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Home My WebLink AboutWI-1225_13146_CA_TCR_20230323 3502 Hayes Road • Monroe, North Carolina 28110 113 West Firetower Road, Suite G • Winterville, North Carolina 28590 Phone (704) 845-4010 • (888) 870-4133 • Fax (704) 845-4012 March 24, 2023 Mr. Stephen Kay NCDEQ-UST Section Wilmington Regional Office 127 Cardinal Drive Extension Wilmington, NC 28405 Re: UST Closure Report March 2023 Veach’s Service Station & Grocery 1349 Veach’s Mill Road Warsaw, Duplin County North Carolina Facility ID Number: 0-00-0000016218 Incident Number: 13146 GRI Project Number: 2580 Dear Mr. Kay, Please find enclosed the referenced report for the abovementioned site. If you have any questions, please contact Rae Brown at 704-845-4010. Sincerely, Geological Resources, Inc. Leslie Maxtone-Graham Administrative Assistant Enclosure Cc: Ms. Jane Cooper; Virginia C. Veach Estate, file 3502 Hayes Road • Monroe, North Carolina 28110 113 West Firetower Road, Suite G • Winterville, North Carolina 28590 Phone (704) 845-4010 • (888) 870-4133 • Fax (704) 845-4012 UST Closure Report March 2023 Veach’s Service Station & Grocery 1349 Veachs Mill Road Warsaw, Duplin County North Carolina Facility ID Number: 0-00-0000016218 Incident Number: 13146 GRI Project Number: 2580 Prepared for: Jane Cooper Virginia C. Veach Estate 4400 Steepleton Way Charlotte, NC 28215 March 23, 2023 Ethan Rogerson, G.I.T. Project Manager William Regenthal, P.G. Report Reviewer _____________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 ii EXECUTIVE SUMMARY Veach’s Service Station & Grocery is an active convenience store. The site is located at 1349 Veachs Mill Road in Warsaw, Duplin County, North Carolina. The adjoining properties are commercial and residential. Municipal water is available to the site. The site contained a UST system consisting of one 4,000-gallon gasoline and one 4,000-gallon diesel USTs, associated product piping and dispenser. The UST system was removed from the site on March 13, 2023. During the March 2023 UST closure activities, one 550-gallon unknown contents orphaned UST was also removed. The former UST basin was located to the west of the store building. During tank removal activities, no contaminated soil was observed. Ground water was not encountered within the UST basin. UST closure soil samples were collected from beneath the USTs, beneath the product piping and dispenser. The collected soil samples were submitted for on-site analysis of TPH-GRO and TPH-DRO using a mobile UVF laboratory. Concentrations of TPH-GRO and TPH-DRO were less than the RALs for all soil samples. Based on the field observations and UVF results, no over-excavation activities were conducted following the UST system removal. Excavated soil was returned to the former UST basin as backfill following the removal of the USTs. Based on these results, no further assessment is warranted. _____________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 iii ACRONYMS ACM: Asbestos Containing Materials AFVR: Aggressive Fluid-Vapor Recovery ARR: Acknowledgement of Report Receipt AS: Air Sparging AST: Aboveground Storage Tank ASTM: American Society for Testing and Materials BGS: Below Ground Surface CAP: Corrective Action Plan CFR: Code of Federal Regulations CSA: Comprehensive Site Assessment DPE: Dual Phase Extraction DRO: Total Petroleum Hydrocarbons Diesel Range Organics DWM: Division of Waste Management DWR: Department of Water Resources EPA: Environmental Protection Agency EPH: Extractible Petroleum Hydrocarbons ESA: Environmental Site Assessment GCL: Gross Contamination Level GRI: Geological Resources, Inc. GRO: Total Petroleum Hydrocarbons Gasoline Range Organics LSA: Limited Site Assessment MAC: Maximum Allowable Concentration as specified in T15A NCAC 2L.0202 MADEP: Massachusetts Department of Environmental Protection MCC: Maximum Contaminant Concentrations MMPE: Mobile Multi-Phase Extraction NAPL: Non-Aqueous Phase Liquid, “Free Product” NCDEQ: North Carolina Department of Environmental Quality NCDOT: North Carolina Department of Transportation NFA: Notice of No Further Action NORR: Notice of Regulatory Requirements NOV: Notice of Violation NPDES: National Pollutant Discharge Elimination System NRP: Notice of Residual Petroleum O&M: Operation and Maintenance PAHs: Polynuclear Aromatic Hydrocarbons PCA: Pre-Construction Assessment RAL: Regulatory Action Level SCLs: Soil Cleanup Level SPCC: Spill Prevention Control and Countermeasures SVE: Soil Vapor Extraction SVOCs: Semi-Volatile Organic Compounds SWPPP: Stormwater Pollution Prevention Plan TCLP: Toxicity Characteristic Leaching Procedure (EPA Method SW-846 1311) TOC: Top of Casing TPH: Total Petroleum Hydrocarbons USGS: United States Geological Survey UST: Underground Storage Tank UVF: Ultraviolet Fluorescence VOCs: Volatile Organic Compounds VPH: Volatile Petroleum Hydrocarbons _____________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 TABLE OF CONTENTS SITE INFORMATION ............................................................................................................................ i EXECUTIVE SUMMARY ....................................................................................................................... ii ACRONYMS ....................................................................................................................................... iii A. SITE HISTORY AND CHARACTERIZATION ...................................................................................1 B. SITE CHECK ..............................................................................................................................1 C. UST CLOSURE ..........................................................................................................................2 D. FREE PRODUCT INVESTIGATION AND RECOVERY REPORT .........................................................3 E. GROUND WATER INVESTIGATION ............................................................................................3 F. INITIAL RESPONSE AND ABATEMENT ACTION ...........................................................................3 G. EXCAVATION OF CONTAMINATED SOIL ....................................................................................3 H. SOIL AND GROUNDWATER SAMPLE RESULTS ...........................................................................4 I. SUMMARY AND CONCLUSIONS ................................................................................................4 J. LIMITATIONS ...........................................................................................................................4 FIGURES Figure 1: Site Location Map Figure 2: Site Map Figure 3: Soil Quality Map TABLES Table 1: UST Owner/Operator Information Table 2: UST System Information Table 3: Summary of Soil Sample Analytical Results APPENDICES Appendix A: Notice of Intent form (UST-3) Appendix B: Health and Safety Plan Appendix C: Duplin County Fire Department – Fire Permit Appendix D: Site Investigation Report for Permanent Closure or Change-in-Service of UST (UST-2A) Appendix E: UST Disposal Manifests Appendix F: Liquid Disposal Manifests Appendix G: UVF Report ____________________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 1 A. SITE HISTORY AND CHARACTERIZATION 1. UST Owner and Operator Information: In accordance with the UST Closure Report guidelines, the UST owner and operator information has been summarized in Table 1. 2. UST System Information: In accordance with the UST Closure Report guidelines, the UST system information has been summarized in Table 2. A copy of the Registered Tank Report is shown below. 3. Non-UST Information: No ASTs were associated with the March 2023 UST closure. 4. Comprehensive Description of the Release: GRI initiated UST closure activities at the site on March 13, 2023. Based on the results of the soil samples collected during UST removal activities, a release was not observed. 5. Description of the Site Characteristics: The Veach’s Service Station & Grocery site is a convenience store located at 1349 Veachs Mill Road in Warsaw, Duplin County, North Carolina (Figure 1). The site is located at the intersection of Veachs Mill Road and Dan Swinson Road. A site map has been included as Figure 2. B. SITE CHECK A site check was not part of the UST closure activities. ____________________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 2 C. UST CLOSURE 1. Preparation for Closure: Prior to closure activities, GRI personnel notified the Duplin County Fire Department. The Duplin County Fire Marshal approved of the inertion methods used by GRI. A copy of the UST-3 Notice of Intent form is included as Appendix A. A copy of the site-specific health and safety plan is included as Appendix B. A copy of the Duplin County Fire Department Permit is included as Appendix C. A copy of the Site Investigation Report for Permanent Closure or Change-in-Service of UST (UST-2A) Form has been included as Appendix D. 2. Closure Procedure: On March 13, 2023, one 4,000-gallon gasoline, one 4,000-gallon diesel and one 550-gallon orphan USTs, associated dispensers and product piping were removed from the site. The 4,000-gallon USTs were located on the western side of the store and covered with grass and soil. The 550-gallon orphan was located on the northern side of the store and was covered by concrete and soil. The 4,000-gallon USTs measured 64 inches in diameter by 24 feet in length and the 550-gallon orphan UST measured 45.5 inches in diameter by 76 inches in length. The 4,000-gallon USTs were constructed of steel coated with fiberglass and were in good condition with no corrosion or pitting. The 550-gallon orphan UST was constructed of single-wall steel and appeared to be in fair condition with minor corrosion and pitting. The USTs were transported off site for proper disposal. A disposal manifest for the USTs removed in March 2023 is included as Appendix E. Photos of the USTs are shown below: 3. Residual Material: A total of 98 gallons of residual liquids was removed from the USTs during UST closure activities. A copy of the liquid disposal manifest is included as Appendix F. 4. Release Information: Free product was not observed, and ground water was not encountered in the UST basin. Based on the soil analytical results, a released was not observed during the March 2023 UST closure. 5. Soil Excavation Activities: All excavated soil was returned to the UST basin as backfill following the removal of the UST system. The excavation boundaries are shown on Figure 2. ____________________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 3 6. Site Investigation: Soil samples (UST-1-1-7', UST-1-2-7', UST-1-3-7', UST-2-1-7', UST-2-2-7' and UST-2-3-7') were collected from beneath the 4,000-gallon USTs at depths of 7 feet BGS, beneath the 550-gallon orphan UST (Orphan- 1-4’) at a depth of 4 feet BGS, from beneath the dispenser islands (DI-1-1’ and DI-2-1’) at a depth of 1 feet BGS, and from beneath the product piping (PP-1-2’) at a depth of 2 feet BGS. The collected soil samples were analyzed on-site for TPH-GRO and TPH-DRO using a mobile UVF laboratory. Soil sample locations are shown on Figure 3. D. FREE PRODUCT INVESTIGATION AND RECOVERY REPORT Free product was not observed during the March 2023 UST closure activities. E. GROUND WATER INVESTIGATION Ground water was not observed during the March 2023 UST closure activities. F. INITIAL RESPONSE AND ABATEMENT ACTION 1. Initial Response Actions: One 4,000-gallon gasoline, one 4,000-gallon diesel and one 550-gallon orphan USTs with associated dispensers and product piping were removed from the site on March 13, 2023. Petroleum contamination was not observed. Ground water was not encountered in the UST basins.  Source Control Actions: One 4,000-gallon gasoline, one 4,000-gallon diesel and one 550-gallon orphan USTs with associated dispensers and product piping were removed from the site on March 13, 2023.  Contaminant Migration Control Measures: A petroleum release was not observed.  Measures Taken to Mitigate Fire/Safety Hazards: Prior to closure, the appropriate officials were notified (i.e. Fire Marshal). Free product was encountered during closure activities.  Measures Taken to Identify and Mitigate Pollution Hazards: A release was not observed; therefore, no migration control measures were necessary. 2. Initial Abatement Actions:  Contaminated Soil Storage/Treatment and/or Disposal: Based on the field observations and UVF results, no over-excavation activities were conducted following the UST system removal. Excavated soil was returned to the former UST basin as backfill following the UST system removal. G. EXCAVATION OF CONTAMINATED SOIL 1. Extent of Soil Contamination: Based on the field observations and UVF results, no over-excavation activities were conducted following the UST system removal. Excavated soil was returned to the former UST basin as backfill. 2. Excavation Process: The excavation activities were conducted using a track-mounted excavator. ____________________________________________________________________________________________ Prepared by: Geological Resources, Inc. UST Closure Report Prepared on: March 23, 2023 Veach’s Service Station & Grocery Project Manager: Ethan Rogerson, G.I.T. GRI Project No. 2580 4 3. Sampling Description: All soil samples were collected directly from the bucket of the excavator or using a hand auger by GRI personnel. Samples were collected with clean, disposable nitrile gloves and immediately transferred to the onsite mobile UVF laboratory for analysis. H. SOIL AND GROUNDWATER SAMPLE RESULTS  Soil: All soil samples collected reported TPH-GRO and TPH-DRO concentrations less than the RALs. A summary of soil sample analytical results is presented as Table 3. A Soil Quality Map has been included as Figure 3. A copy of the UVF report from the soil samples collected during the March 2023 UST closure is included as Appendix G.  Ground Water: Ground water was not encountered during the March 2023 UST closure actives. I. SUMMARY AND CONCLUSIONS  One 4,000-gallon gasoline, one 4,000-gallon diesel and one 550-gallon orphan USTs with associated dispensers and product piping were removed from the site on March 13, 2023.  Free product and ground water were not observed during the March 2023 UST closure. Concentrations of TPH-GRO and TPH-DRO were less than the RALs for all soil samples.  Based on the field observations and UVF results, no over-excavation activities were conducted following the UST system removal. Excavated soil was returned to the former UST basin as backfill.  Based on these results, a new release has not occurred at the site and no further assessment is warranted. J. LIMITATIONS This report has been prepared for the exclusive use of Virginia C. Veach Estate for specific application to the referenced site in Duplin County, North Carolina. The assessment was conducted based on the scope of work and level of effort desired by NCDEQ and with resources adequate only for that scope of work. Our findings have been developed in accordance with generally accepted standards of environmental practices in the State of North Carolina, available information, and our professional judgment. No other warranty is expressed or implied. The data that are presented in this report are indicative of conditions that existed at the precise locations sampled and at the time the samples were collected. In addition, the data obtained from samples would be interpreted as being meaningful with respect to parameters indicated in the laboratory report. No additional information can logically be inferred from these data. FIGURES SITE LOCATION Figure 1 Site Location Veach’s Service Station & Grocery 1349 Veach’s Mill Road Warsaw, North Carolina Duplin County Incident No. 13146 GRI Project No. 2580 300 M 1000 FT Date: 03/18/2023 Location: 35.052545° N -78.024487° W D a d TABLES UST ID Number A1 and A2 Facility ID Number Owner or Operator? Owner UST ID Number 1,2, A1 and A3 Facility ID Number Owner or Operator? Owner Virginia C Veach 01/11/2003 - 03/13/2023 Address Telephone Number 1349 Veachs Mill Road, Warsaw, NC 28398 Unknown Name of Owner or Operator Dates of Ownership / Operation TABLE 1 UST OWNER/OPERATOR INFORMATION VEACH'S SERVICE STATION & GROCERY (INCIDENT NO. 13146) 00-0-0000016218 Address Telephone Number Unknown Unknown 00-0-0000016218 Name of Owner or Operator Dates of Ownership / Operation Ralph L Veach 01/01/1952 - 01/11/2003 Page 1 of 1 Date: 03/16/2023 Was Release Associated with UST System? (Yes / No) 1 Gasoline Gasoline 4,000 4/30/1977 Single Wall Steel Unknown Single Wall Steel Removed 9/13/1994 Yes 2 Diesel Diesel 4,000 4/30/1977 Single Wall Steel Unknown Single Wall Steel Removed 9/13/1994 Yes A1 Gasoline Gasoline 4,000 5/3/1979 Steel with Fiberglass 64" x 24'DW Flex Removed 3/13/23 No A2 Diesel Diesel 4,000 5/3/1980 Steel with Fiberglass 64" x 24'DW Flex Removed 3/13/23 No Orphan Unknown Unknown 550 Unknown Single Wall Steel 45.5" x 76"Unknown Removed 3/13/23 No Tank Dimensions Description of Associated Product Piping and Pumps Status of UST TABLE 2 UST SYSTEM INFORMATION VEACH'S SERVICE STATION & GROCERY (INCIDENT NO. 13146) Facility ID #: 00-0-0000016218 UST ID No. Current or Most Recent Contents Previous Contents Capacity (gallons) Date Installed Construction Details Page 1 of 1 Date: 03/16/2023 Facility ID #: 00-0-0000004090 Sample ID Date Collected (mm/dd/yy) Sample Location Sample Depth (ft-BGS) 50 100 UST-1-1-7'7 <10 <2 UST-1-2-7'7 <10 <2 UST-1-3-7'7 12.8 <2 UST-2-1-7'7 10.6 <2 UST-2-2-7'7 <10 <2 UST-2-3-7'7 34 <2 Orphan-1-4'Orphan UST Basin 4 <10 <2 SP-1 Stock Pile ---17.8 <2 DI-1-'1 10.4 3.6 D-2-1'1 15.6 76.6 PP-1-2'Product Pipping 2 <10 <2 • Concentrations in bold face type indicate the RALs were less than the reported concentrations Notes: • Results reported in mg/kg; samples analyzed onsite by UVF. • ft-BGS: feet below ground surface. • RAL: Regulatory Action Level. • < : Less than the UFV method detection limit . 03/13/23 4,000-gallon UST Basin Dispenser Islands TABLE 3 Diesel-Range TPHVEACH'S SERVICE STATION & GROCERY (INCIDENT NO. 13146) Analytical Method  RAL (mg/kg) Contaminant of Concern Gasoline-Range TPHUVF SUMMARY OF SOIL SAMPLE ANALYTICAL RESULTS - FIELD DATA Page 1 of 1 APPENDICES APPENDIX A Notice of Intent form (UST-3) UST-3 Notice of Intent: UST Permanent Closure or Change-in-Service Return completed form to: The DWM Regional Office located in the area where the facility is located. Also send a copy to the Central Office in Raleigh. SEE MAP ON THE BACK OF THIS FORM FOR THE CENTRAL AND REGIONAL OFFICE ADDRESSES. STATE USE ONLY I.D. #_____________________ Date Received______________ INSTRUCTIONS (READ THIS FIRST) Complete and return a UST-3 form at least thirty (30) days prior to closure or change-in-service activities. Completed UST closure or change-in-service site assessment reports, along with a copy of the UST-2A and/or 2B forms, should be submitted to the appropriate Division of Waste Management (DWM) Regional Office within thirty (30) days following closure activities. The UST-2 form should also be submitted to the Central Office in Raleigh so that the status of the tanks may be changed to permanently closed and your tank fee account can be closed out. Note: Tank fees may be due for unregistered tanks. UST closure and change-in-service site assessments must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank Closure and Initial Response. The guidelines can be obtained at https://deq.nc.gov/about/divisions/waste-management/ust. Note: To close tanks in place you must obtain prior approval from the DWM Regional office located in the region where the facility is located. You must make sure that USTs removed from your property are disposed of properly. When choosing a closure contractor, ask where the tank(s) will be taken for disposal. Usually, USTs are cleaned and cut up for scrap metal. This is dangerous work and must be performed by a qualified company. Tanks disposed of illegally in fields or other dumpsites can leak petroleum products and sludge into the environment. If your tanks are disposed of improperly, you could be held responsible for the cleanup of any environmental damage that occurs. I. OWNERSHIP OF TANKS II. LOCATION Owner Name (Corporation, Individual, Public Agency, or Other Entity) Facility Name or Company Street Address Facility ID # (If known) City County Street Address State Zip Code City County Zip Code Phone Number Email Phone Number III. CONTACT PERSONNEL Name: Company Name: Job Title: Phone Number: IV. TANK REMOVAL, CLOSURE IN PLACE, CHANGE-IN SERVICE 1. Contact local fire marshal. 2. Plan entire closure event. 3. Conduct Site Soil Assessment. 4. If removing tanks or closing in place, refer to API Publication 2015 Cleaning Petroleum Storage Tanks and 1604 Removal and Disposal of Used Underground Petroleum Storage Tanks. 5. Provide a sketch locating piping, tanks and soil sampling locations. 6. Submit a closure report in the format of UST- 12 (including the form UST-2) within thirty (30) days following the site investigation. 7. If a release from the tanks has occurred, the site assessment portion of the tank closure must be conducted under the supervision of a P.E. or L.G., with all closure site assessment reports bearing the signature and seal of the P.E. or L.G. If a release has not occurred, the supervision, signature or seal of a P.E. or L.G. is not required. 8. Keep closure records for three (3) years. V. WORK TO BE PERFORMED BY Contractor Name: Contractor Company Name: Address: City: State: Zip Code: Phone No: Primary Consultant Name: Primary Consultant Company Name: Consultant Phone No: VI. TANKS SCHEDULED FOR CLOSURE OR CHANGE-IN-SERVICE Tank ID No. Size in Gallons Last Contents Proposed Activity Closure Change-In-Service Removal Abandonment in Place * New Contents Stored * Prior written approval to abandon a tank in place must be received from a DWM Regional Office. VII. OWNER OR OWNER’S AUTHORIZED REPRESENTATIVE Has a release from a UST system occurred at this location? Yes No Unknown I understand that I can be held responsible for environmental damage resulting from the improper disposal of my USTs. Print name and official title: Signature Date Signed SCHEDULED REMOVAL DATE Notify your DWM Regional Office 48 hours before this date if scheduled removal date changes UST-3 Rev 6/2022 Virginia C Veach Estate (Jane Cooper, Executrix) 4400 Steepleton Way Charlotte Mecklenburg NC 28398 704-517-2665 jane@graycooper.org Veachs Service Station & Grocery 00-0-0000016218 1349 Veachs Mill Road Warsaw Duplin 28398 Jane Cooper ExecutrixVirginia C. Veach Estate 704-814-7100 Justin Radford Geological Resources, Inc. 3502 Hayes Road 28110 704-845-4010 Ethan Rogerson Geological Resources, Inc. NC 704-845-4010 A1 4000 Gasoline A2 4000 Gasoline Ethan Rogerson, Project Manager 1/20/2023 2/20/2023 Monroe APPENDIX B Health and Safety Plan APPENDIX C Duplin County Fire Marshal’s Office Tank Removal Permit APPENDIX D Site Investigation Report for Permanent Closure or Change-in-Service of UST (UST-2A) UST-2A Site Investigation Report for Permanent Closure or Change-in- Service of REGISTERED UST Return completed form to: NC DEQ / DWM / UST SECTION 1646 MAIL SERVICE CENTER RALEIGH, NC 27699-1646 ATTN: REGISTRATION & PERMITTING phone (919) 707-8171 fax (919) 715-1117 http://www.wastenotnc.org/ STATE USE ONLY: Facility ID # Date Received INSTRUCTIONS (READ THIS FIRST) 1. UST permanent closure or change in service must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank Closure and Initial Response and Abatement. The guidelines can be obtained at http://deq.nc.gov/about/divisions/waste-management/waste- management-permit-guidance/underground-storage-tanks-section. 2. Permanent closure: Complete all sections of this form. 3. Change-in-service: Where a UST system will be converted from storing a regulated substance to a non-regulated substance, complete sections I, II, III, IV, and VI 4. For more than 5 registered UST systems, attach additional forms as needed 5. Tank Fee Refund: An annual tank fee may be refunded for a tank for which a tank fee was not required. An owner or operator must submit a written request and include: (1) contact information, (2) federal identification # or SSN, and (3) a copy of UST-2 form. The annual tank fee will be prorated based on the date of permanent closure. 6. UNREGISTERED USTs use Form UST-2B I. OWNERSHIP OF TANKS II. LOCATION OF TANKS Owner Name (Corporation, Individual, Public Agency, or Other Entity) Facility Name or Company Street Address Facility ID # (If known) City County Street Address State Zip Code City County Zip Code Phone Number Phone Number III. CONTACT PERSONNEL Contact for Facility: Job Title: Phone #: Closure Contractor Name: Closure Contractor Company: Address: Phone # Primary Consultant Name: Primary Consultant Company: Address: Phone # IV. UST INFORMATION FOR REGISTERED UST SYSTEMS UNREGISTERED USTs use Form UST-2B V. EXCAVATION CONDITION Tank ID No. Size in Gallons Last Contents Last Use Date Permanent Close Date Method of Permanent Closure: Indicate REMOVED or enter fill material, such as foam/ concrete/ sand Change-in- Service Date Water in excavation Free product Notable odor or visible soil contaminatio n Yes No Yes No Yes No VI. CERTIFICATION I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true accurate and complete. Print name and official title of owner or owner’s authorized representative Signature Date Signed NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY, DIVISION OF WASTE MANAGEMENT, UST SECTION 1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646 PHONE (919) 707-8171 FAX (919) 715-1117 http://www.wastenotnc.org/ 1/2016 Virginia C. Veach 1349 Veachs Mill Road Warsaw Duplin North Carolina 28398-8580 910-293-4901 Veachs Service Station & Grocery 00-0-0000016218 1349 Veachs Mill Road Warsaw 28398Duplin 910-293-4901 Jane Cooper Executrix 704-517-2665 Justin Radford, P. G.Geological Resources, Inc.3502 Hayes Road 704-845-4010 Ethan Rogerson, GIT Geological Resources, Inc.Monroe, NC 28110 704-845-4010 A1 4000 Gasoline 8/4/2016 3/13/23 REMOVED A2 4000 Diesel 8/4/2016 3/13/23 REMOVED William Regenthal, P. G. - Branch Operations Manager 3/17/23 APPENDIX E UST Disposal Manifest Veach's Services Station & Grocery 1349 Veachs Mill Road, Warsaw, NC 3/13/2023 Foss Recycling 4,000-gallon steel with fiberglass gasoline UST 4,000-gallon steel with fiberglass gasoline UST 550-gallon steel orphan UST Ethan Rogerson 03/13/2023 APPENDIX F Liquid Disposal Manifests APPENDIX G UVF Field Screening Results 3502 Hayes Road • Monroe, North Carolina 28110 113 West Firetower Road, Suite G • Winterville, North Carolina 28590 Phone (704) 845-4010 • (888) 870-4133 • Fax (704) 845-4012 Engineering Certification: C-2727 • Geology Certification: C-127 UVF Trilogy Analytical Report Samples Collected: March 13, 2023 Samples Analyzed: March 13, 2023 Site Name: Veach’s Service Station & Grocery Site Address: 1349 Veach’s Mill Road, Warsaw, NC GRI Project Number: 2580 March 15, 2023 Ethan Rogerson, GIT Operator Technical Procedures Calibration The UFV Trilogy has standard calibrations stored for the following analysis:  GRO  DRO  Total PAH  Target PAH  Heavy PAH Prior to use, calibration standards are used to perform a 5-point verification on the factory stored calibrations for GRO and DRO. The calibration standards used are as follows: GRO  0.5 ppm  1 ppm  3 ppm  5 ppm  10 ppm DRO  0.1 ppm  0.5 ppm  1 ppm  3 ppm  5 ppm Operation Sample Extraction  5mg of soil are weighed into a clean extraction jar  Methanol is added to the extraction jar to create a 2x or 4x dilution o 2x Dilution: 10 mL of methanol o 4x Dilution: 20 mL of methanol  The extraction jar is shaken for several minutes to thoroughly mix the soil with solvent (methanol)  The mixture is allowed to settle for several minutes  A clean syringe is used to draw liquid from the extraction jar  A clean filter is attached to the end of the syringe and the liquid dispensed through the filter into a clean test tube  This liquid is referred to as the extraction Dilution Preparation  An adjustable micropipette is used to precisely measure out the amount of extract needed for the dilution  The measured out amount of the extract is added to a clean test tube and methanol is added dilute the extract. Examples of dilutions are shown below: Extract Amount 500 μL 200 μL 100 μL 50 μL 25 μL Add Solvent to the 5 mL line 5 mL line 5 mL line 5 mL line 5 mL line 2x Extract Dilution Factor 20x 50x 100x 200x 400x 4x Extract Dilution Factor 40x 100x 200x 400x 800x Technical Procedures Sample Analyzation  The dilution is shaken to thoroughly mix, then poured into a clean glass cuvette  The desired module is inserted into the UVF Trilogy and the corresponding factory calibration is selected  “Measure Fluorescence” is pressed on the touchscreen and the reading is recorded  The reading should be between the concentrations of the calibration standards (GRO: 0.5-10 ppm; DRO 0.1-5 ppm) o Reading below the calibration standard range are recorded as below the detection limit  Detection Limit = (lower range of calibration standards range) x dilution factor (i.e. a GRO sample with a 100x dilution factor has a detection limit of 50 ppm) o Readings above the calibration standard range should be further diluted and reanalyzed o Negative readings are an indication of quenching (see below)  The reading is multiplied by the dilution factor to calculate the final concentration  Check suspected contaminated samples for quenching by running additional dilutions o According to the siteLAB Quick Reference Guide: “Quenching” can occur when the detector is swamped by too many hydrocarbons or organic interferences, producing low or negative concentrations. Test the sample at multiple dilutions to confirm results are linear and accurate.” QA/QC Method Blank  A method blank of methanol will be analyzed following calibration and following the last sample analyzed each day Duplicates  One duplicate will be analyzed for every 20 samples  The duplicate will be prepared from the extract of the sample and diluted to the same factor as the sample analyzed Project Name:Date Collected: Project Number:Date Analysed: Project Manager:Operator: Sample ID Matrix Dilution Factor x GRO Output (ppm) =GRO Value (mg/Kg) Dilution Factor x DRO Output (ppm) =DRO Value (mg/Kg) SP-1 Soil 20 0.89 17.8 20 <0.1 <2 DI-1-1'Soil 20 0.52 10.4 20 0.18 3.6 DI-2-1'Soil 20 0.78 15.6 20 3.83 76.6 UST-1-1-7'Soil 20 <0.5 <10 20 <0.1 <2 UST-1-2-7'Soil 20 <0.5 <10 20 <0.1 <2 UST-1-3-7'Soil 20 0.64 12.8 20 <0.1 <2 UST-2-1-7'Soil 20 0.53 10.6 20 <0.1 <2 UST-2-2-7'Soil 20 <0.5 <10 20 <0.1 <2 UST-2-3-7'Soil 20 1.7 34 20 <0.1 <2 PP-1-2'Soil 20 <0.5 <10 20 <0.1 <2 DUP PP-1-2'Soil 20 <0.5 <10 20 0.24 4.8 Orphan-1-4'Soil 20 <0.5 <10 20 <0.1 <2 Soil <0 <0 Soil <0 <0 Soil <0 <0 Soil <0 <0 Soil <0 <0 Soil <0 <0 Soil <0 <0 UVF Analytical Report siteLAB UVF Trilogy 3/13/2023 3/13/2023 Ethan Rogerson Veach's Service Station & Grocery 2580 Ethan Rogerson Site: Veach's Serviec Station Grocery Report Date: 3/15/2023 Page: 1 of 1