HomeMy WebLinkAbout04017_Burlington Mills_LURU Model_20170913NC BROWNFIELDS
LAND USE RESTRICTIONS (“LUR”) UPDATE
Year Certification Made: 2017
Name: Burlington Mills (amended 12/22/2009)
Project #: 04017-00-049
Address: 476 South Main Street
County: Iredell
Property Owner (In part or whole): ____________________________
Read the following LURs and mark each restriction accordingly. Additional remarks may be added for compliance status clarification. Attach any required or supplemental documentation,
sign, notarize and submit to the following address:
NC Division of Waste Management
Attn: Brownfields Program Staff
1646 Mail Service Center
Raleigh, NC 27699-1646
No water supply wells may be installed or used at the Brownfields Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No mining activities may be conducted on or under the Brownfields Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No activities which result in direct exposure to or removal of groundwater (for example, construction or excavation activities which encounter or expose groundwater) may be conducted
on the Property without prior sampling and analysis of groundwater in the area where such activities are to be conducted, submittal of the analytical results to DEQ or its successor
in function along with plans and procedures to protect human health and the environment during those activities, and approval of those activities by DEQ or its successor in function.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No basements and no fountains, ponds, lakes, swimming pools or other items which are supplied, in whole or in part, by groundwater may be constructed on the Brownfields Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
The compounds Chloroform, 1,2-Dichloroethene, and Tetrachloroethene, may not be used, warehoused or otherwise stored at the Brownfields Property, without prior approval of DEQ, which
approval shall not be required for these compounds in de minimis amounts for cleaning and for other routine housekeeping activities.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
(Amended December 22, 2009) During January of each year after the year in which this Amended Notice is recorded, the owner of any part of the Property as of January 1st of that year
shall submit a notarized Land Use Restrictions Update (''LURU") to DEQ, and to the chief public health and environmental officials of Iredell County, certifying that, as of said January
1st, this notice remains recorded at the Iredell County Register of Deeds office and that the land use restrictions are being complied with, and stating:
the name, mailing address, telephone and facsimile numbers, and contact person's email address of the owner submitting the LURU if said owner acquired any part of the Property during
the previous calendar year; and
______________________________________________________________
the transferee's name, mailing address, telephone and facsimile numbers, and contact person's e-mail address, if said owner transferred any part of the Property during the previous calendar
year.
______________________________________________________________
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
Notarized signing and submittal of this Land Use Restrictions Update constitutes certification that the Notice of Brownfields Property remains recorded at the Iredell County Register
of Deeds office and that the Land Use Restrictions are being complied with.
This Land Use Restrictions Update is certified by _____________, owner of at least part of the Brownfields Property on this ___ day of _________, 20__.
Name typed or printed of party making certification: __________________
[Note: additional entities or owners may be added if appropriate (i.e. multiple managing members/entities)]
By: __________________________ (signature)
Name typed or printed: __________________
Title typed or printed: ___________________
NORTH CAROLINA
__________ COUNTY
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated
therein and in the capacity indicated: ______________________.
Date: ____________ ___________________________________ Official Signature of Notary
____________________________________
Notary’s printed or typed name, Notary Public
(Official Seal) My commission expires: _________________