MO-30268_49300_CA_IAR_20231128_Adrienne Travis Property

INITIAL ABATEMENT ACTION REPORT
ADRIENNE TRAVIS PROPERTY
SOURCE: 550 GALLON HEATING OIL UST
133 BOSTIAN LAKE ROAD STATESVILLE, NORTH CAROLINA 28677 IREDELL COUNTY
Prepared For: Mrs. Adrienne Travis 133 Bostian Lake Rd. Statesville, NC 28677
Prepared by:
Ground Technological Services, Inc. (GTSI) 2067 NC-16 Highway North Business Denver, NC 28037
GTSI Project Number: ENV2023ll-360
November 28, 2023
G GROUND T TECHNOLOGICAL S SERVICES
l!!!!!!!!!!!!!!J INC.
GTSI 2067 Hwy. 16 North Business Denver, NC 28037
November 28, 2023
Attn: Mrs. Adrie1me Travis
RE: Initial Abatement Action Report 13 3 Bostian Lake Road Statesville, NC 28677
Iredell County
GTSI-ENV202311-360
Dear Mrs. Travis:
Ground Technological Services Inc. (GTSI) is pleased to provide the attached Initial
Abatement Action Report for the removal of the non-commercial, non-regulated heating
oil underground storage tank (UST) and impacted soil at the referenced property.
GTSI is a N011h Carolina corporation licensed to provide geologic and civil engineering services and routinely provides environmental consulting services throughout the Charlotte Metropolitan area. GTSI appreciates the oppo11unity to provide these services
to you. If you should have any questions or require additional assistance, please call us
at your convenience.
Nancy Y. Patton
Environmental Professional
NON-REGULATED, NON-COMMERCIAL
HEATING FUEL UNDERGROUND STORAGE TANK INITIAL ABATEMENT ACTION REPORT ADRIENNE TRAVIS PROPERTY 133 BOSTIAN LAKE RD. IREDELL COUNTY, STATESVILLE, NC 28677
This report was prepared by Ground Technological Services, Inc. (GTSI) North Carolina Engineering License C-1825 North Carolina Geologists License C-322
This report was prepared under the direction of:
Gary L. Gechter President, P.G. North Carolina Geologists License 996

Ground Technological Services, Inc. (GTSI) is licensed to practice geology and engineering in North Carolina The ce1tification number of the company or corporation is C-322.
Initial Abatement Action Report November 2023-GTSI-ENV2023 I l-360 Site: 133 Bostian Lake Rd, Statesville, NC 28677 By: GTSI [phone]
NON-REGULATED, NON-COMMERCIAL HEATING FUEL UNDERGROUND STORAGE TANK INITIAL ABATEMENT ACTION REPORT
ADRIENNE TRAVIS PROPERTY
133 BOSTIAN LAKE RD. IREDELL COUNTY, STATESVILLE, NC 28677
Table of Contents
A. SITE INFORMATION ......................................................................................... 1
A.1 Site Identification ............................................................................................. 1
A.2 UST Contacts .................................................................................................... 1
A.3 Information About Release ............................................................................... 2
8.SITE HISTORY AND CHARACTERIZATION .......................................................... 2
B.1 Site History ........................................................................................................ 2
B.2 Site Characteristics ............................................................................................. 3
C.INITIAL RESPONSE AND ABATEMENT ACTIVITIES ............................................. 4
C.1 UST Closure Summary ....................................................................................... 4
C.2 Soil Excavation Activities ................................................................................... 5
D.SOILS INVESTIGATION .................................................................................... 6
E.CONCLUSIONS AND RECOMMENDATIONS ...................................................... 6
Initial Abatement Action Report November 2023-GTSl-ENV2023 I 1-360 Site: 133 Bostian Lake Rd, Statesville, NC 28677 By: GTSI [phone]
I
G
S
T
SITE
I
G
S
T
S1
S2S3 S4
S5
S6
I
G
S
T
Sx

APPENDIX A

PHOTOS FROM
NOVEMBER 13, 2023
View of UST and initiation of excavation activities.

View of UST during excavation activities.

View of UST removal.

View of the bottom of the UST.

APPENDIX B

DISPOSAL MANIFESTS

APPENDIX C

LABORATORY ANALYTICAL RESULTS &
CHAIN-OF-CUSTODY

Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.

