22010_Glenwood Square_NORP_20180221

BKO17049PGO2543
WAKE COUNTY, NC 77
CHARLES P. GILLIAM
REGISTER OF DEEDS
PRESENTED 9 RECORDED ON
02/21/2018 15:18:53
BOOK:017049 PAGE:02543 — 02548
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NOTICE OF'RESIDUAL PETROLEUM
Allen's Automotive Wake 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 14313-279.9 and 14313-279.11. 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-2 79.9 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 143B-279.9 and 143B-279.11 and has/shall be recorded at the Wake County Register
of Deeds' office Book , Page (name of county)
Any map or plat required by DEQ has been/shall be recorded at the Wake County Register of
(name of county)
Deeds' office Book , Page , and has been/shall be incorporated into the Notice by this reference.
Source Property
FMW at 701 Hillsborough LLC of Charlotte, NC _ 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 Wake. State of North Carolina, and
is known and legally described as:
Revised January 15, 2013

BKO'I 7049PGO2544
Those certain tracts of land situated, lying and being in the City of Raleigh, Wake
County, North Carolina, containing an aggregate of approximately 18,679 square feet,
and shown as "Parcel 10" and "Parcel 11" on that plat entitled "Recombination of Parcel
10 and 11, Property of: Johnson's Jewelers Inc.," prepared by J. Fred Davis, Jr.,
Professional Land Surveyor, dated July 13, 1987, and recorded in Book of Maps 1987 at
Page 1251 in the Wake County Public Registry.
Additional Affected Prope!1y Also Subject to Restrictions
of is the owner in fee simple of a portion of
(owner's Name) (city & state ofowner
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)
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 Forsyth County
Register of Deed receives and records the written concurrence of the Secretary (or his/her delegate) of
DEQ (or its successor in function).
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:
Revised January 15, 2013
2

BKO17649PGO2545
(Not Applicable)
PERPETUAL LAND USE RESTRICTIONS
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.
Revised January 15, 2013

BKOi 7049PGO2546
IN WITNESS WHEREOF, FMW at 701 Hillsborough LLC has caused this Notice to be
executed pursuant to N.C.G.S. Sections 14313-279.9 and 14313-279.11, this a01 day of Och*r
2017.
�ui-vt �S til r -
(n of r p ibie party if agent is signing)
By:
(signat re f respon0 party, lailorney or other agent if there is one)
(Title of agept for responsible partyif ther i one)
Signatory's name typed or printed: N
NORTH C OLINA
COUNTY
(Name of county in which ac wledgment was taken)
I, , a Notary Public for said County and State, do hereby certify that
_7j� ." 1;aon l personally came before me this day and acknowledged that he is
of � and acknowledged, on behalf of bty l eA W I "bord. j g%jhe grantor
the due exec n of the foregoing instrument. 0 -
WITNESS my hand and official seal, this the 1.747 day of _� _ , 20 j7.
expires: CF- 24 ,Z DV)
(signature of ry P: lic)
printed or typed n me of Notary Public)
Notary Public
My commission
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4 Revised January 15, 2013

1017049PG02547
Approved for the purposes of N.C.G.S. 143B-279.11
(signature oQegional Supervisor)
R P.OL✓6 Q , Regional Supervisor
(printed name of Regional Supervisor)
Rif GC/K//Regional Office
UST Section
Division of Waste Management
Department of Environment Quality
NOR H 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: (, 1l printed name of Regional Supervisor)
Date: to �-
(Official Sea]) % AN �8��/,�
Norg9� 92
expires:
(si atame of Notary Public) zz
C, h
(printed ®rtypeame of Notary Pu tc)
Notary Public
My commission
Revised January 15, 2013

BK017049PG02548
B00K:817849 PAGE:e2543 - 82548
MM"M
o0MO�M=011W.,
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WAKE
COUNTY
NORTH CAROLINA
Please retain yellow trailer page
It is part of the recorded document and must be submitted with the original for re-
recording.
Charles P. Gilliam
Register of Deeds
Wake County Justice Center
300 South Salisbury Street, Suite 1700
Raleigh, NC 27601
❑ New Time Stamp
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This Customer Group
# of Excessive Entities
# of Time Stamps Needed
❑ $25 Non -Standard Fee
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This Document
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F15 J9