WS-96265_96900_CA_UST-62_20221222

Initial Assessment Report
United Road Diesel Fuel Release Incident; Burlington, NC
Page 2

B. Background and Initial Response Activities
On September 28, 2022, a tractor-trailer operated by United Road and Pilot Transport (United) was
involved in an accident alongside Westbound Interstate 40/85, near exit #143, in Burlington, Alamance
County, North Carolina. As a result of the incident, approximately 60 gallons of diesel fuel were released
from one of the vehicle’s saddle fuel tanks to paved and unpaved surfaces of the roadway shoulder. The
approximate location of the site is graphically presented on Figure 1 and Figure 2 (included in Appendix
A) and is situated at approximate coordinates 36.064921278 N and -79.45789998 W. A map of the area
impacted is included as Figure 3.

On the day of the incident, United contacted ERTS and notified them of the incident. ERTS contracted
First Call Environmental (FCE) for spill response services. Personnel and equipment from FCE
responded to the site on the date of the incident. Response activities included the removal of diesel fuel,
and the deployment of granular absorbents and absorbent pads.

After the response activities were completed, additional diesel fuel impacted soil remained at the incident
location and needed to be appropriately remediated. Due to highway safety and traffic concerns, the
NCDOT requested that any soil excavation be conducted during non-daylight hours. On October 19,
2022, FCE subcontracted Highlands Environmental Solutions, Inc. (HES) to provide environmental
oversight, and sampling services.

A site-specific health and safety plan (HASP) was developed by HES for site remediation activities. A
copy of the HASP is included in Appendix B. FCE also contacted the North Carolina 811 service to
locate and identify any potential underground utilities at the site.

On September 29, 2022, ERTS completed and submitted an UST-62 (24-Hour Notification of Discharge
Form) document to the North Carolina Department of Environmental Quality (NCDEQ), Fayetteville
Regional Office, reporting the discovery of the release. A copy of this submittal is included in Appendix
C

C. Free Product Investigation and Recovery
As noted in Section B, on the day of the incident, FCE personnel conducted emergency abatement
activities included the removal of approximately 48 gallons of diesel fuel product from the grassy surface,
and the deployment of granular absorbents, absorbent pads, and hydrocarbon socks along areas of
impact. At the completion of the recovery activities, the area of impacted soil was covered with plastic
sheeting pending excavation activities. The recovered fuel was containerized in one 55-gallon steel drum
and was transported to Spectra Environmental Group in Maryville, Tennessee for disposal. Recovered
sorbents were containerized in one 55-gallon drum and transported to the same facility for disposal.
Copies of waste disposal documentation is included in Appendix D.

D. Groundwater and Surface Water Investigation
As noted above, the released diesel fuel did not migrate beyond the localized areas of impact. The
closest surface water body is a tributary of Gum Creek located approximately 558 feet West of the
release location.

Groundwater was not encountered during initial response activities; therefore, a groundwater
investigation was not performed during site activities.

E. Initial Response and Abatement Activities.
Initial response and abatement actions are summarized above.

Initial Assessment Report
United Road Diesel Fuel Release Incident; Burlington, NC
Page 3

F. Excavation of Petroleum Impacted Soil
On October 25 and 26 , 2022, personnel from HES and FCE mobilized to the site and conducted soil
excavation activities. Select photographs of the site and remediation activities are included in Appendix
E. The ultimate objective for this phase of abatement was to remove petroleum-impacted soils and
collect post-excavation soil samples for laboratory analysis.

FCE utilized a track mounted mini excavator to excavate petroleum-impacted soil. Field indicators were
utilized (i.e., staining, and/or odor) and HES collected random soil samples from excavated areas to field
screen for organic vapors using a photoionization detector (PID – Mini Rae 3000). To field screen the
samples, an aliquot of soil was placed in a clean, labeled, zip-lock bag and allowed to volatilize for
approximately 10 minutes. At the end of the volatilization period, the sampling probe for the PID was
inserted into the bag to screen for the presence of organic vapors. Utilizing these techniques, HES
determined the estimated final limits of the horizontal and vertical extent of impact.

The extent of the excavation resulted in a rectangular shape, measuring approximately 76 feet long, by 6
feet in width with depths ranging from 0.5 to 1.5 feet below the land surface (bls). Following completion of
the excavation, HES personnel collected four sidewall post-excavation confirmation soil samples (“SW-1”
through “SW-4”) and four floor post excavation samples (“FL-1” through “FL-4”) for laboratory analysis. A
diagram depicting the excavation and sample collection locations is included as Figure 4. Select
photographs of the remediation activities are included in Appendix E.

Upon collection, the confirmation samples were split into two aliquots. The first aliquot was placed in a
clean zip-lock bag and field screened for organic vapors using the previously described methodology.
The second aliquot was placed in labeled, laboratory-supplied containers (pre-preserved) and maintained
on ice pending delivery to the analytical laboratory. At the conclusion of the field activities, on October
26, 2022, the soil samples were delivered via overnight courier to SGS North America, Inc., in Orlando,
FL. The samples were analyzed for diesel range organics (DRO), using Method 3541/8015; and gasoline
range organics (GRO), using Method 5035/8015. Sufficient sample volume was also collected and
submitted for potential expanded analysis of volatile organic compounds (VOCs), by Method 8260; and
semi-volatile organic compounds (SVOCs), by Method 8270 if needed.

