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Home My WebLink About18032_Carter Woodson_LURU Model_20180108NC BROWNFIELDS LAND USE RESTRICTIONS (“LUR”) UPDATE Year Certification Made: 2018 Name: Carter G. Woodson Charter School Project #: 18032-14-034 Address: 420, 437 Goldfloss Street County: Forsyth 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 use may be made of the Brownfields Property other than for Institutional, Office and Commercial use unless otherwise approved in advance and in writing by the Department of Environmental Quality (“DEQ”). For purposes of this restriction, the following definitions apply: Institutional refers to the use of land, buildings or structures for public, non-profit or quasi-public purposes, such as for religious institutions, libraries, schools, universities, health institutions, or government-owned or operated buildings in accordance with the following sub-sets of institutional use: Religious Institution: A church, temple, or synagogue, the principal purpose of which is religious worship. Health Institution: A hospital, clinic (not including veterinary), health maintenance organization, or similar use or building, not including a group home, which routinely provides for the care of, treatment of, and testing for physical, emotion, or mental injury, illness, or disability, and for the overnight boarding of patients, either on a for-profit or not-for-profit basis. Schools: A use, whether privately or publicly owned, providing pre-school, elementary school, middle school, junior high school, or high school education, including outdoor recreation and sports areas, including a dorm. University: A university, college, or junior college, a use whether privately-owned or publicly-owned, providing education beyond the high school level. “Office” defined as the provision of business or professional services. “Commercial” refers to an enterprise carried on for profit or nonprofit by the owner, lessee or licensee. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ Within the areas designated “Area of Possible Soil Contamination” on the plat component of the Notice of Brownfields Property (“Notice”), School-related playground, recreational, or athletic activities may not occur, and the soil may not be disturbed, unless and until DEQ approves in writing, and in advance, a plan with a schedule, and its implementation, that requires: fencing, capping, paving (with asphalt, concrete, stone, brick, terrazzo, roofing, ceramic tile or other impervious material approved in writing in advance by DEQ), remediation and/or removal of sufficient soil to satisfy DEQ that the Brownfields Property is suitable for the uses specified in LUR 1 above and that public health and the environment are fully protected despite any remaining soil contamination; and a written report regarding implementation of the plan, submitted no later than 30 days following implementation or completion, and correction of any deficiencies DEQ identifies in the report or in implementation of the plan within 30 days after DEQ provides written notice of any deficiencies. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ Surface water and groundwater at the Brownfields Property may not be used for any purpose without the prior written approval of DEQ. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ No new building may be constructed on the Brownfields Property until DEQ determines in writing, based on submittals from the building’s proponent, that the building’s users, and public health and the environment, would not be at risk from the Brownfields Property’s volatile contaminant plume. Periodic monitoring of indoor air in existing and any new buildings on Tract 3 will be required in accordance with a plan approved in writing by DEQ until DEQ is satisfied that monitoring is no longer needed. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ None of the contaminants known to be present in the environmental media at the Brownfields Property, including those appearing in the Exhibit 2 to Exhibit A, may be used or stored at the Brownfields Property without the prior written approval of DEQ, except: in de minimis amounts for cleaning and other routine housekeeping activities; as constituents of fuels, lubricants and oils in emergency generators, machinery, equipment and vehicles in on-board tanks integral to said equipment or in flammable liquid storage containers totaling no more than 25 gallons; and/or as constituents of products and materials customarily used, stored in Institutional, Office and Commercial environment, provided such products and materials are used, stored, and disposed in accordance with applicable laws and regulations. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ The Brownfields Property may not be used for agriculture or grazing without the prior written approval of DEQ provided, however, gardening may be conducted in raised beds or containers providing that there are barriers to prevent contact with any of the plants with native soils on the Brownfields Property. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ Neither DEQ, nor any party conducting environmental assessment or remediation at the Brownfields Property at the direction of, or pursuant to a permit, order or agreement issued or entered into by DEQ, may be denied access to the Brownfields Property for purposes of conducting such assessment or remediation, which is to be conducted using reasonable efforts to minimize interference with authorized uses of the Brownfields Property. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ Any deed or other instrument conveying an interest in the Brownfields Property shall contain the following notice: “The property which is the subject of this instrument is subject to the Brownfields Agreement attached as Exhibit A to the Notice of Brownfields Property recorded in the Forsyth County land records, Book 3373, Page 858.” A copy of any such instrument shall be sent to the persons listed in Section XV (Notices and Submissions) of the Exhibit A, though financial figures related to the conveyance may be redacted. If DEQ issues prior, written approval, an owner may use the following mechanisms to comply with the obligations of this paragraph, subject to the terms and conditions that DEQ may establish in such approval: (i) If every lease and rider is identical in form, owner may provide DEQ with copies of a form lease or rider evidencing compliance with this paragraph, in lieu of sending copies of actual, executed leases, to the persons listed in Section XV (Notice and Submissions) of Exhibit A; or (ii) Owner may provide abstracts of leases, rather than full copies of said leases, to the persons listed in Section XV of the Exhibit A. ☐ In compliance ☐ Out of compliance Remarks: ______________________________________________________________ During January of each year after the year in which the Notice is recorded, the owner of any part of the Brownfields 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 Forsyth County, certifying that, as of said January 1st, the Notice containing these land use restrictions remains recorded at the Forsyth 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 e-mail 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 Brownfields 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 Forsyth 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: _________________