MO-9528_40963_CA_IAR_20191121_Initial Abatement Action Report

INITIAL ABATEMENT ACTION REPORT
WAGNER RESIDENCE
1132 PROVIDENCE ROAD
CHARLOTTE, MECKLENBURG COUNTY, NORTH CAROLINA
GROUNDWATER INCIDENT: PENDING
FACILITY ID: N/A
NOVEMBER 21, 2019
UST OWNER (NOT OPERATOR):
Sean Wagner
1132 Providence Road
Charlotte, NC 28207
Phone Number: [phone]
PROPERTY OWNER:
Same as UST Owner
CONSULTANT:
Paragon Environmental Consultants, Inc.
P. O. Box 157
Thomasville, NC 27361-0157
Phone Number: [phone]
RELEASE INFORMATION:
Date Discovered: November 20, 2019
Estimated Quantity of Release: Unknown
Cause of Release: Fuel overflowed due to rain water filling tank during storm event
Source of Release: UST
Size and Contents: One (1) 550 Gallon Heating Oil UST
Latitude: N 35.192226290 Longitude: W 80.824739910
The Initial Abatement Action Report for this site has been prepared by Paragon
Environmental Consultants, Inc. under the direct supervision of a licensed geologist. All
activities performed on this project were conducted under my direct supervision:
�N CAR •��Ii,�
�0 S4 N.
2466 ' s
...... • 0
�WRp��.
Benjamin W. Robinson, L.G.
North Carolina License #2466

•
PARAGON
Environmental Consultants, Inc.
November 21, 2018
Sean Wagner
1132 Providence Road
Charlotte, NC 28207
Reference: Initial Abatement Action Report
Wagner Residence
1132 Providence Road
Charlotte, Mecklenburg County, North Carolina
Groundwater Incident: Pending
Facility ID: Not Applicable
Dear Mr. Wagner:
In accordance with the requirements of the current UST Section guidelines, contained
herein is an Initial Abatement Action Report for the release which occurred at the above
referenced facility. These activities have been conducted following the surface release of
petroleum which occurred from one 550 gallon heating oil underground storage tank
(UST). The soil remediation consisted of the excavation and disposal of approximately 23
cubic yards of contaminated soil and confirmatory sampling of in -situ soils. All activities
were conducted in accordance with North Carolina Department of Environmental Quality
(NC DEQ) guidelines and the requirements of 15A NCAC 2N.
Mr. Wagner, if you have questions regarding this report, please contact our office.
Sincerely,
Benjamin W. Robinson, L.G.
Paragon Environmental Consultants, Inc.
R 19-1972
P.O. Box 157 • Thomasville, NC 27361-0157
Business Ph: [phone] • Fax: [phone]

TABLE OF CONTENTS
Section Page
B. Site History
1. Introduction.................................................................... 1
2. Scope of Services........................................................... 1
C. Site Investigation
1. Excavation and Soil Sampling ....................................... 2
2. Soil Disposal.................................................................. 2
3. Conclusions and Recommendations .............................. 3
D. Figures
Figure 1:
Project Location
Figure 2:
Site Layout and Former UST Location
Figure 3:
Remedial Excavation and Soil Sample Locations
E. Tables
Table 1:
Summary of TPH Laboratory Analytical Results
F. Appendices
Appendix A:
Tank Disposal Manifest
Appendix B:
Geologic Log of Excavation
Appendix C:
Soil Analytical Results
Appendix D:
Standard Operating Procedures
Appendix E:
Soil Disposal Manifest

INITIAL ABATEMENT ACTION REPORT
Wagner Residence
1132 Providence Road
Charlotte, North Carolina
B. Site History
1. Introduction
Sean Wagner owns and occupies a property located at 1132 Providence Road in Charlotte,
NC. This property contains one permanent structure which is in use as a residence. Figure
1 illustrates the location of this facility on the Charlotte East Quadrangle U.S.G.S.
Topographic Map. The site formerly contained one 550 gallon heating oil UST which was
used for heating the residence. Figure 2 illustrates the site layout and the location of the
former UST. A surface release from this 550 gallon tank occurred during heavy
precipitation that caused the fuel within the tank to float out the top of the fill and vent
pipes and onto the surface soils. The UST was also removed during the remediation of the
surface soils, and a sample collected from beneath the UST following its removal was
reported at a level of 6,700 milligrams per kilogram (mg/kg) by Diesel Range Organics
(DRO) and 63 mg/kg by Gasoline Range Organics (GRO).
Following discovery of the surficial contamination, Paragon Environmental Consultants,
Inc. was contracted by Sean Wagner to perform soil remediation activities and
confirmatory soil sampling and laboratory analyses from the surface soils down -gradient
of the heating oil UST. Contained herein is a summary of activities which were completed
at the project site.
2. Scope of Services
This Initial Abatement Action Report contains documentation concerning the following
activities which have been conducted at this facility:
o Excavation of contaminated soils and backfilling of the excavation performed by
KBS Earthworks, Inc. of Julian, NC
o Transportation of contaminated soil by KBS Earthworks, Inc. and disposal of the
excavated material at AES of NC in Thomasville, NC
o Collection of soil samples from the final vertical limits ofthe excavation performed
by Paragon Environmental Consultants, Inc.
o Laboratory analyses of soil samples conducted by Prism Laboratories, Inc. of
Charlotte, NC
Page - 1

