injection Operations—Injection wells located within a land surface area not to exceed 10,000
square feet(SF)for the purpose of soil or groundwater remediation or tracer tests.If area to be treated exceeds 10,000
SF do not use this NOI;an injection Permit application shall be submitted,and a Permit issued per 15A NCAC
02C.0225(f).
• In-Situ Pilot Tests-Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy to develop a full-scale remediation plan for future implementation,and where the surface area of
the injection zone wells is located within an area that does not exceed five percent of the land surface above the known
extent of groundwater contamination. Also,if pilot test is going to be conducted on separate groundwater
contaminant plumes do not use this NOI; a Permit application shall be submitted,and a Permit issued as per
15A NCAC 02C.0225(f).
• In-Situ Thermal(IST)—IST wells `heat' contaminated groundwater in-situ to enhance remediation.
(2)AIR INJECTION PERMIT TYPE(15A NCAC 02C.0225)
These permit types are used to inject ambient air to enhance treatment of soil or groundwater.
(3)TRACER WELL PERMIT TYPE(15A NCAC 02C.0229)
These permit types are used to inject substances for determining hydrogeologic properties of aquifers.
(4)AQUIFER TEST PERMIT TYPE(15A NCAC 02C.0220)
These permit types are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
DATE: February 15 ,20 24 NOI TRACKING NO. WI0400615 (To be filled in by DWR)
DIRECTIONS- Submit this NOI only for(1)New deemed`permitted by rule' injection project or(2)If there is going
to be a different permit!ype(listed above)used for a previously issued NOI.
NOTE-After this NOI is processed and acknowledged,any supplemental or additional injections still meeting the
criteria referenced in Section G below shall be reported using Injection Event Records(IERs)and using the NOI
tracking number provided by DWR.
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well....................................... Complete sections B through F,J,M
(2) Aquifer Test Well....................................... Complete sections B through F,J,M
(3) X_Passive Injection System............................... Complete sections B through F,H-M
(4) Small-Scale Injection Operation...................... Complete sections B through M
(5) Pilot Test................................................. Complete sections B through M
(6) Tracer Injection Well................................... Complete sections B through M
(7) In-Situ Thermal(IST)Well........................... Complete sections B through M
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 1

B. STATUS OF WELL OWNER: State Government
C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): NCDEQ-DWM,UST Section,Federal& State Lead Program,Attn: Liz Price
Mailing Address: 127 Cardinal Drive Ext.
City: Wilmington State: NC Zip Code: 28405 County:New Hanover
Day Tele No.: 910-796-7401 Cell No.: NA
EMAIL Address: Liz.price(a)deq.nc.gov Fax No.: 910-350-2004
D. PROPERTY OWNER(S)(if different than well owner/applicant)
Name and Title: John and Faye Cooper,Property Owner
Company Name Mast General Store
Mailing Address: PO Box 417
City: Valle Crucis State: NC_Zip Code: 28691 County: Watauga
Day Tele No.: 828-963-6511 Cell No.: NA
EMAIL Address: NA Fax No.: NA
E. PROJECT CONTACT(Typically Environmental Consulting/Engineering Firm)
Name and Title: Flora D'Souza,Environmental Project Scientist II
Company Name WithersRavenel,Inc.
Mailing Address: 115 Mackenan Drive
City: Cary State: NC_Zip Code: 27511 County:Wake
Day Tele No.: 919-678-3830 Cell No.:
EMAIL Address: fdsouzagwithersravenel.com Fax No.: 919-467-6008
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name&Address: Mast General Store—3565 NC Hwy 194 South,Incident#19273
City: Sugar Grove County:Watauga Zip Code: 28679
(2) Geographic Coordinates: Latitude": 36.2102430
Longitude": -80.781751'
Reference Datum: Google Earth Accuracy: +/-5m
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
Land surface area of inj.well network: square feet(< 10,000 ftz for small-scale injections)
Percent of contaminant plume area to be treated: (must be<5%of plume for pilot test injections)
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 2

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.
(3) Potentiometric surface map(s)indicating the rate and direction of groundwater movement,plus existing
and proposed wells.
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE —Provide a brief narrative
regarding the cause of the contamination,and purpose, scope,goals of the proposed injection activity:
Purpose:The purpose of the passive injection(installation of a Provect-OX2 In Situ Chemical Oxidation(ISCO)
sleeve)in MW-1R is to further reduce dissolved phase contaminants(BTEX)concentrations to values below the
NC 2L Standard to reach site closure.
Scope: The scope of this passive injection event will be to install one 3-ft Provect-OX2 sleeve into MW-IR.The
sleeve will remain in place until the site is sampled in September 2024(approximately 6 months).
Goals: The goal of using the Provect-OX2 sleeves is to further reduce the BTEX concentrations in,groundwater
in the vicinity of MW-1R over an approximate 6-month period.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: Proposed 1 Existing(provide NC Well
Construction Record(GW-1)for each well)
(2) Appx. injection depths(BLS):_10-ft BGS
(3) For Proposed wells or Existing wells not having GW-Is,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(indicate if construction is proposed or as-built):
(a) Well type as permanent,Geoprobe/DPT,or subsurface distribution infiltration gallery
(b) Depth below land surface of casing,each grout type and depth, screen,and sand pack
(c) Well contractor name and certification number
K. INJECTION SUMMARY
NOTE: Only injectants approved by the epidemioloy section of the NC Division ofPublic Health,Department
of Health and Human Services can be injected. Approved iniectants can be found online at
http:Hdeq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/,ground-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
Contact the UIC Projram for more info if you wish to approval for a different additive. However,please
note it may take 3 months or longer. If no injectants are to be used use N/A.
Injectant: Provect-OX2 ISCO Sleeves Total Amt.to be injected(gal)/event: One 3-ft sleeve
Injectant: Total Amt.to be injected(gal)/event:
Injectant: Total Amt.to be injected(gal)/event:
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 3

Injectant: Total Amt.to be injected(gal)/event:
Injectant: Total Amt.to be injected(gal)/event:
Total Amt.to be injected(gal/event):
No.of separate injection events: Total Amt.to be injected(gal):
Source of Water(if applicable):
L. 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.
WR will advise the NCDEO incident manager that the sleeves should be removed in September 2024 and the
site should be re-sampled following the removal of the sleeves.
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: `I hereby certify, under penalty of law, that I 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. 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."
AW10- Flora D'Souza,Environmental Project Scientist II
Signature of Applicant Print or Type Full Name and Title
Property Owner(if the property is not owned by the Well Owner/Applicant):
"As owner of the property on which the injection well(s)are to be constructed and operated,I hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(I5A NCAC 02C.0200)."
"Owner"means any person who holds the fee or other property rights in the well being constructed.A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
See Attached Agreement
Signature*of Property Owner(if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Please send 1 (one)hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least
two(2)weeks prior to injection to:
DWR—UIC Program
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 4

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WASTE MANAGEMENT
MICHAEL F. EASLEY, GOVERNOR NCDENR!���
William G. Ross SECRETARY NOTM C nOLI DEP. .Ew of
Jr., FwviranwwWwr nNa . ., Riw­
Dexter R. Matthews, DIRECTOR
UNDERGROUND STORAGE TANK SECTION
Date „
Post-it®Fax Note 7671 5 7 pages►
Herb Berger To m
Hydrogeoiogist
DWM UST Section ca.roept!- Co. — (A- S
1637 Mail Service Ctr Phone# c r Phone# rr;
Raleigh, NC 27699-1637 Fax# Fax
RE: Mast General Store
Hwy 194
Valle Crucis, Watauga County, NC Na
DWM Incident# 19273c.n„� w
Dear Mr. Berger:
I am/We are the owner(s)of a parcel of property, located at or near the incident in question,and hereby
permit the Department of Environment and Natural Resources(Department)or its contractor to enter upon said
property for the purpose of conducting an investigation of the groundwaters under the authority of G.S. 143-
215.3(a)2.
I am/We are granting permission with the understanding that:
1. The investigation shall be conducted by the UST Section of the Department's Division of Waste
Management or its contractor.
2. The costs of construction and maintenance of the site and access shall be borne by the Department or its
contractor. The Department or its contractor shall protect and prevent damage to the surrounding lands.
3. Unless otherwise agreed, the Department or its contractor shall have access to the site by the shortest
feasible route to the nearest public road. The Department or its contractor may enter upon the land at
reasonable times and have full right of access during the period of the investigation.
4. Any claims which may arise against the Department or its contractor shall be governed by Article 31 of
Chapter 143 of the North Carolina General Statutes,Tort Claims Against State Departments and Agencies,
and as otherwise provided by law.
5. The information derived from the investigation shall be made available to the owner upon request and is
a public record, in accordance with G.S. 132-1. ,
DIVISION OF WASTE MANAGEMENT/UST SECTION
1637 MAIL SERVICE CENTER, RALEIGH, NORTH CAROLINA 27699-1637
PHONE: [phone] FAx: [phone]
INTERNET: http://www.wastenot.enr.state.ne.us
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER-50%RECYCLED11 O%POST-CONSUMER PAPER

b. The activities to be carried out by the Department or its contractor are for the primary benefit of the
Department and of the State of North Carolina. Any benefits accruing to the owner are incidental.
The Department or its contractor is not and shall not be construed to be an agent, employee, or
contractor of the landowner.
I/We agree not to interfere with, remove,or in any way damage the Department's well(s)or its
contractor's well(s)and equipment during the investigation. /
?r We- -iAA,+ Sincerely,/ `e�u �p� n� bIvc� GGcS7'r)Yl+�A-�[ e5S
d''
L.
Sign re
J O{1 h! C . C.00I�✓ .�.
Type/Print Name of Owner or
�43- 4Pt
Phone Number
-7/
Address
VA �e Cr cx.i 5 �C 2 s6w
City/State/Zip Code
ate

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SUMMARY OF GROUNDWATER ANALYTICAL RESULTS
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�Ja MW-1 R 8/16/2023 <1.000 360 543 62.3 75.2 629 1,200 666 337 3,330 3,670 Q
MW-2 8/16/2023 12.8 <U.5U0 <0.500 <0.500 <0.500 <U.SUU <U.SUU <0.500 <0.500 <1.UU U.SUU 2
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FB-1 8/16/2023 <10 <0.500 <0.500 <0.500 <0.500 <0.500 <0.500 <0.500 <0.500 <1.00 <0.500 LU CV
NC 2L Standard 6,000 1 600 70 70 600 400 400 500 500 500 C) cl�
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NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 2856-A
1.WELL CONTRACTOR: d. TOP OF CASING IS 0 FT.Above Land Surface'
Keith A. SDeece 'Top of casing terminated atlor below land surface may require
Well Contractor(Individual)Name a variance in accordance with 15A NCAC 2C 0118,
Carolina Soil Investigations. LLC e. YIELD(gpm) n/a METHOD OF TEST n/a
Well Contractor Company Name
132 Gurney Rd. f. DISINFECTION:Type n/a Amount n/a
Street Address g. WATER ZONES(depth):
Olin N.C. 28660 Top n/a Bottom n/a Top Bottom
City or Town State Zip Code Top Bottom Top Bottom
(704 ) 539-5279 Top Bottom Top Bottom
Area code Phone number Thickness/
2.WELL INFORMATION: 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0 Bottom 3 Ft. 2" sch 40 Svc
OTHER ASSOCIATED PERMIT#(if applicable) Top Bottom Ft.
SITE WELL ID#(if applicable) MW-IR
Top Bottom Ft.
3.WELL USE(Check One Box)Monitoring V Municipal/Public 8. GROUT. Depth Material Method
Industrial/Commercial❑ Agricultural❑ Recovery- Injection C Top 0 Bottom 1 Ft- Portland pour
Irrigation❑ Other❑ (list use) Top 1 Bottom 2 Ft. Bentonite tremie
DATE DRILLED 04/22/2015 Top Bottom Ft.
4.WELL LOCATION: 9. SCREEN: Depth Diameter Slot Size Material
3565 NC HWy 194 South Top 3 Bottom 12 Ft. 2" in. 010 in. pvC
(Street Name.Numbers Community,Subdivision,Lot No.Parcel Zip Code) Top Bottom Ft. In. In.
CITY: Valle Cruis COUNTY Watauaa Top Bottom Ft in. in.
TOPOGRAPHIC/LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat EiRidge ❑Other 10.SAND/GRAVEL PACK:
Depth Size Material
LATITUDE 36 "DMS OR 36.21018 DID
Top 2 Bottom 12 Ft. 10/30 silica sand
LONGITUDE 81 "DMS OR 81.78183 DD
Top Bottom Ft.
Latitude/longitude source: BPS OTopographic map Top Bottom Ft.
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS) 11. DRILLING LOG
5.FACILITY(Name of the business where the well is located.) Top Bottom Formation Description
Mast General Store /
Facility Name Facility ID#(if applicable) /
-965 NC Hwy 194 So11th /
Street Address /
Valle CrLlis NC /
City or Town State Zip Code /
Camino (Rrandnn CLIIhPrsnn) /
Contact Name /
7606 Whitehall FXPctItIVP Center Dr_ Suite 80D /
Mailing Address /
Charlotte NC 28.273 /
City or Town State Zip Code 12.REMARKS:
Area code Phone number
6.WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C.WELL CONSTRUCTION STANDA S.AND THAT A COPY OF THIS
RECOIL EEN PROVIDED JOTHE WE WNER.
a. TOTAL DEPTH: 12
b. DOES WELL REPLACE EXISTING WELL? YES NO:y/ 04/22/15
SIGNATURE OF CERTIFIED LL CONTR C R DATE
c. WATER LEVEL Below Top of Casing: n/a FT Keith A. SnppCP
(Use"+"if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Form Rev.2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

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EN VIRONMENTAI PRODUCTS'
Page 1/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Product identifier
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
Application of the substance/the mixture
In situ and ex situ chemical oxidation of contaminants and compounds of concern for environmental
remediation applications.
Details of the supplier of the safety data sheet
Manufacturer/Supplier: Emergency Number.
Provectus Environmental Products, Inc. Call CHEMTREC
PO Box 358 Toll Free: 1-800-424-9300/[phone]
Freeport, IL 61032 CCN 1010557
Phone: [phone] For Hazardous Materials Incident (Spill, Leak,
Fax: [phone] Fire, Exposure, or Accident)
www.provectusenvironmental.com
Classification of the substance or mixture
Flame over circle
May intensify fire-, oxidizer.
- - - - - - - - - - - - - - - - - - - - - -
Health hazard
May cause allergy or asthma symptoms or breathing
difficulties if inhaled.
1
•
Harmful if swallowed.
Harmful if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause an allergic skin reaction.
May cause respiratory irritation.
Label elements
GHS label elements
The product is classified and labeled according to the Globally Harmonized System (GHS).
Hazard pictograms
<t< >< >
GHS03 GHS07 GHS08
(Contd.on page 2)

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EN VIRONMENTAI PRODUCTS'
Page 219
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 1)
Signal word Danger
Hazard-determining components of labeling:
disodium peroxodisulphate; sodium persulfate
Hazard statements
May intensify fire; oxidizer.
Harmful if swallowed or if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause allergy or asthma symptoms or breathing difficulties if inhaled.
May cause an allergic skin reaction.
May cause respiratory irritation.
Precautionary statements
Take any precaution to avoid mixing with combustibles.
Keep away from heat/sparks/open flames/hot surfaces. - No smoking.
In case of inadequate ventilation wear respiratory protection.
Keep/Store away from clothing/combustible materials.
Avoid breathing dust/fume/gas/mist/vapors/spray.
Use only outdoors or in a well-ventilated area.
Wear protective gloves/protective clothing/eye protection/face protection.
Wash thoroughly after handling.
Do not eat, drink or smoke when using this product.
Contaminated work clothing should not be allowed out of the workplace.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to
do. Continue rinsing.
Specific treatment(see on this label).
Take off contaminated clothing and wash before reuse.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
Wash contaminated clothing before reuse.
IF INHALED: If breathing is difficult, remove victim to fresh air and keep at rest in a position comfortable for
breathing.
If skin irritation occurs: Get medical advice/attention.
If skin irritation or rash occurs: Get medical advice/attention.
If eye irritation persists: Get medical advice/attention.
Rinse mouth.
In case of fire: Use for extinction: CO2, powder or water spray.
IF SWALLOWED: Call a POISON CENTER/doctor if you feel unwell.
IF ON SKIN: Wash with plenty of water.
Call a POISON CENTER/doctor if you feel unwell.
If experiencing respiratory symptoms: Call a POISON CENTER/doctor.
Store locked up.
Store in a well-ventilated place. Keep container tightly closed.
Dispose of contents/container in accordance with local/regional/national/international regulations.
Classification system:
NFPA ratings (scale 0-4)
Health = 2
2 Fire = 3
Ox Reactivity= 2
The s bstance possesses oxidizing properties.
(Contd.on page 3)

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EN VIRONMENTAI PRODUCTS'
Page 319
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name: Buffered Provect-OX211" Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 2)
HMIS-ratings (scale 0-4)
2 Health = *2
s Fire = 3
REACTIVITY Reactivity= 2
Chemical characterization: Mixtures
Description: Mixture of the substances listed below with nonhazardous additions.
Dangerous components:
7727-21-1 Potassium peroxodisulfate; potassium persulfate 50-70%
*Ox. Sol. 2, H272; 40 RResp. Sens. 1, H334; Acute Tox. 4, H302; Acute Tox. 4, H332;
Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
7775-27-1 Disodium peroxodisulphate; sodium persulfate 20-30%
©Ox. Sol. 2, H272; A-V Resp. Sens. 1, H334; 0 Acute Tox. 4, H302; Acute Tox. 4,
H332; Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
1309-37-1 Ferric oxide 1-20%
n.a. Terr-ORTm buffer and ferrate stabilizer(see associated SIDS) 0-5%
Description of first aid measures
General information:
Symptoms of poisoning may even occur after several hours; therefore medical observation for at least 48
hours after the accident.
After inhalation:
Supply fresh air and to be sure call for a doctor.
In case of unconsciousness, place patient securely on side position for transportation.
After skin contact: Immediately wash with water and soap and rinse thoroughly.
After eye contact: Rinse opened eye for several minutes under running water. Then consult a doctor.
After swallowing: Immediately call a doctor.
Most important symptoms and effects, both acute and delayed No further relevant information available.
Indication of any immediate medical attention and special treatment needed
No further relevant information available.
Extinguishing media
Suitable extinguishing agents:
CO2, extinguishing powder or water spray. Fight larger fires with water spray or alcohol resistant foam.
Special hazards arising from the substance or mixture No further relevant information available.
Advice for firefighters
Protective equipment: Mouth respiratory protective device.
Personal precautions,protective equipment and emergency procedures Not required.
Environmental precautions: Do not allow to enter sewers/surface or ground water.
Methods and material for containment and cleaning up:
Dispose contaminated material as waste according to section 13.
Ensure adequate ventilation.
Reference to other sections
See Section 7 for information on safe handling.
See Section 8 for information on personal protection equipment.
See Section 13 for disposal information.
(Contd.on page 4)

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EN VIRONMENTAI PRODUCTS'
Page 419
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 3)
Precautions for safe handling
Thorough dedusting.
Ensure good ventilation/exhaustion at the workplace.
Prevent formation of dust.
Information about protection against explosions and fires: Protect from heat.
Conditions for safe storage, including any incompatibilities
Storage:
Requirements to be met by storerooms and receptacles: No special requirements.
Information about storage in one common storage facility: Not required.
Further information about storage conditions:
Keep receptacle tightly sealed.
Protect from heat and direct sunlight.
Specific end use(s) No further relevant information available.
Additional information about design of technical systems: No further data; see section 7.
Control parameters
Components with occupational exposure limits:
7727-21-1 Potassium peroxodisulfate
TLV Long-term value: 0.1 mg/m3
as Persulfates
7775-27-1 Disodium peroxodisulphate
TLV Long-term value: 0.1 mg/m3
as Persulfates
1309-37-1 Ferric oxide
PEL Long-term value: 10 mg/m3
Fume
REL Long-term value: 5 mg/m3
Dust&fume, as Fe
TLV Long-term value: 5* mg/m3
*as respirable fraction
Additional information:The lists that were valid during the creation were used as basis.
Exposure controls
Personal protective equipment:
General protective and hygienic measures: Keep
away from foodstuffs, beverages and feed. Immediately
remove all soiled and contaminated clothing. Wash hands
before breaks and at the end of work.
Breathing equipment: Not required.
Protection of hands:
(3
Protective gloves
The glove material has to be impermeable and resistant to the product/the substance/the preparation.
Due to missing tests no recommendation to the glove material can be given for the product/ the preparation/
the chemical mixture.
Select glove material based on penetration times, rates of diffusion and degradation.
(Contd.on page 5)

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EN ViRON MENTAI FRODVCTS'
Page 5/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 4)
Material of gloves
The selection of the suitable gloves does not only depend on the material, but also on further marks of quality
and varies from manufacturer to manufacturer. As the product is a preparation of several substances, the
resistance of the glove material cannot be calculated in advance and has therefore to be checked prior to the
application.
Penetration time of glove material
The exact break-through time has to be determined and observed by the manufacturer of the protective
gloves.
. . . -
Information on basic physical and chemical properties
General Information
Appearance:
Form: Powder
Color: Red
Odor: Odorless
Odor threshold: Not determined.
pH-value @ 20 °C(68 °F): 6
Change in condition
Melting point/Melting range: Not determined.
Boiling point/Boiling range: Undetermined.
Flash point: Not applicable.
Flammability(solid, gaseous): Contact with combustible material may cause fire.
Ignition temperature:
Decomposition temperature: Not determined.
Auto igniting: Product is not self-igniting.
Danger of explosion: Not determined.
Explosion limits:
Lower: Not determined.
Upper. Not determined.
Vapor pressure: Not applicable.
Density: Not determined.
Relative density Not determined.
Vapour density Not applicable.
Evaporation rate Not applicable.
Solubility in/Miscibility with
Water: Soluble.
Partition coefficient(n-octanol/water): Not determined.
Viscosity:
Dynamic: Not applicable.
Kinematic: Not applicable.
Solvent content:
Organic solvents: 0.0 %
Solids content: 99.5 %
(Contd.on page 6)

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Page 6/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 5)
Other information No further relevant information available.
Reactivity No further relevant information available.
Chemical stability
Thermal decomposition/conditions to be avoided: No decomposition if used according to specifications.
Possibility of hazardous reactions No dangerous reactions known.
Conditions to avoid No further relevant information available.
Incompatible materials: No further relevant information available.
Hazardous decomposition products: No dangerous decomposition products known.
Information on toxicological effects
Acute toxicity:
LD/LC50 values that are relevant for classification:
Oral LD50 1130 mg/kg (rate)
7775-27-1 disodium peroxodisulphate
Oral LD50 925 mg/kg (rat)
Primary irritant effect:
on the skin: No irritant effect.
on the eye: No irritating effect.
Sensitization:
Sensitization possible through inhalation.
Sensitization possible through skin contact.
Additional toxicological information:
The product shows the following dangers according to internally approved calculation methods for
preparations:
Harmful
Irritant
Carcinogenic categories
/ARC(International Agency for Research on Cancer)
1309-37-1 Ferric oxide 3
NTP(National Toxicology Program)
None of the ingredients is listed.
OSHA-Ca (Occupational Safety& Health Administration)
None of the ingredients is listed.
Toxicity
Aquatic toxicity: No further relevant information available.
Persistence and degradability No further relevant information available.
Bioaccumulative potential No further relevant information available.
Mobility in soil No further relevant information available.
Additional ecological information:
General notes:Water hazard class 1 (Self-assessment): slightly hazardous for water
Results of PBT and vPvB assessment
PBT: Not applicable.
vPvB: Not applicable.
(Contd.on page 7)

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EN ViRON MENTAI FRODVCTS'
Page 719
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 6)
Other adverse effects No further relevant information available.
yj
Waste treatment methods
Recommendation:
Must not be disposed of together with household garbage. Do not allow product to reach sewage system.
Uncleaned packaging:
Recommendation: Disposal must be made according to official regulations.
Recommended cleansing agent:Water, if necessary with cleansing agents.
UN-Number 1505 and 1492
UN proper shipping name Sodium Persulfate and Potassium Persulfate
Transport hazard class(es) 5.1 (Oxidizer)
Packing group III
Environmental hazards:
Marine pollutant: No
Special precautions for user Not applicable.
Transport in bulk according to Annex 11 of
MARPOL73178 and the IBC Code Not applicable.
UN "Model Regulation": UN1505, Sodium persulfate and UN1492, Potassium persulfate
Safety, health and environmental regulations/legislation specific for the substance or mixture
Sara
Section 355(extremely hazardous substances):
None of the ingredients is listed.
Section 313(Specific toxic chemical listings):
None of the ingredients is listed.
TSCA (Toxic Substances Control Act):
All ingredients are listed.
Proposition 65
Chemicals known to cause cancer:
None of the ingredients is listed.
Chemicals known to cause reproductive toxicity for females:
None of the ingredients is listed.
Chemicals known to cause reproductive toxicity for males:
None of the ingredients is listed.
Chemicals known to cause developmental toxicity:
None of the ingredients is listed.
Carcinogenic categories
EPA (Environmental Protection Agency)
None of the ingredients is listed.
(Contd.on page 8)

�rovectus
EN VIRONMENTAI PRODUCTS'
Page 819
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 7)
TLV(Threshold Limit Value established by ACGIH)
1309-37-1 Ferric oxide A4
NIOSH-Ca (National Institute for Occupational Safety and Health)
None of the ingredients is listed.
GHS label elements
The product is classified and labeled according to the Globally Harmonized System (GHS).
Hazard pictograms
<t< >+
GHS03 GHS07 GHS08
Signal word Danger
Hazard-determining components of labeling:
Potassium peroxodisulfate, disodium peroxodisulphate
Hazard statements
May intensify fire; oxidizer.
Harmful if swallowed or if inhaled.
Causes skin irritation.
Causes serious eye irritation.
May cause allergy or asthma symptoms or breathing difficulties if inhaled.
May cause an allergic skin reaction.
May cause respiratory irritation.
Precautionary statements
Take any precaution to avoid mixing with combustibles.
Keep away from heat/sparks/open flames/hot surfaces. - No smoking.
In case of inadequate ventilation wear respiratory protection.
Keep/Store away from clothing/combustible materials.
Avoid breathing dust/fume/gas/mist/vapors/spray.
Use only outdoors or in a well-ventilated area.
Wear protective gloves/protective clothing/eye protection/face protection.
Wash thoroughly after handling.
Do not eat, drink or smoke when using this product.
Contaminated work clothing should not be allowed out of the workplace.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to
do. Continue rinsing.
Specific treatment(see on this label).
Take off contaminated clothing and wash before reuse.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
Wash contaminated clothing before reuse.
IF INHALED: If breathing is difficult, remove victim to fresh air and keep at rest in a position comfortable for
breathing.
If skin irritation occurs: Get medical advice/attention.
If skin irritation or rash occurs: Get medical advice/attention.
If eye irritation persists: Get medical advice/attention.
Rinse mouth.
In case of fire: Use for extinction: CO2, powder or water spray.
IF SWALLOWED: Call a POISON CENTER/doctor if you feel unwell.
IF ON SKIN: Wash with plenty of water.
Call a POISON CENTER/doctor if you feel unwell.
(Contd.on page 9)

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EN ViRON MENTAI FRODVCTS'
Page 9/9
Safety Data Sheet(SDS)
OSHA HazCom 2012 Standard 29 CFR 1910.1200. Prepared to GHS Rev03.
Printing date 0710212018 Revised on 0111312022
Trade name:Buffered Provect-OX2TM Self Activating ISCO Enhanced Bioremediation Reagent
(Contd.of page 8)
If experiencing respiratory symptoms: Call a POISON CENTER/doctor.
Store locked up.
Store in a well-ventilated place. Keep container tightly closed.
Dispose of contents/container in accordance with local/regional/national/international regulations.
National regulations:
The product is subject to be labeled according with the prevailing version of the regulations on hazardous
substances.
State Right to Know
7727-21-1 Potassium peroxodisulfate 50-70%
*Ox. Sol. 2, H272; ®Resp. Sens. 1, H334; U Acute Tox. 4, H302; Acute Tox. 4, H332;
Skin Irrit. 2, H315; Eye Irrit. 213, H319; Skin Sens. 1, H317; STOT SE 3, H335
20-30%
Disodium peroxodisulphate
7775-27-1 Ox. Sol. 2, H272; Resp. Sens. 1, H334; `•'?Acute Tox. 4, H302; Acute Tox. 4,
H332; Skin Irrit. 2, H315; Eye Irrit. 2A, H319; Skin Sens. 1, H317; STOT SE 3, H335
1309-37-1 Ferric oxide 1-20%
-na- Terr-OR buffer and ferrate stabilizer(see associated SDS) 0—5%
All ingredients are listed.
Chemical safety assessment:A Chemical Safety Assessment has not been carried out.
This information is based on our present knowledge. However, this shall not constitute a guarantee for any
specific product features and shall not establish a legally valid contractual relationship.
Date of preparation/last revision 06/02/2014/3
Abbreviations and acronyms:
ACGIH:American Conference of Governmental Industrial Hygienists
EINECS:European Inventory of Existing Commercial Chemical Substances
ELINCS:European List of Notified Chemical Substances
CAS:Chemical Abstracts Service(division of the American Chemical Society)
NFPA:National Fire Protection Association(USA)
HMIS:Hazardous Materials Identification System(USA)
LC50:Lethal concentration,50 percent
LD50:Lethal dose,50 percent
Ox.Sol.2:Oxidizing Solids, Hazard Category 2
Acute Tox.4:Acute toxicity,Hazard Category 4
Skin Irrit.2:Skin corrosion/irritation,Hazard Category 2
Eye Irrit.2A:Serious eye damage/eye irritation,Hazard Category 2A
Resp.Sens. 1:Sensitization-Respirat.,Hazard Category 1
Skin Sens. 1:Sensitization-Skin,Hazard Category 1
STOT SE 3:Specific target organ toxicity-Single exposure,Hazard Category 3
*Data compared to the previous version altered.
SDS/MSDS Created by MSDS Authoring Services (www.MSDSAuthoring.com)