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HomeMy WebLinkAbout0036 WEQUAQUET AVENUE - Health 36 Wequaquet Ave 1 Centerville A = 251 — 122 —T00 Building Sl imp,QlC® � ur UPC 10259 No.H�Rom,. HA�RIMOi. MN See 36 Wequaquet Ave. Hyannis Septic ?w i 1 3 l� W yin � �/- i e-. See 36 Wequaquet Ave. Hyannis Septic Fria 36 x Commonwealth of Massachusetts ��/ /0 �D N u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -rI ,.•�a< 36 Wequaquet Avenue Property Address Mikhail & Sophie Schillerw Owner Owner's Name information is Centerville Ma 02632 2/13/2018 required for every page. City/Town State Zip Code Date of Inspectiony;y 5w.f Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection f� Company Name 74 Beldan Ln. Centerville Ma 02632 -City/Town State Zip Code 774-248-4850 smjonestitle5@gmail.com S14522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 16.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by th -ocal Appro ing-Authority 2/13/2018 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. , t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail & Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 36 Wequaquet Ave Centerville is served by a Title V septic system consisting of 1000 gallon septic tank and a block overflow pit. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System" Pa'ge'2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail & Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water,supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: " This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail & Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts H W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ E Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Sve,� 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: vacant 1 monthDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day Y(gPd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,a 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): Septic tank, block overflow pit t5ins•W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M bvBy�t 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: original system 1967 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5' below TOFfeet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 6" t5ins•3/13 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts L . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 3" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? opened covers, took measurements Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Water level in tank was even with outlet invert, tank was structurally sound and not leaking. Covers are on risers. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Mt 36 Wequaquet Avenue Property Address Mikhail & Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,•°' 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching facility consists of a block overflow pit. Pit was dry at time of inspection with no signs of past hydraulic overloading. Blocks were in good condition, pit was structurally sound.. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owners Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 1 O 6 At Z� �( 22 2 A2 3 `I 52 41 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owners Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Wequaquet Avenue Property Address Mikhail &Sophie Schiller Owner Owner's Name information is required for every Centerville Ma 02632 2/13/2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 > � Town of Barnstable rsnakaetYra,i:�, Department of•nspectitinal Services Public Health Division Date Dec 24, 2A g rtt8+ Mo Main Street,Hyannis NIA 02601 Office:5688462-4644 Date Scheduled _ a //Time ! .. Fee Pd. Soil Saait balaty Assessment for _._._ d E}�ageDisposvq�i Performed'By: ....... _...:'. Lt?C�TIOiV&GE'�TFRAL INT�URMATIOIr'' Location Address 22 JC.. I/t/C J v .!- Otvnar'sNatne Vt Address �t: ItlCfj�q�j✓C�t� /}� Ceti-ervt'tte Assessor's 4ap/Patcel: '2.51 tiLL Engineer's Name �cfVtG{. COi/�i�thi'70✓Y' I,ngineer'sEmI -tVtd CQi7 g i10 -ipt{t�.001ri NEWCONSTRUCTION _ REPAIR !`eleglione# 50f 364 OF Land Use it )� Slopes(%) )�,.� Surface Stones AMR Distances from: Open Water Body;e o ft Possible S'F et Area )2X 4 Drinking Water Welv>/,-tt Drainage Way _____ft Property line .---_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of tst holes ar pi tests,locatewedands in proximity to holes) Parent material(geologic) !'r �1 +'�7"t Depth to Bedrock �L ( p_.. Depth to Groundwater: Standing Water in Hole: N ` Weeping from Pit Face rJ Estimated Seasonal High Groundwater _.—. FBMINAT10? 0R SEASnI'��tl.Ia HIGH WATE t TABLL+' Vlethod�Uud. :�. .... -.. _ Depth't?fisened standing in ebb.hole:_._in: Depth to soil mottles:---......__ T„in. Depth to weeping from side of obs;hole:-_. in 'Groundwater Adjustment R. Index Well# Reading Date:_^ Index Well loves Adj,factor Adj.Groundwater Level -77 PERCOLATION TEST „ :_Rate TYme Observation ••'' " Hole# Time at 4" PJ trL u Depth of Pero — 'Circe at 6" Stan Pre-soak Time r( 1 Time(} 6") tY ' - -- End Prirsoak Rate ly Minh ` Site Suitability Assessment:. Site Passed_. �_ Site Failed:,._..�-_.� Additional Testing Needed(YI41): _w Original: Public Health Division Observation Hole Data To Be Completed on Back- - ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division of least one(1)week prior to beginning. Q:\Applicafion FormOERCFORM 2018.doo -A. OFEPbli8t VXtl&NOLE`LOG Hole Depth from Soil Horizon Soil"texture kil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,Boulders. n istena-%Gravetl _ M a-3 ley" k 32. C/ Wo AA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Conslstency.%Graven it ,;DEEPO$SER�ATIOIV HQLE`=LOG ,'; �.Hole#• , Depth from Soil Horizon Soil Texture: Suit Color Soil Other Surface(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% DEEP°°"QBSER`�AIT(1N Hi?I�E?LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(im) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consisteno,v Own!) Flood Insurance Rate Man: Above 500 year floodboundary No,,��JJ Yes v Within 500 year boundary No VV Yes J, Within 100 year flood boundary No Yes Depth o[Naturaily Occurring Pervious Material Does at least four feet of naturally occurrin p ry material exist in all areas observed•throughout the area proposed for the soil absorption system? _ If not,what is the depth of naturally occtrrr' pervious material? Certification I certify that or,__l_Q �C (date)I have passed the soil evaluator examination approved by the Department of Environmenta tectio and that the above analysis Was performed by me consistent with the required training, expertise and xperipjicedescribqdin3lOCNRl5.017. WIX Signature Date Q:IApplication Forrns\PERCFORM 2018.doc CleanHarW!3 ENVIRONMENTAL SERVICES® Clean Harbors Environmental Services, Inc. 42 Longwater Drive Norwell, MA 02061-9149 Phone: 781-792-5000 Fax: 781-792-5938 www.cleanharbors.com June 5, 2007 Mr. John Klimm Barnstable Town Manager 367 Main Street; 2"d Floor Hyannis, Massachusetts 02601 11:1 -_t--__ 1\G. Div. L 11lJU Llll� Vll 1\vivu:ic 36 Wequaquet Lane Centerville, Massachusetts — MassDEP Release Tracking No. 4-20309 Dear Sir/Madam: co CD On behalf of Mr. Steven Mele, Clean Harbors Environmental Services, Inc. (CHES) is s �mitting�is notification as art of the public involvement process required b the Massachusetts Contingent Plan (I�,CP, notif o p q Y P p 310 CMR 40.0000). Local officials-have