HomeMy WebLinkAboutNCG080896_COMPLETE FILE - HISTORICAL_20170417STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V GCV O � 1� �
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ a o 1% O -1 i
YYYYMMDD
Energy, Mineral &
Land Resources
ENVIRONMENTAL QUALITY
April 17, 2017
Mr. Alan J. Fass, P.G.
Dynamis, Inc.
P.O. Box 50636
Knoxville, TN 37950
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY DAVIS
Director
Subject: NPDES Stormwater Permit NCG080896
PFJ Southeast LLC
Formerly Speedway LLC
Rowan County
Dear Mr. Fass:
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at (919) 707-9220.
Sincerely,
Original Signed by
Robert D. Patterson, P.E.
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Mooresville Regional Office
Mr. Joey Cupp, Pilot Travel Centers, LLC
Stormwater Permitting Program Files
Central Files
State of North Carolina I Environmental Quality I Energy. Mineral and land Resources
512 N. Salisbury Street 11612 Mail Service Center j Raleigh, North Carolina 27699-1612
919 707 9200
ti������!]��l`l�►��i(lI�►Zl��llt;n
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCGO80000
CERTIFICATE OF COVERAGE No. NCGO80896
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
PFJ Southeast LLC
is hereby authorized to discharge stormwater from a facility located at:
PFJ Southeast LLC
985 Peeler Road
Salisbury
Rowan County
to receiving waters designated as Town Creek, a class C; SW water, in the Yadkin Pee Dee River
Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts 1, II, III, and IV of General Permit No. NCG080000 as attached.
This certificate of coverage shall become effective April 17, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 17, 2017.
Original Signed by Robert D. Patterson, P.E.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
tDgnamls,Inc.
P.O.9oxc 80888, Knoxville, TN 37080
Phone: (BOM 5BB-5M Fax: {B9B] 4004BB7
February 10, 2017
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Transmitted via: Federal Express # 7784 0336 2389
RE: Request Transfer of Permit NCGO80000 for 5 Facilities
Sir or Madam:
RECEIVED
FEB 142017
"TOft ATER -UALIy
Please find enclosed facility participation forms for the following facilities:
Pilor6955?'
CNCG084'455M'= �� 'tGialam
.NC��`'""`
Pilot-6978
NCG080716
Candor, NC
.�
Pilot-7976
INCGO80170
ncaftnan, NC
pRildE7983; , },f' .:,;F
,- CGO80896,r;: xT
a Salisb ,NCB tea%
This letter is written on behalf of PFJ Southeast LLC and serves as a formal notice of
transfer of ownership from Speedway LLC (successor by merger with Wilco Hess LLC),
to-PF.I.Southeast- I L-C, 'The deeds are attached for Pilot-6955, Pilot-7971, and 7976. We
are waiting on the deeds for Pilot-6978 and Pilot-7983. These deeds will be transmitted,
upon receipt. Attached are the appropriate forms and/or documentation required to
complete the permit transfer process. If you have any questions or require additional
information, please contact me at 865-588-5422 ext. 208.
Sincerely,
4a�n J. , P.G.
Environmental Program Manager
Dynamis, Inc.
alanfass@dynamis-ine.com
Title Chain and Deeds of Transfer of Ownership for
Pilot-7983
Salisbury, NC
Permit No. NCG080896
Page t of 4
�92Z Air0i431LuUahlFa
This- &M, h dud nnre ere na deibtgseml ad vslaem reel ostitemess, w4dob rho
Roo+a t o�mty 71ta Collector is tSbAWd sa am a lien on
osaY�ga Dad datelumWIM ^ �
Tbuya 1'aneII _ CA I• I
Rwran ca na „o ni inr
pea I0: Ot1110Ba7on04 Tyyppa. GRP
Rsoorded: t4/OZ/2011 at o3 18:02 PM
Fu Mrt: $28.00 Papa t of 4
Revenue Tax: 60.00
Rowan, tOG
Marry L. Welch dr. Register of Oeade
m1189473
'fix Lot / Paaad TD: 408-024, 40IS M. 40W5 and 4OM77 NO TAXABLF CONSIDEItATION
The Property was not Grantor's primary residence.
Mail after recording to Han Law PLLC,1084 West Fourth Sheet, Winston -Sakes, NC 27101
This instrument was metered by Andrew D. Hart
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED made this S" day of November. 201
Lei .?.V A"
WILCOHESS LLC, a Delaware limited liability f WILCOHESS MC, a Delaware limited liability
company comfy
5446 University Pw kway 5446 University Parkway
Winston-Salem, NC 27105 1 Winston-Salem, NC 27105
Ile designation Grantor and Grantee as used herein shall include said parties, their heirs, successortl, and assigns, 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 Rowan County, North Carol ins, and more particularly described as follows:
SEE EXHIBIT A A77ACFFED HERETO AND INCORPORATED HEREIN BY REFERENCE.
The Property is cnrmntly designated as tax parcels 408 "408-060, 40"75 and 408477. The purpose of this
deed Is to combine the four parcels into a single parcel.
TO HAVE ANDTO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to
the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor has done 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, underor through Grantor,
other than the exceptions hereinafter stated.
Title to the property heminabove described is subject to the following exceptions: easements, rights -of -way and
restrictions of record, if any; zoning and other governmental regulations; further subject to taxes for the current year.
Book: 1189 Page: 273 Page 1 of
Page 2 of 4
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to
be signed in the corporate name by its duly authorized ofllcer(sX the day and year first above written.
WILCO /1
By v / v — C./ — (Seal)
tephen T. Williams, President
STATE OF NORTH CAROLINA
COUNTY OF FORSYTH
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that hg or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated:
STEPHEN T. WILLIAMS, President of WilcoHess LLC,
Date: go I f
(Official Seal)
l�htafy q,py�,p,
ft
of Fora1N 412M
O cial Sign ure f otary
e VL'" ' �)(k 1^
Notary's printedror typed name, Notary Public
My commission expires. o�
Book: 1189 Page: 273 Page 2 of 4
Page 3 of 4
EXHIBIT A
BEGINNING at a rebar located South 30° 5 1 ' 44" West 62.48 feet from an existing concrete right-of-way nuAcr that
marks the northernmost corner of the property of the H. J. Peeler Heirs (Book 575 at Page 953, Rowan County
Registry), said rebar also lying in the intersection ofthe west line of Peeler Road (S.R. 2538) and the east line ofthe I-
85 service road (S.R. 2594, Furniture Drive), and running thence with Furniture Drive the following five (5) courses and
distances: (1) South 301 51 ' 44" West 65.62 feet to an existing concrete right-of-way marker, (2) on a curve to the left
having a radius of 328.10 feet and a chord bearing and distance of South 11 ° 20' 50" West 218.76 feet to an existing
concrete right-of-way marker; (3) on a curve to the left having a radius of 2934,79 feet and a chord bearing and distance
of South 10* 40' 57" East 248.25 feet to an existing concrete right-of-way marker, (4) South 13' 13' 34" East 541.42
feet to an existing concrete right-of-way marker; and (5) South 08' 52' 5 1 " Fast 122.92 feet to an existing robin;
running thence South 86° 09' 32" East 5 1. 11 feet to an existing cotton gin spike; running thence South 070 31' 58"
West 104.44 feet to a rebar, running thence South 82° 32' 58" East 72.26 feet to an existing aluminum right-of-way disk
lying in the west line of the on -ramp to 1-85; thence with the west line of the on -ramp the following three (3) courses
and distances: (1) North 199 10' 37" East 357.46 feet to a mbar, (2) North 21 ° 55' 53" fast 187.62 feet to an existing
aluminum right -of --way disk; (3) on a curve to the right having a radius of 726.62 feet and a chord bearing and distance
of North 38° 47 56" East 123.42 feet to an existing aluminum right -of --way disk lying in the southwest line of Peeler
Road; mmningthence with the southwest line of Peeler Road the following six (6) courses and distances: (1) North 320
27' 2 1 " West 68.55 feet to an existing aluminum right -of --way disk; (2) North 330 47' 12" West 157.01 feet to it mag
nail; (3) North 46" 37' 06" East 20.36 feet to a rebar; (4) North 331 16' 24" West 184.30 feet to a rebar, (5) North 070
39' 05" East 79.91 feet to a robin, (6) North 50' 28' 27" West, passing through a rebar at 190.98 feet, for a total
distance of 371.01 feet to the Point and Place of Beginning. Containing 9.619 acres, more or less, according to a survey
by Brad K. Curry, PLS, dated August 16, 2011, and bearing Job #110803WH.
Being the same property described in Deeds recorded in Book 913 at Pages 21, 22, 23 and 24, Rowan County Registry.
Being tax parcels 408-024, 408-060, 409-075 and 40" 77 of the Rowan County Tax Maps as said maps are presently
constituted.
Book: 1189 Page: 273 Page 3 of 4
Page 4 of 4
Vrac t/Lf:.lt
1'riC:t/1_cit
ROWaTI COUnly As*uSsar':; Offica
Multiple Pat -Cal I(JQntj-FjCz)tiLIn
Pal -eel ID
lral;l/Lot Parcel ID
Trac:l/Lot Parcel ID
TracUU)t Parcel tD
'tract/Lot Parcel iD
tmc::t/Lot __ Parcel ID
T' u;t/Lol Parcet 10
Tracl/Lot Parcel ID
Tract/Lot Parcel ID
Tract/Lot
Tra CZ/i_Q 1
Palcl;i ID
Parcel ID
1fncl/t_c.Tt Parcill ID
I"act/Lot Parcel 10
I r�r;t/I,.vE
Parcel il-j
1` MAP IFIMI 1'J111 l 5fF UfIN L11N GICI PA1nT INf
MAP SlIA PAn SIP WIN L/IN c/c ranT I_ �Il
JJ M��Ap4 arIA 1 A{i '$rp VII« �i�N
MAP LM I'AR b!P Ufn{ LIIN CK PanT I+li
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MAP I/M PAA S!P 11fIN LIIN crc PART INT
MAI' 37M PAII S1P VIIN Lem Cie PART INT
MAr SIw FAA 5/P WIN LAI4r CIG PART INT
L -
1 MAP 131MI rhfl 1 $111 t WIN LIIN Crc PaRY INT
MAP VU PAN I SIP I U11N I LIIN C!C PART INT
r,1AP SIM 4•AI{ 5!P Y11N LAN C!C PART INT
MAP 51N rAq 51r U+IN L11N crc PARTY IN�
MAA ><ru PAR SIP V/IN LIIN 1 Eft PART INT
MAP SIM PAR £/P 1711N LIIN f.K PART 1NT
MAN {rN PAR S/r I UMN LIIN ICICI PART 1NT
MAP srN VAN S1P LIIN Lllfl CIL' PAPT INT
Book: 1189 Page: 273 Pegs 4 of 4
Page i of 24
��T.!J■I�.lIIIIIIr��.,��;�llllli:�.��:��+„-.-a�� ,���,1�,
�l.0) i0P141 M=M0c;j t;i
Rowan County Assessor's Office
Thh eatl8a �n those ate ee dtdingaaat ad ww� teal em:e t thleh the xO7tr°r !4 coUecmr u 1 adot 11m oa:
Iod
Doc 1D: 01/,a3BR00024 TYGe: CRP
Raaordad: 12/t0/20s2 at 1t:44:o4 N1
Fs• Mat: �E2.00 Pappa 1,11 24
Mvanue Tsx: $20.OD
Rovan, '
Harry L. llalch Jr. Raplater of Daads
oK1208 PAN
`® Tax tat / Psrcel ID: A portion of 408.005 Excise Tax: $20.00
The Property wss not Grantor's primary residence.
