WM0801173_Application_20210607

hart hickman
SMARTER ENVIRONMENTAL SOLUTIONS
Via USPS and e-mail
June 7, 2020
North Carolina Department of Environmental Quality
Division of Water Resources — Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Attn: Mr. Geoff Kegley
Re: Permit to Construct Monitoring Wells
Former Heritage Cleaners (NC DCSA No. DC650018)
Wilmington, North Carolina
Dear Mr. Kegley:
Hart & Hickman, PC (H&H) is providing the attached monitoring well permit applications for
groundwater assessment activities related to the former Heritage Cleaners site in Wilmington,
North Carolina. H&H is proposing to install five temporary monitoring wells in the North Carolina
Department of Transportation right of way of South Third Street and the South Front
Street/Business 17 Cloverleaf. Three temporary wells are proposed on the west side of South Third
Street, and two temporary wells are proposed on the to the north of Business 17. Enclosed please
find the permit applications, well construction details, site map with the proposed locations, and
other relevant information. Please review the provided information and return the approved
permits to the H&H Raleigh office.
Should you have any questions or need any additional information, please feel free to contact me
at [phone].
Sincerely,
Hart & Hickman, PC
ALX-77- �ILILEJ-L
Robert Harrell
Project Environmental Scientist
Attachments
2923 South Tryan Street, Suite 100 3921 Sunset Fudge Rd, Suite 301
Charlatbe, NC 23203 Raleigh, NC 27607 www.hart.hickmar).corn
704.586-0007 main 919-947.4241 main

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: 6/7/2021 I FOR OFFICE USE ONLY
2. County: New Hanover IPERMIT NO. ISSUED DATE
3. What type of well are you applying for? (monitoring or recovery): temporary monitoring wells
4. Applicant: Alberta Properties LLC (petitioner for DSCA site #DC650018 Telephone: Mike Cunningham
Applicant's Mailing Address: DSCA Program, 1646 Mail Service Center, Raleigh NC 27699-1646
Applicant's Email Address (if available): mike.cunninghamCcDncdenr.gov
5. Contact Person (if different than Applicant): Robert Harrell, Hart & Hickman, PC Telephone: [phone]
Contact Person's Mailing Address: 3921 Sunset Ridge Rd, Suite 301, Raleigh, NC 27607
Contact Person's Email Address (if available): [e-mail]
6. Property Owner (if different than Applicant): NCDOT Right -of -Way (ROW) Telephone: [phone]
Property Owner's Mailing Address: 5501 Barbados Blvd., Castle Hayne, NC 28429
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) South Third Street Right -of -Way (between Castle St. and Queen Street)
City Wilmington County New Hanover Zip Code 28401
8. Reason for Well(s): Environmental assessment for DSCA Program
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9. Type of facility or site for which the well(s) is(are) needed: Former D
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
10. Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
NCDEQ DSCA Site ID # DC650018
11. Type of contaminants being monitored or recovered: Chlorinated Solvent
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existing Monitoring or Recovery Well Construction Permit No(s).: N/A
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): approximately 50-500 feet
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Yes
If yes, give distance(s): Approximately 250 feet- this water supply well is out of service, and previously only used for irrigation
15. Well Contractor: Geologic Exploration Certification No.: 4518, 3098, 4475, 3552, and 4459
Well Contractor Address: 176 Commerce Blvd., Statesville, NC 28677
PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons
C. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals
Continued on Reverse

PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated
material: 3
3. Number of wells to be constructed in bedrock: 0
5. How will the well(s) be secured? Abandoned in
accordance with NC well construction standards
6. Estimated beginning construction date: 7/12/2021
4. Total Number of wells to be constructed: 3 7. Estimated construction completion date: 7/16/2021
(add answers from 2 and 3)
ADDITIONAL INFORMATION
1. As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:
a. All property boundaries, at least one of which is referenced to a minimum of two landmarks such as identified roads,
intersections, streams, or lakes within 500 feet of the proposed well or well system.
b. All existing wells, identified by type of use, within 500 feet of the proposed well or well system.
C. The proposed well or well system.
d. Any test borings within 500 feet of proposed well or well system.
e. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chemical or fuel
storage areas, animal feedlots as defined in G.S. 143-215.10B(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
._:4
Se�7 -_.,",Agent for Petitioner for DSCA Site DC650018
Signature of Applicant or *Agent
Robert Harrell
Printed name of Applicant or *Agent
Agent for Petitioner for DSCA Site DC650018
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
that you have the authority to act as the Agent.
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached property access agreement (Attachment 3) See attached property access agreement (Attachment 3)
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office Raleigh Regional Office Wilmington Regional Office
2090 U.S. Highway 70 3800 Barrett Drive 127 Cardinal Drive Extension
Swannanoa, NC 28778 Raleigh, NC 27609 Wilmington, NC 28405
Phone: [phone] Phone: [phone] Phone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
J R Rev. 3-1-2016

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
2.
3.
4.
5.
6.
7.
8.
9.
10
11
12
13
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
Date: 6/7/2021 I FOR OFFICE USE ONLY
County: New Hanover IPERMIT NO. ISSUED DATE
What type of well are you applying for? (monitoring or recovery): temporary monitoring wells
Applicant: Alberta Properties LLC (petitioner for DSCA site #DC650018 Telephone: Mike Cunningham
Applicant's Mailing Address: DSCA Program, 1646 Mail Service Center, Raleigh NC 27699-1646
Applicant's Email Address (if available): mike.cunninghamCcDncdenr.gov
Contact Person (if different than Applicant): Robert Harrell, Hart & Hickman, PC Telephone: [phone]
Contact Person's Mailing Address: 3921 Sunset Ridge Rd, Suite 301, Raleigh, NC 27607
Contact Person's Email Address (if available): [e-mail]
Property Owner (if different than Applicant): NCDOT Right -of -Way (ROW) Telephone: [phone]
Property Owner's Mailing Address: 5501 Barbados Blvd., Castle Hayne, NC 28429
Property Owner's Email Address (if available):
Property Physical Address (Including PIN Number) Business 17 Right -of -Way (around the Bus.17 and S. Front St. cloverleaf)
City Wilmington County New Hanover Zip Code 28401
Reason for Well(s): Environmental assessment for DSCA Program
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
Type of facility or site for which the well(s) is(are) needed: Former Dry CI
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
DSCA Site ID # DC650018
Type of contaminants being monitored or recovered: Chlorinated Solvent
(ex: organics, nutrients, heavy metals, etc.)
Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existing Monitoring or Recovery Well Construction Permit No(s).: N/A
Distance from proposed well(s) to nearest known waste or pollution source (in feet): approximately 900 feet
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s): N/A
15. Well Contractor: Geologic Exploration Certification No.: 4518, 3098, 4475, 3552, and 4459
Well Contractor Address: 176 Commerce Blvd., Statesville, NC 28677
PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons
C. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals
Continued on Reverse

PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated
material: 2
3. Number of wells to be constructed in bedrock: 0
5. How will the well(s) be secured? Abandoned in
accordance with NC well construction standards
6. Estimated beginning construction date: 7/12/2021
4. Total Number of wells to be constructed: 2 7. Estimated construction completion date: 7/16/2021
(add answers from 2 and 3)
ADDITIONAL INFORMATION
1. As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:
a. All property boundaries, at least one of which is referenced to a minimum of two landmarks such as identified roads,
intersections, streams, or lakes within 500 feet of the proposed well or well system.
b. All existing wells, identified by type of use, within 500 feet of the proposed well or well system.
C. The proposed well or well system.
d. Any test borings within 500 feet of proposed well or well system.
e. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chemical or fuel
storage areas, animal feedlots as defined in G.S. 143-215.10B(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
._:4
Se�7 -_.,",Agent for Petitioner for DSCA Site DC650018
Signature of Applicant or *Agent
Robert Harrell
Printed name of Applicant or *Agent
Agent for Petitioner for DSCA Site DC650018
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
that you have the authority to act as the Agent.
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached property access agreement (Attachment 3) See attached property access agreement (Attachment 3)
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office Raleigh Regional Office Wilmington Regional Office
2090 U.S. Highway 70 3800 Barrett Drive 127 Cardinal Drive Extension
Swannanoa, NC 28778 Raleigh, NC 27609 Wilmington, NC 28405
Phone: [phone] Phone: [phone] Phone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
J R Rev. 3-1-2016

ATTACHMENT 1
TEMPORARY MONITORING WELL DIAGRAM

TEMPORARY MONITORING WELL CONSTRUCTION DETAILS
CROSS SECTIONAL VIEW
GROUND SURFACE
L1
STEEL DPT ROD
L3 (2.5-INCH DIAMETER)
WELL SCREEN
3-FT STAINLESS STEEL
L2 EXPANDABLE WELL SCREEN
(1-INCH DIAMETER)
DRIVE TIP
L1 = 47 FT.
L2 = 3 FT.
L3 = 50 FT.
TITLE Temporary Monitoring Well Diagram
Hart & Hickman, PC
3921 Sunset Ridge Road, Suite 301
Raleigh, North Carolina 27607
FILE PREP. BY REV. BY DATE PROJECT NO.
RH CS 6/7/2021 DSO-155 (DSCA Site: DC650018)

ATTACHMENT 2
PROPOSED TEMPORARY WELL LOCATIONS

-
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LEGEND
SOURCE PROPERTY BOUNDARY
PARCEL BOUNDARY
NOVEMBER 2019 TEMPORARY
MONITORING WELL LOCATION
APRIL 2018 DIRECT -PUSH GROUNDWATER
SAMPLING LOCATION
® IRRIGATION WELL LOCATION
ASSUMED GROUNDWATER FLOW
DIRECTION
SAMPLE ID AND DATE
WSW-5 (8/19/20)
35' * SAMPLE DEPTH (FT BGS)
PCE I 0.0030 CONCENTRATION (mg/L)
CONSTITUENT
p Proposed Direct -Push
_ Sample Location
NOTES:
1. AERIAL IMAGERY OBTAINED FROM NC ONEMAP.
2. PCE = TETRACHLOROETHYLENE
FT BGS = FEET BELOW GROUND SURFACE
3. * = SCREEN INTERVAL FOR WATER SUPPLY WELL
WSW-5 IS UNKNOWN, TOTAL DEPTH IS 35 FT BGS.
0
APPROXIMATE
r 0 120 240
SCALE IN FEET
TITLE
- PCE CONTAMINATION CONCENTRATION MAP
PROJECT HERITAGE CLEANERS
' DSCA ID: DC650018
522 S THIRD STREET
WILMINGTON, NEW HANOVER COUNTY
hart � hickman 3921cigh, Noret th
Carolina
Road, 2760e 301
Ralei h, North Carolina 27607
919-847-4241(p) 919-847-4261(f)
SMARTER ENVIRONMENTAL SOLUTIONS
T.iccnsc # C-1269 / #C-245 Gcolo )
DATE: 1-21-21 REVISION NO. 0
JOB NO. DSO-155 ATTACHMENT NO. 7

ATTACHMENT 3
PROPERTY ACCESS AGREEMENTS

Robert Harrell
From: Chavis, Randy E <rechavis1 @ncdot.gov>
Sent: Tuesday, May 25, 2021 1:51 PM
To: Carlin Slusher
Cc: Hughes, Benjamin T; Roan, Jon; Drees, Nick K; Wurzel, Joseph P; Dennis Rachocki; Vielkanowitz,
Denys; Thomas C. Bradshaw
Subject: FW: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Attachments: DC650018_20210525_NCDOT Letter_rev.pdf, 20070827 CB#24 Attachment 3 NCDOT Access.pdf,
DC650018_20210517_ProposedDPTLocations_REV.pdf; 20200203 Encroachment Agreement Standard
Conditions.pdf
Importance: High
Carlin
This e-mail serves as an approval for work requested by your company to be done within NCDOT R/W, as discussed this
doesn't include the six borings within the S. Front Street/Business 17 cloverleaf. Please follow all MUTCD traffic control
requirements and call for pre -con. See this link for time restrictions,
http://ncdot.maps.arcgis.com/apps/webappviewer/index.html?id=8b52f36d732341aca18eaefl5l7fcf4a
Thanks
From: Carlin Slusher <[e-mail]>
Sent: Tuesday, May 25, 2021 1:34 PM
To: Chavis, Randy E <[e-mail]>; Hughes, Benjamin T <[e-mail]>
Cc: Wurzel, Joseph P <[e-mail]>; Roan, Jon <[e-mail]>; Kimes, D. Chad <[e-mail]>
Subject: RE: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Importance: High
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
All —
After additional discussions with Randy, we have revised our request to only include the three borings located along S.
Third Street and the two borings near the S. Front Street/Business 17 cloverleaf, as identified on the attached
figure. We will forgo the six borings within the S. Front Street/Business 17 cloverleaf, as based on our previous
discussions, these borings would require a temporary road/ramp closure.
Please let me know what additional information you need to approve these five locations.
Thanks again, Carlin
Carlin Slusher, Senior Project Scientist
Hart & Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2517 • Mobile: [phone]

Ad www.harthickman.com
From: Carlin Slusher
Sent: Wednesday, April 14, 2021 11:08 AM
To: Chavis, Randy E <[e-mail]>; Hughes, Benjamin T <[e-mail]>
Cc: Wurzel, Joseph P <[e-mail]>; Roan, Jon <[e-mail]>; Kimes, D. Chad <[e-mail]>
Subject: RE: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Randy,
Good morning. Please let me know if you have any further questions concerning our proposed scope of work.
Thanks again, Carlin
Carlin Slusher, Senior Project Scientist
Hart &Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2517 • Mobile: [phone]
www.harthickman.com
From: Carlin Slusher <[e-mail]>
Sent: Friday, April 9, 2021 11:24 AM
To: Chavis, Randy E <[e-mail]>; Hughes, Benjamin T <[e-mail]>
Cc: Wurzel, Joseph P <[e-mail]>; Roan, Jon <[e-mail]>; Kimes, D. Chad <[e-mail]>
Subject: Re: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Thanks, Randy. We do not anticipate a lane closure.
Thanks, Carlin
Get Outlook for Android
From: Chavis, Randy E <[e-mail]>
Sent: Friday, April 9, 2021, 8:57 AM
To: Carlin Slusher; Hughes, Benjamin T
Cc: Wurzel, Joseph P; Roan, Jon; Kimes, D. Chad
Subject: RE: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Carlin
I will be your contact for this project, Will any this work require a lane closure?
Randy E. Chavis
Engineer Technician
New Hanover County

District 3 Engineer's Office
300 Division Drive
Wilmington, NC 28401-8883
910 398-9100 office
[e-mail] Email
From: Carlin Slusher <[e-mail]>
Sent: Friday, April 9, 2021 8:24 AM
To: Hughes, Benjamin T <[e-mail]>
Cc: Wurzel, Joseph P <[e-mail]>; Chavis, Randy E <[e-mail]>; Roan, Jon <[e-mail]>;
Kimes, D. Chad <[e-mail]>
Subject: RE: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thanks, Benjamin, for the quick response.
Carlin Slusher, Senior Project Scientist
Hart &Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2517 • Mobile: [phone]
www.harthickman.com I n m
From: Hughes, Benjamin T <[e-mail]>
Sent: Friday, April 9, 2021 8:23 AM
To: Carlin Slusher <cslusher(@harthickman.com>
Cc: Wurzel, Joseph P <[e-mail]>; Chavis, Randy E <[e-mail]>; Roan, Jon <[e-mail]>;
Kimes, D. Chad <[e-mail]>
Subject: RE: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
Good Morning Carlin,
Our office will facilitate review and approval of this request — we will reach out to you today.
Thank you,
Benjamin T. Hughes, PE
District Engineer
Division 3 1 District 3
[phone] Direct
[phone] Office
From: Carlin Slusher <[e-mail]>
Sent: Friday, April 9, 2021 8:05 AM
To: Kimes, D. Chad <[e-mail]>
Cc: Wurzel, Joseph P <[e-mail]>; Chavis, Randy E <[e-mail]>; Roan, Jon <[e-mail]>;

Hughes, Benjamin T <[e-mail]>
Subject: [External] Approval Request for Temporary Borings in NCDOT Right -of -Way, Wilmington, NC
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Mr. Kimes,
Good morning. I am contacting you regarding proposed upcoming work by Hart & Hickman, under contract to the
NCDEQ Dry -Cleaning Solvent and Cleanup (DSCA) Program, in the grass ROWS along South 3rd Street and near Business
17 in Wilmington, NC. Please see the attached letter specifying the nature of our proposed work and the proposed
environmental sampling locations.
As highlighted in the red box (page 4) on the attached Encroachment Agreement between the NCDEQ DSCA Program
and NCDOT, the proposed temporary borings require written authorization from the NCDOT Regional District Manager.
Therefore, we are requesting your authorization via e-mail for the proposed work. We would like to conduct the work
during the week of May 10, 2021.
Please let me know if you have questions.
Thanks so much, Carlin
Carlin Slusher, Senior Project Scientist
Hart &Hickman, PC
3921 Sunset Ridge Rd, Ste 301 • Raleigh, NC 27607
Direct: 919-723-2517 • Mobile: [phone]
www.harthickman.com JUDO
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

GP-1 (4/3/18)
} 5-15'
GP-2 (4/3/18) PCE <0.0010
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LEGEND
SOURCE PROPERTY BOUNDARY
PARCEL BOUNDARY
NOVEMBER 2019 TEMPORARY
MONITORING WELL LOCATION
APRIL 2018 DIRECT -PUSH GROUNDWATER
SAMPLING LOCATION
® IRRIGATION WELL LOCATION
ASSUMED GROUNDWATER FLOW
DIRECTION
SAMPLE ID AND DATE
WSW-5 (8/19/20)
35' * SAMPLE DEPTH (FT BGS)
PCE 0.0030 CONCENTRATION (mg/L)
CONSTITUENT
p Proposed Direct -Push
Sample Location
NOTES:
1. AERIAL IMAGERY OBTAINED FROM NC ONEMAP.
2. PCE = TETRACHLOROETHYLENE
FT BGS = FEET BELOW GROUND SURFACE
3. * = SCREEN INTERVAL FOR WATER SUPPLY WELL
WSW-5 IS UNKNOWN, TOTAL DEPTH IS 35 FT BGS.
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APPROXIMATE
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TITLE
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PCE CONTAMINATION CONCENTRATION MAP
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PROJECT HERITAGE CLEANERS
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WILMINGTON, NEW HANOVER COUNTY
hart � hickman 3921cg nset ,Mort CaroliRoad,
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SMARTER ENVIRONMENTAL SOLUTIONS T.iccnsc # C-1269 / #C-245 Gcolog)
POW DATE: 1-21-21 REVISION NO. 0
JOB NO. DSO-155 ATTACHMENT NO. 7

hart '` hickman
SMARTER ENVIRONMENTAL SOLUTIONS
May 25, 2021
Mr. Chad Kimes, PE
District Engineer
North Carolina Department of Transportation
5501 Barbados Blvd.
Castle Hayne, NC 28429
Reference: Temporary Borings in NCDOT Right -of -Way
South Third Street Between Castle Street and Queen Street
US Business 17 Near S. Front Street and S. Second Street
Wilmington, New Hanover County, North Carolina
Dear Mr. Kimes:
Hart & Hickman, PC (H&H), under contract to the North Carolina Dry -Cleaning Solvent
Cleanup Act (DSCA) Program, is requesting authorization to advance up to three
temporary borings in the North Carolina Department of Transportation (NCDOT) Right -
of -Way along S. Third Street and up to eight borings near the Business 17 intersection at
S. Front Street in Wilmington, North Carolina, as shown on the attached figure. The work
will be conducted in the grassy area of the Right -of -Way (see attached figure). The
borings will consist of 3-inch diameter borings advanced between 10 and 50 feet below
ground surface using a small track -mounted drilling rig for groundwater sample
collection via a temporary groundwater sampling point. Following groundwater
sampling, the boring will be properly abandoned and patched to match surface
conditions. Boring advancement and sampling will occur over an approximately 3 to 4-
hour time period. Utilities will be located prior to drilling via NC One Call and a private
utility locator.
Per guidelines issued by the NCDOT, specifically for DSCA sites, the temporary borings
require written authorization from the regional district engineer, but do not require an
encroachment agreement. See the attached guidelines, for reference. If the information
detailed in this submittal appears acceptable, please respond with your written
authorization. A figure showing the proposed boring locations is attached.
2923 South Tryon Street, Suite 100 3921 Sunset Ridge Rd, Suite 301
Charlotte, NC 28203 Raleigh, NC 27607 www.harthickman.com
704.586.0007 main 919.847.4241 main

Mr. Chad Kimes, PE
NC Department of Transportation
Page 2
The following is additional information, as requested in NCDOT guidance:
Contracting Firm: Hart & Hickman, PC
DSCA Site Name: Former Heritage Cleaners
DSCA Site ID #: DC650018
DSCA Site Address: 522 South Third Street, Wilmington, New Hanover County
If you have any questions or require any additional information, please do not hesitate to
contact me.
Sincerely,
X-'�vp-J�
Carlin Slusher
Senior Project Scientist, Hart & Hickman, PC

GP-1 (4/3/18)
} 5-15'
GP-2 (4/3/18) PCE <0.0010
f ' a
;i _ GP-4 (11/16/18)
5-15'
- - r+ PCE <0.0010 5-15'
yam. PCE I <0.00050
GP-1
* # _ F '� .. a 1 GP-2 GP 4
GP-3 (4/3/18) I
I 5-15' GP-6 GP_5 FORMER HERITAGE CLEANERS
m = * _ PCE <0.0010 GP-7 �}
O
-_ CASTLE 01 - GP-7 -1/16/18) GP-5 (11/16/18)
515' 5-15'
PCE 1 0.0056 PCE 0.00097
GP-6 (11/16/18)
5-15, �a
F fA PCE 0.0015 -i
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WSW-5 (8/19/20) 2 W
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- y
LEGEND
SOURCE PROPERTY BOUNDARY
PARCEL BOUNDARY
NOVEMBER 2019 TEMPORARY
MONITORING WELL LOCATION
APRIL 2018 DIRECT -PUSH GROUNDWATER
SAMPLING LOCATION
® IRRIGATION WELL LOCATION
ASSUMED GROUNDWATER FLOW
DIRECTION
SAMPLE ID AND DATE
WSW-5 (8/19/20)
35' * SAMPLE DEPTH (FT BGS)
PCE 0.0030 CONCENTRATION (mg/L)
CONSTITUENT
p Proposed Direct -Push
Sample Location
NOTES:
1. AERIAL IMAGERY OBTAINED FROM NC ONEMAP.
2. PCE = TETRACHLOROETHYLENE
FT BGS = FEET BELOW GROUND SURFACE
3. * = SCREEN INTERVAL FOR WATER SUPPLY WELL
WSW-5 IS UNKNOWN, TOTAL DEPTH IS 35 FT BGS.
QUEEN STREET ;
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APPROXIMATE
0 120 240
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TITLE
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PCE CONTAMINATION CONCENTRATION MAP
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PROJECT HERITAGE CLEANERS
T DSCA ID: DC650018
k„ 522 S THIRD STREET
WILMINGTON, NEW HANOVER COUNTY
hart � hickman 3921cg nset ,Mort CaroliRoad,
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+v Ralei h, North Carolina 27607
w 919-847-4241(p) 919-847-4261(i
SMARTER ENVIRONMENTAL SOLUTIONS T.iccnsc # C-1269 / #C-245 Gcolog)
POW DATE: 1-21-21 REVISION NO. 0
JOB NO. DSO-155 ATTACHMENT NO. 7

Encroachment Agreement Standard Conditions
District Office Contact Information:
300 Division Drive
Wilmington, NC 28401
[phone]
The Standard Conditions in this document apply to this and all encroachment agreements issued by District 3.
SC1 A Pre -Construction Meeting is required prior to beginning work. Contact the District Office to schedule.
SC2 The Encroaching Party shall follow any and all revisions shown in RED on attached plan(s).
SC3 This permit along with all terms and agreements shall be incorporated into any lease or sales agreement.
SC4 If the approved permit encroaches within the limits of an active construction project the Encroaching Party will be
required to coordinate with the NCDOT contractor as well as secure a hold harmless agreement prior to
commencing work. If the approved permit encroaches within the limits of project in preconstruction, the
Encroaching Party will be required to coordinate with the Department's Project Development Unit to ensure no
conflicts are created with the installation.
SC5 A Performance and Indemnity Bond posted with the North Carolina Department of Transportation is hereby
obligated to cover work under this encroachment agreement. This bond is only for work within NCDOT Right of
Way.
SC6 An Initial Construction Inspection is required after the completion of the work. An Initial Inspection Report will be
issued upon satisfactory completion of the work and begins the one year warranty period. Contact the District Office
to schedule an inspection by calling 910-398-9100 or email at [e-mail].
SC7 A Final inspection is required after one year and prior to release of the bond. Contact the District Office three
months prior to the end of the one year bonding period for final inspection and creation of a list of deficiencies; this
should provide enough time for corrective action prior to the end of one year. A Final Inspection Acceptance will be
issued once the work has been completed and any deficiencies addressed.
SC8 All bonds will be held for a minimum of one year from the time of the Initial Construction Inspection Acceptance. At
the end of that time period, the bond may be released at the request of the applicant pending Final Inspection
Acceptance.
SC9 All flagging operations within NCDOT right-of-way require qualified and trained Work Zone Flaggers. Qualified and
trained Work Zone Traffic Control Supervisors will be required on significant projects. Training for this certification is
provided by NCDOT approved training sources and by private entities that have been pre -approved. For more
information, visit https://connect.ncdot.gov/projects/WZTC/Pages/Training.aspx or contact Steve Kite, PE with the
NCDOT Work Zone Traffic Control Unit at [phone], or [e-mail].
SC10 No lane closures shall be allowed on State Holidays (day of, day before, and day after) or during Local events.
SC11 No lane closures or impediment to traffic shall be allowed on weekends without prior written approval from the
District Engineer.
SC12 One lane must always be open to traffic; only one lane closure will be allowed in each direction. Ingress and egress
shall be maintained to all businesses and dwellings affected by the project. Special attention shall be paid to Police
and Fire Stations, fire hydrants and Hospitals.
SC13 All roadway signs removed during project work shall be reinstalled immediately after completion of work. All
equipment and materials shall be removed from the NCDOT right-of-way when not in use.
SC14 Any work requiring personnel or equipment within S' of the travel lane on an undivided roadway, or 10' of the travel
lane, on a divided roadway shall require a lane closure per the latest edition of the MUTCD and the NCDOT
Standard Specifications. The more stringent standards shall apply.
SC15 Approval is only for work within NCDOT right-of-way. Any construction planned or proposed outside NCDOT right-
of-way shall require the permittee to obtain concurrence and/or right-of-way from subject property owner and/or
local government. This approval excludes area(s) within Railroad right-of-way and/or Municipal right-of-way which
will require separate approval from the Railroad, City or Town. Approval is with the understanding that NCDOT does
not guarantee the right-of-way on any road.
Division 3, District 3 Updated 02/03/2020

SC16 All traffic control, asphalt mixes, structures, construction, workmanship and construction methods, and materials
shall be in compliance with the most -recent versions of the following resources: Manual on Uniform Traffic Control
Devices, Policy on Street and Driveway Access to North Carolina Highways, Policies and Procedures for Accommodating
Utilities on Highway Rights of Way, Subdivision Roads Minimum Construction Standards, NCDOT Standard
Specifications for Roads and Structures, NCDOT Roadway Standard Drawings, AASHTO Policy on Geometric Design of
Highways and Streets, NCDOT Asphalt Quality Management System manual, and the approved plans.
SC17 Prior to beginning work, it is the requirement of the Encroaching Party to contact the appropriate Utility Companies
involved and make arrangements to adjust or relocate any utilities that conflict with the proposed work.
SC18 NC 811 services DOES NOT provide locates of traffic signal cables. If the work is located within'/z mile of a
signalized intersection, the Encroaching Party shall contact NCDOT Traffic Services at [phone] no less than
one week prior to beginning work, for the location of all traffic signal and detection cables. Location is required prior
to excavation. Cost to replace or repair NCDOT signs, signals or associated equipment shall be the
responsibility of the Encroaching Party.
SC19 If modifications to a traffic signal are required under this encroachment agreement, a separate traffic agreement is
required prior to work. Contact the Division Traffic Engineer or Deputy Division Traffic Engineer at [phone].
SC20 If pavement markings are required under this encroachment agreement, the Encroaching Party shall have the
pavement markings pre -marked, inspected, and approved by NCDOT personnel prior to the placement of final
pavement markings. Contact Traffic Services at [phone] for pre -marking inspections or field changes.
SC21 All concrete or paved channelization islands shall have a 12 inch diameter round or square smooth wall hole drilled,
cored, formed, or air -hammered to the subgrade and backfilled with soil placed a minimum of 10 feet from the nose
of each end of the island (see Roadway Standard Drawing 904.50), or as directed by the engineer. All sign supports
that are to be erected in existing or proposed concrete or paved channelization islands shall meet the same
requirements. If necessary, contact Traffic Services at [phone] to mark core locations.
SC22 Prior to beginning work, if the area of work is within a municipality limit, it is the responsibility of the Encroaching
Party to notify the municipal authorities.
SC23 The Encroaching Party shall comply with all applicable Federal, State, and local statutes, rules, regulations, and
ordinances that may be imposed by other governmental agencies. The Encroaching Party shall obtain all necessary
Federal, State, and local environmental permits, including but not limited to, those related to sediment control,
storm water, wetlands, streams, endangered species, and historical sites.
SC24 All wiring and related work shall conform to the latest edition of the National Electrical Safety Code.
SC25 No alteration of the approved plan will be allowed without written approval by NCDOT. All design plan changes
proposed by the contractor shall be prepared by the Engineer of Record and submitted by the Owner/Permittee to
NCDOT for review to ensure that the Engineer and Owner participate in all construction changes. Field changes
constructed without prior written approval by NCDOT will not be accepted by NCDOT during the inspection process.
SC26 An executed paper copy of the Encroachment Agreement and approved plans shall be present at the work site at all
times while performing work. NCDOT reserves the right to stop all work unless evidence of approval can be shown.
Additionally, NCDOT reserves the right to further limit, restrict, or suspend operations within the right-of-way.
SC27 Material shall NOT be unloaded or stockpiled on the roadway at any time without proper lane closure during the
project. Work is not permitted when the shoulder material is wet or during adverse weather conditions.
SC28 All erosion control devices shall be placed as needed prior to disturbance and maintained throughout the project.
All areas disturbed (shoulders, ditches, removed accesses, etc.) shall be graded and seeded within 15 calendar days
with an approved NCDOT seed mixture. For disturbance of residential/commercial lawns, vegetation shall be
replaced in like kind.
SC29 For disturbance of plants, vegetation, trees or plant beds in the NCDOT right-of-way, they shall be replaced with
plants, vegetation or trees of like kind or similar shape. Contact the Division Roadside Environmental Engineer at
910-259-4919.
SC30 The placement of curb and gutter is not allowed within shoulder sections of roadway (from the Right of Way to the
edge of pavement).
SC31 It shall be the responsibility of the property owner or local municipality to maintain any proposed sidewalk that will
be placed within the NCDOT Right of Way. It is the responsibility of the Encroaching Party to place the sidewalk and
wheelchair ramps per NCDOT standards and the latest edition of the Americans with Disabilities Act. This
maintenance requires an encroachment agreement through the District Office.
Division 3, District 3 Updated 02/03/2020

SC32 It shall be unlawful to place any highway obstruction, including a driveway headwall, fence, rural mailbox, newspaper
delivery box, or other roadside obstruction, so as to interfere with the traffic or maintenance of the roads and
highways of the state highway system. See North Carolina Administrative Code 19A NCAC 2E.0404.
SC33 Fire Hydrant(s) shall be placed a maximum of 1 foot from the right-of-way line. (STD. 1515.02 in the NCDOT
Roadway Standard Drawings).
SC34 The Encroaching Party shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
SC35 The Encroaching Party is responsible for any and all damages caused from project work within the right-of-way,
including damage to drainage structures, pavement, vegetation, etc.
SC36 Any pavement damaged including settlement of the pavement or damage by equipment used to perform the
project work, shall be re -surfaced to the satisfaction of the District Engineer or their representative. This may include
the removal of pavement and a 50' mechanical overlay. All temporary and final pavement markings are the
responsibility of the Encroaching Party.
SC37 Centerline pavement markings shall be installed the same day resurfacing is accomplished. All other pavement
markings shall be completed within five days of resurfacing.
SC38 All pipes placed within the NCDOT Right of Way shall be NCDOT approved materials. All joints shall be sealed with
mortar or other NCDOT approved material. Backfill compaction shall meet NCDOT Standardized Testing Method.
SC39 Throughout the life of the project, the Encroaching Party shall maintain all drop-offs within the work zone such that
they do not exceed the maximum of 2".
SC40 All removed curb, driveways, and shoulder areas shall be backfilled at a 6:1 slope or flatter at the end of the days'
production.
SC41 For projects with open cuts and roadway improvements, a PE certification may be required. When applicable, upon
completion of construction, a certification memo that has been signed and sealed as appropriate under General
Statute 89C-16 by a North Carolina Professional Engineer or Registered Land Surveyor shall be submitted to the
District Engineer prior to opening the access connection for public use. Supporting documentation shall be attached
certifying that improvements for the driveway access(s) meet the approved plan and NCDOT standards. All
documentation shall be dated and initialed by the contractor. Verification will include inspection reports, testing
reports, or any supporting documentation and calculations. Verification will cover, but is not limited to, subgrade,
pavement structure, drainage, and traffic control items.
SC42 Directional drilling methods have not been given statewide approval for use on NCDOT right-of-way. Under no
condition shall jetting alone or wet boring with water be used for the installation of utility pipelines.
• Directional boring is not allowed in embankment material. Directional boring is allowed beneath embankment
material in naturally occurring soil.
• Any changes shall be submitted to the District Engineer for approval prior to construction.
• Directional bores are not allowed beneath bridge footings, culvert wingwall footings or retaining walls.
• HDPE pipe installed by directional boring shall not be connected to existing pipe or fittings for one (1) week
from the time of installation to allow tensional stresses to relax.
• Directional boring using jetting with a Bentonite (or equivalent material) slurry is approved with the following
conditions:
o Minimum depth of ten (10') feet below the pavement surface of roads with no control of access or
fifteen (15') feet below the surface of roads with partial or full control of access.
o Minimum depth of five (5') feet below any ditch line and/or creek bed.
o Minimum depth of (4') for parallel installations. Must be outside the theoretical 1:1 slope from the
existing edge of pavement except where the parallel installation crosses a paved roadway.
o Minimum horizontal distance of ten (10') feet from the nearest part of any structure, including but not
limited to bridges, footings, pipe culverts, and box culverts.
o Minimum vertical distance of ten (10') feet from the nearest part of pipe culverts or box culverts.
o Tip of the drill string shall have a cutter head and detection wire installed with non-ferrous material.
o All directional drilled piping for sewer force mains and waterlines shall be a minimum of SDR-9.
Division 3, District 3 Updated 02/03/2020

o Minimum horizontal separation of five (5') feet between each conduit which is part of a multiple
conduit installation (including perpendicular and parallel installations). Alternatively, install multiple
conduits within a single duct.
o Overbores for pipe or encasements shall not be more than 1.5 x O.D. for pipe 12 inches or less and
O.D. +6 inches for pipes larger than 12 inches.
o An overbore exceeding the prescribed maximums for pipe or encasements will only be considered if
the encroachment agreement includes a statement signed and sealed by a North Carolina Registered
Professional Engineer indicating that the proposed overbore in excess of NCDOT guidelines of the
diameter of the pipe or encasement will arch and no damage will be done to the pavement or sub -
grade.
SC43 All excavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of the nearest
trench wall shall be done in accordance with the following conditions:
• Any excavation encroaching upon the theoretical 1:1 slope from the edge of pavement of any NCDOT
maintained road shall require temporary active shoring that must be reviewed and approved by NCDOT
prior to work.
• All trench excavation inside the limits of the theoretical 1:1 slope, as defined by the policy, shall be
completely backfilled and compacted at the end of each construction day. No portion of the trench shall be
left open overnight.
• The length of parallel excavation shall be limited to the length necessary to install and backfill one (1)joint of
pipe at a time.
• Traffic shall be moved to a travel lane outside the limits of a theoretical 1:1 slope from the bottom of the
nearest trench wall to the pavement surface.
• Installation of trench shoring shall be accomplished with minimal over -excavation. Trench boxes shall not
be used as shoring.
• An NCDOT Inspector, the cost of which is to be borne by the Encroaching Party, shall be assigned to this
project if deemed necessary by the Division Engineer.
• The trench backfill material shall meet the Statewide Borrow Criteria. The trench shall be backfilled, in
accordance with Section 540-6 of the latest NCDOT Standard Specifications for Roads and Structures, which
requires the backfill material to be placed in thicknesses between 4" and 8" loose and compacted to at least
97% of the maximum density obtained by compacting a sample in accordance with AASHTO T 180, as
modified by the Department.
• At the first sign of trench failure, a trench shall be immediately backfilled with materials consisting of A-1, A-
3, A-2-4 soils or A-4 soils having a maximum of 45% passing a No. 200 sieve and a maximum P.I. of 6. All
work shall cease, and the Division Engineer shall be contacted. The Encroaching Party shall be required to
repair any damage to the pavement caused by the excavation.
• No part of any pit shall be within three (3) feet of edge of pavement or back of curb.
• Detection tape shall be buried in the trench approximately one foot above the utility or fiber optic cable,
whenever conduit is installed in right-of-way and is not of ferrous material.
SC44 The proposed manholes, handholes, valves or other appurtenances shall be installed flush to match the elevation of
the existing ground and shall not be located in the existing ditch line, front slope of a ditch, or in a manner that
would restrict the maintenance or flow of the existing ditch line.
SC45 Any open cutting of pavement shall be repaired using the following method:
• Pavements shall be cut full depth and removed.
• After trench work is complete, the edges of the existing pavement along the trench shall be recut a
minimum of 1' wider on each side of the trench. If the pavement is undermined, the edges of the existing
pavement along the trench shall be recut to 1' beyond the undermined portion and the pavement removed.
The design section stated below is to be placed in those areas.
• The pavement repair shall be performed using the following method and pavement design section:
o 11.0" B25.00 or 1325.013 Asphalt Concrete Base Course (accomplished in 2 lifts minimum) according to
NCDOT Standard 654.01.
o Mill the entire area a depth of 2.0", starting from 15' in front of the edge of the final pavement cut.
Division 3, District 3 Updated 02/03/2020

o Overlay entire area (a minimum 50' length mechanical overlay) with 2.0" S9.5C or S9.5B Asphalt Concrete
Surface Course for a total asphalt depth of 13". Butt joints are required with no feathering of joints.
All open cuts shall be backfilled, paved and traversable prior to removing lane closure.
SC46 Abandoned pipes 12" in diameter and larger in fills 20' or less shall be removed and backfilled, filled with grout, or
plugged, as directed by the Manager of Right -of -Way, Division Engineer or State Design Services Engineer. There
may be unusual circumstances where the same requirements will apply on pipes smaller than 12".
SC47 Any sewer manholes, telephone vaults or valve vaults that are to be abandoned shall either be removed or broken
down two (2) feet below subgrade, plugged and filled with suitable material.
SC48 For trenching excavations within the typical ditch cross-section, positive drainage shall be restored within the
existing ditch by grading between driveway pipe invert elevations or by re-establishing the original hydraulic grade
line.
Division 3, District 3 Updated 02/03/2020

MICHAEL F. EASLEY
GOVERNOR
December 28, 2006
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
UIIHTIES COORDINATION UNIT LYNDO TIPPETT
1555 MAI SFRVICHCWfER, RALDORNC27699-1555 SEeR rARY
Mr. John Powers
Head, Special Remediation Branch
NCDENR — Division of Waste Management
401 Oberlin Road, Suite ISO
1646 Mail Service Center
Raleigh, North Carolina 27699-1646
t AN 2�
s R't1'1 ` g D S C t
Subject: NCDOT Encroachment Agreements for Groundwater Monitoring Wells for the
NCDENR Division of Waste Management Dry CIeaning Solvent Cleanup Program
Dear Mr. Powers:
NCDOT has prepared the attached Guidelines for Processing Groundwater Monitoring Well
Encroachments and Special Provisions for accommodating ground water monitoring wells
associated with the Dry Cleaning Solvent Cleanup Act (DSCA). NCDOT reserves the right to
further limit, restrict or suspend operations associated with this program if safety or traffic
conditions warrant such action. Please distribute this information to the companies contracted by
NCDENR for their use in preparing encroachment submittals. If companies not included in the
list provided by NCDENR of June 23, 2006 are contracted for this program, please notify David
West in writing at the address above.
All encroachments for groundwater monitoring wells should be submitted to the appropriate
NCDOT District Engineer's Office on the enclosed FORM R/W 16.1A, RIGHT OF WAY
ENCROACI4MENT AGREEMENT FOR NON -UTILITY ENCROACHMENTS ON PRIMARY
AND SECONDARY I-IIGHWAYS. The applicant should submit one original and three copies
of the completed agreement along with four sets of the plans or drawings which include the
information described in the Guidelines and in the Instructions section of the FORM R/W16.IA.
Also enclosed is FORM R/W 16B for Continuing Indemnity Bond. NCDOT is requiring a
Continuing Indemnity Bond in the amount of $100,000.00 from each of the companies installing
groundwater monitoring wells within the NCDOT right of way. The Form R/W 16B should be
completed by the surety company and executed by authorized personnel of the applicant and
returned with Power of Attorney from the surety company to the attention of David West at the
address above. NCDOT reserves the right to increase the amount of bond required if, in the
opinion of NCDOT, conditions warrant such action. No encroachment agreements shall be
approved until the applicant's Continuing Indemnity Bond is posted with NCDOT.
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
UTILITIES COORDINATION UNIT
1555 MAIL SERVICE CENTER
RALEIGH NC 27699-1555
TELEPHONE: [phone]
Fax: [phone]
WEBSITE: WWW.DOI-l.DOT.STATE.NG.US
LOCATION:
TRANSPORTATION BUILDING
1 SOUTH WILMINGTON STREET
RALEIGH NC

NCDENR (DSCA)
Page 2
Additional Encroachment Forms and Bond Forms are available on-line at www,ncdg .org under
Business Resources, Electronic Forms or by contacting David West at [phone] x 363.
Do not hesitate to contact us with any questions,
Sincerely,
State Utility Agent
K�MN
Enclosures
cc: Steve Vamcdoe, PE, NCDOT Chief Engineer
Tommy Cozart, PE, NCDOT Project Services

STATE OF NORTH CAROLINA
DEPARTMENT Or T RANSPORTAUON
MICHAEL F. EASLEY 111 LITIM COORDINATION UNIT LYINDo TiPPETT
GOVERNOR 1555MAILSERVICECWIIt RALL-uHtac27699-1555
5rcR1:TARY
Guidelines for Processiniz Goundwater Monitoring Well Encroachments requested under
the North Carolina Dry Cleaning Solvent Cleanup Act.
Encroachment request should.be submitted to the NCDOT District Office on FORM R/W 16.1A
for Non -Utility Encroachments.
Encroachment request for monitoring wells under the North Carolina Dry Cleaning Solvent
Cleanup Act (DSCA) should only be accepted from firms contracted with NCDENR DSCA
Program. (List of contracted firths attached)
All encroachment submittals under the NCDENR DSCA Program shall include a letter to the
NCDOT District Engineer from the NCDENR DSCA Program Project Manager identifying the
Contracting firm, the DSCA Site name, DSCA Site ID number and Site address. (Sample letter
attached)
Any encroachment submittal for a monitoring well within the NCDOT right of way but outside
of the property limits of the subject DCSA Site must include the written permission of the
underlying property owner of the proposed well site.
A Continuing Indemnity Bond of One Hundred Thousand dollars will be required of all
contracted firms prior to working within the NCDOT right of way.
The encroachment submittals should include the following details: location map, plan sheet with
the proposed well (s) clearly marked and referenced by dimensions, existing roadway and right
of way widths, existing edge of pavement, curb and gutter and ditchlines, existing utilities which
may conflict with the proposed installation, distance to the nearest intersection, name and
telephone number of a contact person representing the contracting firm and all other applicable
information required in the instruction section of the encroachment agreement form.
In most cases, encroachment agreements for groundwater monitoring wells submitted under the
NCDENR/ DSCA Program are to be processed at the Division Level. When the proposed wells
are within the limits of an Active Transportation Improvement Project, Controlled Access Right
of Way, or require the technical assistance of the Project Services Unit, they are to be forwarded
to Raleigh for processing.
Monitoring wells shall not be allowed in pavement, medians or traffic islands.
MAILING AI)DRESS:
NC DEPARTMENT OF TRANSPORTATION
UTILITIES COORDINATION UNIT
1655 MAIL SERVICE CENTER
RALEIGIt NC 27699-1555
TELEPHONE: [phone]
Fax: [phone]
WEBSITE: WWW.UON.DOT.STATE.NC.US
LOCATION:
TRANSPORTATION BUILDING
1 SOUTH WILMINGTON STREET
RALEIGH NC

Guidelines
Page 2
Requests for soil sampling or test drilling alone, without the installation of an actual monitoring
well or other installation within the NCDOT right of way do not require an encroachment
agreement but must be authorized in writing by the District Engineer.
Rev. 12/04/2006

SPECIAL PROVISIONS
Special Provisions for groundwater monitoring wells being installed under the
North Carolina Department of Environment and Natural Resources (NCDENR) Dry
Cleaning Solvent Cleanup Act (DSCA) Program should include as applicable, but not be
limited to the following Special Provisions.
1. The encroaching party shall notify the NCDOT District Engineer's Office at telephone
(000 ) 000-000 prior to beginning construction and after construction is complete.
2. An executed copy of this encroachment agreement shall be present at the construction
site at all times during construction. If safety or traffic conditions warrant such an action,
NCDOT reserves the right to further limit, restrict or suspend operations within the right of way.
3. A letter provided by the NCDENR/DSCA Program Project Manager, identifying the encroaching
party as an authorized contractor for the specific site shall be present at the installation site at
all times during installation and subsequent monitoring.
4. A Continuing Indemnity Bond shall be on file with the NCDOT Utility Coordination Unit prior to
beginning any installation within the NCDOT right of way.
5. NCDOT does not guarantee the right of way on this road, nor will it be responsible for any
claim for damages brought about by any property owner by reason of this installation.
G. The encroaching party is required to contact the appropriate Utility Companies involved and make
satisfactory arrangements to adjust the utilities in conflict with the proposed work prior to beginning
construction. No cost to adjust, relocate or repair utilities shall be borne by NCDOT.
7. Excavation, including boring or drilling, within 500 feet of a signalized intersection will require
notification by the party of the second part to the Division Traffic Engineer at telephone number
(000) 000- 0000, All traffic signal or detection cables must be located prior to excavation.
8. The encroaching party shall comply with all applicable Federal, State and local environmental
regulations and shall obtain all necessary Federal, State and local environmental permits, including
but not limited to, those related to sediment control, stormwater, wetland, streams, endangered
species and historical sites.
9. The contractor shall not begin the construction until after the traffic control and erosion control
devices have been installed to the satisfaction of the District Engineer.
10. Trenching, bore pits and/or other excavations shall not be lcft open or unsafe overnight. The
Contractor shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
11. All fill areas/backfill shall be compacted to 95% density in accordance with AASHTO T99 as
modified by the NCDOT.
12. Vegetative cover shall be established on all disturbed areas in accordance with the recommendations
of the Division Roadside Environmental Engineer.

Special Provisions (Cont.)
Page 2
13. Proper temporary and permanent measures shall be used to control erosion and, sedimentation in
accordance with all local, State and Federal regulations.
14, No wells shall be installed that may interfere with the proper drainage or maintenance of any
drainage structure. Any drainage structure disturbed or damaged shall be restored to its original
condition as directed by the District Engineer.
15. Any disturbed guardrail shall be reset according to the applicable standard or as directed by the
District Engineer,
16. All driveways altered during construction shall be returned to a state comparable with the condition
of the driveways prior to construction.
17. Right of Way monuments and property corners disturbed during construction shall be referenced by
a registered Land Surveyor and reset after construction,
18. Proper traffic control devices, signs, etc. shall be installed to ensure public safety in accordance with
the latest edition of the Manual on Uniform Traffic Control Devices and any supplements thereto and
NCDOT Roadway Standard Drawings.
19. All lanes of traffic are to be open during the hours of 6:00 A.M. to 9:00 A.M. and from 4:00 P.M. to
6:00 P.M. Traffic will be maintained at all times.
20. Ingress and egress shall be maintained to all businesses and dwellings affected by the project.
Special attention shall be paid to police and fire stations, fire hydrants and hospitals.
21. Any work requiring equipment or personnel within 5' of the edge of any travel lane of an undivided
facility and within 10' of the edge of any travel lane of a divided facility shall.require a lane closure
with appropriate tapers.
22. No parking or material storage shall be allowed along NCDOT maintained roadways.
23. During non -working hours, equipment'shall be parked as close to the right of way line as possible
and be properly barricaded in order not to have any equipment obstruction within the Clear Recovery
Area.
24. All roadway signs that are removed due to construction shall be reinstalled as soon as possible.
25. Excavation material or spoils from drilling shall not be placed on the pavement. Drainage structures
shall not be blocked with excavation materials.
26. Only the well (s) shown on the attached plan is approved by this agreement. Additional wells at the
site will require a revision to this agreement or a separate encroachment agreement.
27. Any and all costs for adjustments to the proposed wells due to NCDOT construction shall be the
responsibility of the encroaching party.

Special Provisions (Cont.)
Page 3
28. NCDOT or its contractors shall not be held responsible for damage to monitoring wells due to
roadway construction or maintenance activities.
29. Ground water monitoring wells shall not be allowed in pavement, medians, or traffic islands.
30. Well caps shall be flush mounted with the ground surface with the frames and covers of a NCDOT
approved design for HS 20 loading when installed within clear recovery area or within routine
snowing boundaries.
31. Wells proposed outside of the clear recovery area and outside of the boundaries of routine mowing
shall be flush mounted but are not required to be designed for HS 20 loading.
32. Any conversion of a monitoring well to an extraction or remediation system will require a separate
encroachment agreement requiring review by NCDOT's Project Services Unit.
33. Spoils from the well installation shall be disposed of outside NCDOT right of way at an approved
site. Any contaminated soils encountered in construction as spoil from the well installation shall be
removed from the NCDOT right of way immediately upon discovery and properly disposed of in
accordance with the appropriate governing regulations.
34. A copy of all test results from the well (s) within the NCDOT right of way shall be made available
to the NCDOT District Engineer's Office.
35. After the monitoring well (s) has served its intended purpose, the well (s) shall be filled in a manner
approved by NCDENR. and NCDOT. Any flush mounted or above ground obstructions shall be
removed from the right of way and the site shall be returned to a condition satisfactory to the District
Engineer,
Rev. 12/04/2006

ATTACHMENT 4
AGENT AUTHORIZATION AGREEMENT:
DSCA AGREEMENT FOR ASSESSMENT AND REMEDIATION

ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S. REGAN
Secretary
MICHAEL SCOTT
Director
October 19, 2018
JAMES GOODNIGHT
ALBERTA PROPERTIES LLC
2108 CLARK AVE
RALEIGH NC 27605
RE: Petitioner Eligibility
DSCA Site ID DC650018
522 S Third ST
Wilmington, New Hanover County
The Dry -Cleaning Solvent Cleanup Act (DSCA) Program (DSCA Program) has reviewed your petition to enter into
an agreement and considers Petitioner an eligible petitioner. Enclosed, please fmd the executed assessment and
remediation agreement. By entering into this agreement, you agree to cooperate with the DSCA Program to assist in
the assessment and remediation of the dry-cleaning solvent contamination at the Site. By entering into and complying
with the agreement, you obtain the liability protection afforded pursuant to N.C.G.S. § 143-215.104K.
The financial responsibility requirements for this site are detailed in appendix B of the petition.
The owner(s) of the property will be notified prior to the commencement of any site work to be conducted by the
DSCA Program's independent contractors.
If you have any questions, please contact me at delonda.alexanderLamcdeting_ov or [phone].
Sincerely,
Delonda Alexander, DSCA Remediation Unit Supervisor
Division of Waste Management, NCDEQ
Attachments: Notification of Certification into the Dry -Cleaning Solvent Cleanup Act Program
Executed Administrative Agreement for State -Directed Assessment and Remediation
Petition
� EQ-
-
NorthC*rolhu
Department of Envw0Mnentat Qt*y I pM$Wn of waste Moropment
217 West lwnes Street 11646 MA Scrvkc Center ! RakWg North Carolina 27699^1646
919.707.8200

ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S. REGAN
Secretary
MICHAEL SCOTT
Director
Letter of Certification into the Drycleaning Solvent Cleanup Act Program
On October 19, 2018, pursuant to N.C.G.S. § 143-215.104G, the Dry -Cleaning Solvent Cleanup
Act (DSCA) Program has certified the site located at 522 S Third ST, Wilmington in New
Hanover County into the DSCA Program. The site has been assigned the DSCA identification
number DC650418.
Evidence of dry-cleaning solvent contamination has been documented arising from dry-cleaning
operations originating from the site.
Based on information submitted to the Division at the time of certification, the site is an
Abandoned/No Active Drycleaner for the purposes of determining a site's financial
responsibilities as required by N.C.G.S § 143-215.104F(f)(2).
The site will remain certified in the DSCA Program as long as there is at least one eligible
petitioner who is complying with an agreement between the DSCA Program and that petitioner.
Pete Doom, Special Remediation Branch Supervisor
Division of Waste Management, NCDEQ
Narth+Ca OU" Department of BtMrlrtxm eMS Q"Wy 1 DlvWM of Waste Managtmc»t
217 Wit jones Street 1 1" Maki Scrvke Center I RAW* North Carolina 27699.1646
919.707.8200

be&500fe
North Carolina Dry -Cleaning Solvent Cleanup Program
-
Department of Environmental Quality
Division of Waste Management
Superfund Section
DSCA PETITION FOR CERTIFICATION
The North Carolina General Assembly enacted the Dry -Cleaning Solvent Cleanup Act
and Amendments (DSCA) to facilitate the assessment and remediation of Dry -Cleaning
Facilities, Wholesale Distribution Facilities and Abandoned Sites (Facilities)
contaminated with Dry -Cleaning Solvent. In order for the DSCA cleanup fund to be
used at a Facility, the Facility must be certified by the Division of Waste Management
(Division) of the North Carolina Department of Environmental Quality (NCDEQ) as
meeting the eligibility requirements set out in the DSCA. Rules adopted by the
Environmental Management Commission (EMC) require any person petitioning for
certification of a Facility (Petitioner) to use this DSCA Petition for Certification (Petition).
This Petition is designed to enable the Petitioner to provide the Division with the
information necessary to demonstrate that the Petitioner and the Facility meet the
requirements for certification in the DSCA. Each Petitioner must complete this form and
sign the Acknowledgement page. If the Petitioner is a corporation, limited liability
company, partnership or other business entity, the Petition must be signed by an
individual with authority to bind the business entity, and the individual signing the
Petition must certify that he/she is authorized to legally bind the business entity to the
Petition.
In addition to this Petition, an Assessment and Remediation Agreement (ARA) must be
signed and executed in order for the Petitioner to receive the liability protection afforded
pursuant to N.C.G.S. § 143-215.104K. The ARA also gives the DSCA Program the
authority to undertake state -directed assessment and remediation at the site. The
DSCA Program cannot begin any work at a site until the ARA is executed.
A $1,000 application fee must be paid before the petitioner is
considered eligible. Checks should be made to the Division of Waste
Management and included with the completed petition and signed agreement.
Pay Online
Go to our website at www.ncdsca.org and click on the DSCA-ePayments link in the
right blue side bar. Use Invoice # DC650018PAF1
Please review the information in the Site and Petitioner Information
Summary and make any corrections necessary.
DSCA Petition October 2007 Page 1

DSCA PETITIONER SUMMARY
Petitioner's relationship to the Facility Site
Property Owner
Petitioner
Alberta Properties LLC
2108 Clark Ave
Raleigh, NC 27605
Representative
James Goodnight
2108 Clark Ave
Raleigh, NC 27605
[e-mail]
Property Owner
[Petitioner is the Current Property Owner]
Contamination attributed to
Dry -Cleaning
Facility
Heritage Cleaners
522 S Third ST
Wilmington 28401-5161, New Hanover County
Size or Type
Abandoned/No Active Drycleaner
DSCA Petition October 2007 Page 2

OTHER INSTRUCTIONS
1. Documentation of a dry-cleaning related release must be submitted.
Therefore, please submit copies of any reports documenting environmental
assessment or remediation activities previously conducted at this site.
This includes any Phase I or Phase II reports conducted for property
transfers.
2. Please make sure that the Acknowledgement page is signed and notarized.
3. Please make sure that you have initialed the applicable Appendices on the
Acknowledgement page.
4. Please be aware that you are required to provide access to the Certified Facility
Site as part of the Petition if you ARE the property owner.
If you are NOT the property owner of the Certified Facility Site, you will be
required to obtain access for the Division and the Division's independent
contractors in the Assessment and Remediation Agreement (ARA) to
undertake all work to be performed at the Certified Facility Site.
5. Completed petitions should be mailed to:
Division of Waste Management
ATTN: Delonda Alexander - DSCA Program
1646 Mail Service Center
Raleigh, North Carolina 27699-1646
DSCA Petition October 2007 Page 3

ACKNOWLEDGEMENT
The Petitioner has indicated their status as a property owner. Therefore, Appendices A,
B and C apply to this Petitioner. Please proceed to these Appendices and read them
carefully since you will be certifying that you agree with or comply with these
Appendices.
Please initial the spaces below to acknowledge that you have read and are in
compliance with each applicable Appendix.
4�2—Appendix A Appendix B ppendix C
Petitioner (or authorized representative) hereby swears and affirms that the information
provided in this Petition, inclusive of all appendices and attachments, is true and correct
to the best of Petitioner's knowledge.
Petitioner (or authorized representative) hereby affirms Petitioner's intent to make with
the Dry -Cleaning Solvent Cleanup Act Program such agreements as may be reasonably
required under the North Carolina Dry -Cleaning Solvent Cleanup Act for the
assessment and remediation of a Dry -Cleaning Business at the Facility Site.
If signing as an authorized representative, I also hereby affirm that I am authorized to
execute this Petition on behalf of the Petitioner and that I am authorized to legally bind,
and hereby do legally bind, the Petitioner to this Petition and to all certifications
contained in this Petition, inclusive of all appendices and attachments.
This-2— day of Oc_t-4 — , 20 "
Signature of Petitioner (or auth.rep.):.�z
Name of Petitioner (or auth. rep. - typed or printed): 5
Title of Petitioner (or auth. rep. - typed or printed): nu�E
STATE OF N L
COUNTY OF WA)K
1, VKAWq 11 M , a Notary Public of the county aforesaid, do
hereby certify that OWKEri [name of Petitioner]
personally appeared before me th s day nd, having been duly sworn, executed the
foregoing DSCA Petition for Certification in my presence.
DSCA Petition October 2007 Page 4

ESS my hand and official seal this 2. day of f 20 It
ry Public
My Commission expires:
[SEAL]
KELSEY D. MCPHERSON
NOTARY PUBLIC
WAKE COUNTY, N.C.
My Commission Expires 07-26-2022
DSCA Petition October 2007 Page 5

APPENDIX A
ACCESS AGREEMENT A
(Petitioner is the Property Owner)
Heritage Cleaners
522 S Third ST
Wilmington
New Hanover County
DSCA Site ID No. DC650018
Name of Petitioner: Alberta Properties LLC
WHEREAS, the Petitioner is petitioning to the North Carolina Department of
Environmental Quality, Division of Waste Management (Division) for certification of the
Property into the Dry -Cleaning Solvent Cleanup Act Program (Program) pursuant to the
Dry -Cleaning Solvent Cleanup Act of 1997 as amended, Part 6, Article 21A, Chapter
143, N.C.G.S. § 143-215.104A et seq. (DSCA); and
WHEREAS, the Petitioner intends to enter into an Agreement for Assessment and
Remediation (ARA) with the Division concerning the Dry -Cleaning Solvent
contamination on the Property; and
WHEREAS, the Petitioner understands that the implementation of the ARA will require
that the Division and its independent contractors (contractors) have free and
unencumbered access to the Property for the purposes of investigating, assessing and
remediating Dry -Cleaning Solvent contamination on and around the Property; and
WHEREAS, the parties to this Access Agreement are the Division and the Petitioner;
NOW THEREFORE, in consideration of the terms and conditions contained in this
Access Agreement, and for other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties hereto agree as follows:
Grant of License and Permission. Petitioner hereby grants to (a) to the Division a
license to access the Property to monitor and enforce the ARA and (b) to the
Division's contractor(s) a license to access the Property to undertake all work to be
performed at the Property, including, but not limited to, the following purposes:
a) Inspecting, sketching and photographing the Property;
b) Taking such soil, water and air samples as may be necessary;
c) Taking other actions related to the investigation of surface or subsurface
conditions, such as installation of monitoring wells or excavation of
impacted soil;
DSCA Petition October 2007 Page 6

d) Transportation of equipment onto and around the Property as necessary
to accomplish the investigation;
e) Taking response actions necessary to mitigate any threat to human health
and the environment;
f) Remediating dry-cleaning solvent contamination at the Property as
needed; and
g) Undertaking such other activities as necessary to complete the work to be
performed as required or permitted under the ARA.
2. Conditions Precedent. The licenses created in Paragraph 1 shall take effect upon
the certification of the Property into the Program and shall remain in effect, unless
otherwise terminated pursuant to Paragraph 12 below, so long as the Property
remains certified under the Program.
3. Observation. Upon the Petitioner's reasonable notice and request, the Petitioner
and its consultants shall have the right to observe any activities performed by or on
behalf of the Division at the Property. Upon the Petitioner's reasonable notice and
request, the Division or its contractors shall allow the Petitioner to split samples of
any environmental samples obtained on behalf of the Division. All costs associated
with obtaining and analyzing the split samples shall be borne solely by the Petitioner.
4. Interference. The Division and its contractors shall endeavor to perform any
activities authorized hereunder at the Property in a manner that minimizes
interference with the use of the Property. The Division and its contractors will make
reasonable attempts to notify the Petitioner at least 48 hours prior to entering the
Property for the purposes stated in Paragraph 1.
5. Insurance. The Division's contractors have agreed to maintain the insurances as
defined in their agreement with the Division, provided however, that the Division
shall have no liability for its contractor's failure to maintain such insurance.
6. Site Repair. The Division or its contractors shall remove and shall have the right to
remove from the Property all equipment and other materials belonging to the
Division or its contractors within a reasonable period of time after the completion of
the activities at the Property authorized hereunder. To the extent practicable, the
Division's contractors shall restore the Property to the original condition it was in
prior to any activities authorized hereunder at the Property, and except as otherwise
agreed to by the parties, shall properly abandon any monitoring wells in accordance
with any applicable laws and regulations.
7. Protection of Wells and Equipment. The Petitioner shall not damage, remove, pave
over or cover any monitoring or remediation wells on the property. The Petitioner
DSCA Petition October 2007 Page 7

also shall not tamper with or affect the operation of assessment or remediation
equipment installed on the property by the Division's contractors.
8. Notice. Any notices, reports, or other communications required or permitted under
this Access Agreement shall be addressed to the representative for each party as
set forth below:
To Petitioner:
ALBERTA PROPERTIES LLC
c/o JAMES GOODNIGHT
2108 CLARK AVE
RALEIGH NC 27605
To the Division:
North Carolina Division of Waste Management -DSCA Program
Attn: Delonda Alexander
1646 Mail Service Center
Raleigh, North Carolina 27699-1646
9. Limitations. All obligations of the Division pursuant to this Access Agreement shall
be contingent upon the availability of moneys in the North Carolina Dry -Cleaning
Solvent Act Fund.
10. Governing Law. This Access Agreement shall be governed by and construed in
accordance with the laws of the State of North Carolina, without reference to choice
of laws principles.
11.Integration Clause. This Access Agreement represents the entire understanding
and agreement between the parties hereto and supersedes any and all prior
agreements, whether written or oral, that may exist between the parties regarding
same. No amendment or modification to this Access Agreement or any waiver of any
provisions hereof shall be effective unless in writing and signed by both parties.
12.Termination. The licenses created in Paragraph 1 may be terminated upon delivery
of reasonable written notice to the Division, which termination shall be effective upon
receipt of such notice. However, such termination will also terminate the ARA and
cause the forfeiture of liability protection under the DSCA. If no such notice is
served and subject to provisions of Paragraph 2 above, the licenses created herein
shall remain in effect until such time as all work or activities under the Program have
been completed at the Property. The right and obligation set out in the first sentence
of Paragraph 6 shall survive the termination of this license.
13. Modification. This Access Agreement may not be amended except in writing by the
parties to this Access Agreement.
DSCA Petition October 2007 Page 8

The parties each represent and warrant that this Access Agreement is executed by their
duly authorized representatives as of the date accepted and agreed upon below.
Accepted and agreed, this Z day of _ a , 20_a.
of Petitiefier or Signatory for Petitioner)
(Signature for thd''Division)
DSCA Petition October 2007 Page 9

APPENDIX B
CERTIFICATION OF ABILITY TO PAY AND
ACCEPTANCE OF FINANCIAL RESPONSIBILITY
G.S. § 143-215.104F(b)(2) requires that any person petitioning for certification of a Dry -
Cleaning Facility or Wholesale Distribution Facility or Abandoned Site (collectively:
Facility Site) shall provide the North Carolina Department of Environmental Quality
(NCDEQ) with information necessary to demonstrate such person's ability to incur the
response costs specified in G.S. § 143-215.104F(f).
The Petitioner has indicated that this facility is Abandoned/No Active Drycleaner.
Pursuant to G.S. § 143-215.104F(f), the required amount of response costs are as
follows:
For abandoned dry-cleaning facility sites in activities related to dry-
cleaning operations during the calendar year preceding the date of the
Petition, one and one-half percent (1.5%) of the costs of assessment or
remediation not exceeding one million dollars ($1,000,000).
Moreover, G.S. § 143-215.104F(f) requires that each Potentially Responsible Party who
petitions NCDEQ to certify a Facility Site shall accept written responsibility in the
amounts specified in G.S. § 143-215.104F(f), and described above, for the assessment
or remediation of the Dry -Cleaning Solvent contamination identified in the Petition.
Note: if two or more Potentially Responsible Parties petition NCDEQ jointly, the
amounts specified in G.S. § 143-215.104F(f), and described above, shall be the
aggregate requirements for the financial responsibility of all Potentially Responsible
Parties who are party to the Petition. Unless an alternative arrangement is agreed to by
the co -petitioners, the financial responsibility requirements of G.S. § 143-215.104F shall
be apportioned equally among the co -petitioners.
The Petitioner shall demonstrate his ability to incur, and his written acceptance of
financial responsibility for, response costs in the amounts specified in G.S. § 143-
215.104F(f), and described above, for the assessment or remediation of the Dry -
Cleaning Solvent contamination identified in the Petition. The Petitioner shall make this
demonstration by signing the Acknowledgement in this Petition.
DSCA Petition October 2007 Page 10

APPENDIX C
COMPLIANCE WITH STATE AND FEDERAL
ENVIRONMENTAL LAWS, RULES AND REGULATIONS
G.S. § 143-215.104F(b)(4) requires that every Potentially Responsible Party petitioning
for certification of a Dry -Cleaning Facility, Wholesale Distribution Facility or Abandoned
Site (collectively Facility Site) shall provide the North Carolina Department of
Environmental Quality (NCDEQ) with information necessary to demonstrate that the
Petitioner and any parent, subsidiary or other affiliate of the Petitioner, has substantially
complied with:
1. The terms of any dry-cleaning solvent assessment agreement, dry-cleaning
solvent remediation agreement, brownfields agreement, or any other similar agreement
to which the Petitioner or any parent, subsidiary or other affiliate of the Petitioner has
been a party;
2. The requirements applicable to any remediation in which the Petitioner has
previously engaged; and
3. Federal and State laws, regulations, and rules for the protection of the
environment.
By signing the Acknowledgement in this Petition, the Petitioner swears and affirms, to
the best of their knowledge, that the conditions stated above have been met.
DSCA Petition October 2007 Page 11

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WASTE MANAGEMENT
SUPERFUND SECTION
Dry -Cleaning Solvent Cleanup Act of 1997, as amended (DSCA) Program
IN THE MATTER OF:
HERITAGE CLEANERS
UNDER THE AUTHORITY OF
THE DRY-CLEANING SOLVENT
CLEANUP ACT OF 1997, AS AMENDED,
N.C.G.S. § 143-215.104A, et seq.
ALBERTA PROPERTIES LLC
2108 CLARK AVE
RALEIGH, NC 27605
DSCA SITE I.D. DC650018
AGREEMENT
FOR ASSESSMENT AND REMEDIATION
PURSUANT TO THE DRY-CLEANING SOLVENT CLEANUP ACT OF 1997, AS
AMENDED, PART 6, ARTICLE 21A, CHAPTER 143, N.C.G.S. § 143-215.104A ET SEQ.
("DSCA")
I. INTRODUCTION AND STATEMENT OF PURPOSE
The North Carolina Department of Environmental Quality, Division of Waste Management
("Division") and Alberta Properties LLC ("Petitioner"), collectively ("Parties"), hereby enter into
this Agreement for Assessment and Remediation ("Agreement") pursuant to the Dry -Cleaning
Solvent Cleanup Act of 1997, as amended, Part 6, Article 21A, Chapter 143, N.C.G.S. § 143-
215.104A et seq. ("DSCA").
In executing this Agreement, Petitioner agrees to cooperate with the Division's Dry -Cleaning
Solvent Cleanup Act Program ("Program") and the Division's independent contractors
("contractors" or "independent contractors") to assist in the assessment and remediation of the
dry-cleaning solvent contamination at the Site, as defined in Section II. E., below. By entering
into and complying with this Agreement, Petitioner obtains the liability protection afforded
pursuant to N.C.G.S. § 143-215.104K. Unless otherwise expressly provided herein, terms used
in this Agreement that are defined in DSCA or at 15A NCAC 2S .0102, shall have the meaning
assigned to them in those provisions, including any amendments thereto.
II. STATEMENT OF FACTS
A. On October 15, 2018, Petitioner filed with the Division a Petition for Certification for
Heritage Cleaners pursuant to DSCA.
B. On October 19, 2018, the Division certified Heritage Cleaners (hereinafter "Certified Facility
Site") pursuant to DSCA and informed Petitioner of its certification decision.
C. The Certified Facility Site is located at 522 S Third St, Wilmington in New Hanover County,
North Carolina.
DSCA ARAv20140312

D. Petitioner is a potentially responsible party, within the meaning of N.C.G.S. § 143-
215.104B(b)(21), for assessment and remediation of dry-cleaning solvent contamination at
the Site, as defined in subsection E, below.
E. The "Site" consists of all areas at the Certified Facility Site where dry-cleaning solvent
contamination arising from dry-cleaning or wholesale distribution operations is found and all
areas where dry-cleaning solvent contamination originating at the Certified Facility Site has
come to be located.
F. The Division is authorized to enter into this Agreement pursuant to the authority vested in the
Environmental Management Commission pursuant to DSCA and duly delegated to the
Secretary of the North Carolina Department of Environmental Quality and further delegated
from the Secretary to the Division.
NOW, THEREFORE, for the purpose of assessing and remediating the dry-cleaning solvent
contamination at the Site, the Parties agree as follows:
III. WORK TO BE PERFORMED
It is Petitioner's desire that assessment and remediation at the Site as required or permitted under
DSCA, the rules adopted under DSCA and guidance documents provided by the DSCA Program
shall be performed by independent contractors selected by the Division. The Division's
contractors shall maintain a minimum level of insurance as defined in their contract with the
Division.
IV. DISPUTE RESOLUTION
If Petitioner objects to any Division notice of disapproval or decision made pursuant to this
Agreement, Petitioner shall notify the Division in writing of Petitioner's objections within
fourteen (14) calendar days of receipt of the notice of disapproval or decision. The Parties shall
then have an additional fourteen (14) calendar days from receipt by the Division of the notice of
disapproval or decision to reach an agreement. If an agreement cannot be reached within the
fourteen (14) calendar days, or within an additional period if mutually agreed upon by the
Parties, the Division shall provide a written statement of its decision to Petitioner. Any decision
or action by the Division that cannot be resolved through the dispute resolution procedure
established herein may be subject to review pursuant to Chapter 150B of the North Carolina
General Statutes, to the extent such review is provided by law.
V. FINANCIAL RESPONSIBILITY REQUIREMENTS
Upon demand by the Division, Petitioner shall pay to the Division, on behalf of the Dry -
Cleaning Solvent Cleanup Fund ("Fund"), any amounts for which Petitioner is responsible
pursuant to N.C.G.S. § 143-215.104F(f). Petitioner shall have thirty (30) days from the date of
notice of such demand to make payment to the Division. These payments will only be required
by the Division when task -specific work has been completed by the Division's contractor.
DSCA ARAv20140312 2

VI. ADDITIONAL PROVISIONS
A. To obtain a unique EPA ID number for the disposal of hazardous wastes generated during
the assessment and remediation of the Site, Petitioner agrees that Petitioner will be the
Operator on the RCRA Subtitle C Site Identification Form. For the purposes of disposing of
hazardous waste generated during the assessment and remediation of the Site, Petitioner
agrees that Petitioner will be the Generator on Hazardous Waste Manifests.
B. The Petitioner agrees to allow the Division and the Division's independent contractors to act
as its authorized representatives for the preparation, signing, filing and delivery of any
permit application, hazardous waste manifest, non -hazardous waste manifest, National
Pollution Discharge Elimination System ("NPDES") permit, for complying with reporting
requirements and for any administrative activities that may be necessary during the course
of assessment and remediation conducted pursuant to this Agreement on the Petitioner's
behalf. Contemporaneous with the execution of this Agreement, Petitioner has executed the
Limited Power of Attorney, Attachment 1, which is incorporated herein by reference,
granting this authority to the State and its independent contractors.
C. The Petitioner agrees to execute such amendments to this Agreement as may be required in
order to comply with the provisions of DSCA and rules adopted under DSCA. If Petitioner
is a property owner of the Certified Facility Site, Petitioner agrees to file such land use
restrictions as shall be required -by the Division.
D. If, at any time, Petitioner becomes aware of information that may affect the priority of the
Site, Petitioner shall within thirty (30) days provide such information to the Division.
Activities that may alter a Site's priority include, but are not limited to, installation of
nearby water supply wells, new construction/redevelopment over or within contaminated
soil or groundwater at the Site, new occupancy of vacant structures within or near the Site,
or new uses of structures at or near the Site for daycares or schools. The Division may
revise the Site's priority ranking score using the most current version of the DSCA
Prioritization Ranking System.
E. Except as provided by this Agreement, the Division retains all its authority under the
Inactive Hazardous Sites Response Act of 1987, as amended, regarding inactive hazardous
substance or waste disposal sites in relation to the Site. If active dry-cleaning operations or
wholesale distribution operations are occurring at the Site, any hazardous wastes generated
by those operations shall be managed in accordance with Article 9 of Chapter130A of the
North Carolina General Statutes and the rules adopted at 15A NCAC 13A.
F. The signatory for Petitioner to this Agreement certifies that he/she is authorized to execute
this Agreement on behalf of Petitioner.
G. The Petitioner has designated the following representative(s) as the point of contact and the
Division will direct all correspondence related to this Agreement to:
DSCA ARAQ0140312

JAMES GOODNIGHT
ALBERTA PROPERTIES LLC
2108 CLARK AVE
RALEIGH NC 27605
All documents submitted to the Division pursuant to this Agreement shall be mailed or
hand delivered to:
North Carolina Division of Waste Management
DSCA Program
Attn: Delonda Alexander
1646 Mail Service Center
Raleigh, NC 27699-1646
H. Petitioner shall not assign or transfer any interest in this Agreement without the prior
consent of the Division. If Petitioner is the owner or operator of the facility or abandoned
site, Petitioner shall not transfer the ownership or operation of the facility or abandoned site
to another person without the prior written consent of the Division. The consent form can
be downloaded from the Division's web site at www.ncdsca.org or by requesting a copy
from the Division.
I. If Petitioner is a property owner of the Certified Facility Site, Petitioner shall provide a copy
of this Agreement, a copy of the Required Minimum Management Practices Rules, codified
at 15A NCAC 2S .0200 and a copy of the Access Agreement executed by the property
owner to all owners and operators of any dry-cleaning business operating at the Certified
Facility Site before the execution of this Agreement and provide written documentation to
the Division demonstrating that Petitioner has complied with this subsection.
J. If Petitioner owns or operates a wholesale distribution facility or dry-cleaning business
engaged in dry-cleaning operations at the Certified Facility Site, Petitioner shall comply with
the Required Minimum Management Practices Rules, codified at 15A NCAC 2S .0200.
K. All actions taken pursuant to this Agreement shall be in accordance with applicable local,
state and federal laws and regulations.
L. Petitioner understands and agrees that pursuant to N.C.G.S. § 143-215.104T, the State, its
agencies, officers, employees, and agents shall be absolutely immune from any liability in
any proceeding for any injury or claim arising from negotiating, entering into, monitoring, or
enforcing a dry-cleaning solvent assessment agreement, a dry-cleaning solvent remediation
agreement, or a Notice of Dry -Cleaning Solvent Remediation under DSCA or any other
action implementing DSCA. Petitioner agrees to indemnify and save and hold harmless the
Division and its officials and employees from any and all claims or causes of action arising
from or on account of acts or omissions of Petitioner or its officers, employees, receivers,
trustees, agents, or assigns during the term of this Agreement relating to the Site. Neither the
Division nor any official or employee thereof shall be held to be a party to any contract other
DSCA ARAv20140312 4

than (i) this Agreement involving Petitioner relating to the Site or (ii) any other contract
expressly executed by the Division or the State of North Carolina. Petitioner further agrees
that the Division and its officers and employees will not become potentially responsible
parties pursuant to N.C.G.S. § 143-215.104B(21) by virtue of negotiating, entering into,
monitoring, enforcing, or undertaking any other act relating to this Agreement and may not
be held liable for any acts of Petitioner's contractors or representatives in implementing this
Agreement.
M. The, Division's authorization of assessment and/or remediation activities pursuant to this
Agreement shall be contingent upon the availability of monies in the Fund. The Division
shall have no obligation to authorize assessment and/or remediation activities at the Site for
which monies are not available in the Fund.
N. The Parties agree that Petitioner's entry into this Agreement and actions undertaken by
Petitioner in accordance with this Agreement do not constitute an admission of liability by
Petitioner. No approval hereunder or receipt of funds hereby shall be taken as a warranty as
to the sufficiency or efficacy of the assessment or remediation of the Site.
O. Except as provided under N.C.G.S. § 143-215.104K, nothing herein shall constitute a
satisfaction of, or release from, liability for any claim arising as a result of operation,
ownership or use of the Site by Petitioner, its agents, lessees, successors or assigns.
P. This Agreement may not be modified without the written consent of the Parties; provided,
however, Petitioner agrees to execute such amendments to this Agreement as required by
section VI.C.
Q. Petitioner agrees that, except as provided in Section VI.A., all products generated by, from or
as the result of assessment and remediation of the Site are and shall remain the property of
the Division. These products may include but are not limited to documents, remediation
equipment, pumps and monitoring wells. Provided, however, "products" shall not include
any dry-cleaning solvent as defined at N.C.G.S. § 143-215.104B(b)(9), any hazardous
substance as defined at N.C.G.S. § 130A-310(2), or any contaminant as defined at N.C.G.S.
§ 130A-310.31(b)(4).
R. The obligations under Section VI, Paragraphs, (J) (L) and (Q) above shall survive the
termination of this Agreement.
S. This Agreement shall continue in force until (1) it is terminated or dissolved by either or both
Parties pursuant to its terms, (2) the Parties execute a subsequent agreement governing the
assessment and/or remediation of the Site, (3) the Division issues a "no further action" letter
with respect to the Site or (4) the Division is unable to obtain the consent of any property
owner to file any restrictions on the current or future use of any portion of the Site that are
necessary to assure adequate protection of public health and the environment as provided in
rules adopted pursuant to G.S. 143-215.104D(b)(3).
DSCA ARAv20140312
5

T. Termination under Section VI.S. (1) shall be effective upon ten (10) business days prior
written notice to the other Party. Termination by the Petitioner shall affect forfeiture of the
liability protection afforded pursuant to N.C.G.S. § 143-215.104K. Termination by the
Division shall entitle the Petitioner to initiate a contested case pursuant to N.C.G.S. Section
143-215.104S and N.C.G.S. Section 15013-23.
U. In the event that this Agreement is terminated, the Division shall retain all applicable
enforcement rights against Petitioner, and Petitioner shall retain all applicable defenses.
V. If Petitioner is a property owner of the Certified Facility Site, Petitioner agrees to grant
access to the Division and the Division's independent contractors to undertake all work to be
performed at the Certified Facility Site. If Petitioner is not a property owner of the Certified
Facility Site, Petitioner shall obtain access for the Division and the Division's independent
contractors to undertake all work to be performed at the Certified Facility Site.
This Agreement shall be deemed executed on the date on which it is signed by the chief of the
Superfund Section of the Division or his designee.
By: l�
Jun teson, LG [Date]
Ch f, Superfund Section
Division of Waste Management
North Carolina Department of Environmental Quality
By: I2 2 i
ignature of/f etitioner] [Date]
01 t l
[Title of Sign tory]
DSCA ARAv20140312 6

AGREEMENT FOR ASSESSMENT AND REMEDIATION PURSUANT TO DSCA
ATTACHMENT 1
LIMITED POWER OF ATTORNEY
("Petitioner"), do hereby
grant a limited power of attorney to the Division and to the Division's independent contractors,
as follows.
The Division and the Division's independent contractors shall have the limited power of attorney
for the preparation, signing, filing and delivery of any permit application, hazardous waste
manifest, non -hazardous waste manifest, National Pollution Discharge Elimination System
(NPDES) permit, for complying with any reporting requirements and for any administrative
activities that may be necessary in the course of assessment and remediation conducted pursuant
to the Agreement into which this Attachment 1 is incorporated.
This limited power of attorney shall terminate upon termination of the Agreement.
Dated -Or,{- 2 , 2vt
(Seal)
Signature of Petitioner
STATE OF WC COUNTY OF VA t,
On this I day of OCt 201 , personally appeared before me, the said named
Q®l"(S c-1��4da to me known and known to me to be the person described
in and who executed the foregoing limited power of attorney and he (or she) acknowledged that
he (or she) executed the same and being duly sworn by me, made oath that the statements in the
foregoing limited power of attorney are true.
Myr `o�nmission Expires 11T]1
[ 'ygjS q t MqKfoOn
Notary Public (Official Seal)
(Signature of Notary Public)
KELSEY D. MCPHERSON
NOTARY PUBLIC
WAKE COUNTY, N.C.
My Commission Expires 07-26-2022
DSCA ARAv07O5 Attachment 1