C. Site Investigation
1. Excavation and Soil Sampling
On November 11, 2019 personnel from KBS Earthworks, Inc. (KBS) and Paragon
Environmental Consultants, Inc. (Paragon) removed the 550 gallon tank and excavated the
petroleum impacted soil that resulted from the storm related fuel overflow event. The UST
was emptied of liquids by DeBruhl Environmental Excavating, Inc. prior to November 11,
2019. Appendix A contains a copy of the tank disposal manifest for the UST which was
formerly located at the subject property. The impacted soils in the excavation area were
excavated until field analyses indicated that all petroleum contaminated soil had been
removed. In order to verify site conditions, eight samples were collected from beneath the
excavated surface soils at depths ranging between approximately 6 inches to approximately
12 inches below the original surface grade. Appendix B contains a geologic log of
excavation for the soil remediation activities at this facility.
The soil samples collected from the remedial excavation at 1132 Providence Road were
analyzed according to DRO and GRO for Total Petroleum Hydrocarbons (TPH). Eight in -
situ soil samples were obtained from the bottom of the remedial excavation, one composite
stockpile was obtained from the contaminated material, and one in -situ sample was
collected from underneath the former UST. These samples were obtained with the
excavator bucket and were immediately placed into laboratory supplied glassware and
placed on ice for transportation to the analytical laboratory utilizing EPA approved chain -
of -custody procedures.
According to the laboratory analytical results, the eight in -situ samples, labeled as Soil
Sample #1 (SS-1) through Soil Sample #8 (SS-8), were below the laboratory detection
limits for TPH by EPA Methods 5030 and 3550. Based on the soil sample results from the
limits of the remedial excavation, no contamination above the applicable soil standards
remains in this area of the site. The tank sample, labeled as T 1-6.5, indicated TPH by DRO
at a level of 6,700 mg/kg, which is in excess of the current DRO action level of 100 mg/kg,
and TPH by GRO at a level of 63 mg/kg, which is in excess of the current GRO action
level of 50 mg/kg.
Figure 3 illustrates the area of soil remediation and the locations of the soil samples
collected at this residence. The analytical results for the soil analyses are summarized in
Table 1, and a copy of the laboratory analytical report and the chain -of -custody record for
the samples from 1132 Providence Road is included in Appendix C. All samples were
obtained in accordance with Paragon's Standard Operating Procedures which are included
as Appendix D.
2. Soil Disposal
A total of approximately 23 cubic yards (34.75 tons) of heating oil impacted soils were
removed during site remediation activities on November 11, 2019. This material was
transported by KBS to AES of NC's facility in Thomasville, NC for treatment and disposal.
Copies of the soil disposal manifests are contained as Appendix E.
Page - 2

3. Conclusions and Recommendations
3. A Conclusions and Recommendations
The soil remediation activities at the Wagner Residence have been completed. From a
review of all information gathered during this removal project, Paragon Environmental
Consultants, Inc. makes the following conclusions:
A soil sample obtained beneath the former heating oil tank indicated DRO TPH at
a concentration of 8,700 mg/kg and a GRO TPH value of 63 mg/kg.
Laboratory results for soil sampling of in -situ soils following the surface area
remedial excavation activities were below the detection limits for TPH by DRO
and GRO.
A total of 34.75 tons of heating oil impacted soils were removed from the area of
the surface release. This material was transported by KBS Earthworks, Inc. to AES
of NC's facility in Thomasville, NC for disposal.
3. B. Recommendations
Based upon a review of all information gathered during this Initial Abatement project,
Paragon makes the following recommendations:
Since contamination in excess of the current action levels is present beneath the
former UST, deed recordation and public notification will be required to obtain a
notice of No Further Action for the Wagner Residence.
A copy of this report should be forwarded to the following address:
Mooresville Regional Office - UST Section
610 E. Center Avenue — Suite 301
Mooresville, NC 28115
3. C. Limitations
This report has been prepared for the exclusive use of Sean Wagner for the specific
application to the referenced site located in Mecklenburg County, North Carolina. The
assessment was conducted based on the scope of work and level of effort desired by the
client. Our findings have been developed in accordance with generally accepted standards
in the practice of Initial Abatement Action Reports in the State of North Carolina, available
information, and our professional judgment. No other warranty is expressed or implied.
The data presented in this report are indicative of conditions that existed at the precise
locations sampled and at the time the samples were collected. Additionally, the data
obtained from the samples would be interpreted as meaningful with respect to the
parameters indicated in the laboratory reports. No additional information can be logically
inferred from this data.
Page - 3

FIGURES

Z
J
U ¢
J Z U
Q
N
H
zzui
0LU~ o
¢Za z
?i
p0r
¢ � J J
r : J
Z Z >
w0 a
U o
�
W
I�.
f
t
h
Cr U
W Z
~
¢
Park .
0
Z J
LLI
Qa�
Project
��
..
Location
w
}'
$- i..�♦
Z
Uo
C
Cr
F- W Z
U
?
to L
wo-
• �I
UJ
w O
�k
_
M
mom
¢mm
o U
J
¢ N
C1
UZ
rk
O
�
ra ,
w
'
J
0- LD
Z x
O p
Ud00
CD W
U Cl. W
QUADRANGLE L OCATIM4
t.
w o
-, 1-- w
SCALE 1:24000 V
Cr (n
_
0
1 MILE
4_ .
W..._........... ......._....._....._....
Um
1000
0 1000 2000 3000 4000 5000
_ ._. ..._ ..
6000 7000 FIEV
w _
J U
b 0
j KIL6M£TE.R
»^
CONTOUR INTERVAL 10 FEET
DATUM IS MEAN SEA LEVEL
mm
N
s
a
N
m
J
W
>
m
O
Z
FIGURE 1
a
3
3
N
O
O
O

