HomeMy WebLinkAboutMO-88956_97165_CA_IAR_20231011
Drawing / Project Name
Client
Project # Date
N
Base diagram from Bing Maps
Site Location Diagram
Olive Oil Release Incident
General Drive; Charlotte, NC
Wind River Environmental / Bakkavor, Inc.
Site Location
DB Fig. Scale
618003
Not to Scale
October 2023
1
PM PG
JB
PE
KS JB
Drawing / Project Name
Client
Project # Date
N
Base diagram from USGS Topographic Quadrangle; Fort Mill, SC
Topographic Location Diagram
Olive Oil Release Incident
General Drive; Charlotte, NC
Wind River Environmental / Bakkavor, Inc.
Site Location
DB Fig. Scale
618003
Not to Scale
October 2023
2
PM PG
JB
PE
KS JB
Drawing / Project Name
Client
Project # Date
N
Base diagram from Google Earth
Area Diagram
Olive Oil Release Incident
General Drive; Charlotte, NC
Wind River Environmental / Bakkavor, Inc.
Site Location
DB Fig. Scale
618003
Not to Scale
October 2023
3
PM PG
JB
PE
KS JB
S-1 N Fig. Date Project # DB PG PM PE Client Name 618003 Drawing/Project Name: Excavation and Sample Collection Diagram Wind River Environmental / Bakkavor Sept. 2023 JB JB JB4 Scale As Shown Base diagram from Google Earth. Soil Sample Collection Location ƉƉƌŽdžŝŵĂƚĞ^ĐĂůĞĨĞĞƚϬϲϬϯϬS-2 S-3 S-5 S-6 S-4 S-14 S-7 S-8 S-12 S-11 S-10 S-9 S-13 S-15 S-17 S-16 S-18 BKGD Top of Stormwater Basin Berm Excavated Area Outfall to Basin Basin Discharge
Minimum Level of Protection at this site is Level D
Contaminants of Concern are Non-Hazardous Oils
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.
IN THE EVENT OF ANY EMERGENCY, CONTACT PROJECT MANAGER OR
HEALTH AND SAFETY REPRESENTATIVE
Do not endanger your life. Survey the situation before taking any action.
Page 4
Page 5
Page 6
requires full HASP)
Page 7
Page 8
Page 9
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.
UST-62 24-Hour Notification of Discharge Form
For Non-UST
Releases of
Petroleum in NC
This form should be completed and submitted to the UST Section’s regional office following a known or suspected release of
petroleum from a source other than an underground storage tank. This form is required to be submitted within 24 hours of
discovery of a known or suspected petroleum release
(DWM USE ONLY)
Incident # ___________ Priority Rank (H,I,L,U) _____
Received (time/date) ___________________________
Received by ________________ Region __________
Reported by (circle one): Phone, Fax or Report
Suspected Contamination? (Y/N) ___
Confirmed GW Contamination? (Y/N) ___
Confirmed Soil Contamination ?(Y/N) ___
Samples taken?(Y/N) ___ Free product? (Y/N) ___
If Yes(free product), state greatest thickness: _____feet
Release discovered
(time/date):______________
_______________________
INCIDENT DESCRIPTION
Incident Name:
Address (street number/name):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:
Describe suspected or confirmed release (nature of release, time/date of release, quantity of release, amount of free
product):
GPS
Electronic topographic map
GIS Address matching
Describe initial response/abatement (time/date release stopped, cleanup begun/completed, quantity of product
soil removed, confirmation sampling):
Other
Unknown
Describe impacted receptors: Describe location:
