The URL can be used to link to this page

Home My WebLink Aboutenvironmental assessment 2016BENNE TT EN\TIRONIVIENTAL ASSOCIATE S, INC. LICENSED SI'TE PROFESSIONALS, EN\'IRONMENTAL SCIENTISTS, GEOLOGISTS, ENGINEERS 1573 Main Street, P.O. Box 1743 Brewster, MA 02631 Mr. Daniel Crafton, Section Chief MA DEP -SERO Bureau of Waste Site Cleanup/Emergency Resporse Section 20 Riverside Drive takeville, MA 02347 SHIPPING METIIOD: ority Mail Idail Mail tr tr tr tr tr n B nCertified Mail LETTER OF TRANSMITTAL DATtr]: 1l19lt6 (s08) 89G1706 fax (508)89Gs109 JOB NUMtsER: BEAl GI0925 REGARDING: RETRACTION OF RELEASE NOTIFICATION Resideotial Property: RTN,I-26199 67 Adams Road South Yarmoutfu MA [Assessor's Map 62, Parcel 40] COPIES DATE DESCRIPTION I 9/t6116 Retraction Notification witb enclosures, as noted For review atrd comment:tr For approval: 5 As requested: ! REMARI(S: f,'ROM: David C. Bennett, LSP' Presided / John Tad€rna-Wielandt, ES, Senior hoject l\ifanager / lr lf @lo$res srE Dot e! noled, kiDdly aodry r]s a1 oe CC: Ms. Judith A. Ilarmony Foperty ou,ner (flrll report via CD) Carl E. l,awson, Jr. - Yarmouth Health Defnrtsnent* Capt James Amstrong - Yarmouth Fire DeFrtmenl* Peter Johrson-Staub - Yarmouth Interim Town Administsator* * As part ofPublic Notic€ rcquirements, the report Title Page, Naratiye, Indo(, Transmittal forms and Site Plan are included, pursuant to paperwork reduaion policy. The full report is available as public record on the MA DEP website database at htp://public.dep.state.ma.us/Searchsblesites/Search.asp or, upon written request to BEA, full copy (electronic or paper) will be provided. TO: Pick Up Iland Deliver Other-IP!ed Green Card/RR Foryouruse: [] BanqNnrr ENvTRoNMENTAL AssocrATES INC.) LICENSEDSITEPROFESSIONALSaENVIRONMENTALSCIENTISTSIGEOLOGISTSTENGINEERS 1573 Main Street - PO. Box 1743, Brewster, MA02631 L 508-896-1706 t, Fax 50g-896-5109 ! www.bennett-ea.com BEAI6-10925 September 6, 2016 RE: RETRACTION OF RELEASE NOTTFICATION Residential Pro 9 67 A&ms Road - South Yarmouth, MA [Assessor's Map 62,Parcel 40) Dear Mr- Crafton, BENNETT EM/IRONMENTAL ASSOCIATES, INC. (BEA) has prepared the following narrative, and attached Supporting Documentatiorq as establishing the technical rationale and justification for Retacting a Release Notification in accordance with the provisions of 310 CMR 40.0335(1) (c) and 40.0335(2) (a-e). The release investigation demonsEates minor impact to soils with less than two cubic yards total, from two separate areas, were impacted from an above- ground storage tank (AST) release ofNo. 2 fuel oil, in the basemenr ofthe subject dwelling. Emergency response actions resulted in the contair:ment and recovery of the majority of the release, and prevented further release of additional oil to the basement floor and the grognd surface at the top of the bulkhead. Environmental assessment of these two areas of soil impact show tlat only low levels of 2-Methylnaphthalene are reported above the most stringent S- 1/GW-l Risk Characterization Standards in two small areas, with less than two cubic yards of material impacted in aggregate. In addition, anallical results show background conditions, at 3, below both release areas. Based on results of laboratory analysis wherein the 2-methynaphthtalene S-l standard is leaching-based, with no underllng soil impacl and with 4-8'separation to groundwater and calculated soil volumes showing less than 2 cubic yards of impacted material, under the provisions of 310 CMR 40.0315(2) the impact is not sufficient to drive a Reportable Condition and need for Remedial Response under the MA Contingency Plan (MCP), as regulatd under 3 10 CMR 40.0000. A presentation of facts, physical testing data, volume calculations and relevant infomration demonstrates that the release did not meet the Reportable Condition Release Notification criteria and as suclq a Release Retoaction is technically justified in support of regulatory project closure and herein opined. EMERGENcyspr.rRESpoNsEG\MsrEsrTEcunnupt,,*t^rrraara*6pEnurrnrcGsEprcDESGN&rNSpEcnoN WATER SUPPLY DEVELOPMENT, OPER,ATION & MAINIENANCE {" UAqSTCWNTCN TNTNTUEMI OPERATION & MAINTENANCE / Mr. Danie.l Crafton, Section Chief MA DEPARTMENT OF ENTVIRONMENTAI PROTECTION (MA DEP) Southeast Regional OfEce (SERO) Bureau of Waste Site Cleanup/Emergency Response Section (BWSC/ERS) 20 Riverside Drive Lakeville, MA 02347 SEPTEMBER 6,20I6 PAGE 2 OF 9 RESIDENI1AL PROPERTY/tsEAI 6. I0925 RELEASE RETRACTION, RTN 4.261 99 The work represented herein has been conducted under my supervision in a manner consistent with the MCP Response Action Performance Standards, pursuant to 3 10 CMR 40.0191 aod the QA/QC policies of BENNET'I ENVIRONN{ENTAL ASSOCIATES, INC. The facts and statements herein are, to the best of our knowledge, a true and accurate representation ofthe site activities, remedial response actions and enviroomental conditions associated with the project. ENYIRONMENTAL CONDITIONS [Refer to Appendix A] The subject property is entirely upland with the nearest zero-head bormdary being Mill Creek, located approximately 825 feet east of the subject property. Topography at the site is relatively flat with hydrogeologic references reporting groundwater at approximately 19'NGVD (+/-) as reported within 12'(+/-) of grade surface in the area ofthe basement release. Regional groundwater contours indicate a southeasterly grormdwater flow direction towards Mill Pond and Little Sandy Pond and associated wetlands (Refer to Figure 2). The down-gradient Mill Creek and its associated wetlands are considered the primary potential environmental receptor under Method I - Risk Characterization. According to the MA DEP BWSC GIS mapping program, the subject property is located within &e Zone II Protective Radius of a number of Public Water Supply (PWS) wells [Refer to Figure 3]. No private wells are known to exist within 500' of the Site, wherein the area is serviced by the Yarmouth Water Division. The subject property is also located within a Potential Drinking Water Source Area @DWSA), and as part of the Soie Source Aquifer designation for all of Cape Cod east of the canal. Based on this mapping, as well as the proximity to groundwater, the GW-l, GW-2 and GW-3 groundwater categories are applicable to Method 1 - Risk Characterization per 310 CMR 40.0974. Based on Site conditions relative to frequency/intensity of use and accessibility of soils, the S-1, S-2 and S-3 (GW-1/GW-2/GW-3) Method 1 - Risk Characterization standards are applicable to soil impact in accordance with the f The subject property at 67 Adams Road is noted as Map 62, Parcel40 on the Yarmouth Assessors Map. The subject property is located approximately 1,500' southeast of the intetsection of Yarmouth Road and Camp Street in West Yarmouth @efer to Figure I ). The UTM coordinates for the subject property is reported as Northing 4613878, Easting 605235. The subject property contairs 0.34 acres of land area, and is developed by a single-story wood frame, ranch-style, residential dwelling. The surror.mding area is similarly developed seasonal and year- round residential properties, wilh commercial properties firther west along Camp Street. Access to the subject property is rmrestricted with high frequency/high intensity of use, and chil&en potentially present. Access to the area of release, located in the subject dwelling basement, is restricted with low ftequency/low intensity of use, with children potentially present. Access to the back yard where soil staining was investigated is unreshicted with higb frequencyftrigh intensity of use, with children potentially present. The dwelling occupants and visitors to the property are identified as the primary potential human receptors to potential exposures. \ \ I SEPTEMBER6,2016 PAGE 3 OF 9 RESIDENT1AL PROPERTY/BEA I 6- i 0925 RELEASE RETRACNON, RTN 4.26199 provisions of 310 CMR 40.0975. These standards were developed il consideration of potential environmental exposures, and in review of potential leaching of contaminants to groundwater (GW-1/GW-2IGW-3). For the purpose of risk characterization, the most restrictive S-l (GW- 1/GW-2/GW-3) criteria are applied to Method I Risk Characlerization. BACKGROUND/PRELIMINARY RESPONSE ACTIONS [Refer to Appendix B] On July 20, 20i6, BEA received a call from the propefiy o\4ner's son (Mr. Jason Harmony) about a leaking AST in the basement ofthe subject dwelling. The tank was apparently abandoned in 1983 after a