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HomeMy WebLinkAboutWI0400614_Notification of Intent (NOI) – GW Remediation_20240207NC Department of Environmental Quality — Division of Water Resources (DWR) NOTIFICATION OF INTENT (NOI) TO CONSTRUCT OR OPERATE INJECTION WELLS The following are `permitted by rule" and do not require an individual permit when constructed in accordance with the rules of ISA NCAC 02C.0200 (NOTE: This form must be received at least 14 DAYS prior to injection) AQUIFER TEST WELLS (15A NCAC 02C .0220) These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics. IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229): 1) Passive Injection Systems - In -well delivery systems to diffuse injectants into the subsurface. Examples include ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be submitted for replacement of each sock used in ORC systems). 2) Small -Scale Injection Operations —Injection wells located within a land surface area not to exceed 10,000 square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required for test or treatment areas exceeding 10,000 square feet. 3) Pilot Tests - Preliminary studies conducted for the purpose of evaluating the technical feasibility of a remediation strategy in order to develop a full scale remediation plan for future implementation, and where the surface area of the injection zone wells is located within an area that does not exceed five percent of the land surface above the known extent of groundwater contamination. An individual permit shall be required to conduct more than one pilot test on any separate groundwater contaminant plume. 4) Air Injection Wells - Used to inject ambient air to enhance in -situ treatment of soil or groundwater. 5) In -Situ Thermal Wells (IST) — Used to `heat' contaminated groundwater to enhance remediation. Print Clearly or Type Information. Illegible Submittals Will Be Returned as Incomplete. DATE: January 9, 2024 PERMIT NO. WI0400614 (to be filled in by DWR NOTE- If this NOI is being submitted as notification of a modification of a previously issued NOI for this site (e.g., different injection wells, plume, additives, etc.) and still meets the deemed permitted by rule criteria, provide the previously assigned permit tracking number and any needed relevant information to assess and approve injection: Permit No. Issued Date: A. WELL TYPE TO BE CONSTRUCTED OR OPERATED (1) Air Injection Well ....................................... Complete sections B through F, J, M (2) Aquifer Test Well ....................................... Complete sections B through F, J, M (3) Passive Injection System ............................... Complete sections B through F, H-M (4) Small -Scale Injection Operation ...................... Complete sections B through M (5) X Pilot Test ................................................. Complete sections B through M (6) Tracer Injection Well ................................... Complete sections B through M (7) In -Situ Thermal (IST) Well ........................... Complete sections B through M B. STATUS OF WELL OWNER: Federal Government Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 1 C. WELL OWNER(S) — State name of Business/Agency, and Name and Title of person delegated authority to sign on behalf of the business or agency: Name(s): US Army Corps of Engineers USACE)_(Dena Thompson — Project Manager) Mailing Address: 100 W O leg thorpe Ave City: Savannah State: GA Zip Code: 31401 County: Chatham Day Tele No.: 912-652-5087 Cell No.: EMAIL Address: Dena.B.Thompson&usace.army.mil Fax No.: D. PROPERTY OWNER(S) (if different than well owner/applicant) Name and Title: David Tsui — Property Owner (Contact information for property owner's environmental consultant, Jeff Ballsieper with Progress Environmental Group, Inc., is provided below) Company Name Central Park Burlington LLC Mailing Address: 7120 Creek Wood Drive City: Chapel Hill State: NC Zip Code: 27514 County: Orange Day Tele No.: 336-722-9999 Cell No.: 336-782-9725 EMAIL Address: jballsieperkprogressenv.com Fax No.: E. PROJECT CONTACT (Typically Environmental Consulting/Engineering Firm) Name and Title: Ethan Dinwiddie - Terracon Project Manager Company Name Terracon Consultants, Inc. Mailing Address: 2401 Brentwood Road, Suite 107 City: Raleigh State: NC Zip Code: 27604 County: Wake Day Tele No.: 919-436-2965 Cell No.: 828-550-5502 EMAIL Address: ehan.dinwiddie(cr�,terracon.com Fax No.: F. PHYSICAL LOCATION OF WELL SITE (1) Facility Name & Address: Former Tarheel Army Missile Plant, 204 North Graham -Hopedale Road City: Burlington County: Alamance Zip Code: 27217 (2) Geographic Coordinates: Latitude": 36.098803 Longitude":-79.408670 Reference Datum: WGS 1984 Accuracy: Method of Collection: Google Earth "FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES. G. TREATMENT AREA Land surface area of contaminant plume:—1,000,000 square feet Land surface area of inj. well network: —5,000 square feet (< 10,000 W for small-scale injections) Percent of contaminant plume area to be treated: 0.5% (must be < 5% of plume for pilot test injections) Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 2 H. INJECTION ZONE MAPS — Attach the following to the notification. (1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and proposed injection wells; See attached soil and groundwater analytical results maps and "heat" maps for PCE, TCE, and vinyl chloride in plan view and cross-section view. (2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and proposed monitoring wells, and existing and proposed injection wells. See attached soil analytical results map with estimated residual soil contamination extent and cross section view of lithology and proposed injection wells. (3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing and proposed wells. See attached potentiometric surface maps for saprolite and bedrock aquifers in August 2022. Groundwater on the site has historically been mapped flowing to the northwest. I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES AT THE SITE — Provide a brief narrative regarding the cause of the contamination, and purpose, scope, goals of the proposed injection activity: The site is a former U.S. Armv owned facilitv that operated as a missile, aircraft, and electronics Droduction plant. Operations at the site have resulted in contaminated soil and groundwater. Known ,groundwater contaminants include, but are not limited to PCE, TCE, chlorinated degradation compounds, and petroleum - related compounds. Thirteen (13) temporarnjection wells will be used to construct an in situ reactive zone perpendicular to groundwater flow to promote enhanced reductive dechlorination (ERD). The temporarX injection wells will be constructed using sonic drillingtechniques. chniques. The injectant will be hydraulically fractured into the saprolite and bedrock units through the drill rods at depths up to 45 feet below ground surface. The Dumose of the Droiect is to implement an interim remedial action to limit the off -site migration of the contaminants in ,groundwater. J. WELL CONSTRUCTION DATA (1) No. of injection wells: 13 Proposed 0 Existing (provide NC Well Construction Record (GW-1) for each well) (2) Appx. injection depths (BLS): Saprolite Zone (15-25 ft bgs): In bedrock (25-45 ft bgs) (3) For Proposed wells or Existing wells not having GW-Is, provide well construction details for each injection well in a diagram or table format. A single diagram or line in a table can be used for multiple wells with the same construction details. Well construction details shall include the following (indicate if construction is proposed or as -built): (a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery (b) Depth below land surface of casing, each grout type and depth, screen, and sand pack (c) Well contractor name and certification number K. INJECTION SUMMARY NOTE: Only iniectants approved by the epidemiology section ofthe NC Division of Public Health. Department of Health and Human Services can be injected. Approved iniectants can be found online at hiip:Hdeg.nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/2round-water- Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 3 protection/,ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info if you wish to get approval for a different additive. However, please note it may take 3 months or longer. If no injectants are to be used use N/A. Injectant: ABC+ Total Amt. to be injected (gal)/event: 50,140 lbs Injectant: RTB-l/DHC (dehalococcoides)_Total Amt. to be injected (gal)/event: 30 Liters Injectant: Total Amt. to be injected (gal)/event: Injectant: Total Amt. to be injected (gal)/event: Total Amt. to be injected (gal/event): Approximately 50,000 lbs of iniectant material mixed with approximately 8,500 gallons of water to form approximately 13,150 gallons of a 40 weight percent slurry. No. of separate injection events: l Total Amt. to be injected (gal): 13,150 Source of Water (if applicable): fire hydrant or equivalent municipal water source L. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used to determine if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity. One existing monitoring well up_cradient and five existing monitoring wells downgradient of the treatment area will be used to monitor the progress of the injected permeable reactive barrier. A groundwater monitoringeven vent will be performed prior to the injection activities. Terracon will prepare and submit an Injection Event Record (NCDEO Form UIC-IER) to document the injection activities in addition to an Interim Action Completion Report for the in situ groundwater treatment activities. Quarterly groundwater monitoring events will be conducted to track changes to the aquifer geochemical parameters including pH, oxidation-reduction potential, temperature, conductivity, and turbidity. Semiannual groundwater sampling events will be conducted to monitor concentrations of VOCs, dissolved gases, and total organic carbon, and track changes in the aquifer geochemical parameters. M. SIGNATURE OF APPLICANT AND PROPERTY OWNER Well Owner/Applicant: "I hereby certijy, under penalty of law, that I am familiar with the information submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obtaining said information, I believe that the information is true, accurate and complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the 1 SA NCAC 02C 0200 Rules. " Ethan Dinwiddie, Project Geologist, as Agent of USACE Signature of Applicant Print or Type Full Name and Title Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 4 Property Owner (if the property is not owned by the Well Owner/Applicant "As owner of the property on which the injection well(s) are to be constructed and operated, I hereby consent to allow the applicant to construct each injection well as outlined in this application and agree that it shall be the responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards (15A NCAC 02C .0200). " "Owner" means any person who holds the fee or other property rights in the well being constructed. A well is real property and its construction on land shall be deemed to vest ownership in the land owner, in the absence of contrary agreement in writing. See attached Quitclaim Deed granting USACE access to the site for environmental remediation activities. Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title *An access agreement between the applicant and property owner may be submitted in lieu of a signature on this form. Please send 1 (one) hard color copy of this NOI along with a copy on an attached CD or Flash Drive at least two (2) weeks prior to injection to: DWR — UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: (919) 707-9000 Deemed Permitted GW Remediation NOI Rev. 2-17-2020 Page 5 Injection Zone Maps _J e r a�o$ego$�o ���� ��o og� E� r • �_� nffi0° g"° "Bnnm dg'x J 8S ^E adve c€od saga°a° €°°oom � E � _ e ov �r o e awe s""fig ° M 5 p �. IL . - —°� • V A fi? � r p � � o — ,, • �a o5e yes 1 s'A � • � �� m d • CO «dW;IIf _ 1i.1 1, ` s m w o a wa w wgs wa w�a �ry - z „ r P d z — I s�.� _ __ �N"nm"�5:^ace A A s IR �4- $ aoo` tta4� - teees3 a �. a ti¢(CGLtib �t Fc Y a s r c a n o ry o 0 0� u r ... 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L O s V C s F0 U N - O O � Q O Q � O �— \ a � J c 0 t� LM go- �i N i O-L Z �n LL ILU � � C O m a �: C u la C C U U O CoE C M 4-1 U) 1 LI I �6 a N a C E C L ~ O a O � � U -p C H U)� V O ♦Z 'a OL O O O ♦Z OL (O N -tilLO N M U COZ r C FEE X ohms LL Amk ICD ,Ryi ITI !L_ 1 lot 0 N 0 c 0, m c �a O L N co I I O N 60 c N, Z� ° @ mU 7 p p W p p T m T m m N C 3 y� p m a0i a 5/9/2023 Project: Burlington, NC Terracon Page 4 of 7 bedrock, injections will be conducted using straddle packers to isolate specific 2 to 3 foot long zones, injecting into natural flow paths. Where competent rock is encountered, no injections will be performed. Figure 1. Reactive Zone Location and Layout Redox Tech recommends applying 49,400lbs of ABC' within the reactive zone. Within the saprolite the ZVI is equivalent to 0.2 weight percent with respect to soil assuming a soil density of 110 lbs per cubic foot. The ABC® will be diluted with potable water to form a 15 weight percent solution equating to approximately 5,600 gallons of slurry which is equivalent to approximately 5 percent of the available pore space assuming a porosity of 30 percent. For the bedrock zone, we are recommending applying a similar slurry mixture but targeting 10 percent of the effective porosity (estimated at 10 percent). This equates to 7,550 gallons of slurry. Redox Tech assumes a water source will be available on site (i.e. a fire hydrant or equivalent). Redox Tech will provide all hoses and connections, including a backflow preventer if needed, to transfer water from the hydrant to a storage vessel. Redox Tech has Redox Tech, LLC OZn I OLn 9 O o j4-1) DIVOS laan LO m I I -2 �m Iva W ozL-Mw _9= g a „€ �, cc Do a so Tws�-i4 ..aa W�E� o d� o d Lp L z 1 - ?i�N a... 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Li 1 is ✓l� r fix..` �V - L e i#Tl/ l6(6, � � 1 I�EF E fl 6 fkl-1 aVOU 31V03dOH WVr4"9 H1aON N ZfL I ,,,i- r 1 r M, �... rc a rn t Z ❑-('� a r . a i 1 c ❑ 1 a _ T 4 x � °a d Oy Wb0 I i- L — 3=7�. { -- - — - - ���� 3nN3Atl 8800 H1aON _ - - m I i L _ 3nN3AV OOOM3WOH i - - " _ 41 r } Injection Well Diagram Well ID: IRA-IW-01 through IW-13 Site Location: 204 N. Graham -Hopedale Rd, Burlington, NC Terracon Project No.: 70237017 Ow Elmo Expkw*vd*vs NCDEQ Site ID: NC7210020544 Injection Location: Northwestern portion of site Drilling Method: Sonic 2401 Brentwood Road Suite 107 Driller: Redox Tech, LLC (Cert No. 3516-A/4419-C) Raleigh, NC 27604 Date of Injection: Anticipated Feb 2024 919.873.2211 Temporary Injection Point Construction Diagram Land Surface Sonic Drill Rod Casing --- Diameter 4-6 inches Length 15-43 ft Material Steel Rod Screen --------------------- Diameter 4-6 inches Length 2-5 ft Slot Size 0.010 Material Steel Depth Below Land Surface (feet) Top of Screen 15 - 43 ft Bottom of Screen 17 - 45 ft Bottom of Injection Point 17 - 45 ft 4-6 Borehole Diameter (inches) Note: Injectant will be injected via hydraulic fracturing through drill rods in 3-5 foot intervals in saprolite zone and 2- 3 foot intervals in bedrock zone. Straddle packers will be used to isolate specific injection sections. The temporary injection points will be abandoned with bentonite and/or grout after completion. ABC+ Safety Data Sheet ABC+rM January 2024 SAFETY DATA SHEET ABC+TM 1. PRODUCT AND COMPANY IDENTIFICATION PRODUCT NAME: ABC+, Anaerobic BioChem (ABC®) Plus Zero Valent Iron (ZVI) GENERAL USE: Chemical and Biological Reduction for Soil and Groundwater Treatment MANUFACTURER: Redox Tech, LLC 200 Quade Drive Cary, NC 27513 919-678-0140 EMERGENCY TELEPHONE: Within USA and Canada: 1-800-424-9300 +1 703-527-3887 (collect calls accepted) 2. HAZARDS IDENTIFICATION EMERGENCY OVERVIEW: Product is generally recognized as safe. May cause irritation exposure to eyes. Long term contact to skin may cause some drying and minor irritation. 3. COMPOSITION INFORMATION ON INGREDIENTS Component CAS No Weight Percent Vegetable Oil 68956-68-3 10 - 60 Zero Valent Iron 7439-89-6 10 - 50 Proprietary Food Grade Emulsifier NA 4 - 10 Glycerin 56-81-5 2 - 50 Food Grade Guar 9000-30-0 0.1 — 2 Magnesium Oxide 1309-48-4 < 1 Soluble Phosphate Salts 7783-28-0 or 7758-11-4 < 0.1 4. FIRST AID MEASURES EYES: Immediately flush with water for up to 15 minutes. If irritation persists, seek medical attention. SKIN: Rinse with water. Irritation is unlikely, but if irritation occurs or persists, seek medical attention. INGESTION: Generally safe to ingest but not recommended. INHALATION: No first aid required. Redox Tech, LLC ABC+TM January 2024 5. FIRE FIGHTING MEASURES EXTINGUISHING MEDIA: Deluge with water FIRE/EXPLOSION HAZARDS: Product is combustible only at temperatures above 600C. ZVI should not be mixed with oxidants FIRE FIGHTING PROCEDURES: Use flooding with plenty of water, carbon dioxide or other inert gasses. Wear full protective clothing and self-contained breathing apparatus. Deluging with water is the best method to control combustion of the product. FLAMMABILITY LIMITS: non-combustible SENSITIVITY TO IMPACT: non -sensitive SENSITIVITY TO STATIC DISCHARGE: non -sensitive 6. ACCIDENTAL RELEASE MEASURES Confine and collect spill. Transfer to an approved DOT container and properly dispose. Do not dispose of or rinse material into sewer, stormwater or surface water. Discharge of product to surface water could result in depressed dissolved oxygen levels and subsequent biological impacts. 