Mail after recording to Hut & Ellis PLLC,1084 W. Fourth Street, Winston-Salem, NC 27101
This instrument cna prepared by Astdrew D. Hut
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this Q day of a &W seer 2012, by and between:
GRANTOR
SHUFORD KIRK PEELER, JR. and spouse, LINDA
WHITE PEELER (a 111'" undivided interest); JUDY
PEELER COGGINS and spouse, LARRY MARTIN
COGGINS (a I/7° undivided interest); BETTY SUE
SCHIEFER, unmarried (a 1/7ei undivided interest); JERRY
A. MYERS, unmarried (a 1114's undivided interest);
JEFFREY L, ANDERSON, unmarried (a III 4s' undivided
interest); DONNA A. CRAFT, unmarried (a I/146 undivided
interest); PATRICK G. GLASS and spouse, SUSAN GLASS
(a 1/21" undivided interest); HARVEY M. GLASS, unmarried
(a 1/21" undivided interest); PHILLIP D. GLASS, unmarried
(a I/21" undivided interest); MARY C, FULLINGTON and
spouse, KEVIN EDWARD FULLINGTON (a 1/28'
undivided interest); KATHLEEN C. WINKOWSKI and
spouse, DAVID OWEN WINKOWSKI, JR. (a IaRL'
undivided interest); KATHLEEN A. SUMMERS and spouse
BRANDON D. SUMMERS (a 1/56'" undivided interest);
LOUIS W. KONYHA and spouse, ROCHELLE KONYHA
(a 1/560 undivided interest); JULIE MARIE KONYHA,
unmarried (a 113e undivided interest),, KAREN
ELIZABETH FORD and spouse, CLINT FORD (a We
undivided Interest); JAMES L. GILLON, unmarried (a 1/70"'
undivided Interest); MARCUS J. GILLON and spouse,
LINDA OLIPHANT GILLON (a 1/70e4 undivided interest);
BARBARA G. ELLIS and spouse, ADRIAN ELLIS (a V706
undivided interest); CHARLES S. GILLON and spouse,
BELINDA CAMPBELL GILLON (a I/10m undivided
interest); and WHITSON K. GILLON, unmarried (a I/7D'�
undivided interest)
WILCOHESS LLC,
a Delaware limited liability company
5446 University Parkway
Winston-Salem, NC 27105
Book 1208 Page: 423 Page 1 of 24
Page 2 o124
The designation of Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall
include singular, plural, masculine, feminine, or neuter as rewired 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 the city of Salisbury, Rowan County, North Carolina, and more
particularly described as follows:
BEGINNING at the right-of-way monument found at the southwest intersection of Peeler Road
and Furniture Drive; thence running South 30° 50' 5" West 62.59 feet to the 5/8" Rebar in the
northern most comer of property of WilcoHess LLC; thence running South 50' 30' 50" East
189.92 Feet to the 5/8" Rebar on the right-of-way line for Peeler Road; thence running northwest
along the Peeler Road right-of-way North 33' 16' 09" West 208,71 feet to the POINT AND
PLACE OF BEGINNING containing 0.135 acres, more or less, according to a survey by Lupton
dt Webb, P.A., dated November 18, 2011. and updated February 7, 2012.
Being a triangular -shaped portion of Tax Parcel ID # 409-005, lying on the southwest right-of-
way of Peeler Road.
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.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to
convey the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will
warrant and defend the title against the lawful claims of all persons whomsoever except for the exceptions
hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions: easements, rights -of -way and
restrictions of record, if any; zoning and other govemmental regulations; further subject to taxes for the current
year.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seat, or if corporate, has caused this
instrument to be signed in the corporate name by its duly authorized officer(s), the day and year first above written.
(Separate signature and notary pages follow)
Book: 1208 Page: 423 Page 2 o124
Page 3 of 24
State of /V Oa'* `c'm L. ,, a
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Sj}yfad
lw
Official ftnature of Notary
2�ea►Aa ee � I Ybj
Notary's printed or typed name, Notary Public
My commission expires: 0 ';L-.1aS~f .fi! S--
Book: 1208 Page: 423 Page 3 of 24
Page 4 of 24
1 c
iSeal)
elyPeeler oggins arry Martin Coggi
State of mauki Cn¢oteN+4 - County of . _ 014nnellU S
1 certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose herein and ' apaci ndicated: Jgdy
Date; Oc-kbu it 2pja_
Official gnattim of Notary
JAMIL SMITH
Notary's rriri tted or�uname, p typed Notary Public
cial SedipTARY PUBLIC
FLtj
Cebarrus County, North Catalina
My commission expires: Ma trwraeg 1 ..2
Cmffl* On Ele W Nowm6e♦r 16, M4, ,
Boa*: 1208 Pegs: 423 Page 4 of 24
Page 5 o124
_ R (Seal)
Betty S Schiefer
State of - County of Ork
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntWy signed the foregoing document for the purpose stated therein and in the cap ity indicated: BM
Sue SchiJJefer,
Date: I 1
(Offlclal Seal)
Nonry poplk: • Stato of FWridb
' Lty Comm. E%plrn MY 16, 2015
1� Commiuion I EE 74066
Notary's printed or typed name, otary ublic
My commission expires: %
Back: 1208 Page: 423 Page 5 of 24
Page B of 24
a, 2ZIUAIJ (Seal)
JeIVA. Mfers
State of A r ( �o— - County of 6y Va-L
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: agay A.
MM
Date: OCA. 101
iOfjiclo! Seat),A IOA CM tm
h
4&;Lt
Official Signature of Notary
�r? C-0 115
Notary's printed or typed name, Notary Public
My commission expires: f f3
Book; 1209 Page: 423 Pepe 6 of 24
Page 7 of 24
OR j
State of are+ l'. -County of _ Qtawitv5
f certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in a capaci indicated: 3effm
L. Anderson.
Date: CAbv
OfficlaAgnaf6m of Notary
JAM' ISFA�L+-
IC SMITH Notary's printed or typed name, Notary Public
( lAiSea! NOTARY PUBLIC
cou�Y Nwm �IMA
My commission expires: 1 � IL t=L(
CabawsW C;a mr hjkm Fspkes November tE, 90%
Book: 12DB Page: 423 Page 7 of 24
Page ti o124
a-C (Seal)
nna A. Craft
State of A/C - County of Ct,
1 certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stafted therein and in the capacity indicated: �g
A. Craft,
Date: �"
Official Si re of Notary
,OtIt+If rl lir;!
�L�(O*Ial feat) o
ti t~ n f
e'Wdl J, 0,,IT
Notary's printed or typed name, Notary Public
My commission expires: AY*Aeco, A/ ?AA?
Book 1209 Page: 423 Page 8 of 24
Page 9 of 24
_(seal) (�4WN O v, �rLD�J/�. (seal)
Patrick G. Glass Susan Glass
State of L 0V4 CM ID I r* Countyof LA TN i o t 1
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Patrick
G. Glass and Susan Glass,
Date: I 0 - I 0 - .AO } .%
(Official Seafi
tyolaK Not
�
KOO
Ofi�gnature of Notary
3ame-4 S. 'Ross
Notary's printed or typed name, Notary Public
My commission expires: a- a3- anti 5
Book 1208 Page: 423 Page 9 of 24
Page 10 of 24
i}AV (Seal)
Harvey M. G ss
State ofbj6Lffi- County of _ ay i de-00
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Harvey
Date: _1 n �Y)D - 12 m
Official Sign of Votary
rI Sloon -
Notary's pr4nted or typed name, Notary Public
(Official Seal) 2— i y' I+
My commission expires:
May JAIII
Notary Public. North Carolina
Davidson County
My Cornmtaaion Explraa
February 14, 2017
Book: 1208 Page: 423 Page 10 of 24
Page 11 of 24
hillip &OIaMSS
State of� _ • County of eAm,4 of
I certify that the following person(s) personally appeared before me
she voluntarily signed the foregoing document for the purpose states
Official
1) �-, G Ze '
Notary's
�1 p��g: 3-7d d -
each acknowledging to me that he or
and in she capacity Indicated: Phillip
v of Notary
I�
or typed name,
Book: 1208 Page: 423 Page 11 o124
Page 12 of 24
b Q GI {Seal,
Maly' C. PWIngton
State of -County of 1.]$►.>
4V
(sear
Kevin Edward Fallington
1 certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Mm�
Fullinlrton and Kevin Edward Full in on.
Date: i
(Qffi%lal Seal)
Official Signatuh of Not
_4�etlw 'A. GDanwi q
Now ed or typed name, Notary Public
My commission expires: $ sl .1A
Book: 1208 Page: 423 Page 12 of 24
age 13 of 24
1
(Seal)
Kathleen C7. Winkowski
'{Seal)
D id en inko ski, Jr.
State of (2,0N N eG + i (AA County of M R- I 1:0 iet�)
l certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity Indicated:
Kathleen , Wi owski and David QMn )MjjjkMki. Jr.
Date: 1, LA v _ i� ►R�ti�ti"••.,,
Official Signature of Notary
�v
g� to, >�
Notary's printed or typed namo, Nouuy P#o•t
(t�cialSeal) :, Y 4
My commission expires:! :° ' ';.aZ
Sdi Oli pl
7 bft k 31, 2017
Book: 1208 Page: 423 Page 13 of 24
Page 14 of 24
Seal)
A. Summers
State of 0 (, . 0 . County of
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose atwA ftrein and in the capacity indicated:
Kathleen A. Summers Md Brandon D. Summgm.
o.tc IL- 3-1L
cMdnSbcpires: D
4.,�
Odic ignat ue of Notary
fYAN . 5 W.1k14
Notary's printed or typed name, Notary Public
Book: 1248 Page: 423 Page 14 d24
Page 15 of 24
N 'A (saw)
Louis K
Rochelle Konyha (Seal)
State of f&Ixern `County of O arm
I certify that the following persoo(s) personalty appearod before me this day, each aclmowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: jail
W. Konvha and Rochelle Konvba.
Date:
(Official Seel)
My commission expires:
1209
�� � a6xbrA or_CglftiKia- Alm *tm+
Official Signature of Notary
Notary's printed or typed name, Notary Public
Book: 120E Pepe: 423 Pepe 15 o124
Page 16 of 24
CAUFORNUI ALL-PURPOSE ACKNOIAREDOMENT
0M cow a Ila
State of Celffomis
County of
On IlnMnbja4%1hr before me, .Sr a,n Qflecrar r g%n P�hlic
nM. ae �r er ones me" s
personalty appeared L*wn _ - n ems _ na Rocjhrj1& _►colnhl►9�
HE"*) of Nw r(a)
who Proved to me on the basis of satisfactory
evklence to be the pence whose name®{stare
subscribed to the within Instrument and acknowledged
to me that t they exemAed the same in
blak 4heir authorized c apadyM and that by
4*OherRheir signature on the instrummind the
SEM PROCTOR
1 amRllielan 11944550
perao�e Or lFla entity upon behalf of which the
person cted, exomded the Instrument.
Notary Pubfir - Crllfornis
Onng1 County
M Comm. Ea ins tu117, 2015 r
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
Paragraph Is two pnd correct.
WITNESS my hand and official seal.
Signature:
Pb 11o1■y htl 116we d Ma1rY FWK
OPROIYAL
Thmo Ow Ndbmw*n Debw Is no mq~ by law, 0 may prove ►■koM b pws= re"V an ohs docur wu
and could pwtnr frou dW rMnovar and MattaftnW or VA ban to smear daoaararlr.
Desc ption of Attadted Numb
Tills or Type of D06Umrrl: e�lcnmjlvd . (AMEXAa Uhsmow tua1.
