Hello;
You are creating the new association for each image i.e. on OnStoreRequest this is why it is slow. What I suggest you to open the new association when you receive the association request i.e. in OnReceiveAssociationRequest and just forward the DicomCStoreRequest on the opened association.
The ideal way of creating the simple mediator is
1) OnAssociation request receive simply pass the same request to the final receiver and send the response which you receive from final receiver to the originator requester.
2) OnCStore request receive pass the request to the final receiver and send the response which you receive from final receiver to the originator requester.
3) Close the association with the final receiver when originator requester closes the association.
Advance mediators have some more functionality like making the request compatible, if the final receiver are not comfortable with the presentation context negotiated by the original requester.