MO-27805_47113_CA_UST-61_20200618_Report Form & Tank Inspection Report

UST-61
24-Hour Release and UST Leak Reporting Form.
For Releases This form should be completed and submitted to the UST Section's regional office following a known or suspected release from
an underground
storage tank (UST) system. This form is required to be submitted within 24 hours of discovery of a known or
in NC
suspected release
(DWM USE ONLY)
Suspected Contamination? (Y/N)
Facility ID Number
Incident # Risk (H,I,L,U)
Confirmed GW Contamination? (Y/N)
Date Leak Discovered
Received On Received
By
Confirmed Soil Contamination ?(Y/N)
Comm/Non-Commercial?
Reported by (circle one): Phone, Fax or Report
Samples Taken?(Y/N)
Reg/Non-regulated?
Region
Free Product? (Y/N) If Yes, State Greatest
Thickness
INCIDENT DESCRIPTION
Incident Name:
Address:
County:
Regional Office (circle one): Asheville, Mooresville, Fayetteville,
City/Town:
Zip Code:
Raleigh, Washington, Wilmington, Winston-Salem
Latitude (decimal degrees):
Longitude (decimal degrees) :
Obtained by:
❑ GPS
Briefly describe suspected or confirmed release: (including but not limited to: nature of release, date of release, amount
of release, amount of free product
present and recovery efforts, initial responses conducted, impacts to receptors
❑ Topographic map
❑ GIS Address matching
❑ Other
❑ Unknown
Describe location:
HOW RELEASE WAS DISCOVERED (Release code)
(Check one)
❑ Release Detection Equipment or Methods ❑ Visual/Odor ❑ Groundwater Contamination
❑ During UST Closure/Removal
❑ Water in Tank ❑ Surface Water Contamination
❑ Property Transfer
❑ Water Supply Well Contamination ❑ Other (specify)
SOURCE OF CONTAMINATION
Source of Release
Cause of Release Type of Release Product Type Released
(Check one to indicate primary
(Check one to indicate primary (Check one) (Check one to indicate primary product type
source)
cause) released)
❑ Tank
❑ Spill ❑ Petroleum ❑ Gasoline/ Diesel/ ❑ Diesel/Veg. Oil
❑ Piping
Kerosene Blend
❑Overfill ❑Non -Petroleum
❑ Heating Oil ❑ Vegetable Oil 100%
❑ Dispenser
❑ Corrosion ❑ Both ❑ Other Petroleum ❑ E10 — E20
❑ Submersible Turbine Pump
❑ Physical or Mechanical Products
❑ E21 E84
❑ Delivery Problem
—
Damage Location ❑ Metals
❑ ❑ E85 E99
oOther Inorganics —
❑ Install Problem (Checkne )
❑ Other
❑ Other ❑ Other Organics ❑ Ethanol 100%
❑Facility
❑ Unknown
❑ Unknown ❑ Residence ❑ E01 — E09
Definitions presented on reverse
I Definitions presented on reverse I ❑ Other
Ownership
1. Municipal 2. Military 3. Unknown
4. Private 5. Federal 6. County 7. State
Operation Type
1. Public Service 2. Agricultural
3. Residential 4. Education/Relig. 5. Industrial 6. Commercial 7. Mining
UST Form 61 (02/08) Page 1 of 2

IMPACT ON DRINKING WATER SUPPLIES
Water Supply Wells Affected? 1. Yes 2. No 3. Unknown
Number of Water Supply Wells Affected
Water Supply Wells Contaminated:
1.
2.
3.
(Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
UST Owner/Company
UST SYSTEM OWNER
Point of Contact
Address
City
State
Zip Code
Telephone Number
UST SYSTEM OPERATOR
UST Operator/Company
Address
City
State
Zip Code
Telephone Number
LANDOWNER AT LOCATION OF UST INCIDENT
Landowner
Address
City
State
Zip Code
Telephone Number
Draw Sketch of Area (showing two major road intersections) or Attach Map
Person Reporting Incident
Company
Telephone Number
Title
Address
Date
UST Form 61 (02/08)
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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Data use subject to license. aTN Scale 1 : 12,000
0 no go 600 800 1000
© DeLorme. Topo North America TM 10. MN (e.,^w) /VNII m
0 3M MO
www.delorme.com 1" = 1.000.0 ft Data Zoom 14-3