As a result of the soil excavation activities, approximately 11.25 tons of impacted soils were transported
off site to Environmental Soils Inc, located in Lattimore, N.C. for final disposal. A copy of the waste
manifests are included in Appendix D.

A summary of the soil analytical data is presented in Table 1 included as Appendix F. The complete
laboratory analytical data reports and chain-of-custody records for all samples are included as Appendix
G.

Laboratory analysis of the soil samples resulted in the detection of DRO in all eight samples at
concentrations ranging from 4.0 mg/kg, to 97.8 mg/kg. GRO was not detected at concentrations greater
than the detection limit in all eight samples analyzed. None of the reported concentrations of DRO
exceeded the NCDEQ State Action Limits of 100 mg/kg.

G. Conclusions and Recommendations
As a result of a tractor trailer accident on September 28, 2022, a release of approximately 60 gallons of
diesel fuel impacted the unpaved and paved surfaces of the roadway shoulder alongside Westbound
Interstate 40/85, near Exit #43, in Burlington, Alamance County, North Carolina.

On the day of the incident, United contacted ERTS regarding the incident, and ERTS contacted FCE to
conduct emergency response activities. Initial response activities included the removal of approximately
44 gallons of diesel fuel, and the deployment of granular absorbents, and absorbent pads.

Initial Assessment Report
United Road Diesel Fuel Release Incident; Burlington, NC
Page 4

On October 25 and 26, 2022, personnel from HES, and FCE mobilized to the site and conducted soil
removal/abatement activities. A total of 11.25 tons of petroleum impacted soils were removed for
disposal.

Laboratory analysis of the eight post-excavation soil samples did not result in the detection of DRO or
GRO at concentrations greater than their respective NCDEQ State Action Limits.

All appropriate environmental remediation activities have been completed, and all waste materials have
been properly disposed. Based on the results of this investigation, HES concludes that the subject
release has been properly remediated and does not pose a threat to the environment or human health
and safety. HES recommends that this incident receive regulatory closure, and that correspondence
documenting no further action required notification be forwarded to United Road for this incident.

491

APPENDIX A

Drawing / Project Name
Client
Project # Date
N
Base diagram from Google Maps
Incident Location Diagram
Westbound Interstate 40-US (near Exit 143)
Alamance County, NC
First Call Environmental / United Road and Pilot Transport
Incident
Location
DB Fig. Scale
340049
NTS
Nov 2022
1
PM PG
RS
PE
JB JB

Drawing / Project Name
Client
Project #
DB Fig. Scale
Date
N
Base diagram from USGS Topographic Quadrangle; Burlington, NC
Topographic Location Diagram
Diesel Fuel Spill Assessment
Burlington, Alamance County, NC
First Call Environmental / United Road and Pilot Transport
340049
JBNot to Scale
Nov 2022
2
PM PG
RS
PE

JB
Incident Location

Drawing / Project Name
Client
Project # Date
N
Base diagram from Google Earth
Area Diagram
Diesel Fuel Spill Assessment
Burlington; Alamance County, NC
First Call Environmental / United Road and Pilot Transport
Incident
Location
DB Fig. Scale
340049
As Shown
Nov 2022
3
PM PG
RS
PE
JB JB

feet 
Approximate Scale
0 275 550
Limits of Excavation: (76' by 6' at depth of 0.5' /1.5') US Hwy 70/Interstate 40 (West Bound)SW-1Edge of PavementConcrete MedianFL-11.5' Depth1.0' Depth0.5' DepthSW-4SW-3SW-2FL-4FL-3FL-2PG:DB:Project Number:Date:Scale:PE:PM:Drawing NameSite / Client NameFig.LegendApproximate Scale02040NfeetExcavated Area 1.0' DepthSoil Sample LocationExcavation Area 1.5' DepthExcavation and Sample Location DiagramDiesel Fuel Release IncidentBurlington, NCFirst Call Environmental / United RoadJBRSRS340049November 2022As Shown4Excavated Area 0.5' Depth
491

APPENDIX B

Highlands Environmental Solutions, Inc.

HEALTH AND SAFETY PLAN

For Site Activities at:

Diesel Fuel Release
I-40W @ Exit 143
Burlington, NC

October 2022

Minimum Level of Protection at this site is Level D
Contaminants of Concern are Petroleum Hydrocarbons

Robert Shaut
Project Manager

The information in this HASP is provided solely for the protection of the health and safety of Highlands
Environmental Solutions employees and subcontractors working under the direct supervision and control of
Highlands Environmental Solutions on this project. Highlands Environmental Solutions assumes no liability
for, or responsibility to, any other parties for the accuracy or completeness of the information contained herein
for any use or reliance upon this HASP by any other party.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 2

IN THE EVENT OF ANY EMERGENCY, CONTACT PROJECT MANAGER OR
HEALTH AND SAFETY REPRESENTATIVE
SITE EMERGENCY FORM
Contaminants of Concern: Petroleum Hydrocarbons
Minimum Level of Protection: Level D

Do not endanger your life. Survey the situation before taking any action.
Highlands Environmental Solutions Office
Telephone: [phone]
Site Location Address: I-40W @ Exit 143; Burlington, NC
Telephone Located at: HES Personnel (cellular phone)

