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HomeMy WebLinkAbout7407_Pitt_C&DLandfillInc_CDLF_Phase1_Phase2_Phase3_Permit_LFGMP_FID1664530_20220414Attachment Landfill Gas Monitoring Plan Site Study and Permit to Construct Application Egg Landfill, Inc. Phases 3 and 4 Greenville, North Carolina This page intentionally left blank. DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 Landfill Gas Monitoring Plan Phases 1, 2 and 3 Egg Landfill, Inc. Greenville, North Carolina Prepared for: COD Landfill, Inc. Greenville, North Carolina March 2022 VLIC.NU. E-iM (ENGINEERING) SMITH GARDNER 14 N. Boylan Avenue, Raleigh NC 27603 191g.B28.0577 4 PRINTED ON MI RECYCLED PAPER O = Smith Gardner, Inc. This document is intended for the sole use of the client for which it was prepared and for the purpose agreed upon by the client and Smith Gardner, Inc. DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 This page intentionally left blank. DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 Landfill Gas Monitoring Plan Phases 1, 2 and 3 CAD Landfill, Inc. Greenville, North Carolina Prepared For: COD Landfill, Inc. Greenville, North Carolina S+G Project No. EJE-20-1 ED ocuSigned by:can c— iZlcl�ct�5 RR305C97RFA4Fft Seth Rickerts, P.G. Staff Geologist DocuSigned by: ; ERA��R ti Joan A. Smyth, P.G. Senior Hydrogeologist March 2022 NCLIUC.Fim (ENGINEERING) SMITH GARDNER 14 N. Boylan Avenue, Raleigh NC 27503 1 919.028.0577 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 This page intentionally left blank. DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 EGO Landfill, Inc. Greenville, North Carolina Landfill Gas Monitoring Plan Table of Contents Page 1.0 INTRODUCTION........................................................................................................... 1 1.1 Regulatory Requirements - C&D Landfills.............................................................. 1 1.2 Guidance Document.................................................................................................. 2 1.3 Contact Information..................................................................................................2 1.3.1 Owner............................................................................................................2 1.3.2 Engineer........................................................................................................2 1.3.3 North Carolina Department of Environmental Quality................................3 1.4 Existing Site Conditions.............................................................................................3 1.4.1 Site Geology...................................................................................................3 1.4.2 Local Groundwater Regime..........................................................................3 2.0 MONITORING PROGRAM.............................................................................................. 4 2.5 Monitoring of Facility Structures..............................................................................4 2.6 Monitoring and Reporting.........................................................................................4 2.6.1 Frequency......................................................................................................4 2.6.2 Personnel......................................................................................................4 2.6.3 Equipment..................................................................................................... 5 2.6.4 Procedures....................................................................................................5 2.6.5 Precautionary Action Plan............................................................................6 2.6.6 Record Keeping.............................................................................................7 2.7 Maintenance.............................................................................................................. 7 3.0 CONTINGENCY PLAN................................................................................................... 8 3.1 Immediate Action Plan..............................................................................................8 3.1.1 Reporting and Documentation......................................................................8 3.2 Remediation Plan......................................................................................................8 FIGURES Figure 1 Existing Landfill Gas Monitoring Locations Figure 2 Flowchart of Methane Monitoring Requirements APPENDIX Appendix A Reporting Forms CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Table of Contents Page i DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 This page intentionally left blank. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Table of Contents Page ii DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 1.0 INTRODUCTION This Landfill Gas (LFG) Monitoring Plan (plan) was prepared by Smith Gardner, Inc. to describe the LFG monitoring program at C&D Landfill, Inc. INC Solid Waste Permits 7407-CDLF-2001 and 7407-CDLF-2009), which is located at 802 Recycling Lane in Greenville, North Carolina. The facility contains two active, unlined construction & demolition (C&D) landfill units. The Facility was developed in two non-contiguous footprints, Phases 1 and 2 approximately midway between US 264, i.e., a localized topographic divide, and Grindle Creek. The phases became operational in May 2001 and August 2009, respectively. Phase 1 was the regional repository for flood -damage debris after Hurricane Floyd in 1999. Phase 2 was a staging area, where flood -debris was stored temporarily. Both areas were used for agriculture, and a former railroad corridor traverses the site, including the northern Phase 2 footprint. A permit to begin construction on Phase 3 is currently being drafted. Upon approval, Phase 3 will also be included under this Landfill Gas Monitoring Plan. This plan describes the necessary procedures to satisfy applicable regulatory requirements (see Section 1.1) for landfill gas monitoring. The Engineer has utilized the best available site data, practices, experience, and judgment to develop this plan. However, the plan may require modifications over time to accommodate changing landfill conditions, changing receptors in areas adjacent to and around the landfill, or other conditions that cannot be fully anticipated. Uncontrolled migration of LFG (particularly methane (CH4)) can result in, loss of life, injury, loss of property, vegetative damage, and intolerable odors. Landfill monitoring includes exposure to explosive gases. Monitoring personnel should be specifically trained in the management and response for situations such as fire or explosion and confined space entry and possess an awareness of changing conditions around the landfill. Note that this plan does not address landfill gas collection and control, air quality, or other related landfill gas regulations or requirements which may be applicable to this site at present or in the future. 1.1 Regulatory Requirements — CEO Landfills Rule 15A NCAC 13B .0544(d) of the North Carolina Solid Waste Management Rules requires the following for facilities having a C&D landfill: • Owners or operators of C&D landfill units must ensure that: o the concentration of methane gas or other explosive gases generated by the facility does not exceed 25% of the lower explosive limit (LEL) for methane (1.25% methane) in on -site facility structures (excluding gas control or recovery system components); o the concentration of methane gas or other explosive gases does not exceed the LEL for methane (5% methane) at the facility property boundary; and o the facility does not release methane gas or other explosive gases in any concentration that can be detected in off -site structures. CGD Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 1 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 • Owners or operators of C&D landfill units must implement a routine methane monitoring program and perform monitoring on at least a quarterly basis. • If regulatory limits for methane gas concentrations are exceeded, a contingency plan must be implemented for the protection of human health and safety. 1.2 Guidance Document This plan was developed generally following the Landfill Gas Monitoring Guidance document prepared by the North Carolina Department of Environmental (NC DEQ), Division of Waste Management (DWM)'. 1.3 Contact Information Correspondence and questions concerning this plan should be directed to the appropriate contact below: 1.3.1 Owner C&D Landfill, Inc. 802 Recycling Lane Greenville, NC 27834 Phone: (252) 752-8274 Contacts: Judson Whitehurst, Landfill Owner iudson.ejerecycling(agmail.com 1.3.2 Engineer Smith Gardner, Inc. 14 N. Boylan Avenue Raleigh, North Carolina 27603 Phone: (919) 828-0577 Contacts: Joan A. Smyth, P.G., Senior Hydrogeologist 0oan(asmithgardnerinc.com Michael W. Brinchek, P.E., Project Manager mikefasmithgardnerinc.com NC DENR DWM (2010), "Landfill Gas Monitoring Guidance", NC DENR DWM Solid Waste Section, November 2010. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 2 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 1.3.3 North Carolina Department of Environmental Duali Division of Waste Management (DWM) - Solid Waste Section: North Carolina DEQ — Raleigh Central Office (RCO) 217 W Jones Street Raleigh, North Carolina 27603 Phone: (919) 707-8200 Contact: Ms. Jaclynne Drummond iaclvnne.drummondfdncdenr.aov 1.4 Existing Site Conditions The facility is located approximately twelve miles east of downtown Greenville on US-264 E. Area development is mixed agricultural, industrial, and rural residential. The permitted facility is bordered to the north by US-264 E. and to the south by Grindle Creek. A mix of wooded marshlands and agricultural lands border the eastern and western boundaries of the facility. Grindle Creek and smaller streams create a natural barrier to LFG migration to the south and west. Ground surface elevations range from approximately El. 16 (feet above mean sea level) along Grindle Creek to El. 120 at the top of the Phase 2B cell. 1.4.1 Site Geology Historical literature and available geologic maps indicate that C&D Landfill, Inc. sits within the NC Coastal Plain. The coastal plain is characterized as an eastward thickening wedge of sedimentary layers that alternate between sandy aquifers an aquitards. Information taken from The Geologic Map of North Carolina, 1985 shows that the C&D landfill is underlain by the Yorktown Formation, which is described as "fossillifferous clay with varying amounts of fine-grained sand, silty sand, sandy silt, silty clay, and blueish gray shell material" 1.4.2 Local Groundwater Reoime Ground water depths generally range from 3 ft to 9 ft below ground surface (bgs) across the facility. Ground water generally flows south and west toward Grindle Creek to the southwest of the site. There are minor seasonal variations in the flow pattern, but overall flow direction is consistent. The site is surrounded by wetlands and perennial streams on the east, south and west sides. The shallow groundwater in the wetlands and surface water in the streams is a natural barrier to landfill gas migration. This has been considered in evaluating the proposed network. CGD Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 3 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 2.0 MONITORING PROGRAM The plan contained herein includes landfill gas monitoring wells to monitor subsurface landfill gas migration. There are no structures close enough to the landfills to warrant structure monitoring. The current LFG monitoring network, consisting of 6 landfill gas monitoring wells, is shown on Figure 1, and the table below. Probe Relative Location GP-1 Northern edge of Phase 2 GP-2 Northern edge of Phase 2 GP-3 Northern edge of Phase 2 GP-4 Northern edge of Phase 2 GP-10 North of Phase 1 GP-11 East of Phase 2 GP-12 Northeast of (proposed) Phase 3 GP-13 Northwest of (proposed) Phase 3 2.5 Monitoring of Facility Structures No structures are close enough to the landfills to warrant structure monitoring at this time. If landfill gas exceedances are noted in the LFG monitoring network, structural monitoring will be considered, if necessary. 2.6 Monitoring and Reporting Monitoring and reporting of LFG concentrations will be performed as outlined below. 2.6.1 Frequency Routine LFG monitoring will be conducted on a quarterly basis. 2.6.2 Personnel LFG monitoring will be performed by personnel who are familiar with the requirements of this plan and who are trained in LFG hazards and explosive gas meter use. As practical, a designated technician will be assigned to regular LFG monitoring duty. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 4 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 2.6.3 Equipment An Elkins Earthworks, LLC ENVISION infrared portable gas analyzer (or equivalent) will be used to collect measurements from the landfill gas monitoring network. This analyzer, which is calibrated to methane (CH4), operates using the infrared spectral property of methane to measure concentrations in air. Measurements of oxygen (02) and carbon dioxide (CO2) will also be made with this meter. Additionally hydrogen sulfide (H2S) will be monitored. This meter may be used in oxygen deficient areas (less than 10% 02) since oxygen is not required for a chemical combustion of flammable gases within the meter. On the day of monitoring, prior to monitoring activities, the meter(s) will be field calibrated. Additionally, all monitoring equipment should be regularly calibrated in accordance with manufacturer's specifications and operated only as instructed. 2.6.4 Procedures Prior to each monitoring event, the portable gas analyzer will be calibrated with a known calibration standard in accordance with manufacturer's recommendations. General information related to the monitoring event, equipment used, calibration procedures, weather conditions, and results for each monitoring event will be recorded on the landfill gas monitoring data form (see Appendix A). The following steps outline the procedure for the monitoring of LFG wells and facility structures: • Check calibration date on the meter and calibrate according to manufacturers instructions; allowing equipment to warm up properly prior to use, per manufacturers direction. • Purge sample tube for one minute before monitoring. LFG Monitoring Wells: o Connect instrument tubing to sample port on the monitoring well without removing the cap. o Open the valve and record both the initial and stabilized methane concentrations. A stabilized concentration will not vary more than 0.5 percent by volume on the instrument's scale. Also record the oxygen concentration (at two percent per volume or less to indicate air is not being drawn into the system and providing false readings) and the carbon dioxide concentration. o Close the valve and disconnect the tubing. o Record monitoring data on the LFG monitoring data form provided in Appendix A. o If any methane concentration is greater than 50% of the LEL (2.5% CH41, monitoring personnel should implement the Precautionary Action Plan (see Section 2.3.5). CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 5 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 o If both initial and stabilized methane concentrations are less than 50% of the LEL (2.5% CH4), move to next LFG monitoring well. Structures: o Walk through the facility structure with a methane analyzer and monitor the perimeter wall interface of the structure, the floor to wall interface in hallways and rooms, and any floor penetrations in the structure. Record the initial and stabilized methane concentrations, oxygen concentration and carbon dioxide concentration. o Record monitoring data on the LFG monitoring data form provided in Appendix A. o Notify the Solid Waste Operations Manager and the Engineer for any methane concentration greater than 5% of the LEL and any H2S concentration greater than 10 ppm. IFA STABILIZED METHANE CONCENTRA TION IS GREA TER THAN 100% OF THE LEL IN A LFG MONI TORINO WEL L OR GREA TER THAN 25% OF THE LEL OR HYDROGEN SULFIDE IS GREATER THAN 20 PPM IN A FACILITY STRUCTURE, THE FOLLOWING ACTIONS WILL BE IMPLEMENTED: 1) Recalibrate monitoring equipment and confirm results. 2) If results are confirmed, IMMEDIATELY contact the Owner and Consulting Engineer. 3) Implement the Compliance Action Plan located in Section 3.1. A flowchart of propsed action for noted exceedances is presented as Figure 2. 2.6.5 Precautionary Action Plan If an initial or stabilized methane concentration is equal to or greater than 50% of the LEL in a LFG monitoring well, monitoring personnel should perform the following additional steps at this location: • Measure gas pressure in the well head (in inches of water) using magnehelic gauge or other appropriate metering device. • Record at least one additional methane and/or hydrogen sulfide concentration measurement, inside the well just below the top of casing. • Evaluate the surrounding area for potential receptors to or signs of LFG migration. LFG can stress vegetation and can kill trees and grass by root asphyxiation. Note stressed/dead vegetation areas on the monitoring form. • Notify the Owner and the Engineer for further evaluation. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 6 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 2.6.6 Record Keeping Routine LFG monitoring events will be documented on the LFG monitoring data form provided in Appendix A. Completed forms will be placed in the landfill operating record located at the landfill office at 802 Recycling Lane, Greenville, North Carolina 27834. These forms will be available for review by DWM personnel on request. Documentation of any contingency plan actions (see Section 3.0) will also be kept in the operating record. 