WS-3844_12787_CA_HRE_20230224_HRE-Request-SW-3

February 24, 2023 MEMORANDUM TO: Dave Lilley, Environmental Toxicologist, Division of Waste Management, 1646 Mail Service Center, Raleigh, NC 27699-1646 (FAX [phone]) FROM: Linda Estkowski, Winston-Salem Regional Office, UST Section SUBJECT: Request for Health Risk Evaluation of Water Supply Tracking ID: Bonnies Grocery, Incident # 12787
Enclosed please find the analytical results for a water sample collected on August 11, 2022 from the Harry Tilley water supply well, identified as SW-3, located at Lot 2 Baileytown Church & Hwy 89, Walnut Cove, 27052, Stokes County. Please perform a health risk evaluation and send the evaluations with your
recommendations and a copy of this memo to me. I will then forward the health risk evaluations and recommendations to any well users.
If you have questions or need additional information, please contact me at the address or telephone number below. Thank you for your assistance. Attachment(s): Analytical Results cc: WSRO

,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 27416-0265
22-228-0040
01168
Pyramid Environmental, Inc
PO Box 16265
Tim Leatherman
Greensboro
Received : 08/16/2022
Bonnie's Grocery
Revised Report Date: 09/01/2022
Original Report Date : 08/26/2022
Sample ID :
Lab No :
Sampled:SW-3
97200 Matrix:
8/11/2022 15:15
Aqueous
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
<1.00 µg/L 1.00 10.03,3-Dimethyl-1-butanol 1 08/25/22 05:11 6200BJLB
Surrogate: 4-Bromofluorobenzene 98.4 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: Dibromofluoromethane 97.4 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: 1,2-Dichloroethane - d4 98.8 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: Toluene-d8 99.6 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: 4-Bromofluorobenzene 98.4 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: Dibromofluoromethane 97.4 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: 1,2-Dichloroethane - d4 98.8 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: Toluene-d8 99.6 Limits: 70-130%08/25/22 05:111 JLB V23199
Qualifiers/
Definitions
Estimated valueJDilution FactorDF
Method Quantitation LimitMQL
Page 103 of 166
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 27416-0265
22-228-0040
01168
Pyramid Environmental, Inc
PO Box 16265
Tim Leatherman
Greensboro
Received : 08/16/2022
Bonnie's Grocery
Revised Report Date: 09/01/2022
Original Report Date : 08/26/2022
Sample ID :
Lab No :
Sampled:SW-3
97200 Matrix:
8/11/2022 15:15
Aqueous
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
6200 PT
6200B Prep Batch(es):V23129 08/24/22 09:00 V23198 08/24/22 09:00
<1.80 µg/L 1.80 10.0Acetone 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500
Benzene 1 08/25/22 05:11 V23130JLB
<0.210 µg/L 0.210 0.500Bromobenzene 1 08/25/22 05:11 V23130JLB
<0.420 µg/L 0.420 1.00Bromochloromethane 1 08/25/22 05:11 V23130JLB
<0.160 µg/L 0.160 0.500Bromodichloromethane 1 08/25/22 05:11 V23130JLB
<1.50 µg/L 1.50 5.00Bromoform 1 08/25/22 05:11 V23130JLB
<0.280 µg/L 0.280 1.00Bromomethane 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500n-Butylbenzene 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.500
sec-Butyl benzene 1 08/25/22 05:11 V23130JLB
