MO-4618_15622_G_C_20181218_State Lead Recommendation Form with Submittal Package

Beverly, Trudy
From: Beverly, Trudy
Sent: Tuesday, December 18, 2018 12:19 PM
To: Bullock, Scott
Cc: Taraban, Ron; Watson, Edward M
Subject: RE: Johnny's Sav-A-Sum #15622 - State Lead Referral
Wonderful. Thanks for the update.
Trudy
From: Bullock, Scott
Sent: Tuesday, December 18, 2018 12:18 PM
To: Beverly, Trudy <[e-mail]>
Cc: Taraban, Ron <[e-mail]>; Watson, Edward M <[e-mail]>
Subject: RE: Johnny's Sav-A-Sum #15622 - State Lead Referral
Hi Beverly:
Great submittal. Sent to Bill Hunneke today.
.0-e QWCZA
D, E
Scott Bullock
Corrective Action Branch Head, DWM UST Section
North Carolina Department of Environmental Quality
919-707-8298 (Office)
Scott.bullockL&ncdenr.gov
EmW aorM00o +dance to and from 1hi> mess is SuW to the
North C raWr q Public Records Law and rmay be dwkksed to turd parties.
From: Beverly, Trudy
Sent: Tuesday, December 18, 2018 11:27 AM
To: Bullock, Scott <[e-mail]>
Cc: Taraban, Ron <[e-mail]>; Watson, Edward M <[e-mail]>
Subject: Johnny's Sav-A-Sum #15622 - State Lead Referral
Importance: High
Good Morning Scott,

Please see the attached state lead referral for Johnny's Sav-A-Sum located at 3970 US Hwy 601, Concord, Cabarrus
County, NC. Johnny's Sav-A-Sum is part of the Techno, LLC dissolution. Ron has reviewed the submittal package. The
signed state lead recommendation form is attached to this email along with the required documentation.
*Immediate action is necessary to protect human health and the environment. The plume has been migrating since
the treatment system was last shut down to monitor for plume stability. For the first time since 2003, a gasoline related
constituent (MTBE) was detected in an offsite residential water supply well (WSW-2144). The level detected was 0.62
micrograms per liter (µg/L) which is below the 2L Standard of 20 µg/L. Techno, LLC has also been providing bottled
water to two well owners due to lead detections in their water supply.
Techno, LLC/Holding Brothers, Inc. has an NPDES permit NCG510462 system. Ed Watson is the Water Resources
Mooresville Regional Office contact. Edward. WatsonL&ncdenr.gov or [phone]
* All site files can be found on Laserfiche *
http://edocs.deq.nc.gov/WasteManagement/Search.aspx?searchcommand=%7b%5bWM%5d%3a%5bProgram ID%5d%
3d%22* MO-4618*%22%7d&dbid=0
Trudy
I Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environment Quality
Underground Storage Tanks Section
Corrective Action Branch
okomumrni-*Ifa.�.� iLd?QWI ,Je Mooresville Regional Office
[phone] (Office)
Tru dv.Beve rlv(cDncd enr.gov
&Md OYTOSpor der ce to er d from ME$ a Tess 0$ subject to the
No4h CarOff)a Rac Records Law and may be dwk)sed to thffd paoes-
Branch's Underground Storage Tanks Website Address: https://deg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deg.nc.gov/about/divisions/waste-
management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https://deg.nc.gov/about/divisions/waste-management/waste-management-rules-data/waste-management-gis-maps
File Review Procedures:
https://deg.nc.gov/about/divisions/waste-management/ust/file-review-procedures#mooresviIIe-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
https://edocs.deq.nc.gov/WasteManagement/Search.aspx
Document Submittal & UST File Names for Laserfiche Policies:
https://files.nc.gov/ncdeq/Waste%20Management/DWM/UST/Corrective%2OAction/Electronic%2ODocument%2OSubmi
ttal%20Memo%2OUpdate.pdf
https://files.nc.gov/ncdeq/Waste%20Management/DWM/UST/Corrective%2OAction/UST%20file%20names%20for%20
Laserfiche.docx

RECOMMENDATION OF SITE FOR STATE LEAD CLEANUP
Incident Name: Johnny's Sav-A-Sum
Site Address: 3970 US Hwy 601
City: Concord
Current Landowner: Mrs. J L Smith Estate,
C/O Jeff Harris
Recommended by: Trudy Beverly
Step 1: Private/Public water supply well within 1000'
Has a water supply been contaminated?
Has alternate water been provided?
UST #: MO-4618
County: Cabarrus
Incident #: 15622
Site Priority Risk/Rank:
High/240
Address: 13422 Scanlan Way, Davidson, NC 28036
Region: MRO Date of Last Site Visit: 10/10/2007
® yes ❑ no
® yes ❑ no
❑ yes ® no
Step 2: This incident is recommended for State Lead Cleanup because (check all that apply):
❑ The RO has not been able to positively identify the source(s) of contamination
N The RO has not been able to positively identify the RP
N The RO has positively identified the source(s) but RP cannot be located, or is deceased/dissolved
N The RP has been identified but refuses to comply with investigative requirements
N The RP has been identified but claims financial hardship or bankruptcy
❑ The RO is continuing its investigation of sources and RPs, but immediate action is necessary to protect
human health and the environment. (Additional detail in comments below.)
Step 3: Attach a statement documenting or supporting the site risk determination (RRA Form) based upon a confirmed
UST release of petroleum to soil and/or groundwater.
Step 4: Attach cover memo with a summary of site history and chronology of events, including RO actions taken to date.
Step 5: Attach or provide a link to scans of the entire original Regional Office file, and be sure it includes:
® 24-Hour Release and UST Leak Reporting Form (Form 61) and ranking forms
® Topographic map with site location clearly identified
® NORRs, NOVs, and any other correspondence issued and received
N Alternate water requests and any information on available water sources
® Telephone logs and any supplemental information
Step 6: Check all that apply for any UST located at the site:
❑ UST is a heating oil tank 100 gallons or less
❑ UST is a heating oil tank greater than 1100 gallons for four or fewer households
❑ UST is a farm or residential, 1100 gallons or less of motor fuel for non-commercial purposes
❑ The UST is a non -regulated, commercial UST
® The UST is a regulated, commercial UST
Comments: Immediate action is necessary to protect human health and the environment. The plume has been
migrating since the treatment system was last shut down to monitor for plume stability. For the first time since 2003,
a gasoline related constituent (MTBE) was detected in an offsite residential water supply well (WSW-2144). The level
detected was 0.62 micrograms per liter (µg/L) which is below the 2L Standard of 20 jig/L. Techno, LLC has also been
providing bottled water to two well owners due to lead detections in their water supply.
** All site files can be found on Laserfiche **
http://edocs.deg.nc.goy/WasteManggementZSearch.aspx?searchcommand=%7b%5bWM%5d%3a%5bProgram ID%5d%3d%22*MO-4618*%22%7d&dbid-0
* Updated RP contact info: Dave Holdind, Achno, LLC, 3511 Milford Court, Concord, NC, 28027 [phone] *
Ron Taraban
Regional Supervisor
December 18, 2018
Signature Date
Attachment: Incident File ❑
http://edocs.deg.nc.goy/WasteManagement/Search.aspx?searchcommand=%7b%5bWM%Sd%3a%5bProgram ID%5d%3d%22*MO-4618*%22%7d&dbid=0
(Revised October 2018)

