MO-28415_47669_CA_WSW_20210119_Well abandonment Records

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION #3584-A
1. WELL CONTRACTOR:
M. Zavislak
Well Contractor (Individual) Name
SUMMIT ELT, PC
Well Contractor Company Name
STREET ADDRESS 3575 Centre Circle
Fort Mill SC 29715
City or Town State Zip Code
7( 04 )- 504-1717
Area code - Phone number
2. WELL INFORMATION: '
SITE WELL ID # (if applicable)
STATE WELL PERMIT # (if applicable) _
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use): ❑ Monitoring Z Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery ❑ Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
coUNTY Mecklenburc QUADRANGLE NAME
NEAREST TOWN: Charlotte
9920 Mallard Glen Dr, Charlotte, NC
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
Z Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
(Check appropriate setting)
LATITUDE 35° 19'49.93"N May be in degrees'
minutes, seconds, or in a
LONGITUDE-80°43'56.82"W decimal format
Latitude/longitude source: Z GPS ❑ Topographic Wrap
(Location of well must be shown on a USGS topo map and
attached to this form if not using GPS.)
4a. FACHITY- The name of the business where the well is located. Complete 4a and4b.
(If a residential well, slop 4a; complete 4b, well owner information only.)
FACILITY ID #(if applicable)
NAME OF FACILITY
STREET ADDRESS
City or Town State Zip Code
4b. CONTACT PERSON/WELL OWNER:
NAME York Acquisitions _
STREET ADDRESS 8008 Corporate Center Drive, CLT
5. WELL DETAILS:
a. Total Depth: unknown ft. Diameter: 2.5 in.
b. Water Level (Below Measuring Point): unk ft.
Measuring point is 0 ft, above land surface.
6. CASING: Length Diameter
a. Casing Depth (if known): ft. in.
b. Casing Removed: ft. in.
7. DISINFECTION: 1 /4 tablet
(Amount of 650/o-75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement lb.
Water gal. Water gal.
Be t u' e
Bentonite lb.
Type: ❑ Slurry ❑Pellets
Water gal.
Other
Type material cement/sand
Amount 0.3 cubic yard
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
concrete truck
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials used.
11. DATE WELL ABANDONED 1 /14/21
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN>QWMED 10ZliF WELL OWNER
1 /19/2021
NA RTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual who personally abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
Michael Zavislak
PRINTED NAME OF PERSON ABANDONING THE WELL
Submit a copy to the owner and the original to the Division of Water Quality within 30 days. Form GW -30
Attn: Information Management, 1617 Mail Service Center— Raleigh, NC 27699-1617, Phone No. [phone] ext 568. Rev. 5/06

PermitToConductRepairOrAbandon
1 Page 1 of 1
Mecklenburg County Health department
Groundwater &Wastewater Services
3205 Freedom Dr., Suite 6000
Charlotte, NC 28208
Phone: [phone]Fax:
U7.�
[phone]
PERMIT TO CONDUCT MAJOR REPAIR AND10R ABANDON A WATER SUPPLY WF1 I
Permit#: 10011580 File #: 10742B
Property Owner: KEVIN EVANS
Job Location Address:9920 MALLARD GLEN DR
City/ETJ,CHARLOTTE State: NC
Permit Issuance Date: 9/15/2020
Use of Well: NIA
Type of Facility Served by Well: House
Project Type: Abandonment
Area of Regulated Groundwater Usage Review: YES
ions of
Tax Parcel #: 029-031-12
Zip Code: 28262
. The Water Supply Well repair or abandonment must meet all requirements set forth in the
Mecklenburg County Groundwater Well Regulations and any other applicable rules and laws.
. A North Carolina Certified Well Contractor must perform the well construction activities.
• Repair of any Water Supply Well with the well head terminating below ground surface (buried seal)
shall include extending the well casing at least twelve inches above the surface.
. This Permit shall be VALID for a period not to exceed 12 months from the date of issuance.
Specific Conditions of This Permit (Check all that apply):
❑ Grout must be placed the full extent of the casing.
0 Initial water sample to taken and analyzed for (check all that apply):
0 Volatile Organic Compounds (VCC's) ❑ Semi -volatile Compounds Metals (Spe6lt in Other Conditions)
11 Pesticides 11 Herbicides Other (See Below)
Other Conditions of This Permit:
Weli shall remain sealed and protected from damage during any debris removal, grading and i
construction work. Well area shall be fenced off with orange fencing if demolition and grading activities
occur prior to well abandonment.
\:-Y &Va"It74, 2teH:3
Authorized Agent: Print Name
Signature:
Michel Zavislak (SUMMIT)
Owner/Legal Agent: Print Name
Signature: �
http://hmc-ms-zone 1 /wasps/P ermitToConductRepairOrAbandon. aspx?appid= l 15 8 0&useri.,.. 9/ 15/2020

