MO-9528_40963_G_C_20191121_Draft Notice of Residual Petroleum for UST Review

•
PARAGON
Environmental Consultants, Inc.
NOV 2 5 2019
November 21, 2019
Trudy Beverly
Mooresville Regional Office - NCDEQ
610 East Center Avenue — Suite 301
Mooresville, NC 28115
Reference: Notice of Residual Petroleum
Wagner Residence
1132 Providence Road
Charlotte, Mecklenburg County, North Carolina
Incident # Pending
Dear Ms. Beverly:
Please find enclosed a Notice of Residual Petroleum for the above referenced groundwater
incident. Please review and have the Regional Supervisor sign the attached Notice of
Residual Petroleum and return it to Paragon by mail. Paragon's mailing address is:
Paragon Environmental Consultants, Inc.
P.O. Box 157
Thomasville, NC 27361-0157
We will then file the notice with the Mecklenburg County Register of Deeds.
Please contact our office at [phone] if you have any questions or require any
additional information concerning this notice for the Wagner Residence.
Sincerely,
Benjamin W. Robinson, L.G.
Paragon Environmental Consultants, Inc.
NRPItr-1972
P.O. Box 1 57 - Thomasville, NC 27361-0157
Business Ph: [phone] - Fax: [phone]

NOTICE OF RESIDUAL PETROLEUM
Wagner Residence 1132 Providence Road Charlotte, NC Incident # Pending
Mecklenburg County, North Carolina
Current Property Owners Deed Book # 32960 Page # 78
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
14313-279.9 and 14313-279.11. 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 14313-279.9 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 14313-279.11 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.
Sean C. Wagner 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 6, in Block 1, as shown on map of the J.S.Harris Estate Property recorded in Map
Book 4, at Page 525 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 standards) 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.
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
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, Sean C. Wagner has caused this Notice to be executed pursuant to N.C.G.S.
Sections 14313-279.9 and 14313-279.11, this \'M- day of 2019.
By:
Signatory's name typed or printed: Sean C. Wagner
NORTH CAROLINA
MecAl4uf COUNTY
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: ,Seam C. 0y1ey'
CJ
Date: N01 ember 11, Z1 I
(Official Seal)
9enj min W Robinson
lotary Public
Rowan County
North Carolina
1111�.
si ature of Notary Public)
(�Lv1�Ccvn;v► fit/ �obinso�l
(printed or typed name of Notary Public)
Notary Public
My commission expires r 2023.

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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