EMERGENCY
PHONE NUMBERS

Ambulance: 911
Fire: 911
Police: 911
Hospital Name: Cone Health
Hospital Phone: [phone]
Project Manager: Robert Shaut (984-289-9992)
Health and Safety Specialist: Joe Beaman (919-414-7081)
Client Contact: Taylor Hartman (First Call) (804-305-1171
Poison Control: [phone]
State Agency: NCDEQ (WSRO) 336-771-5000

UTILITY MARKER EMERGENCY TELEPHONE NUMBERS

Utility Color Code

Telephone Number
Water
Gas
Electric
Telephone
Cable
Sewer
Blue
Yellow
Red
Orange
Orange
Green
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
Dig Safe Telephone Number: [phone]
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 3

HOSPITAL LOCATION MAP

Directions:
West on I-40; Exit onto Huffman Mill Road; Turn
Left on Huffman Mill Road; Continue to hospital.
Hospital Information:
Name: Cone Health
Address: 1240 Huffman Mill Road
City, State: Burlington, NC
Phone: [phone]
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 4

FIRST AID FOR PETROLEUM HYDROCARBON EMERGENCIES

Ingestion: DO NOT INDUCE VOMITING. Call Poison Control; follow instructions. Administer
cardiopulmonary resuscitation (CPR), if necessary. Seek medical attention.

Inhalation: Remove person from contaminated environment. DO NOT ENTER A CONFINED
SPACE TO RESCUE SOMEONE WHO HAS BEEN OVERCOME UNLESS
PROPERLY EQUIPPED AND A STANDBY PERSON IS PRESENT. Administer
CPR if necessary. Seek medical attention.

Skin Contact: Brush off dry material, remove wet or contaminated clothing. Flush skin thoroughly
with water. Seek medical attention if irritation persists.

Eye Contact: Flush eyes with water for 15 minutes. Seek medical attention.

Exposure Symptoms: Headache, dizziness, nausea, drowsiness, irritation of eyes, nose, throat, breathing
difficulties.

Contingency Plan: Report incident to Project Manager (PM) after emergency procedures have been
implemented.

RESPONDER MUST HAVE A CURRENT CERTIFICATE TO ADMINISTER FIRST AID OR CPR

1. Survey the situation. Do not endanger your own life. DO NOT ENTER A CONFINED SPACE TO
RESCUE SOMEONE WHO HAS BEEN OVERCOME UNLESS PROPERLY EQUIPPED AND A
STANDBY PERSON IS PRESENT.

2. Call 911 (if available) or the fire department IMMEDIATELY. Explain the physical injury, chemical
exposure, fire, or release.

3. Decontaminate the victim without delaying life-saving procedures.

4. If the victim's condition appears to be noncritical, but seems to be more severe than minor cuts,
he/she should be transported to the nearest hospital by trained Emergency Medical Services (EMS)
personnel: let the doctor assume the responsibility for determining the severity of the injury. If the
condition is obviously serious, EMS must transport the victim.

5. Notify the PM.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 5

EMERGENCY FIRST AID PROCEDURES
To Stop Bleeding CPR

1. Give medical statement.
2. Assure airway, breathing, and
circulation.
3. Use DIRECT PRESSURE over the
wound with clean dressing or your
hand (use nonpermeable gloves).
Direct pressure will control most
bleeding.
4. Bleeding from an artery or several
injury sites may require DIRECT
PRESSURE on a PRESSURE
POINT. Use pressure points for
30 - 60 seconds to help control
severe bleeding.
5. Continue primary care and seek
medical aid as needed.
1. Call for help.
2. Arousal: check for consciousness.
3. Open airway with chin-lift.
4. Look, listen, and feel for breathing.
5. If breathing is absent, give 2 slow, full
rescue breaths.
6. Check the pulse for 5 to 10 seconds.
7. If pulse is present, continue rescue
breathing: 1 breath every
5 seconds
8. If pulse is absent, start CPR:
15 compressions, 2 breaths (1 man)
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 6

Project and Health and Safety Information
HES will be performing an environmental remediation at the subject site for First Call Environmental.

All work will comply with the Occupational Safety and Health Act (OSHA) standard, "Hazardous Waste
Operations and Emergency Response," (29 CFR 1910.120), and other federal, state and local procedures
that require the development and implementation of a HASP. Generation of this document certifies that the
workplace has been evaluated for the hazards as described. A hazard assessment has been performed and
the adequacy of the personal protective equipment (PPE) selected is hereby certified per
29 CFR 1910.132(d) and is duly noted by the signature(s) and date appearing on the cover page of this
document. If any site conditions are encountered that are different from typical retail petroleum operations,
the field investigator is to stop work immediately and notify the Project Manager.

This plan addresses the safety issues associated environmental investigation and assessment activities
performed at retail petroleum operations. For this project, site investigation activities will involve the
following (checked items):

Phase I Environmental Site Assessment Phase II Environmental Site Assessment
x Spill Response and Abatement x Soil sampling (hand auger)
Soil sampling (drilling) Monitoring well installation
UST removal (requires full HASP) x Soil excavation
Groundwater sampling/monitoring Groundwater remediation
Drum removal Site surveying
Soil Gas / VI assessment/survey Pump/Slug testing

All activities of this project will be carried out under Level D or Modified Level D. At a minimum, all personnel
will wear the following PPE based on the task to be performed at the site (checked items):

x Hard Hat x Safety Vest
x Steel Toe Boots Chemical Boots
x Nitrile gloves (sampling gloves) Heavy Nitrile gloves
x Safety glasses Ear plugs/ear muffs (sound suppression)
White Tyvek Yellow (polycoated) Tyvek

Site is on an interstate highway and work will be performed at night. Use caution.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 7

HAZARD IDENTIFICATION AND CONTROL
Precautions must be taken to prevent injuries and exposures to the following potential hazards.

. Potential Hazards and Control

Potential Hazard

Control

Exposure to
Petroleum
Products

1. Stand up-wind of petroleum products whenever possible.
2. Minimize contact and contact time with petroleum products.
3. Avoid walking through discolored areas, puddles, leaning on drums, or
contacting anything that is likely to be contaminated.
4. Do not eat, drink, smoke and/or apply cosmetics in the hot or warm
zones.
5. Wear gloves when in contact with contaminated surfaces.
6. Safety glasses must be worn at a minimum.
7. Splash goggles must be worn when working with liquids.
8. >25 ppm organic vapors in breathing zone requires upgrade to Level C.
9. >250 ppm organic vapors in breathing zone requires upgrade from
Level C to Level B.
10. If unknown materials are encountered, call the HSS.
Vehicular
Traffic

1. Wear traffic safety vest when vehicle hazard exists.
2. Use cones, flags, barricades, and caution tape to define work area.
3. Use vehicle to block work area.
4. Engage police detail for high-traffic situations.
Vault Entry

1. HES Personnel do not perform Confined Space Entry.

Utility Lines
Contact

1. Contact Dig Safe to have utility lines marked prior to excavation/trenching.
2. Refer to site drawings or customer interviews if on private property for
utility locations.
3. Hand dig 3 to 5 feet down and 5 feet each side of utility marker to avoid
breaking utility lines.
Inclement
Weather

1. Stop outdoor work during electrical storms and other extreme weather
conditions such as extreme heat or cold temperatures.
2. Take cover indoors or in vehicle.
3. Listen to local forecasts for warnings about specific weather hazards such
as tornados, hurricanes, and flash floods.
Noise

1. Wear hearing protection when equipment such as a drill rig, jackhammer,
cut saw, air compressor, blower or other heavy equipment is operating on
the site.
2. Wear hearing protection whenever you need to raise your voice above
normal conversational speech due to a loud noise source; this much noise
indicates the need for protection.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 8

Potential Hazard

Control

Electric
Shock

1. Maintain appropriate distance from overhead utilities;
20-foot minimum clearance from power lines required;
10-foot minimum clearance from shielded power lines.
2. Use ground-fault circuit interrupters as required.
3. Perform lockout/tagout procedures (Appendix C).
4. Use three-pronged plugs and extension cords.
5. Contact your local underground utility-locating service.
6. Follow code requirements for electrical installations in hazardous
locations.
Physical
Injury

1. Wear hard hats and safety glasses when on-site.
2. Maintain visual contact with the equipment operator and wear orange
safety vest when heavy equipment is used on-site.
3. Avoid loose-fitting clothing (driller and driller's helper).
4. Prevent slips, trips and falls; keep work area uncluttered.
5. Keep your hands away from moving parts (i.e., augers).
6. Test the emergency shutoff switch on the drill rig daily.
Back Injury

1. Use a mechanical lifting device or a lifting aid where appropriate.
2. If you must lift, plan the lift before doing it.
3. Check your route for clearance.
4. Bend at the knees and use leg muscles when lifting.
5. Use the buddy system when lifting heavy or awkward objects.
6. Do not twist your body while lifting.
Heat Stress

1. Increase water intake while working.
2. Increase number of rest breaks and/or rotate workers in shorter work
shifts.
3. Watch for signs and symptoms of heat exhaustion and fatigue.
4. Plan work for early morning or evening during hot months.
5. Use ice vests when necessary.
6. Rest in cool, dry areas.
7. In the event of heat stroke, bring the victim to a cool environment and
initiate first aid procedures.
Cold Stress

1. Take breaks in heated shelters when working in extremely cold
temperatures .
2. Remove the outer layer of clothing and loosen other layers to promote
evaporation of perspiration, upon entering the shelter.
3. Drink warm liquids to reduce the susceptibility to cold stress.
High Crime
Areas

1. Be aware of surroundings.
2. Use the buddy system.
3. Request police detail when appropriate.
Insects

1. Tuck pants into socks.
2. Wear long sleeves.
3. Use insect repellent.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 9

Potential Hazard

Control

Poisonous Plants
(Such as Poison
Ivy, Oak, etc.)

1. Don't enter areas infested with poisonous plants.
2. Immediately wash any areas that come into contact with poisonous
plants.
Ladders

1. Make sure ladder rungs are sturdy and free of cracks.
2. Use ladders with secure safety feet.
3. Pitch ladders at a 4:1 ratio.
4. Secure ladders at the top when possible.
5. Do not use ladders for access to air stripper towers.
6. Use non-conductive ladders near electrical wires.
Fire Control

1. Smoke only in designated areas.
2. Keep flammable liquids in closed containers.
3. Keep site clean; avoid accumulating combustible debris such as paper.
4. Follow Hot Work Safety Procedures when welding or performing other
activities requiring an open flame.
5. Isolate flammable and combustible materials from ignition sources.
6. Ensure fire safety integrity of equipment installations according to Hazard
Classification Diagram (Appendix G).
Static Electricity

1. Do not create static discharge in flammable atmospheres.
2. Electrically bond and ground pumps transfer vessels, tanks, drums,
bailers and probes, when moving liquids.
3. Electrically bond and ground vacuum trucks and the tanks they are
emptying.
4. Do not splash fill containers with flammable liquids.
Drilling/Boring
Operations

1. Driller and helper must be present during all active operations.
2. Driller helper and other site personnel must know location of emergency
shut off switch.
3. Unauthorized personnel must be kept clear of drilling rig.
4. Area of drilling operation must be cordoned off/barricaded.
5. When hazardous conditions are deemed present, operation must be shut
down.
Well Installation,
Well
Development,
Well Gauging,
Well Bailing,
Soil/Ground-
water Sampling

1. Wear appropriate PPE to avoid skin, eye, and inhalation contact with
contaminated groundwater and/or soil.
2. Stand upwind when conducting tasks and minimize possible inhalation
exposure; especially when first opening monitoring wells.
3. Conduct air monitoring to determine level of respiratory protection.
4. Utilize engineering controls such as portable venturi air movers to draw
away or blow away chemical vapors. Welding, Cutting,
Brazing
1. Before conducting welding at a project site, contact the Project Manager..

Cleaning
Equipment

1. Wear appropriate PPE to avoid skin and eye contact with isopropyl
alcohol, alconox, or other cleaning materials.
2. Stand upwind to minimize any potential inhalation exposure.
3. Dispose of spent cleaning solutions and rinses accordingly.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 10

Potential Hazard

Control

First aid kit, emergency eye wash station, fire extinguisher, and absorbent
pads will be located on-site in the vehicle or site remediation system.
Health and Safety Plan
Diesel Fuel Release; Burlington, NC
Page 11

Signature Sheet

All persons entering the work zone, or visiting the subject site for the purposes associated with the subject
investigation(s), or activities associated with the subject investigation(s) are required to notify the HES
representative on-site immediately upon arrival. All persons entering the work zone, or visiting the subject
site for the purposes associated with the subject investigation(s), or activities associated with the subject
investigation(s) are required to review appropriate health and safety procedures, and provide a signature
documenting they have been properly briefed on health and safety policies and procedures to be followed
while on-site. HES will not be responsible for personal injuries or death resulting from personal actions that
are considered negligent, or that result from personal activities that are contrary to this health and safety plan.

By my signature, I acknowledge that I have been briefed on site specific health and safety procedures,
that I am familiar with said health and safety procedures, and that I will follow all indicated health and
safety procedures while on-site.

Name Signature

491

APPENDIX C

UST-62 24-Hour Notification of Discharge Form
For Non-UST This form should be completed and submitted to the UST Section’s regional office following a known or suspected release of
Releases of petroleum from a source other than an underground storage tank. This form is required to be submitted within 24 hours of
discovery of a known or suspected petroleum release Petroleum in NC
(DWM USE ONLY)
Incident Priority Rank (H,I,L,U):
Received (time/date): Received by: Region:
Reported by: (circle one): Phone, Fax or Report

Suspected Contamination? Yes No
Confirmed GW Contamination? Yes No
Confirmed Soil Contamination? Yes No
Samples taken? Yes No
Free product? Yes No
If Yes(free product), state greatest thickness: feet

Release discovered:
(date):
(time):
INCIDENT DESCRIPTION
Incident Name:
Address (street number/name): County:
City/Town: Zip Code: Regional Office (circle one): Asheville, Mooresville,
Fayetteville,
Latitude (decimal degrees): Longitude (decimal degrees) Obtained by: GPS Electronic topographic map
GIS Address matching
Other Unknown Describe location:
Describe suspected or confirmed release (nature of release, time/date of release, quantity of release, amount of free

Describe initial response/abatement (time/date release stopped, cleanup begun/completed, quantity of product soil removed, confirmation sampling):

Describe impacted receptors:

HOW RELEASE WAS DISCOVERED (Release Code)
(Check one) Observation of Release at Occurrence Visual or Olfactory Evidence Soil Contamination Groundwater Contamination
Water Supply Well Contamination Surface Water Contamination Other (specify)
SOURCE OF CONTAMINATION
Source of Release Cause of Release Type of Release Product Type Released
(Check one to indicate primary (Check one to indicate primary (Check one) (Check one to indicate primary petroleum product source) cause) type released)
AST (tank)
AST Piping/ Dispenser
AST Delivery Problem
OTR Vehicle Tank
OTR Bulk Transport Tank
RR Bulk Transport Tank
Transformer
Unknown
Other

Definitions presented on reverse

Spill (Accidental)
Spill (Intentional)
Corrosion
Physical or Mechanical
Damage
Equipment Failure
AST Overspill
AST Installation Problem
Unknown
Other
Definitions presented on reverse

Petroleum
Both Petroleum
& Non-Petroleum

Location (Check one)
Facility
Residence
Highway/Road
Railway
Other
Gasoline/ Diesel/ Diesel/Veg. Oil
Kerosene
E11 – E20 Vegetable Oil 100%
E21 – E84 Heating Oil
E85 – E99 Waste Oil
Ethanol 100% Mineral Oil-no PCBs
Mineral Oil-PCBs
Other Petroleum
Products
Ownership
1. Municipal 2. Military 3. Unknown 4. Private 5. Federal 6. County 7. State
Operation Type
1. Public Service 2. Agricultural 3. Residential 4. Education/Relig. 5. Industrial 6. Commercial 7. Mining
Guidance presented on reverse
UST Form 62 (04/10) Page 1 of 2

IMPACT ON DRINKING WATER SUPPLIES Water Supply Wells Affected? 1. Yes 2. No 3. Unknown Number of Water Supply Wells Affected
List of Water Supply Wells Contaminated: (Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
PARTY RESPONSIBLE FOR RELEASE
(if the source of the release is not an AST system or if it is an AST system and there is a responsible party other than the AST system owner/ operator)
Name of Person/Company: Address:
City: Winston-Salem State Zip Code Telephone Number
AST SYSTEM OWNER (if the source of the release is an AST system)
AST Owner/Company Address
City State Zip Code Telephone Number
AST SYSTEM OPERATOR (if the source of the release is an AST system)
UST Operator/Company Address
City State Zip Code Telephone Number
LANDOWNER AT LOCATION OF INCIDENT
Landowner Address
City State Zip Code Telephone Number
Draw Sketch of Area or Provide Map (showing incident site, location of release, two major road intersections, potential
receptors) Attach sketch or map to form.
Give Directions to Incident Site Attach directions to form if necessary.
Person Reporting Incident: Company: Telephone Number:
Title: Address: Date:
UST Form 62 (04/10) Page 2 of 2 Definitions of Sources AST (Tank): means the tank is used to store product AST Piping: means the piping and connectors running from the tank to the dispenser or other end-use equipment AST Dispenser: includes the dispenser and the equipment used to connect the dispenser to the piping AST Delivery Problem: identifies releases that occurred during product delivery to the tank. OTR Vehicle Tank: means the tank is used to store product to fuel an over the road vehicle OTR Bulk Transport Tank: means a tank that is used to transport product in bulk over the road (by truck) RR :bulk Transport Tank: means a tank that is used to transport product in bulk by train Transformer: means electrical transformer Other: serves as the option to use when the release source is known but does not fit into one of the preceding categories Unknown: identifies releases for which the source has not been determined Definitions of Causes Spill (Accidental): use this cause when a spill occurs accidentally(e.g., when the delivery hose is disconnected from a fill pipe) Spill (Intentional): use this cause when a spill occurs intentionally (e.g., intentional dumping or breakage) Corrosion: use when a metal tank, piping, or other component has a release due to corrosion Physical or Mechanical Damage: use for all types of physical or mechanical damage, except corrosion Equipment failure: use when a release occurs due to equipment failure other than corrosion or physical or mechanical damage AST Overfill: use when an overfill occurs (e.g., overfills may occur from the fill pipe at the tank or when the nozzle fails to shut off at the dispenser) AST Installation Problem: use when the problem is determined to have occurred specifically because the AST system was not installed properly Other: use this option when the cause is known but does not fit into one of the preceding categories Unknown: use when the cause has not been determined Guidance: Ownership and Operator Type Ownership select the category which describes owner of the AST system, bulk transport tank, or other release source Operator Type select the category which describes the operation in which owner uses the AST system, bulk transport tank, or other release source
491

APPENDIX D

491

APPENDIX E

Photograph Number 1: Location of the diesel fuel release incident, alongside Westbound I-
40/85, Burlington, NC looking West, prior to abatement (10-25-22).
Photograph Number 2: Impacted area, during initial stages of excavation (10-25-22).

Photograph Number 3: Impacted soils were removed using a mini track hoe excavator (10-25-
22).

Photograph Number 4: Clean imported soils for backfill purposes, were delivered to the site (10-
25-22).

Photograph Number 5: Impacted soils were loaded onto a dump truck and transported off site
for disposal (10-25-22).
Photograph Number 6: Excavation activities (10-25-22), looking West.

Photograph Number 7: Excavation activities looking East (10-26-2022).
Photograph Number 8: Excavation activities looking East (10-26-22).

491

APPENDIX F

FieldCollection DateSample Depth (feet BGS)SW-1 10/25/22 0.5 0.8 ND 44.2SW-2 10/25/22 0.5 0.1 ND 97.8SW-3 10/25/22 0.5 0.1 ND 69.2SW-4 10/25/22 0.5 0.1 ND 42.4FL-1 10/25/22 1.5 0.3 ND 4FL-2 10/25/22 0.5 0.2 ND 66FL-3 10/25/22 1.0 0.1 ND 71.7FL-4 10/25/22 1.0 0.6 ND 2350 100Notes:"ND" denotes not detected. "cs" denotes compound specific.Bold denotes concentration greater than State Action Limits. (Soil Samples)Table 1First Call Environmental / United Road and Pilot TransportDiesel Fuel Release Incident - Burlington, NC HES Project #340049Summary of Analytical Data (SVOCs) NCDEQ State Action Limit (mg/kg)NCDEQ Soil-to-Water MSCC (mg/kg)Analytical Method (e.g., VOC by EPA 8260B) 8015B (mg/Kg)Sample ID NumberConstituent of ConcernPID Screening (ppm)Gasoline Range Organics (GRO) Diesel Range Organics (DRO)RO1 of 1
491

APPENDIX G
11/04/22
Technical Report for
Highlands Environmental Solutions, Inc
340049; NC
SGS Job Number: FC82
Sampling Dates: 10/25/22 - 10/26/22
Report to:
[e-mail]
[e-mail]
[e-mail]
[e-mail]
ATTN: Distribution1
Total number of pages in report:
Certifications: FL(E83510), LA(03051), KS(E-10327), NC(573), NJ(FL002), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AL, AK, AR, CT, IA, KY, MA, MI. MS, ND, NH, NV, OK, OR, IL, UT, VT, WA, WI, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone]
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
Client Service contact: Ariel Hartney 407-425-6700
Norm Farmer
Technical Director
Orlando, FL 11/04/22
e-Hardcopy 2.0
Automated Report
24
SGS is the sole authority for authorizing edits or modifications to this document.
Unauthorized modification of this report is strictly prohibited.
Review standard terms at: http://www.sgs.com/en/terms-and-conditions
The results set forth herein are provided by SGS North America Inc.
Please share your ideas about
how we can serve you better at:
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1 of 24
FC82
Table of Contents
-1-
Sections:
Section 1: Sample Summary ................................................................................................... 3
Section 2: Summary of Hits .................................................................................................... 4
Section 3: Sample Results ........................................................................................................5
3.1: FC82-1: SW-1 ............................................................................................................... 6
3.2: FC82-2: FL-1 ................................................................................................................ 8
3.3: FC82-3: SW-2 ............................................................................................................... 10
3.4: FC82-4: FL-4 ................................................................................................................ 12
3.5: FC82-5: FL-3 ................................................................................................................ 14
3.6: FC82-6: SW-3 ............................................................................................................... 16
3.7: FC82-7: FL-2 ................................................................................................................ 18
3.8: FC82-8: SW-4 ............................................................................................................... 20
Section 4: Misc. Forms ............................................................................................................22
4.1: Chain of Custody ........................................................................................................... 23 12342 of 24
FC82
SGS LabLink@15:21 04-Nov-2022
Sample Summary
Highlands Environmental Solutions, Inc
Job No:FC82
340049; NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
This report contains results reported as ND = Not detected. The following applies:
Organics ND = Not detected above the MDL
FC82-1 10/25/22 22:40 RS 10/27/22 SO Soil SW-1
FC82-2 10/25/22 22:54 RS 10/27/22 SO Soil FL-1
FC82-3 10/25/22 23:13 RS 10/27/22 SO Soil SW-2
FC82-4 10/26/22 00:26 RS 10/27/22 SO Soil FL-4
FC82-5 10/26/22 00:30 RS 10/27/22 SO Soil FL-3
FC82-6 10/26/22 00:38 RS 10/27/22 SO Soil SW-3
FC82-7 10/25/22 23:20 RS 10/27/22 SO Soil FL-2
FC82-8 10/26/22 00:50 RS 10/27/22 SO Soil SW-4
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3 of 24
FC821
Summary of Hits Page 1 of 1
Job Number:FC82
Account:Highlands Environmental Solutions, Inc
Project:340049; NC
Collected:10/25/22 thru 10/26/22
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FC82-1 SW-1
TPH (C10-C28) a 44.2 J 58 29 mg/kg SW846 8015C
FC82-2 FL-1
TPH (C10-C28) b 4.00 J 6.0 3.0 mg/kg SW846 8015C
FC82-3 SW-2
TPH (C10-C28) a 97.8 58 29 mg/kg SW846 8015C
FC82-4 FL-4
TPH (C10-C28) a 23.0 J 29 15 mg/kg SW846 8015C
FC82-5 FL-3
TPH (C10-C28) a 71.7 57 28 mg/kg SW846 8015C
FC82-6 SW-3
TPH (C10-C28) a 69.2 55 27 mg/kg SW846 8015C
FC82-7 FL-2
TPH (C10-C28) a 66.0 57 28 mg/kg SW846 8015C
FC82-8 SW-4
TPH (C10-C28) a 42.4 J 55 27 mg/kg SW846 8015C
(a) Dilution required due to matrix interference; extract was viscous. Petroleum hydrocarbon pattern extends
beyond C28.
(b) Petroleum hydrocarbon pattern extends beyond C28.
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FC822
SGS LabLink@15:21 04-Nov-2022
Sample Results
Report of Analysis
Orlando, FL
Section 3
5 of 24
FC823
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-1
Lab Sample ID:FC82-1 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:85.6
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12771.D 1 11/01/22 20:33 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 6.93 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 5.1 2.0 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 90%56-149%
98-08-8 aaa-Trifluorotoluene 90%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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FC8233.1
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-1
Lab Sample ID:FC82-1 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:85.6
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36107.D 10 11/01/22 04:03 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.1 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 44.2 58 29 mg/kg J
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 74%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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Report of Analysis Page 1 of 1
Client Sample ID:FL-1
Lab Sample ID:FC82-2 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:83.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12772.D 1 11/01/22 20:58 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 6.81 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 5.4 2.2 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 89%56-149%
98-08-8 aaa-Trifluorotoluene 88%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
8 of 24
FC8233.2
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-1
Lab Sample ID:FC82-2 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:83.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 WW36108.D 1 11/01/22 04:32 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.1 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) a 4.00 6.0 3.0 mg/kg J
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 72%56-122%
(a) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9 of 24
FC8233.2
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-2
Lab Sample ID:FC82-3 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:86.5
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12773.D 1 11/01/22 21:22 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 8.12 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 4.3 1.7 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 89%56-149%
98-08-8 aaa-Trifluorotoluene 89%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
10 of 24
FC8233.3
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-2
Lab Sample ID:FC82-3 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:86.5
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36109.D 10 11/01/22 05:02 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.0 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 97.8 58 29 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 71%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
11 of 24
FC8233.3
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-4
Lab Sample ID:FC82-4 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:83.6
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12774.D 1 11/01/22 21:46 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 7.69 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 4.9 1.9 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 91%56-149%
98-08-8 aaa-Trifluorotoluene 90%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
12 of 24
FC8233.4
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-4
Lab Sample ID:FC82-4 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:83.6
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36110.D 5 11/01/22 05:31 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.3 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 23.0 29 15 mg/kg J
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 76%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
13 of 24
FC8233.4
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-3
Lab Sample ID:FC82-5 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:88.2
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12775.D 1 11/01/22 22:10 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 6.32 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 5.2 2.1 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 90%56-149%
98-08-8 aaa-Trifluorotoluene 89%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
14 of 24
FC8233.5
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-3
Lab Sample ID:FC82-5 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:88.2
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36111.D 10 11/01/22 06:01 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.0 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 71.7 57 28 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 73%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
15 of 24
FC8233.5
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-3
Lab Sample ID:FC82-6 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:91.0
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12776.D 1 11/01/22 22:35 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 8.15 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 3.9 1.5 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 90%56-149%
98-08-8 aaa-Trifluorotoluene 89%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
16 of 24
FC8233.6
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:SW-3
Lab Sample ID:FC82-6 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:91.0
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36112.D 10 11/01/22 06:30 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.0 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 69.2 55 27 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 73%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
17 of 24
FC8233.6
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-2
Lab Sample ID:FC82-7 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:88.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12777.D 1 11/01/22 22:59 JR n/a n/a G1U550
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 6.92 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 4.8 1.9 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 89%56-149%
98-08-8 aaa-Trifluorotoluene 88%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
18 of 24
FC8233.7
SGS LabLink@15:21 04-Nov-2022
Report of Analysis Page 1 of 1
Client Sample ID:FL-2
Lab Sample ID:FC82-7 Date Sampled:10/25/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:88.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36113.D 10 11/01/22 07:00 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.0 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 66.0 57 28 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 84%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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Report of Analysis Page 1 of 1
Client Sample ID:SW-4
Lab Sample ID:FC82-8 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C Percent Solids:91.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 1U12822.D 1 11/03/22 02:10 JR n/a n/a G1U552
Run #2
Initial Weight Final Volume Methanol Aliquot
Run #1 6.72 g 5.0 ml 100 ul
Run #2
CAS No. Compound Result RL MDL Units Q
TPH-GRO (C6-C10)ND 4.6 1.8 mg/kg
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
460-00-4 4-Bromofluorobenzene 94%56-149%
98-08-8 aaa-Trifluorotoluene 94%66-132%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
20 of 24
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Report of Analysis Page 1 of 1
Client Sample ID:SW-4
Lab Sample ID:FC82-8 Date Sampled:10/26/22
Matrix:SO - Soil Date Received:10/27/22
Method:SW846 8015C SW846 3546 Percent Solids:91.3
Project:340049; NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a WW36114.D 10 11/01/22 07:29 EG 10/31/22 07:00 OP93809 GWW1431
Run #2
Initial Weight Final Volume
Run #1 20.0 g 1.0 ml
Run #2
CAS No. Compound Result RL MDL Units Q
TPH (C10-C28) b 42.4 55 27 mg/kg J
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
84-15-1 o-Terphenyl 74%56-122%
(a) Dilution required due to matrix interference; extract was viscous.
(b) Petroleum hydrocarbon pattern extends beyond C28.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
RL = Reporting Limit B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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FC8233.8
SGS LabLink@15:21 04-Nov-2022
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Orlando, FL
Section 4
22 of 24
FC824
FC82: Chain of Custody
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FC8244.1
Job Number:FC82 Client:HES, INC
Date / Time Received:10/27/2022 9:30:00 AM Delivery Method:FEDEX
Project:340049
Airbill #'s:5707 9050 3423
Cooler Information
1. Custody Seals Present
2. Custody Seals Intact
4. Cooler temp verification
3. Temp criteria achieved
5. Cooler media
IR Gun
Ice (Bag)
Trip Blank Information
1. Trip Blank present / cooler
2. Trip Blank listed on COC
2. Samples preserved properly
Sample Information
1. Sample labels present on bottles
5. Sample recvd within HT
4. Condition of sample
3. Sufficient volume/containers recvd for analysis:
Intact
Comments FROZEN @ 10/27/22 // 1130.
SM001Rev. Date 05/24/17
SGS Sample Receipt Summary
Cooler Temps (Raw Measured) °C:
Cooler Temps (Corrected) °C:
Cooler 1: (3.4);
Cooler 1: (4.0);
3. Type Of TB Received
W or S N/A
6. Dates/Times/IDs on COC match Sample Label
7. VOCs have headspace
8. Bottles received for unspecified tests
9. Compositing instructions clear
10. Voa Soil Kits/Jars received past 48hrs?
11. % Solids Jar received?
Misc. Information
25-Gram 5-GramNumber of Encores:Number of 5035 Field Kits:Number of Lab Filtered Metals:
Test Strip Lot #s:pH 0-3 230315 pH 10-12 219813A Other: (Specify)
Y or N N/A
Y or N
Therm ID:IR 1; Therm CF:0.6; # of Coolers:1
Y or N N/A
12. Residual Chlorine Present?
Residual Chlorine Test Strip Lot #:
Technician:Reviewer:SAMUELM Date:Date: 10/27/2022 9:30:00 A
FC82: Chain of Custody
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