WI0100716_Notification of Intent (NOI) – GW Remediation_20240318

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 15A 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 injectats 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
ISA 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.02291
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: 03/18 ,2024_NOI TRACKING NO. WI0100716 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 type(listed above)used for a previously issued NOT.
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) Passive Injection System...............................Complete sections B through F,H-M
(4) X Small-Scale Injection Operation......................Complete sections B through M
(5) X 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: Business/Organization
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): Mull Oil,Inc.Kristan Jenkins
Mailing Address: PO Box 8309
City: Morganton State:_NC_Zip Code: 28680 County:Burke
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
D. PROPERTY OWNER(S)(if different than well ownerlapplicant)
Name and Title: Maxine Epley and Doris Epley Brown
Company Name
Mailing Address: 4019 Kathy Rd
City: Morganton State: NC Zip Code: 28655 County: Burke
Day Tele No.: 828-584-1096,828-584-2920(store phone number) Cell No.:
EMAIL Address: Fax No.:
E. PROJECT CONTACT(Typically Environmental Consulting/Engineering Firm)
Name and Title: Sara Rose, Project Manager
Company Name Alpha Environmental
Mailing Address: P.O.Box 2155
City: Asheville State: NC Zip Code: 28802 County: Buncombe
Day Tele No.: 828-398-2040 Cell No.:
EMAIL Address: srose(aMlnhaenviron.com Fax No.: 828-398-2041
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name&Address: Incident name:Kathy Rd(Incident#5419)
Address:4020 Kathy Rd
City: Morganton,NC County: Burke Zip Code: 28655
(2) Geographic Coordinates: Latitude": ° "or °
Longitude": ° "or °
Reference Datum: Accuracy:
Method of Collection:
"FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPIIIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: —6,000 square feet
Land surface area of inj.well network: —300 square feet(< 10,000 112 for small-scale injections)
Percent of contaminant plume area to be treated: <5% (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:
The source of the release is from a leaking line fitting from piping connected to the fuel dispensers. Six USTs
were removed in 1992 and included 1-4,000 gasoline UST 1-1 000 gallon gasoline UST 1-2,000 gallon gasoline
UST,2-550 gallon diesel UST and 1-550 gallon kerosene UST. Ivey-Sol,product of Ivey International is the
chosen iniectate_ Ivey International proposes to iniect Ivey-Sol 103 into two injection wells Approximately 265
gallons of--4%Ivey-so]103 will be injected into each well over two separate applications Following a residence
time of approximately 12-24 hours groundwater extraction will take place approximately 1 5 to 3 times the
injected volume) at each well. The goal is to reduce NAPL and reduce groundwater contamination levels to
below gross contamination levels in the areas of monitoring wells.
J. WELL CONSTRUCTION DATA
(1) No. of injection wells: 2 Proposed 0 Existing(provide NC Well
Construction Record(GW-1)for each well)
(2) Appx.injection depths(BLS):_approximately 35 ft
(3) For Proposed wells or Existing wells not having GW-ls,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 inieclanls approved by the epidemiology section ofthe NCDivlsion of Public Health Dartment
of. Health and Human Services can be infected Approved injectants can be found online at
http:/Idea.nc.goviabout/divisions/water-resources/water-resources-permits/wastewater-branch/gmund-water-
protection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use
Contact the UIC Program for more info if You wish to get approval for a different additive However please
note it may take 3 months or longer. If no iniectants are to be used use N/A
Injectant: Ivey-Sol 103 Total Amt.to be injected(gal)/event_ 1,060 gallons of Ivey-Sol 103
water mix: 10 izal of Ivey-Sol 103 into 255 gallons of water per well(two days of injections two wells each day)
Injectant: Total Amt.to be injected(gal)/event:
Deemed Permitted GW Remediation NOI Rev.3-1-2023 Page 3

lnjectant: Total Amt.to be injected(gal)/event:
Injectant: Total Amt.to be injected(gal)/event:
Total Amt.to be injected(gal/event): 530 gallons of Ivey-Sol/water mixture per event.
No.of separate injection events:2 Total Amt.to be injected(gal):1,060 gallons of 4%Ivey-Sol 103 water
mix
Source of Water(if applicable): brought from offsite by injection contractor
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.
Groundwater monitoring will be conducted two weeks after the injection activities There are 7 monitoring wells
that will be sampled. These wells are located in the area of injection,upgradient of the area of injection and
downgradient of the area of iniection.Groundwater in these wells will be analyzed for VOCS
M. SIGNATURE OF APPLICANT AND PROPERTY OWNER
Well Owner/Applicant: `I hereby certij�, 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
=ture
related appurtenances in accordance with the 1 SA NCAC 02C 0200 Rules."
r, Fo
n Print or Type Full Name and Title
1'r
Property Owner(if thg property is not owned by the Well Owner/Ap licant)•
"As owner of the property on which the injection wells)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 wells)conform to the Well Construction Standards
(1 SA 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.
Signature*of Property Owner(if differen from applicant) Print or Type Full Name;ad Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature on this farm.
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 Remodiation NOI Rev.3-1-2023 Page 4

Benchmark location for well survey is location of MW-10 REFERENCE PLAT
WGS-84 reference system was used to obtain benchmark elevation, latitude and longitude
MW-8®
MW-7
MW-9
®MW-6
MW—� Storage
Kathy Rd Grace
MW-4 Approximate Extent of
_ Dissolved contaminant Plume
W-1/ W-1
1
Asphalt MW-5
Proposed II jection Well Location
Approximate Loco
of Former Fuel
MW-2 Dispenser Amo
ZZZ
Kathy Rd
® LEGEND
MW-10
®Existing Monitoring Well Location
®Monitoring Wells Not Found
*Soil Boring/Groundwater Sample
Location
Kathy Rd Grocery g�d9 Morganton, NC
Base Ma
�U B�d9 Incident #5419
SCALE: 1"=40' ALPHA
zo ao so
DRAWN BY: CU BnMamelaW Sciences,Inc.
o ao
SCALE 1-40' DATE: 03/04/24 Figure 1

Benchmark location for well survey is location of MW-10 EF RENCE PLAT
WGS-84 reference system was used to obtain benchmark elevation, latitude and longitude
�O
O
M W`$
® MW-9
Storage M W—6 `
MW-3®
�. Kathy`f�ai ' Grace
MW-4
124.62 ,�V1 V1-1 1 /274.51
M W—1 127.68
\` �of FormerLFocat/on :MW:-5
J..—Dispenser Area
® MW-2 Asphalt"-,
1275.69 `
Kathy Rd
`�1275.07
®M10 LEGEND
\ ®Existing Monitoring Well Location
®Monitoring Wells Not Found
1275.00 Groundwater Elevation in Feet
——— Groundwater Contour
Kathy Rd Grocery
�� Bldg Morganton, NC
GROUNDWATER CONTOUR MAP
Incident #5419 TA #19
SCALE: "=4°'�
ALPHA
0 20 4o so s0
fDATE-
RAWN BY: KMC Environmental Sciences,Ine.
scnL,er=40 01/12/22 Figure 4