WI0400443_DEEMED FILES_20160208

D~
INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources -Division of Water Resources
Permit Number WI0400443
I . Permit Information
Euliss Propane Company
Permittee
· S&S Auto Service -Incident No. 14143
Facility Name
8081 Old Liberty Road, Liberty, NC 27298
Facility Address
2. Injection Contractor Information
EnviroTrac Ltd.
Injection Contractor I Company Name
Street Address 7343 W. Friendly Ave, Suite J
Greeosbara NC 27410
City State Zip Code
[phone]
Area code -Phone number
3. Well Information
Number of wells used for injection _,l......._ __ _
Well names.-=MW=-'-~-=3R~---------
Were any new wens installed during this injection
event?
D Yes l~(No
If yes, please provide the following infonnation:
Number ofMonitoring Wells ______ _
Number of Injection Wells _______ _
Type of Well Installed (Check applicable type):
0 Bored O Drilled O Direct-Push
D Hand-Augured O Other (specify) __ _
Please include a copy of the GW-1 form for each
well installed
Were any wells abandoned during this injection
event?
0 Yes [?(No
If yes, please provide the following information:
Number of Monitoring Wells _____ _
Number of Injection Wells, _______ _
Please include a copy of the GW-30/or each well
abandoned
4. Injectant Information
Oxyg en gas
Injectant Type
Concentration 44-52 ppm dissolved in water
If the injectant is diluted please indicate the source
dilution fluid .. ...,N_,.,A,.,,_ _________ _
Total Volume Injected Continuous gas injection
Volume Injected per well.""'N..,.A~------
5. Injection History
Injection date(s) Continuous in jection started 12/18/15
Injection number (e.g. 3 of 5)~N..!.!A~-----
Ejhis the last injecti~.af this site?
Yes No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON TIIlS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE MTI THAT 1HE
INJECTION WAS PERFORMED WITlllN 1HE
STANDtS LAID OUT IN TIIB PERMIT: .
0~:t~\¼\ __________ ~!~b~ _
SIGNATURE OfjINJECTION CONTRACTOR DA TE
__C~~ _\~~ I e~--Jv~ri \_,~\~ \:.-~)~ __ _
PRINT NAME OFfi>ElsoN PERFORMING TIIB INJECTION
Submit the original ofthis fonn to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 8/5/2013
GROU N DW ATER M O N ITORI NG REPORT
Site:
FORMER S&S AUTO SERVICE
8081 OLD LIBERTY ROAD
LIBERTY, RANDOLPH COUNTY, NORTH CAROLINA
Submitted To:
MR. CHRIS H. STANLEY
EULISS PROPANE COMPANY
POST OFFICE BOX 789
LIBERTY, NORTH CAROLINA 27298
Prepared By:
ENVIROTRAC LTD.
7343 WEST FRIENDLY AVENUE, SUITE J
GREENSBORO, NORTH CAROLINA 27410
[phone]
JULY 2016
A Full Service Environmental Consulting
and Contracting Firm
EnvTri-o_l_r,_a_c
July 27, 2016
Mr. Chris H. Stanley
Euliss Propane Company
Post Office Box 789
Liberty , North Carolina 27298
Envi ronm ent al Services
Reference: Groundwater Monitoring Report
Former S&S Auto Service
8081 Old Liberty Road
Liberty, North Carolina
Incident No. 14143
Dear Mr. Stanley:
EnviroTrac Ltd. has prepared the enclosed report summarizing groundwater sampling activities
at the referenced site . This report includes details of our field activities, observations,
recommendations, and conclusions.
Should questions arise or additional information be required, please contact the undersigned.
Sincerely,
ENVIROTRAC LTD.
ffeil~
Gail G. Hay, PE
Senior Engineer
(1 . '1 0 ' -H,-
Chris W. HayJ El
Principal
Enclosure
cc: Stephen Williams -UST Section, w/enc.
Michael Rogers -UIC Program
RECEIVED/NCDEQ/OWR
JUL 2 8 2016
Water Quality Regional
Operations Section
7343 West Friendly Avenue, Suite J, Greensboro, North Carolina 27410 I Office: (336) 763-60251 Fax: [phone]
www.envirotrac.com
EnvTrolrac
Environmental Services
GROUNDWATER MONITORING REPORT
Site Name and Location:
Risk Classification
Incident Number
Latitude and Longitude:
Date of Report:
Land Use Category:
UST Owner:
Consultant:
Former S&S Auto Service
8081 Old Liberty Road
Liberty, North Carolina
High
14143
35° 50' 48.71" North, 79° 38' 39.85" West
July 27, 2016
Commercial
Euliss Propane Company
Post Office Box 789
Liberty, North Carolina 27298
Attn: Mr. Chris Stanley
Phone: [phone]
EnviroTrac Ltd.
7343 W. Friendly Avenue, Suite J
Greensboro, North Carolina 27410
Attn: Mr. Christopher W . Hay
Phone: [phone]
Release Information: A release from two 1,000-gallon gasoline underground storage tanks
was discovered during removal on August 15, 1994. The quantity of gasoline released is
unknown.
SEAL AND SIGNATURE OF CERTIFYING PROFESSIONAL ENGINEER
I, Gail G. Hay, P.E., a Professional Engineer for EnviroTrac Engineering, P.E., P.C., do certify
that the in{orill'Hatflf11,~P.ntained in this report is correct and accurate to the best of my knowledge. ,, oC''4.CARtQ 11
,.,,'' ~' ······•·· ~~ ',,, l ~~-·oft:.ss,o.iii·•~;,-:.
.: :'q_~ lof(\ -:. .. . . -
: i SEAL : :
-4 • -
: ! 031532 ; :
\~/j~ f
Gail G"::F@i-~ffl:::=; J-12.7 /th
North Caro''31h,~~~'t"ion No. 031532
EnviroTrac is licensed to practice geology (certification number C-457) and engineering
(certification number C-4170) in North Carolina.
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Pagei July 27, 2016
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Environmental Servi ces
TABLE OF CONTENTS
1.0 INTRODUCTION ............................................................................................................... 1
2.0 OXYGEN INJECTION ....................................................................................................... 1
3.0 FIELD METHODS ............................................................................................................. 2
3.1 Monitoring Well Sampling ........................................................................................ 2
3.2 Water Supply Well Sampling ................................................................................... 2
4.0 RESULTS ......................................................................................................................... 3
4.1 Groundwater Flow Direction .................................................................................... 3
4.2 Monitoring Well Samples ......................................................................................... 3
4.3 Supply Well Samples .............................................................................................. 3
5.0 CONCLUSIONS AND RECOMMENDATIONS ................................................................ 3
6.0 LIMITATIONS ................................................................................................................... 4
TABLES
1 Site History and UST Information
2 Summary of Monitoring Well and Groundwater Elevation Data
3 Aquifer Characteristics Field Analysis Summary
4 Groundwater Analytical Summary
5 Historical Groundwater Analytical Summary
FIGURES
1 Site Location Map
2 Site Map
3 Groundwater Flow Map
APPENDICES
A BTEX Concentration vs. Time in MW-3R
B Laboratory Report
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1.0 INTRODUCTION
The site is located at 8081 Old Liberty Road in Liberty, North Carolina (Figure 1). The site
consists of a single building on approximately one acre. The building was formerly used as an
auto repair shop (S&S Auto Service) and is currently vacant.
Two 1,000-gallon gasoline underground storage tanks (USTs) were removed from the site on
August 15, 1994 (Table 1). Contamination was detected during removal of the USTs. Eleven
monitoring wells have been installed at the site (Figure 2). Gasoline associated hydrocarbons
have been detected in MW-3, located down gradient of the former USTs, at concentrations
above the NCDEQ groundwater quality standards . Monitoring well MW-3 repeatedly contained a
low volume of water and sand was entering the well . Therefore, a new monitoring well (MW-3R)
was installed between the former tank pit and MW-3, and MW-3 was abandoned (Figure 2).
Previously, the NCDEQ UST Section agreed to a monitoring schedule which included sampling
MW-3R and the supply well located at 8076 Liberty Road (Frazier) on a semi-annual basis with
annual reporting. In a letter dated March 16, 2015, NCDEQ requested recommendations for
active remediation and sampling monitoring wells MW-3R, MW-6, MW-7, and MW-8 at the site
and supply wells within 500 feet of the site during the July 2015 sampling event. EnviroTrac
installed an oxygen diffusion device within existing monitoring well MW-3R to increase the
degradation rate of petroleum hydrocarbons. Subsequent monitoring includes sampling
monitoring wells MW-3R and MW-8 and the Frazier water supply well on a semi-annual basis.
The purpose of this report is to summarize the July 2016 monitoring event.
2.0 OXYGEN INJECTION
The oxygen diffuser was installed at the site in existing monitoring well MW-3R on December
18, 2015. The oxygen diffuser consists of silicone tubing wrapped around approximately 4.5
feet of 0.75-inch diameter PVC pipe. Oxygen is supplied from a compressed gas cylinder with a
regulator and gauge connected to the oxygen diffuser by Parflex tubing and a support cable.
The oxygen injection system provides dissolved oxygen to the treatment well , typically at a
concentration of 40 to 200 parts per million (ppm) depending on the immersion depth of the unit
in groundwater. The dissolved oxygen concentration achieved in the injection well depends on
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the height of the water column in the well. Each atmosphere of pressure allows for a maximum
of approximately 41 ppm of dissolved oxygen. The estimated dissolved oxygen concentration in
MW-3R is 44 to 52 ppm . The concentration is estimated based on the approximate pressure at
the installation depth of the oxygen diffuser in the injection well. The calculation is made with
the assumption that 41 ppm of oxygen is dissolved in the groundwater per atmosphere of
pressure.
Oxygen is infused into the treatment well from the diffuser at a typical rate of 15 standard cubic
centimeters per minute or approximately 0.8 cubic feet per day. The oxygen consumption in the
injection well is tracked to estimate the remaining service life of the oxygen cylinder.
The oxygen delivery system produces a convection current in the well to distribute dissolved
oxygen throughout the screened interval. A curtain of oxygen rich water disperses around the
well into the adjacent groundwater forming a treatment zone allowing enhanced bioremediation
to degrade the target contaminants.
3.0 FIELD METHODS
3.1 Monitoring Well Sampling
On July 19, 2016, EnviroTrac mobilized to the site to collect groundwater samples from
monitoring wells MW-3R and MW-8. The water levels were gauged in each of the wells onsite.
Field parameters including oxidation-reduction potential, pH, conductivity, dissolved oxygen,
and temperature of representative groundwater samples were also recorded from the
monitoring wells sampled. Prior to sampling, each well was purged by removal of a minimum of
three well volumes of water or until the well was bailed dry. Groundwater samples were
collected with a new disposable bailer and placed in laboratory supplied bottles , placed on ice in
a cooler, and sent to Pace Analytical Laboratories (Pace) in Huntersville, North Carolina under
chain-of-custody. The groundwater samples were analyzed for volatile organic compounds
(VOCs) using Standard Method 6200B.
3.2 Water Supply Well Sampling
The Frazier water supply well located at 8076 Old Liberty Road was sampled on July 19, 2016.
The sample was collected from an outside spigot. The water was allowed to run for 10 minutes
prior to collecting the sample in laboratory prepared containers. The sample was maintained on
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ice until delivery to Pace, where the sample was analyzed for VOCs using Standard Method
6200B.
4.0 RESULTS
4.1 Groundwater Flow Direction
The depth to the water table ranged from approximately 21 feet to 31 feet below top of casing in
the monitoring wells on July 19, 2016. Based upon the water level measurements, groundwater
was moving to the southeast under an approximate gradient of 0.06 feet per foot as measured
between MW-5 and MW-7 (Figure 3). The water level data are summarized in Table 2.
4.2 Monitoring Well Samples
The field measurements recorded on July 19, 2016 are summarized in Table 3. Conductivity is
recorded for quality control and sampling consistency. Dissolved oxygen is significantly higher
than background levels in oxygen injection wells.
The laboratory analysis of the groundwater sample collected from monitoring well MW-3R
detected benzene and naphthalene above the North Carolina groundwater quality standards
established in 15A NCAC, Subchapter 2L (2L Standards). VOC concentrations have decreased
since the July 2015 sampling event. The sum of benzene, toluene, ethylbenzene, and total
xylenes (BTEX) has decreased 91 % since the July 2015 sampling event. A graph of the BTEX
concentration vs. time for MW-3R is presented in Appendix A. No VOCs were detected above
the laboratory detection limit in MW-8. The laboratory results are summarized in Table 4 and
historical analytical results are summarized in Table 5. The laboratory reports and associated
chain-of-custody documents are included in Appendix B.
4.3 Water Supply Well Samples
No VOCs were detected above the laboratory detection limit in the Frazier water supply well in
the July 19, 2016 sample. The laboratory results are summarized in Table 4 and historical
analytical results are summarized in Table 5. The laboratory report is included as Appendix B.
5.0 CONCLUSIONS AND RECOMMENDATIONS
Based on the results of the laboratory analysis and field activities, EnviroTrac presents the
following conclusions:
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• Groundwater aquifer characteristics monitored during the sampling event
indicate suitable conditions for natural attenuation of petroleum hydrocarbons
exist within a localized area around MW-3R.
• Benzene and naphthalene were detected above the 2L Standards in
monitoring well MW-3R.
• Petroleum hydrocarbons were not detected above the laboratory detection
limits in monitoring well MW-8 or the Frazier water supply well.
Based on the results of the laboratory analysis, EnviroTrac recommends:
• Corrective action monitoring of monitoring wells MW-3R and MW-8 and the
Frazier water supply well should continue to be conducted on a semi-annual
schedule . Monthly system checks should also be conducted to monitor the
rate of oxygen consumption from the passive injection system .
6.0 LIMITATIONS
EnviroTrac's work was performed in a manner consistent with that level of care and skill
ordinarily exercised by other members of its profession practicing in the same locality, under
similar conditions and at the date the services are provided . EnviroTrac's conclusions, opinions
and recommendations are based on a limited number of observations and data . It is possible
that conditions could vary between or beyond the data evaluated. EnviroTrac makes no
guarantee or warranty, express or implied, regarding the services, communication (oral or
written), report, opinion, or instrument of service provided.
The information included on graphic representations in the report has been compiled from a
variety of sources and is subject to change without notice. Enviro Trac makes no representations
or warranties, express or implied, as to accuracy, completeness, timeliness, or rights to the use
of such information. These documents are not intended for use as a land survey product, nor
are they designed or intended as a construction design document. The use of the information
contained on these graphic representations is at the sole risk of the party using the information.
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TABLE 1: SITE HISTORY AND UST INFORMATION
USTID Last Capacity Construction Tank
Number Contents (in Gallons) Details Dimensions
Cylindrical UST-1 Gasoline 1,000 Steel 4' X 10' 9"
Cylindrical UST-2 Gasoline 1,000 Steel 4' X 10' 9"
NOTE:
Former locations of the USTs are shown on Figure 2.
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Last Date Installation Status Release Used Date
Closed by
08/15/94 07/05/66 Removal Yes
08/15/94
Closed by
08/15/94 07/05/66 Removal Yes
08/15/94
July 2016
TABLE 2: SUMMARY OF MONITORING WELL AND GROUNDWATER ELEVATION DATA
Well No.
C Top of Casing
0 :,;:; Top of Screen
C'CI > Bottom of Screen G)
jjj Depth of Well
01/05/10 Depth (ft)
Elevation
06/29/10 Depth (ft)
Elevation
01/19/11 Depth (ft)
Elevation
07/18/11 Depth (ft)
Elevation
03/08/12 Depth (ft)
Elevation
10/04/12 Depth (ft)
Elevation
07/25/13 Depth (ft)
Elevation
01/20/14 Depth (ft)
Elevation
07/01/14 Depth (ft)
Elevation
02/04/15 Depth (ft)
Elevation
07/21/15 Depth (ft)
Elevation
01/26/16 Depth (ft)
Elevation
07/19/16 Depth (ft)
Elevation
NOTES:
All data in feet (ft)
AB = Abandoned
NM = Not Measured
MW-1 MW-2
680.41 680.20
671.41 655.20
641.41 640.20
39 40
AB 34.18
--646.02
AB 31.73
--648.47
AB 35.11
--645.09
AB NM
-- --
AB NM
-- --
AB NM
-- --
AB NM
-- --
AB NM
----
AB 30.20
--650.00
AB 33.79
--646.41
AB 32.22
--647.98
AB 30.75
--649.45
AB 30.08
--650.12
MW-3 MW-3R MW-3D MW-3D0
679.69 680.57 680.00 680.30
658.69 650.57 605.00 573.30
643.69 640.57 595.00 563.30
36 40 85 117
33.16 --34.25 34.78
646.53 --645.75 645.52
31.61 --NM NM
648.08 -- -- --
34.97 --NM NM
644.72 -- -- --
AB 37.75 NM NM
--642.82 ---
AB 36.02 NM NM
--644.55 -- --
AB 37.02 NM NM
--643.55 -- --
AB 33.53 NM NM
--647.04 ----
AB 32.12 NM NM
--648.45 -- --
AB 30.86 31.02 31.63
--649.71 648.98 648.67
AB 34.41 34.41 35.06
--646.16 645.59 645.24
AB 32.73 32.79 33.46
--647.84 647.21 646.84
AB 24.09 30.86 31.39
--656.48 649.14 648.91
AB 30.73 30.85 31.63
--649.84 649.15 648.67
Elevations surveyed from top of casing of MW-3D with an assumed elevation of 680.00 feet.
Depth of well measured from top of casing
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MW-4 MW-5 MW-6 MW-7 MW-8
680.38 681.24 680.38 676.37 676.98
655.38 661.24 655.38 646.37 646.98
640.38 646.24 645.38 636.37 636.98
40 35 35 40 40
34.31 24.35 34.33 29.85 30.84
646.07 656.89 646.05 646.52 646.14
32.17 21.97 32.42 29.04 28.68
648.21 659.27 647.96 647.33 648.30
35.83 25.81 34.58 32.75 32.14
644.55 655.43 645.80 643.62 644.84
NM NM NM NM NM
----------
NM NM NM NM NM
----------
NM NM NM NM NM
-- --
------
NM NM NM NM NM
----------
NM NM NM NM NM
-- ---- --
--
30.76 NM 30.96 27.54 27.08
649.62 --649.42 648.83 649.90
34.28 24.86 34.47 30.94 30.76
646.10 656.38 645.91 645.43 646.22
32.81 23.97 32.95 29.29 28.92
647.57 657.27 647.43 647.08 648.06
30.77 21.59 30.52 26.43 26.34
649.61 659.65 649.86 649.94 650.64
30.59 21.79 30.84 27.50 27.02
649.79 659.45 649.54 648.87 649.96
July 2016
TABLE 3: AQUIFER CHARACTERISTICS FIELD ANALYSIS SUMMARY
Temperature Conductivity Well ID Sample Date ( oc) (mS/cm)
MW-3R 07/19/16 18.41 0.107
MW-8 07/19/16 17.78 0.219
NOTES:
°C = degrees Celsius
mS/cm = millisiemens per centimeter
mg/L = milligrams per liter, analogous to parts per million
ORP = oxidation-reduction potential
mV = millivolts
pH
6.16
6.38
Conductivity is measured for consistency in groundwater sample collection.
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Dissolved ORP Oxygen
(mg/L) (mV)
28 .31 88.5
1.43 -78.8
July 2016
TABLE 4: GROUNDWATER ANALYTICAL SUMMARY
PARAMETER
Sample ID MW-3R MW-8
Collection Date 07/19/16 07/19/16
Volatile Organic Compounds by Standard Method 6200B (µg/L)
Benzene 71.0
Toluene 173
Ethyl benzene 67.2
Xylenes (total) 317.4
lsopropylbenzene 2.1
Methyl-tert-butyl ether 6.4
Naphthalene 13.6
Styrene 0.91
n-Propylbenzene 6.3
1,2,4-Trimethylbenzene 49.8
NOTES:
Results presented in micrograms per liter (µg/I)
Bold denotes concentration is greater than 2L Standard
BRL = Not detected at or above reporting limit
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BRL
BRL
BRL
BRL
BRL
BRL
BRL
BRL
BRL
BRL
COMPARISON
CRITERIA
Frazier 2L Groundwater
Standard
07/19/16
BRL 1
BRL 600
BRL 600
BRL 500
BRL 70
BRL 20
BRL 6
BRL 70
BRL 70
BRL 400
July 2016
TABLE 5: HISTORICAL GROUNDWATER ANAi
Sample ID Volatile Organic Compounds (µg/L)
Collection Ethylben Xylenes -opyl-Benzene Toluene Date zene (total) zene
2L Standard 1 600 600 500 ro
MW-3R
07/18/11 850 2,400 370 1,470 ;4
03/08/12 2,900 4,800 2,200 10,000 10
10/04/12 2,000 4,800 2,200 12,000 60
07/25/13 2,000 2,900 2,300 12,000 90
01/20/14 1,400 2,400 1,800 10,000 60
07/01/14 1,200 820 1,500 8,100 60
02/04/15 712 467 1,200 6,170 RL
07/21/15 641 285 526 5,610 30
01/26/16 17.2 59.0 22.5 105.6 .6
07/19/16 71.0 173 67.2 317.4 i.3
MW-6
07/21/15 BRL BRL BRL BRL RL
MW-7
07/21/15 BRL BRL BRL BRL RL
MW-8
07/21/15 BRL BRL BRL BRL RL
01/26/16 BRL BRL BRL BRL RL
07/19/16 BRL BRL BRL BRL RL
Frazier
07/01/14 BRL BRL BRL BRL RL
02/04/15 BRL BRL BRL BRL RL
07/21/15 BRL BRL BRL BRL RL
01/26/16 BRL BRL BRL BRL RL
07/19/16 BRL BRL BRL BRL RL
NOTES:
Results presented in micrograms per liter (µg/L)
Bold denotes concentration is greater than 2L Standar
BRL = Not detected at or above reporting limit
J = Concentration estimated below the reporting limit
NA = Not analyzed for the compound
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© 2016 EnviroTrac
Trichloro-1,2,4-1,3,5-Vinyl Styrene fluoro-Tri methyl-Tri methyl-
methane benzene benzene chloride
70 2,000 400 400 0.03
29 BRL 290 83 BRL
30 BRL 1,900 540 BRL
BRL BRL 2,100 610 BRL
BRL BRL 2,500 710 BRL
BRL BRL 2,600 690 BRL
BRL 140 2,200 620 120
4 BRL 1,770 450 BRL
BRL BRL 1,570 454 BRL
BRL BRL 13.8 3.7 BRL
0.91 BRL 49.8 BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
BRL BRL BRL BRL BRL
July 2016
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tt 7343 W. FRIEND LYAVENUE, SUITEI
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FIGURE 1
SITE LOCATION MAP
FORMER S&5AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY:
DATE:
rD
DRAWN BY: AB
ATE: 02/12/15
APPROVED BY:
CWH
SCALE: AS SHOWN
PROJECT NO: 11.990O23.00

