MO-28945_48148_CA_UST-61_20211203_UST Leak Reporting

UST-61 .
For Releases
in NC
This form should be completed and submitted to the UST Section’s regional office following a known or suspected release from
an underground storage tank (UST) system. This form is required to be submitted within 24 hours of discovery of a known or
suspected release
(DWM USE ONLY)
Incident # ________ Risk (H,I,L,U)_______
Received On ________ Received By ________
Reported by (circle one): Phone, Fax or Report
Region _______
Suspected Contamination? (Y/N) ________
Confirmed GW Contamination? (Y/N) ______
Confirmed Soil Contamination ?(Y/N) ______
Samples Taken?(Y/N) ______
Free Product? (Y/N) _____ If Yes, State Greatest
Thickness ______________
Facility ID Number ______________
Date Leak Discovered ___________
Comm/Non-Commercial? ________
Reg/Non-regulated? _____________
INCIDENT DESCRIPTION
Incident Name:
Address:County:
City/Town: Zip Code:
Regional Office (circle one): Asheville, Mooresville, Fayetteville,
Raleigh, Washington, Wilmington, Winston-Salem
Latitude (decimal degrees): Longitude (decimal degrees) :Obtained by:
Briefly describe suspected or confirmed release: (including but not limited to: nature of release, date of release, amount
of release, amount of free product present and recovery efforts, initial responses conducted, impacts to receptors) GPS
Topographic map
GIS Address matching
Other
Unknown
Describe location:
HOW RELEASE WAS DISCOVERED (Release Code)
(Check one)
Release Detection Equipment or Methods
During UST Closure/Removal
Property Transfer
Visual/Odor
Water in Tank
Water Supply Well Contamination
Groundwater Contamination
Surface Water Contamination
Other (specify) _______________
SOURCE OF CONTAMINATION
Source of Release
(Check one to indicate primary
source)
Cause of Release
(Check one to indicate primary
cause)
Type of Release
(Check one)
Product Type Released
(Check one to indicate primary product type
released)
Tank
Piping
Dispenser
Submersible Turbine Pump
Delivery Problem
Other
Unknown
Definitions presented on reverse
Spill
Overfill
Corrosion
Physical or Mechanical
Damage
Install Problem
Other
Unknown
Definitions presented on reverse
Petroleum
Non-Petroleum
Both
Location
(Check one)
Facility
Residence
Other
Gasoline/ Diesel/
Kerosene
Heating Oil
Other Petroleum
Products
Metals
Other Inorganics
Other Organics
Diesel/Veg. Oil
Blend
Vegetable Oil 100%
E10 – E20
E21 – E84
E85 – E99
Ethanol 100%
E01 – E09
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
UST Form 61 (02/08)Page 1 of 2
NNYYN
0-02453212/3/2021CommReg
Buttery & Beanery
1653 Mecklenburg Highway
Mooresville 28115
Iredell
_______
35.534601 -80.846361
X
Soil samples collected during UST removal indicated TPH-GRO concentrations
greater than 100 mg/kg.
X
X
X
X
X
X
X
______
________
IMPACT ON DRINKING WATER SUPPLIES
Water Supply Wells Affected? 1. Yes 2. No 3. Unknown
Number of Water Supply Wells Affected __________________
Water Supply Wells Contaminated: (Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
UST SYSTEM OWNER
UST Owner/Company
Point of Contact Address
City State Zip Code Telephone Number
UST SYSTEM OPERATOR
UST Operator/Company Address
City State Zip Code Telephone Number
LANDOWNER AT LOCATION OF UST INCIDENT
Landowner Address
City State Zip Code Telephone Number
Draw Sketch of Area (showing two major road intersections) or Attach Map
Person Reporting Incident Company Telephone Number
Title Address Date
UST Form 61 (02/08)Page 2 of 2
Definitions of Sources
Tank: means the tank that stores the product and is part of the underground storage tank system
Piping: means the piping and connectors running from the tank or submersible turbine pump to the dispenser or other end-use equipment (Vent, vapor recovery, or fill
lines are excluded.)
