MO-28176_47436_C_NRP_20200916_Filed Notice of Residual Petroleum

For Registration
Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2020 Sep 16 09:00 AM RE Excise Tax: $ 0.00
Book: 35057 Page: 928 - 933 Fee: $ 26.00
Instrument Number: 2020149231
3MLS ".
NOTICE OF RESIDUAL PETROLEUM
Ryan Kozusko Property Mecklenburg_ 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 Environmental 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 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 143B-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
Mecklenburg_ Register of Deeds' office Book , Page
(name of county)
Any map or plat required by DEQ has been/shall be recorded at the Mecklenburg Register of
(name of county)
Deeds' office Book , Page , and has been/shall be incorporated into the Notice by this reference.
Source Property
David Ryan Kozusko of Charlotte, North Carolina
(Owner's name) (city & state of homeowner)
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:
See Attachment A (excerpted from Mecklenburg County Register of Deeds Book
32866, Page 365).
Revised January 15, 2013
Page 1 of 4
submitted electronically by "Cedar Rock Environmental, P.C."
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register of Deeds.

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 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: Soil containing residual petroleum above applicable regulatory standards) remains on the site in
the area identified in Figure 1, Attachment B. No soil shall be excavated or disturbed within 3
feet of the area identified in Figure 1 Attachment B 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.
Revised January 15, 2013
Page 2 of 4

IN WITNESS WHEREOF, David Ryan Kozusko has caused this Notice to be executed
pursuant to N.C.G.S. Sections 14313-279.9 and 14313-279.11, this 15" day of September , 2020.
David Rvan Kozusko
(nam responsible party if agent is signing)
By:
(signature of responsible party, atto ey or other agent if there is one)
President, Cedar Rock Environmental, P. C.
(Title of agent for responsible party if there is one)
Signatory's name typed or printed: Robert A. Payne
NORTH CAROLINA
Al,,m&na- COUNTY
(Name of county in which 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: Robert A. Payne
Date: �e 124?,IA L&e 15: ZO20
(Official Seal)
JOSIAH D PAYNE
NOTARY PUBLIC
ALAMANCE COUNTY, N.C.
My Commission Expires 10-22-2020.
rgnature of Notary Publi
printed or typed name of Notary Public)
Notary Public
My commission expires:. zz_, zo e,:, .
Revised January 15, 2013
Page 3 of 4

Approved for the purposes of N.C.G.S. 14313-279.11
(signature of Regional Supervisor)
Mark R. Powers , Regional Supervisor
(printed name of Regional Supervisor)
Raleigh_ Regional Office
UST Section
Division of Waste Management
Department of Environment Quality
NORTH CAROLINA
I J&Le. 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: IUlack /2, i�o wors (fullprinted name of Regional Supervisor)
Date: .jar. (S 7F�2p
(Official Seal) (signature of Notary Public)
JOSIAH D PAYNE ) 'i &k �P` (tea'' 6-'-
NOTARY PUBLIC (printed or typed name of Notary ublic)
ALAMANCE COUNTY, N.C. Notary Public
My Commission Expires 10-22-2020.
My commission expires: Oa. z-z, K,
Revised January 15, 2013
Page 4 of 4

ATTACHMENT A
BEING known and designated as all of Lot 8 in Block 4 of that subdivision known as LAKE FOREST as shown
on a map thereof recorded in the Mecklenburg County Public Registry in Map Book 12 at Page 405;
reference to which is hereby made for a more particular description.
Property Address: 7527 Glencannon Drive, Charlotte, NC 28227
Parcel No. 10913304

ATTACHMENT B
Tina Stewart I Thomas Teal Jose Vega
Property Property Property
i
i
i
Habtemichale Bairu '
Property
Glencannon Drive
4
N
NOTE:
This map may not be a certified survey
and has not been reviewed by a local
government agency for compliance with
any applicable land development regulations
and has not been reviewed for compliance
with recording requirements for plats.
' Michelle Floyd
Property
0 20 40 80
1 Inch = 40 Feet ----
RESTRICTED AREA (estimated
extent of soil contamination
exceeding applicable cleanup standards.)
Property Lines
T1 = 270-Gallon UST
PROJECT: Ryan Kozusko Proper CEDAR ROCK
INCIDENT # Pending ENVIRONMENTAL, P.C. I G U R E 1
LOCATION: 7527 Glencannon Drive
Charlotte, Mecklenburg Co. FILENAME: _ 3022NoRP.fc7
CRE PROJECT NUMBER: 302222590 VERSION DATE: 9/10/2020

Beverly, Trudy
From: [e-mail]
Sent: Monday, December 21, 2020 11:14 AM
To: Beverly, Trudy
Subject: [External] Conditional NFA letters
Attachments: 3022-nrp.pdf; 3040-nrp.pdf
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Hi Trudy
Just cleaning up for end of year and I am wondering if the conditional NFA letters are available for these two sites:
Ryan Kozusko Property, 7527 Glencannon Drive, Charlotte
Tim Cool Property, 4411 Bellwood Lane, Charlotte
I've attached copies of the filed NRPs in case you did not receive them as yet. When the conditional NFA letters are
available please forward copies to myself and Bob Payne.
Thanks
Damien Callaghan
Cedar Rock Environmental