conversion to natual gas, but was never emptied of the remaining product or removed. The property owner had noticed a petroletm odor for a few days prior, when dudng the early moming of July 20th, the tank was discovered actively leaking to the basement floor. Mr. Harmony began to capture the leaking fuel in plastic containets before transferring the product to s-gallon buckets. Mr. Harmony also used an automobile jack to lift the end of the tank in ao attempt 10 stop the leak. The captured fuel oil was ttren placed outside of the basement on a tarp. After capturing 30+ gallons of product, with no sign of the leak stopping, Mr. Harmony contacted the Yarmouth lire Department for assistance. Yarmouth Fire Deparhent personnel (Captain James Amrstrong) responded to the release to assist. Yarmouth F. D. personnel proceeded to apply Speedy Dry to the basement floor below the ta::k and placed a collapsible spill containment pool beneath the leaking AST. Yarmouth Fire Deparment personnel subsequently contacted Health Departnoent personnel, Hazardous Waste Inspector, Carl E. Lawson, Jr., who l.aler responded to the scene. Photogreph l: Vicw of AST upon lrrival et thc sit. with ,bsorbcnt Ertcri.l lnd contrinm.trt pool blnerth. T k RESIDENTIAI - PROPERTY/BEA I 6.I 0925 RELEASE RETRACTION, RTN 4.26199 Mr. Harmony also contacted Tank Removal Services, LLC. (TRS) to pump the remaining fuel from the tank. TRS personnel arrived shortly thereafter and began pumping fuel oil from the 5-gallon buckets and the subject AST wherein some 47 gallons were removed and hansported for disposal under a uniforrn hazardous waste manifest. Mr. Harmony then contacted BEA at the request of Fire and Health Department persorulel to provide LSP oversight to investigate the release for appropriate Notification and Remedial Response under the MCP. Upon arrival at the site, BEA personnel met with the property owner and her son to review circumstances of discovery aud containment efforts. Based on the uncertainty of the volume of fuel released, the duration ofloss aod the enviroomental sensitivity of the location of the property with.in the Zone 2 area of conhibution for the To*u of Yarmouth Public Water Supply (PWS) well, with the depth to gror.rndwater estimated at less than 15'below grade, David Bennett, LSP opined that a 2-hour condition existed based on a Threat of Release, wherein greater than l0-gallons of oil in a 24 hour had been possibly released to the environment. Subsequent to discussion, with concurrence and authorization from the homeowner, the MA DEP was contacted to make Release Notification. Reiease Tracking Number (RTN) 4-26199 was assigned to expedite assessmant and any cleanup under an Immediate Response Action. Photograph 2: Are. ofst ising beneeth AST rflcr rcmovll ofebsorbeDi materials Not€ wicking up foutrdetior wrll. BEA personnel inspected the release area in the basement and performed indoor air screening, with a photoionization detector (PID). PID screening of the interior portions of the residence reported no concentrations of organic vapors above backgound in the fust floor and SEPTEMBER 6,2016 PAGE 4 OF 9 SEPTEMBER 6 2OI6 PACE 5 OF 9 RESIDENTIAL PROPERTY,tsEAI G I0925 RELEASE RETRACIION, RTN 4,26 I 99 low organic vapor readings (0.4 ppmv) in the basement near the release area. The AST was observed propped up on one end by an automobile jack, with the containment pool and Speedy Dry beneath. Subsequent to authorization by the homeowner, BEA personnel began to drum the spent absorbents and containment materials, along with any petroleum-contarninated debris in the basement. BEA personnel also pumped the remaining 7-gallons+/- of oil from the taok and placed the oil in the drum wi& the spent absorbents. The tank was then stood on end within the basement. After sweeping up the absorbents an approximate 8' x 4' area of faint staining was observed on the basement floo1 with minor wicking observed on the foundation wall in one area closest to the bulkhead. BEA personnel also set up a vapor barrier in the basement as an engineering control to guard against petroleum vapors entering the living space, in consideration of potential ir:halation exposures. The drum of spent absorbents and