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HomeMy WebLinkAbout0268 STEVENS STREET - Health 268 STEVENS -ST. , '1IYANNIS A=308-017 HYANNIS NISSAN i i 1 r f �v ENNIETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-17 Brewster,l*U 02631 fax(508)896-514 LETTER OF TRANSMITTAL TO: (DATE: JOB ER: NJ Mr.Jaime o r s,Case Officer 8/31/16 BEA16-10824A 'a MA DEP,Southeast t Regional Office(SERO) �J Bureau of Waste Site Cleanup(BWSC) 20 Riverside Drive REGARDING: Lakeville,MA 02347 IMMEDIATE RESPONSE ACTION PLAN w/Supporting Documentation Former Car Dealership: RTN 4-26151 SHIPPING METHOD: 268 Stevens Street Hyannis,MA Regular Mail ❑ Pick Up ❑ [Assessor's Map/Parcel ID 308/17] Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other upload RX Certified Mail ❑ GreenCard/RR ❑ COPIES (DATE (DESCRIPTION 1 8/4/16 IRAP Report with Supporting Documentation(Appendices A-F) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ RE CC via CD:Stuart Bornstein,Owner,PRP—Holly Management and Supply Corporation Tina L. Simmons,Environmental Claims Specialist(Zurich North America,Claim#4120004093) *Abbreviated hard copy: Thomas McKean,_Director—Barnstable Health Division John Cosmo,Fire Prevention Officer/Lieutenant —Hyannis Fire Department Mark S.Ells—Barnstable Town Manager * As part of Public Notice requirements,the report Title Page,Narrative,Index,Transmittal forms and Site Plan are included,pursuant to paperwork reduction policy. The full report is available as public record on the MA DEP website database at http://public.dep.state.ma.us/SearchableSites/Search.asp or, upon written request to BEA,full copy(electronic or paper)will be provided. FROM: David C.Bennett,LSP,President/Todd M.Everson,ES,Senior Project Manager!lr If enclosures are not as noted,kindly notify us at once IMMEDIATE RESPONSE ACTION PLAN REMEDIAL MONITORING REPORT SUPPORTING DOCUMENTATION RTN 4-26151 Former Car Dealership 268 Stevens Street, Hyannis, MA BEA16-10824A AUGUST 4, 2016 4 -uENNETT ENVIRONMENTAL AssOCIATEs9 NCO LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 0 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 6 508-896-1706 6 Fax 508-896-5109 www.bennett-ea.com BEA16-10824A August 4, 2016 Mr. Jaime Goncalves, Case Officer MA DEPARTMENT OF ENVIRONMENTAL PROTECTION (MA DEP) Southeast Regional Office (SERO) Bureau of Waste Site Cleanup (BWSC) 20 Riverside Drive Lakeville, MA 02347 RE: IMMEDIATE RESPONSE ACTION PLAN Former Car Dealership: RTN 4-26151 268 Stevens Street—Hyannis, MA [Assessor's Map/Parcel ID 308/17] Dear Mr. Goncalves, BENNETT ENVIRONMENTAL ASSOCIATES, INC. (BEA) has prepared the following Immediate Response Action Plan (IRAP) and Supporting Documentation, as a summary of release discovery,preliminary response,environmental assessment,and remedial response actions conducted under verbal authorizations since Release Notification on June 10, 2016. Immediate Response Actions were undertaken to evaluate the presence of any Imminent Hazards, and to mitigate potential human exposures and environmental impacts associated with the sudden release of some 30 gallons (+/-) of gasoline and hydraulic oil from a mechanical lift that fell through the first floor to the basement within the subject building at the above referenced property. The gasoline and hydraulic oil spill was released to standing water, representing exposed groundwater, in the basement of the subject building. The containment provided by the concrete foundation walls and floor and expedited removal of floating free gasoline/hydraulic oil(LNAPL)with treatment of dissolved phase petroleum hydrocarbons was the remedial strategy implemented, to prevent the release from mobilizing to the environment. Response actions performed under the IRA in the initial 60-Day period have.included: 1)the active and passive ventilation of the subject building to absolve accumulated VOCs on the day of the release; 2) the removal of approximately 3,955 gallons of impacted water and LNAPL from the basement via vacuum truck; 3) the use and containerization of oil absorbent pads and booms to recover LNAPL from standing water in the basement;4)the operation and maintenance of a Granular Activated Carbon(GAC)pump-and-treat system to remediate some 31,572 gallons of impacted water from within the basement; and 5) the sampling and analysis of five on-site, pre-existing monitoring wells,to qualify potential impacts to local groundwater as a result of the release. These IRA activities have been conducted under MA DEP verbal authorizations, described herein. Field screening results and laboratory analytical data were used to evaluate exposure risks to identified human and environmental receptors. Based on the results of oily-water removal, GAC EMERGENCY SPILL RESPONSE © WASTE SITE CLEANUP Q SITE ASSESSMENT Q PERMITTING © SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE WASTEWATER TREATMENT,OPERATION&MAINTENANCE r AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 2 OF 15 IRAP,RTN 4-26151 Influent/Effluent testing and groundwater monitoring, No Substantial or Imminent Hazards are presently associated with environmental conditions at the Site,wherein the applicable GW-2 and GW- 3 Risk Characterization standards are met. The physical hazards associated with the collapsed floor and remaining structural and overhead issues in the basement around the perimeter of the lift have precluded the removal of remaining automotive fluids in the area of the fallen lift, to be addressed when feasible. Additionally,the soils in the area of the drive-under entry to the basement where oily water was observed needs to be investigated. Such determinations of all potential exposure and risks will continue to be evaluated with the development of additional data though the next reporting period and with the benefit of additional remedial response measures, described herein. The majority of work proposed to address the subject release has been completed under verbal authorizations. Additional environmental assessment and monitoring is appropriate and necessary to collect representative data and qualify potential environmental impacts and exposure risk to identified receptors,to support a finding of No Significant Risk. The IRA Plan prescribes such additional testing of soil and groundwater in review of treatment performance, and management of remaining remedial waste. Future environmental assessment activities will evaluate potential exposures to human and environmental receptors, as will establish the need for any appropriate additional remedial response actions necessary to develop a preponderance of evidence to support a finding of No Significant Risk. These findings will be represented in future IRA Status reports filed within 60 days of this IRA Plan, and then every six months thereafter until physical data supports project closure. Remedial response activities performed, and potentially to follow, are intended to mitigate any Critical Exposure Pathways and Significant Risk to identified human and environmental receptors,towards a Permanent Solution Statement(PSS). This work has and will continue to precede under direct LSP oversight in a manner consistent with the MCP Response Action Performance Standards (RAPS) pursuant to 310 CMR 40.0191 and the QA/QC policies of BENNETT ENVIRONMENTAL ASSOCIATES, INC. The facts and statements herein are, to the best of our knowledge, a true and accurate representation of the Site activities, remedial response actions and environmental conditions associated with the project and LSP Opinions acknowledged by the certification on the attached BWSC-105 Transmittal Form. ENVIRONMENTAL CONDITIONS [Refer to Appendix A] I The property at 268 Stevens Street is located on the west side of Stevens Street, at the intersection of North Street and Stevens Street [Refer to Figure 1]. Assessor's records identify the 1.48 acre lot as Parcel 17 on Map 308. The Subject Property is developed by a 1.5 story building with a partial full basement. The surrounding area is highly developed in mixed use with commercial and residential properties. The latitude and longitude coordinates for the property are 41.65088 N, 70.29436 W. The property is unoccupied,vacant and without power,effectively abandoned,pending sale of the property and intended demolition and redevelopment. The building is kept locked. Access to the subject property is restricted by temporary, metal security fencing, with high frequency/low intensity of use and children potentially present. Access to the area of release,located in the basement of the locked building,is restricted with low frequency/low intensity of use, with children unlikely to be present. On-site workers and visitors to the subject property are identified as the primary potential human receptors to potential exposures. AUGUST 4,2016 FORMER CAR DEALERSHIPBEAI6-10824A PAGE 3 OF 15 1 IRAP,RTN 4-26151 The subject property is upland. The topography is generally flat at approximate 31' NGVD, although grade gently slopes away from the building to the east, south and west, respectively. Hydrogeologic references report groundwater at approximately 15'NGVD (+/-) and within some 15' (+/-) of grade surface. Static water level measurements recorded at pre-existing monitoring wells report local groundwater within 10' of ground surface, with some 4-6" of standing water present in the basement at the time of release, consistent with the elevation of measured groundwater in monitoring wells.The periodic flooding of the basement by groundwater is evidenced by the elaborate dewatering system that was constructed and operated within the basement of the building until the building was abandoned, some 6-12 months prior to release. Regional groundwater contours indicate a south-southeast groundwater flow direction towards Snow's Creek and Lewis Bay beyond [Refer to Figure 2]. Local groundwater flow based on static water level measurements recorded from on-site monitoring wells indicates local south to southeasterly groundwater flow direction towards Stewart's Creek. Stewart's Creek, Snow's Creek and Lewis Bay are considered the primary potential environmental receptors under Method 1 Risk Characterization. According to the MA DEP BWSC GIS mapping,the Subject Property is located within a Non- Potential Drinking Water Source Area(NPDWSA)based on the intensity of development, including commercial and industrial use businesses [Refer to Figure 3]. As such, the RCGW-2 Reportable Concentrations are applicable for groundwater quality pursuant to 310 CMR 40.0362. Similarly, the GW-2 and GW-3 groundwater categories are applicable to Method 1 Risk Characterization, relative to potential human exposures and significant environmental impact, pursuant to 310 CMR 40.0974. Based on the site features with nearby residential properties, the RCS-1 Reportable Concentrations are considered applicable for soils per 310 CMR 40.0361. The S-1, S-2 and S-3 (GW-2/GW-3) soil categories are considered applicable to Method 1 Risk Characterization relative to potential human exposures and significant environmental impact per 310 CMR 40.0975. These standards were developed in consideration of potential ingestion,particulate inhalation and environmental exposures, and in review of potential leaching of contaminants to groundwater (GW-2/GW-3). For the purpose of risk characterization in consideration of future use of the property, the most stringent S-1 (GW- 2/GW-3) criteria are applied to Method 1 Risk Characterization. BACKGROUND [Refer to Appendix B] On June 10, 2016, workers for the perspective buyer were using a mechanical lift inside the subject building to facilitate the removal of OHM building materials in preparation for the eventual demolition of the building. During such use,the concrete slab beneath the mechanical lift failed and the lift fell through the floor into the basement. As a result, several workers were thrown from the lift's platform, landed on competent portions of the first floor slab and suffered serious injuries. As a result of the mechanical lift falling into the basement, gasoline and hydraulic fluid were released to the exposed groundwater standing in the basement. Hyannis Fire and Rescue personnel responded to the incident. Subsequent to caring for the injured workers and transporting them to hospitals for emergency medical attention, Hyannis Fire Department personnel (Deputy Chief Dean L. Melanson) remained in control of the scene due to the intensity of gasoline vapors both inside and immediately Y AUGUST 4,2016 FORMER CAR DEALERSHIPBEAI6-10824A PAGE 4 OF 15 IRAP,RTN 4-26151 outside the building,as a fire hazard. The fire department opened garage doors for passive ventilation, and established a perimeter outside the building against inhalation exposures. BEA and Global Remediation were contacted by the property owner to respond to the scene in order to recover LNAPL from the standing water, monitor organic volatile concentrations inside the building, and improve ventilation to reduce gasoline vapors inside the building, so that Hyannis Fire Department personnel could safely inspect the lift and eliminate potential ignition sources. PRELIMINARY RESPONSE ACTIONS Upon arrival that afternoon, BEA personnel consulted with Hyannis Fire Department personnel (Deputy Chief Melanson) about hazards and authorized areas of passage; the Hyannis Fire Department reported that there was no electricity to the building as it had been removed prior to the release. Global Remediation Services personnel arrived shortly thereafter. Based on the collapsed concrete slab and potential for further structural compromise of the first floor, the entire area around the collapsed floor and mechanical lift, on both the basement and first floors, was precluded from passage. BEA performed indoor air screening with a photoionization detector(PID) [MiniRAE 3 000, 10.2 eV lamp, calibrated to benzene standard] along the basement area, wherein Total Organic Volatiles (TOV) concentrations were reported between 19 and 30 ppmv,with a strong gasoline odor. BEA set up a commercial-grade ventilation fan at the basement stairs near the south end of the building, to initiate positive ventilation and direct TOVs outside the building. Hyannis Fire Department provided electric power and lighting from the generator on one of the trucks on scene. Subsequent to active ventilation, BEA personnel donned full-face respirators and other appropriate Personal Protection Equipment(PPE)and,with approval by incident commander,entered the basement to start LNAPL recovery. At that point, a vacuum truck contracted by Global Remediation Services arrived to skim LNAPL and dissolved-phase impacts from the standing water in the basement. The vacuum truck set-up at the exterior ramp near the north end of the building. BEA and Global Remediation personnel employed hydrophobic oil-absorbent booms and pads to corral LNAPL and direct it towards the vacuum truck. During such work, groundwater was observed actively infiltrating the concrete floor at several sumps noted throughout basement, thereby precluding mobilization of the LNAPL and impacted groundwater from the basement to the environment. Expired booms and pads were placed and secured in a steel 55-gallon drum. Booms and pads that had remaining utility were left on the standing water surface to passively absorb LNAPL. With work ongoing, BEA called the MA DEP after-hours emergency line in order to make Release Notification for a 2-Hour Reportable Condition, based on a sudden release. MA DEP Emergency Response personnel from the Southeast Regional Office(Jaime Goncalves,Case Officer) followed up with Deputy Chief Melanson. It was reported that approximately ten gallons of gasoline were released, as were approximately 20 gallons of hydraulic fluid. The Department provided verbal authorization to continue the ongoing response, including active ventilation and skimming of free floating product from the standing water. The Department registered the subject release as an Immediate Response Action and assigned Release Tracking Number(RTN) 4-26151. I AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 5 OF 15 IRAP,RTN 4-26151 At approximately 6:30 pm, after some three hours of preliminary response actions, BEA performed indoor air quality screening,wherein TOV concentrations were reported between 6 and 10 mv. Given the reduced TOV concentrations Hyannis pp y is Fire Department personnel entered the basement, approached the mechanical lift and removed the battery as the final potential ignition source. BEA subsequently recovered equipment and departed the Site as Hyannis Fire Department personnel secured the building. The vacuum truck removed approximately 775 gallons of LNAPL and impacted water that day, taken off-site for disposal under a properly executed hazardous waste manifest. ENVIRONMENTAL ASSESSMENT BEA (David Bennett, LSP) returned to the subject property on June 13, 2016, to meet with representatives from the Hyannis Fire Department and the Barnstable Health Department to review the circumstances of release, discuss work already undertaken, and develop a plan of action. BEA proposed additional skimming of the standing water in the basement with a vacuum truck to further remove LNAPL. BEA also proposed a pump-and-treat system using Granular Activated Carbon (GAC) to remove dissolved-phase organic