the right to request additional public involvement ac 'vities ui_iOr 310 CMR 40.1403 (9). The conclusions of the Response Action Outcome Statement are present below M On February 7, 2007, a release estimated to be greater than 10 gallons of No. 2 home heating fuel was discovered in the basement of the vacant residence located at 36 Wequaquet Lane in Centerville. The release impacted the basement floor and underlying soils via a floor drain. The basement was cleaned, the house was demolished (as previously scheduled), and the petroleum- impacted soil was removed. No groundwater was encountered within the excavation, which extended to a depth of 34 feet below grade. Spent absorbents and debris generated from the basement floor cleaning were collected within six 55-gallon drums subsequently transported off-site for disposal. Additionally, 90 cubic yards of petroleum-impacted soil and stained basement floor concrete were removed and transported for recycling as an aggregate in asphalt batching. Following the response, no petroleum odors remained within the excavation and field-screening results were consistently low. To confirm site conditions, two of the soil samples were further submitted for laboratory analysis and revealed no detectable EPH concentrations. Because the site has been remediated to background or pre-existing conditions, a level of No Significant Risk with respect to human health and the environment has been achieved. Furthermore, no risk to public safety was identified at the site following the response. Based on these results, a Permanent Solution has been achieved for this release, and the requirements for a Class A-1 Response Action Outcome have been met. a RTN:4-20309 Page 2 of 2 view at the Southeast Regional File Facility of the Massachusetts Department of This report is available for re g Y Environmental Protection (20 Riverside Drive, Lakeville, Massachusetts 02347) or by contacting Mr. Steven Mele (contact information on attached copy of Release Notification Form). No action other than the receipt of this letter is necessary by your office. Sincerely, Lisa Irwin Senior Project Scientist Mr.Thomas McKean Barnstable Health Director 200 Main Street Hyannis,Massachusetts 02601 Project file EO1437188 Clean Harbors Environmental Services,Inc. a Massachusetts Department of Environmental Protection BWSC103 Bureau of Waste Site Cleanup Release Tracking Number RELEASE NOTIFICATION & NOTIFICATION 0309 Ll RETRACTION FORM E _ Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) A. RELEASE OR THREAT OF RELEASE LOCATION: 1. Release Name/Location Aid: 2. Street Address: 36 We ua uet Lane 3. City/Town: Centerville 4. zip Code: 02632-0580 5.UTM Coordinates: a.UTM N: 4612896 b. UTM E: 389522 B. THIS FORM IS BEING USED TO: (check one) Q 1. Submit a Release Notification 2. Submit a Revised Relea se Notification 3. Submit a Retraction of a Previously Reported Notification of a release or threat of release including supporting documentation required pursuant to 310 CMR 40.0335 (Section C is not required) (All sections of this tra nsmittal form must be filled out unless otherwise noted above) C. INFORMATION DE SCRIBING THE RELEASE OR THREAT OF RELEASE ITORI: 15:00 � AM Q PM 1. Date and time of Oral Notification,if applicable: 02/07/2007 Time: __---- mm/dd/yM hh:mm 02/07/2007 Time: 13:00 0 AM 0 PM 2. Date and time you obtained knowledge of the Release or TOR: mm/dd/yyyy hh:mm Time: _.-----� AM � PM 3. Dale and time release or TOR occurred,if known: mm/dd/yyyy hh:mm Check all Notification Thresholds that apply to the Release or Threat of Release: (for more information see 310 CMR 40.0310-40.0315) 4. 2 HOUR REPORTING CONDITIONS 5. 72 HOUR REPORTING CONDITIONS 6. 120 DAY REPORTING CONDITIONS 571 a. Subsurface Non-Aqueous a. Release of Hazardous a. Sudden Release Material(s)to Soil or Phase Liquid(NAPL)Equal to Groundwater Exceeding b. Threat of Sudden Release or Greater than 1/21nch Reportable Concentration(s) c. Oil Sheen on Surface Water b. Underground Storage Tank (UST)Release b. Release of Oil to Soil d. Poses imminent Hazard Exceeding Reportable El c. Threat of UST Release Concentration(s)and Affecting e. Could Pose imminent More than 2 Cubic Yards Hazard d. Release to Groundwater c. Release of Oil to f. Release Detected in near Water Supply Ej Groundwater Exceeding Private Well e. Release to Groundwater Reportable Concentration(s) g. Release to Storm Drain El near School or Residence d. Subsurface Non-Aqueous f. Substantial Release Migration Phase Liquid(NAPL)Equal to Qh. Sanitary Sewer Release or Greater than 1/8 Inch and (Imminent Hazard Only) Less than 1/2 Inch Page 1 of 3 Revised:02/10/2006 Y Massachusetts Department of Environmental Protection BWSC103 Bureau of Waste Site Cleanup Release Tracking Number RELEASE NOTIFICATION & NOTIFICATION _ 20309 RETRACTION FORM _ .. Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) C. INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR):(cunt.) 7. List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity (RQ)by the greatest amount. O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if if known Concentration Applicable(RCS-1,RCS-2, RCGW-1,RCGW-2) No. 2 Heating Oil 68476-30-2 O >10 GAL 8. Check here if a list of additional Oil and Hazardous Materials subject to reporting is attached. D. PERSON REQUIRED TO NOTIFY: c. change in the person 1. Check all that apply: Fla.change in contact name b.change of address ❑ notifying 2. Name of Organization: 3. Contact First Name: Steve 4.Last Name: Mele 5. Street: 56 Lakeview Drive 6.Title: 7. City/Town: Centerville 8. State: MA 9. zIP code: 02632-1413 10. Telephone: (508)362-0393 11.Ext.: 12. FAX: Ej13. Check here if attaching names and addresses of owners of properties affected by the Release or Threat of Release, other than an owner who is submitting this Release Notification(required). E. RELATIONSHIP OF PERSON TO RELEASE OR THREAT OF RELEASE: 1. RP or PRP F] a. Owner b. Operator n c. Generator d. Transporter e. Other RP or PRP Specify: 2. Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21 E,s.50)) 4. Any Other Person Otherwise Required to Notify Specify Relationship: Page 2 of 3 Revised:02/10/2006 J Massachusetts Department of Environmental Protection BWSC7Number Bureau of Waste Site Cleanup Release TrRELEASE NOTIFICATION & NOTIFICATION RETRACTION FORM Y. Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) F. CERTIFICATION OF PERSON REQUIRED TO NOTIFY: 1. I,Steve Mele attest under the pains and penalties of perjury(1)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material Information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. Ilthe person or entity on whose behalf this sub ,lal is made am/is aware that there are significant penalties,including,but not limited to, possible fines d imprisonme t, r willfully submitting false,inaccurate,or incomplete information. N�� 3. Title: vim+ 2. By: Signature 5. Dale: 4, For: mmlddlyyyy (Name of person or entity recorded in Section D) 6. Check here if the address of the person providing certification is different from address recorded In Section D. 7. Street: 8. City/Town: 9. Stale: 10. ZIP Code: 11. Telephone: 12.Ext.: 13. FAX: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO a10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE. YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE, IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Page 3 of 3 Revised:02110/2006 Postal r E p M A I LITIORECEIPT c(Domestic Mail • Provided) For delivery information visit obr welosite at www.usps.come r!1 Lr) m Postage $ 0 3 1 Sps C3 Certified Fee M Return Receipt Fee • CD Qtmerk O (Endorsement Required) p f��eb O Restricted Delivery Fee qui 6 r-q (Endorsement Rered) CO M Total Postage&Fees $ S�NNd�N C3 VSen,To M Vito ... ---- dY i _Box No. j Cpl'�(,(`e W `rr'� Ci Sta ZIP 4 Certified Mail Provides: aoo is■ Amailing receipt (MaABa) -0=1 Sd rr A unique identifier for your mallpiece ■ A record of delivery kept by the Postal Service for two years important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mails or Priority Mails. 