Document Dots: Number of Paper:
Sipner(e) Other Than No Above: ,_
Capoe"Ies) ClaNned•by Slptter(e)
Signer's Name:
Signer's Na":
❑ Corporate Officer — Title(e): ❑ Corporate OHloer — Tide(e):
fJ Individual
❑ Partner — ❑ Limited ❑ GerMA Top of tlrrre hen
❑ Attorney In Fad
0 Trustee
❑ Guardian or Conservator
❑ Other:
Sigrw Is Representing:
o sma Naemu
❑ Individual
❑ Partner — ❑ Limited ❑ General Tap at ffwm rope
❑ Aeomey in Fad
❑ Trustee
❑ Guardian or Conservator
Signer Is Reprosenft
-u
Book: 120H Page: 423 Pegs 16 or 24
Pap 17 of 24
ie Marie onyha 04
State of - County of
1 certify that the following person(s) personally appeared before me this day, each acknoolWng to me that he or
she voluntarily signed the foregoing document for the purpose stated therein capacity indicated: Ipjk
Marie Konyha. -A'I
C/�-'tj ffFficial Signature
Notary's printed or typed name, Notary Public
(Official Seal)
My commit'
Book: 1208 Page: 423 Papa 17 o124
Page 18 of 24
i
}
1 '
i
]rM90011 .J41I� PMERAM #dmo-Wi �JWk
State of California
County of �{yw►bois��'
On 2 N6vtrwt6c,r 71012 before me, aS6V%GAvel1 Notary Public.
personally appeared ui;e Mane Kv,,,,,a
who proved to me on the basis of satisfactory
evidence to be the person(&) whose name(e)
is/m subscribed to the within Instrument and
acknowledged to me that Ae/sheAhe�r.
executed the same in +dh/herAMW authorized
capacity0es), and that by *Wher/ hOW
signatures) on the instrument the person(,
or the entity upon behalf of which the
persono) acted, executed the instrument.
I certify under PENALTY OF PEIR]URY under
the laws of the State of California that the
foregoing paragraph Is true and correct.
A caweu
WITNESS my hand and official seal.
coated. IliumHUMMIM
R
■mu'
Signature
Place Notary Swi Above wore e of NGts "ic
OPTIONAL
Though the udornmoon bebw ts not rewwed by law, 4t may prom vaimbe to parsons relying on the doagrou
and could Prevent fraudulent removal and reaCtactvrient of this form to anotilmr donmmt.
Description of Attached Document
Title or Type of Document: NoorVA"t C�sro1 � _ cyvw'al _wa•_ nL', ptej
Document Date: Z Noyo.w,ker ZQ1Z Number of Pages: .3
' Signer(s) Other Than Named Above:
i
Hook: 1208 Page: 423 Page 18 of 24
Page 19 of 24
(Seal)
Karen Elizabeth Ford
State of County of
ilm
..
r
[itiirr
1 certify that the following penson(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Karen
Elizabeth Ford and Clint lord.
Date: W. Vorllalr r to rlor9-
BRIAN BENJAMIN
+may PkAft state of Navada
No. 1 1-4575-1
MY AM, UP. Ap8122, 2ot5
QVICfa! S
El My commission expires: 8� is
Offict Notary
' A
Notary's printed or tylWd name, Notary Public
gook: 1208 Page: 423 Page 19 of 24
age 20 of 24
se
i ,
/v�2"(Seal)
�ftes L. Qillon
State of o_oQ CGraii, -County of r Gam.
1 certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: ,I =
L. Gillon.
Date: Ike (.1,20 0-
JEt181CA CHURCFf
( acial Seal) Maury Pow
CartaIM CWAKY
11" CHOM A
My Cwanh" BONN AM 30, 201b
Official S store of Notary
_ CS i t [. 2'- C l/1 v L l_
Notary's printed or typed name, Notary Public
My commission expires: 71.r 3e)
Book: 1208 Page: 423 Page 20 nt 24
Page 21 of 24
JYAA, _(sea)) It A', U J1. . la" 1.1.
.' ,: OliphaAtGillon
i
State of
1 i., d .
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: blaSus
J. Gii)pn and Linda Oliphant Gillon.
Date:
Sead*WAf#,. "
AV6L%G ci
Official Signat of Notary
J l 1
1�111d1`�V � 1�e1Gh� �-
Notary's printed or typed name, Notary Public
My commission expires: Se aQ ti
Book: 1208 Page: 423 Page 21 of 24
Page 22 of 24
a
040h PX-ILA�'
(Seal)ZA (Seal)
ar ara G. 9111s Arlan Ellis
State of ) • County of
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Barbara
Q.EI]ippd Adrian Ellis.
Dale: to
kou-
(racial Seal)
(6, V
fcial Silature of
Ts . 6V
atary's printed or typdd name, N Public
�� My commission expires: — 4
Book: 1208 Page: 423 Page 22 of 24
Page 23 of 24
j
Charl S. Gillon Belinda Campbei Gillon
State of kbklH County of fVAs �4
1 certifythat the following person(s) s personally appeared before me this day, each acknowledging to me that he or
g Pe (} P Y PP Y 8t g
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Charles
S. Gillon ant! Belinda Camnbe11 OR=
Date:,QQI2'
Q ial igmature o Notary
WWI _ -
` �MttE Api SEA Notar % printed or typed name, Notary Public
' cJal Sea NOWY Pubk
Font, C"T" My commission expires
Cerogns
�, tora
Book: 1208 Page: 423 Page 23 of 24
Page 24 of 24
W�/ ' •.2�
State of Foot✓ Lda __ - County of trn e k--
1 certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Whitson
K. Gillon•
late: a'.)- DC eQ ao�a
Official Signature of kmwyl-
Cat-a
Notary's printed or typed neane, rvalary Public
(Official Seal) Lam— 3
My commission expires:
NOTARYPUSLIC4 CFFLOHIDA
kw
Cara vVolfggaanngg
Cammissioa i EPA. WI
xpires; OCI 13,2014
co: AM\T1C u mm Oa,a1C
Book: 1208 Pape: 423 Page 24 or 24
SOSID: 0586362
Date Filed: 1/5/2016 10:40:00 AM
Elaine F. Marshall
North Carolina Secretary of State
C2016 004 01133
Delaware- page 1
The First State
I, JEMMY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF'
DELAXARE, DO iD; MY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF THE CERTIFICATE OF iIMRGER, WHICH BERMS
"WILCO FOOD SERVICES LLC", A DELAWARE LIMITED LIABILITY
COWANY,
"MESS WILCO HOLDINGS, LLC", A DELAMM ZDffTED . LIABILITY
COMANY,
"WILCOHBSS IX", A DELAHARE ZZWTTED LIABILITY. CCWANY,
"HESS RETAIL HOLDINGS LLC", A DELAMM LIMITED LIABILITY
COWANY,
WITH AND INTO "SPEEDWAY LLC" UNDER THE MW OF "SPEEDWAY
LLC", A LIMITED LIABILITY COMPANY ORGANISED AND MCISTING UNDER
THE LAWS OF THE STATE OF DWLAlW=, AS 'RKCLVXVKD•"AND' FILED: IN 'THIS
OFFICE ON THE TWENTY-SECOND DAY OF DECEMM, - A,: D.--201•S, ' AT":1:A 7
O'CLOCK P.H.
AND I DO HEREBY FURTHER CERTIFY THAT THE 'EFFECTIVE:DATE OF
THE AFORESAID CERTIFICATE OF J=GER IS THE FIRST DAY OF JAmmy,
A.D. 2016 AT 12:01 O'CLOCK A.H.
rA w. dvwck�w.r
R
2775076 8100M Authentication:2016037§3
SRi120151490339 :" Wte:01-04-16
You may verify this certificate online at corp.delaware.gov/authver.shtmi
2775076 8100M "
SR# 20151490339
You may verify this certificate online at corp.delaware.gov/authver.shtml
Authentication: 201603793
Date: 01-04-16
State of Dibware
SeiiMI, of State
Dh ki of Corporations
beikertd- 01:47 PM Iki/2015
FIUD 01:47 PM 1Z122l201S
SR 20151/90339 Flu -Number 2775076
Stagy#. Qrt Deuwnre
CortfiT.1cate.of.Me er, of :..
Dome.sOic .LWii - Lisibflity Col,npanies
Pursuant•to.Tide 6,-Section.18-209 ofthe Delaware--imited Upbility.Cofnpany•Act,.the ndersi$ -
linnited'habaity company executed, the ;fo3lowit t• rtil ate, of ii r:.
lF'lltM: The name. of the surviving- Limited Liaaility • Company ' . ' &peedii�ay :. ` L:1: : "
arltl:tite names of ilie,limited liability bti m$bd into #>ii,��.stntrriving Yitxiiruy
pP.nY :are WilcoHess I L•''C; ,%i o Fcko4-%-S0rvice9 LLC; 1"less !� p: ;H01016,. T:,i4l" '.
at AA
lriingsi
Sited: 3• w. Agreemcut.•QWer-ger,itas=been app m.. d..4dopted.-aerdf cd.: executed..atI1
a�a►owledgea:by of a caal>stiti nt.Uu*e+d'UaliaiWcompanies.
'i'bW: T e.+r►tc:the swry+i ing l cnittci liability' cu 1p yia 9pe 'aY LLCc
.Fourth.- Tlw-merget.is ta beouneeffoctive..on Junumy 1,.2016 st.12.014L ii.
i h. Thy Agreement of Niergtrc is c3fi file -at. 5 : $ ifvuay —
Drm &non, Ohio 453Z.1056! the
#PrincipOlplace.ol"busines».ofthe.swrviving:Limiifed blibility.-ConVany.
Sizt6:. �►: copy a�.'tha Agrrx�nent-of:�Icrger will.be.fbrni�hed.:by�t>�;sur?viving,:l'lmited .
1#itiI+ rut»pmsyt stst! �vlttiot>It:+cost,.tn::ietier aft:crmstilt;iltc;ti�ability.
:1 , ,1'lr3`ir1ES�3 WHEREOF, said smvivigg. limited lisbiiily company has...cWw this. egrtifiaate
#p' re: ptrerl :lYy: apt► andib 'pawn, t1re:2'�tid day'ol*i t>Slicr.:A�i�,; ;24� 3�. .
.ley;
;�i�1t11ati�d..
Name. Shane.-T. Pfleiderer.
Ti+tle: Assistant:��cretriry" .
See Addendum
This certifies that there are no delinquent ad valorem real estate taxes, which the
Rowan County Tax Collector Is charged with collecting, that are a hen on:
Property Identification Number See Addendum
This Is not a certification that the Rowan County Property Identification Number
matches this Dead description.
Tonve Pamet� RED 12-06-2Q16 04:58:2R
Rowan Ca Tex Collections Manager Clark Date/Time
NORTH CAROLINA
ROWAN COUNTY
Type: CONSOLIDATED REAL PROPERTY
Recorded: 12n12016 8:00:19 AM
Fee Amt: $5.407.00 Pape 1 of 7
Revenue Tax: $5,381.00
Rowan,NC
J. E. Brindle Register of peads
BK 1281 PG 260
Tax Lot No. 408 024 and 409 089............................................ Parcel Identifier No. ..............................................
Verifiedby.................................................................. County on the ......................day of .................................. . 20 .............
by...........................................................................................................................................................................................
Mail after recording to First American Title Insarance Company, Attn: Hilda Bubose, 30 North LaSalle Street, Suite 2700, Chicago,
IL6%02.......:........... ................ .................. .......................................... ............................................................................................ ...........
