WS-28371_47632_G_NORR_20210504

May 4, 2021

Quality Oil Company, Inc.
Mr. John Shutt
P.O. Box 2736
Winston-Salem, NC 27101

Re: Notice of Regulatory Requirements NCGS
143B-279.9 and 143B-279.11
Notice of Residual Petroleum

Quality Mart #42
1465 River Ridge Road, Clemmons
Forsyth County
Incident Number: 47623
Risk Classification: Low
Ranking: L90A

Dear Mr. Shutt:

North Carolina General Statute (NCGS) 143B-279.9 and 143B-279.11 require a Notice of Residual
Petroleum (Notice) to be filed with the Register of Deeds in Forsyth County, where the release is located,
when a release from an underground storage tank has not been remediated to below “unrestricted use
standards”. The Notice is required either prior to conveyance of a contaminated property or prior to
receiving a Notice of No Further Action. “Unrestricted use standards” for groundwater are the groundwater
quality standards and interim standards contained in Title 15A NCAC 2L .0202, and “unrestricted use
standards” for soil are the residential maximum soil contaminant concentrations (MSCCs) established in
Title 15A NCAC 2L .0411.

The Notice must be prepared in accordance with the attached instructions and format. It must contain a
legal description of the property containing the source of contamination and legal descriptions of any other
properties which you own (or control) which are contaminated by the release. The Notice must also include
appropriate land use restrictions for these properties. In addition, the Notice must identify all other
properties (adjacent, adjoining, downgradient, etc.) on which contamination is known to exist at the time
the Notice is prepared.

The Notice must be sent to this regional office of the UST Section within 30 days of the date of this letter
for approval and notarization. The approved and notarized Notice must then be filed by you with the
Register of Deeds, and a certified copy of the filed Notice must be submitted to this office within 30 days
of its return to you.

Effective October 1, 2004, the Department of Environmental Quality requires that all work following the
submittal of the Limited Site Assessment Report (Title 15A NCAC 2L .0405) be preapproved if State Trust
Fund reimbursement is anticipated. To comply with this requirement, a completed Preapproval/Claim
Authorization Form, encompassing the required remedial activities, must be received in this office within

14 days of the date of this letter. Upon completion of the preapproved activities, you should submit your
claim promptly. Reimbursement funds are budgeted based on completed preapprovals, but lengthy delays
in reimbursement can occur if claims are not submitted immediately following work completion.

Failure to comply with this letter is a violation of North Carolina law and may result in the assessment of
civil penalties and/or the use of other enforcement mechanisms available to the state. If you have any
questions regarding this letter, please contact Karen J. Hall at the address or telephone number listed below.

Sincerely,
Karen J. Hall
Environmental Sr. Specialist
Winston-Salem Regional Office
UST Section, Division of Waste Management, NCDEQ

Attachment: Instruction for Preparing Notice of Residual Petroleum