WA-28270_47531_CA_RPTS_20210205

APPENDIX A

Drawing / Project Name
Client
Project #
DB Fig. Scale
Date
N
Base diagram from Google Maps
Site Location Diagram
Diesel Fuel UST Closure
223 Nash Street W; Wilson, NC
D.H Griffin Companies / BB&T
514008
JBAs Shown
January 2021
1
PM PG
BA
PE
Approximate Scale 
feet
0 580 290 
JB
Location of
Former UST

Drawing / Project Name
Client
Project #
DB Fig. Scale
Date
N
Base diagram from USGS Topographic Quadrangle; Wilson, NC; 2016
Topographic Location Diagram
Diesel Fuel UST Closure
223 Nash Street W; Wilson, NC
D H Griffin Companies / BB&T
514008
JBAs Shown
January 2021
2
PM PG
Site Location
BA
PE
Approximate Scale 
feet 
0 1400 700 
JB

Drawing / Project Name
Client
Project #
DB Fig. Scale
Date
N
Base diagram from Google Earth
Former UST Location Diagram
Diesel Fuel UST Closure
223 Nash Street W; Wilson, NC
D H Griffin Companies / BB&T
514008
JBAs Shown
January 2021
3
PM PG
Location of
Former UST
JB
PE
Approximate Scale 
feet 
0 290 145 
JB
S-1S-2P-1P-2 P-3P-4P-5Approximate Extent of UST BasinStructureFormer GeneratorBuildingFormer ProductLineFenceAsphaltAsphaltGrassPG:DB:Project Number:Date:Scale:PE:PM:Drawing NameSite / Client NameFig.LegendApproximate Scale01020NfeetSoil sample locationExcavation and Sampling DiagramUST ClosureD.H. Griffin / BB&TWilson, NCJBJBJB514008February 2021As Shown4

APPENDIX B

Tank Number Status Installation Date Size In Gallons Tank Dimensions Last Contents1 Removed Not determined 4,000 6' x 16' Diesel FuelTable 1Summary of UST InformationUST Closure223 Nash Street North; Wilson, North CarolinaHES Project #514008
1 Branch Bank & Trust Co Branch Bank & Trust CoUST ID Number Name of Owner or OperatorDates of Ownership/ Operation Owner or OperatorN/APO Box 167 Winston Salem NC 27102-0167N/ATelephone NumberAddressTable 2Summary of UST Ownership InformationUST Closure223 Nash Street North; Wilson, North CarolinaHES Project #514008
Field
Date of
Collection
Depth of
Collection
(feet)
S-1 1/20/21 10 17.4 1387.0 23197
S-2 1/20/21 10 7.6 <0.8 3.2
P-1 1/20/21 1.5 1.4 2.1 8.6
P-2 1/20/21 1.5 1.1 <0.79 1.5
P-3 1/20/21 1.5 12.9 395.0 7668
P-4 1/20/21 1.5 5.9 <131 4137
P-5 1/20/21 1.5 2.1 <8.2 23.2
50 100
Notes:Bold denotes concentration greater than State Action Limits.
NCDEQ State Action Limit
Constituent of Concern
Table 3
UST Closure
223 Nash Street North; Wilson, North Carolina
HES Project #514008
Summary of Analytical Data
(Soil Samples)
Analytical Method (e.g., VOC by EPA 8260B)
Sample
Number PID Screening (ppm)Diesel Range Organics (mg/kg)Gasoline Range Organics (mg/kg)REDLab UVF

APPENDIX C

Highlands Environmental Solutions, Inc.

HEALTH AND SAFETY PLAN

For Site Activities at:
BB&T
223 Nash Street West;
Wilson, NC 27893

January 2021

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

Joe Beaman, P.G.
Project Manager

The information in this HASP is provided solely for the protection of the health and safety of Highlands
Environmental Solutions employees and subcontractors working under the direct supervision and control of
Highlands Environmental Solutions on this project. Highlands Environmental Solutions assumes no liability
for, or responsibility to, any other parties for the accuracy or completeness of the information contained herein
for any use or reliance upon this HASP by any other party.
Health and Safety Plan Page 2
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

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

Do not endanger your life. Survey the situation before taking any action.
Highlands Environmental Solutions Office
Telephone: [phone]
Site Location Address: 223 Nash Street W; Wilson, NC
Telephone Located at: HES Personnel (cellular phone)