impacted materials was subsequently taken off-site for disposal by Clean Venture, lnc. on July 29, 201 6. ENI'IRONMENTAL ASSESSMENT [Refer to Appendix Bl BEA personnel (David Bennett, LSP/Rory Trimble, ES tr) retumed to the subject property on July 25,2016 to perform assessment activities to determine the nature and extent of sigrrificant impact. An LSP representing the homeowner's insurance company (Cosmo Gallinaro, LSP) and an i.nsurance adjuster were also at the site to oversee the assessment work and meet with the homeowner. BEA personnel advanced a series of five (5) hand borings at the site. Two hand borings were performed outside of the dwelling in an area of staining where the recovered fuel oil was stored. The hand borings were performed u5ing a tlree-inch, stait'ls5s- steel bucket auger. Hand borings HB-1 and tIB-2 were advanced to a depth of three feet below grade. Soil samples were collected from the 0-2' interval and the 2-3' interval. Soii samples were placed in 8-ormce glass jars sealed with aluminum septa. The samples were agitated to develop organic vapors and field screened with a PID (I4iniRAX 3000, l0.6eV lamp, calibrated to benzene standard) by jar headspace method consistent with the Interim Soils Policy (#WSC- 94-400). Field screening of soil samples collected from the hand borings repoded moderate headspace concentrations (31 - 1 ppmv), decreasing with depth. Three holes were cored in the basement floor corresponding to the area of staining. Hand borings HB-3, IIB4 and HB-5 were advanced initially by bucket auger and then by a driven "geo-probe" coring unit to 2-5' below ttre basement floor (8-1 1' below grade). Soil samples were again placed in 8-ounce jars for field screening by jar-headspace method. Organic vapor readings reported no concentrations above background (non-detect) in HB-4. Low concentrations (< 5 ppmv) of organic vapors were reported in HB-5. Moderate concentrations (45 ppmv) of organic vapors were reported in HB-3. Soil samples from each of the hand borings were placed in the appropriate containers and sent to R.l. Analytical for ex&actable petroleum hydrocarbon @PII) analysis with target Polycyclic Aromatic Hydrocarbons (PAIIs), with some of the sarnples submitted for Volatile Petroleum Hydrocarbon (VPH) and target Benzene, Toluene, Ethylbenzene and Xylenes @TEIQ analysis. The laboratory anal}tical results are presented in the following Table. The sigrrificance of these results is discussed in the fusk Characterization section of this report. SEPTEMBER 6,20I6 PAGE 6 OF 9 RESIDENTIAL PROPERTY,tsEAI6.I0925 RELEASE REIRACTION, RTN 4.26199 Laboratory analytical reported all VPH/BTEX concentrations in all soil samples as less than the strictest applicable S-1/S-2/S-3 (GW-1), Method I Risk Characterization standards. In fact, all sarnples reported all VPTVBTEX concentations as Non-Detect (ND) wherein the reporting limits were less than the most testrictive S-1/GW-1, Method I Risk Characterization Standards. Low concentrations of EPH and target PAHs were reported in the HB-1/HB-2: 0-2' composite sample, and the HB-3: 0-3' sample. Each of these sarnples also repoded 2- Methylnaphthalene above the S-I/S-2IS-3(GW-1) fusk Characterization Standards of 0 .7 mg/kC. All of the remaining samples, including the underlying HB-1/HB-2: 2-3' composite and the underlying HB-3: 3-5' composite sample were reported as non-detect, wherein each of the reporting limits were below the most stringent S-1/GW-1 Method 1 criteria, demonstrating background conditions at 2' below grade outside and at 3' below the basement floor (9'bgs). RISK CIIARACTERIZATION [Refer to Appendix Cl Table t Results otSoil samples Compared to S-VGW-I Risk Charaderizaton Standards Residenthl prcpe.ty - 67 Adam no.d - wdt YarDouth, MA xevHs-2l},2',x3-r/H3-2: 2-3',Method r Ritk ch.6ct.rb:don st.nd.rds 5rO 150 !3 7,1 1,2 1,1 30@ 1 1o 10@ 7 2 o.7 1@ 3@ 1CDo 20 80 @ l@ t@ 5q) 1@ 1qDt@'| TO 7 70 2 7 q7 jqD 10() 30@ 1o@ 50 30 10 1@ tqD 50lm 1(Dl@ 7 70 7 70 2 7 q7 1@ 30m 50@ 1000 1 ID fr@@IE ,t0 M :o !@ 7 {o @ A 8o @ 3@ 3@ 1@@ 3@m4 4@4 f {0 @ 3@ 5@ 3000 500 300 i0@ 50 10 30@ @ 1@ 30q) 3@ 30@,o ,m 4 {t*} lo 3@ '| 5@ 4 5(D 5d) 5m0 3& 3@om 30a! 30 5@ b &) 600 5@O 5@0 3@O 5&O 5@0 5@O &0 3@Os 3@0 30 30o 5@O 50ao 5000 5&0 ,o 500 10 50@ 50@ 3000 5@ 5oo 506 3m @ 3m 3@ 30 3m 30 500 Adl ca<D AilEd6(Fo) T.r!.t^tm:tl.