'a Certified Mail is not available for any class of international mail. is NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. 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Article Number ; (Aansfer from service label)' I :!!:'. .i 17 0 0 6 08101 0 0 0 0f 3'5 2'5 0 0 5 2: PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540; UNITED ST �sS; s�STAL., cRVIG:fi n -i: r.5,• a-�„ � _�I Is � »,rt_r,� o ',B;M;r,.. 9••p�s i a•::..%•°" 'l,._!e� � :.w.ti,�yr r• $t- 'A 2S�"�'dmt�>�� Ate•, e, F,ees�pici �^. hAye• aYWW ..{.,�� iCf7 2�.�• _)j��;R„� ,t 'r�'.�f]�{ ,-s. � �. ���'ratl,mav�. .I l T\(�,Ci-`'r'�+'"Ica Sender. Please print your name, address,-and ZIP+4 in this box• V I I Public Health Health Division own of Barnstable 200 Main St. '-!yannis, Massachusetts 02601 I I I I I t a Certified Mail: 7006 0810 0000 3525 0052 Town of Barnstable Regulatory Services MRNSTABLE Thomas F. Geiler, Director 09. Public Health Division ATfi0 tr4A�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 21, 2007 Steven A Mele 56 Lakeview Drive Centerville, MA 02632 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE CODE The property owned by you located at 0 Falmouth Road, Hyannis, Assessors Map\Parcel 250-023-XO1 was observed in violation on March 20, 2007 by Health Inspector David W. Stanton R.S. The following violation of the Town of Barnstable Board Code was observed: § 353-1 Responsibilities of Owners: A 55 gallon drum and two 5 gallon buckets. One of the 5 gallon buckets had some oily product on the ground around it. You are directed to remove the 55 gallon drum, two 5 gallon buckets and the contaminated soil around the 5 gallon bucket on your property and dispose of it properly within 30 days of your receipt of this notice. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Failure to comply with an order will result in a fine of$100.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, RS, CHO Health Agent QAOrder letterMazmat\falmouth road-0 Wequaget lane.doc ®R w Enviro-Safe Corporation Environmental Services Field Service Center March 5, 2007 Massachusetts Department of Environmental Protection Bureau of Waste Site Clean Up 20 Riverside Drive Lakeville, MA 02347 RE: Immediate Response Action Plan Residence 36 Wequaquet Lane Centerville,Massachusetts j �, rz MA DEP RTN: 4-20309 C3457 f 'XI To Whom It May Concern: On behalf"of Mr. Steve Me1e 'Enviroo-Safe Corporation (ESC) is submitting the follovv�#g r- information to address a release of#2 fuel oil at 36 Wequaquet Lane,Centerville;Massachusetts(the "site"). This report provides an Immediate Response Action(IRA)Plan addressing respo�se actions conducted and proposed at the site for the assessment and remediation of petroleum-impacted soil resulting from this release.Please refer to Figures 1 through 3 in Appendix A for a depiction of the site and surrounding area. In support of these activities,a copy of the Immediate Response Action Transmittal Form (BWSC-105).is attached (Appendix B). In addition, a Release Notification& Notification Retraction Form(BWSC-103) is included in Appendix B for this release condition. In accordance with 310 CMR 40.0000,the Massachusetts Contingency Plan(MCP),a copy of this IRA Plan has been submitted to the Massachusetts Department of Environmental Protection(MA DEP)Southeast Regional Office along with original Transmittal Forms BWSC-103 and BWSC-105. This report was prepared by ESC on behalf of Mr. Steve Mete, 56 Lakeview Drive, Centerville, Massachusetts 02632 [Phone:(508)362-0393],as the potential responsible party(PRP)associated with this release. Mr. Steve Mete is the property owner for the site. 1.0 REGULATORY BACKGROUND At approximately 3:00 P.M.on February 7,2007,the MA DEP was notified by the Centerville Fire Department of a release of#2 fuel oil at the site.The amount of#2 fuel oil released was estimated to be greater than 10 gallons.The release occurred as a result of vandalism in the unoccupied residence. 31 Granite Street Milford, MA 01757 • PH (508) 634-9800 • FX (508) 634-8259 C .t r RNF and 1RA Plan 36 Wequaquet Lane,Centerville,MA RTN 4-20309 Page 2 of 5 During an inspection of the unoccupied residence by Pastore Excavation of Forestdale,MA,the feed line from the aboveground storage tank(AST)to the boiler system was observed to be cut and an oil stain was observed in the immediate area on the cracked concrete basement floor. At that time,the MA DEP assigned Release Tracking Number 4-20309 to this 2-hour Reporting Condition and orally approved the following IRA activities: ♦ Apply absorbent materials to the impacted media, as necessary; ♦ Remove the existing 275-gallon steel AST from the basement; and • Excavate up to 100 cubic yards of petroleum impacted soil. It should also be noted that the residential structure is slated to be demolished in late March/early April, 2007 and will be developed as a new residential development complex. The Licensed.Site Professional (LSP)associated with this project is Mr. Michael C. Bricher, License Number 3926. 2.0 IMMEDIATE RESPONSE ACTION PLAN In accordance with 310 CMR 40.0420(7)(a),an Immediate Response Action Plan is required to be submitted to the MA DEP within 60 days of providing oral notification of the release to the MA DEP. The effective date of oral notification for this release was February 7, 2007. In accordance with 310 CMR 40.0424, ESC is submitting the following IRA Plan regarding the assessment of release conditions,response actions conducted at the site to-date,and proposed IRA activities to further address the release of#2 fuel oil. The objectives of this IRA Plan are to: 1)assess the vertical and horizontal extent of all petroleum- impacted media at the site;2)remove petroleum-impacted soil from the site to the extent feasible;3) stabilize site conditions as necessary;and 4)assess site conditions during and at the completion of response activities to determine the need to conduct further response actions. In addition,the need to perform an Imminent Hazard Evaluation will continue to be assessed as part of the IRA and potential Critical Exposure Pathways(CEP)at the site will be addressed as part of the IRA. 3.0 DESCRIPTION OF THE RELEASE, SITE CONDITIONS, AND SURROUNDING RECEPTORS As previously discussed,on February 7,2007,the MA DEP received notification that a release of#2 fuel oil occurred at the site. The release occurred at the site as a result of an act of vandalism on the feed line from the AST to the boiler system.It is unknown when the vandalism and release of#2 fuel oil occurred at the site.' The site is located in a residential and commercial area of Centerville. The property at 36 Wequaquet Lane consists of an unoccupied single-family dwelling and detached garage. The RNF and[RA Plan 36 Wequaquet Lane,Centerville,MA RTN 4-20309 Page 3 of 5 universal transverse mercator(UTM) coordinates of the site are approximately 4612896 north and 389522 east. The approximate elevation of the site is 65 feet above mean sea level(Figure 1). Site topography is relatively flat. Utilities serving the site include municipal water, electrical, cable television, and telephone services. The site is also serviced by an on-site sewage disposal system located south of the residential structure. The area surroundingthe site is serviced b a municipal water supply system. According to the Y p PP Y Y g Barnstable Board of Health, no private supply wells are located within 500 feet of the.site. According to the Massachusetts Geographical'Information System(Mass GIS) Map (refer to Figure 3), the site is located within a Zone II, Potentially Productive Aquifer,.and Sole Source Aquifer. No wetland areas exist within 1,000 feet of the site. 4.0 IMMEDIATE RESPONSE ACTIONS UNDERTAKEN TO DATE 4.1 Containerization of Household Products On February 8, 2007, ESC personnel containerized the petroleum-impacted household items(i.e., cardboard boxes,papers, computer accessories,etc.)in the vicinity of the release area in 557gallon drums.In addition,several paint cans/paint thinners located in the garage were containerized in 55- gallon drums. All the above-referenced containerized materials will be transported off site in accordance with State and Federal regulations. 4.2 Aboveground Storage Tank Removal Activities On February 8, 2007, Pastore Excavation removed the 275-gallon AST from the basement using hand tools. No staining was observed underneath the AST on the basement floor. The AST was transported to the Mid City Scrap metal disposal facility in Westport,MA for recycling. 4.3 Soil Sample Collection On February 8,2007;ESC personnel removed impacted soil/gravel from within a floor drain located in the basement, approximately 15 feet west of the AST. The excavated soil/gravel sample was screened for volatile organic compounds(VOCs)utilizing a PID calibrated to respond in parts per million volume (ppmv) as benzene. Field screening results of the soil/gravel sample yielded PID responses up to 449 ppmv in the basement. This PID field screening result may been influence by background petroleum containers in the basement. 4.4 Indoor Air Assessment Activities On February 8,2007,ESC personnel performed an indoor screening assessment in the basement and living area of the subject residence property. The indoor air was screened for VOC utilizing a PID calibrated to respond in ppmv as benzene. Field screening of the air from within the basement yielded PID responses up to 0.1 ppmv in the basement by the fuel oil AST. V RNF and IRA Plan 36 Wequaquet Lane,Centerville, MA RTN 4-20309 Page 4 of 5 5.0 ASSESSMENT OF IMMINENT HAZARD, SUBSTANTIAL RELEASE MIGRATION, AND CRITICAL EXPOSURE PATHWAY CONDITIONS Pursuant to 310 CMR 40.321(1)(a through f) and 310 CMR 40.0321(2)(a through c),no reporting requirement for any existing Imminent Hazards (IH) were identified at the site. Based on the site conditions described previously in this document, no Imminent Hazard-conditions exist. At this time, based on visual inspections of the source area and the size of the petroleum release, no CEP or potential conditions of substantial release migration(SRM)are viewed to exist. 6.0 PROPOSED IMMEDIATE RESPONSE ACTIONS 6.1 Soil Excavation The majority of petroleum-impacted soil at the disposal site appears to be situated underneath the concrete basement floor of the house. Construction plans are underway to demolished the existing house and redevelop as a residential complex. According to Pastore Excavation,general contractor for these site construction activities,permit applications for site demolition have been submitted to the local municipalities for review and approval. Once site demolition activities are underway,the impacted areas can be accessed, and soil will be removed using an excavator. Groundwater is not anticipated to be encountered during soil excavation activities. 6.2 Remediation Waste Management Remediation waste generated as a result of these IRA activities will consist of petroleum-impacted soil. Impacted soil will be managed under the Bill-of-Lading process(310 CMR 40.0034)and will be transported from the site to an approved recycling facility following pre-characterization activities. Previously generated and future containerized waste (i.e., cardboard boxes, papers, computer accessories,paint containers,etc.)will be transported off site in accordance with State and Federal regulations. i 6.3 Permits The proposed IRA activities will be conducted under the existing oral MA DEP authorizations and those contained in the Notice of Responsibility. All appropriate communications and necessary submittals will be made to the Barnstable Board of Health and Chief Municipal Officer during the on-going IRA activities at the site. 6.4 Environmental Monitoring Soil laboratory data collected from the site will be compared to the applicable risk characterization standards of 310 CMR 40.0000,the MCP. The results of the comparison will be documented in a future submittal. ` M RNF and IRA Plan 36 Wequaquet Lane,Centerville, MA RTN 4-20309 Page 5 of 5 6.5 Schedule An anticipated timeline for future IRA activities at the site are as follows: • General contractor demolition permitting- March,2007; • Demolition of building structure and soil excavation— Late March/early April,2007; • Soil sample collection and analysis-April,2007; and • IRA Status/Completion/Response Action Outcome Report- on or before June 7,2007 7.0 LSP OPINION It is the opinion of the LSP-of-Record for this disposal site that this IRA Plan conforms to the requirements of 310 CMR 40.0424. If you have any questions regarding the information presented herein, please do not hesitate to contact the undersigned at(508)634-9800. Very truly yours ENVIRO-SAFE CORPORATION Michael C. Bricher, P.G., L.S.P. Crai Sasse Senior Environmental Engineer Se 'or nvironmental Engineer cc: Mr. Steve Mete, 56 Lakeview Drive, Centerville, Massachusetts 02632 Mr.Thomas McKean,Barnstable Health Director,200 Main Street,Hyannis,MA 02601 Mr.John Klimm,Barnstable Town Manager,2 'Floor,367 Main Street,Hyannis,MA 02601 APPENDICIES Appendix A- Figures Figure 1 - Locus Map Figure 2 - Site Plan Figure 3 - MassGIS Map Appendix B -MA DEP Bureau of Waste Site Cleanup Transmittal Forms COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. S:� ❑Agent ■ Print your name and address on the reverse ❑Addressee item 4 if Restricted Delivery is desired. X so that we can return the card to you. B. Received by(Printed Name) C. a of Delivery ■ Attach this card to the back of the mailpiece, t^ P ,P i �� o or on the front if space permits. J D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No 3. S�,ervice Type Ce J v I e IM 0 a b 3 y Certified Mail ❑Express Mail ❑Registered `� Return Receipt for Merchandise ❑Insured Mail 0 C.O.D. � 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number i7 p Q 6 0`8 7; I ��p p` 3 5 2�0 4 (transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATEfa M EMME R c 1.-RY25fir *o m sa= • Sender: Please print your name, address, and ZIP+4 in this box• I - I Public Health Division Town of Bamstable 200 Main St. �I Hyannis,Massachusetts 02601 tjJtt It It !i f 1 i))t SI 1 !S! !1 ) j { 1ldiiitititifild iililtlhhtilt'iifofifIIliilillIIMtt:l?lit! Certified Mail: 7006 0810 0000 3525 0045 4rt Town of Barnstable Regulatory Services Thomas F. Geiler, Director c;axxSTXBLE,MASS Public Health Division T�'c Mv't Thomas McKean,Director 200 Main Street;Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 February 8, 2007 Steven A Mele 56 Lakeview Drive Centerville, MA 02632 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE CODE The properties owned by you located at #0 Wequaquet Lane, Centerville, Assessors Map\Parcel 250-023-X02 (AKA W36 Wequaquet lane) and #0 Falmouth Road, Hyannis, Assessors Map\Parcel 250-023-X017 were observed with-a large accumulation of garbage and rubbish on February 7, 2006 by Town of Barnstable Health Inspector David W. Stanton, R.S. The following violation of the Town of Barnstable Board Code was observed: & 353-1 Responsibilities of Owners: Large quantities of garbage and rubbish were observed on your properties. You are directed to remove the garbage and rubbish from your property and dispose of it properly within 30 days of your receipt of this notice. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Failure to comply with an order will result in a fine of$100.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF TH BOARD,OF HEALTH Tho as McKean, RS, BOARD Health Agent QAOrder letters\Refuse\0 wequaquet lane-falmouth road.doc �Nk po Citizen Request Management - Internal Use Request ID: 20711 Created, 2/7/2007 4:11:58 PM Status: Assigned To Staff Assigned To: Stanton, David Health Office / Chapter 108 b � Anonymous: No Category: Hazardous Materials E.C. Date: 2/9/2007 Created By: Fontaine, Tina Citations: Health Office Y Time Worked: 3.50 Response Time: 0.50 Requestor Details: COMM Fire Email: Request Location: 0 WEQUAQUET LANE Centerville, Ma 02632 _.�__.._..__�—_ ____.._..._...__._.._......._._.._ __._.._.. Parcel Number: Map: 250 Block: 023 Lot: X02 Request: Centerville fire called to tell us there's an oil spill in the basement of this vacant lot. Due to someone taking the copper pipes. s Request Work History: Entered on 2/8/2007 9:55:51 AM by Stanton, David Frank P. of COMM fire called. The location of the home with oil spill is #0 Wequaquet Lane, Centerville, Assessors Map\parcel: 250-023-x02. 275 Gallon oil tank with product located outside on the ground is located at #0 Falmouth Road, Hyannis, Assessors Map\Parcel: 250-023-41. Nick Christiani pulled AST removal permits for said locations. At the time of removal, Christiani contacted COMM fire to report that there was a prior release at #0 Wequaquet Lane in the basement. Christiani said they have an LSP, unknown name and who the LSP represents. Product present in basement (odor and staining on basement floor) It appears that someone was in the property to remove all the copper. The supply line from the AST to the.boiler was cut (source of release) Police notified as it appears the property had been broken into. Officer Scott Kynoch onsite, Call# 07-4586. Tank in field appears intact without any release. Soil below the tank in field will be checked after removal to ensure no contamination. DEP notified. Andrew Jones of DEP onsite. Also present was a lot of rubbish in the garage and next to the garage. Several cans of paint present. DS will contact owner to clean up all the rubbish at said location. Entered on 2/8/2007 10:22:11 AM by Stanton, David On 2/8/07 DS e-mailed the report to DEP and COMM Fire. DS also printed and order letter 7006-0810-0000-3525-0045 to be sent to owner to clean up rubbish within 30 days of receipt. Internal Note History: System entry on 2/7/2007 4:11:19 PM: Assigned to Stanton, David Entered on 2/8/2007 9:55:51 AM by Stanton, David Frank P. Cell# 978-230-1838. Removal contact info: Nick Christiani N.P. Christiani PO Box 247 Forestdale, MA 02644 Property Owner: Steven A. Mele 56 Lakeview Drive Centerville, MA 02632 DOB 8/4/1955 System entry on 2/8/2007 10:22:22 AM: -Please Review- email sent to McKean, Thomas t50011 ' 2� 1:17 250O.2 TO0 y h #•2$ , "e_"5 0010 50023X ut�t #,12 # = 7 Gallon Oio , nip on ground5nrla 5 Z I # 1 4511023X01 ,# 0 # 1 WR 1 +fi r 2500"27;ti0 Ars At 1W"d } # 11_ ll A , L Z 250004 # 250005 #.1L4� LAk 13t.566 k,g35 010640 OL—1 6-2001 Cd oa :@ 1 p STEVFN A. MFLF of: 56 Lakeview Drive, Barnstable (Centerville), Barnstable County, Massachusetts_ being unmarried, for consideration paid, grant to THE CAPE. COD COOPERATIVE BANK a corporation duly established by 5 law and having its usual place of business in Yarmouthpor.t, Barnstable County, Massachusetts, with MORTGAGE COVENANTS, to secure the payment of FIVI, HUNDRED NINETY WO THOUSAND FINE HUNDRED AND 00/100****** ($592.500.00) H in Twenty (20) years with interest per annum payable as provided in a note of even date, and also to secure the performance of all covenants and agreements herein contained, the land in CENTERVILLE, i a SEE SC}IEDULF "A" ATTACHED HERETO AND MADE A PART HEREOF. H u� Cr The aforesaid Note has an "Initial Interest Rate" of 9 .25%. o `1.Tie Note interest rate may be increased or decreased on the 1.6"' day of the month beginning on February 16, 2004 and on that day of the month every thirty-six (36) months thereafter. M lncludi.ng all portable of sectional buildings at any time < placed upon said premises and all furnaces, heaters and heating N apparatus, ranges, oil burners, stoves, mantels, plumbing, gas and electric light fixtures, gas and electric refrigerators, electric pumps, screens, screen doors, awnings, storm doors and windows, a, and all other fixtures of whatever kind and nature at present N contained in the buildings on said land, and all material, lumber, apparatus or supplies intended to enter into the construction, L repair or remodeling of the buildings on said premises now in sail Cj V. buildings or on said premises or placed therein or thereon prior �10 to the full payment and discharge of this mortgage. 00 G The Mortgagor covenants to keep the buildings now or hereafter on said premises insured against fire, and such other. hazards as the Mortgagee may from timE! to time require, in -a sum and with companies satisfactory from time to time to the Mortgagee, all such insurance policies to be deposited with 0 companies first payable in case of loss the Mortgagee, and in the event of the foreclosure of this mortgage, all such policies, shall become the absolute property of the Mortgagee, which shall U; have full authority as attorney irrevocable of the Mortgagor to cancel such policies and to retain the return premiums thereof or to transfer such policies to the purchaser at a foreclosure sale, without accounting for the same. a The Mortgagor covenants to pay to the Mortgagee on demand the o amount of any tax payable by the Mortgagee which is attributable p� to debt hereby secured whether such tax be measured by the principal of or interest upon the debt. hereby secured, or by its. real. estate mortgage investments, or however other-wise measured. kik 1 3ti66 Pg36 ##1 06416 The Mortgagor covenants to keep the premises in good order, condition and repair. The Mortgagor covenants that no occupant will use the premises or any portion thereof in violation of any law, and that whenever, in consequence of an alleged violation, the occupant ' s use of the premises shall be prohibited. or enjoined by any public official or court, the violation shall be deemed conclusively proved for the purposes of this mortgage. The Mortgagor covenants that the Mortgagee may, without notice to any person, deal with any successor in interest