EMERGENCY
PHONE NUMBERS

Ambulance: 911
Fire: 911
Police: 911
Hospital Name: Wilson Medical Center
Hospital Phone: [phone]
Project Manager: Joe Beaman (919-414-7081)
Health and Safety Specialist: Bakri Abushouk (919-523-3679)
Client Contact: Mr. Eric McManus 336-214-9012
Poison Control: [phone]
State Agency: NCDEQ – Washington Regional Office [phone]

UTILITY MARKER EMERGENCY TELEPHONE NUMBERS

Utility Color Code

Telephone Number
Water
Gas
Electric
Telephone
Cable
Sewer
Blue
Yellow
Red
Orange
Orange
Green
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
Dig Safe Telephone Number:

Health and Safety Plan Page 3
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

HOSPITAL LOCATION MAP

Hospital Directions:
1705 Tarboro St SW, Wilson, NC 27893
Head southeast on Nash St N toward Pine St W
0.9 mi
Pin St W turns slightly right and becomes
Tarboro St W
1.6 mi
Turn Left
243 ft

Destination will be on the right

Hospital Information:
Name: Wilson Medical Center
Address: 1705 Tarboro St SW
City, State: Wilson, NC 27893
Phone: [phone]

Health and Safety Plan Page 4
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

FIRST AID FOR PETROLEUM HYDROCARBON EMERGENCIES

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

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

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

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

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

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

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

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

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

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

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

5. Notify the PM.
Health and Safety Plan Page 5
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

EMERGENCY FIRST AID PROCEDURES
To Stop Bleeding CPR

1. Give medical statement.
2. Assure airway, breathing, and
circulation.
3. Use DIRECT PRESSURE over the
wound with clean dressing or your
hand (use nonpermeable gloves).
Direct pressure will control most
bleeding.
4. Bleeding from an artery or several
injury sites may require DIRECT
PRESSURE on a PRESSURE
POINT. Use pressure points for
30 - 60 seconds to help control
severe bleeding.
5. Continue primary care and seek
medical aid as needed.
1. Call for help.
2. Arousal: check for consciousness.
3. Open airway with chin-lift.
4. Look, listen, and feel for breathing.
5. If breathing is absent, give 2 slow, full
rescue breaths.
6. Check the pulse for 5 to 10 seconds.
7. If pulse is present, continue rescue
breathing: 1 breath every
5 seconds
8. If pulse is absent, start CPR:
15 compressions, 2 breaths (1 man)
Health and Safety Plan Page 6
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

Project and Health and Safety Information
HES will be performing a soil excavation for a gasoline release incident at the subject location.

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

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

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

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

x Hard Hat x Safety Vest
x Steel Toe Boots Chemical Boots
x Nitrile gloves (sampling gloves) Heavy Nitrile gloves
x Safety glasses Ear plugs/earmuffs (sound suppression as
needed)
White Tyvek Yellow (polycoated) Tyvek
Health and Safety Plan Page 7
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

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

. Potential Hazards and Control

Potential Hazard

Control

Exposure to
Petroleum
Products

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

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

1. HES Personnel do not perform Confined Space Entry.

Utility Lines
Contact

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

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

1. Wear hearing protection when equipment such as a drill rig, jackhammer,
cut saw, air compressor, blower or other heavy equipment is operating on
the site.
2. Wear hearing protection whenever you need to raise your voice above
normal conversational speech due to a loud noise source; this much noise
indicates the need for protection.
Health and Safety Plan Page 8
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

Potential Hazard

Control

Electric
Shock

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

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

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

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

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

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

1. Tuck pants into socks.
2. Wear long sleeves.
3. Use insect repellent.
Poisonous Plants
(Such as Poison
Ivy, Oak, etc.)

1. Don't enter areas infested with poisonous plants.
2. Immediately wash any areas that come into contact with poisonous
plants.
Health and Safety Plan Page 9
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

Potential Hazard

Control

Ladders

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

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

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

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

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

1. Before conducting welding at a project site, contact the Project Manager..

Cleaning
Equipment

1. Wear appropriate PPE to avoid skin and eye contact with isopropyl
alcohol, alconox, or other cleaning materials.
2. Stand upwind to minimize any potential inhalation exposure.
3. Dispose of spent cleaning solutions and rinses accordingly.
First aid kit, emergency eye wash station, fire extinguisher, and absorbent
pads will be located on-site in the vehicle or site remediation system.
Health and Safety Plan Page 10
BB&T / DH Griffin – 223 Nash St W; Wilson, NC January 2021

Signature Sheet

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

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

Name Signature

APPENDIX D

APPENDIX E

Legend
223 Nash St N
1000 ft
N➤➤N
© 2020 Google
© 2020 Google
© 2020 Google

APPENDIX F

Photograph Number 1: Removal of liquids from UST.
Photograph Number 2: Removal of concrete pad.

Photograph Number 3: Pea gravel beneath concrete pad.
Photograph Number 4: Exposure of UST.

Photograph Number 5: Removal of UST.
Photograph Number 6: UST after removal.

Photograph Number 7: UST after removal.
Photograph Number 8: UST after removal.

Photograph Number 9: UST after removal.
Photograph Number 10: Exposure and removal of underground piping.

Photograph Number 11: “T” connection in underground piping.
Photograph Number 12: Over-excavation of piping trench.

APPENDIX G

Hydrocarbon Analysis ResultsClient:HESSamples takenWednesday, January 20, 2021Address:8410-D RALEIGH, NC Samples extractedThursday, January 21, 2021Samples analysedThursday, January 21, 2021Contact:JOE BEAMANOperatorTORI KELLY Project:#5140087F03640Matrix Sample IDDilution usedBTEX (C6 - C9)GRO (C5 - C10)DRO (C10 - C35)TPH (C5 - C35)Total Aromatics (C10-C35)16 EPA PAHsBaP HC Fingerprint Match% light % mid% heavys S-1 5638.0 <140.9 1387 23197 24584 7101 267 <5.6 64.4 33.7 1.8Deg.Diesel 86.5%,(FCM)s S-2 32.1 <0.8 <0.8 3.2 3.2 0.97 <0.26 <0.032 0 100 0Deg.Diesel 74.9%,(FCM)s P-1 34.1 <0.85 2.1 8.6 10.7 4.6 <0.27 <0.034 46.3 36.5 17.2Deg.Fuel 78.6%,(FCM)s P-2 31.8 <0.79 <0.79 1.5 1.5 0.47 <0.25 <0.032 0 64.5 35.5Deg Fuel 61.8%,(FCM)s P-3 2055.0 <51.4 395 7668 8063 2336 87.7 <2.1 61.6 36.2 2.3Deg.Diesel 81.8%,(FCM)s P-4 5241.0 <131 <131 4137 4137 1013 <41.9 <5.2 0 95.1 4.9Deg.Diesel 76.6%,(FCM)Initial Calibrator QC checkOKFinal FCM QC CheckOK 104.2 %Results generated by a QED HC-1 analyser. Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values are not corrected for moisture or stone contentFingerprints provide a tentative hydrocarbon identification. The abbreviations are:- FCM = Results calculated using Fundamental Calibration Mode : % = confidence for sample fingerprint match to library(SBS) or (LBS) = Site Specific or Library Background Subtraction applied to result : (PFM) = Poor Fingerprint Match : (T) = Turbid : (P) = Particulate presentRatios
Hydrocarbon Analysis ResultsClient:HESSamples takenWednesday, January 20, 2021Address:8410-D RALEIGH, NC Samples extractedThursday, January 21, 2021Samples analysedThursday, January 21, 2021Contact:JOE BEAMAN OperatorTORI KELLYProject:#5140081F03640Matrix Sample IDDilution usedBTEX (C6 - C9)GRO (C5 - C10)DRO (C10 - C35)TPH (C5 - C35)Total Aromatics (C10-C35)16 EPA PAHsBaP HC Fingerprint Match% light % mid% heavys P-5 326.0 <8.2 <8.2 23.2 23.2 15.8 <2.6 <0.33 20.4 66.8 12.8Deg Fuel 71%,(FCM)Initial Calibrator QC checkOKFinal FCM QC CheckOK 105.4 %Results generated by a QED HC-1 analyser. Concentration values in mg/kg for soil samples and mg/L for water samples. Soil values are not corrected for moisture or stone contentFingerprints provide a tentative hydrocarbon identification. The abbreviations are:- FCM = Results calculated using Fundamental Calibration Mode : % = confidence for sample fingerprint match to library(SBS) or (LBS) = Site Specific or Library Background Subtraction applied to result : (PFM) = Poor Fingerprint Match : (T) = Turbid : (P) = Particulate presentRatios

APPENDIX H

APPENDIX I
UST-2 Site Investigation Report for Permanent Closure or Change-in-Service of UST
Return completed form to:
The DWM Regional Office located in the area where the facility is located. Send a copy to the Central Office in Raleigh so that
the status of the tank may be changed to "PERMANENTLY CLOSED" and your tank fee account can be closed out.
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)
For more than five UST systems you may attach additional forms as needed.
Permanent closure – For permanent closure, complete all sections of this form.
Change-in-service – For change-in-service where UST systems will be converted from containing a regulated substance to storing a non-regulated
substance, complete sections I, II, III, IV, and VIII
Effective February 1, 1995, all UST closure/change-in-service reports must be submitted in the format provided in the UST-12 form. UST closure and
change-in-services must be completed in accordance with the latest version of the Guidelines for Tank Closure. A copy of the UST-12 form and the
Guidelines for Tank Closure can be obtained at www.wastenotnc.org.
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.
NOTE: If a release from the tank(s) 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.
I. OWNERSHIP OF TANKS II. LOCATION OF TANKS
Owner Name (Corporation, Individual, Public Agency, or Other Entity)
BB&T
Facility Name or Company
Former BB&T Site
Street Address
P.O. Box 167
Facility ID # (If known)
none
City
Winston Salem
County
Forsyth
Street Address
223 Nash Street North
State
NC Zip Code
27102-0167 City
Wilson
County
Wilson
Zip Code
27893
Phone Number
336-733-2500 Phone Number
none
III. CONTACT PERSONNEL
Contact for Facility:
TBD
Job Title:
TBE
Phone. No:
336-733-2500
Closure Contractor Name:
Mr. Eric McManus
Closure Contractor Company:
DH Griffin Companies
Address:
4716 Hilltop Road; Greensboro, NC 2
Phone. No:
336-855-7030
Primary Consultant Name:
Mr. Joe Beaman
Primary Consultant Company:
Highlands Env. Solutions, Inc.
Address:
8410-D Falls of Neuse Road; Raleigh
Phone. No:

IV. UST INFORMATION FOR REGISTERED UST SYSTEMS V. EXCAVATION CONDITION
Tank
ID No.
Size in
Gallons
Tank
Dimensions
Last
Contents
Last Use
Date
Permanent
Close Date
Change-in-
Service
Date
Water in
excavation
Free
product
Notable odor or visible
soil contamination
Yes No Yes No Yes No

VI. UST INFORMATION FOR UNREGISTERED UST SYSTEMS VII. EXCAVATION CONDITION
Tank
ID No.
Size in
Gallons
Tank
Dimensions
Last
Contents
Last Use
Date
Permanent
Close Date
Tank Owner
Name *
Water in
excavation
Free
product
Notable odor or visible
soil contamination
Yes No Yes No Yes No
1 4000 6'x16' Dielsel, Diels 1-20-21 BB&T

* If the tank owner address is different from the one listed in Section I., then enter the street address, city, state, zip code and telephone no. below:

VIII. 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
Joe Beaman, P.G - Principal Geologist 2/3/2021
UST-2 Rev 12/2011
North Carolina Department of Environment and Natural Resources Division of Waste Management UST Section Central Office 1637 Mail Service Center Raleigh, NC 27699-1637 [phone] FAX [phone] portal.ncdenr.org/web/wm/ CherokeeClayGrahamMaconSwainJacksonHaywoodTransylvaniaMadisonHendersonMcDowellRutherfordYanceyM itc he llAveryCaldwellBurkeBuncombePolkClevelandLincolnGastonCatawbaIredellRowanCabarrusStanlyUnionWataugaAsheWilkesAlleghanySurryYadkinStokesForsythDavieDavidsonRockinghamGuilfordRandolphCaswellMontgomeryMooreAnsonR ichm on dHokeRobesonCumberlandHarnettBladenSampsonPersonWakeChatamLeeWarrenHalifaxNorthamptonNashFranklinJohnstonWilsonDuplinOnslowColumbusBrunswickNew HanoverPenderCarteretJonesLenoirWayneGreenePittBeaufortCravenPamlicoHydeMartinBertieWashingtonTyrrellDareHertfordGatesChowanCurrituck 8/06Asheville Regional Office2090 U.S. Highway 70Swannanoa, NC 28778Phone: [phone]Fax: [phone]Fayetteville Regional OfficeSystel Building, Suite 714225 Green StreetFayetteville, NC 28301Phone: [phone]Fax: [phone]Mooresville Regional Office610 East Center Avenue, Suite 301Mooresville, NC 28115Phone: [phone]Fax: [phone]Raleigh Regional Office3800 Barrett DriveRaleigh, NC 27609Phone: [phone]Fax: [phone]Washington Regional Office943 Washington Square MallWashington, NC 27889Phone: [phone]Fax: [phone]Wilmington Regional Office127 Cardinal Drive ExtensionWilmington, NC 28405Phone: [phone]Fax: [phone]Winston-Salem Regional Office585 Waughtown StreetWinston-Salem, NC 27107Phone: [phone]Fax: [phone]Guilford County Dept. of Public Health1203 Maple StreetGreensboro, NC 27405Phone: [phone]Fax: [phone]Regional Office