Cedar Rock
ENVIRONMENTAL
June 25, 2020
Ms. Trudy Beverly
NCDEQ
Division of Waste Management - UST Section
610 East Center Avenue
Mooresville, North Carolina 28115
CEDAR ROCK ENVIRONMENTAL, P.C.
107 Pioneer Trail
Graham, NC 27253
[phone]
Reference: Initial Abatement Action Report for the Brian Morgan Property
14800 Cumberland Drive, Charlotte, Mecklenburg County
Incident Number: Pending
Cedar Rock Project Number: 293822590
Dear Ms. Beverly:
Please accept this Initial Abatement Action Report for a release of fuel oil from one non-
commercial underground storage tank (UST) formerly located at the above referenced property.
This report satisfies the requirements specified in the Underground Storage Tank Section
Guidelines for Site Checks, Tank Closure, and Initial Response and Abatement, Change 9
(February 1, 2019).
One UST, used for storing home heating oil, was removed from the subject property on June 12,
2020. A total of 20.85 tons of impacted soil were excavated and transported to a permitted
facility for bioremediation as an initial abatement measure. The laboratory results for five soil
samples collected from the limits of the excavation showed that no petroleum residuals remain in
the unexcavated soils. Cedar Rock recommends that the DWM should issue a "Notice of No
Further Action" (NFA) letter to close out the release incident.
If you have any questions or need additional information, please give me a call.
Sincerely,
pr&/�
Robert A. Payne,L.G.
Enclosure
cc: Mr. Brian Morgan — Property Owner

Cedar Rock
ENVIRONMENTAL
June 25, 2020
Mr. Brian Morgan
14800 Cumberland Drive
Charlotte, NC 28227
Reference: Initial Abatement Action Report
Dear Mr. Morgan:
CEDAR ROCK ENVIRONMENTAL, P.C.
107 Pioneer Trail
Graham, NC 27253
[phone]
Cedar Rock Environmental, P.C. (Cedar Rock) is pleased to submit this Initial Abatement Action
Report to satisfy the requirements specified in the Underground Storage Tank Section Guidelines
for Site Checks, Tank Closure, and Initial Response and Abatement, Change 9 (February 1,
2019) for a release of fuel oil from the former underground heating oil system located at the
14800 Cumberland Drive property in Charlotte, North Carolina. This report should be
maintained for your records. A copy of this report has been sent to the North Carolina
Department of Environmental Quality (NCDEQ), Division of Waste Management (DWM), UST
Section in Mooresville.
Enclosed is an invoice for this work effort. If you have any questions, please feel free to contact
me at 336-376-0394.
Sincerely,
Robert
EA. Payne, L.G.
President

INITIAL ABATEMENT
ACTION REPORT
BRIAN MORGAN PROPERTY
14800 CUMBERLAND DRIVE
CHARLOTTE, MECKLENBURG COUNTY
Date Release Discovered: June 4, 2020
Source: One 550-Gallon Heating Oil UST
Incident No.: Pending
Prepared by:
Cedar Rock Environmental, P. C.
107 Pioneer Trail, Graham, North Carolina
June 24, 2020
CRE Project #293822590

INITIAL ABATEMENT ACTION REPORT
A. Site Information
1. Project name: Brian Morgan Property
2. Facility ID #: N/A (residential)
3. Site Facility address, county, and telephone no.: 14800 Cumberland Drive, Charlotte, NC
28227, Mecklenburg County. Phone: [phone]
4. Latitude and longitude of release: 35.222375 °N / 80.609141 °W (from Google Earth).
B. Release Information
1. Incident number: Pending.
2. Date release discovered: June 4, 2020.
3. Estimated quantity of release: Unknown.
4. Cause of release: Corrosion of UST.
5. Source of release: One 550-gallon heating oil UST.
C. Ownership Information
1. Name, address, and telephone number of current UST owner: Brian Morgan, 14800
Cumberland Drive, Charlotte, NC 28227. Phone: [phone]
2. Name and address of current property owner: Same as above.
D. Consultant/contractors
1. Primary consultant: Cedar Rock Environmental, P.C.
107 Pioneer Trail, Graham, NC 27253
Robert A. Payne, L.G. [phone]
2. Excavation: Zebra Environmental & Industrial Services Inc.
901 East Springfield Road,
High Point, NC 27263 [phone]
3. Soil Disposal: Earthtec of NC, Inc.
P.O. Box 130, Sanford, NC 27331 [phone]
4. Laboratory: Research & Analytical Laboratories, Inc.
North Carolina Certification #34
106 Short Street, Kernersville, NC 27284 [phone]
E. Report Certification
I, Robert A. Pae, a Licensed Geologist for
Cedar Rock Environmental, P.C., do certify that
the information contained in this report is correct
and accurate to the best of my knowledge.
License #: 970
(Signature & Seal)
Cedar Rock Environmental, P.C. is licensed to practice geology in North Carolina. The
number of the corporation is C-324 .
June 24, 2020
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Title Page

TABLE OF CONTENTS
Section Pam
1.0 SITE HISTORY AND CHARACTERIZATION ............................... 1
2.0 INITIAL RESPONSE AND ABATEMENT ACTIVITIES ....................... 1
3.0 EXCAVATION OF CONTAMINATED SOIL ................................ 1
3.1 Field Activities...................................................... 1
3.2 Soils Investigation.................................................... 2
3.3 Discussion of Results .................................................. 2
4.0 CONCLUSIONS AND RECOMMENDATIONS ............................... 3
5.0 REFERENCES.......................................................... 3
Fifzures
1 Site Location Map (USGS 7 1/2 Minute Topographical Quadrangle Map)
2 Site Map
3 Sample Locations and Results
Table
1 UST Owner and Operator Information
2 UST System Information
3 Summary of Soil Sampling Results
Appendices
A Photographic Documentation
B Disposal Manifests
C Excavation Log
D Sampling & Decontamination Procedures
E Laboratory Report & Chain -of -Custody
i

