WS-29087_48275_CA_DR_20220322_Recorded NORP

BK 1806 PG 195 - 198 (4)
This document presented and filed:
0311812022 02:01:35 PM
Fee $26 00
ill llllllllllllllllllillllll ll lll
Surry CountY North Carolina
W TODD HARRIS, Register of Deeds
C-Z-z
After recording, mail to:
ATC c/o Maureen Jackson
l2l Spier Falls Ruad
Gansevoort, NY 12831
NOTICE OF RESIDUAL PETROLEUM
Breeze Thru #31132, 1225 W . Lebanon St., Mount Airy, Surry County, North Carolina
UST incident#48275, Book I 552,Page 467 and Book I 539, Page 513
(lncident Number) (Deed tsook. Pages ol'Property Deed to be Restricted)
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 1438-279.11. 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 1438-2i9.9 'anrd
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 1438-279.9 and
1438-279.1I and has/shall be recorded at the Surry County Register of Deeds' office
Any map or plat required by DEQ has been/shall be recorded at the Surry County Register of Deeds' office
Book and Page referenced above, and has been/shall be incorporated into the Notice by this reference.
Source Propeft.v
COC Properties of Cary, North Carolina is the owner in fee simple of all or a portion of the Site, which is
located in the County of Surry, State of North Carolina, and is known and legally described as:
Revised August 201 9-CLK
Being as described by Parcel ID #5021-13-23-0831, located at 1225
County, North Carolina, Deed Book 1552, Page 167 and Deed Book
Office of the Register of Deeds of Surry County, North Carolina.
W. Lebanon St., Mount Airy, Surry
1539, Page 5I3, recorded with the
For protection of public health and the environment, the following land use restrictions required by
N.C.G.S. Section l439-279.9(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 Surry County Register of Deed receives
and records the written concurrence of the Secretary (or hisftrer delegate) of DEQ (or is successor in
function).
PERPETUAL LAND USE RESTRICTIONS
Soil: The Site shqll be usedfor industriql/commercial use only. Industrial/commercial use meons a use
where exposure to soil contamination is limited in lime and does not involve exposure to children
or other sensitive populations such as the elderly or sick. The real property shall not be developed
or utilized for residential purposes including but not limited to: primary or secondary residences
(permanent or temporary), schools, daycare centers, nursing homes, playgrounds, parks,
recreation areas and/or picnic areas.
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.
Revised August 201 9-CLK
ENFORCEMENT
e any ofthe above restriction(s) shall in no event beo the same violation or as to one occurring prior or
IN wlrNESS wHEREo F, VY(01'(l-hn/t Vnhr.ath, vL)
Sections t 438-27 e i :#l;ffilii Notice to be executed pursuant to N.C.G.S.
022.
I certifo that the following person(s) personally athat he or she signed the foiegoing do"ur"nt,
o^t",?hMaYr4'ZL, 7 oZL
(Official Seal)
Signatory's name typed or printed:
COUNTY
1 N o m" o7
"
ou, ty ii h xii
"
kno.,, h d g e n t w o s ta ke n )
a"bv Ul.(/
My commission expires , tl/Lt'1l 17 | 2 o 23
N,Iy dogera Lr ngnir,tr:l
i/there is one)
before me this , each acknowledging to me
of Norary Public.
(printed or ryped name of Norary pubtic)
Julia Eubanks
NOTARYPUBLIC
Chatham County, wCMy Commission ixpires
Revised Augusr 2019-CLK
Approved for the purposes of N.C.G.S. 143F._Z7g.l1
Supervisor)fvrlsv \,..'^. Regional Supervisor
Dlvision of Waste Management
Department of Environmint euality
LINTY
nt was taken)
I certifi,'that the following person(s) personall this day.. each acknow.ledging to methat he or she signed the ioiegoins iJ;r1rt : u printed name of Regiorut supervisor)
Date:
(signature of Notary public)
(printed or typed name of Notary public)
Notary Public
My commission expires:
4
Aurella E. Boseman
NOTARYPUBUC
r,.. A^ . G.ullford County, NCMy (nmmission Expires November T, 20p,
Revised August 2019-CLK