MO-9485_40926_G_C_20190827_NPR for UST review

CES N C¢ AUG J 2U19
August 27, 2019
Ms. Trudy Beverly
North Carolina Department of Environmental Quality
Division of Waste Management
Underground Storage Tank Section. - MoRO
610 East Center Avenue, Suite 301
Mooresville, North Carolina 28115
RE: NOTICE OF RESIDUAL PETROLEUM
CIRCLE K 2708383
873 OLD CHARLOTTE ROAD SW
CONCORD, CABARRUS COUNTY, NORTH CAROLINA
UST INCIDENT No.: 40926
Dear Ms. Beverly:
On behalf of Circle K Stores, Inc., CES of NC, PLLC is providing the enclosed original of the Notice of
Residual Petroleum executed by the responsible party for the referenced site per your correspondence dated
August 16, 2019. If you have any questions, please contact me at [phone].
Sincerely,
CES of NC, PLLC
Aaron Williamson
Project Manager
Enclosure
CC: Ms. Debrah Carl, Circle K Stores, Inc. — Charlotte, NC (electronic)

NOTICE OF RESIDUAL PETROLEUM
Circle K 2708383, Cabarrus 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 Environment 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 Environment 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 14313-279.11, 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 14313-279.9 and 14313-279.1 1 and has/shall be recorded at the Carbarrus Register
(name of county)
of Deeds' office
Book , Page
Any map or plat required by DEQ has been/shall be recorded at the _Carbarrus Register of
(name ofcount})
Deeds' office Book Page , and has been/shall be incorporated into the Notice by this reference.
Source Property
_Hickory Woods, Inc. of _Concord, North Carolina is the owner in fee
(owner's name) (city & state ofhomeowner)
simple of all or a portion of the Site, which is located in the County of _Cabarrus State of
North Carolina, and is known and legally described as:
Revised February 5, 2019

873 Old Charlotte Road SW
Lying and being in No. 11 Township, Cabarrus County, North Carolina, on the southeast side of the
National Highway, and being Lot Nos. 11,12,13,14, and 15 in Block `A " of Highland Park as shown on a
map made by E.M. Yoder, Surveyor, and recorded in the Office of the Register of Deeds for Cabarrus
County, North Carolina in Plat Book 2, page 13, to which plat reference is made for a more complete and
accurate description of subject property, reserving, however, a right-of-way offive foot in which fronting
on the State Highway for purposes of a sidewalk, and is that property conveyed by S.H. Linker and wife
Flossie Lee Linker to M.L. Early and wife Willene Early by deed dated March 9, 1937, and recorded in
Record of Deeds Book No. 140, page 294.
Additional Affected Property Also Subject to Restrictions
N/A of is the owner in fee simple of a portion of
(owner's Name) (city & state of owner)
the Site, which is located in the County of , State of North Carolina. Petroleum
contamination is located on this property at the time this Notice is approved. This property was also
owned or controlled by the underground storage tank owner or operator or another party responsible for
the petroleum discharge or release at the time the discharge or release was discovered or reported, or at
any time thereafter. This property is known and legally described as:
Not Applicable
Additional Affected Property Not Subject to Restrictions
Additionally, residual petroleum is also located on the following property. The following
property is not subject to land use restrictions pursuant to N.C.G.S. Section 143B-279.9(b). The
following property is known and legally described as:
Not Applicable
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 _Cabarrus County
Revised February 5, 2019

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: The Site shall be used for industrial/commercial use only. Industrial/commercial use means a use
where exposure to soil contamination is limited in time and does not involve exposure to children
or other sensitive populations such as the elderly or sick. The real property shall not be
developed or utilized for residential purposes including but not limited to: primary or secondary
residences (permanent or temporary), schools, daycare centers, nursing homes, playgrounds,
parks, recreation areas and/or picnic areas.
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.
IN WITNESS WHEREOF,A&,Ah C a»/ has caused this Notice to be executed pursuant to
N.C.G.S. Sections 14313-279.9 and 14313-279.11, this ;LZ day of v vS?-,20 /,9.
eiI'G11 A/ SfD/1, /1,.
namee�reof res)ponsible parryy%fagent is signing)
By: "4, / f/
(signature of responsible party, attorney or other agent if there is one)
440; A,"t47ifl AQi44461/
(Title of agent for responsible parry if the)leis one)
Signatory's name typed or printed: 04hA h —�/
Revised February 5, 2019

NORTH CAROLINA
tAccklenbvr COUNTY
(Name of county in iW 'ch 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: No+jce of- 0ey-'AyoJ Petroleum.
Date: 8/-z7/19
U,ature
, IofNotag Public
IMeja
printed or gped name of No ary Public)
Notary Public
My commission expires:
Revised February 5, 2019

Approved for the purposes of N.C.G.S. 143B-279.11
(Signature of Regional Supervisor)
Ronald H. Taraban
Regional Supervisor
Mooresville Regional Office
UST Section Division of Waste Management
Department of Environment Quality
NORTH CAROLINA
PAC L I COUNTY
I certify that the following person personally appeared before me this day, each
Acknowledging to that he signed the foregoing document:
Ronald H . Taraban (full printed name of Regional Supervisor)
Date: `7 2 Lq
(official Seal)
1AN O. B
V1SSMr
MRgS
42
00 U NT..�i►�`'��
Sherian R. Black
Notary Public
Notary Public Number 20041820022
My commission expires:
July 12, 2024