7. HANDLING AND STORAGE HANDLING: Protective gloves and safety glasses are recommended. STORAGE: Keep dry. Use first in, first out storage system. Keep container tightly closed when not in use. Avoid contamination of opened product. Avoid contact and storage with oxidizing agents. 8. EXPOSURE CONTROLS - PERSONAL PROTECTION EXPOSURE LIMITS Chemical Name ACGIH OSHA Supplier ABC+ NA ��] NA NA ENGINEERING CONTROLS: None are required PERSONAL PROTECTIVE EQUIPMENT EYES and FACE: Safety glasses recommended RESPIRATOR: none necessary PROTECTIVE CLOTHING: None necessary GLOVES: rubber, latex or neoprene recommended but not required Redox Tech, LLC ABC+TM January 2024 9. PHYSICAL AND CHEMICAL PROPERTIES Odor: none to mild pleasant organic odor Appearance: clear to light amber Auto -ignition Temperature Non-combustible Boiling Point >600 C Melting Point NA Density varies — 0.75 to 1.2 grams per ml Solubility infinite pH 7-9 10. STABILITY AND REACTIVITY CONDITIONS TO AVOID: Do not contact with strong oxidizers STABILITY: product is stable POLYMERIZATION: will not occur INCOMPATIBLE MATERIALS: strong oxidizers HAZARDOUS DECOMPOSITION PRODUCTS: 11. TOXICOLOGICAL INFORMATION Acute Toxicity A: General Product Information Acute exposure may cause mild skin and eye irritation. B: Component Analysis - LD50/LC50 No information available. B: Component Analysis - TDLo/LDLo TDLo (Oral -Man) none Carcinogenicity A: General Product Information No information available. B: Component Carcinogenicity Product is not listed by ACGIH, IARC, OSHA, NIOSH, or NTP. Epidemiology No information available. Neurotoxicity No information available. Redox Tech, LLC ABC+rM January 2024 12. ECOLOGICAL INFORMATION Ecotoxicity Discharge to water may cause depressed dissolved oxygen and subsequent ecological stresses Environmental Fate No potential for food chain concentration 13. DISPOSAL CONSIDERATIONS DISPOSAL METHOD: Material is not considered hazardous, but consult with local, state and federal agencies prior to disposal to ensure all applicable laws are met. 14. TRANSPORT INFORMATION NOTE: The shipping classification information in this section (Section 14) is meant as a guide to the overall classification of the product. However, transportation classifications may be subject to change with changes in package size. Consult shipper requirements under I.M.O., I.C.A.O. (I.A.T.A.) and 49 CFR to assure regulatory compliance. US DOT Information Shipping Name: Not Regulated Hazard Class: Not Classified UN/NA #: Not Classified Packing Group: None Required Label(s):None 50t"Edition International Air Transport Association (IATA): Not hazardous and not regulated INTERNATIONAL MARITIME DANGEROUS GOODS (IMDG) Material is not regulated under IMDG 15. REGULATORY INFORMATION UNITED STATES SARA TITLE III SECTION 311 No Hazard for Immediate health Hazard SECTION 312 No Threshold Quantity SECTION 313 Not listed CERCLA NOT REGULATED UNDER CERCLA Redox Tech, LLC ADC+TM January 2024 TSCA NOT REGULATED UNDER TSCA CANADA (WHIMS): NOT REGULATED 16. OTHER INFORMATION HMIS: Health 1 Flammability 0 Physical Hazard 0 Personal Protection E E: Safety Glasses, gloves Redox Tech, LLC Property Access Agreement Through Quitclaim Deed IR Book 2169 page 675 Alamance county, NC Recorded 11130Z2004 11:41:03am No 9DDD-00143708 1 of 16 pages rlurlel N Tarpley, Register of Deeds Revenue Stamps: None (Exempt) !DY*b—' PIN: Prepared by: Gabriel N. Steinberg, Special Counsel for Real Estate, Office of Regional Counsel (41L), General Services Administration, Region IV, Atlanta, GA, GSA Control No.: 4-D-NC-793, GSA Contract No.: GS-04-D-04-CBE-0009 Return to: Attn: Jay Jones, 2609 Tucker Street Extension, Burlington, NC 27215 QUITCLAIM DEED THIS DEED made this the q hh day of 6 2004, by the UNITED STATES OF AMERICA, acting by and through the Administrator of General Services ("GSA"), under and pursuant to the powers and authority contained in the provisions of the Federal Property and Administrative Services Act of 1949, 63 Stat. 377, as amended (formerly codified at 40 U.S.C. 484, now codified at 40 U.S.C. §§ 541 et seg.), and regulations and orders promulgated thereunder, Grantor, to HOPEDALE INVESTMENT, LLC, a North Carolina Limited Liability company, whose mailing address is 2609 Tucker St. Extension, Burlington, North Carolina 27215, G rantee. a Book 2169 Page 676 No 9999-o0143708 2 of 16 papas WITNESSETH, that the Grantor, without representation or warranty, express or implied, except as specifically stated herein, for and in consideration of the sum of ONE MILLION FIVE HUNDRED EIGHTY FIVE THOUSAND AND NO/100 DOLLARS ($1,585,000.00) paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that parcel of land situated in Alamance County, North Carolina, commonly known as "the buildings portion" of the "Tarheel Army Missile Plant" ("TAMP, Tract No. 1"), and more particularly described in Exhibit °A", which is attached hereto, made a part thereof and consists of two (2) pages. And also including the following easement: A railroad spur track that extends 5,240 ft., more or less, running from the south right-of-way line of U.S. Highway No. 70 in a southerly direction 5,240 ft. and contains 12.00 acres, more or less, all as more particularly describe in Exhibit "B", which is attached hereto, made a part hereof, and consists of one (1) page. TOGETHER with all and singular the tenements, hereditaments, and appurtenances thereto appertaining, and every right, title, or interest, legal or equitable, of the said Grantor may have in the banks, beds, and waters of any streams bordering the aforesaid lands and also all interest in any alleys, roads, streets, ways, strips, gores, or railroad rights -of -way abutting or adjoining said lands, and any means of ingress or egress appurtenant thereto. SUBJECT, however, to any and all existing easements and rights -of -way for public roads, highways, streets, railroads, pipelines, drainage and sewer lines and public and private utilities; rights of tenants in possession, if any; and to any state of 2 Book 2169 `age 677 No 9999-00143708 3 of 16 pages facts which may be disclosed by an inspection and current, detailed survey of the premises described above, including an encroachment on the easement. The Grantee covenants for itself, its successors and assigns, and every successor in interest to the property hereby conveyed, or any part thereof, that the said Grantee has received the asbestos warning notice, which is attached hereto, made a part hereof, and consists of two (2) pages, and agrees to comply with any conditions and requirements as stated in Exhibit "C", including those conditions, requirements and regulations for asbestos containing materials listed on Table 1 of Exhibit "C." The Grantee also covenants for itself, its successors and assigns, and every successor in interest to the property hereby conveyed, or any part thereof, that the said Grantee has received information from the Grantor about lead -based paint and lead -based paint hazards, and, although the property has not been used and is not currently used for residential purposes, has been informed of its obligations under 42 U.S.C. 4852d and is aware of its responsibility to ensure compliance thereof. The Grantor has determined that Tract 1 of the Tarheel Army Missile Plant, Burlington, North Carolina ("TAMP"), is environmentally suitable for transfer to the Grantee and has informed the Grantee of the environmental condition of the property hereby conveyed ("Property"). In accordance with Section 120(h)(3) of the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA), as amended, and codified at 42. U.S.C. § 9620(h)(3), and pursuant to the terms of the Covenant Deferral Request for the TAMP, dated August 1, 2003, by the Deputy Assistant Secretary of the Army, Environmental Safety and Occupational Health, Office of the Assistant Secretary of the Army (Installation and Environment) and 3 Book 2169 Page 678 V approved September 25, 20W"1fMV8G0e?Aor36V of° a 9es State of North Carolina, (hereinafter referred to as the "CDR"), the Grantor includes the following notices, covenants, reservations, assurances, and warranties that run with the land and inure to the