HomeMy WebLinkAboutWS-27979_47268_CA_LSA_20201014_FHPPropertyLIMITED SITE ASSESSMENT
FHP PROPERTY
720 N. MAIN STREET
HIGH POINT, GUILFORD COUNTY, NORTH CAROLINA
GROUNDWATER INCIDENT: 47268 FACILITY ID: N/A
OCTOBER 14, 2020
FORMER BUSINESS OPERATOR:
Foreign Auto Repair (current contact information is not known)
PROPERTY OWNER / RESPONSIBLE PARTY:
Forward High Point, Inc. 164 S. Main Street – Suite 606 High Point, NC 27260 (336) 883-9890
CONSULTANT:
Paragon Environmental Consultants, Inc.
P. O. Box 157
Thomasville, NC 27361-0157
Phone Number: (336) 669-6037
RELEASE INFORMATION:
Date Discovered: September 3, 2020 Estimated Quantity of Release: Unknown Cause of Release: Former Auto Garage Activities Source of Release: Gasoline UST(s) and Unknown Chlorinated Solvents Size and Contents: Unknown Latitude: N 35.963316o Longitude: W 80.010182o
The Limited Site Assessment for this site has been prepared by Paragon Environmental
Consultants, Inc. under the direct supervision of a licensed geologist. All activities
performed on this project were conducted under my direct supervision:
Benjamin W. Robinson, L.G. North Carolina License #2466
October 14, 2020
Raymond J. Gibbs
Forward High Point, Inc. 164 S. Main Street – Suite 606 High Point, NC 27260 Reference: Limited Site Assessment FHP Property 720 N. Main Street High Point, Guilford County, North Carolina Groundwater Incident: 47268 Facility ID: N/A
Dear Mr. Gibbs:
In accordance with the directive of a Notice of Regulatory Requirements (NORR) from the
North Carolina Department of Environmental Quality (NC DEQ) dated September 25,
2020, contained herein is a Limited Site Assessment for the release which occurred at the
above referenced facility. These activities have been conducted following the release or
releases which occurred in the vicinity of the former on-site auto garage operations at this
subject site. All activities were conducted in accordance with NC DEQ guidelines and the
requirements of 15A NCAC 2L .0115.
Mr. Gibbs, if you have questions regarding this report, please contact our office.
Sincerely,
Benjamin W. Robinson, L.G. Paragon Environmental Consultants, Inc.
R20-2065A
PARAGON
Environmental Consultants, Inc.
P.O. Box 157 • Thomasville, NC 27361-0157
Business Ph: (336) 669-6037 • Fax: (336) 476-7708
TABLE OF CONTENTS
Page 1.0 SITE HISTORY AND SOURCE CHARACTERIZATION 1 2.0 RISK CHARACTERIZATION 1 3.0 RECEPTOR INFORMATION 4 4.0 SITE GEOLOGY AND HYDROGEOLOGY 5 5.0 SAMPLING RESULTS 6 6.0 CONCLUSIONS AND RECOMMENDATIONS 7 LIST OF FIGURES
Figure 1: Project Location/U.S.G.S. Topographic Map
Figure 2: Site Layout
Figure 3: Subsurface Utilities Map
Figure 4: Adjacent Properties Map
Figure 5: Site Layout and Soil Sample Locations
Figure 6: Site Layout and Monitor Well Locations
LIST OF TABLES
Table 1: Adjacent Property Owners Table 2: Summary of Soil Laboratory Analytical Results Table 3: Monitoring Well Information and Groundwater Elevations Table 4: Summary of Groundwater Laboratory Analytical Results
APPENDICES
Appendix A: Soil Boring Log Appendix B: Laboratory Analytical Results Appendix C: Well Construction Records Appendix D: Standard Operating Procedures
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LIMITED SITE ASSESSMENT FHP Property 720 N. Main Street High Point, North Carolina 1.0. - SITE HISTORY AND SOURCE CHARACTERIZATION
Forward High Point, Inc. owns a property at 720 N. Main Street in High Point, NC. This parcels formerly contained an auto service facility. The former auto service garage, referred to as Former Foreign Auto Repair, is no longer in operation and the former auto facility building has been demolished. A former UST system used for the retail sale of petroleum was removed in the mid-1980s. Figure 1 illustrates the location of this facility on the High Point West Quadrangle U.S.G.S. Topographic Map. Figure 2 illustrates the site layout and the location of the former building at this facility. A release (or releases) was discovered at the subject site during a Phase II Environmental Site Assessment (ESA) performed by Paragon Environmental Consultants, Inc. in September of 2020. The Phase II ESA for this project site was submitted to the NC DEQ by Paragon. An UST-61 form was submitted on September 10, 2020 to report the discovered contamination.
2.0 - RISK CHARACTERIZATION AND LAND USE FORM
Part I Groundwater/Surface water/Vapor impact
High Risk
1. Has discharge or release contaminated any water supply wells including any used for non-drinking purposes?
NO
2. Is a water supply well used for drinking water located within 1,000 feet of the source area the discharge or release?
NO
3. Is a water supply well used for any purpose (e.g., irrigation, washing cars, industrial
cooling water, filling swimming pools) located within 250 feet of the source area
of the discharge or release?
NO
4. Does groundwater within 500 feet of the source area of the discharge or release have the potential for future use in that there is no other source of water supply other than the groundwater?
NO
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5. Do vapors from the discharge or release pose a threat of explosion because of accumulation of the vapors in a confined space or pose any other serious threat to public health, public safety or the environment?
NO 6. Are there any factors that would cause the discharge or release to pose an imminent danger to public health, public safety or the environment?
NONE KNOWN
Intermediate Risk
7. Is a surface body located within 500 feet of the source area of the discharge or release?
NO
If yes, does the maximum groundwater contaminant concentration exceed the surface water quality standards and criteria found in 15A NCAC 2B .0200 by a factor of 10?
N/A
8. Is the source area of the discharge or release located within a designated wellhead
protection area as defined in 42 USC 300h-7(e)?
NO
9. Is the discharge or release located in the Coastal Plain physiographic region as designated on a map entitled "Geology of North Carolina" published by the Department in 1985?
NO
If yes, is the source area of the discharge or release located in an area in which there is recharge to an unconfined or semi-confined deeper aquifer that is being used or may be used as a source of drinking water?
N/A
10. Do the levels of groundwater contamination for any contaminant exceed the gross
contamination levels established (see Table 7 in guidelines) by the department?
YES
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Part II-Land Use
Property containing Source Area of Discharge or Release
The questions below pertain to the property containing the source area of the release.
1. Does the property contain one or more primary or secondary residences (permanent or temporary)?
NO
2. Does the property contain a school, daycare center, hospital, playground, park, recreation area, church, nursing home, or other place of public assembly?
NO
3. Does the property contain a commercial (e.g., retail, warehouse, office/business space, etc.) or industrial (e.g., manufacturing, utilities, industrial research and development, chemical/petroleum bulk storage, etc.) enterprise, an inactive commercial or industrial enterprise, or is the land undeveloped?
NO
4. Do children visit the property?
NO
5. Is access to the property reliably restricted consistent with its use?
YES
6. Do pavement, buildings, or other structures cap the contaminated soil?
NO
If yes, what mechanisms are in place or can be put into place to ensure that the contaminated soil will remain capped in the foreseeable future?
N/A
7. What is the zoning status of the property?
COMMERCIAL 8. Is the use of the property likely to change in the next 20 years?
NO
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Property Surrounding Source Area of Discharge or Release.
9. What is the distance from the source area of the release to the nearest primary or secondary residence (permanent or temporary)
APPROXIMATELY 750 FEET TO THE EAST
10. What is the distance from the source area of the release to the nearest school, daycare center, hospital, playground, park, recreation area, church, nursing home, or other place of public assembly?
WAKE FOREST BAPTIST HEALTH HIGH POINT MEDICAL CENTER IS
LOCATED APPROXIMATELY 850 FEET TO THE WEST OF THE SITE
11. What is the zoning status of properties in the surrounding areas?
COMMERCIAL
12. Briefly characterize the use and activities of the land in the surrounding area.
COMMERCIAL
3.0 - RECEPTOR INFORMATION
3.1 Water Supply Wells
A supply well survey has been conducted within a radius of 1,500 feet from the release area. During this reconnaissance, no supply wells were found to be located within this radius.
3.2 Public Water Supplies
Public water supplies are available from City of High Point to all of the surrounding properties within a radius of 1,500 feet from 720 N. Main Street.
3.3 Surface Water
The partial U.S.G.S. map included as Figure 1 indicates that surface waters in the vicinity of the release area generally drain towards Payne Creek which is located approximately 1,400 feet to the southwest of the release area. Muddy Creek flows into Rich Fork approximately 28,750 feet to the northeast. Rich Fork is situated within the Yadkin Pee-Dee River Drainage Basin.
Page - 5
3.4 Wellhead Protection Areas
No wellhead protection areas are known to exist within the area of this release. 3.5 Deep Aquifers in the Coastal Plain Physiographic Region
This release is not located in the coastal plain.
3.6 Subsurface Structures
Former water and sewer drain lines are located in the vicinity of the contaminated area at this facility. The building formerly located on the impacted property has been demolished so the lot is currently vacant. Any other subsurface utilities present at the site are located within the DOT right-of-way along N. Main Street. Figure 3 illustrates the locations of all known subsurface utilities. 3.7 Land Use
The possibility of human exposure to soil contamination at the FHP Property is minimal. The site is not currently in use for any purpose. The facility lies within a primarily commercial area.
3.8 Property Owners and Occupants
Figure 4 illustrates the surrounding properties, and Table 1 contains information regarding the adjacent property owners. This information was obtained from the Guilford County Tax Department’s records.
4.0 - SITE GEOLOGY AND HYDROGEOLOGY
4.1 Site Geology
The site is situated in the Piedmont Region of the North Carolina Slate Belt. According to
the Geological Map of North Carolina local bedrock geology of the region consists of Late
Proterozoic to Cambrian aged metamorphosed granitic bedrock. Competent bedrock was
not encountered to a depth of 30 feet below land surface which was the maximum depth
explored during the subsurface investigation.
4.2 Soils Investigation
The soils at the project site consist of clay and silt of varying proportions. A soil boring log for two borings advanced for monitor well installation at the site are contained as Appendix A.
Page - 6
On September 28, 2020 two soil samples were collected from each of the two areas identified during the Phase II ESA as being impacted. The two samples from the former gasoline UST basin, labeled as MW1-7 and MW1-12, were analyzed according to EPA Method 8260 and by MADEP methods for Volatile Petroleum Hydrocarbons (VPH). The two samples from the area of the chlorinated solvent release, labeled as MW2-9 and MW2-14, were analyzed according to EPA Method 8260. Contamination in excess of the Industrial / Commercial Standards was present in one of these soil samples. A concentration of Tetrachloroethene (PCE) was reported in MW2-9 above the Industrial / Commercial standard. According to the laboratory analytical results for MW2-9, PCE was reported at a concentration of 50.4 milligrams per kilogram (mg/kg), which exceeds the Industrial / Commercial Standard of 10 mg/kg. All other target compounds by EPA Method 8260 were below the Industrial / Commercial Standards in soil sample MW2-9. Soil sample MW2-14 was below the Industrial / Commercial Standards for all target compounds by EPA Method 8260. Soil samples MW1-7 and MW1-12 were below the Industrial / Commercial Standards for all target compounds by EPA Method 8260 and the three carbon fraction classes by VPH. Table 2 summarizes the laboratory results for the “Risk-Based” soil samples collected at 720 N. Main Street, and Figure 5 illustrates the locations of the soil samples obtained by Paragon at this subject site. Appendix B contains a copy of the laboratory analytical report and the chain-of-custody record for the “Risk-Based” soil samples collected on September 28, 2020.
5.0 - SAMPLING RESULTS
5.1 Monitor Well Installation
Two North Carolina Type II groundwater monitoring wells have been installed at the site.
Figure 6 illustrates the site layout and the location of the monitor wells which were labeled
as MW-1 and MW-2. The monitoring wells were constructed of 4-inch Schedule 40 PVC
pipe with 20 feet of 0.010 inch slotted screen. Based on the assumption that the
contaminants being addressed were primarily constituents with specific gravities of less
than 1.0, the groundwater monitoring wells were installed so that the screened interval
intersected the shallow groundwater table at the time of installation. Table 3 summarizes
the monitoring well information and the groundwater elevations as measured on September
29, 2020. Appendix C contains copies of the monitor well construction records for the two
wells installed at the FHP Property during this investigation.
5.2 Groundwater Analyses
Following installation, the monitoring wells were developed and sampled in accordance with Paragon’s Standard Operating Procedures, which are contained as Appendix D. The groundwater samples from MW-1 and MW-2 were submitted to Meritech, Inc. for analyses according to EPA Method 6200B, Lead, and MADEP methods for Volatile Petroleum Hydrocarbons (VPH).
Page - 7
According to the laboratory analytical results for monitor well MW-1, Benzene and 1,2-Dichloroethane were reported at concentrations in excess of the Gross Contaminant Levels (GCLs). Benzene was shown at a concentration of 33,500 micrograms per Liter (ug/L), which exceeds the GCL of 5,000 ug/L. 1,2-Dichloroethane was listed at a level of 1,600 ug/L, which is over the GCL of 400 ug/L. All other target compounds by EPA Method 6200B and Lead were below the GCLs in the sample collected from MW-1. The three carbon fraction classes by VPH were above the 2L Standards; however, no GCLs exist for the carbon fraction classes. The groundwater sample collected from monitor well MW-2 was below the GCLs for all target compounds by EPA Method 6200B. The VPH carbon fraction classes and Lead were below the 2L Standards in the sample collected from monitor well MW-2. Table 4 summarizes the groundwater analytical results, and Appendix B contains a copy of the laboratory analytical report and the chain-of-custody record for the groundwater samples.
6.0 - CONCLUSIONS AND RECOMMENDATIONS
6.1 General Summary
Limited Site Assessment activities at the FHP Property have been completed. From a review of all information gathered during this project, Paragon Environmental Consultants, Inc. makes the following conclusions:
o A release or releases of unknown quantity has occurred at this site. Contaminated
soil which remains in place above the shallow groundwater table is at levels
exceeding the Industrial / Commercial Standards.
o Two groundwater monitoring wells were constructed at the site during this
investigation. Free product was not observed in any of the monitor wells.
o The analytical results for the groundwater sample collected from MW-1 reported Benzene and 1,2-Dichloroethane GCL violations. The results for the groundwater sample from MW-2 were below the GCLs by EPA Method 6200B and below the 2L Standards for Lead and VPH.
6.2 Recommendations
Based upon a review of all information gathered during this project, Paragon makes the following recommendations:
o An Aggressive Fluid Vapor Recovery (AFVR) or Mobile Multi-Phase Extraction (MMPE) event should be conducted at this facility in an attempt to lower the groundwater contaminant concentrations to levels below the GCLs, which will enable the risk ranking to be lowered and allow site closure with deed recordation and public notice.
o A copy of this report should be forwarded to the following address:
Guilford County Environmental Health
400 W. Market Street – Suite 300
Greensboro, NC 27401
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6.3 Limitations
This report has been prepared for the exclusive use of Forward High Point, Inc. for the specific application to the referenced site located in Guilford County, North Carolina. The evaluation was conducted based on the scope of work and level of effort desired by the client and with resources adequate only for the scope of work. Our findings have been developed in accordance with generally accepted standards for Limited Site Assessments in the State of North Carolina, available information, and our professional judgment. No other warranty is expressed or implied. The data presented in this report are indicative of conditions at the precise locations sampled and the time the sample was collected. Additionally, the data obtained from the samples would be interpreted as meaningful with respect to the parameters in the laboratory reports. No additional information can be logically inferred from this data.
FIGURES
TABLES
TABLE 1: ADJACENT PROPERTY OWNERS FHP PROPERTY 720 N. MAIN STREET HIGH POINT, NORTH CAROLINA SITE ID OWNER INFO 1 FHP Properties, LLC 1912 Eastchester Drive – Suite 400 High Point, NC 27265 (Project Location) 2 Redeeming Love Word Ministries, Inc. P.O. Box 1772 High Point, NC 27261 (740 N. Main Street) 3 First Citizens Bank & Co. 100 Tryon Road Raleigh, NC 27603 (505 N. Wrenn Street) 4 FHP Properties, LLC 1912 Eastchester Drive – Suite 400 High Point, NC 27265 (704 N. Main Street) 5 High Point Regional Hospital P.O. Box HP-5 High Point, NC 27261 (717 N. Main Street) 6 High Point Regional Hospital P.O. Box HP-5 High Point, NC 27261 (727 N. Main Street) M20-2065P
TABLE 2
Summary of Soil Laboratory Analytical Results
FHP Property
High Point, North Carolina
Constituent SS-12 MW1-7 MW1-12 MW2-9 MW2-14 Lowest MSCCs Res. Standard Ind. / Comm. Standard
Date 8/18/2020 9/28/2020 9/28/2020 9/28/2020 9/28/2020
Method 8260 (mg/kg)
Acetone 0.089 BDL 140 BDL BDL 24 14,000 360,000
Benzene 0.068 BDL 3.54 BDL BDL 0.0056 18 164
n-Butylbenzene 0.018 4.7 12.8 BDL BDL 4.3 626 16,350
sec-Butylbenzene 0.02 BDL 4.62 BDL BDL 3.3 626 16,350
tert-Butylbenzene BDL BDL BDL BDL BDL 3.4 626 16,350
Chloromethane 0.016 BDL BDL BDL BDL 0.02 49 440
2-Chlorotoluene 0.862 BDL BDL 12.1 BDL NSE NSE NSE
4-Chlorotoluene 0.843 BDL BDL 11.9 BDL 0.1 1,000 20,000
1,4-Dichlorobenzene 0.167 BDL BDL 3.22 BDL 0.099 110 1,000
1,2-Dichlorobenzene 0.779 BDL BDL 4.46 BDL 0.23 1,400 36,000
1,3-Dichlorobenzene 0.036 BDL BDL BDL BDL 7.6 460 12,000
1,1-Dichloroethene 0.055 BDL BDL BDL BDL 0.045 780 20,000
cis-1,2-Dichloroethene 3.92 BDL BDL BDL BDL 0.35 156 4,000
trans-1,2-Dichloroethene 0.093 BDL BDL BDL BDL 0.54 310 8,200
1,2-Dichloropropane 0.04 BDL BDL BDL BDL 0.003 10 92
Ethanol 6.61 BDL BDL BDL 34.2 16 7,000 200,000
Ethylbenzene 1.06 15.5 115 1.28 BDL 4.9 1,560 40,000
Isopropylbenzene 0.035 3.93 13.9 BDL BDL 1.7 1,564 40,880
4-Isopropyltoluene 0.018 4.19 9.94 BDL BDL 0.12 100 4,000
Methylene Chloride 0.079 BDL BDL BDL BDL 0.02 85 763
Naphthalene 0.068 13.7 39 2.61 1.03 0.16 313 8,176
n-Propylbenzene 0.11 9.18 29.7 BDL BDL 1.7 626 16,350
Tetrachloroethene (PCE)12.8 BDL BDL 50.4 BDL 0.0074 1.1 10
Toluene 2.19 0.96 43.3 BDL BDL 4.3 1,200 32,000
Trichloroethene (TCE)3.14 BDL BDL BDL BDL 0.019 4.6 120
1,2,4-Trichlorobenzene 0.025 BDL BDL BDL BDL 2.6 156 4,088
1,2,4-Trimethylbenzene 0.561 54.1 180 3.63 BDL 8.5 782 20,440
1,3,5-Trimethylbenzene 0.18 21.1 69.5 1.18 BDL 8.3 782 20,440
Vinyl Chloride 0.015 BDL BDL BDL BDL 0.00018 0.46 4.1
Xylenes (total)2.618 53.43 503 4.99 BDL 4.6 3,129 81,760
MTBE 0.005 BDL BDL BDL BDL 0.091 350 3,100
IPE BDL BDL BDL BDL BDL 0.37 156 4,088
Aliphatic Fraction Classes (mg/kg)
C5-C8 Volatile Aliphatics N/A 332 2,590 N/A N/A 68 939 24,528
C9-C12 Volatile Aliphatics N/A 951 1,610 N/A N/A NSE NSE NSE
C9-C18 Extractable Aliphatics N/A N/A N/A N/A N/A NSE NSE NSE
C9-C18 Aliphatics (total)N/A 951 1,610 N/A N/A 540 1,500 40,000
C19-C36 Extractable Aliphatics N/A N/A N/A N/A N/A NSE 31,000 810,000
Aromatic Fraction Classes (mg/kg)
C9-C10 Volatile Aromatics N/A 293 617 N/A N/A NSE NSE NSE
C11-C22 Extractable Aromatics N/A N/A N/A N/A N/A NSE NSE NSE
C9-C22 Aromatics (total)N/A 293 617 N/A N/A 31 469 12,264
N/A= Not Analyzed
BDL= Below Detection Limits X20-2065
TABLE 3
Monitoring Well Information and Groundwater Elevation
FHP Property
High Point, NC
Well Number Top of Casing Elevation Top of Screen Elevation Bottom of Screen Elevation Depth to Water Groundwater Elevation
MW-1 100.00 90.00 70.00 14.07 85.93
MW-2 100.00 90.00 70.00 14.48 85.52
Note: All measurements taken in feet and based on an arbitrary benchmark of 100.00 feet; groundwater levels measured on September 29, 2020.
X20-2065B
TABLE 4
Summary of Groundwater Laboratory Analytical Results
FHP Property
High Point, NC
Constituent MW-1 MW-2 2L Standard GCL
Date 9/29/2020 9/29/2020
Method 6200B (ug/L)
Benzene 33,500 15.6 1 5,000
Toluene 9,670 22.3 600 260,000
Ethylbenzene 1,590 8.13 600 84,500
Xylenes (total)6,600 30.24 500 85,500
BTEX (total)51,360 76.27 NSE NSE
2-Butanone (MEK)1,670 BDL 4,000 4,000,000
n-Butylbenzene BDL 0.54 70 6,900
2-Chlorotoluene BDL 74.8 100 NSE
4-Chlorotoluene BDL 73.1 24 7,500
1,2-Dichloroethane 1,660 BDL 0.4 400
1,2-Dichlorobenzene BDL 22.6 20 20,000
cis-1,2-Dichloroethene BDL 33.9 70 70,000
Ethanol BDL 577 4,000 4,000,000
Isopropylbenzene 65 BDL 70 25,000
Methylene Chloride BDL 2.61 5 5,000
Methyl Isobutyl Ketone (MIBK)187 BDL 100 100,000
Naphthalene 452 2.76 6 6,000
n-Propylbenzene 97 BDL 70 30,000
Tetrachloroethene (PCE)BDL 508 0.7 700
Trichloroethene (TCE)BDL 34.6 3 3,000
1,2,4-Trimethylbenzene 740 5.93 400 28,500
1,3,5 Trimethylbenzene 233 4.74 400 25,000
MTBE BDL BDL 20 20,000
IPE 3,100 BDL 70 70,000
Method 3030C (ug/L)
Lead 49 BDL 15 15,000
Aliphatic Fraction Classes (ug/L)
C5-C8 Volatile Aliphatics 34,700 218 400 NSE
C9-C12 Volatile Aliphatics 16,900 258 NSE NSE
C9-C18 Extractable Aliphatics N/A N/A NSE NSE
C9-C18 Aliphatics (total)16,900 258 700 NSE
C19-C36 Extractable Aliphatics N/A N/A 10,000 NSE
Aromatic Fraction Classes (ug/L)
C9-C10 Volatile Aromatics 3,040 128 NSE NSE
C11-C22 Extractable Aromatics N/A N/A NSE NSE
C9-C22 Aromatics (total)3,040 128 200 NSE
BDL = Below Detection Limits
N/A = Not Analyzed
NSE = No Standard Established X20-2065A
APPENDIX A
SOIL BORING LOG
SOIL BORING LOG
Paragon Environmental Consultants, Inc.
Job Name:FHP Property
Address:720 N. Main Street High Point, NC
Job No:P-2065
Start Date:9/29/2020
Driller:Innovative Environmental Technologies, Inc.
Boring No.:MW-1 and MW-2
Comments:
Sample Depth Blow OVA
Number (ft.)Soil Description (color, soil type, moisture)Counts (ppm)
MW-1 5 Backfill N/A
10 Orange/red, CLAY with silt, damp N/A
15 Tan, CLAY with silt, damp N/A
20 Dark tan, CLAY with silt, damp N/A
25 Olive, CLAY with silt, damp N/A
30 Olive, CLAY with silt, moist N/A
MW-2 5 Orange/red, CLAY with silt, damp N/A
10 Orange/red, CLAY with silt, damp N/A
15 Tan, CLAY with silt, damp N/A
20 Dark tan, CLAY with silt, damp N/A
25 Tan, CLAY with silt, damp N/A
30 Dark tan, CLAY with silt, moist N/A
P-2065A
Soil Boring Terminated at 30'
Soil Boring Terminated at 30'
APPENDIX B
LABORATORY ANALYTICAL RESULTS
APPENDIX C
WELL CONSTRUCTION RECORDS
WELL CONSTRUCTION RECORD (GW-1) For Internal Use Only:
Form GW-1 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016
1. Well Contractor Information:
Well Contractor Name
NC Well Contractor Certification Number
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Water Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
□Monitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquifer Storage and Recovery □Salinity Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Heating/Cooling Return) □Other (explain under #21 Remarks)
4. Date Well(s) Completed: Well ID#
5a. Well Location:
Facility/Owner Name Facility ID# (if applicable)
Physical Address, City, and Zip
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
N W
6. Is(are) the well(s): □Permanent or □Temporary
7. Is this a repair to an existing well: □Yes or □No
If this is a repair, fill out known well construction information and explain the nature of the
repair under #21 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:
9. Total well depth below land surface: (ft.)
For multiple wells list all depths if different (example- 3@200’ and 2@100′)
10. Static water level below top of casing: (ft.)
If water level is above casing, use “+”
11. Borehole diameter: (in.)
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM TO DESCRIPTION
ft.ft.
ft.ft.
15. OUTER CASING (for multi-cased wells) OR LINER (if applicable)
FROM TO DIAMETER THICKNESS MATERIAL
ft.ft.in.
16. INNER CASING OR TUBING (geothermal closed-loop)
FROM TO DIAMETER THICKNESS MATERIAL
ft.ft.in.
ft.ft.in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
ft.ft.in.
ft.ft.in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
ft.ft.
ft.ft.
ft.ft.
19. SAND/GRAVEL PACK (if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
ft.ft.
ft.ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM TO DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
21. REMARKS
22. Certification:
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Mike Tynan
2725-A
IET
9/28/20 MW-1
Former Service Stattion
720 N. Main St, High Point 27262
Guilford
35 57 47.89 80 00 36.59
30
~15
10.5
auger
9/29/20
15 30 clayey silt
0 10 4 Sch40 PVC
10 30 4 0.010 Sch40 PVC
0
3
8
3
8
30
concrete
bentonite
#2 silica sand pour through augers
pour
See Report
Wells completed at surface with flush mount covers
and 2'x2' concrete pads.
Print Form
pour
WELL CONSTRUCTION RECORD (GW-1) For Internal Use Only:
Form GW-1 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016
1. Well Contractor Information:
Well Contractor Name
NC Well Contractor Certification Number
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply) □Residential Water Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
□Monitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquifer Storage and Recovery □Salinity Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop) □Tracer
□Geothermal (Heating/Cooling Return) □Other (explain under #21 Remarks)
4. Date Well(s) Completed: Well ID#
5a. Well Location:
Facility/Owner Name Facility ID# (if applicable)
Physical Address, City, and Zip
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
N W
6. Is(are) the well(s): □Permanent or □Temporary
7. Is this a repair to an existing well: □Yes or □No
If this is a repair, fill out known well construction information and explain the nature of the
repair under #21 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:
9. Total well depth below land surface: (ft.)
For multiple wells list all depths if different (example- 3@200’ and 2@100′)
10. Static water level below top of casing: (ft.)
If water level is above casing, use “+”
11. Borehole diameter: (in.)
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM TO DESCRIPTION
ft.ft.
ft.ft.
15. OUTER CASING (for multi-cased wells) OR LINER (if applicable)
FROM TO DIAMETER THICKNESS MATERIAL
ft.ft.in.
16. INNER CASING OR TUBING (geothermal closed-loop)
FROM TO DIAMETER THICKNESS MATERIAL
ft.ft.in.
ft.ft.in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
ft.ft.in.
ft.ft.in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
ft.ft.
ft.ft.
ft.ft.
19. SAND/GRAVEL PACK (if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
ft.ft.
ft.ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM TO DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
ft.ft.
21. REMARKS
22. Certification:
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Mike Tynan
2725-A
IET
9/28/20 MW-2
Former Service Station
720 N. Main St, High Point 27262
Guilford
35 57 48.40 80 00 36.43
30
~15
10.5
auger
9/29/20
15 30 clayey silt
0 10 4 Sch40 PVC
10 30 4 0.010 Sch40 PVC
0
3
8
3
8
30
concrete
bentonite
#2 silica sand pour through augers
pour
See Report
Wells completed at surface with flush mount covers
and 2'x2' concrete pads.
Print Form
pour
APPENDIX D
STANDARD OPERATING PROCEDURES
STANDARD OPERATING PROCEDURES
PARAGON ENVIRONMENTAL CONSULTANTS, INC.
I. SOIL SAMPLE PROCEDURES
1. Collect all samples using disposable Latex gloves. Gloves are not to be re- used. 2. Place samples into laboratory supplied glassware following requirements for specific analysis. 3. Label samples with sample ID, date, time, and job number. Immediately place samples on ice or in refrigerator to be cooled to approximately 4 degrees Celsius. 4. Store all samples on ice or refrigerate until samples are delivered to the laboratory. 5. Complete a chain of custody record for samples to be submitted to laboratory. Sign and date the chain of custody when samples are relinquished in accordance with EPA chain of custody protocol. II. GROUNDWATER SAMPLING 1. Use new disposable bailer and new nylon string to develop well and collect sample. Handle bailer and string with Latex gloves. 2. Develop well by removing 3 well volumes of water. Dispose of water in accordance with NCDEQ guidelines. 3. Following well development obtain samples in laboratory supplied glassware following requirements for specific analysis. 4. Handle, store, and transport samples in same manner as for soil samples. See items I.3, I.4, and I.5 above. III. EQUIPMENT CONTAMINATION 1. Decontaminate augers, split spoons, and other sampling equipment by the following procedure: A. Soap and tap water wash B. Tap water rinse C. Distilled deionized water rinse D. Isopropyl alcohol rinse E. Distilled water rinse 2. Use new disposable sampling equipment whenever practical.
SOP