^n.lyt. <0.21 100 0.1 2 !0 t@ ,o 500 5@ 1q) 1@ fr 100 l@ 5a0 5@ 5@ 5@ 5@ 1@ 1@ 1@ ffi 300 0.1 2 30 4@ :l((, 3dE 500 100 *J 1@0 lIm ,@ 100 N 5&ru 10@ 1m 1@ 1@ 1m 3!@ 5@ 5@ 5@ 300 ol 2 30 4a lo @ 2@O 100 1@ 1@ z) 5@ 5000 500 5@ 10@ 30@ @ @ 3oo 30o 5m 50@ 500 Numbd|n,.,ird6t.on..ntElioBEport.d.boveth.appli.aHeM.trodlRGkCh.Ect.nEtionSland.d Soil 50@ 5000 1000 5@O 5@0 5@0 SEPTEMBER 6,20I6 PAGE 7 OF 9 RESIDENTIAL PROPERTY/BEAI6-I0925 RELEASE RETRACTION, RTN 4-26I99 Based on the provisions of 310 CMR 40.0933 the S-1 and S-2 (GW-I/GW-2/GW-3) Method I Risk Characterization soils categories are applicable to those surficial soils outside of the dwelling, where the captured oil was stored. The S-3 (GW-1/GW-2/GW-3) Method I Risk Characterization soil categories are applicable to those soils underlying the conqete basement floor, where the fomrer AST was located. These standards were developed to evaluate potential ingestion exposures to humans, leaching to groundwater and significant environmental impacts. For the purposes of risk characterization, the strictest S-1 (GW-l), Method 1 - Risk Characterization standards are considered in review of ingestion, inhalation and dermal contact exposures, and potential leaching to grormdwater, as related to foreseeable future uses and activities at the Site. Emergency response actions were initiated soon after the leaking tank was discovered, wherein the recovery of free-phase product from the leaking tank was performed by capturing the fuel in containers aod pumping out the remaining product from the tank. The application of absorbents and a spill contaiment device limited the amount of fuel oil released to the environment. These response actions documented the recovery of47 gallons of fuel oil and the disposal ofa single 55-gallon drum (120 pounds) of spent absorbents and impacted debris. Two areas of impact were investigated; an area of staini-ng in the back yard where the caph:red fuel oil was stored, and an area of staining in the basement of the subject dwelling, below the former AST. Laboratory analysis of the soil samples collected from each of the two areas reported low concentrations of 2-Methylnaphthalene above the applicable S-1/S-2 and S-3 (GW-l/GW-3), Method l Risk Characterization criteria. However, volume calculations of the areas ofsoil impacted; an approximate 5'long x 1'wide x 2'deep area outside (5'x 1'x 2'= 10 ft.3,10 ft.3 /27 ft.3/yard3 : 027 yards3 of impacted soil); and an approximate 3' long x 3'wide x 3' deep area within the basement (3'x 3'x3'= 27 ft..3,27 fr..3 /27 fr..3lyard:1.0 yards), indicate that less than two yards of soil are aflected, and as such, the release does not meet the criteria of a Reportable Condition, pusuant to 310 CMR 40-0315(2). As such, a Release Retraction is technically justified in zupport of regulatory project closure. Groundwater Based on the PDWSA desigrration for the subject property, and proximity to groundwater, the GW- 1, GW-2 and GW-3 groundwater categories are applicable to Method I Risk Characterization. These standards were developed in review ofpotential ingestion and inhalation exposures and environmental impacts associated with the intercept of contaminated groundwater by surlace water. Based on the results of laboratory analysis wherein background conditions are documented at 2' bgs outside and 3' below the basement floor under the footprint ofthe dwelling, no impact to groundwater is apparent. As such, the installation and testing of monitoring wells was not deemed necessa4/ or warranted given the circumstances ofrelease. Indoor Air / SEPTEMBER 6, 20T6 PAOE 8 OF 9 RESIDENTLAL PROPERTY/BEAI 6. ] 0925 RELEASE RETRACTION. RTN 4.26199 The subject release occurred was confined to the basement with no significant release to the environment and not subject to the provision of310 CMR 40.0942(1) (d). Notwithstanding, freld PiD screening has reported Non-Detect TOV concentrations tkoughout the dwelling wherein no petroleum odor is reported. The removal of the subject AST, contaminated household items, and absorbents from the subject basement has eliminated the sources