This instrtnnent was prepared by: Kevin C. Lewis, Attorney-m-lAw, Soo Speedway Drive, Enon, OH 45323
Brief description for the index 408 024 aitd 408 089
Excise tax: $S,381.00
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED made effective this 60 day of December. 2016, by and between
GRANTOR GRANTEE
SPEEDWAY LLC (successor by merger with
WiicoHess LLC)
a Delaware limited liability company
500 Speedway Drive
Enon, OH 45323
PFJ SOUTHEAST LLC
a Delaware limited liability company
do Intax, Inc.
P.O. Box 54650
Lexington, KY 40355
Eeta in appropdau biwk rw each psr); rums, eddrear, and, if eppmprim, e4fwor of prdry, aq. lion et pwm=hip...
The designation Onnntor and Grantee as used herein shall include said parties, theirheirs, successors, and anigns, and shall inchuteaingulu,
plural, masculine, feminine or neuter as required by context
WITNESSETH, thatthe Grantor, for a valuable consideration paid bythe Grantee, the receipt of which ishereby 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, together with all
buildings and other improvements situated in Rowan County, North Carolina and more particularly described as follows:
See Exhibit "A" attached hereto and made a part thereof.
Said property having been previously conveyed to Grantor by insb ument(s), dated November 8, 2011. recorded in Book 1189. Page 273
and dated December 10, 2012, recorded in Book 1208 Page 243 in Rowan County, North Carolina.
All or a portion of the property herein conveyed,_ includes or X_ does not include the primary residence of a Grantor.
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.
Unit 0:7983 (LWD)
Address: 985 Peekr Rod
Salisbury, NC
I of 3
Submitted electronically by "First American Title Insurance Company - NCS"
in Compliance with North Carolina statutes governing recordable documents
and the terns of the submitter agreement with the Rowan County Register of naads.
Book: 12131 Poge�260 Page 1 of 7
And the Grantor covenants with the Grantee, that Grantor has done nothing to Impair such title as Grantor received, and Grantor will
wan -ant and defend the title against the lawful claims of all pennons claiming by, under or through Grantor, except for the Permitted
Exceptions as defined in that certain Contribution, Assignment and Assumption Agreement dated June 17, 2016. by and between Speedway
LLC, Pilot Travel Centers LLC and PFJ Southeast LLC.
IN WITNESS WHEREOF, the Grantor has bereuntosSI. his hand and seal, or if corporate, has caused this instrument to be signed in its
corporate name by its duly authorized officers, this day of December, 2016.
SPEEDWAY LLC
as successor by merger with WileoNes/s
By: ....... ....N......................................... .
Printed: Gregory S. Whihnan............................ .........
...............:.....
Title: Director, Real Estate and Operations Punning .......................
SEAL,STAMP
State of Ohio, Clerk County
1, the undersigned Notary Public offt County of lark and State aforessid, certify that$,
W.himgn Director.Beal Estate tiom Punning___. of Speedway LLC personally
appeared before me this day and acknowledged that due execution of the foregoing instrument for the
purposes therein expressed. Witness my hand and Notarial sump or seal, this day of Do ember,
2016. KniwUNR S. BORGWALD
NOTARY PUSUC • STATE OF OHIO
Mya0mords lonexplras3114119
My commission expires: {%- Notary Public
Unit /:7911 iLWt71
Address 913 Ikeda find
Salisbury. NC
2of3
Book: 12at Pegs: 2e0 Pogo 2 of 7
EXHIBIT A
Speedway 7983
985 Peeler Road
Salisbury, NC
Tract One.
BEGINNING at a rebar located South 300 51. 44" West 62.48 feet from an existing concrete
right-of-way marker that marks the northernmost corner of the property of the H. J. Peeler Hein
(Book 575 at Page 953, Rowan County Registry), said mbar also lying in the intersection orthe
west line of Peeler Road (S.R. 2539) and the east line of the 1.85 service road (S.R. 2584,
Furniture Drive), and running thence with Furniture Drive the following five (5) courses and
distances: (1) South 300 5 P 44" West 65.62 feet to an existing concrete right -of --way marker; (2)
on a curve to the left having a radius of 328.10 feet and a chord bearing and distance of South I v
20' 50" West 218.76 feet to an existing concrete right-of-way marker, (3) on a curve to the left
having a radius of 2834.79 feet and a chord bearing and distance of South 10" 40' 37" East 249.25
feet to an existing concrete right-of-way marker, (4) South 13a 13' 34" East 541.42 feet to an
existing concrete right-of-way marker, and (5) South 08° 52' 51" East 122.92 feet to an existing
Taber, running thence South 86° 09' 32" East St.I 1 feet to an existing cotton gin spike; running
thence South 070 31, 58" West 104.44 feet to a mbar; running thence South $24 32' 58" East
72.26 foot to an existing aluminum right-of-way disk lying in the west line of the on -ramp to 1-95,
thence with the west line of the on -ramp the following three (3) courses and distances: (1) North
19. 10' 37" East 357A6 feet to a rebar; (2) North 211 55' 53" East 187.62 feet to an existing
aluminum right-of-way disk; (3) on a curve to the right having a radius of 726.62 feet and a chord
bearing and distance of North 38" 47' 56" East 123.42 feet to an existing aluminum right-of-way
disk lying in the southwest line of Peeler Road; running thence with the southwest line of Peeler
Road the following six (6) courses and distances: (1) North 320 27' 21" West 68.55 feet to an
existing aluminum right-of-way disk; (2) North 330 47' 12" West 157.01 feet to a mag nail; (3)
North 460 37' 06" East 20.36 feet to a rebar; (4) North 33° 16' 24" West 184.30 feet to a rebar; (5)
North 07e 39' 05" East 79.91 feet to a rebar; (6) North 50' 28' 27" West, passing through a rebar
at 180.98 feet, fora total distance of 371.01 feet to the Point and Place of Beginning, Containing
8.619 acres, more or less, according to a survey by Brad K. Curry, PLS. dated August 16, 2011,
and bearing Job # 110903 WH.
Prior deed reference: Book 1189, Page 273
Tax Parcel No.: 408 024
Tract Two:
BEGINNING at the right-of-way monument found at the southwest intersection of Peeler Road
and Furniture Drive; thence running South 300 50' 5" West 62.59 feet to the 518" Reber in the
notthem most corner of property of WilcoHess LLC; thence running South 50" 30' 50" East
189.92 feet to the Sl8" Reber on the right-of-way line for Peeler Road; thence running northwest
along the Peeler Road right-of-way North 339 16, 09" West 208.71 feet to the POINT AND
PLACE OF BEGINNING containing 0.135 acres, more or leas, according to a survey by Gupton
do Webb, P.A., dated November 18, 2011, and updated February 7, 2012.
Being a triangular -shaped portion, lying on the southwest right-of-way of Peeler Road.
Prior deed reference: Book 1208, Page 423
Tax Parcel No.: 408 089
THIS iNSTF'"""'T FILED FOR RECOnO BY MSTAWACAN
TITHASNOTBEcNE; 1NEO.%5010irbEXL` "0N
OR AS TO rTt 51FCT UPON TITLE.
W t 01M (LwP)
Addreu: 985 Puler Raid
Salisbury. NC
3of3
Book: 1281 Pogo: 280 Page 3 o1 7
Delaware
Page a
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATIC OF THE STATE OF
DELAWARE, DO IUMBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF THE CER2'IFICATE OF MERGER, WHICH MERGES:
"WILCO FOOD SERVICES LLC", A DELAWARE LZMITWD LIABILITY
COMPANY,
"BESS WILCO HOLDINGS, LLC", A DELAVARE UNITED LIABILITY
COb1PAHY,
"WILCOHESS LLC", A DELAILUM LIMITED LIABILITY COMPANY,
wHWSS RETAIL HOLDINGS LLC", A DELAWARE LIMITED LIABILITY
CONWANY,
WITH AND INTO "SPEEDWAY LLC" UNDER THE NAVE OF "SPEEDWAY
LLC-, A LIMITED LIABILITY COMPANY ORGANIZED AND EXISTING MMM
THE LAWS OF THE STATE OF DELAWAIM, AS RECEIVED AND FILED IN THIS
OFFICE ON THE TiiENTY—SECOND DAY OF DECW=, A.D. 2015, AT 1:47
O'CLOCK B.M.
AND I DO IUMEHY FVRTMM CERTIFY THAT THE EFFECTIVE DATE OY
THE AFIDRESAzD CEIZTIYICATE OF M p=p z8 Tim FIRST DAY of JANUARY,
A.D. 2016 AT 12:01 O'CLOCK A.M.
2775076 8100M Authentication:201603793
Sft# 20151490339 Date: 01r04-16
You may verily this certificate online at carp.delaware.gov/authver.shtml
Book: 1281 Page: 260 Page 4 of 7
Delaware Page
The First State
2775076 8100M
SR# 20151490339
You may verify this certificate online at corp.delaware.gov/muthvershtml
1 F-
Authentication: 201603793
Date: 01.04-16
Book: 1281 Page: 260 Page 5 of 7
Stott of Mwax
Stcftry of Stott
Dkwn of carponwul
DdlTuid 01:41 M 12424016
FM 01A7P4121724015
SK 2DIS1490339 - FBPNumbw 2775076 $Wp. pf DORWArle
Powstle, LlmltO. , Ulibility Companies
fummt.,WT.Ac 6,:8wdcomA,8209,.pf th*-Delwmm.LtndW.L-AabRay...Compmy.,Act,.Qw uDd&dgno
limited liaMUty company exwstod Maim
First: Mw Heine of the nwvhftg Un*cd UWWlity. Compmy is $pe04�wax W.. ,.
oompmx aae W.Ilj*Hao. U 'q%* *
ror%gW-11CO.-HOA O". ".Anf.f4.*
LAI
-odopt4vadfied, ma has bm Mp*vW,
y
*g.bmtWd,H."KyvmppanyAsSpwd%W-LLC,
Foudh-. IU-murM.-Isttct-beomeeffftfive-onJ=uu.y. 1,2010A 12:01,am.
Fddr.. 11.m. Agreen=t. of MaMa, is -on nc,at. SM.Speadwq Dfiva. Erm4 .0bio 4532.3,1056. Ow
p1wol-budnew.9fthem mv*g-.Lirnit.0-1-AiWiW.-Comp=y.
IN. WILTWMW VMCRW,, said wmlvxe jinu*Wd lWft =y has.=*W this. c.cMfiqft
mow
By.:
AUM
Naaw. Shmo•T. PAcidam
r-dic
94MLWFI
Book: 1281 P89W 260 Page 6 of 7
Tract/Lot 1_Parcel l A JI j
408 024 1 1 3
Rowan County Assessor's Office
Tract/Lott Parcel I SIM I PAR I SIT L/IN I C C I PART INT
408 1 108913
Rowan County Assessor's Office
Book: 1281 Pegs: 260 Page 7 of 7
t,a
Energy, Mineral &
Land Resources
ENVIRONMENTAL OVALITY
April 17, 2017
Mr. Alan J. Fass, P.G.
Dynamis, Inc.
P.O. Box 50636
Knoxville, TN 37950
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY DAVIS
Director
RIVED
APR 18 2017
CENTRAL FILES
DWR SECTION
Subject: NPDES Stormwater Permit NCGO80896
PFJ Southeast LLC
Formerly Speedway LLC
Rowan County
Dear Mr. Fass:
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at (919) 707-9220.