ROY COOPER
Governor
MICHAEL S. REGAN
Secrerary
MICHAEL SCOTT
Direcror
NORTH CAROLINA
Environmental Quality
Division of Waste Mana;ement - UST Section
MEMO — Recommendation for State Lead Cleanup
To: William Hunneke, Trust Fund Branch Head
(via email)
From: Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
UST Section, Corrective Action Branch
Mooresville Regional Office
Email: Trudy.Beverly(&ncdenr.gov
Phone: [phone]
Via: Scott Bullock, Corrective Action Branch Head
Ron Taraban, CAB Mooresville Region Supervisor
Subject: Recommendation for State Lead Cleanup — Elderly, Financially Limited, Sole Surviving Managing Member
SITE INFORMATION:
Site Name: JOHNNY'S SAV-A-SUM
Incident #15622, UST # MO-4618
Facility ID # 00-0-0000004305
Address: 3970 US HWY 601
City: Concord, zip 28025 County: Cabarrus
Risk: High Rank: 240
On November 27, 2018 Shield Engineering emailed the Underground Storage Tank (UST) Correct Action
Branch (CAB) head stating that "Techno, LLC has minimal assets and no income, and therefore no longer has the
financial ability to attend to the projects on the attached project tracking spreadsheet. David Holding, the sole
surviving managing member, is eighty years old and not in a position to volitionally manage company affairs any
more. The other partner in Techno, LLC, Bob Holding, passed away in October, 2016. The assets that remain in
Techno, LLC are barely sufficient to cover the cost of an orderly winding up. Therefore, Techno, LLC has been
dissolved. To the extent helpful, we would be happy to attend a call to discuss David Holding's status and help
transition Techno, LLC's project sites to the State Leads Trust Fund."
Potential Release Source(s): Tank #3: 2,000-gallon gasoline underground storage tank (UST), Tank #4: 550-gallon
fuel oil/gasoline UST, Tank #5: 1,000-gallon gasoline UST, Tank #6: 550-gallon fuel oil/gasoline UST. Release
reported in July 1992. Quantity of release unknown.
Release Cause: USTs and/or lines and/or dispensers. A release was not detected from Tank #1, the only UST that
Holding Brothers, Inc. owned or operated at the site. Tank #3 is the only UST, out of the above, for which the
NCDEQ has held Holding Brothers, Inc. responsible. Contamination was detected in the UST basin, which contained
Tank #3 and #4.
E cew 0- f
NORTH CAROL!NA� ��5
unry of EmlmmYeHsl 9� r
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional 0Mce 1 610 East Center Avenue, Suite 301 1 Mooresville. North Carolina 28115
704.663.1699