1.0 SITE HISTORY AND CHARACTERIZATION
The project site is a residential property located at 14800 Cumberland Drive in Charlotte, North
Carolina (see Figure 1). One 550-gallon underground storage tank (UST), identified as T1, was
located as shown in Figure 2. According to the Mecklenburg County tax office records, the
building was constructed in 1969. Table 1 lists pertinent storage tank system ownership
information. Table 2 lists specific UST information for T1. The subject site is surrounded by
residential properties. There is an onsite water supply well within 150 feet of the release area.
The location of the well is shown in Figure 2.
2.0 INITIAL RESPONSE AND ABATEMENT ACTIVITIES
Tank removal activities were performed on June 12, 2020 under the supervision of Cedar Rock.
Prior to removing T 1 from the ground, approximately 76 gallons of water and fuel oil were
removed from the tank. The fluids were disposed of by Zebra Environmental & Industrial
Services of High Point, North Carolina. Upon removal from the ground, T1 was observed to be
corroded, and the underlying soils were observed to have been impacted by leakage (petroleum
odor and soil discoloration).
Initial abatement activities consisted of excavating 20.85 tons of obviously contaminated soil
from the source area of the release. Soil removal continued to a maximum depth of 11.0 feet.
The lateral dimensions of the excavation pit measured about 8.0 feet by 7.0 feet at the pit floor.
The excavated contaminated soil was transported to a permitted disposal facility located in
Sanford, North Carolina for bioremediation.
No free product was encountered during the initial abatement activities. There are no other
subsurface structures on the subject site where free product or vapors could accumulate, or that
would provide a migration pathway for the release. The possibility of an explosion or the threat
to public health and safety or to the environment from the accumulation of vapors does not
appear to be of concern at this time. Therefore, the release is unlikely to be a significant
fire/safety/health hazard.
The 24-Hour Release Report and UST Leak Reporting Form (UST-61) was submitted to the
North Carolina Department of Environmental Quality (NCDEQ), Division of Waste
Management (DWM), UST Section in Mooresville on June 18, 2020.
3.0 EXCAVATION OF CONTAMINATED SOIL
3.1 Field Activities
Tank closure activities were performed on June 12, 2020 (see photographs in Appendix A).
Petroleum -impacted soils were encountered in the source area at a depth of about 5.0 feet
below land surface (bls). As impacted soil was removed from the source area, the soils were
periodically inspected by a North Carolina licensed geologist for evidence of petroleum
residuals (staining and odors). Soil removal continued to a maximum depth of 11.0 feet.

The lateral dimensions of the excavation pit measured about 8.0 feet by 7.0 feet at the pit
floor (see Figure 3). Bedrock was not encountered during excavation activities.
Groundwater was observed entering the excavation pit at a depth of 11 feet bls.
A total of 20.85 tons of contaminated soil were transported to a permitted disposal facility
located in Thomasville, North Carolina for bioremediation. The subject UST was disposed
of by Zebra Environmental at the D. H. Griffin facility in Greensboro, North Carolina.
Copies of the fluids, UST and soils disposal manifests are included in Appendix B.
3.2 Soils Investigation
According to the Geologic Map of North Carolina (1985), the subject site is underlain by
granitic rock. The native soils in the source area of the release consisted of a mottled, light
gray and orange -brown sandy SILT. A copy of the excavation log for the excavation is
included in Appendix C.
On June 12, 2020, Cedar Rock collected six soil samples to document the effectiveness of
soil excavation. One soil sample, CR-1, was collected from one foot below the center of T1.
Five soil samples, CR-2 through CR-6, were collected from the limits of the excavation
above the groundwater level. Sample locations are shown in Figure 3. The soil samples
were collected according to the sampling procedures included in Appendix D.
Soil samples CR-1 through CR-6 were submitted to the laboratory to be analyzed for TPH by
EPA Methods 3550 and 5030.
TPH were quantified in soil sample CR-1 at a concentration of 24,300 ppm by EPA Method
3550 and at a concentration of 575 ppm by EPA Method 5030. No TPH were quantified in
soil samples CR-2 through CR-6 by either of the methods. Soil sampling activities and
results are summarized in Table 3. A copy of the laboratory report and chain -of -custody is
included in Appendix E.
3.3 Discussion of Results
Figure 3 shows a plan view of the source area, limits of the excavation, and soil sample
locations in relation to the former location of the UST.
Petroleum -impacted soils were encountered in the source area at a depth of about 5.0 feet bls.
Soil removal continued to a maximum depth of 11.0 feet. The lateral dimensions of the
excavation pit measured about 8.0 feet by 7.0 feet at the pit floor.
Five soil samples were collected from the limits of the excavation where contamination was
most likely to remain. As shown in Table 3, no petroleum constituents were quantified in
these soil samples.
2