11/16/2023
GTSI Nancy Patton
2067 NC-16 HWY Business Denver, NC, 28037
Ref: Analytical Testing
Lab Report Number: 23-317-0020 Client Project Description: GTSI-ENV202311-360
Dear Nancy Patton:
Waypoint Analytical, LLC (Charlotte) received sample(s) on 11/13/2023 for the analyses presented in the
following report.
The above referenced project has been analyzed per your instructions. The analyses were performed in accordance with the applicable analytical method.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all parameters were performed in accordance with guidelines established by the USEPA (including 40 CFR 136
Method Update Rule May 2021) unless otherwise indicated. Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time. Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as-received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report. Please do not hesitate to contact me or client services if you have any questions or need additional information. Sincerely,
Angela D Overcash Senior Project Manager
Page 1 of 20
Certification Summary
Laboratory ID: WP CNC: Waypoint Analytical Carolina, Inc. (C), Charlotte, NC
State Program Lab ID Expiration Date
07/31/202437735State ProgramNorth Carolina
12/31/2023402State ProgramNorth Carolina
07/31/202499012State ProgramSouth Carolina
12/31/202399012State ProgramSouth Carolina
Page 1 of 1 00016/23-317-0020
Page 2 of 20
Report Number:
Sample Summary Table
Client Project Description:
23-317-0020
GTSI-ENV202311-360
Lab No Client Sample ID Matrix Date Collected Date Received
11/13/2023 09:45Solids 89081 S1 11/13/2023 16:05
11/13/2023 10:18Solids 89082 S2 11/13/2023 16:05
11/13/2023 10:25Solids 89083 S3 11/13/2023 16:05
11/13/2023 10:37Solids 89084 S4 11/13/2023 16:05
11/13/2023 10:45Solids 89085 S5 11/13/2023 16:05
11/13/2023 11:05Solids 89086 S6 11/13/2023 16:05
11/13/2023 12:10Solids 89087 S7 11/13/2023 16:05
Page 3 of 20

Client: GTSI CASE NARRATIVE
Project: GTSI-ENV202311-360 Lab Report Number: 23-317-0020
Date: 11/16/2023
Total Petroleum Hydrocarbons - Extractable Method 8015C DRO Sample 89081 (S1) QC Batch No: V40271/V40184
Surrogate(s) flagged for recovery outside QC limits in this project sample due to a required dilution. The dilution factor resulted in surrogate concentration(s) below the minimum detectable level. Batch QC samples (method
blank and laboratory control samples) all showed surrogates within QC limits.
Sample 89087 (S7) QC Batch No: V40271/V40184
Surrogate(s) flagged for recovery outside QC limits in this project sample due to a required dilution. The dilution factor resulted in surrogate concentration(s) below the minimum detectable level. Batch QC samples (method
blank and laboratory control samples) all showed surrogates within QC limits.
Sample 99786 (NW-1) QC Batch No: V40271/V40184
Surrogate recovery(s) was flagged as outside QC limits due to high levels of target and/or non-target analytes. Batch QC samples (method blank and laboratory control samples) all showed surrogates within QC limits.
Sample 99786 (NW-1)
QC Batch No: V40271/V40184 Relative Percent Difference (RPD) for the duplicate analysis was outside of the allowable QC limits. Total Petroleum Hydrocarbons - Volatile Method 8015C GRO Sample 89084 (S4) Analyte: a,a,a-Trifluorotoluene
QC Batch No: V40290/V40289 Surrogate(s) exhibited a high bias in this project sample where no target analytes were detected. The high
recovery(s) had no impact on the data. Batch QC samples (method blank and laboratory control samples) all showed surrogates within QC limits. Sample 89085 (S5)
Analyte: a,a,a-Trifluorotoluene QC Batch No: V40290/V40289
Surrogate(s) exhibited a high bias in this project sample where no target analytes were detected. The high recovery(s) had no impact on the data. Batch QC samples (method blank and laboratory control samples) all showed surrogates within QC limits. Sample 89086 (S6) Analyte: a,a,a-Trifluorotoluene
QC Batch No: V40290/V40289 Surrogate(s) exhibited a high bias in this project sample where no target analytes were detected. The high recovery(s) had no impact on the data. Batch QC samples (method blank and laboratory control samples) all showed surrogates within QC limits.
Page 4 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S1
89081 Matrix:
11/13/2023 9:45
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
16.8 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 5 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S1
89081 Matrix:
11/13/2023 9:45
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
29800 mg/Kg - dry 1390 3000Diesel Range Organics (C10-C28)250 11/15/23 14:47 V40271NDL
Surrogate: OTP Surrogate 0 *
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
186 mg/Kg - dry 24.9 60.1Gasoline Range Organics (C6-C10)500 11/16/23 00:12 V40290TBL
Surrogate: a,a,a-Trifluorotoluene
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 6 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S2
89082 Matrix:
11/13/2023 10:18
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
12.4 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 7 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S2
89082 Matrix:
11/13/2023 10:18
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
<5.31 mg/Kg - dry 5.31 11.4Diesel Range Organics (C10-C28)1 11/14/23 21:02 V40271NDL
Surrogate: OTP Surrogate
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
<2.36 mg/Kg - dry 2.36 5.71Gasoline Range Organics (C6-C10)50 11/15/23 17:33 V40290TBL
Surrogate: a,a,a-Trifluorotoluene
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 8 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S3
89083 Matrix:
11/13/2023 10:25
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
16.8 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 9 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S3
89083 Matrix:
11/13/2023 10:25
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
<5.59 mg/Kg - dry 5.59 12.0Diesel Range Organics (C10-C28)1 11/14/23 21:23 V40271NDL
Surrogate: OTP Surrogate
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
<2.49 mg/Kg - dry 2.49 6.01Gasoline Range Organics (C6-C10)50 11/15/23 18:02 V40290TBL
Surrogate: a,a,a-Trifluorotoluene
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 10 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S4
89084 Matrix:
11/13/2023 10:37
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
15.5 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 11 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S4
89084 Matrix:
11/13/2023 10:37
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
<5.50 mg/Kg - dry 5.50 11.8Diesel Range Organics (C10-C28)1 11/14/23 22:06 V40271NDL
Surrogate: OTP Surrogate
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
<2.45 mg/Kg - dry 2.45 5.92Gasoline Range Organics (C6-C10)50 11/15/23 18:30 V40290TBL
Surrogate: a,a,a-Trifluorotoluene 163 *
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 12 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S5
89085 Matrix:
11/13/2023 10:45
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
16.5 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 13 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S5
89085 Matrix:
11/13/2023 10:45
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
<5.57 mg/Kg - dry 5.57 12.0Diesel Range Organics (C10-C28)1 11/14/23 22:27 V40271NDL
Surrogate: OTP Surrogate
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
<2.48 mg/Kg - dry 2.48 5.99Gasoline Range Organics (C6-C10)50 11/15/23 18:58 V40290TBL
Surrogate: a,a,a-Trifluorotoluene 172 *
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 14 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S6
89086 Matrix:
11/13/2023 11:05
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
12.7 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 15 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S6
89086 Matrix:
11/13/2023 11:05
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
<5.33 mg/Kg - dry 5.33 11.5Diesel Range Organics (C10-C28)1 11/14/23 22:48 V40271NDL
Surrogate: OTP Surrogate
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
5035 MED
8015C GRO Prep Batch(es):11/15/23 08:00
<2.37 mg/Kg - dry 2.37 5.73Gasoline Range Organics (C6-C10)50 11/15/23 19:26 V40290TBL
Surrogate: a,a,a-Trifluorotoluene 182 *
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 16 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S7
89087 Matrix:
11/13/2023 12:10
Solids
Test Results Units MDL MQL By Analytical
Method
Date / Time
Analyzed
DF
15.7 %Moisture 1 11/14/23 15:32 SW-DRYWTCNC
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 17 of 20
,
REPORT OF ANALYSISReport Number :
Project
Information :
NC 28037
23-317-0020
00217
GTSI
2067 NC-16 HWY Business
Nancy Patton
Denver
Received : 11/13/2023
GTSI-ENV202311-360
Report Date : 11/16/2023
Sample ID :
Lab No :
Sampled:S7
89087 Matrix:
11/13/2023 12:10
Solids
Analytical Method:
Prep Method:
Test Results Units MDL MQL By Analytical
Batch
Date / Time
Analyzed
DF
3546
8015C DRO Prep Batch(es):11/14/23 09:50
11500 mg/Kg - dry 552 1190Diesel Range Organics (C10-C28)100 11/15/23 15:08 V40271NDL
Surrogate: OTP Surrogate 0 *
Qualifiers/
Definitions
Dilution FactorDFOutside QC Limit*
Method Quantitation LimitMQL
Page 18 of 20
Fed Ex
UPS
US Postal
Client
Lab
Courier
Other :
Shipment Receipt Form
Customer Number:
Customer Name:
Report Number:23-317-0020
GTSI
00217
Shipping Method
Shipping container/cooler uncompromised?
Thermometer ID:IRT15 3.7C
Chain of Custody (COC) present?Yes No
Yes No Not Present
Yes No Not Present
Yes No
COC agrees with sample label(s)?Yes No
COC properly completed
Samples in proper containers?
Sample containers intact?
Sufficient sample volume for indicated test(s)?
All samples received within holding time?
Cooler temperature in compliance?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes NoCooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
Yes No
Yes No N/A
Yes No N/A
Yes No N/ASoil VOA method 5035 – compliance criteria met
Water - Sample containers properly preserved
Water - VOA vials free of headspace Yes No N/A
Trip Blanks received with VOAs
ü
Low concentration EnCore samplers (48 hr)
High concentration pre-weighed (methanol -14 d) Low conc pre-weighed vials (Sod Bis -14 d)ü
High concentration container (48 hr)
Custody seals intact on shipping container/cooler?
Custody seals intact on sample bottles?
Number of coolers/boxes received
Yes No
1
Signature:Angelo Norvell Date & Time:11/13/2023 16:52:39
Special precautions or instructions included?
Comments:
Page 19 of 20
Page 20 of 20