MO-27893_47196_CA_UST-61_20200618_24-Hour Release and UST Leak Reporting Form

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

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

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Case Narrative
Waypoint.
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Chart)
David Hanley
2801 Yorkmont Rd. #100
Charlotte, NC 28208
NC Certification No. 402
NC Drinking Water Cert No. 37735
SC Certification No. 99012
Project: West Sugar Creek UST
Lab Submittal Date: 06/11/2020
Work Order: 0060930
6/16/20 15:40
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,
WAYPOINT ANALYTICAL
a,j
Angela D. Overcash
Senior Project Manager
Data Qualifiers Key Reference:
DO Surrogates diluted out.
J Detected but below the Reporting Limit; therefore, result is an estimated concentration (CLP J-Flag).
M Matrix spike outside of the control 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 Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 1 of 12

Sample Receipt Summary
Way� nt
06/16/2020
poiA
Work Order: 0060930
NALYTICAL
Client Sample ID
Lab Sample ID
Matrix
Date/Time Sampled Date/Time Received
S-1
0060930-01
Solid
06/11/20 12:00 06/11/20 14:00
S-2
0060930-02
Solid
06/11/20 12:10 06/11/20 14:00
S-3
0060930-03
Solid
06/11/20 12:30 06/11/20 14:00
Samples were received in good condition at 5.0 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 2 of 12

WayPAoi nt .
NALYTICAL
Summary of Detections
06/1693 0
Work Order: 00600
Waypoint ID
Client ID
Parameter
Method
Result
Units
0060930-01
S-1
Diesel Range Organics
`8015C
6900
mg/kg dry
0060930-01
S-1
Gasoline Range Organics
'8015C
240
mg/kg dry
0060930-01
S-1
Ethylbenzene
8260D
0.17 J
mg/kg dry
0060930-01
S-1
m,p-Xylenes
8260D
2.2
mg/kg dry
0060930-01
S-1
o-Xylene
8260D
0.041 J
mg/kg dry
0060930-01
S-1
Xylenes, total
8260D
2.3
mg/kg dry
0060930-02
S-2
Diesel Range Organics
'8015C
15000
mg/kg dry
0060930-02
S-2
Gasoline Range Organics
`8015C
220
mg/kg dry
0060930-02
S-2
Ethylbenzene
8260D
0.17 J
mg/kg dry
0060930-02
S-2
m,p-Xylenes
8260D
0.25 J
mg/kg dry
0060930-02
S-2
Xylenes, total
8260D
0.25 J
mg/kg dry
0060930-03
S-3
Diesel Range Organics
'8015C
220
mg/kg dry
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 3 of 12

�
Laboratory Report
•
Waynt.
06/16/2020
PA
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Client Sample ID: S-1
Attn: David Hanley
Sample ID: 0060930-01
2801 Yorkmont Rd. #100
Work Order: 0060930
Charlotte, NC 28208
Sample Matrix: Solid
Time Collected: 06/11/20 12:00
Time Submitted: 06/11/20 14:00
Parameter
Result
Units
Report
MDL
Dilution Method Analysis
Analyst Batch
Limit
Factor Date/Time
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
6900
mg/kg dry
470
160
50 *8015C 6/12/20 13:21
ZRC POF0917
Surrogate
Recovery
Control Limits
o-Terphenyl
0 %
31-123 DO
Gasoline Range Organics by GC/FID
Gasoline Range Organics
240
mg/kg dry
59
16
500 *8015C 6/12/20 15:22
TBL POF0918
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
90 %
50-137
General Chemistry Parameters
% Solids
74.4
% by
0.100
0.100
1 *SM2540 G 6/12/20 7:50
EDV POF0914
Weight
Volatile Organic Compounds by GUMS (Medium Level)
Benzene
BRL
mg/kg dry
0.26
0.041
50 8260D 6/16/20 10:42
TBL POF0974
Ethylbenzene
0.17 J
mg/kg dry
0.26
0.040
50 8260D 6/16/20 10:42
TBL POF0974
m,p-Xylenes
2.2
mg/kg dry
0.53
0.068
50 8260D 6/16/20 10:42
TBL POF0974
o-Xylene
0.041 J
mg/kg dry
0.26
0.028
50 8260D 6/16/20 10:42
TBL POF0974
Toluene
BRL
mg/kg dry
0.26
0.042
50 8260D 6/16/20 10:42
TBL POF0974
Xylenes, total
2.3
mg/kg dry
0.79
0.095
50 8260D 6/16/20 10:42
TBL POF0974
Surrogate
Recovery
Control Limits
4-Bromofluorobenzene
83 %
70-130
Dibromofluoromethane
97 %
70-130
Toluene-d8
79 %
70-130
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, INC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 4 of 12