4.0 CONCLUSIONS AND RECOMMENDATIONS
One UST, used for storing home heating oil, was removed from the subject property on June 12,
2020. A total of 20.85 tons of impacted soil were excavated and transported to a permitted
facility for bioremediation as an initial abatement measure. The laboratory results for five soil
samples collected from the limits of the excavation showed that no petroleum residuals remain in
the unexcavated soils. Cedar Rock recommends that the DWM should issue a "Notice of No
Further Action" (NFA) letter to close out the release incident.
5.0 REFERENCES
24-Hour Release Report and UST Leak Reporting Form (UST-61); submitted to the North
Carolina Department of Environmental Quality, Division of Waste Management, UST
Section, Mooresville Regional Office on June 18, 2020.
Underground Storage Tank Section Guidelines for Site Checks, Tank Closure, and Initial
Response and Abatement, Change 9; published by the North Carolina Department of
Environmental Quality, Division of Waste Management, UST Section, February 1, 2019.
Geologic Map of North Carolina; published by the North Carolina Department of Natural
Resources and Community Development, Division of Land Resources, 1985.

FIGURES

Data use subject to license. aTN Scale 1 : 12,000
0 no go 600 800 1000
© DeLorme. Topo North America TM 10. MN (e.,^w) /VNII m
0 3M MO
www.delorme.com 1" = 1.000.0 ft Data Zoom 14-3

N
Cumberland Drive
House ,
Supply Well ® Petr
Meroshnik
Property
T1
Bridwell Homes LLC
Property
0 20 40 80
iiiii
1 Inch = 40 Feet
Bridwell Homes LLC
Property
T1 = 550-Gallon UST
— - Property Lines
PROJECT: Brian Morgan Property CEDAR ROCK
INCIDENT# Pending ENVIRONMENTAL, P.C. SITE MAP
LOCATION: 14800 Cumberland Drive
Charlotte Mecklenburg Co. FILENAME: 2938-2.fc7
CRE PROJECT NUMBER: 293822590 VERSION DATE: 6/18/2020 FIGURE 2

Supply Well
SOIL SAMPLE ANALYTICAL SUMMARY
Sample ID
Depth (ft).
TPH 5030 (ppm)
TPH 3550 (ppm)
CR-1
5.5
575
24,300
Sample ID
Depth (ft).
TPH 5030 (ppm)
TPH 3550 (ppm)
CR-2
10.5
BQL
BQL
CR-3
10.0
BQL
BQL
CR-4
10.5
BQL
BQL
CR-5
10.0
BQL
BQL
CR-6
11.0
BQL
BQL
T1 = 550-Gallon UST
0 10 20 40
-- — - Limits of Excavation
1 Inch = 20 Feet
PROJECT: Brian Morgan Property
INCIDENT # Pending
LOCATION: 14800 Cumberland Drive
Charlotte Mecklenburg Co.
CRE PROJECT NUMBER: 293822590
CEDAR ROCK
ENVIRONMENTAL, P.C.
FILENAME: 2938-3.fc7
VERSION DATE: 6/18/2020
• Sample Locations (CR-x)
SAMPLE
LOCATIONS
AND RESULTS
FIGURE 3

TABLES

TABLE I
UST OWNER AND OPERATOR INFORMATION
Brian Morgan Property
14800 Cumberland Drive, Charlotte, Mecklenburg County
UST ID Number
T1
Facility ID Number
N/A (residential)
Name of Owner/Operator
Dates of Ownership
Brian Morgan
? — present
Street Address
14800 Cumberland Drive
City
State
Zip
Telephone Number
Charlotte
NC
28227
[phone]

TABLE 2
UST SYSTEM
INFORMATION
Brian Morgan Property
14800 Cumberland Drive, Charlotte, Mecklenburg County
Tank
Description
Was a release
UST ID
Current/Last
Previous
Capacity
Construction
Dimensions
of Assoc.
Date Tank
Status of
associated
Number
Contents
Contents
(in gallons)
Details
(in feet)
Piping/Pumps
Installed
UST/AST
with the
system?
T1 (UST)
#2 Fuel Oil
#2 Fuel Oil
550
Steel
4.0 x 6.0
Copper
Unknown
Removed
Yes,
tubing to &
on
discovered on
from
6/12/2020.
6/4/2020.
foundation
wall.

TABLE 3
SUMMARY OF SOIL SAMPLING RESULTS
Brian Morgan Property
14800 Cumberland Drive, Charlotte, Mecklenburg County
Parameter
TPH Action
CR-1
CR-2
CR-3
CR-4
CR-5
CR-6
(Analytical Method)
Limit
Total Petroleum Hydrocarbons
100
24,300
BQL
BQL
BQL
BQL
BQL
(3550)
Total Petroleum Hydrocarbons
50
BQL
BQL
BQL
BQL
BQL
(5030)
il
Sample Collection Procedure
Hand Grab
Hand Grab
Hand Grab
Hand Grab
Hand Grab
Hand Grab
Sample Location
1 ft. below
North wall of
East wall of
South wall
West wall of
Center ofpit
center of T 1.
pit.
pit.
of pit.
pit.
floor.
Sample Depth (ft. bls)
5.5
10.5
10.0
10.5
10.0
11.0
Date of Sample Collection
6/12/2020
6/12/2020
6/12/2020
6/12/2020
6/12/2020
6/12/2020
Incident Phase
UST Closure
UST Closure
UST Closure
UST Closure
UST Closure
UST Closure
Results and TPH Action Limit in parts per million (ppm).
bls = below land surface
N/A = Not Applicable
Results for in bold and shaded exceeded the TPH Action Limits.

APPENDIX A
Photographic Documentation

Photo 1. View of the UST site prior to excavation activities.
Photo 2. View of the UST being lifted from the ground.

Photo 3. View of the UST after removal. Note the corrosion hole.
Photo 4. View of the loading of contaminated soils.

APPENDIX B
Disposal Manifests

MATERIAL
��:
Manifest Docment No.
r .
SPebria
MANIFEST
Page
of
i
EA "tW ld , k"
EMERGENCY PHONE NO.
POST OFFICE BOX 357 TEL [phone]
[phone]
HIGH POINT, NC 27261 FAX [phone]Q9
`
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x
. ,. ,� < As`.'t5+r
GENERATOR INFORMATION
.� Z4'.iF'��5- + �'y, i9 .�i^F�yaN'Af''.A
Name
US EPA ID No.
(G /1A aA r
Street Address M fling Adctess Phone No.
y6)0 _2% 3 03a -
` Contact
1366 a ate.
DESCRIPTION OF MATERIALS
USDOT Proper Shipping Name
Hazard
UN I NA
Packing
Containers
Total
Unit
HMI (Complete All Items for Hazardous Materials)
Class or Div
ID No.
Group
Qty. Type
Qu ntity
Wt./Vol.
a.
N d l'Z
A
1J %
i
T(
b.
C.
ADDITIONAL
INFORMATION
ERG No.
"
a.'.
a ,�
':T,
v,L a�..�b
'.i.
ri-�'a` n xti g`r�-'-
f ,y efy
1. a...>.J.. x,
�°^.r�
M1 w.., i m.
�nT y-+•w'��,.r-,%,.hL,s�
,.�'«...vn ... �ase�,.
b.���C.
:tKI II-IGAI IUN
This is to certify that the above -described materials are properly classified, described, packaged, marked and labeled, and are in
proper condition for transportation according to the applicable regulations of the Department of Transportation. I further certify that
none of the materials described above are a hazardous waste as defined by EPA 40 CFR Part 261 or any applicable state law, and
unless specifically identified above, the materials contain less than 1,000 ppm total halogens and do not contain quantifiable levels
(2 ppm) of PCBs as defined by EPA 40 CFR Parts 279 and 761.
--� Z - zou
TRANSPORTER4KFORMATION=;'-�
Transporter Zebra Environmental & Industrial Services Inc
I hereby acknowledge receipt of the above-descr'bed materials for transport
from the generator site listed ov .
Address
901 East Springfield Road
Y qSpLtntate
High Point, NC 27263
Signature
I hereby acknowledge recei t of the above -described materials were received
from the generator site and were transported to the facility listed below.
Transporter or
NCO991302669
Unit No.
EPA ID No:
�"
Phone [phone]
- Delive Date Signaturery
FACILITY INFORMA
ION sk x.., }, _777
Facility Zebra Environmental & Industrial Services, Inc.
i hereby acknowledge receipt of the materials covered by this manifest
except for any discrepancy'noted below.
—f
Address
901 East Springfield Road
High Point, NC 27263
- - _a'�-�__
Signature__-e_ Receipt Date
Facility orx
NCO991302669
* ' xk�
�tF
EPA ID No.
v y 1
Phone
( 336) 841-5276
-
Contact
Bill Hunter
ORIGINAL - Facility Retain COPY 2 -Return to Generator COPY 3 -Transporter Retain COPY 4 - Generator Retain

Tank Disposal Manifest
Tank Owner/Authorized Representative: Name and Mailing address
f 4ou G K 4Lor,-f:i Imo! C.
Tank Owner/Authorized Representative: Contact: W PA , jC- Ck6wr
Phone: 3-3(o - 3 7(o -. 03 f
Description of Tanks:
Tank No. - Capacily Previous Contents
650 GAL FQU OIL
Comments
Tank Owner/Authorized Representative Certification: The undersigned certifies that the above
listed storage tanks have been removed from the premises of the tank owner.
Signature
Printed Name
G !2 ZO
Month/Day/Year
Transporter: The under signed certifies that the above listed storage tanks have been transported to
Zebra Environmental & industrial Services Inc, 901 East Springfield Road High Point, NC 27263
r(�
N�
0-12-lc,
Month/Day/Year
Disposal Certification: The undersigned certifies that the above -named storage tank(s) have been
accepted by the metal recycling facility.
Recycling Facility: ..p �t c' a,
Signature Printed Name Month/Day/Year

