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HomeMy WebLinkAboutMO-28475_47727_CA_IAR_20210301_Inital Abatement Action ReportGeological 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 (704) 845-4010 • (888) 870-4133 • Fax (704) 845-4012 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 (704) 845-4010 - (888) 870-4133 - Fax (704) 845-4012 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 svpanara@hotmail.com 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 msmith@geologicalresourcesinc.com 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 msmith@geologicalresourcesinc.com 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 (919) 707-8171 fax (919) 715-1117 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 #: 980-722-3751 Owner Closure Contractor Name: Justin Fbdford Closure Contractor Company: Geological Resources, Inc. Address: 3502 Hayes Pd, MonroE Phone # 704-845-4010 Primary Consultant Name: Matthew Smith Primary Consultant Company: Geological Resources, Inc. Address: 3502 Hayes Fdd, Monroe, Phone # 704-845-4010 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 (919) 707-8171 FAX (919) 715-1117 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. (866) 744-5220 2) Chemtrec (24 Hours) (800) 424-9300 3) Bureau of Explosives (24 Hours) (888) 283-2662 4) National Response Center, NRC (800) 424-8802 (Oil/Hazardous Substances) 5) DOT, Off. Of Haz. Operations (800) 467-4922 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 Five, T { CFr1nb GOt PUM( is rr4 dr y `wig :, r F ach'vlllc 'f k * } Y Ir r Fi 'he- Town e — - KL4r}.i rpUlis IPL HopeyYell ` k Odell'chool Twell Ik CD ,{ r Targetdo s '# 4 + s "sVille- Skybrook Golf Y fone n Ik rr CREE14 #T w At rt i pp' •--DAVISLAI€E 1 M�ENQCRSdN RROSR[RITY_ I' •- ,} ^e' ^ / L'/CIRC tEy +C14URCII ROAU`, • / 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: 919-774-4517 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: 919-774-4517 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:919- 4-4517 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: 919-774-4517 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: 919-774-4517 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 <Img@geologicalresourcesinc.com> 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:trudy.beverly@ncdenr.gov] Sent: Monday, March 1, 2021 2:31 PM To: Taraban, Ron <ron.taraban@ncdenr.gov>; Leslie Maxtone-Graham <Img@geologicalresourcesinc.com> Cc: Matt Smith<msmith@geologicalresourcesinc.com> 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 <trudy.beverly@ncdenr.gov> Subject: FW: [External] Bethpage Grocery From: Leslie Maxtone-Graham<Img@geologicalresourcesinc.com> Sent: Monday, March 01, 2021 1:39 PM To: Taraban, Ron <ron.taraban@ncdenr.gov> Cc: Matt Smith<msmith@geologicalresourcesinc.com> 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 Img@geologicalresourcesinc.com www.geologicalresourcesinc.com Beverly, Trudy From: Leslie Maxtone-Graham <Img@geologicalresourcesinc.com> 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:trudy.beverly@ncdenr.gov] Sent: Monday, March 1, 2021 2:31 PM To: Taraban, Ron <ron.taraban@ncdenr.gov>; Leslie Maxtone-Graham <Img@geologicalresourcesinc.com> Cc: Matt Smith<msmith@geologicalresourcesinc.com> 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 <trudy.beverly@ncdenr.gov> Subject: FW: [External] Bethpage Grocery From: Leslie Maxtone-Graham<Img@geologicalresourcesinc.com> Sent: Monday, March 01, 2021 1:39 PM To: Taraban, Ron <ron.taraban@ncdenr.gov> Cc: Matt Smith<msmith@geologicalresourcesinc.com> 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 Img@geologicalresourcesinc.com www.geologicalresourcesinc.com