of the grantor herein regarding this mortgage and the debt hereby secured in all respects as it might deal with the grantor herein, without in any way affecting the liability hereunder or upon the debt hereby secured of any predecessor in interest of: the person so dealt with; and no sale of the premises hereby mortgaged, nor any forbearance on the part of the Mortgagee nor any extension by the Mortgagee of the time for payment of the debt hereby secured, shall operate to release, discharge, modify, change or affect the original liability of any predecessor in interest of the equity owner at the time of: such sale, forbearance or extension. The Mortgagor covenants to pay promptly all insurance premiums and water charges, and covenants that, in case all. taxes and assessments, water charges and insurance premiums are not paid when due, in addition to any remedy provided by law or herein, the Mortgagee shall have the right to pay the same or any of them, and to add to the principal sum due hereunder any amounts so paid. In the case of default in the making of any payment of principal or interest when due, or in the performance of any condition or covenant in the note hereby secured, and the continuance of such default for more than thirty (30) days, or in the event of the insolvency of or the filing of a petition of bankruptcy by any maker, co-maker, endorser or guarantor of said note, the entire balance of principal and interest accrued thereon shall forthwith, at the option of the holder and without notice, become due and payable. In case of a foreclosure sale, the Mortgagee shall be entitled to retain one per cent of the purchase money in addition to the costs, charges and expenses allowed under the statutory power of sale: that in case proceedings to foreclosure have been begun, the Mortgagee shall be entitled to collect a11, costs, charges, and expenses up to the time of payment . The Mortgagor agrees and covenants to deliver to Mortgagee within sixty (60) days after the close of Mortgagor' s fiscal year an accountant ' s certified financial statement showing the results of business done from the mortgaged premises during such year and further covenants and agrees to deliver- to Mortgagee within thirty (30) days after written demand a detailed statement certified to by Mortgagor of such business operations during the period set forth in such demand. k:�k 1:3:i6fi Vg37 #110�40 The Mortgagor covenants and agrees that in the event the ownership of any part of the mortgaged premises shall become vested in any person other than the Mortgagor, the entire mortgage debt shall become due and payable at the option of the Mortgagee. In the event the mortgagor consists of more than one individual or other legal entity who hold the premises as tenants in common, joint tenants or tenants by the entirety, or where life estates and/or remainders and/or reversions might be applicable and the ownership of: any part of the mortgaged premises should become vested in less than the total number of such persons or entities who might collectively constitute the mortgagor, the entire mortgage debt shall likewise become due and payable at the option of the mortgagee. Any and all deposits or other sump: at any time credited by or due from the Bank to the undersigned or to any endorser or guarantor of the within note, and any cash, securities, instruments, or other property of the undersigned or such endorser or guarantor in the possession of the bank, whether for safekeeping, or otherwise, shall at all times constitute security for the within Note and for any and all liabilities of the undersigned to the Bank including, without limitation, the liability evidenced hereby, and may be applied or set off by the Bank against such liabilities at any time whether or not such liabilities are then due and whether or not other collateral is available to the Bank. If the mortgagor is a trust having transferable shares and said shares have been sold or transferred without the consent, of the mortgagee, or if the mortgagor is a trust without transferable shares and there is a change in the holders of the beneficial interest or a change of trustees without the consent of.: the mortgagee, then the entire mortgage debt shall. become due and payable at the option of the mortgagee. The mortgagor covenants and agrees that the mortgagee at. mortgagee' s sole option may agree to a postponement of the date of payment as provided for in the note secured hereby conditioned upon an increase in the interest rate called for by said note to that interest rate then being charged by the mortgagee on similar loans made by the mortgagee at the timE! of said postponement. This MORTGAGE is upon the STATUTORY CONDITION and upon the further conditions that all covenants on the part of the mortgagor herein contained shall be kept and fully performed, for any breach of any of which conditions the MORTGAGEE shall have the STATUTORY POWER OF SALE. AND I:T IS AGREED that the grantee or its assigns, or any person or persons in its or their behalf may purchase at any sale made as aforesaid, and that no other purchaser shall be answerable 13k 13bbB Vg38 # 10640 for the application of the purchase money. WITNESS hand and seal this 16th day of February 2001 Signed and sealed in presence of cam_ STEVEN A. MELE Commonwealth of Massachusetts EMUSTABLE ss. February 16, A.D. 2001 Then personally appeared the above named STEVEN A. MEJY and acknowledged the foregoing instrument to be 11IS free act and deed. Before me, I Notary Public My commission expires: Bk 1356E Pg39 010640 SCHEDULE"A" PARCELI The land with the buildings located thereon situated in Barnstable(Centerville), Barnstable County,Massachusetts,being bounded and described as follows: Beginning at the Southwesterly corner of the granted premises on the Northerly sideline of Hyannis By-pass(Route 28)and at land now or formerly of Jack Winet; thence N 7 34' 20" W by said land now or formerly of Jack Winet, 62.79 feet to a point;thence N 81 09' 20" W by said land now or formerly of Winet, I20.00 feet to the Easterly sideline of Strawberry Hill Road, thence Northerly by Strawberry Hill Road, about 183 feet to a cement bound at land now or formerly of Wilfred E. Calmus; thence S 73 11',30" E by said land now or formerly of Calmus,272.73 feet to a cement bound at land now or formerly of John M. Berto,Jr.,et ux;thence S 7 43" 20" W by said land now or formerly of Berto et ux,45.12 feet to a point;thence N 83 11' 00" E by said land now or formerly of Berto et ux,268.97 feet to an iron axle at land now or formerly of Father McSwiney Associates, Inc.,thence S 16 32' E by said land now or formerly of Father McSwiney Associates, Inc., 84.61 feet to the Northerly sideline of Hyannis By-pass,which said point is 270.00 feet Westerly from land now or formerly of Early H. Webster,et ux as shown on a plan of land drawn by Bearse& Law, Surveyors, for Richard B. Orpin and Leslie E.Parsons,dated September 4, 1969, and recorded with the Barnstable County Registry of Deeds in Plan Book 234,Page 153; thence S 78 34' 20" W by Hyannis By-pass,446.93 feet to the first mentioned boundary or place of beginning. The premises contain 1.93 acres,more or less,and is a portion of the land shown on a plan of land entitled"Plan of Land in Centerville,Mass.: belonging to Edward O' Griffin et ux, Scale 1" = 80', August 3, 1967,Nelson Bearse &Richard Law, Surveyors,"recorded with said Registry of Deeds in Plan Book 213,Page 67. Bk 1 :6568 Pg40 4410640 PARCEL II The land with the buildings thereon, situated in Barnstable(Centerville and Hyannis), Barnstable County, Massachusetts,bounded and described as follows: Northeasterly by land now or formerly of Robert S. Elliott as shown on a plan hereinafter referred to on two courses a total distance of four hundred thirty-six and 46/100 (436,46) feet; Easterly by land now or formerly of Father McSwiney Assoc. Inc., as shown on said plan on three courses a total distance of two hundred forty two and 95/100(242.95) feet; Southerly by land now or formerly of Richard B. Orpin and Leslie E. Orpin as shown on said plan two hundred sixty-nine and 97/100(269.97)feet; Westerly again by land now or formerly of Orpins as shown on said plan forty-five and 09/100(45.09)feet; again Westerly by land now or formerly of Wilfred E. Calmas as shown on said plan, seventy-six and 16/100 (76.16)feet; again Westerly by land shown on a plan dated June 1943 prepared by Herbert Richardson and recorded in Plan Book 68, Page 83,ninety-six (96) feet, Southerly again by land shown on said plan in Plan Book 68,Page 83, two hundred forty- two and 40/100(242.40) feet; and Westerly by Wequaquet Lane,one hundred forty-three(143) feet, more or less. Said parcels of land are also shown as"New Lot" and"Remains of A.M. 250 Lots 23, 24 and 27"on a Plan entitled"Plan of Land in Barnstable,Massachusetts Village of Centerville A.M. 250 Lots 23, 24 and 27"prepared for D.P. Realty Trust by Vanesse Hangen Brustlin, Inc. dated June 6, 1998 and recorded at Barnstable Registry of Deeds in Plan Book 557, Page 089. A portion of said land is shown on a "Plan of Land in Centerville,Barnstable Mass. for Marie Hallett"dated August 28, 1971 and recorded with the Barnstable County Registry of Deeds in Plan Book 255,Page 72 and is a combination of the parcel on said Plan containing 1.72 acres of land more or less and the Northerly portion of land of Benjamin J.Zalgenas,Jr. and Alita R. Zalgenas. For title see Deed recorded herewith. 9ARNSTA9I.E REGISTRY OF DEEDS Mar. 1. 2007 9: 09AM MASS DEP No. 1785 P. 1/4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE 20 Riverside Drive, Lakeville, MA 02347 508 946-2700 DEVAL L.PATRICK LAN A BOWIES Governor Secretary TIMOTHY P.MLMRAY AR.LEEN O'DONNELL Lieutenant Governor Commissioner FAX COVER SHEET FAX # (508) 946-2865 TELEPHONE # (508) 946-2851 DATE: March 2007 FROM: Roberta Edwards PLEASE DELIVER TOz Barnstable Board of Health 508 790 6304 Barnstable Town Manager 508 790 6226 TOTAL NUMBER OF PAGES: 4 (INCLUDING COVER PAGE) PLEASE CALL IF YOU DO NOT RECEIVE CONPPLETE FAX. Notice of Responsibility, Vacant Residence, 36 Wequaquet Lane I e- �a I1 This information is available in alternate format.Call Donald M.Gomel ADA Coordinator at 617-55&1057.TDD Semite-1-tU0&M-2207. DEP on the World Wide Web: hhpMyww.mass.govldep 0 Printed on Recycled Paper I Mar. 1. 2007 9: 09AM MASS DEP No. 1785 P. 2/4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PRO rya r � SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE DRIVE, LAKEVILLE, MA 02847 308-946- DEVAL L.PATRICK IAN A.BOWLES Governor Secretary TIMOTHY P.MURRAY ARLEEN O'DONNELL Lieutenant Governor Commissioner --URGENT'ZZGAL MATTER:PROMPT ACTION NECESSARY February 22,2007 Steven Mele RE: BARNSTABLE-BWSC 56 Lakeview Drive Vacant Residence Centerville,MA 02632-1417 36 Wequaquet Lane,Centerville RTN#4-20309 NOTICE OFRESPONSIBILITY M.G.L.c.21E,310 CAR 40.0000 ATTENTION:Mr.Mele On February 7, 2007 at 4:12 pm the Department of Environmental Protection ("MassDEP") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions.An undetermined quantity of#2 Fuel Oil was released from a vandalized oil feed line. The release impacted the basement of an unoccupied residence. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. e.21E, and the Massachusetts Contingency Plan (the "MCP"), 310 CUR 40.0000,require the performance of response actions to prevent harm to health, safety,public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the turns and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe-that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in this letter, "you"refers to Stephen Mele)are a Potentially Responsible Party(a"PRP")with liability under M.G.L. e.21E §5, for response action costs. This liability is "strict",meaning that it is not based on fault, but solely on your status as owner, operator, generator, transporter, disposer or other person specified in M.G.L. c.21E§5. This liability is also "joint and several",meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. II This information is available to alternate format Call Donald M.Gnaw,ADA Coonlinotor st 617.55G1057.TDD Servlcs-1.800.299-2207. DEP on the World Wlde Web: hnp:/A~.mass.pov/dep 10 Prided an Recycled Paper J 1 I v ` Mar. 1. 2007 9: 09AM MASS DEP No, 1785 P. 3/4 2 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials.By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by MassDEP in taldng such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. 0.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L.c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages,including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed bylaws which establish the time allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. At the time of oral notification to MassDEP,no response actions were approved as an Immediate Response Action(IRA). On February 8, 2007 MassDEP subsequently approved the following response actions as an Immediate Response Action(IRA). • Continued assessment. • Deployment of absorbent/containment materials. • Excavation and disposal of up to 10 cubic yards of contaminated soil. • All Remediation Waste must be properly stored/handled and disposed of within 120 days from the date of generation per 310 CMR 40.0030. ACTIONS REOUIltED Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of$1,200 be submitted to MassDEP when an RAO statement is filed greater than 120 days from the date of initial notification. Specific approval is required from MassDEP for the implementation of all IRAs pursuant to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities,the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form (BWSC-103, attached) be submitted to MassDEP within sixty (60) calendar days of February 7, 2007. You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling(617)556-1091 or visiting http://www.state ma.uOE2. Ma r, 1. 2007 9: 09AM MASS DEP No. 1785 P. 4/4 3 Unless otherwise provided by MassDEP, potentially responsible parties ("PRP's") have one year from the initial date of notification to MassDEP of a release or threat of a release,pursuant to 310 CMR 40.0300,or from the date MassDEP issues a Notice of Responsibility,whichever occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two submittals for this disposal site is February 7, 2008. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP. If you have any questions relative to this Notice,please contact Andrew L. Jones at the letterhead address or at (508) 946-2785. All future communications regarding this release must reference the following Release Tracldng Number:4.20309. very truly yours, ecv, a7,— Dan Crafton,Acting Chief Emergency Response/Release Notification Section C/A X= PM-20309-iORdoc Attachments: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L.c.21E MassDEP's guide to hiring a Licensed Site Professional. fc: Board of Health Board of Selectmen cc: B e Fire Dept. C ;r P.O.Box 94 C 4'n"r� Barnstable,MA 02630 4X4 d Town of Barnstable P O Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main.Street, Hyannis, MA 02601 WE .MEN_ i3�"�w. MMx'.a.�'..:.T J;,'r 101�`%s.,. DATE: 3 6- NUMBER OF PAGES TO FOLLOW: TO: FROM: NAIL ls' 4r DCAVI 4o PHONE: PHONE: (508)862-4644 FAX PHONE,-, 7 l 0 , 3 FAX PHONE: (508)790-6304 cc: � Y yi 1 *.,,,_':S "��'�, a NOTES/COMMENTS: QAFax Form.doc I t. 1 ' � I �l dS CENTERVILLE-OSTERVIL LE.,MARSTONS MILLS FIRE DISTRICT 1875 ROUTE 28 j CENTERVILLE, MA 02632 iI (508)790-2380IFAX6(508)790-2385 1 � i i OILIHAZARDOUS MATERIAL RELEASE FORM F.A.#_„�a�l- 38a i �l s LOCATION: ' ADDRESS OF RELEASE:_?,I„ Ec��4c�� � L-NoZ 1 DATE OF RELEASE:_.._ i� -rZ� D2-0-7-0-7 PRODUCT RELEASED.,�uy I ESTIMATED QUANTITY: uF -312 CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY: TiEMovAI CU�s.►t.�c�R. nI,t� �. -'�t,a��n�a;►o,J--� S2E.+aa�� � F;t.7c_�Ss RyS��SP �sS�U� �yCZ.. C.1ySZV1JME+.)TAI. COb.a i�tANA�-ZQhr, ���� NOTIFICATIONS: { FIRE DEPARTMENT: YES(}() NO( } DATE: CUB-0-1-o-7 TIME: 1600 NATIONAL RESPONSE CENTER YES( ) NO(>() DATE:_ TIME: M, 1 DEPT. OF ENVIRONMENTAL PROTECTION YES(x) NO( ) DATE:,,a2o7 TIME: OIL SPILL COORDINATOR: YES( ) NO(x) DATE: TIME: t r TOWN BOARD OF HEALTH: YES(X) NO( ) DATE:�)-2-0-7 TIME: J�ac TOWN HARBORMASTER: YES( ) NO(yj DATE: TIME: OTHER AGENCIES: -3.ptar n L r COMMENTS:..,1 SBA �12���? ?L•� �1^- '���7An� �sz cxancx•-) - C'�xiacn ;i9 Rt 0146 - 1��1 "?ao'�uc.5 fi2saM 1.i�J�i� - iaNK Is .37lff [jvAtjm ric -?ttr�uci 2a Y'(1t7+ s,� ..ire ltJt��7C� �j" Ai"1 - w REPORTED BY: DATE: t ;)-Sad' 0­7 WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.E.P. PINK COPY-BOARD OF HEALTH 1 C-0-Mbi FORM"8 (I ' i r �_ iS2iis�fa3 "kr' ' A; EPA-R'M TN OF EIN`VI?€��? �T `p l r' NOv 2 i 200Z TOWN OF BARNSTABLE HEALTH DEPT. Til ' PA.r'A Pry ,r-y.•A-c � MAP Owner's im. { '6' v+. 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S)are rcp- c re=ed- NO ccx�iaix o OIFIRCLAL FORM-NOT FOR VOLUNTARY ASSE S�'-� SUIRSUIRFACE SEWAGE ISIPOSkL SYSTEM UNIT SPE O-IN FORM PAR Date ofc€ion_ _ O a Farther Ev2hwfiom is by the of HeCkh: Co--t winch require frrdieer evah s)a by the Board of: �orci�ro�cir�i<�e :5j,jMg€o Dra-t_=MM nea3ty, o=:L--�v .en i_ System vrill pass unkss of H—kh deter es ir, a_rd2nce with 310 CMIR 25-303(11)(b}that time system is aot m a warner which wM p public beallfil,saf i!ry aP-d the envr�ay ~ C.•Ici navy is wi din 50-fied of a _ C oo=or pm.-;4 is'ImhM 50 of a b etam Yid Or a salt ash 2. Sys em yr:Ai fau unless the 3cara©f `ea?ii:(and 3PuYlk Wester Suvp ,if any)determn-nes that fite system is Tuntdming in a tenet- p-retects the public thealth-s^ ,r and ea-n-rot-me-mr- !ie s}5ac x has a Septic' an-a soil ?`Sorp-don 5,vsz-m-(SAS)azd the SA'S is wi-lir, 100 I'M Of B s'm5m=ri"za .Sv ly or-s z" ! to 2 -wateru5--7_ply- ve system. IMS e S=V ter,-c aza SAS a-rid the SAS is vnithin a Zone ? of a?obim V+a€er sLppiy- i.e sy�. ?as a sic ad S�S and&e SAS is e 50 3� a nvam� s ; r_�ari�.,�sws st=��.s-s .c mA�- and SASS± mace.me SAS isless 100 ixa 50 feet or€ ore a te xftnr i r;�S�+sie31] if d=W-01 wam-r analysL, t 7r.P terrified laboratory,for i.:#'L{O L ke presence Of •affia nit oath andFcFC fa�s'6.iEl is equal to or Less dr. ii 5 pi}: Rrovided hoax w admr faiiw-_trite- irigg�ea-A copy of ihe amhysis must be aaache to tb�s form 3. Gther- FOR. -N, WART A Jo�r. �'� s9 {3PSzA3C "c.� ..+�/ �SAS .� o ' �����lRs��'� ��� Ja-.SZY���M 52Y Tyn75+li=Vi a G 3��c^�3 -tS 3'..:`e:�.emu Sr+.r'^"T` - ih D z'�ssi 3 G- sf ���..til 3U T-em SY '* t pft- 'omed ata DzP :dtabo_a � -cam 83 C,-Myr`sibe� Yesn'-0) system ` �31S.3 a3a �, "awM.����... � bZ cad System ttt�e�must 3 Ta.SSC �Ei�":cd�cs+'�'ft<�e��XZ-iLs ` An t_ '~ i y!�'* '- ' w E' `Sys,--�-is # 3� '� a S ��� s - ice:Si'� S y-,r' ..£ ..�"'v � L'1' c. `.s 8s'z ::�d" •{ y rM Meat OM, CIAO "Z CTI- '-N-FOB — O t FOR VO —N-TARY S-F-�5� 'N:TS SUBSURFACE SE kGE DISPOSAL SYSTEM E ON-11FORIM PART B PrGpet-t-Ark&ess- b 3 e4.XiTef kkX -r: S Date of i tiam: If a i62.to!M ME 'done_ Y'-'c maw iz&caze"Yef or-n:;"es-to eact Of k es NO r Pumcming @z To--.ac.Fon z as pmv---de s:b ;he own::,cc--%p2nL or Z3cT Of Hie t- --e 33J of the System 3 3�v Y 0m,in 3!'Be m ev?E3t-S--va v`lw2- Has t'---System received normal bows it the previous two;V�peric�. 7- Have:fie voitume'S of wee;-bv=?n?'oemc*d zo the sysmm r". =dly C: as pa:oft baspec2im W`yam as bmir-v.am. o_i2 e Sy� 35�obtained andexi aq�°—:i+�ni?r-� �5�.�,•.2.�m..�t3G.2�_�...iSv'1{�G +YIAf Was the�H'Ey or dw'elibme inSpe,---ed`sir signs of SV-WP,*ebzCk= ? r Was mh e site ,-Sp fc;sirs of-brealk om Were zi Cam—��monnejzs,exthadiag the SAS-_ Cm.site N�'e The Sepik mz):K uncove---i operm-a:id'fhe 333a`�+30t of the m,-k impecr"d for the cond-hion o> es or-l.es, ctcox-=s u se. ions,= o` r.:: deist of s:ud-get ma de=of scam ? _he ii=ti overlaid oc- �=rs ifdif_—::t-t-orm owrrei)provided with infronrarion oa-me proper zr e of sui;sr_� e stvt?ge d sUOSW s;SIems' 'T'--=sbZe and lomfica'Of the Soil ;'er-piien System tS—AS)m:he sne has b" ft£erm b Cm: P--ism-e jniO3',�'.a�-ori For Sze,a iaian-at the cf�;ca-I:h- +/1 r bezerinizied in idle field(i ar`V o:the.aihze in--ia-relzied.to art e is W--issue apprOxImmat-m..Of.d S=ICr 1'ii1F{ ic3!e i 3 0'-- s 3 3,0 sf 3,ri -'ICE: smo-W FORIM-- urFmvm- lTff?r _ PAX.C RW m A'ff?-lm e� FLOW COMTI-lom RXS�'D MIAL o€�� ale&uam J— a sue _ S:4=era m- �0—s Last 11-M aIfO=vpMCY--Zt�e Benms rax Wig. -A Grease-- pnem—,PZ w —,.. -- - Last de----c pump Was rs cas:be .erg=cr not ovexff _ — idm to ^ a Cop:Eases DEMP (e > O-k—kIC" sPECTIO-,N,- OK'd-NOT OR V€$ILUNT P a ASSESSMENTS SLTBSL '-ACE SEWAGE DI5 '€ S_ SY SPE ON FORS 7AJR T C of€ns�"m: 13T3-aM T—K-G SE Vv--;r R r OL•sr—P!a--) Lt gade Ebf La: i3L cast� V 40 PVC (CXP : Co enLs{on ccar-�op-of T� `�`* cz.. c:of LP Dst:il:biejQw grade: :=`mac is ne_ai Is Vie:— is a?e ccnnr eci y a C Lcaw of Ct�m -ance(,y'es or no): iJ=�i�tsly 5: ��n C`o pdr Ds'—ce 570m cov o` �e.t�ecs v L of sir;sei:ce er sa e: 5cmn: e t rnes :__� I— tr Dis3a-sca L orn top of sr~--to wp Off aude2—tom'sae: ZD r Slo },we---dm-eos oos dczm--.=� F ^etF t w ':e C, t Ir3L' ,Sia T"'�-+'-grLY,ii£'�L`.�d leNe-IIs ?3ite °Iite t aT: . r3 leakage, C-t fL� 4 G GREASE T.AP-`0110CM Mr see P: 1 M.-n-erialt of C?nsS 'i� iQI3^s'e :—r—t'o7�w'g1 3L`_�Y ewe J'tt�e7 ✓.��iSI£T�5' �LZTI !h;ck ess: Dice�&-- top of sc= aop of ot.:eiet tee ar br—m-Ifflr: Distance L-om�O% tiffs.to�3£iOs41 4f;rL{dc?F?�Or �ame; Dam-el rL.l,,t_�?s'�?eu £�:3 .• - 3L:�'irl,�^ 3 a'te3 ".$: ieF 3` 0;£ae£'Q�LY3e�e C G�3�.S"�Caff:2I as red- i crti-' t j:veM evidence of iea cazzae, f: i OFMCIAL S YMONN FORM-INFOIFFM VOLUNTARY ASSEESM�IN .SUBSURFACE SEWAGE DISPOSAL SrEMI ON FORM PART C STEM-MOAON(cam; -P-mperfy Ad W e oat s �af��• tt �a(o'�. 1%18 ial of ra cti= concreft Des*-a Flow- level: _ :� ; teems{w �� _ m fmsOldeex es, —r Comm (now.-if b(---is aE± `j'� d list t,Avion zs acdets eq mt,awy,ewidence of soi-ids mover_any ev-_�of into'•fie �c ar of�.a.; .��- � C O j7M?- ;JVOM 'fl�ts Site � ps in vro CT dyes or�-my: Ass i�•tea�izr(��r ,: _ su2TS"nos 0�10 zi;s mc Qrt,--_%cq 6,mi'd _10 szc) mimm-lo M_d;a ol -.U�U VCX -dsm4 la uqedse� -los ,s-_oj__-u;nLmjp _mqumma'spjag;chal ma—, sz�rmil Tle- mea, T d waTLS7,s NxmixaOsev mos -XIM- ow lou U-S mow.�*d� :xamlao 0 wa- -la jbaouvj 02, k ISAS Z AT3 -!,SAS Wso aavmas aDVA'�_Frks -doa 1C.&T—I&THOA:MOLIDUISIA9,TVIDI-140 1► r CIE YSEW wpose