MO-29770_00000_CA_UST-12_20230203

3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]
February 6, 2023

Mr. Ron Taraban
NCDEQ-UST Section
Mooresville Regional Office
610 East Center Ave.
Mooresville, NC 28115

Re: UST Closure Report
January 2023
Shell Bros Distr Auto Fac 2
3230 16th Avenue SE
Conover, Catawba County
North Carolina
Facility ID Number: 0-00-0000035959
Incident Number: N/A
GRI Project Number: 5712

Dear Mr. Taraban,

Please find enclosed the referenced report for the above-mentioned site.
If you have any questions, please contact Joanna Alley at 704-845-4010

Sincerely,
Geological Resources, Inc.

Leslie Maxtone-Graham
Administrative Assistant

Enclosure

Cc Bumgarner Oil Company, Inc., file

3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]
Engineering Certification: C-2727 • Geology Certification: C-127
UST Closure Report
January 2023
Shell Bros Distr Auto Fac 2
3230 16th Avenue SE
Conover, Catawba County
North Carolina
Facility ID Number: 0-00-0000035959
Incident Number: N/A
GRI Project Number: 5712

Prepared for:

Bumgarner Oil Company, Inc.
Post Office Box 126
Hickory, NC 28601

February 3, 2023

Joanna Alley, P.E.
Project Manager

_____________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
i
EXECUTIVE SUMMARY
Shell Bros Distr Auto Fac 2 is a former petroleum retail facility that has been inactive since 2016. The site
is located at 3230 16th Avenue SE in Conover, Catawba County, North Carolina. The adjoining properties
are primarily commercial and undeveloped. Municipal water is available to the site. The site contained
one UST basin located on the north side of the site. The UST basin contained one 15,000-gallon
compartmentalized UST with a 9,000-gallon regular gasoline compartment and a 6,000-gallon premium
gasoline compartment, and one 15,000-gallon compartmentalized UST with a 9,000-gallon diesel
compartment and a 6,000-gallon off-road diesel compartment. The USTs, associated product piping, and
dispensers were removed from the site on January 26 and 27, 2023.

During tank removal activities, no petroleum odors were noted in the overburden soil or beneath the UST.
Ground water was not encountered in the UST basin. UST closure soil samples were collected from
beneath the USTs (UST-1-1-12’ through UST-1-4-12’ and UST-2-1-12’ through UST-2-4-12’), the product
piping (PP-1-3’ through PP-6-3’), and the dispenser islands (DI-1-3’, DI-2/3-3’, and DI-4/5-3’) and
submitted for on-site analysis of TPH-GRO and TPH-DRO using UVF technology. The contaminant
concentrations in all soil samples were below the RALs. Based on the field observations and UVF field
screening results, no over-excavation was conducted, and confirmation samples were not collected. The
overburden soil was placed back into the UST basin and additional truckloads of clean fill were used as
backfill.

Based on field observations and UVF results, no further action should be required for this site.

_____________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
ii
SITE INFORMATION
1. Site Identification
 Shell Bros Distr Auto Fac 2 (Facility ID 0-00-0000035959)
 Incident Number N/A – Risk Ranking Undetermined
 Location of Source Area: 3230 16th Avenue SE
Conover, NC 28613
Catawba County
35.700437°N, 81.264695°W (Topographical Map)
2. Information about Contacts Associated with the Leaking UST System
UST Owner/Operator
Bumgarner Oil Company, Inc.
P.O. Box 126
Hickory, NC 28601
[e-mail]
[phone]

Property Owner
Glenda A. Frazier
P.O. Box 87
Newton, NC 28658
Email Unknown
Phone Unknown

Property Occupant
Unoccupied

Consultant/Contractor
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
[e-mail]
704-845-4010

Analytical Laboratory
Geological Resources, Inc.
3502 Hayes Road
Monroe, NC 28110
[e-mail]
704-845-4010

3. Information about Release
 One 15,000-gallon compartmentalized UST with a 9,000-gallon regular gasoline compartment and a
6,000-gallon premium gasoline compartment and one 15,000-gallon compartmentalized UST with a
9,000-gallon diesel compartment and a 6,000-gallon off-road diesel compartment were removed from
the site on January 27, 2023.
 Currently, there are no active USTs at the site.

Certification:
I, Eric M. Eubanks, a Licensed Geologist for Geological Resources, Inc., do certify that the information contained
in this report is correct and accurate to the best of my knowledge.

Geological Resources, Inc. is licensed to practice geology and engineering in North Carolina. The certification
numbers of the corporation are C-127 and C-2727, respectively.

_____________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
iii
ACRONYMS
ACM: Asbestos Containing Materials
AFVR: Aggressive Fluid-Vapor Recovery
ARR: Acknowledgement of Report Receipt
AS: Air Sparging
AST: Aboveground Storage Tank
ASTM: American Society for Testing and
Materials
BGS: Below Ground Surface
CAP: Corrective Action Plan
CERT: Carolina Environmental Response
Team
CFR: Code of Federal Regulations
CSA: Comprehensive Site Assessment
DPE: Dual Phase Extraction
DRO: Total Petroleum Hydrocarbons Diesel
Range Organics
DWM: Division of Waste Management
DWR: Department of Water Resources
EPA: Environmental Protection Agency
EPH: Extractible Petroleum Hydrocarbons
ESA: Environmental Site Assessment
GCL: Gross Contamination Level
GRI: Geological Resources, Inc.
GRO: Total Petroleum Hydrocarbons
Gasoline Range Organics
LSA: Limited Site Assessment
MAC: Maximum Allowable Concentration as
specified in T15A NCAC 2L.0202
MADEP: Massachusetts Department of
Environmental Protection
MCC: Maximum Contaminant
Concentrations
MMPE: Mobile Multi-Phase Extraction
NAPL: Non-Aqueous Phase Liquid, “Free
Product”
NCDEQ: North Carolina Department of
Environmental Quality
NCDOT: North Carolina Department of
Transportation
NFA: Notice of No Further Action
NORR: Notice of Regulatory Requirements
NOV: Notice of Violation
NPDES: National Pollutant Discharge
Elimination System
NRP: Notice of Residual Petroleum
O&M: Operation and Maintenance
PAHs: Polynuclear Aromatic Hydrocarbons
PCA: Pre-Construction Assessment
RAL: Regulatory Action Level
SCLs: Soil Cleanup Level
SPCC: Spill Prevention Control and
Countermeasures
SVE: Soil Vapor Extraction
SVOCs: Semi-Volatile Organic Compounds
SWPPP: Stormwater Pollution Prevention Plan
TCLP: Toxicity Characteristic Leaching
Procedure (EPA Method SW-846 1311)
TOC: Top of Casing
TPH: Total Petroleum Hydrocarbons
USGS: United States Geological Survey
UST: Underground Storage Tank
UVF: Ultraviolet Fluorescence
VOCs: Volatile Organic Compounds
VPH: Volatile Petroleum Hydrocarbons

_____________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
TABLE OF CONTENTS

EXECUTIVE SUMMARY ....................................................................................................................... i
SITE INFORMATION ............................................................................................................................ ii
ACRONYMS ....................................................................................................................................... iii
A. SITE HISTORY AND CHARACTERIZATION ...................................................................................1
B. INITIAL RESPONSE AND ABATEMENT ACTIVITIES ......................................................................2
C. SOURCE INVESTIGATION ..........................................................................................................3
D. SUMMARY AND CONCLUSIONS ................................................................................................4
E. LIMITATIONS ...........................................................................................................................5
FIGURES
Figure 1: Site Location Map
Figure 2: Site Map
Figure 3: Soil Quality Map

TABLES
Table 1: UST Owner/Operator Information
Table 2: UST System Information
Table 3: Summary of Soil Sample Analytical Results – Field Data

APPENDICES
Appendix A: Notice of Intent Form (UST-3)
Appendix B: Site Investigation Report for Permanent Closure or Change-in-Service of UST (UST-2A)
Appendix C: Site-Specific Health and Safety Plan
Appendix D: Liquid Disposal Manifest
Appendix E: UST Removal Permit
Appendix F: UST Disposal Manifest
Appendix G: UVF Analytical Report

____________________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
1
A. SITE HISTORY AND CHARACTERIZATION
1. UST Owner and Operator Information:
In accordance with the 20-Day Report guidelines, the UST owner and operator information is summarized
in Table 1.
2. UST System Information:
In accordance with the 20-Day Report guidelines, the UST system information is summarized in Table 2.
A copy of the Registered Tank Report is shown below:

3. Non-UST Information:
There are no ASTs present at the site.
4. Comprehensive Description of the Release:
GRI conducted UST removal activities at the site between January 24, 2023 and January 27, 2023. The site
contained one UST basin located on the north side of the site. The UST basin contained one 15,000-gallon
compartmentalized UST with a 9,000-gallon regular gasoline compartment and a 6,000-gallon premium
gasoline compartment, and one 15,000-gallon compartmentalized UST with a 9,000-gallon diesel
compartment and a 6,000-gallon off-road diesel compartment. During UST closure activities, no
petroleum odors were noted in the overburden soils or beneath the USTs. The contaminant
concentrations in all soil samples collected from the UST basin were below the RALs.
5. Description of the Site Characteristics:
Shell Bros Distr Auto Fac 2 is a former petroleum retail facility that has been inactive since 2016. The site
is located at 3230 16th Avenue SE in Conover, Catawba County, North Carolina (Figure 1). The site is
bordered to the north by 16th Avenue SE. A site map is included as Figure 2.
6. Summary of Initial Abatement Actions, Assessment Activities, and Corrective Actions:

____________________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
2
Prior to closure, the appropriate officials (i.e. Fire Marshal and NCDEQ) were notified by GRI personnel. A
copy of the UST-3 Notice of Intent form is included as Appendix A. One 15,000-gallon compartmentalized
UST with a 9,000-gallon regular gasoline compartment and a 6,000-gallon premium gasoline
compartment, one 15,000-gallon compartmentalized UST with a 9,000-gallon diesel compartment and a
6,000-gallon off-road diesel compartment, approximately 60 feet of product piping, and five dispensers
were removed from the site on January 26 and 27, 2023. No petroleum odors were noted in the
overburden soils or below the USTs. The contaminant concentrations in all soil samples analyzed using
UVF technology were below the RALs. Therefore, no over-excavation was conducted at the site. Ground
water was not encountered in the UST basin. A copy of the Site Investigation Report for Permanent
Closure or Change-in-Service of UST (UST-2A) Form is included as Appendix B. A copy of the site-specific
health and safety plan used during UST closure activities is included as Appendix C.

B. INITIAL RESPONSE AND ABATEMENT ACTIVITIES
1. Removal of Regulated Substances from UST:
Prior to the initiation of the UST closure activities, the USTs were emptied and product and residual liquid
were removed by CERT. Approximately 1,356 gallons of residual liquid were vacuumed out of the UST and
disposed of at a licensed disposal facility. The liquid disposal manifest is included as Appendix D.
2. Source Control Actions:
Two 15,000-gallon compartmentalized USTs, approximately 60 feet of product piping, and five dispensers
were removed from the site on January 26 and 27, 2023.
3. Contaminant Migration Control Measures:
No petroleum odors were observed in the overburden soils or beneath the UST. The contaminant
concentrations in all soil samples were below the RALs.
4. Measures Taken to Mitigate Fire/Safety Hazards:
The City of Hickory Fire Department approved GRI’s tank inertion methods and removal procedures. The
UST removal permit is included as Appendix E. Prior to closure, the atmosphere of the USTs was checked
with an LEL/02 meter. Both USTs registered a reading of less than 10% LEL and were summarily removed.
Photographs of the USTs after the overburden soils were removed are shown below:

____________________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
3
5. Measures Taken to Identify and Mitigate Pollution Hazards:
No petroleum odors were observed in the overburden soils or beneath the USTs. The contaminant
concentrations in all soil samples were below the RALs.
6. Contaminated Soil Storage/Treatment and/or Disposal:
No contaminated soils were encountered during UST removal activities. The overburden was placed back
into the UST basin and additional truckloads of clean fill were used as backfill.
C. SOURCE INVESTIGATION
GRI was contracted to remove two 15,000-gallon compartmentalized USTs, approximately 60 feet of
product piping, and five dispensers from the site. The removal activities were conducted between January
24, 2023 and January 30, 2023. The UST basin was located on the north side of the site and was covered
with concrete and pea gravel. The two 15,000-gallon compartmentalized USTs measured 8 feet in
diameter by 39 feet and 6 inches in length. The USTs were visually inspected and appeared to be in good
condition with little to no corrosion or pitting. The USTs were constructed of steel. The USTs were
transported offsite for proper disposal. The UST disposal manifest is included as Appendix F. Photographs
of the UST basin before and after removal activities were conducted are shown below:

During excavation activities, GRI personnel collected soil samples for on-site field screening of TPH-GRO
and TPH-DRO using UVF technology. The on-site field screening technology was used to screen the
excavated soil to determine whether petroleum contamination above the RALs was present beneath the
UST system. Petroleum contamination in the soil that exceeded the RALs was not encountered during UST
closure activities. No ground water was encountered in the UST basin. Soil samples were collected from
beneath the USTs, product piping, and dispensers.

The facility included five dispensers located to the south of the UST basin and approximately 60 feet of
product piping in two separate trenches. Closure soil samples (UST-1-1-12’ through UST-1-4-12’) were
collected from beneath the compartmentalized gasoline UST and submitted for on-site analysis of TPH-
GRO. Closure samples (UST-2-1-12’ through UST-2-4-12’) were collected from beneath the diesel UST and
submitted for on-site analysis of TPH-GRO and TPH-DRO. Closure samples (PP-1-3’ through PP-6-3’) were
collected from beneath the product piping and submitted for on-site analysis of TPH-GRO and TPH-DRO.
Closure samples (DI-1-3’, DI-2/3-3’, and DI-4/5-3’) were collected from beneath the dispensers and

____________________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
4
submitted for on-site analysis of TPH-GRO and TPH-DRO. All contaminant concentrations were below the
RALs. The soil samples were collected at depths ranging from approximately 3 to 12 feet BGS. During
excavation activities, the USTs, dispensers, and product piping were removed.

Based on field observations and UVF results, no over-excavation activities were conducted at the site.
Therefore, no confirmation soil samples were collected. The closure samples were collected directly from
the bucket of the excavator. A summary of the field analytical results is included as Table 3. Soil sample
locations are shown on Figure 3. The UVF analytical report is included as Appendix G. A summary of the
soil sampling data from the January 2023 UST closure activities is shown below: Sample ID Sample Depth (ft-BGS) Gasoline-Range TPH Diesel-Range TPH RAL (mg/kg) 50 100
UST-1-1-12’ 12 <10 ---
UST-1-2-12’ 12 <10 ---
UST-1-3-12’ 12 <10 ---
UST-1-4-12’ 12 <10 ---
UST-2-1-12’ 12 10.8 <2
UST-2-2-12’ 12 10 <2
UST-2-3-12’ 12 <10 <2
UST-2-4-12’ 12 <10 <2
PP-1-3’ 3 <10 <2
PP-2-3’ 3 <10 <2
PP-3-3’ 3 <10 <2
PP-4-3’ 3 <10 <2
PP-5-3’ 3 <10 <2
PP-6-3’ 3 <10 <2
DI-1-3’ 3 <10 <2
DI-2/3-3’ 3 <10 <2
DI-4/5-3’ 3 <20 <4
2. Ground Water Sampling Performed to-date:
Ground water was not encountered during the UST closure activities; therefore, no ground water samples
were collected.
D. SUMMARY AND CONCLUSIONS
 The Shell Bros Distr Auto Fac 2 site is located in Conover, Catawba County, North Carolina. The site is
a former petroleum retail facility that has been inactive since 2016.
 On January 26 and 27, 2023, one 15,000-gallon compartmentalized UST with a 9,000-gallon regular
gasoline compartment and a 6,000-gallon premium gasoline compartment, one 15,000-gallon
compartmentalized UST with a 9,000-gallon diesel compartment and a 6,000-gallon off-road diesel
compartment, approximately 60 feet of product piping, and five dispensers were removed from the
site.
 Petroleum contamination was not noted in the overburden soils. No odors were noted in the
overburden soils or beneath the USTs.

____________________________________________________________________________________________
Prepared by: Geological Resources, Inc. UST Closure Report
Prepared on: February 3, 2023 Shell Bros Distr Auto Fac 2
Project Manager: Joanna Alley, P.E. GRI Project No. 5712
5
 Ground water was not encountered in the excavation area.
 UST closure soil samples were collected from beneath the two USTs, product piping, and dispenser
islands, and were analyzed on-site for TPH-GRO and/or TPH-DRO.
 Based on field observations and UVF results, no over-excavation activities were necessary.
 The concentrations of TPH-GRO and TPH-DRO in all collected soil samples were below the RALs.
E. LIMITATIONS
This report has been prepared for the exclusive use of Bumgarner Oil Company, Inc. for specific application
to the referenced site in Catawba County, North Carolina. The assessment was conducted based on the
scope of work and level of effort desired by the NCDEQ and with resources adequate only for that scope
of work. Our findings have been developed in accordance with generally accepted standards of
environmental practices in the State of North Carolina, available information, and our professional
judgment. No other warranty is expressed or implied.

The data that is presented in this report is indicative of conditions that existed at the precise locations
sampled and at the time the samples were collected. In addition, the data obtained from samples would
be interpreted as being meaningful with respect to parameters indicated in the laboratory report. No
additional information can logically be inferred from this data.

FIGURES
SITE LOCATIONFigure 1 Site Location Shell Bros DistrAuto Fac 2500 M2000 FTDate: 12/26/2022Location: 35.700437° N -81.264695° W Dad 3230 16th Avenue SE Conover, North Carolina Catawba County Incident No. N/A GRI Project No. 5712

TABLES
UST ID Number 1 through 4 Facility ID Number
Owner or Operator?
Owner/Operator
UST ID Number 1 through 4 Facility ID Number
Owner or Operator?
Owner/Operator
UST ID Number 1 through 4 Facility ID Number
Owner or Operator?
Owner
Address Telephone Number
649 1st Ave Drive SE, Taylorsville, NC 28681 828-632-3071
828-322-4377
00-0-0000035959
Name of Owner or Operator Dates of Ownership / Operation
P.O. Box 126, Hickory, NC 28601
00-0-0000035959
Name of Owner or Operator Dates of Ownership / Operation
GDL Operations, Inc.09/30/2006 - 10/01/2018
Address Telephone Number
TABLE 1
UST OWNER/OPERATOR INFORMATION
SHELL BROS DISTR AUTO FAC 2 (INCIDENT NO. N/A)
Shell Brothers Distributors, Inc.03/01/1999 - 09/30/2006
00-0-0000035959
Name of Owner or Operator Dates of Ownership / Operation
Bumgarner Oil Company, Inc.10/01/2018 - 01/27/2023
Address Telephone Number
Unknown Unknown
Page 1 of 1
Date: 01/25/23
Was Release
Associated
with UST
System?
(Yes / No)
1*Gasoline Gasoline 9,000 2/15/1999 Single Wall Steel 8' x 39' 6"Single Wall FRP Removed
01/27/2023 No
2**Diesel Diesel 6,000 2/15/1999 Single Wall Steel 8' x 39' 6"Single Wall FRP Removed
01/27/2023 No
3**Diesel Diesel 9,000 2/15/1999 Single Wall Steel 8' x 39' 6"Single Wall FRP Removed
01/27/2023 No
4*Gasoline Gasoline 6,000 2/15/1999 Single Wall Steel 8' x 39' 6"Single Wall FRP Removed
01/27/2023 No
Notes:
** UST-2 and UST-3 are two compartments of one 15,000-gallon compartmentalized UST
* UST-1 and UST-4 are two compartments of one 15,000-gallon compartmentalized UST
Tank
Dimensions
Description of
Associated
Product Piping
and
Pumps
Status
of
UST
TABLE 2
UST SYSTEM INFORMATION
SHELL BROS DISTR AUTO FAC 2 (INCIDENT NO. N/A)
Facility ID #: 0-035959
UST
ID
No.
Current
or Most
Recent
Contents
Previous
Contents
Capacity
(gallons)
Date
Installed
Construction
Details
Page 1 of 1
Date: 01/25/23 Facility ID #: 0-035959
Sample ID
Date
Collected
(mm/dd/yy)
Sample
Location
Sample
Depth
(ft-BGS)
50 100
UST-1-1-12'01/26/23 12 <10 ---
UST-1-2-12'01/26/23 12 <10 ---
UST-1-3-12'01/26/23 12 <10 ---
UST-1-4-12'01/26/23 12 <10 ---
UST-2-1-12'01/26/23 12 10.8 <2
UST-2-2-12'01/26/23 12 10 <2
UST-2-3-12'01/26/23 12 <10 <2
UST-2-4-12'01/26/23 12 <10 <2
PP-1-3'01/26/23 3 <10 <2
PP-2-3'01/26/23 3 <10 <2
PP-3-3'01/26/23 3 <10 <2
PP-4-3'01/26/23 3 <10 <2
PP-5-3'01/26/23 3 <10 <2
PP-6-3'01/26/23 3 <10 <2
DI-1-3'01/26/23 3 <10 <2
DI-2/3-3'01/26/23 3 <10 <2
DI-4/5-3'01/26/23 3 <20 <4
UST Basin
Product Piping
Dispenser
Islands
TABLE 3
Diesel-Range TPHSHELL BROS DISTR AUTO FAC 2 (INCIDENT NO. N/A)
Analytical Method 
RAL (mg/kg)
Contaminant of Concern Gasoline-Range TPHUVF
SUMMARY OF SOIL SAMPLE ANALYTICAL RESULTS - FIELD DATA
• Concentrations in bold face type indicate the reported concentrations were
less than the RALs
Notes:
• Results reported in mg/kg; samples analyzed onsite by UVF.
• ft-BGS: feet below ground surface.
• RAL: Regulatory Action Level.
• < : Less than the UFV method detection limit .
Page 1 of 1

APPENDICES

APPENDIX A
Notice of Intent Form (UST-3)
UST-3 Notice of Intent: UST Permanent Closure or Change-in-Service
Return completed form to:
The DWM Regional Office located in the area where the facility is located. Also send a copy to the Central Office in Raleigh.
SEE MAP ON THE BACK OF THIS FORM FOR THE CENTRAL AND REGIONAL OFFICE ADDRESSES.
STATE USE ONLY I.D. #_____________________ Date Received______________
INSTRUCTIONS (READ THIS FIRST)
Complete and return a UST-3 form at least thirty (30) days prior to closure or change-in-service activities.
Completed UST closure or change-in-service site assessment reports, along with a copy of the UST-2A and/or 2B forms, should be submitted
to the appropriate Division of Waste Management (DWM) Regional Office within thirty (30) days following closure activities. The UST-2 form
should also be submitted to the Central Office in Raleigh so that the status of the tanks may be changed to permanently closed and your
tank fee account can be closed out. Note: Tank fees may be due for unregistered tanks.
UST closure and change-in-service site assessments must be completed in accordance with the latest version of the Guidelines for Site
Checks, Tank Closure and Initial Response. The guidelines can be obtained at https://deq.nc.gov/about/divisions/waste-management/ust.
Note: To close tanks in place you must obtain prior approval from the DWM Regional office located in the region where the facility is located.
You must make sure that USTs removed from your property are disposed of properly. When choosing a closure contractor, ask where the
tank(s) will be taken for disposal. Usually, USTs are cleaned and cut up for scrap metal. This is dangerous work and must be performed
by a qualified company. Tanks disposed of illegally in fields or other dumpsites can leak petroleum products and sludge into the environment.
If your tanks are disposed of improperly, you could be held responsible for the cleanup of any environmental damage that occurs.
I. OWNERSHIP OF TANKS II. LOCATION
Owner Name (Corporation, Individual, Public Agency, or Other Entity)

Facility Name or Company

Street Address
Facility ID # (If known)

City

County
Street Address

State
Zip Code
City
County
Zip Code

Phone Number

Email
Phone Number

III. CONTACT PERSONNEL
Name:

Company Name:

Job Title:

Phone Number:

IV. TANK REMOVAL, CLOSURE IN PLACE, CHANGE-IN SERVICE
1. Contact local fire marshal.
2. Plan entire closure event.
3. Conduct Site Soil Assessment.
4. If removing tanks or closing in place, refer to
API Publication 2015 Cleaning Petroleum
Storage Tanks and 1604 Removal and
Disposal of Used Underground Petroleum
Storage Tanks.
5. Provide a sketch locating piping, tanks and
soil sampling locations.
6. Submit a closure report in the format of UST-
12 (including the form UST-2) within thirty
(30) days following the site investigation.
7. If a release from the tanks has occurred, the
site assessment portion of the tank closure
must be conducted under the supervision of
a P.E. or L.G., with all closure site assessment
reports bearing the signature and seal of the
P.E. or L.G. If a release has not occurred, the
supervision, signature or seal of a P.E. or L.G.
is not required.
8. Keep closure records for three (3) years.
V. WORK TO BE PERFORMED BY
Contractor Name:

Contractor Company Name:

Address:

City:

State:

Zip Code:

Phone No:

Primary Consultant Name:

Primary Consultant Company Name:

Consultant Phone No:

VI. TANKS SCHEDULED FOR CLOSURE OR CHANGE-IN-SERVICE

Tank ID No.

Size in Gallons

Last Contents
Proposed Activity
Closure Change-In-Service
Removal Abandonment in Place * New Contents Stored

* Prior written approval to abandon a tank in place must be received from a DWM Regional Office.
VII. OWNER OR OWNER’S AUTHORIZED REPRESENTATIVE
Has a release from a UST system occurred at this location? Yes No Unknown
I understand that I can be held responsible for environmental damage resulting from the improper disposal of my USTs.
Print name and official title:
Signature Date Signed

SCHEDULED REMOVAL DATE

Notify your DWM Regional Office
48 hours before this date if
scheduled removal date changes
UST-3 Rev 6/2022
Bumgarner Oil Company
2004 Highland Avenue
Hickory Catawba
NC 28601
828-322-4377 [e-mail]
Shell Bros Distr Auto Fac 2
00-0-0000035959
3230 16th Avenue SE
Hickory Catawba 28601
Zach Bumgarner Vice PresidentBumgarner Oil Company 828-322-4377
Justin Radford Geological Resources, Inc.
3502 Hayes Road 28110 704-845-4010
Joanna Alley Geological Resources, Inc.
NC
704-845-4010
1 9000 Gasoline
2 6000 Off Road Diesel
3 9000 Diesel
4 6000 Gasoline
Tomie Benton, VP of Account Management
12/13/2022 1/13/2023
Hickory

APPENDIX B
Site Investigation Report for Permanent Closure or Change-in-Service of UST (UST-2A)
UST-2A Site Investigation Report for Permanent Closure or Change-in-
Service of
REGISTERED UST

Return completed form to:
NC DEQ / DWM / UST SECTION
1646 MAIL SERVICE CENTER
RALEIGH, NC 27699-1646
ATTN: REGISTRATION & PERMITTING

phone [phone] fax [phone] http://www.wastenotnc.org/

STATE USE ONLY: Facility ID #

Date Received

INSTRUCTIONS (READ THIS FIRST)
1. UST permanent closure or change in service must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank
Closure and Initial Response and Abatement. The guidelines can be obtained at http://deq.nc.gov/about/divisions/waste-management/waste-
management-permit-guidance/underground-storage-tanks-section.
2. Permanent closure: Complete all sections of this form.
3. Change-in-service: Where a UST system will be converted from storing a regulated substance to a non-regulated substance, complete sections I, II, III, IV, and VI
4. For more than 5 registered UST systems, attach additional forms as needed
5. Tank Fee Refund: An annual tank fee may be refunded for a tank for which a tank fee was not required. An owner or operator must submit
a written request and include: (1) contact information, (2) federal identification # or SSN, and (3) a copy of UST-2 form. The annual tank
fee will be prorated based on the date of permanent closure.
6. UNREGISTERED USTs use Form UST-2B
I. OWNERSHIP OF TANKS II. LOCATION OF TANKS
Owner Name (Corporation, Individual, Public Agency, or Other Entity)

Facility Name or Company

Street Address

Facility ID # (If known)

City County Street Address
State

Zip Code

City

County

Zip Code

Phone Number
Phone Number

III. CONTACT PERSONNEL
Contact for Facility:

Job Title:

Phone #:

Closure Contractor Name:

Closure Contractor Company:

Address:

Phone #

Primary Consultant Name:

Primary Consultant Company:

Address:

Phone #

IV. UST INFORMATION FOR REGISTERED UST SYSTEMS
UNREGISTERED USTs use Form UST-2B V. EXCAVATION CONDITION
Tank ID
No.
Size in
Gallons
Last
Contents
Last
Use
Date
Permanent
Close Date Method of Permanent Closure:
Indicate REMOVED or enter fill
material, such as foam/ concrete/ sand
Change-in-
Service
Date
Water in excavation Free product
Notable
odor or
visible soil
contaminatio
n
Yes No Yes No Yes No

VI. CERTIFICATION
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents and that
based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true accurate and complete.
Print name and official title of owner or owner’s authorized representative

Signature Date Signed

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY, DIVISION OF WASTE MANAGEMENT, UST SECTION
1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646 PHONE [phone] FAX [phone] http://www.wastenotnc.org/ 1/2016

Bumgarner Oil Company, Inc.
2004 Highland Avenue
Hickory Catawba
NC 28601
828-322-4377
Shell Bros Distr Auto Fac 2
00-0-0000035959
3230 16th Avenue
Hickory 28601Catawba
Zach Bumgarner Vice President 828-322-4377
Joanna Alley Geological Resources, Inc.3502 Hayes Rd. Monroe, NC 704-845-4010
Joanna Alley Geological Resources, Inc.3502 Hayes Rd. Monroe, NC 704-845-4010
1 9,000 Gasoline 12/1/16 1/27/23 Removed
2 6,000 Diesel 12/1/16 1/27/23
3 9,000 Diesel 12/1/16 1/27/23
4 6,000 Gasoline 12/1/16 1/27/23
Removed
Removed
Removed
Kyle Perry
01/31/2023

APPENDIX C
Site-Specific Health and Safety Plan

1
GEOLOGICAL RESOURCES, INC.
Site Specific Health and Safety Plan

1.0 General Information:
a. Project name: Shell Bros Distr Auto Fac 2
b. Location: 3230 16th Avenue SE, Hickory, NC
c. GRI Job #: 5712

2.0 Project Organization:
a. Site Supervisor/H&S Officer:
b. Project Manager: Joanna Alley
c. Subcontractor(s):

3.0 Safety Plan Preparation:
a. Prepared by & date: Joanna Alley, 12/22/22
b. Reviewed/approved by & date:

4.0 Site History and Description:
a. Type of site (i.e., spill, leaking UST system, etc.):
b. Site/project description:
Current activities include UST closure.

5.0 Potential Hazards:
Physical Hazards: (check)
Slips X Overhead X Explosion X Sun burn X Electricity
X Trips utilities X Noise Cold Weather Pressurized
line/vessels
X Falls X Underground X Pinch points Hot Weather
X Fire utilities X Burns X Crush

Chemical Hazards: (check)
X Gasoline Used Oil
X Diesel Solvents
Kerosene Antifreeze
New Oil Acid (sample preservative)

Equipment/Vehicular/Other: (i.e., Geoprobe, drill rig, back hoe, track hoe, traffic, skid steer etc.)

Back hoe
Bobcat
Dump trucks

Biological Hazards: (i.e., toxic insects, spiders, poisonous plants, poisonous snakes, aggressive dogs)

2
6.0 Site Organization and Safety Control: (Evaluate the need for site control to protect persons from
exposure to hazardous conditions; i.e. work permits, cones, barricade tape, exclusion zones, etc.)
a. Work area(s) identified: __Entire site _________________________________________
b. Work area marked _____ Yes ___X__ No
c. Work area barricaded _____ Yes __X___ No
d. Support area established: ___n/a_____________________________________________
e. Entry and escape routes identified: __n/a ______________________________________
f. Rally point identified: _____ Yes __X__ No Location:____________________________
g. Emergency shut-off for water identified _____ Yes __X___ No
h. Emergency fuel shut-off identified _____ Yes __X___ No
i. Site map attached: _____ Yes _____ No
**Emergency Response Procedures**
Action (i.e. shut off all power equipment) Assemble at rally point
Call 911 for medical or utilities emergency Do NOT enter confined spaces
Discuss what to do if …..cut product line, water line, cable/electric line

7.0 Job Activities in Work Plan:
X UST Removal Soil Sampling Manual FP Recovery
Soil Excavation System O&M Other (specify)
Powered Drilling MMPE/AFVR __________________
Hand Augering _ Water sampling __________________
8.0 Required Education and/or Training:
X OSHA 40 hr X Annual 8 hr Refresher OSHA Site Supervisor

9.0 Air Monitoring:
If, in the opinion of the site supervisor, petroleum hydrocarbon vapor concentrations are excessive, site
activities will cease until petroleum hydrocarbon vapor concentrations diminish to acceptable levels.

10.0 Equipment:
X FID/PID Combustible gas indicator Interface Probe
O2 meter Other Water level meter

11.0 Personnel Protection Equipment:
X Hard hat Rubber boots Respirator X Hearing
X Safety glasses X Work gloves X Sun screen protectio
n
X Steel toe boots X First aid kit Repellent X Nitrile
Tyvek suit X Fire extinguisher Dust mask gloves

12.0 Decontamination Procedures: (evaluate need for decon, describe procedures)

3
13.0 Emergency Contacts:
a. Local Assistance:
Site Phone Fire Department 911
Police 911 Ambulance 911
Water Department Sanitary Sewer
Natural Gas Power Company

Nearest Hospital with Emergency Room (directions attached)
Name Frye Regional Medical Center
Address 420 N Center St
Hickory, NC 28601
Number 828-315-5000

b. National or Regional Sources of Assistance:
1) Geological Resources, Inc. [phone]
2) Chemtrec (24 Hours) [phone]
3) Bureau of Explosives (24 Hours) [phone]
4) National Response Center, NRC [phone]
(Oil/Hazardous Substances)
5) DOT, Off. Of Haz. Operations [phone]

14.0 Signatures:

This plan has been reviewed by all on-site personnel and all provisions are clear (signatures
required).

Project Manager:

Site Supervisor:
Other personnel:

4
15.0 Amendments:

a. Site Specific Health and Safety Plans are based on information available at the time of plan
preparation. Unexpected conditions may arise. It is important that personal protective
measures be thoroughly assessed prior to and during the planned activities. Unplanned
activities and/or changes in the hazard status should initiate a review of this plan and may
result in major changes to it.
b. Changes in the hazard status or unplanned activities are to be submitted on “Amendment to
the Site Specific Health and Safety Plan” which is included bellow.
c. Amendment must be approved by the Project Manager prior to implementation of the
amendment.

AMENDMENT TO THE SITE SPECIFIC HEALTH AND SAFETY PLAN

A. Changes in field activities or hazards:

B. Proposed amendment:

C. Approval:

Proposed by: ___________________________________date ______________________

Approved by: ___________________________________date _____________________

Amendment number: ____________________________

Amendment effective date: _______________________

APPENDIX D
Liquid Disposal Manifest

APPENDIX E
UST Removal Permit

APPENDIX F
UST Disposal Manifest
Shell Bros. Distr. Auto Fac. 2
3230 16th Avenue SE, Conover, NC
January 27, 2023
15,000-gallon compartmentalized gasoline UST
Eric Eubanks
1/27/2023
15,000-gallon compartmentalized diesel UST
JMB Recycling and Demolition

APPENDIX G
UVF Analytical Report

3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]
Engineering Certification: C-2727 • Geology Certification: C-127
UVF Trilogy Analytical Report

Samples Collected: January 26, 2023
Samples Analyzed: January 26, 2023
Site Name: Shell Bros Distr Auto Fac 2
Site Address: 3230 16th Avenue SE, Conover, NC
GRI Project Number: 5712

January 27, 2023

Xavier Farmer
Operator

Technical Procedures
Sample Collection and Handling
Soil samples may be collected using any acceptable procedure. Sampler must use a clean pair of nitrile
gloves for each sample collected. The sample will be placed in a clean, sealable bag (ziplock). Once
collected, the sample must be analyzed immediately or placed on ice. The sample may be kept on ice for
up to 48 hours prior to UVF analyses. If the sample cannot be analyzed within 48 hours, the sample may
be extracted and kept at 4 degrees C for up to 14 days. Proper chain-of-custody procedures must be
followed.
Calibration
The UVF Trilogy has standard calibrations stored for the following analysis:
 GRO
 DRO
 Total PAH
 Target PAH
 Heavy PAH
Prior to use, calibration standards are used to perform a 5-point verification on the factory stored
calibrations for GRO and DRO. The calibration standards used are as follows:
GRO
 0.5 ppm
 1 ppm
 3 ppm
 5 ppm
 10 ppm
DRO
 0.1 ppm
 0.5 ppm
 1 ppm
 3 ppm
 5 ppm
Operation
Sample Extraction
 5mg of soil are weighed into a clean extraction jar
 Methanol is added to the extraction jar to create a 2x or 4x dilution
o 2x Dilution: 10 mL of methanol
o 4x Dilution: 20 mL of methanol
 The extraction jar is shaken for several minutes to thoroughly mix the soil with solvent
(methanol)
 The mixture is allowed to settle for several minutes
 A clean syringe is used to draw liquid from the extraction jar
 A clean filter is attached to the end of the syringe and the liquid dispensed through the filter
into a clean test tube
 This liquid is referred to as the extraction
 Please note that any samples extracted and/or analyzed offsite require a Chain of Custody
documenting the collection, extraction and custody of the sample(s)

Technical Procedures
Dilution Preparation
 An adjustable micropipette is used to precisely measure out the amount of extract needed for
the dilution
 The measured out amount of the extract is added to a clean test tube and methanol is added to
dilute the extract. Examples of dilutions are shown below:

Extract Amount
500 μL
200 μL
100 μL
50 μL
25 μL

Add Solvent to the
5 mL line
5 mL line
5 mL line
5 mL line
5 mL line
2x Extract
Dilution Factor
20x
50x
100x
200x
400x
4x Extract
Dilution Factor
40x
100x
200x
400x
800x

Sample Analyzation
 The dilution is shaken to thoroughly mix, then poured into a clean glass cuvette
 The desired module is inserted into the UVF Trilogy and the corresponding factory calibration is
selected
 “Measure Fluorescence” is pressed on the touchscreen and the reading is recorded
 The reading should be between the concentrations of the calibration standards (GRO: 0.5-10
ppm; DRO 0.1-5 ppm)
o Reading below the calibration standard range are recorded as below the detection limit
 Detection Limit = (lower range of calibration standards range) x dilution factor
(i.e. a GRO sample with a 100x dilution factor has a detection limit of 50 ppm)
o Readings above the calibration standard range should be further diluted and reanalyzed
o Negative readings are an indication of quenching (see below)
 The reading is multiplied by the dilution factor to calculate the final concentration
 Check suspected contaminated samples for quenching by running additional dilutions
o According to the siteLAB Quick Reference Guide:
“Quenching” can occur when the detector is swamped by too many hydrocarbons or
organic interferences, producing low or negative concentrations. Test the sample at
multiple dilutions to confirm results are linear and accurate.”
QA/QC
Calibration
 The UVF Trilogy will be calibrated daily prior to use
 The calibration results will be saved and entered into the calibration log
Method Blank
 A method blank of methanol will be analyzed following calibration and following the last sample
analyzed for each day
Duplicates
 One duplicate will be analyzed for every 20 samples
 The duplicate will be prepared from the extract of the sample and diluted to the same factor as
the sample analyzed
Project Name:Date Collected:
Project Number:Date Analysed:
Project Manager:Operator:
Sample ID Matrix Dilution
Factor x
GRO
Output
(ppm)
=GRO Value
(mg/Kg)
Dilution
Factor x
DRO
Output
(ppm)
=DRO Value
(mg/Kg)
PP-1-3'Soil 20 <0.5 <10 20 <0.1 <2
PP-2-3'Soil 20 <0.5 <10 20 <0.1 <2
PP-3-3'Soil 20 <0.5 <10 20 <0.1 <2
PP-4-3'Soil 20 <0.5 <10 20 <0.1 <2
PP-5-3'Soil 20 <0.5 <10 20 <0.1 <2
PP-6-3'Soil 20 <0.5 <10 20 <0.1 <2
DI-1-3'Soil 20 <0.5 <10 20 <0.1 <2
DI-2/3-3'Soil 20 <0.5 <10 20 <0.1 <2
DI-4/5-3'Soil 40 <0.5 <20 40 <0.1 <4
UST-1-1-12'Soil 20 <0.5 <10 ---------
UST-1-2-12'Soil 20 <0.5 <10 ---------
UST-1-3-12'Soil 20 <0.5 <10 ---------
UST-1-4-12'Soil 20 <0.5 <10 ---------
UST-2-1-12'Soil 20 0.54 10.8 20 <0.1 <2
UST-2-2-12'Soil 20 0.5 10 20 <0.1 <2
UST-2-3-12'Soil 20 <0.5 <10 20 <0.1 <2
UST-2-4-12'Soil 20 <0.5 <10 20 <0.1 <2
UVF Analytical Report
siteLAB UVF Trilogy
1/26/2023
1/26/2023
Xavier Farmer
Shell Bros Distr Auto Fac 2
5712
Joanna Alley, P.E.
Site:
Shell Bros Distr Auto Fac 2
Report Date:
1/27/2023
Page:
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