MO-28509_47761_CA_LSA_20210428_ Limited Site Assessment Report

+ESP
April 28, 2021
Ms. Trudy Beverly, L.G.
North Carolina Department of Environmental Quality
UST Section
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville, North Carolina 28115
Reference: LIMITED SITE ASSESSMENT REPORT
Camp Stewart Road Site
Mecklenburg County Tax Parcel #11109204
Charlotte, North Carolina
NCDEQ Incident No. Pending
ESP Project No. E6-GP56.601
Dear Ms. Beverly:
On behalf of Professional Child Centers, Inc. (property owner) and Pulte Home Company, LLC
(prospective property purchaser), ESP Associates, Inc. is pleased to provide the attached Limited
Site Assessment Report for the subject site. As detailed in the attached report, ESP respectively
requests classification of the release as Low Risk.
Thank you for your attention in this matter. If you should have any questions, please do not
hesitate to contact us at 704-583-4949.
Sincerely,
ESP Associates, Inc.
Nora A. Zirps, PE, RSM Christopher J. Ward, PG, RSM
Senior Project Engineer Department Manager
NC License No. 023838 NC License No. 1600
cc: Mr. Dean Davidson, Professional Child Centers, Inc.
Mr. Fred Matrulli, Pulte Home Company, LLC
Attachment - Limited Site Assessment Report

+ ESP
LIMITED SITE
ASSESSMENT
REPORT
CAMP STEWART ROAD SITE
MECKLENBURG COUNTY TAX PARCEL #11109204
CHARLOTTE, NORTH CAROLINA
NCDEQ INCIDENT NO. PENDING
ESP PROJECT NO. E6-GP56.601
Prepared For:
North Carolina Department of Environmental Quality
UST Section
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville, North Carolina 28115
On Behalf of:
Professional Child Centers, Inc.
505 Beachland Blvd., Suite #1
Vero Beach, Florida 32963
Prepared By:
ESP Associates, Inc.
P. 0. Box 7030
Charlotte, North Carolina 28241
April 28, 2021

Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
Limited Site Assessment Report
Camp Stewart Road Site
SITE INFORMATION
1. Site Identification
0 Date of Report: April 28, 2021
O Site Risk: Low
o Facility ID: N/A
O UST Incident Number: Pending
O Site Name: Camp Stewart Road Site
O Site Street Address: Camp Stewart Road (Tax Parcel #11109204)
O City/County/Zip Code: Charlotte, Mecklenburg County, 28215
O Description of Geographical Data Point: Location of Removed UST-2 & UST-3
O Location Method: Survey
O Latitude: 35.24115
O Longitude:-80.66125
2. Information about Contacts Associated with the Leaking UST System
0 UST Owner: Professional Child Centers, Inc.
O UST Operator: Professional Child Centers, Inc.
0 Property Owner:
11 Property Occupant:
0 Contractor:
0 Driller:
O Analytical Laboratory
3. Information about Release
Professional Child Centers, Inc.
Attn: Dean Davidson (772-913-1152)
505 Beachland Blvd, Suite #1
Vero Beach, FL 32963
Professional Child Centers, Inc.
ESP Associates, Inc. - Nora Zirps, PE (704-583-4949)
PO Box 7030, Charlotte, NC 28241
Environmental Drilling & Probing Services, LLC -
Tommy Bolyard (704-607-7529)
17538 Greenhill Road, Charlotte, NC 28278
Pace Analytical Services, Inc. (704-875-9092)
9800 Kincey Avenue, Suite 100
Huntersville, NC 28078
NC Certification No. 37706
0 Date Discovered: February 9, 2021
0 Estimated Quantity of Release: Unknown
0 Cause of Release: Apparent leak from UST-3
0 Source of Release: UST-3
0 Size and contents of UST system
from which release occurred: 550-gallon heating oil
4. Certification
�1II11111/�I
I, Nora A. Zirps, a Professional Engineer for ESP Associates, Inc., do certify that the
``XXX V\ CARD *formation contained in this report is correct and accurate to the best of my knowledge.
:' QUO ti9 • ; '
SEAL
i 023838 i =
-I-: :c)
'��i � �• •�,HGINE�o•• ��
,9 '••••.••••' �`P Associates, Inc. is licensed to practice both geology and engineering in North Carolina. ESP
�;,,,,,Xs-
; , ssociates, Inc.' certification numbers are: Geology: C-556 / Engineering: F-1407
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Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
TABLE OF CONTENTS
Section Page
1.0 INTRODUCTION................................................................................................................................. I
2.0 PHYSICAL SITE SETTING...............................................................................................................1
2.1 Site Description..............................................................................................................................1
2.2 Land Use of Subject Property and Surrounding Area................................................................. 2
2.3 Potential Receptors........................................................................................................................ 2
2.4 Site Geology/Hydrogeology......................................................................................................... 2
3.0 PREVIOUS UST REMOVAL AND INITIAL ABATEMENT ACTIONS .................................. 3
4.0 LIMITED SITE ASSESSMENT ACTIVITIES...............................................................................4
4.1 Well Permits..........................................................................................................................5
4.2 Soil Boring Advancement and Soil Sample Collection/Analysis............................................5
4.3 Temporary Monitoring Well Installation and Development....................................................7
4.4 Groundwater Sample Collection/Analysis.............................................................................. 7
4.5 Temporary Monitoring Well Abandonment...........................................................................8
4.6 Soil and Groundwater Analytical Results...............................................................................8
4.6.1 Soil Sample Analytical Results.......................................................................................... 8
4.6.2 Groundwater Sample Analytical Results........................................................................... 9
5.0 SUMMARY AND CONCLUSIONS.................................................................................................10
FIGURES
Figure 1 USGS Topographic Site Location Map
Figure 2 UST Location Map
Figure 3 Adjoining Property Identification Map
Figure 4 150-Foot Radius Receptors Map
Figure 5 UST-2 & UST-3 Soil Sample Locations and Results
TABLES
Table B-3 Summary of Soil Sampling Results
Table B-4 Summary of Groundwater and Surface Water Sampling Results
Table B-6 Adjoining Property Owners / Occupants
Table B-7 Monitoring and Remediation Well Construction Information
APPENDICES
Appendix A Well Permits
Appendix B Field Documentation and Electronic Boring/Well Log for TMW-1
Appendix C Well Construction & Abandonment Records Submitted to
NCDEQ and Mecklenburg County
Appendix D Laboratory Analytical Reports
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Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
1. INTRODUCTION
Pulte Home Company, LLC (Pulte) is considering the purchase of the approximate 53.27-acre
property identified as Mecklenburg County Tax Parcel ID No. 11109204, which is located south
of Camp Stewart Road, east of its intersection with Harrisburg Road in Charlotte, North Carolina
(see location of the subject site on Figure 1). The property is currently owned by Professional
Child Centers, Inc. As part of their pre -purchase due diligence, Pulte, on behalf of the property
owner, procured the services of ESP Associates, Inc. (ESP) to facilitate the removal of three
underground storage tanks (USTs), identified as UST-1 through UST-3, from the subject site
(refer to Figures I and 2 for the former UST locations). During removal, UST-3, an approximate
550-gallon heating oil UST, was found to have leaked. Releases had not occurred from UST-1,
an approximate 550-gallon heating oil UST, or UST-2, an approximate 600-gallon heating oil UST
that was located adjacent to UST-3 in the same tank pit. Subsequent to the UST removals, ESP
performed initial abatement action activities for the UST-3 release.
As a result of exceedances of the North Carolina Department of Environmental Quality's
(NCDEQ's) residential and/or soil -to -groundwater maximum soil contaminant concentrations
(MSCCs) at the base of the UST-2 and UST-3 excavation following completion of the initial
abatement action activities completed through March 22, 2021, a Limited Site Assessment (LSA)
was performed to further assess the extent of soil contamination and to assess impacts, if any, on
groundwater quality. This report documents the LSA activities and findings.
2. PHYSICAL SITE SETTING
2.1 Site Description
The heavily -wooded subject site has a listed street address of 5501 Camp Stewart Road and
includes remnants of structures associated with the closed Camp Stewart summer camp facility.
An approximate two -acre pond is located on the southern portion of the site with several streams
flowing throughout the site. A concrete in -ground swimming pool is located on the eastern
portion of the site.
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Limited Site Assessment Report ESP Project E6-GP56.601
Camp Stewart Road Site April 28, 2021
2.2 Land Use of Subject Property and Surrounding Area
The subject property is zoned R-3, single-family residential with a maximum density of 3 units
per acre.
The surrounding area consists of residential subdivisions, single-family residences,
commercial/retail properties, a fire station, and undeveloped woods and fields. The names and
addresses of the owners of the properties adjoining the northern portion of the subject tax parcel
where the UST-3 release occurred are summarized on Table B-6 and identified by location on
Figure 3. All of the adjoining properties listed in Table B-6 are single-family residences except
for adjoining parcel # 35/36 which is identified as the Mason Center of the First Korean
Presbyterian Church of Charlotte.
2.3 Potential Receptors
On March 22, 2021, ESP performed a visual site reconnaissance to identify potential receptors
within an approximate 150-foot radius of the UST-3 release location (see Figure 4). No water
supply wells or surface water bodies were observed within 150 feet (ft) of the UST-3 release
location during the reconnaissance.
2.4 Site Geology/Hydrogeology
During installation of temporary monitoring well TMW-1, soil encountered within the boring
consisted of residuum comprised of brown fine to coarse sandy to slightly clayey silt (see
boring/well log for TMW-1 in Appendix B). Moist soil was first encountered at approximately
28 ft below ground surface (BGS), while saturated conditions were encountered within the
boring at approximately 40 ft BGS. Based on site topography, groundwater flow in the vicinity
of the former UST-2 and UST-3 location is likely to be toward the east (see Figures 1 and 3).
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Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
3. PREVIOUS UST REMOVAL AND INITIAL ABATEMENT ACTIONS
Previous UST removal and initial abatement action activities are documented in detail in our
"Initial Abatement Action Report" (IAA Report) dated April 28, 2021. The following bullets
summarize our findings as presented in the IAA Report:
• On February 9, 2021, three 550- to 600-gallon heating oil USTs (UST-1 through UST-3)
and one approximate 550-gallon heating oil above -ground storage tank (AST) were
removed from the subject site and transported off -site where they were recycled. UST-2
and UST-3 were located adjacent to each other within the sample tank pit.
• Based on release detection soil sample laboratory analytical results, a release had not
occurred from UST-1.
• Based on laboratory analytical results for the release detection soil samples collected
from the UST-2 and UST-3 tank pit, a release had occurred. NCDEQ's soil screening
level for total petroleum hydrocarbons (TPH) diesel range organics (DRO) of 100
milligrams per kilogram (mg/kg) was exceeded in all four of the release detection soil
samples collected from the base of the tank pit, with detected concentrations ranging
from 2,040 to 10,500 mg/kg. Although TPH gasoline range organics (GRO) was
detected in all four leak detection soil samples, only the sample at the north end of UST-2
(designated #2 NS) with a concentration of 75 mg/kg exceeded NCDEQ's soil screening
level for TPH GRO of 50 mg/kg. Although the highest TPH DRO and TPH GRO
detections were observed in a soil sample collected from beneath UST-2, UST-2 is not
believed to have been the source of the release since UST-2 was full of heating oil at the
time of removal. UST-3 is believed to have been the source of the release since it was
basically empty at the time of removal.
• On behalf of the property owner on March 9, 2021, ESP submitted a 24-Hour Release
and UST Leak Reporting Form for the UST-3 release incident to NCDEQ via email.
• A total of 109.9 tons of petroleum -impacted soil were excavated for off -site permitted
treatment/disposal from the UST-2 and UST-3 location during two events
(February 9-10, 2021, and March 22, 2021). The final surface footprint of the excavation
was approximately 42.5 ft long and ranged from 7 to 14.2 ft in width (see the excavation
footprint on Figure 5). The center section of the excavation extended to 15 ft BGS (the
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Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
trackhoe's excavation depth limit), while the extended excavations to the north and south
extended to 7 ft BGS and 8 ft BGS, respectively. The excavation did not encounter
groundwater or bedrock.
• The analytical results for the eastern and western sidewall samples (#2 EW and #2 WW,
located as shown on Figure 5) were either non -detect or less than both residential and
soil -to -groundwater MSCCs. Based on confirmatory soil sample results for soil samples
#2 NW-2 and #2 SW-2, located as shown on Figure 5, all compounds along the sidewalls
at the final March 22, 2021, excavation extent were less than residential MSCCs. Note
that confirmatory soil sample locations #2 NW and #2 SW, where there were residential
MSCC exceedances, were subsequently removed during the March 22, 2021, excavation
activities.
• Confirmatory soil sample results at the center of the excavation's base (location
#2 BASE, as shown on Figure 5) exceeded residential MSCCs for Aromatics C9-C22
(2,277.2 mg/kg compared to the residential MSCC of 469 mg/kg) and Aliphatics C9-C 18
(10,194 mg/kg compared to the residential MSCC of 1,560 mg/kg). Aromatics C9-C22,
Aliphatics C9-C18, 1-methylnaphthalene, 2-methylnaphthlene, p-isopropyltoluene, and
naphthalene exceeded their corresponding soil -to -groundwater MSCCs at the center of
the base of the excavation.
• On March 22, 2021, the excavation was backfilled with unimpacted overburden soil and
imported backfill material.
4. LIMITED SITE ASSESSMENT ACTIVITIES
During performance of the LSA, additional soil samples were collected within the area defined
by the March 22, 2021, excavation to the north and south to better delineate the lateral and
vertical extent of residential soil MSCC exceedances in those directions. In addition, a
temporary monitoring well (designated TMW-1) was installed from which a groundwater sample
was collected to assess groundwater quality in the immediate vicinity of the UST-3 release.
Field documentation associated with the LSA field effort is provided in Appendix B, as is an
electronic boring/well log for temporary monitoring well TMW-1.
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Limited Site Assessment Report
Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
4.1 Well Permits
In advance of mobilization for the LSA field activities, the following well permits were obtained
for the installation of temporary monitoring well TMW-1 (see copies of permits in Appendix A):
NCDEQ Monitoring Well Construction Permit # WM0301I11; and Mecklenburg County
Subsurface Investigation Permit (SIP) # 70002849. Upon abandonment of TMW-1 following
