MO-27897_47200_G_NORR_20200824_Notice of Regulatory Requirements

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
MICHAEL SCOTT
Director
Bent Oaks, LLC
Attn: Jared Dullum
6012 Bayfield Pkwy, #312
Concord, NC 28027
Dear Mr. Dullum:
NORTH CAROLINA
Environmental Quality
August 24, 2020
Re: Notice of Regulatory Requirements
15A NCAC 2L .0404 and 2L .0405
Risk -based Assessment and Corrective Action
for Petroleum Underground Storage Tanks
Bent Oaks LLC Property
201 Lowrance Avenue, Kannapolis
Cabarrus County
Incident Number: 47200
Risk Classification: Unknown
The Initial Action Abatement Report received by the Underground Storage Tank (UST)
Section, Division of Waste Management, Mooresville Regional Office on July 9, 2020 has been
reviewed. The Initial Action Abatement Report documents the removal of the home heating oil ust
system from the above referenced property. The pit bottom sample results exceed the applicable
total petroleum hydrocarbons (TPH) limits for gasoline range organics and diesel range organics
established in the July 26, 2016 Guidelines for North Carolina Action Limits for Total Petroleum
Hydrocarbons prior to encountering bedrock in the excavation. No groundwater sample nor receptor
information has been submitted to the UST Section.
North Carolina General Statute (NCGS) 14313-279.9 and 143B-279.11 require a Notice of
Residual Petroleum (Notice) to be filed with the Register of Deeds in Cabarrus County, where the
release is located, when a release from an underground storage tank has not been remediated to
below "unrestricted use standards". The Notice is required either prior to conveyance of a
contaminated property or prior to receiving a Notice of No Further Action. "Unrestricted use
standards" for groundwater are the groundwater quality standards and interim standards contained in
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
704.663.1699

Title 15A NCAC 2L .0202, and "unrestricted use standards" for soil are the residential maximum soil
contaminant concentrations (MSCCs) established in Title 15A NCAC 2L .0411.
The Notice must be prepared in accordance with the attached instructions and format. It must
contain a legal description of the property containing the source of contamination and legal
descriptions of any other properties which you own (or control) which are contaminated by the
release. The Notice must also include appropriate land use restrictions for these properties. In
addition, the Notice must identify all other properties (adjacent, adjoining, downgradient, etc.) on
which contamination is known to exist at the time the Notice is prepared. Provide proof of consent
from the current property owner if you are filing the Notice on their behalf.
The Notice must be sent to this regional office of the UST Section for approval and
notarization. The approved and notarized Notice must then be filed by you with the Register of
Deeds, and a certified copy of the filed Notice must be submitted to this office within 30 days of its
return to you.
Failure to comply with this letter is a violation of North Carolina law and may result in the
assessment of civil penalties and/or the use of other enforcement mechanisms available to the state.
If you have any questions regarding the actions or the rules mentioned in this letter, please contact
me by email at Trudy.Beverlygncdenr.gov or telephone at [phone].
Sincerely,
6 1-/11 ;6w+
Trudy Beverly, L.G.
Hydrogeologist
Mooresville Regional Office
UST Section, Division of Waste Management, NCDEQ
Attachment: Instructions and Form for Notice of Residual Petroleum with Alternate Land
Use Restriction
https://deq.nc.gov/about/divisions/waste-mana)zement/ust/forms
cc: Chrystal Swinger, Cabarrus County Environmental Health (via email)
Mike Downs, Cabarrus County Manager (via email)
Bob Payne, Cedar Rock Environmental (via email)
D F.
North Carolina Department of Environmental Quality I Division of Waste Management
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
704.663.1699

