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HomeMy WebLinkAboutMO-29309_48472_CA_UST-3_20220405_Notice of Intent UST Permanent Closure‐Change in ServiceUST-3 Notice of Intent: UST Permanent Closure or Change -in -Service STATE USE ONLY Return completed form to: The DWM Regional Office located in the area where the facility is located. Also send a copy to the Central Office in Raleigh. 1.D• # SEE MAP ON THE BACK OF THIS FORM FOR THE CENTRAL AND REGIONAL OFFICE ADDRESSES. Date Received INSTRUCTIONS (READ THIS Complete and return a UST-3 form at least thirty (30) days prior to closure or change -in-service activities. Completed UST closure or change -in-service site assessment reports, along with a copy of the UST-2A and/or 26 forms, should be submitted to the appropriate Division of Waste Management (DWM; Regional Office within thirty (30) days following closure activities. The UST-2 form should also be submitted to the Central Office in Raleigh so that the status of the tanks may be changed to permanently closed and your tank fee account can be closed out. Note: Tank fees may be due for unregistered tanks. UST closure and change -in-service site assessments must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank Closure and Initial Response. The guidelines can be obtained at htt s:Ifde .nc. ovlabouUdivisions/waste-mans g mentlust. Note: To close tanks in place you must obtain prior approval from the DWM Regional office located in the region where the facility is located. You must make sure that USTs removed from your property are disposed of properly. When choosing a closure contractor, ask where the tank(s) will be taken for disposal. Usually, USTs are cleaned and cut up for scrap metal. This is dangerous work and must be performed by a qualified company. Tanks disposed of illegally in fields or other dumpsites can leak petroleum products and sludge into the environment. If your tanks are disposed of improperly, you could be held responsible for the cleanup of any environmental damage that occurs. (.OWNERSHIP OF TANKS II. LOCATION. Owner Name (Corporation, Individual, Public Agency, or Other Entity) Facility Name or Company Hidden Valley Solullons LLC D's Ex Tess Street Address Facility ID # (If known) 11211 Hyde Pointe Ct 00-0-0000007440 City County Charlotte Mecklenburg State Zip Code NC 28262 Phone Number Email 478-250-1135 hiddenvalleysofutions@gf Name: Yannick Tuwamo Street Address 223 Cabarrus Ave W Clty County Zip Code Concord Cabarrus 28025 Phone Number III. CONTACT PERSONNEL Company Name: Job Title: Hidden Valley Solutions LLC Owner IV. TANK REP 1. Contact local fire marshal. 5. 2. Plan entire closure event. 3. Conduct Site Soil Assessment. 6. 4. If removing tanks or closing in place, refer to API Publication 2015 Cleaning Petroleum 7 Storage Tanks and 1604 Removal and Disposal of Used Underground Petroleum Storage Tanks. Contractor Name: Tony Disher Address: 1702 Vargrave Street Primary Consultant N Steve Libbey, PG Tank ID No. Size in Gal 1 10000 2 6000 3 6000 )VAL., CLOSURE IN PLACE. CHANGE - Provide a sketch locating piping, tanks and soil sampling locations. Submit a closure report in the format of UST- 12 (including the form UST-2) within thirty (30) days following the site investigation. If a release from the tanks has occurred, the site assessment portion of the tank closure must be conducted under the supervision of V. WORK TO BE PERFORMED BY Contractor Company Name: EVO Corp. Phone Number: 7120844 a P.E. or L.G., with all closure site assessment reports bearing the signature and seal of the P.E. or L.G. If a release has not occurred, the supervision, signature or seal of a P.E. or L.G. is not required. 8. Keep closure records for three (3) years. State: Zip Code: NC 27107 Primary Consultant Company Name: Hart & Hickman VI. TANKS SCHEDULED FOR CLOSURE OR CHANGE-IN»SE Gasoline, Gas Mix Gasoline, Gas Mix Gasoline, Gas Mix Phone No: 336-725-5844 Consultant Phone No: 704-302-4404 Closure I Chan e-In•5ervice Removal I Abandonment in Place' I New Contents Stored Prior written approval to abandon a tank in place must be received from a DWM Regional Office. VII. OWNER OR OWNER'S AUTHORIZED REPRESENTATIVE Has a release from a UST system occurred at this location? ❑ Yes ❑ No ® Unknown I understand that I can be held responsible for environmental damage resulting from the improper disposal of my USTs. Print name and official title: Steve Libbey/Project Manager Signature Date Signed SCHEDULED REM�OLATE Notify your DWM Regional Office 48 hours before this date if �� 9 scheduled removal date changes Beverly, Trudy From: Strauss, Ruth Sent: Thursday, April 7, 2022 9:15 AM To: Beverly, Trudy Subject: RE: [External] D's Express NOI; Concord, NC - UST-3 Thanks Trudy! Ruth Strauss :L.G. Had, uyrpanfalls andInspeellon Bmnvr UST 9 Detim. Dii isiurn ofW3!;te NIME5MMt North Carolina D-p rtment of F wif mtnetit al Quality - 919. 707.8299 (Offtc5 & Fax) Ru th. S trau55ncd6nr. E Dv �e1pa►dfronhpaO;k=zw4WloeA! AWh C4,vimPOW Q�6-�faxiV li�Y L�c3 dfSGt��Y la frr/1t}1�Zt°S From: Beverly, Trudy <trudy.beverly@ncdenr.gov> Sent: Wednesday, April 6, 2022 6:45 AM To: Steve Libbey <slibbey@harthickman.com>; Osman, Hassan <hassan.osman@ncdenr.gov>; Randolph, Wayne <wayne.randolph@ncdenr.gov>; Strauss, Ruth <ruth.strauss@ncdenr.gov> Cc: Taraban, Ron <ron.taraban@ncdenr.gov> Subject: RE: [External] D's Express NOI; Concord, NC - UST-3 Thank you Steve. Ruth, Wayne, & Osman - Please see the attached UST-3 for D's Express located at 223 Cabarrus Avenue West, Concord, Cabarrus County (Facility ID 00-0-0000007440). Tanks are scheduled to be removed on May 9tn Trudy Trudy Beverly, L.G. Hydrogeologist, Division of Waste Management e:,eo:--fD,EQ North Carolina Department of Environmental Quality r n h "�"�,�,�• UST Section, Mooresville Regional Office 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: https://deq.nc.gov/about/divisions/waste-management/ust Branch's Above Ground Storage Tanks Website Address: hitps://deg.nc.gov/about/divisions/waste-management/ust/ast-proeram INTERACTIVE MAPS WITH DWM SITES AND PERMITTED FACILITIES: httns://deo.nc. eov/about/divisions/waste-manaeement/waste-manaeement-rules-data/waste-manaeement-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): htips://deq.ne.gov/about/divisions/waste-management/laserfiche Document Submittal & UST File Names for Laserfiche Policies: httys:Hflles.nc.aov/nedea/Waste%2OManaeement/DWM/UST[WhatsNew/Final-Electronic-Document-Submittal-Policy.odf htips://files.nc. gov/ncdeq/Waste%2OManagement/D WMiUST/Corrective%2OAction/UST%20file%20names%20for%2OLaserfiche.docx From: Steve Libbey[mailto:slibbey@harthickman.com] Sent: Tuesday, April 5, 2022 6:25 PM To: Beverly, Trudy <trudy.beverly@ncdenr.gov> Subject: [External] D's Express NOI; Concord, NC 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, the Notice of Intent (UST-3) for D's Express is attached. I was as able to move it to May 91n Thanks, Steve Stephen Libbey, PG, Project Manager Hart &Hickman, PC 2923 S Tryon Street, Suite 100 • Charlotte, NC 28203 Direct:704-887-4606 Mobile:704-302-4404 www.harthickman.com I 0