benefit of the Grantor and Grantee, and their respective successors and assigns, as the case may be, all as more fully set forth in the Environmental Protection Deed Provisions, Exhibit "D," which is attached hereto, made a part hereof, and consists of four (4) pages. These provisions for Tract 1 of the TAMP shall remain in effect until soil and groundwater remediation activities are completed and include land use restrictions that limit the Property to non-residential use and prohibit excavation in certain areas without the Director approval of the North Carolina Department of Environmental Natural Resources (NCDENR) approval. Besides being attached and made a part hereof, these provisions are located in and identified as "Enclosure 3 to the Finding of Suitability for Early Transfer (FOSET) Tarheel Army Missile Plant (TAMP), Burlington, NC July 2003," signed January 1, 2004, The property hereby conveyed has heretofore been declared surplus to the needs of the UNITED STATES OF AMERICA, is presently under the jurisdiction of the General Services Administration, is available for disposal and its disposal has been heretofore authorized by the Administrator of General Services, acting pursuant to the above referred to laws, regulations and orders. TO HAVE AND TO HOLD the hereinbefore described property, together with improvements thereon, unto the said Grantee, its successors and assigns, forever. 4 13" 2169 pa°` 679 4 708 5 of 16 psga IN WITNESe')ft998F, the UNITED STATES OF AMERICA has caused these presents to be executed in its name and on its behalf by its duly authorized officers and its seal affixed the day and year first above written. [SEAL] WIZESSE By: � C GEORGIA, FULTON COUNTY UNITED STATES OF AMERICA Acting by and through the nistrator of General ZSeces L)AMES BRA DON Contracting Officer, Property Disposal Division General Services Administration Region IV, Atlanta, GA �-Ina nth C , 5�4d,:'a Notary Public of the County and State aforesaid, certify that James Brandon personally appeared before me today and acknowledged that he is the Contracting Officer, Property Disposal Division, General Services Administration, Region IV, Atlanta, Georgia and that he executed the foregoing instrument in the foregoing capacity as an authorized act of Grantor. Witness my hand and official stamp or seal of office in Atlanta, Gegraii ,th, is the 7, day of ��Ot1�u, 2004. �.�`��P........,.. ,�M�ssioN��y MAY D � * • 23 Q: t Public commission expires: [Pi ."T Here] The foregoing Certificates) o L • Ware certified to be correct. This instrument and thi certificate are duly registered at the date and time and in the Book and Page shown on the first page hereof. ��. _• Cl ,4�� Book 2169 Page 680 No 9999-60143798 6 of 16 pages CERTIFICATE I, Gabriel N. Steinberg, Certifying Attorney, General Services Administration, Region 4, Atlanta, Georgia, do hereby certify that authority for conducting the business of General Services Administration (GSA) has been delegated to the Regional Administrator by the Administrator of General Services pursuant to the authority vested in said Administrator by the Federal Property and Administrative Services Act of 1949, 63 Stat. 377, as amended (formerly codified at 40 U.S.C. 484, now codified at 40 U.S.C. §§ 541 et seg.), and other applicable laws and regulations promulgated thereunder, and re -delegated to the Director, Property Disposal Division, GSA, Region 4, and has been further re -delegated to James Brandon, Contracting Officer, Property Disposal Division, GSA, Atlanta, Georgia Dated at Atlanta, Georgia, this Z 917% day of —&0 flew 12004. GABRIEL N. STEINB Special Counsel for Real Estate General Services Administration Atlanta, Georgia Book 2169 Page 681 No 9999-00143708 7 of 16 pages Acknowledged, agreed and accepted by Hopedale Investment, LLC, by its duly authorized officials and representatives acting under authority granted by the said Board. Witnesses: HOPEDALE INVESTMENT, LLC By: Burlington Holdings, LLC Member/Manager Witnesses: r By: rill Britt, Manager By: Peg B anager [SEAL] NORTH CAROLINA, hRAArt COUNTY I, a Notary Public of the County and State aforesaid, certify that Bill Britt and Peggy Britt personally appeared before me this day and acknowledged that they are Managers of Hopedale Inv tment, LLC and, being authorized to do so, executed the foregoing instpuTne,pt oehalf-of_tlb, cgnvanv. =-60W (Place Notary Seal Here) rqoo°.. �Ka i[miJi 8 Book 2169 Page 682 No 9999-00143708 8 of 16 pages Exhibit A To Quitclaim Deed from the United States of America to Hopedale Investment, LLC "Plant Tract" All that certain lot or parcel of land situated in Alamance County, North Carolina and more particularly described as follows: STARTING at a point which is located by starting at NCGS "Plymouth" (Northing: 854237.4798 feet, Easting: 1872394.282 feet), thence North 819 6' 43" East 3,467.64 feet to NCGS "Kirk" (Northing: 854773.1885 feet, Easting: 1875819.926 feet); thence South 819 5' 32" East 3,213.92 feet to a disk (Northing: 854275.5349 feet, Easting: 1878995.0872 feet) the point and place of BEGINNING; thence North 22 39' 31" West 920.56 feet to an iron pin; thence North 892 41' 39" East 1,069.48 feet to a disk in the right of way of North Graham -Hopedale Road; thence South 3° 23' 52" West 922.47 feet to an iron pin; thence South 892 41' 37" West 493.49 feet to a point; thence South 17 11' 36" West 15.90 feet; thence South 89° 43' 21" West 235.95 feet to a point; thence North 17° 11' 36" East 15.77 feet to an iron pin; thence South 892 41' 37" West 279.18 feet to the point and place of BEGINNING and being 22.04 acres according to the survey entitled "Plat for Hopedale Investment, LLC" prepared by Boswell Surveyors, Inc., dated September 24, 2004. 199Q 16: _'r' �HSKt Book page �• 2169 9 683 _ No 490-00143708 9 of 16 pApes ` C r DATE: 29 Xufte 976 f *GAL rascr Mott 12 00 ACM DIAPOSAL AMA IOL OPXWCE PLANT Ail that tract o? land, I feet in width and 5,240 feet il l'enrh , being Government AcQWieitlon Traict "B", of the Tarheel Ordnance alit, situAte in the City of turliAgton,; Aiem nco County, North Carolina being bound an the no_-Tb by the south right -of -war line of U.A. Highway N . TO. east by the land of the. City of BSttrlington acid by lead of T. E. 8t ed, sout7s by the north right -of `ray lirw 61' the Southern Railroad and w at by land of T. Z. Stood, by land of R, 9. Boutheriand and by land off' t e City of Burling- ton, the centerline of wh4eh is more particularly describe as follows Beginning at a point in tlft center of in existing railroad right-of-wey� at its intersection with tie Gouth right -.of -way line of U. S. No.. To, said point being approximately 554 feet southoast from the intersection of the east right-of-way ins of OrA:heA-Hopedale Road and he south right- of-way lane of U. S. No. O;,thence frbm the point of begs ning•in a general southerly direction along'thez centarline of the existing 1 0 foot railroud right-of-way thraugh the land of the City of Burlington, aid lesSd of T. B. steed, crossing Midway Av+nua, and to the north right-of-viy line of the Southern 'Railway main lin}, the total length of the hereiq described strip of land 'being approxiinato�y 5,240 feet and containing 12. acres, more or lest, F ME PAC,E EXHIBIT "n" : �� '� 1:9F40 09b eifi� Se13�NtON� delOJ �wae Sll { Book 2169 Page 684 No 9999-00143708 10 of 16 page$ EXHIBIT "C" NOTICE OF THE PRESENCE OF ASBESTOS WARNING Asbestos has been determined present in the property to be sold. The Grantee is warned that the property offered for sale contains asbestos -containing materials. Unprotected or unregulated exposure to asbestos in produce manufacturing, shipyard, and building construction workplace have been associated with asbestos -related disease. Both the Occupational Safety and Health Administration (OSHA) and the Environmental protection Agency (EPA) regulate asbestos because of the potential hazards associated with exposure to airborne asbestos fibers. Both OSHA and EPA have determined that such exposure increases the risk of asbestos -related diseases, which include certain cancers and which can result in disability or death. The Grantee was invited, urged and cautioned to inspect the property to be sold prior to submitting a bid (offer). More particularly, the Grantee was invited, urged and cautioned to inspect the property as to its asbestos content and condition and any hazardous or environmental conditions relating thereto. The disposal agency will assist bidders (offerors) in obtaining any authorization (a) which may be required in order to carry out any such