Dispenser:includes the dispenser and the equipment used to connect the dispenser to the piping (e.g., a release from a suction pump or from components located above
the shear valve)
Submersible Turbine Pump (STP) Area includes the submersible turbine pump head (typically located in the tank sump), the line leak detector, and the piping that
connects the submersible turbine pump to the tank
Delivery Problem: identifies releases that occurred during product delivery to the tank. (Typical causes associated with this source are spills and overfills.)
Other: serves as the option to use when the release source is known but does not fit into one of the preceding categories (e.g., for releases from vent lines, vapor
recovery lines, and fill lines)
Unknown: identifies releases for which the source has not been determined
Definitions of Causes
Spill: use this cause when a spill occurs (e.g., when the delivery hose is disconnected from the tank fill pipe or when the nozzle is removed from the dispenser)
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)
Physical or Mechanical Damage:use for all types of physical or mechanical damage, except corrosion (e.g., puncture of tank or piping, loose fittings, broken
components, and components that have changed dimension)
Corrosion:use when a metal tank, piping, or other component has a release due to corrosion (e.g., for steel, corrosion takes the form of rust)
Installation Problem: use when the problem is determined to have occurred specifically because the UST system was not installed properly
Other: use this option when the cause is known but does not fit into one of the preceding categories (e.g., putting regulated substances into monitoring wells)
Unknown: use when the cause has not been determined
________
Estate of Linda Holthouser
Kathy Holthouser 1653 Mecklenburg Hwy.
Mooresville NC 28115 704-892-0263
As above
As Above
See attached
Michael Shaw ATC Associates of NC 704-529-3200
Sr. Program Manager 7606 Whitehall Exec Center Dr
Charlotte, NC 28273
12/3/2021
Tabl 3: Soil Analial aa
an
3 lnb ia
ooill o aolina
Sal ollion
a

S
T

T

ain

TA 11/23/21 10 758
T11/23/21 10 36
TA 11/23/21 10 5 00
T11/23/21 10 85 00
T3A 11/23/21 6 106 67 00
T311/23/21 6 61 00
A 11/22/21 5 56
11/22/21 5 2210 35
A 11/23/21 5 150
11/23/21 5 87 00
3A 11/23/21 2 0 213 00
11/23/21 2 700
11/23/21 2 700

TS:

AT
#=CL#
December 01, 2021
LIMS USE: FR - MICHAEL SHAW
LIMS OBJECT ID: 92574121
92574121
Project:
Pace Project No.:
RE:
Michael Shaw
ATC Group Services LLC
7606 Whitehall Executive Cente
Suite 800
Charlotte, NC 28273
BUTTERY & BEANERY
Dear Michael Shaw:
Enclosed are the analytical results for sample(s) received by the laboratory on November 23, 2021. The results relate only
to the samples included in this report. Results reported herein conform to the applicable TNI/NELAC Standards and the
laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
• Pace Analytical Services - Charlotte
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Bonnie Vang
[e-mail]
Project Manager
[phone]
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 1 of 30
#=CP#
CERTIFICATIONS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Pace Analytical Services Charlotte
South Carolina Laboratory ID: 99006
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Laboratory ID: 99006
South Carolina Certification #: 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
Louisiana DoH Drinking Water #: LA029
Virginia/VELAP Certification #: 460221
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 2 of 30
#=SS#
SAMPLE SUMMARY
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Lab ID Sample ID Matrix Date Collected Date Received
92574121001 T-1 A Solid 11/23/21 09:10 11/23/21 13:30
92574121002 T-1 B Solid 11/23/21 09:15 11/23/21 13:30
92574121003 T-3 A Solid 11/23/21 09:00 11/23/21 13:30
92574121004 T-3 B Solid 11/23/21 09:05 11/23/21 13:30
92574121005 D-3 A Solid 11/23/21 09:40 11/23/21 13:30
92574121006 T-2 A Solid 11/23/21 09:20 11/23/21 13:30
92574121007 T-2 B Solid 11/23/21 09:25 11/23/21 13:30
92574121008 D-1 A Solid 11/22/21 16:00 11/23/21 13:30
92574121009 D-1 B Solid 11/22/21 16:05 11/23/21 13:30
92574121010 D-2 A Solid 11/23/21 09:30 11/23/21 13:30
92574121011 D-2 B Solid 11/23/21 09:35 11/23/21 13:30
92574121012 L-1 Solid 11/23/21 09:45 11/23/21 13:30
92574121013 L-2 Solid 11/23/21 10:50 11/23/21 13:30
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 3 of 30
#=SA#
SAMPLE ANALYTE COUNT
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Lab ID Sample ID Method
Analytes
Reported LaboratoryAnalysts
92574121001 T-1 A EPA 8015C 2 PASI-CAP2
EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121002 T-1 B EPA 8015C 2 PASI-CHH
EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121003 T-3 A EPA 8015C 2 PASI-CHH
EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121004 T-3 B EPA 8015C 2 PASI-CHH
EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121005 D-3 A EPA 8015C 2 PASI-CHH
EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121006 T-2 A EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121007 T-2 B EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121008 D-1 A EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121009 D-1 B EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121010 D-2 A EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121011 D-2 B EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121012 L-1 EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
92574121013 L-2 EPA 8015C 2 PASI-CMAD
SW-846 1 PASI-CKDF
PASI-C = Pace Analytical Services - Charlotte
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 4 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-1 A Lab ID:92574121001 Collected:11/23/21 09:10 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 3546
Pace Analytical Services - Charlotte
8015 GCS THC-Diesel
Diesel Range Organics(C10-C28)1000 mg/kg 11/29/21 10:3711/24/21 11:1026.8 4
Surrogates
n-Pentacosane (S)75 %11/29/21 10:37 629-99-211/24/21 11:1032-130 4
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)48900 mg/kg 11/30/21 06:0811/29/21 12:00998100
Surrogates
4-Bromofluorobenzene (S)116 %11/30/21 06:08 460-00-411/29/21 12:0066-131 100
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 24.7 %11/23/21 17:11 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 5 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-1 B Lab ID:92574121002 Collected:11/23/21 09:15 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 3546
Pace Analytical Services - Charlotte
8015 GCS THC-Diesel
Diesel Range Organics(C10-C28)148 mg/kg 11/24/21 16:2211/24/21 11:106.9 1
Surrogates
n-Pentacosane (S)73 %11/24/21 16:22 629-99-211/24/21 11:1032-130 1
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)2080 mg/kg 11/30/21 06:3611/29/21 12:0052.7 5
Surrogates
4-Bromofluorobenzene (S)137 %11/30/21 06:36 460-00-4 S211/29/21 12:0066-131 5
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 25.9 %11/23/21 17:11 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 6 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-3 A Lab ID:92574121003 Collected:11/23/21 09:00 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 3546
Pace Analytical Services - Charlotte
8015 GCS THC-Diesel
Diesel Range Organics(C10-C28)ND mg/kg 11/24/21 16:3911/24/21 11:106.7 1
Surrogates
n-Pentacosane (S)80 %11/24/21 16:39 629-99-211/24/21 11:1032-130 1
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/29/21 15:0711/29/21 12:0010.6 1
Surrogates
4-Bromofluorobenzene (S)91 %11/29/21 15:07 460-00-411/29/21 12:0066-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 24.8 %11/23/21 17:11 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 7 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-3 B Lab ID:92574121004 Collected:11/23/21 09:05 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 3546
Pace Analytical Services - Charlotte
8015 GCS THC-Diesel
Diesel Range Organics(C10-C28)ND mg/kg 11/24/21 16:3911/24/21 11:106.1 1
Surrogates
n-Pentacosane (S)85 %11/24/21 16:39 629-99-211/24/21 11:1032-130 1
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/24/21 21:4211/24/21 10:199.4 1
Surrogates
4-Bromofluorobenzene (S)93 %11/24/21 21:42 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 18.7 %11/23/21 17:32 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 8 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:D-3 A Lab ID:92574121005 Collected:11/23/21 09:40 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 3546
Pace Analytical Services - Charlotte
8015 GCS THC-Diesel
Diesel Range Organics(C10-C28)21.3 mg/kg 11/24/21 16:5511/24/21 11:106.5 1
Surrogates
n-Pentacosane (S)75 %11/24/21 16:55 629-99-211/24/21 11:1032-130 1
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/24/21 22:1011/24/21 10:199.0 1
Surrogates
4-Bromofluorobenzene (S)87 %11/24/21 22:10 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 22.0 %11/23/21 17:32 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 9 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-2 A Lab ID:92574121006 Collected:11/23/21 09:20 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/24/21 22:3811/24/21 10:199.5 1
Surrogates
4-Bromofluorobenzene (S)90 %11/24/21 22:38 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 12.7 %11/23/21 17:32 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 10 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:T-2 B Lab ID:92574121007 Collected:11/23/21 09:25 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/24/21 23:0611/24/21 10:198.5 1
Surrogates
4-Bromofluorobenzene (S)93 %11/24/21 23:06 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 15.0 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 11 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:D-1 A Lab ID:92574121008 Collected:11/22/21 16:00 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)2870 mg/kg 11/30/21 07:0411/29/21 12:0049.4 5
Surrogates
4-Bromofluorobenzene (S)187 %11/30/21 07:04 460-00-4 S211/29/21 12:0066-131 5
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 26.2 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 12 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:D-1 B Lab ID:92574121009 Collected:11/22/21 16:05 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)2210 mg/kg 11/30/21 07:3211/29/21 12:0048.2 5
Surrogates
4-Bromofluorobenzene (S)171 %11/30/21 07:32 460-00-4 S211/29/21 12:0066-131 5
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 24.9 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 13 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:D-2 A Lab ID:92574121010 Collected:11/23/21 09:30 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)56.1 mg/kg 11/24/21 23:3411/24/21 10:1910.0 1
Surrogates
4-Bromofluorobenzene (S)109 %11/24/21 23:34 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 27.1 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 14 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:D-2 B Lab ID:92574121011 Collected:11/23/21 09:35 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/25/21 00:0211/24/21 10:198.7 1
Surrogates
4-Bromofluorobenzene (S)86 %11/25/21 00:02 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 20.7 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
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9800 Kincey Ave. Suite 100
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Page 15 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:L-1 Lab ID:92574121012 Collected:11/23/21 09:45 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/25/21 00:3111/24/21 10:197.9 1
Surrogates
4-Bromofluorobenzene (S)91 %11/25/21 00:31 460-00-411/24/21 10:1966-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 18.3 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
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Page 16 of 30
#=AR#
ANALYTICAL RESULTS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Sample:L-2 Lab ID:92574121013 Collected:11/23/21 10:50 Received:11/23/21 13:30 Matrix:Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units DF Prepared Analyzed CAS No.QualReport Limit
Analytical Method: EPA 8015C Preparation Method: EPA 5030B
Pace Analytical Services - Charlotte
Gasoline Range Organics
Gas Range Organics (C6-C10)ND mg/kg 11/30/21 00:3011/29/21 12:007.4 1
Surrogates
4-Bromofluorobenzene (S)89 %11/30/21 00:30 460-00-411/29/21 12:0066-131 1
Analytical Method: SW-846
Pace Analytical Services - Charlotte
Percent Moisture
Percent Moisture 20.6 %11/23/21 17:33 N20.10 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 17 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
662106
EPA 5030B
EPA 8015C
Gasoline Range Organics
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121004, 92574121005, 92574121006, 92574121007, 92574121010, 92574121011, 92574121012
Parameter Units
Blank
Result
Reporting
Limit Qualifiers
METHOD BLANK:3468972
Associated Lab Samples:92574121004, 92574121005, 92574121006, 92574121007, 92574121010, 92574121011, 92574121012
Matrix:Solid
Analyzed
Gas Range Organics (C6-C10)mg/kg ND 5.9 11/24/21 18:25
4-Bromofluorobenzene (S)%87 66-131 11/24/21 18:25
Parameter Units
LCS
Result
% Rec
Limits Qualifiers% RecConc.
3468973LABORATORY CONTROL SAMPLE:
LCSSpike
Gas Range Organics (C6-C10)mg/kg 48.249.5 97 70-130
4-Bromofluorobenzene (S)%94 66-131
Parameter Units
MS
Result
% Rec
Limits Qualifiers% RecConc.
3468975MATRIX SPIKE SAMPLE:
MSSpike
Result
92573596004
Gas Range Organics (C6-C10)mg/kg 81.662.4 131 70-145ND
4-Bromofluorobenzene (S)%97 66-131
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92573491001
3468974SAMPLE DUPLICATE:
Gas Range Organics (C6-C10)mg/kg ND 30ND
4-Bromofluorobenzene (S)%8991
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 18 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
662541
EPA 5030B
EPA 8015C
Gasoline Range Organics
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121003, 92574121013
Parameter Units
Blank
Result
Reporting
Limit Qualifiers
METHOD BLANK:3471082
Associated Lab Samples:92574121003, 92574121013
Matrix:Solid
Analyzed
Gas Range Organics (C6-C10)mg/kg ND 5.9 11/29/21 14:11
4-Bromofluorobenzene (S)%92 66-131 11/29/21 14:11
Parameter Units
LCS
Result
% Rec
Limits Qualifiers% RecConc.
3471083LABORATORY CONTROL SAMPLE:
LCSSpike
Gas Range Organics (C6-C10)mg/kg 54.949.5 111 70-130
4-Bromofluorobenzene (S)%95 66-131
Parameter Units
MS
Result
% Rec
Limits Qualifiers% RecConc.
3471085MATRIX SPIKE SAMPLE:
MSSpike
Result
92574229002
Gas Range Organics (C6-C10)mg/kg 11771.3 139 70-14518.0
4-Bromofluorobenzene (S)%S213766-131
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574121003
3471084SAMPLE DUPLICATE:
Gas Range Organics (C6-C10)mg/kg ND 30ND
4-Bromofluorobenzene (S)%9091
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 19 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
662543
EPA 5030B
EPA 8015C
Gasoline Range Organics
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121001, 92574121002, 92574121008, 92574121009
Parameter Units
Blank
Result
Reporting
Limit Qualifiers
METHOD BLANK:3471088
Associated Lab Samples:92574121001, 92574121002, 92574121008, 92574121009
Matrix:Solid
Analyzed
Gas Range Organics (C6-C10)mg/kg ND 5.9 11/29/21 14:39
4-Bromofluorobenzene (S)%92 66-131 11/29/21 14:39
Parameter Units
LCS
Result
% Rec
Limits Qualifiers% RecConc.
3471089LABORATORY CONTROL SAMPLE:
LCSSpike
Gas Range Organics (C6-C10)mg/kg 49.749.5 100 70-130
4-Bromofluorobenzene (S)%97 66-131
Parameter Units
MS
Result
% Rec
Limits Qualifiers% RecConc.
3471091MATRIX SPIKE SAMPLE:
MSSpike
Result
92574238003
Gas Range Organics (C6-C10)mg/kg 83.868.8 122 70-145ND
4-Bromofluorobenzene (S)%95 66-131
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574238002
3471090SAMPLE DUPLICATE:
Gas Range Organics (C6-C10)mg/kg ND 30ND
4-Bromofluorobenzene (S)%9090
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 20 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
662110
EPA 3546
EPA 8015C
8015 Solid GCSV
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121001, 92574121002, 92574121003, 92574121004, 92574121005
Parameter Units
Blank
Result
Reporting
Limit Qualifiers
METHOD BLANK:3468987
Associated Lab Samples:92574121001, 92574121002, 92574121003, 92574121004, 92574121005
Matrix:Solid
Analyzed
Diesel Range Organics(C10-C28)mg/kg ND 5.0 11/24/21 14:29
n-Pentacosane (S)%86 32-130 11/24/21 14:29
Parameter Units
LCS
Result
% Rec
Limits Qualifiers% RecConc.
3468988LABORATORY CONTROL SAMPLE:
LCSSpike
Diesel Range Organics(C10-C28)mg/kg 53.266.4 80 47-130
n-Pentacosane (S)%84 32-130
Parameter Units
MS
Result
% Rec
Limits Qualifiers% RecConc.
3468989MATRIX SPIKE SAMPLE:
MSSpike
Result
92574089001
Diesel Range Organics(C10-C28)mg/kg 66.685 76 10-133ND
n-Pentacosane (S)%73 32-130
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574109001
3468990SAMPLE DUPLICATE:
Diesel Range Organics(C10-C28)mg/kg 5500 D6653010800
n-Pentacosane (S)%0 S40
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 21 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
661928
SW-846
SW-846
Dry Weight/Percent Moisture
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121001, 92574121002, 92574121003
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92573830003
3468171SAMPLE DUPLICATE:
Percent Moisture %13.1 N292514.3
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574121003
3468645SAMPLE DUPLICATE:
Percent Moisture %24.8 N202524.8
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 22 of 30
#=QC#
QUALITY CONTROL DATA
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
QC Batch:
QC Batch Method:
Analysis Method:
Analysis Description:
661998
SW-846
SW-846
Dry Weight/Percent Moisture
Laboratory:Pace Analytical Services - Charlotte
Associated Lab Samples:92574121004, 92574121005, 92574121006, 92574121007, 92574121008, 92574121009, 92574121010,
92574121011, 92574121012, 92574121013
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574109001
3468713SAMPLE DUPLICATE:
Percent Moisture %23.2 N212523.4
Parameter Units
Dup
Result
Max
RPD QualifiersRPDResult
92574121013
3468714SAMPLE DUPLICATE:
Percent Moisture %21.1 N232520.6
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 23 of 30
#=QL#
QUALIFIERS
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL - Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean-Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Reported results are not rounded until the final step prior to reporting. Therefore, calculated parameters that are typically reported as
"Total" may vary slightly from the sum of the reported component parameters.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
ANALYTE QUALIFIERS
The precision between the sample and sample duplicate exceeded laboratory control limits.D6
The lab does not hold NELAC/TNI accreditation for this parameter but other accreditations/certifications may apply. A
complete list of accreditations/certifications is available upon request.
N2
Surrogate recovery outside laboratory control limits due to matrix interferences (confirmed by similar results from sample
re-analysis).
S2
Surrogate recovery not evaluated against control limits due to sample dilution.S4
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 24 of 30
#=CR#
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Project No.:
Project:
92574121
BUTTERY & BEANERY
Lab ID Sample ID QC Batch Method QC Batch Analytical Method
Analytical
Batch
92574121001 662110 662283T-1 A EPA 3546 EPA 8015C
92574121002 662110 662283T-1 B EPA 3546 EPA 8015C
92574121003 662110 662283T-3 A EPA 3546 EPA 8015C
92574121004 662110 662283T-3 B EPA 3546 EPA 8015C
92574121005 662110 662283D-3 A EPA 3546 EPA 8015C
92574121001 662543 662621T-1 A EPA 5030B EPA 8015C
92574121002 662543 662621T-1 B EPA 5030B EPA 8015C
92574121003 662541 662576T-3 A EPA 5030B EPA 8015C
92574121004 662106 662149T-3 B EPA 5030B EPA 8015C
92574121005 662106 662149D-3 A EPA 5030B EPA 8015C
92574121006 662106 662149T-2 A EPA 5030B EPA 8015C
92574121007 662106 662149T-2 B EPA 5030B EPA 8015C
92574121008 662543 662621D-1 A EPA 5030B EPA 8015C
92574121009 662543 662621D-1 B EPA 5030B EPA 8015C
92574121010 662106 662149D-2 A EPA 5030B EPA 8015C
92574121011 662106 662149D-2 B EPA 5030B EPA 8015C
92574121012 662106 662149L-1 EPA 5030B EPA 8015C
92574121013 662541 662576L-2 EPA 5030B EPA 8015C
92574121001 661928T-1 A SW-846
92574121002 661928T-1 B SW-846
92574121003 661928T-3 A SW-846
92574121004 661998T-3 B SW-846
92574121005 661998D-3 A SW-846
92574121006 661998T-2 A SW-846
92574121007 661998T-2 B SW-846
92574121008 661998D-1 A SW-846
92574121009 661998D-1 B SW-846
92574121010 661998D-2 A SW-846
92574121011 661998D-2 B SW-846
92574121012 661998L-1 SW-846
92574121013 661998L-2 SW-846
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.Date: 12/01/2021 05:18 PM
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 25 of 30
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