of
WOODED
AREA
FRAZIER SUPPLY WELL
APPROXIMATELY 150 FEET SOUTHWEST
BRAXTON SUPPLYYAELL
APPROXIMATELY 1,000 FEEY 5OUTHINE ST
20' 0 40'
APPROXIMATE SCALE
i#MW-2
MW-SL' f "I
VV-3H
MW-313D 1 - MW-3D
MW-3
+MNR4
MW-8
4,MW-7 � NOTE:
BASE MAP FROM ALLIED ENVIRONMENTAL SERVICES OVERALL
SITE MAP, PROJECT 02-1002, DWG, NOL D001, DATED 12-17-07.
LEGEND
MONITORING WELL
ABANDONED MONITORING WELL
DEEP MONITORING WELL
FORMER LOCATION OF THE
UNDERGROUND STORAGE TANK
Environmental Services
7343 W. FRIENDLY AVENUE, SUITE)
GREENSBORO, NORTH CAROLINA
FIGURE 2
SITE MAP
FORMER 5 &S AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY: GGH
DATE: 07/22/15
DRAWN BY: AS
DATE: 02/12/15
APPROVED IY:
CVVH
SCALE: AS SHOWN
PROJECT' NO: 11.990023.00

OLD
avesR mRpgD
slS&S Auto
WOODED
AREA
1
MWIFB
649.96
FRAZ ER SUPPLY NELL
APPROXIMATELY 250 FEET8OLRNYYEST
BRAXTON SUPPLY WELL
- APPROXIMATELY 1 000 FEET SOUTI-1NEST
0023.00 Eul
0 20' 0 40'
APPROXIMATE SCALE
•MW2
650.12
.159.45
_ — — — — — 659
W-3
649.84
r MW-5DD* `41-MII9-3D
r 648.67 649.15
r M W-3
•
nvuro rah
Environmental Services
7343 W. FRIENDLY AVENUE, SUITE)
GREENSBORO, NORTH CAROLINA
—852
651
8so
Mw4
849,79
401).MW-6
849,54
646
LEGEND
MONITORING WELL
ABANDONED MONITORING WELL
DEEP MONITORING WELL
FORMER LOCATION OF THE
UNDERGROUND STORAGE TANK
yµc�R MONITORING WELL WITH
eac ae GROUNDWATER ELEVATION IN FEET
GROUNDWATER CONTOUR LINES
— GROUNDWATER FLOW DIRECTION
NOTE:
BASE MAP FROM ALLIED ENVIRONMENTAL SERVICES OVERALL
SITE MAP, PROJECT 02-1002, DWG, NOL D001, DATED 12-17-07,
MONITORING WELLS MW-3D AND MW-3DD WERE NOT USED IN
CREATING THE GROUNDWATER FLOW MAP.
FIGURE 3
GROUNDWATER FLAW MAP` L°Iljl)
FORMER S&SAUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY: GGH
DATE: 07/22/16
DRAWN BY:AB
DATE: 02/12/15
APPROVED BY:
CWH
SCALE: AS SHOWN
PROJECT NO: 11.990023.00

APPENDIX A
BTEX CONCENTRATION VS. TIME IN MW-3R

JUL-11
JAN-12
BTEX CONCENTRATION VS. TIME IN MW-3R
JUL-12
—0—Benzene Toluene--Ethylhenzene—4—Xylenes(total)
JAN-13
JUL-13
JAN-14
TIME
JUL-14
JAN-15
JUL-15
Oxygen
Injection
Initiated
12/18/15
JAN-16
14,000
12,000
10,000
8,000
6,000
4,000
JUL-1G
2,000
0
(i,6 1) NOiiv iNDN0j