Site History
5/8/1986 - Holding Brothers, Inc. registered two 6,000-gallon USTs (one estimated to be 30 years old and one
estimated to be 15 years old) and one 2,000-gallon UST (estimated to be 30 years old).
7/1/1992 - Holding Brothers, Inc. permanently closed/removed five USTs at the site. In the excavation containing a
6,000-gallon gasoline UST, no contamination was found. Soil contamination was documented above action levels in
the excavation containing a 2,000-gallon gasoline UST (Tank #3) and a 550-gallon fuel oil UST (Tank #4) and in the
excavation containing a 1,000-gallon gasoline UST (Tank #5) and a 550-gallon fuel oil UST (Tank #6).
7/1/1993 - Tank Ownership Affidavit received from Holding Brothers (D.M. Holding). Holding Brothers claimed
responsibility for the contamination found in the excavation containing the 2,000-gallon gasoline UST and a 550-
gallon fuel oil UST. Holding Brothers denied responsibility for the contamination in the area containing a 1,000-
gallon gasoline UST and a 550-gallon fuel oil UST.
7/6/1993 — John L. Smith, Jr. affidavit on behalf of the Margie Cline Smith heirs (property owners) was received
claiming that neither their father nor their mother ever owned or operated the tanks at the site. The affidavit states that
their father leased the lot on the corner to several persons who operated the station located there. The heirs state that
they never owned, operated, knew the location, number of tanks, or tank contents until the tanks were permanently
closed by Holding Brothers, Inc. Three Holding Brothers registered tanks on the property (6,000-gallon installed
5/5/1971, 6,000-gallon installed 5/8/1956, and 2,000-gallon installed 5/8/1956) according to NC tank records.
7/29/1993 — Tank closure report received. 220 ppm by 5030 documented in soil tank pit at the front of the store.
7/10/1997 — NORR issued to Holding Brothers, Inc. requiring a 20 day report, 45 day report, Site Assessment &
Corrective Action to address contamination in the area of the 2,000-gallon gasoline UST and a 550-gallon fuel oil
USTs. Site risk was unknown.
8/15/1997 A letter from Geo-Environmental Consultants, Inc. (Holding Brothers, Inc.'s consultant) stated that Holding
Brothers, Inc. never owned or operated any tanks at the site except on 6,000-gallon UST. This tank did not show any
contamination at the time of permanent closure.
8/19/1997 — UST staff (Dan Graham) spoke with Dave Holding by phone. Mr. Holding stated that the last operated
was Rich Page. Mr. Page had been deceased at this time for approximately nine years.
3/7/2000 — NORR stating that the CSA is incomplete due to failure to define the horizontal plume extent.
7/24/2000 - Corrective Action Plan submitted
8/l/2000 — Letter from the property owners objecting to the less stringent cleanup standards proposed by Shield
Engineering.
8/29/2000 — NORR approving the Corrective Action Plan. Letter to the property owner from CSF stating the goal for
soil cleanup, soil to groundwater standards, and 2L standard goals for groundwater cleanup.
9/14/2001 — Notice from Shield Engineering that the Pump and Treat System was installed.
8/19/2002 — NORR. A review of soil excavation results shows three confirmed exceedances of soil to groundwater
MSCCs after over excavation.
10/23/2002 — NORR describing operation problems with the corrective action system. Shield engineer indicated that
adding more carbon canisters would solve the issues.
6/2/2003 — NORR describing corrective action system operational problems (system down 43% of the period) and
deficiencies in the Active Remediation Monitoring Report.
8/ 13/2003 — NORR concerning the repeated failure of the transfer pump from the air stripper attendant to design and
installation flaws.
8/22/2003 — Holding Brothers change of address to Holding Bros, Inc., 3511 Milford Court NW, Concord, NC 28027.
3/11/2004 — Shield Engineering submitted results of water quality testing requested to solve biofouling and chemical
precipitation problems. Letter states that bacterial fouling could not be identified during pilot studies.
2012-2013 — Shield Engineering made multiple requests to connect 3965, 9325, and 3910 US Hwy 601 South,
Concord, NC residences to the City of Concord water supply.
11/4/2013 - Shield Engineering letter stating that they will no longer seek to connect 3965, 9325, and 3910 US Hwy
601 South, Concord, NC residences to the City of Concord water supply. Shield was not able to guarantee that the
City of Concord would not require annexation of these properties to gain the connection unless something pertinent
changes. Techno, LLC providing bottled water to two residences due to lead detections in their water supply wells.
DEQaNORTH
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional office 1610 East Center Avenue, Suite 301 I Mooresville. North Carolina 28115
704.663.1699

Shield states that there is no lead plume offite and that the lead detections are unrelated to the contamination from
Johnny's Sav-A-Sum.
Treatment System Background Information
The site currently has an operational remedial action system that was placed into operation on September 20,
2001. The remedial pump and treat system at the site consists of five groundwater recovery wells (RW-1, RW-2, RW-
3, RW-4, and RW-5), an oil/water separator, and an air stripper. The remedial system was temporarily shut down in
2004, per the instructions of the NCDEQ, due to the low levels of funding but restarted in 2007. During that time
period, there were reductions of contamination in some wells and increases in others. No real attenuation was
observed, just movement of the contamination. Shield installed oxygen releasing compound (ORC) socks in key
perimeter monitoring wells MW-2, MW-3, MW-5, MW-8, MW-11R, MW-12, and MW-13 on January 26, 2018.
ORC socks were installed while the treatment system was operating with the intention of drawing oxygen into the
plumes to accelerate biodegradation of the petroleum constituents in those areas. The system was shut down in
February 2018 to monitor for off -site migration of contaminants with no hydraulic control of contaminant plumes.
The October 31, 2018 Monitoring Report relayed that dissolved phase petroleum constituents of concern
concentrations have increased in eight of the twelve monitoring wells sampled (MW-1R, MW-2, MW-4, MW-5, MW-
7, MW-8, MW-9, and MW-11R) and all five recovery wells (RW-1 through RW-5) sampled during the September
2018 event. Dissolved phase petroleum constituents of concern concentrations had increased to levels above the 2L
Standards in monitoring and recovery wells MW-2, MW-7, MW-8, RW-2, and RW-3 since the previous sampling
event in March 2018. For the first time since 2003, a gasoline related constituent (MTBE) was detected in an offsite
water supply well (WSW-2144). The level detected was 0.62 micrograms per liter (µg/L) which is below the 2L
Standard of 20 µg/L.
*Techno, LLC/Holding Brothers, Inc. has an NPDES permit NCG510462 system. Ed Watson is the Water Resources
Mooresville Regional Office contact. Edward.Watson(a)ncdenr.gov or [phone]*
Per the November 20, 2018 Notice of Regulatory Requirements to Techno, LLC for Holding Brothers, Inc.:
• Re -start the remediation system to regain hydraulic control of the contaminant plume(s) and to reduce
the levels of contamination.
• Continue sampling monitoring wells (MW-1R, MW-2 through MW-9, MW-11R, MW-12, MW-13,
and MW-16) on a semi-annual basis as required in the May 7, 2004 Notice of Regulatory
Requirements and approved in the July 24, 2000 Corrective Action Plan.
• Continue sampling water supply wells (2144, 3910, 3925/3965, 4036, and 4085) on a semi-annual
basis as approved in the July 24, 2000 Corrective Action Plan.
• Continue sampling recovery wells (RW-1 through RW-5) on a semi-annual basis as required in the
May 7, 2004 Notice of Regulatory Requirements.
• The next remediation monitoring report is due no later than April 30, 2019.
11/27/2018 - Shield Engineering emailed the UST CAB head stating that Holding Brother, Inc. had been dissolved.
11/29/2018 - The 11/20/2018 NORR letter addressed to David Holding was returned to sender. The email copy to
Shield Engineering was received by the consultant.
12/4/2018 - UST -CAB email to Shield Engineering requesting immediate return to service of the treatment system to
protect the residential water supply of WSW-2144 during the approval process period for acceptance into the state lead
trust fund program and updated contact information. 2:43pm phone call with David Stoner (Shield Engineering)
requesting reactivation of the treatment system and updated contact information. Mr. Stoner stated that he would
provide a response to treatment system activation and contact information.
12/5/2018 - Email stating the Techno LLC is unable to return the treatment system into operation and updated contact
information for David Holding and Techno, LLC: Dave Holding, Techno, LLC, 3511 Milford Court, Concord, NC,
28027 [phone]. Techno, LLC was still providing bottled water to the two residences with lead detections in
their water supply wells.
_,!�
��OU EA
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional Office 1610 East Center Avenue, Suite 301 I Mooresville. North Carolina 28115
704.663.1699