groundwater sample collection, the Well Construction Record (Form GW-1) and the Well
Abandonment Record (Form GW-30) prepared by Environmental Drilling & Probing Services,
LLC (EDPS), a North Carolina -licensed well driller, were submitted to the NCDEQ Division of
Water Resources Information Processing Unit and uploaded to the Mecklenburg County on-line
SIP system (see the submitted Well Construction Record and Well Abandonment Record for
TMW-1 in Appendix Q.
4.2 Soil Boring Advancement and Soil Sample Collection/Analysis
On March 30, 2021, ESP documented the advancement of two soil borings (designated B-1 and
TMW-1 at the approximate locations shown on Figure 5) by EDPS. The soil borings were
advanced using a track -mounted Geoprobe® 7822DT rig utilizing direct push technology. For
each soil boring, continuous soil sample cores were collected using a 5-ft long Macro -Core®
sampling device equipped with acetate liners. The retrieved 5-ft long soil cores were field
screened for total volatile organic compounds (VOCs) using a photoionization detector (PID).
Field boring logs for soil borings B-1 and TMW-1 and an electronic boring/well log for TMW-1
are provided in Appendix B.
Soil boring B-1 was advanced within the prior excavation footprint approximately 5 ft south of
the southern extent of the original February 9-10, 2021, excavation. Soil boring B-1 was
advanced through the clean backfill material into native soil. Native soil was encountered at
8.8 ft BASE, and a soil sample (designated B-1) was collected from a depth of 9-10 ft BGS. The
PID reading at the sampled depth was 0.8 parts per million (ppm). The purpose of this soil
sample was to assess the possibility that soils less than residential MSCCs were achieved closer
to the original February 9-10, 2021, excavation than the location of the #2 SW-2 confirmatory
soil sample collected on March 22, 2021.
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Limited Site Assessment Report ESP Project E6-GP56.601
Camp Stewart Road Site April 28, 2021
Soil boring TMW-1 was advanced within the prior excavation footprint approximately 5 ft north
of the northern extent of the original February 9-10, 2021, excavation. The location of TMW-1
was also approximately 10 ft topographically downgradient of the tank pit associated with the
removed UST-2 and UST-3. Soil boring TMW-1 was advanced into the water table aquifer and
extended to a depth of 49 ft BGS. During advancement of the TMW-I soil boring, soil samples
of native soil were collected at approximate 5-foot intervals, beginning at the approximate depth
at which native soil was first encountered (i.e., 6-7 ft BGS). A total of four soil samples were
collected from the TMW-1 soil boring: TMW-1-S1 from a depth of 6-7 ft BGS; TMW-1-S2
from a depth of 11-12 ft BGS; TMW-I-S3 from a depth of 16-17 ft BGS; and TMW-1-S4 from a
depth of 21-22 ft BGS. PID readings at the sampled locations were as follows:
TMW-I-S1 (6-7 ft) - 5.3 ppm
TMW-1-S2 (11-12 ft) - 30.6 ppm
TMW-1-S3 (16-17 ft) - 51.2 ppm
TMW-1-S4 (21-22 ft) - 11.3 ppm
TMW-1 at 26-27 ft BGS (not sampled) - 42.3 ppm
The purposes of these soil samples were to: 1) assess the possibility that soils less than
residential MSCCs were achieved closer to the original February 9-10, 2021, excavation than the
location of the #2 NW-2 confirmatory soil sample collected on March 22, 2021; and 2) to assess
the vertical extent of soil contamination.
The soil samples collected from soil borings B-1 and TMW-1 (i.e., B-1 and TMW-I-SI through
TMW-1-S4) were placed in laboratory -provided containers, labeled, stored on ice in a cooler,
and hand delivered under standard chain -of -custody procedures to Pace Analytical Laboratories'
(Pace's) North Carolina -certified laboratory located in Huntersville, North Carolina, for
laboratory analysis. All five collected soil samples (B-1 and TMW-1-S1 through TMW-1-S4)
were analyzed for MADEP extractable petroleum hydrocarbons (EPH) and MADEP volatile
petroleum hydrocarbons (VPH), while soil samples TMW-1-S1 and TMW-1-S2 were also
analyzed for semi -volatile organic compounds (SVOCs) by EPA 8270 and volatile organic
compounds (VOCs) by EPA 8260.
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Limited Site Assessment Report ESP Project E6-GP56.601
Camp Stewart Road Site April 28, 2021
4.3 Temporary Monitoring Well Installation and Development
On March 30, 2021, ESP documented the installation of temporary monitoring well TMW-1 by
EDPS at the location of soil boring TMW-1 (see Figure 5). Soil boring TMW-1 was over -drilled
using 8-inch outside diameter hollow -stem augers to 49 ft BGS. During advancement of soil
boring TMW-1, moist soil was encountered at approximately 28 ft BGS, while wet soil was
encountered at approximately 40 ft BGS. Therefore, temporary monitoring well TMW-1 was
installed to a depth of 49 ft BGS. Temporary monitoring well TMW-1 was constructed using
2-inch diameter Schedule 40 polyvinyl chloride (PVC) riser and 15 ft of 0.010-inch slot
Schedule 40 PVC screen. The interval in which temporary monitoring well TMW-1 was
screened represents the surficial water table aquifer. Filter sand was placed in the annular space
around the screen/riser from the base of the borehole to approximately 2 ft above the top of the
screen. A 2-ft thick bentonite seal was placed above the filter sand. The remaining annular
space was left empty. Following completion of the temporary monitoring well installation, the
depth to groundwater was measured at 30.1 ft BGS. The well construction details for temporary
monitoring well TMW-1 are presented on the TMW-1 boring/well log in Appendix B, the Well
Construction Record (Form GW-1) in Appendix C, and in Table B-7.
Temporary monitoring well TMW-1 was developed by removing approximately 75 gallons of
water (roughly 24.8 well volumes) using a decontaminated mini -Typhoon pump and new tubing
until recovered water appeared relatively clear. Measured turbidity at the completion of well
development was 41.2 Nephelometric Turbidity Units (NTU).
Free product was not observed within temporary monitor well TMW-1.
4.4 Groundwater Sample Collection/Analysis
On March 31, 2021, temporary monitoring well TMW-1 was purged, and a groundwater sample
was collected. Both well purging and groundwater sample collection were accomplished using a
dedicated/disposable Teflon® bailer. Prior to purging, the depth to groundwater in temporary
monitoring well TMW-1 was measured at 29.7 ft BGS (see Table B-7). A total of approximately
10 gallons of water (roughly 3.3 well volumes) were purged from the well, and then the
groundwater sample (designated TMW-1) was collected by transferring extracted water from the
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Limited Site Assessment Report ESP Project E6-GP56.601
Camp Stewart Road Site April 28, 2021
bailer into pre -preserved, laboratory -provided containers. The groundwater sample containers
were labeled, stored on ice in a cooler, and hand delivered under standard chain -of -custody
procedures to Pace's North Carolina -certified laboratory located in Huntersville, North Carolina,
for laboratory analysis. Groundwater sample TMW-1 was analyzed for MADEP EPH, MADEP
VPH, SVOCs by EPA 625.1 plus 10 largest non -target peaks, and VOCs by SM 6200.
4.5 Temporary Monitoring Well Abandonment
On April 1, 2021, temporary monitoring well TMW-1 was abandoned by EDPS. Prior to
abandonment, the depth to groundwater in temporary monitoring well TMW-1 was measured at
29.1 ft BGS.
Temporary monitoring well TMW-1 was abandoned by pulling approximately 15 ft of PVC riser
from the ground. The remaining PVC well riser/screen and open borehole were then tremie
grouted with bentonite pellets from the base of the well/boring to the ground surface, and topped
off with cement once the grout had settled (see Well Abandonment Record [Form GW-30] in
Appendix Q.
4.6 Soil and Groundwater Analytical Results
A summary of the soil sample laboratory analytical results is presented in Table B-3, and a
summary of groundwater sample laboratory analytical results is presented in Table B-4. Soil
analytical results are illustrated in relation to their location on Figure 5. The laboratory
analytical reports are provided in Appendix D.
4.6.1 Soil Sample Analytical Results
Soil sample B-1 was analyzed for MADEP EPH and MADEP VPH, and all measured
compounds were non -detect. Based on this result, it is believed that the location of soil boring
B-1 marks the southern extent of petroleum -impacted soil.
Soil samples TMW-1-S1 through TMW-1-S4 were all analyzed for MADEP EPH and MADEP
VPH. As indicated in Table B-3, Aromatics C9-C22, Aliphatics C5-C8, and/or Aliphatics
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Limited Site Assessment Report ESP Project E6-GP56.601
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C9-C 18 were detected in these soil samples; however, all detections were below residential
MSCCs. The only MADEP EPH/VPH compound to exceed its soil -to -groundwater MSCC in
the soil samples collected from soil boring TMW-1 was Aromatics C9-C22 in soil samples
TMW-1-S2 (75.7 mg/kg at 11-12 ft BGS) and TMW-1-S3 (89.4 mg/kg at 16-17 ft BGS). The
soil -to -groundwater MSCC for Aromatics C9-C22 is 31 mg/kg. At a depth of 21-22 ft BGS at
the TMW-1 location, Aromatics C9-C22 was non -detect.
Soil samples TMW-1-S1 (6-7 ft BGS) and TMW-1-S2 (11-12 ft BGS) were also analyzed for
SVOCs and VOCs. A number of SVOCs and VOCs were detected at trace concentrations in
samples TMW-1-S 1 and TMW-1-S2; however, all of the detections were below their
corresponding residential MSCCs. The following SVOCs and VOCs were found to exceed their
soil -to -groundwater MSCCs in these two soil samples: 1-methylnaphthalene at 6-7 ft BGS
(TMW-1-S 1); and 1-methylnaphthalene, 2-methylnaphthalene, p-isopropyltoluene, and
naphthalene at 11-12 ft BGS (TMW-1-S2). It is possible that slight exceedances of the soil -to -
groundwater MSCCs for these SVOCs and VOCs could extend to a depth between 17 and 22 ft
BGS at the TMW-1 location as was the case for Aromatics C9-C22. The SVOC analysis
included estimated quantification of a number of tentatively identified compounds (TICS) as
listed in the laboratory analytical report (refer to Appendix D). MSCCs have not been
established for any of the TICS.
Based on the laboratory analytical results for the soil samples collected from soil boring TMW-1,
it is believed that the location of soil boring TMW-1 marks the northern extent of petroleum -
impacted soil exceeding residential MSCCs. However, petroleum -impacted soil still exceeds
soil -to -groundwater MSCCs at the TMW-1 location to a depth of between 17 and 22 ft BGS.
4.6.2 Groundwater Sample Analytical Results
The groundwater sample collected from temporary monitoring well TMW-1 was analyzed for
MADEP EPH, MADEP VPH, SVOCs, and VOCs, and the only detected target compound was
phenol at a concentration of 1.4 micrograms per liter (ug/1). The detected concentration of
phenol in the groundwater sample was below its North Carolina 2L groundwater standard of
30 ug/l. The SVOC analysis included estimated quantification of one TIC (i.e.,
cyclohexasiloxane, dodec) in the groundwater sample (see laboratory analytical report in
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Camp Stewart Road Site
ESP Project E6-GP56.601
April28, 2021
Appendix D). MSCCs have not been established for cyclohexasiloxane, dodec. Based on these
groundwater sample analytical results, the release from UST-3 has not adversely impacted
groundwater.
5. SUMMARY AND CONCLUSIONS
The following bullets summarize our findings based on completion of the LSA activities along
with associated soil and groundwater sample laboratory analytical results:
• The lateral extent of petroleum -impacted soil above residential MSCCs has been defined
by soil samples TMW-1 to the north, #2 EW to the east, B-1 to the south, and #2 WW to
the west as being an area having dimensions of approximately 14 ft wide and 25.5 ft long.
The vertical depth of petroleum -impacted soil above residential MSCCs has not been
fully defined based on the soil sample analytical results collected to date, but is greater
than 15 ft BGS at the center of the original February 9-10, 2021, excavation. Based on
the downgradient soil sample analytical results from the TMW-1 location, it is not
unreasonable to assume that the vertical extent of residential MSCC exceedances at the
#2 BASE location could be as deep as 20 ft BGS, and possibly deeper. However, moving
laterally away from the center point, it appears that petroleum -impacted soil above
residential MSCCs is not as deep.
• The lateral extent of petroleum -impacted soil above soil -to -groundwater MSCCs has
been defined by soil samples #2 EW to the east, B-1 to the south, and #2 WW to the
west; however, the lateral extent of petroleum -impacted soil above soil -to -groundwater
MSCCs has not been fully defined to the north. Exceedances of the soil -to -groundwater
MSCCs for Aromatics C9-C22 and several SVOCsNOCs were observed at soil sample
location TMW-1 to depths of at least 17 ft BGS. Exceedances of soil -to -groundwater
MSCCs at the center point of the February 9-10, 2021, excavation are expected to extend
deeper that the exceedances of the residential MSCCs given the significantly lower
criteria concentrations.
• Groundwater in temporary monitoring well TMW-1 was encountered at a depth ranging
from 29.1 to 30.1 ft BGS.
• Groundwater sample analytical results from temporary monitoring well TMW-1 were
non -detect for all target compounds except phenol which was detected at a concentration
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Limited Site Assessment Report
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ESP Project E6-GP56.601
April28, 2021
well below its North Carolina 2L groundwater standard. Therefore, groundwater use
restrictions are not warranted as a result of the UST-3 release.
No water supply wells or surface water bodies are located within 150 ft of the UST-3
release location.
Based on the results of the LSA, the UST-3 release should be classified as Low Risk.
11

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APPENDIX A
WELL PERMITS

ROY COOPER
Governor
DIONNE DELLFGATTI
Secretary
S. DANIEL SMITH
Director
Mr. Fred Matrulli (via email)
V.P. of Land Acquisition
Pulte Home Company, LLC
11121 Carmel Commons Blvd.
Suite 450
Charlotte, NC 28226
Dear Mr. Matrulli,
NORTH CAROLINA
Environmental Quality
March 15, 2021
RE: Monitoring Well Construction Permit
Permit # WM0301111
Pulte Camp Stewart Rd. Site, Charlotte,
Mecklenburg County
In accordance with your completed application received on March 15, 2021, we are forwarding
herewith Monitoring Well Construction Permit Numbered WM0301111 and issued for the
construction of one monitoring well located at the subject site in Charlotte, Mecklenburg County.
This Permit will be effective for one year from the date of issuance and shall be subject to the
conditions and limitations as specified therein.
Should you have any questions, please contact Edward Watson at [phone], or by
email at eward.watson(a-ncdenr.gov.
Sincerely,
EADocuSigned by:
s.�w H P;z, "
F161FB69A2D84A3...
Andrew H. Pitner, P.G., Assistant Regional Supervisor
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources
CC: WQROS, Central Office (via Laserfiche)
Nora Zirps P.E., RSM, ESP Associates (via email)
Environmental Drilling and Probing Services, LLC (via email)
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1610 East Center Avenue. Suite 301 1 Mooresville. North Carolina 28115
Noan+cnaouNA
a�o�ro�mm�na^^e^4im�u` r 704,663,1699

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other applicable Laws,
Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Pulte Home Company, LLC (ESP Associates as Agent)
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of one monitoring well owned by Pulte Home
Company, LLC, at the subject site, in Charlotte, Mecklenburg County. This Permit is issued in accordance with the
application received on March 15, 2021, in conformity with specifications and supporting data, all of which are filed with the
Department of Environmental Quality and are considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any other applicable law or
regulation. Construction of any well under this Permit shall be in strict compliance with the North Carolina Well Construction
Regulations and Standards (15A NCAC 02C .0100), and other State and Local Laws and regulations pertaining to well
construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an adjudicatory hearing upon
written request within 30 days of receipt of this Permit. The request must be in the form of a written petition conforming to
Chapter 150B of the North Carolina General Statutes and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other specified conditions,
limitations, or exceptions as follows:
1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these wells are being installed as
part of an investigation for contamination from an underground storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water Resources' Information
Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC 02C .0113 and a
well abandonment record (GW-30) shall be submitted to the Division of Water Resources' Information Processing
Unit within 30 days of the well abandonment.
7. If the well penetrates any water -bearing zone that contains contaminated waters, the upper three feet of the well
shall be grouted within one day after the casing is set or the well abandoned.
8. Temporary wells must be permanently abandoned or converted to a permanent well within seven days (168 hours)
of completion of drilling the borehole.
9. Adequate permits shall be obtained from Mecklenburg County Groundwater and Wastewater Services.
Permit issued the 15t" day of March, 2021
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
EA
DocuSigned by:
H pall
F161FB69A2D84A3...
Andrew H. Pitner, P.G., Assistant Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
Permit No. # WM03011111

Mecklenburg County Health Department
Groundwater & Wastewater Services
700 N. Tryon St., Suite 211 v�N�UR[i Charlotte, NC 28202 "° z Permit Issuance Date:
Phone: [phone]
Fax: [phone] �yF.. Permit Number:
http://groundwater.charmeck.orgo�w
CFR
SUBSURFACE INVESTIGATION PERMIT
I. Well Owner Information
Name: Professional Child Centers, Inc.
Attn: Dean Davidson
Phone #: [phone]
Address 1: 505 Beachland Blvd, Suite 1
Address 2:
City: Vero Beach State: FL Zip: 32936
Agent Information (if applicable)
Name: ESP Associates, Inc.
Attn: Christopher ward
Phone #: [phone]
Address 1: PO Box 7030
Address 2:
City: Charlotte
III. Site Information
Site Name; Camp Stewart Site
Parcel ID Number: 11109204
Address:
City:
General Conditions of This Permit:
State: NC
Zip: 28241
State: NC Zip:
Bill To: Agent
3/15/2021
70002849
• This permit shall be VALID for a period not to exceed twelve (12) months from the date of issuance.
• This permit is VALID for the site specified above and must be on -site during the course of the investigation
and made available to a Department representative upon request.
• A North Carolina Certified Well Contrator must perform any well contractor activities associated with this
permit.
• All wells shall be constructed and abandoned to the standards of Chapter VI, Section V and Section VI
of the Mecklenburg County Groundwater Well Regulations.
• All temporary wells, including those installed using Direct Push Technology, must be abandoned
to the standards of Chapter VI, Section VI of the Mecklenburg County Groundwater Well Regulations.
• Registration information for all wells must be submitted to the Department within thirty (30) days of well
completion. If water samples are collected, it is recommended that the well NOT be registered until the
analytical results are received.
Page 1 of 1 SIP Form — revised 2/15/11

APPENDIX B
FIELD DOCUMENTATION AND ELECTRONIC
BORING/WELL LOG FOR TMW-1

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FIELD BORING LOG
Project: Camp Stewart Road Site (GP56.601)
Boring No,: W-1
Logged By (Name and Signature):
Drilling Company:
Drilling Method/Sampling Equipment:
-r
Driller: �
Drill Rig- ✓'2
DateMme Boring Started: i Qf'� # t)V3
Total Depth of Baring (ft bgs):
Date/Time Boring Complete!.I,
Depth to Groundwater at Time of Drilling (ft bgs): ' r
Weather:,
Depth to Bedrock (ft bgs):
GPS Coo7dlnate5(Nc State Plane NAB 63 in dmmal degrees to no sm,.Mh arder):
Depth
USCS
(ft)
Material Description
Class,
Observations
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AY,.f✓Ai;Xf`•t
ESP

FIELD BORING LOG
Project: Camp Stewart Road Site (GP58.6o1)
Boring Flo.: )
Logged By (lame and Signature):
Drilling Company: F—P PS
Dt%ing Method/Sampling Egsalpment: 1);P _ M ; , em L o-x..
Driller: e .� ct fw� c �f
Drill Rig:
DateiTime Boring Startedl/,�?O/A I
Total Depth of Boring (ft bgs): /0
Date/Time Boring Completed, .�c�f,2 l ?3;'0 1
Depth to Groundwater at Time of Drilling (ft bgs):
Weather: �^ f
Depth to Bedrock (ft bgs): N1
GPS Coordinates (NG State Plane NAD US in decimal degrees to tho scvanth order):
Depth
(ft)
Material Description
USCS
Glass.
Observations
(.� `Q',��
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E S P

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x
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Y

WELL RISER
2" I.D. PVC I
INSTALL DATE:
INSTALLED BY:
ESP SITE PERSONNEL:
STATIC WATER DEPTH (FT) BELOW TOC:
IGROUND SURFACEI
I O'WELL SCREEN
2" I.D. PVC 0,010" Slot
I CAP I
BENTONITE SEAL
8" DIAMETER
BOREHOLE I
SAND FILTER
BOTTOM OF
TMW-1
TEMPORARY MONITORING WELL DIAGRAM
CAMP STEWART ROAD SITE
r'UA01 n77C: hir',OTU rlAont iKIA

WELL DEVELOPMENT FORM
:ci: Camp Stewart Road Site (GP56.601)
iorinrj Well No.: TMW-t
DevolopmentStarted 1�,
Development Completed
of Pump Used (Makeltvtodel): -
e l V
Developers (Names and Signatures):
Cher Conditions:°,. „
lj
Well Diameter (inches): `
Total Well Depth (€t below TOC): '
Static Water Level Depth (it below TOG):
r 't Water Column Height (ft):
7, . }
3-Voiumo ExtfaGbon Estimate (Gallons); "
" For 2-inch diameter wA, 3-volumes = 0.45 x water column height (tt).
Measurements 24 Hours After Cnmptefion of Well Development
Total Well Depth (ft Wow TOC):
Static Water Level Depth (it below TOC): t 7 ,, 5
Datel
Time
(24 hrs)
Flow
Rate
{gal/min}
Cumulative Volume
Extracted
(gal€ons)
Water Level
Depth
(it TOG)
pH
Temp
CC)
Conductly€ty
{lrSfcrn)
Trsmity
(N)
�pr��'f gt,eFY.
_._......
jf}IV hey
jF tgi'j�4
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•�wiy=i $>..r
.__...._

Camp Stewart Road Site
BORING/WELL LOG
PROJECT:
Charlotte, North Carolina
TMW-1
PROJECT No.:
ELEVATION:
DRILLING METHOD:
AUGER O.D.:
DRILLING COMPANY:
GP56.601
Existing Ground Surface
DP-Macrocore/HSAMicrocore
EDPSEDPS
LOGGED BY:
BORING DEPTH:
DRILL RIG:
NOTES:
Eddie Rogers
49.0 Feet
GP 7822 DTP 7822 DT
DATE DRILLED:
WATER LEVEL:
03/30/202121
3(X130.1 Feet IF 29.7 Feet @ 1 day
ee
a
co
J J
w¢
D E
a a
LAB SAMPLE
w
L
v
V
_(D
a 0
SOIL DESCRIPTION
w w
�>
>
w x
wo
i j
s
COLLECTED
¢
J
w
O
ML
FILL: Tannish, Brown, Sandy SILT
5
-5.0
10
-10.0
15
Space left open
-15.0
ML
RESIDUUM: Reddish, Tannish, Brown, fine
Sandy, SILT, with magnesium oxide mottling
20
-20.0
25
-25.0
30
-30.0
Bentonite
I
_
Backfilled with
sand to 2 feet
above 15-ft screen
(approximately 32
feet below existing
35
ground surface)
-35.0
Page 1 of 22
DEPTH MEASUREMENTS ARE SHOWN TO ILLUSTRATE THE OF THE SOIL
DEPTHARRANGEMENTSASURE
TYPES ENCOUNTERED AT THE BOREHOLE LOCATIONS. DO NOT USE DEPTH MEASUREMENTS FOR
NOT USE
.``
DETERMINATION OF DISTANCES OR QUANTITIES. in

Camp Stewart Road Site
BORING/WELL LOG
PROJECT:
Charlotte, North Carolina
TMW-1
PROJECT No.:
ELEVATION:
DRILLING METHOD:
AUGER O.D.:
DRILLING COMPANY:
GP56.601
Existing Ground Surface
DP-Macrocore/HSA
EDPS
LOGGED BY:
BORING DEPTH:
DRILL RIG:
NOTES:
Eddie Rogers
49.0 Feet
GP 7822 DT
DATE DRILLED:
WATER LEVEL:
03/30/2021
= 30.1 Feet s 29.7 Feet @ 1 day
a
cn
J J
w¢
D E
a a
LAB SAMPLE
w
a
v
V
= c7
. 6
SOIL DESCRIPTION
w w
>
>
w x
wo
i j
s
COLLECTED
¢
J
w
O
RESIDUUM: Reddish, Tannish, Brown, fine
ML
I
Sandy, SILT, with magnesium oxide mottling
40
ML
Tan to Greenish, Brown, fine Sandy, Clayey, SILT,
-40.0
ack with
wet material at 40 feet bgs
sand to 2 to 2 feet
s
above 15-ft screen
(approximately 32
feet below existing
ground surface)
ML
�
Tannish, Brown, fine to coarse Sandy, SILT
45
-45.0
ML
/
Tannish, Brown, fine to medium Sandy, Clayey, SILT
50
-50.0
55
-55.0
60
-60.0
65
-65.0
Page 2 of 2
DEPTH MEASUREMENTS ARE SHOWN TO ILLUSTRATE THE OF THE SOIL
TYPES ENCOUNTERED AT THE BOREHOLE LOCATIONS. DO NOT USE DEPTH MEASUREMENTS FOR
NOT USE DEPTHARRANGEMENTSASURE
DETERMINATION OF DISTANCES OR QUANTITIES.

APPENDIX C
WELL CONSTRUCTION & ABANDONMENT RECORDS
SUBMITTED TO NCDEQ AND MECKLENBURG COUNTY

NESP
April 16, 2021
NCDEQ Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Reference: FORMS GW-1 & GW-30
NCDEQ MONITORING WELL CONSTRUCTION PERMIT # WM0301111
Camp Stewart Road Site (TAX PIN # 11109204)
Charlotte, North Carolina
ESP Project No. E6-GP56.601
To Whom it May Concern:
As required by "Permit for the Construction of a Monitoring Well" # WM0301111 provided by
the NCDEQ Division of Water Resources Mooresville Regional Office to Pulte Home Company
LLC on March 15, 2021, ESP, on behalf of Pulte Home Company LLC, is pleased to present well
construction and abandonment records (Forms GW-1 and GW-30) associated with the temporary
monitoring well installed on the subject site located along Camp Stewart Road in Charlotte.
Mecklenburg County, North Carolina. The temporary monitoring well was installed as part of Pulte
Home Company LLC's pre -purchase assessment/Limited Site Assessment of a leaking underground
storage tank at the subject property.
One temporary monitoring well (TMW-1) was installed on March 30, 2021, and subsequently
abandoned on April 1, 2021, by Environmental Drilling & Probing Services, Inc. (EDPS)
(Certification No. 3307). Completed and signed NCDEQ Forms GW-1 and GW-30 for TMW-1
are attached.
ESP Associates, Inc.
P.O. Box 7030 • Charlotte, NC 28241
1.800.960.7317 • NC: 704.583.4949, fax [phone] • SC: 803.802.2440, fax [phone]
www.espassociates.com

Forms GW-1 & GW-30 for Monitoring Well Construction Permit # WM0301111 ESP Project No. E6-GP56.601
Camp Stewart Road Site April 16, 2021
If you should have any questions, please do not hesitate to contact me at [phone].
Sincerely,
ESP Associates, Inc.
&A.
Nora A. Zirps, PE, RSM
Project Manager
License No. 023838
cc: Mr. Fred Matrulli, Pulte Home Company LLC (via email)
Attachments
Forms GW-1 and GW-30
2

WELL CONSTRUCTION RECORD (6W-I)
I. Well Contractor loforauitioa:
W d l [-❑ntraclor ''gamc -�
3307
N(' W'c11 ( ontf w--Iol [. nt, fiealmn Nimi 1+ r
rv>ran n►�►n�-a ._fl2;liv►� 4- P,mbtn,`r�s
(:ottpmy Name '1
2. Well Construction Permit #:
L.iu all applicable well consrn.ceton prrm,rs fi-e- P:!(.: a 'uunn--4.5rure, a urrarw•r, VfC e
3. Well Use (check well use):
Agricultural ❑ k1unicipal/puhk
Geuthemull (Iicating/C aching Supply) DRemdenual Water Supply (-s« tglc)
lndustriallCommmial E)Rcsidential Water Supply (shared)
Water Supply Well:
Aquifer Recharge
Aquifer Storage and Ret overy
Aquifer Test
E'.xpenmental Techwioa
Geothermal ([Nosed Loop)
RocuvLrti
n0ruundualer Remrdiatioii
El wmity nattier
nsionmvater Drainage
Subsidence C:owrol
lra"r
under' 1� I
a. Bate Well(s) Completed: 3 30 2T Well I00
Sa. Well Location:
cmmp siv war �9ft A
1'acibtv,'Owner Name 1,:tctlt y 11)» tifThle)
Yh7slcal Adctrcss, (•ity- and Lip
lrMeek _ _ P l r 0-12-DAf ..
Cumly Parcel Identification Vu (PIN)
Sb I +Crud and kl hide ' d eesl t 1 d d' 1.1
IWA-i R ZONES
}tli TO DESCRUITION
� fL ft.
ft k.
OUTJER CASING far mnlli-cased welts
7�TO DIAMEIt'R
n. ft.LIL
-•---
17. SCREF.h
�F.R,tOM i 0 I)XA-M, -fBtR SEAT $IZE 1MICIQNM MATERLLL
'l9 ft. c�7. 1 k• "�. in. 0.0) emu' C l'�r40 P11C
ft. R. in. - —
I& GROUT' —
ZRQNI r(1 RIA I ERLIL _ _ F-MPI.ACFM VgT slk-[: OD & AMUtiNt
3 m 3a ft. � o�titp 'TR- 3D �eltR
ft. ft.
fL k_
Z rneo (aeVR
iI.
re. ._
fl. (L
V.RENTA"S
a e tt In egr rnrnu es strou sor cc Ina cercea.........
flf vtll 6eld_77one 19y1JIvag IS suttc{r-e-nl) r, 22. Certifiication:
1e
6. Ware) the or Temporary Signature of C'erutied LVdI Contractor Date
Lf+ sinning ibis form. I herebi- eerhfi+ that the well(sr was iwere) cwtsfmcdrd in u cord nce
7. Is tills a repair to an existing well: ©yes ar Na with 15A VC-.4C b2C -0100 or 159 .VCAL' 0?C .0100 Well C'vrurrvcrian Standards and that a
l this is a repair- fill ottr known well ccm.structhon informal ion and rain the narure gfthe eopt uJ'dris rec•c rd has been provided to the well owner.
repair wider =21 remarks section or on the buck of this form-
23. Site diagram or additianal well details: -
S. For Geoprobe(I]P'I' or Closed -Loop Geothermal Wells having the satnc You may use the hack o€ this page In provide addilional well siEe details or well
c insuvaion, only I GW- is needed. Indicate TOTAI. NE3MBER of wells construction details. You may also attach addizicunal pages if necessar)'-
drilled: �� _ -• --
- j SI+13hii'I"f'AI. ittiti'1'Iit_'C'T'IUlV5
9. Total well depth below land surface: r � � � _(ft-) 24a. For M Wells: Submit this Form within 34 days of completion of well
For multiple wells hsr all depths if dti ferew lerample- 3'di300' and .,ZE 001 cc,nslructit'll ttt the fuilutiti3nV.
Ili. Static water level below top of casing; _ (ft) Divsioa of Water Resonrers, Informatino Processing t{ttit,
!f wafer level is abo, a rasing, rise 1617 Mail Service Center, Raleigh, NC 276"-1617
11. Borehole diameter: (in.) 24b. For i ' ction Wells- In addition to sending the form zo the address in 24a
�{ abovt% alw uw
submit one �py of Ihis tbrm within 30 days ul' mpletion of well
12 Well construction method- c5 wristructim to the fol lu-A ing-
(i-e- auger, roan_ cable, duen push, tic. t
1)ivision of' -'Pater iiRt-sourcex, E'ndergrvulEd Injection Control 1'riWatu,
FOR WATER SUPPLY WELLS ONLY- - —1 T- _ - I&% flail Service Center, Raleigh, Vi- 276"-1636
13a. Yield (gpm) Me [hod of test 24c. For !Pater Sunoh' & lniection Wrllx In addition to sending the form to
the address(eO above. also submit one copy of this Corm within 30 days of
i3b. Disinf"oa type: Amotnit: canzplt.'ISQu 0I nt'el[ utnstru Wtl to the county health dgrartmcnt of the count
where consinwiLd.
Form GW-I Rcxi+ed 2.22.2111E

WELL ABANDONMENT RECORD
I- Well Cootractor lnformatioa:
Well Contractor dame for wct] ownrr personalty abandomng weil on hts73er propertyI
3 3o 7
tiC We II Contractor Certification Number
EnJ1r'AY4P_r&1 Dot;1A 4- Prob,'nq . Qrylcr5
C:ornpan Name 11
2- Weil Cnostruceao Permit 4: �C:5C 1 1 j 7CIT
iu: ail app(ica8 re *t/1 'i.e L•'I(' ('a UAi J. Sr fe• i'arra)jrc. e?I • 7f knOwn
3. Weil use[check well use]:
Water Snppty Well:
Agricultural C kiun Ft; ipa1. PtibI is
! :DGeflthermal (HealiripKocling Suppiy) WResidential Water Supply Isingier
ZlndustriaK mmmia] CResidcnaal Water SunpN i.sharedl
i
Non -Water Supph Well:
j �Iomtvrtng-•Reco%'m
Aquifer Rec[iargc
=Groundwater Remedialion
WAquifer Storage and Recovery
w Salinity Bamer
-aquifer Test
CStorntwater Diainagc
=F:xpcnmcntal Technoingy
C Subsidence Control
—_Geothermal (Ctosed 1xx-.p)
CTmccr
-('.enthcrma] (Heat ine^C'noling Return)
-Other rcxnlain under . n
4. Date welf(s) abandoned: q — I — z I
Sa. Well ioeatiop:
(:.tx"... Stew ft geAA '�i le-
Nlk
Facilily'Qwxr Name
}"Ihn IU= iif applicable i
�► S e ward C hadlade Mc
Physical Adless- Cirv. and lip
Comas
ParcclIdenti$cauon'10 iP[N-i
Sh. Latitude and longitude in degreevminvtes/seconds or decimal degrees:
:i` -ell field_ one �stlorsg «sufLcjemi
CONSTRUCi'IOPi 0ETA M OF WE S BJE IN Q ARANDOLN D
ttta h well ronrrrvcrron mordrsr .f mailable r r r nulrrpfe inrerrivn or non -+carer supah +.Nits
0:31.Y' wifh The same eonsrmcrion a.h—do nm enf i.�u car. subrnr1 one for ..
6a. Well ID*tt m W j --
6b. Total well depth: (fL)
tic. Borehnle diameter:
6d. Water level blow ground surfacer _(ft )
For LnUTml Use 04'Ll
WELL ABAJNL7otNIl fEINT DETAriS
7a, For Geopro be/DPT or Closed -Loop Geothermal Welk having the same
well oonsttucuonldepth, only 1 GW-30 is needed, Indicate TOTAL NUMBER of
weIIs abandoned:, _ Q W
7b_ Approrimate volume of water remaining in well
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used {check all that app
C Neal Cernent Groul Bentortire Chips or Pellets
C Sand Cement Grouz C Dry Clay
C Concrute Grout C Drill Currings
C. Specialty G-mut Z: Gravel
C Bemonile Slurry- C Ocher {ezpiam under 7g}
7f. For each material selected above, pr"de amount of materia-s used:
11 �"eaf be Ae l e`-s
7g, Provide a brief description of the abandoamciat procedure:
" 4*m v,-W was fe "y-P_J bo P i
Boric wads IL
boil m -to p coc AZd W1 eer_Aeyt„j_
$. ('ertiFcatiau:
21
Signature cruh ell bi)ua for o ell.•. l}atc
8i s r s fo , 1 here char the well(s) was (were) abandoned in
accordance with 15. _. 02C 0100 or 2C 0200 Well Corisrrucrion Stan&u-&
and that o copy- of rha record has been prodder/ to the we11 owner-
9. Sirc diagram or additional well details:
You rosy use the back of this page to provide additional well site details or ur.Il
abandonment details. You may also Attach additonal pages if necessary.
S[BhnTTAL LNSTRLi-I'I0NS
10a. For All Wells: Submit this form within 30 days of completion of %yell
abandonment to the follo%ving:
Division of Water Resources, Information Procemffig Unit,
161' !tail Sen-ice Center, Raleigh, NC 27699-161'
Ii1b. For In ection Wells- In addition W sending the form zo the address in Wa
ab.'%c. alsp submit One c(ipy� Of this form '.%Ithin 3O days of completion of well
abandonment to the following.
Division of Water Resources, 1'oderground Injection Control Program,
16M Mail Seri ice Center. Itaieigb. NC 27699-1636
6a Outer casing Itngt6 (if Imown): ` Iy— T�t lfi l IQr. For Water _Supph• & injectionWells: In addition to sending the form to the
addrecst.csl a4 , v c, a]so t:nmiI one copy of ttus form within ?O days of cvrnpietion
of Weil aiiandnnmcn! Ic the county health depanmem of the county where
6E Inner casi tubi lea u.
ng/ n,.0 length {if known): �abandorie
�(ftJ
6g. Screen length C'if known): 15 {ft }
Form GW-30 North Curniina Depanmet,i o1' En%ironoxntal (Quality • Dr scan of" aier Resources Rtvued 2-22-201E

Nora Zirps
From: Chris Ward
Sent: Wednesday, April 14, 2021 7:05 AM
To: Nora Zirps
Subject: FW: [External]RE: 70002849
From: Caldwell, Shawna <[e-mail]>
Sent: Tuesday, April 13, 2021 7:22 PM
To: Chris Ward <[e-mail]>
Subject: RE: [External]RE: 70002849
THIS MESSAGE ORIGINATED OUTSIDE OF ESP ASSOCIATES, INC. USE CAUTION WHEN OPENING ATTACHMENTS, CLICKING LINKS, OR RESPONDING
TO REQUESTS FOR INFORMATION.
Hi Chris,
Good to talk to you this morning.
The well is now documented as abandoned in our database. Pls let me know if you have any questions. Have a great
day.

M.A.M. X Cityworks X I Map X NC NC DEG',' Waste X I i� Division of
Not secure I hmc-ms-zones/maps_�idefault.aspx
Mecklenburg County, NC
s JA. I
Groundwater & Wastewater Services - "
. .P, . Monitoring Well registration And Subsurface Investigation Permitting
HCrre
Neer SIP
I SIP Rere%vs
•Jada_c Slo
F.L i=_=er.L' �a=ti "Ve!'s
Abt
GW S et
2gac:: SIPS
Monitoring Well Registration
21aistratior HeIF
Site Information
Oviner Information
Agent Information
SITE_NAME Camp stewar: Si:e
Pro-a_ainnal Child Centers.
Agent Name
ESP Pssoriat
Owner Name
—
Inc.
51TE_ADDRESS 5501 CAMP STEv.'�:�T RD
ATTN
Christopher+
ATTN
dean Oavidson
SITE_PARCEL 11109204
Addressl
PO Sox 703C
Addressl
505 Beachland Blvd, Suite 1
SIP# 70002E49
Address2
Address2
Charaokke KC
Vero teach FL 32935
PhOnE
704-565-757
[Select
Phone
772-913-1L52
WELL NAME WELL TYPE WELL STATUS PARCEL IO INSTALL —DATE DATE
ABANDON DEPTH TQ GW DELETE
7NIW-1 Monitoring Permanent
Ahandoned
11109204
43/30}2021 :� _.
___
❑
Add A Well View Summary I Delete Checked Wells I View in WI
ra

APPENDIX D
LABORATORY ANALYTICAL REPORTS

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aanrpie wnuition upon rreceipttawrt} rage [ oT [
aCB; �Rc�IlCc��r Document No.: Issuing Authority:
F-CAR-05-033-Rev.07 Pace Carolinas Quaiity Office
`Check mark top half of lox if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water) 00C, LLHg
"Bottom half of box is to list number of bottles
Project WO# : 9253Q360
PM: BV Due Date: 04/08/21
CLIENT: 92—ESP Assoc
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ply Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
oate preservation adjusted
Time presenatbr
Amount of Preservative
Lot 8
adjusted
added
Note: whenever there is a discrepancy affecting North Carolina compliance samples, a copy oP this Torm will Ment to the North Carolina DEHNR Certification Office (i.e.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 38 of 38

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Sample Condition Upon Receipt(SCUR) Page 2 of 2
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*Check mark top half of box if pH and/or dechlorination is
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Page 18 of 18
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy or tnis rorm wul ue�ent to [ne Norm tarouna ucrnvrs Lei Uncdkiwi vii 1Lr t'.r.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 18 of 18

Beverly, Trudy
From: Nora Zirps <[e-mail]>
Sent: Thursday, May 13, 2021 10:48 AM
To: Beverly, Trudy
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal
of IAA and LSA Reports
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Will do. It will likely be tomorrow.
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 1 Cell
From: Beverly, Trudy <[e-mail]>
Sent: Thursday, May 13, 2021 10:36 AM
To: Nora Zirps <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
Nora,
I didn't see a statement in the IAA nor LSA about the AST, aside from it being removed. If there was no evidence of
contamination, sent me a signed/seal short statement for the file.
Thanks,
Trudy
From: Beverly, Trudy
Sent: Thursday, May 13, 2021 10:20 AM
To: Nora Zirps <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
Hey Nora,
I named the site Camp Stewart Property in the RUST database (Incident #47761, UST Number MO-28509). See link
below for the Alternate Land Use Restriction NORP. Add a 5' buffer in the soil restriction area. Do you have an email
address for Dean Davidson with Professional Child Care Centers, Inc.?
Instructions and Form for Notice of Residual Petroleum with Alternate Land Use Restriction
https://deg.nc.gov/about/divisions/waste-management/ust/forms
1

Let me know if you have questions.
Trudy
beRrUmntKA Ummmental 4ua
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlyga,ncdenr. 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://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: hgps://dee .nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httDs://dea.nc. aov/about/divisions/waste-management/waste-management-rules-data/waste-management-gis-mans
File Review Procedures:
https:Hdeq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
https://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httos://files.nc.2oy/ncdeci/Waste%2OManagement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.vdf
htips:Hfiles.nc. gov/ncdeq/Wastc%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Nora Zirps [mailto:[e-mail]]
Sent: Tuesday, May 11, 20218:33 AM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
Just a quick note ... the rectangular area will not be situated due north to south. The area slants more like northeast to
southwest. The north -south terminology was used for simplicity.
Talk to you later this week.
Nora
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 Cell

From: Nora Zirps
Sent: Monday, May 10, 2021 5:42 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
I understand. Thank you, Trudy.
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 Cell
From: Beverly, Trudy <[e-mail]>
Sent: Monday, May 10, 2021 3:48 PM
To: Nora Zirps <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
Hey Nora,
It may be later in the week before I can review the information. I'll get back with you as soon as it's reviewed.
Have a great day,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
,."g0p,-dmwD--1E North Carolina Department of Environmental Quality
�tai �,/ UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy.Beverlygncdenr. -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://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: hgps://deq.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httos://deo.nc. gov/about/divisions/waste-manaizement/waste-management-rules-data/waste-management-ais-mans
File Review Procedures:
hops://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
htt2s://deg.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httos://fiiles.nc.2ov/ncdea/Waste%2OManagement/DWM/USTIWhatsNew/Final-Electronic-Document-Submittal-Policv.udf
https: Hfiles.nc. gov/ncdeg/Waste%20Mana2ement/D WM/UST/Corrective%2OAction/UST%2Ofile%20names%20for%2OLaserfiche. docx

From: Nora Zirps [ma iIto: [e-mail]]
Sent: Monday, May 10, 2021 12:31 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
I hope your husband's surgery went well, and he is recovering quickly.
I imagine today is a busy day for you playing catch-up, but I did want to reach out to you since I would like to discuss the
soil deed restriction for the subject site with you this week. It would be helpful to know if what we are proposing is
acceptable prior to us preparing the plat to avoid iterations. We feel it is necessary to record a plat to define the
location since the parcel is over 50 acres.
As you will see when you review the submitted IAA and LSA reports, we have completed a good bit of sample
analysis. Based on that, we would like to suggested using the following points to define a "rectangular" area
(approximately 14 ft x 25.5 ft) for the soil deed restriction bounded by the following points:
TMW-1 to the north
#2 EW to the east
B-1 to the south
#2 WW to the west
Soil sample results were below residential MSCCs at each of these locations, plus all but the TMW-1 location were also
below soil -to -groundwater MSCCs. The soil sample collected from the base of the approximate center of the area
exceeded residential MSCCs, resulting in the need for the soil deed restriction. Groundwater is below NC 2L
groundwater standards, so we do not plan to include a groundwater deed restriction.
I look forward to your response as to the acceptability of our proposed soil deed restricted area. If a telephone call is
warranted, please let me know what time would work for you.
Thank you.
Nora
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 Cell
From: Nora Zirps
Sent: Thursday, April 29, 2021 12:34 PM

To: Beverly, Trudy <[e-mail]>
Cc: Fred Matrulli <[e-mail]>; Cameron Caudle, Jr. ([e-mail])
<[e-mail]>; Chris Ward <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
Trudy,
I hope all goes well with your husband's surgery.
I look forward to speaking with you the week of May 10.
Nora
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 Cell
From: Beverly, Trudy <[e-mail]>
Sent: Thursday, April 29, 2021 12:32 PM
To: Nora Zirps <[e-mail]>
Cc: Fred Matrulli <[e-mail]>; Cameron Caudle, Jr. ([e-mail])
<[e-mail]>; Chris Ward <[e-mail]>
Subject: RE: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
THIS MESSAGE ORIGINATED OUTSIDE OF ESP ASSOCIATES, INC. USE CAUTION WHEN OPENING ATTACHMENTS, CLICKING LINKS, OR RESPONDING
TO REQUESTS FOR INFORMATION.
Hey Nora,
Document received. No need to mail a paper copy. I have meetings this afternoon and will be on leave tomorrow
through May 7t". I'll be back to working remotely on May 10th. Unfortunately, a discussion will have to wait until that
week. My husband is having surgery.
Have a wonderful day,
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
e:!5:!fD,1EQNorth Carolina Department of Environmental Quality
{e� UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlyk nc denr. 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://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.nc.gov/about/divisions/waste-mana2ement/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httns://dea.nc.2ov/about/divisions/waste-management/waste-management-rules-data/waste-management-eis-mans
File Review Procedures:
https:Hdeq.nc.gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
httns://deo.nc. eov/about/divi sions/waste-manaeement/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
https://files.ne.uov/nedeg/Waste%2OMana2ement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policy.pdf
https://files.nc. gov/ncdeq/Waste%20Mana2ement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Nora Zirps [mailto:[e-mail]]
Sent: Thursday, April 29, 2021 10:12 AM
To: Beverly, Trudy <[e-mail]>
Cc: Fred Matrulli <[e-mail]>; Cameron Caudle, Jr. ([e-mail])
<[e-mail]>; Chris Ward <[e-mail]>
Subject: [External] Camp Stewart Road Site - Residential Heating Oil UST Release - Submittal of IAA and LSA Reports
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
Attached please find the Initial Abatement Action (IAA) Report and the Limited Site Assessment (LSA) Report for the
approximate 550-galIon residential heating oil UST (designated UST-3) removed from the Camp Stewart Road Site located within
Mecklenburg County Tax Parcel No.11109204 in Charlotte, NC. You had indicated prior that electronic submittal of these reports was
sufficient.
These reports relate to the release reported to you on March 9, 2021, that we have discussed on several occasions.
Our next step in the process is to submit a draft Notice of Residual Petroleum and associated plat to you for
review. Based on the data that have been collected, I would like to discuss the proposed area for the soil deed
restriction with you. Please let me know a time that would be convenient for you.
Regards,
Nora
Nora A. Zirps, PE, RSM
ESP Associates, Inc.
7011 Albert Pick Road, Suite E
Greensboro, NC 27409
www.espassociates.com
[e-mail]
336.232.5213 Direct
336.334.7724 Office
336.420.6979 Cell