APPENDIX B
LABORATORY REPORT

Z'ceAnalytica!'
www.pacelabs.com
I
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 1 oo
Hunte rsville , NC 28078
[phone]
July 22, 2016
Chris Hay
EnviroTrac
7343 W. Friendly Avenue
Suite J
Greensboro, NC 27410
RE : Project: S & S Auto
Pace Project No.: 92305855
Dear Chris Hay:
Enclosed are the analytical results for sample(s) received by the laboratory on July 20, 2016. The
results relate only to the samples included in this report . Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
~./:kvu~v-~
Nicole Gasiorowski
nicole [e-mail]
Project Manager
Enclosures
cc : Annamarie Blauser
Gail Hay, EnviroTrac, Ltd .
Carrie Lawson, EnviroTrac
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, Inc .. Page 1 of 18
•
PaceAnalytical
ensvwpscelabS
Pace Analytical Services, Inc.
9800 KlnceyAve. Suite 100
Iiuntersville, NC 28078
[phone]
CERTIFICATIONS
Project S & 3 Auto
Pace Project No.: 92305855
Charlotte Certification 1Os
9800 KinceyAve. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #. 37706
North Carolina Field Services Certification # 5342
North Carolina Wastewater Certification #; 12
South Carolina Certification* 99006001
FloridafNELAP Certification #: E87627
Kentucky UST Certification #: 84
VirglniaNELAP Certification #: 460221
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
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Project: S & SAuto
Pace Project No.: 92305855
Lab ID Sample ID
92305855001 MW-3R
92305855002 MW-8
92305855003 Frazier
SAMPLE ANALYTE COUNT
Method
SM6200B
SM 6200B
SM 62008
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc ..
Analysts
NB
NB
NB
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 280 78
[phone]
Analytes
Reported Laboratory
63 PASI-C
63 PASI-C
63 PASI-C
Page 3 of 18
f/ceA__.~:1·
Pace Analytical Services, Inc.
9800 Kincey Ave . Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: S & SAuto
Pace Project No.: 92305855
Sample: MW-3R Lab ID: 92305855001 Collected: 07/19/16 12:24 Received: 07/20/16 16:30 Matrix: Water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No . Qual
6200B MSV Analytical Method: SM 6200B
Benzene 71.0 ug/L 0 .50 07/21/16 21:52 71-43-2
Bromobenzene ND ug/L 0.50 07/21/16 21:52 108-86-1
Bromochloromethane ND ug/L 0.50 07/21/16 21:52 74-97-5
Bromodichloromethane ND ug/L 0.50 07/21/16 21:52 75-27-4
Bromoform ND ug/L 0.50 07/21/16 21:52 75-25-2
Bromomethane ND ug/L 5.0 07/21/1621 :52 74-83-9
n-Butylbenzene ND ug/L 0.50 07/21/1621 :52 104-51-8
sec-Butylbenzene ND ug/L 0.50 07/21/1621 :52 135-98-8
tert-Butylbenzene ND ug/L 0.50 07/21/1621 :52 98-06-6
Carbon tetrachloride ND ug/L 0.50 07/21/16 21 :52 56-23-5
Chlorobenzene ND ug/L 0 .50 1 07/21/16 21 :52 108-90-7
Chloroethane ND ug/L 1.0 1 07/21/1621 :52 75-00-3
Chloroform ND ug/L 0.50 07/21/1621 :52 67-66-3
Chloromethane ND ug/L 1.0 07/21/1621 :52 74-87-3
2-Chlorotoluene ND ug/L 0.50 07/21/1621 :52 95-49-8
4-Chlorotoluene ND ug/L 0.50 07/21/1621 :52 106-43-4
1,2-Dibromo-3-chloropropane ND ug/L 1.0 07/21/1621 :52 96-12-8
Dibromochloromethane ND ug/L 0.50 07/21/1621 :52 124-48-1
1,2-Dibromoethane (EDB) ND ug/L 0.50 07/21/1621 :52 106-93-4
Dibromomethane ND ug/L 0.50 07/21/1621 :52 74-95-3
1,2-Dichlorobenzene ND ug/L 0 .50 07/21/1621 :52 95-50-1
1,3-Dichlorobenzene ND ug/L 0.50 07/21/1621 :52 541-73-1
1,4-Dichlorobenzene ND ug/L 0 .50 07/21/1621 :52 106-46-7
Dichlorodifluoromethane ND ug/L 0 .50 07/21/1621 :52 75-71-8
1, 1-Dichloroethane ND ug/L 0.50 07/21/1621 :52 75-34-3
1,2-Dichloroethane ND ug/L 0.50 07/21/16 21:52 107-06-2
1, 1-Dichloroethene ND ug/L 0.50 07/21/1621 :52 75-35-4
cis-1,2-Dichloroethene ND ug/L 0 .50 07/21/1621 :52 156-59-2
trans-1,2-Dichloroethene ND ug/L 0 .50 07/21/1621 :52 156-60-5
1,2-Dichloropropane ND ug/L 0 .50 07/21/16 21:52 78-87-5
1,3-Dichloropropane ND ug/L 0.50 07/21/1621 :52 142-28-9
2,2-Dichloropropane ND ug/L 0.50 07/21/16 21:52 594-20-7
1, 1-Dichloropropene ND ug/L 0.50 07/21/16 21:52 563-58-6
cis-1,3-Dichloropropene ND ug/L 0 .50 07/21/1621 :52 10061-01-5
trans-1,3-Dichloropropene ND ug/L 0.50 07/21/16 21:52 10061-02-6
Diisopropyl ether ND ug/L 0.50 07/21/1621 :52 108-20-3
Ethylbenzene 67.2 ug/L 0 .50 07/21/1621 :52 100-41-4
Hexachloro-1,3-butadiene ND ug/L 2.0 07/21/1621 :52 87-68-3
lsopropylbenzene (Cumene) 2.1 ug/L 0.50 07/21/1621 :52 98-82-8
Methylene Chloride ND ug/L 2.0 07/21/16 21:52 75-09-2
Methyl-tert-butyl ether 6.4 ug/L 0.50 07/21/16 21:52 1634-04-4
Naphthalene 13.6 ug/L 2.0 07/21/1621 :52 91-20-3
n-Propylbenzene 6.3 ug/L 0 .50 07/21/1621 :52 103-65-1
Styrene 0.91 ug/L 0 .50 07/21/1621 :52 100-42-5
1, 1,1,2-Tetrachloroethane ND ug/L 0.50 07/21/1621 :52 630-20-6
1, 1,2,2-Tetrachloroethane ND ug/L 0 .50 07/21/1621 :52 79-34-5
Tetrachloroethene ND ug/L 0 .50 07/21/1621 :52 127-18-4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/22/2016 10:29 AM without the written consent of Pace Analytical Services, Inc .. Page 4 of 18
Z'ceAnalytica!'
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I
Project: S & SAuto
Pace Project No .: 92305855
Sample: MW-3R
Parameters
6200B MSV
Toluene
1,2,3-Trichlorobenzene
1,2,4-Trichlorobenzene
1, 1, 1-Trichloroethane
1, 1,2-Trichloroethane
Trichloroethene
Trichlorofluoromethane
1,2,3-Trichloropropane
1,2,4-Trimethylbenzene
1,3,5-Trimethylbenzene
Vinyl chloride
m&p-Xylene
a-Xylene
Surrogates
1 ,2-Dichloroethane-d4 (S)
4-Bromofluorobenzene (S)
Toluene-dB (S)
Date: 07/22/201610:29AM
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave . Su ite 100
Huntersville, NC 28078
[phone]
Lab ID: 92305855001 Collected : 07/19/16 12:24 Received: 07/20/16 16:30 Matrix: Water
Results Units Report Limit DF Prepared
Analytical Method: SM 6200B
173 ug/L 0.50
ND ug/L 2 .0
ND ug/L 2 .0
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 0 .50
ND ug/L 1.0
ND ug/L 0 .50
49.8 ug/L 0.50
ND ug/L 0.50 1
ND ug/L 1.0 1
218 ug/L 1.0
99.4 ug/L 0 .50
100 % 70-130
98 % 70-130
99 % 70-130
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc ..
Analyzed CAS No . Qual
07/21/1621 :52 108-88-3
07/21/1621 :52 87-61-6
07/21/1621 :52 120-82-1
07/21/1621 :52 71-55-6
07/21/1621 :52 79-00-5
07/21/1621 :52 79-01-6
07/21/1621 :52 75-69-4
07/21/16 21:52 96-18-4
07/21/16 21 :52 95-63-6
07/21/16 21 :52 108-67-8
07/21/16 21 :52 75-01-4
07/21/1621 :52 179601-23-1
07/21 /16 21 :52 95-47-6
07/21/1621 :52 17060-07-0
07/21 /16 21 :52 460-00-4
07/21/1621 :52 2037-26-5
Page 5 of 18
2111
/ .. aceAnalyticar
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Pace Analytical Services, Inc.
9800 Kincey Ave. Sulte 100
I-k ntersviile, NC 28078
[phone]
ANALYTICAL RESULTS
Project. S & S Auto
Pace Project No.: 92305855
Sample: MW-8 Lab ID: 92305855002 Collected: 07/19/16 12:25 Received: 07/20/16 16:30 Matrix. Water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Quaff
620013 MSV Analytical Method. SM 6200B
Benzene ND ug/L 0.50 1 07/21/16 21:35 71-43-2
8romobenzene NO ug/L 0.50 1 07/21/16 21:35 108-86-1
Bromoohioromethane ND ug/L 0.50 1 07/21/16 21:35 74-97-5
Bromodichloromethane ND ug/L 0.50 1 07121/1621:35 75-27-4
Bromoform ND ug/L 0.50 1 0712111E 21:35 75-25-2
Bromomethane NO ug/L 5.0 1 07/21/16 21:35 74-83-9
n-Butyibenzene ND ugfL 0.50 1 07121/1521.35 104-51-8
sec-Butylbenzene ND ug/L 0.50 1 07/21/16 21:35 135-98-8
tert-Butyibenzene ND ug/L 0.50 1 07/21/16 21:35 98-06-6
Carbon tetrachloride NO ug/L 0.50 1 07/21/16 21:35 56-23-5
Chlorobenzene NO ugfL 0.50 1 07/21/16 21:35 108-90-7
Chloroethane NO ug/L 1.0 1 07/21/16 21:35 75-00-3
Chloroform ND ug/L 0.50 1 07/21/16 21:35 67-66-3
Chlorornethane N❑ ug/L 1.0 1 07/21/16 21:35 74-87-3
2-Chlorotoluene ND ug/L 0.50 1 07/21/16 21:35 95-49-8
4-Chlorotoluene NO ug/L 0.50 1 07/21/16 2135 106-43-4
1,2-Dibromo-3-chloropropane NO ug/L 1.0 1 07/21116 21:35 96-12-8
Dibromochloromethane ND ug/L 0.50 1 07/21/16 21:35 124-48-1
1,2-Dlbromoethane (ERB) ND ug/L 0.50 1 07/21/16 21:35 106-93-4
Dibromomethane ND ug/L 0.50 1 07/21/16 21:35 74-95-3
1,2-Dichlorobenzene ND ug/L. 0.50 1 07/21/16 21 35 95-50-1
1,3-Dichlorobenzene ND ug/L 0.50 1 07/21/16 21:35 541-73-1
1,4-Dichlorobenzene ND ug/L 0.50 1 07/21/16 21;35 106-46-7
Dichlorodifiuoromethane ND ug/L 0.50 1 07/21/16 21:35 75-71-8
1,1-Dichloroethene ND ug/L 0.50 1 07/21/16 21:35 75-34-3
1,2-Dichloroethane ND ug/L 0.50 1 07/21/16 21:35 107-06-2
1,1-❑ichloroethene ND ug/L 0.50 1 07/21/1621:35 75-35-4
cis-1,2-DlchIoraethene ND ug/L 0.50 1 07/21/1621:35 156-59-2
trans-1,2-Dichloroethene ND ug/L 0.50 1 07/21/16 21:35 156-60-5
1,2-Dichloropropane ND ugfL 0.50 1 07/21/16 21:35 78-87-5
1,3-Dichloropropane ND ug/L 0,50 1 07/21/1621:35 142-28-9
2,2-Dichloropropane ND ug/L 0.50 1 07/21/16 21:35 594-20-7
1,1-Dichloropropene ND ug/L 0.50 1 07/21/1621:35 563-56-6
cis-1,3-Dichlaropropene ND ug/L 0.50 1 07/21/1621:35 10061-01-5
trans-1,3-Dichloropropene ND ug/L 0.50 1 07/21/1621:35 10061-02-6
Diisopropylether ND ug/L 0,50 1 07/21/1621:35 108.20-3
Ethylbenzene ND ug/L 0.50 1 0712111E 21:35 100-41-4
Hexachloro-1,3-butadiene ND ug/L 2.0 1 07/21/16 21:35 87-68-3
Isopropylbenzene (Cumene) NO ug/L 0.50 1 07/21/16 21:35 98-82-8
Methylene Chloride NO ugfL 2.0 1 0712111E 21:35 75-09-2
Methyl-tert-butyl ether ND ug/L 0.50 1 07/21/16 21:35 1634.04-4
Naphthalene ND ug/L 2.0 1 0712111E 21:35 91-20-3
n-Propylbenzene ND ug/L 0.50 1 0712111E 21:35 103-65-1
Styrene ND ug/L 0.50 1 07/21/16 21:35 100-42-5
1,1,1,2-Tetrachlaroethane ND ugfL 0.50 'I 0712111E 21:35 630-20-6
1,1,2,2-Tetrachloraethane ND ug/L 0.50 1 0712111621:35 79-34-5
Tetrachloroethene ND ug/L 0.50 1 07/21/16 21:35 127-18-4
REPORT OF LABORATORY ANALYSIS
Date: 07/22/2016 10:29 AM
This report snail not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. page 5 of 18

~eAna.lytica!'
www.pacelabs.com
I
Project: S & SAuto
Pace Project No.: 92305855
Sample: MW-8
Parameters
6200B MSV
Toluene
1,2,3-Trichlorobenzene
1,2,4-Trichlorobenzene
1, 1, 1-Trichloroethane
1, 1,2-Trichloroethane
Trichloroethene
Trichlorofluoromethane
1,2,3-Trichloropropane
1,2,4-Trimethylbenzene
1,3,5-Trimethylbenzene
Vinyl chloride
m&p-Xylene
a-Xylene
Surrogates
1,2-Dichloroethane-d4 (S)
4-Bromofluorobenzene (S)
Toluene-dB (S)
Date: 07/22/201610:29AM
ANALYTICAL RESULTS
Lab ID: 92305855002 Collected: 07/19/16 12:25 Received:
Results Units Report Limit DF Prepared
Analytical Method: SM 6200B
ND ug/L 0.50
ND ug/L 2.0
ND ug/L 2.0
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 1.0
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 1.0
ND ug/L 1.0
ND ug/L 0.50
103 % 70-130
97 % 70-130
102 % 70-130
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc ..
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
07 /20/16 16:30 Matrix: Water
Analyzed GAS No. Qual
07/21/1621 :35 108-88-3
07/21/1621 :35 87-61-6
07/21/1621 :35 120-82-1
07/21/1621 :35 71-55-6
07/21/1621 :35 79-00-5
07/21 /16 21 :35 79-01-6
07/21 /16 21 :35 75-69-4
07/21/16 21:35 96-18-4
07/21/1621 :35 95-63-6
07/21/1621 :35 108-67-8
07/21/1621 :35 75-01-4
07/21/1621 :35 179601-23-1
07/21/1621 :35 95-47-6
07/21/16 21:35 17060-07-0
07/21/16 21:35 460-00-4
07/21/16 21:35 2037-26-5
Page 7 of 18
f'~• Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 1 oo
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: S & SAuto
Pace Project No.: 92305855
Sample: Frazier Lab ID: 92305855003 Collected: 07/19/1612:05 Received: 07/20/16 16:30 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed GAS No. Qual
6200B MSV Analytical Method: SM 6200B
Benzene ND ug/L 0.50 07/21/16 22:09 71-43-2
Bromobenzene ND ug/L 0.50 07/21/16 22:09 108-86-1
Bromochloromethane ND ug/L 0.50 07/21/16 22:09 74-97-5
Bromodichloromethane ND ug/L 0.50 07/21/16 22:09 75-27-4
Bromoform ND ug/L 0.50 07/21/16 22:09 75-25-2
Bromomethane ND ug/L 5.0 07/21/16 22:09 74-83-9
n-Butylbenzene ND ug/L 0.50 07/21/16 22:09 104-51-8
sec-Butyl benzene ND ug/L 0.50 07/21/16 22:09 135-98-8
tert-Butylbenzene ND ug/L 0.50 07/21/16 22:09 98-06-6
Carbon tetrachloride ND ug/L 0.50 07/21/16 22:09 56-23-5
Chlorobenzene ND ug/L 0.50 07/21/16 22:09 108-90-7
Chloroethane ND ug/L 1.0 07/21/16 22:09 75-00-3
Chloroform ND ug/L 0.50 07/21/16 22:09 67-66-3
Chloromethane ND ug/L 1.0 07/21 /16 22:09 74-87-3
2-Chlorotoluene ND ug/L 0.50 07/21/16 22:09 95-49-8
4-Chlorotoluene ND ug/L 0.50 07/21/16 22:09 106-43-4
1,2-Dibromo-3-chloropropane ND ug/L 1.0 07/21/16 22:09 96-12-8
Dibromochloromethane ND ug/L 0.50 07/21 /16 22:09 124-48-1
1,2-Dibromoethane (EDB) ND ug/L 0.50 07/21/16 22:09 106-93-4
Dibromomethane ND ug/L 0.50 07/21/16 22:09 74-95-3
1,2-Dichlorobenzene ND ug/L 0.50 07/21/16 22:09 95-50-1
1,3-Dichlorobenzene ND ug/L 0.50 07/21/16 22:09 541-73-1
1,4-Dichlorobenzene ND ug/L 0.50 07/21/16 22:09 106-46-7
Dichlorodifluoromethane ND ug/L 0.50 07/21/16 22:09 75-71-8
1, 1-Dichloroethane ND ug/L 0.50 07/21/16 22:09 75-34-3
1,2-Dichloroethane ND ug/L 0.50 07/21/16 22:09 107-06-2
1, 1-Dichloroethene ND ug/L 0.50 07/21/16 22:09 75-35-4
cis-1,2-Dichloroethene ND ug/L 0.50 07/21/16 22:09 156-59-2
trans-1,2-Dichloroethene ND ug/L 0.50 07/21/16 22:09 156-60-5
1,2-Dichloropropane ND ug/L 0.50 07/21/16 22:09 78-87-5
1,3-Dichloropropane ND ug/L 0.50 07/21/16 22:09 142-28-9
2,2-Dichloropropane ND ug/L 0.50 07/21/16 22:09 594-20-7
1, 1-Dichloropropene ND ug/L 0.50 07/21/16 22:09 563-58-6
cis-1,3-Dichloropropene ND ug/L 0.50 07/21/16 22:09 10061-01-5
trans-1,3-Dichloropropene ND ug/L 0.50 07/21/16 22:09 10061-02-6
Diisopropyl ether ND ug/L 0.50 07/21/16 22:09 108-20-3
Ethylbenzene ND ug/L 0.50 07/21/16 22:09 100-41-4
Hexachloro-1,3-butadiene ND ug/L 2.0 07/21/16 22:09 87-68-3
lsopropylbenzene (Cumene) ND ug/L 0.50 07/21/16 22:09 98-82-8
Methylene Chloride ND ug/L 2.0 07/21/16 22:09 75-09-2
Methyl-tert-butyl ether ND ug/L 0.50 07/21 /16 22:09 1634-04-4
Naphthalene ND ug/L 2.0 07/21 /16 22:09 91-20-3
n-Propylbenzene ND ug/L 0.50 07/21/16 22:09 103-65-1
Styrene ND ug/L 0.50 07/21/16 22:09 100-42-5
1, 1, 1,2-Tetrachloroethane ND ug/L 0.50 07/21/16 22:09 630-20-6
1, 1,2,2-Tetrachloroethane ND ug/L 0.50 07/21/16 22:09 79-34-5
Tetrachloroethene ND ug/L 0.50 07/21/16 22:09 127-18-4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/22/201610:29AM without the written consent of Pace Analytical Services, Inc .. Page 8 of 18
Z'ceAnalyticaJ°
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I
Project: S & SAuto
Pace Project No.: 92305855
Sample: Frazier
Parameters
6200B MSV
Toluene
1,2,3-Trichlorobenzene
1,2,4-Trichlorobenzene
1, 1, 1-Trichloroethane
1, 1,2-Trichloroethane
Trichloroethene
Trichlorofluoromethane
1,2,3-Trichloropropane
1,2,4-Trimethylbenzene
1,3,5-Trimethylbenzene
Vinyl chloride
m&p-Xylene
o-Xylene
Surrogates
1,2-Dichloroethane-d4 (S)
4-Bromofluorobenzene (S)
Toluene-dB (S)
Date: 07/22/2016 10:29AM
ANALYTICAL RESULTS
Lab ID: 92305855003 Collected: 07/19/16 12:05 Received:
Results Units Report Limit DF Prepared
Analytical Method: SM 6200B
ND ug/L 0.50
ND ug/L 2.0
ND ug/L 2.0
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 1.0
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 0.50
ND ug/L 1.0
ND ug/L 1.0
ND ug/L 0.50
100 % 70-130
96 % 70-130
100 % 70-130
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc ..
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 1 oo
Huntersville, NC 28078
[phone]
07/20/16 16:30 Matrix: Water
Analyzed GAS No. Qual
07/21/16 22:09 108-88-3
07/21/16 22:09 87-61-6
07/21/16 22:09 120-82-1
07/21/16 22:09 71-55-6
07/21/16 22:09 79-00-5
07/21/16 22:09 79-01-6
07/21/16 22:09 75-69-4
07/21/16 22:09 96-18-4
07/21/16 22:09 95-63-6
07/21/16 22:09 108-67-8
07/21/16 22:09 75-01-4
07/21/16 22:09 179601-23-1
07/21/16 22:09 95-47-6
07/21/16 22:09 17060-07-0
07/21/16 22:09 460-00-4
07/21/16 22:09 2037-26-5
Page 9 of 18
> eAna/ytical
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QUALITY CONTROL DATA
Project. S & S Auto
Pace Project No.: 92305855
Pace Analytical Services, Inc.
9800 KlnceyAve. Suite 100
Huntersville, NC 26078
[phone]
QC Batch 322096 Analysis Method: SM 6200B
QC Batch Method: SM 6200B Analysis Description: 6200E MSV
Associated Lab Samples: 92305855001, 92305855002, 92305855003
METHOD BLANK: 1785061 Matrix. Water
Associated Lab Samples:
Parameter
92305855001, 92305855002, 92305855003
Blank Reporting
Units Result Limit Analyzed Qualifiers
1,1,1,2-Tetrachloroethane ugfL NO 0.50 07/21/16 18:28
1,1,1-Trichloroethane ug/L ND 0.50 07/21/16 18:28
1,1,2,2-Tetrechloroethane ugfL ND 0,50 07/21/1618:28
1,1,2-Trichloroethane ug/L ND 0.50 07/21/16 18:28
1.1-Dichloroethane ug/L ND 0.50 07/21/16 18:28
1,1-Dichloroethene ug/L ND 0.50 07/21/16 18:28
1,1-Oichtorapropene ugfL ND 0.50 07/21/16 18:28
1,2,3-Trichlorobenzene ug/L NO 2.0 07/21/16 18:28
1.2,3-Trichloropropane ug/L ND 0.50 07/21/16 18:28
1,2,4-Trichlcrobenzene ugfL ND 2.0 07/21/16 18:28
1,2,4-Trimethylbenzene ug/L ND 0.50 07/21/16 18:28
1,2-Dibromo-3-chioropropane ugfL ND 1.0 07/211161828
1,2-Dibromoethane (EDS) ugfL ND 0.50 07/21/16 18:28
1,2-Dichiarobenzene ug/L ND 0.50 07/21/16 18:28
1,2-Dichloroethane ugfL NID 0.50 07/21/16 18:28
1,2-Dichloropropane ugfL NO 0.50 07/21/1618:28
1,3,5-Trirnethyibenzene ug/L ND 0.50 07/21/16 18:28
1,3-Dichkorobenzene ug/L ND 0.50 07/21/16 18:28
1,3-Dichloropropane ug/L ND 0.50 07/21/16 18:28
1,4-Dichlorobenzene ug/L ND 0.50 07/21/16 18:28
2,2-Dichloropropane ug/L ND 0.50 07/21/16 18:28
2-Chlorotoluene ugfL ND 0.50 07/21/1618:28
4-Chlorotoluene ugfL. ND 0.50 07/21/1618:28
Benzene ug/L ND 0.50 07/21/16 18'.28
Bromobenzene ugfL ND 0.50 07/21/1618:28
Bromochloromethane ug/L ND 0.50 07/21/16 18:28
Bromodichloromethane ug/L NO 0.50 07/21/16 18:28
Brornoforrn ug/L NO 0.50 07/21/16 18:28
Bromomethane ugfL ND 5,0 07/21/16 18:28
Carbon tetrachloride ug/L ND 0.50 07/21/16 18:28
Chlarobenzene ug/L NO 0.50 07/21/1618:28
Chloroethane ug/L ND 1.0 07/21/16 18:28
Chloroform ug/L NO 0.50 07/21116 18:28
Chloromethane ug/L ND 1.0 07/21/16 18;28
cis-1,2-Dichloroethene ug/L ND 0.50 07/21/1618:28
cis-1,3-Dichloropropane ugfL ND 0.50 07/21/1618:26
Dibromochloromethane ug/L ND 0.50 07/21/16 18:28
Dibromomethane ug/L ND 0.50 07/21/1818128
Dichlorodifkuorarnethane ugfL ND 0.50 07/21/16 18:28
Dusopropyl ether ugfL NO 0.50 07/21/16 18:28
Ethylbenzene ugfL NO 0.50 07/21/1618:28
Results presented on this page are In the units htdTcate d by the "Units" column except where en alternate unit is presented to the fight of the result.
REPORT OF LABORATORY ANALYSIS
Date: 07/22/2016 10:29 AM
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, inc.. Page 10 of 18