Q
Z
J
U ¢
Q Z U
H
Z Z N
O W I— ¢
Co z Z z
PROVIDENCE ROAD cr zo a
Q 0' J
0_ "" m J
cn
Z Z N
W O a
U
0
CONCRETE WALK
1----------————————— — — — — —— — — — —— — — —
�
I I
I 1
I I
I I
I I
I I
, I
I W I cr v
I > , w z
1 cr I Z w
O , ¢
W I 3 0
y W I Z J
J¢ m I Q ¢
( 3 z I N v
I ¢ O
1 cr W U
I D w
cr
I ~ U I z
I z I w
O
I —PORCH
I w
CH
I I
I Z
Z 1 , O
o
W I I vo
O¢ I x x , ¢ cr U
¢ I I ZWz
Z U I , LLj U W
LdW I I �ZF-
xWoWPx iX
ORCH I ¢mo¢w ¢�=
v7I U
Jx XIawZ
I o
xl za 5,D , r
W = , W Z
� CD U 1 O_
O J cr 0
O I 0= OZ H
1 x tL� W 1 a ¢¢
I X, f- o
Z) J
I , 0
x x, ¢ cn
, � J
I , W �
I x
I � cr
Lu
O
O e z 1 co �`
Lu co
z I X -a
,
W J I I c, X1
(-D Q e a I I
Lo 3 I 1 N
W X I x XI N N;
a
I
X 1 > O
X FIGURE 2 z
u ¢ 3 3
U7 O O O

z
z
J
U 0
Z
¢ V
H
Z Z (n H
OW F- ¢
Z
PROVIDENCE ROAO
zo -
CL J
>
Z Z
N
LL1 O a
U 2
0
CONCRETE WALK
——
— — — — —
——
———
—————— — — — — —— —
— — ——
— — —
f-
I
�
I
s
I
I
I
I
1
I
I
I
I
I
I
1
I
I
I
W
U
>
,
W z
c
1
z W
1
¢ -
~
W
1
3 O
Y
U
W
I
I
Z
N
3
�
I
¢ ¢
¢
z
OU
(n U
I
¢
W
LD
F
m
1
I
1
U
z
I
z
w
_
I
I
�
t
I
PORCH
1
I
z
1
1
z
o
,
,
a
c� F-
I
I
�- O
W U
I
I
U
cr W
I X
X
t
O
¢ MU
O -J
I
1
F-
W�
I
I
wLLJ UW
�
I
I
X w t~-
x
I
uip0
I
;
PORCH
I
¢ >
�+
ui
N
¢�00 ¢
2
x
-I
�
JdU
I
=
x
XI
¢ N
_'
I
,
L) Z
Ix
N
,
I
+ U)
X,
i
(n
I
z
a
I I J
X
r1
I
XI
r
Ir
O
¢
I
N+
U
I
a
O
x
p
,
cr
a
z H
O
d
XI
v
+
co
o ¢
+U1
Ul+
I
x
M
cf)
(n
U)+
U)
,
U W
X J
xl
W d
oW J
~
�
1
I
o
x 1
� o
z o
I
o
i
�W V)
W J
z W
, X
W
� a
,
J
w ,y W
I
LL >
X,
Q m J a
1
oU
(n
W � 3 a
i
Z x
Z W
¢
cr
II
x
I x
to
1
xl
m
3
°,
-
J
1
x
W
\
m
Q
m Or
,
I
J
1
1
..
>
m
Z
z
x+
FIGURE 3
I
X,
J
'a
w
I
Z
C7
U
N
¢
I coO
3
3
O

TABLES

i
z
z
z
z
z
z
z
z
z
O
O
O
O
O
O
O
O.
M
V
V
V
V
V
V
V
V
0
O
O
O
O
O
O
O
O
oll
of
o,
o�
a\
(71
o�
C�
a,
w
a
a
a
a
a
a
co
co
cz
Cc
co
m
m
Cd
cr
C/)
cn
cn
cn
cn
C'n
cr
cn
cn°
(A
�n°
cn°
(n
VS
E-
�6
i
00
CA
Ln
�
c
VV
chin
c"n
cn
VD

APPENDIX A
TANK DISPOSAL MANIFEST

ME39
Earthworks ins.
Tank Disposal Manifest
KBS Earthworks, INC.
5616 Coble Church Rd.
Julian, NC 27283
(p) 336.362.0289
(f) 336.685.4339
Tank Owner / Authorized Representative
Name & Mailing Address
Tank Owner / Authorized xepresentative
Contact Phone Number:
Description of Tanks:
KBS Job/Invoice # q q tY 1
Tank # Capacity Previous Contents Comments
Tank Owner / Authorized Representative Certification:
The Undersigned certifies that the above listed storage tank(s) have been removed from the premises of the tank
owner
Transporter:
The Undersigned certifies that the above listed storage tank(s) have been transported to KBS Earthworks, Inc.
Julian, NC.
Disposal certification:
The Undersigned certifies that the above listed
s) have been cut into pieces & disposed of.
Name 1 Signatur� Date

