WA-92993_96847_C_NFA_20221026_CFNA

North Carolina Department of Environmental Quality | Division of Waste Management
Washington Regional Office | 943 Washington Square Mall | Washington, NC 27889 | [phone]

October 26, 2022

Cathy Bayer
Post Office Box 436
Havelock, North Carolina 28532
VIA EMAIL

Re: Conditional Notice of No Further Action
15A NCAC 2L .0507(d)
Risk-based Assessment and Corrective Action for
Petroleum Aboveground Storage Tanks and
Other Petroleum Sources

Cathy Bayer Property
407 West Main Street, Havelock
Incident Number: 96847
Risk Classification: Low
Ranking: L 60 R
Dear Ms. Bayer:
A review of information on file with the UST Section, Division of Waste Management, Washington
Regional Office indicates that groundwater contamination meets the cleanup requirements for a low-risk
release from an aboveground storage tank (AST) or other source under Title 15A NCAC 2L .0202 and
.0500, but contamination exceeds the limits allowed for unrestricted closure of a site.
The UST Section determines the subject incident to be eligible conditionally for no further action
status. However, final approval of no further action status is contingent on the filing of the approved Notice
of Residual Petroleum (attached) with the Register of Deeds in the county in which the release is located,
as verified by the receipt of certified copies of the filed Notice of Residual Petroleum by this office; and
upon receipt of confirmation that public notice requirements have been completed, as described in the
following paragraphs.
Be advised that, as contamination may exceed the groundwater quality standards established in
Title 15A NCAC 2L .0202, groundwater within the area where contamination is present or is expected to
migrate is not suitable for use as a water supply.
As groundwater contamination may exceed the groundwater quality standards established in Title
15A NCAC 2L .0202, pursuant to NCGS 143B-279.9 and 143B-279.11, you must file the Notice of
Residual Petroleum (attached) with the Register of Deeds in the county in which the release is located and
submit a certified copy to the UST Section within 30 days of receipt of this letter.

North Carolina Department of Environmental Quality | Division of Waste Management
Washington Regional Office | 943 Washington Square Mall | Washington, NC 27889 | [phone]

As groundwater contamination may exceed the groundwater quality standards established in Title
15A NCAC 2L .0202, public notice in accordance with 15A NCAC 2L .0509(b) also is required. Thus,
within 30 days of receipt of this letter, a copy of the letter must be provided by certified mail, or by posting
in a prominent place, if certified mail is impractical, to the local health director, the chief administrative
officer of each political jurisdiction in which the contamination occurs, all property owners and occupants
within or contiguous to the area containing contamination, and all property owners and occupants within
or contiguous to the area where the contamination is expected to migrate.
Within 60 days of receiving this letter, this office must be provided with proof of receipt of the
copy of the letter or of refusal by the addressee to accept delivery of the copy of the letter or with a
description of the manner in which the letter was posted. Interested parties may examine the information
on file about this site by contacting this regional office, and may submit comments on the site to the regional
office at the address or telephone number listed below.
This conditional No Further Action determination will not become valid until the UST Section
receives certified copies of the Notice of Residual Petroleum that showing it has been filed with the
Register of Deeds and until public notice requirements are completed.
If you have any questions regarding this notice, please contact me at the address or telephone
number listed below.

Sincerely,

Allison Ward
Hydrogeologist
Washington Regional Office
UST Section, Division of Waste Management, NCDEQ

Attachments: Notice of Residual Petroleum

Washington Regional Office | 943 Washington Square Mall | Washington, NC 27889 | [phone]

NFA I conditional low non-UST_NRP NOR 1017.dotx

Revised January 15, 2013
INSTRUCTIONS FOR PREPARING A 'NOTICE OF RESIDUAL PETROLEUM' REFERENCING LAND USE RESTRICTIONS 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 land use restrictions. (REWORDING OF THE NOTICE IS NOT
RECOMMENDED AND WILL SUBSTANTIALLY DELAY APPROVAL.) 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 petroleum contamination is located at the time the remedial action plan is approved and that was owned or controlled by any owner or operator of an underground storage tank, aboveground storage tank, or other petroleum source, or the 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 BY DEPARTMENT.) 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 shows the parcel but is not required to do so. 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. 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. (ALL CONTENTS OF THE PLAT MUST BE DRAWN IN INDELIBLE INK.) The plat shall include: 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 NOTARY SEALS, AS WITH ALL MARKINGS ON THE PLAT, MUST
BE MADE IN INDELIBLE INK); d. The following language: "The areas of contamination depicted upon the map are approximations
Revised January 15, 2013 2
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. 143B-279.9 and 143B-279.11 _____________________ (signature of Regional Supervisor) _____________________, Regional Supervisor
(printed name of Regional Supervisor ______________ Regional Office
(name of Region) UST Section Division of Waste Management Department of Environmental 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: _____________(printed full
name of Regional Supervisor). Date: _______________
(Official Seal) ____________________________
(signature of Notary Public) _______________________________________ (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 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 January 15, 2013 3
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 a petroleum release incident under North Carolina’s Statutes and Regulations, which consist of N.C.G.S. §143-215.94 and §143-215.104AA, 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. §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. §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. §143B-279.9 and §143B-279.11 and has/shall be recorded at the ________________ Register of Deeds’ office Book ____, Page ____. (name of county)
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 January 15, 2013 4
(Insert Real Property Description Here for Source Property)
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. IN WITNESS WHEREOF, ________________ has caused this Notice to be executed pursuant to N.C.G.S. §143B-279.9 and §143B-279.11, this _____ day of ___________,200_.
______________________________________________ (name of responsible party if agent is signing) By: ___________________________________________ (signature of responsible party, attorney or other agent if there is one) ___________________________________________
(Title of agent for responsible party if there is one) Signatory’s name typed or printed: ___________________________________
NORTH CAROLINA
_____________________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:_____________________________. Date: ________________________
________________________________ (Official Seal) (signature of Notary Public) ________________________________
(printed or typed name of Notary Public)

Revised January 15, 2013 5
Notary Public
My commission expires:_____________

Approved for the purposes of N.C.G.S. 143B-279.11 _____________________________
(signature of Regional Supervisor) _____________________________, Regional Supervisor
(printed name of Regional Supervisor) ______________ Regional Office UST Section Division of Waste Management Department of Environmental 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) (signature of Notary Public)
________________________________
(printed or typed name of Notary Public)
Notary Public
My commission expires:_____________