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MO-4051_12019_CA_CLO_19940228_UST Closure Report
COPYA PRECISION ENVIRONMENTAL February 28, 1994 Fletcher Oil Company 508 Crow Street Monroe, North Carolina 28110 Attention: Mr. Harlin Brooks Subject: UST Closure Assessment Beatty's Indian River Fruit Grocery Highway 601 and 24/27 Midland, North Carolina Dear Mr. Brooks: V OF WiA�,j 1 4 1994 o1Vis"cm of 1, 1h00% 1100R�SVim REGI m OFF!C>: Precision Environmental Inc. completed an Underground Storage Tank (UST) closure assessment for the above referenced facility. A brief description of the field work performed by Precision Environmental Inc., along with laboratory results, are included below. Petroleum hydrocarbons were detected in both groundwater and soils beneath the three USTs which were removed on February 8, 1994. Petroleum compounds detected in the groundwater did not exceed North Carolina Action Leves for those compounds. However, one of the ten soil samples did contain Total Petroleum Hydrocarbons (TPH) concentrations exceeding State Action Levels. Therefore, Precision Environmental Inc. expects that the State of North Carolina, through the Division of Environmental Management (NCDEM), may require further assessment activities at this site related to the UST closure activities described below. UST Closure Activities: The referenced site is located at Highway 601 and Highways 24/27 in Midland, North Carolina as shown on the Site Location Map (Figure 1). The site was used in the past as a gasoline retail store. Two (2) 4,000 gallon USTs and (1) 6,000 gallon UST were removed from their locations on February 8, 1994 by Precision Environmental, Inc. All three USTs had contained gasoline. Holes were not observed in any of the USTs. Excavated soils did have a petroleum odor. The excavated soils were stockpiled on site. Backfill was added to the excavation representing the volume of the USTs and stockpiled soil. All USTs were together in one area. The excavation was extended to a depth of about 12 feet below land surface. Groundwater was observed to collect in the excavation. Bedrock was encountered at the bottom of the excavation. 120 Penmarc Drive F Suite 101 --] Raleigh, NC 27603 'D Tel. (919) 829-0305 D FAX (919) 829-0807 Precision Environmental Inc. disposed of the USTs by cleaning them of sludge and cutting the ends out. The USTs were transported by Nationwide Tank Services to their site in Matthews, North Carolina. All three USTs were disposed of as scrap metal. Documentation of UST destruction and waste disposal is attached. Soil Sampling On February 8, 1994, Precision Environmental Inc. collected ten (10) soil samples at the locations shown of Figure 2. Soil samples were collected beneath the USTs and the dispensers to determine if soils have been impacted by petroleum products. UST excavations encompassed the areas containing product piping. The borings were advanced below the bottom of the excavations with a hand auger and decontaminated between each boring with soap and distilled water. One soil sample (D-Sl) was also collected beneath the dispenser island. A soil sample was also collected from the stockpiled soil; and one water sample was collected from the groundwater that accumulated in the excavation. Field Screening Hand Auger samples were collected by our field representative. A portion of each sample was retained in a sealable plastic bag for headspace screening with a HeathTech Porta FID II Organic Vapor Detector (OVD) model PFII, and the other half placed in a clean laboratory supplied glass jar. After allowing the volatile organic constituents in the soils to equilibrate with the headspace of the bag, the probe of the OVD was inserted into the bag and the OVD reading recorded. OVD readings ranged from 0 parts per million (ppm) to 150 ppm(See Table 1). Analytical Testing In addition to screening the soil samples, one portion of each sample was collected and transferred to specially prepared laboratory glass containers and placed in a refrigerated package for transport to a sub -contracted laboratory. The analytical methods selected for the samples were based on NCDEM (North Carolina Division of Environmental Management) guidelines for the products stored on site. A summary of the analytical data is presented in Table 1. The laboratory report and chain -of -custody forms are attached. Ten (10) soil samples were collected and submitted for laboratory analysis. All soil samples were analyzed for Total Petroleum Hydrocarbons (TPH) in the gasoline distillation range by Method 5030 (Table 1). The laboratory analysis did identify concentrations of petroleum hydrocarbons above analytical method quantitation limits in two of the soil samples. Sample D-S 1, collected beneath the dispenser island, contained 2.6 ppm TPH. Sample TB-S3, collected beneath Tank B, contained 61.5 ppm. Only the sample TB-S3 contains TPH concentrations exceeding the North Carolina action limit of .10 ppm for petroleum hydrocarbons (as gasoline) in soils. The water sample, collected from groundwater in the excavation, contained detectable concentrations of ethylbenzene, toluene, and total xylene, although not at concentrations exceeding State Action Levels (See Table 2). Conclusions The OVD and analytical data appear to indicate that petroleum hydrocarbons in the distillation range of gasoline are present in the soils and groundwater beneath one former UST location at this site. Precision Environmental Inc. expects that NCDEM may require further assessment activities related to the closure activities described above. A copy of this report has been included along with the original. The copy should be submitted by Fletcher Oil Company to the Mooresville Regional Office of NCDEM to meet their reporting requirements. Their address is 919 North Main Street, Mooresville, NC. 28115-0950. The form "Site Investigation Report for Permanent Closure of U.S.T." (MUST-2) has been completed and is attached to this report as required by NCDEM. Precision Environmental, Inc. appreciates the opportunity to provide our services for the UST Closure Assessment. Please contact us at your convenience if there are any questions regarding the information contained in this report. Sincerely •y/• J w C rA Y, �V � 03 • � William L. Lyke .•` Licensed Geologist(I q M TABLE 1 Summary of Soil Sample Collection Data and Analytical Results Beatty's Indian River Fruit Grocery Highway 601 and 24/27 Midland, North Carolina Samples Collected February 8, 1994 Sample ID Sample Depth OVD Reading TPH 5030 TA-S 1 12 0 BDL TA-S2 12 80 BDL TB-S3 12 150 61.5 TB-S4 12 6 BDL TB-S5 12 8 BDL TC-S6 12 12 BDL TC-S7 12 20 BDL TC-S8 12 0 BDL D-S 1 3 1 2.6 Stockpile Stockpile 100 BDL Sample Depth in Feet OVD Reading in parts per million (ppm) TPH units in milligrams per kilogram (or ppm) BDL = Below analytical method Detection Limit TABLE 2 Summary of Groundwater Sample Analytical Results Beatty's Indian River Fruit Grocery Highway 601 and 24/27 Midland, North Carolina Grab Sample Collected February 8, 1994 Compound Detected Concentration Detected North Carolina Action Level Eth lbenzene 1.8 29 Toluene 6.2 1,000 Total X lene 11.7 400 All concentrations in parts per billion (ppb) 1 0 1 MILE 1000 0 1000 2000 3000. 4000 5000. 6000 7000 FEET 1 .5 0 1 KILOMETER CONTOUR INTERVAL 10 FEET NATIONAL GEODETIC VERTICAL DATUM OF 1929 PRECISION ENVIRONMENTAL INC. BEATTY'S INDIAN RIVER FRUIT COMPANY 120 PENMARC DRIVE, SUITE 101 HIGHWAY 601 AND 24/27 RALEIGH, NORTH CAROLINA 27603 MIDLAND, NORTH CAROLINA MN GN 5 �/z 98 MILS 0'15' 4 MILS UTM GRID AND 1987 MAGNETIC NORTH DECLINATION AT CENTER OF SHEET N. C. QUADRANGLE LOCATION CONCORD SE, N. C. 35080-05-TF-024 1969 PHOTOREVISED 1987 DMA 4854 1 SE -SERIES V842 FIGURE 1: GENERAL LOCATION MAP USING U.S. GEOLOGICAL SURVEY TOPOGRAPHIC MAP LEGEND HIGHWAY 24/27 S1e Soil Sample L000tion| Stockpiled Soil Scale is approximate North ]/Grass nc Concrete Dispenser Island ' - . -- . 601 PRECISION ENVIRONMENTAL INC. 12OPENMARCDRIVE, SUITE 101 RALE|CH.NORTH CAROL|NA275O3 Concrete -117 Gross Asphalt Gross The Sundae Shop BEATTY'S|NDiANRIVER FRUIT COMPANY HIGHWAY 601 AND 24/27 MIDLAND, NORTH CAROUNA Asphalt FIGURE 2: GENERAL SITE MAP SHOWING LOCATION OF SOIL SAMPLES FOR Retum Completed. Form To: Sate Use Only TANKS The appropriate DEM Regional Office aoaording to the county of the facilitys location. I.D. Number IN [SEE MAP ON REVERSE SIDE OF OWNER'S COPY (BLUE) FOR REGIONAL _ NC OFFICE ADDRESS]. Date Received Please complete and return witfyn (30) days followi-)g completion of site investigation. le-%cL-L 0 i 1. CO) w. i Olmer Name (Co+poratan, Indvidtsl Prbk A3.rcy. or Cther Enb ) SOR G ('a w S e Street Address ;couMa-T,.rae No- -"?llo City State Z i p Code 7o q -,129— 36 i7 ,'vea Code Telephone Number Name Rr,,,,k Closure Contractor r c' (Name) Lab (Name) .lob Title Nc- I(e Nc Z.-7-514U ( - ---- Tank j No. l ---- _..- - _. Size in Gallons Tank Dimensions Last Contents Warer In Excavation Frea Product Notable Odor or veble S61 Contamnation Yes No Yes No Yes No l ydUp (�YrrX Uc/z t1G.cn(:nQ_ Check the activities Contact local fire marshal) Notify DEM Regonal Office before abandonment Drain & flush piping into tank. Remove all product and residuals from tank Excavate down l o tank Clean and inspect tank 0 Remove drop tube, fig pipe, gauge pipe, vapor recovery tank connections, submersible pumps and other tank fixtures. Cap or plug all lines except the vent and fill lines. Purge tank of all product & flammable vapors. Cut one or more large holes in the tanks. Backfill the area. / Date Tank Permanently closed: completed. See reverse side of blue copy (owner's copy) for additional information required by N.C. - DEM in the written report and sketch. ABANDONMENT IN PLACE Fill tank until material overflows tank opening; Plug or cap all openings;. I� Disconnect and cap or remove vent line (� Solid inert material used - please specify: REMOVAL 0 Create vent hole 0 Label tank i� Dispose of tank in approved Final tank destination:14l c (/ `Q lei. v- AJ C— I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete. (Print name and official title of owner or owner's authorized representative Signature Date Signed a a Tank # 94� Size � , 000 allon :r This is to certify that the above tank has been disposed of by Nationwide Tank Disposal in accordance with and exceeding EPA regulations on Petroleum Tank Disposal. � On Fel 17; 192 this tank was cut into 30" x 18' strips of steel scrap and shipped to Foil's Recycling Center in Harrisburg, NC to be melted down into new steel. .�Q ` Certified by �f �l Date IV< 1 ' �! zT a. Preciti -)n. ')ur; ronmeni:.aJ 7! I t 1 oo- H Y D R 0 L 0 G I C I N C February 24, 1994 REPORTING: Hydrologic -Morris., Inc. 2500 Gateway Centre Suite #900 Morrisville, NC 27560 Attention: Pomeroy Smith PROJECT NUMBER: FL94-1543 DATE C.'C4'LETED: February 24, 1994 DATE RECEIVED: February 15, 1994 INVOICING: Hydrologic -Morris., Inc. 2500 Gateway Centre Suite #900 Morrisville, NC 27560 PROJECT DESCRIPTION: #94-109--10 soil samples to be analyzed for 5030 and 1 water sample to be analyzed for 602; sampled on 02/07 and 02/08/94. Enclosed is the laboratory report for the project described above. If you have any questions or if we can be of further assistance, please feel free to contact us. We appreciate your business and look forward to serving you again soon. Respectfully, &talz�- �if LL16 enjamin Carl Est 1 t Laboratory Director 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 ❑ Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: HydroLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1543 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TA-S1 DATE SAMPLED: 2/7/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (ing/kg) (mg/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sample Detection Limit COMME1M : ESTIMATED QMMTATION BASED ON REPEATED LOW SURROGATE RECOVERY DUE TO SAMPLE MATRIX 1491 Twilight Trail ❑ Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 ❑ Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: 11drdLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: EL94-1543 HYDROLOGIC SAMPLE NUMBER: 1544 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TA-S2 DATE SAMPLED: 2/7/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (ing/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sample Detection Limit COMMENTS: ESTIMATED QUANTITATION BASED ON REPEATED LOW SURROGATE RECOVERY DUE TO SAMPLE MATRIX ERENCE. 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 ❑ Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: Hydrologic -Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1545 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TB--S3 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (niJ/kg) Gasoline 2.3 61.5 BDL = Below Sample Detection Limit SDL = Sample Detection Limit COMMENTS: 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 ❑ FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: 1y? roLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: EL94-1543 HYDROLOGIC SAMPLE NUMBER: 1546 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TB-S4 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (mg/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sample Detection Limit COMMENTS: 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: Hy dLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 . HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1547 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDEOTIFICATION: TB-S5 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (mg/kg) Gasoline 2.0 BDL BDL = Belaw Sample Detection Limit SDL = Sample Detection Limit COMMKM : 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 ❑ Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C i N C COMPANY NAME: . HydroLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1548 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TC-S6 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (mg/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sample Detection Limit COMMENTS: 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R O L O O I C I N C COMPANY NAME: Hy&dLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1549 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TC-S7 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 N,>E'PiiOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (mg/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sable Detection Limit CONVENT'S: ESTIMATED QUANPITATION BASED ON REPEATED LOW SURROGNIE RECOVERY DUE TO SAMPLE MATRIX INTERFERENCE. 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: HydroLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1550 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: TC-S8 DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIKE ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (ing/kg) (iJ/kg) Gasoline 2.0 BDL BDL = Below Sample Detection Limit SDL = Sample Detection Limit 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 ❑ FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C 1 N C COMPANY NAME: Hy dLogic-Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: FL94-1543 HYDROLOGIC SAMPLE NUMBER: 1551 HYDROLOGIC LAB I . D . # : 399 SAMPLE IDENTIFICATION: D-S1 DATE SAMPLED: 2/7/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (mg/kg) (rnJ/kg) Gasoline 2.4 2.6 BDL = Below Sample Detection Limit SDL = Sample Detection Limit Con am : 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: Hydrologic -Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: EL94-1543 HYDROLOGIC SAMPLE NUMBER: 1552 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: Stockpile DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED:. 2/23/94 METHOD TPH 5030 ANALYSIS CAS NO. SDL RESULT (in3/kg) (iJ/kg) Gasoline 2.0 BDL BDL = Belaw Sample Detection Limit SDL = Sample Detection Limit COMMENTS: 1491 Twilight Trail 0 Frankfort, KY 40601 ❑ 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 H Y D R 0 L 0 G I C I N C COMPANY NAME: Hydrologic -Morris., Inc. COMPANY PROJECT NUMBER: #94-109 HYDROLOGIC PROJECT NUMBER: EL94-1543 HYDROLOGIC SAMPLE NUMBER: 1553 HYDROLOGIC LAB I.D.#: 399 SAMPLE IDENTIFICATION: Excavation DATE SAMPLED: 2/8/94 DATE EXTRACTED: N/A DATE/TIME ANALYZED: 2/17/94 N=M EPA 602 ANALYSIS CAS NO. SDL RESULT ( u9/1) ( u9/1) Benzene 71-43-2 1.0 BDL Chlorobenzene 108-90-7 1.0 BDL 1,2-Dichlorobenzene 95-50-1 0.5 BDL 1,3-Dichlorobenzene 541-73-1 0.5 BDL 1,4-Dichlorobenzene 106-46-7 0.5 BDL Ethylbenzene 100-41-4 1.0 - 1.8 Toluene 108-88-3 1.0 6.2 Xylene (Total) 1330-20-7 1.0 11.7 BDL = Below Sauple Detection Limit SDL = Sanple Detection Limit COMMENTS: 1491 Twilight Trail 0 Frankfort, KY 40601 0 502/223-0251 0 FAX 502/875-8016 0 Toll Free 1-800/728-2251 qq-l5y-_�3 Subcontractor: - Contact Name: Date Shipped: t�. Comments: P- SUBCONTRACT COC Project Name/No: ©l nP Cyr c��l Project Contact/Phone: — low P.O. i : Reporting Information: Report To: Verbal Phone No a�'�$rtC GgCI Fax 0 9i9- 3ry - Invoice To: ��:..If;\f 0� Fax No: -r'71 'T Typed Copy 0 Date: ONE CONTAINER PER LINE SAMPLE TYPE A.4i t 1'1 I!ivliiF� � L � I AR I Lqe nU V ......... ..... Turn Around Time (Please Specify) Rush ❑ Two Week ❑ Three Week ❑ QC Level: i ❑ II ❑ III ❑ Project Specific, DISKETTES: Comma Delimited: Standard ASCII: Relinquished by:(Signature) [( �, , Ta Cc_ ((� Received by:(Signature) DateMme Method of Shipment: -U-461.o�G%q ����aY3 Received for Laboratory by teMme J y REPORT TO: CHAIN OF CUSTODY PO # Hydrologic, Inc. 2500 Gateway Centre Blvd., Suite 900 Morrisville, NC 27560 800-241-4174 919-380-9699 PAGE OF Method of Shipment CLIENT:ANALYSES` `j u7 S l L--L PROI7FX'I' ID #: PHONE: rl REPORT!DUE: PROD #:^�L C PO #: VERBAL DOPYCW 0Q6 SAMPLER: (� FIELD ID RAF MATRIEX TIM 0C)LLB j"ID DATE COLLECTS REMARKS 1 q b 2� C- - 100 v c-- ` a I to Z, < G Ju -Si sod :,(71W RELINQUISHED BY: �L . DATE / TIME: Z RECEIVED B DATE / TIME: L-11 -71 (p - RELINQUISHED BY: DATE / TIME: RECEIVED BY: VDATE / TIME: RELINQUISHED BY: DATE / TIME: RECEIVED BY: DATE / TIME: DISPATCHED BY: DATE / TIME: RECEIVED BY: DATE / TIME: REPORT TO: CHAIN OF CUSTODY PO # Hydrologic, Inc. 2500 Gateway Centre Blvd., Suite 900 Morrisville, NC 27560 800-241-4174 919-380-9699 PAGE 4c-L OF Method of Shipment PHONE: REPORT�DUE; VL ■�■■���■iiiiii■ii lor i RELINQUISHED BY: DATE TIME: RECEIVED B DATE TIME: RELINQUISHED BY: DATE /TIME: DATE / TIME: P1211 Ila DATE TIME: RECEIVED BY: DATE / TIME: =j