All site files are available on Laserfiche at the following link
hlt 2s:Hedocs.deg.nc.goviWasteManagement/Search.aspx?dbid=0&searchcommand=%7B%SBWM%5D%3A%SBProg
ram ID%5D%3D%22%2AMO-4618%2A%22%7D&cr=1.
ez-5� NORTH C.4R0.'+1A� E Q
�Y
un of iw.'r..wrM.I quasiIr
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional 0Mce 1 610 East Center Avenue, Suite 301 1 Mooresville. North Carolina 28115
704.663.1699

Site Name: JOHNNY'S SAV-A-SUM
Incident #15622, UST # MO-4618
Facility ID # 00-0-0000004305
Address: 3970 US HWY 601
City: Concord, zip 28025 County: Cabarrus
Risk: High, Rank: 240
Tank Information
Facility Contact
Financial Provider
Tanks
Facility Identification
Facility Name
Fa cility I❑
0— Name
Owner I❑
JOHNNY'S SAV-A-SUM
00-0-0090004305
ESTATE OF JL SMITH 0I0 SMITH.
JR
19668
FacilityTank List 1-1
tDk
Product
Sire
SUM.
MaralF Date
Temporary Permaneniry
Registmlia
&Ilab6e
Tank apg
Comp Tank
Reg Tank Root Tard
0.-1 Clasetl Date
Dale
Receivetln
1
Gasoline. Gas Mix
6000
Removed
05101309%
071010992
Yes
Yes
No
No
Yes
2
Gasoline, Gas Mix
2000
Removed
051080956
071010992
Yes
Yes
No
No
Yes
3
Gasoline, Gas Mix
1000
Removed
051050971
07010992
Yes
Yes
No
No
Yes
4
Unknown
1000
Removed
01MV1964
1212111988 07MVIIJ92
Yes
No
No
No
Yes
5
Unknown
550
Removed
011910964
12210988 07DW992
Yes
No
No
No
Yes
Cancel
Find Facility Select Id

Johnny's Sav-A-Sum Site & Parcel Map
12/4/2018 3:10:10 PM
1:2,257
RUST
Low Risk
�
Muncipal Solid Waste
9
Inactive Eligible
0 0.02 0.I 0.08 ml
High Risk Unknown Risk
Tire
P
Pending
I
0 0.04 0 0.14 km
NC Brownfields
Location
9
No Further Interest
Blank Risk
Blank Risk
—View
RAST
�y
*
Recorded
Ineligible
NCDOT GIS Unit, NCCGIA, Esri, HERE, Garmin, © OpenStreetMap
Active Permitted Landfills
RFR PC Complete
--,
L_�
County Boundary Polygon
contributors, and the GIS user community, NC Counties, NCCGIA,
High Risk Construction Debris
v
Complete
NC OneMap, US EPA, Source: Esri, DigitalGlobe, GeoEye,
0 Industrial
❑
Parcels
Earthstar Geographics, CNES/Airbus DS, USDA, USGS,
Intermediate Risk
�
Active Eligible
_
0 Land Clearing / Inert Debris
National Pollutant Discharge Elimination System Sites - NPDES
Web AppBuilder for ArcGIS
Microsoft I Esri, HERE, Garmin, © OpenStreetMap
contributors, and the GIS user
community I NCCGIA I NC Center for Geographic Information & Analysis I NC Counties, NCCGIA, NC OneMap, US
EPA I NCDOT GIS Unit I NC OneMap, NC Center for Geographic Information and Analysis, NC DOT- GIS Unit, NC

NORTH CAROLINA
UNDERGROUND STORAGE TANK SECTION
RISK, RANK AND ABATEMENT RATING FORM
Incident Name: ToBN/1 y' S4p-4 - SUi"l Region:
Incident Number: �sz�a-� County: L�L39�rcUS SCORE
Date: 9-/S'-a00y- Ranking Performed by: z, LG"9Cf/
Note: a new ranking form must he completed whenever site conditions may have changed
SECTION I. Risk Classification (Check all that apply)
1. High Risk
A. An existing water supply well, including one used for non -drinking purposes, has been
contaminated by the release;
B. A water supply well used for drinking water is located within 1,000 feet of the source area of a
confirmed release; t/
C. A water supply well not used for drinking water is located within 250 feet of the source area of a
confirmed release;
D. The groundwater within 500 feet of the source area of a confirmed release has the potential for
future use in that there is no source of water supply other than the groundwater;
E. There exists a serious threat of explosion due to the accumulation of vapors in a confined space, as
a result of the release; or
F. There exists an imminent danger to public health, public safety or the environment, as a result of the
release.
2. Intermediate Risk
A. Surface water is located within 500 feet of the source area of a confirmed release and the maximum
groundwater contaminant concentration exceeds the applicable surface water quality standard and
criteria found in 15A NCAC 2B .0200 by a factor of 10;
B. 'In the Coastal Plain Physiographic Province (as designated on a map entitled Geologic Map of
North Carolina published by the Department in 1985), the source area of a confirmed release is
located where there is recharge to an unconfined or semi -confined deeper aquifer which the
Department determines is bein¢ used or may be used as a source of drinkine water:
C. The source area of a confirmed release is located within a designated wellhead protection area, as
defined in 42 USC 300h-7(e);
D. The levels of groundwater contamination for any contaminant (except ethylene dibromide, benzene
and the aliphatic and aromatic carbon fraction classes) exceed 50 percent of the solubility of the
contaminant at 25 degrees Celsius or 1,000 times the groundwater quality standard or interim
standard established in 15A NCAC 2L .0202, whichever is lower (these levels have been termed
"gross contamination levels"); or
E. The levels of groundwater contamination for ethylene dibromide or benzene exceed 1,000 times the
federal drinking water standard set out in 40 CFR 141(these levels have also been termed "gross
contamination levels").
3. Low Risk
A. A low risk classification means that the risk posed by a release does not meet any of the high or
intermediate risk criteria or, based on site -specific information received by the Department, the
release does not pose a significant risk.
SECTION I. Risk Classification
UST/200 Rev. 9/04 1 of 4

SECTION II. Release Ranking (Assign points as applicable)
1. EMERGENCY HAZARD ASSESSMENT POINTS
An emergency situation exists whenever the Department determines that the release poses an imminent
danger to public health, public safety, or the environment. EmE2cetvcv
Complete entire form and assign letter E to final rating in Section /O, Once Emergency is abated a new rating must be performed
2. EXPOSURE ASSESSMENT
Groundwater
A. Impacted Water Supplies
Public Supply Wells (each well can only be counted once)
1. Public or institutional water supply well containing substances in concentrations
exceeding 15A NCAC 2L groundwater quality standards; award 600 points per well
Private Supply Wells (each well can only be counted once)
2. Private domestic drinking water supply well containing substances in concentrations
exceeding 15A NCAC 2L groundwater quality standards; award 200 points per well
3. Private well, not used for drinking, containing contamination in detectable
concentrations; award 75 points per well
Public or Private Wells Below 2L .0202 Standards (each well can only be counted once)
4. Public or private drinking water supply contains substances that are below the 15A
NCAC 2L groundwater quality standards; award 100 points per well
B. Threat to Uncontaminated Drinking Water Supplies
Public Supply Wells (each well can only be counted once)
1. Public or institutional water supply well within 500 ft of plume edge, plume edge is
within radius of influence of public well, or threat currently unknown; award 40 points
per well
2. Public or institutional water supply well between 500 and 1000 ft of plume edge or
threat is reasonably known; award 10 points per well
Private Supply Wells (each well can only be counted once)
3. Private water supply, including non -drinking well, located within 250 feet of plume
edge, wells threatened or the threat is currently unknown; award 20 points per well
a Q
4. Private water supply, not including non -drinking well, located between 251 and 500
feet of the plume edge, wells threatened or the threat is currently unknown; award 10
p
points per well
5. Private water supply, not including non -drinking well, located between 501 and 1000
feet of plume edge or wells located within 1000 feet but threat to wells is reasonably
known or alternate water source is available; award 5 points per well
�p
a yy
6. Private non -drinking well, located between 251 and 1000 feet of plume edge; award 2
points per well
Surface Water
1. Violation of Class HQW,ORW,WS-1, WS-II or SA surface water quality standards as a
result of groundwater discharge; award 10 points
2. Free product or sheen discovered on surface waters as a result of groundwater
discharge; award 5 points
UST/200 Rev. 9/04 2 of 4

" Soil
A Land Use Choose required soil clean-up level then apply points only if soil contamination
exceeds requirement
No Risk Data Soil to GW Residential Industrial/Commercial
❑ W ❑ ❑
Air
1. Maximum soil contaminant concentration exceeds "Soil to Groundwater" but below
"Residential" exposure concentration; award 5 points total
OR
2. Maximum soil contaminant concentration exceeds 'Residential' but is below the
"Industrial/Commercial" exposure concentration; award 10 points total
OR
3. Maximum soil contaminant concentration exceeds the "Industrial/Commercial"
exposure concentration or no risk -based data available; award 15 points total
A. Vapor Phase Exposure
1. Contaminant vapors detected in inhabitable building(s), but levels are below 20% of
the lower explosive limit and health concern levels; award 20 points total
2. Contaminant vapors detected in other confined areas (uninhabitable buildings, sewer
lines, utility vaults, etc.) but levels are below 20% of the lower explosive limit; award
5 points total
3. HYDROGEOLOGY AND LITHOLOGY
A. Bedrock - contamination is located in, on or within five feet of bedrock; award 20 points eC 0
B. Vertical Contaminant Migration -Literature or well logs indicate that no confining layer is present J D
above bedrock or within twenty feet of land surface; award 10 points
C. Horizontal Contaminant Migration -Data or observations indicate that no discharge points or aquifer
discontinuities exist between the discharge, release or known extent of contamination and the Is -
nearest down gradient drinking water supply; award 5 points total
4. ENVIRONMENTAL VULNERABILITY ASSESSMENT
Contamination Concentrations
A. Existing Groundwater Quality -The worst case monitor or supply well, assign only one
1. At less than 10 times the 2L groundwater standards; award 5 points
OR
2. Between 10 and 100 times the 2L groundwater standards; award 20 points
OR
3. Greater than 100 times the 2L groundwater standards; award 40 points 40
OR
4. Free Product; award 80 points
Contaminant Types
A. Predominant Contamination Type
I. Low boiling point petroleum products (gasoline, aviation fuel); award 20 points 1? 0
2. High boiling point petroleum products (fuel oil, kerosene, diesel fuel or similar
products); award 0 points
SECTION II. Release Ranking ®p
UST/200 Rev. 9/04 3 of 4

SECTION III. Source Abatement Assignment (Award Points and Assign Letter)
A. Abated or Unabated Contaminant Source
1. Emergency Situation, Assign Letter E (from Section II.1.)
OR
2. UST remains in active use and continues to discharge into the environment; Award
100 points and assign Letter A
OR
3. UST release has been abated. However, contaminated soil continues to release
product or contaminants into the environment; Award 50 points and assign Letter D
OR
4. UST release has been abated. Contaminated soil has been removed or remediated;
Award 0 points and assign Letter R
SECTION III. Source Abatement Assignment
SECTION IV. Risk, Rank and Abatement Score
S'o b
Total: Risk, Rank and Abatement Score
(Insert risk letter from Section 1, total all points from Section 11 and 111, and insert abatement letter from Section 111) (e.g H750D)
Upon completion transfer final score to box on page 1.
UST/200 Rev. 9/04 4 of 4

+
{ ,_ ' _ t.'{' r, r- � r� r�' 1' �■ _ _ I � L ��' 1.• '. ` k �� i r1yG'' : .�L
qr
F+�'rr
r
+���`'_�}y 1 {' r ' ■' ■ 5k Ly �r#Y ��,1r-' +r '•'`Lam} ? r�.dry•�`u - ' J• ' 1 , J
PL
-�.. '•f 7 r + *� ■ { 1 , + It p'�`, :ti• 1• iT*'Jv ,' +.i+r: IR Ir
} i �y..r~'+ _ { •+,` F yr '•;fir~ I F'.r �M1 ~•;I'j� I. ,� M1 :•,}+} ,14 ` -1 .�rJ J� fk �' L'� ; `r #■+ T r
+ w' - -' fi - f. 'Y +1: .�•'� t�, 1 1•kkti� : L .�. •�'. f OF -b'' 1{� •r �• r•' +, ,, .'k
� Y ', � '• ' •�LA �06
F'•�r y,r F' � �,• ; � r�' I �- k �, �. •�'}� - y :i• ' _� Y., ' ' L`� � � .� �•� - r F L' •':+ � T"
IlL
•� r fi-� '. y {'• : J •, , f' { ' •{ - { {' •f yr• , i.: -L� J
- F l A �4` r. S, � i J5 r .. ',1 .�. 7; FI h• �•# I �s + i ■'• ■� + iA
R.
y,�) L ,F 51• 'k I 1 r 1 :.y� ' 1 _ _ T PIKI •,1 �Yin
'x ' - •.'w� -
`+ ■ 4'_s+'.ti•.� '_+-I a ,N y� F !•+■I` i* `* + 1? { r 1"_t -
' - - �lp
?- -v 'L - ?* ■� ' :f 4, r -'± Y' i4 .�k •. f#' Ii ••fj - r -
%
MP. I s._ Y +' Y `'• - ~f� J<'I �� �.I�L1 ■'r r•X'f t. t J rrM 1�ep
` 't: •l,w� i �5 'k��•• J� y !•y•+ r 't•I'�� *'�� f.it 1 :� f - +-+.t -•
+ l+:� ,5 �:- 'n. IF " 'ii F r I i1YF +' �{' �' #'2�; r. FF +{�� rr T ~ 'L �t ti' ■rF f t FFFF } �yI 2I
1• 1 .•I r � r h y, 1 � #�r ,.��' �� •+ � �"f h4 l•'•i �''{r c�y� rl }5r - J _�� _�,i•�+ rr- �, -- + �- t
i y F p1�'.f_4�_ �Y.{ }y **y' r, ",r ' •+•�� F i {I. fir'■ �•' r�•i� �� -i - ,++.rL �. _yx•, -
Iar +x �!+'. '* � 1 '. i� •''y 1 �r JM�=�I +•F , '% J PSI t{ �J ■ 'F Lr' _ rI-, -P
••�Lr c. Y - L _ r 1 •+ + I F y',`. •� `f r
I� s y ,*ry f iu ,. j`�-, _ = r. 4'1i., .. t.' T. :`�, 4 .. ,L' , +�'�. .,'fir* :.. li. rIF� }A',., M'•, r• "J: t•'• - -.4 ',
ir : _+ - r ' 1 x y,r r �` F€ } r y �'.• r-A,'f i y' ,+y•
�� + f ' �' ` r•r - ; #t,..r 4�'+,' `• '• + }' r - r rw h * r r M1 1+L+ , - '• * .
•i;ry { I r -- �r '.:� r J .Tr• 1+ Y - y■� + 4ti
IL
r.. _. - irk_ T + # # Y ; } _ `JL
F �aq
LF
'� twv ,{ 1 ,r J ■ y :r • - •. �t, kz r %r •21 r-r r rt{ + 5• r} Ak-
pr
IV
• + r 1-- 5 y F *r'y �, i•' i SJ� ~ -IF
S _ 'ram r
_ Fp
impbr
•-L M _ L'
■
1F k{J� _ �s '+ {' * * ''•jl,• _ . ■ , r 1 r ;
-L3 +
"yjJ L *
1' -In PR
'. ■ , +N_ i r'7 ' Fr r•� • ■ +r i Cr r J.y _ _ •' : { } + ` Ia ' ' { r
rr• r ' - �• ` ' }iJ r + }FJL, ! ^■ '•{..• F , a,. r� J
f �+' �' J% - + ~� T
It
Hwy Imo % i, ' Lr *, �' :L ; +r �I`� ./ * '
1 .1, �Wv
IF
• , •,, T~ fir' �' ' e ,:,,_ J T . rah- • + r '+� ` - • • _� {f �LF. - l• { r .9 • ' F _.+ - F
Rol jo - Store a IL
pp %
1:bt + v #'
r •y '{ yr 1 r� `' `qF t s.� _ 4k +&. .�. �11 r �_- *p +`
TI•M.� 4. {: ate' ; + Y' ',k � y { r+L r 4• *2 ti` r a
` • J } ' + # + r;4+F' , r_, �' •F r J� , f - r ti +' - T f ,
�i x ' 'I • rti 1. 1 i' r . - • .�'q `i • _ -T- '� _ ~•"K■ ~' -
+� X}� - ~' _ *1 ., _ y F,r•�•• 1= ' .,�. a �!� r`r' � F .`'�• 'L.r _ .. �
tit
- 3�., r LI r r Yr+•F yl ar } y4k.�_1� f ti �Y iy #,
d.
or di.
_ '• . r' _
• ' f ` ' 1 ti �'i r F :- 1 r L Y �' r rY'� - a'- J
Al
Ic
f ~`era
41 ' rdL41� f ti� J 10
- _ = - t Tk . # k' i tst } , ' �■ ` r 'IN '` f PIPE
NIP
1, L r _ -
F t� f'L' F �� ! .i iri • %+• �k� ' #.•' F S'' rr• + F ti x
■, ' �? _ _ }t i ' Ly • �r��r 1 r
# Y r 1 _ x 5 { ! * r y,�• Ali'.:_
`k 'l"�� r rr„T: .max t �� ,r *• k•4F. r �' - 4'J Jam'
{� T
r•I� r y riS }L } y_.' r'i` _ + _ * F'�+� r - Y y : "' r ■ � ++ �• L . 'Y,Iki
%' l ; 61 r - }
dr
d y Irf Jr� .+R.r rrr ter_ �.i.
t JL ' r f 11- . - F . �'• L, y f - - `P ' 4 �r■+� L� 1} ■yl l WL • '4 r ,+5
Act
P.
"S■1
J:
}.IL .
rl' t rI
4 I ' r ' Yr 1 \ � LYr � r � ' •4 Ii � �'+ 4�
` - -• '
Air
+ r e
' ti 'L• , - Y' 1 r T 1� r
r •s ti is • _- r J .
� L 4 .
r JI'
� L L
.s _ r
W6 • ' • • ,
.L

it - -- .�. _ ..
r
5539902295 03/26/2003

I ft
5539902295 06/10/2004

Cabarrus County Property Report
Parcel Information Number Property Real ID Legal Description
55399022950000 11-049-0034.00 HARTSELL
Land Units Land Units Type
17.44000000 AC
a \
en U M
Ma
1Nma°Or 'L`°° M1ami Chyhh qd G�
� k
� Lo
3 fA1 °
81uey,'p q. B'g
Pintailp 4
c © 2018 Microsoft Corporation, © 2018 HF_RF_
First Owner Name
SMITH J L MRS ESTATE
Second Owner Name
Mailing Address
Physical Address(es)
C/O JEFF HARRIS 13422 SCANLAN WAY DAVIDSON NC 28036
3970 US HWY 601 S CONCORD NC 28025
Land Value Building Value
Assessed Value
Market Value
442020 1000
115140
444910
Sale Year Sale Month
Sale Price
Deed Book Deed Page
Elementary School
Middle School
High School
AT Allen ES
C C Griffin MS
Central Cabarrus HS
Voter Precinct Zoning
Muncipal District
Township
11-01 PUD
CITY OF CONCORD
Township 11, Central Cabarrus
Soil Report for Parcel
Floodplain Report for Parcel
Soil Type Acreage Percentage
Floodway 100 Year
500 Year FIRM Panel Number
EnB 6.05 39.27
No No
No 5539
MeB 3.62 23.47
PoD 0.09 0.58
PoF 5.65 36.68
Permits Issued on Parcel
Permit Number Permit Type
Status Issue Date
EL2014-00272 Trade Electrical
Final Complete 2014.02.04
Cabarrus County shall not be held liable for any errors in the data represented on this record. This includes errors of omission, commission, concerning the content of
the data, and relative positional accuracy of the data. The data cannot be construed to be a legal document. Primary sources from which this data was compiled must be
consulted for verification of information represented on this map document.
Report Created By Cabarrus County IT Department. 11/29/2018 2:50:45 PM
Data Sources: Cabarrus County Land Records, Microsoft Bing Maps 40
1

Appraisal Card
Page 1 of 1
CABARRUS COUNTY. NC
12/7/2019 11:S0:10 AM
MITH J L MRS ESTATE Return/Appeal Notes: Parcel: 5539 90 2295 0000
3970 US HIGHWAY 601 S NC PLAT: /
6503100 ID NO: 11 049 0034.00 0000
CONCORD CITY TAX (100), COUNTY TAX (100) CARD NO. 1 of 1
Reval Year: 2016 Tax Year: 2018 HARTSELL 17.440 AC SRC= Inspection
Appraised by SM on 08 08 2017 05003 CENTRAL CABARRUS HIGH SCH TW-11 CI-02 FR-00 EX- AT- LAST ACTION 20170929
CONSTRUCTION DETAIL
MARKET VALUE
DEPRECIATION
CORRELATION OF VALUE
Foundation - 3
EOBS Economic
0.15000
Continuous Footing 5.00
Obsolescence
Sub Floor System - 5
AP Additional
0.40000
Wood 9.00
USE
MOD
Eff.
Area
QUAL
BASE
RATE
RCN
EYB
AYB
Physical
REDENCE TO MARKET
Exterior Walls - 05
Asbestos Shingle 27.00
Standard
0.65000
Roofing Structure - 03
Gable 7.0001
01
1,381
97
72.27
99806
1951
1951
% GOOD 11.0
EPR. BUILDING VALUE - CARD 1,00
Roof ng Cover - 03
EPR. OB/XF VALUE - CARD 1,89
Asphalt or Composition 3.00
TYPE: SINGLE FAMILY RURAL SINGLE FAMILY HOME
Shingle
STYLE: 1 - 1.0 Story
MARKET LAND VALUE - CARD 442,02
OTAL MARKET VALUE - CARD 444,91
Interior Wall Construction - 5
D wall/Sheetrock 20.00
Interior Floor Cover - 09
OTAL APPRAISED VALUE - CARD 444,91
Pine or Soft Woods 10.00
FOP
Heating Fuel -
Oil, Wood or Coaall 0.00
6' 24' [144 ftl]
OTAL APPRAISED VALUE - PARCEL 444,91
Heating Type - 04
Forced Air - Ducted 4.00
OTAL PRESENT USE VALUE - PARCEL 115,14
OTAL VALUE DEFERRED - PARCEL 329,77
Air Conditioning Type - 01
None 0.00
�
OTAL TAXABLE VALUE - PARCEL $ 115,14
Bedrooms/Bathrooms/Half-
Bathrooms
PRIOR
1 0 7.000
Bedrooms
BUILDING VALUE 1,00
BAS - 2 FUS - 0 LL - 0
BXF VALUE 1,89
ND VALUE 442,02
Bathrooms
BAS - 1 FUS - 0 LL - 0
ails
11302 W1
RESENT USE VALUE 112,25
EFERRED VALUE 329,77
OTAL VALUE 444,91(
Half -Bathrooms
BAS - 0 FUS - 0 LL - 0
Office
BAS - 0 FUS - 0 LL - 0 0
28'
35'
OTAL POINT VALUE 92.000
BUILDING
ADJUSTMENTS
uali
3
Avera a 1.0000
Sha a Desi n
3
MF3 1.0000
PERMIT
Size
ISizel
Size 11.0500
CODE I DATE I NOTE I NUMBER I AMOUNT
OTAL ADJUSTMENT FACTOR 1.050
OTAL QUALITY INDEX 97
ROUT: WTRSHD:
SALES DATA
FF.
INDICATE
:3 f
RECORD
DATE
DEED
SALES
BOOK AGE
MO
TYPE
/U
/I
PRICE
USP
7' 7'
10' 14' €96 'I
HEATED AREA 1,302
NOTES
Click on image to enlarge
SUBAREA
ODE
DESCRIPTIONCOUN
LTH
THUNIT
UNIT I
PRICE
ORIG ^/o
COND
LDG41
SIZE
FACT
AYB
EYB
ANN DEP
RATE
V
%
COND
OB/XF DEPR
VALUE
GS
RPL
1
TORAGE WD
16
1
19
14.3
100
1 1.25
20012001
S3
55
188
TYPE
AREA
%
CS
BAS
1,302
10
94096
OTAL
OB XF VALUE
1,8819
FOP
14
03
3614
SP
9803
2096
FIREPLACE 1 - None 0
SUBAREA
1,54
99,806
OTALS
BUILDING DIMENSIONS FOP= N6W24S6E24Area: 144; BAS =W44S35E ION7E34N 28Area: 1302;USP=E14N7W14S7Area: 98;Tota lArea: 1544
LAND INFORMATION
OTHER
ADJUSTMENTS
HIGHEST
AND NOTES
LAND
TOTAL
AND BEST
USE
LOCAL
FRON
DEPTH / LND
COND
RF AC LC TO
ROAD
UNIT
LAND
LINT
TOTAL
ADJUSTED LAND
OVERRIDE
LAND
USE
CODE
ZONING
TAGE DEPTH
SIZE MOD
FACT
OT
TYPE
PRICE
UNITS
TYP
ADJST
UNIT PRICE VALUE
VALUE
NOTES
RURAL AC
0120
PUD
775
0
1.0380
4
1.3200
+02 +30 +00 +00
PW
18,500.00
17.44C
AC
1.370
25,345.00 442017
0
CNR
+00
H WY601
OTAL MARKET LAND DATA
17.440
442,020
Forestry II
6210
PUD
0 1
0
1 1.0000 1
5
1.0000
PW
1 245.00
13.13
AC
1.000
245.0
321
0
DQ FOREST
6800
PUD
0
0
1.0380
5
1.3200
PW
18,500.00
4.30
AC
1.370
25,345.0 10903
0
LAND
OTAL PRESENT USE DATA
17.44
112,250
http://tax.cabarruscounty.us/AppraisalCard.aspx?idP=7711992&Action=Auto 12/7/2018

_.y JaiLi�lYa:til'a.'u.e:r%.Y'it v:.]w uYK..�kuf.u.;�_L..aat64.S'.t �♦
*R.t?�IM�.I+t�Yi -'iii.5"rLr'arl'a2ubt---•. r93d4:�i.._1.n'i,4iLti:lltmifG 'w�.,.IY`i.m.....An.:<Gi SIc�.2..;..i N,M.L�rc1
-------------
Record 124
,r
THIS INDENTURE, Made this the.......8th November in the year of our Lord one thnosand, nine
_...day of ..................................._.........
hundred and thirty one
between
ll
Merlie Faggert Smith and husband R.it.Smith
I'
111111�
of the County of .._�ab8rrua ... and State of NorthCarolina, part lee of the first part, and
J.L.Smith and wife Margie Smith
of the County of......GOa1CF.UN ...........................and State of North Carolina, Pam.;,leeof the second part,
i
WITNESSETH, That the said part..lea, of the $rat part, for and in consideration of the sum of..9A4.. M=Alted ,DQ11ara,;
( and other valuable oonaiderationsto ,rt 1ea r paid,Ihereacipt
_..... then p _ the fist part, in hand whereof
is hereby acknowledged, ha Yfl...... bargained, sold and conveyed, and by throe prwate do.-.... bargain. sell and eonvev. unto the said na.t_10 a
•