MO-9461_40901_G_C_20190529_Draft NRP w Figure for UST Review

NOTICE OF RESIDUAL PETROLEUM
Gornto Property 2727 Palm Avenue Charlotte, NC Incident # Pending
Mecklenburg County, North Carolina
Current Property Owners Deed Book # 12729 Page # 478
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 County
Register of Deeds' office Book , Page
Any map or plat required by DEQ has been/shall be recorded at the Mecklenburg County Register of Deeds'
office Book , Page , and has been/shall be incorporated into the Notice by this reference.
Paula Faye Gornto of Charlotte, North Carolina 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:
BEING all of Lot E, Block F of the revision of EASTWAY, as same is shown in Map Book 6, Page 789 of the
Mecklenburg County Public Registry.
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 Deeds receives and records the written concurrence
of the Secretary (or his/her delegate) of DEQ (or its successor in function).

PERPETUAL LAND USE RESTRICTIONS
[Restrictions apply to activities on, over, or under the land.]
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 1, Attachment A 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.
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
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.
IN WITNESS WHEREOF, Paula Fa a ornto has causel this Notice to be executed- pursuant to N.C.G.S.
Sections 143B-279.9 and 143B-279.11, this day of , 2019.
By: N
Signatory's name typed or printed: Paula Faye Gornto
NOItTRC ROLINA
r COUNTY
I certify that the following person(s) Rersonally appeared before me tois day, each acknowledging to me that he or '
she signed the foregoing document: AUk - X-0f- W-5` jyu0q, PM-0eta kVk
Date: r
(Official Seal)
M
NoCarolina
MY er 6,2922
itluL
(signature ofNcUry Public)
V 1 -1A-QP--
(printed or typed name of Notary Public)
Notary Public
My commission expires 0(74 tG , 20 2-7-

Approved for the purposes of N.C.G.S. 14313-279.11.
Ronald H. Taraban, Ph.D., Regional Supervisor
Mooresville Regional Office
UST Section
Division of Waste Management
Department of Environmental Quality
NORTH CAROLINA
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: (full printed name of Regional Supervisor)
Date:
(Official Seal) (signature of Notary Public)
(printed or typed name of Notary Public)
Notary Public
My commission expires , 20_.

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THIS MAP MAY NOT BE A CERTIFIED SURVEY AND HAS NOT BEEN REVIEWED BY A LOCAL
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GOVERNMENT AGENCY FOR 'COMPLIANCE WITH ANY APPLICABLE LAND DEVELOPMENT REGULATIONS
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AND HAS NOT BEEN REVIEWED FOR COMPLIANCE WITH RECORDING REOUIREMENTS FOR PLATS.
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Beverly, Trudy
From: Ben Robinson <[e-mail]>
Sent: Wednesday, May 29, 2019 3:35 PM
To: Brandon Moore
Cc: Beverly, Trudy, Taraban, Ron
Subject: Re: [External] UST-61 for 2727 Palm Avenue in Charlotte
Attachments: P-1931 Gornto Property RP -signed NRP w Figure.pdf
eternal em ' nn nnr gg iink� nr nnnn mg—k-te 11nip« vnu verify. Send allsus►�icious email as an attachment
c.o
Hello Trudy,
please find attached to this e-mail the NRP signed by Ms. Gornto including Figure 1. I will be bringing the hard
copy of this tomorrow morning to be signed. Thank you very much!
Ben Robinson, L.G.
Paragon Environmental Consultants, Inc.
On Wed, May 29, 2019 at 9:26 AM Brandon Moore <para-og n�(anorthstate.net> wrote:
Just in case you want to review this portion — we will forward it again with the map later this afternoon