Sincerely,
810�'100 �/00010
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Mooresville Regional Office
Mr. Joey Cupp, Pilot Travel Centers, LLC
Stormwater Permitting Program Files
Central Files
State of North Carolina I Environmental Quality i Energy, Mineral and Land Resources
512 N, Salisbury Street 1612 Mail Service Center I Raleigh, North Carolina 27699-1612
919 707 9200
W ti
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE No. NCGO80896
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
PFJ Southeast LLC
is hereby authorized to discharge stormwater from a facility located at:
PFJ Southeast LLC
985 Peeler Road
Salisbury
Rowan County
to receiving waters designated as Town Creek, a class C; SW water, in the Yadkin Pee Dee River
Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, II, II1, and IV of General Permit No. NCGO80000 as attached.
This certificate of coverage shall become effective April 17, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 17, 2017.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
IDUnamls,Inc.
P.O. Box 80838, Knoxville, TN 37950
Phone: (885)88S-5= Fax: (888)8884857
February 10, 2017
Division of Water Quality '
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Transmitted via: Federal Express # 7784 0336 2389
RE: Request Transfer of Permit NCG080000 for 5 Facilities
Sir or Madam:
ReCEI VED
Please find enclosed facility participation forms for the following facilities:
ri
,Pil7ot=6955'-- -- —
Pilot-6978
NCG080716
Candor, NC
IM-0 `tll`
Pilot-7976
NCG080170
Troutman,NC
Pilot-7983
NCGO80896
Salisbury, NC
This letter is written on behalf of PFJ Southeast LLC and serves as a formal notice of
transfer of ownership from Speedway LLC (successor by merger with Wilco Hess LLC),
toTFJ',So ittieast4LILC The deeds are attached -for Pilot-6955, Pilot-7971, and 7976. We
are waiting on the deeds for Pilot-6978 and Pilot-7983. These deeds will be transmitted,
upon receipt. Attached are the appropriate forms and/or documentation required to
complete the permit transfer process. If you have any questions or require additional
information, please contact me at 865-588-5422 ext. 208.
Sincerely,
Ta F , P.G.
Environmental Program Manager
Dynamis, Inc.
alanfass@dyLiamis-inc.com
Permit Name/Ownership. Change Form &
Deed of Transfer of Ownership for
Pilot-7971
Conover, NC
Permit No. NCG080428
PAT MCCRORY
dhwe v
�s DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
• Pin't*w
WarerResources
ENVIAONNEWAt QUALITY
PERMIT NAM IOW, NERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number. NCGQ-Z_1•o1—U1-&1K or NCGS-1 / I 1
1. Facility Name: !1 I
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
—)—(a. Change in ownership of property/company
b. Name change only
c. Other (please explain):
2. New owner's name (name to be put on permit):
3. New owners or signing official's name and title:
(Pi-r—soff legall trespon4ille for permit)
(Title) j —T
4. Mailing address; Lwves hci City:_ _ 4 1{
State Zip Code: 3� Phone: M)
E-mail
L CEWVN ,
THIS APPLICATION PACKAGE WILL NO1 BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed application form
2. Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation, or sales agreement)
[see reverse side of this page for signature requirements]
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6300 919-807.6389 FAX
httpsJideq.nc.govlabout/divisionstwater-msources/vmlcr•resources-pennits/vmsmwawr-brmchtnpdes-wastewater-permits
;NPOES Name & ownership Change
Page 2 of 2
Applicant's Certification:
I, , attest that this application for a
namelowriers ip change has been reviewed and is accurate. and complete to the best of my
knowledge. I understand that if all required parts of this application are not completed and that
if all required supporting information and attachments are not included, this application
package will be returned as incomplete.
Signature:
THE C ED APPLICATION PACKAGE,'INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING; ADDDRESS:
NC DEQ 1 DWR 1 NPDES
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
Verson 712016
FIB C810VAR courdy
an Nov 14, 2016 at 10:40.00 am
LxalseTu $=4&00 (MC)
mw. 019657
001111A FiICRSSMCER,
Raw" of Daft
Ew03371 PV105T-1062
NORTH CAROLINA
CATAWBA COUNTY
Tax Lot No. 375213 0425 84 .................................................. Parcel Identifier No.....................................................
Verifiedby................................................................ County on the ......................day of.................................. 20............
by..........................................................................................................................................................................................._..
Mail after recording to First �merican Title Insurance Company, Attn: Hilda Barbosa, 30 North LaSalle Street, Suite 2700,
Chicago, IL 60602..... tMP'4�...............................................................................................................................................................
. ....Yt.3AJ.35.. b-rr0.......................................................................................................................................................
This instrument was prepared by: Kevin C. Lewis, Attornay-at-Lsw, 500 Speedway Drive, Paton, OH 45323
375213042584
Briefdescription for the Index
Excise Tax: $3,948.00
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED made effective this 6th day of November, 2016, by and between
GRANTOR
SPEEDWAY LLC (successor by merger with
WilcoHess LLC)
a Delaware limited liability company
500 Speedway Drive
Enon, OH 45323
GRANTEE
PFJ SOUTHEAST LLC
a Delaware limited liability company
whose tax mailing address will be
c/o Intax, Inc.
P.O. Sox 54650
Lexington, KY 40555
Eater b appmprlalo black for oath Wty; Hamm, addmsr, uL% If of ro clwwer of entry, e.q. ampomlio t or pa mnbip.
'Ilse designation Grantorand Grantee as used heroin shall include said partits,theirbotra,sueteasers, and assigns, and shall include singular,
plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, fora valuable consideration paid by the Grantee, the receipt ofwhich is herebyaclmawledged, 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, together with all
buildings and other improvements situated in the City Of Conover, Catawba County, North Carolina and more particularly described as
follows:
Sea PadliW "A" attached herate and made a part thereof.
Said property having been previously conveyed to Grantor by instruments) recorded in Book 2282, Pago 1788 and Book 2282, Page 17B5
at Catawba County, North Carolina.
Unit V971
Add,m: 1343 Rods Ba. Rd.
Conow.NC
1 of 3
10
IMB
All or a portion of the property herein conveyed _ includes or X does not include the primary residence ora Grantor.
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.
And the Grantor covenants with the Grantee, that Grantor has done 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, except for the Permitted
Exceptions as defined in that certain Contribution, Assignment and Assumption Agreement dated June 17, 2016, by and between Speedway
LLC, Pilot Travel Centers LLC and PFJ Southeast LLC.
1N WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused tins instrument to be signed in its
corporate name by its duly authorized officers, this —tt day of 2016.
SPEEDWAY LLC
as successor by merger with WilcoHess LLC lm�
BY: ..�f g 4�.............................................................
Printed: Gregory 9. Whitman..........................................................
Title: Director, Real Estate and Operations Planning ......................
SEAL -STAMP
State of Ohio, Clark County.
1, the undersigned Notary Public of the County of C4uk� and State aforesaid, certify that Gregory S. WhIlMila of SpUdway
LLC. personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein
expressed. Witness my hand and Notarial stamp or seal this 40k day of November, 2016.
My Commission Expires:3
(Affix Seal)
Kom min S. BORGWALD
NOTARY PUBLIC a STATE OF OHIO
My commisalonw plw X18118
Hail 0:7971
Address: 1343 Rock Ram Rd,
Conover, NC
2of3
Notary Public
Notary's Printed or Typed game
EXHIBIT A
Speedway 7971
1343 Rock Barn Rd.
Conover, NC
Tract One — (5.21 acres)
"911
BEING all of that certain 5.21 acre tract as shown on survey by Sam Rowe, Jr, dated October 31, 1994, entitled "Minor
Subdivision, Clarence E. Roseman, Jr. & Horace J. Eisenhower Jr. Pro., Clines Tshp., Catawba County, N. C." and of
record in Plat Book 36 at page 106, Catawba County Registry, and reference to said record is hereby made for a more
complete and detailed description.
AND BEING the same property conveyed to Grantor from A. T. Williams Oil Company, Inc. by deed dated June S.
2001, recorded in Book 2282, page 1785, Catawba County Registry.
Prior deed reference: Book 2282 Page 1785
Tract Two (1.05 acres)
BEGINNING at an iron pin located at the Southwest corner of the 5.21 acre -tract owned by A.T. Williams Oil Co.,
which said iron pin is located North 370 58' 40" East a total of 45O.48 feet from a control corner located at the
Northeast corner of A. T. Williams Oil Co.; and running thence with the line of A.T. Williams Oil Co. North 37°
59' 19" West 602.54 to an iron pin; thence continuing North 370 58' 19" West 57.26 feet to an iron pin, a new
comer of Clarence R. Roseman, Jr. and Horace J. Isenhower, Jr.; and running thence with the tine Clarence R.
Roseman, Jr. and Horace J. Isenhower, Jr., South 8" 08' West 103.55 feet a new iron pin, another new corner of
Clarence R. Roseman, Jr, and Horace J. Isenhower, Jr.; and running another new line of Clarence R. Roseman, Jr.
and Horace 1. Isenhower, Jr., South 370 58' 19" East 79.4 to a new iron pin; thence continuing South 37a 58' 19"
East 500,83 feet to an iron pin in the Western edge of right of way of Rock Barn Road; thence running with the
Western edge of right of way of Rock Barn Road, North 370 58' 40" East 75.0 feet to the point of Beginning,
containing 1.05 acres, more or less, according to a survey and plat thereof prepared by Sam Rowe, Jr. Registered
Surveyor, on March 11, 1995.
AND BEING the same property conveyed to Grantor from A. T. Williams Oil Company, Inc. by deed dated June
8, 2001, recorded in Book 2282, page 1788, Catawba County Registry.
Prior deed reference: Book 2282 Page 1788
Tax Parcel No.: 375213042584 (Tract One & Two)
THIS INSMUMENT FILED Pon RECOPO BY FIRSTAMERICAN
TITLE INSURAncE CO. AS AN ACCOMMODATION ONLY.
IT HAS NOT BEEN EMINED.15 TO ITS EUcuTION
OR AS TO ITS EFFECT UFON TITLE,
Unil N:7971
Addrm: 1343 Rack Bun Rd.
Conover. NC
3 of 3
FILED C81ffV a C015ft
on Nov 14, 2016 at 10.10.00 am
Evalse Tatt QD (MC)
INST. i 19657
WNllA MCKS0010M
der or Doom
e1t03371 Pq 1057-1062
NORTH CAROLINA
CATAWBA COUNTY
Tax Lot No. 375213042584.................................................. Parcel Identifier No .....................................................
Verifledby................................................................ County on the ......................day of .................................. 20............
by.........................................................................................................................................................................................
Mail afar recording to First American Title Insurance Company, Attn: Hilda Barbosa, 30 North LaSalle Street, Suite 2700,
Chicago, IL 6o6o2 .....t ".4a........................................................................................................................................................
. ......................................................................................................................................................
This instrument was prepared by: -Kevin C. Lewis, Attorney -at -Law, 500 Speedway Drive, Enon, OH 45323
Brief description for the index 375313042594
Excise Tax: $3,848.00
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED made effective this 6th day of November, 2016, by and between
GRANTOR GRANTEE
SPEEDWAY LLC (successor by merger with PFf SOUTHEAST LLC
WilcoHess LLQ a Delaware limited liability company
a Delaware limited liability company whose tax mailing address will be
500 Speedway Drive c/o Intax, Inc.
Enon, OH 45323 P.O. Box 54650
Lexington, KY 40555
Eaux In "pp ieide tlmk for w4i putty; mma, "ddota Q d, If "MprWy, ehuacter of an8ty, e.q. enrp rift or putnmh1p. .. ,....^
Thedeelgastion Grantor and Grantee as used heroin shall include said parties, their heirs, sum ccasors, andassigns, and shall includeahugular,
plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt ofwhkh Isherebyaclmowledged, has and by
these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lmtt or parcel of land, together with all
buildings and other improvements situated in the City Of Conover, Catawba County, North Carolina and more particularly described as
follows:
See Exhibit "A" attached hereto and made a part thereof.