contaminants, with the effluent treated to at least the applicable GW-2/GW-3 Method 1 Risk Characterization standards and discharged to the basement. The MA DEP was in agreement with the concept. At the conclusion of the meeting, BEA screened indoor air at the entry point to the basement with a PID,with greatly diminished odor noted as a result of prior remedial response efforts. A TOV concentration of<0.5 ppmv was reported. Inspection of the standing water reported a heavy sheen and saturated pads, but no visible LNAPL. BEA collected a sample of the standing water for MA Certified analysis of extractable petroleum hydrocarbons and target polynuclear aromatic hydrocarbons (EPH/PAH), as well volatile petroleum hydrocarbons (VPH) and target analytes, to compare against applicable Method 1 standards, and in consideration of carbon use for treatment system specifications. Laboratory analysis reported significant fractional EPH concentrations (C 11-C22 Aromatics, C 19-C36 Aliphatics) greater than the applicable GW-3, Method 1 Risk Characterization standards. Detectable concentrations of C9-C18 Aliphatics, as well target PAHs, and fractional VPH and associated target analytes were also reported; however, such concentrations were less than the applicable GW-2/GW-3 Method 1 criteria. These laboratory results are summarized in Table I. The significance of these results is further discussed on the Risk Characterization section of this report. AUGUST 4,2016 FORMER CAR DEALERSHIPBEAI6-10824A PAGE 6 OF 15 IRAP,RTN 4-26151 TABLE I:268 STEVENS STREET,HYANNIS,MA--RTN 4-26151 SUMMARY OF STANDING WATER ANALYSES-EPH,VPH METHOD 1 RISKCHARACTERI7ATION Sample Number: 1 Sample Identification: STANDING WATER IN BASEMENT Sample Date: 6/13/2016 VPH/TARGET ANALYTES(ug/1) GW-2 GW-3 Adj C5-C8 Aliphatics 3000 50000 <100 Adj C9-C12 Aliphatics 5000 50000 220 C9-C10 Aromatics 4000 50000 <100 Methyl-tert-butylether 50000 .50000. <5 Benzene 1000 10000 <5 Toluene 50000: 40000 20 Ethylbenzene 20000 5000 10 m,p-Xylene 3000 -500.0 37 o-Xylene 3000. 5000: 21 Naphthalene _ 700 20000 13 EPH/PAH(ug/1) C9-C18 Aliphatics 5000 50000 2300 C19-06 Aliphatics 50000 150000 Adj.C1 1-C22 Aromatics 500% 5000 5600 Naphthalene 700: 20000 13 2-Meth Ina hthalene 2006 y p '�`20000` 110 Acenaphthylene 10000 40 14 Acenaphthene 10000 8.8 Fluorene 40, <7 Phenanthrene 10000 10 Anthracene 30 <7 Fluoranthene r 200 <7 Pyrene 20 . <7 Benzo(a)anthracene 10:00 <7 Chrysene 70 <7 Benzo(b)fluoranthene 400 <7 Benzo(k)fluoranthene .100 <7 Benzo(a)pyrene 500 <7 Indeno(1,2,3-cd)pyrene 100 9.2 Dibenzo(a,h)anthracene 40 13 Benzo(g,h,i)perylene 20 7.9 VPH=Volatile Petroleum Hydrocarbon. EPH=E-Aractable Petroleum Hydrocarbon,PAH=Polynuclear Aromatic Hydrocarbon. Bold indicates greaterthan Method 1 standard.<indicates Non-Detect concentration. AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 7 OF 15 IRAP,RTN 4-26151 On June 24, 2016, BEA contacted the Department (Jaime Goncalves, Case Officer) to discuss additional response actions proposed in prior communications. The Department granted verbal authorization for the removal of LNAPL and treatment of contaminated groundwater in the subject basement with a GAC system wherein three volumes of water (45,000 gallons) was anticipated. That morning, BEA met with Global Remediation Services personnel at the Site to discuss logistics for set-up and operation of the proposed GAC system to be complemented with skimming of standing water with a vacuum truck. BEA and Global personnel identified an existing sump area that could be retrofit with a portable sump pump towards active pump-and-treat. This sump was centrally located within the basement, an appropriate location to draw LNAPL towards for recovery,as well as treatment of dissolved phase impacts. BEA and Global used oil absorbent booms to corral LNAPL towards the centrally located sump, and subsequently containerized spent pads in a steel 55-gallon drum before securing the Site and departing. In the following week,BEA coordinated carbon usage estimates and equipment rental from Carbon Filtration Systems of Pascoag, RI. The proposed treatment system would utilize a portable sump pump to direct impacted standing water to a frac tank, and from there use a trash pump to direct contaminated water through a series of two, 2,000-pound, welded steel GAC units, with discharge to the standing water in the basement. The beginning of such work was scheduled to begin July 5, 2016. REMEDIAL RESPONSE On July 5,2016,BEA returned to the Site to implement the Immediate Response Action. The frac tank and GAC filters were positioned along the east sidewall of the building. A vacuum truck provided by Global Remediation was set up to skim the standing water in the basement. Upon completion of setting up the equipment, BEA directed a safety tailgate meeting. Through the remainder of the day, standing water was pumped from the basement to the frac tank. Standing water was also pumped from the sump directly to the GAC filters, in order to off-gas and soak the carbon overnight against channeling and otherwise incomplete treatment. The vacuum truck removed some 1,869 gallons of LNAPL and impacted water that day, transported off-site under a proper hazardous waste manifest. At the end of the day, all hoses, cords and pumps were secured inside the building and BEA's equipment trailer. BEA returned the next day, July 6, 2016 to start batch treatment of exposed groundwater in the basement and to remove dissolved phase petroleum hydrocarbons using granular activated carbon (GAC). Additionally, a sample of the concrete in the impacted area of the basement was taken, to qualify potential impact in consideration of future demolition and disposal of the concrete foundation. During the startup of the groundwater treatment system, BEA directed Global Remediation Services to skim the standing water with a vacuum truck in the sump area used to pump standing water into the weir tank and through the GAC system. Upon start-up of the GAC treatment system, BEA collected Influent and Effluent samples for EPH/VPH analyses to qualify significant residual impacts and treatment performance. The Influent sample was collected from the standing water in the basement at the sump pump intake as representative of the water entering the frac tank and treatment system. The Effluent sample was collected after the second in-series GAC filter as representative of the water returned to the basement. Approximately 10,552 gallons of impacted standing water were treated that day. Some 1,131 gallons of oily water were removed that day. At the end of the work, AUGUST 4,2016 FORMER CAR DEALERSHIPBEAI6-10824A PAGE 8 OF 15 IRAP,RTN 4-26151 skimming and treatment operations were successful in removing LNAPL, wherein globules of free floating product were rare, and the petroleum odor and sheen was diminished to barely noticeable. Laboratory analysis reported marginal concentrations of fractional EPH compounds less than the applicable S-1 (GW-2/GW-3), and strictest S-1 (GW-1), Method 1 Risk Characterization standards. These laboratory results indicated that the concrete floor did not require special handling or disposal as remedial waste. Laboratory analytical reported all EPH, VPH and target analyte concentrations for the Effluent as Non-Detect (ND), wherein the reporting limits were less than the applicable GW-2/GW-3 Method 1 Risk Characterization standards. The Effluent reporting limits were also less than or equal to the strictest GW-1 Method 1 criteria,indicating background conditions with respect to groundwater quality. Laboratory analysis reported modest fractional EPH (C 11-C22 Aromatics, C19-C36 Aliphatics) concentrations for the Influent as less than the applicable GW- 2/GW-3 Method 1 criteria. The Influent and Effluent analytical results are summarized in Table II. The significance of these results is discussed in the Risk Characterization section of this report. ._ TABLEII 268 STEVEIVS STRIEC�HYANNIS,_MA,RTN 4-26151 .. .._.... ...... SUMMARYOFREMMIALSYSTFMO&M(AIFLUFNT/EFFLUENT) EPH,VPH.. ........ . _ .. .......___ . ....... ........_. METHOD 1 RISKCHARACT'ERQATION ffnum INFLUENT EFFLUENT INFLUENT EFFLUENT INFLUENT SAMPLINGDATE _ 06-JUL-16 06_JU416 07-JU1.16 07-JUL16 20JUL-16 - 20-JUL16 LAB SAMPLEID L1620858-01 L1620858-02 L1621063-01 L1621063-02 L1622767-01 L1622767-02 VPEDTARGECANALYM GW=2-14 GW-3'14 UnitsQua] QualQua] QLW Qual al Benane _1000...` 10000 ug/I._. 2 ,_.U.. .. U ............ 