MO-7075_00_CA_O_20010913_AffidavitWithReply

North Carolina Department of Environment
and Natural Resources
Division of Waste Management
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Dexter R. Matthews, Interim Director
Mr. Ed Hatley
2001 Kiser Road
Concord, North Carolina 28025
Dear Mr. Halley:
NCDENR
September 13, 2001
RE: Underground Storage Tank
Hatley's Tire Store
2140 Old Salisbury -Concord Road
Concord, Cabarrus County
The Division of Waste Management (DWM) received the response to the July 31, 2001 affidavit on
September 4, 2001. Your response indicated that your father, now deceased, was the only owner and
operator of the on site underground storage tank (UST). Since there is no other party responsible for
ownership of this UST, this site has been referred to the state lead program. You will be notified if this site is
accepted to the program.
If you have any questions, please contact me at the letterhead address or at [phone] ext. 248.
Sincerely,
Am er indon
Hydrogeological Technician II
919 North Main Street, Mooresville, North Carolina 28115
Phone: [phone] \ FAX: [phone] \ Internet: http://ust.enr.sEate.nc.us/
AN EQUAL OPPORTUNITY \ AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED / 10% POST CONSUMER PAPER

North Carolina Department of Environment
and Natural Resources
Division of Waste Management
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Dexter R. Matthews, Interim Director
COPY
NCDENR
CERTIFIED MAIL CM # 7000 1670 0001 5513 0088
RETURN RECEIPT REQUEST
Mr. Ed Hatley
2001 Kiser Road
Concord, North Carolina 28025
Subject: Underground Storage Tank
Halley's Tire Store
2140 Old Salisbury -Concord Road
Cabarrus County, North Carolina
Dear Mr. Hatley:
July 31, 2001
In order to help the Division of Waste Management (DWM) determine if an underground storage tank (UST) is
present, please answer the following questions on the attached affidavit. Please be as specific as possible and attach any
additional information necessary to substantiate your responses.
1. When and from whom did you purchase the property?
2. What were the past uses of the property?
3. When was the UST installed and who installed it?
4. Did you ever use the UST?
5. When was the UST last used?
6. What product was stored in the UST and what was the use of the UST?
7. Was the UST properly closed (removed or filled with an inert substance) and if so, when?
8. Include any other information that you think is relevant regarding the UST.
Please provide a current phone number and mailing address for each individual that is mentioned in your
affidavit. Please submit the attached affidavit within 30 days of receipt of this letter. The information you provide will
be used to determine the status of the UST.
Should you have any questions, please call me at [phone], ext. 248.
Sincerely,
Amber R. Lindon
Hydrogeological Technician II
Enclosure
919 North Main Street, Mooresville, North Carolina 28115
Phone: [phone] \ FAX: [phone] \ Internet: http://ust.em.sLate.nc.us/
AN EQUAL OPPORTUNITY \ AFFIRMATIVE ACTION EMPLOYER — 50% RECYCLED / 10% POST CONSUMER PAPER

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1. Article Addressed to:
MR ED HATLEY
2001 KISER ROAD
CONCORD NC 28025
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Division of Waste Management
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Dexter R. Matthews, Interim Director
North Carolina Department of Environment <1014
and Natural Resources
NCDENR
July 31, 2001
CERTIFIED MAIL CM # 7000 1670 00015513 0088
RETURN RECEIPT REQUEST
Mr. Ed Harley R IF (7!E: N! P D
2001 Kiser Road
Concord, North Carolina 28025 3EP 0 4 2001
Subject: Underground Storage Tank AN DEFT.OF L RESom(_,n„
AND NATURAL RESOL'S:.ii''^
Harley's Tire Store MOORESVILLEREGIONALOi:FiCE
2140 Old Salisbury -Concord Road
Cabarrus County, North Carolina
Dear Mr. Hatley:
In order to help the Division of Waste Management (DWM) determine if an underground storage tank (UST) is
present, please answer the following questions on the attached affidavit. Please be as specific as possible and attach any
additional information necessary to substantiate your responses.
I. When and from whom did you purchase the property?
2. What were the past uses of the property?
3. When was the UST installed and who installed it?
4. Did you ever use the UST?
5. When was the UST last used?
6. What product was stored in the UST and what was the use of the UST?
7. Was the UST properly closed (removed or filled with an inert substance) and if so, when?
8. Include any other information that you think is relevant regarding the UST.
Please provide a current phone number and mailing address for each individual that is mentioned in your
affidavit. Please submit the attached affidavit within 30 days of receipt of this letter. The information you provide will
be used to determine the status of the UST.
Should you have any questions, please call me at [phone], ext. 248.
Enclosure
Sincerely,
Amber R. Lindon
Hydrogeological Technician II
919 North Main Street, Mooresville, North Carolina 28115
Phone:[phone] \ FAX: [phone] \ Internet: http://ust.enr.state.nc.us/
AN EQUAL OPPORTUNITY \ AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED / 10% POST CONSUMER PAPER

Page Three
3. Attached to this affidavit are
support hereof (attach copies
records, tax records, business
RECEIN/r- D
SEP 0 4 2001
NC DEPT. OF ENWONNENT
AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
copies of any documents in
of any documents such as tank
licenses, sales receipts, etc.)
4. I understand that submission of a false statement,
representation, or documentation to the North Carolina
Department of Environment and Natural Resources under Article
21 of Chapter 143 of the General Statutes, or under any rules
adopted shall be guilty of a misdemeanor; punished by a fine
not to exceed ten thousand ($10,000), or by imprisonment not
to exceed six months or both.
Signat re
This F031 day of QAh+Sua�. 200
Before me personally appeared S C�u1o�?, C . aXOA\tv, to me
well known and known to me to be the person described 'n and
who executed the foregoing instrument, and acknowledge to and
before me that Cc\— C _c� ���, executed said
instrument for the purposes therein expressed.
W TNESS my hand and official seal, this ;2)N day of
A.D., 2C)6
Notary Public J ,� �'• a tiffs'.
o z •y
c: �•� O i
My Commission expires .Fz�'�• n ay X
f
STATE OF �L yp'•*ar•p~
COUNTY OF

LFFrnnv7T
In the matter of:
Facility Name: Hatley's Tire Store
Facility Address: 2140 Old Salisbury -Concord Road
Concord, North Carolina
being duly sworn says:
(name)
1. That he is a citizen and resident of aKI Q,�, R&
(address)
2. That in reference to property/facility located at
�I40 n4.R_ SAA�t, I offer the following responses) to questions
in the attached letter:
(.
F.1