' • I
GEOLOGIC LOG OF EXCAVATION

GEOLOGIC LOG OF EXCAVATION
Paragon Environmental Consultants, Inc.
Job Name: Wapner Residence
Address:
1132 Providence Road Charlotte, NC 28207
Job No.:
P-1972 Excavation Method:
Excavator
Start Date:
11/11/19
Sample Method:
Excavator Bucket
Contractor:
KBS Earthworks, Inc.
Sampled By:
BWR
Sample ID:
Tank / Soil Remediation Samples
Logged By:
BWR
Comments:
Sample
Number
Depth
(FT.)
Soil Decription (color, soil type, moisture)
OVA
(ppm)
T1-6.5
6.5
Tan/gray, CLAY with silt, damp
N/A
SS-1
1
Brown, SILT with clay, damp
N/A
SS-2
1
Brown, SILT with clay, damp
N/A
SS-3
1
Tan, CLAY with silt, damp
N/A
SS-4
0.5
Brown, SILT with clay, damp
N/A
SS-5
1
Tan, CLAY with silt, damp
N/A
SS-6
0.5
Tan, CLAY with silt, damp
N/A
SS-7
0.5
Tan, CLAY with silt, damp
N/A
SS-8
0.5
Tan, CLAY with silt, damp
N/A
P-1972X

APPENDIX C
SOIL ANALYTICAL RESULTS

Case Narrative
S M
'fLA9ORATORIES, INC.
Full -Service Analytical &
Environmental Solutions
Paragon Environmental Consultants, Inc.
Brandon Moore
PO Box 157
Thomasville, NC 27361
NC Certification No. 402
NC Drinking Water Cert No. 37735
SC Certification No. 99012
Project: Wagner Residence
Lab Submittal Date: 11 /13/2019
Prism Work Order: 9110220
11 /20/19 15:28
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
a--j
Angela D. Overcash
VP Laboratory Services
Data Qualifiers Key Reference:
Reviewed By Angela D. Overcash
VP Laboratory Services
DO Surrogates diluted out.
RLM Sample container suspected to have low methanol content. Results possibly biased high.
SR Surrogate recovery outside the QC limits.
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, INC 28224-0643
Phone: [phone] -Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 1 of 17

/FAR ' n n i Full -Service Analytical &
'v' i Environmental Solutions
LAUOAATORIE& INC.
Sample Receipt Summary
11 /20/2019
Prism Work Order: 9110220
Client Sample ID
Lab Sample ID
Matrix
Date/Time Sampled
Date/Time Received
TI-6.5
9110220-01
Solid
11/11/19 10:30
11/13/19
8:00
X-1
9110220-02
Solid
11/11/19 10:45
11/13/19
8:00
SS-1
9110220-03
Solid
11/11/19 11:15
11/13/19
8:00
SS-2
9110220-04
Solid
11/11/19 11:30
11/13/19
8:00
SS-3
9110220-05
Solid
11/11/19 12:00
11/13/19
8:00
SS-4
9110220-06
Solid
11/11/19 13:30
11/13/19
8:00
SS-5
9110220-07
Solid
11/11/19 14:00
11/13/19
8:00
SS-6
9110220-08
Solid
11/11/19 14:30
11/13/19
8:00
SS-7
9110220-09
Solid
11/11/19 15:00
11/13/19
8:00
SS-8
9110220-10
Solid
11/11/19 15:30
11/13/19
8:00
Samples were received in good condition at 2.9 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone] Page 2 of 17

'v I '11-Service Analytical s
Environmental Solutions
LAnORATONIE3, INI: ,
Summary of Detections
11 /20/2019
Prism Work Order: 9110220
Prism ID
Client ID
Parameter
Method
Result
Units
9110220-01
TI-6.5
Diesel Range Organics
8015C
8700
mg/kg dry
9110220-01
TI-6.5
Gasoline Range Organics
•8015C
63
mg/kg dry
9110220-02
X-1
Diesel Range Organics
'8015C
11000
mg/kg dry
9110220-02
X-1
Gasoline Range Organics
'8015C
51
mg/kg dry
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-800/629-6364 - Fax: [phone]
Page 3 of 17

hFull -Service Analytical &
Environmental Solutions
VIiOP.'i'0111FS ING
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361 Sample Matrix: Solid
Laboratory Report
11 /20/2019
Client Sample ID: TI-6.5
Prism Sample ID: 9110220-01
Prism Work Order: 9110220
Time Collected: 11/11/19 10:30
Time Submitted: 11/13/19 08:00
Parameter
Result
Units
Report
MDL
Dilution
Method Analysis Analyst Batch
Limit
Factor
DateMme
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
8700
mg/kg dry
630
180
60
*8016C 11/20/19 10:18
ZRC P91K0322
Surrogate
Recovery
Control Limits
o-Terphenyl
0 %
31-123 DO
Gasoline Range Organics by GC/FID
Gasoline Range Organics
63
mglkg dry
7.8
2.1
50
"8015C 11/19/19 10:11
TBL PSK0286
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
85 %
50-137
General Chemistry Parameters
% Solids
65.5
% by
0.100
0.100
1
'SM2640 G 11/18119 7:66
EDV P9K0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone]
Page 4 of 17

nService Analytical Environmental
Environmental Solutions
LJppflATJNIL$ ING
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc.
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Project: Wagner Residence
Sample Matrix: Solid
Client Sample ID: X-1
Prism Sample ID: 9110220-02
Prism Work Order: 9110220
Time Collected: 11/11/19 10:45
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DateMme ID
Diesel Range Organics by GC/FID
Diesel Range Organics 11000 mg/kg dry 590 200 50 *8015C 11120/19 10:55 ZRC P9K0322
Surrogate Recovery Control Limits
o-Terphenyl 0 % 31-123 DO
Gasoline Range Organics by GC/FID
Gasoline Range Organics 51 mg/kg dry 9.4 2.6 50 *8015C 11/19/19 9:43 TBL PSK0286
Surrogate
a,a, a-Trifluorotoluene
Recovery Control Limits
124 % 50-137
General Chemistry Parameters
% Solids 59.8 % by 0.100 0.100 1 •SM2640 G 11/18/19 7:55 EDV P9K0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1.800/629-6364 - Fax: [phone] Page 5 of 17