2. U ..?.. U _,..._..?..... U 2 U CS-CSAphattcs Adjusted 30DO 50000: ugA 50 U 50 U TO U 50 U 50 U 50 U C9-CIOAromancs 4000 SOODO ugA 50 U 50 U _50 U 50 U 50 U 50 U C9-C12 Aliphatm;Adlusted., SODD 50000 ugA 50 U 50 U 50 _U 50 U 50 U 50 U Fihylbenane 20000 5000 ug/I. __2 U 2 U 2 U 2 U 2 U Methyl tart butyl ether _509DO .500W u.0 3 U 3 U 3 U 3 U 3 U 3 U Naphthalene.._. .700- 200DO .ug/1 .. .4 U 4 U 4 U 4 U _ 4 U 4 ...U. o-Xylene... ... ... .. ... '3000 S000., ug/I .2 U 2 U 2 U 2 U 2 U 2 ... .0.. p/mXylene 3WO 50OD'. ugA 2 U 2 U 2 U 2 U 2 U 2 U Toluene 50000� x:400D0. u 2 U 2 U 2 U 2 U 2 U 2 ( U EPH/PAH . 244c0ylnaphthalene - 3000 20000 ug/I 0.4 U 0.4 U 0.4 U 0.4 U 0.4 ; U 0.4 U Acenaphthene 10000 ug/1 0.4 U 04 U 0.4 U D;4 U 0.4 U 0.4 U Acenap.Mhylene 10000 40.- ugA 0.4 U 04__ U 0.4 U 0.4 U 0.4 - U 0.4 U Anthracene 30.., ug/I 0.4 U.......0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Benm(a)anthmceoe 10W ugA 0.4 U 0.4 U 0.4 _U 0.4 U, OA U OA U Benm(a),tyrene 560 ugA 0.2 U 0.2 U 0.2 U 0.2 U 0.2 U 0.2 ! U Benm(b)fluorandtene '- 406 ug/1 0.4 U 0.4 U 0.4 U Q4. U 0.4 U 0.4 ` U Benm(gh)perylene d0 ug/1 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U _._._ ._ _4 .. Benin(k)fluoranthene, ;, 100 ugA 0.4 U 0.4 ! U _ .0.4 U 0_4 U 0.4 U 0.4 U C11-C22Amtrmbcs,Adjusted., 50000 5000.: ugA 100 U 284 100 U 153 207 100 U C19L36 Ahphatics ,. 50000 ugA 100 U 6280 100 U 2920 100 U 100 U -C18Afiphatics 50DO 50o00 ug/1 100 U 100 U 100 U 100 U ]011 C9 U 389 Qrysene 70 ug/1 0.4 ! U 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U IDibenm(aih)anthmcene ''40 U 0.4 U 0.4 U 0.4 U 0.4 U 0.4 ! U ETuo-the 20D; ugA 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U ......... .. _ ._.... . U .. - - -.. ... ... ... . . Fluorene 40 ugA 04 U 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Indeno(1,2,3-cd)Pymne 100, ugA 04 U OA U 0.4 U 0. U 0.4 U OA U Naphthalene 700 20D60 ug/1. 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Phenanthrene IOD00 ug/I 0.4 U 0.4 U 0.4 U 0.4 U 6.4 U 0.4 U rene 20 u I 0.4i U 1 0.4 U 1 0.4 U 6.4 U 0.4 U 0.4 U VPH=VoIaNe Petroleum Hydrocarbon,EPH-Eatmctable Petroleum Hydmcatbon,PAH=PolynuclearArotmtic Hydmcabon. U indicates Non-Detect concentration. BEA returned again on July 7, 2016,to run the system for another day in order to process the impacted standing water again towards complete treatment. Influent and Effluent samples were collected in review of significant impacts and treatment performance. Approximately 21,020 gallons of standing water were treated through the GAC system that day, bringing the total volume over two days of treatment to approximately 31,572 gallons. Laboratory analysis reported all EPH, VPH and target analyte concentrations for the Effluent as ND, wherein the reportable limits were less than the applicable GW-2/GW-3 Method 1 criteria [Refer to Table II]. Laboratory analysis reported diminished fractional EPH(C11-C22 Aromatics, C19-C36 Aliphatics) concentrations for the Influent AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 9 OF 15 IRAP,RTN 4-26151 as less than the applicable GW-2/GW-3 Method 1 criteria. During treatment system operation, BEA completed a level-loop to survey the top-of-casing elevations of six pre-existing monitoring wells to a common vertical datum,in order to establish local groundwater flow direction and a projected solute transport pathway,in review of data representativeness and usability. Static water level measurements recorded at the on-site wells have demonstrated a south to southeasterly groundwater flow direction, consistent with regional flow,and monitoring wells MW-6 and MW-5 have been established as within the projected spatial solute pathway. Also on July 7, 2016, BEA collected groundwater samples from wells MW-6 and MW-1, respectively, via low-flow methodology, for EPH, VPH and target analyte concentrations,to qualify potential impacts related to the release in review of risk characterization. Laboratory analysis reported A petroleum hydrocarbon and target analyte concentrations for both wells as ND, wherein the reporting limits were less than the applicable GW-2/GW-3 Method 1 Risk Characterization criteria. The reporting limits were also less than or equal to the strictest GW-1 Method 1 criteria, indicating background conditions with respect to groundwater quality. On July 11, 2016, BEA collected groundwater samples from monitoring wells MW-3, MW-4 and MW-5 to complete the initial groundwater assessment;monitoring well MW-2 was not sampled based on its location as up-gradient from the area of release. Laboratory analysis reported all EPH,VPH and target analyte concentrations as ND, wherein all reporting limits were less than the applicable GW-2/GW-3, Method 1 Risk Characterization standards. The reporting limits were also less than or equal to the strictest GW-1 Method 1 criteria indicatingbackground conditions with respect to groundwater quality. The to P t�' q Y laboratory results for the monitoring well testing are summarized in Table III. The significance of these results is discussed in the Risk Characterization section of this report. AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 10 OF 15 IRAP,RTN 4-26151 TABLE IIL•268 STEVENS STREET,HYANNIS,MA-RTN 4-26151 SUMMARY OF MONITORING WELL ANALYSES-EPA VPH METHOD 1 RISK CHARACTERIZATION CLiINTSAMPLEID i AM-6 MW-1 NM-3 MW-4 MW-5 ' SAMPLING DATE i 07 JUL16 07JUL-16 11JUL-JUL 11.TUL•16 I1-JUL-16 . ....... ._.. ....... _. .. .._. _..._-._.. L-16 _......-._.. .. LAB SAMPLE ID L1621067-01 L1621067-02 L1621345-01 L1621345-02 L1 62 134 5-0 3 i VPH/TARGEFANALY1ES GW-2-14 GW-3-141 Units i Qual :Qual zeal Qual 'Qual Benzene 1000 10600 ug/1 2 U 2 U 2 U 2 U 2 i U CS C8 Ahphaucs,Adjusted 3000 50000 ug/l 50 U 50 U 50 U 50 U 50 U C9 C10 Aromatics 4000• 50000 ug/l 50 U 50 U 50 U 50 U 5o U C9 C12 AH hatics,Adjusted 5000 -50000 ug/l 50 ` U 50 U 50 U 50 U 50 U ,2o0oo.` ..5000 ug/1 2 U 2 U 2 U 2 U 2 U Methyl tert butyl ether 50000. 50000 ugh 3 U 3 U 3 ! U 3 U 3 U ... _. .... ..... ...... ._ ._ _..3._ Naphthalene t 700 '. 20600 ug/1 4 U 4 U 4 U 4 U 4 U o Xylene _. .... 3000 -5000 ug/I 2 U 2 U 2 U 2 U 2 U p/m-Xylene.. ,.._ ,.3000_- 5000 ug/l 2 U 2 U 2 U 2 U 2 U Toluene 50000 :',�W. ug/l . . .2 iJ .2. U ...2 .. U ...2... U 2 U EPH/PAH 2-Methyhiaphthalene - 2000 `20000 ug/1 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Acenaphthene 10000 u9/1 0.4 U 0.4 U 0.4 : U 0.4 Acenaphthylene 10000 40 us/] 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Anthracene .- ,30-' ug/1 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Benzo(a)anthracene 1000 ug/l 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Benzo(a)pyrene Soo ug/I 02 U 0.2 U 0.2 U 0.2 U 0.2 U. . ._ . ..- - -__ - - .- -. ... _... . . _. B el.nzo.Nquora nth ene -.400� ug/I 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Benw(ghi)perylene 20`. ug/1 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Benzo(k)fluoranthene - 100 - ug/l 0.4 U 6.4 U 0.4 U 0.4 U 0.4 U Cll-M Aromatics,Adjusted 50000 5000 ug/l ]00 U 100 U 100 U 100 U 100 U C69 63 Aliphatic's 50000 ug/1 100 U 100 U 100 U 100 U 100 U C9-CI8Ahphatics 5000 ,50000 ug/1__ ]00 U I— U 100_ U 100 U 100 U Chrysene ,c 70 ug/l 0.4 U 0.4 U 0.4 U 0.4 U 0.4 ' U Ihbenzo(a,h)anthmcene - 40 _ ug/l 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Fluoranthene 200. ug/l 0.4 U 0:4 U 0.4 U 0.4 U 0.4 U Fluorene `+40 ug/l 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Indeno(Jj, d)Py.Tne iloo ug/l 0.4 U 0.4 - U 0.4 ' U 0.4 U 0.4 U Na hthalene 700 20000 ug/l 0.4 U 0.4 U 0.4 U 0.4 U 0.4 U Phenanthrene '10000 ugA 0.4 U 0.4 U 0.4 - U 0.4 U 0.4 U ..._..______._.. _. ..__. ..... .___.... _.. _.- ._.. _. ..__ _. ___ . [rene. 20.- ug/l 0.4 U 0.4 - U 0.4 U 0.4 U 0.4 U VPH=Volatile Petroleum Hydrocarbon,FPH=&SractablePetroleumHydrocarbon,PAH=Polynuclear Aromatic Hydrocafion U indicates Non-Detect concentration. BEA returned to the subject property on July 20, 2016, to perform additional groundwater treatment as well as a series of slug tests to qualify hydraulic conductivity, in order to estimate groundwater velocity and solute Time of Travel. BEA personnel performed a series of three slug tests at monitoring well MW-1, wherein the recharge time within the well was recorded. The AQTESOLV software (Geraghty & Miller, Inc.) was used to interpret the slug test results, and a hydraulic gradient wherein a Hydraulic Conductivity(K) of 0.79 ft/day was calculated. Based on the hydraulic conductivity and hydraulic gradient across the Site, the Time of Travel from the release area to the down-gradient monitoring wells MW-5 and MW-6 were estimated as 56 days (August 5, 2016) and 85 days (September 3, 2016), respectively [Refer to Appendix B]. As such, the initial groundwater sampling was done outside the Time of Travel, and additional sampling within the Time of Travel remains appropriate and necessary to evaluate groundwater within the spatial and temporal solute transport pathways. That same day, BEA conducted another batch treatment of the standing groundwater in the basement through the GAC system. The standing water in the basement was noted to have dropped with each successive treatment and on this day, the groundwater level was noted as below the level of the basement floor, though standing water remained in the sump used as the intake point for treatment of the impacted water. BEA processed the water left in the frac tank through the GAC filters and return it to the basement. Approximately 5,200-gallons of water were pumped from the frac tank through the GAC filters and returned to the basement that day. The total volume of impacted AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 11 OF 15 IRAP,RTN 4-26151 water treated over the three days of GAC system operation was approximately 36,772-gallons. BEA again collected Influent and Effluent samples for performance evaluation,wherein laboratory analysis reported all EPH, VPH and target analyte concentrations less than the applicable GW-2/GW-3, Method 1 Risk Characterization standards [Refer to Table II]. Counter to previous treatment system testing,the influent sample reported a fractional EPH compound(C 11-C22 Aromatics)concentration marginally greater than the GW-1 threshold. Laboratory QA/QC identified multiple issues with surrogate recoveries and Relative Percent Differences (RPDs) as indicating potential low bias. Re- analysis of the Effluent sample reported all EPH,VPH and target analyte compounds as ND. Despite the analytical issues, the data was considered appropriate to meet Presumptive Certainty for its intended use to evaluate treatment performance, wherein all tested compounds met the treatment objective concentrations: the applicable GW-2/GW-3, Method 1 Risk Characterization standards. Having met treatment objectives through GAC remedial system operation, BEA coordinated system shutdown, cleaning and removal of the treatment system equipment. The remaining water in the frac tank was pumped and vessel cleaned by Global Remediation Services on July 22,2016. Some 350-gallons of wastewater were generated by such cleaning, as was transported off-site for appropriate disposal under a properly executed hazardous waste manifest. On July 27, 2016, BEA personnel provided access for the frac tank to be hauled off-site by the vendor. Per the vendor requirements for GAC disposal/regeneration, BEA also collected a sample of the used carbon from the second in-line GAC filter for TCLP analyses (RCRA 8 Metals, VOCs, and Semivolatiles). Laboratory analytical reported all TCLP results as ND with the exception of Barium; all TCLP analyses reported concentrations within acceptable limits for return/reactivation of the used carbon. The analytical results for the Used Carbon are presented in the final laboratory report in Appendix D [Alpha Analytical — Lab #L1623496 (8/2/16)]. The GAC filters and associated appurtenances were hauled away from the Site by the vendor on August 4, 2016. RISK CHARACTERIZATION Soil Based on site conditions relative to frequency/intensity of use and accessibility of soils at the commercial property,the RCS-1 Reportable Concentrations apply to soil,per 310 CMR 40.0361,and the S-1/S-2/S-3 (GW-2/GW-3) Method 1 Risk Characterization standards are applicable to soil impact in accordance with the provisions of 310 CMR 40.0975. For the purposes of risk characterization, the strictest S-1 (GW-2/GW-3), Method 1 Risk Characterization standards are considered in review of ingestion, inhalation and dermal contact exposures, and potential leaching to groundwater, as related to foreseeable future uses and activities at the Site. Based on groundwater elevation greater than that of the basement floor at the time of release, demonstrated by infiltration of the basement floor wherein no power was available to run the existing sumps, hydrostatic pressure would not have allowed the subject release and associated LNAPL to infiltrate soils underlying the basement floor. However, soil that had accumulated over time at the bottom of the exterior ramp may have received impacted standing water or LNAPL. Therefore, it is appropriate and necessary to evaluate such soils for petroleum hydrocarbon and target analyte concentrations in order to qualify significant impacts in review of additional response actions and risk AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 12 OF 15 IRAP,RTN 4-26151 characterization. Such work is proposed under the IRA Plan section of this report towards establishing a condition of No Significant Risk, in support of a Permanent Solution Statement (PSS) and project closure. Groundwater The GW-2 and GW-3 groundwater categories are applicable to Method 1 Risk Characterization per 310 CMR 40.0974. Based on the observed groundwater infiltrating the basement floor, hydrostatic pressure would have prevented the released gasoline and hydraulic oil from mobilizing to groundwater surrounding/underlying the basement. In addition, laboratory analysis of groundwater samples reported all EPH, VPH and target analyte concentrations as ND, wherein the reporting limits were less than the RCGW-2 Reportable Concentrations and the applicable GW- 2/GW-3, Method 1 Risk Characterization standards. Based on laboratory analysis.for groundwater samples analyzed,no significant impacts to standing water remain and no impact to surrounding groundwater have been reported as associated with the subject release. Additional groundwater monitoring is appropriate and necessary to evaluate and qualify such impacts through a preponderance of physical evidence, inclusive of solute modeling, to demonstrate a condition of No Significant Risk, with respect to groundwater associated with the subject release. Indoor Air The subject release occurred in the basement of the commercial building on the subject property as affected indoor air quality based on olfactory observations and indoor air quality screening. Subsequently, no noticeable or persistent petroleum-related odor have been reported in the subject building. Upon activation of the GAC treatment system, sampling and analysis of the Influent (i.e., standing water) from the basement has reported all EPH, VPH and target analyte concentrations as ND,wherein the reporting limits were less than the applicable GW-2/GW-3 Method 1 criteria. Wherein the GW-2 criteria is established to consider vapor entry into a occupied structure, and no impact to the concrete foundation and floors is documented by laboratory analysis, and the building is scheduled for demolition and redevelopment, vapor entry and degraded indoor air is not a media of concern. Unless the existing building will be re-occupied, no further indoor air screening or testing of Air Phase Petroleum Hydrocarbons (APH) is intended or necessary to support project closure. Such needs will be re-evaluated as based on future groundwater analysis framed within the IRA Plan herein. Imminent Hazard Evaluation The subject building was vacant at the time of release, and has been for some time, with the electric service cut at the meter. Appropriate PPE was employed against inhalation of VOCs to facilitate active ventilation of the basement, and LNAPL recovery, on the day of the release. Subsequent inspections reported significantly diminished TOV concentrations with no persistent petroleum hydrocarbon odor. Notwithstanding on-site workers for remedial response actions, the building has been kept locked to restrict access. Additionally,temporary fencing has been established along the perimeter of the subject property, further restricting access to the Site. Spent absorbents have been placed in secure 55-gallon drums outside the building. Some 3,775-gallons of LNAPL and AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 13 OF 15 IRAP,RTN 4-26151 impacted standing water have been removed from the basement for off-site disposal. Some 36,772- gallons of standing water have been treated to background via the GAC pump-and-treat system. Based on the Site and environmental conditions documented, there is no apparent Imminent or Substantial Hazard associated with the release of gasoline and hydraulic fluid in the basement at the subject property. IMMEDIATE RESPONSE ACTION PLAN MODIFICATION The collection and analysis of soils at the bottom of the exterior ramp leading to the basement is proposed to qualify potential petroleum hydrocarbon impacts associated with the intercept of LNAPL and dissolved phase impacts in the basement standing water at the time of release, as the staging area for LNAPL recovery and groundwater treatment. Based on the laboratory analytical results, soil may be removed from this area to absolve any significant soil impacts (>S-1/GW-2, S- 1/GW-3). Based on construction of the subject building and exterior ramp, it appears that asphalt pavement and/or concrete underlies the soil at the bottom of the ramp and the continuation of the IRA includes the removal of up to 10 yards of impacted soil as may be appropriate. MA certified analyses of EPH, VPH and target analyte concentrations will be relied on to qualify potential significant impacts, and also to evaluate remedial response performance via end-point sampling, should contaminated soil removal be necessary. Additional groundwater analysis is proposed to collect representative samples of the exterior monitoring wells within the both the spatial and temporal solute transport pathways in order to evaluate potential significant groundwater impacts. MA certified analyses of EPH, VPH and target analyte concentrations will be relied on to qualify potential significant impacts. Additional quarterly groundwater sampling and analysis is anticipated in the 3`d and 4 h quarters of 2016, as through the projected time of travel for potential solute migration from the area of the building to the down- gradient monitoring wells. Air quality monitoring will be considered as based on the results of the above noted soil and groundwater analysis. In the next reporting period the balance of remedial waste(6 drums absorbents LNAPL recovery, any soil from ramp area and remaining automotive fluids in lift) will be appropriately managed and documented. All such work will be compiled on "Inspector's Daily Record of Work Progress" reports and documented in the IRA Status I Report (IRAS I) or IRA Completion(IRAQ to be submitted within 120 days of Release Notification. ENVIRONMENTAL MONITORING BEA will perform quarterly monitoring well testing,within the Time of Travel,for EPH/VPH and target analytes as appropriate to qualify potential significant impacts to groundwater. The need for further treatment of soils and/or groundwater will be evaluated based on the results of future soil sampling and groundwater monitoring. Field measurements of groundwater elevations,olfactory and visual observations and the field-testing of pH, dissolved oxygen, conductivity and temperature will be reported on Monitoring Well Sampling Logs. Field inspections will be conducted and documented on"Inspector's Daily Record of Work Progress"reports. AUGUST 4,2016 FORMER CAR DEALERSHIP/BEA16-10824A PAGE 14 OF 15 IRAP,RTN 4-26151 Remedial response and environmental assessment work will proceed as consistent with the QA/QC Policies of BEA, as well as the Site-specific Health and Safety Plan (HASP), presented in Appendices E and F, respectively. Future environmental assessment/monitoring activities will dictate the need for any additional remedial measures to be represented in future IRA Status reports as will be filed within 60 days of this IRA Plan, and then every six months thereafter. Remedial response activities considered herein, and potentially to follow in subsequent IRA Status reports, are intended to mitigate all Significant Risk to identified human and environmental receptors, to facilitate a Permanent Solution in support of project closure, as defined within the governing MCP. CONCLUSIONS) Some 30-gallons of gasoline and hydraulic oil were released from the mechanical lift onto standing water within the basement of subject building. Hydrostatic pressure, manifest by groundwater infiltrating the basement floor, prevented the release from reaching the environment. Response actions were initiated that day to recover L•NAPL and dissolved-phase impacts. LNAPL recovery and treatment of water through carbon adsorption (GAC filters) have been used to remove the contaminant source and absolve significant impacts to standing water in the basement, wherein Influent and Effluent testing reported all petroleum hydrocarbon and target analyte concentrations less than the applicable GW-2/GW-3, Method 1 criteria. Groundwater testing at on-site monitoring wells reported all EPH, VPH and target analyte concentrations as ND, wherein the reporting limits were less than the applicable GW-2/GW-3, Method 1 Risk Characterization standards. As such, the established lines of evidence indicate no significant impact to the environment associated with the subject release. However, additional soil testing is proposed to qualify potential impact to the soil at the bottom of the exterior ramp. Quarterly groundwater monitoring is also proposed to collect representative samples within the projected spatial and temporal solute transport pathways and qualify potential significant impacts. Modest soil removal may be performed to absolve potential impacts as subject to the results of the soil assessment proposed herein. The effectiveness of the IRA and the evaluation of any potential significant exposures to identified human and environmental receptors will continue over the next reporting period as outlined herein. This information will be used to refine the Conceptual Site Model and evaluate potential exposure risk in consideration of ongoing response actions and project closure objectives, as will be framed in the next report. The IRAS I or IRAC/PSS, to be filed within 120 days of Release Notification, subject to the collection, analysis and evaluation of additional environmental data. The findings of this investigation, as represented herein, set forth the rationale and technical justification for the LSP Opinions offered, as established by the certifications made on the attached Immediate Response Action Transmittal Form (BWSC-105) and Remedial Monitoring Report (BWSC-105A,-B). The LSP Opinions are based on available data and regulations in effect at the time of this reporting specific to the subject Site. AUGUST 4,2016 FORMER CAR DEALERSHIPBEAI6-10824A PAGE 15 OF 15 IRAP,RTN 4-26151 Should the Department have any questions regarding this project,please contact our office at your earliest convenience. Sincerely, BE TT ENVIRONMENTAL ASSOCIATES, INC. t�etn ett, LSP Todd M. Ev rson, ES Senior Proje anager Encl: Supporting Documentation(Appendices A—F) cc: Stuart Bornstein, Owner, PRP—Holly Management and Supply Corporation Thomas McKean, Director—Barnstable Health Division* Fire Prevention Officer/Lieutenant John Cosmo—Hyannis Fire Department* Mark S. Ells—Barnstable Town Manager* * As part of Public Notice requirements, the report Title Page, Narrative, Index, Transmittal forms and Site Plan are included,pursuant to paperwork reduction policy. The full report is available as public record on the N A DEP website database at hq://public.dep.state.ma.us/SearchableSites/Search.asp or,upon written request to BEA,full copy(electronic or paper)will be provided. IMMEDIATE RESPONSE ACTION PLAN WITH SUPPORTING DOCUMENTATION RTN 4-26184 Averett Residence 251 Great Neck Road North [Assessors Map 52,Parcel 2] Mashpee,MA 02649 BEA16-10921 AUGUST 24, 2016 Prepared For: MA DEPARTMENT OF ENVIRONMENTAL PROTECTION Southeast Regional Offices: Bureau of Waste Site Cleanup/Emergency Response Section 20 Riverside Drive-Lakeville, MA 02347 Dan Crafton,Emergency Response Section Chief Prepared Bv: BENNETT ENVIRONMENTAL ASSOCIATES,INC. 1573 Main Street-Brewster, MA 02631 David C. Bennett,LSP On Behalf Of: Judith Averett, Homeowner 251 Great Neck Rd. North [Assessors Map 52,Parcel 2] Mashpee,MA 02649 APPENDIX Ae Reference Plans -Figure 1: Site Locus Plan [USGS Topographic Quad., Mashpee,MA. 1998] (excerpt) -Figure 2: Ground-Water Resources of the Cape Cod,MA...[LeBlanc et al, 1986] (excerpt) -Figure 3: MA DEP BWSC GIS Map [2016] -Site Plan entitled, "Immediate Response Action Plan..."Prepared by BENNETT ENVIRONMENTAL ASSOCIATES, INC., Dated August 23, 2016 APPENDIX B: Field Reports -Field Response Log APPENDIX Ce Environmental Records/Permits/Correspondence -Mashpee Fire Department Incident Report -BWSC-101: Release Log Form -BWSC-102: Release Amendment Form(7/11/16) -BWSC-102: Release Amendment Form(7/27/16) -BWSC-112: Bill of Lading(pre-shipment)/Aggregate Industries Soil Recycling Submittal -BWSC-112: Bill of Lading(post-shipment/acknowledgement of receipt) -BWSC-103: Release Notification Form w/eDEP Submittal Summary and Receipt -BWSC-105: Immediate Response Action Transmittal Form w/eDEP Submittal Summary and Receipt APPENDIX De Remedial Additive Specifications Regenesis REGENOX Product Literature/SDSs APPENDIX Ee Laboratory Analysis -Waste Characterization/Assessment- Soil [RI Analytical, Inc.] (Lab#1607-15543, 7/13/16) APPENDIX F: Quality Assurance/Quality Control Plan APPENDIX Ge Site health and Safety Plan Massachusetts Department of Environmental Protection eDEP Transaction copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: D"IDBENNETT Transaction ID: 859953 Document: BWSC126 Miscellaneous Document Transmittal Form Size of File: 146.70K Status of Transaction: In Process Date and Time Created: 8/30/2016:5:14:55 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy"from the Current Submittals page. Massachusetts Department of Environmental Protection BWSC 126 Bureau of Waste Site Cleanup Miscellaneous Document'Transmittal Form Release Tracking Number , - - 26151 A.DISPOSAL,SITE LOCATION: 1.Disposal Site Name: FORMER CAR DEALERSHIP 2. Street Address: 268 STEVENS STREET 3.City/Town: HYANNIS 4.Zip Code: B.THIS FORM IS BEING USED TO:(check all that apply) 1. Correct typographical errors and/or make corrections that do not materially affect the nature or complexity of the response actions.If changes are materially significant,then a revised or modified submittal must be made to the Department.List the report/form that is being corrected that is associated with the above Release Tracking Number (RTN).Attach an errata sheet containing a description of the errors and/or corrections. Form/Report Submittal Transaction ID Date(mm/dd/yyyy) P 2. Submit other documents associated with this RTN that cannot be submitted to the Department using any other BWSC transmittal form.Do not submit documents that are of a time-critical nature and/or that require a direct response from the Department and/or that require an LSP Opinion pursuant to 310 CMR 40.0015.(Section C is not required). Description of Submittal REINSTATE PROFESSIONAL SERVICES&LSP OVERSIGHT r 3. Resign as LSP-of-Record for the above Release Tracking Number(RTN).Attach a copy of the LSP resignation letter. (Section D,E,and F are not required). r 4. Submit copies of Public Notices required pursuant to 310 CMR 40.1400:(check all that apply) (Section C is not required) r a.Tier I Classification r Check here if submitting a copy of a legal notice I—b.Tier II Classification r Check here if submitting a copy of a legal notice r c.Immediate Response Action(IRA) r d.Release Abatement Measure(RAM) r e.Downgradient Property Status(DPS) r f.Utility-related Abatement Measure(DRAM) r g.Comprehensive Response Actions r h.Activities related to r Check here if submitting a copy of a legal notice recording/registering an Activity and Use Limitation(AUL) r i.Permanent or Temporary Solution (All sections of this transmittal form ,must be filled out unless otherwise noted) Revised:09/17/2013 Page 1 of 4 Massachusetts.Department of Environmental Protection BWSC 126 Bureau of Waste Site Cleanup Miscellaneous Document Transmittal Form Release Tracking Number 4 - 26151 B.THIS FORM IS BEING USED TO(cont.): (check all that apply) F 5. Submit Public Involvement Petition documents.(check all that apply).(Section C is not required). r a.Submit a Public Involvement Petition r b.Submit a Public Involvement Petition Retraction r c.Submit a Positive Public Involvement Petition Designation Letter r d.Submit a Negative Public Involvement Designation Letter e. Submit a Draft Public Involvement Petition Plan f.Submit a Revised Public Involvement Petition Plan r g.Submit a Final Public Involvement Petition Plan h. Submit a Notice of Public Comment Period Date of Close of Comment Period: (mm/dd/yyyy) r i.Submit a copy of a Public Involvement Petition legal notice r-j.Submit a Notice of Public Meeting Meeting Date: (mm/dd/yyyy) r k.Submit other Public Involvement Petition related documents not specified above: Describe: r 6. Submit a RCRA Contained-In-Determination to document that soil and/or groundwater is no longer considered a hazardous waste pursuant to state(310 CMR 30.00)and federal(Title 40,Chapter I,Part 261 of the Code of Federal Regulations)hazardous waste regulations. r—7. Submit notification and documentation of Reclamation Soil Reuse pursuant to 310 CMR 40.0031(2). C.LSP SIGNATURE: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form, including any and all documents accompanying this submittal.I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 2.First Name: 3.Last Name: 4.Telephone: 5.Ext.: 6.Email: 7.Signature: 8.Date: (mm/dd/yyyy) Revised:09/17/2013 Page 2 of 4 Massachusetts Department of Environmental Protection BWSC 126 Lit\ Bureau of Waste Site Cleanup Miscellaneous Document Transmittal Form Release Tracking Number 4 - 261 11 1. D.PERSON MAKING A SUBMITTAL: 1.Check all that apply: 1`a.Change in contact name F-b.Change of address $V-c.Change in person undertaking response actions 2.Name of Organization: HOLLY MANAGEMENT 3.Contact First Name: STUART 4.Last Name: BORNSTEIN 5.Street: 297 NORTH STREET 6.Title: OWNER 7.City/Town: HYANNIS 8.State: MA 9.ZIP Code: 026010000 10.Telephone: 5083989090 11.Ext.: 12.Email: r- 13.Check here if the person is a Public Involvement Petitioner E.RELATIONSHIP TO SITE OF PERSON MAKING SUBMITTAL: Check here to change relationship 1.RP or PRP 17 a. Owner F-D. Operator r c.Generator r d.Transporter r 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) r 3.Agency or Public Utility on a Right of Way(as defir_ed by M.G.L.c.21E,s.50)) r 4.Any Other Person Undertaking Response Actions Specify Relationship: F.CERTIFICATION OF PERSON MAKING SUIBMITTAL: 1. 1, STUART BORNSTEIN ,attest under the pains and penalties or perjury(i)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.I/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. 2.By: STUART BORNSTEIN 3.Title: signature 4.For: HOLLY MANAGEMENT 5.Date: 8/30/2016 (Name of person or entity recorded in Se:tion D) mm/dd/yyyy 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.State: 10.ZIP Code: 11.Telephone: 12.Ext.: 13.Email: Revised:09/17/2013 Page 3 of 4 Massachusetts Department of Environmental Protection BWSC 126 Bureau of Waste Site Cleanup Miscellaneous Document Transmittal Form Release Tracking Number L r 1 [4:] 26151 Check here if any non-updatable information provided on this form is incorrect,e.g.property address. Send corrections to BWSC.eDEP@state.ma.us YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF TINS 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): Received by DEP on 8/30/2016 5:10:32 PM I Revised:09/17/2013 Page 4 of 4 8/30/2016 eDEP-MassDEP's OnlineFiling System 15M 13'R E MassDEP Home I Contact i Privacy Policy MassDEP's Online Filing System Ig Usemame:DAVIDBENNETT Nickname:BENNETTDAVID 7 Receipt Forms Attach Files Signature Receipt ;Summary/Receipt _ print receipt Exit Your submission is complete. Thank you for using DEP's online reporting 'system. You can select "My eDEP" to see a list of your transactions. i I eDEP Transaction ID: 859953 ;Date and Time Submitted: 8/30/2016 5:10:32 PM Other Email : i i !Form Name: BWSC126 Miscellaneous Document Transmittal Form ! lRTN: 4-26151 Location: FORMER CAR DEALERSHIP Address: 268 STEVENS STREET, HYANNIS, Person Making Submittal !HOLLY MANAGEMENT lSTUART BORNSTEIN 297 NORTH STREET !HYANNIS, MA 026010000 I lLSP jLSP # ILSP Name i Person Making Certification !Stuart Bornstein Additional Forms Submitted ;Ancillary Document Uploaded/Mailed iBWSC-126 Ques.132 - Other Documents - Uploaded (Professional Services- ILSP Reinstatement.pdo My eDEP MassDEP Home Contact Privacy Policy MassDEP's Online Filing System ver.12.25.3.0©2016 MassDEP httr)s://edep.dep.mass.qov/Pages/PrintReceipt.aspx 1/1 Massachusetts Department of Environmental Protection $WSC 103 L `: Bureau of Waste Site Cleanup RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number RETRACTION FORM 14Pursuant to 310 CMR40.0335 and 310 CMR 40.0371(SubpartC) A.RELEASE OR THREAT OF RELEASE LOCATION: 1.Release Name/Location Aid: FORMER CAR DEALERSHIP 2.Street Address: 268 STEVENS STREET 3.City/Town: HYANNIS 4.ZIP Code: 5.Coordinates: a.Latitude:N 41.65088 b.Longitude:W 70.29436 B.THIS FORM IS BEING USED TO: (check one) 1.Submit a Release Notification 2.Submit a Revised Release Notification r 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 transmittal form must be filled out unless otherwise noted above) C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): 1.Date and time of Oral Notification,if applicable: 6/10/2016 Time: 05:28 AM r�.PM mm/dd/yyyy hh:mm 2.Date and time you obtained knowledge of the Release or TOR: 6/10/2016 Time: 04:30 r AM r PM mm/dd/yyyy hh:mm 3.Date and time release or TOR occurred,if known: Time: AM PM 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 r: a.Sudden Release r a.Subsurface Non-Aqueous Phase r a.Release of Hazardous Material(s)to Liquid(NAPL)Equal to or Greater than Soil or Groundwater Exceeding 1/2Inch(.04 feet) Reportable Concentration(s) " b.Threat of Sudden Release r b.Underground Storage Tank(UST) b.Release of Oil