HOW RELEASE WAS DISCOVERED (Release Code)
(Check one)
Observation of Release at Occurrence
Visual or Olfactory Evidence
Soil Contamination
Groundwater Contamination
Water Supply Well 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 petroleum product
type released)
AST (tank)
AST Piping/ Dispenser
AST Delivery Problem
OTR Vehicle Tank
OTR Bulk Transport Tank
RR Bulk Transport Tank
Transformer
Unknown
Other ______________
Definitions presented on reverse
Spill (Accidental)
Spill (Intentional)
Corrosion
Physical or Mechanical
Damage
Equipment Failure
AST Overfill
AST Installation Problem
Unknown
Other ______________
Definitions presented on reverse
Petroleum
Both Petroleum
& Non-Petroleum
Location
(Check one)
Facility
Residence
Highway/Road
Railway
Other
Gasoline/ Diesel/
Kerosene
E11 – E20
E21 – E84
E85 – E99
Ethanol 100%
Diesel/Veg. Oil
Blend
Vegetable Oil 100%
Heating Oil
Waste Oil
Mineral Oil-no
PCBs
Mineral Oil-PCBs
Other Petroleum
Products ________
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
Guidance presented on reverse
UST Form 62 (04/10) Page 1 of 2
Y
N
N 06-14-23 @ 08:00
N N
Olive Oil Release Incident
10240 Western Ridge Road Mecklenburg
Charlotte
A release of olive oil and food grease due to the overflow of a wastewater lift station. The release impacted paved and
unpaved surfaces, and a suspected wetland. The volume of the release has not been determined. The release has
been stopped
✔
The release has been stopped and abatement activities are underway.
Dry stormwater pond and associated stormwater inlets
Industrial facility
✔
✔
✔
✔
✔✔
lift station olive oil
IMPACT ON DRINKING WATER SUPPLIES
Water Supply Wells Affected? 1. Yes 2. No 3. Unknown Number of Water Supply Wells Affected ______
List of Water Supply Wells Contaminated: (Include Users Names, Addresses and Phone Numbers. Attach additional sheet if necessary)
1.
2.
3.
PARTY RESPONSIBLE FOR RELEASE
(if the source of the release is not an AST system or if it is an AST system and there is a responsible party other than the AST system owner/ operator)
Name of Person/Company Address
City State Zip Code Telephone Number
AST SYSTEM OWNER (if the source of the release is an AST system)
AST Owner/Company Address
City State Zip Code Telephone Number
AST SYSTEM OPERATOR (if the source of the release is an AST system)
UST Operator/Company Address
City State Zip Code Telephone Number
LANDOWNER AT LOCATION OF INCIDENT
Landowner Address
City State Zip Code Telephone Number
Draw Sketch of Area or Provide Map (showing incident site, location of release, two major road intersections, potential
receptors)
Attach sketch or map to form.
Give Directions to Incident Site Attach directions to form if necessary.
Person Reporting Incident Company Telephone Number
Title Address Date
UST Form 62 (04/10) Page 2 of 2
Definitions of Sources
AST (Tank): means the tank is used to store product
AST Piping: means the piping and connectors running from the tank to the dispenser or other end-use equipment
AST Dispenser: includes the dispenser and the equipment used to connect the dispenser to the piping
AST Delivery Problem: identifies releases that occurred during product delivery to the tank.
OTR Vehicle Tank: means the tank is used to store product to fuel an over the road vehicle
OTR Bulk Transport Tank: means a tank that is used to transport product in bulk over the road (by truck)
RR :bulk Transport Tank: means a tank that is used to transport product in bulk by train
Transformer: means electrical transformer
Other: serves as the option to use when the release source is known but does not fit into one of the preceding categories
Unknown: identifies releases for which the source has not been determined
Definitions of Causes
Spill (Accidental): use this cause when a spill occurs accidentally(e.g., when the delivery hose is disconnected from a fill pipe)
Spill (Intentional): use this cause when a spill occurs intentionally (e.g., intentional dumping or breakage)
Corrosion: use when a metal tank, piping, or other component has a release due to corrosion
Physical or Mechanical Damage: use for all types of physical or mechanical damage, except corrosion
Equipment failure: use when a release occurs due to equipment failure other than corrosion or physical or mechanical damage
AST 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)
AST Installation Problem: use when the problem is determined to have occurred specifically because the AST system was not installed properly
Other: use this option when the cause is known but does not fit into one of the preceding categories
Unknown: use when the cause has not been determined
Guidance: Ownership and Operator Type
Ownership select the category which describes owner of the AST system, bulk transport tank, or other release source
Operator Type select the category which describes the operation in which owner uses the AST system, bulk transport tank, or other release source
Bakkavor 10240 Western Ridge Road
Charlotte NC 28273 704-522-1977
Same
Same
CK Ridge Creek West III, LLC 301 South College Street, #2800
Charlotte NC 28202 TBD
See attached
Joe Beaman, P.G>Highlands Environmental Solutions, Inc. 919-848-3155
Principal Geologist 8410-D Falls of Neuse Road; Raleigh, NC 27615 06-16-2023
Notes:
09/18/23
Technical Report for
Highlands Environmental Solutions, Inc
618003; NC
SGS Job Number: FC9413
Sampling Date: 09/06/23
Report to:
Highlands Environmental Solutions, Inc
8410-D Falls of Neuse Rd
Raleigh, NC 27615
ksutler@hesnc.com; jbeaman@hesnc.com
ATTN: Joe Beaman
Total number of pages in report:
Certifications: FL(E83510), LA(03051), KS(E-10327), NC(573), NJ(FL002), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AL, AK, AR, CT, IA, KY, MA, MI. MS, ND, NH, NV, OK, OR, IL, UT, VT, WA, WI, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: 407-425-6700 •
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable unless noted
in the narrative, comments or footnotes.
Client Service contact: Ariel Hartney 407-425-6700
Norm Farmer
Technical Director
Orlando, FL 09/18/23
e-Hardcopy 2.0
Automated Report
37
SGS is the sole authority for authorizing edits or modifications to this document.
Unauthorized modification of this report is strictly prohibited.
Review standard terms at: http://www.sgs.com/en/terms-and-conditions
The results set forth herein are provided by SGS North America Inc.
Please share your ideas about
how we can serve you better at:
EHS.US.CustomerCare@sgs.com
1 of 37
FC9413
Table of Contents
-1-
Sections:
Section 1: Sample Summary ................................................................................................... 3
Section 2: Summary of Hits ....................................................................................................5
Section 3: Sample Results ........................................................................................................ 7
3.1:FC9413-1: S-1 .............................................................................................................. 8
3.2:FC9413-2: S-2 .............................................................................................................. 9
3.3:FC9413-3: S-3 .............................................................................................................. 10
3.4:FC9413-4: S-4 .............................................................................................................. 11
3.5:FC9413-5: S-5 .............................................................................................................. 12
3.6:FC9413-6: S-6 .............................................................................................................. 13
3.7:FC9413-7: S-7 .............................................................................................................. 14
3.8:FC9413-8: S-8 .............................................................................................................. 15
3.9:FC9413-9: S-9 .............................................................................................................. 16
3.10:FC9413-10: S-10 ........................................................................................................ 17
3.11: FC9413-11: S-11 ......................................................................................................... 18
3.12:FC9413-12: S-12 ........................................................................................................ 19
3.13:FC9413-13: S-13 ........................................................................................................ 20
3.14:FC9413-14: S-14 ........................................................................................................ 21
3.15:FC9413-15: S-15 ........................................................................................................ 22
3.16:FC9413-16: S-16 ........................................................................................................ 23
3.17:FC9413-17: S-17 ........................................................................................................ 24
3.18:FC9413-18: S-18 ........................................................................................................ 25
3.19:FC9413-19: BKGD ..................................................................................................... 26
Section 4: Misc. Forms ............................................................................................................ 27
4.1:Chain of Custody ........................................................................................................... 28
Section 5: Misc. Forms (SGS Dayton, NJ) ............................................................................. 30
5.1:Chain of Custody ........................................................................................................... 31
Section 6: General Chemistry - QC Data (SGS Dayton, NJ) ............................................... 34
6.1:Method Blank and Spike Results Summary .................................................................. 35
6.2:Duplicate Results Summary .......................................................................................... 36
6.3:Matrix Spike Results Summary ..................................................................................... 37 1234562 of 37
FC9413
SGS North America Inc.
Sample Summary
Highlands Environmental Solutions, Inc
Job No:FC9413
618003; NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FC9413-1 09/06/23 08:40 JB 09/07/23 SO Soil S-1
FC9413-2 09/06/23 08:50 JB 09/07/23 SO Soil S-2
FC9413-3 09/06/23 09:00 JB 09/07/23 SO Soil S-3
FC9413-4 09/06/23 09:10 JB 09/07/23 SO Soil S-4
FC9413-5 09/06/23 09:20 JB 09/07/23 SO Soil S-5
FC9413-6 09/06/23 09:30 JB 09/07/23 SO Soil S-6
FC9413-7 09/06/23 09:45 JB 09/07/23 SO Soil S-7
FC9413-8 09/06/23 09:55 JB 09/07/23 SO Soil S-8
FC9413-9 09/06/23 10:15 JB 09/07/23 SO Soil S-9
FC9413-10 09/06/23 10:25 JB 09/07/23 SO Soil S-10
FC9413-11 09/06/23 10:35 JB 09/07/23 SO Soil S-11
FC9413-12 09/06/23 10:45 JB 09/07/23 SO Soil S-12
FC9413-13 09/06/23 10:55 JB 09/07/23 SO Soil S-13
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3 of 37
FC94131
SGS North America Inc.
Sample Summary
(continued)
Highlands Environmental Solutions, Inc
Job No:FC9413
618003; NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FC9413-14 09/06/23 11:05 JB 09/07/23 SO Soil S-14
FC9413-15 09/06/23 11:20 JB 09/07/23 SO Soil S-15
FC9413-16 09/06/23 11:30 JB 09/07/23 SO Soil S-16
FC9413-17 09/06/23 11:45 JB 09/07/23 SO Soil S-17
FC9413-18 09/06/23 12:05 JB 09/07/23 SO Soil S-18
FC9413-19 09/06/23 12:30 JB 09/07/23 SO Soil BKGD
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
4 of 37
FC94131
Summary of Hits Page 1 of 2
Job Number:FC9413
Account:Highlands Environmental Solutions, Inc
Project:618003; NC
Collected:09/06/23
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FC9413-1 S-1
No hits reported in this sample.
FC9413-2 S-2
No hits reported in this sample.
FC9413-3 S-3
No hits reported in this sample.
FC9413-4 S-4
No hits reported in this sample.
FC9413-5 S-5
No hits reported in this sample.
FC9413-6 S-6
No hits reported in this sample.
FC9413-7 S-7
No hits reported in this sample.
FC9413-8 S-8
No hits reported in this sample.
FC9413-9 S-9
No hits reported in this sample.
FC9413-10 S-10
No hits reported in this sample.
FC9413-11 S-11
No hits reported in this sample.
5 of 37
FC94132
Summary of Hits Page 2 of 2
Job Number:FC9413
Account:Highlands Environmental Solutions, Inc
Project:618003; NC
Collected:09/06/23
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FC9413-12 S-12
No hits reported in this sample.
FC9413-13 S-13
No hits reported in this sample.
FC9413-14 S-14
No hits reported in this sample.
FC9413-15 S-15
No hits reported in this sample.
FC9413-16 S-16
No hits reported in this sample.
FC9413-17 S-17
HEM Oil and Grease a 6760 2200 mg/kg SW846 9071B
FC9413-18 S-18
No hits reported in this sample.
FC9413-19 BKGD
No hits reported in this sample.
(a) Analysis performed at SGS Dayton, NJ.
6 of 37
FC94132
SGS North America Inc.
Sample Results
Report of Analysis
Orlando, FL
Section 3
7 of 37
FC94133
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-1
Lab Sample ID:FC9413-1 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:78.1
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2600 2600 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 78.1 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
8 of 37
FC941333.1
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-2
Lab Sample ID:FC9413-2 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:85.3
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2300 2300 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 85.3 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
9 of 37
FC941333.2
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-3
Lab Sample ID:FC9413-3 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:82.0
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2400 2400 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 82 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
10 of 37
FC941333.3
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-4
Lab Sample ID:FC9413-4 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:90.9
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2200 2200 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 90.9 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
11 of 37
FC941333.4
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-5
Lab Sample ID:FC9413-5 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:82.4
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2400 2400 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 82.4 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
12 of 37
FC941333.5
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-6
Lab Sample ID:FC9413-6 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:79.4
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2500 2500 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 79.4 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
13 of 37
FC941333.6
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-7
Lab Sample ID:FC9413-7 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:74.6
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2700 2700 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 74.6 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
14 of 37
FC941333.7
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-8
Lab Sample ID:FC9413-8 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:68.3
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2900 2900 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 68.3 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
15 of 37
FC941333.8
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-9
Lab Sample ID:FC9413-9 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:89.1
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2200 2200 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 89.1 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
16 of 37
FC941333.9
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-10
Lab Sample ID:FC9413-10 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:82.1
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2400 2400 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 82.1 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
17 of 37
FC941333.10
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-11
Lab Sample ID:FC9413-11 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:86.1
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2300 2300 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 86.1 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
18 of 37
FC941333.11
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-12
Lab Sample ID:FC9413-12 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:82.3
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2400 2400 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 82.3 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
19 of 37
FC941333.12
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-13
Lab Sample ID:FC9413-13 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:72.4
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2800 2800 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 72.4 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
20 of 37
FC941333.13
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-14
Lab Sample ID:FC9413-14 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:74.7
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2700 2700 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 74.7 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
21 of 37
FC941333.14
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-15
Lab Sample ID:FC9413-15 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:75.3
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2700 2700 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 75.3 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
22 of 37
FC941333.15
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-16
Lab Sample ID:FC9413-16 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:82.2
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2400 2400 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 82.2 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
23 of 37
FC941333.16
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-17
Lab Sample ID:FC9413-17 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:92.9
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a 6760 2200 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 92.9 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
24 of 37
FC941333.17
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:S-18
Lab Sample ID:FC9413-18 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:69.1
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2900 2900 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 69.1 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
25 of 37
FC941333.18
SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID:BKGD
Lab Sample ID:FC9413-19 Date Sampled:09/06/23
Matrix:SO - Soil Date Received:09/07/23
Percent Solids:92.7
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a < 2200 2200 mg/kg 1 09/14/23 09:30 ANJ SW846 9071B
Solids, Percent a 92.7 % 1 09/13/23 16:21 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
26 of 37
FC941333.19
SGS North America Inc.
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Orlando, FL
Section 4
27 of 37
FC94134
FC9413: Chain of Custody
Page 1 of 2
28 of 37
FC941344.1
FC9413: Chain of Custody
Page 2 of 2
29 of 37
FC941344.1
SGS North America Inc.
Misc. Forms
Custody Documents and Other Forms
(SGS Dayton, NJ)
Includes the following where applicable:
• Chain of Custody
Orlando, FL
Section 5
30 of 37
FC94135
FC9413: Chain of Custody
Page 1 of 3
SGS Dayton, NJ
31 of 37
FC941355.1
FC9413: Chain of Custody
Page 2 of 3
32 of 37
FC941355.1
Job Number:FC9413 Client:SGS NORTH AMERICA INC
Date / Time Received:9/13/2023 10:05:00 AM Delivery Method:FEDEX
Project:618003; NC
4. No. Coolers:1
Airbill #'s:
Cooler Security
1. Custody Seals Present:
Y or N
2. Custody Seals Intact:
3. COC Present:
4. Smpl Dates/Time OK
2. Cooler temp verification:
Cooler Temperature Y or N
1. Temp criteria achieved:
3. Cooler media:
IR Gun 40
Ice (Bag)
Quality Control Preservation Y or N N/A
1. Trip Blank present / cooler:
2. Trip Blank listed on COC:
3. Samples preserved properly:
4. VOCs headspace free:
Sample Integrity - Documentation Y or N
1. Sample labels present on bottles:
2. Container labeling complete:
3. Sample container label / COC agree:
Sample Integrity - Condition Y or N
1. Sample recvd within HT:
3. Condition of sample:
2. All containers accounted for:
Sample Integrity - Instructions
1. Analysis requested is clear:
2. Bottles received for unspecified tests
3. Sufficient volume recvd for analysis:
4. Compositing instructions clear:
5. Filtering instructions clear:
Intact
Y or N
Comments
Y or N N/A
Cooler Temps (Raw Measured) °C:
Cooler Temps (Corrected) °C:
Cooler 1: (4.0);
Cooler 1: (3.7);
SM089-03
Rev. Date 12/7/17
SGS Sample Receipt Summary
Test Strip Lot #s:pH 1-12:231619 pH 12+:203117A Other: (Specify)
FC9413: Chain of Custody
Page 3 of 3
33 of 37
FC941355.1
SGS North America Inc.
General Chemistry
QC Data Summaries
(SGS Dayton, NJ)
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
Orlando, FL
Section 6
34 of 37
FC94136
METHOD BLANK AND SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FC9413
Account: ALSE - SGS Orlando, FL
Project: HESNCR: 618003; NC
MB Spike BSP BSP QC
Analyte Batch ID RL Result Units Amount Result %Recov Limits
HEM Oil and Grease GP49262/GN45953 500 0.00 mg/kg 3990 3990 100.0 80-120%
Associated Samples:
Batch GP49262: FC9413-1, FC9413-2, FC9413-3, FC9413-4, FC9413-5, FC9413-6, FC9413-7, FC9413-8, FC9413-9, FC9413-10,
FC9413-11, FC9413-12, FC9413-13, FC9413-14, FC9413-15, FC9413-16, FC9413-17, FC9413-18, FC9413-19
(*) Outside of QC limits
__________________________________________________________________________________________________________________________
Page 1
35 of 37
FC941366.1
DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FC9413
Account: ALSE - SGS Orlando, FL
Project: HESNCR: 618003; NC
QC Original DUP QC
Analyte Batch ID Sample Units Result Result RPD Limits
HEM Oil and Grease GP49262/GN45953 FC9413-1 mg/kg 0.00 0.00 0.0 0-38%
Solids, Percent GN45945 FC9413-1 % 78.1 77.3 1.0 0-10%
Associated Samples:
Batch GN45945: FC9413-1, FC9413-2, FC9413-3, FC9413-4, FC9413-5, FC9413-6, FC9413-7, FC9413-8, FC9413-9, FC9413-10,
FC9413-11, FC9413-12, FC9413-13, FC9413-14, FC9413-15, FC9413-16, FC9413-17, FC9413-18, FC9413-19
Batch GP49262: FC9413-1, FC9413-2, FC9413-3, FC9413-4, FC9413-5, FC9413-6, FC9413-7, FC9413-8, FC9413-9, FC9413-10,
FC9413-11, FC9413-12, FC9413-13, FC9413-14, FC9413-15, FC9413-16, FC9413-17, FC9413-18, FC9413-19
(*) Outside of QC limits
__________________________________________________________________________________________________________________________
Page 1
36 of 37
FC941366.2
MATRIX SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FC9413
Account: ALSE - SGS Orlando, FL
Project: HESNCR: 618003; NC
QC Original Spike MS QC
Analyte Batch ID Sample Units Result Amount Result %Rec Limits
HEM Oil and Grease GP49262/GN45953 FC9413-1 mg/kg 0.00 37000 28900 78.1 10-194%