`,�' Full -Service Analytical &
Environmental Solutions
LAOONATONIL'S ING
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc.
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Project: Wagner Residence
Sample Matrix: Solid
Client Sample ID: SS-1
Prism Sample ID: 9110220-03
Prism Work Order: 9110220
Time Collected: 11/11/19 11:15
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DateMme ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/kg dry 8.6 2.9 1 `8015C 11/20/19 3:32 ZRC P91<0322
Surrogate
o-Terphenyl
Recovery Control Limits
72 % 31-123
Gasoline Range Organics by GC/FID RLM
Gasoline Range Organics BRL mg/kg dry 6.3 1.7 50 *8015C 11/18/19 13:44 TBL P91<0286
Surrogate Recovery Control Limits
a,a,a-Trifluorotoluene 168 % 50-137 SR
General Chemistry Parameters
% Solids 81.0 % by 0.100 0.100 1 `SM2640 G 11/18/19 7:55 EDV P91<0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] -Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 6 of 17

I S n � I Fuli-Service Analytical &
'v' Environmental Solutions
LAOORATORIES ING
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc.
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Project: Wagner Residence
Sample Matrix: Solid
Client Sample ID: SS-2
Prism Sample ID: 9110220-04
Prism Work Order: 9110220
Time Collected: 11/11/19 11:30
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DateMme ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/kg dry 8.3 2.8 1 '8015C 11/20/19 4:09 ZRC P91<0322
Surrogate
o-Terphenyl
Recovery Control Limits
79 % 31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics BRL mg/kg dry 6.4 1.7 50 '8015C 11/19/19 11:37 TBL P91<0286
Surrogate Recovery Control Limits
a,a,a-Trifluorotoluene 135 % 50-137
General Chemistry Parameters
% Solids 83.6 % by 0.100 0.100 1 'SM2640 G 11/18/19 7:65 EDV PSK0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone]
I Page 7 of 17

. t,R' n n Full -Service Analytical &
'v, Environmental Solutions
( BORAT AIE& INC
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc.
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Project: Wagner Residence
Sample Matrix: Solid
Client Sample ID: SS-3
Prism Sample ID: 9110220-05
Prism Work Order: 9110220
Time Collected: 11/11/19 12:00
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DatefTime ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/kg dry 8.7 2.9 1 `8015C 11/20/19 4:46 ZRC P91<0322
Surrogate
o-Terphenyl
Recovery Control Limits
77 % 31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics BRL mg/kg dry 7.0 1.9 50 '8015C 11/19/19 12:06 TBL P9K0286
Surrogate Recovery Control Limits
a,a,a-Trifluorotoluene 122 % 50-137
General Chemistry Parameters
Solids 80.2 % by 0.100 0.100 1 ASM2640 G 11/18/19 7:66 EDV P9K0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 8 of 17

Full -Service Anai tical &
Evironmental Solutions
1plipp
RIM INC
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc.
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Project: Wagner Residence
Sample Matrix: Solid
Client Sample ID: SS-4
Prism Sample ID: 9110220-06
Prism Work Order: 9110220
Time Collected: 11/11/19 13:30
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DateTme ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/kg dry 8.6 2.9 1 '8015C 11/20/19 5:22 ZRC P91<0322
Surrogate
o-Terphenyl
Recovery Control Limits
78 % 31-123
Gasoline Range Organics by GC/FID RLM
Gasoline Range Organics BRL mg/kg dry 6.3 1.7 50 '8015C 11/18/19 15:08 TBL P91<0286
Surrogate Recovery Control Limits
a,a,a-Trifluorotoluene 147 % 50-137 SR
General Chemistry Parameters
% Solids 81.5 % by 0.100 0.100 1 •SM2640 G 11/18/19 7:66 EDV PSK0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 9 of 17

iRISn n Full -Service Analytical &
' V' Environmental Solutions
LA[WPATOPIES INC
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361 Sample Matrix: Solid
Laboratory Report
11 /20/2019
Client Sample ID: SS-5
Prism Sample ID: 9110220-07
Prism Work Order: 9110220
Time Collected: 11/11/19 14:00
Time Submitted: 11/13/19 08:00
Parameter
Result
Units
Report
MDL
Dilution
Method Analysis Analyst Batch
Limit
Factor
DateMme
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
BRL
mg/kg dry
8.6
2.9
1
'8015C 11/20/19 5:59
ZRC P91<0322
Surrogate
Recovery
Control Limits
o-Terphenyl
87 %
31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics
BRL
mg/kg dry
6.3
1.7
50
'8015C 11/19/19 12:34
TBL P91<0286
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
119 %
50-137
General Chemistry Parameters
% Solids
81.0
% by
0.100
0.100
1
'SM2640 G 11/18/19 7:55
EDV P91K0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] -Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 10 of 17

R'ti ,... I S n A I Full -Service Analytical &
' V' Environmental Solutions
. �Ae A.oA,C. ING
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361 Sample Matrix: Solid
Client Sample ID: SS-6
Prism Sample ID: 9110220-08
Prism Work Order: 9110220
Time Collected: 11/11/19 14:30
Time Submitted: 11/13/19 08:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor Date/Time ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/kg dry 8.4 2.8 1 '8015C 11/20/19 12:09 ZRC P91<0322
Surrogate Recovery Control Limits
o-Terphenyl
71 %
31-123
Gasoline Range Organics by GC/FID
RLM
Gasoline Range Organics BRL
mg/kg dry
6.6 1.8
50 '8015C 11/18/19 16:05
TBL P91<0286
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
158 %
50-137 SR
General Chemistry Parameters
% Solids 83.0
% by
0.100 0.100
1 'SM2540 G 11/18/19 7:56
EDV P91{0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] -Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 11 of 17

P. Full -Service Analytical &
Environmental Solutions
'LADowomca ING
Laboratory Report
11 /20/2019
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361 Sample Matrix: Solid
Client Sample ID: SS-7
Prism Sample ID: 9110220-09
Prism Work Order: 9110220
Time Collected: 11/11/19 15:00
Time Submitted: 11/13/19 08:00
Parameter Result
Units Report MDL
Dilution
Method Analysis Analyst Batch
Limit
Factor
Date/Time ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL
mg/kg dry 8.4 2.8
1
`8015C 11/20/19 12:46 ZRC P91<0322
Surrogate
Recovery Control Limits
c-Terphenyl
74 % 31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics BRL RLM
mg/kg dry 5.2 1.4
50
`8015C 11/19/19 13:02 TBL P91<0286
Surrogate
Recovery Control Limits
General Chemistry Parameters
% Solids 82.8 % by 0.100 0.100 1 'SM2640 G 11/18/19 7:55 EDV P91<0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-800/629-6364 - Fax: [phone] Page 12 of 17

i €ts Full -Service Analytical &
Environmental Solutions
L 00-T .Ica I.a
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361 Sample Matrix: Solid
Laboratory Report
11 /20/2019
Client Sample ID: SS-8
Prism Sample ID: 9110220-10
Prism Work Order: 9110220
Time Collected: 11/11/19 15:30
Time Submitted: 11/13/19 08:00
Parameter
Result
Units
Report
MDL
Dilution
Method Analysis Analyst Batch
Limit
Factor
Date[Time
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
BRL
mg/kg dry
8.4
2.8
1
'8015C 11/20/19 13:23
ZRC P91<0322
Surrogate
Recovery
Control Limits
o-Terphenyl
75 %
31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics
BRL
mg/kg dry
4.9
1.3
50
'8015C 11/18/19 17:01
TBL P91<0286
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
131 %
50-137
General Chemistry Parameters
% Solids
83.0
% by
0.100
0.100
1
'SM2640 G 11/18/19 7:65
EDV P9K0291
Weight
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone] Page 13 of 17

z , Full -Service Analytical &
Environmental Solutions
,utA(IOHATOHILS IFO.
Level II QC Report
11 /20/19
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
Gasoline Range Organics by GC/FID - Quality Control
Prism Work Order: 9110220
Time Submitted: 11/13/2019 8:00:OOAM
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P9K0249 - 5030B
Blank (P9K0249-BLK1) Prepared &Analyzed: 11/14/19
Gasoline Range Organics BRL 5.0 mg/kg wet
Surrogate: a, a,a-Trifluorotoluene 4.90 mg/kg wet 5.000 98 50-137
Matrix Spike (P9K0249-MS1) Source: 9110220-03 Prepared: 11/13/19 Analyzed: 11/14/19
Gasoline Range Organics 70.0 6.2 mg/kg dry 61.71 BRL 114 41-138
Surrogate: a,a,a-Trifluorotoluene 6.91 mg/kg dry 6.171 112 50-137
Batch P9KO286 - 5030B
Blank (1291<0286-BLK1)
Prepared &Analyzed: 11/18/19
Gasoline Range Organics
BRL
5.0 mg/kg wet
Surrogate: a, a,a-Trifluorotoluene
5.30
mg/kg wet
5.000 106
50-137
LCS (P9K0286-BSI)
Prepared & Analyzed: 11/18/19
Gasoline Range Organics
64.0
5.0 mg/kg wet
50.00 128
41-138
Surrogate: a,a,a-Trifluorotoluene
6.10
mg/kg wet
5.000 122
50-137
LCS Dup (PSK0286-BSD1)
Prepared & Analyzed: 11/18/19
Gasoline Range Organics
66.2
5.0 mg/kg wet
50.00 132
41-138 3 20
Surrogate: a, a,a-Trifluorotoluene
5.60
mg/kg wet
5.000 112
50-137
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1.800/629-6364 - Fax: [phone] Page 14 of 17

A WA ik i�I S Full -Service Analytical &
Environmental Solutions
%LABOflATOnIES IHC.
Level II QC Report
11/20/19
Paragon Environmental Consultants, Inc. Project: Wagner Residence Prism Work Order: 9110220
Attn: Brandon Moore Time Submitted: 11/13/2019 8:00:OOAM
PO Box 157
Thomasville, NC 27361
Diesel Range Organics by GC/FID - Quality Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P9K0322 - 3546
Blank (P9K0322-BLK1)
Prepared: 11/18/19 Analyzed: 11/20/19
Diesel Range Organics
BRL
7.0 mg/kg wet
Surrogate: o-Terphenyl
1.07
mglkg wet
1.333 80 31-123
LCS (P9K0322-BSI)
Prepared: 11/18/19 Analyzed: 11/20/19
Diesel Range Organics
49.5
7.0 mg/kg wet
66.40 75 46-126
Surrogate: o-Terphenyl
1.02
mglkg wet
1.328 77 31-123
LCS Dup (1391<0322-13SD1)
Prepared: 11/18/19 Analyzed: 11/20/19
Diesel Range Organics
54.5
7.0 mg/kg wet
66.60 82 46-126 10 20
Surrogate: o-Terphenyl
1.19
mglkg wet
1.332 89 31-123
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] -Toll Free Number: 1-800/629.6364 - Fax: [phone] Page 15 of 17