Said property having been previously conveyed to Grantor by instrumanKs) recorded in Book 2282,Page 178E and Book2282, Page 1785
at Catawba County, North Carolina.
Unihx:7v71
Addnw: 1343 Rack Bun Rd.
Conover. NC
Iof3
b
Delaware
Page 1
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO =REBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF TBE CERTIFICATE OF Mlu'ROM, WHICH MUMS;
"WILG10 MOOD SERVICES LLC", A DELAWARE LIMITED LIABILITY
CObWANY,
"BESS WILCO HOLDINGS, LLC", A DELAitm LIMITED LIABILITY
C.CWANY,
"WILCOHESS LLC", A DELAVAPS LIM= LIABILITY COMPANY,
"HESS RETAIL HOLDINGS LLC", A DELAWARE LIMITED LIABILITY
OCw"Y,
WITH AND INw "SPEEDWAY LLC" UNDER nm mom OF "SPEEDWAY
A LIMITED LIABILITY COMPANY ORGANISED AND EXISTING UNDER
THE LAWS OF THW STATE OF DELAWARE, AS RECEIVED AND FILED IN THIS
OFFICE ON THE TNENTY—SECOND DAY OF DEMSIM, A.D. 2015, AT I:47
O'CLOCK P.M.
r
AND I DO HEREBY FURTHMR CERrZFY THAT THW EFFECTIVE DATE OF
THE AFORESAID CLRTIFIC ArZ OF MZRGSR IS TAW FIRST DAY OF JAMMY,
A.D. 2016 AT 12:01 O'CLOCK R.H.
2775076 8100M 'il��'
5ftit 20152490339
You may verify this certificate online at corp.delawaregov/authver.shtmi
Authentication: 201603793
Date: 01-04-16
r
Delaware Page 1061
The First State
2775076 9100M
SR# 20151490339
You may verlN this certificate online at corp.delaware,gov/authver.ahtmI
Authentication: 201603793
Date: 01-04-16
Slate of Name
smury d 841t
DM*m of Orpmdovi
Ddlrffd 01.47PM 1102212015
FILED 01:4701IM24015
5R,201514900 - Wombrr 1775076 Owe qtApkaware
Cardfir4te of Merger of
j)o;4e.sflv. Llmkkd Liability Gpiqpsoptes
Purivanuo.T.We 6,S- thy. dw undersi
, moon:48-209..ofthe-DelawaM.lAmited-lanbi .Co Ac�,. 8.nO
limitedliability coihpany
Fftst: The name of the surviving Umiled Liability Company is Speedway LLQ,,
ai a le names of -se jimited ifewity. companies Wwmeigtd into -this
CqmPM j,'Pj'W.fi6q F*6'4..')S.
Y am WHOWess L LT;Q,-,H.eO W-vab. L-LC-.Aq4,HP(9.
has been
fired.. eNwut4.and
Third: The Hance -qflhe s%"Ang.1jm1tedjtqWl1ty,wm pen , yisj5peod.wayLLG
Fourth: IU menw.-is--to -become.affective.onJanuory- 1,20.1.0-ag 12.01 ^m.
Fifth:- The Agreement of Merger Is on.ffleat. SOO.-Speedway Ddve , Er m -Ohio 45.3-2.3-105.6, the
prinpipalpiam o .buiinea-lp Oie survivihg,ukt;a tiOiiiity'lbo"y-
i Ifindko
Y-OA4;=14--vn any
CIMPAPS.
IN VATN C-@ ad OU
US WHER40F, said swWAng timiW liability comWony has.. u. thiq- c. If!Cate
lobe* of %�D. -264's.
p*6yan-q4&,qi.ze4 1)60 -'!
-1D
Name: Shane t Pflaiderer.
Title: AssistantSecretaw
ff17-1,q
Title Chain and Deeds of Transfer of Ownership for
Pilot-7971
Conover, NC
Permit No. NCG080428
7971 (1.05 acres) r�J S a
1343 Rock Barn Rd. BOOK 2 2 8 2 Rb6E 1 1y 8 Qu
NO REONUIa Conover, NC FILED
RMT11 hfljCKfE
0193117 M11 JUN 27 AEI 101.1
EGiSTr-';j '' f DEEDS
Prepared by and Mail to: David W. Bailey, Jr., Bailey & Thomas, P.OATAWli,l Co., N. C.
P. 0. Box 52, Wiiuton-Salem, NC 27102
Mail tax bill to: WileoHess LIZ, 5446 University Parkway, Winston-Salem, NC 27105
Excise Tax $-0- (Com*lidadon) N.C.G.S. 105-226.29(7)
NORTH CAROLINA
GENERAL WARRANTY DEED
CATAWBA COUNTY
THIS DEED made this, d y of 2001, by and between
A.T. WILLIAM$ OIL COMPANY, INC:, a Carolina coigoration with its pribcW office in
^+ Forsyth County, North Carolina, hereinafter refin7- .to as "Grantor"; and -WlkoE[m LLC, .
a Delaware -limited liability cpmpany, riereit after referred to as 'G=te6";
WITNESSETH:
That.the..Grantor, for a valuable consideration paid by, the Grantee, the receipt of which is
hereby acknowledged, etas and by these presents.does.grant; ha gain, htufer and convey unto tbbi
Grantee in fee, simple, all that certain lot opt8ited r parcel of land aiin Catawba County,. North
CaroUna, alai more'particnlarly described, as follows;
SEE EXHIBIT "A" ATTACHED HERETO AND MADE APART HEREOF.
Said. property is being transferred and conv..eyed as a contribution to capital as part of
the formation of a new limited liability compaW,
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.
And the Grantor -covenants with the Grantee, that :Grantor is seized of the premises in fee
simple, has th6 ight to convey the same in fee simple; that title is'markctableiM free and clear of
all enmmbn uu:es, and that Grantor°will warrant and defend the-tide•against the tawiW claims of all
persons whomsoever except for the exceptions hereinafter stated: Easements and restrictions of
record.
IN WnNESS WHEREOF, the.Grantor has hereunto set their band and seal the day and year
A.T. OIL COMPANY, INC.
By: .
Stephen T. Williams, President
[CORPORATE SEAL]
BOOK 2 2 8 2 PAGE 17 s 9
STATE OF NORTH CAROUNA -- COUNTY OF
a Notary'Public of the County and State aforesaid, certify that
Roger S. p personal y came before me this day and acknowledged that he is Secretary of A.T.
OtL COMPANY, INC., a North Carolina corporation, and that by authority duly given
and as the act of the corporation, the foregoing Instrument was signed in its name by its President,
sealed witb its corpoiate seal and attested by hiji as its Secretary.
Secretary.
Witness my band and official stamp or seal. this -4L4y of , 2001.
My Commission Expires: GI'JJr
a awN
IrorwsriMMMrUill
Miaonn+eeoo
ys*wss��sss*r**sss*s**sssssss*M*ss*s*ss*ss•***t*s***s***sss***s**
'"` The foregoing certificate(s) of
islare certified to be correct. This instrument and this certiiicaite am duly registered at ttie date an<l
time and In the Book and Page shown on the first page hereof.
By:
REGISTER OF DEEDS Deputy/Assistant-Register of Deeds
COUNTY
1-1
UVI BOOK 2282PAoE1790
BEGINNING at an iron pin located at the Southwest corner of the 5.21.
acre -tract owned by A.T, Williams Oil Co., which said Iron pin is
located North 370 58' 400 East a total of 450.46 feet from a control
corner located at the. Northeast corner of A. T. Williams oil Co.; and
running thence with the line of A.T. Williams Oil Co. North 370 58, 19N
West 602.54 to an iron pine thence continuing North 370 58' 194 west
57.26 feet to an iron pin, a new corner of Clarence R. Roseman, Jr. and
Horace J. Isenhower, Jr.; and running thence with the line Clarence R.
Roseman, Jr. and Horace J. Isenhower, Jr., South 80 08' Kest 103.55
feet a new iron.pin, another new corner of Clarence R. Roseman, Jr. and
Horace J. Isenhower, Jr.; and running another new line of Clarence R.
Roseman, Jr. and Horace J. Isenhower, Jr., South 370 58' 19" East 79.4
to a new iron pin; thence continuing South 37' 58' 19" Last 500'.83 feet
to an iron pin in the Western edge of right of way of Rock Barn Road;
thence running.with'the Western edge of right of way of Rock Barn Road,
North 370 58, 400 East 7�,o feet to the point of Beginning, containing
1.05 acres, more or less, according to a survey and plat thereof
prepared by Sam Rowe, Jr. Registered Surveyor, on March 11, 1995.
AND BEING the same property conveyed to Grantor from Horace J.
Isenhower by deed dated 3-22-95, recorded in Book 1922, page 1495,
Catawba County Registry.
41.
STATE OF NORTH CAROLINA
CATAWBA COUNTY
The foregoing certificate of E. Marie Davis a Notary
Public of Forsyth County, NC is
certified to be correct. Filed for registration this
27th day of June 2001 at 10:17 A.M., and duly
recorded n the offfe of the Register of
Deeds for Catawba County, NC
in Book 2282 at Page 1788
This 27tFi- day of June, 20T.
Ruth Mackle Register o eeds Ps
�4V: 4, /,
7971 (5.21 acres) 1100x 2 28 2PA6E.1 7 8 5
ko REVEMUE 1343 Rock Barn Rd.
I
Conover, NC 131TIi
2014 JUN V Orl 10
V
Pm paTed by and M40 to: David W, 11alley. Jr.. Bailey A ThoftraTv'�:'. ta"
P. O. Box 52, Winston-Salem. NC 27102
Mail W bill to, WilebHus L.LC. 5446 University Parkway, Winston-Salem NC,27105
E.Xcin T" $-0- (Corwlidatioq) N.C.0,11. 103.229.29
6163:LG
NORTH CAROLINA
GENERAL WARRANTY DEED
CATAWBA COUITIT
THIS DEED made-ft ftay of .2W1-j by: and between
A.T. WILLIAM8'O]1Lr,C0MP-A1NVi INC.'., 8-06io'cliolira;;;;;Mlionwiih its PrinciPalofn= In
Fatzytlt Coumy. North rtlf
a wmft -iled,lia I bill . ttnlim.y 5446 U . niy,ersity
Parkwrity, 4n�; irislaSalem,1C 271)5
WIT $ T
That the Gotupr.for a valuable 2ralk'Arpal .'Grardw. the r=49 of which Is
6iilVciriowlp(getj' hq:ond by fts 8'9�"i I.'and convey,jiw the
idke sWpli, all dut certain or'A"I >-sibjalid j:j C&PA"S County; North
Cliolimand pakicularly'dqN
. m 41ft
SEEEXIIIBtT-�A'ATT -Ht:.D'^IiREiO'A$15'MkD#.APART HEREOF.
Said ;property isbvlhg trand \no cm eyed, as a contribution ID.capjjjIrQ$.Pafl of
the 7fo0iWi611.o( a' new limited liability company'.
TO IIAVr.-,ANP, TO HOLD the arbressid lot or parcel ofland :and all privileges and
pKairienart"s thereto belonging. to the Grantee In fee simple.
And IM Grantor covtinants with The Gringet, that Grantor js; seized of the p!fMiW in ko
simple, has the'rijbi to convey late same
. fee . "I sb"
wk. diii Iiiie 'Is mirkIt and fr6e2am ilck of
all emumbrimc�', iM that Griant6i will"' WImiWiiiil-&foiid t1ii'fitter aigiinn'thd lawful claims of all
pemu : ns whnmsa�vCr ekept for the exceptions hereinafter mated: Easements and restrictions of,
IN WITNESS WIIFA-EOF. the 136ritnr has her1runto $a their hw.W artil seal the day and Y"r
first ahn,.-4: v,,ritlell.
ATTEST!
A.T..T. W7 'OIL COMPANY. INC.
0hen T_ Williams.
Ps
Cohen T- Williams. Picsident
UOLK 2282FAK1786
STATE OF WORTH CAROUNA -- COUNTY OP
1. . *Notary Public of tree County and State that
ereoaforesaid. cWHY
Roger S: !p ptally came berom ina thi, day aorl ockmwkdVd ft bA is Secretary of A.T.,
WII.I.IAM OIL COMPANY' INC.. a Nonh Camtina carponin. , aM'd' t'by m-4' ky duty. given
and as the act of tho corpurm"i the'ft'nnegoing'liuuuineiit was sWW'in ki haamaby its deal
ssakd whh ita oorposata sent aM #tteited by'lnini asks Secretary.
Wim a my hand and official stamp or will. this 4 &O'day of . 2WI.
My Connmiasion Patpirev f
Note ;Publi
' itwtltrgsb
... _ t+OttlirnMNtltattr t1tM
!!r!!l•�A4lti*!!•M►!••i�!!l•�!!!!!•!!il�l�f•�i!!i!!N�!!!!!!M!!!!!f
mia faregaing certificate(s) of
me certified to be corma. InWinumment`and this: i . " ase,wly'rtgism" r<t the'
its "arid In the' Book and Page shown on the flrtt lazed'
CO[
um 2..282PAGE1787
BSHIRIT "A"
BRING all of that certain 5.21 acre tract as shorn on survey by gain
Rare; Jr, dated�Ortober 31, 1994, entitled 'Minor Subdivision. Clarence
E. "neinan, Jr. & Horace J.- Ieenhower Jr. Pro., Clines Tshp., Catawba
County; N.C." and.oE'rscord in Plat Book 36 at page 106, Cata%pba County
Registry, and reference to.eaid record is'hbreby made for a more
complete and detailed description.
AND BEING the same property conveyed to Grantor from Horace J.
Tsenhower by deed dated 11723694. recorded 1n Book 1916, page 687,
Catawba County Registry.
aa.
STATE OF NORTH CAROLINA
CATAWBA COUNTY
Tile foregoing certificate of E. Marie is a ar
Public of Forsyth.County,.Nor" C liin s
to certified -be torreet: Filed for g4tra t
27th day of Jame 2001. at '16. + f, duly
recorded ice o n the off the a ' to
Oeeds for Catawba Couety,.NC.
i n Book, 7til2 at Page 1785
p is 2 . day of T"
11 Mackie -Register fee " `✓ PS
Wit.
Delaw-a''re"'."
The first State
I, JEFB'REY W. BULLOM, SECRETARY OF STATE OF "m STATE OF'
DELAWARE, DO IM=r CERTIFY nM ATTACHED IS A TRUE AND CORRECT
COPY OF Tnx CERTIFICATE OF mmGzR, WEIGH JIERGE9:
"WILCO FOOD MMWCE9 LW", A DELAMIM ,LZWTED LIABILITY
CCWANY, "r
"Ht88 WILCO HOLDZNGs, LLC", A DELANIM LIHITED.LIABILITY
COWANY,
"WILCOBXSS LW", A DELAMM UNITED LIABILITY COMPANY,
"BEGS RETAIL HOLDINGS LLC", A DELAMM LZWMD LIABILITY
CCWANY, _
WITH AND IIITTO "8mwivAY LLc" tnlmER TmE mm OF "sPEDmY
LLC-, A LIHITED LIABILITY C OMANY ORMNISB'D AND EXISTING MMU
Tit$ LAWS OF IW STATE OF DELAWARE, AS 'RECErM,7AND''FILED: 'IN 'THIS
OFFICE ON THE TWENTY-8EC0= DAY OF M=R[R, . A•:D.7"'2015,-AT-:I..67
O'CLOCK P.H. :
AND I DO =MY FVRTBER CERTIFY THAT THE EFFECTIVE: "DATE OF
2NE Ati10RESAID CZRTIFICATE OF MIMMR IS THE FIRST any OF JAmmr,
A.D. 2016 AT 12: 01 O'CLOCK A.H.
a .
IW ryd
2775076 8100M Authentication:201603703
SR#20151490339 -:' :"" - (1ite:01-04-16
You may verify this certificate online at corp.deiaware.goy/authver.shtml
2775076 8100M '`
SR# 20151490339
You may verity this certificate online at corp.delaware.gov/authver.shtml
M,-R�O
1, /,�
Authentication: 201603793
Date: 01-04-16
Sli"te of Ddlaaare
g!Rlt��f of Smti
Uhiilvn of corpo"dons
Ddka d• 01WPM1l12211015
FM k 47 PI1i 1liE ws
SR, 20151440339 f9tNnmba 2775076 ;
Sft�e. Qf �laware' ;
C-,erW-a.#e.afMeof '
Dourest - trJUnA1 U40HIy �'o —n" pits
Pursuant,wTitle 6,-Secdon,18-209 of the-DdlwM e- -imW •Act, tlne and geed
1#rm"to��fl�#iti! copy c��the:lRio.�itg8.&aate,q�"ii+ier�Qr;. . • ' - .:.:. , :' : ' : - .
is The name of the swWving L•lmited Lisbft Company •b ' $ ►ay :.:1:M£; .
arnilte nemlas gtlie;.limitefi liiftjrmpatties .uoatt irrto'tl�isvingr;l#aitj+:
tcouqwn , , yr it-IjAm s LLB, i +o d ' E�: v� t t ,: L
campals M
j
'Tbirdt:Thp-t Rme.ctiftite st>arvi ing.l it Ci itl r'cc+np -ie-9 twwLQ
Fourth: Ilve-meW into bec =,eff4adve.an Jmus - I.-ID16it;12.014wii.
Fifth.-: IU Agreement of NC W is ott .f le :at. 5W:,.8pwdway Calve. gexm, .Olin 45-32 40M, the
O19:P.1weot'btainesa:oftlic.mrM�g•L vRWdUaWity.- Cowpwy.
Slat. A:Po W-ofthe Agrednent of crger Wili,�.fiarniahed.:b�r tl ;stl uiixitl :]imitetC
iiit�.�iiiip�,y ��' �+ill+aut'�lt,�tb;airy�•:zt�hcr.��ie: corladit�f;ll�it`:,Iiu�ili+ty..
;IX VYmw w"EREoF, said ,prAviag. liv*wd "lily cgTAp9a y 'hw..,"*cd ccWfioate
jc azt a bi `pemm #bo:2
Nwe.: Shane;T. PfMeitlow
i
{388D�S.RrF:�
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Delaware
Page 1
The First State
I, JEFBREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELARAPZ, DO HEREBY CERTIFY THE ATTACUED IS A TRUE AND CORRECT
COPY OF THE CERTIFICATE OF b=I:V R, WHICH MERGES:
"WZZDD BWD SERVICES LLC", A DELAWARE LIMITED LIABILITY
COMPANY,
"HESS WILC0 HOLDINGS, LLC", A DELAWARE LIMITED LIABILITY
COMPANY,
-VXZCQ=SS LLC", A DELAWARE LIMITED LIABILITY COMPANY,
"HESS RETAIL HOLDINGS LLC', A DELAWARE LIMITED LIABILITY
COMPANY,
WITH AND INTO "SPEEDWAY LLC" UNDER 72M NAM OF "SPEEDWAY
LLC"', A LIFTED LIABILITY COIdPANY ORrpANZZXD AND EXISTING UNDER
THV LAWS OS TBE STATE OF DELAWARE, AS RELIVED AND FILED IN THIS
OFFICE ON THE TWENTY—SECOND DAY OF ENCE11MM, A.D. 20I5, AT 1:47
O'CLOCK F.M.
r
AND I DO ID;REBY FURTHER CERTIFY TEAT THE EFFECTIVE DATE OF
THE AFORESAID CERTIFICATE OF MB:RGER IS TZIZ FIRST DAY OF JANUARY,
A.D. 2016 AT 12:01 O'CLOCK A.H.
2775076 8200M F
SR# 20251490339
You may verify this certlflcate online at corp.delaware.gov/authver.shtml
ih-lial a
VI
X, 7, � *
Authentication: 201603793
Date: 01-04-16
z
() mil,
Delaware Page ,am
The First State
2775076 9100M
SR# 20151490339
You may verify this certif ete online at carp.delawara.gov/authver,shtml
1110,
U, ROM", L"
Authentication: 201603793
Date: 01-04-16
State of Mart
Seuvhq of Suit
DhIn of Corpamtkis
DeOMW 01-47 IMI 1242401S
FILED 01,47FMI21l14015
SR 20151490139 - FlIeNumba 1775076 State of'Vpj#WA"
C. 'Praoc4te.-Of Merger of
tDomesitig Limit tA Liability Qompanies
Pumuant,to, Mde 6,..-Smdon,49-209..of-the-DelawwcUniW.taabi*...Conn.my-Ac,t .Ow undevAg.md
limited y, awqsOc4,4he *MowhVVeMficatc qfM
First: no Warne of the surviving Limited Liability Compm is $peadwa - u.
y y 4W
and ihe vamm of-sq jimiwd p6alty-compawes tAfft-marw into .&S'.s1kMhAng dm1w)f*m*
pm i am WilicoHms 4W.." WOCIO. FOO 49��A* LM- H"s W1100-0914EnA. Lbq, and A*
k . awl,m- f
fm
execu.takand
y is.'$ co L.&C.,
poTway
Fourth: no meWis-.tobecome,offective.onJantoy 1,20.1.0-A 12:01 .;Lm.
Fifth:. The Agreanent of Merger Is on 111c..at. SOO.-Speodwa-y Ddve, Emm%. -Ohio 45323-105.6t the
principal place. of businm pf,the. sumiviog. Undtpil tAO)fflit—y. -bo" y.
Sbdb:,A..00py.pf..theAtmenumt..ofMcnpr.will,bofumiohed,.by.4m.4v.m*v'm A' Red
4cs
IN VAMM WHEREOF, said surviving HmiW liability cauWmy has..caused this.c;rdficaft
AID
Ay. 0-j
4,jarmi", -.W:fr�j aid
Ate: Pw 67'
Name: Shane T.Pflaidaw.
Tithe:
ffi:�
All or a portion of the property herein conveyed_ includes or X does not include the primary residence of a Grantor.
TO RAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor has done 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, except for the Permitted
Exceptions as defined in that certain Contribution, Assignment and Assumption Agreementdated June 17, 2016, by and between Speedway
LLC, Pilot Travel Centers LLC and PFJ Southeast LLC.
IN WITNESS WHEREOF, the Grantor has hereunto gel his hand and seal, or if corporate, has caused this instrument to be signed in its
corporate name by its duly authorized officers, this —tLi~day of Numbec 2016,
SPEEDWAY LLC
as successor by merger w//ithWiicoHess LLC
By: (rt........................................................
Printed: Gregory S. Whitman .........
Title: Director, Real Estate and Operations Planning .:....................
SEAL -STAMP
State of Ohio, Clark County.
1, the undersigned Notary Public of the County of C.6gK and State aforesaid, certify that GMgory S. WhftMan of 5Radwav
LLC. personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein
expressed. Witness my hand and Notarial stamp or seal this Aj!� day of November, 2016.
My Commission Expires:3
(Affix Seal)
KATHERM 8. BORMALa
NOTARY PUBLIC + STATE OF OHIO
MY oommBsbrt attpitsa ;f,119118
Unit #:7971
Addreu: 13(] Rock Barn Rd.
Conover, MC
2of3
Notary Public
Notary's Printed or Typed game
EXHIBIT A
Speedway 7971
1343 Rock Bam Rd.
Conover, NC
Tract One — (5.21 acres)
UK�1'
BEING all of that certain 5.21 acre tract as shown on survey by Sam Rowe, Jr, dated October 31, 1994, entitled "Minor
Subdivision, Clarence E. Roseman, Jr. & Horace J. Eisenhower Jr. Pro., Clines Tshp., Catawba County, N. C." and of
record in Plat Book 36 at page 106, Catawba County Registry, and reference to said record is hereby made for a more
complete and detailed description.
AND BEING the same property conveyed to Grantor from A. T. Williams 011 Company, Inc. by deed dated June 8,
2001, recorded in Book 2282, page 1795. Catawba County Registry.
Prior deed reference: Book 2282 Page 1785
Tract Two (1,05 acres)
BEGINNING at an iron pin located at the Southwest comer of the 5.21 acre -tract owned by A.T. Williams Oil Co.,
which said iron pin is located North 37° S8' 40" East a total of 450.48 feet from a control corner located at the
Northeast corner of A. T. Williams Oil Co.; and running thence with the line of A.T. Williams Oil Co. North 370
58' 19" West 602.54 to an iron pin; thence continuing North 37° 58' 19" West 57.26 feet to an iron pin, a new
comer of Clarence R. Roseman, Jr. and Horace J. Isenhower, Jr.; and running thence with the line Clarence R.
Roseman, Jr. and Horace J. Iscnhower, Jr., South 80 08' West 103.55 feet a new iron pin, another new tamer of
Clarence R. Roseman, Jr. and Horace J. Isenhower, Jr.; and running another new line of Clarence R. Roseman, Jr.
and Horace J. Isenhower, IT., South 37° 58' 19" East 79.4 to a new iron pin; thence continuing South 37° 58' 19"
East 500.83 feet to an iron pin in the Western edge of right of way of Rock Ham Road; thence running with the
Western edge of right of way of Rock Barn Road, North 37` 58' 40" East 75.0 feet to the point of Beginning,
containing 1.05 acres, more or less, according to a survey and plat thereof prepared by Sam Rowe, Jr. Registered
Surveyor, on March 11, 1995.
AND BEING the same property conveyed to Grantor from A. T. Williams Oil Company, Inc. by deed dated June
8, 2001, recorded in Book 2282, page 1788, Catawba County Registry.
Prior deed reference: Book 2282 Page 1789
Tax Parcel No.: 375213042584 (Tract One & Two)
THIS HISTRUMENT FILED FOn RECO[!O SYFIRSTAMERICAN
TITLE INSURAMCE CO. ASAN ACCNLIODATMN ONLY,
IT HAS NOT BEEN EXANNED SS TO ITS EXECUTION
ORAS TO ITS EFFECT UPON TITLE,
Unit N:m I
Addrou: M3 Rock earn Rd.
Conover, NC
3 of 3
Energy, Mineral &
Land Resources
ENVIRONMENTAL OUALITY
Mr. Alan J. Fass, P.G.
Dynamis, Inc.
P.O. Box 50636
Knoxville, TN 37950
Dear Mr. Fass:
4 ..
April 17, 2017
l
all
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY DAVIS
Director
Subject: NPDES Stormwater Permit NCG080896
PFJ Southeast LLC
Formerly Speedway LLC
Rowan County
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at (919) 707-9220.
Sincerely,
Original Signed by
Robert D. Patterson, P.E.
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Mooresville Regional Office
Mr. Joey Cupp, Pilot Travel Centers, LLC
Stormwater Permitting Program Files
Central Files
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
512 N. Salisbury Street 1 1612 Mail Service Center I Raleigh, North Carolina 27699-1612
919 707 9200
STATE OF NORTH CAROLINA
a
DEPARTMENT OF ENVIRONMENTAL QUALITY
.
DIVISION OF ENERGY, MINERAL, AND LAND RESO.-WR�CES :
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE No. NCG080894a C�;
STORMWATER DISCHARGES,
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
PFJ Southeast LLC
is hereby authorized to discharge stormwater from a facility located at:
PFJ Southeast LLC
985 Peeler Road
Salisbury
Rowan County
to receiving waters designated as Town Creek, a class C; SW water, in the Yadkin Pee Dee River
Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, II, III, and IV of General Permit No. NCG080000 as attached.
This certificate of coverage shall become effective April 17, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 17, 2017.
Original Signed by Robert D. Patterson, P.E.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
4 LT*.WA
CCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Charles Wakild, P. E.
Director
October 12, 2012
Mr. Stephen T. Williams, President
A.T. Williams Oil Company
5446 University Parkway
Winston-Salem, North Carolina 27105
Dee Freeman
Secretary
RECEIVED
DIVISION OF WATER QUALITY
OCT 17 2012
SVVP SECTION
MOORESVILLE REGIONAL OFFICE
Subject: General Permit No. NG080000
Wilco Travel Plaza 4364
COC No. NCGO80896
Rowan County
Dear Mr. Williams:
In accordance with your application for a stormwater discharge permit received on July 13, 2012,'
we are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless.such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Water Quality. The Division of Water Quality may require modification or revocation and
reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the Division
of Land Resources, Coastal Area Management Act or any other federal or local governmental permit that
may be required.
Please note that the attached permit expires on October 31, 2012, Your COC will be
automatically renewed to cover the full 5 year term of the soon to be reissued permit. In the interim you
must abide by the terms of the expiring permit. You can review the proposed general permit changes
once they are posted at: http://portal.nedenr.org/web/wq/ws/su/current-notices
If you have any questions concerning this permit, please contact Bill Diuguid, Staff Planner,
Stormwater Permitting, at telephone number (919) 807-6369.
Sincerely,
ORIGINAL SIGNED 131
for AgWd, P.E.
1617 Mail Service Center, Raleigh, North Carollna 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 919-807-63001 FAX: 9IM07-6492 4 Customer Service: 1-877-623.6748
lnternel: www.ncwaterguality.org
No ehCarohna
Amala!!
An Equal Opportunity 1 Affirmative Action Employnr
COC No. NCG080896
Mr. Stephen T. Williams, President
A:T. Williams Oil Company
October 12, 2012
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
Page 2of2
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCGO80000
CERTIFICATE OF COVERAGE No. NCGO80896
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
A.T. Williams Oil Company
is hereby authorized to discharge stormwater from a facility located at
Wileo Travel Plaza #364
985 Peeler Road
Salisbury
Rowan County
to receiving waters designated as Town Creek, a Class C; Sw water body, Yadkin River Basin; in accordance with
the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, [I, 1[], IV, V and VI of
General Permit No. NCG080000, as attached.
This Certificate of Coverage shall become effective October 12, 2012.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 12, 2012.
ORIGINAL SIGNED M
KEN PICKLE
Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
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CCDEEIR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Quality
Charles Wakild, P. E.
Director
October 12, 2012
Mr. Stephen T. Williams, President
A.T. Williams Oil Company
5446 University Parkway
Winston-Salem, North Carolina 27105.
Subject: General Permit No. NG080000
Wilco Travel Plaza #364
COC No. NCGO80896
Rowan County
Dee Freeman
Secretary
Dear Mr. Williams:
In accordance with your application for a stormwater discharge permit received on July 13, 2012,
we are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Water Quality. The Division of Water Quality may require modification or revocation and
reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the Division
of Land Resources, Coastal Area Management Act or any other federal or local governmental permit that
may be required.
Please note that the attached permit expires on October 31, 2012. Your COC will be
automatically renewed to cover the full 5 year term of the soon to be reissued permit. In the interim you
must abide by the terms of the expiring permit. You can review the proposed general permit changes
once they are posted at: http_//portal.ncdenr,org/web/wq/ws/su/current-notices
If you have any questions concerning this permit, please contact Bill Diuguid, Staff Planner,
Stormwater Permitting, at telephone number (919) 807-6369.
Sincerely,
ORIGINAL. SIGNED E)
for Cam, P.E.
1617 Marl Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone 919-807-63001 FAX: 919.807-64921 Customer Service: 1-87 7-623-6748
Internet: Www.%waterouality.org
An Equal Opportunity l Affirmalive Action Employer
One
No hCarohna
Naturallb
COC No. NCG080896.
Mr. Stephen T. Williams, President
A.T. Williams Oil Company
October 12, 2012
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
Page 2 of 2
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE No. NCG080896
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
A.T. Williams Oil Company
is hereby authorized to discharge stormwater from a facility located at
Wilco Travel Plaza ##364
985 Peeler Road
Salisbury
Rowan County
to receiving waters designated as Town Creek, a Class C; Sw water body, Yadkin River Basin; in accordance with
the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, III, IV, V and VI of
General Permit No. NCG080000, as attached.
This Certificate of Coverage shall become effective October 12, 2012.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 12, 2012,
ORIGINAL SIGNED M
KEN PICKLE
Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
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NCGO80000 N.O.I.
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDENR
❑ This completed application and all supporting documents
❑ A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
(f) impervious areas, (g) site property lines.
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee coverage under the NPDES General Permit.
For questions, please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
(828) 296-4500
Fayetteville Office ...
(910) 433-3300
Mooresville Office ...
(704) 663-1699
Raleigh Office ........
(919) 791-4200
Washington Office ...
(252) 946-6481
Wilmington Office ...
(910) 796-7215
Winston' -Salem ......
(336) 771-5000
Central Office .........
(919) 807-6300
Page 4 of 4 ,
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TELEPHONE (336) 767-6280 1
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"1617 MAIL SERVICEtENTER
RALEIGH NC 21699-1617
n■
Diuguid, Bill
From:
Parker, Michael
Sent:
Thursday, September 13, 2012 7:55 AM
To:
Diuguid, Bill
Subject:
RE: NCG080896 Wilco Travel Plaza #364
You can issue this one as well....
From: Dluguid, Bill
Sent: Wednesday, September 12, 2012 12:34 PM
To: Parker, Michael
Subject: NCG080896 Wilco Travel Plaza #364
Michael Parker, Mooresville Regional Office:
Please review the attached NOI application with the objective of responding to me with a recommendation to issue the
permit. I recognize that you may not visit each new permittee during this N01 review, but it affords you the opportunity
to log the permit into your regional database and add the facility to a future monitoring and compliance visit schedule.
Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the facility is located
in your region, (2) that there are no current complaints outstanding about the facility that have not been dealt with, and
(3) that the facility may ultimately be inspected by the regional staff. I've also attached a scanned copy of the N01 and a
location map for your review.
COC # Facility IlLocation City/County j
NCGO80896 Wilco Travel Plaza #364 98S Peeler Road Salisbury/Rowan
. ..... _ ► _.... _- -_. _ . _ .. - --- ----� - - - --- - -- -- - - - - 1
If you need any more info, give me a call. If you could send me a recommendation to issue the permit by 10/12/2012,
I'd appreciate it, so I can issue their COC. I cannot issue'the permit until the respective regional office reviews and
comments back to me with a recommendation to issue the permit.
Thanks.
Sill
Bill Diuguid, AICP
Staff Planner, Stormwater Permitting
Wetlands and Stormwater Branch
Division of Water Quality I NCDENR
1617 Mail Service Center (Mail)
512 N. Salisbury St, Raleigh, NC 27604 1 9th Floor (Location & Parcels)
Raleigh North Carolina 27699-1617
Phone: 919-807-6369 1 Fax:919-807-6494
Website: httn://uortal,ncdenr.org/web/wq/ws/au
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties.