HomeMy WebLinkAboutWI0501133_Notification of Intent (NOI) – GW Remediation_20240226NC Department of Environmental Quality — Division of Water Resources (DWR)
NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS
ThefolloWng are "permitted by rule" and tio not reqaire an in(livitlualpermit when constructed in aceordanee
with the rules of 15A N(A('02(7.0200 (NOTE-. This form must be received at least 14 DAYS prior to injection)
AQUIFER TEST WELLS (L5�� IBC, �COXPLN
-0
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION k j)1jgsjjor TRACER WELLS (1Z, ANCkCAX M222)
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 (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
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 is 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.
5) In -Situ Thermal Wells (IST — Used to 'heat' contaminated groundwater to enhance remediation.
Print Cleariv or Type Information, Illegible .Vubndttals Will Be Returned as Incomplete.
DATE: January 2 12023 PERMIT NO. 11' (to be filled in by DWR)
NOTE- If this NOI is being submitted as notification of a modification of a previously issued NO] for this site (e.g.,
different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the
previously assigned permit tracking number and any needed relevant information to assess and approve injection:
Permit No. WI 0 !sb I I S -a-) Issued Date: 0 Zlz bh! oz�
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)
Passive Injection System_ ............................
Complete sections B through F, H-M
(4) X
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
B. STATUS OF WELL OWNER: State Government
Deemed Peniii(ted GW Remediation N01 Rev, 2-17-2020 Page 1
L"
la
E.
LV
G.
WELL OWNER(S) — State narne of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): North Carolina Department of Environmental Quality Underground StOra e TankJState Lead
Mailing Address: 3800 Barrett Dr.
City: Raleigh State: _NC Zip Code: 27609 County: Wake
Day Tele No.. 919-707-8166 Cell No.:
EMAIL Address: wa ne randolph@deg nc oov Fax No.:
PROPERTY OWNER(S) (if different than well owner/applicant)
Name and Title: William P. Alston
Company Name Alsfon's Convenience Mart
Mailing Address: 1159 Dr Martin Luther King Jr. Boulevard
City: Warrenton State: NC Zip Code: 27589 County: Warren,
Day Tele No.: 252-257-4109 Cell No.: Unknown
EMAIL, Address: Unknown Fax No.:
PROJECT CONTACT (Typically Environmental. Consulting/Engineering Firm)
Name and Title: Sean O Neil, PE Contract Manaaer
Company Name CATLIN Engineers and Scientists
Mailing Address: 1044 Washington Sheet
City: Raleigh State: NC Lip Code: 27605 County: Wake
Day Tele No.: 984-222-1214 Cell No.: 91.9-539-4403
(EMAIL Address: sean.oneiil a catlinusa.com. Fax No.:
PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Alston's Convenience Mart
1159 Dr. Martin Luther King Jr. Boulevard
City: Warrenton County: Warren 'Lip Code. 27589
(2) Geographic Coordinates: Latitude":
Longitude**
or 3611.376695
or -78 0,197314
Reference Datum: NAD 1983 Accuracy: Sub -meter
Method of Collection: CPS
"FOR AIR INJECTION AND AQUIFER TEST W ELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
TREATMENT AREA
Land surface area of contaminant plume: 10,555 square feet
Land surface area of inj, well network: 3,826 ®square feet (z 10,000 ftz for small-scale injections)
Percent of contaminant plume area to be treated: < 5% (must be < 5% of plume for pilot test infections)
Deemed Permitted GW Reniediation NON Rev, 2-17-2020 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 -sections) 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:
Five USTs were previously operated on -site. One 550- allon diesel one 8 000- allon 7asoline and three 2 000-
allon gasoline USTs were removed from the site in October 2009. A petroleum release was discovered durin
tank closure activities conducted by URS Corporation North Carolina URS and documented in an Initial
Abatement Action Report t dated January 13 2010. Some minor pitting and corrosion were observed on the tanks
and a strong petroleum odor was noted in the soil beneath the removed USTs. Injecting 25 gallons of PetroSoly
with 500 gallons of water into existing well MW-01.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 1 Proposed Existing (provide NC Well
Construction Record (GW-1) for each well)
(2) Appx, injection depths (BLS): 30 to 50 feet BLS
(3) For Proposed wells or Existing wells not having GW-1s, 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: OnI
.X h ectarats approved by the epidenfiology section of the NC Division a Parblic health Dg artment
of Health and 1-Iia aan Ser-vices can be injectecd. Approved iniectants can be found online at
d itt tr'ci� l o c ..... ---wit--aviti,—t�ua...:t���eatrMit� �� t t,��� tt� t k�raar�cl�l utrttincl �vttt,r:
am! cw i)gnCm'D.0 d _��<�te��-a a wr�aw e i__�:�ew tarts Ill other substances must be reviewved b r the PHHS rior� to arse.
Contact the ITIC Pro grarra eir raaore info if you wish to get aR p roval b�a• a different additive. However, please
mote it may take 3 months or longer. If no in'ectants are to be used use NIA...
lnjectant: PetroSoly Total Amt. to be injected (gal)/event: 25 gallons
Injectant: Water "Total Amt. to be injected (gal)/event: 500 gallons
Deemed Permitted GW Remediation N01 Rev. 2-17-2020 Page 3
Total Amt. to be injected (gal/event): 525 gallons
No. of separate injection events: I Total Amt. to be injected (gal): 525 gallons
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 Su!2 11a)ter -02-1, result from the injection activity.
An additional samplink-event ..will occur followinp, the infection and extraction event. Provided results are over
QCL standards svecified in S,ubehapter 02L the ageM..will be notified immediatelL .. ..........
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant- "I hereby cent under penally of law, that I ain fianfiliar 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 ain aivare that there are significant penalties, including the possibility offines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and it'applicable, abandon the
injection well and all related appurtenances in accordance with the .15,4 NC.4C 026'0200 Rules.
Digitally signed by Sean J. ONO
Date: 2024,02.23 06:55:24-05'00' Sean O'Neil (on behalf ofNCDEQ
Signature of Applicant Print or Type Full Name and Title
Property Owner fif thepropertyis not owned by the Well Owner/At)Dlicant):
"As o)vner of the property on ii,hich the injection ivell(s) are to be contracted and operated, Ihereby consent to
allow the applicant to construct each injection vvell 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
"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 access agreement
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
'An access agreement betimen the applicant and property oitner may be submitted in lieu qf a signature on thisfibrin.
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: (919) 707-9000
Deemed Permitted GW Reinediatiou N01 Rev. 2-17-2020 Page 4
ATTACHMENT H
INJECTION ZONE DETAILS
Deemed Permitted GW Remediation N01 Rev, 2-17-2020 Page 5
NOTES:
1. Well and tank locations were obtained from previous reports 20 10 0 20 40
prepared by other consultants and are approximate. Feet
2. The groundwater elevation contour is 0, 10 feet.
CATLIN
PROJECT
ALSTON'S
CONVENIENCE MART
1159 DR. MLK JR. BLVD
TITLE
GROUNDWATER ELEVATION -
APRlL 5, 2023
FIGURE
WARRENTON,NC
4
Engineers and Scientists
INGIOENT ND..
JOBNO
DATE
SCALE
DRAWN BYYCHECKUD OY
339001
221046
I MAY 2023
AS SHOWN
KMC/SJO,
NOTES:
1, Well' and tank locations were obtained from previous reports 40 20 0 40 80
prepared by other consultants and are approximate. Feet
2, LNAPL = Light Non -Aqueous Phase Liquid!
PROJECT
ALSTON'S
CONVENIENCE MART
1159 DR. MLK JR, BLVD
CATLIN WARRENTON,NC
Eingineers, and Scientists . ......
MONITORING WELL
GROUNDWATER SAMPLE
ANALYTICAL RESULTS —
APRIL 5, 2023
SCALE I DRAWN BY4HECKED SY
MAY 2023 1 ASSHOWN I(MC/SiO
Ardligs
Waste Management
ENVIRONMENTAL QUALITY
June 3, 2021
Ms. Linda Blalock
Environmental Engineer
DWM UST Section
1646 Mail Service Center
Raleigh, NC 27699-1646
RE: Site Access
Alston's Convenience Mart
1159 Dr. Martin Luther King, Jr. Blvd.
Warrenton, Warren County, NC
Incident Number 33900
Dear Ms. Blalock:
ROY COOPER
Goveo 1101.
DIONNE DELLI-GATTI
Secreeaty
MIC14AEL SCOTT
Dh ector
I an-L/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 Quality (Department) or its contractor to enter upon said
property for the purpose of conducting an assessment and/or remediation of the groundwater and/or soils
under the authority of G.S. 143-215.94G.
I am/We are granting permission with the understanding that:
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 in accordance with the acceptance of the site into the State -Lead Program, The
Department or its contractor shall protect and prevent damage to the surrounding lands. Any damages
will be restored by the Department or its contractor to as close to the pre -work condition as practicably
possible.
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 will notify the land owners
48 hours prior to entry and 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.
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.
--��Nothing Compares
State of North Carolina [ Environmental Quality I Waste Management
1646 Mail service Center 1 217 West Jones Street I Raleigh, NC 27699-1646
919 707 8200 T
5. 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, ernployce, or
contractor of the landowner.
Me agree not to interfere with, remove or any ways damage the Department's well(s) or its
contractor's well(s) and equipment during the investigation.
Sincerely,
Signature
Type/Print Name of Owner or Agent
"t I A
Phone Number
Address
4A
City/State/Zip Code
Date
RE: Site Access
Alston's Convenience Mart
1159 Dr. Martin Luther King, Jr. Blvd.
Warrenton, Warren County, NC
Incident Number 33900
-�Notting Cornpares-`-11--Al-
Stake of North Carolina I Environmental Quality 11 Waste Management
1646 Mail Service Cenkcr 1 217 West Jones Street I Raleigh,NC27699-16416
919 707 8200 T
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