�
Laboratory Report
•
Waynt.
06/16/2020
PA
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Client Sample ID: S-2
Attn: David Hanley
Sample ID: 0060930-02
2801 Yorkmont Rd. #100
Work Order: 0060930
Charlotte, NC 28208
Sample Matrix: Solid
Time Collected: 06/11/20 12:10
Time Submitted: 06/11/20 14:00
Parameter
Result
Units
Report
MDL
Dilution Method Analysis
Analyst Batch
Limit
Factor Date/Time
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
15000
mg/kg dry
940
320
100 *8015C 6/12/20 15:12
ZRC POF0917
Surrogate
Recovery
Control Limits
o-Terphenyl
0 %
31-123 DO
Gasoline Range Organics by GC/FID
Gasoline Range Organics
220
mg/kg dry
59
16
500 *8015C 6/12/20 14:54
TBL POF0918
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
110 %
50-137
General Chemistry Parameters
% Solids
74.3
% by
0.100
0.100
1 *SM2540 G 6/12/20 7:50
EDV POF0914
Weight
Volatile Organic Compounds by GUMS (Medium Level)
Benzene
BRL
mg/kg dry
0.28
0.043
50 8260D 6/16/20 11:42
TBL POF0974
Ethylbenzene
0.17 J
mg/kg dry
0.28
0.042
50 8260D 6/16/20 11:42
TBL POF0974
m,p-Xylenes
0.25 J
mg/kg dry
0.55
0.071
50 8260D 6116/20 11:42
TBL POF0974
o-Xylene
BRL
mg/kg dry
0.28
0.029
50 8260D 6/16/20 11:42
TBL POF0974
Toluene
BRL
mg/kg dry
0.28
0.044
50 8260D 6/16/20 11:42
TBL POF0974
Xylenes, total
0.25 J
mg/kg dry
0.83
0.099
50 8260D 6116/20 11:42
TBL POF0974
Surrogate
Recovery
Control Limits
4-Bromofluorobenzene
107 %
70-130
Dibromofluoromethane
96 %
70-130
Toluene-d8
106 %
70-130
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, INC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 5 of 12

�
Laboratory Report
•
Waynt.
06/16/2020
PA
ANALYTICAL
Wood Environ. & Infrastructure Solutions
(Ch
Project: West Sugar Creek UST
Client Sample ID: S-3
Attn: David Hanley
Sample ID: 0060930-03
2801 Yorkmont Rd. #100
Work Order: 0060930
Charlotte, NC 28208
Sample Matrix: Solid
Time Collected: 06/11/20 12:30
Time Submitted: 06/11/20 14:00
Parameter
Result Units
Report
MDL
Dilution Method Analysis
Analyst Batch
Limit
Factor Date/Time
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
220
mg/kg dry
44
15
5 *8015C 6/12/20 15:49
ZRC POF0917
Surrogate
Recovery
Control Limits
o-Terphenyl
61 %
31-123
Gasoline Range Organics by GC/FID
Gasoline Range Organics
BRL
mg/kg dry
5.2
1.4
50 *8015C 6/12/20 14:26
TBL POF0918
Surrogate
Recovery
Control Limits
a,a,a-Trifluorotoluene
109 %
50-137
General Chemistry Parameters
% Solids
80.0
% by
0.100
0.100
1 *SM2540 G 6/12/20 7:50
EDV POF0914
Weight
Volatile Organic Compounds by GUMS
Benzene
BRL
mg/kg dry
0.0065
0.0010
1 8260D 6/16/20 10:12
TBL POF0972
Ethylbenzene
BRL
mg/kg dry
0.0065
0.00098
1 8260D 6/16/20 10:12
TBL POF0972
m,p-Xylenes
BRL
mg/kg dry
0.013
0.0017
1 8260D 6/16/20 10:12
TBL POF0972
o-Xylene
BRL
mg/kg dry
0.0065
0.00069
1 8260D 6/16/20 10:12
TBL POF0972
Toluene
BRL
mg/kg dry
0.0065
0.0010
1 8260D 6/16/20 10:12
TBL POF0972
Xylenes, total
BRL
mg/kg dry
0.020
0.0023
1 8260D 6/16/20 10:12
TBL POF0972
Surrogate
Recovery
Control Limits
4-Bromofluorobenzene
103 %
70-130
Dibromofluoromethane
103 %
84-123
Toluene-d8
114 %
76-129
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, INC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 6 of 12

