WS-5631_19835_G_NORR_20230328_NORR-MRP

North Carolina Department of Environmental Quality | Division of Waste Management
Winston-Salem Regional Office | 450 West Hanes Mill Road | Suite 300 | Winston-Salem,
NC 27105 | [phone]

March 28, 2023 Chris Nuckolls
County of Davie Inspections Director/Facilities Management Davie Development Services
298 E. Depot Street, Suite 100 Mocksville, NC 27028
Re: Notice of Regulatory Requirements 15A NCAC 2L .0400 Risk-Based Assessment and Corrective Action for Petroleum Underground Storage Tanks Davie County Hospital 223 Hospital Street, Mocksville Davie County Incident Number: 19835 Risk Classification: Intermediate
Ranking: 135 Dear Mr. Nuckolls:
Based on a review of the above-referenced incident file, it has been determined that the following needs to be conducted:
1.) Sample all the monitoring wells and analyze using SM 6200B (+MTBE, IPE, & EDB + 5 oxygenates, ethanol) 2.) Take a trip blank and analyze using SM 6200B (+MTBE, IPE, & EDB + 5 oxygenates, ethanol), 3.) Submit a complete monitoring report, as outlined in the template found on page 125 of the Comprehensive Appendices for Corrective Action Guidelines, by June 1, 2023. Effective October 1, 2004, the Department requires that all work following the submittal of the Limited Site Assessment Report (Title 15A NCAC 2L .0405) be preapproved if State Trust Fund reimbursement is anticipated. To comply with this requirement, a completed Preapproval/Claim Authorization Form, encompassing the required remedial activities, must be received in this office within 14 days of the date of
this letter. Upon completion of the preapproved activities, you should submit your claim promptly. Reimbursement funds are budgeted based on completed preapprovals, but lengthy delays in reimbursement can occur if claims are not submitted immediately following work completion.
Because a release or discharge has been confirmed, a Licensed Geologist or a Professional Engineer, certified by the State of North Carolina, is required to prepare and certify all reports submitted to the Department in accordance with Title 15A NCAC 2L .0103(e) and 2L .0111(e).
Page 2 of 2 Incident Number 44711 March 3, 2023

North Carolina Department of Environmental Quality | Division of Waste Management
Winston-Salem Regional Office | 450 West Hanes Mill Road | Suite 300 | Winston-Salem,
NC 27105 | [phone]

Please note that before you sell, transfer, or request a “No Further Action” determination for a property that has not been remediated to below “unrestricted use” standards, you must file a Notice of Residual Petroleum ("Notice") with the Register of Deeds in the county where the property is located (NCGS 143B-279.9 and
143B-279.11). If you have any questions regarding trust fund eligibility or reimbursement from the Commercial Petroleum Underground Storage Tank Cleanup Funds, please contact the UST Section Trust Fund Branch at [phone]. If you have any questions regarding the actions that must be taken or the rules mentioned in this letter, please contact me at the address and telephone number below. A complete monitoring report is due, in this office, by June 1, 2023. Sincerely,
Linda Estkowski Hydrogeologist Winston-Salem Regional Office UST Section, Division of Waste Management, NCDEQ
cc: WSRO Connie Crews, Davie County Health Department, via email [e-mail] Edmund Henriques, S&ME, Inc, via email [e-mail]