<0.920 µg/L 0.920 2.00tert-Butyl benzene 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500Carbon Tetrachloride 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.500Chlorobenzene 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.500Chlorodibromomethane 1 08/25/22 05:11 V23130JLB
<0.430 µg/L 0.430 1.00Chloroethane 1 08/25/22 05:11 V23130JLB
<0.220 µg/L 0.220 0.500Chloroform 1 08/25/22 05:11 V23130JLB
<0.220 µg/L 0.220 0.500Chloromethane 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.5002-Chlorotoluene 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.5004-Chlorotoluene 1 08/25/22 05:11 V23130JLB
<0.500 µg/L 0.500 0.500Di-Isopropyl Ether (DIPE)1 08/25/22 05:11 V23130JLB
<1.10 µg/L 1.10 2.001,2-Dibromo-3-Chloropropane 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.5001,2-Dibromoethane 1 08/25/22 05:11 V23130JLB
<0.230 µg/L 0.230 0.500Dibromomethane 1 08/25/22 05:11 V23130JLB
Qualifiers/
Definitions
Estimated valueJDilution FactorDF
Method Quantitation LimitMQL
Page 104 of 166
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 27416-0265
22-228-0040
01168
Pyramid Environmental, Inc
PO Box 16265
Tim Leatherman
Greensboro
Received : 08/16/2022
Bonnie's Grocery
Revised Report Date: 09/01/2022
Original Report Date : 08/26/2022
Sample ID :
Lab No :
Sampled:SW-3
97200 Matrix:
8/11/2022 15:15
Aqueous
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
6200 PT
6200B Prep Batch(es):V23129 08/24/22 09:00 V23198 08/24/22 09:00
<0.220 µg/L 0.220 0.5001,2-Dichlorobenzene 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.500
1,3-Dichlorobenzene 1 08/25/22 05:11 V23130JLB
<0.210 µg/L 0.210 0.5001,4-Dichlorobenzene 1 08/25/22 05:11 V23130JLB
<1.20 µg/L 1.20 5.00Dichlorodifluoromethane 1 08/25/22 05:11 V23130JLB
<0.240 µg/L 0.240 0.5001,1-Dichloroethane 1 08/25/22 05:11 V23130JLB
<0.150 µg/L 0.150 0.5001,2-Dichloroethane 1 08/25/22 05:11 V23130JLB
<0.150 µg/L 0.150 0.5001,1-Dichloroethene 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.500cis-1,2-Dichloroethene 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500
trans-1,2-Dichloroethene 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.5001,2-Dichloropropane 1 08/25/22 05:11 V23130JLB
<0.130 µg/L 0.130 0.5001,3-Dichloropropane 1 08/25/22 05:11 V23130JLB
<0.210 µg/L 0.210 2.002,2-Dichloropropane 1 08/25/22 05:11 V23130JLB
<0.200 µg/L 0.200 0.5001,1-Dichloropropene 1 08/25/22 05:11 V23130JLB
<0.210 µg/L 0.210 0.500cis-1,3-Dichloropropene 1 08/25/22 05:11 V23130JLB
<0.150 µg/L 0.150 0.500trans-1,3-Dichloropropene 1 08/25/22 05:11 V23130JLB
<42.0 µg/L 42.0 200Ethanol 1 08/25/22 05:11 V23130JLB
<0.170 µg/L 0.170 0.500Ethylbenzene 1 08/25/22 05:11 V23130JLB
<0.350 µg/L 0.350 3.00Hexachlorobutadiene 1 08/25/22 05:11 V23130JLB
<0.380 µg/L 0.380 1.002-Hexanone 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500Isopropylbenzene 1 08/25/22 05:11 V23130JLB
<0.089 µg/L 0.089 0.5004-Isopropyl toluene 1 08/25/22 05:11 V23130JLB
<0.710 µg/L 0.710 5.00Methyl Ethyl Ketone (MEK)1 08/25/22 05:11 V23130JLB
Qualifiers/
Definitions
Estimated valueJDilution FactorDF
Method Quantitation LimitMQL
Page 105 of 166
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 27416-0265
22-228-0040
01168
Pyramid Environmental, Inc
PO Box 16265
Tim Leatherman
Greensboro
Received : 08/16/2022
Bonnie's Grocery
Revised Report Date: 09/01/2022
Original Report Date : 08/26/2022
Sample ID :
Lab No :
Sampled:SW-3
97200 Matrix:
8/11/2022 15:15
Aqueous
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
6200 PT
6200B Prep Batch(es):V23129 08/24/22 09:00 V23198 08/24/22 09:00
<0.140 µg/L 0.140 1.00Methyl tert-butyl ether (MTBE)1 08/25/22 05:11 V23130JLB
<0.078 µg/L 0.078 1.00
4-Methyl-2-Pentanone 1 08/25/22 05:11 V23130JLB
<0.330 µg/L 0.330 2.00Methylene Chloride 1 08/25/22 05:11 V23130JLB
<0.470 µg/L 0.470 1.00Naphthalene 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.500n-Propylbenzene 1 08/25/22 05:11 V23130JLB
<0.220 µg/L 0.220 0.500Styrene 1 08/25/22 05:11 V23130JLB
<1.60 µg/L 1.60 10.0tert-Butyl Alcohol (TBA)1 08/25/22 05:11 V23199JLB
<0.350 µg/L 0.350 10.0tert-Butyl formate (TBF)1 08/25/22 05:11 V23199JLB
<1.90 µg/L 1.90 10.0
tert-Amyl Alcohol (TAA)1 08/25/22 05:11 V23199JLB
<0.280 µg/L 0.280 10.0tert-Amyl Methyl Ether (TAME)1 08/25/22 05:11 V23199JLB
<0.160 µg/L 0.160 0.5001,1,1,2-Tetrachloroethane 1 08/25/22 05:11 V23130JLB
<0.160 µg/L 0.160 0.5001,1,2,2-Tetrachloroethane 1 08/25/22 05:11 V23130JLB
0.446 J µg/L 0.220 0.500Tetrachloroethene 1 08/25/22 05:11 V23130JLB
<0.220 µg/L 0.220 0.500Toluene 1 08/25/22 05:11 V23130JLB
<0.380 µg/L 0.380 0.5001,2,3-Trichlorobenzene 1 08/25/22 05:11 V23130JLB
<0.310 µg/L 0.310 0.5001,2,4-Trichlorobenzene 1 08/25/22 05:11 V23130JLB
<0.160 µg/L 0.160 0.5001,1,1-Trichloroethane 1 08/25/22 05:11 V23130JLB
<0.096 µg/L 0.096 0.5001,1,2-Trichloroethane 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500Trichloroethene 1 08/25/22 05:11 V23130JLB
<0.180 µg/L 0.180 0.500Trichlorofluoromethane 1 08/25/22 05:11 V23130JLB
<0.270 µg/L 0.270 0.5001,2,3-Trichloropropane 1 08/25/22 05:11 V23130JLB
<0.190 µg/L 0.190 0.5001,2,4-Trimethylbenzene 1 08/25/22 05:11 V23130JLB
Qualifiers/
Definitions
Estimated valueJDilution FactorDF
Method Quantitation LimitMQL
Page 106 of 166
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 27416-0265
22-228-0040
01168
Pyramid Environmental, Inc
PO Box 16265
Tim Leatherman
Greensboro
Received : 08/16/2022
Bonnie's Grocery
Revised Report Date: 09/01/2022
Original Report Date : 08/26/2022
Sample ID :
Lab No :
Sampled:SW-3
97200 Matrix:
8/11/2022 15:15
Aqueous
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
6200 PT
6200B Prep Batch(es):V23129 08/24/22 09:00 V23198 08/24/22 09:00
<0.180 µg/L 0.180 0.5001,3,5-Trimethylbenzene 1 08/25/22 05:11 V23130JLB
<1.00 µg/L 1.00 5.00
Vinyl Acetate 1 08/25/22 05:11 V23130JLB
<0.170 µg/L 0.170 0.500Vinyl Chloride 1 08/25/22 05:11 V23130JLB
<0.210 µg/L 0.210 0.500o-Xylene 1 08/25/22 05:11 V23130JLB
<0.420 µg/L 0.420 1.00m,p-Xylene 1 08/25/22 05:11 V23130JLB
<0.21 µg/L 0.210 0.500Xylene (Total)1 08/25/22 05:11 V23130
Surrogate: 4-Bromofluorobenzene 98.4 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: Dibromofluoromethane 97.4 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: 1,2-Dichloroethane - d4 98.8 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: Toluene-d8 99.6 Limits: 70-130%08/25/22 05:111 JLB V23130
Surrogate: 4-Bromofluorobenzene 98.4 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: Dibromofluoromethane 97.4 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: 1,2-Dichloroethane - d4 98.8 Limits: 70-130%08/25/22 05:111 JLB V23199
Surrogate: Toluene-d8 99.6 Limits: 70-130%08/25/22 05:111 JLB V23199
Qualifiers/
Definitions
Estimated valueJDilution FactorDF
Method Quantitation LimitMQL
Page 107 of 166