of residual fuel oil vapors. CONCLUSIONS Emergency response actions resulted in the recovery of47 gallons of fuel oil remaining in the AST, as well as the disposal of a single drum (120 lbs.) of spent absorbents and impacted debris. Environmental assessment and laboratory analysis reported low concentrations of 2- Methylmphthalene above the applicable S- 1, S-2 and S-3/GW- i Risk Characterization Standards. However, based on calculatiors of the volume of impacted soil, whereia the impacted soil is less than two cubic yards, it is apparent that the release does not meet the criteria of a Reportable Condition, pursuant to 310 CMR 40.0315(2). As such, a Release Retraction is technically justified in support of regulatory project closwe wherein appropriate remedial response actions and management of remedial waste have been conducted outside the MCP. All remedial waste generated has been managed in a marner consistent with the provisions of 3 l0 CMR 40.0031. As such, the property owner formally requests that the Release Notification be retracted per the provisions of 310 CMR 40.0335(1) and 40.0335(2) (a-e) as signified by the Release Retraction Transmittal Fonn @WSC- I 03) submitted. The findings of this investigation, as represented herein, set forth the rationale and technical justification for the Retraction of Release Notification as based on available data and regulations in effect at the time of this reporting speci.fic to the subject Site. Should the Deparunent have any questions regarding this project, please contact our ofEce at your earliest convenience. Sincerely, B ENVIRONMENTAI ASSOCIATES, INC. LSP Jo Project ManagerS Encl: -Site Plan entitled "Release Retraction - 67 Adams Steet, West Yarrnouth by BEA, Dated September 6,2016. -Reference Maps: Figure 1 - Site Locus MaP Figure 2 - Regional Groundwater Fiow Map Prepared SEPTEMBER 5, 2016 PAGE 9 OF 9 RESTDENTIAL PROPERTY/BEA16.I 0925 RELEASE RETRACIION, RTN +26 I99 Figure 3-MassGIS Priority Resource Map -BWSC-101: Release Log Form -BWSC-103: Release Notification Retraction Transmittal Forrn -Talk Removal Permit/Disposal Receipt -Uniform Hazardous Waste Manifest 015125240 JJK (vhgin fuel oil 47 gallons) -Uniform Hazardous Waste Manifest 014392856 JJK (oily solitls virgin fuel oil 120 lbs) -Iaboratory Analltical Results with Method 1 Surnmary: RIA 1607-17371 (7125116) cc Ms. Judith A. Harmony - property owner Carl E. lawson, Jr, - Yarmouth Health Deparbnentl Capt. James Armstong - Yarrnouth Fire Deparbnentl Peter Johnson-Staub - Yarmouth lnterim Town Administratorl I A" prrt ofPubli" Notice requtements, the report Title Page, Narative, Inde)! Traasmittal forms and Site Plan are included, prnsuaot to paperwork reduction policy. The firll report is available as public record on the MA DEP website ditabase at http:/public.dep.statc.ma.us,/Searchablesites/Search.asp or, upon writtfl request to BEA, full copy (electronic or paper) will be provided- Massachusetts Department of Environmental Protection eDEP Transaction Gopy Here is the file you requested for your records. To retain a copy of this file you must save and/or print Usemame: BotNc Transaction lD: 861693 Document: BWSC1O3 Release Notification & Retraction Form Size of File: 148.7sK Status of Transaction: gugm;tts6 Date and Time Created: 9/15/2016:1,t:28:34 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. lf you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Departm€nt of Environmental Protection Bureau of Waste Site Cleanup RELf,ASE NOTMICATION & NOTIFICATION RETRACTIONFORM Pursuant to 310 CMR 40.0335 and 310 CMR 40.03? I (Subpart C) llwsc 103 Release Tracking Number E]26t99 A. RELEASE OR THRSAT OF RELEASE LOCATION: l. Release Nade,{-ocation Aid: suctE FAI\,jLY REsDEtlcE 2. Street Address 6TADAMS ROAD 3. City/Town \AEST YARMOUTH 4. ZIP Code: 5. Coordinates a" Latitude: N 41.66966 b. Longitude: W 70.26403 B. THIS FORM IS BEING USED TO: (check otre) F l. Submit a Releasc Notificetion f 2. SubBit a R.vised Rclcesc Notifcatiotr fZ 3. Submit a Retractiou ofa Previously Reported Notfficatiou ofa release o! thjeat ofrelease including supporting documentatiotr requircd pur$ant to 310 CMR 40.0335 (Section C is not rcquired) (All scctions ofthi! trinsmittel form mult bc fllcd out trnlcrs othcrwise uoted ebove) C.INF'ORMATION DESCRIBING THT', RELEASE OR THR"EAT OF RXLEASE (TOR): l. Date atrd tioe ofola.l Notificario!, ifapplcsble: Tiroe: _do/ddlyyyy hh:EE 2. Date and tiEe you obtaiaed howledge of the Release or TOR: T:@ 3. Date and time release or TOR occurre4 ifknovn: nnlddlyyyf trh:mm Tre: mD./dd/yyry hh:ED Check all Notificatior Thlesholds thal apply to the Release or TbEat ofRelease: (fo! Eote idoErdioD see 310 o\,IR ,+0.03 l0 - ,$.031, 4.2 HOI]RREPORIING CONDMCNIS 5.72 HOURREPORIING @NDIIIONS 6. I2O DAYREPORTING CONDMONS IAM Fau TAM IPM IPM I-pu l- a- Suddea Releasc l- a- Subsurface Non-Aquoous Phase Liquid (NAPL) Equal to o! Gleater tiatr l/2 Inch (.04 feet) f b. Tbreat of SuddeD Release T b. Uodergmund Slorage Taak (USI Release T c. Oil Sheetr or! Surface Waier l- c. ThEat ofUST Releas€ T d. Poses l[o.mioeDt Hazard f d- Release to Groutrdwaler Eear Water Supply [- e. Could Pose Inainent Hazard f f Release Detecled in Private Well f g- Release to Storh Drain l- h. Sanitary Sewer Release (mhinent Hazard ODIY) f e. Substartial Release Migratioa li a. Release ofHazardous Marerial(s) to Soil or Croundwater Exceedilg Reportable CoDc€trtratiotr(s) f b. Release ofoil to soil Exceeding Reportable Concetrtration(s) aod Affectitrg Mor6 than 2 Cubic Yards T c. Release of Oilto Groundwater Exceedhg Repoftable Conceltration(s) J- d. Subsurfacc Nou-Aqueous Phase Liquid (NA.PL) Equal to or Greater than 1/8 hch (.01 feet) and Less than l/2 Inch (.04 fee| Page 1 of 3 j'. Revised: 07/1812013 \ Massachusetts Department of Environmental Protection Bureau of ll/aste Site Clea up RELEASE NOTIFICATION & NOTIFICATION RETRACTIONFORM PDrsuarf to 310 CMR 40.0335 and 310 CMR 40.037I (Subpan C) BWSC IO3 Release Tracking Number 26199 7. List below the Oils (O) or Haz$dous Materials (I{vf) that exceed their R€portable CoBcetrtmtioa (RC) or Repotuble Quantity (RQ) by the greatest amoutrt. l- Check hele ifarl smo[trt or cotrceDtration is utrknowE or less than detectable. O or IIM Releas.d CAS Numbcr, if known O or IIiU Concentlstion tinits RCs Erceed.d, if Applicable (RCS-1, RCS-2,RCGW-1, RCGW-2) f Check here ifa list of additional Oil and Ilazardous Materials subject to rcporting, or any other docurnentation relatilg to this qotificatioE is attached- D. PERSON REQUIRID TO NOTItr"f: I . Chcc,k a[ that apply: l- a- change ia cotrtact llne l- b. changc of address F c. chaogc in the person aotifoing 2. Name of Orgadzarion: 3. Codact First Name: LEfiH 5. Street 7. City/To*!: 10. Telephode: 67 ADAMS STREET O\ANB \,AJEST YARMOUTH 8. Star€: MA 9.ZE C&, O2673oom 508-957-2803 l1.ExL:12. Email: 13. Check here ifattaching da.aes and addresses ofowners ofproperties aJfected by lhe Rele.se or Theat ofRelease, other than an o*ner who is submittiDg this Release Notiication (requfued). E. RXLATIONSHIP OF PERSON TO RELEASE OR THRXAT OF RXLEASE. TChECK hETC tO ChANgC ICI tiODShiP F I . riP or PRP F a. owner F b. operator I- c. Generator I- d. Transporter l- e. Orher Rp or pRp Specifi: f 2- Fiduciary, Secued t-cDder or Municipality with Exempt Status (as defured by M.G.L. c. 2ll s. 2) 4 Revised:07/182013 Page 2 of3 C. INI'ORMATION DESCRIBING TIIE RELEASE OR TIIREAT OF RELEASE (TOR): (cont.) 4. lrst Name: 6. Title: FIAFMONY T T 3. Ageocy or Public Utility oo a Right of Way (as defined by M.G.L. c. 2lE, s. 5() l-4. Any Other Persotr Otherwise Requted to Noti& Speci& Relationship: Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup RELEASE NOTIFICATION & NOTIFICATION RETRACTION FOR.IU Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpafl C) BWSC IO3 Release Tracking Number E]26199 F. CERTIF'ICATION OF PERSON REQUIRED TO NOTIFY: I . I, JUDIH HARt\rOl{Y attest under the pains ard penalties of perjury (i) that I have p€rsoDally examhed and al]l faEiliar with the informatiotr cotrtailed itr this submittal iocluding any and all documetrts accoEpatrying this trarsmittal form, (ii) that, based on my inquiry ofthose individuals if,.oediately responsible for obtahing the informatioq the material information cotrtained itr this submittal is, to the best ofmy ktrowledge and beliet true, accu.rate and complete, and (iii) that I am firlly authorized to make this aftestation oD behalfofthe entity legally responsible for this submittal. Vthe persoa or eftity otr whose behalfthis submittal is made aElis awarc that there are significant penalties, iocludiag, but not limited to, possible fines atrd imprisonment, for willfully submiuiog false, r.traccEate, or incomplete information. 2.Bv: 4. For JUOIIH HARIr'ONY 3. Title ONN.JER Signature JUDI]H H,ARVONY 5. Date 9115n016 (Name ofperson or eotity rccorded io Sectiotr D) anlddlyyyy f 6. Check here ifthe address ofthe persoo providiag ocrtifroation is differeat from ad&ess recordcd in Section D. ?. St e€t 8. City/Town: I I . Telephone: 9. State 10. ZIP Code: 12. ExL 13. Ena YOU AR.E SI]BIECT TO ANIYUAL COMPIJANCE ASSURANCE TEES FOR EACII BILI,ABI,E YEAR FOR TIM. CI-ASSIFIED DISP(XAL STIES' YOU MUST LEGIBLY COMPI,EIE ALL RU,EVANT SECTIONS OF TEIS FORM OR DF,PMAYRETURNTmDOCUMU1IASINCOMPLETE IF YOU SUBMIT ANINCOMPLEIE rORM YOU MAYEE PB.{ALIZu)FORMISSINGAREQINRM DE{)LINE Date Slamp (DEP USE ONLY) R.ceiv.d by DEP oD 9/152016 1l:03:37 A' Revised: 07/182013 Page 3 of3 eDEP - MassDEP's OnlineFiling System IVaSSDEP s Online Filing System My eDEP Forms rl My Profile E Help Notifications Page 1 of I l',iassDEP Home I Contact I Privacy Policy Nickname: BENNETT @ --l--+ fqE! att ch Fll€5 shnatllrs R Yel print receipt Exit Mv eDEP MassDEP HonE I Contact I Privacy Policy Receipt Summary/Receipt Your submission is complete. Thank you for using DEP's online reporting system. You can select "My eDEP" to see a list ofyour transactions. DEP Transaction lD: 861693 Date and Time Submitted: 911512016 1 1:03:37 AM Other Email : Form Name: BWSC103 Release Notiflcation & Retraction Form RTN: 4-26199 Location: SINGLE FAMILY RESIDENCE Address: 67 ADAMS ROAD, WEST YARMOUTH, Person Making Submittal JUDITH HARMONY 67 ADAMS STREET WEST YARMOUTH, MA 026730000 Person Making Certification JUDITH HARMONY Judith Harmony Additional Forms Submitted Ancillary Document Uploaded/Mailed BWSC-103 SEC B Q.3 - Supporting Documentation for Release Retraction MassDEP's Online Filing System ver.12.25.3.0O 2016 MassDEP 1^a.^..11^A^ ,{-- -^.. ^^',/Do^^. /D;-+D onair+ oonv ol1<11n't L Kara Risk From: Sent: To: Subject: Thank you for using eDEP Online Filing from the Massachusetts Department of Environmental Protection. Your transaction is complete and has been submitted to MassDEP. This email is your receipt for the eDEP Online Filing transaction described below. Please review it and keep a copy for your records. Please do NOT reply to this message, this email address will not receive messages. For assistance with eDEP Online Filing, please emailthe EEA Help Desk at mailto: EEA.ServiceDesk@State.MA.US or call 6L7-626-71L1. MassDEP is interested in how we can serve you better. To help us make improvements to eDEP, please take a minute to complete our eDEP Online Filing Survey at http://www.mass.gov/eea/agencies/massdep/service/online/edep-contacts- and-feedback.html. To contact MassDEP Programs, please see http://mass.gov/dep/about/contacts.htm * * * ** * *,1* * * *:! + i(*+ 'i:f *:!.i.t 't*:!+:*+:t:i:1.*i(*+.t'i'rt*,i*,*:t******:t+.!.i*.i,i,*******,t*+**+*+,*,t*:****,****** DEP Transaction lD: 861693 Date and Time submitted: 09/15/2016 11:03:31 *********:i******+ **,1+ + * +:t:i:t rt:i +:i +ir {. '}*:t:i+ + 'i * * r* * * ***:}:}+ 't*,}*+******* **:i:i:F ++ + **:a,} * * ** * * *,i:}:t Form Name: BWSC1O3 Release Notification & Retraction Form RTN:4-25199 Location: SINGLE FAMItY RESIDENCE Address: 67 ADAMS ROAD WEST YARMOUTH Person Making Submittal JUDITH HARMONY 67 ADAMS STREET WEST YARMOUTH MA 026730000 Person Making Certification JUDITH HARMONY Judith Harmony Additional Forms Submitted Ancillary Document Uploaded/Mailed : BWSC-103 SEC B Q.3 - Supporting Documentation for Release Retraction - Uploaded (BEA16-10925 Retraction 9.6.16.pdf) eDEPConfi rmation@massmail.state.ma.us Thursday, September 15, 2016 11:04 AM Kara Risk eDEP Submittal Confirmation for DEP Transaction ID: 86L693 1 ++:i+***************,***,**:t************,r+*++,a**,*****+it+*,i**,t*r.*,rjt+++,!*****+**+{r+*,*,t {.,},N* * EMAIL lD OF THE USER: krisk@bennett-ea.com ** ****:i**** *:*x***jt,a***,* t******:i****,* **:t***:i!a*** *x*++* *****t**:i*:i i***** **,*,** j**,t,*** * ** *,t + 2.