2.7 Maintenance Periodic maintenance and site observations will be conducted routinely to address monitoring program components (at a minimum): • Maintain access to LFG monitoring locations. • Perform LFG monitoring well maintenance (maintain well locks, steel casing, concrete pad, etc.). • Observe landfill cover conditions, areas of dead vegetation, leachate seeps, odors, etc. as indications of potential LFG-related problems. Note deficiencies on the monitoring forms and report to the Owner for repair or replacement as necessary. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 7 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 3.0 CONTINGENCY PLAN If a stabilized methane concentration is greater than 100% of the LEL in a LFG monitoring well or greater than 25% of the LEL or if hydrogen sulfide is greater than 20 ppm in a facility structure, Site Personnel will perform both an immediate action and plan and a remediation plan as described below and as summarized on Figure 2. 3.1 Immediate Action Plan The Solid Waste Operations Manager will perform the following actions for the protection of human health and safety: 1) Evacuate affected facility structures and the immediately surrounding area. 2) Determine nearby potential receptors (facility and off -site structures). 3) Perform monitoring in any other facility structure near the monitoring location having the high concentration. 4) Verbally notify the Owner, or his/her designee. 5) Verbally notify the NCDEQ DWM (see Section 1.1) as soon as practical. 6) Investigate and identify the potential source(s) and conduit(s) for LFG migration that may have caused the high concentration (i.e. the path the LFG may be following to the monitoring location). 7) Identify the LFG extent using bar hole punch sampling methodology or other applicable alternative method as practical. 8) As appropriate, evaluate corrective actions to control methane concentrations in structures surrounding the landfill site. 3.1.1 Regortlno and Documentation Within seven days of the high methane concentration detection, site personnel will prepare and submit an Environmental Monitoring Reporting Form (see Appendix A) with the monitoring event results to the DWM. Site Personnel will also place a description of the actions performed to protect human health in the operating record. 3.2 Remediation Plan Within sixty days of a high methane concentration detection, a remediation plan describing the problem nature, extent, and proposed remedy will be prepared and submitted to NCDEQ for approval. Following approval, the plan will be implemented and a copy will be placed in the operating record. The DWM will also be notified once the plan has been implemented. An extension may be requested from the DWM depending on severity of the situation. CH Landfill, Inc. Landfill Gas Monitoring Plan July 2021 Page 8 DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 Figures Landfill Gas Monitoring Plan — Phases 1, 2 and 3 CGD Landfill, Inc. Greenville, North Carolina DocuSign Envelope ID: ECOE65B7-3C24-4AA3-8A77-FAB2631 D56132 This page intentionally left blank. DocuSign Envelope ID: 560557E8-52C6-4A1A-B027-6BA6EC58FB6B DocuSign Envelope ID: 560557E8-52C6-4A1A-B027-6BA6EC58FB6B 2 a 0 N N N 0 N OD 1. IMMEDIATELY: TAKE STEPS TO ENSURE PROTECTION OF HUMAN HEALTH AND SAFETY SMITH+ NOTIFY THE ENGINEER AND GARDNER DIVISION WITHIN 24 HOURS EVALUATE THE NEED FOR ADDITIONAL MONITORING [=MONITORING FREQUENCY RTERLY METHANE CONCENTRATION MUST NOT EXCEED: 1. 25% OF THE LEL IN FACILITY STRUCTURES; AND 2. 100% OF THE LEL AT THE FACILITY PROPERTY BOUNDARY. IF METHANE CONCENTRATION EXCEEDS EITHER OF THE ABOVE, THE OWNER MUST: i RECALIBRATE METER AND CONFIRM READINGS (SEE SECTION 2.3.4 OF LFG MANAGEMENT PLAN) IF CONFIRMED READINGS EXCEED LIMITS, (SEE SECTION 3.0 OF THE LFG MANAGEMENT PLAN) AND:: 2. WITHIN 7 DAYS. PLACE THE METHANE READINGS AND STEPS TAKEN TO PROTECT HUMAN HEALTH IN THE OPERATING RECORD LANDFILL GAS MONITORING REQUIREMENTS FLOW CHART CRD LANDFILL, INC. GREENVILLE, NC C.T.J. I J.A.S. I N.T.S WITHIN 60 DAYS: PREPARE A REMEDIATION PLAN. SUBMIT PLAN TO NCDENR FOR APPROVAL. UPON APPROVAL, IMPLEMENT PLAN. PLACE A COPY OF THE REMEDIATION PLAN IN THE OPERATING RECORD, AND 1 NOTIFY THE DIVISION THAT THE PLAN HAS BEEN IMPLEMENTED NO LIC. NO. F-1370 [ENGINEERING] SC COA NO. C01488 SMITH+GARONER 14 N. Boylan Avenue, Raleigh NC 27603 1919.828.0577 1526 Richland St., Columbia SC 29201 Apr 2021 I EJE 20-1 I 2 I EJE-A0010 © 2021 Smith Gardner, Inc. DocuSign Envelope ID: 560557E8-52C6-4A1A-B027-6BA6EC58FB6B Appendix A Reporting Forms Landfill Gas Monitoring Plan — Phases 1, 2 and 3 COD Landfill, Inc. Greenville, North Carolina DocuSign Envelope ID: 560557E8-52C6-4A1A-B027-6BA6EC58FB6B This page intentionally left blank. DocuSign Envelope ID: 560557E8-52C6-4A1A-B027-6BA6EC58FB6B NC Division of Waste Management - Solid Waste Section Landfill Gas Monitoring Data Form Notice: This form and any information attached to it are 'Public Records" as defined in NC General Statute 132-1. As such, these documents are available for inspection and examination by any person upon request (NC General Statute 132-6). Facility Name: Permit Number: Sampling Date: NC Landfill Rule (.0500 or.1600): Sample Collector Name & Position: Gas Meter Type & Serial Number: Field Calibration Date & Time: Field Calibration Gas Type (15115 or 35/5 Gas Meter Pump Rate: Gas Meter Calibration Date: eld Calibration Gas Canister Expiration Date: Ambient Air Temperature: Barometric Pressure (in. or mm Hg): Weather Conditions: Instructions: Under "Location or LFG Well", list monitoring well # or describe monitoring location (e.g., inside field office). Attach a test location map or drawing. Report methane readings as both % LEL and % CH4 by volume. Convert % CH4 (by volume) to % LEL as follows: % methane (by volume)/20 = % LEL. *Hydrogen Sulfide (H2S) gas monitoring may be required for Construction & Demolition Landfills (CDLFs). See individual permit conditions and/or Facility LFG monitoring plan. Location or LFG Well ID S ample Tube Purge Time of Day Time Pumped (sec) Initial % LEL Stabilized % LEL % CH4 ( volume ) % 02 (volume) % CO2 (volume) % H2S* (volume) NOTES NOTE: If needed, attach additional data forms to include additional LFG monitoring data locations for the facility. ACTION LEVELS: Methane: >1.25% by volume (inside structures) AND >5% by volume (at facility boundary) Hydrogen Sulfide: >1% by volume (inside structures) AND >4% by volume (at facility boundary) Certification To the best of my knowledge, the information reported and statements made on this data submittal and attachments are true and correct. I am aware that there are significant penalties for making any false statement, representation, or certification including the possibility of a fine and imprisonment. SIGNATURE TITLE Revised — March 6, 2017 DocuSign Certificate Of Completion Envelope Id: 560557E852C64A1AB0276BA6EC58FB6B Subject: Please DocuSign: FINAL C&D Disposal, Inc. LFG Monitoring Plan April 2021.pdf Source Envelope: Document Pages: 21 Signatures: 2 Certificate Pages: 2 Initials: 0 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) Record Tracking Status: Original 7/23/2021 1:59:03 PM Signer Events Seth C. Rickerts seth@smithgardnerinc.com Smith Gardner, Inc. Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Joan Smyth joan@smithgardnerinc.com Vice President Smith Gardner, Inc. Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Editor Delivery Events Agent Delivery Events Intermediary Delivery Events Certified Delivery Events Carbon Copy Events Witness Events Notary Events Envelope Summary Events Envelope Sent Certified Delivered Signing Complete Holder: Joan Smyth joan@smithgardnerinc.com Signature ED S'g d by: ah 3B8305CMEME6... Signature Adoption: Pre -selected Style Using IP Address: 98.121.55.254 Signed using mobile cyty�:,y[D111Sign_S1d EBA711F 8 Signature Adoption: Pre -selected Style Using IP Address: 24.106.183.110 Signature Status Status Status Status Status Signature Signature Status Hashed/Encrypted Security Checked Security Checked Status: Completed Envelope Originator: Joan Smyth 14 N. Boylan Ave Raleigh, NC 27603 joan@smithgardnerinc.com IP Address: 24.106.183.110 Location: DocuSign Timestamp Sent: 7/23/2021 2:04:57 PM Viewed: 7/23/2021 2:05:38 PM Signed: 7/23/2021 2:05:45 PM Sent: 7/23/2021 2:05:46 PM Viewed: 7/23/2021 2:06:29 PM Signed: 7/23/2021 2:06:36 PM Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Timestamps 7/23/2021 2:04:57 PM 7/23/2021 2:06:29 PM 7/23/2021 2:06:36 PM Envelope Summary Events Completed Status Security Checked Timestamps 7/23/2021 2:06:36 PM Payment Events Status Timestamps