9920 Mallard Glen Drive, Charlotte, NC
Mecklenburg County Parcel: 02903112
2-inch well, unknown depth

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3584-A
1. WELL CONTRACTOR:
M. Zavislak
Well Contractor (Individual) Name
SUMMIT ELT, PC
Well Contractor Company Name
STREET ADDRESS 3575 Centre Circle
Fort Mill SC 29715
City or Town State Zip Code
7( 04 ) - 504-1717
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable)
STATE WELL PERMIT # (if applicable)
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use): ❑ Monitoring Z Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery ❑ Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY MecklenburS QUADRANGLE NAME
NEAREST TOWN: Charlotte
9920 Mallard Glen Dr, Charlotte, NC
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
® Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other_
(Check appropriate setting)
LATITUDE 35° 19'49.93"N May be in degrees,
minutes, seconds, or in a
LONGITUDE -80043'56.82"W decimal format
Latitude/longitude source: Z GPS ❑ Topographic map
(Location of well must be shown on a USGS topo map and
attached to this form if not using GPS.)
4a. FACILITY- The name of the business where the well is located Complete 4a and4b.
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACII.ITY ID #(if applicable)
NAME OF FACILITY
STREET ADDRESS
City or Town State Zip Code
4b. CONTACT PERSON/WELL OWNER:
NAME York Acquisitions
STREET ADDRESS 8008 Corporate Center Drive, CLT
5. WELL DETAILS:
a Total Depth: 170 ft. Diameter: 6 in.
b. Water Level (Below Measuring Point): 60 ft.
Measuring point is 0 ft. above land surface.
6. CASING: Length Diameter
a Casing Depth (if known): ft. in.
b. Casing Removed: ft. in.
7. DISINFECTION: 1/2 tablet
(Amount of 65%/ 75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement _ lb.
Water gal. Water gal.
Bentonite
Bentonite lb.
Type: ❑ Slurry ❑Pellets
Water gal.
Other
Type material cement/sand
Amount 1 cubic yard
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
concrete truck
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials used.
11. DATE WELL ABANDONED 1 /14/21
1 DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN PRO ED TO L OWNER.
1 /19/2021
OF RTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual who personally abandons his/her residential we] I
in accordance with I M NCAC 2C .0113.)
Michael Zavislak
PRINTED NAME OF PERSON ABANDONING THE WELL
Submit a copy to the owner and the original to the Division of Water Quality within 30 days. Form GW -30
Attn: Information Management, 1617 Mail Service Center — Raleigh, NC 27699-1617, Phone No. [phone] ext 568. Rev. 5/06

PerniitToConductRepairOrAbandon Page I of i
Mecklenburg County Health Department
-Wig;;-.,
Groundwater & Wastewater Services'
3205 Freedom Dr- Suite 8000
Charlotte, NC 28208
Phone: [phone]
Kyy1111-'''h;t�Rrt�;�;
Fax: [phone]
PERMIT TO CONDUCT MAJOR REPAIR AND/OR ABANDON A WATER SUPPLY WELL
Permit#: 10011859 File #: 10742b
Property Owner: KEVIN EVANS
Job Location Address:9920 MALLARD GLEN DR
City/ETJ:CHARLOTTE State: NC
Permit Issuance Date: 1/14/2021
Use of Well: N/A
Type of Facility Served by Well: House
Project Type: Abandonment
Area of Regulated Groundwater Usage Review: YES
rmit:
Tax Parcel #: 029-031-12
Zip Code: 28262
• The Water Supply Well repair or abandonment must meet all requirements set forth in the
Mecklenburg County Groundwater Well Regulations and any other applicable rules and laws.
• A North Carolina Certified Well Contractor must perform the well construction activities.
• Repair of any Water Supply Well with the well head terminating below ground surface (buried seal)
shall include extending the well casing at least twelve inches above the surface.
. This Permit shall be VALID for a period not to exceed 12 months from the date of issuance.
Specific Conditions of This Permit (Check all that apply):
Grout must be placed the full extent of the casing.
® Initial water sample to taken and analyzed for (check all that apply):
® Volatile Organic Compounds (VOC's) ® Semi -volatile Compounds ® Metals (Specify in Other Conditions)
® Pesticides ® Herbicides Other (See Below)
Other Conditions of This Permit:
None
Authorized Agent: Pont Name
V? 1�& , ky�m
StAt
Owner/Legal Agent: Print Name
Signature:
http://hme-ms-zone 1 /wasps/PermitToConductRepairOrAbandon.aspx?appid=I 1859&useri... 1 / 14/2021