Associated Samples:
Batch GP49262: FC9413-1, FC9413-2, FC9413-3, FC9413-4, FC9413-5, FC9413-6, FC9413-7, FC9413-8, FC9413-9, FC9413-10,
FC9413-11, FC9413-12, FC9413-13, FC9413-14, FC9413-15, FC9413-16, FC9413-17, FC9413-18, FC9413-19
(*) Outside of QC limits
(N) Matrix Spike Rec. outside of QC limits
__________________________________________________________________________________________________________________________
Page 1
37 of 37
FC941366.3
07/07/23
Technical Report for
Highlands Environmental Solutions, Inc
618003; NC
SGS Job Number: FC7333
Sampling Date: 06/26/23
Report to:
jbeaman@hesnc.com
ksutler@hesnc.com
rshaut@hesnc.com
ariel.hartney@sgs.com
Jeanne.Rivenbark@sgs.com
ATTN: Distribution5
Total number of pages in report:
Certifications: FL(E83510), LA(03051), KS(E-10327), NC(573), NJ(FL002), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AL, AK, AR, CT, IA, KY, MA, MI. MS, ND, NH, NV, OK, OR, IL, UT, VT, WA, WI, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: 407-425-6700 •
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable unless noted
in the narrative, comments or footnotes.
Client Service contact: Ariel Hartney 407-425-6700
Norm Farmer
Technical Director
Orlando, FL 07/07/23
e-Hardcopy 2.0
Automated Report
11
SGS is the sole authority for authorizing edits or modifications to this document.
Unauthorized modification of this report is strictly prohibited.
Review standard terms at: http://www.sgs.com/en/terms-and-conditions
The results set forth herein are provided by SGS North America Inc.
Please share your ideas about
how we can serve you better at:
EHS.US.CustomerCare@sgs.com
1 of 11
FC7333
Table of Contents
-1-
Sections:
Section 1: Sample Summary ................................................................................................... 3
Section 2: Summary of Hits ....................................................................................................4
Section 3: Sample Results ........................................................................................................ 5
3.1:FC7333-1: WP-1 ........................................................................................................... 6
Section 4: Misc. Forms ............................................................................................................ 7
4.1:Chain of Custody ........................................................................................................... 8
4.2:Chain of Custody (SGS Dayton, NJ) ............................................................................. 10 12342 of 11
FC7333
SGS LabLink@13:14 07-Jul-2023
Sample Summary
Highlands Environmental Solutions, Inc
Job No:FC7333
618003; NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FC7333-1 06/26/23 12:15 JB 06/28/23 SO Soil WP-1
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3 of 11
FC73331
Summary of Hits Page 1 of 1
Job Number:FC7333
Account:Highlands Environmental Solutions, Inc
Project:618003; NC
Collected:06/26/23
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FC7333-1 WP-1
HEM Oil and Grease a 46400 1700 mg/kg SW846 9071B
(a) Analysis performed at SGS Dayton, NJ.
4 of 11
FC73332
SGS LabLink@13:14 07-Jul-2023
Sample Results
Report of Analysis
Orlando, FL
Section 3
5 of 11
FC73333
SGS LabLink@13:14 07-Jul-2023
Report of Analysis Page 1 of 1
Client Sample ID:WP-1
Lab Sample ID:FC7333-1 Date Sampled:06/26/23
Matrix:SO - Soil Date Received:06/28/23
Percent Solids:60.3
Project:618003; NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
HEM Oil and Grease a 46400 1700 mg/kg 1 07/07/23 10:00 ANJ SW846 9071B
Solids, Percent a 60.3 % 1 07/07/23 07:45 ANJ SM2540 G 18TH ED MOD
(a) Analysis performed at SGS Dayton, NJ.
RL = Reporting Limit
6 of 11
FC733333.1
SGS LabLink@13:14 07-Jul-2023
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
• Chain of Custody (SGS Dayton, NJ)
Orlando, FL
Section 4
7 of 11
FC73334
FC7333: Chain of Custody
Page 1 of 2
8 of 11
FC733344.1
Job Number:FC7333 Client:HES, INC
Date / Time Received:6/28/2023 9:45:00 AM Delivery Method:FED EX
Project:618003
Airbill #'s:5707 9051 6240
Cooler Information
1. Custody Seals Present
2. Custody Seals Intact
4. Cooler temp verification
3. Temp criteria achieved
5. Cooler media
IR Gun
Ice (Bag)
Trip Blank Information
1. Trip Blank present / cooler
2. Trip Blank listed on COC
2. Samples preserved properly
Sample Information
1. Sample labels present on bottles
5. Sample recvd within HT
4. Condition of sample
3. Sufficient volume/containers recvd for analysis:
Intact
Comments
SM001
Rev. Date 05/24/17
SGS Sample Receipt Summary
Cooler Temps (Raw Measured) °C:
Cooler Temps (Corrected) °C:
Cooler 1: (2.6);
Cooler 1: (2.4);
3. Type Of TB Received
W or S N/A
6. Dates/Times/IDs on COC match Sample Label
7. VOCs have headspace
8. Bottles received for unspecified tests
9. Compositing instructions clear
10. Voa Soil Kits/Jars received past 48hrs?
11. % Solids Jar received?
Misc. Information
25-Gram 5-GramNumber of Encores:Number of 5035 Field Kits:Number of Lab Filtered Metals:
Test Strip Lot #s:pH 0-3 230320 pH 10-12 Other: (Specify)pH 1.0 - 12.0 222221
Y or N N/A
Y or N
Therm ID:IR 1; Therm CF:-0.2; # of Coolers:1
Y or N N/A
12. Residual Chlorine Present?
Residual Chlorine Test Strip Lot #:
Technician:Reviewer:SHAYLAP Date:Date: 6/28/2023 9:45:00 AM
FC7333: Chain of Custody
Page 2 of 2
9 of 11
FC733344.1
FC7333: Chain of Custody
Page 1 of 2
SGS Dayton, NJ
10 of 11
FC733344.2
Job Number:FC7333 Client:
Date / Time Received:7/6/2023 10:10:00 AM Delivery Method:Fedex
Project:
4. No. Coolers:1
Airbill #'s:
Cooler Security
1. Custody Seals Present:
Y or N
2. Custody Seals Intact:
3. COC Present:
4. Smpl Dates/Time OK
2. Cooler temp verification:
Cooler Temperature Y or N
1. Temp criteria achieved:
3. Cooler media:
IR Gun 40
Ice (Bag)
Quality Control Preservation Y or N N/A
1. Trip Blank present / cooler:
2. Trip Blank listed on COC:
3. Samples preserved properly:
4. VOCs headspace free:
Sample Integrity - Documentation Y or N
1. Sample labels present on bottles:
2. Container labeling complete:
3. Sample container label / COC agree:
Sample Integrity - Condition Y or N
1. Sample recvd within HT:
3. Condition of sample:
2. All containers accounted for:
Sample Integrity - Instructions
1. Analysis requested is clear:
2. Bottles received for unspecified tests
3. Sufficient volume recvd for analysis:
4. Compositing instructions clear:
5. Filtering instructions clear:
Intact
Y or N
Comments
Y or N N/A
Cooler Temps (Raw Measured) °C:
Cooler Temps (Corrected) °C:
Cooler 1: (0.6);
Cooler 1: (0.4);
SM089-03
Rev. Date 12/7/17
SGS Sample Receipt Summary
Test Strip Lot #s:pH 1-12:231619 pH 12+:203117A Other: (Specify)
FC7333: Chain of Custody
Page 2 of 2
11 of 11
FC733344.2