S FullService Analytical &
Environmental Solutions
'71.AEORNTORIE& INC.
Paragon Environmental Consultants, Inc. Project: Wagner Residence
Attn: Brandon Moore
PO Box 157
Thomasville, NC 27361
General Chemistry Parameters - Quality Control
Level II QC Report
11 /20/19
Prism Work Order: 9110220
Time Submitted: 11/13/2019 8:00:OOAM
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P9KO291 - Solids, Dry Weight
Duplicate (P9K0291-DUP1) Source: 9110220-01 Prepared: 11/15/19 Analyzed: 11/18/19
Solids 63.5 0.100 % by Weight 65.5 3 20
Sample Extraction Data
Prep Method: 3646
Lab Number Batch Initial Final Date/Time
9110220-01
P91<0322
30.08
g 1 mL
11/18/19 11:45
9110220-02
P91<0322
30
g 1 mL
11/18/19 11:45
9110220-03
P91<0322
30.06
g 1 mL
11/18/19 11:45
9110220-04
P91<0322
30.14
g 1 mL
11/18/19 11:45
9110220-05
P91<0322
30.03
g 1 mL
11/18/19 11:45
9110220-06
P91<0322
30.07
g 1 mL
11/18/19 11:45
9110220-07
P91<0322
30.02
g 1 mL
11/18/19 11:45
9110220-08
P91<0322
30.06
g 1 mL
11/18/19 11:45
9110220-09
P91<0322
30.04
g 1 mL
11/18/19 11:45
9110220-10
P91<0322
30.02
g 1 mL
11/18/19 11:45
Prep Method: 5030E
Lab Number
Batch
Initial
Final
Daternme
9110220-01
P91<0286
4.9
mL
5 mL
11/18/19
8:11
9110220-02
P91<0286
4.47
mL
5 mL
11/18/19
8:11
9110220-03
P91<0286
4.9
mL
5 mL
11/18/19
8:11
9110220-04
P91<0286
4.68
mL
5 mL
11/18/19
8:11
9110220-05
P91<0286
4.48
mL
5 mL
11/18/19
8:11
9110220-06
P91<0286
4.85
mL
5 mL
11/18/19
8:11
9110220-07
P91<0286
4.89
mL
5 mL
11/18/19
8:11
9110220-08
P91<0286
4.59
mL
5 mL
11/18/19
8:11
9110220-09
P91<0286
5.8
mL
5 mL
11/18/19
8:11
9110220-10
P91<0286
6.13
mL
5 mL
11/18/19
8:11
Prep Method: Solids, Dry Weight
Lab Number
Batch
Initial
Final
DateTme
9110220-01
P91<0291
30
g 30 g
11/15/19 10:03
9110220-02
P91<0291
30
g 30 g
11/15/19 10:03
9110220-03
P91<0291
30
g 30 g
11/15/19 10:03
911022CW04
PSK0291
30
g 30 g
11/15/19 10:03
9110220-05
P91<0291
30
g 30 g
11/15/19 10:03
9110220-06
P91<0291
30
g 30 g
11/15/19 10:03
9110220-07
P91<0291
30
g 30 g
11/15/19 10:03
9110220-08
P91<0291
30
g 30 g
11/15/19 10:03
9110220-09
P91<0291
30
g 30 g
11/15/19 10:03
9110220-10
P91<0291
30
g 30 g
11/15/19 10:03
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Chariotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-800/629-6364 - Fax: [phone]
Page 16 of 17

n
71
i
❑ O z cKI
#
v m s
x o
-
'1
!
0
in
m n
r°s c°'
c 3 c v� (o
to
(b
m m
o o
L
_U Z
n D
Z
F
U) m ..
� r � 3
C,
c>
� �n
m my �y
.-
OAe
G CI.O o r 9 `
—i--
>to
o�i
m ° I
nC �o oc
I
f
mm
m -(
Q m gyp'
.Si
O
^.. i'0
t\
cn m "'
v-
C� p m M0 � 3•c
o
m0 !o W
C>
(''�
Q
W
d
�`
t
'1-
v�-'. ,,
0 -1 m
t'C
G ❑� nm
7
C
�p
p m I =r
n z R b m �. 1 W a•
a
CD
z
OHO �y �M ro
a
cDiinp
M -�
n A a m
m 0 x
RI Cn ro
to
j p
jOy m< ay v
d
i
m<
rm
D
m m c N O N
v�nm n
O
G
N r'
ZO m> CJ c 2��
n
O
;
A
pc-m d c0 O
1
o r S v
m 6.
r
m
O to a
- 0
-bi �t 3
CJ O t
m y �-
LJ
t.J
�.J
�..71
LJ
i
�l
y
O
n
z
mmy
< a m
o
h 5
M
I
m O❑
O
p `S
DQ„ A�
�omm m_
��
Shy, `°
z m
IN"
D
O z 0 a p A
O n 0 Q
(•� y
O SN
N Q
A v
m 4 w N j N CD
N -
-I
I
Z y m W ❑ SOD
co � � cr
to
I
�
<CA
ocmic m o p
z m m N
C�
I
y;Mu
0%' 5- d N
00
OrD .v
ma F y
1om� O D
U) N m A
M
<v, m DSm
X
X��
><
X
..
-
n D ri///}
❑�
CQ
N�
�-x
x
X
Xoa
pp d bD `.� O O
���
Cn
'TI
U
�' N CV fD
•``L
�
m m
m
�
�
1
U) r .�-> H
D
G O
_ l _
W
cA ^
°' `� n OI
m N w z
(
!
I
W
LJ r c
cn G n
c
=� m
tD n
? r
\
a o 0 r
a
O
C 3
O (D cn z
CL n (m
D -G
° rn n
_..__......--
.....
o
_
-.�
c�
m to r
0
m
_m
z -M—
3
0 0 D
T Cfi Ct71
M
rn �
I M
m >
m
z r
m -o
PL
p Z
rn
m m 3
%t1
Io
z cn
0 z
— I
I
c
o
a
c,
c
o
�sz
z
m
�z
O- cn m O ro 3
13 O M D z m Z b
C; _A a r; Z T m -1
r '2 T 1 ,cc
-0O4Or,� m3
...t @ m '.' O CO v
O m y
m
m Cam} v
rn
N J
m
I o
i i D
Page 17 of 17

APPENDIX D
STANDARD OPERATING PROCEDURES

STANDARD OPERATING PROCEDURES
PARAGON ENVIRONMENTAL CONSULTANTS, INC.
I. SOIL SAMPLE PROCEDURES
1. Collect all samples using disposable Latex gloves. Gloves are not to be re-
used.
2. Place samples into laboratory supplied glassware following requirements for
specific analysis.
3. Label samples with sample ID, date, time, and job number. Immediately place
samples on ice or in refrigerator to be cooled to approximately 4 degrees Celsius.
4. Store all samples on ice or refrigerate until samples are delivered to the laboratory.
5. Complete a chain of custody record for samples to be submitted to laboratory.
Sign and date the chain of custody when samples are relinquished in accordance
with EPA chain of custody protocol.
II. GROUNDWATER SAMPLING
1. Use new disposable bailer and new nylon string to develop well and collect
sample. Handle bailer and string with Latex gloves.
2. Develop well by removing 3 well volumes of water. Dispose of water in
accordance with NCDEQ guidelines.
3. Following well development obtain samples in laboratory supplied glassware
following requirements for specific analysis.
4. Handle, store, and transport samples in same manner as for soil samples. See
items 1.3, I.4, and 1.5 above.
III. EQUIPMENT CONTAMINATION
Decontaminate augers, split spoons, and other sampling equipment by the
following procedure:
A. Soap and tap water wash
B. Tap water rinse
C. Distilled deionized water rinse
D. Isopropyl alcohol rinse
E. Dist111QJ water rinsc
2. Use new disposable sampling equipment whenever practical.
6103S

APPENDIX E
SOIL DISPOSAL MANIFESTS

IWW
t
EariWv of N(� Inc.
Post Of &e, Box 130
SaffoTd, NC 27331 P U 13 L I C W E i GH MASTER
Phow #,. 919-774-4517 LICENSEXXPIRES"iJURE30,2019 211 ID. Nsx
JOH ' FREE -ASM�
Fax #: [phone] b bF
NON -H&ZARDWS WASTE MWNWnIr
4��MiAbwq- 10-
I L2,
Load Number:
Comultvint: Paragm EmkonomAst
—
Contact: B Mom
Phovic: 336-669-6037
Codwd:'-IPoi,)
Phone:
K0, Y
Phcine:I—
Deginafim Ewraim EnviroummtsJ, inc
....... . ...
Costam: Sceft Keller
3145 Rom,—. Road, Bear Creek, NC 27207
Phone: [phone]
wwite
wwo don. "Y'
61c&,
iV(-
Truck
Gross W6&:
Tare 20- 10. Not
633W ,L,.- = &E["Q; "-:,---
Not Wei&: nm lib TR
cir prstor-s CeMlieWatt I ofttity VW the MgMab dftMbOd abMe on this merest sm not
sqbject to federal negulatim for reportk* proper dispomd of HAZARDOUS WASTE.
Otn�rxtor / A49cht S,4'040ft
Ac'kinnwWament =F-
DrWm Sizaatum Daft
hiapoctcd & AccqAod (excog as wtod abow By: Em*tm EnviromcntA hic.
Accopted-By: z. Datc:

20 ID.
l lb r
.Akerald";IL' soklumsof Xc, T c NORTH CAROLINA
11t Ofike Da 310 PUBLIC WEiGHMASTER
xf-1 2mm LICENSE,,EXPIRES JUNE 30, 201.,
� � y JOHN G©DFREY , �42573
Fax uaara i( nnY eee eueucn
i J
I
'7c f'?. ..}?"4.C,
o!G,
More
A&&4X.d' Ix��
..,......,...,......_.�_._.
#i�'�.
�ECiVil�l�fti`� Q"�,,
t%t Co
E'�
»� i'}-:�` ,,��
``
-X,ii
(.Cffi� 4 ,e N( t
T *:
' "W .-
Tan Wew
lb TRI
.................
nnuntpst must
?xj t$ # al r z�ati exsfoz xcg�rsiip s nra df�?E A. S WAMt
1 Aost S 91
eats