INSTRUCTIONS FOR PREPARING A 'NOTICE OF RESIDUAL PETROLEUM' REFERENCING
ALTERNATE LAND USE RESTRICTIONS (FOR EXISTING RESIDENCES ONLY) FOR FILING
The following is a list of instructions to assist in the preparation and filing of a Notice of Residual
Petroleum
1. The Notice shall be prepared in accordance with the format provided in these instructions and shall
include reference to the appropriate alternate land use restrictions. (REWORDING OF THE NOTICE IS
NOT RECOMMENDED AND WILL SUBSTANTIALLYDELAYAPPROVAL.)
2. The Notice shall include a description that would be sufficient as a description in an instrument of
conveyance of the (i) real property on which the source of contamination is located and (ii) any real
property on which contamination is located at the time the remedial action plan is approved and that was
owned or controlled by any owner or operator of the underground storage tank or other responsible party
at the time the discharge or release of petroleum is discovered or reported or at any time thereafter.
3. The Notice shall also identify the location (legal description) of any residual petroleum on other real
property on which contamination is known to exist at the time the Notice is prepared and that is a result of
the release.
4. The Notice shall reference any restrictions on the current or future use of the real property that are
imposed by the Secretary to protect public health, the environment, or users of the property.
5. (IF REQUIRED BYDEPARTMENT OF ENVIRONMENTAL QUALITY.) If the contamination is
located on more than one parcel or tract of land, the Department may require that the owner, operator, or
other person responsible for the discharge or release prepare a composite map or plat that shows all
parcels or tracts.
If the contamination is located on one parcel or tract of land, the owner, operator, or other person
responsible for the discharge or release may prepare a map or plat that delineates the contamination but is
not required to do so.
When the Department has approved a map or plat, it shall be recorded in the office of the register of
deeds and shall be incorporated into the Notice by reference.
Any map or plat shall be prepared and certified by a professional land surveyor, shall meet the
requirements of G.S. 47-30 and any requirements of the county Register of Deeds, and shall be submitted
to the Department for approval. The plat shall include: (ALL CONTENTS OF THE PLAT MUST BE
DRA WN IN INDELIBLE INK)
a. Property lines, north arrow, scale, bearings and distances as appearing on the deed;
b. With respect to permanently surveyed benchmarks, location and dimensions of areas of the
property where contamination is known to exist in
groundwater at a concentration exceeding the standard or interim standard established in 15A
NCAC 2L .0202 and/or
soil at a concentration exceeding the residential maximum soil contaminant concentration
established in 15A NCAC 2L .0411.
c. The printed name(s) and title(s) and properly notarized signature(s) of individual(s) with authority
to legally bind the responsible party(ies) (i.e., responsible party(ies), an individual with power of
attorney for the responsible party(ies), officer of a corporation, etc.) (PRINTED TEXT,
SIGNATURES, AND NOTAR YSEALS, AS WITH ALL MARKINGS ON THE PLAT, MUST
BE MADE IN INDELIBLE INK);
Revised February 7, 2019

d. The following language: "The areas of contamination depicted upon the map are approximations
derived from the best available information at the time of filing.";
e. The following language, for use by the Department, positioned in the upper left corner of the plat:
"Approved for the purposes of N.C.G.S. 14313-279.9 and 143B-279.11
(signature of Regional Supervisor)
, Regional Supervisor
(printed name of Regional Supervisor)
Regional Office
UST Section
Division of Waste Management
Department of Environment Quality
NORTH CAROLINA
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: (printedfull
name of Regional Supervisor)
Date:
(signature of Notary Public)
(Official Seal)
(printed or typed name of Notary Public)
Notary Public
My commission expires:
f. Surveyor's certification and seal (using a permanent ink stamp).
6. The signed and notarized Notice (with all indicated attachments) shall be sent to the appropriate UST
Section Regional Office.
7. After the Department approves, notarizes and returns the Notice, the responsible party shall, within
thirty (30) days of its return:
a. File approved Notice in the County Register of Deeds' office of the county or counties in which
the site is located; and
b. Send to the appropriate UST Section Regional Office, a certified copy of the Notice affixed with
the seal of the Register of Deeds and reflecting the book(s) and page number(s) where recorded
and a copy of the page(s) in the grantor index where the Notice is referenced.
Revised February 7, 2019
2

NOTICE OF RESIDUAL PETROLEUM
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 14313-279.9 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
Register of Deeds' office Book , Page
(name ofcounty)
Any map or plat required by DEQ has been/shall be recorded at the Register of
(name of county)
Deeds' office Book , Page , and has been/shall be incorporated into the Notice by this reference.
Source Property
of
is the owner in fee
(owner's name) (city & state of homeowner)
simple of all or a portion of the Site, which is located in the County of , State of North
Carolina, and is known and legally described as:
Revised February 7, 2019

(Insert Real Property Description Here for Source Property)
Additional Affected Property Also Subject to Restrictions
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:
(Insert Real Property Description Here for Additional Properties Owned or Controlled by Any Owner or
Operator of the Underground Storage Tank or Other Responsible Party, if 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:
(Insert Legal Description of Other Real Property Affected by Residual Petroleum Not Owned or
Controlled by Any Owner or Operator of the Underground Storage Tank or Other Responsible Party, if
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 County
Register of Deed receives and records the written concurrence of the Secretary (or his/her delegate) of
Revised February 7, 2019
2

DEQ (or its successor in function).
PERPETUAL LAND USE RESTRICTIONS
[Restrictions apply to activities on, over, or under the land. Choose one or more of the following as
appropriate.]
Soil: Alternate]) Soil containing residual petroleum, above applicable regulatory
standard(s), remains on the site at/within/etc. (Description of specific location on
the site of remaining petroleum contaminated soil). No soil shall be excavated or
disturbed, within _ feet of (Description of specific location on the site of remaining
petroleum contaminated soil), except to remediate the soil in accordance with all
applicable state and federal statutes, regulations and guidelines.
Alternate 2) Soil containing residual petroleum above applicable regulatory
standard(s) remains on the site in the area identified in Figure 1, Attachment A
(Refer to extent of contamination as diagrammed in an existing report and attach
copy of that figure(s)). 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 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, has caused this Notice to be executed pursuant to
N.C.G.S. Sections 14313-279.9 and 14313-279.11, this day of , 20_
LM
Signatory's name typed or printed:
(name of responsible party if agent is signing)
(signature of responsible party, attorney or other agent if there is one)
(title of agent for responsible party if there is one)
(Note to be deleted on final document: Preparer of document must assure that the correct
acknowledgement is used and complies with changes effective October 1, 2006)
Choice One: Instrument signed by one person
Revised February 7, 2019

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:
Date:
(Official Seal)
expires:
Choice Two: Acknowledge by attorney in fact
NORTH CAROLINA
COUNTY
(Name of county in which acknowledgment was taken)
(signature of Notary Public)
printed or typed name of Notary Public)
Notary Public
My commission
I, , a Notary Public for said County and State, do hereby certify that
, attorney in fact for , personally appeared before me this day, and being by
me duly sworn, says that he executed the foregoing and annexed instrument for and in behalf of the said
, and that his authority to execute and acknowledge said instrument is contained in an instrument duly
executed, acknowledged, and recorded in the office of in the County of
, State of , on the day of , 20—and
that this instrument was executed under and by virtue of the authority given by said instrument granting
him power of attorney.
I do further certify that the said acknowledged the due execution of the
foregoing and annexed instrument for the purposes therein expressed for and in behalf of the said
WITNESS my hand and official seal, this the day of 120
(Official Seal)
expires:
(signature of Notary Public)
printed or typed name of Notary Public)
Notary Public
My commission
Choice Three: Conveying security interest in personal property of a corporation
NORTH CAROLINA
COUNTY
(Name of county in which acknowledgment was taken)
Revised February 7, 2019
4

a Notary Public for said County and State, do hereby certify that
personally came before me this day and acknowledged that he is
of and acknowledged, on behalf of , the grantor
the due execution of the foregoing instrument.
WITNESS my hand and official seal, this the day of , 20
(Official Seal)
expires:
Approved for the purposes of N.C.G.S. 14313-279.11
(signature of Regional Supervisor)
, Regional Supervisor
(printed name of Regional Supervisor)
Regional Office
(signature of Notary Public)
printed or typed name of Notary Public)
Notary Public
My commission
UST Section
Division of Waste Management
Department of Environment 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)
expires:
(signature of Notary Public)
printed or typed name of Notary Public)
Notary Public
My commission
Revised February 7, 2019
5

Beverly, Trudy
From: Beverly, Trudy
Sent: Monday, August 24, 2020 9:23 AM
To: 'Robert Payne'; 'Chrystal Swinger'; 'Mike Downs'
Subject: Bent Oaks LLC Property - UST Incident #47200 — Notice of Regulatory Requirements
Attachments: MO-27897_47200_G_NORR_20200824_Notice of Regulatory Requirements.pdf
Please see the attached Notice of Regulatory Requirements letter for Bent Oaks LLC Property located at 201 Lowrance
Avenue, Kannapolis, Cabarrus County, North Carolina (UST Incident #47200).
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy. B everlykncdenn gov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Office Mailing Address:
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Branch's Underground Storage Tanks Website Address: ht_pt s://deg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httos://dea.nc. gov/about/divisions/waste-management/waste-management-rules-data/waste-management-ais-mans
File Review Procedures:
hitps://deq.ne. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
bit.ps://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.ne.izov/ncdea[Waste%2OMana2ement/DWM/UST/WhatsNew/Final-Electronic-Document-Submittal-Policv.l)df
https:Hfiles.nc.gov/ncdeq/Waste%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx