AS-30049_0_C_UST-2_20230707

UST-2B Site Investigation Report for Permanent Closure or Change-in-
Service of
UN-REGISTERED UST
Return completed form to: STATE USE ONLY:
NC DEQ / DWM / UST SECTION Facility ID #
1646 MAIL SERVICE CENTER
RALEIGH, NC 27699-1646 Date Received ATTN: REGISTRATION & PERMITTING
phone [phone] fax [phone] bttirttwww wasleoctoc crgl
INSTRUCTIONS (READ THIS FIRST)
1. UST permanent dosure or change in service must be completed in accordance with the latest version of the Guidelines for Site Checks, Tank
Closure and Initial Response and Abatement. The guidelines can be obtained at bltp"lldeQ oc gcvlabcutldjvjsicoslltr'.asle-roaoageroeol/v,lasle-
2. Permanent dosure: Complete all sections of this form.
3. Change-in-service: Where UST systems will be converted from storing a regulated substance to a non-regulated substance, complete sections I,
II, 111, N, and VI.
4. For more than 5 un-registered UST systems, attach additional forms as needed.
5. Un-Registered USTs may be subject to unpaid fees and late penalties.
6. REGISTERED USTs use Form UST-2A.
I. OWNERSHIP OF TANKS II. LOCATION OF TANKS
Owner Name (Corporation, Individual, Public Agency, or Other Entity) Facility Name or Company
TREES PROPERTY MANAGEMENT, LLC SAME
Street Address Facility ID # (If known)
1419ASHEVILLE HIGHWAY
City County Street Address HENDERSONVILLE HENDERSON SAME
State Zip Code 28791 City County SAME Zip Code SAME NC SAME
Phone Number Phone Number 8288083103 8288083103
Ill. CONTACT PERSONNEL
Contact for Facility: MARGARET TREES AND PHILLIP TREES Job Title: Phone #:[phone] 8282163492
OWNER
Closure Contractor Name: Closure Contractor Company: Address: Phone#
Kevin Durden Oil Tanks Asheville PO Box532 8285454459 Enka, NC 28728
Primary Consultant Name: Primary Consultant Company: Address: Phone# Kevin Durden OIL TANKS ASHEVILLE POBox532 8285454459 oiltanksasheville.com Enka, NC 28728
IV. UST INFORMATION FOR UN-REGISTERED UST SYSTEMS
REGISTERED USTs use Form UST-2A. V. EXCAVATION CONDITION
Tank ID Size in Last Last Use Permanent Method of Permanent Closure: Change-in-Notable odor
No. Gallons Contents Date Close Date Indicate REMOVED or enter fill Service waterin Freeprowct or visible soil excavation ainlaninatio material, such as foam/ Date n
concrete/ sand Yes No Yes No Yes No
500 OILOR 1960s MAY2023 REMOVED X X X GAS
250 OILOR 1960s MAY REMOVED X X X GAS 2023
VI. CERTIACATION
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those individuals immediately responsible for obtaining the Information, I believe that the submitted information is true accurate
and complete.
Print name and official title of owner or owner's authorized representative
PHILLIP TREES
Signature /4. Date Signed / -'~ ENT OF ENVl~ONMENTAL QUALITY, DIVISION OF WASTE NAGE
H, NC 27699-1646 PHONE [phone] FAX [phone] IJ1t,:JjyjlWfi,wa:s1e.lilll.ln!..llig/. 1/2016