MO-28415_47669_CA_UST-61_20200403_24-Hour Release and UST Leak Reporting Form

UST-61
24-Hour Release and UST Leak Reporting Form.
For Releases This form should be completed and submitted to the UST Section's regional office following a known or suspected release from
an underground storage tank (UST) system. This form is required to be submitted within 24 hours of discovery of a known or
in NC suspected release
(DWM USE ONLY)
Suspected Contamination? (Y/N) Y
Facility ID Number
Incident # Risk (H,I,L,U)
Confirmed GW Contamination? (Y/N) N
Date Leak Discovered 11/25/19
Received On Received By
Confirmed Soil Contamination ?(Y/N) N
Comm/Non-Commercial? Non-Com
Reported by (circle one): Phone, Fax or Report
Samples Taken?(Y/N) N
Reg/Non-regulated? Non -Reg
Region
Free Product? (Y/N) If Yes, State Greatest
Thickness
INCIDENT DESCRIPTION
Incident Name: Evans Property
Address: 9920 Mallard Glen Drive
County: Mecklenbur
Regional Office (circle one): Ashevill ,Mooresville, ayetteville,
City/Town: Charlotte
Zip Code: 28262
Raleigh, Washington, Wilmington, Wi
Latitude (decimal degrees): 35.330495 Longitude (decimal degrees) : _80.732292 Obtained by:
Briefly describe suspected or confirmed release: (including but not limited to: nature of release, date of release, amount ❑GPS
of release, amount of free product resent and recoveryefforts, initial responses conducted, impacts to receptors)
Limited assessment by soil borings identified soil staining at one end of heating oil UST. ❑Topographic map
Lab analysis confirmed petro impacts. See report attached. ®GIs Address matching
❑Other
❑ Unknown
Describe location:
HOW RELEASE WAS DISCOVERED (Release code)
(Check one)
❑Release Detection Equipment or Methods ❑X Visual/Odor ❑Groundwater Contamination
❑During UST Closure/Removal ❑Water in Tank ❑Surface Water Contamination
©Property Transfer ❑Water Supply Well Contamination ❑Other (specify)
SOURCE OF CONTAMINATION
Source of Release Cause of Release Type of Release Product Type Released
(Check primary source) (Check primary cause) (Check one) (Check primary product type released)
® Tank ❑ Spill ® Petroleum ❑ Gasoline/ Diesel/ ❑ Diesel/Veg. Oil
❑ Piping ❑ Overfill ❑ Non -Petroleum Kerosene Blend
Heating Oil ❑ Vegetable Oil 100%
®❑ Dispenser ®Corrosion Both
❑
❑ Other Petroleum ❑ E10 - E20
❑ Submersible Turbine Pump ❑Physical/Mechanical
Location Products
❑ (Check one) Metals Delivery Problem Damage ❑ E21 - E84
❑
❑ Install Problem ❑ E85 - E99
❑ Spill Bucket ❑ Other Inorganics
❑ Other [-]Facility ❑Ethanol 100%
❑ Other ❑ Other Organics
❑ Unknown Residence ❑ E01 - E09
❑ Unknown
❑Other
Definitions presented on reverse
Definitions presented on reverse
Ownership
1. Municipal 2. Military 3. Unknow 4. Private Federal 6. County 7. State
Operation Type
1. Public Service 2. Agricultural Residential 4. Education/Relig. 5. Industrial 6. Commercial 7. Mining
UST Form 61 (02/19) Page 1 of 2

IMPACT ON DRINKING WATER SUPPLIES
Water Supply Wells Affected?
1. Yes 2. No Unknow
Number of Water Supply Wells Affected
Water Supply Wells Contaminated:
(Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
UST SYSTEM OWNER
UST Owner/Company
Kevin Evans
Point of Contact
Address
1150 Liberty Road
City
State
Zip Code
Telephone Number
Gold Hill
NC
28071
UST SYSTEM OPERATOR
Same as above
UST Operator/Company
Address
City
State
Zip Code
Telephone Number
LANDOWNER AT LOCATION OF UST INCIDENT
Same as above
Landowner
Address
City
State
Zip Code
Telephone Number
Draw Sketch of Area (showing two major road intersections) or Attach Map
See Attached investigation report
Person Reporting Incident Patrick Lowery, PG
Company SUMMIT ELT, PC [e-mail]
Telephone Number 803-230-5087
Title Env Manager
Address 3575 Centre Circle Drive, Ft. Mill, SC 29715
Date 4/3/20
UST Form 61 (02/19)
Page 2 of 2
Definitions of Sources
Tank: means the tank that stores the product and is part of the underground storage tank system
Piping: means the piping and connectors running from the tank or submersible turbine pump to the dispenser or other end -use equipment (Vent, vapor recovery, or fill
lines are excluded.)
Dispenser: includes the dispenser and the equipment used to connect the dispenser to the piping (e.g., a release from a suction pump or from components located above
the shear valve)
Submersible Turbine Pump (STP) Area includes the submersible turbine pump head (typically located in the tank sump), the line leak detector, and the piping that
connects the submersible turbine pump to the tank
Delivery Problem: identifies releases that occurred during product delivery to the tank. (Typical causes associated with this source are spills and overfills.)
Other: serves as the option to use when the release source is known but does not fit into one of the preceding categories (e.g., for releases from vent lines, vapor
recovery lines, and fill lines)
Unknown: identifies releases for which the source has not been determined
Definitions of Causes
Spill: use this cause when a spill occurs (e.g., when the delivery hose is disconnected from the tank fill pipe or when the nozzle is removed from the dispenser)
Overfill: use when an overfill occurs (e.g., overfills may occur from the fill pipe at the tank or when the nozzle fails to shut off at the dispenser)
Physical or Mechanical Damage: use for all types of physical or mechanical damage, except corrosion (e.g., puncture of tank or piping, loose fittings, broken
components, and components that have changed dimension)
Corrosion: use when a metal tank, piping, or other component has a release due to corrosion (e.g., for steel, corrosion takes the form of rust)
Installation Problem: use when the problem is determined to have occurred specifically because the UST system was not installed properly
Other: use this option when the cause is known but does not fit into one of the preceding categories (e.g., putting regulated substances into monitoring wells)
Unknown: use when the cause has not been determined

MECKLENBURG COUNTY - PROPERTY RECORD CARD PROPERTY SEARCH
PARCEL ID: 02903112
EVANS KEVIN, EVANS ANN
9920 MALLARD GLEN DR
1150 LIBERTY RD
CHARLOTTE NC
GOLD HILL NC 28071
KEY INFORMATION
Land Use Code R120
Neighborhood
Land Use Desc SINGLE FAMILY RESIDENTIAL - ACREAGE Land
Exemption/Deferment
Municipality
Last Sale Date
Fire District
Last Sale Price
Special District
Legal Description NA
ASSESSMENT DETAILS
Land Value
Building Value
Features
Total
BUILDING (1)
Finished Area
Story
Foundation
Full Bath(s)
Total (SgFt)
LAND
Use
R120
Units
1.49
1,246
1 STORY
CRAWL SPACE
1
1,285
Type
ACRE
FEATURES
Year Built Type
1984 STORAGE
1956 PUMP HOUSE
Notice of 2019 Real Estate Assessed Value
Total Appraised Value
$119,300
C901
1.49 ACRE
CHARLOTTE
CITY OF CHARLOTTE
NA
Year Built 1956 Built Use / Style
Heat FORCED AIR - NOT Fuel
DUCTED
External Wall FACE BRICK Fireplace(s)
Half Bath(s) Bedroom(s)
$32,900
$85,600
$800
$119,300
SINGLE FAMILY
RESIDENTIAL
OIL, WOOD OR
COAL
1
3
Neighborhood Assessment
C901 $32,900
Quantity Units Value
1 1 $500
1 72 $300

VALUE CHANGES
The value change history shows only changes in appraised value; it does not show exemptions, exclusions or deferrals that could
reduce a property's taxable value. If any of these are in effect for a particular tax year, it will be shown on the property tax bill for
that year. It is also possible that some previous value changes might be missing from this list or listed in the wrong order. If you
have any questions, please call the County Assessor's Office at 704-336-7600.
Date of Value Change
01 /14/2019
08/08/2014
02/04/2011
01/02/2003
Tiger Lar),
500 ft
Effective for Tax Year
Reason for Change
New Value
2019
COUNTYWIDE REVALUATION
$119,300
2011
REVALUATION REVIEW - PEARSON
$116,200
2011
COUNTYWIDE REVALUATION
$116,300
2003
COUNTYWIDE REVALUATION
$94,800
�t
029 2
5y
Hyde Pointe Cox){`
Disclaimer
Mecklenburg County makes every effort to produce the most accurate information possible. No warranties, expressed or implied, are provided for the data
herein, its use or interpretation.

m�
CELEBRATING 15 YEARS 4
■
SUMMIT"
aNGINLMNG. W0RA7OR7.7iS"NO., RC.
November 25, 2019
Stefan Gassner
Aspen Heights Partners
8008 Corporate Center Drive
Suite 201
Charlotte, NC 28226
SUMMIT Engineering, Laboratory & Testing, P.C.
3575 Centre Circle
Fort Mill, South Carolina 29715
www.SUMNUT-coMpanies.com
Phone: [phone]
Fax: [phone]
Subject: Letter of Limited UST Assessment and Sampling
The Heritage at UNCC
9920 Mallard Glen Drive
Charlotte, Mecklenburg County, North Carolina
SUMMIT Project No. 5778.500
SUMMIT ENGINEERING, LABRATORY & TESTING, P.C. (SUMMIT) has completed a limited
assessment of a Home Heating Oil (HHO) underground storage tank (UST) at 9920 Mallard Glenb
Drive, Mecklenburg County, North Carolina. SUMMIT personnel conducted the site field work on
November 8, 2019.
The site is irregular in shape and was noted to be comprised of one (1) parcel totaling approximately
1.49 acres in area. The site is developed with one (1) single family home and associated outbuildings.
The residential structure is approximately a 1,2464 SF home, constructed in 1956.
SUMMIT personnel visited the site on November 8, 2019. The HHO UST was observed to be
located near the southeast of the home near the driveway. Utilizing a soil probe, SUMMIT personnel
determined the size of the UST to be approximately 8 feet in length and 4 feet in diameter. SUMMIT
completed five (5) geo-probe borings around the UST. Boring SB-1 and SB-2 were located at the
approximate end of the UST. SB-3 was located on the downgradient side of the UST. SB-4 and SB-
5 were offset away from the UST. Each soil boring was extended to 10 feet below ground surface
(bgs). Typical brown -tan sandy Silts were encountered in the soil borings. SB-2 exhibited petroleum
soil staining, odors and positive detections of field screening equipment from 3 to 6 ff bgs. Soil
sample SS-1 was collected from 5 ft bgs and soil sample SS-2 collected from 7 ft bgs. The collection
of SS-1 and SS-2 will help define the vertical extent of impacts. SB-4 and SB-5 were spaced out in
2 directions from SB-2 in order to help define the lateral extent of impacts. SB-4 did not display
indicators of petroleum impact. SB-5 detected slight petroleum staining and odors at approximately
5 ft bgs. SS-3 was collected from SB-5 at 5 ft bgs. Typical brown -tan sandy Silts were encountered
in the soil borings. Soil samples collected were bottled for submittal to a North Carolina certified

The Heritage at UNCC SUMMIT Project No. 5778.500
Charlotte, North Carolina November 25, 2019
laboratory for analysis of BTEX, Naphthalene and Poly -cyclic Aromatic Hydrocarbons (PAHs). (It
should be noted that groundwater was not encountered)
Laboratory results were compared to North Carolina Department of Environmental Quality
(NCDEQ) Maximum Soil Contaminant Concentrations (MSCCs). Table 1.0 attached to this
document summarizes the detections. As indicated on the attached summary table, sample SS-1,
collected at 5 ft bgs adjacent to the northern tank end, detected the presence of petroleum compound
Naphthalene above the established Soil to Groundwater MSCC. No detections were reported for SS-
2 or SS-3.
Based on the results of our inspection, SUMMIT concludes that the HHO USTs has released
petroleum products into the surrounding soils. Per NCDEQ regulations, the UST owner is required
to submit a 24-Hour Release notification (Form UST-6 1). A copy of this form is attached to this letter
and a copy can be obtained at https://deq.nc.gov/about/divisions/waste-management/ust/forfns. A
copy of this limited assessment should be submitted along with the UST 61 to the NCDEQ
Mooresville Regional Office.
SUMMIT recommends the removal and proper closure of the UST in accordance with NCDEQ UST
guidelines. Based on the detections of concentrations above the established Residential MSCCs, the
Notice of Residual Petroleum (NRP) would be required if soils are to remain in place following UST
removal. Soil over -excavation would be required in order to avoid an NRP and receive a No Further
Action status from NCDEQ.
This letter includes a description of the methodology of our investigation and a summary of our
findings and conclusions. If you have any questions regarding our assessment of the subject property,
our conclusions or recommendations, please do not hesitate to call us at [phone].
Sincerely,
SUMMIT ENGINEERING, LABORATORY & TESTING, P.C.
Patrick W. Lowery, PG
Senior Environmental Manager
Attachments
Table 1.0 — Summary of Soil Detections (3 pages)
Site Figures
Analytical Laboratory Report
UST 61
Morgan W. Drakeford, SC Forester # 1805
Environmental Professional
ENGINEERING IN • LABORATORY • TESTING
3575 Centre Circle Drive I Fort Mill, South Carolina 29715 1 (704) SW - 1717 1 (704) 504 - 1125 (Fox)
WVI W. UMMIT- MPANIE . M

The Heritage at UNCC
Charlotte, North Carolina
APPENDIX I
TABLES
SUMMIT Project No. 5778.500
November 25, 2019
DA\Project Forms\Projects\5778.500 The UNCC Heritage Phase I - Test Pits\Phase II\Appendix Lrtf

Page 1 of 1
TABLE 1.0 - Summary of Soil Detections (Continued)
Project: Heritage
Project #: 5778.5
Analytical Method (e.g., VOC by EPA 8260)
8260B
8260B
8260B
8270D
8270D
8270D
4
Contaminant of Concern
o
Incident
Sample
Date
Source
Sample
Phase
Cd
C
Collected
Depth (ft
(Closure,
ID
(m/dd/yy)
Area
BGS),
20Day,
W
Z
>
d
Z
a
LSA, etc...
SS-1
11/8/2019
Tank End
5
Initial
0.011
5.8
0.0
.470 J
5.8
3.4
SS-2
11/8/2019
Tank End
7
Initial
ND
ND
ND
ND
ND
ND
SS-3
11/8/2019
Offset
5
Initial
ND
ND
ND
ND
ND
ND
Minimum Reporting Limit m /k
0.002
0.300
0.0041
0.290
0.3
0.250
Soil to groundwater MSCC m /k
4.9
0.160
4.60
940
0.160
56
Residential MSCC m /k'
1590
313
3129
4600
313
469
Industrial/Commercial MSCC m /k
400001
8176
81760
1220001
81761
12264
Bold -Reported concentration exceeds Soil to Groundwater MSCC
Bold -Reported concentration exceeds Residential MSCC
ND - Non Detection
NA - Not Available

The Heritage at UNCC
Charlotte, North Carolina
APPENDIX II
FIGURES
SUMMIT Project No. 5778.500
November 25, 2019
DA\Project Forms\Projects\5778.500 The UNCC Heritage Phase I - Test Pits\Phase II\Appendix II.rtf

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SUMMIT
ENGINEERING • LABORATORY • TESTING
rl 1� l
TOPOGRAPHIC MAP
The Heritage at UNCC
300 Heritage Lake Drive
Charlotte, North Carolina 28262
10/31 /2019

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ENGINEERING • LABORATORY. TESTING
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Boundaries are approximate
SITE LOCATION MAP
The Heritage at UNCC
300 Heritage Lake Drive
Charlotte, North Carolina 28262
10/31 /2019

//Aa&
SUMMIT
Aspen Heights Partners Scale
8008 Corporate Center Drive, Suite 201
Charotte, NC 28226
t ivy
T
Checked By\Date: MZ/11/19
Aerial Map
9920 Mallard Glen Drive
Charlotte, North Carolina
NTS
Figure 1

Well House
Gravel Driveway
—40'
i
i
i
i
i
i
i
i
"35'
S B-4
SS,1 (5' bgs)
SS; 2 (7' bgs) ~®
SB-5
SB 2 SS-3 (5' bgs)
UST
4x8 ® SB-3
-------------------
Gravel Driveway

The Heritage at UNCC
Charlotte, North Carolina
APPENDIX III
SUMMIT Project No. 5778.500
November 25, 2019
ANALYTICAL LABORATORY REPORT
DA\Project Forms\Projects\5778.500 The UNCC Heritage Phase I - Test Pits\Phase II\Appendix III.rtf

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
SUMMIT Engineering, Laboratory & Testing, P.C.
3575 Centre Circle
Fort Mill, SC 28715
Attention: Patrick Lowery
Project Name: Heritage
Project Number: 5778.5
Lot Number:UK08120
Date Completed:11/15/2019
11 /15/2019 2:37 PM
Approved and released by:
Lab Director - Greenville: Lucas Odom
pCCRF�4
AM
AC CF ED I T E D
qB
11900 ELAP
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 1 of 23

SHEALY ENVIRONMENTAL SERVICES, INC.
SC DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
SUMMIT Engineering, Laboratory & Testing, P.C.
Lot Number: UK08120
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary
following this Case Narrative. The sample receiving date is documented in the header information
associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most
current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality
Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any
exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or
discussed below.
Where applicable, all soil sample analysis are reported on a dry weight basis unless flagged with a "W"
qualifier
If you have any questions regarding this report please contact the Shealy Project Manager listed on the
cover page.
PAHs by GC/MS
The following sample was diluted due to the nature of the sample matrix: UK08120-003. The LOQ has
been elevated to reflect the dilution.
VOCs by GC/MS
The following sample was diluted due to the nature of the sample matrix: UK08120-003. The LOQ has
been elevated to reflect the dilution.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 2 of 23

SHEALY ENVIRONMENTAL SERVICES, INC.
Sample Summary
SUMMIT Engineering, Laboratory & Testing, P.C.
Lot Number: UK08120
Sample Number
Sample ID
Matrix
Date Sampled
Date Received
001
SS-1
Solid
11/08/20191000
11/08/2019
002
SS-2
Solid
11/08/20191020
11/08/2019
003
SS-3
Solid
11/08/20191040
11/08/2019
(3 samples)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of 23

SHEALY ENVIRONMENTAL SERVICES, INC.
Detection Summary
SUMMIT Engineering, Laboratory & Testing, P.C.
Lot Number: UK08120
Sample Sample ID
Matrix
Parameter
Method
Result Q
Units
Page
001
SS-1
Solid
Ethylbenzene
8260B
11
ug/kg
5
001
SS-1
Solid
Naphthalene
8260B
5800
ug/kg
5
001
SS-1
Solid
Xylenes (total)
8260B
33
ug/kg
5
001
SS-1
Solid
Anthracene
8270D
470 J
ug/kg
5
001
SS-1
Solid
Naphthalene
8270D
5800
ug/kg
5
001
SS-1
Solid
Phenanthrene
8270D
3400
ug/kg
5
(6 detections)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 4 of 23

Client: SUMMIT Engineering, Laboratory & Testing, P.C. Laboratory ID:UK08120-001
Description: SS-1 Matrix: Solid
Date Sampled:11/08/2019 1000 % Solids: 86.7 11/09/2019 0343
)ate Received: 11 /08/2019
Volatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
Sample Wt.(g)
1 5035
8260B 1 11/13/2019 0222 ALR1
35469
5.65
2 5035 High
8260B 1 11/13/2019 2238 ALR1
35622
5.51
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Benzene
71-43-2 8260B
ND
5.1
2.0
ug/kg
1
Ethylbenzene
100-41-4 8260B
11
5.1
2.0
ug/kg
1
Naphthalene
91-20-3 8260B
5800
300
120
ug/kg
2
Toluene
108-88-3 8260B
ND
5.1
2.0
ug/kg
1
Xylenes (total)
1330-20-7 8260B
33
10
4.1
ug/kg
1
Run 1 Acceptance Run
2 Acceptance
Surrogate
Q % Recovery Limits Q % Recovery Limits
1,2-Dichloroethane-d4
82 53-142 76
53-142
Bromofluorobenzene
92 47-138 85
47-138
Toluene-d8
106 68-124 84
68-124
Semivolatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
1 3546
8270D 100 11/12/2019 2022 SCD
11/11/2019 2045
35280
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Acenaphthene
83-32-9 8270D
ND
1500
560
ug/kg
1
Acenaphthylene
208-96-8 8270D
ND
1500
350
ug/kg
1
Anthracene
120-12-7 8270D
470 J
1500
290
ug/kg
1
Benzo(a)anthracene
56-55-3 8270D
ND
1500
220
ug/kg
1
Benzo(a)pyrene
50-32-8 8270D
ND
1500
190
ug/kg
1
Benzo(b)fluoranthene
205-99-2 8270D
ND
1500
220
ug/kg
1
Benzo(g,h,i)perylene
191-24-2 8270D
ND
1500
420
ug/kg
1
Benzo(k)fluoranthene
207-08-9 8270D
ND
1500
240
ug/kg
1
Chrysene
218-01-9 8270D
ND
1500
340
ug/kg
1
Dibenzo(a,h)anthracene
53-70-3 8270D
ND
1500
330
ug/kg
1
Fluoranthene
206-44-0 8270D
ND
1500
240
ug/kg
1
Fluorene
86-73-7 8270D
ND
1500
210
ug/kg
1
Indeno(1,2,3-c,d)pyrene
193-39-5 8270D
ND
1500
300
ug/kg
1
Naphthalene
91-20-3 8270D
5800
1500
520
ug/kg
1
Phenanthrene
85-01-8 8270D
3400
1500
250
ug/kg
1
Pyrene
129-00-0 8270D
ND
1500
310
ug/kg
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
2-Fluorobiphenyl
125 24-137
Nitrobenzene-d5
90 12-144
Terphenyl-d14
100 20-127
LOQ = Limit of Quantitation
B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL =
Detection Limit
NO = Not detected at or above the DL
N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated
result < LOQ and > DL
H = Out of holding time
W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 5 of 23

Client: SUMMIT Engineering, Laboratory & Testing, P.C. Laboratory ID:UK08120-002
Description: SS-2 Matrix: Solid
Date Sampled:11/08/2019 1020 % Solids: 85.7 11/09/2019 0343
Date Received: 11 /08/2019
Volatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst Prep Date
Batch
Sample Wt.(g)
1 5035
8260B 1 11/13/2019 0244 ALR1
35469
5.60
2 5035
8260B 1 11/14/2019 0009 ALR1
35621
5.57
CAS Analytical
Parameter
Number Method Result Q
LOQ
DL
Units
Run
Benzene
71-43-2 8260B ND
5.2
2.1
ug/kg
1
Ethylbenzene
100-41-4 8260B ND
5.2
2.1
ug/kg
1
Naphthalene
91-20-3 8260B ND
5.2
2.1
ug/kg
2
Toluene
108-88-3 8260B ND
5.2
2.1
ug/kg
1
Xylenes (total)
1330-20-7 8260B ND
10
4.2
ug/kg
1
Run 1 Acceptance Run 2 Acceptance
Surrogate
Q % Recovery Limits Q % Recovery Limits
1,2-Dichloroethane-d4
79 53-142 79 53-142
Bromofluorobenzene
100 47-138 100 47-138
Toluene-d8
96 68-124 95 68-124
Semivolatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst Prep Date
Batch
1 3546
8270D 1 11/12/2019 1957 SCD 11/11/2019 2045
35280
CAS Analytical
Parameter
Number Method Result Q
LOQ
DL
Units
Run
Acenaphthene
83-32-9 8270D ND
15
5.6
ug/kg
1
Acenaphthylene
208-96-8 8270D ND
15
3.6
ug/kg
1
Anthracene
120-12-7 8270D ND
15
2.9
ug/kg
1
Benzo(a)anthracene
56-55-3 8270D ND
15
2.2
ug/kg
1
Benzo(a)pyrene
50-32-8 8270D ND
15
1.9
ug/kg
1
Benzo(b)fluoranthene
205-99-2 8270D ND
15
2.2
ug/kg
1
Benzo(g,h,i)perylene
191-24-2 8270D ND
15
4.2
ug/kg
1
Benzo(k)fluoranthene
207-08-9 8270D ND
15
2.4
ug/kg
1
Chrysene
218-01-9 8270D ND
15
3.5
ug/kg
1
Dibenzo(a,h)anthracene
53-70-3 8270D ND
15
3.3
ug/kg
1
Fluoranthene
206-44-0 8270D ND
15
2.4
ug/kg
1
Fluorene
86-73-7 8270D ND
15
2.2
ug/kg
1
Indeno(1,2,3-c,d)pyrene
193-39-5 8270D ND
15
3.0
ug/kg
1
Naphthalene
91-20-3 8270D ND
15
5.2
ug/kg
1
Phenanthrene
85-01-8 8270D ND
15
2.5
ug/kg
1
Pyrene
129-00-0 8270D ND
15
3.2
ug/kg
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
2-Fluorobiphenyl
88 24-137
Nitrobenzene-d5
96 12-144
Terphenyl-d14
106 20-127
LOQ = Limit of Quantitation
B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL =
Detection Limit
NO = Not detected at or above the DL
N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated
result < LOQ and > DL
H = Out of holding time
W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 6 of 23

Client: SUMMIT Engineering, Laboratory & Testing, P.C. Laboratory ID:UK08120-003
Description: SS-3 Matrix: Solid
Date Sampled:11/08/2019 1040 % Solids: 82.8 11/09/2019 0343
Date Received: 11 /08/2019
Volatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
Sample Wt.(g)
2 5035 High
8260B 1 11/13/2019 2301 ALR1
35622
4.76
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Benzene
71-43-2 8260B
ND
370
150
ug/kg
2
Ethylbenzene
100-41-4 8260B
ND
370
150
ug/kg
2
Naphthalene
91-20-3 8260B
ND
370
150
ug/kg
2
Toluene
108-88-3 8260B
ND
370
150
ug/kg
2
Xylenes (total)
1330-20-7 8260B
ND
740
300
ug/kg
2
Run 2 Acceptance
Surrogate
Q % Recovery Limits
1,2-Dichloroethane-d4
81 53-142
Bromofluorobenzene
85 47-138
Toluene-d8
86 68-124
Semivolatile Organic Compounds by GC/MS
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
1 3546
8270D 50 11/12/2019 1817 SCD
11/11/2019 2045 35280
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Acenaphthene
83-32-9 8270D
ND
800
300
ug/kg
1
Acenaphthylene
208-96-8 8270D
ND
800
190
ug/kg
1
Anthracene
120-12-7 8270D
ND
800
150
ug/kg
1
Benzo(a)anthracene
56-55-3 8270D
ND
800
120
ug/kg
1
Benzo(a)pyrene
50-32-8 8270D
ND
800
100
ug/kg
1
Benzo(b)fluoranthene
205-99-2 8270D
ND
800
120
ug/kg
1
Benzo(g,h,i)perylene
191-24-2 8270D
ND
800
230
ug/kg
1
Benzo(k)fluoranthene
207-08-9 8270D
ND
800
130
ug/kg
1
Chrysene
218-01-9 8270D
ND
800
190
ug/kg
1
Dibenzo(a,h)anthracene
53-70-3 8270D
ND
800
180
ug/kg
1
Fluoranthene
206-44-0 8270D
ND
800
130
ug/kg
1
Fluorene
86-73-7 8270D
ND
800
120
ug/kg
1
Indeno(1,2,3-c,d)pyrene
193-39-5 8270D
ND
800
160
ug/kg
1
Naphthalene
91-20-3 8270D
ND
800
280
ug/kg
1
Phenanthrene
85-01-8 8270D
ND
800
130
ug/kg
1
Pyrene
129-00-0 8270D
ND
800
170
ug/kg
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
2-Fluorobiphenyl
130 24-137
Nitrobenzene-d5
N 211 12-144
Terphenyl-d14
95 20-127
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
NO = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated result < LOQ and > DL
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 7 of 23

QC Summary
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 8 of 23

Volatile Organic Compounds by GC/MS - MB
Sample ID: UQ35469-001 Matrix: Solid
Batch: 35469 Prep Method: 5035
Analytical Method: 8260B
Parameter
Result Q
Dil
LOQ
DL
Units
Analysis Date
Benzene
ND
1
5.0
2.0
ug/kg
11/12/2019 2111
Ethylbenzene
ND
1
5.0
2.0
ug/kg
11/12/2019 2111
Toluene
ND
1
5.0
2.0
ug/kg
11/12/2019 2111
Xylenes (total)
ND
1
10
4.0
ug/kg
11/12/2019 2111
Acceptance
Surrogate Q % Rec Limit
1,2-Dichloroethane-d4 84 53-142
Bromofluorobenzene 100 47-138
Toluene-d8 98 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 9 of 23

Volatile Organic Compounds by GC/MS - LCS
Sample ID: UQ35469-002
Matrix:
Solid
Batch: 35469
Prep Method:
5035
Analytical Method: 8260B
Spike
Amount
Result
% Rec
Parameter
(ug/kg)
(ug/kg) Q
Dil
% Rec
Limit
Analysis Date
Benzene
50
48
1
96
70-130
11/12/2019 2008
Ethylbenzene
50
50
1
101
70-130
11/12/2019 2008
Toluene
50
49
1
98
70-130
11/12/2019 2008
Xylenes (total)
100
100
1
101
70-130
11/12/2019 2008
Acceptance
Surrogate
Q % Rec
Limit
1,2-Dichloroethane-d4 86 53-142
Bromofluorobenzene 103 47-138
Toluene-d8 101 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 10 of 23

Volatile Organic Compounds by GC/MS - LCSD
Sample ID: UQ35469-003
Matrix: Solid
Batch: 35469
Prep
Method: 5035
Analytical Method: 8260B
Spike
Amount
Result
% Rec
% RPD
Parameter
(ug/kg)
(ug/kg) Q
Dil
% Rec % RPD
Limit
Limit
Analysis Date
Benzene
50
46
1
93
3.4
70-130
20
11/12/2019 2031
Ethylbenzene
50
49
1
98
3.1
70-130
20
11/12/2019 2031
Toluene
50
49
1
98
0.28
70-130
20
11/12/2019 2031
Xylenes (total)
100
98
1
98
2.4
70-130
20
11/12/2019 2031
Acceptance
Surrogate Q % Rec Limit
1,2-Dichloroethane-d4 83 53-142
Bromofluorobenzene 99 47-138
Toluene-d8 98 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 11 of 23

Volatile Organic Compounds by GC/MS - MB
Sample ID: UQ35621-001 Matrix: Solid
Batch:35621 Prep Method: 5035
Analytical Method: 8260B
Parameter Result Q Dil LOQ DL Units Analysis Date
Naphthalene ND 1 5.0 2.0 ug/kg 11/13/2019 2157
Acceptance
Surrogate Q % Rec Limit
1,2-Dichloroethane-d4 80 53-142
Bromofluorobenzene 99 47-138
Toluene-d8 96 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 12 of 23

Volatile Organic Compounds by GC/MS - LCS
Sample ID: UQ35621-002 Matrix: Solid
Batch:35621 Prep Method: 5035
Analytical Method: 8260B
Spike
Amount Result % Rec
Parameter (ug/kg) (ug/kg) Q Dil % Rec Limit Analysis Date
Naphthalene 50 50 1 101 70-130 11 /13/2019 1958
Acceptance
Surrogate Q % Rec Limit
1,2-Dichloroethane-d4 79 53-142
Bromofluorobenzene 98 47-138
Toluene-d8 96 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 13 of 23

Volatile Organic Compounds by GC/MS - LCSD
Sample ID: UQ35621-003 Matrix: Solid
Batch:35621 Prep Method: 5035
Analytical Method: 8260B
Spike
Amount Result % Rec % RPD
Parameter (ug/kg) (ug/kg) Q Dil % Rec % RPD Limit Limit Analysis Date
Naphthalene 50 51 1 101 0.53 70-130 20 11/13/2019 2020
Acceptance
Surrogate Q % Rec Limit
1,2-Dichloroethane-d4 77 53-142
Bromofluorobenzene 95 47-138
Toluene-d8 97 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 14 of 23

Volatile Organic Compounds by GC/MS - MB
Sample ID: UQ35622-001 Matrix: Solid
Batch: 35622 Prep Method: 5035 High
Analytical Method: 8260B
Parameter
Result
Q Dil
LOQ
DL
Units
Analysis Date
Benzene
ND
1
250
100
ug/kg
11/13/2019 2122
Ethylbenzene
ND
1
250
100
ug/kg
11/13/2019 2122
Naphthalene
ND
1
250
100
ug/kg
11/13/2019 2122
Toluene
ND
1
250
100
ug/kg
11/13/2019 2122
Xylenes (total)
ND
1
500
200
ug/kg
11/13/2019 2122
Surrogate
Q % Rec
Acceptance
Limit
1,2-Dichloroethane-d4 83 53-142
Bromofluorobenzene 93 47-138
Toluene-d8 91 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 15 of 23

Volatile Organic Compounds by GC/MS - LCS
Sample ID: UQ35622-002
Matrix:
Solid
Batch: 35622
Prep Method:
5035 High
Analytical Method: 8260B
Spike
Amount
Result
% Rec
Parameter
(ug/kg)
(ug/kg) Q
Dil
% Rec
Limit
Analysis Date
Benzene
2500
2400
1
96
70-130
11/13/2019 2059
Ethylbenzene
2500
2700
1
106
70-130
11/13/2019 2059
Naphthalene
2500
2500
1
102
70-130
11/13/2019 2059
Toluene
2500
2600
1
104
70-130
11/13/2019 2059
Xylenes (total)
5000
5300
1
106
70-130
11/13/2019 2059
Acceptance
Surrogate
Q % Rec
Limit
1,2-Dichloroethane-d4 79 53-142
Bromofluorobenzene 93 47-138
Toluene-d8 91 68-124
LOQ = Limit of Quantitation P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
DL = Detection Limit J = Estimated result < LOQ and > DL + = RPD is out of criteria
LOD = Limit of Detection ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 16 of 23

Semivolatile Organic Compounds by GC/MS - MB
Sample ID: UQ35280-001 Matrix: Solid
Batch: 35280 Prep Method: 3546
Analytical Method: 8270D Prep Date: 11/11/2019 2045
Parameter
Result Q
Dil
LOQ
DL
Units
Analysis Date
Acenaphthene
ND
1
13
5.0
ug/kg
11/12/20191431
Acenaphthylene
ND
1
13
3.2
ug/kg
11/12/20191431
Anthracene
ND
1
13
2.6
ug/kg
11/12/20191431
Benzo(a)anthracene
ND
1
13
2.0
ug/kg
11/12/20191431
Benzo(a)pyrene
ND
1
13
1.7
ug/kg
11/12/20191431
Benzo(b)fluoranthene
ND
1
13
1.9
ug/kg
11/12/20191431
Benzo(g,h,i)perylene
ND
1
13
3.8
ug/kg
11/12/20191431
Benzo(k)fluoranthene
ND
1
13
2.1
ug/kg
11/12/20191431
Chrysene
ND
1
13
3.1
ug/kg
11/12/20191431
Dibenzo(a,h)anthracene
ND
1
13
3.0
ug/kg
11/12/20191431
Fluoranthene
ND
1
13
2.2
ug/kg
11/12/20191431
Fluorene
ND
1
13
1.9
ug/kg
11/12/20191431
Indeno(1,2,3-c,d)pyrene
ND
1
13
2.7
ug/kg
11/12/20191431
Naphthalene
ND
1
13
4.7
ug/kg
11/12/20191431
Phenanthrene
ND
1
13
2.3
ug/kg
11/12/20191431
Pyrene
ND
1
13
2.8
ug/kg
11/12/20191431
Surrogate Q % Rec Acceptance
Limit
2-Fluorobiphenyl 89 24-137
Nitrobenzene-d5 100 12-144
Terphenyl-d14 116 20-127
LOQ = Limit of Quantitation
DL = Detection Limit
LOD = Limit of Detection
P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
J = Estimated result < LOQ and > DL + = RPD is out of criteria
ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 17 of 23

Semivolatile Organic Compounds by GC/MS - LCS
Sample ID: UQ35280-002
Matrix:
Solid
Batch: 35280
Prep Method:
3546
Analytical Method: 8270D
Prep Date: 11/11/2019 2045
Spike
Amount
Result
% Rec
Parameter
(ug/kg)
(ug/kg)
Q Dil
% Rec
Limit
Analysis Date
Acenaphthene
670
550
1
83
46-114
11/12/20191456
Acenaphthylene
670
580
1
87
44-122
11/12/20191456
Anthracene
670
620
1
93
50-119
11/12/20191456
Benzo(a)anthracene
670
600
1
90
47-121
11/12/20191456
Benzo(a)pyrene
670
630
1
94
55-134
11/12/20191456
Benzo(b)fluoranthene
670
550
1
83
28-139
11/12/20191456
Benzo(g,h,i)perylene
670
700
1
105
36-125
11/12/20191456
Benzo(k)fluoranthene
670
550
1
82
47-130
11/12/20191456
Chrysene
670
630
1
95
45-126
11/12/20191456
Dibenzo(a,h)anthracene
670
660
1
100
45-122
11/12/20191456
Fluoranthene
670
610
1
92
50-123
11/12/20191456
Fluorene
670
590
1
89
48-117
11/12/20191456
Indeno(1,2,3-c,d)pyrene
670
650
1
97
45-123
11/12/20191456
Naphthalene
670
560
1
84
36-110
11/12/20191456
Phenanthrene
670
590
1
89
49-117
11/12/20191456
Pyrene
670
590
1
88
47-119
11/12/20191456
Surrogate Q % Rec Acceptance
Limit
2-Fluorobiphenyl 88 24-137
Nitrobenzene-d5 112 12-144
Terphenyl-d14 107 20-127
LOQ = Limit of Quantitation
DL = Detection Limit
LOD = Limit of Detection
P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
J = Estimated result < LOQ and > DL + = RPD is out of criteria
ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 18 of 23

Semivolatile Organic Compounds by GC/MS - MS
Sample ID: UK08120-001 MS
Matrix:
Solid
Batch: 35280
Prep Method:
3546
Analytical Method: 8270D
Prep Date: 11/11/2019 2045
Sample
Spike
Amount
Amount
Result
% Rec
Parameter
(ug/kg)
(ug/kg)
(ug/kg)
Q
Dil
% Rec
Limit
Analysis Date
Acenaphthene
ND
750
1300
N
100
167
46-114
11/12/2019 2047
Acenaphthylene
ND
750
1500
N
100
201
44-122
11/12/2019 2047
Anthracene
470
750
1400
100
119
50-119
11/12/2019 2047
Benzo(a)anthracene
ND
750
1000
N
100
133
47-121
11/12/2019 2047
Benzo(a)pyrene
ND
750
700
100
93
55-134
11/12/2019 2047
Benzo(b)fluoranthene
ND
750
700
100
93
28-139
11/12/2019 2047
Benzo(g,h,i)perylene
ND
750
460
100
61
36-125
11/12/2019 2047
Benzo(k)fluoranthene
ND
750
680
100
90
47-130
11/12/2019 2047
Chrysene
ND
750
770
100
102
45-126
11/12/2019 2047
Dibenzo(a,h)anthracene
ND
750
ND
N
100
0.00
45-122
11/12/2019 2047
Fluoranthene
ND
750
1000
N
100
136
50-123
11/12/2019 2047
Fluorene
ND
750
2700
N
100
365
48-117
11/12/2019 2047
Indeno(1,2,3-c,d)pyrene
ND
750
ND
N
100
0.00
45-123
11/12/2019 2047
Naphthalene
5800
750
6600
100
101
36-110
11/12/2019 2047
Phenanthrene
3400
750
4300
100
117
49-117
11/12/2019 2047
Pyrene
ND
750
820
100
109
47-119
11/12/2019 2047
Surrogate Q % Rec Acceptance
Limit
2-Fluorobiphenyl 121 24-137
Nitrobenzene-d5 31 12-144
Terphenyl-d14 98 20-127
LOQ = Limit of Quantitation
DL = Detection Limit
LOD = Limit of Detection
P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
J = Estimated result < LOQ and > DL + = RPD is out of criteria
ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 19 of 23

Semivolatile Organic Compounds by GC/MS - MSD
Sample ID: UK08120-001 MD
Matrix:
Solid
Batch: 35280
Prep
Method:
3546
Analytical Method: 8270D
Prep Date: 11/11/2019 2045
Sample
Spike
Amount
Amount
Result
% Rec
% RPD
Parameter
(ug/kg)
(ug/kg)
(ug/kg)
Q
Dil
% Rec
% RPD
Limit
Limit
Analysis Date
Acenaphthene
ND
760
1100
N
100
139
17
46-114
30
11/12/2019 2112
Acenaphthylene
ND
760
1300
N
100
173
14
44-122
30
11/12/2019 2112
Anthracene
470
760
1300
100
112
3.4
50-119
30
11/12/2019 2112
Benzo(a)anthracene
ND
760
1000
N
100
130
0.76
47-121
30
11/12/2019 2112
Benzo(a)pyrene
ND
760
680
100
89
3.7
55-134
30
11/12/2019 2112
Benzo(b)fluoranthene
ND
760
710
100
94
2.0
28-139
30
11/12/2019 2112
Benzo(g,h,i)perylene
ND
760
ND
N,+
100
0.00
200
36-125
30
11/12/2019 2112
Benzo(k)fluoranthene
ND
760
720
100
94
5.2
47-130
30
11/12/2019 2112
Chrysene
ND
760
810
100
106
5.2
45-126
30
11/12/2019 2112
Dibenzo(a,h)anthracene
ND
760
ND
N
100
0.00
0.00
45-122
30
11/12/2019 2112
Fluoranthene
ND
760
1100
N
100
150
11
50-123
30
11/12/2019 2112
Fluorene
ND
760
2700
N
100
359
0.11
48-117
30
11/12/2019 2112
Indeno(1,2,3-c,d)pyrene
ND
760
ND
N
100
0.00
0.00
45-123
30
11/12/2019 2112
Naphthalene
5800
760
6200
100
50
6.0
36-110
30
11/12/2019 2112
Phenanthrene
3400
760
4100
100
93
4.1
49-117
30
11/12/2019 2112
Pyrene
ND
760
990
N
100
130
19
47-119
30
11/12/2019 2112
Surrogate Q % Rec Acceptance
Limit
2-Fluorobiphenyl 128 24-137
Nitrobenzene-d5 21 12-144
Terphenyl-d14 95 20-127
LOQ = Limit of Quantitation
DL = Detection Limit
LOD = Limit of Detection
P = The RPD between two GC columns exceeds 40 % N = Recovery is out of criteria
J = Estimated result < LOQ and > DL + = RPD is out of criteria
ND = Not detected at or above the DL
Note: Calculations are performed before rounding to avoid round -off errors in calculated results
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 20 of 23

Chain of Custody
and
Miscellaneous Documents
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 21 of 23

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106 Vantage Point Drive West Columbia, SC 29172 (803)
791-9700
Fax [phone] www.shealylab.com
Page
22 of 23

SHEALY ENVIRONMENTAL SERVICES, INC.
Sheaf &vlronmcntal SrTvum, Im Pugs 1 nF1
Pxrurami Nnrnhs MFM I Rf r 14 Ef Edda-Wim. W2120111
Sample ReeALApt Clk"I list { RQ
C',licrll.: 5111013it Cooler lnsuccted bvidate: WO 11N4119 1_a 4: UKOS120
';,kEtnyof r4; ipt; &3 5U31 ❑ C<ILunt ❑ UP5 ❑ FedEx n Other:
Yes
I W1 No
m m
11, Wcrc custody seals present on the cooler''
1-1 Yes
Nu-1
14NA
12. if cost ' seals were vent, a erg hkm intact and tutor oke,l?
phi Strip FD: NA Chlurinc Strip lb: TEA T W by; NA
rJrigiaal temperature upon receipt f 37eriv cl (CQrrcetcd) L-mperatuiv upon receipt %,gcFlid Snap -Cup lb: 19-1616
11 11.8 -' NA ,'Kk -,C NA ?VA_wC: NA .,,NA EC
MQ:Lhudl. ®'I mp iratilrc Nail EjrL�,ainst Baal as TR Gun 111 � _ IR Chen Carreaiai rm=Lur 0 °C`-
ahod of coolant Q1 U10 Ice ❑ 1L:v Pack; ❑ TIlry Xaa ❑ None
D No
I1 NA
I' If temperature of any cooler exceeded 6.0°C. vh%9 Project Manager K ntifmd?
PM -,vas N otifred bv" phatie ? email 1 rave-lu-fax (chic one)-
❑ N(1
I1NA
- Is the cornm&eial anurieT'R packing slip a[#adjed [o Ulis Corm?
El No
5. Wam prupe_� custody pmMduTex (Telinqu3shedfrefielv�(E) toila,4td?
FU0001yyy
Ntl
6. Were sample If]5 IiSRCtI on the COC'
❑ No
7- Weir sample fl]� IiAW un all sample ommjn=''
n No
�.Was coIlectinn dale & Ili= listed on the C.00?
❑1Ko
Was Colleetiva data & time listed On a.11 5XIn le GOI!Aaint�?
❑ l+o
10. Did all c4ntalioet Lobel informs#ion (11), date, Lime) p with flee COCe-
❑ Nq
11. Were tests to bs performed listed.011 the CQC?
0 Yes
❑ No
12. Did 3l1.3alripks ard%-. in did prnper containers for pact test andlor in good SonCli[iwl
(unhlnlcpn, lids an, etc-)''
Yes
❑ No
13. %Ym adequate sample volume avail W7
Ycs
—Yes
TO
=4. �4�crc all sainplest+et6i1,etl witllin V2 the holding Emu ur48 hours. whichever rorlu's lill'Sto
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1f1- Fur VOA and RSK-175 samples, were bubbles present zzF-viae'd (�."or 6mrn in diameter)
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❑ Yes
❑ IVU
NA
17-'None all DR4Xm,4al9rnutrient sam les receivext at N pH of<2F
Yes
No
O NA
18. %Vera W1 cyanidg yam pies received at a VH > 12 and sul fide s¢utlpl es received at a114> 9?
❑ Y�-v
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21. Was the tjwle riumbu 16tcd on the cowaiMrr EPba"' li es Qkjoue 4 NA
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13irre t)t'preservation NA TFrnom than one prese;ryalivr is netadod, pieagn-note iti 111W COITIMe11ts brio'Lv.
ample(3) were received with bubbles >6 rllm in diametier
err,p[cs(s) NA wcne received -,with TRC > 4.5 ing, !- (1f 419 is no) and wem
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SR barcede labels applied bl'; B[b G7SH lam- 11MV19
C4mmerlts.• .
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 23 of 23

The Heritage at UNCC
Charlotte, North Carolina
APPENDIX IV
UST 61
SUMMIT Project No. 5778.500
November 25, 2019
DA\Project Forms\Projects\5778.500 The UNCC Heritage Phase I - Test Pits\Phase II\Appendix IV.rtf

UST-61
24-Hour Release and UST Leak Reporting Form.
For Releases This form should be completed and submitted to the UST Section's regional office following a known or suspected release from
an underground storage tank (UST) system. This form is required to be submitted within 24 hours of discovery of a known or
in NC
suspected release
(DWM USE ONLY)
Suspected Contamination? (Y/N)
Facility ID Number
Incident # Risk (H,I,L,U)
Confirmed GW Contamination? (Y/N)
Date Leak Discovered
Received On Received By
Confirmed Soil Contamination ?(Y/N)
Comm/Non-Commercial?
Reported by (circle one): Phone, Fax or Report
Samples Taken?(Y/N)
Reg/Non-regulated?
Region
Free Product? (Y/N) If Yes, State Greatest
Thickness
INCIDENT DESCRIPTION
Incident Name:
Address:
County:
Regional Office (circle one): Asheville, Mooresville, Fayetteville,
City/Town:
Zip Code:
Raleigh, Washington, Wilmington, Winston-Salem
Latitude (decimal degrees):
Longitude (decimal degrees) :
Obtained by:
❑GPS
Briefly describe suspected or confirmed release: (including but not limited to: nature of release, date of release, amount
of release, amount of free product present and recovery efforts, initial responses conducted, impacts to receptors)
❑Topographic map
❑GIS Address matching
❑Other
❑ Unknown
Describe location:
HOW RELEASE WAS DISCOVERED (Release code)
(Check one)
❑Release Detection Equipment or Methods ❑Visual/Odor ❑Groundwater Contamination
❑During UST Closure/Removal
❑Water in Tank ❑Surface Water Contamination
❑Property Transfer
❑Water Supply Well Contamination ❑Other (specify)
SOURCE OF CONTAMINATION
Source of Release
Cause of Release Type of Release Product Type Released
(Check primary source)
(Check primary cause) (Check one) (Check primary product type released)
❑ Tank
❑ Spill ❑ Petroleum ❑ Gasoline/ Diesel/ ❑ Diesel/Veg. Oil
❑ Piping
❑ Overfill ❑ Non -Petroleum Kerosene Blend
❑ Dispenser
❑Heating Oil ❑ Vegetable Oil 100%
Corrosion Both
❑❑
❑ Other Petroleum ❑ E10 - E20
❑ Submersible Turbine Pump
❑Physical/Mechanical
❑ Delivery Problem
Location Products
Damage ❑ E21 - E84
(Check one) Metals
❑
❑ Install Problem ❑ E85 - E99
❑ Spill Bucket
❑ Other Inorganics
❑ Other [-]Facility ❑Ethanol 100%
❑ Other
❑ Other Organics
❑ Unknown ❑Residence ❑ E01 - E09
❑ Unknown
❑Other
Definitions presented on reverse
Definitions presented on reverse
Ownership
1. Municipal 2. Military 3. Unknown
4. Private 5. Federal 6. County 7. State
Operation Type
1. Public Service 2. Agricultural 3.
Residential 4. Education/Relig. 5. Industrial 6. Commercial 7. Mining
UST Form 61 (02/19) Page 1 of 2