inspection(s). The Grantee shall be deemed to have relied solely on its own judgment in assessing the overall condition or all or any portion of the property including, without limitation, any asbestos hazards or concerns. No warranties either express or implied are given with regard to the condition of the property including, without limitation, whether the property does or does not contain asbestos or is or is not safe for a particular purpose. This failure of the Grantee to inspect, or to be fully informed as to the condition of all or any portion of the property offered, will not constitute grounds for any claim or demand for adjustment after this transfer. The description of the property set forth herein and any other information provided therein with respect to said property is based on the best information available to the Government and is believed to be correct, but an error or omission, including but not limited to the omission of any information available to the agency having custody over the property and/or any other Federal agency shall not constitute grounds or reason for nonperformance of the transfer, or any claim by the Grantee against the Government including, without limitation, any claim for allowance, reformation, or other relief at law or in equity. The Government assumes no liability for damages for personal injury, illness, disability or death, to the Grantee, or to the Grantee's successors, assigns, employees, invitees, or any other person subject to Grantee's control or direction, or to any other person, including members of the general public, arising from or incident to the purchase, transportation, removal, handling, use, disposition, or other activity causing or leading to contact of any kind whatsoever with asbestos on the property which is the subject of this sale, whether the Grantee, its successors or assigns have or have properly warned or failed properly to warn the individual(s) injured. The Grantee further agrees that in its use and occupancy of the property it will comply with all Federal and local laws relating to asbestos. EXHIBIT "C" Page f of 2 Book 2169 Page 685 No 9999-00143708 11 of .16 pages SUMMARY ESTIMATES FOR ASBESTOS CONTAINING MATERIALS Type Material Estimated Total Quality Pipe Linear Feet 20,200 linA, # of Pipe Fittings 1,675 Trowelled Surfacing 36,697 square feet Floor Title & Mastic 295,915 square feet Roll Floor Covering (ASB. Back) 46,768 square feet Roll Insul. (ASB. Paper Backing) 15,000 square feet Friable ACM Ceiling Titles 1,500 square feet Roof Shingles +16,800 square feet NonSkid Painted Surfaces 165 square feet Caulking (Windows Etc.) 5,6501in. feet Roof Felts/Flashing 4,300 [in. feet HVAC "Flex Joint" 425 lin. feet Transite Pipe 280 lin. feet Asbestos Gaskets/Wiring 55 lin. Feet Textured Exterior Silver Paint +110,750 square feet Table 1. Book 2169 page 686 No 9999-ee143708 12 of 16 pages ENCLOSURE3 ENVIRONMENTAL PROTECTION DEED PROVISIONS 1. CERCLA Provisions Introduction A. Notice Pursuant to Section 120(h)(3)(A)(i) of the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as amended (CERCLA) (42 U.S.C. §9620(h)(3)(A)(i), and North Carolina General Statutes (N.C.G.S.) 130A-310.3(f), and based upon a complete search of Army files, the Grantor hereby imposes the land use restrictions set forth below and provides notice of: (1) the type and quantity of hazardous substances that were known to have been released or disposed of or stored for one year or more on the property: (2) the time such storage, release or disposal took place; and, (3) a description of remedial action taken, if any. The property is an inactive hazardous substance or waste disposal site as defined by North Carolina's Inactive Hazardous Sites Response Act, which consists of Section 130A-310 through Section 130A-310.19 of the North Carolina General Statutes (N.C.G.S.). This Declaration is part of a Remedial Action Plan for the property that has been approved by the Secretary of the North Carolina. Department of Environment and Natural Resources (or its successor in function), or his/her delegate, as authorized by N.C.G.S. Section 130A-310.3(0. B. covenant Pursuant to Section 120(h)(3)(A)(ii)(II) of CERCLA, Grantor covenants that it shall take any additional response action found to be necessary after the date of this conveyance regarding hazardous substances located on the property on the date of this conveyance. (11) This covenant shall not apply with respect to any portion of the Property as to which Grantee, its successor(s) or assign(s), or any successor in interest is a Potentially Responsible Party (PRP) immediately prior to the date of this conveyance. (2) In the event Grantee, its successor(s)-or assign(s), seeks to have Grantor conduct or pay for any additional response action, and, as a condition precedent to Grantor incurring any additional cleanup obligation or related expenses, the Grantee, its successor(s) or assign(s), shall provide Grantor written notice of such a claim and provide credible evidence that the associated contamination existed prior to the date of this conveyance. Grantor shall have 45 days within which to respond to the notice of such claim. C. Access Pursuant to Section 120(h)(3)(A)(ii)(III) of CERCLA. Grantor reserves a right of access for itself and Lucent Technologies, Inc. (Lucent) to all portions of the property for environmental investigation, remediation or other corrective action. This reservation includes the right of access to and use of available utilities at reasonable cost to Grantor. These rights shall be exercisable in any case in which an environmental investigation, remedial action, response action-. 16 llh�.11t�� Book 2169 Page 687 or corrective action is faun 8 Meeec ssary 13 f 18 p 4 ��o �e necessary after tRe date opus conveyance, or in which access is necessary to carry out a remedial action, response action, or corrective action on adjoining property. Pursuant to this reservation, Grantor and Lucent and their respective officers, agents, employees, contractors and subcontractors shall have the right (upon reasonable notice to the record title owner) to enter upon the property and conduct investigations and surveys, to include drilling, test -pitting, borings, data and records compilation and other activities related to environmental investigation, and to carry out remedial or removal actions as required or necessary, including but not limited to the installation and operation of monitoring wells, pumping wells, and treatment facilities. Any such entry, including such activities, responses or remedial actions, shall be coordinated with the record title owner and shall be performed in a manner which minimizes interruption with activities of authorized occupants. Grantor will provide the record title owner reasonable advance notice of such activities, responses, or remedial actions. D. Non -Interference Grantee: covenants and agrees for itself, its successors and assigns and every successor in interest to the Property, or part thereof, that it or any party occupying the Property shall not disrupt or prevent the Army or Lucent, or their officers, employees, agents, contractors and subcontractors, or any other authorized party or entity from conducting required remedial investigations, response actions or oversight activities or from the proper and necessary construction, upgrading, operating, maintaining and monitoring of any treatment facilities or environmental monitoring network on the Property. E. CERCLA Warranty The Grantor warrants that when all response actions to protect human health and the environment with, respect to any substance remaining on the property on the date of transfer has been taken, the Grantor shall execute and deliver to the Grantee an appropriate document containing a warranty that all such response actions have been taken. The making of the warranty shall be considered to satisfy the requirements of CERCLA 120(h)(3)(a)(ii)(I). 2. Land Use Restrictions A. Non -Residential Use Restriction Grantee, for itself and its successors and assigns, covenants and agrees, pursuant to N.C.G.S„ 130A-3I03(f), that, without the approval of the North Carolina Department of Environment and Natural Resources (NCDENR) or its successor in function, the use of the property shall be limited to commercial and industrial purposes and not residential purposes, the Property having been remediated only for commercial and industrial uses. Commercial and industrial uses include, but may not be limited to, administrative/office space, manufacturing, warehousing, restaurants, hoteWmotels, and retail activities. Residential uses include, but may not be limited to, housing, day care facilities, schools. and other child -related uses. In connection with these land use restrictions, NCDENR may be contacted as follows: Nile Testerman Superfund EMU 17 ��� 401 Oberlin Road, Suite 150 Raleigh, NC 27605 B. Ground Disturbance Restriction 2169 Page 688 Book No 9999-09143709 14 01 t6 pap*8 Grantee, for itself and its successors and assigns, covenants and agrees that Grantee, its successor(s) or assign(s), shall not conduct any excavation, digging, drilling or other disturbance of the subsurface of the Property without the written approval of NCDENR, unless: (i) the disturbance occurs outside of a ten (10) foot radius surrounding the former Underground Storage Tank and Waste Accumulation Pad areas, as indicated on the plat and (ii) the total depth of the disturbance is at least five feet above the permanent high water table. A map illustrating these areas is provided on the survey plat map (Attachment ). C. Groundwater Use Restriction Grantee, for itself and its successors and assigns, covenants and agrees that Grantee, its successors or assign(s), shall not construct or permit to be constructed any well, and shall not extract, utilize, consume or permit to be extracted, any water from any aquifer below the surfaces of the ground for the purpose of human consumption, or other use, unless such has been expressly approved, in writing, by the NCDENR. D. Remediation Equipment Disturbance Restriction Grantee, for itself and its successors and assigns, covenants and agrees that Grantee, its successors or assign(s), shall not disturb environmental remediation equipment without the written approval of the NCDENR. E. Modification of Use Restrictions (I) In the event Grantee, its successors or assigns, desires to use the property for any use other than non-residential use or remove the ground disturbance or groundwater use restrictions, then Grantee, its successors or assigns, shall perform all additional environmental remediation required by law and NCDENR for such other uses. (2) Any such additional remediation beyond non-residential use, or requests to remove the ground disturbance or groundwater use restrictions, by Grantee, its successors or assigns shall also be subject to the review and advance approval of the applicable federal or state authorities. All costs associated with any such additional environmental remediation necessary shall be the sole responsibility of Grantee, its successors or assigns. (3) Upon written request by Grantee. its successors or assigns, and without any payment of funds by Grantor.. Grantor agrees, upon completion of any additional remedial action is Eoff 80°k 2169 Page 689 No 9999-00143798 15 of 16 pages performed by Grantee, its successors or assigns, under this paragraph, to cooperate with Grantee, its successors or assigns, in any application, permit, order, or effort to obtain approval from appropriate regulators for other than non-residential use or to remove ground disturbance or groundwater use restrictions and the removal or revision of the restriction. �wrr�0rr' PaA-t— a �f �• 6 C7 e. 2169 Paga 690 No 9999-9914379e 16 of 16 pages 3 'E %,l W r nO 1� St •v O � n 4Lk �. p a c • 03 nO` W �{� A 7 9 • W v •l •+ r V V I. •v � � 1 r O a m v m m 1� 9 m C C v V � A C N m v o N O Wjj r A _ O Y Cm .JC w a P A r w p v _ r .o ti C. a o a a m 0 tl a A � 'a 9 T �7E _ E :� q .... c rn a rr W O A ` O V a - ~y c e 3 0 2, a ILvc o S p 7 m C } •� F y p e a u m V e Y O C 4 N 20. O A # d y C O d C C 6 M N n •v m •� tl � T � O 0. O m C •� tl m f4A ter-. a `u y C e a r 0 0i Q Id U for the purposes of N.C.G.S. 103A-310.8 Dexter Matthews, Director Division of Waste Management North Carolina Wake County I, a Notary Public of the said County and State, do hereby certify that did personally appear and sign before me this the day of - Notary Public (official seal) My commission expires Surveyor's Certification State of North Corolin Couty of Alamance I, S� certify that under my direction and supervision this mop was drawn from an actual field land survey made by me; that the error of closure as calculated by latitudes and departures is 1 • 20,000 for the perimeter and 1 ; 20,000 for platting of interior lot lines; that the boundaries not surveyed are shown as broken lines plotted from deed information found In deed book 234 page 3188 ; that this map was prepared in a accordance with GS 47-30 as amended, that the survey was requested by the owner or his duly authorized agent; that all required monuments and markers have been Installed; that all new lines calculated from data not obtained in the field are indicated by a "C". This survey is of an existing parcel or parcels of land and does not create a new street or change on existing street; itness my hand and seal this day of `i t 2003. :; Profes4na L nd urveyor L-4009 Z. Owner's Certification i I, (we) hereby certify that I (we) am (are) the owner(s) of the property, shown and described hereon, which was conveyed to me (us) by deed as recorded in deed book 234 , page 318 , and that I (we) hereby acknowledge this plat and allotment to be my (our) free act and deed and do hereby -- -- dedicate to public use as streets, rights -of -way, and easements forever, all areas so shown or - indicated on said plat. AGENT TITLE State of North Carolina, County of Alamance I, a notary public of the county and state aforesaid, certify that personally appeared before me this day and acknowledged the execution of the foregoing instrument. Witness my hand and official stamp or seal, this day of 2003. Notary Public My commission expires Planning Director Certification No approval required under section 33-1 of the code of ordinances of the City of Burlington. Planning Director Review Officer's Certificate State of North Carolina County of I, , Review Officer of County, certify that the mop or plat to which this certification is affixed meets all statutory requirements for recording. Review Officer Date Deed Restrictions: 1) Any excavation, digging, drilling, other disturbance of the subsurface without the written approval of NCDENR is prohibited except when: i. the disturbance occurs outside of a 10 foot radius surrounding the former UST and WAP areas; and ii, the total depth of the disturbance is at least five feet above the permanent high water table. 2) Disturbance of the environmental remediation installations without the written approval of NCDENR is prohibited. 3) Removal or use of groundwater beneath the site without the written approval of NCDENR Is prohibited. NCDENR Division of Waste Management may be contacted at 919-733-2801. When all response action necessary to protect human health and the environment with respect to any substance remaining on the property on the date the transfer has been taken, the United States shall execute and deliver to the transferee on appropriate document containing a warranty that oil such response has been taken as determined by the North Carolina Department of Environment and Natural Resources, and the environmental restrictions on the property shall be deemed to be of no further cause or effect. 0 PB. 4 P. 47 O N t 37 1 136 1 135 1 134 01 1132 1131 113 I O I I I I I I zo I� ❑1 i 2 1 I❑I 1 3 1❑11 t- -, 141 I I I L -J I I I I I I N 89'41 59" E 'CONTROL CORNER' • LEASE LOT 470.23' - - M W -1 12 DB. 253 P.235 DUKE POWER COMPANY 1 N 5910.4521 £ 5001.1727 N 5847.8863 50' R/W k - O E 5223.8931 MW-1 10 -------------'-- J • MW-104 0 N 5855.7923 PZ _ 1 £ 5056.9381 N 58370565 LEGEND E 5168.8.:56 Existing Iron Pipe ' • ® 1 ;',ME"I New Iron Pipe O Monument O {>+!":'•' ! "%f1 !1 Monitor Well 0 MW-5 MW- 1 11 O N 5784.6811 N 5763.0211 Spurge/Extraction iWell Q ,F N. (D E 50261714 £ 51809384 O Piezometer PZ- i ry rn Groundwater Extraction �<< and Treatment Remediatlon System Waste Accumulation Pad taAF 2 ❑ Soil Vapor Extraction/ ? E/A; Air Sparging Remediation System ,`ttt7flill/1j+ CARO;''�., - j--------- �s�` l/ -Z--------- ,As st, cJ' ;V + 20' SANITARY & STORM SEWER EASEMENT T v�X�o Q. � h+ az L YH ��`` ° W 4W ct -_ W2�ON - Q. a ° V °b o �WLJ y e o N 5154.3040 N 5579.66J2 E 518J 5729 MW-101 0 1 z Q FAIRCHILD HEIGHTS RE-DIWS/ON OF A PART OF W THE SMITH PROPERTY ,. P8.4 P.47 J "FAIRCHILD HEIGHTS" P8.4 P.146 > m I o toll tot O I 0 J 19; a 0 8 L-J I Q 10 )F 'N ORrH 0.51' NORTH of LINE �� 1069.40' I O 1 t 99 Ot' 368.97' -f �- :.EW-'5 l�1 O MW-2 J I 0 35' SOUTH N 5852.5291 N 5911.5961 _ v N 5909.0026 R/tY MON Iin• OF LINE E 5611.7f94 E 5802.3565 ` E 5857.5747 1.96- SOUTH f MW-1 18 MW-1 14 OF LINE 0 yzT 4rec I I '90. 027s 5784.1222 16. P c H • 194 6145 N 5604. 7 8N 57el.J7JO N 5901 5915 E 54 E 5684. 7926 E 580J 1202 I -102 N 5764.31/4 SEW- 1 1 1I E 5532 8857 .,"W- i.. M9 in EI N 5748.9634 LUUJ `;r VJ 1 .; 57178990 O i N 5734 9193 E I i N 571J.3595 £ 5590.2980 MW- 103 1 3 1 LISTCHEMICALS F E 5456 5576 MW- 1 1 5 N 5706.6275 r 1 E 5653 5039 I O LUCENT. IE p MW-109 _ a; F r _ - O N 5734 888 rt S V I , 1 _-- ��!' En. nment •� • F'`� '� E 5744-5677 ! ;� PETROLEUM HYDROCARBO S-...--' ---- F N 5714.5570 0 cV CHLORINATED VOLATILE ORGANIC COMPOUNDS Ih-lal! triili �V:--`i E5581.9474 N5669.1814 sEVv' 14 1 O TAMP: CHEMICALS OF CONCERN N 5676 938J N 5711.9744 ® E 56JZ2835 N 5655 9824 £ 560J.0797 £ 5487.6979 MW-108 E 5720 7776 N MW-2- BENZENE N 5609 0111 c Srv+ - 1 \01 0 MW-1 1 6 I I TRICHLOROETHENEC-V £ 5420 2819 -!y 3 N 5629.7049 N 5645.956E MW- 1 17O ❑ N 5600.9886 0 E 5603.2349 E 57452814 MW-5: BENZENE • E 5550.1906 I TRICHLOROETHENE 0 MP- 1 El MW-1 13 e C-VOCS* N 5601.6032 ' 1 T Ar a N 5610.7258 MP-2 £ 5654.1429 It)' , � too' R W MW-1 1: BENZENE Fc�-. I O TRICHLOROETHENE E 5456.0875 VP-1 \ MW- 107 PUBLIC IQ1 AP-1 --'1 N5655.7834 C-VOCS• ❑-' O MW- 1 1 N 5573.5208 E 56883614 I I MW-102• BENZENE 1, 106 LPL.___ N 55475261 E 5592-6968 TRICHLOROETHENE J � T �`,r •>:-! � F-''4 -. � E 5621. t56 C-VOCS• 0 PI, I N55J89522 �F„ 4 I MW-103: BENZENE N 5556.9946 N 5539.64J3 E 5513 8245 r, ' TRICHLOROETHENE vt'�+ E 54831333 VJAr' are . E 5609.1765 GRAHAM - HOPEDALE ROAD R/W 50' R W C-VOCs• 'r-i• P,t•1 IS SHOWN AS 100' WIDE ON I ! MW-104: BENZENE N 5543.4235 ALAMANCE COUNTY TAX MAP PUBLIC TRICHLOROETHENE E 5580.3280 148-598-600 PB 47 P 18 C-VOCs• VICINITY MAP VAUGHN ROAD o� p HI L TON ROAD 7- W S%TE m p = I MARTIN N. US )0 9 Sr H � CyUR� c S7�- MEBANE PB.30 P 126, PB.4 P. 146, I I MW-106: BENZENE C- AND PB.4 P.47. TRICHLOROETHENE ' MW-107: BENZENE WASHINGTON NATIONAL INSURANCE CO. 1. TRICHLOROETHENE GRAHAM - HOPEDALE ROAD R/W I C-VOCs• (CAROLINA RAYON MILLS) TRACT NO. 1 IS SHOWN AS 50' WIDE ON NCDOT P8.4 P.125 CONSTRUCTION PLANS, PROJECT ' MW-108 BENZENE � � a TRICHLOROETHENE NO. 9.7070103, AND ON PB.4 ALSO REFERENCE- PART OF LOT 1, 22.04 ACRES± P.125, AND PB 1 P.155. ai - - - M1h=109: BENZENE- - - - - BURLINGTON RAYON MILLS ' ITRICHLOROETHENE PB. 4 P. 1,38 RECORD DEED CLOSURE ERROR. 1.55' PLAT AT P8.25 P 135 SHOWS MW- 110: BENZENE DUKE POWER COMPANY S 35' 24' 15" W ; DB.234 PG.318. BOTH 50' AND 100' R/W'S, AND I w J Q TRICHLOROETHENE RELOCATION OF SUBSTATION L 0 T & TRANSMISSION LINE SERVING WESTERN ELECTRIC CO., INC. pp In P. 72 o E 5035.4850 DEFENSE S TREE T CL OSED MW-105 DB. 497 P 594 z REFERENCE R/W: V RESUBDIVISION OF LOTS O 00 REVELL STREET CLOSED NOS. 2 TO 12, INC. OF THE 0 OB. 744 P. 232, DB. 792 P• 337 L YNN DURHAM PROPERTY REFERENCE R/W. PB.4 P.21 PB.4 P.21 Of0 BENCHMARK 089' SOUTH 2.19' SOUTH 0.25' NORTH COORDINATES OF LINE OF LINEN 1p5 cj , �cjg /OF LINE N 5000 0000 10 04' E 5000.0000 269.13' \ _ 'CONTROL CORNER" 279.17' -- S 89'41'36" W v S 89'48757" W - - 493.52' -235.77----- PROPER TY OF � l � SD MR. L YNN DURHAM �Q l If PB.1 P.155 / W +o l / IR �O��N Q �° l l PROPERTY OF o BETTY T. WOOD QQQ� US PB. 65 P.352 O QQ� Q m (13 ` O, NOTES A) NO TITLE SEARCH WAS PERFORMED BY THIS FIRM DURING THE COURSE OF THIS SURVEY. B) THE PROPERTY SHOWN HEREON IS SUBJECT TO F) THE SURVEY RECORDED IN PLAT BOOK 1, PAGE 155 ALL EASEMENTS OF RECORD AFFECTING SAME. CALLS FOR A 10-FOOT RIGHT OF WAY ON TH15 REFERENCE PLAT.• TRACT NO. 1, PROPERTY OF REPORTS THAT RECORD VERIFICATION i C-VOCs WAS NOT ESTABLISHED. ACCORDING MW-1 1 1 • BENZENE TO A NON -RECORDED SURVEY BY I 0) c TRICHLOROETHENE MONT B. GILMORE ON 10/24/90, C,I -� _ C VOCs• A LETTER FROM NORTH CAROLINA CN m MART/N MW-112 BENZENE DEPARTMENT OF TRANSPORTATION z e � TRICHLOROETHENE TO THE ARMY CORPS OF ENGINEERS STREET C-vOCs• ON 9/9/82 VERIFIED A 50' R/W. I MW-113: BENZENE / TRICHLOROETHENE C-VOCs• MW-114• BENZENE TRICHLOROETHENE N 5030 9712 C-VOCS* E 5829 7220 MW-1 15: BENZENE o.as' NA4TH MW-5 If *CHLORIDE VOCs TRICHLOROETHENE OF LINE -METHYLENE CHLORIDE C-VOCs• I / 3 -CHLOROFORM MW-116: BENZENE c -1,1-DICHLOROETHENE TRICHLOROETHENE 89'41'36" W ai a> 't-DICHLOROETHENE -1,2-DICHLOROETHENE �TOTALS CIS)C-VOCs1,1-DICHLOROETHENE JO_HN N. BAKA TSIAS TRANS) MW-1 17: BENZENE & in -1.1-DICHLOROETHENE TRICHLOROETHENE -' "" TERRY N. BAKA- TSIAS cn I -1,2-DICHLOROETHENE C-VOCs• OB.401 P.843 -1,1,1-TRICHLORETHENE -TRICHLORETHENE MW-118 BENZENE / PB1 P155 I -TETRACHLOROETHENE TRICHLOROETHENE -CARBON TETRACHLORIDE -VO C-VOCs -VINYL CHLORIDE PROPER T Y OF I JOHN NICK BAKA TSIAS THEODORE NICK BAKA TSIAS - -�- GEORGE NICK BAKA TSIAS PB. 30 P.126 1 FINAL PLA T NOTICE OF INACTIVE HAZARDOUS SUBSTANCE SITE SURVEY OF THE TARHEEL ARMY MISSILE PLANT C) THIS FIRM MAKES NO GUARANTEE AS TO THE PROPERTY, ALONG THE NORTH SIDE OF THE o� J PROPERTY LOCATED AT Q BURLINGTON TOWNSHIP ALAMANCE COUNTY NORTH CAROLINA EXISTENCE OR LOCATION OF ANY UNDERGROUND SOUTHERN PROPERTY LINE. THERE IS NO OTHER 204 GRAHAM-HOPEDALE ROAD BURLINGTON, NORTH CAROLINA U77L1nES OR IMPROVEMENTS ON OR ACROSS RECORD OF ANY RIGHT OF WAY FOUND THERE. DATE: GT� : 09�11 �01 SCALE: 1 "= 100' THIS PROPERTY. ANY UNDERGROUND U77LITIES G) OTHER PLATS OF REFERENCE. 100' So' 0' 100' 200' OR IMPROVEMENTS SHOWN HEREON HAVE BEEN P8.24 RIZ AND P6.25 P.138. PROPERTY OF: GRAPHIC SCALE LOCATED FROM VISIBLE EVIDENCE AND AVAILABLE INFORMATION. H) ORIGINAL SURVEY SIGNED AND SEALED BY K. GARY UNITED STATES OF AMERICA SIMMONS ENGINEERING & SURVEYING, INC. JOB # 01-09-02 SURVEY BY JLA SIMMONS, PLS-2482, ON SEPTEMBER 11, 2001. SURVEYED FOR: 0) NO NORTH CAROLINA GEOOE71C CONTROL THE 01WSION OF WASTE MANAGEMENT AN THE LIST OF CONCERNED CHEMICALS ADDEDFIOATTHE PLAT U.S. ARMY ENWRONAIENTAL nTOEAA� ND MISSILE COMMAND 115 GLENDALE AVENUE BURLINGTON, N.C. DWG BY RWJ APP'D BY KGS MONUMENTS WERE FOUND WITHIN 2,000 FEET ON AUGUST 15, 2003. AMSAM-EN OF THIS PROPERTY. ENGINEERING, ENVIRONMENT AND LOGIS77C5 OVERSIGHT OFFICE PHONE: (336) 222-9700 FACSIMILE: (336) 222-9637 E) TAX MAP REFERENCE: 148-600-214. REDSTONE ARSENAL, AL J5898 REVISED: 08/15/03 BK 03777 PG 0599 FILED ELECTRONICALLY ALAMANCE COUNTY NC HUGH WEBSTER This instrument prepared by: Kennon Craver, PLLC, a licensed North Carolina attorney, Delinquent taxes, if any, to be paid by the closing attorney to the Tax Collector upon disbursement of closing proceedings. FILED May 31, 2018 AT 12:25:27 PM BOOK 03777 START PAGE 0599 END PAGE 0602 INSTRUMENT # 08973 EXCISE TAX $3,500.00 NORTH CAROLINA. SPECIAL WARRANTY DEED Excise Tax: $3,500.00 Return to: Grantee This instrument was prepared by: Richard H. Hicks, Ir. Attorne aft L,a��lithout examination cftitle Brief description for the Index: Parcel Identifier No. 8875945707 el f THIS DEED made this _CI_L_ day of /t/AL,/ 2018, by and between GRANTOR Donald G. Neuenberger, Trustee of the R.D.N Trust dated December 5, 2016, and any amendments thereto c/o Hicks McDonald Noecker LLP 100 South Elm Street, Suite 510 Greensboro, NC 27401 GRANTEE CENTRAL PARK BURLINGTON, LLC, a North Carolina limited liability company 7 120 Creek Wood Road Chapel 1-1111, NC 27514-7450 The designation Grantor and Grantee as used herein shall include said par -ties, their heirs, successors, and assign, and shall include singular, plural, masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in Burlington Township, Alamance County, North Carolina, and more particularly described as follows: ALL OF THAT PROPERTY DESCRIBED ON EXHIBIT A ATTACHED HERETO AND INCORPORATED HEREIN. The property hereinabove described was acquired by Grantor by instrument recorded in Book I _, page_ A map showing the above described property is recorded in Plat Book page TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple, submitted electronically by "Kennon Craver, PLLC" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement with the Alamance county Register of Deeds. BK 03777 PG 0600 The property conveyed hereby does not include the primary residence of Grantor. And the Grantor covenants with the Grantee, that Grantor has (lone nothing to impair such title as Grantor received, and Grantor will warrant and defend the title against the lawful claims of all persons claiming by, under or through Grantor, other than the following exceptions: Those exceptions set out on EXHIBIT B, which is attached hereto and incorporated herein by reference. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written ze�n� Y,--- [SEAL] �i'Neuenberg, , Tr e of the R.D.N Trust December 5, 6, < -/,-�,��'nd any amendments thereto (Name of Notary Public), a Notary Public of the County of and State of f certify that Donald G. Neuenberger, Trustee aL of the R.D.N Trust dated December 5, 2016, an any amendments thereto personally came before me this day and acknowledged the execution of the foregoing instrument. ,WT64S my hand and official seal or stamp, this the day of Aj 20/� 0 [Af fikisl0 /Stamp] • t Jul 0 PUbfic Signature of Notary PWic *--4� cc� My CNi"kM Expires: BK 03777 PG 0601 All that certain tract or parcel of land situated in Alamance County, North Carolina and more particularly described as follows: STARTING at a point which is located by starting at NCGS "Plymouth" (Northing: 854237.4798 feet, Fasting: 11872394.282 feet), thence North 81 degrees 6' 43" East 3,467.64 feet to NCGS "Kirk" (Northing: 854773.1885 feet, Fasting: 181/5819,926 feet); thence South 81 degrees 5' 32" East 3,213.92 feet to a disk (Northing: 854275.5349 feet, Fasting: 1878995.0872 feet) the point and place of BEGINNING; thence North 00 degrees 23' 00" West 920.56 feet to an iron pin; thence North 89 degrees 41' 39" East 1,069.48 feet to a disk in the light of way of North Graham -Hopedale Road; thence South 3 degrees 23' 521" West 922.47 feet to an iron pin; thence South 89 degrees 41' 37" West 493.49 feet to a point-, thence South 17 degrees I 1' 36" West 15.90 feet; thence South 89 degrees 43' 21" West 235.95 feet to a point; thence North 17 degrees I V 36" East 15.77 feet to an iron pin; thence South 89 degrees 41' 37" West 279.18 feet to the point and place of BEGINNING and being 22.04 acres, more or less, according to the survey entitled "Plat for Hopedale Investment, LLC" prepared by Boswell Surveyors, Inc., dated September 24, 2004. TOGETHER WITH all improvements located on the land and all fixtures attached or appurtenant to the land or improvements; and TOGETHER WITH all rights now or ever possessed by Grantor as to the United States governi-nent regarding responsibility for the investigation, remediation, removal and cleanup of hazardous substances or wastes present on the property, including but not limited to all rights and interests arising from that Quitclaim Deed from the United States of America to Hopedale Investment, LLC dated November 29, 2004, recorded on November 30, 2004 in Book 2169, Page 675, Alan ance County Registry and under that Consent Agreement entered into on February 19, 2004 between the Director of the Division of Waste Management of the North Carolina Department of Environment and Natural Resources and the Deputy Assistant Secretary of the Army and the Remedial Action Plan, attached thereto. BK 03777 PG 0602 EXHIBIT B TO SPECIAL WARRANTY DEED FROM DON ,I) G. NEUENBERGER, TRUSTEE OF THE R.D.NTRUST DATED DECEMBER 5,2016 TO CENTRAL PARK BURLINGTON LEG This conveyance is made subject to the following exceptions: 1. 2018 ad valorem taxes, and subsequent years'. 2. Title to any portion of the land lying within the light of way of Graham -Hopedale Road, F Martin Street, and US 70; 3. Restrictions and other matters contained in Quitclaim Deed(s) filed for record in Book 2169, Page 675, and in Book 2169, Page 691, Alamance County Registry; and 4. Rights of tenants in possession, as tenants only, under unrecorded leases for a duration of less than three (3) years; and 5. Easements, covenants, restrictions and rights of way appearing of record which affect the property and which are legally enforceable. Agent Signature Authorization STATEMENT AND ACKNOWLEDGMENT OMB No.: 9000-0014 Expires: 6/30/2027 Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat, (VIR), Regulatory and Federal Assistance Division, GSA, Washington, DC 20405; and to the Office of Management and Budget, Paperwork Reduction Project (9000-0014), Washington, DC 20503. PART I - STATEMENT OF PRIME CONTRACTOR 1. PRIME CONTRACT NO. 2. DATE SUBCONTRACT 3. SUBCONTRACT NUMBER AWARDED W912HN21 F1006 W912HN21 F1008-01 2023, July 12 4. PRIME 5. SUBCONTRACTOR a. NAME a. NAME NORTHWIND ENGINEERING, LLC. TERRACON CONSULTANTS, INCj b. STREET ADDRESS C. STREET ADDRESS 105 MAIN ST., PO BOX 232 2401 Brentwood Rd. Suite 107 d. CITY d. STATE e. ZIP CODE c. CITY d. STATE ZIP CODE SHELOCTA PA 15774 Raleigh NC �f. 27604 6. The prime contract L)q does, U does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation." 7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm: a. NAME UF AVVAHUINU FIRM NORTHWIND ENGINEERING, LLC. b. DESCRIPTION OF WORK BY SUBCONTRACTOR For detailed scope, see Exhibit A and A.1 within their subcontract agreement. 7. PROJECT 9. LOCATION REMEDIAL INVESTIGATION FOR TARHEEL ARMY MISSILE PLANT, BURLINGTON, NC BURLINGTON, NC 10a. NAME OF PERSON SIGNING 11. BY (Signature) 12. DATE SIGNED Darcia North Wind ( 10b. TITLE OF PERSON SIGNING �� � ` 8/2/2023 Managing Member - - PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR 13. The Subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract: Contract Work Hours and Safety Davis -Bacon Act Standards Act - Overtime Apprentices and Trainees Compensation - (If included in prime contract see Block 6) Pay- Compliance with Copeland Act Requirements rolls and Basic Records Subcontracts (Labor Standards) Con - Withholding of Funds tract Termination - Debarment Disputes Concerning Labor Standards Certification of Eligibility Compliance with Davis -Bacon and Related Act Regulations 14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY A SR&R Environmental, Inc. C Eurofins Environment Testing B Redox Tech, LLC D D. A&DTEnvironmental Services, Inc. 15a. NAME OF PERSON SIGNING Michael T. Jordan 15b. TITLE OF PERSON SIGNING SE Division Manager 16. BY (Signature) 4 STANDARD FORM 1413 (REV. 7/2005) Prescribed by GSA/FAR (48 CFR) 53.222(e) Page 22 of 24 17. DATE SIGNED 08/02/2023 ORDER FOR SUPPLIES OR SERVICES PAGE I OF 10 I. CONTRACT/PURCH. ORDER/ 2. DELIVERY ORDER/CALL NO. 3. DATE OF ORDER/CALL 4. REQJ PURCH. REQUEST NO. 5.PRIORITY AGREEMENTNO. (YYYYMMMDD) W912HN18D1006 W912HN23F1012 2023 Jun 07 W33SJG31530180 6. ISSUED BY CODE I W912HN 7. ADMINISTERED BY (ifotherthan 6) CODE 8. DELIVERY FOB USACE -SAVANNAH DISTRICT 100 W. OGLETHORPE AVE SEE ITEM 6 DESTINATION SAVANNAH GA 31401 eX OTHER (See Schedule if other) 9. CONTRACTOR CODE 6Y F10 FACILITY 10. DELIVER TO FOB POINT BY (Date) 11. MARK IF BUSINESS IS (YYYYMMMDD) )( SMALL NORTHWIND-JACOBS JOINT VENTURE SEE SCHEDULE NAME 105 MAIN ST )( SMALL 12. DISCOUNT TERMS Net 30 Days AND SHELOCTA PA 15774-7433 X DISADVANTAGED ADDRESS WOMEN -OWNED 13. MAIL INVOICES TO THE ADDRESS IN BLOCK See Item 15 14. SHIP TO CODE W912HN 15. PAYMENT WILL BE MADE BY CODE 1 964145 USACE -SAVANNAH DISTRICT US ARMY CORPS OF ENGRS FINANCE CENTER ALL SEE SCHEDULE FOR DELIVERY LOCATION CEFMARK 100 W. OGLETHORPE AVE PACKAGES AND SAVANNAH GA31401 5722 INTEGRITY DRIVE 722 PAPERS WITH MILLINGTON TN 38054-5005 IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2. 16. DELIVERY/ X This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions ofabove numbered contract. TYPE CALL OF PURCHASE Reference your quote dated ORDER Furnish the following on terms specified herein. REF: ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDIT IONS SET FORTH, AND AGREES TO PERFORM THE SAME. NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED (YYYYMMMDD) ❑ If this box is marked, supplier must sign Acceptance and return the following number of copies: 17. ACCOUNTING AND APPROPRIATION DATA/ LOCAL USE See Schedule 18. ITEM NO. 19. SCHEDULE OF SUPPLIES/ SERVICES 20. QUANTITY ORDERED/ 21. UNIT 22. UNIT PRICE 23. AMOUNT ACCEPTED* SEE SCHEDULE 24. UNITED STATES OF AMERICA ppp * Ifquantity accepted bythe Government is sameas TEL:912-652-5105 0,.A26 25.TOTAL quantity ordered, indicate by X. 7fdifferent, enter actual EMAIL: Chad. A.Arnett@usace. army. mil quantity accepted below quantity ordered and encircle. BY: CHAD A ARNETT CONTRACTING / ORDERING OFFICER DIFFERENCES 27a. QUANTITY IN COLUMN 20 HAS BEEN INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO THE CONTRACT EXCEPT ASNOTED b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c. DATE d. PRINTED NAME AND TITLE OF AUTHORIZED (YYYYMMMDD) GOVERNMENT REPRESENTATIVE e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 28. SHIP NO. 29. DO VOUCHER NO.30. INITIALS H PARTIAL 32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR f. TELEPHONE NUMBER E-MAIL ADDRESS 1g. FINAL 36. 1 certify this account is correct and proper for payment. 31. PAYMENT COMPLETE 34. CHECK NUMBER a. DATE b. SIGNATURE AND TITLE OF CERTIFYING OFFICER (YYYYMMMDD) PARTIAL 35. BILL OF LADING NO. FINAL 37. RECEIVED AT 38. RECEIVED BY 39. DATE RECEIVED 40.TOTAL 41. S/R ACCOUNT NO 42. S/R VOUCHER NO. (YYYYMMMDD) CONTAINERS DD Form 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE.