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WI0700552_Notification of Intent (NOI) – GW Remediation_20240925 (2)
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:_September 10,2024 NOI TRACKING NO. W10700552 (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.06-20-2024 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: Scott Ryals,PE Mailing Address: 1646 Mail Service Center City: Raleigh State: NC Zip Code: 27699-1646 County: Wake Day Tele No.: 919-707-8168 Cell No.: EMAIL Address: Scott.Ryals(&deq.nc.gov Fax No.: D. PROPERTY OWNER(S)(if different than well owner/applicant) Name and Title: Anastacio Bartolon DeLeon Company Name DeLeon Starter&Alternator Mailing Address: 2455 NC HWY 581 N City: Pikeville State: NC Zip Code: 27863 County: Wayne Day Tele No.: 919-734-3381 Cell No.: EMAIL Address: Fax No.: E. PROJECT CONTACT(Typically Environmental Consulting/Engineering Firm) Name and Title: David C.Vail,P.E.,Environmental Project Engineer I Company Name WithersRavenel Mailing Address: 115 MacKenan Drive City: Cary State: NC Zip Code: 27511 County: Wake Day Tele No.: 919-469-3340 Cell No.: EMAIL Address: DVailgWithersRavenel.com Fax No.: F. PHYSICAL LOCATION OF WELL SITE (1) Facility Name&Address: RB's Package Store(Former)—TF#20283 City: Goldsboro County: Wayne Zip Code: (2) Geographic Coordinates: Latitude": 35.3928790 Longitude": -77.996231' Reference Datum: Google Earth Accuracy: +/-5 m 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: —9,600 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: —80 sgft (must be<5%of plume for pilot test injections) Deemed Permitted GW Remediation NOI Rev.06-20-2024 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. (3) Injection Zone(IZ)map(typically the Radius of Influence)and existing and proposed injection wells. (4) 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 two Provectus Provect-OX2 in situ chemical oxidation(ISCO,) sleeves) in MW-3R is to further reduce dissolved phase contaminants below the GCL levels to aide in reaching site closure. Scope: The scope of this passive injection event will be to install two 3-ft Provect-OX2 sleeves into MW-3R. The sleeves will remain in place until the site is sampled approximately 6 months later (January — February 2025). Goals: The goal of using the Provect-OX2 Sleeves is to further reduce the petroleum concentrations in groundwater in the vicinity of MW-3R over an approximate 6-month period. J. WELL CONSTRUCTION DATA (1) No. of injection wells: 0 Proposed 1 Existing(provide NC Well Construction Record(GW-1)for each well) (2) Appx. injection depths(BLS): 9-15-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 iniectants approved by the epidemiology section of the NC Division o{Public 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-watgr- 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 or a different additive. However,please note it may take 3 months or lonjzer. If no iniectants are to be used use N/A. Injectant: Provectus-OX2 ISCO Sleeves Total Amt.to be injected(gal)/event: Two 3-ft Sleeves Deemed Permitted GW Remediation NOI Rev.06-20-2024 Page 3 Injectant: Total Amt.to be injected(gal)/event: 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: 1 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. AIR will advise the NCDEQ incident manager that the sleeves should be removed in January-Februg 2025 (gpproximately 6 months after installation). The site should be sampled following the removal of the sleeves. M. SIGNATURE OF APPLICANT AND PROPERTY OWNER Well Owner/Applicant: `I hereby certi, 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." Z David C.Vail,P.E.,Environmental Project Engineer I 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 (1 SA NCAC 02C C.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 Sijzned Access 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: (919)707-9000 Deemed Permitted GW Remediation NOI Rev.06-20-2024 Page 4 � o O 0 40 its z zoo A M _ N ` O O O m 'm > � Q z V > - 3 ° w o a 4 MW-4� MW-7 \ a MW-6 ~ / _ ZQ MW-3RM 31 — . 5,000 / H MW-2 ug/L 1 Z / MW-5 _ O / I MW-1 i / 00 LV z / 0 ~ ~ MW-11 O w z I / MW-9 � c i� D / o W (Iw w / QNL ¢ LU Z O / a ~gym �� I MW-10 CC o MW-8 N / C/ Tcl� vM > > ° I ro MW-12 12 LEGEND " z 3 TYPE II MONITORING WELL LOCATION 3 P--� ESTIMATED EXTENT OF BENZENE L--J EXCEEDING 2L STANDARD - iw ESTIMATED EXTENT OF BENZENE GRAPHIC SCALE Y v EXCEEDING GCL 0 10 20 40 — NO;AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT. �_ O , • , , ,, , v , ,. LEGEND EXISTING MONITORING WELL o cV °z M I B Z w o ESTIMATED BENZENE PLUME IL MW-4 0 N C= ABOVE 2L STANDARD / MW-7 MW-6 a �Mr" 31 o ESTIMATED BENZENE PLUME w 0 N v ABOVE GCL / NLli o NOTES: MW 2 jug 00 `/ \ 120 a ° o 1. 2019 AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT. J' MW-5 / / / m GRAPHIC SCALE I Cl MW y / B- / Q o o W 0 20 40 80 110 o a 1 inch=40 ft. ~ �6p MW-1 MW-3 MW-7SURFACE GRADE MW-11 aH CLAYEY z __ SAND % WATER TABLE H o 90 - SAND Z � m I Mw-10 — is LTY SAND �v W a 80 ESTIMATED EXTENT W Vf Q OF BENZENE2L H EXCEEDANCES a tn 0 Q / 70 ESTIMATED EXTENT Qua g c OF BENZENE GCL Z EXCEEDANCES MW-12 O g I A o GROUNDWATER CONTAMINANT °C CROSS-SECTION _ 0 10 20 ao A-A' CORP0RA7;F gyp 70 gyp 117 —' —� SUBJECT SITE 70 F � o (D o (D 70 1 � - 1 .00 ACRES �� B Bl N = QZ ° 3 - - - - - - - - - - - - - - - - -I a ~ Z � STR�� - �, 120 m v o 0 110 �T ' \ SURFACE GRADE MW-4 MW 3R MW 3 MW 5 Bus ;�� .-� � J � 100 o CLAYEY r D WATER a90 >CLAEY - o0a nLr.Lv Bus SILTY SI T �ESTIMATEDEXTENT OF BENZENE 2L EXCEEDANCE70 CLAY S / v ^r ` .3 ESTIMATED EXTENT 1 7 a ArCANT/ICI. / 0 EOXCEEDANCESCL L v v v f GRAP IC S �! GROUNDWATER CONTAMINANT "' Y <<'V pq 2 �; \ �-a.-� soo l000 o CROSS-SECTION N `I QQ %` �r► _ _ �C�S f inch=1000 ft.� - 0 10 20 40 ,, 0 c) Z o Z w M � � N � a O O O ti F N _ m z U Q - 3¢ Q a W 0 Q a MW-4 w z MW-i � MW-6 p N MV*-3R M+3 O MW-2 w MW-5 z MW-1 a i W z z � r O wZ MW-ll 1 MW-9 i o c i OD Lu C4 z QN0Q 3 � 0 � a Z 07 N I m Q MW-10 MW-8 N CSo a Sol M 7 v ro i MW-1 '3 L- a z 3 W vi Z'3 LEGEND ` GRAPHIC SCALE w Y TYPE II MONITORING WELL LOCATION 0 10 20 40 u `` � N NOTES: RAW1.)AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT. �� — - o zcl O w O M u 0 N Cl) OC.,/ N 11 MW-4R - _ w o s (90.36) •{/ a a FSl o MW-7 GI MW-7 TO MW-11 A(9;0.3 ) �(90.38) ygMST v - 0.007 FT/FT MW-2 � MW-6 _ (90.35)� MW-3 < IF Lu �MW-5 Q w_ N 0(90.32) 0 C N MW ``♦ Z °� Z Oct9 O A • �. 90� ♦� M£RRg�SPgA/vOAIT o ♦ ♦ C"AGi RHAT p (NM) _ ,� ay 9•` ♦ ♦ ORF� R — # �9.8A) �� W 1 O u oo � N Z aqq W w NMr z O t Q OU qi3 C) U N � ol aLuwO } o MW-8 oa (....., O z 0 0 14, m It in 1 COMMERCIAL OWL Lu ^ o BUILDING O i LL. I � (90.07) C va/ `n LEGEND fp 7 v c TYPE II MONITORING WELL / V) a (90.06) GROUNDWATER SURFACE ELEVATION (FEET) _ 90.1—— —IMPLIED GROUNDWATER ELEVATION w0l" INFERRED GROUNDWATER FLOW DIRECTION w ° GRAPHIC SCALE a y 0 10 20 40 NOTES: 1.) 2021 AERIAL OBTAINED FROM NC ONE MAP. 2.) GROUNDWATER SURFACE ELEVATIONS ARE BASED ON AN ARBITRARY BENCHMARK ELEVATION OF 100 FEET ABOVE MEAN SEA LEVEL. 1 inch=20 ft. TABLE B-7 MONITORING & REMEDIATION WELL CONSTRUCTION INFORMATION Former RB's Package Store Incident Number: 20283 714 North George Street Goldsboro,Wayne County, NC Well Well Top-of- Depth-to-Water Well Coordinates Total Screened Date Water LNAPL Groundwater Well ID Date Installed Well T ype Depth Interval Level Thickness Elevation Casing Casing Casing from (NC State Plane NAD 83 Feet) /Driller Diameter Depth Elevation Top-of-Casing (inches) (feet) feet (feet) feet Measured feet (feet) (feet) (i ) (feet) (feet) (feet) Easting Northing Permanent MW-3R Unknown Type II 2 15.0 5.0 5-15 99.89 6/21/2023 9.50 --- 90.39 2299146.17 599422.91 (as-built) Notes: 1.)Well construction information was obtained from previous consultants reports. 2.)Top-of-Casing elevations were determined by previous consultants and are relative to an approximate site elevation of 100.00 feet above mean sea level. 3.)Groundwater elevation calculated by:(Top-of-Casing-Depth-to-Water)+(LNAPL Thickness x 0.8581) 4.)N/A=Not Applicable 5.)NM=Not Measured Page 1 of 1 �<E STATE,,, ROY COOPER Governor ELIZABETH S.BISER . '°^ �21 .� Secretary QUAM V`w MICHAEL SCOTT NORTH CAROLINA Director Environmental Quality Mr. Scott C. Ryals, P.E. DWM UST Section Trust Fund Branch-State Lead Program 1646 Mail Service Center Raleigh,NC 27699-1646 Dear Mr. Ryals: RE: Site Access Agreement Former RB Package Store 714 N George Street Goldsboro, Wayne County,NC Incident#- 20283 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 Environmental Quality(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. D North Carolina Department of Environmental Quality Division of Waste Management E Q�� 217 West Jones Street 1 1646 Mail Service Center I Raleigh,North Carolina 27699-1646 NORM CAROLINA DepaNneM of Emironmenfal quail /`� 919.707.8200 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. 6. 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 any way damage the Department's well(s)or its contractor's well(s)and equipment during the investigation. Sincerely, z4g Signature Type nt Na e of Owner or Agent pia 9f973C/ 3]? Phone Number 9 (a✓1 / &,/qb Id lei Ght�< < < con Email Address -7 1 y Address City/State/Zip Code trf Date f•�y s T DNorth Carolina Department of Environmental Quality I Division of Wa mL,wycrnent QP`� 217 West Jones street 1 1646 Mail service Center I Ralei h 9 .North Carolina.?lb41+•1646 919.707.8200 �rovectus 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/+1 703-527-3887 Freeport, IL 61032 CCN 1010557 Phone: 815-650-2230 For Hazardous Materials Incident (Spill, Leak, Fax: 815-650-2232 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) �rovectus 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) �rovectus 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) �rovectus 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) �rovectus 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) �rovectus EN VtRON MENTAI FRODVCTS' 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) �rovectus 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) �rovectus 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)