MO-9318_40776_CA_UST-61_20170920_24-Hour Release and UST Leak Reporting Form

North Carolina
8320 University Executive Park Dr.,
Suite 106
Charlotte, NC 28262
t: 877.884.6775
t: 704.782.0555
September 20, 2017
Mr. Brett Morris
NCDEQ — UST Section
610 East Center Avenue
Mooresville, NC 28115
Re: 24-Hour Release Notification
Joyce Needham Residence
1830 Old Salisbury -Concord Road
Concord, NC 28025
Incident No. Pending
Dear Mr. Morris,
On behalf of Ms. Joyce Needham, current owner and responsible party for the property
addressed at 1830 Old Salisbury -Concord Road, Concord, Cabarrus County, North
Carolina, PM Environmental (PM) is submitting a 24-hour release notification. The
release was discovered during soil sampling post the removal of one estimated 550-
gallon heating oil UST. Based on analytical results from post removal soil sample
collected at the base and sidewalls of the UST basin, soils have been impacted.
If you have any questions regarding this submittal, please contact me [phone].
Sincerely,
PM Environmental, Inc.
Donald D. Warren
Regional Manager/Senior Consultant
CC: Ms. Joyce Needham, 257 Ponderosa Circle,
Mooresville, North Carolina 28117
Enclosed:
ENVIRONMENTAL 8& ENGINEERING SERVICES NATIONWIDE I WWW.PMENV.COM 1 1.800.313.2966

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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) N
Date Leak Discovered W29'2017
Received On Received By
Confirmed Soil Contamination ?(Y/N) Y
Comm/Non-Commercial? NON
Reported by (circle one): Phone, Fax or Report
Samples Taken?(Y/N)y
Reg/Non-regulated? Non
Region
Free Product? (YIN) N If Yes, State Greatest
Thickness
INCIDENT DESCRIPTION
Incident Name: Joyce Needham Residence
Address: 130 Old Salisbury -Concord Road
county: Cabarrus
Regional Office (circle one): Asheville, Mooresville, Fayetteville,
City/Town: Concord
Zip Code: 28025
Raleigh, Washington, Wilmington, Winston-Salem
Latitude (decimal degrees): 35 26' 30.87" N Longitude (decimal degrees) : 80 32' 48. 0 VV
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
On August 20, 2017, PM Environmental collected soil samples from the base and
sideWalls of the former UST basin. Sail samples confirmed TPH-DRO soil ranging frorr❑
70 mg/kg to 18,200 mg/kg and TPH-GRO ranging from BRL to 888 mg/kg. The source
the release is associated With a former estimated 550-gallon heating Oil UST.
Describe location:
HOW RELEASE WAS DISCOVERED (Release code)
(Check one)
❑ Release Detection Equipment or Methods ❑ Visual/Odor ❑ Groundwater Contamination
IA 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 one to indicate primary (Check one to indicate primary (Check one) (Check one to indicate primary product type
source) cause) released)
❑ Tank ❑ Spill LA Petroleum ❑ Gasoline/ Diesel/ ❑ Diesel/Veg. Oil
Kerosene Blend
❑ Piping ❑Overfill ❑Nov -Petroleum (A Heating Oil ❑ Vegetable Oil 100%
❑ Dispenser ❑ Corrosion ❑ Both ❑ Other Petroleum ❑ E10 — E20
❑ Submersible Turbine Pump ❑ Physical or Mechanical Products ❑ E21 — E84
El
❑ Delivery Damage Location Metals
ry Problem (Check one) ❑ Other Inorganics ❑ E85 — E99
❑Install Problem
❑ Other ❑ Other Organics ❑ Ethanol 100%
❑Other ❑Facility
❑ Unknown
Unknown ® Residence ❑ E01 — E09
Definitions presented on reverse I Definitions presented on reverse I ❑ Other
Ownership
1. Municipal 2. Military 3. Unknown 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 (02/08) rage -1 or z

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: (Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
UST SYSTEM OWNER
UST Owner/Company
Ms. Joyce Needham
Point of Contact
Address
r. Scott Needham (son)
257 Ponderosa Circle
City
State
Zip Code
Telephone Number
Mooresville
NC
28117
704-363-942 (Son)
UST SYSTEM OPERATOR
UST Operator/Company
Address
City
State
Zip Code
Telephone Number
LANDOWNER AT LOCATION OF UST INCIDENT
Landowner
Address
Ms. Joyce Needham
130 Old Salisbury -Concord Rd
City
State
Zip Code
Telephone Number
Concord
NC
28025
704-363-9942
Draw Sketch of Area (showing two major road intersections) or Attach Map
Person Reporting Incident r�on vvarre.,
Company PNI Envirenrnerital
Telephone Number 704200-9995
Title negionai Manage,
I Address 8,120 University Exec Park Dr, Ste 106: Chan tte; NC 28262
Date 9/20;2017
UST Form 61 (02/08)
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

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SGS ACCUTEST iS PART Of SGS, THE ORLD'$ LEADING INSPECTION, __.----- --
VERIFICATION, TESTING AND CERTIFICATION COMPANY.
Technical Report for
PM Environmental
Residential Property; Concord, NC
15-4231-0-0001
SGS Accutest Job Number: FA47237
Sampling Date: 08/29/17
Report to:
PM Environmental
8320 University Executive Park Dr Suite 106
Charlotte, NC 28262
[e-mail]
ATTN: Don Warren
Total number of pages in report: 34
Atrt'oratcc ed Rtpor!
Test results contained within this data package meet the requirements ZtlinBrice, M.S.
of the National Environmental Laboratory Accreditation Program General Manager
and/or state specific certification programs as applicable.
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL(E83510), LA(03051), KS(E-10327), IL(200063), NC(573), NI(FLO02), NY(12022), SC(96038001)
DoD ELAP(L-A-B L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AK, AR, GA, IA, KY, MA, NV, OK, OR, UT, WA
This report shall not be reproduced, except in its entirety, without the written approval of SGS Accutest.
Test results relate only to samples analyzed.
Southeast 4405 Vineland Road Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone] • http://www.accutest.com
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Table of
is
-I-
Section1: Sample Summary...................................................................................................
Section2: Summary of Flits....................................................................................................
Section: Sample �l esulh......>...,.a.a�.®®..>.�.,.....�s.®s�a®®....®�g,,,...®...,.,....>.«..»..a,.®a��..«y..�At®..®���..<.>...
, , FA47237-1: TP-1..........................................................................................................
3.: FA47237-2: TP-2..........................................................................................................
3,3: FA47237-3: TP-3..........................................................................................................
3,4: FA47237-4: TP-4..........................................................................................................
3g5: FA47237-5: TP-5..........................................................................................................
Section 4: Misc. Forms ...............
4.1.: Chain of Custody ...................................................................................................
Section 5: NIS Volatiles - QC Data Summaries
5.1. Method Blank Summary................................................................................................
5.2: Blank Spike Summary...................................................................................................
5.3: Matrix Spike/Matrix Spike Duplicate Summary...........................................................
Section : CSC `olatiles - (.' Data Summaries........................---.....—...............,.....--....
6.1: Method Blank Summary................................................................................................
6.2: Blank Spike Summary...................................................................................................
6.3: Matrix Spike/Matrix Spike Duplicate Summary ...........................................................
Section 7: GC/LC Semi-volatiles - QC Data Summaries .....................................................
7.1.- Method Blank Summary................................................................................................
7.2: Blank Spike Summary...................................................................................................
7.3: Matrix Spike/Matrix Spike Duplicate Summary...........................................................
3
4
5
6
8
10
12
14
17
18
20
21
22
23
4
25
27
29
3
32
33
34
2 of 34
SGS ACCUTEST
Fa472;1r

SGS Accutest
Sample Summary
PM Environmental
Residential Property; Concord, NC
Project No: 15-4231-0-0001
Job No: FA47237
;ample Collected Matrix Client
lumber Date Time By Received Code Type Sample ID
FA47237-1 08/29/17 10:15 DW 08/31/17 SO Soil
FA47237-2 08/29/17 10:20 DW 08/31/17 SO Soil
FA47237-3 08/29/17 10:25 DW 08/31/17 SO Soil
FA47237-4 08/29/17 10:30 DW 08/31/17 SO Soil
FA47237-5 08/29/17 10:35 DW 08/31/17 SO Soil
TP-1
TP-2
TP-3
TP-4
TP-5
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3 of 34
fASGS S
Fa 17 z37

Summary of Hits
Job Number: FA47237
Account: PM Environmental
Project: Residential Property; Concord, NC
Collected: 08/29/17
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA47237-1 TP-1
TPH-GRO (C6-C10)
888
260
130
mg/kg
SW846 8015C
TPH (C10-C28)
18200 B
540
270
mg/kg
SW846 8015C
FA47237-2 TP-2
TPH-GRO (C6-C10)
445
60
30
mg/kg
SW846 8015C
TPH (C10-C28)
10800
1100
530
mg/kg
SW846 8015C
FA47237-3 TP-3
TPH-GRO (C6-C10)
296
58
29
mg/kg
SW846 8015C
TPH (C10-C28)
11700
1100
550
mg/kg
SW846 8015C
FA47237-4 TP-4
TPH (C10-C28)
70.0
" 5.4
2.7
mg/kg
SW846 8015C
FA47237-5 TP-5
Toluene
0.0662 J
0.28
0.055
mg/kg
SW846 8260B
Ethylbenzene
0.440
0.28
0.055
mg/kg
SW846 8260B
Xylene (total)
243
0.83
0.12
mg/kg
SW846 8260B
TPH-GRO (C6-C10)
104
12
5.9
mg/kg
SW846 8015C
TPH (C10-C28)
8010 B
540
270
mg/kg
SW846 8015C
Page 1 of 1
4 of 34
SGS CC"

ACCU
South*
Sample Results
Report of Analysis
Section 3
of 34
SGS ACC511TEST
}zA472V

SGS Accutest
Report of Analysis
Client Sample ID: TP-1
Lab Sample ID: FA47237-1 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C Percent Solids: 91.6
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CD145810.D 1 09/05/17 18:28 EG n/a n/a GCD6082
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 4.46 g 5.0 ml 2.5 ul
Run #2
CAS No.
Compound
TPH-GRO (C6-C1O)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result
RL MDL Units Q
888
;'260 130 mg/kg
Run# 1
Run# 2 Limits
108%
56-149%
76%
66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
of 34
SGS ACC'UTEST
FA47z37

SGS Accutest
Report of Analysis
Client Sample ID: TP-1
Lab Sample ID: FA47237-1 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C SW846 3546 Percent Solids: 91.6
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 JJ016665.1) 100 09/06/17 17:15 SJL 09/05/17 10:19 OP66706 GJJ701
Run #2
Initial Weight Final Volume
Run #1 20.2 g 1.0 ml
Run #2
CAS No. Compound
TPH (CIO-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits due to dilution.
Result RL
18200 540
Run# 1 Run# 2
0% a
MDL Units Q
270 mg/kg B
Limits
56-122%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
ti
7 of 34
FA47237

SGS Accutest
Report of Analysis Page 1 of 1
Client Sample ID: TP-2
Lab Sample ID: FA47237-2 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C Percent Solids: 91.4
Project: Residential Property; Concord, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CD145811.D 1 09/05/17 18:55 EG n/a n/a GCD6082
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 4.94 g 5.0 ml 10.0 ul
Run #2
CAS No.
Compound
TPH-GRO (C6-CIO)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result
RL MDL Units Q
445 -
` 60 30 mg/kg
Run# 1
Run# 2 Limits
120%
56-149%
80%
66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
8 of 34
SGS Q)TES
?^A47237

SGS Accutest
Report of Analysis
Client Sample ID: TP-2
Lab Sample ID: FA47237-2 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C SW846 3546 Percent Solids: 91.4
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 JJ016702.D 200 09/07/17 17:50 SJL 09/05/17 10:19 OP66706 GJJ703
Run #2
Initial Weight Final Volume
Run #1 20.5 g 1.0 ml
Run #2
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits due to dilution.
Result
RL MDL Units Q
10800
1100 530 mg/kg
Run# 1
Run# 2 Limits
0% a
56-122%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9of14
CCUTfT
MA47237

SGS Accutest
Report of Analysis
Client Sample ID: TP-3
Lab Sample ID: FA47237-3 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C Percent Solids: 90.6
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CD145793.D 1 09/02/17 03:57 EG n/a n/a GCD6081
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 5.21 g 5.0 ml 10.0 ul
Run #2
CAS No.
Compound
TPH-GRO (C6-CIO)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result
RL MDL Units Q
296
58 29 mg/kg
Run# 1
Run# 2 Limits
109%
56-149%
78%
66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
10 of 34
SGS CC TES T
FA47237

SGS Accutest
Report of Analysis Page 1 of 1
Client Sample ID: TP-3
Lab Sample ID: FA47237-3 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C SW846 3546 Percent Solids: 90.6
Project: Residential Property; Concord, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 JJ016703.1) 200 09/07/17 18:18 SJL 09/05/17 10:19 OP66706 GJJ703
Run #2
Initial Weight Final Volume
Run #1 20.2 g 1.0 ml
Run #2
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits due to dilution.
Result
RL MDL Units Q
11700
1100 550 mg/kg
Run# 1
Run# 2 Limits
0% a
56-122%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
11 of 34
SGS CCU EST
hAa72s7

SGS Accutest
Report of Analysis Page 1 of 1
Client Sample ID: TP-4
Lab Sample ID: FA47237-4 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C Percent Solids: 91.3
Project: Residential Property; Concord, NC
File ID DF Analyzed By . Prep Date Prep Batch Analytical Batch
Run #1 CD145788.D 1 09/02/17 01:43 EG n/a n/a GCD6081
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 5.04 g 5.0 ml 100 ul
Run #2
CAS No.
Compound
TPH-GRO (C6-C10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result
RL MDL Units Q
ND
;' 5.9 3.0 mg/kg
Run# 1
Run# 2 Limits
95%
56-149%
75% `,
66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
1 of 3
SGS r
FA47237

SGS Accutest
Report of Analysis
Client Sample ID: TP-4
Lab Sample ID: FA47237-4 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C SW846 3546 Percent Solids: 91.3
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 JJ016704.1) 1 09/07/17 18:47 SJL 09/05/17 10:19 OP66706 GJJ703
Run #2
Initial Weight Final Volume
Run #1 20.4 g 1.0 ml
Run #2
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
Result
RL MDL Units Q
70.0
5.4 2.7 mg/kg
Run# 1
Run# 2 Limits
121%
56-122%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
13 of 34
SGS ACCUTEST
A4fz37

SGS Accutest
Report of Analysis Page 1 of 1tA
Client Sample ID: TP-5
Lab Sample ID: FA47237-5 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8260B Percent Solids: 91.2
Project: Residential Property; Concord, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 Y35986.1) 1 09/01/17 18:16 EP n/a n/a VY1429
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 5.44 g 5.0 ml 100 ul
Run #2
Purgeable Aromatics
CAS No.
Compound
71-43-2
Benzene
108-88-3
Toluene
100-41-4
Ethylbenzene
1330-20-7
Xylene (total)
CAS No.
Surrogate Recoveries
1868-53-7
Dibromofluoromethane
17060-07-0
1, 2-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorobenzene
Result
RL
MDL Units Q
ND
0.28
0.067 mg/kg
00662
0.28
0.055 mg/kg J
0.440
0.28
0.055 mg/kg
2,43
0.83
0.12 mg/kg
Run# 1
Run# 2
Limits
100%
75-124%
104%
72-135%
96%
75-126%
95%
71-133%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
14 of 34
sras tMCUTE,
FA47237

SGS Accutest
Report of Analysis
Client Sample ID: TP-5
Lab Sample ID: FA47237-5 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C Percent Solids: 91.2
Project: Residential Property; Concord, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CD145794.D 1 09/02/17 04:23 EG n/a n/a GCD6081
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 5.08 g 5.0 ml 50.0 ul
Run #2
CAS No.
Compound
TPH-GRO (C6-C10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result
RL MDL Units Q
104
> 12 5.9 mg/kg
Run# 1
Run# 2 Limits
>.111%
56-149%
85%
66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
a of 34
SGS aft Tf
FA47237

SGS Accutest
Report of Analysis
Client Sample ID: TP-5
Lab Sample ID: FA47237-5 Date Sampled: 08/29/17
Matrix: SO - Soil Date Received: 08/31/17
Method: SW846 8015C SW846 3546 Percent Solids: 91.2
Project: Residential Property; Concord, NC
Page 1 of 1CA
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 JJ016671.1) 100 09/06/17 20:07 SJL 09/05/17 10:19 OP66706 GJJ701
Run #2
Initial Weight Final Volume
Run #1 20.2 g 1.0 ml
Run #2
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits due to dilution.
Result RL
8010 >'540
Run# 1 Run# 2
0% a
MDL Units Q
270 mg/kg B
Limits
56-122%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
E
t 6 of 34
SGS ii T
FA47237

`Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
- Chain of Custody
Section 4
#aw
SGS A2CU#«T
° FA4z

$I -Sol
zo T
SGS Accutest Southeast FALAI to
Chain of Custodv SOS ACCUTESTJOB #: P.
FA47237: Chain of Custody
133 of 34
SGS ACCUTEST
FA47237

SGS Accutest Sample Receipt Summary
Job Number: FA47237 Client: PM ENV. Project: RESIDENTIAL PROPERTY
Date / Time Received: 8/31/2017 9:00:00 AM Delivery Method: FED EX Airbill #'s: 8043 9730 3933
Therm ID: IR 1; Therm CF: -0.2; # of Coolers: 1
Cooler Temps (Raw Measured) °C: Cooler 1: (0.8);
Cooler Temps (Corrected)'C: Cooler 1: (0.6);
Cooler Information
Y or N
Samole Information
Y or
N
_N/A
1. Custody Seals Present
©
❑
1. Sample labels present on bottles
©
❑
2. Custody Seals Intact
❑
2. Samples preserved property
❑
3. Temp criteria achieved
❑
3. Sufficient volume/containers recvd for analysis:
V
❑
4. Cooler temp verification
IR Gun
4. Condition of sample
Intact
5. Cooler media
Ice Ba
5. Sample recvd within HT
❑Q
❑
6. Dates/Times/IDs on CDC match Sample Label
W
❑
Trio Blank Information
Y or
N N/A
7. VOCs have headspace
❑
❑
1. Trip Blank present / cooler
❑
❑d ❑
8. Bottles received for unspecified tests
❑
S6
2. Trip Blank listed on CDC
❑
❑J ❑
9. Compositing instructions clear
❑
❑
W
S N/A
10. Voa Soil Kits/Jars received pasl48hrs?
El
El
or
11. %Solids Jar received?
©
❑
❑
3. Type Of TB Received
❑
❑ W
12. Residual Chlorine Present?
❑
❑
❑J
Misc. Information
Number of Encores: 25-Gram
5-Gram
Number of 5035 Field Kits: 5 Number of Lab Filtered Metals:
I
Test Strip Lot #s:
pH 0-3
230315
pH 10-12 219813A Other: (Specify)
Residual Chlorine Test Strip Lot #:
;omments
smoo1 Technician: SHAYLAP Date: 8/31/2017 9:00:00 AM Reviewer. Date:
Rev. Date 0524/17
'.,k ' 2 a Chain of Custody
Fags 2 of 2
19 of 34
SGS ACCUTEST
FA47237

yy�.....a.
«: « w »> «,III
I-I#■RIO 7
\M§<VQ 42es
QC Data Summaries
Includes the following where applicable:
• Method Blank Summaries
• Blank Spike Summaries
• Matrix Spike and Duplicate Smmrs
ydy
\ « \ ACCUTEST

Method Blank Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
VY1429-MB
Y35967.D
1
09/01/17
EP
n/a
n/a
VY1429
The QC reported here applies to the following samples:
FA47237-5
CAS No. Compound
71-43-2 Benzene
100-41-4 Ethylbenzene
108-88-3 Toluene
1330-20-7 Xylene (total)
CAS No. Surrogate Recoveries
1868-53-7 Dibromofluoromethane
17060-07-0 1, 2-Dichloroethane-D4
2037-26-5 Toluene-D8
460-00-4 4-Bromofluorobenzene
Result RL
ND "''-' 5.0
ND 5.0
ND 5.0
ND 15
Method: SW846 8260B
MDL Units Q
1.2 ug/kg
1.0 ug/kg
1.0 ug/kg
2.1 ug/kg
Limits
107°fo
75-124%
104%
72-135%
97%
75-126%
106%
71-133%
21 of 34
ACCUTEST
F,A4"r2J7

Blank Spike Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
VY1429-BS Y35968.D 1 09/01/17 EP n/a n/a VY1429
The QC reported here applies to the following samples:
FA47237-5
CAS No. Compound
71-43-2
Benzene
100-41-4
Ethylbenzene
108-88-3
Toluene
1330-20-7
Xylene (total)
CAS No. Surrogate Recoveries
1868-53-7
Dibromofluoromethane
17060-07-0
1, 2-Dichloroethane-D4
2037-26-5
Toluene-D8
460-00-4
4-Bromofluorobenzene
* = Outside of Control Limits.
Spike
BSP
BSP
ug/kg
ug/kg
%
Limits
50
58.0
116
76-126
50
56.8
114
77-123
50
56.6
113
76-124
150
170
113
80-129
BSP Limits
1'04°fo
75-124%
98%
72-135%
101%
75-126%
101%
71-133%
Method: SW846 8260B
22 of 34
SGS CCU BEST
FzA472s,

Matrix Spike/Matrix Spike Duplicate Summary Page 1 of 1
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
FA47224-33MS
Y35984.1)
1
09/01/17
EP
n/a
n/a
VY1429
FA47224-33MSD
Y35985.1)
1
09/01/17
EP
n/a
n/a
VY1429
FA47224-33
Y35973.1)
1
09/01/17
EP
n/a
n/a
VY1429
The QC reported here applies to the following samples: Method: SW846 8260B
FA47237-5
FA47224-33 Spike
MS MS
Spike
MSD
MSD
Limits
CAS No.
Compound
ug/kg
Q ug/kg
ug/kg %
ug/kg
ug/kg
%
RPD
Rec/RPD
71-43-2
Benzene
ND
60.2
53.7 89
61.7
55.1
89
3
76-126/26
100-41-4
Ethylbenzene
ND
60.2
51.9 86
61.7
52.2
85
1
77-123/31
108-88-3
Toluene
ND
60.2
53.0 88
" 61.7
53.1
86
0
76-124/30
1330-20-7
Xylene (total)
ND
181
159 88
185
161
87
1
80-129/30
CAS No.
Surrogate Recoveries
MS
MSD
FA47224-33
Limits
1868-53-7
Dibromofluoromethane
98% "
104%
107%
75-124%
17060-07-0
1,2-Dichloroethane-D4
100%
99%
104%
" 72-135%
2037-26-5
Toluene-D8
99%
99%
97%
75-126%
460-00-4
4-Bromofluorobenzene
102%
104%
102%
71-133%
* = Outside of Control Limits.
21 of 34
ACCUTEST
F,A4r23x

GC Volatiles
QC Data Summaries
Includes the following where applicable:
• Method Blank Summaries
• Blank Spike Summaries
• Matrix Spike and Duplicate Summaries
24 of 34
ACCUTEST
PA472 57

Method Blank Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
GCD6081-MB
CD145770.D
1
09/01/17
EG
n/a
n/a
GCD6081
The QC reported here applies to the following samples:
FA47237-3, FA47237-4, FA47237-5
CAS No. Compound
TPH-GRO (C6-C 10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result RL
ND 5.0
Method: SW846 8015C
MDL Units Q
2.5 mg/kg
Limits
76°fo 56-149%
74°l0 66-132%
25 of 34
SGS CC EST
FA47237

Method Blank Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
GCD6082-MB
CD145809.1)
1
09/05/17
EG
n/a
n/a
GCD6082
The QC reported here applies to the following samples:
FA47237-1, FA47237-2
CAS No. Compound
TPH-GRO (C6-C10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
Result RL
ND 5.0
Method: SW846 8015C
MDL Units Q
2.5 mg/kg
Limits
87% 56-149%
74% 66-132%
26 of 34
SGS a°
FA,4rz3r

Blank Spike Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
GCD6081-BS
CD145769.1)
1
09/01/17
EG
n/a
u/a
GCD6081
The QC reported here applies to the following samples: Method: SW846 8015C
FA47237-3, FA47237-4, FA47237-5
CAS No. Compound
TPH-GRO (C6-C10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
* = Outside of Control Limits.
Spike BSP BSP
mg/kg mg/kg % Limits
20 19.5 98 74-128
BSP Limits
91% 56-149%
93% 66-132%
27 of 34
ACCUTEST
FA47237

Blank Spike Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
GCD6082-BS
CD145808.1)
1
09/05/17
EG
n/a
n/a
GCD6082
The QC reported here applies to the following samples: Method: SW846 8015C
FA47237-1, FA47237-2
CAS No. Compound
TPH-GRO (C6-C10)
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
* = Outside of Control Limits.
Spike BSP BSP
mg/kg mg/kg % Limits
20 19.3 97 74-128
BSP Limits
97% 56-149%
90% 66-132%
28 of 3
SGS ACCUTEST
FA47237

Matrix Spike/Matrix Spike Duplicate Summary Page I of 1
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
FA47201-1MS
CD145777.D
1
09/01/17
EG
n/a
n/a
GCD6081
FA47201-1MSD
CD145778.D
1
09/01/17
EG
n/a
n/a
GCD6081
FA47201-1
CD145771.1)
1
09/01/17
EG
n/a
n/a
GCD6081
The QC reported here applies to the following samples: Method: SW846 8015C
FA47237-3, FA47237-4, FA47237-5
FA47201-1 Spike MS MS Spike MSD MSD Limits
CAS No. Compound mg/kg Q mg/kg mg/kg % mg(kg mg/kg % RPD Rec/RPD
TPH-GRO (C6-C10) ND 18 18.1 101 18 17.3 96 > 5 74-128/17
CAS No.
Surrogate Recoveries
MS
MSD
FA47201-1
Limits
460-00-4
4-Bromofluorobenzene
90%
86%
77%
56-149%
98-08-8
aaa-Trifluorotoluene
93%
93%
74%
66-132%
* = Outside of Control Limits.
29 of 34
SGS CCUTEST
FA47237

Matrix Spike/Matrix Spike Duplicate Summary Page 1 of 1
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
FA47238-1MS
CD145813.1)
1
09/05/17
EG
n/a
n/a
GCD6082
FA47238-1MSD
CD145814.1)
1
09/05/17
EG
n/a
n/a
GCD6082
FA47238-1
CD145812.1)
1
09/05/17
EG
n/a
n/a
GCD6082
The QC reported here applies to the following samples: Method: SW846 8015C
FA47237-1, FA47237-2
FA47238-1 Spike MS MS Spike MSD MSD Limits
CAS No. Compound mg/kg Q mg/kg mg/kg % mg/kg mg/kg % RPD Rec/RPD
TPH-GRO (C6-CIO) 165 129 286 94 129 290 97 1 74-128/17
CAS No.
Surrogate Recoveries
460-00-4
4-Bromofluorobenzene
98-08-8
aaa-Trifluorotoluene
* = Outside of Control Limits.
MS
MSD
FA47238-1
Limits
108%
108%
104%°
56-149%
94%
94%
79%
66-132%
30 of 34
SGS ACCUTEST
FA47237

✓�jrf/4 r
GC/LC Semi valatiles
QC Data Summaries IN
Includes the following where applicable:
• Method Blank Summaries
• Blank Spike Summaries
• Matrix Spike and Duplicate Summaries
3� of 34
SGS STT
�:xarz37

Method Blank Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
OP66706-MB
JJ016664.1)
1
09/06/17
SJL
09/05/17
OP66706
GJJ701
The QC reported here applies to the following samples:
FA47237-1, FA47237-2, FA47237-3, FA47237-4, FA47237-5
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits.
Result RL
2.70 5.0
Method: SW846 8015C
MDL Units Q
2.5 mg/kg J
Limits
1116% a 56-122%
32 of 34
SGS t;1 UTEST
FA47237

Blank Spike Summary
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Page 1 of 1
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
OP66706-BS
JJ016663.1)
1
09/06/17
SJL
09/05/17
OP66706
GJJ701
The QC reported here applies to the following samples: Method: SW846 8015C
FA47237-1, FA47237-2, FA47237-3, FA47237-4, FA47237-5
CAS No. Compound
TPH (C10-C28)
CAS No. Surrogate Recoveries
84-15-1 o-Terphenyl
(a) Outside control limits.
* = Outside of Control Limits.
Spike BSP BSP
mg/kg mg/kg % Limits
50 53.5 107 62-116
BSP Limits
123% * 56-122%
33 of 34
SCIS CC TEV
€A47237

Matrix Spike/Matrix Spike Duplicate Summary Page 1 of 1
Job Number: FA47237
Account: PMENCC PM Environmental
Project: Residential Property; Concord, NC
Sample
File ID
DF
Analyzed
By
Prep Date
Prep Batch
Analytical Batch
OP66706-MS
JJ016672.D
100
09/06/17
SJL
09/05/17
OP66706
GJJ701
OP66706-MSD
JJ016673.D
100
09/06/17
SJL
09/05/17
OP66706
GJJ701
FA47237-5
JJ016671.D
100
09/06/17
SJL
09/05/17
OP66706
GJJ701
The QC reported here applies to the following samples: Method: SW846 8015C
-4
FA47237-1, FA47237-2, FA47237-3, FA47237-4, FA47237-5
s
FA47237-5 Spike MS MS Spike MSD MSD Limits
CAS No. Compound mg/kg Q mg/kg mg/kg % mg/kg mg/kg % RPD Rec/RPD
TPH (C10-C28) 8010 B 53.7 7550 -856* a 53.5 7290-1346*a4 62-116/35
CAS No. Surrogate Recoveries MS MSD FA47237-5 Limits
84-15-1 o-Terphenyl 0%* b 0%* b 0%* b 56-122%
(a) Outside control limits due to high level in sample relative to spike amount.
(b) Outside control limits due to dilution.
* = Outside of Control Limits.
34 of 34
SGS ACCUTEST
FA47237

Morris, Brett
From: Donald Warren <[e-mail]>
Sent: Wednesday, September 20, 2017 11:55 AM
To: Morris, Brett
Cc: Scott Needham
Subject: 24-Hour Release Notification (1830 Old Salisbury -Concord Rd, Concord, NC)
Attachments: 1830 Old Salisbury -Concord Rd, Concord, NC 24-HR Release Notification Submittal
Let ... pdf
Hey Brett,
I hope you are doing well. I've attached a release notification for the above referenced property. The release is related
to a former heating oil UST. Currently only soils have been determined to have been impacted. We are planning to
perform IAA activities next week. Once the overexcavation activities are complete I will touch base with you to discuss
the outcome.
Please let me know if you have any questions or concerns.
Thanks
Don Warren ( Regional Manager/Senior Consultant
PM ENVIRONMENTAL, INC.
8320 University Executive Park Drive
Suite 106 1 Charlotte, NC 28262 1 www.pmenv.com
p: 704-200-9995 1 f: 877-884-6775 1 c: 980-722-2252 1 [e-mail]
Environmental& Engineering Services Nationwide
rCelebrating
of Risk WWI