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QUALITY CONTROL DATA
Project: S & S Auto
Pace Project No.: 92305855
METHOD BLANK: 1785061 Matrix: Water
Associated Lab Samples: 92305855001, 92305855002, 92305855003
Blank
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 1 oo
Huntersville, NC 28078
[phone]
Parameter Units Result
Reporting
Limit Analyzed Qualifiers
Hexachloro-1,3-butadiene
lsopropylbenzene (Cumene)
m&p-Xylene
Methyl-tert-butyl ether
Methylene Chloride
n-Butylbenzene
n-Propylbenzene
Naphthalene
a-Xylene
sec-Butylbenzene
Styrene
tert-Butylbenzene
Tetrachloroethene
Toluene
trans-1,2-Dichloroethene
trans-1,3-Dichloropropene
Trichloroethene
Trichlorofluoromethane
Vinyl chloride
1,2-Dichloroethane-d4 (S)
4-Bromofluorobenzene (S)
Toluene-dB (S)
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
%
%
%
LABORATORY CONTROL SAMPLE: 1785062
Parameter
1 , 1, 1 ,2-Tetrachloroethane
1, 1, 1-Trichloroethane
1 , 1,2,2-Tetrachloroethane
1 , 1,2-Trichloroethane
1, 1-Dichloroethane
1, 1-Dichloroethene
1, 1-Dichloropropene
1,2,3-Trichlorobenzene
1,2,3-Trichloropropane
1,2,4-Trichlorobenzene
1,2,4-Trimethylbenzene
1,2-Dibromo-3-chloropropane
1,2-Dibromoethane (EDB)
1,2-Dichlorobenzene
1,2-Dichloroethane
1,2-Dichloropropane
1,3,5-Trimethylbenzene
1,3-Dichlorobenzene
Units
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
ug/L
Spike
Cone.
50
50
50
50
50
50
50
50
50
50
50
50
50
50
50
50
50
50
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
98
97
100
2.0 07/21/1618:28
0.50 07/21/1618:28
1.0 07/21/1618:28
0.50 07/21/16 18:28
2.0 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/1618:28
2.0 07/21/1618:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
0.50 07/21/16 18:28
1.0 07/21/16 18:28
1.0 07/21/1618:28
70-130 07/21/1618:28
70-130 07/21/1618:28
70-130 07/21/1618:28
LCS
Result
LCS
%Rec
%Rec
Limits
42.9
44.8
41.4
42.6
42.7
47.2
45.4
43.8
40.8
44.7
44.0
44.2
43.3
42.9
40.0
42.7
43.1
43.4
86
90
83
85
85
94
91
88
82
89
88
88
87
86
80
85
86
87
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
60-140
Qualifiers
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result
Date: 07/22/2016 10:29 AM
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, Inc .. Page 11 of 18
µe~:;' Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 1 oo
Huntersville, NC 28078
[phone]
I
QUALITY CONTROL DATA
Project: S & SAuto
Pace Project No.: 92305855
LABORATORY CONTROL SAMPLE: 1785062
Spike LCS LCS % Rec
Parameter Units Cone. Result %Rec Limits Qualifiers
1,3-Dichloropropane ug/L 50 41.0 82 60-140
1,4-Dichlorobenzene ug/L 50 43.5 87 60-140
2,2-Dichloropropane ug/L 50 46.0 92 60-140
2-Chlorotoluene ug/L 50 43.1 86 60-140
4-Chlorotoluene ug/L 50 43.8 88 60-140
Benzene ug/L 50 43.0 86 60-140
Bromobenzene ug/L 50 46.9 94 60-140
Bromochloromethane ug/L 50 43.0 86 60-140
Bromodichloromethane ug/L 50 42.2 84 60-140
Bromoform ug/L 50 42.1 84 60-140
Bromomethane ug/L 50 48.6 97 60-140
Carbon tetrachloride ug/L 50 46.1 92 60-140
Chlorobenzene ug/L 50 43.5 87 60-140
Chloroethane ug/L 50 47.2 94 60-140
Chloroform ug/L 50 42.7 85 60-140
Chloromethane ug/L 50 35.7 71 60-140
cis-1,2-Dichloroethene ug/L 50 44.0 88 60-140
cis-1,3-Dichloropropene ug/L 50 44.9 90 60-140
Dibromochloromethane ug/L 50 42.2 84 60-140
Dibromomethane ug/L 50 42.7 85 60-140
Dichlorod ifluoromethane ug/L 50 45.2 90 60-140
Diisopropyl ether ug/L 50 46.2 92 60-140
Ethyl benzene ug/L 50 43.1 86 60-140
Hexachloro-1,3-butadiene ug/L 50 44.1 88 60-140
lsopropylbenzene (Cumene) ug/L 50 43.2 86 60-140
m&p-Xylene ug/L 100 84.7 85 60-140
Methyl-tert-butyl ether ug/L 50 46.4 93 60-140
Methylene Chloride ug/L 50 49.5 99 60-140
n-Butylbenzene ug/L 50 45.5 91 60-140
n-Propylbenzene ug/L 50 42.3 85 60-140
Naphthalene ug/L 50 43.9 88 60-140
a-Xylene ug/L 50 42.3 85 60-140
sec-Butylbenzene ug/L 50 43.1 86 60-140
Styrene ug/L 50 44.9 90 60-140
tert-Butylbenzene ug/L 50 35.4 71 60-140
Tetrachloroethene ug/L 50 41.8 84 60-140
Toluene ug/L 50 42.4 85 60-140
trans-1,2-Dichloroethene ug/L 50 44.6 89 60-140
trans-1,3-Dichloropropene ug/L 50 43.2 86 60-140
Trichloroethene ug/L 50 42.5 85 60-140
Trichlorofluoromethane ug/L 50 44.1 88 60-140
Vinyl chloride ug/L 50 45.8 92 60-140
1,2-Dichloroethane-d4 (S) % 102 70-130
4-Bromofluorobenzene (S) % 101 70-130
Toluene-dB (S) % 100 70-130
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
Date: 07/22/2016 10:29AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc .. Page 12 of 18
z,fceAnaJytica/'
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
www.pacelabs.com [phone]
(
QUALITY CONTROL DATA
Project: S & SAuto
Pace Project No.: 92305855
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1785063 1785064
MS MSD
92305873001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result %Rec %Rec Limits RPO Qual
1, 1, 1,2-Tetrachloroethane ug/L <0.50 20 20 17.8 18.1 89 91 60-140 2
1, 1, 1-Trichloroethane ug/L <0.50 20 20 20.2 20.2 101 101 60-140 0
1, 1,2,2-Tetrachloroethane ug/L <0.50 20 20 16.6 16.9 83 84 60-140 2
1, 1,2-Trichloroethane ug/L <0.50 20 20 17.4 18.0 87 90 60-140 3
1, 1-Dichloroethane ug/L <0.50 20 20 18.9 19.0 95 95 60-140 0
1, 1-Dichloroethene ug/L <0.50 20 20 20.8 20.8 104 104 60-140 0
1, 1-Dichloropropene ug/L <0.50 20 20 18.7 19.0 94 95 60-140
1,2,3-Trichlorobenzene ug/L <2.0 20 20 17.6 18.4 88 92 60-140 4
1,2,3-Trichloropropane ug/L <0.50 20 20 16.7 17.2 84 86 60-140 3
1,2,4-Trichlorobenzene ug/L <2.0 20 20 18.1 18.8 91 94 60-140 4
1,2,4-Trimethylbenzene ug/L 1.9 20 20 20.8 20.6 94 94 60-140 1
1,2-Dibromo-3-chloropropane ug/L <1.0 20 20 17.1 18.0 86 90 60-140 5
1,2-Dibromoethane (EDB) ug/L <0.50 20 20 17.9 18.3 89 92 60-140 2
1,2-Dichlorobenzene ug/L <0.50 20 20 18.7 18.6 93 93 60-140 0
1,2-Dichloroethane ug/L <0.50 20 20 16.8 17.0 83 84 60-140
1,2-Dichloropropane ug/L <0.50 20 20 17.4 17.6 87 88 60-140
1,3,5-Trimethylbenzene ug/L 3.7 20 20 22.5 22.4 94 93 60-140
1,3-Dichlorobenzene ug/L <0.50 20 20 18.3 18.2 91 91 60-140
1,3-Dichloropropane ug/L <0.50 20 20 16.7 17.1 84 86 60-140 2
1,4-Dichlorobenzene ug/L <0.50 20 20 18.1 18.3 91 91 60-140
2,2-Dichloropropane ug/L <0.50 20 20 18.0 18.2 90 91 60-140
2-Chlorotoluene ug/L <0.50 20 20 18.9 18.3 95 91 60-140 4
4-Chlorotoluene ug/L <0.50 20 20 18.6 18.5 93 92 60-140 1
Benzene ug/L 8.1 20 20 26.6 27.1 92 95 60-140 2
Bromobenzene ug/L <0.50 20 20 18.8 19.2 94 96 60-140 2
Bromochloromethane ug/L <0.50 20 20 18.2 18.6 91 93 60-140 2
Bromodichloromethane ug/L <0.50 20 20 18.1 18.6 90 93 60-140 3
Bromoform ug/L <0.50 20 20 15.9 16.5 79 83 60-140 4
Bromomethane ug/L <5.0 20 20 16.0 16.7 80 84 60-140 5
Carbon tetrachloride ug/L <0.50 20 20 20.2 20.5 101 102 60-140 2
Chlorobenzene ug/L <0.50 20 20 18.7 18.8 93 94 60-140 1
Chloroethane ug/L <1.0 20 20 19.8 20.6 99 103 60-140 4
Chloroform ug/L 4.4 20 20 23.3 23.6 95 96 60-140
Chloromethane ug/L <1.0 20 20 19.4 19.4 97 97 60-140 0
cis-1,2-Dichloroethene ug/L <0.50 20 20 19.0 18.9 95 95 60-140 0
cis-1,3-Dichloropropene ug/L <0.50 20 20 17.2 18.1 86 90 60-140 5
Dibromochloromethane ug/L <0.50 20 20 17.0 17.3 85 87 60-140 2
Dibromomethane ug/L <0.50 20 20 17.5 17.9 88 90 60-140 2
Dichlorodifluoromethane ug/L <0.50 20 20 20.3 20.6 101 103 60-140
Diisopropyl ether ug/L <0.50 20 20 19.9 18.8 99 94 60-140 5
Ethyl benzene ug/L 9.0 20 20 27.9 27.7 94 93 60-140
Hexachloro-1,3-butadiene ug/L <2.0 20 20 18.3 19.5 91 98 60-140 7
lsopropylbenzene (Cumene) ug/L 0.78 20 20 19.7 19.6 94 94 60-140 0
m&p-Xylene ug/L 17.0 40 40 53.2 53.4 90 91 60-140 0
Methyl-tert-butyl ether ug/L 5.8 20 20 25.3 24.3 97 93 60-140 4
Methylene Chloride ug/L <2.0 20 20 17.7 17.6 89 88 60-140
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/22/2016 10:29 AM without the written consent of Pace Analytical Services, Inc .. Page 13 of 18
Pace Analytical
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QUALITY CONTROL DATA
Project; 5 & SAuto
Pace Project No.; 92305855
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 2E078
[phone]
MATRIX SPIKE & MATRIX SPIKE DUPLICATE_ 1785063 1785064
MS MSD
92305873001 Spike Spike MS MSC) MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Quail
n-Butylbenzene uglL <0.50 20 20 19.2 19.4 96 97 60-140 1
n-Propylbenzene uglL 0.42J 20 20 19.1 191 94 93 60-140 0
Naphthalene ug/L <2.0 20 20 16.8 17.4 83 86 60-140 4
o-Xylene ug/L 11.2 20 20 29.2 29.1 90 89 60-140 1
sec-Butylbenzene ug/L <0.50 20 20 19.1 19.1 95 96 60-140 0
Styrene ug/L a0.50 20 20 19,3 19.3 97 96 60-140 0
tert-Butylbenzene ug/L <0.50 20 20 15.8 15.6 79 78 60-140 1
Tetrachloroethene uglL <0.50 20 20 17,9 17.9 90 89 60-140 0
Toluene uglL 14.1 20 20 31.4 30.9 87 84 60-140 2
trans•1,2-Dichloroethene ug!L <0.50 20 20 19.3 19.5 97 98 60-140 1
trans-1,3-Dichbropropene ug!L <0_50 20 20 16.8 17.3 84 87 60-140 3
Trichbroethene uglL <0.50 20 20 18.4 18.9 92 94 60-140 3
Trichtorofluoromethane ug/L <1.0 20 20 21.2 20.7 106 104 60-140 2
Vinyl chloride ug/L <1.0 20 20 18.9 19.4 94 97 60-140 2
1,2-Dichlaroethane-d4 (5) % 101 99 70-130
4-Bromofluorobenzene (5) % 100 100 70-130
Toluene-d8 (S) % 100 100 70-130
Results presented an this page are in the units indicated by the "Units' column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
Date. 071221201E 10.29 AM
This report shall not be reproduced, except in full,
without tite written consent of Pace Analytical Services, Inc. Page 14 of 18

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Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: S & S Auto
Pace Project No.: 92305855
DEFINITIONS
DF -Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND -Not Detected at or above adjusted reporting limit.
J -Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
PQL -Practical Quantitation Limit.
RL -Reporting Limit.
S -Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) -Laboratory Control Sample (Duplicate)
MS(D) -Matrix Spike (Duplicate)
DUP -Sample Duplicate
RPD -Relative Percent Difference
NC -Not Calculable.
SG -Silica Gel -Clean-Up
U -Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PASI-C Pace Analytical Services -Charlotte
Date: 07/22/2016 10:29 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc .. Page 15 of 18
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QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project S & S Auto
Pace Project No.: 923051355
Pace Analytical ServIces> Inc.
9800 Kinney Ave. Suite 100
Huntersville, NC 28078
704)875-9092
Lab 10 Sample ID
Analytical
QC Batch Method QC Batch Analytical Method Batch
92305855001 MW-3R SM 6200B 322096
92305855002 MW-8 SM 62°013 322096
92305855003 Frazier SM 6200B 322096
REPORT OF LABORATORY ANALYSIS
Date: 07/22/2016 10:29 AM
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. Page 16 of 18

/f
.-PaceARaiytical
..-....p.m wund°HVl1 IJpUU nwceIpLtat.un]
Document No.:
F-CHR-05-003-rev.19
rage or
Issuing Authority:
Pace Huntersville Quality Office
Sarnp[e Condition Upon
•
Receipt
Client Name:
iYl
Project #:
Courier: ❑Fed Ex ['UPS ['UPS ❑Client
❑ Commercial [}]P ❑Other:
Custody Seal Present? ['Yes I0 Seals Intact?
Packing Material: :Nubble Wrap
Thermometer: T1505
Correction Factor: 0.0°C Cooler Ternp Corrected CO
QRubble Bags
1:3-Yer—❑ND
■ OU ` 92305V5t5al ilSe ol141
111111 89S 1r11111111111111
923;d�i
fC-w
Date/Initials Person Examining Contents, l • •
['None ❑other:
ce: et [Niue [None
TT%
Temp should be above freez�i g to 6°C
USDA Regulated Soil (g'N/A, water sample)
Did samples originate In a quarantine zone within the United States: CA, NY, or SC (check maps)?
Yes F 1Nor'
©SaKplea on ice, cooling process has begun
Biological Tissue Frozen? ['Yes ❑pia UNA—
Did samples originate from a foreign source (internationally,
including Hawaii and Puerto Rita]? OYes - N
Comments/Discrepancy:
Chain of Custody Present?
giYes ❑No CI N/A
1.
Samples Arrived within Hold Time?
ri]ye` ©No ❑N/A
2.
Short Hold Time Analysis (=72 hr.)?
3.
■Yes ll� o ©N/A
Rush Turn Around Time Requested?
❑Yes BNii ID N/A
4.
Sufficient Volume?
pier- ONG ONJA
r
5.
Correct Containers Used?
-Pace Containers Used?
6.
,@ • No ©N/A
Derr ❑No ❑N/A
' :ontainers intact?
OY.es•❑Na ❑N/A
7.
,amples Field Filtered?
❑Yes ❑No ciN/1
8. Note if sediment Is visible In the dissolved container
Sample Labels Match COC?
-Includes Date/Time/ID/Analysis Matrix: l r '
IgY s ©No El NA
_
9.
_
Ali containers needing acid/base preservation have been
-h•oked?_
I0. HP1(3 01,Z
PI Yes ---0No--IlN/A-
y�f
❑Yes ONO I f
All containers needing preservation are found to be in
.ompliance with EPA recommendation?
IHNO3, FIx504, HCia2; NaOH >9 Sulfide, Na0Ha12 Cyanide)
_xceptlons: VOA, Coiiform, TOC, Oil and Grease,
)RO/8015(water) DOC,LLHg
H°AH`x
H2509 7. pH.
N.4HpN,i,
H1Oiljln0Acg4H9
•Yes ❑Na ON/A-
Samples checked for dechlorination?
©Yes ❑No jpsv'f
11.
rleadspacein VOA Vials (>5-6mm)?
12.
■ Yes UN a ION/A
;'rip Blank Present?
'rip Blank Custody Seals Present?
pace Trip E!ank Lot # (If purchased):
13.
•Yes ❑No gNIA
'❑Yes ■No p{A
_
CLIENT NOTIFICATION/RESOLUTION
Person Contacted:
Com meats/yam ple
Discrepancy:
Date/Time:
Field data Required? ❑Yes ❑Na
Project Manager SCURF Review:
Project Manager SRF Review:
L`i Date: —TA
Date:
Note: WFarieverthere is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina bEHNR Certification Office (l.e.
Out of holi, Incorrect preservative, out of temp, incorrect containers)
Page 17 of 18

~
Pace Analytical "
CHAIN-OF-CUSTODY/ Analytical Request Document
The Chain-of-Custody is a LEGAL DOCUMENT. All relevant fields must be compleled accurately.
/
<Xl
~
'a
www.pacelabs.com -
I ~
Page: I of Q)
Section B Section C C)
Required Project lnfoonation: Invoice Information: Cl..
Company: h T, Gf-d Report To: C-viri& l-\0-1.j Altenllon: C.1,1 v-r J H-~ -1 09: .
jlviVD f"~(. -"' • ._, \oJ;. -.....
Address:13'-tJ IN, ni~!,-, Jw!,Qc..J" Copy To: I Company Name: i~me.. REGULATORY AGENCY
G, ~ hu,,e N c. Z.7'ttv Address: I -NPDES i-GROUND WATER ,.... DRINKING WATER I
Email To: ditt'T.s-fo j) h1Z,,d,'i@e£-t Vl'rh-V~ Purchase Order No.: Pace auole
Roforcncc:
r✓usr RCRA r-OTHER
Phone: I Fax: -r'roject Name: s~s At.v-h> Paco Projoct fJi'C-Olt. 6 ti.s;orows&i-,; Site Location M<tnagcr: 1']6 Requested Due DaterTAT: Project Number: 11-'i'i 002,"3.DD Pace Prolila #: ?!.tfZ ~ I STATE: s+-d
Requested Analysis Filtered (Y/N) -Section D Matrix Codes = ii: z
Roquirod Client lnlorn,ation MATRIX/ CQDE ~ :::; COLLECTED Prese,vatives ;;: g 0 Drinking Waler ow j u z
Waler WT II 0 u ;:: Waste Waler WW COJ.IPOSITE COMPOSITE .,, co u z Product p ~ ~ START END/GRAB w _, ~ Soil/Solid SL " (')
_, ... 0
SAMPLE ID Oil OL ~ II u en Q) Q. 0: 1ii Wipe WP I-w C:
(A-Z, 0-91 ,-) w <( z Cl) ·g
Air AR 0 w 0. ~ ,:, 1-:c Sample IDs MUST BE UNIQUE Tissue TS 0 0. :;,; Q) f/l tO (.) () ~ w z ~ ui Other OT I-0 X w w 0 Ql 0 >, C ro
<t (.) "' ~ C: ::, ct .J .J J: N <11 ~ iii Cb 9 'l-3o'5~5S ::;; 0. 0. u. ~o 0 Cl) .c Ql
,:,
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!:: <( <( C: N z 0 <11 Ql -c( ~ Ql ::. (/) DATE TIME DATE TIME (/) <t ::, I I IZ z ~o -0:: Pace Project No./ Lab LD .
1 MIN.,.,3 i1-WT' G 1/1'i/i~ f22i '-t \/. 'I-C'D i
2 M"v-6 I I I 1125 I )( y.. OD2-.
3 i::.-.t_:,...;,. _.A,,.. -} ., t 12.05 ,v )( 'I co;,
4
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ADDITIONAL COMMENTS RELINQUISHED BY I AFFILIATION DATE TIME ACCEPTED BY I AFFILIATION DATE TIME SAMPLE CONDITIONS -,,,
1&w ~ I EnvfX>7Ytu, 1,/u /tep C>Cj5 '-{ ( ~ ,;t✓-f'~ ?4v1' 0Y5 y"
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SAMPLER NAME AND SIGNATURE C: ~ u
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.,_
SIGNATURE of SAMPLER : I-oc " ro (MM/OD/VY): (/) (/)
"Important Noto : By sigi,ing lhis form you are accepting Pace's NET 30 day payment lerms and agreeing lo late charges or 1.5% per month ror any invoices not paid within 30 days. F-ALL-Q-020rev.07, 15-May-2007
1
Central Files: APS — SWP
1 2/1612015
Permit Number WI0400443 Permit Tracking Slip
Program Category
Deemed Ground Water
Permit Type
Injection Deemed In -situ Groundwater Remediation Well
Primary Reviewer
michaeLrogers
Coastal SWRuIe
Permitted Flaw
Facility
Status Project Type
Active New Project
Version Permit Classification
1. 0 Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Former S&S Auto Minor Winston-Salem
Location Address County
8081 Old Liberty Rd Randolph
Facility Contact Affiliation
Liberty NC 27298
Owner
Owner Name
Euliss Propane Company
Dates/Events
Owner Type
Non -Government
Owner Affiliation
Chris Stanley
PO Box 789
Liberty
NC 27298
Orig Issue
12/16/2015
Scheduled
App Received Draft initiated Issuance Public Notice Issue Effective Expiration
12115/2015
12/16/2015 12/16/2016
Regulated Activities Requested /Received Events
Groundwater remediatior
Outfal l
Waterbody Name Streamtndex Number Current Class Subbasin

Ro gers, Michael
From: Rogers, Michael
Sent:
To:
Wednesday, December 16, 2015 3:43 PM
'Christopher Hay, El, RSM'
Cc: Knight, Sherri
Subject: RE: WI0400443 NOi Submittal of Notification of Intent to Construct or Operate Injection Wells
Thank you for submitting the Notice of Intent to Construct or Operate Injection Wells (NOi) for the Former S&S Auto
located at 8081 Old Liberty Road, Liberty, Randolph County, NC 27298.
Please remember to submit the following regarding this injection activity:
1} Well Construction Records (GW-1) and Abandonment Records (GW-30) when completed. Please provide copies of
the GW-ls and GW-30s if not already submitted (ori ginals go the address printed on the form). NOTE: Direct push
or Geoprobe wells are considered wells and require construction (GW-1) and abandonment forms (GW-30). If well
construction/abandonment information is the same for the wells, only one form needs to be completed-just
indicate total number of injection points in the Comments/Remarks section of form. These forms can be found on
our website at http://portal.ncdenr.o rg/web/wq/aps/gwpro/reporting-forms.
2} Injection Event Records {IER). All injections, including air and passive systems require an IER. The IER can be
modified for air sparge wells (e.g., air flow 'continuous' for date or rate of injection, etc.).
You can scan and send these forms directly to me at michael.ro gers @ncdenr.gov, send by fax to my attention at 919-
807-6406, or via regular mail to address below. When submitting the above forms, you will need to enter the nine-digit
alpha-numeric number on the form (i.e ., WI0XXXXXX} that has been assigned to the injection activity at this site. This
notification has been given the deemed permit number W10400443. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in re p ly to this email, as it will already have the
assigned deemed permit number in the subject line.
Thank you for your cooperation .
Michael Rogers, P.G. (NC & FL)
Underground Injection Control (UIC} Program Manager -Hydrogeologist
NCDEQ-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://portal.ncdenr.org/web/wg/aps/gwpro/reporting-forms
NOTE: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North Carolina Public
Records Law dnd may be disclosed to third parties.
Frcim: Christopher Hay, El, RSM [mailto :[e-mail]]
Sent: Wednesday, December 09, 2015 11:09 AM
1
To: Rogers, Michael [e-mail]>
Subject: RE: Submittal of Notification of Intent to Construct or Operate Injection Wells
It will be in the mail today.
From: Rogers, Michael [mailto, michael.rogers(a+ncdenr,gov]
Sent: Tuesday, December 08, 2015 2:15 PM
To: Christopher Hay, El, RSM
Subject: RE: Submittal of Notification of Intent to Construct or Operate Injection Wells
Please follow up with hard copy. Thanks.
From: Christopher Hay, El, RSM [mailto:christopherhPenvirotrac.com]
Sent: Friday, December 04, 2015 2:00 PM
To: Rogers, Michael <michael.rogers(,ncdenr,sov>
Subject: Submittal of Notification of Intent to Construct or Operate Injection Wells
Mr. Rogers,
Please find the attached notification to install a passive oxygen diffusion device in one existing monitoring well at the
AS Auto Service Site (Incident No. 14143). Please let me know if you have any questions or require additional
information.
Christopher Hay, >=I, RSM J Regional Operations Manager I EnviroTrac Ltd. 17343 West Friendly Ave Suite J. Greensboro NC 27410
336.763.6025 (Office) 1336.763,6034 (Fax) J 336.6d2.0977 (Cell) J christopherhri»envirotrac.com
Solutions in Action - http i wvw.envirotrac.com
E� i
CR-1- lac
Think before you print
e
CONFIDENTIALITY: This e-mail (including any attachments) may contain confidential, proprietary and privileged information, and unauthorized
disclosure or use is prohibited. If you received this e-mail in error, please notify the sender and delete this e-mail from your system.
2

Rogers, Michael
From: Rogers, Michael
Sent: Wednesday, December 16, 2015 4:22 PM
To: Knight, Sherri
Subject: FW: WI0400443 NOI Submittal of Notification of Intent to Construct or Operate Injection Wells
Attachments: S&S_Notification_112515s. pdf
From: Rogers, Michael
Sent: Wednesday, December 16, 2015 4:20 PM
To: Knight, Sherri <[e-mail]>
Subject: FW: Submittal of Notification of Intent to Construct or Operate Injection Wells
Please find attached a NOI>
From: Christopher Hay, El, RSM (mailto:christopi}erh 1envirotrac.com]
Sent: Friday, December 04, 2015 2:00 PM
To: Rogers, Michael <michael.rogers ncdenr.gov>
Subject: Submittal of Notification of Intent to Construct or Operate Injection Wells
Mr. Rogers,
Please find the attached notification to install a passive oxygen diffusion device in one existing monitoring well at the
S&5 Auto Service Site (Incident No. 14143). Please let me know if you have any questions or require additional
information.
Christopher Hay, El, RSM 1 Regional Operations Manager I EnviroTrac Ltd_ 17343 West Friendly Ave Suite J, Greensboro NC 27410
336.763.6025 (Office) l 336.763.6034 (Fax) 1 336.602A977 {Cell) I christopherh afenvirotrac.corn
Solutions in Action - httze://www.envirotrac.com
414 Mik rrE
Think before you Print
yiNse
CONFIDENTIALITY: This e-mail {including any attachments) may contain confidential, proprietary and privileged information, and unauthorized
disclosure or use is prohibited. If you received this e-mail in error, please notify the sender and delete this e-mail from your system.
1

• r
rs
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are "permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NC4C 02C.02001. This form shall be submitted at least 2 weeks prior to injection.
AQUIFER TEST WELLS (15A NCAC 02C.0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (.15A NCAC 02C .0229):
I) Passive Infection S. stems - In -well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small -Scale Injection Operations — Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: November 25 . 2015
A.
PERMIT NO. J': - ; ? (to be filled in by DWR)
WELL TYPE TO BE CONSTRUCTED OR OPERATED
(1) Air Injection Well ,Complete sections B-F, K, N
(2) Aquifer Test Well Complete sections B-F, K, N
(3) X Passive Injection System , Complete sections B-F, H-N
(4) Small -Scale Injection Operation Complete sections B-N
(5) Pilot Test Complete sections B-N
(6) Tracer Injection Well Complete sections B-N
B. STATUS OF WELL OWNER: Business/Organization
C.
WELL OWNER — State name of entity and name of person delegated authority to sign on behalf of the business
or agency:
Name: Euliss Pror ane Coml!an.. Mr. Chris Stanle.
Mailing Address: Post Office Box 789
City: _ Liberty
Day Te1e No.: (3361622-3055
State: NC
Zip Code: 27298 County: Randolph
Ce11 No.:
EMAIL Address:chris<u.eulisspronane.com
UIC11n Situ Reined. Notification (Revised 3/2/2015)
Fax No.:
Page 1,

D. PROPERTY OWNER (if different than well owner)
Name: ------------------------------------
Mailing Address:---------------------------------
City: _____________ State: __ Zip Code:. _______ County: _____ _
Day Tele No.: ____________ _ Cell No.: __________ _
EMAIL Address: _____________ _ Fax No.: ___________ _
E. PROJECT CONTACT -Person who can answer technical questions about the proposed injection project.
Name: ___ _.M=r.'-'C=hr=is"""'H==av,_,.'-"E=n=v=ir"-'o'-'T=r=acaa,._ ______________________ _
Mailing Address: --~7~3~4=3_W"'--=F-=r=ie=n=d"'-l v._A~v=e.~S=t=e~J ___________________ _
City: Greensboro State: NC Zip Code: 27410 County: Guilford
Day Tele No.: [phone] Cell No.: [phone]
EMAIL Address:christo pherh@ envirotrac.com FaxNo.: ___________ _
F. PHYSICAL LOCATION OF WELL SITE
(1)
(2)
Physical Address: ---=S=&=S""'Aa..=.=u=to""'S~e=rv~ic=e_-~l=n=c=id=e=n"""t .:..N=o~. -=-l-'-4.:..14~3~------------
-~8~0-=8-=-l ~O~l=d ~L=ib~e=-rtv~R=o=a=d'-____________ County:~R=an=d=ol=p=h _____ _ ---, ... --
City: Libertv State: NC Zip Code: ~2~7=29~8~------
Geographic Coordinates: Latitude**: -~3~5_0 _2Q__' 48.71 "or ____ 0 _______ _
Longitude**: -79 ° ..]L' 39.85 "or ____ 0 _______ _
Reference Datum:c_ _______ .Accuracy: ________ _
Method of Collection: h tt p://itouchmap.com/latlong .html
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LlEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: _______ square feet
Land surface area ofinj. well network: square feet(::; 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: (must be.::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
Figure 2 shows the site layout and existing monitoring well locations. Figure 4 shows the extent of
impacted groundwater. The passive oxygen injection system is proposed to be installed into MW-
3R.
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical
extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
UIC!In Situ Remed. Notification (Revised 3/2/2015) Page 2
Figure 5 shows the location of the cross sections. Figures 6 and 7 are cross sections of impacted
groundwater. The figures estimate the extent of petroleum hydrocarbon concentrations which
exceed the NCGS 2L Standard.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Figure J shows the potentiometric surface map.
I. DESCRIPTION OF PROPOSED INJECTION ACTMTIES-Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate , volume, and
duration of injection over time.
The in jection activities are intended to im prove groundwater concentrations . Monitoring well MW-3R will have
a passive oxyg en delive r system installed inside the monitoring well. This system will allow ox ve.en to be
in jected into the gr oundwater affecting a localized area. The performance of this s stem will be monitored
durin e. the current semi-annual monitoring events .
J. INJECTANTS -Provide a MSDS and the following for each injectant. Attach additional sheets ifnecessary.
NOTE: Approved injectants (tracers and remediation additives) can be found online at
http://portal.ncdenr.org/weblwqlaps/gwpro. All other substances must be reviewed by the Division of Public
Health, Department of Health and Human Services. Contact the UIC Program for more i,nfo (919-807-6496).
Injectant: ___ O~x=v .... !!=e=n~--M~S=D~S~at~t~ac=h=e~d ____________________ _
Volume of injectant: continuous release of oxyg en I!.~ at one cubic foot per dav
Concentration at point of injection: MW-3R will ran r1.e from 44 to 52 ppm (based on 2 to 9 feet of
submer gence ). The oxygen concentrations are estimated based on a saturated oxve.en content of 41
pp m per atmos phere.
Percent if in a mixture with other injectants: --~N~/=A~-----------------
lnjectant: ----------------------------------
Volume of injectant: _____________________________ _
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: _______ Proposed ___ l~-----'Existing MW-JR
(2) Provide well construction details for each injection well in a diagram or table format. A single
diagram or line in a table can be used for multiple wells with the same construction details . Well
construction details shall include the following:
(a) well type as permanent, direct-push, or subsurface distribution system (infiltration gallery)
(b) depth below land surface of grout, screen, and casing intervals
( c) well contractor name and certification number
Well Construction Record for MW-JR is attached.
UIC/Jn Situ Remed . Notification (Revised 3/2/2015) Page3
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities.
Envirotrac will travel to the site and install the delivery system prior to the January 2016 sampling event. The
oxyten will be injected continuously and the content of the oxygen cylinder will be monitored monthly.
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchat>ter 02L result from the injection activity.
Groundwater samples will be collected from MW-3R semi-annually concurrent with the ongoing monitoring
schedule.
N. SIGNATiURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "1 hereby certify, under penalty of law, that 1 am familiar with the information submitted in this
document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible
for obtaining said information, 1 believe that the information is true. accurate and complete. 1 am aware that
there are significant penalties, including the possibility of fines and imprisonment. for submitting false
information. 1 agree to construct, operate, maintain, repair; and if applicable, abandon the injection well and
all related appurtenances in accordance with the 15.4 NCAC 02C 0200 Rules." c5i704. (e/
AAA.. Ci2ri6k1T her Hei'Fiy[t
Signature of Applicant � l L int or ype Full Name
PROPERTY OWNER (if the oroperty is not owned by the permit applicant):
" 4!s owner of the properly on which the injection well(s) are to be constructed and operated, 1 hereby consent to
allow the applicant to construct each injection well as outlined in this application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(S) confirm to the Well Construction Standards
(1.5A NCAC 02C .0200), "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is real property and its construction on land shall be deemed to vest ownership in the land owner, in the
absence of contrary agreement in writing.
Signature" of Property O►rner (ifdiffcrent from applicant) Print or Type Full Name
* An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form.
Submit the completed notification package to:
DWR —UIC Program
1636 Mail Service Center
Raleigh. NC 27699-1636
Telephone: [phone]
LnCttn Situ Remed. Notification (Revised 3I2/2015) Page 4

FIGURES
0
.\J( . �
pY. FEK-COURCH40/, ,
2000
4,000
SCALE IN FEET
�viro ra
Environmental Services Environmental Services
FIGURE 1
SITE LOCATION MAP
FORMER S&S AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
7343 W. FRIENDLY AVENUE, SUITE J
GREENSBORO, NORTH CAROLINA
DRAWN BY: AB
APPROVED BY:
CWH
SCALE: AS SHOWN
PROJECT NO:11.990023.00

s\S&S Auto Fi
S&S AutolFI iu
2
a
1.990023.00 Euli
0
rZ
ui
J
LL
U
OLD 1,
!Rr
WOODED
AREA
• MW-B
FRAZIER SUPPLY WELL
APPROXIMATELY 250 FEET SOUTHWEST
BRAXTON SUPPLY WELL
- APPROXIMATELY 1,000 FEET SOUTHWEST
20' 0 40'
APPROXIMATE SCALE
MW-5
MW-3DD- 'MW-3D
LEGEND
0 MONITORING WELL
ABANDONED MONITORING WELL
DEEP MONITORING WELL
FORMER LOCATION OF THE
--- UNDERGROUND STORAGE TANK
NOTE:
BASE MAP FROM ALUED ENVIRONMENTAL SERVICES OVERALL
SITE MAP. PROJECT 02-1002, DWG, NOL D001, DATED 12-17-07,
Eii'?roira
c
1 Environmental Servitors
7343 W. FRIENDLY AVENUE, SUDE 1
GREENSBORO, NORTH CAROLINA
FIGURE 2
SITE MAP
FORMER S&S AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY: GGH
DATE: 07/22/15
DRAWN BY: AB
DATE: ❑2/12/15
APPROVED BY:
CWH
SCALE: AS SHOWN
PROJECT NO: 11,990023.00

s1S&S Auto Fiuures.d
Proi_:ane S&S AuLolFiL!u
OLO
nr
�r
WOODED
AREA
•
•
MW-8
648.06
FRAZIER SUPPLY WELL
APPROX ATELY 250 FEET SOUHWEST
BRAXT(NJ SUPPLY WELL
' J APPROXIMATELY 1,000 FEET SOUTHWEST
648
20' 0
40'
APPROXIMATE SCALE
MW-2
647.96
MW�
657
SE16
654
FORMER S&S �B51
AUTO SALES
— — — -549
—�_� sae
547.57
W3R_
647.84
MW-300 -Of
x�* Ml�-3D
C 46.A4 647,21
MW3
•
M W-7
647.08
MW-6
647A3
LEGEND
MONITORING WELL
ABANDONED MONITORING WELL
DEEP MONITORING WELL
FORMER LOCATION OF THE
UNDERGROUND STORAGE TANK
MONITORING WELL WITH
GROUNDWATER ELEVATION IN FEET
GROUNDWATER CONTOUR LINES
GROUNDWATER FLOW DIRECTION
NOTE:
BASE MAP FROM ALLIED ENVIRONMENTAL SERVICES OVERALL
SITE MAP, PROJECT 02-1004 DWG,. NOL D001, DATED 12-17-07.
MONITORING WELLS MW-3D AND MW-3DD WERE NOT USED IN
CREATING THE GROUNDWATER FLOW MAP.
s
nv�rra
Envivonmwta 18sry lass
FIGURE 3
GROUNDWATER FLOW MAP
FORMER 5&5 AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY: GGH
DATE: 07/22/15
DRAWN BY: AB
DATE: 02/12/15
APPROVED AY;
CWH
SCALE: AS SHOWN
7343 W. FRIENDLY AVENUE, SUITE J
GREENSBORO, NORTH CAROLINA
PROJECT NO:11.990023.00

OLD u,
WOODED
AREA
MW-8
FRAZIER SUPPLY WELL
APPROX$MAT LY 250 FEET SOUTHWEST
BRAXTON SUPPLY WELL
— APPROXIMATELY 1,005 FEET SOUTHWEST
20'
0
::_
APPROXIMATE SCALE
Mw-5
(77
MW-6
MW-6
0Lr 21:5
LEGEND
MONITORING WELL
ABANDONED MONITORING WELL
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FORMER LOCATION OF THE
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cnvirTAM
Environmental Services
7343 W. FRIENDLY AVENUE, SUITE 1
GREENSBORO, NORTH CAROLINA
FIGURE 4
GROUNDWATER EXTENT OF CONTAMINATION MAP
FORMER 5&SAUTO
B0B1 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
REVISED BY: DRAWN BY: GGFI APPROVED BY:
DATE: DATE:11/25/15 CWH
SCALE: AS SHOWN
PROJECT NO: 11.990023.00

res\S&S Auto
s\ t 1.990023.00 E
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r7YCSR hsr ROAD
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20' 0 40'
APPROXIMATE SCALE
MWS
MW-6
LEGEND
�j MONITORING WELL
AHANDONED MONiTDRSNG WELL
j DEEP MONITORING WELL
FORMER LOCATION OF THE
UNDERGROUND STORAGE TANK
MW-7 NOTE:
BASE MAP FROM ALLIED ENVIRONMENTAL SERVICES OVERALL
SITE MAP, PROJECT 02-1002, DWG, NOL D001, DATED 12-17-07_
WATIFE
Environmental $*rvl01a
FIGURE 5
LOCATION OF CROSS SECTIONS
REVISED BY:
DATE:
FORMER S&S AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
DRAWN BYE GGH
DATE_ 11/25/15
APPROVED BY:
CWH
SCALE: AS SHOWN
7343 W. FRIENDLY AVENUE, SUITE J
GREENSBORO, NORTH CAROLINA
PROJECT NO:13.990023.00

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cn~TroiraS CROSS SECTION A-A'
! 20' 0 40' • • ~---I • FORMER S&S AUTO
HORIZONTAL SCALE Envlronm,nt111 8ervl~aa I 8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
--
7343 W. FRIENDLY AVENUE , SUITE J REVISED BY: DRAWN BY : GGH APPROVED BY: SCALE : AS SHOWN
GREENSBORO, NORTH CAROLINA DATE : DATE : 11/25/15 CWH PROJECT NO : 11.990023 .00
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LEGEND
¥'. GROUNDWATER ELEVATION IN WELL
APPRO XIMAT E POTENTIOMETRIC
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EXCEEDANCES IN GROUNDWATER
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FIGURE 7
CROSS SECTION B-B'
FORMER S&S AUTO
8081 OLD LIBERTY ROAD
LIBERTY, NORTH CAROLINA
...J
LL 7343 W . FRIENDLY AVEN UE, SUITE J REVISED BY: DRAWN BY : GGH APPROVED BY :
9 GREEN SBORO NORTH CAROLINA DATE : DATE : 11/25/15 CWH
SCALE : AS SHOWN
o ' PROJECT NO : 11 .990023 .00
OXYGEN MSDS
ROBERTS ;
f' OXYG EN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
1
PRODUCT AND COMPANY IDENTIFICATION
Product Identifier: Oxygen Compressed
Common Name: Oxygen
SOS Number: 20
Revision Date: 10/21/2015
Version: 2.0
CAS Number: 7782-44-7
Chemical Formula: 02
Product Use: Industrial, Medical, Food Applications
Supplier Details:
Emergency:
Phone:
Web:
2
Roberts Oxygen Company, Inc.
P,O. Box 5507
Rockville, MD 20855
Chemtrec: 24 hr/day 7 dayslwk [phone]. for spills, leaks, fire, exposure or accidents involving this product
Customer Service; [phone], Mon through Fri from 7:30 am to 5:00 pm ET
www.robertsoxygen,com
HAZARDS IDENTIFICATION
Classification of the substance or mixture
GHS Classification in accordance with 29 CFR 1910 (OSHA HCS):
Physical, Oxidizing Gases, 1
Physical, Gases Under Pressure, Compressed Gas
GHS Label elements, including precautionary statements
GHS Signal Word: DANGER
GHS Hazard Pictograms:
GHS Hazard Statements:
H270 - May cause or intensify fire; oxidizer
H280 - Contains gas under pressure, may explode if heated
GHS Precautionary Statements:
P202 - Do not handle until all safety precautions have been read and understood.
P220 - Keep/Store away from clothing/combustible materials.
P244 - Keep reduction valves free from grease and oil.
P271+P403 - Use only outdoors or in a well -ventilated area.
P370+P376 - In case of fire: Stop leak if safe to do so,
CGA-PG05 - Use a back flow preventive device in the piping.
CGA-PG20 - Use only equipment of compatible materials of construction.
CGA-PG10 - Use only with equipment rated for cylinder pressure.
CGA-PG22 - Use only with equipment cleaned for oxygen service.
CGA-PG21 - Open valve slowly.
CGA-PG06 - Close valve after each use and when empty.
CGA-PG02 - Protect from sunlight when ambient temperature exceeds 52 °C (125 °F)_
OSHA-PG01 - DO NOT REMOVE THIS PRODUCT LABEL (or equivalent wording).
CGA-PG27 - Read and follow the Safety Data Sheet (SIDS) before use.
SOS Number: 20
Page 1 of 7 Revision Date: 10/21/2015

ROB ERTS
'OXYGEN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
COMPOSITION/INFORMATION ON INGREDIENTS
Ingredients:
Cas# % Chemical Name
7782-44-7 Oxygen, compressed
4
Inhalation:
Skin Contact:
Eye Contact:
Ingestion:
FIRST AID MEASURES
Remove victim to uncontaminated area wearing self-contained breathing apparatus (SCBA). Keep victim warm and
rested. Call a doctor. Apply artificial respiration if breathing has stopped.
Adverse effects are not expected from this product
immediately flush eyes thoroughly with water for at least 15 minutes. Hold the eyelids open and away from the eyeballs
to ensure that all surfaces are flushed thoroughly. Contact an ophthalmologist immediately. Get immediate medical
attention.
Ingestion is not considered a potential route of exposure.
FIRE FIGHTING MEASURES
Flammability:
Flash Point:
Flash Point Method:
Burning Rate:
Autoignition Temp:
LE L:
Fire Fighting Instructions:
Non -Flammable
N/a
N/a
N/a
N/a
Nla
Evacuate all personnel from the danger area. tJse self-contained breathing apparatus (SCBA) and protective clothing. Immediately cool
containers with water from maximum distance. Stop flow of gas if safe to do so, while continuing cooling water spray. Remove ignition
sources if safe to do so. Remove containers from area of fire if safe to do so. On -site fire brigades must comply with OSHA 29 CFR
1910.156 and applicable standards under 29 CFR 1910 Subpart L—Fire
Standard Protective Clothing and Equipment: SCBA for fire fighters
Use fire control measures appropriate for the surrounding fire. Exposure to fire and heat radiation may cause gas containers to rupture.
Cool endangered containers with water spray jet from a protected position. Prevent water used in emergency cases from entering sewers
and drainage systems. Stop flow of product if safe to do so. Use water spray or fog to knock down fire fumes if possible.
Oxidizing agent; vigorously accelerates combustion.
Contact with flammable materials may cause Ire or explosion.
Smoking, flames and electric sparts are potential explosion hazards.
ACCIDENTAL RELEASE MEASURES
Evacuate area.
Remove all sources of ignition. Contact with flammable materials may cause fire or explosion.
Ventilate area or move container to a well -ventilated area. Wear self-contained breathing apparatus (SCBA) when entering area, unless
atmosphere is proven to be safe
Stop leak if safe to do so.
SDS Number 20
Page 2 of 7 Revision Date: 10/21/2015

ROBERTS"'
OXYGEN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
7
Handling Precautions:
Storage Requirements:
HANDLING AND STORAGE
Wear leather safety gloves and safety shoes when handling cylinders. Protect cylinders from physical
damage; do not drag, roll, slide or drop. While moving cylinder, always keep in place removable valve
cover. Never attempt to lift a cylinder by its cap; the cap is intended solely to protect the valve. When
moving cylinders, even for short distances, use a cart (trolley, hand truck, etc.) designed to transport
cylinders. Never insert an object (e.g., wrench, screwdriver, pry bar) into cap openings; doing so may
damage the valve and cause a leak. Use an adjustable scrap wrench to remove over -tight or rusted
caps. Slowly open the valve. If the valve is hard to open, discontinue use and contact your supplier.
Close the container valve after each use; keep closed even when empty. Never apply flame or Localized
heat directly to any part of the container. High temperatures may damage the container and could cause
the pressure relief device to fail prematurely, venting the container contents.
For additional handling recommendations, consult Compressed Gas Association's Pamphlet P-1,
Store in a cool, well -ventilated place. Store and use with adequate ventilation. Store only where
temperature will not exceed 125°F (52°C). Post No Smoking or Open Flame signs in storage and use
areas. There must be no source of ignition. Separate packages to protect against potential fire and/or
explosion damage following appropriate codes and requirements (e.g., NFPA 30, NFPA 55, NFPA 70
and/or NFPA 221) or according to requirements determined by the Authority Having Jurisidiction.
Firmly secure containers upright to keep them from falling or being knocked over. Install valve protection
cap, if provided, firmly in place by hand. Store full and empty containers separately. Use a first -in,
first -out inventory system to prevent storing full containers for long periods. OTHER PRECAUTIONS
FOR HANDLING, STORAGE, AND USE: When handling product under pressure, use piping and
equipment adequately designed to withstand the pressures to be encountered. Never work on a
pressurized system. Use a backflow preventive device in the piping. Gases can cause rapid suffocation
because of oxygen deficiency; store and use with adequate ventilation. If a leak occurs, close the
container valve and blow down the system in a safe and environmentally correct manner in compliance
with all international, federal/national, state/provincial. and local laws; then repair the leak. Never place a
container where it may become part of an electrical circuit.
For additional storage recommendations, consult Compressed Gas Association's Pamphlet P-1
SDS Number: 20 Page 3 of 7 Revision Date: 10/21/2015

ROBERTS
OXYGEN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
EXPOSURE CONTROLSIPERSONAL PROTECTION
Engineering Controls:
Personal Protective
Equipment:
Avoid oxygen rich (>23.5°/D) atmospheres. Systems under presure should be regularly checked for
leakages. Ensure exposure is below occupational exposure limits (where available). Gas detectors
should be used when oxidizing gases may be released. Oxygen detectors should be used when
asphyxiating gases may be released. Provide adequate general and local exhaust ventilation. Consider
work permit system; e.g., for maintenance activities.
Respiratory protection: None necessary
Hand protection: Handle gas containers with working gloves. Gloves must be inspected pnor to use.
Eye protection: Wear safety glasses with side shields. Use equipment for eye protection tested and
approved under appropriate government standards such as NIOSH (U5) or EN 166 (EU).
Skin and body protection: Wear hand, head, and body protection to help prevent injury from process
associated hazards, e.g., for welding exposure to radiation and sparks wear welder's gloves and
protective goggles. The type of protective equipment must be selected according to the concentration
and amount of the dangerous substance at the specific workplace and the user process and may include
anrn protectors, hats, and shoulder protection worn over substantial clothing. Consider wearing
flame -resistant safety clothing and appropriate safety shoes while handling.
Hygiene measures: Handle in accordance with good industrial hygiene and safety practice. Wash hands
before breaks and at the end of workday.
Oxygen, compressed (7782-44-7) [100%] : no data available
PHYSICAL AND CHEMICAL PROPERTIES
Appearance:
Physical State:
Odor Threshold:
Particle Size:
Spec Grav/Density:
Viscosity:
Sat Vap. Conc.:
Boiling Point:
Flammability:
Partition Coefficient:
Vapor Pressure:
pH:
Evap. Rate:
Molecular weight_
Decamp Temp:
Colorless gas
Gas
Not applicable
Not applicable
.08279 I b/ft3
Not applicable
Not applicable
-118.6°C
Non -Flammable
Not applicable
Not applicable
Not applicable
Not applicable
32 g/mol
650°C
Odor:
Molecular Formula:
Solubility:
Softening Point:
Percent Volatile:
Heat Value:
Freezing/Melting Pt.:
Flash Point:
Octanol:
Vapor Density:
VOC:
Sulk Density:
Auto -Ignition Temp:
UFL/LFL:
Not applicable
02
Water 0.0491 mg/I
Not applicable
Not applicable
Not applicable
No data available
No data available
Not applicable
No data available
Not applicable
Not applicable
Not applicable
Not applicable
Gas/vapor is heavier than air. May accumulate in confined spaces, particularly at or below ground level.
SDS Number: 20 Page 4 of 7 Revision Date: 10/21/2015

Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
ref.
Stability:
Conditions to Avoid:
Materials to Avoid:
STABILITY AND REACTIVITY
No reactivity
None
Keep equipment free from ail and grease. Consider the potential toxicity hazard due to the presence of
chlorinated or fluorinated polymers in high pressure (.30 bar) oxygen lines in case of combustion. May
react violently with combustible materials. May react violently with reducing agents.
Hazardous Decomposition: None
Hazardous Polymerization: None
TOXICOLOGICAL INFORMATION
Oxygen, compressed (7782-44-7)
Information on toxicological effects
Acute toxicity:
Oral LD50: No data available
Inhalation LC50
Dermal LD5O
Other information cn acute toxicity
Skin corrosion/irritation: No data available
Serious eye damage/eye irritation: No data available
Respiratory or skin sensitization: No data available
Germ cell mutagenicity: No data available
Carcinogenicity No component of this product present at levels greater than or equal to 0,1% is identified as probable, possible or
confirmed human carcinogen by IARC, ACGIH, NTP, or OSHA.
Reproductive toxicity: no data available
Teratogenlcity: No data available
Specific target organ toxicity - single exposure (Globally Harmonized System): No data available
Specific target organ toxicity - repeated exposure (Globally Harmonized System): No data available
Aspiration hazard: no data available
Potential health effects: Inhalation: May be harmful if inhaled. May cause respiratory tract irritation. Ingestion: May be harmful if swallowed.
Skin: May be harmful if absorbed through skin. May cause skin and eye irritation.
Signs and Symptoms of Exposure Nausea, Dizziness, Unconsciousness.
Synergistic effects; No data available
SDS Number: 20 Page 5 of 7 Revision Date: 10/21/2015

ROBERTS
OXYGEN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
ECOLOGICAL INFORMATION
Oxygen, compressed (7782-44-7)
Information on ecological effects
Toxicity: No data available
Persistence and degradability: No data available
Bioaccumuiative potential No data available
Mobility in soil: No data available
PBT and vPvB assessment: No data available
Other adverse effects: No data available
MINIM
DISPOSAL CONSIDERATIONS
Waste treatment methods:
May be vented to atmosphere in a well -ventilated place. Do not discharge into any place where its accumulation could be dangerous.
Waste disposal recommendations:
Dispose of contents/container in accordance with local/regional/national/international regulations. Contact supplier for any special
requirements.
14
TRANSPORT INFORMATION
UN1472, Oxygen, compressed, 2.20,1)
Avoid transport on vehicles where the load space is not separated from the driver's compartment. Ensure vehicle driver is aware of the potential
hazards of the load and knows what to do in the event of an accident or an emergency. Before transporting cylinders, ensure there is adequate
ventilation. Ensure that cylinders are firmly secured. Ensure cylinder valve is closed and not leaking. Ensure valve outlet cap (where provided) is
correctly fitted, Ensure valve protection device (where provided) is correctly fitted..
15
REGULATORY INFORMATION
Component (CAS#) [%] - CODES
Oxygen. compressed (7782-44-7) [n/a°/o] MASS. PA, NJ, TSCA
Listed on the United States TSCA (Toxic Substances Control Act) inventory
SARA Section 311/312 Hazard Classes: Sudden release of pressure hazard, Fire hazard
Regulatory CODE Descriptions
MASS = MA Massachusetts Hazardous Substances List
PA = PA Right -To -Know List of Hazardous Substances
NJ = NJ Right -To -Know List of Hazardous Substances
TSCA = Toxic Substances Control Act
SDS Number: 20 Page 6 of 7 Revision Date: 10/21/2015

ROBERTS
OXYGEN
Safety Data Sheet
Roberts Oxygen Company, Inc.
Oxygen Compressed
76
OTHER INFORMATION
The information contained in this Safety Data Sheet is believed reliable, based an technical information and industry experience. Roberts
Oxygen Company, Inc. provides no warranties or guarantees pertaining to the information provided in connection with the safety
suggestions made. Moreover, it should not be assumed that every acceptable safety procedure, precaution, or device is listed. Abnormal or
unusual circumstances may warrant or suggest further requirements or additional precautions. Roberts Oxygen Company, Inc. requests
Users to thoroughly review this SDS and become aware of the product hazards and safety information. it is the User's responsibility to
determine the conditions for safe use of the product and to confrm the compatibility of any other materials in their use or processes that
come in contact with this product.
User acknowledges that the chemicals listed may be hazardous and must be handled accordingly. User further acknowledges its
understanding that the chemicals listed may be classified by OSHA as hazardous chemicals, and that there are hazards associated with the
possession, transportation and use of the chemical(s), containers, and related equipment and that the User must take proper account of
those hazards and deal with them appropriately.
User shall warn all persons who may be exposed to any hazards relating to the chemical(s), containers, and related equipment. User
acknowledges that the Seller has supplied the User with all relevant (Material) Safety Data Sheets (SDS) relating to the Products, and that
additional copies of the SDS are available on request. OSHA regulations require User to develop and implement a written chemical hazard
communications program for its employees regarding all hazardous chemicals.
Further, federal, state and local regulations may exist that are not addressed.
SDS Number 20
Page 7 of 7 Revision Date: 10/21/2015

NON ONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3367
1. WELL CONTRACTOR:
Gary Ellinc worth
Well Contractor (Individual) Name
Parrett -Wolff, Inc.
Well Contractor Company Name
501 Millstone Drive
Street Address
Hillsboyouoh NC 27278
City or Town State Zip Code
(919 ) 644-2814
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if a pplkabie) _
SITE WELL ID #Cd applicable) M W-3R
3. WELL USE (Check One Box) Monitoring llMunicdpallPubllc 0
Industrial/Commercial p Agricultural ❑ Recovery ❑ injection 0
Irrtgalion❑ Other 0 (list use)
DATE DRILLED 7/18/11
4. WELL LOCATION:
8081 Old Liberty Road
(Street Name, Numbers, Community, SubdNlslon, Lot No., Parcel, Zip Code)
CITY, Liberty COUNTY Randolph
TOPOGRAPHIC 1 LAND SETTING: (check approprtaie box)
DStope ❑Valley El Flat ❑Ridge ©Other
LATITUDE 35 • so + 810.001,0 • OMS OR 3x.xxxxx XXX DD
LONGITUDE 78 ' Bea.n°a° * DMS OR 7x.i0000ta0004 DD
LatitudeAangltude source: EPPS 12ropographic map
(focatlon of well must be shown on a USGS topo map andattached to
this form not using GPS)
5. FACILITY (Name of the business where the well is located.)
S & S Auto Center
,Feclllty Name
9Q81 Qldi ihedv Road.
Street Address
I i berty
City or Town
Facility ID l (if applicable)
NC 2729F
State bp Code
Contact Name
Mailing Address
City or Town State Zip Code
L—�
Area code Phone number
IL WELL DETAILS:
a. TOTAL DEPTH: 4..0'
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1 /
c. WATER LEVEL Below Top of Casing: _)� FT.
(Use "+- If Above Top of Casing)
d. TOP OF CASING IS 0 FT. Above Land Surface*
"Top of casing terminated affor below land surface may require
a variance In accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type NIA Amount
p. WATER ZONES (depth):
Top_IIUA Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top
7. CASING: Depth Diameter Material
Top O Bottom 30.0 Ft, 2" PVC
Top Bottom Ft.
Top Bottom Ft.
Bottom
Thickness)
Weight
Sch40
8. GROUT: Depth Materiel Method
Top 0 Bottom 24.0 ,Ft. Portland TIvrnie
Top 24.0 Bottom 26.0 Ft. Bentonite Tretrtie
Top Bottom Ft.
S. SCREEN: Depth Diameter Stot Size Material
Top 30.0 Bottom 40.0 Ft. 2 in. ,010 in. PVC..
Top Bottom Ft. in. in. _
.Top Bottom FL in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 26.0 Bottom 40.0 Ft #1 Sand
Top Bottom Ft.
Top,_ Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
! No samples taken
1
1
1
1
1
1
1
1
12. REMARKS:
100 HER
I SA NCA
REC
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE MTH
. WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
eEEN rs VIDEDTOTHE LOWN
SIG ATIJR OF CER I
Ellinaworth
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
WELL CONTR ACFDR FDA
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mali Service Center, Raleigh, NC 27699.161, Phone : [phone]
Form OW -lb
Rev. 2109

WELL CONSTRUCTION RECORD