e F-PA-C "cam
AFS of INC.
lllo4 Office Box 310
S %w-ford, NC 27391
Phone 0.- 336481-977,
W)RTH CAROLINA
mim ic WEIGHMASTER____
KANTIRST
Conmitant Zebra UOWAKC Weve Vancillum
Fhone- 336-841-5276
I
clr J-4k,
Contact:
rk;;.,
phone. -3
T�-Mspmter
C tzact:
i
Phone,
iit AE9 NC
3,9141 C.pnr�=ham- Rd., Thomas-A�a,
NC. 27Y_160 1
Phona: 919' A2584119197710-795
70
Wei te DescTiption:
Truck #-
D13
Alleight:
-UP
Tare Weight:
44 Net Weiev-1-M.,
flee
Generkw, S CeAfficati W. I cerfifi that the matenals described above Oft UNS =MteSt age not 5UVOCT 10'
Federal regulatiom for rev otfing mWer disposal oil HA2ARMIUS'WAS TE.
erato .4crern Signature ;0"
Ackrawledgment a', Receipt zif J'Jatefial:
Driv rsSigrl ure Date
Noted Discrepancleci:
Inspected &Accepted (except as noted above by: AE'Sqf NC)
" 1_211�11e
Acrepted, By:

APPENDIX C
Excavation Log

EXCAVATION LOG
PROJECT NO.: 293822590
PROJECT: Brian Morgan Property
LOC.: 14800 Cumberland Drive, Charlotte
COUNTY: Mecklenburg
DATE STARTED: 6/12/20
DATE COMPLETED: 6/12/20
CONTRACTOR: Zebra Environmental, Inc
BACKFILL: brown silt
DIA. x DEPTH TO
TANK # GALS. LENGTH (ft.) CONTENTS BOTTOM (ft.)
T1 550 4.0 x 6.0 #2 fuel oil 4.5
FREE PRODUCT ENCOUNTERED? No
DEPTH TO BEDROCK: n/a GROUNDWATER: n/a
FINAL DIMENSIONS OF EXC.: 8.0' (W) x 7.0' (L) x 11.0' (D)
VOL. REMOVED & DISPOSAL: 20.85 tons
= w
J O"
a s
z a
W�
0 m
DESCRIPTION OF MATERIAL
REMARKS
WW
LL
Z
r2 Q O
Q V "_
tq O
d p
r2 Z
fn rL
}
N
R
y Q
3
0 - 4.5' backfill
1
2
3
4
5
4.5 - 11.0' : mottled, light gray & orange -brown sandy SILT
CR-1
6
7
8
9
10
CR-
CR-2&4
CR-6
11
_ _ _ _
Excavation terminated at 11.0 feet (pit center).
12
13
14
15
16
17
CEDAR ROCK ENVIRONMENTAL, P.C.

APPENDIX D
Sampling & Decontamination Procedures

CEDAR ROCK ENVIRONMENTAL, P.C.
EQUIPMENT DECONTAMINATION PROCEDURES
Every effort will be made to prevent cross -contamination of soil and groundwater samples before,
during, and after sample collection. It is company policy that drillers contracted by Cedar Rock
decontaminate their drilling and sampling equipment with steam prior to, and after, each use and/or
each boring. The following procedures apply to the decontamination of field equipment used by
Cedar Rock employees.
Soil Sampling Equipment
Stainless steel hand augers, spoons, and knives will be cleaned prior to, and after, each use and/or
each boring. If hand auger advancement of a borehole through contaminated soil is obvious or
suspected, a clean auger bucket will be used to retrieve the sample portion. A fresh pair of
disposable vinyl gloves will be worn while handling the sample container.
Sampling equipment will be decontaminated by washing with phosphate -free soapy water; rinsing
in tap water followed by an isopropyl alcohol rinse; and a final "triple" rinse with distilled water.
The equipment will then be allowed to air dry. Clean sampling spoons and knives will be stored
in a fresh ziplock bag.
If available, steam may be used instead of the above procedure.
Groundwater Sampling quipment
Use of groundwater level measuring devices will proceed from the wells known to be the least
contaminated to those known to be more contaminated. If it is not known how contaminated the
wells are, measurements will be taken on the up gradient wells prior to the down gradient wells.
A fresh pair of disposable vinyl gloves will be worn at each well during water level and sample
collection.
Water level measuring and well sampling (i.e., pumps and lines) devices will be decontaminated
between wells by washing the wetted portion of the device as described above.
Each well will be sampled with a new disposable or decontaminated, dedicated bailer during each
sampling event. New nylon or cotton string will be used during each sampling event on each
bailer. If the bailer contains a significant quantity of silt or sand after purging the well of stagnant
water, the bailer may be flushed with distilled water. The bailer will never come into contact with
anything other than a gloved hand or the inside of the well casing. While allowing the well to
recover, the bailer will be hung inside the well at the top of the casing. The string will be coiled
and placed in a ziplock bag or vinyl glove such that it does not come into contact with other objects.
Groundwater sample containers will be wiped dry and stored in individual ziplock bags.