6-inch well, 170 feet deep, 60 feet to water

D:\!Michael!\!SUMMIT!\5778 - Aspen Heights Partners\5778.E0776 - 9920 Mallard Glen Drive\well map.doc

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3584-A
1. WELL CONTRACTOR:
M. Zavislak
Well Contractor (Individual) Name
SUMMIT ELT, PC
Well Contractor Company Name
STREET ADDRESS 3575 Centre Circle
Fort Mill SC 29715
City or Town State Zip Code
7( 04 )- 504-1717
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable)
STATE WELL PERMIT # (if applicable)
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERNHT # (if applicable) __
WELL USE (Check applicable use): ❑ Monitoring © Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery ❑ Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY Mecklen burs QUADRANGLE NAME
NEAREST TOWN: Charlotte
9920 Mallard Glen Dr, Charlotte, NC
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
® Slope []Valley [:]Flat ❑ Ridge ❑ Other
(Check appropriate setting)
LATITUDE 35° 19'49.70"N May be in degrees,
minutes, seconds, or in a
LONGITUDE -80°43'38.56"W decimal format
Latitudetlongitude source: ®GPS ❑ Topographic map
(Location of well must be shown on a USGS topo map and
attached to this form if not using GPS.)
4a. FACILITY- The name of the business where the well is located Complete 4a and4b.
(If a residential well, slip 4a, complete 4b, well owner information only.)
FACILITY ID #(if applicable)
NAME OF FACILITY
STREET ADDRESS
City or Town State Zip Code
4b. CONTACT PERSON/WELL OWNER:
NAME York Acquisitions
STREET ADDRESS 8008 Corporate Center Drive, CLT
6. WELL DETAILS:
a. Total Depth: 12 ft. Diameter: 2 in.
b. Water Level (Below Measuring Point): 11 ft.
Measuring point is 0 ft. above land surface.
6. CASING: Length Diameter
a Casing Depth (if known): ft. in.
b. Casing Removed: ft. in.
7. DISINFECTION: 1/16 tablet
(Amount of 650/,75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement _ lb. Cement lb.
Water gal. Water gal.
Bentorrite
Bentonite lb,
Type: ❑ Slurry []Pellets
Water gal.
Other
Type material cement/sand
Amount 0.1 cubic yard
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
pour
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials used.
11. DATE WELL ABANDONED 1 /14/21
1 DO IIERSBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WrM 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN ED TO THE WELL OWNER
1 /19/2021
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual who 2mQu llv abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
Michael Zavislak
PRINTED NAME OF PERSON ABANDONING THE WELL
Submit a copy to the owner and the original to the Division of Water Quality within 30 days. Form GW -30
Attn: Information Management,1617 Mail Service Center —Raleigh, NC 27699-1617, Phone No. [phone] ext 568. Rev. 5/06

Mecklenburg County Health Department
Groundwater & Wastewater Services �Ng°R° c
700 N. Tryon St., Suite 211 °
Charlotte, NC 28202 0� z Permit Issuance Date:
Phone: [phone]
Fax: [phone] �2 JAI ¢ Permit Number:
http://groundwater.charmeck.org
Tti CARD .z
SUBSURFACE INVESTIGATION PERMIT
I. Well Owner Information
Name: York Acquisitions
Attn: Stefan Gassner
Phone #: [phone]
Address 1: 8008 Corporate Center Drive
Address 2:
City: Charlotte State: NC
Agent Information (if applicable)
Name
Attn:
Phone #:
Address 1:
Address 2:
City:
Site Information
Site Name; 1601 Sir Anthony Drive
Parcel ID Number: 02903125
Address:
City:
State:
Zip: 28226
Zip:
State: NC Zip:
Owner
1 /11 /2021
70002816
General Conditions of This Permit:
• This permit shall be VALID fora period not to exceed twelve (12) months from the date of issuance.
• This permit is VALID for the site specified above and must be on -site during the course of the investigation
and made available to a Department representative upon request.
• A North Carolina Certified Well Contrator must perform any well contractor activities associated with this
permit.
• All wells shall be constructed and abandoned to the standards of Chapter VI, Section V and Section VI
of the Mecklenburg County Groundwater Well Regulations.
• All temporary wells, including those installed using Direct Push Technology, must be abandoned
to the standards of Chapter VI, Section VI of the Mecklenburg County Groundwater Well Regulations.
• Registration information for all wells must be submitted to the Department within thirty (30) days of well
completion. If water samples are collected, it is recommended that the well NOT be registered until the
analytical results are received.
SIP Form — revised 2/15/11

2-inch monitoring well, 12 feet deep, 11 feet to water
a

- - T
Figure 1
1601 Sir Anthony Drive
Charlotte, NC
SUMMIT ELT, PC
AL Project: 5778.EO776
SUMMIT
D:\!Michael!\!SUMMIT!\5778 - Aspen Heights Partners\5778.E0776 - 9920 Mallard Glen Drive\well map - sir anthony drive.doc

Beverly, Trudy
From: Beverly, Trudy
Sent: Wednesday, June 23, 2021 1:51 PM
To: Patrick Lowery
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Great. Thank you for the info.
Trudy
D
ny iraa
rm�ene � om�R
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: hgps:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httns://deu.nc. gov/about/divisions/waste-management/waste-management-rules-data/waste-management-gis-mans
File Review Procedures:
ht_pt s://deq.nc.gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
htt2s://deg.nc.gov/about/divisions/waste-mana2ement/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httys:Hfiles.nc.eov/nedea/Waste%2OMana2ement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policy.odf
https:Hfiles.nc.gov/ncdeg/Waste%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Patrick Lowery [mailto:[e-mail]]
Sent: Wednesday, June 23, 2021 1:39 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
Attached are well abandonment records for the 9920 Mallard Glen Dr property. I spoke to our engineer and well driller
for some context.
The well abandonment was applied for in September 2020. The UST removal was completed in December 2020. 1 was
on -site for the removal and the home and well house was being demolished. Apparently the well abandonment
happened the following month because the rain made site access for the concrete trucks impossible. When they
abandoned the existing 170' 6-inch well, SUMMIT and the county identified a 2-inch unknown well. They abandoned
that as -well
A 3 d well located on a different parcel is included in the paperwork. That was a monitoring well that was abandoned
and not related to the Evans property.

An email for Beth Evans is included below:
Beth Evans [e-mail]
Thanks
Patrick
1A W
SUMMI
4itpVK
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston
From: Beverly, Trudy <[e-mail]>
Sent: Wednesday, June 23, 2021 1:18 PM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Do you have an email address for Kevin Evans?
Thanks,
Trudy
From: Patrick Lowery [mailto:[e-mail]]
Sent: Wednesday, June 23, 2021 11:54 AM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Yes,
Let me get that from our engineer that abandoned the wells. I know the county was present for abandonment.
Thanks
Patrick
From: Beverly, Trudy <[e-mail]>
Sent: Wednesday, June 23, 2021 11:47 AM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Hey Patrick,
The IAAR states that "One water supply well and one 500-gallon heating oil UST was observed in the October 2019 site
reconnaissance. The water supply well was out of service and the home appeared vacant. The water well was
ra

subsequently abandoned prior to UST closure in preparation for future site development." I didn't see the water supply
well abandonment paperwork in the report. Please email me a copy.
Thanks,
Trudy
D- E
RM f H QV"
#+fir
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 everlygncdenn 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: hops://deg.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: h_ptt s://deg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httDs://dea.nc. eov/about/divisions/waste-manaeement/waste-manaeement-rules-data/waste-manaeement-eis-mans
File Review Procedures:
hops://deg.nc. gov/about/divisions/waste-manaaement/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
https://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.nc.¢ov/ncdeq/Waste%2OManaizement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.pdf
https:Hfiles.nc. gov/ncdeq/Waste%2OManagement/D WM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Beverly, Trudy
Sent: Thursday, June 17, 2021 11:19 AM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Hey Patrick,
I will try to have the report reviewed by the end of next week and get back with you.
Have a great day,
Trudy
-, - -A Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
`V UST Section, Mooresville Regional Office
rsnene �� o�ry
704.235.2182 (Office)
Trudy. B everlykncdenr. 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: hops://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.nc.gov/about/divisions/waste-mana2ement/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httDs://dea.nc. eov/about/divisions/waste-manaeement/waste-manaeement-rules-data/waste-manaeement-eis-mans
File Review Procedures:
hops://deg.nc. gov/about/divisions/waste-manaaement/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
https://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
https:Hfiles.nc.eov/ncdeq/Waste%2OManatiement/DWM/USTfWhatsNew/Final-Electronic-Document-Submittal-Policv.pdf
hns:Hfiles.nc. gov/ncdeq/Waste%2OManagement/DWM/UST/Corrective%2OAction/UST%2Ofile%20names%20for%2OLaserfiche.docx

From: Patrick Lowery [mailto:[e-mail]]
Sent: Thursday, June 17, 2021 11:14 AM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Trudy,
Have you had a chance to review this IAA. If you have any questions, I am available by phone today and tomorrow at
803-230-5087.
Thanks!
Patrick
From: Patrick Lowery
Sent: Tuesday, June 8, 2021 9:03 AM
To: 'Beverly, Trudy' <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Thank you! I know you have tons to review and don't care to bug you unless explicitly asked by the client. Appreciate
the help.
Thank you,
Patrick
From: Beverly, Trudy <[e-mail]>
Sent: Tuesday, June 8, 2021 6:37 AM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Hey Patrick,
I'll get back with you by the end of the week.
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
brw --' �d �cd ' UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy.Beverlya,ncdenr.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: hitps://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.nc.gov/about/divisions/waste-management/ust/ast-proeram
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httDs:Hdeu.ne. aov/about/divisions/waste-manaeement/waste-manaeement-rules-data/waste-manaaement-eis-mans
File Review Procedures:
https:Hdcq.nc. gov/about/divisions/waste-manaaement/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
httns://deo.nc. aov/about/divisions/waste-manaeement/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
https:Hfiles.nc.gov/ncdeg[Waste*/`20Manatiement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.pdf
https:Hfiles.nc.gov/ncdeq/Waste%20Management/DWM/UST/Corrective%2OAction/UST%20filc%20nwnes%20for%2OLaserfiche.docx
From: Patrick Lowery [mailto:[e-mail]]
Sent: Monday, June 7, 20214:37 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Trudy,
Hope you are well. I wanted to check in on this IAA and closure request for the Evans Property (incident #47669). Our
client asked that I reach out for an update.
Thank you very much,
Patrick
SUMMIT
L9'i�LLEiF1Q-L'Nil6'UY to V.Wr'hS.M
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston
From: Beverly, Trudy <[e-mail]>
Sent: Monday, May 10, 2021 3:57 PM
To: Patrick Lowery <[e-mail]>
Cc: Michael Zavislak <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Received. Thanks Patrick.
Trudy
Q —,%N Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
North Carolina Department of Environmental Quality
UepirlmeWO Lmrmment3� UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy.Beverlykncdenr. 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: https://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: hitps:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
httns://deo.nc. eov/about/divisions/waste-management/waste-management-rules-data/waste-management-eis-mans
File Review Procedures:
https://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
htt2s://deg.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
httys:Hfiles.nc.eov/nedea/Waste%2OMana2ement/DWM/UST/W hatsNew/Final-Electronic-Document-Submittal-Policv.l)df
https:Hfiles.nc. gov/ncdeq/Waste%2OManagement/D WMiUST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Patrick Lowery [mailto:[e-mail]]
Sent: Monday, May 10, 2021 2:52 PM
To: Beverly, Trudy <[e-mail]>
Cc: Michael Zavislak <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Ms. Beverly,
Attached is the IAA and Closure request for the 9920 Mallard Glen Dr. incident (Evans Property). As discussed over the
phone, please provide any comments you may have as we continue to streamline our reporting for DEQ. I appreciate
your assistance on this project.
Thank you,
Patrick
11A&
summ!WA.UK.
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston
From: Beverly, Trudy <[e-mail]>
Sent: Monday, April 5, 2021 3:43 PM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Hey Patrick,
Incident #47669
Updated guidance documents were put on the UST website 1/19/2021. Report templates can be found at the following
link

Comprehesive Guidelines Appendices or STIRA, Assessment Guidelines and Corrective Action
Guidelines (appendices)
https://deg.nc.gov/about/divisions/waste-management/ust/guidance-documents
(starts on page 25 of 211) Appendix A 8. Initial Abatement Action (Site Check, UST Closure with UST-2
Form, Excavation, Post -Excavation Soil Contamination Assessment) Report
Trudy
Trudy Beverly, L.G.
Hydrogeologist, Division of Waste Management
rc���DEQ North Carolina Department of Environmental Quality
UST Section, Mooresville Regional Office
704.235.2182 (Office)
Trudy.l3everly(a. ncdenr. 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: hops://deq.nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: h_ptt s:Hdeg.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https://deq.nc.eov/about divisions/waste-man a,gement/waste-management-rules-data waste-manap_ement_eis-mates
File Review Procedures:
hops://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
hitps://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.nc.¢ov/ncdeci/Waste%2OManaizement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policv.adf
https:Hfiles.nc. gov/ncdeq/Waste%2OManagement/DWM[UST/Corrective%2OAction/UST%2Ofilc%20names%20for%2OLaserfiche.docx
From: Patrick Lowery [mailto:[e-mail]]
Sent: Monday, April 5, 2021 2:14 PM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Trudy,
Good afternoon. We submitted the attached release notification last May for the heating oil tank at 9920 Mallard Glen
Drive. I cant seem to locate a incident # for this release on laserfiche or DWM GIS. Not sure this one got logged in as I
initially sent this over to Dan.
Either way, our client finely moved forward with closure earlier this year and we need to submit the documentation for
closure. Soil was excavated and we were able to get clean margins on all 4 sidewalls and base. Looking at the updated
Corrective Action report formats, it looks like the Initial Abatement Action report is no longer presented. Would we be
going the format for Soil Cleanup with Closure Request (#12)? Since this appears new I wanted to reach out and get
your advise on how to proceed. Could you point me to a recent approved heating oil tank closure site that I can look up
and review to ensure I cover all my bases. I will have a few more of these to produce so I want to be sure I get you
exactly what you are needing.
Feel free to call me on my cell at 803-230-5087 anytime.
Thank you,
Patrick

From: Patrick Lowery
Sent: Monday, May 4, 2020 11:48 AM
To: Beverly, Trudy <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Thank you Trudy. I will keep your information for future notifications.
Thanks
Patrick
From: Beverly, Trudy <[e-mail]>
Sent: Monday, May 4, 2020 6:35 AM
To: Patrick Lowery <[e-mail]>
Subject: RE: [External] Release Notification - 9920 Mallard Glen Drive
Good Morning Patrick,
I handle non -regulated ust releases in Mecklenburg County. Please send future Mecklenburg County non -regulated ust
related documents to my attention.
Thank you and have a wonderful day,
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.Beverlykncdenn 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: https:Hdeq_nc.gov/about/divisions/waste-management/ust
Branch's Above Ground Storage Tanks Website Address: https://deq.nc.gov/about/divisions/waste-management/ust/ast-program
INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES:
https://deq.nc.gov/about/divisions/waste-management/waste-management-rules-data/waste-mana ee ment- ie s-maps
File Review Procedures:
hops://deq.nc. gov/about/divisions/waste-management/ust/file-review-procedures#mooresville-regional-office
ONLINE ACCESS TO UST SECTION DOCUMENTS (Laserfiche):
b!Vs://deq.nc.gov/about/divisions/waste-management/laserfiche
Document Submittal & UST File Names for Laserfiche Policies:
htti)s:Hfiles.ne.izov/nedeafWaste%2OManaQement/DWM/UST/W hatsNew/Final-Electronic-Document-Submittal-Policv.ndf
https:Hfiles.nc. gov/ncdeq/Waste%20Management/DWM/UST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx
From: Bowser, Daniel P
Sent: Friday, May 1, 2020 5:08 PM
To: Beverly, Trudy <[e-mail]>
Subject: Fwd: [External] Release Notification - 9920 Mallard Glen Drive
Dan Bowser, PG
NCDEQ
UST Section
Corrective Action Branch

From: Patrick Lowery <[e-mail]>
Sent: Friday, May 1, 2020 4:44:08 PM
To: Bowser, Daniel P <[e-mail]>
Subject: [External] Release Notification - 9920 Mallard Glen Drive
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Dan,
I hope you are well. I have attached a release notification for a heating oil UST we assessed in November last year. Our
client requested the owner complete the attached, however it did not get completed. We are submitting on their behalf
prior to real-estate transaction. If there is a person or admin I should be sending these too, please let me know.
Thanks
Patrick
//J&
SUMMIT
PATRICK W. LOWERY, P.G.
Senior Environmental Manager
[e-mail]
Columbia Office • 101 Rice Bent Way, Unit 9 • Columbia, SC 29229
803.708.7945 Office • 803.708.7946 Fax • 803.230.5087 Cell
www.summit-companies.com [summit-companies.coml
Charlotte -HQ • Raleigh • Columbia • Greenville • Charleston