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0050 OCEAN STREET - Health
350TOcean-Street;Hya n.i�, �A d Chris s r i I 1 I o Vegrvowj of ftnstable atoe ices Richard V. Scali,Director oFt"e�w Public Health Division* BARNSTABLE ASTABLE, Y Thomas McKean,Director 16;"a;Ws''°ren 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 Av's *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. petLtK-0-AjA-t 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,I DICAT THER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HA_z s unn _c AAr_A T_L'D_T_A GREATER THAN HOUSEHOLD QUANT :. 4. FULL NAME OF APPLICANT: i SPEEDWAY#2437 50.OCEAN STREET 5. NAME OF ESTABLISHMENT: HYANNIS, MA 02601 _ 6. ADDRESS OF ESTABLISHME 7. MAILING ADDRESS (IF FERENT FROM ABOVE: 8. TELEPHONE NU R OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. W PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT TE Q\Application FormsUiAZMAT APP 2017 REVI D.docLc ICENSE COOF5021NATOR /J6 ^uzZ �"f•�eli3 Environmental Services ND July 13,�, 017 -r7 Paul Cniff, Chair Town ofZarnstable Board of Health 200 Main Street Hyannis, Massachusetts 02601 Re: Availability of a Permanent Solution Statement Speedway Store#2437 50 Ocean Street Hyannis, Massachusetts 01603 MassDEP RTN 4-26238 Dear Mr. Canniff: In accordance with the Massachusetts Contingency Plan (MCP) as set forth at 310 CMR 40.1403(3)(0, notification is hereby made that a Permanent Solution Statement was submitted to the Massachusetts.Department of Environmental Protection (MassDEP) for the above-referenced location. Between July 27 and September 6, 2016, leaks from underground storage tank (UST)- related piping were identified within submersible turbine pump (STP) sumps located above each of the three USTs at the location. There was no evidence of a release to the environment. The affected USTs were taken out of service, and the contents of the USTs were subsequently removed. The leaks constituted a Threat of Release (TOR), which was reported to MassDEP. The USTs and associated piping and dispensers were removed on June 13, 2017. Soil observations and screening and analytical data obtained during UST system removal activities demonstrate the absence of a release at the Disposal Site. As a result,the TOR was eliminated and a Permanent Solution with no Conditions was attained for the TOR. A copy of the report can be obtained from EnviroTrac, by calling (781) 793-0074 or by sending a request in writing to 2 Merchant Street, Suite 2, Sharon, Massachusetts 02067-1630. Sincerely, EnviroTrac Ltd., Patrick D. Corcoran, LSP Senior Project Manager cc: MassDEP SERO Speedway LLC 2 Merchant Street, Suite 2, Sharon MA 02067(781)793-0074 Fax: (781)793-7877 www.envirotrac.com o Commonwealth of Massachusetts Executive Office of Energy & Environmental Affairs Department of Environmental Protection Southeast Regional Office•20 Riverside Drive, Lakeville MA 02347 .508-946-2700 Charles D.Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner August 17,2016 Corey Damron RE: Barnstable:Speedway 2437 Speedway LLC 50 Ocean Street 500 Speedway Drive Barnstable, MA 02601 Enron,OH 45323 MassDEP Facility ID No.327390 DFS Facility ID No.1092 NOTICE OF NONCOMPLIANCE: NON-SE-16-0007 THIS IS AN IMPORTANT NOTICE. FAILURE TO TAKE ADEQUATE ACTION IN RESPONSE TO THIS NOTICE COULD RESULT IN SERIOUS LEGAL CONSEQUENCES. Noncompliance with M.G.L.Chapter(s) 21A,21C,21E,210,310 CMR 80.00 Dear Mr. Damron, During an inspection conducted on August 1,2016, Department of Environmental Protection ("MassDEP") personnel observed or determined that activity occurred at Speedway 2437,located at 50 Ocean Street, Barnstable, MA, in noncompliance with one or more laws,regulations,orders, licenses,permits,or approvals enforced by MassDEP. On those dates,MassDEP conducted a field inspection of the underground storage tank (UST)system at the facility identified above. Enclosed please find a Notice of Noncompliance,an important legal document describing the activities that are in noncompliance.This Notice lists the violations)and those action(s)that are required to achieve compliance. MassDEP's Notice of Noncompliance is based on the observations and information reviewed during the inspection. This Notice does not: (1)apply to actions or other aspects of the facility that were not reviewed during the inspection, (2) preclude future inspections of past,current,or future actions at the facility, (3)in any way constitute a release from any liability,obligation,action or penalty under 310 CMR 7.00,310 CMR 80.00,or any other law,regulation,or requirement,or(4) limit the MassDEP's authority to take,or arrange,or to require any facility to conduct,any action authorized by 310 CMR 80.00 which MassDEP deems necessary to protect health,safety, public welfare,or the environment. This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5761.TTY#MassRelay Service 1-800439-2370 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper NON-SE-16-0007 Page 2 If you have any questions regarding this Notice, please contact Daniel Gavin at(508)946-2776. Sincerely, Daniel DiSalvio Compliance and Enforcement Chief Bureau of Air and Waste D/DG/Ig W:\Document Prep Folder\BAW\C&E\Gavin\Speedway 2437 UST NON SE-1E-0007.docx Enclosure CERTIFIED MAIL#7014 2120 0003 6904 2481 Cc: Speedway 2437 50 Ocean Street Barnstable,MA 02601 Barnstable Fire Department P.O. Box 94 3249 Main Street Barnstable, MA 02630 Gordon Bullard, MassDOR bullardgh@dor.state.ma.us Barnstable Health Department 200 Main Street Hyannis, MA 02601 Ec: DEP-SERO ATTN: Lisa Ramos, REO ATTN: Daniel DiSalvio I ® Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Lo Department of Environmental Protection Southeast Regional Office•20 Riverside Drive, Lakeville MA 02347.508-946-2700 Charles 0.Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner NOTICE OF NONCOMPLIANCE THIS IS AN IMPORTANT NOTICE. FAILURE TO TAKE ADEQUATE ACTION IN RESPONSE TO THIS NOTICE COULD RESULT IN SERIOUS LEGAL CONSEQUENCES. Based on the Department of Environmental Protection's ("MassDEP") investigation on August 1, 2016, noncompliance occurred at Speedway 2437, 50 Ocean Street, Barnstable, MA, in violation of one or more laws, regulations,orders, licenses, permits or approvals enforced by MassDEP. This Notice of Noncompliance describes (1) the requirement violated, (2) the date and place on which MassDEP asserts the requirement was violated, (3)either the specific actions which must be taken in order to return to compliance or direction to submit a written proposal describing how and when you plan to return to compliance,and(4)the deadline for taking such actions or submitting such a proposal. If the required actions are not completed by the deadlines specified below, an administrative penalty may be assessed for every day after the date of receipt of this. Notice that the noncompliance occurs or continues. MassDEP reserves its rights to exercise the full extent of its legal authority in order to obtain full compliance with all applicable requirements, including, but not limited to, criminal prosecution, civil action including court-imposed civil penalties, or administrative action, including administrative penalties imposed by MassDEP. NAME OF ENTITY(S) IN NONCOMPLIANCE: Speedway 2437 50 Ocean Street Barnstable, MA02601 (hereinafter referred to as"Respondent") LOCATION(S)WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED: Speedway 2437 50 Ocean Street Barnstable, MA 02601 DATE(S)WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED: August 1,2016 This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TTY#MassRelay Service 1-800-439-2370 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper t NON-SE-16-0007 Page 4 of 5 DESCRIPTION OF NONCOMPLIANCE: The Department's investigation shows that the"Respondent" had the following violations: 1. Respondent's UST system employs continuous monitoring of the tank and piping interstitial space for purposes of leak detection. The UST system piping interstitial space is configured of single wall flexible pipe routed within flexible containment conduit or rock-guard. Test boots installed for initial or upon system installation testing of the piping interstitial space were observed to be still tightly installed thus preventing the open communication of the interstitial space with the liquid level sensors in the tank top sumps and therefore compromising continuous pipe leak detection. This constitutes a condition of noncompliance with 310 CMR 80.19(4)(a)1.c. 2. Respondent's UST system incorporates an intermediate piping sump that houses an interruption o- the piping interstitial space. This sump is not monitored by the UST ATG through a liquid level sensor. An intermediate sump that is not monitored is a trap or_pocket and is prohibited per 310 CMR 80.16(14). This constitutes a condition of noncompliance with 310 CMR 80.16(14). 3. Respondent's UST system tank top sumps contain debris. This constitutes a condition of noncompliance with 310 CMR 80.27(2). 4. Respondent's liquid level sensor in the regular grade product master tank top sump was in a raised •position. This constitutes a condition of noncompliance with 310 CMR 80.27(3). Be advised, Respondent's UST system's piping was identified by inspection on February 29, 2016 and the inspection on August 1, 2016 to be Enviroflex 1500 yellow piping single wall flexible piping routed within containment conduit. This particular make and model of piping has history of failure and is of concern for continued use. MassDEP advises Respondent to address this concern by replacement of all of this particular piping at their facilities. ACTION(S)TO BE TAKEN AND THE DEADLINE FOR TAKING SUCH ACTION(S): The following action(s) to be taken have individual deadlines associated with them. The Facility shall take the necessary, steps to correct the violations within the specified deadlines as noted and shall return to compliance with the requirements described below. MassDEP's regulations at 310 CMR 5.09 presume that you receive this Notice of Noncompliance, if delivered by regular mail,three business days after it was issued (i.e.,the date of the cover letter). Furthermore, the Facility shall submit a written response within fifteen (15) days of receipt of this Notice, acknowledging receipt of this Notice, describing the actions already taken, and describing actions intended to be taken in order to achieve and maintain compliance with the Regulations. 1. Within three(3)days from the date of receipt of this Notice,the Respondent shall open up the piping interstitial space to the sumps as required by 310 CMR 80.19(4)(a)1.c. 2. Within thirty(30)days from the date of receipt of this Notice,the Respondent shall install continuous monitoring in the intermediate piping sump as required by 310 CMR 80.16(14). cR NON-SE-16-U007 Page 5 of 5 3. Within seven (7)days from the date of receipt of this Notice,the Respondent shall remove solid debris from the tank top sumps as required by 310 CMR 80.27(2). 4. Within seven(7)days from the date of receipt of this Notice,the Respondent shall install the liquid level sensor in the regular grade product master tank top sump at the bottom of the sump as.required by 310 CMR 80.27(3). By: Daniel DiSalvio t Compliance and Enforcement Chief Bureau of Air and Waste Date: Massachusetts Fire Incident Report Hyannis Fire Department LTo�� 1 2 2003 ( _ C9 _r ! t,Fa,Lry OErT • Date of Time Of Arrival----T-ime-I.n, FD.I'D Incident No. Exposure #. Incident Day of week Call Time Service 01922 A230960 0� 9/ 03 Friday © 7 :25 7:29 08:26 Address zip Census Tract 5 0 Ocean Street 4-67 1 Hyannis 4 0 Type of Situation Found Type o Actio aken Mutual Aid 41 Spill/leak W/o Ignition 41 1 4 Remove Hazard Fixed Property Use Ignition Factor "uncovered Parking Area." 9 6 5 00 No Fire Found Occupant Name Occupant Telephone Mcgrath, Michael U. S. Food 61 7-3 8 9-3 3 0 0 Owner Name Owner Address Owner Telephone U. S. Food Service I JEverett, Ma. 61 7-3 8 9-3 3 0 0 Method Of Alarm Shift No Of Alarms # of Personnel Responded Hazardous 1 Telephone �. �A 1� 0 "es Engines Tankers Aerial Other.Vehicles 64 1 ___ 0 � is Fatalities ;<O;;,r, - - "" Injuries 0 .!. -: {Fatalities 0 Resouesl Fire Service Other Injuries In ur.es ,0 , :: *'Mob ile..P rope rt _Use.__ _._. __l Is--Car Stolen` ``�' _._. ... ..._Insurance Company. ___ .... ...�:•alb. .. . Mobile Property..Make Year Model Color ,.;, License Number .,.. VIN: Complex Area Of Origin Estimated Loss Equipment Involved In Ignition Form Of Heat Of Ignition If Equipment Was Involved In lqnition Material Ignited Year �Make Model Equipment Serial Number _ Method of Extinguishment Level'Of Fire Orii ig n Number Of Stories Construction.Type Detector ,Performance Sprinkler Performance Extent Of Damage _... .. .. ,ih7 " .:—, t , ..s, Flame _ __.. ._ Smoke ;.,Material GeneratingvMost Smoket f,F3i o Type OfJIMaterialj Gene ratinJ':M& Smoke i .--.Avenue Of Smoke-Travel - Weather Conditions Commanding-,Officer Rainin- - 0 ......, Cat C. Farrenkopf Report By JCapt C. Farrenkopf F HYANNIS FIRE DEPARTMENT - INCIDENT REPORT COMMENT PAGE Incidenj No. IA230960 Address 50 OCEAN STREET4-67 Date of Report 9/05/2003 ommanding Officer lCapt C. Farrenkopf Report By lCapt C. Farrenkopf FIRE ALARM RECEIVED A CALL FROM THE MANAGER OF CHRISTY'S 50 OCEAN STREET REPORTING A LARGE DIESEL SPILL IN THEIR LOT. CALLER PETER [508-775-2627]STATED THAT THIS SPILL FROM A DELIVERY TRUCK HAPPEN ABOUT THIRTY [30] MINUTES AGO?????????? ARRIVING ON SCENE,OCEAN STREET,WE FOUND CAPE WAY TOWING ON SITE,SPEEDY DRY,AND ABSORBENT PADS DEPLOYED,AND DEAN SPEAKING WITH A TRUCK DRIVER. TRUCK WAS PARK TOP SIDE OF LOT NEXT TO OCEAN STREET. THERE WAS AN OBVIOUS SPILL PRESENT. INVESTIGATING WE SPOKE WITH DEAN FROM CAPE WAY WHO TOLD US THERE HAD BEEN A PROBLEM WITH THE FUEL FILTER AND HE HAD SECURED THE LEAK. DEAN ALSO SPREAD THE SPEEDY DRY AND PADS. THERE WAS ALSO THREE TWO GALLON PLASTIC CONTAINERS THAT THE DRIVER WAS USING TO CONTAIN THIS SPILL PARTLY FULL OF FUEL. DRIVER MR.MCGRATH HAD CONTACTED HIS MAIN OFFICE IN EVERETT AND THEY CONTACTED THEIR CLEAN-UP COMPANY CYN ENVIRONMENTAL SERVICE OUT OF STOUGHTON MA. MR. MCGRATH TOLD US THEY WERE SENDING A CREW FROM STOUGHTON AND WERE EXPECTED TO ARRIVE SOMETIME AROUND 08:00 HOURS. INVESTIGATING FURTHER BOARD OF HEALTH MR.DAVID STANTON R.S.ARRIVED ON SCENE,OBSERVED THE SITUATION,AND DIRECTED THE CLEAN-UP COMPANY CYN IN HOW[HE]BOARD OF HEALTH WOULD LIKE THINGS TAKEN CARE OF. DEAN FROM CAPE WAY MADE NECESSARY REPAIRS[REPLACED FILTER]MADE SURE THE LEAK HAD STOP,STARTED THE VEHICLE,AND MOVED IT OUT OF THE WAY SO CLEAN-UP COULD PROCEED. MR.MCGRATH WAS HEADED FOR THE STEAMSHIP WHEN THIS INCIDENT OCCURRED. AFTER CLEARANCE FROM THE BOARD OF HEALTH MR.MCGRATH LEFT THE SCENE AND MOVED TO THE PARKING LOT OFF SOUTH STREET, STEAMSHIP AUTHORITY. CAUSE:DIESEL FUEL FILTER LEAKING. DRIVER: MR. MICHAEL MCGRATH 8 PHEASANT LANE,WOBURN MA. 01801. LIC: # S46039472 D. O. B. 10/15/1951. TRUCK:SINGLE AXLE LARGE FOOD DELIVERY TRUCK, U.S. FOOD SERVICE REG:53357 MA. # T2924-ST261 U. S. DOT 358597 EVERETT MA. 617-389-3300. CLEAN-UP COMPANY: CYN ENVIRONMENTAL SERVICE STOUGHTON, MA. 1-800-622-6365. FORMAN: MR.JAY ROBERT 174 FOREST STREET,WEST BRIDGEWATER MA. 02379. D. O. B. 06/30/78 LIC: 3 S40815278. BOARD OF HEALTH MR. DAVID STANTON R. S. 508-682-4644. 200 MAIN STREET. FF. R.STORY, FF. R.CLOUGH. WEATHER CONDITION: RAINY,WARM,WIND OUT OF THE SOUTHWEST ABOUT 2 MPH,T 680 F. FARRENKOPF, C. CAPT. 09/05/03. r ilk Mike Is Petroleum Service Inc. 15 Jan Sebastian Way - -- -- Sandwich, Ma 02563 508-888-8785 800-564-0311 ?/ fax 508-833-0186 November 1;i995 Hyannis Fire Department �EN�10�R�;REAu" 95 High School Road Ext. pR� Hyannis, MA 02601 °°HEAR IRE FIRE DEPARTMEN g5 HIGN SCN041. MA 02601 To Whom It May Concern: H`tFNN1S, This letter is in regards to the-Christy's Market#122,located—on O—cean Street, Hyannis1 MA. — lS On October 31, 1995 we tested three line leak detectors and six crash valves at this site f for operation. This test was completed in strict compliance with the latest CMR-9, Federal, and NFPA requirements. The crash valves and line leak detectors are operational. � s If you should have any further questions, please call us at the above noted number. Very Truly Yours, Mike's Petroleum Service I 'c ael R Camara President Enclosure cc: Barnstable County BOH Tom Wilburn j L �ptHETpy, Town of Barnstable Department of Health, Safety, and Environmental Services MUWSrABLE, MASS. Public Health Division t63q. �0 '°TEn tit& 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 9, 1997 Christy's Market 50 Ocean St. Hyannis, MA 02601 RE: Underground Fuel Storage System located at 50 Ocean St.,Hyannis and listed as Assessor's Map 327,Parcel 264. Dear Sir: Our records indicate that you have three(3)fuel oil.underground storage tanks that are presently unregistered with the Health Department. You are now required by the"Health Regulation Regarding Fuel and Chemical Storage Systems" published in the December 17, 1987 issue of the Barnstable Patriot,to register your underground tank(s) with the Board of Health. Please complete the enclosed Registration card(s). Include any evidence of the date of purchase and installation,a copy of the permit from the Fire Chief,and a sketch map showing the location of such tank(s)on the property. Upon entire completetion of the Registration card(s),you will be issued a brass valve tag(s)by the Board of Health. These valve tags shall be picked up by you or your representative at the Health Department located in the Barnstable Town Hall. The tag(s)shall then be attached to the filler pipe/cap of the underground tank(s). Please return completed Registration card(s)to: Town of Barnstable Health Department,P.O.Box 534, Hyannis,MA 02601,as soon as possible. You are required to comply with this regulation by 1995. If you have any questions,please telephone(508)790-6265 for Donna Miorandi or myself during office hours. Office hours are Monday through Friday from 8:15-9:30 a.m. and 1:00-2:00 p.m. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health of Town of Barnstable xsTns> s Department of Health, Safety, and Environmental Services 9�A 1659. ,0� Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-8624644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health December 17, 1999 Ron Gass Christy's 50 Ocean Street Hyannis, MA 02601 Ir ORDER TO COMPLY WITH THE BOARD OF HEALTH FLOOR DRAIN REGULATION,PART H,SECTION 1.00 You are hereby notified on September 28, 1999, the Town of Barnstable Board of Health adopted the attached Floor Drain Regulation. All owners/operators of facilities with floor drains connected into a leaching structure have three options: 1. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separators). These tanks are for non-hazardous, industrial wastewater. If solvents, antifreeze, oil and other fluids are washed down the drain,the waste is likely to be hazardous. 2. Connect the floor drain to a municipal sewer system, if available. An oil/water separator is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million(10 PPM). 3. Seal the floor drain. Contact your local plumbing inspector for the appropriate filing form. If choosing this option, all previous discharges to the drain must be eliminated at their source. For example, cars should no longer be washed and floors should no longer be hosed down. Therefore, you are directed to comply with the Board of Health Floor Drain Regulations by informing this department in writing of what your intentions are to comply with the regulation within ten (10) days of receipt of this notice and by completing the work within ninety (90) days. You may request a hearing if written petition requesting same is received within ten(10)days your receipt of this order letter. Failure to comply with an order of the Board of Health may result in a fee of not less than $200, nor more than$1,000.00. Each day of failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH _ •s- omas A. McKean Director of Public Health Enc. Board of Health Floor Drain Regulation cc: Ed Jenkins,Town of Barnstable Plumbing Inspector i Stanton, David From: Burgmann, Bob Sent: Monday, May 23, 2005 8:55 PM To: Stanton, David Subject: Re: Oil water separator Dave, If they have an oil/water seperator, I am not aware of it. We get involved in seperators for connection of floor drains to the sanitary sewer. They do not have floor drains. They may have catch basins with hoods. But, I doubt a true oil/water seperator. You might want to check with Robin in planning to see what her Site Plan Review files may show. Bob -----Original Message----- From: Stanton, David <David.Stanton@town.barnstable.ma.us> To: Burgmann, Bob <Bob.Burgmann@town.barnstable.ma.us> Sent: Mon May 23 10:03:26 .2005 Subject: Oil water separator Good Morning Bob, I am just checking to verify that the Christy's gas station at 50 Ocean Street, Hyannis (map 327-264) has an approved oil water separator in the SE corner of the lot connected to the storm drain. They had a small fuel spill that was released into the drain and they said it did have an approved oil water separator on that drain that they were mandated to put in. Thanks, David W. Stanton, RS Health Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 Direct phone: (508) 862-4647 Health Dept. phone: (508) 862-4644 Health Dept. fax (508) 790-6304 1 TO 0 $TLE �s t. .- •6A'rr'+ - "._;:'y{x.^"- -5r...:� :.k�3 Q F BARN AB �* _W 2072 !Y Ordinance or Regulation lation r g a WARNING NOTICE 1 Name of Offender/Manager PC{�-� �irOr.12 ,, Address of Offender_-So Oct, S47" /�,�a►v� MV/MB Reg.# Village/State/Zip Business Name C�N-t.c j S / ctic/ /(f —77-6-© 3-� am/al on �r /v .19z /mac✓ �^ / (� Business Address Sd 4CCcw,��G klG�l�Y (. !'-.I3►, Signature of Enfpr6ing Officer Village/State/Zip Yct Location of Offense a2ct .Shy Gch,o ArQG141(11 .Enforcing Dept/Division /� / -T 1 Offense ..lj`/'drG . X XXI Z� PY((. �..Zc 41j -�4-*4_C/1 Facts0, 6ef `VIV 3 4Q!/` ..5.`w i 4 V-1 (ram tjtil ) 94-C .4-1-Itkc Zy k d Y4 C1 g ro "A This will serve- only as . a.,,warning. At. this time no, legal action"has :been :taken. It 'is the, goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations Education efforts and wa g : rnin 'notic:es .are g attempts to gain voluntary compliance. Subsequent violations will result in , appropriate:.legal action .by the Town. �, Z (_"'r -;j G' J . .., _^' t...,...,.J!..t . :', ..✓H Yl �paa��olt�`aQaac� �eficr��a� r�xe V ea�sicea -Q Notification for Storage Tanks Regulated Under 527 CMR 9.00 Forward completed forrn,signed by local fire department,to:Mass. UST Program,Dept. - -a - of Fire Services,P.O. Box 1025-State Road, Stow, MA 01775 - Use Form FP-29OR to notify of tank removals or closures in place. Date Received: .3 9 Telephone (978)567-3302 Fire Dept. ID# O/ 3-�— (Fire Department retains one copy of FP-290) Fire Dept. Sig. ❑ A. New Facility(see instructions,111) JA B.Amended ❑ C. Renewal • JSTRUCTiONS: Form FP-296(Notification for Aboveground and Undergidund Storage Tanks)Is to be trompleted for ach location containing underground or aboveground storage tanks regulated under 527 CMR 9.00.'If more than five Inks are owned at this location,photocopy the following pages and staple continuation sheets to the form. The FP-290 A. Facility Number w 7� tust be completed in duplicate. Although the form may photocopied,the facility owner or owners representative must ign each copy separately;photocopied signatures are not sufficient. Both copies of the FP-290 are to be forwarded B. Date Entered 2 the focal fire department,who will check all information and certify the forms. The fire department will retain one opy of the FP-290 for its records,and the facility owner shall be responsible for forwarding the other copy to the C. Clerk's Initials iepL of Fire Services at the address above. The local fire department will Issue the permit portion of the FP-290; owever,registration Is not complete until the FP-296 is received and checked by the UST Regulatory Compllarhce Unit. Q. Comments / 'New Facil V means tank or tanks answered. a Incomplete she,where tanks a returned. �Z� questions have riot been previously located. • 'Facility street address"must include both a street number and it street name. Post office box numbers are not acceptable,and will cause a registration to be returned.11 geographic location of facility Is not provided,please indicate distance and direction from closest Intersection,e.g.. (facility at 199:North Street is located)400 yards southeast of Commons Road{Intersection). GENERALO Notification Required t(gp;(a)afarm or residential tank of 1.100 gallons or less capacity used for storing motor Fire Prevention Form FP-290 is to be used as Notification,Registration,and Permit for fuelfornohdommerclalpurposss,or(b)stank used forstoring heating oil fore onsumptive aboveground and underground storage tanks and tank facilities regulated under 527 use on the premises where stored are not required to be registered under527 CMR 9.00. Code of Massachusetts Regulations 9.00.No regulated aboveground or underground Pena storage tank facility shall beinstalled,mainfakted,replaced,substantially modfiedor �ownerwholawwingyfailstonodyorsubmks false Information shall besubject to a civil penaltji rat to exceed S2S,000 for each tank for which ratification is not given or for removed without a permit(FP-290)Issued by;the head of the local tine depaent which false Information is submitted,(MGL Chapter 148,section 38H,527 CMR 9.00) The owner of any storage fatty shad wNhiri seven working days notify the head of the. local fire department and the Dept.of fire Services of any change In the name, Aboveground Storage Tanks address,or telephone number of the owner or operator of a storage facility subject to 527 CMR 9.00 requires the registration of any,aboveground storage tank which meets the regulation by Chapter 148,Mass.General law and by 527 CMR 9.00. following definition;a horizontal or vertical tank,equal to or less than 10,000 gallons underground Storage Tanks capacity,that is intended for fixed Installationwilhout back fill above or below grade,and is Each owner of an underground tank first put Into operation on or after Jan.1.1991. used, 0 storage 04Hazardous Substances,Hazardous Wastes,.or Flammable or shall,within ihirty days after the tank is first put brio operation,notify the Department of Combustible Liquids. Fire Services(the department)of the existence of such tank,specifying,to.the extent Exception i11:Aboveground tanks of more than 10.000 gallons capacity regulated by520CMR known,the owner of the tank,date of Insbill on, capacity,type,locatom and uses of 12.00(Requirements for the Installation of Tanks Containing Fluids Other Than Water in such tank.By no later than Jan.31,1991,earls owner of An underground storage tank Excess of 10,000 Gallons)are not required to be registered under 527-CMR 9.00. that was in operation at any time after Jan.1.1974. regardless of whether or not such tank was removed from beneath the surface of the ground at any time,sM. "notify the Exception N2-(a)a farm or residential tank of 1.100 gallons or less capacity used for storing department of the existence of such tank,speciyirg,to the extent known,the owner of motor fuel for noncommercial purposes, or(b) a tank used for storing heating oil for the tank,date of installation,capacity,type,and location of the tank,and the type and consumptive use on premises where stored are not required to be registered under 527 quantity of substances stored in such tank or which were stored in such tank Before CMR 9.00. the tank ceased being In operation if the tank was removed from beneath the surface Penafties.Anhy person who knowingly violates any rule or regulation made by the Board of Fire of the ground prior to the submittal of such notice to the department Such entice shall Prevention Regulations shall,except as otherwise provided,be punished by a fine of not less also specify.to the extent known,the date the tank was removed from beneath the than one hundred dollars nor.more than one thousand dollars. (MGL,Chapter 148.section surface of the ground prior to the submittal of such notice to the department.The 10e.and 527 CMR 9.00) operator of any tank d has ep owner o whose owner cannot be definitely: to the where to Notify?Two completed notification forms should be signed by both the tank owner ascertained,shag nod the department of tote"existence of such fank.specilying• extent known,any Information relating to ownership of the tank and date of and the local fire department.One copy will be retained by the fire department,and the tank Installation,capacity,type,and location of the tank and due type Arid quantity of owner shall send a separate copy to the address at the top of this page. substances stored in such tank or which were stored-in such tank before the tank When to Notify?1.Owners of storage tanks in use or that have been taken out of operation ceased being in operation if the tank was removed from beneath the surface of the must notify within thirty days. ground prior to the submittal of such notice to the department.If the tank was abandoned beneath the surface of the ground prior to the submittal of such notice to Owners and Operators of Regulated Storage Tank Systems must maintain records the department,such notice shall also specify,to the extent known to the owner or certifying that all leak detection,inventory control and 6919ess testing requirements operator,the date the tank was abandoned In the ground and all methods used to for the Regulated Storage Tank System are current Thele rds must be readily stabilize the tank after the tank ceased being In operation. available for inspection. Ie I. OWNERSHIP OF TANK(S) If. LOCATION OF TAN )wner Name(Corporation,Individual,Public Agency,or Other Entity) If known,give the geographic location of tanks by de re'�si�t 1 hand 04� a O , �� seconds.Example:LaL 42,36,12 N Long.85,24, Latitude Longitude �'� �' Street Address - Distance and direction kcdoseSl tnlerseclion(sell instructions M2) CIA J 60 Facility Name or Complid Site identifier.as appliclible w pity n late Zip�e Street Address(P.O.Box not acceptable-see instructions e2) County city State Tip Code Phone Number(Include Area Code) Ownies Employer Federal ID r County -290(revised 11/96) Pagel III. TYPE OF OWNER IV. INDIAN LANDS y' ❑ Federal Government W Commercial ❑ Tanks are located on land within an Indian Reservation or on ' ❑State Government (storage and sale) other trust lands. " ❑Local GGovernment ❑ Private ment ❑ Tanks are owned by native American nation,tribe,or individual. (storage and use) V. TYPE OF FACILITY Select the Appropriate Facility Description: (check all that apply) Gas Station Manna Trucking/Transport Petroleum Distributor Railroad Utilities Airport Federal-Military Residential Aircraft Owner Industrial Farm Vehicle Dealership Contractor X Other(explain) &VtVe-M i4e41W, VI. CONTACT PERSON IN CHARGE OF TANKS Name: C Ktot4ig Address: Phone Number(include area cgde): Job Title: ?,c e {i'K t"0e 10S PI St Home: S08 - 49? - -7/l3 - ! ycttr►d�LS �O( Business; M' Ra — D VI1. FINANCIAL RESPONSIBILITY 191 have met the financial responsibility requirements in accordance with 527 CMR 9:00. ————————————— ————————— ——— --- —————— Check all that apply r - ❑ Self Insurance ( Q Guarantee ❑ Letter of Credit l8 Commercial Insurance ❑ Surety Bond O Trust Fund ❑ Risk Retention Group X State Fund ❑ Other Method Allowed-Specify VIII. ENVIRONMENTAL SITE INFORMATION This information should be available from local health agent,conservation commission,or planning department. 1.Tank site located in wellhead protection area ❑Yes CS No o Unknown 2.Tank site located in surface drinking water supply protection area ❑Yes M No ❑Unknown 3.Tank site located within 100 feet of a wetland ❑Yes I9 No ❑Unknown 4.Tank site located within 300 feet of a stream or water body ❑Yes ®.No o Unknown IX. DESCRIPTION OF STORAGE TANKS AND PIPING (COMPLETE FOR EACH TANK AT THIS LOCATION) Tank Identification Number Tank No.--L Tank No._A Tank No._3__ Tank No. _ Tank No. 1.Tank status a.Tank m1`6 serial# (if known) b.Currently in Use c.Temporarily Out of Use (Start Date) 0 0 0 t 0 d. Permanently Out of Use 0 0 0 0 •e. Aboveground storage tank(AST)or rJ- AST X UST ❑AST fq UST ❑AST IN UST ❑AST RUST ❑AST ❑UST Underground storage tank(UST) 2. Date of Installation (mo./daytyr.) 1 icicrz 1,14 3. Estimated Total Capacity(gallons) 00 FP•290(revised 11/96) Page 2 Tank Identification Number(cont.) Tank No. I Tank No. A Tank No.� Tank No. Tank No. 4. Substance Currently or Last Stored a. Gasoline ] Motor vehicle or other use O MV O Marina ❑ MV ❑Marina O MV ❑Marina ❑ MV ❑ Marina ❑ MV ❑Marina O other ❑other ❑other ❑other O other b. Diesel E] L Motor vehicle or other use O MV ❑Marina ❑ MV O Marina O MV O Marina ❑ MV ❑ Marina ❑ MV ❑Marina ❑other ❑other ❑other ❑ other ❑other c. Kerosene E= I __1 1-1 d. Fuel Oil C� '"Consumptive Use'tanks need not be registered.. . ronsumpWe Use'fuel used exclusively for area heating and/or hot water. e. Waste Oil f.Other, Please specify ( Hazardous Substance) other than 4a thru 4e abovve CERCLA name and/or CAS number Mixture of Substances Please specify 5. Material of Construction-Tank(mark only one) Bare steel(includes asphalt,galvanized and epoxy coated) Cathodically protected steel Composite (steel with fiberglass) Fiberglass reinforced plastic (FRP) C� Concrete Unknown Other Please specify 6.Type of Construction-Tank (mark only one) Single walled Double walled ® �� Unknown Other Please specify Is tank lined? ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑ Yes ❑ No ❑Yes ❑No Does tank have excavation'liner? ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑No ❑Yes ❑ No ❑Yes ❑ No FP-290(revised 11/96) Page 3 Tank Identification Number(cont.) Tank No. f Tank No. Tank No._ Tank No. TankfNo. 7. Material of Construction-Piping(mark only one) - I Bare steel (includes asphalt,galvanized and epoxy coated) Cathodically protected steel 0 . Fiberglass reinforced plastic (FRP) Flexible 0 �� Copper 0 �� Unknown Other Please specify &,IvikO96 4 8. Type of Construction-Piping(mark only one) Single walled Double walled Unknown Other 0 0 0 0 Please specify Has piping been repaired? ❑Yes X No ❑ Yes ®No ❑Yes Iq No ❑Yes Q No ❑ Yes ❑ No Is piping gravity feed? ❑ Yes ❑ No ❑ Yes ❑ No ❑Yes ❑No ❑Yes ❑ No ❑ Yes ❑ No Date X. CERTIFICATION OF COMPLIANCE 1. Installation A. Installer certified by tank and piping ® 0 manufacturers B. Installer certified or licensed by the implementing agency C. Installation inspected by a registered 0 0 0 engineer D. Installation inspected and approved by the implementing agency E. Manufacturers' installation checklists 0 0 0 have been completed F. Another method allowed by 527 CMR 9.00. Please specify 2.Tank Leak Detection Tank Tank Tank Tank Tank (mark only one) ol A. Double-wall tank- Interstitial monitoring B.Approved in-tank monitor oo C.Soil vapor monitoring (check one below) ❑ Monthly ❑ Continuous El r El o El El E. Inventory record-keeping and tank testing ❑ F. Other method allowed by 527 CMR 9.00. Please specify FP-290(revised 11/96) Page 4 Tank Identification Number(cont.) Tank No. Tank No.� Tank No._3_ Tank No. 4 Tank No. 3. Pipin'g Leak Detection (mark only one) Piping Z2, Piping Piping Piping Piping A.Pressurized a.'lnterstibal space�monitor ❑ ❑ ❑ ❑ ❑ b. Product line leak detector ® ® ® ❑ (mark all that apply below) CR Automatic flow restrictor* EK Automatic shut-off device* KL Continuous alarm* ' Also requires annual test of device and piping tightness test or monthly vapor monitoring of soil. B. Suction:Check valve at tank only ❑ ❑ El ❑ ❑ (Requires interstitial space monitor or line tightness test every three years) ❑ Interstitial space monitor. ❑ Line tightness test C. Suction: Check valve at dispenser only ❑ ❑ El ❑ ❑ (No monitor required) D. Other method allowed by 527 CMR 9.00. Please specify 4. Date of last tightness test(tank& piping) 3, t" S 3 IF I 5. Gravity feed piping ❑ ❑ jM ❑ ❑ ❑ 6. Spill containment and overfill protection Tank Tank Tank Tank Tank A. Spill containment device installed � � ® ❑ B. Overfill prevention device installed ® V F�9 ❑ 7. Daily Inventory Control (mark only one) A. Manual gauging by stick and records ❑ ❑ ❑ ❑ ❑ reconciliation B. Mechanical tank gauge and records ❑ ❑ ❑ ❑ ❑ reconciliation C. Automatic gauging system ® ® ® ❑ 8. Cathodic Protection (if applicable) Tank Piping Tank Piping Tank Piping Tank Piping Tank Piping A. Sacrificial Anode Type ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ B. Impressed Current Type ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ C. Date of Last Test Certification of Compliance No.: X1. CERT11FICATION (Read and sign after completing all sections) NOTE:Both the copy being sent to the Dept.of Fire Services and the copy retained by the local fire department must be signed separately. A photocopied signature will not be accepted on either document. I declare under penalty of periury that I have personally examined and am familiar with the information submitted in this and all attached documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information,I believe that the submitted information is true,accurate,and complete. Name and official title of owner or owner's authorized representative(Print) Signature: Date: � .(_ M(. GO W 4 'Ex V P 2 Ll �..r 31ayj FP-290(revised 11/96) Page 5 FEB-26 99 15:55 FROM:PECKHAM RENTAL CTR. 508-997-6954 TO:508 771 0925 PAGaE:02 �19J�Natlflcatlon for Fiernvvai or Closure of In Place Storage Tanks Regulated Under 527 CMR 9.00 Forward completed form, signed by local fire department,to: Mass. UST Compliance Urrit, , p - a . Dept.of Fire Services, One Asllblrrton Place-Room 1310, Boston, MA 02108-1618 Telephone (617) 7274500 Date Received. c3 9 9 Fire Dept, ID# (Fire Department retains one copy of FP•290R) Fire Dept. Sig. Ttys form is to be used for notification for removal of Underground Storage Tanks/ Piping. If a storage facility has UST's which are to remain in use, an entire amended FP-290 , A. Facility Number l o`1, (long form) must be filed. 8. Dale Entered Note:"Facility street address"must include both a street number and a street name. C. Clerk's Initials Post office box numbers are not acceptable,and will cause a registration to be O. Comments returned. It geographic location of facility is not provided, please indicate distance and direction.from closest Intersection;e.g.,.(facility at 199 North Street is located)Am yards southeast of Commons Road(Intersection). I. OWNERSHIP OF TANK(S) Ii. LOCATION OF TANK(S) Owner Name(Corporation,Individual,Public Agency,or Other Entity) It known,give tho geographic location of lank.,by degrees,rrdnutos,and soconds.P-xample:LaL 42.36. 12 N Lang.65,24,17W ` u Latitude Longitude Stlew POS aas anw a eCtbrl afrl sl ntelsacl sea rat°nOw° I Ck LL66 F"M:/Name or 514 laorkmar.as a o y "° Waal Ad*"g M.O.am nor.a oppOM•vie rot°et a", ' I oar to Mel uboi L) (SCs.r State zip C.oda VPau NYntMF tMOL4e Nea coda! p~,[mptaVer Fadan to° C-N*Y III. TANKS/PIPINck REMOVED OR FILLED IN PLACE Tank Number Tank No._I_ Tank No..7 Tank No. Tenk No. Tank No. 1•Tank/Piping removed or filled In plact (mark all that apply) A: Substance last stored B.Tank capacity gallons Ariv C. Estimated date last used (moJday/yr.) �,� — D. Estimated date of removal — (rno./day/yr.) --�--- E.Tank was removed from ground F. Tank was not removed from ground Tank was tilled with Inert material, Describe material used: G.Piping was removed from ground H.Piping was not removed from ground / I. Other, please specify FP-20Ori(rovlsod 1 t/9G) Hy SC pAR � Ov: , . '�NN,s M of Ro MTNT QEq�I,, 02/26/99 FRI 14:50 [TX/RX NO 84561 Z 002 FEe-26 99 15:55 FROM:PECKHAM RENTAL CTR. 508-997-6954 TO:508 771 0925 PAGE:01 t ank Number(con[-) Tank No. Tank No. ^ Tank No. Tank No. 2. Tank closed In accordance Tank No. with 527 CMFt 9.00 ' O Yes O No ❑Yes ❑No A. Evidence of leak detected O Yes O No • g4es 0 No O Yes ❑No 0Yes O No 0 Yes ONO 8 O Yes O No. Mass. DtP notified 0 Yes ". O Ye9 O No O Yes ❑No 0 Yes 0 No 1. Mass,DEP tracking number 4 Yas 0 No O Yes No O Yes p No 2.Agency or company performing 1~ ------- co.nlam:I.n.a.tion assessment• "-`" *927 CMR 9.07 q 36e Commoriwealth of Massachusetts,UndergniiJnd Storage Tank goaura Assessment Manual'Ap j#9.1988 OEP Policy p WSC-402-96 I declare under penalty of perjury that I have personally examined and am familiar with the into all attached documents,and that based on my Inquiry of those Individuals Immediately res ortslbfe lion, 1 believe that the submitted information Is true,accurate, and complete, Information submitted In this end P for obtaining the Inforrna_ Name and official title of owner or owner's Signature: authorized representative(Print) Date: L, �t j 1 y5 • 1 . 1 ' . ' 1 4(ravtsed t Itse) 02/26/99 FRI 14:50 [T%/R% NO 84561 Z 001 - @ ? TOW *OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY y S 'f (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS etno e6elu, �'� . Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS ove ,. _ , , IN OUT IN OUT IN OUT #&gallons 777 Test �� 3600v Fuels: Gasoline,Jet Fuel (A) Gcrw Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) �\ new motor oil (C) x transmission/by4mojJic k Synthetic Organics: degreasers Miscellaneous: p X �a a Z; x � G�asal kl�l 411= f. DISPOSALIRECLAMATION REMARKS: / 1. Sanitary Sewage 2.Water Supply f Q� ON OTown Sewer aPublic 0 On-site QPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank: MDC �t��l Catch basin/Dry well Q}df/1 On-site system 5.Waste Transporter Name 1Hauler Destination11 YES NO 1. 2. �w y 19-2 a Person(s) In-terview�e`d Inspector Date r- i Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: Z�_Jlf-15!`/ Is BUSINESS LOCATION: 5U d Cer1N ST" ,(f/� .ytS ,/✓IA- 0"0 MAILINGADDRESS: 5-0 Qc_eAn/ 57' #1,g,vAi(_% JY74, Mail To: TELEPHONE NUMBER: .50 7 76 —R G o2 7 Board of HealthTown of Barnstable CONTACTPERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS:_ C'nn�/✓, 'Vpt C-AS Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES Y- NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: D AJ S t l TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity %`f G d/ Antifreeze(for gasoline or coolant systems) ; Drain cleaners —�L NEW USED Cesspool cleaners Automatic transmission fluid 001z� Disinfectants Engine and radiator flushes lfal& Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides X NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel --�J Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil . NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote). Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners lr Car waxes and polishes Leather dyes `f Asphalt & roofing tar Fertilizers: Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) PT5_ Metal polishes Laundry soil & stain removers % Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids ///?��ol� S��rJ -✓ �Zvu fY7 (dry. cleaners) 3 G4t Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Make application to local Fire Department. Fire Department retains original application and issues duplicate as Permit. d� fZ�G�P�S APPLICATION and PERMIT � for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: Tank Owner Tank Owner Name(please print)Christy i s of Cape Cod LLC X Signature apllying for perrnrt Address 105 l a ant reet Hyannis MA 02601 street City state Trp • . Uj teqj(*jm HOISTING LICENSE # HE 032659 Company NameFernandeG & Spi , Constr-Co-Tnr .. Co.or Individual Print Print Address 31 Stowell St. New Bedford MA Address Pdnt Pant Signatu applyin for Signature(if applying for permit) ❑ IFCI Certified Other ❑ IFCI Certified ❑ LSP# Other Tank Location 50 0cerV=Street- HSranni 9- Steet-Address " CBY-- Tank Capacity(gallons) 1 .000 Substance Last Stored Hea t i n-g_n.i 1.-__ Tank Dimensions(diameter x length) 48" x 12 '0" � I Remarks: Firm transporting waste State Lic.# Hazardous waste manifest# E.P.A.# Approved tank disposal yard "AdF4 ' ' efc//- i//��AY Tank yard# Type of inert gas Air/Purg Tank yard address —27V V//. City or Town /r Weill" FDID# [/1 V;2 Permit# Date of issue Date of expiration Dig safe approval number: 19 9 9 0 3 0 2 8 3 5 — ' /9 8 Dig Safe Toll Free Tel. Number-800-322-4844 Signature/Title of Officer granting permit s / After removal(s)send Form FP-29OR signed by Local Fire Dep ! o Api q�Unit,One Ashburton Place, Room 1310, Boston, MA 02108-1618. CERTIFICATE UNDERGROUND STORAGE TAN` )YSTEM,TESTING rANKNOL06Y-NOE TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512)451-6334 FAX(512)459-1459 TEST RESULT SITE SUMMARY REPORT TEST TYPE: Sure Test PURPOSE: INTEGRITY TEST DATE: 03/03/98.•` WORK ORDER NUMBER: 710 9217 CLIENT: CITY, HAYES, MEAGHER S DISSETTE, SIT' CHRISTY'S #122 LI . 50 CONGRESS STREET C 50 OCEAN STREET BOSTON, MA 02109 HYANNIS, MA 62601 2 � . ATTN: MICHAEL DISSETTE The following test(s)were conducted at the site above in accordance with all applicable portions of Federal,NFPA and local regulations Tank Tests 9 1 REG UNLEAD 6,136 72.00 PASS —0.016 PASS 2 PREMIUM 6,136 72.00 PASS 0.006 PASS 3 MIDGRADE 6,136 72.00 PASS —0.012 PASS 4 HEAT OIL 1,000 48.00 PASS —0.003 PASS s Line and Leak Detector Tests O E. MEzG G - UM N _ B O 9 - B 1 REG UNLEAD 0.000 P Y P 2 PREMIUM 0.000 P Y P 3 MIDGRADE 0.000 P Y P 4 HEAT OIL 3 � TANKNOLOGY-NDE appreciates the opportunity to serve you,and looks forward to working with you in the future.Please call anytime,day or night,when you need us. TANKNOLOGY-NDE Representative: Test conducted by: TOM PRESNAL SHAWN P. CONRAD Reviewed: Technician Certification Number: 5019 Printed 03/13/98 09:05 GIBSON INDIVIDVA L TANK/LINE/LEAK DETECTOR T-IT REPORT TEST DATE: 03/03/98 WORK ORDER NUMBER: 7109217 CLIENT: CITY, HAYES, MEAGHER SITE: CHRISTY,S #122 Tank ID: 1 Material: Dw FISERG Bottom to top fill in inches: 118.0 Product: REG UNREAD Tank manifolded: NO Bottom to grade fill in inches: 124.0 Capacity in gallons: 6,136 Vent manifolded: YES Fill pipe length in inches: 46.0 Diameter in inches: 72.00 Vapor recovery manifolded: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Impact Valves Operational: Stage I vapor recovery: DUAL, Tank age(years): Overfill protection: YES Stage II vapor recovery: ASSIST Fuel pure rating: Overspill protection: YES Installed: ATG COMMENTS CP installed on: _ cUtg �8- _ . .vim. ._ PSI at tank bottom: 1.00 New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: 38.00 L.D.#1 L.D.#1 L.D.#2 L.D.#2 UFTIOFT: UFT Make:RED JACKET Fluid volume in gallons: 3,427 Model:X.L.D. Tank water level in inches: 0.00 SIN: 40493-3162 Test time: 09:12-12:21 Open time in sec: 1.00 Number of thermisters: 4 Holding psi: 12 Specific gravity: 0.730 Resiliancy cc: 110 Water table depth in inches: 999.00 Test leak rate mVm: 378.0 Determined by(method): MoNTR WELL Metering psi: 8 Leak rate in gph: -0.016 Calib. leak in gph: 6.00 Result: PASS Results: PASS COMMENTS COMMENTS LL;AGExTEST-F UL r si< `efhOd"U3r 4 _e Test time: 12:48-12:50 Material: ENVIRO=x Ullage volume: 2,709 Diameter(in): 1.5 Ullage pressure: Length (ft): 50.0 Results: PASS Test psi: 5o Bleedback cc: 220 DATA FOR UTS-4T ONLY: Test time(min): 30 Test 1:Start time: 12:04 Time of test 1: Finish psi: 50 Temperature: Vol change cc: 0 Test 2: Start time: 12:14 Flow rate(cfh): Finish psi: 50 Time of test 2: Vol change cc: 0 Test 3:Start time: 12:24 Temperature: Finish psi: so Flow rate(cfh): Vol change cc: 0 Time of test 3: Final gph: 0.000 Temperature: Result: PASS Flow rate(cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKET ACOUSTIC ULLAGE USED, NO LEAKS COMMENTS DETECTED. Printed 03/13/98 09:05 GIBSON 8900 SHOAL CREEK, BUILDING 200,AUSTIN,TEXAS 78757(512)451-6334 ' INDIVID4)"'_ TANK/LINE/LEAK DETECTOR T—IT REPORT TEST DATE: 03/03/98 WORK ORDER NUMBER: 7109217 CLIENT: CITY, HAYES, MEAGHER SITE: CHRISTY'S #122 Tank ID: 2 Material: Dw FISERG Bottom to top fill in inches: 126.0 Product: pRE14JUM Tank manifolded: No Bottom to grade fill in inches: 132.0 Capacity in gallons: 6,136 Vent manifolded: YES Fill pipe length in inches: 54.0 Diameter in inches: 72.00 Vapor recovery manifolded: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Impact Valves Operational: Stage I vapor recovery: DUAL, Tank age(years): Overfill protection: YES Stage II vapor recovery: ASSIST Fuel pure rating: Overspill protection: YES Installed: ATG COMMENTS CP installed on: v. _ . .. �. urn ea= W s - tur PSI at tank bottom: 1.00 New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: 28.00 L.D.#1 L.D.#1 L.D.#2 L.D.#2 LIFT/OFT: UFT Make:RED JACKET Fluid volume in gallons: 2,246 Model:X.L.D. Tank water level in inches: 0.00 S/N: 20493-3178 Test time: 09:15-12:21 Open time in sec: 1.00 Number of thermisters: 3 Holding psi: 23 Specific gravity: 0.751 Resiliancy cc: 110 Water table depth in inches: 999.00 Test leak rate ml/m: 378.0 Determined by(method): MONTR WELL Metering psi: 8 Leak rate in gph: 0.006 Calib. leak in gph: 6.00 Result: PASS Results: PASS COMMENTS COMMENTS Y Test time: 12:50-12:52 Material: ENVIROFLEX Ullage volume: 3,890 Diameter(in): 1.5 Ullage pressure: Length(ft): 50.0 Results: pASS Test psi: 50 Bleedback cc: 120 DATA FOR UTS-4T ONLY: Test time(min): 30 Test 1:Start time: 12:12 Time of test 1: Finish psi: so Temperature: Vol change cc: o Test 2:Start time: 12:22 Flow rate(cfh): Finish psi: so Time of test 2: Vol change cc: o Test 3: Start time: 12:32 Temperature: Finish psi: so Flow rate(cfh): Vol change cc: o Time of test 3: Final gph: 0.000 Temperature: Result: PASS Flow rate(cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKET ACOUSTIC ULLAGE USED, NO LEAKS COMMENTS DETECTED. Printed 03/13/98 09:05 GIBSON 8900 SHOAL CREEK, BUILDING 200,AUSTIN,TEXAS 78757(512)451-6334 INDIVIDU-"' . TANK/LINE/LEAK DETECTOR T T REPORT TEST DATE: 03/03/98 WORK ORDER NUMBER: 7109217 CLIENT: CITY, HAYES, MEAGHER SITE: CHRISTYaS #122 R - Tank ID: 3 Material: Dw FISERG Bottom to top fill in inches: 134.0 Product: MIDGRADE Tank manifolded: No Bottom to grade fill in inches: 140.0 Capacity in gallons: 6,136 Vent manifolded: YES Fill pipe length in inches: 62.0 Diameter in inches: 72.00 Vapor recovery manifolded: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Impact Valves Operational: Stage I vapor recovery: DUAL Tank age(years): Overfill protection: YES Stage II vapor recovery: ASSIST Fuel pure rating: Overspill protection: YES Installed: ATG COMMENTS CP installed on: sua�w - { - PSI at tank bottom: 1.00 New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: 32.00 L.D.#1 L.D.#1 L.D.#2 L.D.#2 UFT/OFT: UFT Make:RED JACKET Fluid volume in gallons: 2,646 Model:X.L.D. Tank water level in inches: 0.00 S/N: 20493-3131 Test time: 09:17-12:23 Open time in sec: 1.00 Number of thermisters: 4 Holding psi: 21 Specific gravity: 0.740 Resiliancy cc: 110 Water table depth in inches: 999.00 Test leak rate ml/m: 378.0 Determined by(method): MoNTR wELL Metering psi: 9 Leak rate in gph: -0.012 Calib. leak in gph: 6.00 Result: PASS Results: PASS COMMENTS COMMENTS CC r,r 1:1All 8 - - a Test time: 12:53-12:55 Material: ENVIROFLEX Ullage volume: 3,490 Diameter(in): 1.5 Ullage pressure: Length (ft): 50.0 Results: PASS Test psi: 50 Bleedback cc: 240 DATA FOR UTS-4T ONLY: Test time(min): 30 Test 1:Start time: 12:13 Time of test 1: Finish psi: 50 Temperature: Vol change cc: 0 Test 2:Start time: 12:23 Flow rate (cfh): Finish psi: 50 Time of test 2: Vol change cc: 0 Test 3:Start time: 12:33 Temperature: Finish psi: so Flow rate (cfh): Vol change cc: 0 Time of test 3: Final gph: 0.000 Temperature: Result: PASS Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKET ACOUSTIC ULLAGE USED, NO LEAKS COMMENTS DETECTED. Printed 03/13/98 09:05 GIBSON 8900 SHOAL CREEK, BUILDING 200.AUSTIN,TEXAS 78757(512)451-6334 INDIVID¢'_.-'_ TANK/LINE/LEAK DETECTOR ' IT REPORT TEST DATE: 03/03/98 WORK ORDER NUMBER: 7109217 CLIENT: CITY, HAYES, MEAGHER SITE: CHRISTY 1 S #122 Tank ID: 4 Material: Dw FIBERG Bottom to top fill in inches: 76.0 Product: HEAT OIL Tank manifolded: No Bottom to grade fill in inches: 82.0 Capacity in gallons: 1,000 Vent manifolded: No Fill pipe length in inches: 28.0 Diameter in inches: 48.00 Vapor recovery manifolded: No Fill pipe diameter in inches: 4.0 Length in inches: 131 Impact Valves Operational: Stage I vapor recovery: NONE Tank age(years): Overfill protection: YES Stage 11 vapor recovery: NONE Fuel pure rating: Overspill protection: YES Installed: ATG COMMENTS CP installed on: uToa PSI at tank bottom: 1.50 New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: 40.00 L.D.#1 L.D.#1 L.D.#2 L.D.#2 LIFT/OFT: UFT Make: Fluid volume in gallons: 874 Model: Tank water level in inches: 0.00 S/N: Test time: 09:24-13:12 Open time in sec: Number of thermisters: 5 Holding psi: Specific gravity: 0.850 Resiliancy cc: Water table depth in inches: 999.00 Test leak rate ml/m: Determined by(method): MONTR WELL Metering psi: Leak rate in gph: -0.003 Calib.leak in gph: Result: PASS Results: COMMENTS COMMENTS .... ..... .... .0 F - Test time: 13:25-13:27 Material: COPPER COPPER Ullage volume: 126 Diameter(in): 0.5 0.5 Ullage pressure: Length (ft): 25.0 25.0 Results: PASS Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time(min): Test 1:Start time: Time of test 1: Finish psi: Temperature: Vol change cc: Test 2:Start time: Flow rate(cfh): Finish psi: Time of test 2: Vol change cc: Test 3:Start time: Temperature: Finish psi: Flow rate(cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate(cfh): Pump type: BOILER BOILER COMMENTS Pump make: UNKNOWN UNKNOWN ACOUSTIC ULLAGE USED, No LEAKS COMMENTS DETECTED. Printed 03/13/98 09:05 GIBSON 8900 SHOAL CREEK, BUILDING 200,AUSTIN,TEXAS 78757(512)451-6334 SITE DIAGRAM T NKNOLOGY-NDf TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512)451-6334 FAX (512)459-1459 TEST DATE: 03/03/98 WORK ORDER NUMBER: 7109217 CLIENT: CITY, HAYES, MEAGHER DISSETTE, SITE: CHRISTY'S #122 1K FUE F A A A OIL 3"VENT O 1 F V A STP 6K PREM GF V A STP 6K ( #) MID I F O O STP 6K REG Printed 03/13/98 09:05 GIBSON TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair2.Printers BOARD OF HEALTH O satisfactory 3.Auto Body Shops �, _ `- O unsatisfactory- 4.Manufacturers COMPANY Q2VS�k `4 t�l.A-� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 'FN (e __Q&C)' SA Class: 7.Miscellaneous k Qzk MI S QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) 1 CAU '� new motor oil(C) CG S ansmis ' raulic Synthetic Organics: degreasers i x Miscellaneous: DISPOSAL/R.ECLAMATION REMARKS: 1. Sanitary Sewage 2Water Supply M611l -t-c'nt Town Sewer Public 0 (Uj CCWr 27w- O On-site OPrivate 3.Indoor Floor Drains YES.)� NO O Holding tank:MDC A Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N04 ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system w 5.Waste Transporter e� y. . gsic :bsca. ,s h a r s }i Ps .vr '�.. YES NO 2. P&stA Interviewed Inspector Date VERIZON FACILITY PARK / \ / DISPENSER \ BASED ON TOWN OF BARNSTABLE • - / \ / - PAD / \ G-COGRAPHIC INFORMATION SYSTEM. / CANOPY \ ALL LOCATIONS APPROXIMATE. / NOT FOR CONSTRUCTION PURPOSES. / / SPEEDWAY VERIZON PARKING s-1o10 o STORE Z\ LEGEND: / ! SIB-1 #2437 / UST PAD v� \ ® = CATCH BASIN. / STP SUMP �n / 0 = SOIL BORING __ 4 --- __; PROPERTY LINE (APPROX.) ----------- d, ____------1 DISPENSERS \ / r / '------------ \ UST -----, i 1 -----------i LANDSCAPED S-102 Q0(0 0 t' LOCATION OF THREAT OF SB-2 o RELEASE (RTN 4-26238) ® p TRANSITION SUMP r- - - - I 0 15 FT 30 APPROX. SCALE � TRENCH DRAIN - - - - - - -� DRAWN BY: PDC FIGURE: Z DRAWING DATE: 07/07/2017 2 UA 1 DRAWING TITLE E SITE PLAN OLD COLONY ROAD p i PROJECT NAME SPEEDWAY STORE#2437 50 OCEAN STREET HYANNIS, MASSACHUSETTS SENIOR HOUSING P EnVoupou 2 r, ENVIRONMENTAL SERVICES 2 MERCHANT STREET, STE. 2, SHARON, MA 02067-1630 PHONE: (781) 793-0074 FAX: (781) 793-7877