CEDAR ROCK ENVIRONMENTAL, P.C.
SOIL SAMPLING PROCEDURES
(Collection and Handling)
Soil sampling will be performed by, or under, the direct supervision of a North Carolina licensed
geologist. Care will be taken to minimize the loss of contaminants from the sample during sample
collection, storage, and transport through disturbance of the internal structure of the soil and
exposure to heat, sunlight, and air. Decontamination and handling procedures will be used that
minimize the chance of cross -contamination of the samples during and after sample collection.
All tools used to retrieve, divide, and collect the sample portion (e.g., hand augers, split -barrel
sampler, stainless steel spoons, etc.) will be decontaminated prior to and after each use (between
samples). See Decontamination Procedures.
Vinyl disposable gloves will be worn during sample collection. Gloves will be changed as
necessary after handling the sampling equipment (i.e., after breaking open split -barrels) to avoid
cross -contamination. Contact between the gloved hand and the soil will be minimized by dividing
and collecting the sample portion using a stainless steel spoon or knife.
The sample portion will be collected from the core of the soil at the end of the sampling device
where the deepest retrieved soil is represented (e.g., hand auger teeth). If the sample is being
retrieved using the backhoe bucket, the sample portion will be collected from the consolidated
material located directly behind one of the bucket teeth. A separate sampling implement will be
used to scrape away foreign material if present and/or the soil which came into contact with the
sample retrieving device in order to expose the core of the sample portion to be collected.
Immediately upon removal from the ground, the sample will be placed in a laboratory -provided,
decontaminated container. The sample container will be precooled, if possible, to minimize loss
of volatiles. The sample portion will be disturbed as little as possible during placement into the
container. The container will be filled leaving no head -space and immediately capped and sealed.
Immediately upon collection, the exterior of the sample container will be wiped free of soil, if
necessary, and placed in a ziplock bag to minimize cross -contamination. The sample will
immediately be placed in a cooler of ice for storage and transport to the analytical laboratory.
The sample will be labeled with sample identification number, project number, date and time of
collection, and analyses to be conducted. The sample will be transported as soon as practical to a
North Carolina certified laboratory under chain -of -custody.

APPENDIX E
Laboratory Report & Chain -of -Custody

RESEARCh & ANA[yTICA[
LAbORATORIESI INC.
Analytical/Process Consultations
June 18, 2020
Cedar Rock Environmental, P.C.
107 Pioneer Trail
Graham, NC 27253
Attention: Robert Payne
Chemical Analysis for Total Petroleum Hydrocarbons (TPH) for Selected Sampling Location Identified as Brian Morgan Property
(A Cedar Rock Environmental, P.C. Project #293822590, collected 12 June 2020)
Quantitation
EPA Method
Surrogate
Sample
RAL
Date
Time
Limit
5030
Date
Time
Recovery
Identification
Sample#
Taken
Mrs
(me/ke)
(me/ke)
Analyzed
Analyzed
(Flurobenzene)
CR-1
83493-01
06/12/20
0945
100
575
06/17/20
2042
87%
CR-2
83493-02
06/12/20
1000
10
BQL
06/17/20
2331
88%
CR-3
83493-03
06/12/20
1015
10
BQL
06/18/20
0054
86%
CR-4
83493-04
06/12/20
1030
10
BQL
06/18/20
0136
86%
CR-5
83493-05
06/12/20
1045
10
BQL
06/18/20
0217
86%
CR-6
83493-06
06/12/20
1100
10
BQL
06/18/20
0502
85%
EPA Method 5030 = Total Petroleum Hydrocarbons as Gasoline BQL = Below Quantitation Limits
mg/kg = milligrams per kilogram = parts per million (ppm) Surrogate Recovery Range = 70-130%

RESEARCh & ANAlyTICAI
LABORATORIES, INC.
Analytical/Process Consultations
June 18,2020
Cedar Rock Environmental, P.C.
107 Pioneer Trail
Graham, NC 27253
Attention: Robert Payne
Chemical Analysis for Total Petroleum Hydrocarbons (TPH) for Selected Sampling Location Identified as Brian Morgan Property
(A Cedar Rock Environmental, P.C. Project #293822590, collected 12 June 2020)
Quantitation EPA Method
Surrogate
Sample
RAL
Date
Time
Limit
3550
Date
Date
Time
Recovery
Identification
Sample#
Taken
.(hrs)
(me/ke)
(me/ka)
Extracted
Analyzed
Analyzed
(P-Terphenvl d-14)
CR-1
83493-01
06/12/20
0945
200
24,300
06/16/20
06/16/20
1740
Dilution
CR-2
83493-02
06/12/20
1000
10
BQL
06/16/20
06/16/20
1906
130%
CR-3
83493-03
06/12/20
1015
10
BQL
06/16/20
06/16/20
2103
129%
CR-4
83493-04
06/12/20
1030
10
BQL
06/16/20
06/16/20
2230
106%
CR-5
83493-05
06/12/20
1045
10
BQL
O6/16/20
06/16/20
2328
116%
CR-6
83493-06
06/12/20
I100
10
BQL
06/16/20
06/17/20
0124
102%
mg/kg = milligrams per kilogram = parts per million (ppm) BQL = Below Quantitation Limits
EPA Method 3550 = Total Petroleum Hydrocarbons as Diesel Surrogate Recovery Range = 70-130%

REQUESTED ANALYSIS
SAMPLES COLLECTED BY: Robert A. Payne
SAMPLERS` SIGNATURE: fio b'
o
LABORATORY UTILIZED: Research & Anal tical
o
z
h
�'
Laboratories. Inc.
Kernersville, NC
?
�h`'fab<6
o
�a �r �`� ate-
LAB ID NO.
DATE
TIME
coup
GRAa
SAMPLE ID
SAMPLE MATRIX
6/12/2020
0945
X
CR-1
1
X
X
I
I
I
SOIL
-�p�
6/12/2020
1000
X
CR-2
1
X
X
SOIL
-0
6/12/2020
1015
X
CR-3
1
X
X
SOIL
.,Ckj
6/12/2020
1030
X
CR-4
1
X
X
SOIL
6/12/2020
1045
X
CR-5
1
X
X
soil
-0(4)
6/12/2020
1100
X
CR-6
1
X
X
SOIL
F! UISHED EY
u� � ,�
DATE
G IL o
TIVE
(gov
RECEPIED 2'11
�C'
RE%%RK-c:
3 day turn around, please Sid!
r- '�S�G� �q01
RE CUI H D BY
DATE
TIC+E
REGEPaD fi _
12U
SO �. c�rc acr: c t Samples on ice.
PROJECT: an Morgan Property
107 Pioneer Trail
INCIDENT # Pending
14800 Cumberland Drive
Cedar Rock Graham, NC 27253
CHAIN OF
LOCATION:
Charlotte; Mecklenburg Co.
Environmental, P.C. Attn: Robert Payne
[phone]
CUSTODY RECORD
CRE PROJECT NUMBER 293822590

RESEARCh & ANA[yTICAI
LABORATORIES, INC.
Analytical/Process Consultations
CN7.Y7jZ/_:: IV1 M
Sig (6) soil samples were received in good condition on 15 June 2020. The
samples were analyzed without difficulties unless noted below.
Sidney L. Champion
Director of Laboratory Services
Date
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalahs.com

ANEW Summary
Method 5030
Project: Cedar Rock Environmental, P.C. -Brian Morgan Property
Page 1 of 1
Sample ID
83493-01-06
Sample Prep Method
5030
Volume/Used
5 mis
Final Extract Volume
NIA
Date Analyzed
06/17/20
% Surrogate Recovery
97
Acceptance Limits
(70-130)
LCS
MDL
Method
Trip/Field
LCS %
Acceptance
Compound
m
Blank
Blank
RecoveryRange
Sample
Duplicate
°iaRrn
Control Limits
Gasoline
0.57
BQL
N/A
101
72-128
91
98
6.85
20%
NIA = Data Not Available

QA/QC Summary
Method 3550
Project: Cedar Rock Environmental, AC. - Brian Morgan Property
Page 1 of 1
Sample ID
83493-01-06
Sample Prep Method
3550
Volume/Used
15 g
Final Extract Volume
10 mis
Date Analyzed
06/16/20
% Surrogate Recovery
121
Acceptance Limits
(70-130)
L�CS
MDL
Method
Trip/Field
LCS %
Acceptance
Compound
m
Blank
Blank
RecoveryRange
Sample
Duplicate
°i°�D
Control Limits
Diesel
1.36
BQL
N/A
102
80-120
541
509
6.00
20
NIA = Data Not Available

Beverly, Trudy
From: Beverly, Trudy
Sent: Friday, June 19, 2020 6:45 AM
To: [e-mail]
Subject: RE: [External] UST-61 form submission for the Brian Morgan Property, 14800
Cumberland Drive, Charlotte; Cedar Rock Inspection report
Received.
Have a great weekend,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
Q,
Dr" 'el UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlykncdenn gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: ht_pt s://deg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httos://dea.nc. gov/about/divisions/waste-management/waste-management-rules-data/waste-management-ais-mans
File Review Procedures:
hitps://deq.ne. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
bit.ps://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.ne.izov/ncdea[Waste%2OMana2ement/DWM/UST/WhatsNew/Final-Electronic-Document-Submittal-Policv.l)df
https:Hfiles.nc.gov/ncdeq/Waste%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: [e-mail] [mailto:[e-mail]]
Sent: Thursday, June 18, 2020 4:00 PM
To: Beverly, Trudy <[e-mail]>
Subject: [External] UST-61 form submission for the Brian Morgan Property, 14800 Cumberland Drive, Charlotte; Cedar
Rock Inspection report
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Hi Trudy
Please find attached the UST-61 form and our site inspection report for a release at the above property. An Initial
Abatement report will follow shortly for an excavation carried out on 6/12/20.
Thanks
Damien Callaghan
Cedar Rock Environmental