IMPACT ON DRINKING WATER SUPPLIES
Water Supply Wells Affected? 1. Yes 2. No 3. Unknown
Number of Water Supply Wells Affected
Water Supply Wells Contaminated:
1.
2.
3.
(Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
UST Owner/Company
UST SYSTEM OWNER
Point of Contact
Address
City
State
Zip Code
Telephone Number
UST SYSTEM OPERATOR
UST Operator/Company
Address
City
State
Zip Code
Telephone Number
LANDOWNER AT LOCATION OF UST INCIDENT
Landowner
Address
City
State
Zip Code
Telephone Number
Draw Sketch of Area (showing two major road intersections) or Attach Map
Person Reporting Incident
Company
Telephone Number
Title
Address
Date
UST Form 61 (02/19)
Page 2 of 2
Definitions of Sources
Tank: means the tank that stores the product and is part of the underground storage tank system
Piping: means the piping and connectors running from the tank or submersible turbine pump to the dispenser or other end -use equipment (Vent, vapor recovery, or fill
lines are excluded.)
Dispenser: includes the dispenser and the equipment used to connect the dispenser to the piping (e.g., a release from a suction pump or from components located above
the shear valve)
Submersible Turbine Pump (STP) Area includes the submersible turbine pump head (typically located in the tank sump), the line leak detector, and the piping that
connects the submersible turbine pump to the tank
Delivery Problem: identifies releases that occurred during product delivery to the tank. (Typical causes associated with this source are spills and overfills.)
Other: serves as the option to use when the release source is known but does not fit into one of the preceding categories (e.g., for releases from vent lines, vapor
recovery lines, and fill lines)
Unknown: identifies releases for which the source has not been determined
Definitions of Causes
Spill: use this cause when a spill occurs (e.g., when the delivery hose is disconnected from the tank fill pipe or when the nozzle is removed from the dispenser)
Overfill: use when an overfill occurs (e.g., overfills may occur from the fill pipe at the tank or when the nozzle fails to shut off at the dispenser)
Physical or Mechanical Damage: use for all types of physical or mechanical damage, except corrosion (e.g., puncture of tank or piping, loose fittings, broken
components, and components that have changed dimension)
Corrosion: use when a metal tank, piping, or other component has a release due to corrosion (e.g., for steel, corrosion takes the form of rust)
Installation Problem: use when the problem is determined to have occurred specifically because the UST system was not installed properly
Other: use this option when the cause is known but does not fit into one of the preceding categories (e.g., putting regulated substances into monitoring wells)
Unknown: use when the cause has not been determined

Beverly, Trudy
From: Patrick Lowery <[e-mail]>
Sent: Monday, April 19, 2021 1:08 PM
To: Beverly, Trudy
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Trudy,
Thanks for sending over this information. Im working up the IAA report for this closure and ran into an issue. Just
wanted to confirm with you before we jumped back in the field.
We did the initial closure and had exceedances of the MSCC Soil to groundwater in a few sidewalls and base. The
developer wants to go for clean closure so we went out and pulled more soil out. All sidewalls were excavated and
base. We collected samples from the sidewalls and base that we determined to be over MSCC. I overlooked a sidewall
that had previously shown 0.061 mg/kg benzo(a)pyrene above the Soil to Groundwater of 0.058 mg/k and Aromatics at
53 mg/kg above the 31 mg/kg MSCC. We did remove more from that sidewall, but I do not have a confirmation
sample. If submitted as is, would you need that sidewall sample for NFA? If so, can we run only the analysis for the
compound that was above MSCC (PAHs, EPH/VPH for this one) previously?
Feel free to call my cell if that is easier. Thanks for your help.
Patrick
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston
From: Beverly, Trudy <[e-mail]>
Sent: Monday, April 5, 2021 3:43 PM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Hey Patrick,
Incident #47669
Updated guidance documents were put on the UST website 1/19/2021. Report templates can be found at the following
link
Comprehesive Guidelines Appendices or STIRA, Assessment Guidelines and Corrective Action
Guidelines (appendices)
https://deg.nc.gov/about/divisions/waste-management/ust/guidance-documents

(starts on page 25 of 211) Appendix A 8. Initial Abatement Action (Site Check, UST Closure with UST-2
Form, Excavation, Post -Excavation Soil Contamination Assessment) Report
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
r4rvnR mt qu.Yry�`
704.235.2182 (Office)
Trudy.B everly(ancdenr. gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: hit2s://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: hitps://deg.nc.gov/about/divisions/waste-management/ust/ast-proeram
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https://dea.nc. eov/about/divisions/waste-manaaement/waste-management-rules-data/waste-management-eis-mans
File Review Procedures:
https://deq.nc. gov/about/divisions/waste-mana2ement/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hitps://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.nc.¢ov/ncdea/Waste%2OManaizement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.adf
https:Hfiles.nc. gov/ncdeq/Waste%2OManagement/D WMiUST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Patrick Lowery [mailto:[e-mail]]
Sent: Monday, April 5, 2021 2:14 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
Good afternoon. We submitted the attached release notification last May for the heating oil tank at 9920 Mallard Glen
Drive. I cant seem to locate a incident # for this release on laserfiche or DWM GIS. Not sure this one got logged in as I
initially sent this over to Dan.
Either way, our client finely moved forward with closure earlier this year and we need to submit the documentation for
closure. Soil was excavated and we were able to get clean margins on all 4 sidewalls and base. Looking at the updated
Corrective Action report formats, it looks like the Initial Abatement Action report is no longer presented. Would we be
going the format for Soil Cleanup with Closure Request (#12)? Since this appears new I wanted to reach out and get
your advise on how to proceed. Could you point me to a recent approved heating oil tank closure site that I can look up
and review to ensure I cover all my bases. I will have a few more of these to produce so I want to be sure I get you
exactly what you are needing.
Feel free to call me on my cell at 803-230-5087 anytime.
Thank you,
Patrick
From: Patrick Lowery
Sent: Monday, May 4, 2020 11:48 AM

To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Thank you Trudy. I will keep your information for future notifications.
Thanks
Patrick
From: Beverly, Trudy <[e-mail]>
Sent: Monday, May 4, 2020 6:35 AM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Good Morning Patrick,
I handle non -regulated ust releases in Mecklenburg County. Please send future Mecklenburg County non -regulated ust
related documents to my attention.
Thank you and have a wonderful day,
Trudy
cc���DE W
rH V44 _�
dt aWny��
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlygncdenn gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: https://deg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https:Hdeq.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httDs://dea.nc. eov/about/divisions/waste-management/waste-management-rules-data/waste-management-eis-mans
File Review Procedures:
https://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hqps://deg.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httys://files.nc.¢ov/ncdeci/Waste%2OManagement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.adf
https:Hfiles.nc. gov/ncdeq/Waste%2OManagement/D WM[UST/Corrective%2OAction/UST%2Ofile%20names%20for%2OLaserfiche.docx
From: Bowser, Daniel P
Sent: Friday, May 1, 2020 5:08 PM
To: Beverly, Trudy <[e-mail]>
Subject: Fwd: [External] Release Notification - 9920 Mallard Glen Drive
Dan Bowser, PG
NCDEQ
UST Section
Corrective Action Branch

From: Patrick Lowery <[e-mail]>
Sent: Friday, May 1, 2020 4:44:08 PM
To: Bowser, Daniel P <[e-mail]>
Subject: [External] Release Notification - 9920 Mallard Glen Drive
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Dan,
I hope you are well. I have attached a release notification for a heating oil UST we assessed in November last year. Our
client requested the owner complete the attached, however it did not get completed. We are submitting on their behalf
prior to real-estate transaction. If there is a person or admin I should be sending these too, please let me know.
Thanks
Patrick
"k.
MIA M
SUMMIT
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com [summit-companies.coml
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston