MO-28067_47337_C_NRP_20200916_Filed Notice of Residual Petroleum

For Registration
Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2020 Sep 16 08:59 AM RE Excise Tax: $ 0.00
Book: 35057 Page: 916 - 921 Fee: $ 26.00
Instrument Number: 2020149229
3MLS ".
NOTICE OF RESIDUAL PETROLEUM
Richard Davis Property Mecklenburg_ County, North Carolina
(Site name)
The property that is the subject of this Notice (hereinafter referred to as the "Site")
contains residual petroleum and is an Underground Storage Tank (UST) incident under North
Carolina's Statutes and Regulations, which consist of N.C.G.S. 143-215.94 and regulations adopted
thereunder. This Notice is part of a remedial action for the Site that has been approved by the
Secretary (or his/her delegate) of the North Carolina Department of Environmental Quality (or its
successor in function), as authorized by N.C.G.S. Section 143B-279.9 and 143B-279.11. The North
Carolina Department of Environmental Quality shall hereinafter be referred to as "DEQ".
NOTICE
Petroleum product was released and/or discharged at the Site. Petroleum constituents remain
on the site, but are not a danger to public health and the environment, provided that the
restrictions described herein, and any other measures required by DEQ pursuant to N.C.G.S.
Sections 143B-279.9 and 143B-279.11, are strictly complied with. This "Notice of Residual
Petroleum" is composed of a description of the property, the location of the residual petroleum and the
land use restrictions on the Site. The Notice has been approved and notarized by DEQ pursuant to
N.C.G.S. Sections 143B-279.9 and 143B-279.11 and has/shall be recorded at the
Mecklenburg_ Register of Deeds' office Book , Page
(name of county)
Any map or plat required by DEQ has been/shall be recorded at the Mecklenburg Register of
(name of county)
Deeds' office Book , Page , and has been/shall be incorporated into the Notice by this reference.
Source Property
Jeanette T. Davis of Charlotte, North Carolina
(Owner's name) (city & state of homeowner)
is the owner in fee simple of all or a portion of the Site, which is located in the County of Mecklenburg,
State of North Carolina, and is known and legally described as:
See Attachment A (excerpted from Mecklenburg County Register of Deeds Book
4431, Page 680).
Revised January 15, 2013
Page 1 of 4
submitted electronically by "Cedar Rock Environmental, P.C."
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register of Deeds.

For protection of public health and the environment, the following land use restrictions required
by N.C.G.S. Section 143B-279.9(b) shall apply to all of the above -described real property. These
restrictions shall continue in effect as long as residual petroleum remains on the site in excess of
unrestricted use standards and cannot be amended or cancelled unless and until the Mecklenburg County
Register of Deed receives and records the written concurrence of the Secretary (or his/her delegate) of
DEQ (or its successor in function).
PERPETUAL LAND USE RESTRICTIONS
Soil: Soil containing residual petroleum above applicable regulatory standard(s) remains on the site in
the area identified in Figure 1, Attachment A No soil shall be excavated or disturbed within 3
feet of the area identified in Figure I Attachment B except to remediate the soil in accordance
with all applicable state and federal statutes, regulations and guidelines.
Groundwater: Groundwater from the site is prohibited from use as a water supply. Water supply wells
of any kind shall not be installed or operated on the site.
ENFORCEMENT
The above land use restriction(s) shall be enforced by any owner, operator, or other party
responsible for the Site. The above land use restriction(s) may also be enforced by DEQ through any of
the remedies provided by law or by means of a civil action, and may also be enforced by any unit of local
government having jurisdiction over any part of the Site. Any attempt to cancel this Notice without the
approval of DEQ (or its successor in function) shall be subject to enforcement by DEQ to the full extent
of the law. Failure by any party required or authorized to enforce any of the above restriction(s) shall in
no event be deemed a waiver of the right to do so thereafter as to the same violation or as to one occurring
prior or subsequent thereto.
Revised January 15, 2013
Page 2 of 4

IN WITNESS WHEREOF, Jeanette T. Davis has caused this Notice to be executed pursuant
to N.C.G.S. Sections 143B-279.9 and 14313-279.11, this 151 day of September , 2020.
Jeanette T. Davis
( me f r ponsible party ?gent is signing)
By:
(signature of responsible party, attornGe or other agent if there is one)
President, Cedar Rock Environmental, P. C.
(Title of agent for responsible parry if there is one)
Signatory's name typed or printed: Robert A. Payne
NORTH CAROLINA
Al e-m &n Ue COUNTY
(Name of county in which acknowledgment was taken)
I certify that the following person personally appeared before me this day, acknowledging to me that he or
she signed the foregoing document: Robert A. Payne
Date: �<t,? ka-r 15-, 202y
(Official Seal)
JOSIAH Q PAYNE
NOTARY PUBLIC
ALAMANCE COUNTY, N.C.
My Commission Expires 10-22-2020.
�-
(s)Rature of Notary Public)
T07 ! Gl I 12.-
(printed or typed name of Notary Public)
Notary Public
My commission expires: Z-z 2020
Revised January 15, 2013
Page 3 of 4

Approved for the purposes of N.C.G.S. 14313-279.11
(signature of Regional Supervisor)
Mark R. Powers , Regional Supervisor
(printed name of Regional Supervisor)
Raleigh_ Regional Office
UST Section
Division of Waste Management
Department of Environment Quality
NORTH CAROLINA
W 0- k e. COUNTY
(Name of county in which acknowledgment was taken)
I certify that the following person(s) personally appeared before me this day, each acknowledging to me
that he or she signed the foregoing document: Mar( ?2 ire ('� (full printed name of Regional Supervisor)
Date:
(Official Seal) (signature of Notary Public)
JOSIAH D PAYNE �65��
NOTARY PUBLIC (printed or typed name of Notary Public)
ALAMANCE COUNTY, N.C. Notary Public
MY Commission Expires 10-22-2020.
My commission expires: _ zz ? b
Revised January 15, 2013
Page 4 of 4

ATTACHMENT A
BEING all of Lots 108, 109, 110 and 111 of WEST VIEW HILLS, as shown on map thereof recorded in Map
Book 6, at Page 671, in the Office of the Register of Deeds for Mecklenburg County, North Carolina.
Being the same property conveyed to William Henry Hoover and wife, Grace R. Hoover by Deed dated the
4th day of May, 1973 and duly recorded in the Office of the Register of Deeds for Mecklenburg County in
Book 3574, at Page 412.

N
ATTACHMENT B
David Merritt
Property
J I
I I
NOTE:
This map may not be a certified survey
and has not been reviewed by a local
government agency for compliance with
any applicable land development regulations
and has not been reviewed for compliance
with recording requirements for plats.
Ilena Young
i
Property
House
Rowan way
0 20 40 80
1 Inch = 40 Feet
PROJECT: Richard Davis Property
INCIDENT # Pending
LOCATION: 1335 Lake Way Drive
Charlotte, Mecklenburg Co.
CRE PROJECT NUMBER: 300922590
M
CEDAR ROCK
ENVIRONMENTAL, P.C.
FILENAME: 3009NoRP.fc7
VERSION DATE: 9/9/2020
RESTRICTED AREA (estimated
extent of soil contamination
exceeding applicable cleanup standards.)
Property Lines
T1 = 270-Gallon UST
FIGURE 1

Beverly, Trudy
From: Beverly, Trudy
Sent: Wednesday, September 16, 2020 6:25 PM
To: Josiah Payne
Subject: RE: FW: [External] NRP Review
Received.
Thanks
Trudy
Trudy Beverly, L.G.
D_ I E Q Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlykncdenn gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: htips://deq.nc.gov/about/divisions/waste-manaaement/ust
Branch's Above Ground Storage Tanks Website Address: ht!ps:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-proeram
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httns://deo.nc. eov/about/divisions/waste-management/waste-management-rules-data/waste-management-eis-mans
File Review Procedures:
https://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hit 2s: //deg.nc. gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httys:Hfiles.nc.eov/nedeci/Waste%2OMana2ement/DWM/UST/WhatsNew/Final-Electronic-Document-Submittal-Policy.odf
htips:Hfiles.nc. gov/ncdeq/\Vaste%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Josiah Payne [mailto:[e-mail]]
Sent: Wednesday, September 16, 2020 12:24 PM
To: Beverly, Trudy <[e-mail]>
Subject: Re: FW: [External] NRP Review
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Good afternoon Trudy,
Please see the attached copies of the filed NRPs for the Richard Davis Property and the Ryan Kozusko
Property. I have also attached our abandonment report for the Richard Davis Property. Haven't abandoned the
tank for the other site yet.
Josiah Payne

Cedar Rock
ENVIRONMENTAL
On Tue, Sep 15, 2020 at 11:48 AM Josiah Payne <josiah.cre9gmail.com> wrote:
Ok, sounds good. Thanks!
Josiah Payne
Cedar Rock
ENVIRONMENTAL
On Tue, Sep 15, 2020 at 11:47 AM Beverly, Trudy <trudy.beverly(&ncdenr.gov> wrote:
No need to change the site name. I'll keep that the same in the database. I'll change the rp to Jeanette Davis in the
database.
Thanks for the update,
Trudy
.r.,--D E �P
;,1 1114 &�"
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. Beverlykncdenr. gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: htWs:Hdeg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https:Hdeq.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https:Hdeq.nc.gov/about/divisions/waste-managementlwaste-management-rules-datalwaste-mana eg ment ig s-maps

File Review Procedures:
https:Hdeq.nc.gov/about/divisions/waste-management/ustlfile-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hqps:Hdeq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
https://files.nc.Qov/ncdea/Waste%20Mana¢ement/D WM/UST/WhatsNew/Final-Electronic-Document-Submittal-Policv.udf
htgps:Hfiles.nc. gov/ncdeq/Waste%20ManagementIDWMIUST/Corr ective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Josiah Payne [mailto:[e-mail]]
Sent: Tuesday, September 15, 2020 11:22 AM
To: Beverly, Trudy <[e-mail]>
Subject: Re: FW: [External] NRP Review
Aur-17ternal email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Emort.s
Good morning Trudy,
I just wanted to let you know that for the Richard Davis Property we found out Richard Davis is deceased and
so the property belongs to just Jeanette Davis, his wife. I have made this change on the NRP. I did not
change the site name, so that is still Richard Davis Property. Please let me know if you want to just keep it
like that or if you want to change it in your database and I will change it on the NRP before we file it. I have
attached the revised NRP as I have it now.
Josiah Payne
Cedar Rock
ENVIRONMENTAL

On Fri, Sep 11, 2020 at 11:43 AM Josiah Payne <josiah.crekgmail.com> wrote:
Ok, will do. Thank you, Trudy!
Josiah
On September 11, 2020 10:42:54 AM "Beverly, Trudy" <trudy.beverly�a ncdenr.gov> wrote:
Hey Josiah,
The 2 Mecklenburg Counties ones look good for Mark's signature. Dan Graham handles Iredell County. I see that he
is on leave until September 17, 2020. You may want to discuss this one with Ron if you need it sooner.
Have a great day,
Trudy
ID E
urnarunen[ olM1�mirnnmant�� aa.m�`�
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy.B everly(a),ncdenr. gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: https://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https:Hdeq.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https: //dcq.nc. gov/about/divisions/waste-management/waste-management-rules-data/waste-management-gi s-macs

File Review Procedures:
hi!ps:Hdeg.ne. gov/about/divisions/waste-management/ustlfile-review-procedures#mooresville-re gional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hqps:Hdeg.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httos://files.nc.Eov/ncdeg/W aste%20Manaeement/D WM/UST/W hatsNew/Final-Electronic-Document-Submittal-Policv.pdf
https: //files.nc. gov/ncdegl W aste%20Management/D WMfUST/Corrective%2OAction/UST%2Ofile%20names%20for%2OLaserfiche. docx
From: Josiah Payne [mailto:[e-mail]]
Sent: Friday, September 11, 2020 9:13 AM
To: Beverly, Trudy <[e-mail]>
Cc: Powers, Mark <[e-mail]>; Robert Payne <[e-mail]>
Subject: [External] NRP Review
jil• ernal email. Do not click links or open attachments unless you verify. Send all.susnicious email as an attachments
nc. ov
Good morning Trudy,
Would you mind taking a look at the three attached NRPs for approval? We would like to take them by
Mark at the beginning of next week for him to sign.
The NRP for 262 Tuckers Grove Rd. in Statesville has alternate verbiage for the groundwater use restriction
because they have an active supply well on the property greater than 150 ft from the release used as a sole
source of drinking water. The site is currently classified as High Risk due to another inactive well onsite
within 150 feet of the release. They are in the process of having that well abandoned so the site can be Low
Risk. Please let me know if you have any questions.
The other two NRPs are pretty straight forward. The 1335 Lake Way Dr. site in Charlotte is High Risk
right now but they are in the process of abandoning the inactive onsite well at which point the site should be

Low Risk. Thank you!
Josiah Payne
Cedar Rock
ENVIRONMENTAL