Waypo�nt
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Attn: David Hanley
2801 Yorkmont Rd. #100
Charlotte, NC 28208
Volatile Organic Compounds by GC/MS - Quality Control
Analyte
Batch POF0972 - 5035
Reporting
Result Limit Units
Level II QC Report
6/16/20
Work Order: 0060930
Time Submitted: 6/11/2020 2:00:OOPM
Spike Source %REC RPD
Level Result %REC Limits RPD Limit Notes
Blank (POF0972-BLK1)
Prepared & Analyzed: 06/16/20
Benzene
BRL
0.0050
mg/kg wet
Ethylbenzene
BRL
0.0050
mg/kg wet
m,p-Xylenes
BRL
0.010
mg/kg wet
o-Xylene
BRL
0.0050
mg/kg wet
Toluene
0.00152
0.0050
mg/kg wet
J
Surrogate:4-Bromofluorobenzene
55.7
ug/L
50.00 111
70-130
Surrogate: Dibromofluoromethane
50.0
ug/L
50.00 100
84-123
Surrogate: Toluene-d8
38.0
ug/L
50.00 76
76-129
LCS (POF0972-BS1)
Prepared &Analyzed: 06/16/20
Benzene
0.0445
0.0050
mg/kg wet
0.05000 89
74-127
Ethylbenzene
0.0527
0.0050
mg/kg wet
0.05000 105
74-128
m,p-Xylenes
0.113
0.010
mg/kg wet
0.1000 113
75-124
o-Xylene
0.0441
0.0050
mg/kg wet
0.05000 88
74-126
Toluene
0.0572
0.0050
mg/kg wet
0.05000 114
71-129
Surrogate:4-Bromofluorobenzene
51.4
ug/L
50.00 103
70-130
Surrogate: Dibromofluoromethane
50.2
ug/L
50.00 100
84-123
Surrogate: Toluene-d8
60.0
ug/L
50.00 120
76-129
Matrix Spike (POF0972-MS1)
Source: 0060930-03
Prepared & Analyzed: 06/16/20
Benzene
0.0473
0.0062
mg/kg dry
0.06248 BRL 76
60-135
Ethylbenzene
0.0435
0.0062
mg/kg dry
0.06248 BRL 70
44-144
m,p-Xylenes
0.0817
0.012
mg/kg dry
0.1250 BRL 65
36-148
o-Xylene
0.0403
0.0062
mg/kg dry
0.06248 BRL 64
43-143
Toluene
0.0483
0.0062
mg/kg dry
0.06248 BRL 77
57-135
Surrogate:4-Bromofluorobenzene
48.6
ug/L
50.00 97
70-130
Surrogate: Dibromofluoromethane
50.5
ug/L
50.00 101
84-123
Surrogate: Toluene-d8
38.1
ug/L
50.00 76
76-129
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 7 of 12

(2)
Waypoint.
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Attn: David Hanley
2801 Yorkmont Rd. #100
Charlotte, NC 28208
Volatile Organic Compounds by GC/MS - Quality Control
Level II QC Report
6/16/20
Work Order: 0060930
Time Submitted: 6/11/2020 2:00:OOPM
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch POF0972 - 5035
Matrix Spike Dup (POF0972-MSD1)
Source: 0060930-03
Prepared & Analyzed: 06/16/20
Benzene
0.0445
0.0062
mg/kg dry
0.06248
BRL
71
60-135
6 20
Ethylbenzene
0.0387
0.0062
mg/kg dry
0.06248
BRL
62
44-144
12 19
m,p-Xylenes
0.0776
0.012
mg/kg dry
0.1250
BRL
62
36-148
5 20
o-Xylene
0.0372
0.0062
mg/kg dry
0.06248
BRL
60
43-143
8 17
Toluene
0.0438
0.0062
mg/kg dry
0.06248
BRL
70
57-135
10 22
Surrogate:4-Bromofluorobenzene
52.0
ug/L
50.00
104
70-130
Surrogate: Dibromofluoromethane
49.9
ug/L
50.00
100
84-123
Surrogate: Toluene-d8
52.6
ug/L
50.00
105
76-129
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, INC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 8 of 12

Waypoint.
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Attn: David Hanley
2801 Yorkmont Rd. #100
Charlotte, NC 28208
Volatile Organic Compounds by GC/MS (Medium Level) - Quality Control
Reporting
Analyte Result Limit Units
Batch POF0974 - 5035
Level II QC Report
6/16/20
Work Order: 0060930
Time Submitted: 6/11/2020 2:00:OOPM
Spike Source %REC RPD
Level Result %REC Limits RPD Limit Notes
Blank (POF0974-BLK1)
Prepared & Analyzed: 06/16/20
Benzene
BRL
0.0050
mg/kg wet
Ethylbenzene
BRL
0.0050
mg/kg wet
m,p-Xylenes
BRL
0.010
mg/kg wet
o-Xylene
BRL
0.0050
mg/kg wet
Toluene
BRL
0.0050
mg/kg wet
Xylenes, total
BRL
0.015
mg/kg wet
Surrogate:4-Bromofluorobenzene
55.7
ug/L
50.00
111
70-130
Surrogate: Dibromofluoromethane
50.0
ug/L
50.00
100
70-130
Surrogate: Toluene-d8
38.0
ug/L
50.00
76
70-130
LCS (POF0974-BS1)
Prepared &Analyzed:
06/16/20
Benzene
0.0445
0.0050
mg/kg wet
0.05000
89
74-123
Ethylbenzene
0.0527
0.0050
mg/kg wet
0.05000
105
69-125
m,p-Xylenes
0.113
0.010
mg/kg wet
0.1000
113
64-125
o-Xylene
0.0441
0.0050
mg/kg wet
0.05000
88
69-121
Toluene
0.0572
0.0050
mg/kg wet
0.05000
114
74-122
Xylenes, total
0.157
0.015
mg/kg wet
0.1500
105
74-126
Surrogate:4-Bromofluorobenzene
51.4
ug/L
50.00
103
70-130
Surrogate: Dibromofluoromethane
50.2
ug/L
50.00
100
70-130
Surrogate: Toluene-d8
57.6
ug/L
50.00
115
70-130
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 9 of 12

(2)
Waypoint.
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST
Attn: David Hanley
2801 Yorkmont Rd. #100
Charlotte, NC 28208
Gasoline Range Organics by GC/FID - Quality Control
Level II QC Report
6/16/20
Work Order: 0060930
Time Submitted: 6/11/2020 2:00:OOPM
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch POF0918 - 5030B
Blank (POF0918-BLK1)
Gasoline Range Organics
Surrogate: a,a,a-Trifluorotoluene
LCS(POF0918-BS1)
Gasoline Range Organics
Surrogate: a,a,a-Trifluorotoluene
Matrix Spike (POF0918-MS1)
Gasoline Range Organics
Surrogate: a,a,a-Trifluorotoluene
Matrix Spike Dup (POF0918-MSD1
Gasoline Range Organics
Surrogate: a,a,a-Trifluorotoluene
Prepared & Analyzed: 06/12/20
BRL
5.0 mg/kg wet
6.20
mg/kg wet
5.000 124
50-137
Prepared & Analyzed: 06/12/20
54.8
5.0 mg/kg wet
50.00 110
41-138
6.00
mg/kg wet
5.000 120
50-137
Source: 0060930-03
Prepared & Analyzed: 06/12/20
113
6.2 mg/kg dry
62.48 BRL 181
41-138
7.56
mg/kg dry
6.248 121
50-137
Source: 0060930-03
Prepared & Analyzed: 06/12/20
95.4
6.2 mg/kg dry
62.48 BRL 153
41-138
7.25
mg/kg dry
6.248 116
50-137
17 34
M
M
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 10 of 12

® Level II QC Report
Waynt.
� 6/16/20
poi
ANALYTICAL
Wood Environ. & Infrastructure Solutions (Ch Project: West Sugar Creek UST Work Order: 0060930
Attn: David Hanley Time Submitted: 6/11/2020 2:00:00PM
2801 Yorkmont Rd. #100
Charlotte, NC 28208
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 POF0917 - 3546
Blank (POF0917-BLK1)
Prepared: 06/11/20 Analyzed: 06/12/20
Diesel Range Organics
BRL
7.0 mg/kg wet
Surrogate: o-Terphenyl
0.911
mg/kg wet
1.333 68 31-123
LCS (POF0917-BS1)
Prepared: 06/11/20 Analyzed: 06/12/20
Diesel Range Organics
65.3
7.0 mg/kg wet
66.67 98 46-126
Surrogate: o-Terphenyl
1.12
mg/kg wet
1.333 84 31-123
LCS Dup (POF0917-BSD1)
Prepared: 06/11/20 Analyzed: 06/12/20
Diesel Range Organics
64.0
7.0 mg/kg wet
66.67 96 46-126 2 20
Surrogate: o-Terphenyl
1.10
mg/kg wet
1.333 82 31-123
Sample Extraction
Data
Prep Method: 3546
Lab Number
Batch
Initial
Final
Date/Time
0060930-01
POF0917
30 g
1 mL
06/11/20 16:00
0060930-02
POF0917
30 g
1 mL
06/11/20 16:00
0060930-03
POF0917
30 g
1 mL
06/11/20 16:00
Prep Method: 5030E
Lab Number
Batch
Initial
Final
Date/Time
0060930-01
POF0918
5.7 mL
5 mL
06/12/20 10:03
0060930-02
POF0918
5.7 mL
5 mL
06/12/20 10:03
0060930-03
POF0918
5.97 mL
5 mL
06/12/20 10:03
Prep Method: Solids, Dry Weight
Lab Number
Batch
Initial
Final
Date/Time
0060930-01
POF0914
30 g
30 g
06/11/20 15:10
0060930-02
POF0914
30 g
30 g
06/11/20 15:10
0060930-03
POF0914
30 g
30 g
06/11/20 15:10
Prep Method: 5035
Lab Number
Batch
Initial
Final
Date/Time
0060930-03
POF0972
4.8 g
5 mL
06/16/20 8:07
Prep Method: 5035
Lab Number
Batch
Initial
Final
Date/Time
0060930-01
POF0974
6.36 g
5 mL
06/16/20 8:58
0060930-01
POF0974
6.36 g
5 mL
06/16/20 8:58
0060930-02
POF0974
6.1 g
5 mL
06/16/20 8:58
0060930-02
POF0974
6.1 g
5 mL
06/16/20 8:58
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 11 of 12

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Beverly, Trudy
From: Beverly, Trudy
Sent: Thursday, June 18, 2020 2:00 PM
To: Corley, Helen
Cc: '[e-mail]'; Gucciardi, Steve
Subject: RE: [External] UST-61, 4732 W. Sugar Creek, Heating Oil UST
Received. Thank you, Helen. You can email me a copy of the excavation report when completed. Make sure to include
water supply well receptor information to 150'.
Have a wonderful day,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mille Regional Office
irvrc,� on, Mooresville g
704.235.2182 (Office)
Trudy.Beverlykncdenr. ov
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:Hdeg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deg.nc.aov/about/divisions/waste-mana2ement/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httos://deo.nc. gov/about/divisions/waste-management/waste-management-rules-data/waste-management-ais-mans
File Review Procedures:
htlps://deg.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
httos: //deq.nc. gov/about/divisions/waste-manai4ement/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httns://files.ne.izov/nedeafWaste%2OMana2ement/DWM/UST/WhatsNew/Final-Electronic-Document-Submittal-Policy.odf
https:Hfiles.nc.gov/ncdeq/Waste%20Management/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Corley, Helen [mailto:[e-mail]]
Sent: Thursday, June 18, 2020 1:56 PM
To: Beverly, Trudy <[e-mail]>
Cc:'[e-mail]' <[e-mail]>; Gucciardi, Steve <[e-mail]>
Subject: [External] UST-61, 4732 W. Sugar Creek, Heating Oil UST
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Good afternoon Trudy,
On behalf of the City of Charlotte, Environmental Services Division, we are submitting this paperwork to your office after
last week's removal of this heating oil UST and this week's receipt of soil sample data. A few days ago you emailed with
my colleague David Hanley PE regarding this project, for which I have assumed the lead. Feel free to contact me or
those copied above with any questions. Over -excavation work is scheduled for next week.
Best regards,

Helen P. Corley, LG, RSM, BCES
Principal Hydrogeologist, Charlotte, NC
Wood Environment & Infrastructure Solutions
Mobile: [phone]
helen.corley(a�woodplc.com
www.woodplc.com fwoodplc.coml
wood
Safety Shield
prepw& Groom Inurrma
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