MO-28475_47727_CA_IAR_20210301_Inital Abatement Action Report

Geological Resources, Inc.
March 1, 2021
Mr. Ron Taraban
NCDEQ-UST Section
Mooresville Regional Office
610 East Center Ave.
Mooresville, NC 28115
Re: Initial Abatement Action Report
February 2021
Bethpage Grocery
4940 Mooresville Road
Kannapolis, Cabarrus County
North Carolina
Facility ID Number: 0-00-0000004437
Incident Number: Pending
GRI Project No: 5567
Dear Mr. Taraban,
Please find enclosed the referenced report for the above mentioned site.
If you have any questions, please contact Matthew Smith at 704-845-4010.
Sincerely,
Geological Resources, Inc.
'�� � I )""L
Leslie Maxtone-Graham
Administrative Assistant
Enclosure
Cc Mr. Shailesh Panara; Prime Business LLC, file
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]

40
Geological Resources, Inc.
Initial Abatement Action Report
February 2021
Bethpage Grocery
4940 Mooresville Road
Kannapolis, Cabarrus County
North Carolina
Facility ID Number: 0-00-0000004437
Incident Number: Pending
GRI Project Number: 5567
Prepared for:
Shailesh Panara
Prime Business, LLC
1534 Copperplate Road
Charlotte, NC 28262
March 1, 2021
Matthew T. Smith
Project Manager
3502 Hayes Road - Monroe, North Carolina 28110
113 West Firetower Road, Suite G - Winterville, North Carolina 28590
Phone [phone] - Fax [phone]

SITE INFORMATION
1. Site Identification
Bethpage Grocery (Facility ID 0-00-0000004437)
Incident Number Pending— Risk Ranking Undetermined
Location of Source Area: 4940 Mooresville Road
Kannapolis, NC 28081
Cabarrus County
35.488624°N, 80.661416°W (Topographical Map)
2. Information about Contacts Associated with the Leaking UST System
UST/AST Owner/Operator
VSP Business, LLC
1534 Copperplate Road
Charlotte, INC 28262
[e-mail]
980-722-3751
Property Owner
VSP Business, LLC
1534 Copperplate Road
Charlotte, INC 28262
sypanarak—hotmail.com
980-722-3751
Property Occupant
Bethpage Grocery
4940 Mooresville Road
Kannapolis, NC 28081
Email: Unknown
Phone: Unknown
Consultant/Contractor
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
[e-mail]
704-845-4010
Analytical Laboratory
REDLab, LLC
5598 Marvin Moss Lane, Suite 2003
Wilmington, North Carolina 28409
State Certification No. n/a
844-384-7815
Closure Contractor
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
[e-mail]
704-845-4010
3. Information about Release
13 Release was discovered on February 9, 2021.
13 An unknown amount of product was released from the leaking UST System.
13 One 20,000-gallon compartmentalized gasoline UST was removed from the site in February 2021.
Certification:
I, John M. Brown, a Licensed Geologist for Geological Resources, Inc., do certify that the information contained
in this report is correct and accurate to the best of my knowledge.
Geological Resources, Inc. is licensed to practice geology and engineering in North Carolina. The certification
numbers of the corporation are C-127 and C-2727, respectively.
Prepared By: Geological Resources, Inc. Initial Abatement Action Report
Prepared On: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith Geo1og1Cd1PeSY es1n, GRI Project No. 5567

EXECUTIVE SUMMARY
Bethpage Grocery is a former petroleum retail facility and convenience store. The site is located at 4940
Mooresville Road in Kannapolis, Cabarrus County, North Carolina. The adjoining properties are
predominately residential. Municipal water is available to the site. A UST system consisting of one 20,000-
gallon compartmentalized gasoline UST, two dispensers, and associated piping was removed from the site
on February 8 through 10, 2021.
During UST closure activities, petroleum contamination was observed in the soil beneath one of the two
gasoline dispenser sumps. Ground water was not encountered during UST Closure activities. UST closure
soil samples were collected from the base of the UST basin, beneath the product piping, and beneath the
dispenser sumps. The collected soil samples were submitted for on -site analyses of TPH-GRO and TPH-
DRO using REDLab's mobile UVF laboratory. Based on the field observations and UVF field screening
results, over -excavation activities were conducted following the UST system removal. A total of 83.28
tons of petroleum contaminated soil was excavated and transported to a permitted disposal facility.
Following over -excavation activities, confirmation samples were collected from the base of the over -
excavation area and submitted for laboratory analysis by REDLab for TPH-GRO and TPH-DRO. The
concentration of TPH-GRO was above the RALs reported in over -excavation soil sample 0-1-B, collected
at 12 feet bgs. This area was excavated further until the soils were below the RALs, based on the analytical
results received from the on -site mobile UVF laboratory.
Based on these results, a release has occurred at the site. However, the petroleum -impacted soils were
removed to below the RALs and groundwater was not encountered. Therefore, this incident should be
closed with a No Further Action.
Prepared by: Geological Resources, Inc. Initial Abatement Action Report
Prepared on: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith Geo1ogica1peSY e5,,�, GRI Project No. 5567

TABLE OF CONTENTS
SITEINFORMATION
............................................................................................................................ i
EXECUTIVESUMMARY.......................................................................................................................ii
A.
SITE HISTORY AND CHARACTERIZATION...................................................................................1
B.
SITE CHECK..............................................................................................................................2
C.
UST CLOSURE..........................................................................................................................2
D.
FREE PRODUCT INVESTIGATION AND RECOVERY REPORT.........................................................5
E.
GROUND WATER INVESTIGATION............................................................................................5
F.
INITIAL RESPONSE AND ABATEMENT ACTIVITIES......................................................................5
G.
EXCAVATION OF CONTAMINATED SOIL....................................................................................6
H.
SOIL AND GROUNDWATER SAMPLE RESULTS...........................................................................6
I.
SUMMARY AND CONCLUSIONS................................................................................................7
J. LIMITATIONS...........................................................................................................................8
FIGURES
Figure 1: Site Location Map
Figure 2: Site Map
Figure 3: Soil Quality Map
TABLES
Table 1: UST Owner/Operator Information
Table 2: UST System Information
Table 3: Summary of Soil Sample Analytical Results
APPENDICES
Appendix A: 24-Hour Release and UST Leak Reporting Form (UST-61)
Appendix B: Notice of Intent form (UST-3)
Appendix C: Site Investigation Report for Permanent Closure or Change -in -Service of UST (UST-2A)
Appendix D: Health and Safety Plan
Appendix E: UST Disposal Manifest
Appendix F: Fluid Disposal Manifest
Appendix G: Soil Disposal Manifests & Weight Tickets
Appendix H: REDLab's Field Screening Results
Prepared by: Geological Resources, Inc. Initial Abatement Action Report
Prepared on: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith Geo1og, a pe OYrce GRI Project No. 5567

A. SITE HISTORY AND CHARACTERIZATION
1. UST Owner and Operator Information:
In accordance with the Initial Abatement Action Report guidelines, the underground storage tank (UST)
owner and operator information has been summarized in Table 1.
2. UST System Information:
In accordance with the Initial Abatement Action Report guidelines, the UST system information has been
summarized in Table 2. A copy of the Registered Tank Report is shown below:
NCDEQ Registered Tank Report
a. ty Id OOQ4437
aulity Name ETH PAGE GROCERY
ddress W MOO RE$%'ILLE RO.; D
ay KANNAPOLIS Stale NC
aunty Caharruskip 2SO31
ngitude-SO.661013 Latitude 35.338533
troll Owns► VSP BUSINESS, LLC
tlress 2534 COPPERPLATE ROAD
City CHARLOTTE
Seale 'tic lip 28262.6438
Tank Information
ank ld Product Ham* Capacity rnstallation tat Perm ciosa oat k Conseruct d&n Piping Construction arfill Protection ill Protection ank status
1 GasOhne, Gas !Alex 15coQ 512119715 1/11/1599 single Wall sted/F single •:call FCC Ball Float valve catcnment Basin Removed
2 Gasoline, Gas Mix 40M 512/1916 1/11/1"9 single Will Steel/F single Mill FRP pill F$Cat Valve CatChment B*Sin Removed
S Gasoline, Gas Mix a000 S/211976 IV11/1999 sin &wall Steel" single yVaII FRP Ball Float Valve Catchment Basin Removed
Al Gasoline, Ga3 Mix 120W 2/29/1999 Single Will FRP Single Wall FRP A=Shtgo f O"Ce Catchment Bash Current
:.2 Gasoline, Gat Mix 8000 2/25/1999 single wall FRP single Wall FRP Auto Shuiorf Device Catchment Basin Curwt
3. Non -UST Information:
A 2,000-gallon kerosene aboveground storage tank (AST) was formerly located at the site. This AST was
removed prior to the commencement of UST Closure activities in February 2021.
4. Comprehensive Description of the Release:
On February 8, 2021, Geological Resources, Inc. (GRI) initiated UST closure activities at the site. The UST
system consisted of one 20,000-gallon gasoline compartmentalized UST, two gasoline dispensers, and
associated product piping. During UST closure activities, notable petroleum odors were observed in the
soil surrounding one of the two gasoline dispenser sumps. On February 24, 2021, a 24-Hour Release and
UST Leak Reporting Form (UST-61) was submitted to the Mooresville Regional office of North Carolina
Department of Environment Quality (NCDEQ) (Appendix A).
S. Description of the Site Characteristics:
The Bethpage Grocery site is a former petroleum retail facility located at 4940 Mooresville Road in
Kannapolis, Cabarrus County, North Carolina (Figure 1). The site is bordered to the east by Marion
Avenue, to the west by Charlie Walker Road and to the south by Mooresville Road. A site map has been
included as Figure 2.
Prepared by: Geological Resources, Inc. �� Initial Abatement Action Report
Prepared on: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith G-I.q MR....."1— GRI Project No. 5567
1

6. Summary of Initial Abatement Actions, Assessment Activities, and Corrective Actions:
Prior to closure, the appropriate officials were notified by GRI (i.e. Fire Marshal and NCDEQ). A copy of
the UST-3 Notice of Intent form is included as Appendix B.
On February 8 through 10, 2021, one 20,000-gallon compartmentalized gasoline UST, associated
dispensers and product piping were removed from the site. Petroleum contamination was noted in the
soil underneath one of the two gasoline dispenser sumps. Over excavation was conducted during the
removal of the UST system. Ground water was not encountered during UST Closure activities. A copy of
the Site Investigation Report for Permanent Closure or Change -in -Service of UST (UST-2A) Form has been
included as Appendix C. A copy of the site -specific health and safety plan used during UST closure
activities is included as Appendix D.
B. SITE CHECK
A site check was not part of the initial abatement activities.
C. UST CLOSURE
1. Preparation for Closure:
Prime Business, LLC contracted GRI to conduct closure activities of one 20,000-gallon compartmentalized
gasoline UST, associated gasoline dispensers, and product piping from the site. Prior to closure activities,
GRI notified the Kannapolis Fire Department. A UST-3 Form was submitted to the NCDEQ Mooresville
Regional office prior to initiating UST Closure activities. A site -specific health and safety plan was on -site
during the UST Closure activities.
2. Closure Procedure:
The removal activities were conducted at the site on February 8 through 10, 2021. The 20,000-gallon
compartmentalized gasoline UST was covered with gravel, grass, and soil. The 20,000-gallon UST
measured approximately 120 inches in diameter by 34 feet in length. The UST appeared to be in fair
condition. The UST was transported off site for proper disposal. A disposal manifest for the UST removed
in February 2021 is included as Appendix E. Photos of the UST are shown below:
Prepared by: Geological Resources, Inc. ��
Prepared on: March 1, 2021
Project Manager: Matthew T. Smith Geological Resources, Inc.
Initial Abatement Action Report
Bethpage Grocery
GRI Project No. 5567
2

Prepared by: Geological Resources, Inc. �� Initial Abatement Action Report
Prepared on: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith G-Wq d1P—... 1 GRI Project No. 5567

3. Residual Material:
Residual water and/or product was present in the registered UST prior to the initiation of the February
2021 closure activities. Approximately 138 gallons of residual liquid were pumped out and properly
disposed of prior to the removal of the UST. A copy of the disposal manifest for the residual fluids
recovered from the UST prior to closure activities is provided as Appendix F.
4. Release Information:
During UST Closure and over -excavation activities, soil samples collected confirmed a release to
subsurface soils underneath one of the two dispenser sumps. The release was reported to the NCDEQ
Mooresville Regional Office on February 24, 2021.
5. Soil Excavation Activities:
Based on the observations and direction of GRI staff, 83.28 tons of contaminated soil were removed from
the site during the February 2021 UST closure activities. The excavation boundaries are shown on Figure
3. Soil disposal manifests are included as Appendix G.
6. Site Investigation:
During excavation activities, GRI personnel collected soil samples for on -site field screening by Rapid
Environmental Diagnostics (REDLab) for total petroleum hydrocarbons gasoline range organics (TPH-GRO)
and diesel range organics (TPH-DRO) using North Carolina accepted QED Environmental Systems
ultraviolet fluorescence (UVF) technology. The UVF technology was used to screen the excavated soil to
determine the extent of over -excavation activities.
Ground water was not encountered in the UST basin, therefore soil samples (UST-1-14', UST-2-14', UST-
3-14', and UST-4-14') were collected beneath the UST. The collected soil samples were submitted for on -
site analyses of TPH-GRO and TPH-DRO using the mobile UVF laboratory. The soil samples were collected
at approximate depths of 14 feet below ground surface (bgs).
The facility included two gasoline dispensers, which were located to the southeast of the store. Soil
samples (DI-1 and DI-2) were collected from beneath the dispenser sumps and submitted for on -site
analyses of TPH-GRO and TPH-DRO. The soil samples were collected at approximate depths of 2 to 3.5
feet bgs.
During the excavation activities, the FRP product piping was removed. Soil samples (PL-1 through PL-10)
were collected beneath the product piping and were submitted for on -site analyses of TPH-GRO and TPH-
DRO. The soil samples were collected at approximate depths of 2.5 to 4 feet bgs.
Based on the field observations and UVF results, over -excavation activities were conducted in the area of
one of the two gasoline dispenser sumps. The over -excavation of the sidewalls and base of the dispenser
sump area was extended in all directions based on strong odors and field screening results.
Prepared by: Geological Resources, Inc. �� Initial Abatement Action Report
Prepared on: March 1, 2021 Bethpage Grocery
Project Manager: Matthew T. Smith G-1.9. MH..... 1- GRI Project No. 5567
4

Following over -excavation of the dispenser sump area, confirmation soil samples were collected at the
base of the excavation (0-1-B and 0-1-132) and submitted for on -site analysis by REDLab for TPH-GRO and
TPH-DRO. Soil was excavated until on -site analysis results were below the Regulatory Action Levels (RALs).
The soil samples were collected at varying depths.
Soil samples collected from beneath the UST components and soil samples collected from the on -site
stockpiles represent contaminated soil removal during initial abatement activities and were submitted for
on -site analyses of TPH-GRO and TPH-DRO using the UVF mobile laboratory. All soil samples were
collected using either a hand auger or directly from the bucket of the excavator. Soil sample locations are
shown on Figure 3. A summary of field data soil sample analytical results is presented as Table 3. A copy
of REDLab's field screening results is included as Appendix H.
D. FREE PRODUCT INVESTIGATION AND RECOVERY REPORT
Free product was not encountered during the February 2021 UST closure activities.
E. GROUND WATER INVESTIGATION
Ground water was not encountered during the February 2021 UST Closure activities
F. INITIAL RESPONSE AND ABATEMENT ACTIVITIES
1. Initial Response Actions:
Prior to the initiation of the UST closure activities the UST was emptied; product and residual liquid were
removed from the 20,000-gallon compartmentalized gasoline UST.
• Source Control Actions: One 20,000-gallon compartmentalized gasoline UST, associated gasoline
dispensers, and product piping were removed from the site on February 8 through 10, 2021.
• Contaminant Migration Control Measures: The release was to the subsurface. The petroleum
affected soil was removed from the site.
• Measures Taken to Mitigate Fire/Safety Hazards: Prior to closure, the appropriate officials were
notified (i.e. Fire Marshal). The atmosphere of each compartment of the UST was checked with
an LEL/02 meter; once the UST atmosphere reached less than 10% LEL, the tank was removed.
There did not appear to be any immediate fire or safety hazards present as a result of the release.
• Measures Taken to Identify and Mitigate Pollution Hazards: The release was to the subsurface.
Removal of petroleum affected soil was conducted.
Prepared by: Geological Resources, Inc.
Prepared on: March 1, 2021
Project Manager: Matthew T. Smith Geological Pesources, Inc.
Initial Abatement Action Report
Bethpage Grocery
GRI Project No. 5567
5

2. Initial Abatement Actions:
• Contaminated Soil Storage/Treatment and/or Disposal: Between February 8 and February 9,
2021, GRI supervised the soil excavation activities. Contaminated soil was loaded directly into
dump trucks and transported to a permitted disposal facility.
G. EXCAVATION OF CONTAMINATED SOIL
1. Extent of Soil Contamination:
Over -excavation activities were conducted in the area of one of the two gasoline dispenser sumps.
Over -excavation of this area was extended in all directions based on the field screening results. A
total of 83.28 tons of contaminated soil was transported offsite to a permitted disposal facility during
the February 2021 UST closure activities.
2. Excavation Process:
The excavation activities were conducted using a track -mounted excavator. GRI conducted and
supervised the excavation activities and directed the equipment operators as to what to excavate.
Photos showing the backfilled UST basin and dispenser area are shown below:
3. Sampling Description:
All soil samples were collected directly from the bucket of the excavator or using a hand auger by GRI
personnel. Samples were collected with clean, disposable nitrile gloves, and immediately provided to
the on -site mobile laboratory for sample analysis.
H. SOIL AND GROUNDWATER SAMPLE RESULTS
• Soil:
The concentration of TPH-GRO was above the RALs reported in over -excavation soil sample 0-1-B
collected at 12 feet bgs, in the area of the gasoline dispenser. This area was excavated until the soils
were below the RALs, based on the analytical results received from the on -site mobile UVF laboratory.
A summary of soil sample analytical results is presented as Table 3. A Soil Quality Map has been
Prepared by: Geological Resources, Inc. ��
Prepared on: March 1, 2021
Project Manager: Matthew T. Smith Geological H....." Inc.
Initial Abatement Action Report
Bethpage Grocery
GRI Project No. 5567
N.

included as Figure 3. A copy of the REDLab laboratory report is included as Appendix H. A summary
of the over -excavation soil sampling data from the February 2021 UST closure activities is show below:
s
y
0
CL
a) N
c
M
oe
_
v
p
z
ro
a
a m
a
r
a
r
N
£
N
�
N
m
Vr
p
RAL(mg/kg)
50
100
Soil to Water MCC (mg/kg)
NE
NE
Residential SCLs (mg/kg)
NE
NE
0-1-B
12
58.3
25
0-1-132
16
4.5
4.3
• Ground Water:
Ground water was not encountered during the February 2021 UST closure activities.
I. SUMMARY AND CONCLUSIONS
• The Bethpage Grocery site is located in Kannapolis, Cabarrus County, North Carolina. The site is a
former petroleum retail facility and convenience store.
• One 20,000-gallon compartmentalized gasoline UST, associated gasoline dispensers, and product
piping were removed from the site on February 8 through 10, 2021.
• A total of 138 gallons of residual liquids were removed from the UST prior to the commencement of
UST Closure activities.
• Free product was not observed during UST Closure and over -excavation activities. Petroleum
contamination was noted beneath one of the two dispenser sumps.
• Based on the field observations and UVF results, over -excavation activities were conducted in the area
of one of the two gasoline dispenser sumps.
• A total of 83.28 tons of contaminated soil was removed during the February 2021 UST Closure
activities.
• Ground water was not encountered during UST Closure activities.
• The over -excavation of the sidewalls and base of the gasoline dispenser sump area was extended in
all directions based on strong odors and field screening results following the removal of the dispenser
sump.
• The concentration of TPH-GRO was above the RALs reported in over -excavation soil sample 0-1-B
collected at 12 feet bgs, in the area of the gasoline dispenser. This area was excavated until the soils
were below the RALs, based on the analytical results received from the on -site mobile UVF laboratory.
• Based on the results, a release has occurred at the site. However, the petroleum -impacted soils were
removed to below the RALs and groundwater was not encountered. Therefore, this incident should
be closed out with a No Further Action.
Prepared by: Geological Resources, Inc.
Prepared on: March 1, 2021
Project Manager: Matthew T. Smith Geological Pesources, Inc.
Initial Abatement Action Report
Bethpage Grocery
GRI Project No. 5567
7

J. LIMITATIONS
This report has been prepared for the exclusive use of Prime Business, LLC for specific application to the
referenced site in Cabarrus County, North Carolina. The assessment was conducted based on the scope
of work and level of effort desired by NCDEQ and with resources adequate only for that scope of work.
Our findings have been developed in accordance with generally accepted standards of environmental
practices in the State of North Carolina, available information, and our professional judgment. No other
warranty is expressed or implied.
The data that are presented in this report are indicative of conditions that existed at the precise locations
sampled and at the time the samples were collected. In addition, the data obtained from samples would
be interpreted as being meaningful with respect to parameters indicated in the laboratory report. No
additional information can logically be inferred from these data.
Prepared by: Geological Resources, Inc. ��
Prepared on: March 1, 2021
Project Manager: Matthew T. Smith Geological H—..."Inc.
Initial Abatement Action Report
Bethpage Grocery
GRI Project No. 5567

FIGURES

.F -_
rN .. 1
¢p f ��~ '4���� i-tip,{:. Ff�' `' � .. '~ � I:•: 4
VAY
in
4.
r1i
�r3
•� �r�� � '�5� j J' �?. �!� � t� sue. � ,
;. 'r.. .� .. ..�. � •tom. ....
f � 'f''�� 1 -. -'/" 1 '` •' ' !; 5 � { jam" '/ i*yi•• ,
f
Figure 1
r ;;: Site Location
Bethpage Grocery
_ f T 4940 Mooresville Road
Kannapolis, North Carolina
Cabarrus County
o 500 M Incident No. N/A
C 2000 FT GRI Project No. 5567
Date: 02/07/2021 Location: 35.488624° N-80.661416° W

LEGEND
TREE LINE
- - - - UNDERGROUND STORAGE TANK
FUEL DISPENSER
PRODUCT PIPING LINE
Note:
1. This Site Map is based on data from the Cabarrus County, NC GIS
office.
2. This site was not professionally surveyed; locations of utilities, tank
components and other site features are approximate.
Residential
Tree
�Grass�
Q
�Grass� L
N
Bethpage AST 8K—Gallon
Grocery 111 — 1/Premium UST
1 \
1 1
O 1
12K—Gallon
/Regular UST
1 1 ///
Fuel Canopy 1 1
1
0 0 L — �
�Grass�
MOORESVILLE ROAD
SITE MAP
0 20 40 80
Bethpage Grocery 4940 Mooresville Road
Incident No. N/A Kannapolis, North Carolina
( IN FEET) GRI Project No. 5567 Cabarrus County
Geological Resources, Inc. 1 inch =40 ft Date: 02/28/2021 Drawn by. DTH I Figure: 2

LEGEND
TREE LINE
- - - - UNDERGROUND STORAGE TANK
FUEL DISPENSER
- - - - - - - - - - EXCAVATION BOUNDARY
PRODUCT PIPING LINE
f SOIL SAMPLE LOCATION
Contaminant of Concern 4
2
�
a
oa
Date
Sam le
Sample
te'a,CF
Sample ID
Collected
Loca ton
Depth
c
�,
(mm/dd/yy)
(ft-BGS)
c
cA
RAL (mg/kg)
50
100
UST-1-14'
2/9/2021
UST Basin
14
<0.3
3.7
UST-2-14'
2/9/2021
14
<0.3
0.09
UST-3-14'
2/9/2021
14
<0.3
<0.12
UST-4-14'
2/9/2021
14
<0.15
<0.06
PL-1
02/09/21
Product Piping
2.5
<0.27
<0.11
PL-2
02/09/21
3
<0.22
<0.09
PL-3
02/09/21
3
<0.27
<0.11
PL-4
02/09/21
3.5
<0.4
0.7
PL-5
02/09/21
3.5
<0.6
<0.25
PL-6
02/09/21
4
<0.4
0.8
PL-7
02/09/21
4
<0.5
<0.21
PL-8
02/09/21
4
<0.5
<0.23
PL-9
02/09/21
4
<0.5
0.3
PL-10
02/09/21
3.5
<0.4
0.13
DI-1
02/09/21
Dispenser
Islands
2
8,594
234
DI-2
02/09/21
3.5
<0.5
<0.2
0-1-B
02/09/21
Overexcavation
Area
12
58.3
24.5
0-1-82
02/09/21
16
4.5
4.3
Residential
�Grass�
IZZ!,Grasss
'z::rTree1;�,
G
Bethpage AST._.._._.�` \
Grocery i- -i 1 UST-4-14'
O1 UST-3-14'
10
'j' P' -4.'�. P'. fY''�_P�Lj'"_':_�:P _-4'-�PL-�9� �1 Jf' UST-1-14'
DI-1 _ '
t._ .� _•s
0-1-B/0-1-B2 R'
J
DI-2
PL-3
Over PL-2
Excavation PL-1 �GraS�
Area
MOORESVILLE ROAD
0 20 40 80 SOIL QUALITY MAP (02/09/21)
Bethpage Grocery 4940 Mooresville Road
Incident No. N/A Kannapolis, North Carolina
( IN FEET) GRI Project No. 5567 Cabarrus County
Geological Resources, Inc. 1 inch =40 ft Date: 02/28/2021 Drawn by. DTH I Figure: 3

TABLES

TABLE 1
UST OWNER/OPERATOR INFORMATION
BETHPAGE GROCERY (INCIDENT NO. PENDING)
UST ID Number
Al and A2
Facility ID Number
00-0-0000004437
Name of Owner or Operator
Dates of Ownership / Operation
Owner or Operator?
Shailesh V. Panara
10/29/2010-Present
Operator
Address
Telephone Number
1534 Copperplate Road, Charlotte, NC 28262
980-722-3751
UST ID Number
Al and A2
Facility ID Number
00-0-0000004437
Name of Owner or Operator
Dates of Ownership / Operation
Owner or Operator?
VSP Business, LLC
10/13/2010-Present
Owner
Address
Telephone Number
1534 Copperplate Road, Charlotte, NC 28262
980-722-3751
UST ID Number
Al and A2
Facility ID Number
00-0-0000004437
Name of Owner or Operator
Dates of Ownership / Operation
Owner or Operator?
Ronald Overcash DBA Overcash ENT
2/25/1999-10/13/2010
Owner
Address
Telephone Number
Unknown
Unknown
UST ID Number
1 through 3
Facility ID Number
00-0-0000004437
Name of Owner or Operator
Dates of Ownership / Operation
Owner or Operator?
Unknown
5/2/1976-1/11/1999
Owner
Address
Telephone Number
Unknown
Unknown
Page 1 of 1

TABLE 2
UST SYSTEM INFORMATION
BETHPAGE GROCERY (INCIDENT NO. PENDING)
Date: 02/15/2021
Facility ID #: 0-004437
Description of
Was Release
UST
Current
Associated
Status
Associated
ID
or Most
Previous
Capacity
Date
Construction
Tank
Product Piping
of
with UST
No.
Recent
Contents
(gallons)
Installed
Details
Dimensions
and
UST
System?
Contents
Pumps
(Yes / No)
Removed
1
Gasoline
Gasoline
6,000
5/2/1976
Single Wall Steel
Unknown
Single Wall FRP
No
1/11/1999
Removed
2
Gasoline
Gasoline
4,000
5/2/1976
Single Wall Steel
Unknown
Single Wall FRP
No
1/11/2000
Removed
RemoRemo
3
Gasoline
Gasoline
4,000
5/2/1976
Single Wall Steel
Unknown
Single Wall FRP
No
0
Single Wall FRP -
Removed
Al/A2
Gasoline
Gasoline
20,000
2/25/1999
120" x 34'
Single Wall FRP
Yes
Compartmentalized
2/10/2021
Page 1 of 1

TABLE 3
SUMMARY OF SOIL SAMPLE ANALYTICAL RESULTS - FIELD DATA
BETHPAGE GROCERY (INCIDENT NO. PENDING)
Date: 02/15/2021 Facility ID #: 0-004437
Analytical Method 4
UVF
Contaminant of Concern 4
a
C
a°10
OF
a,
CU
o
a
x
v
tw
°C
v
o
Sample ID
Date
Collected
(mm/dd/yy)
Sample
Location
Sample
Depth
(ft-BGS)
RAIL (mg/kg)
50
100
UST-1-14'
2/9/2021
UST Basin
14
<0.3
3.7
UST-2-14'
2/9/2021
14
<0.3
0.09
UST-3-14'
2/9/2021
14
<0.3
<0.12
UST-4-14'
2/9/2021
14
<0.15
<0.06
PL-1
02/09/21
Product Piping
2.5
<0.27
<0.11
PL-2
02/09/21
3
<0.22
<0.09
PL-3
02/09/21
3
<0.27
<0.11
PL-4
02/09/21
3.5
<0.4
0.7
PL-5
02/09/21
3.5
<0.6
<0.25
PL-6
02/09/21
4
<0.4
0.8
PL-7
02/09/21
4
<0.5
<0.21
PL-8
02/09/21
4
<0.5
<0.23
PL-9
02/09/21
4
<0.5
0.3
PL-10
02/09/21
3.5
<0.4
0.13
DI-1
02/09/21
Dispenser Islands
2
8,594
234
DI-2
02/09/21
3.5
<0.5
<0.2
0-1-B
02/09/21
Overexcavation
Area
12
58.3
24.5
0-1-B2
02/09/21
16
4.5
4.3
OB-1
02/09/21
UST Overburden
---
<0.22
1.2
OB-2
02/09/21
---
<0.22
1
OB-3
02/09/21
---
<0.22
0.5
TL-1
02/09/21
Stockpile
---
4,662
141.5
TL-2
02/09/21
---
2,675
1,350
TL-3
02/09/21
---
2,467
82.9
TL-4
02/09/21
---
1,359
922
TL-5
02/09/21
---
4,062
160.7
Notes:
• Results reported in mg/kg; samples analyzed onsite by UVF.
• ft-BGS: feet below ground surface.
• RAL: Regulatory Action Level.
• < : Less than the UFV method detection limit .
• Concentrations in bold face type indicate the RALs were less than the
reported concentrations
Page 1 of 1

APPENDICES

APPENDIX A
24-Hour Release and UST Leak Reporting Form (UST-61)

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

Water Supply Wells Affected? 1. Yes
Number of Water Supply Wells Affected
IMPACT ON DRINKING WATER SUPPLIES
2. No 3. Unknown
Water Supply Wells Contaminated: (Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
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

APPENDIX B
Notice of Intent Form (UST-3)

UST-UST-3 Notice of intent: UST Permanent Closure or Change -In- ervice
NUM UM ONLY
Retum "rn pled form to:
Di DWrlr'I Reig rwl Orf6vo &H*A d wl the area where flee FACiIHk iE; faeWm AND Wnd a a}py kv the CCrtrpI affi-,Q m RA12gh I D x
MAR ON T14E GACK OF Tif6S FORM TW C12NTHV�;- AND HE4DNAL OFricE ADDRESSES
LIMc ia�
INSTRUCTKM JRE D THIS FIFti�Tj _
Corn" ai-Fif fVurn a UST-3 fofm a least Ihktyr �34ys priaf M do�LLr*e a chsr':tje-m-Servbe adiviUes. I! :a Rraressiaaial Emginee r 4P.E.} of a I w*nrlr+
13Cob9ist (L C ' prov*r. sw�or *ian t*r r cure Or ch2rnge-YFSi t-oD sflo 35sessm4?nt sa%litres and s&n5 and seals a!1 -oIosure ropor;s .hen at Wst a M "B
�5) wwking days' ixotioe is aoceplable
r„ onVrrppd! Uu1` cloSum w r riggi-Inter ico sW a zcmo runt repoU., prong YoHh s Wy ol the UST-2A ar!dfor 2E3 Wms. s+loubd ; o subm tc the
approprre* DwisrOn Or ValgEe filanNen'res i. (CUM; Regitmal Offira within thirty (30} days Fallowing cbsrae ac-&ific , The LF.S'T.2 f,,m 53hould 31so btu
w4rn4Ie4 W.W CcrArv1 ffficc In Ralcgh so teal the s'=s of Me tanM may be changed kff perrrkareritly =ed and your tank tee wwurrt can ba dosM oul
Ntrie Tank N.Le& ni" be due fir unrra,3isbrmai iankv;
UST ❑Ocurr_ and charjgr_•5qt en irn Site � rn45t tc Q: +mpWW in ar 0an[� %%Mh .rq Ii�7 ve7 �)n o�;h� Cf�+d5 +0? rS+ r#h7r�µ, Tyr �r L.
ar.+d ff3WO The gu6eline3 Can be ebu3if*d 211 Ye_ Pb you c . _ •• _•�:r w ^�L4iui�•ar_•.va_'�. Vim, u�r •n � f�_� r� k� o rr 7sn 3 ifr r�
abtw prior zipormRr from Sh$ D'irN on onipq WAted in It* %e h 0 n wfrrf# the taco# is 10cated. -
Yqv moat mafaa suro that t*I s fQrrroved from +dour property ere dispozed or properIV. Whers one 3 CJo#ure emLfaLin f, a3R whefe the :snNa.) vra be
bakers Fa dish 1. tJsuzflyr. USTg &q gbannd F n d c3A up fqr aMp mCaI Tft* is 4arig mroM wgrk end mftl W pgr'fp-KI, by a qU;3IKW VXrp;Rnyr Tank
dtspawc: of iusgacy In fields or Ot!w Wmpsdas can leak netft{evn products and 9?ndge irrlo Lhe enyifrnment. Ir vouf links are diLpaaea or kWmerly, you
miald bc! Wd ruWpnpible for the clii;�Rnup of err!' e-oor--,rd�,I !;.3—]e nal oG ors
t, iA_Ww KP OF TANKS — ®. LO�CATf)N
Owner Name { CLWrst�r-i, Indi-YWj1. Public Abe", Or 0Ww. • CfAILY) Faci1�yy Nnrsra tc 06ri' yr im
VSP luskivm LLiC 501; 0!1� �afr `yr
t�lr"t A"c"
Faplky rD :g (If xngwn j
1534 CQpW--rpl-it 0 rW 0
W4-I30X004437
5tru0t Add e:s
coy
CoU*
Mscklacbur9
4&Q MWr-0Sui;I0 R _
Slale
zip code
zo CO*
KC
262e2
Kannaswis M1131
Piv rr� Numow
F'hor* NunttLL-
Email
9dCi-722.3751
Swpanara&hatn-.;ail.ccCn
7 1 741
Ill. CONTACT PERSONNEL Tr
Nafr*
= Cump,]r5V Nftirtra'_ LMb Tih- harp NWrbat-
Mfrrlhew Smrih
CsdSolp[�^ 9! F¢e�.a3uree :_LnO.- --- .l#Inior Rro or_w-Msyr, r 704-945_4010
FV. TAW !��L, gLOSURFF IN KAgk t ILEM 3JERVICE
1 CtrntzcA head fife rrerrshal.
5. PFovkIk! a mketch k "g pQirr3 lark and a P r or L.G , with al dvsuse nde nssgssrnrrl
2. Plan eMife dosure a real
s011:5xMiln9 sn"Ons roporta boaralg VA v9satwo and seal of Me
3. Coildl�Cl Si6e `mod Assessment.
C. txcJinSun9 a closdro report trle format dUS7- Pr�I 4DF L Grr. rgna a8 o P rnoDr L C
7� (inuding the form 1�$T•2} wvF n mirtyr ,'
d It irernoY•ig ranks w Gaa+ng RI
place. refer to (30r dep rOli.--MN 1P* inveogmian. is not rKuifed.
APL Ruhlirakm 2015 C,bardurg Pr.-jm:Jaalh R ° Keep :GurC r4Nxr#s fgr khr#e 1 3) � iDm
754�1 Kdemvar � fr a f4�6�Sa tram Ms thas Ocwrred,
Smf%ia Tanks arrd and
re
� �Rd �� Pch�leiam siL� aSsesSaYrePs p8ilio�n r5 t+f the! Lanktrri:utrt
muss tie cond=M under tree suporaf:ron Or
V, WORK TO BE PERFORMED BY
114r.7aPr mi-no,
Corntf&CW CQMWny Ndma
Matthew Sffm
Gw1 RP toUr0e5, the
dr{ 5'
C alp Phwu No-
U502 HVve's Aw. morkrp0
NG 2al 10 704-a45-4010
P�idr]r 6ar*su rrt•Harnc'
- -
�'rffZ3 Camularft ComDeny Name: Cflnwftant PMorts lea:
r f of wr rnl�fl
G#?INi� FIteOurces. Feic 71014-84 i-4QEO
VI- TANKS SCHEDULED FOR C'LOGURE: OR CHAHGE4N �—
F'ro ~sad
C
ha nge_!7 ,fie rvrce
05--M ym
,5bandoin.— in Pt5=e'
Nee carrft!ift &'tared
Tar* Ib
Sizo Irk Ca
L"t Cary.e7ts
13er50W4 ff --
C. asaw
Al
12F0W
x
- -�
A2
• -8.CQ0
N Q r 34nMr; apProv3110 abaM0f% a [artk_irz _mull LW tP[eiva-4 ff ,& � �i'ihl l�gicn�l Qf£k�
VIL GMER 0R 04iRER°S AUTHOFUZED REPRES£NTATIVr
Hdt a release Flom a UST sps:erm accun and a I* la}raWn? ❑ Yr* [) RD ® U"now.
1 urrdw-amd that f -can be held -wu. oneiA Fir erwiforimrrtal dwfflMe feSufhsv frtm the "roper ftpcmd d my tjFs -s
Prrrk nam: and q ipol mic- Shd PrIn Owrw
SFynfrruro [/� Date SiWied SCI iEUEAL M ROM)VAL DAT>= IN4 your DYA1 Rtgio� rot
+i_ j r i—I } : S f �RDR1 44h0UF5 N90rG#tvi ijWW rf
J f $Charmed rernOYal dale dhairr ft
WI-3 F�w YZWO

APPENDIX C
Site Investigation Report for Permanent Closure or Change -in -Service of UST (UST-2A)

UST'2A
Site Investigation Report for Permanent Closure or Change -in -
KZ
Service of
REGISTERED UST f.a4rF..ti;
Return completed form to:
STATE USE ONLY:
NC DEQ / DWM / UST SECTION
Facility ID #
1646 MAIL SERVICE CENTER
RALEIGH, NC 27699-1646
ATTN: REGISTRATION & PERMITTING
Date Received
phone [phone] fax [phone] http://www.wastenotnc.org/
INSTRUCTIONS (READ THIS FIRST)
1. UST permanent closure or change in service must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank
Closure and Initial Response and Abatement. The guidelines can be obtained at http://deg.nc.gov/about/divisions/waste-management/waste-
management-permit-quidance/underground-storage-tanks-section.
2. Permanent closure: Complete all sections of this form.
3. Change -in-service: Where a UST system will be converted from storing a regulated substance to a non -regulated substance, complete sections I, ll,
III, IV, and VI
4. For more than 5 registered UST systems, attach additional forms as needed
5. Tank Fee Refund: An annual tank fee may be refunded for a tank for which a tank fee was not required. An owner or operator must submit
a written request and include: (1) contact information, (2) federal identification # or SSN, and (3) a copy of UST-2 form. The annual tank
fee will be prorated based on the date of permanent closure.
6. UNREGISTERED USTs use Form UST-213
I. OWNERSHIP OF TANKS
II. LOCATION OF TANKS
Owner Name (Corporation, Individual, Public Agency, or Other Entity)
Facility Name or Company
VSP Business, LLC
Bethpage Grocery
Street Address
Facility ID # If known)
1534 Copperplate Fbad
00-0-0000 04437
City County
Street Address
Charlotte Mecklenburg
4940 Mooresville Fbad
State NC Zip Code 28262
City County Zip Code
Kannapolis Cabarrus 28081
Phone Number
Phone Number
980-722-3751
III. CONTACT PERSONNEL
Contact for Facility: Shailesh Pdnara
Job Title:
Phone #: [phone]
Owner
Closure Contractor Name:
Justin Fbdford
Closure Contractor Company:
Geological Resources, Inc.
Address:
3502 Hayes Pd, MonroE
Phone # [phone]
Primary Consultant Name:
Matthew Smith
Primary Consultant Company:
Geological Resources, Inc.
Address:
3502 Hayes Fdd, Monroe,
Phone # [phone]
IV. UST INFORMATION FOR REGISTERED UST SYSTEMS
V. EXCAVATION CONDITION
UNREGISTERED LISTS use Form UST-213
Tank ID
Size in
Last
Last
Permanent
Method of Permanent Closure:
Change -in-
Notable
No.
Gallons
Contents
Use
Close Date
Indicate REMOVED or enter fill
Service
Water in
Free product
odor or
visible soil
Date
material, such as foam/
Date
excavation
contaminatio
concrete/ sand
n
Yes
No
Yes
No
Yes
No
Al
12,000
Gasoline
Unk
02/09/2021
Femoved
❑
0
❑
❑■
❑■
❑
A2
8,000
Gasoline
Unk
02/09/2021
Fbmoved
❑
0
❑
❑■
■❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
VI. CERTIFICATION
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents and that
based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true accurate
and complete.
Print name and official title of owner or owner's authorized representative
Matthew T. Smith GRI Agent
Signature
�
Date Signed
02/ 24/ 2021
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY, DIVISION OF WASTE MANAGEMENT, UST SECTION
1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646 PHONE [phone] FAX [phone] http://www.wastenotaLgMI 1/2016

APPENDIX D
Health and Safety Plan

GEOLOGICAL RESOURCES, INC.
Site Specific Health and Safety Plan
1.0 General Information:
a.Projectname: Beth]
b. Location: 4940
c. GRI Job #: 5567
2.0 Project Organization:
a. Site Supervisor/H&S Officer:
b. Project Manager: Matthew T. Smtih, GRI
c. Subcontractor(s): NA
3.0 Safety Plan Preparation:
a. Prepared by & date:
b. Reviewed/approved by & date:
Matthew Smith. 2/3/21
4.0 Site History and Description:
a. Type of site (i.e., spill, leaking UST system, etc.): UST Closure
b. Site/project description: Commercial property -Gas & Convenience Store
Current activities include UST Closure activities
5.0
Potential Hazards:
sical Hazards: (check)
X
slips 0 Overhead
Explosion
TPh
X
Trips utilities
Noise
X
Falls X] UndergroundPinch
TX
points
X
Fire utilities
Burns
Chemical Hazards: (check)
X Gasoline Used Oil
Diesel Solvents
Kerosene Antifreeze
New Oil H Acid (sample preservative)
on
burn X Electricity
X Cold Weather X Pressurized line/vessels
Hot Weather
X Crush
Heating Oil
Equipment/Vehicular/Other: (i.e., Geoprobe, drill rig, back hoe, track hoe, traffic, skid steer etc.)
[Back/track hoe, traffic, skid steer, dumptrucks
Biological Hazards: (i.e., toxic insects, spiders, poisonous plants, poisonous snakes, aggressive dogs)
Spiders

6.0 Site Organization and Safety Control: (Evaluate the need for site control to protect
persons from exposure to hazardous conditions; i.e. work permits, cones, barricade tape,
exclusion zones, etc.)
a. Work area(s) identified: _Entire site
b. Work area marked Yes X No
c. Work area barricaded _X_ Yes No
d. Support area established: _GRI truck
e. Entry and escape routes identified: South — Mooresville Road
f. Rally point identified: _X_ Yes No Location:_
g. Emergency shut-off for water identified _ Yes _X_ No
h. Emergency fuel shut-off identified _ Yes _X_ No
i. Site map attached: _X— Yes No
"Emergency Response Procedures"
Action (i.e. shut off all power equipment) Assemble at rally point
Call 911 for medical or utilities emergency Do NOT enter confined spaces
Discuss what to do if .....cut product line, water line, cable/electric line
7.0 Job Activities in Work Plan:
X UST Removal X Soil Sampling
X Soil Excavation _ System O&M
Powered Drilling _ MMPE/AFVR
X Hand Angering : Water sampling
8.0 Re uired Education and/or Training:
NOSHA 40 hr X Annual 8 hr Refresher
Manual FP Recovery
. Other (specify)
OSHA Site Supervisor
9.0 Air Monitoring:
If, in the opinion of the site supervisor, petroleum hydrocarbon vapor concentrations are
excessive, site activities will cease until petroleum hydrocarbon vapor concentrations diminish to
acceptable levels.
10.0 Equipment:
_ FID/PID _ Combustible gas indicator _ Interface Probe
02 meter X Other LEL Meter
11.0 Personnel Protection Equipment:
X Hard hat Rubber boots Respirator 0 Hearing
X Safety glasses X Work gloves X Sun screen protection
X Steel toe boots X First aid kit Repellent X Nitrile
Tyvek suit X Fire extinguisher X Dust mask gloves
tim r►econtamrnauun rroeeuures: ievarume neeu ror uecon, uescrme
Use Alconox and DI water to decontaminate WLM/IFP between gauging each well. Use new,
clean bailers, gloves and string for each monitoring well during sampling. Decon hand auger
between sampling locations using DI water and Alconox, followed by a DI water rinse.

13.0 Emergency Contacts:
a. Local Assistance:
Site Phone
Police
Water Department
Natural Gas
704-938-2413
911
Fire Department
Ambulance
Sanitary Sewer
Power Company
Nearest Hospital with Emergency Room (directions attached)
Name Atrium Health Cabarrus
Address 920 Church Street North, Concord, NC 28025
Number 704-403-3000
b. National or Regional Sources of Assistance:
1) Geological Resources, Inc. [phone]
2) Chemtrec (24 Hours) [phone]
3) Bureau of Explosives (24 Hours) [phone]
4) National Response Center, NRC [phone]
(Oil/Hazardous Substances)
5) DOT, Off. Of Haz. Operations [phone]
14.0 Signatures:
911
911
This plan has been reviewed by all on -site personnel and all provisions are clear (signatures
required).
Project Manager:
Site Supervisor:
Other personnel:
Matthew T Smith, GRI 2/3/21

15.0 Amendments:
a. Site Specific Health and Safety Plans are based on information available at the time of
plan preparation. Unexpected conditions may arise. It is important that personal
protective measures be thoroughly assessed prior to and during the planned activities.
Unplanned activities and/or changes in the hazard status should initiate a review of this
plan and may result in major changes to it.
b. Changes in the hazard status or unplanned activities are to be submitted on "Amendment
to the Site Specific Health and Safety Plan" which is included bellow.
c. Amendment must be approved by the Project Manager prior to implementation of the
amendment.
AMENDMENT TO THE SITE SPECIFIC HEALTH AND SAFETY PLAN
A. Changes in field activities or hazards:
B. Proposed amendment:
C. Approval:
Proposed by:
Approved by:
Amendment number:
Amendment effective date:
date

IFIL
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2/3/2021 4940 Mooresville Rd, Kannapolis, NC 28081 to Atrium Health Cabarrus - Google Maps
4940 Mooresville Rd
Kannapolis, INC 28081
Take Isenhour Rd, Rogers Lake Rd, S Main St and
Kannapolis Hwy to Mall Dr NE in Concord
13 min (7.1 mi)
t 1. Head west on NC-3 N/Mooresville Rd toward
Charlie Walker Rd
'"1 2. Turn left onto Boy Scout Camp Rd
*1 3. Turn left onto Isenhour Rd
'1 4. Turn left onto Rogers Lake Rd
r' 5. Turn right onto S Main St
0.5 mi
0.1 mi
1.3 mi
2.1 mi
1.9 mi
t 6. Continue onto US-29A S/Kannapolis Hwy
10 Continue to follow Kannapolis Hwy
1.2mi
Drive to Medical Park Dr NE
2 min (0.2 mi)
t 7. Continue straight onto Mall Dr NE
233 ft
r' 8. Turn right onto Medical Park Dr NE
0.1 mi
r' 9. Turn right to stay on Medical Park Dr NE
Destination will be on the right
377 ft
Atrium Health Cabarrus
920 Church St N, Concord, NC 28025
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
https://www.goog le.com/maps/d ir/4940+Mooresville+Rd,+Kan napolis,+N C+28081 /Atrium+Health+Cabarrus,+Church+Street+North,+Concord,+N C/@... 2/2

Appendix E
UST Disposal Manifest

UST DISPOSAL MANIFEST
Site Name: 8e;gya t� Owey
Site Address:," aar ok /UC
The following UST(s) were removed from the above- noted site on Q JC aOZ j and
transported to { rIts +gc6Ko, , ( Sf-, t'aai[� vt ( where the UST will be properly
disposed of at a future date. / j
C.-aviol U It (f: j Aft-, '
1. ao, 000 -gall V(OJ's V-5 .
0
M
Signature:
Printed Name: us�n
Date: 04-� 20Z 1

Appendix F
Fluid Disposal Manifest

NON -HAZARDOUS WASTE MANIFEST
Please print or type (Form designed for use on elite (12 pitch) typewriter)
W
H
N
Q
0
0
cc
N
N
Q
Z
0
Z
NON -HAZARDOUS
1. General US EPA ID No.
fill
Docum No.
2. Page 1
WASTE MANIFEST
-57-
l
of
3. Generator's Name and Melling Address /_'2= O�d--•�-y�M1
4. Generator's Phone
S. Transporter 1 Company Name B. US EPA ID Number
A. State Trenaorter's ID
B. Transporter 1 Phone
14
T. Transporter Company Name 8. US EPA ID Number
C. State Transporters ID
D. Transporter 2 Phone
9. Designated Facility Name and Site Address 10, US EPA ID Number
E. State Facifty'91D
1+ r✓ �nC.
F. Facllity's Phone
60,1 �Q4s. Si'rc��" ♦ //1 /J .tv yl /.�/] (///
VV��''1 i6 �P
vc 75
9 -
11. WASTE DESCRIPTION
12. Containers
T 3ta1
Unit
No.
Type
Quall
Wt.N01.
a.�On- % .CZR✓A!dC'`.S /`��e�-%- �w/Lia�"�/
OF
l
TT
G
b.
E
N
E
R
A
T
O
R
d
G. Addkonal Descriptions for Materials Usted Above
H. Handling Codes for Wastes Listed Above
15. Special Handling Instructions and Additional Information
16. GENERATOR'S CERTIFICATION: I hereby certify that the contents of this shipment are fully and accurately described and are In
all respects
in proper condition for transport. The materials described on this manifest are not subject to federal hazardous waste regulations.
Data
ntecinyped Name
Sig re
Month
Day Year
J Shil Pan,,A
1z,
TR
1ZTransporter 1 Acknow gement of Receipt of Materials
Date
N
Prmiled/fYped N e
Signature
Month
Day Year
P
v c
2
GS zi
Q
1 B. Transporter Acknowledgement of Receipt of M Nmals
Data
R
E
PrintedRypetl Name
Signature
9
Month
Day Year
R
F
19. Discrepancy Indication Space
A
C
L20.
Facility Owner or Operator: Certification of receipt of the waste materials covered by mis modest, except as noted In Item 19.
S
oafs
T
Printecirlyped Name
Signature
Monts
Day Year
Yynl�PJ
$ I
F-1402002 LABEY'IASTFR OR800) 621-5808 www.labelmaster.com
t%Pa1BfE00N RfCVCt£p PA All ftev.3/95

Appendix G
Soil Disposal Manifests

N �-
NORTH CAROLINA
PUBLIC WEIGHMASTER
Xh - LfCENSE EXPIRES JUNE 30, 2020
117 G NLESS SIGNED
NAN-AAZARtNNfC WAkTF naawrVvem
Project Number:
---
Load Number:
t
Consultaz}t,
Contact: M Q H
�L1
Phone: g2fj
Generator
Contact: Phone:
Vpmp ZXotsSl LAC-
Rg©
Transporter: ,.L^'� _ IF_,4W"K e.�,v
Contact: --
�i'�^.' �`
Phone:
Destination: , e ^K1
Contact: ScotLx4er
Phone: 4F9-i7d=4.rt?-
r
Waste Description:
Description:
Waste Origination -
Pe-;O Ctn+an'nitltd SOtI{
ggqD Moor ui tie, PA, VwI"0f 0l�t A)C,
Truck#: ��m
Gross Weight: -- --
'Tare Weight:
Net Weight: -,
Generamr-s certmcanon: t Canty that the n atermts described above on this manifest are not
subject to federal regulations for reporting proper disposal of HAZARDOUS WASTE.
�zo7
Generator / Agent Signature Title Date
Acknowledgment of Receipt of Materi
Driv rs Signatt,a Date
Noted Discrepancies: _
Inspected & Accepted (except as noted above By: Earthtec Environmental, Inc.
Accepted BY:�v Date:{q/�-/

arthtec otN tic. ` S P NORTH CAROLINA
' L!CF UBIIC WEIGHMASTER
Po co
x 130 N I EXPIRES JU
Sanford, 27331 CijR+' I OGE NE 30, 2020
Phon 919--4517�—f�
P #: 919-77464 - INVA in UNLESS E
NO1N-IIA7ARll0US WASTE mANIFEST
Project Number:
Load Number: 2 ',
Consultant
Contact: f-)
Pone -
Generator
Contact: Phone:
nmp- B tn.KV LL,(.
CI D-322-3?<-I
Transporter: n Sf1V I
Contact:
�1
Phone:
Destination: FA>it+t�F�%mc tl?�� Alit,
Contact: Scott Keller
e o
Waste Description:
Phone: [phone]
Waste Origination
NA -TV G,(+` . NtAlj 1D11f
yRaC .�afrelUn/P lianxyah�
Truck #: �S
Gross Weight:
Tare Weight:
Net Weight:
Generator s Certification: I certify that the materials described above on this manifest are not
subiect to federal regulations for reporting proper disposal of HAZARDOUS WASTE.
�7 cu ter+ 9Ioj :> t
Acknowledgment of Receipt of Material: -2 Dz
Signature Date
Noted Discrepancies:
Inspected & Accepted {except as noted above By: Barthtec Bnvironmetttal, Inc.
Accepted By: am%- , � Date:AUW

NORTH CAROLINA
tec of NC, c. /��� Pt-' L'C WEIOHMASTER
Post O ce $ 130 rt � ' -l4SE EXPIRES JUNE 30, 2020
Sanfor�774-
E I3858
Phone17UNLESS SI p
F :
NON-RA7ARDOITS
WACTF MANTVVQa
Project Number:
U1
Load Number:
Consultant ^^ gIyym�
l71`',y
Contact:
Phone:g-Z2ii-30B
Generator
Contact: Phone:
Transporter: tSC-�
Sow
Contact: _
Phone:
Destination: EazthW-4fl+vrenme a, m AIA,
Contact: Scott Keller
3 07
Phone: [phone]
Waste Description:
Waste Origination lie 1
flro CsAicU �p12
Nqt1O rleoV-Jv
uCVN��pftr A1r
Truck M
Gross Weight r
Tare Weight: -----...
Net Weight: . fO
Generator's Certnicatton: 1 ceruty that the materials described above on this manifest are not
subject to federal regulations for reporting proper disposal of HAZARDOUS WASTE.
Gnu e,,+ Z zoZ
Generator / Agent Signature "tle Date
Acknowledgment of Receipt of Material:
Noted Discrepancies:
Inspected & Accepted {except as noted above By: Earthtec Emdronmental, Inc.
Accepted By: a _ Date:-QZ9lo�__

tee of NC kc
.
Post ce 130 Aj%S
Sanford 27331 NORTH CAROLINA
PUBLIC WEIGHMASTER
Phone:[phone] LIC'iBE EXPIRES JUt�E 30,,PQt?
F #: 919-774- 15 HOLBERe
C
INVALID UNLESS SIGNED
NON-BAZARDOUS WASTF. MANfFRNT
Project Number: �t1t `f
Ui
Load Number: 1
7
Consultant
�-�
Contact:
Phone:
Generator
Contact: Phone:
QF(Mv
f3vSn LLL
96D-i22-3�rS"
Transporter:
cr Se�vlee
Contact
Phone:
Destination:
a, nc A
Contact: Scod Keller
Phone: [phone]
3745
Waste Description:
Waste Origination
rl
2m
� _�
Cow'^ Solis
t 410 �"oosav, -
t MA o1rJ
A)e
Truck #:
Gross Weight:
Tare Weight:
Net Weight: ---
-------I
Generator's Certification: I certify that the materials described above on this manifest are not I _�
subject to federal regulations for reporting proper disposal of BAZAR bOUS WASTE. Q Q 4o
Zj Cl/z©z�
Acknowledgment
Noted Discrepancies:
Inspected & Accepted
'(except
�a�ss noted above By: Earthtee Environmental, Inc.
Accepted By: I P— Na(d-er — Date: 2/�

1,OrrIj1)ii�
htec of NC, Nn
Post ce 30 / '�✓
Sanford 27331
Phon :91 774-4517
P :919-77 15
NORTH CAROLI
PUBLIC WEIGNMASNATER
ENSE EXPIRES JUNE 3
OE F. HOLDEfti
UNLLLESS SIGNED
NON-HAZARD0113 WARTY MANWRCT
Project Number: >�
d
LoaNumber: �� C
Consultant
Contact: M
Phone: g'j-2Z$-3'3g)
Generator
Pr'ML
Contact: Phone:
9 0
Transporter:
G� S �U t f. e'
Contact:
Phone:
Destination: Aef
3I 7 J
Contact: Scott Keller
Phone: [phone]
Waste Description: },
�G 4 �i -�0 GMT ✓�G-T .�Dtl l
Waste Origination
gcivo "" >M>r7C`reb u, , /
VVLA np VI, J//V l-
Truck #: S 3
Gross Weight:
SIG_
Tare Weight: - .,.- -
Net Weight:
Generator's Cenifiestiow I certify that the materials described above on this manifest are not
subject to federal regulations for reporting proper disposal of HAZARDOUS WASTE.
&F-7
Generator / Agent Signature
Acknowledgment of Receipt of Material:
W.
hers Signature Date
Noted Discrepancies:
Inspected & Accepted (except as noted/above By: Earthtee Environmental, Inc.
Accepted By: -eptCln e- l" 7�Y% ___ Date:_
L:

Appendix H
REDLab's Field Screening Results

igwrbon
Analysis Results
CDCD
Client: GRI
Samples taken
Tuesday, February 9, 2021
Q E d LA Bry
Address:
a µa,o cruv,no,ux+�rurww o,nGr+O StCi
Samples extracted
Tuesday, February 9, 2021
Samples analysed
Tuesday, February 9, 2021
Contact: MATT SMITH
Operator
MAX MOYER
Project: BETH PAGE GROCERY
T03308
Matrix
Sample ID
Dilution
BTEX
GRO
DRO
TPH
Total
16 EPA
BaP
% Ratios
HC Fingerprint Match
used
Aromatics
PAHs
C5:10
C1108.0
C18+
C6-C9
C5-C10
C10-C35
C5-C35
C10-C35
Soil
JOB - 1
9.0
<0.22
<0.22
1.2
1.2
0.5
0.027
<0.003
0
94
6
Deg.Fuel 84.2%,(FCM),(TD)
Soil
OB - 2
9.0
<0.22
<0.22
1
1
0.4
0.016
<0.003
0
93.9
6.1
V.Deg.Light Fuel 84.9%,(FCM),(TD)
Soil
OB - 3
9.0
<0.22
<0.22
0.5
0.5
0.27
0.013
<0.003
0
79
21
V.Deg.PHC 86.5%,(FCM),(TD)
Soil
UST - 1 - 14'
13.0
<0.3
<0.3
3.7
3.7
2.5
0.13
0.001
0
92.4
7.6
Deg.Light Fuel 80.3%,(FCM),(BO),(TD)
Soil
UST - 2 - 14'
12.0
<0.3
<0.3
0.09
0.09
0.04
0.002
<0.004
0
81.1
18.9
Residual HC,(TD)
Soil
UST - 3 - 14'
12.0
<0.3
<0.3
<0.12
0.017
0.017
0.001
<0.004
0
34
66
Residual HC,(TD)
Soil
UST - 4 - 14'
6.0
<0.15
<0.15
<0.06
0.01
0.01
<0.001
<0.002
0
100
0
Residual HC,(TD)
Soil
PL - 1
11.0
<0.27
<0.27
<0.11
<0.27
<0.006
<0.006
<0.003
Q
0
Q
PHC ND,(FCM),(TD)
Soil
PL - 2
9.0
<0.22
<0.22
<0.09
0.008
0.008
<0.001
<0.003
0
100
0
Residual HC,(TD)
Soil PL - 3
<0.27
<0.27
<0.11 <0.27
<0.006
<0.006
<0.003 0 100
0 Residual HC,(TD)
QC ch
iir
87.2%
Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values uncorrected for moisture or stone content. Fingerprints provide a tentative hydrocarbon identification.
Abbreviations :- FCM = Results calculated using Fundamental
Calibration Mode:
% = confidence of hydrocarbon identification : (PFM) = Poor Fingerprint
Match : (T) = Turbid : (P) = Particulate detected
B = Blank Drift: (SBS)/(LBS) = Site Specific or Library Background Subtraction
applied to result: (BO) = Background Organics detected : (OCR)
= Outside cal range : (M) = Modifed Result.
% Ratios estimated aromatic carbon number proportions : HC = Hydrocarbon :
PHC = Petroleum HC : FP = Fingerprint only. Data generated by HC-1 Analyser

CDCD
Client: GRI
Samples taken
Tuesday, February 9, 2021
Q E d LA Bry
Address:
a pa,o cruv,no,utnirurww o,nGr+O StCi
Samples extracted
Tuesday, February 9, 2021
Samples analysed
Tuesday, February 9, 2021
Contact: MATT SMITH
Operator
MAX MOYER
Project: BETH PAGE GROCERY
3308
Matrix
Sample ID
Dilution
BTEX
GRO
DRO
TPH
Total
16 EPA
BaP
% Ratios
used
Aromatics
PAHs
4
C6-C9
C5-C10
C10-C35
C5-C35
C10-C35
C5:10
C 108.0
C18+
Soil
DI - 1
448.0
1934
8594
233.6
8827.6
201.5
7.8
<0.009
96.6
3.4
O
Undeg.Gas 85.5%,(FCM)
Soil
DI-2
20.0
<0.5
<0.5
<0.2
0.014
0.014
0.002
<0.006
0
0
100
Residual HC
Soil
PL - 4
17.0
<0.4
<0.4
0.7
0.7
0.06
0.004
<0.005
0
84.9
15.1
Deg Fuel 56.8%,(FCM)
Soil
PL - 5
25.0
<0.6
<0.6
<0.25
<0.6
<0.013
<0.013
<0.008
0
0
0
PHC ND,(FCM)
Soil
PL - 6
19.0
<0.4
<0.4
0.8
0.8
0.09
0.007
<0.006
0
89.8
10.2
Deg Fuel 71.8%,(FCM)
Soil
PL - 7
21.0
<0.5
<0.5
<0.21
0.018
0.018
0.002
<0.006
0
34
66
PHC ND,(FCM)
Soil
PL - 8
23.0
<0.5
<0.5
<0.23
<0.5
<0.012
<0.012
<0.007
0
0
O
PHC ND,(FCM)
Soil
PL - 9
21.0
<0.5
<0.5
0.3
0.3
0.27
0.028
<0.006
0
92.4
7.6
Residual PHC
Soil
PL - 10
19.0
<0.4
<0.4
0.13
0.13
0.1
0.011
<0.006
0
100
0
Residual HC
Soil 0 - 1 - B
5
58.3
24.5 82.8 3.3
0.13
<0.007 95.5 4.4
0.1 Deg Gas 61.4%,(FCM),(TD)
QC cl
kr
FC
Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values uncorrected for moisture or stone content. Fingerprints provide a tentative hydrocarbon identification.
Abbreviations :- FCM = Results calculated using Fundamental
Calibration Mode:
% = confidence of hydrocarbon identification : (PFM) = Poor Fingerprint
Match : (T) = Turbid : (P) = Particulate detected
B = Blank Drift: (SBS)/(LBS) = Site Specific or Library Background Subtraction
applied to result:
(BO) = Background Organics detected : (OCR)
= Outside cal range : (M) = Modifed Result.
% Ratios estimated aromatic carbon number proportions : HC = Hydrocarbon :
PHC = Petroleum HC : FP = Fingerprint only. Data generated by HC-1 Analyser

i9wrbon Analysis Results
CDCD
Client: GRI
Address:
Contact: MATT SMITH
Project: BETH PAGE GROCERY
Samples taken
Q E d LA Bry Samples extracted
a pa,o cruv,no,utnirurww o,nGr+O StCi
Samples analysed
Operator
Tuesday, February 9, 2021
Tuesday, February 9, 2021
Tuesday, February 9, 2021
MAX MOYER
T03308
Matrix
Sample ID
44
Dilution
used
BTEX
C6-C9
GRO
C5-C10
DRO
C10-C35
TPH
C5-C35
Total
Aromatics
C10-C35
16 EPA
PAHs
BaP
% Ratios
HC Fingerprint Match
I C5:10
C 108.0
C18+
Soil
TL - 1
264.0
709
4662
141.5
4803.5
117.8
4.6
<0.07
96.4
3.6
0
Undeg.Gas 79.8%,(FCM)
Soil
0-1 - B2
19.0
<0.9
4.5
4.3
8.8
0.4
0.019
<0.006
91.8
8.2
0
50%,(FCM)
Soil
TL - 2
346.0
564
2675
1350
4025
131.7
5.1
<0.10
96.1
3.9
0
Deg.Gas 69%,(FCM)
or nc chec 101.1 %
Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values uncorrected for moisture or stone content. Fingerprints provide a tentative hydrocarbon identification.
Abbreviations :- FCM = Results calculated using Fundamental Calibration Mode: % = confidence of hydrocarbon identification : (PFM) = Poor Fingerprint Match : (T) = Turbid : (P) = Particulate detected
B = Blank Drift: (SBS)/(LBS) = Site Specific or Library Background Subtraction applied to result: (BO) = Background Organics detected : (OCR) = Outside cal range : (M) = Modifed Result.
% Ratios estimated aromatic carbon number proportions : HC = Hydrocarbon : PHC = Petroleum HC : FP = Fingerprint only. Data generated by HC-1 Analyser

i9wrbon Analysis Results
CDCD
Client: GRI
Address:
Contact: MATT SMITH
Project: BETH PAGE GROCERY
Q E d LA Bry
a pa,o cruv,no,utnirurww o,nGr+O StCi
Samples taken
Samples extracted
Samples analysed
Operator
Tuesday, February 9, 2021
Tuesday, February 9, 2021
Tuesday, February 9, 2021
MAX MOYER
T03308
Matrix
Sample ID
Dilution
used
BTEX
C6-C9
GRO
C5-C10
DRO
C10-C35
TPH
C5-C35
Total
Aromatics
C10-C35
16 EPA
PAHs
BaP
% Ratios
HC Fingerprint Match
C5:10
C1108.0
C18+
Soil
ITL - 3
588.0
362
2467
82.9
2549.9
68.8
2.6
<0.17
96
4
0
Undeg.Gas 81.1 %,(FCM)
Soil
TL - 4
775.0
226.6
1359
922
2281
84.7
3.3
<0.002
95.1
4.9
0
Deg.Gas 75.6%,(FCM)
Soil
TL - 5
410.0
239.4
4062
160.7
4222.7
127.1
5
<0.12
95.5
4.4
0
Deg Gas 77.3%,(FCM)
or nc chec
Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values uncorrected for moisture or stone content. Fingerprints provide a tentative hydrocarbon identification.
Abbreviations :- FCM = Results calculated using Fundamental Calibration Mode: % = confidence of hydrocarbon identification : (PFM) = Poor Fingerprint Match : (T) = Turbid : (P) = Particulate detected
B = Blank Drift: (SBS)/(LBS) = Site Specific or Library Background Subtraction applied to result: (BO) = Background Organics detected : (OCR) = Outside cal range : (M) = Modifed Result.
% Ratios estimated aromatic carbon number proportions : HC = Hydrocarbon : PHC = Petroleum HC : FP = Fingerprint only. Data generated by HC-1 Analyser

Beverly, Trudy
From: Leslie Maxtone-Graham <[e-mail]>
Sent: Monday, March 1, 2021 2:38 PM
To: Beverly, Trudy
Subject: RE: [External] Bethpage Grocery
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Ah, perfect. I will update our data base.
Thank you,
Leslie
From: Beverly, Trudy [mailto:[e-mail]]
Sent: Monday, March 1, 2021 2:31 PM
To: Taraban, Ron <[e-mail]>; Leslie Maxtone-Graham <[e-mail]>
Cc: Matt Smith<[e-mail]>
Subject: RE: [External] Bethpage Grocery
Hey Leslie and Matt,
Ron forward this report to me. I am the UST CAB project manager for Cabarrus County sites.
Have a wonderful day,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
`'�` "`�
mL oorar�
704.235.2182 (Office)
Trudy.Beverlykncdenn 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: https:Hdeq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.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:
https://deq.nc. 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/nedeafWaste%2OMana2ement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policy.ndf
b!Vs:Hfiles.nc. gov/ncdegfWaste%20Management/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Taraban, Ron
Sent: Monday, March 1, 2021 2:08 PM
To: Beverly, Trudy <[e-mail]>
Subject: FW: [External] Bethpage Grocery

From: Leslie Maxtone-Graham<[e-mail]>
Sent: Monday, March 01, 2021 1:39 PM
To: Taraban, Ron <[e-mail]>
Cc: Matt Smith<[e-mail]>
Subject: [External] Bethpage Grocery
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Afternoon Ron,
Please find attached the initial abatement action report for the above mentioned site.
Kind regards,
Leslie
Leslie Maxtone-Graham
Administrative Assistant
Geological Resources, Inc.
Celebrating 5o years of serving our clients
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office 1704-236-1120-cell 1704-845-4012-fax
[e-mail]
www.geologicalresourcesinc.com

Beverly, Trudy
From: Leslie Maxtone-Graham <[e-mail]>
Sent: Monday, March 1, 2021 2:38 PM
To: Beverly, Trudy
Subject: RE: [External] Bethpage Grocery
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Ah, perfect. I will update our data base.
Thank you,
Leslie
From: Beverly, Trudy [mailto:[e-mail]]
Sent: Monday, March 1, 2021 2:31 PM
To: Taraban, Ron <[e-mail]>; Leslie Maxtone-Graham <[e-mail]>
Cc: Matt Smith<[e-mail]>
Subject: RE: [External] Bethpage Grocery
Hey Leslie and Matt,
Ron forward this report to me. I am the UST CAB project manager for Cabarrus County sites.
Have a wonderful day,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
`'�` "`�
mL oorar�
704.235.2182 (Office)
Trudy.Beverlykncdenn 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: https:Hdeq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.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:
https://deq.nc. 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/nedeafWaste%2OMana2ement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policy.ndf
b!Vs:Hfiles.nc. gov/ncdegfWaste%20Management/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Taraban, Ron
Sent: Monday, March 1, 2021 2:08 PM
To: Beverly, Trudy <[e-mail]>
Subject: FW: [External] Bethpage Grocery

From: Leslie Maxtone-Graham<[e-mail]>
Sent: Monday, March 01, 2021 1:39 PM
To: Taraban, Ron <[e-mail]>
Cc: Matt Smith<[e-mail]>
Subject: [External] Bethpage Grocery
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Afternoon Ron,
Please find attached the initial abatement action report for the above mentioned site.
Kind regards,
Leslie
Leslie Maxtone-Graham
Administrative Assistant
Geological Resources, Inc.
Celebrating 5o years of serving our clients
3502 Hayes Road I Monroe, NC 28110 1 website I facebook
704-845-4010-office 1704-236-1120-cell 1704-845-4012-fax
[e-mail]
www.geologicalresourcesinc.com