to Soil Exceeding Release Reportable Concentration(s)and Affecting More than 2 Cubic Yards r c.Oil Sheen on Surface Water r c.Threat of UST Release r c.Release of Oil to Groundwater Exceeding Reportable Concentration(s) r d.Poses Imminent Hazard r d.Release to Groundwater near Water r d.Subsurface Non-Aqueous Phase Supply Liquid(NAPL)Equal to or Greater than 1/8 Inch(.01 feet)and Less than 1/2 Inch (.04 feet) . e.Could Pose Imminent Hazard r e.Substantial Release Migration r f.Release Detected in Private Well r g.Release to Storm Drain r h.Sanitary Sewer Release (Imminent Hazard Only) Revised: 07/18/2013 Page 1 of 3 Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: BOINC Transaction ID: 844333 Document: BWSC103 Release Notification &Retraction Form Size of File: 149.87K Status of Transaction: Submitted Date and Time Created: 8/30/2016:5:13:23 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection BWSC 103 L7, I Bureau of Waste Site Cleanup RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number RETRACTION FORM I ` I - 26151 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C) C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): (cont.) 7.List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity(RQ)by the greatest amount. �.Check here if an amount or concentration is unknown or less than detectable. O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable if known Concentration (RCS-1,RCS-2,RCGW-1, RCGW-2) GASOLINE O 10 GAL N/A HYDRAULIC OIL O 20 GAL N/A Check here if a list of additional Oil and Hazardous Materials subject to reporting,or any other documentation relating to this notification is attached. D.PERSON REQUIRED TO NOTIFY: 1.Check all that apply: -a.change in contact name T—b.change of address P—c.change in the person notifying 2.Name of Organization: HOLLY MANAGEMENT COMPANY 3.Contact First Name: STUART 4.Last Name: BORNSTEIN 5.Street: 297 NORTH ST. 6.Title: OWNER 7.City/Town: HYANNIS 8.State: MA 9.ZIP Code: 026010000 10.Telephone: 508-328-9090 11.Ext: 12.Email: 13.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: r Check here to change relationship r 1.RP or PRP rv-1 a.Owner r b.Operator r c.Generator r'd.Transporter e.Other RP or PRP Specify: r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50)) r 4.Any Other Person Otherwise Required to Notify Specify Relationship: Revised: 07/18/2013 Page 2 of 3 Massachusetts Department of Environmental Protection BWSC 103 Bureau of Waste Site Cleanup RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number f 2 a. RETRACTION FORM 4 - 26151 Pursuant to 310 CMR 40.0335 and 310 CMR 43.0371(Subpart C) F.CERTIFICATION OF PERSON REQUIRED TO NOTIFY: 1.I,STUART BORNSTEIN ,attest under the pains and penalties of perjury(i)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 immediLtely responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and telief,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.1/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to,possible fees and imprisonment,for willfully submitting false, inaccurate,or incomplete information. 2.By: STUART BORNSTEIN 3.Title: OWNER Signature 4.For: HOLLY MANAGEMENT COMPANY 5.Date: 8/30/2016 (Name of person or entity recorded in Section D) mm/dd/yyyy r 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.State: 10.ZIP Code: 11.Telephone: 12.Ext: 13.Email: YOU ARE SUBJECT TO ANNUAL COMPLIANCE ASSURANCE FEES FOR EACH BILLABLE YEAR FOR TIER CLASSIFIED DISPOSAL SITES.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN TBE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAYBE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Received by DEP on 8/30/2016 2:16:10 PM Revised: 07/18/2013 Page 3 of 3 eDEP -MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System USemame:B01NC Nickname:BENNETT My eDEP I Forms m My Profile® Help i Notifications Receipt I Forms Signature Receipt Summary/Receipt _ print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP" to see a list of your transactions. DEP Transaction ID: 844333 Date and Time Submitted: 8/30/2016 2:16:10 PM Other Email : Form Name: BWSC103 Release Notification & Retraction Form RTN: 4-26151 Location: FORMER CAR DEALERSHIP Address: 268 STEVENS STREET, HYANNIS, Person Making Submittal HOLLY MANAGEMENT COMPANY STUART BORNSTEIN 297 NORTH ST. HYANNIS, MA 026010000 Person Making Certification HOLLY MANAGEMENT COMPANY Stuart Bornstein Additional Forms Submitted My eDEP MassDEP Home Contact i Privacy Policy MassDEP's Online Filing System ver.12.25.3.0©2016 MassDEP httns:Heden.dCD.mass.gov/Pages/PrintReceint.asnx 9/30/2016 r • Massachusetts Department of Environmental Protection e®EP Transaction ConftvL11 , Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: TODDEVERSON Transaction ID: 853667 Document: BWSC105 Immediate Response Action Transmittal Form Size of File: 639.42K Status of Transaction: In Process Date and Time Created: 8/30/2016:5:16:22 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. i Massachusetts Department of Environmental Protection s p BWSC 105 _ Bureau of Waste Site Cleanup Immediate Response Action (IRA) Transmittal Form Release Tracking Number Pursuant to 310 CMR 40.0424-40.0427(Subpart'D) - 126151 A.SITE LOCATION: 1.Release Name/Location Aid: FORMER CAR DEALERSHIP 2.Street Address: 268 STEVENS STREET 3.City/Town: HYANNIS 4.Zip Code: 5.Check here if this location is Adequately Regulated,pursuant to 310 CMR 40.0110-0114. I—a CERCLA r b.HSWA Corrective Action r c.Solid Waste Management r-d.RCRA State Program(21 C Facilities) B.THIS FORM IS BEING USED TO:(check all that apply) 1.List Submittal Date of Initial IRA Written Plan(if previously submitted): 6/9/2016 2.Submit an Initial IRA Plan. r 3.Submit a Modified IRA Plan of a previously submitted written IRA Plan. l- 4.Submit an Imminent Hazard Evaluation.(check one) r-a.An Imminent Hazard exists in connection with this Release or Threat of Release. 170 b.An Imminent Hazard does not exist in connection with this Release or Threat of Release. c.It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release,and fiuther assessment activities will be undertaken. r-d.It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release.However,response actions will address those conditions that could pose an Imminent Hazard. 5.Submit a request to Terminate an Active Remedial System or Response Action(s)Taken to Address an Imminent Hazard. r 6.Submit an IRA Status Report rv- 7.Submit a Remedial Monitoring Report.(This report can only be submitted through eDEP.) a.Type of Report:(check one) 17 i.Initial Repor r ii.Interim Report iii.Final Report b.Frequency of Submittal:(check all that apply) r-i.A Remedial Monitoring Report(s)submitted monthly to address an Imminent Hazard. r ii.A Remedial Monitoring Report(s)submitted monthly to address a Condition of Substantial Release Migration. ry iii.A Remedial Monitoring Report(s)submitted every six months,concurrent with an IRA Status Report. r-iv.A Remedial Monitoring Report(s)submitted annually,concurrent with an IRA Status Report. c.Number of Remedial Systems and/or Monitoring Programs: 1 A separate BWSC105A,IRA Remedial Monitoring Report,must be filled out for each Remedial System and/or Monitoring Program addressed by this transmittal form. Revised: 11/14/2013 Page 1 of 6 Massachusetts Department of Environmental Protection BwSC 105 Bureau of Waste Site Cleanup LlFj Release Tracking NumberImmediate Response Action (IRA) Transmittal Form Pursuant to 310 CMR 40.0424-40.0427(Subpart D) - 26151 8.Submit an IRA Completion Statement. r-a.Check here if future response actions addressing this Release or Threat of Release notification condition will be conducted as part of the Response Actions planned or ongoing at a Site that has already been Tier Classified under a different Release Tracking Number (RTM b.Provide Release Tracking Number of Tier Classified Site(Primary RTN): These additional response actions must occur according to the deadlines applicable to the Primary RTN.Use the Primary RTN when making all future submittals for the site unless specifically relating to this Immediate Response Action. " 9.Submit a Revised IRA Completion Statement. 10.Submit a Plan for the Application of Remedial Additives near a sensitive receptor,pursuant to 310 CMR 40.0046(3). (All sections of this transmittal form must be filled out unless otherwise noted above) C.RELEASE OR THREAT OF RELEASE CONDITIONS THAT WARRANT IRA: 1.Media Impacted and Receptors Affected:(check all that apply) r_.a.Paved Surface F—b.Basement r c.School r-d.Public Water Supply r e.Surface Water r f.Zone 2 r g.Private Well rh.Residence r i.Soil r j.Groundwater r k.Sediments r 1.Wetland r m.Storm Drain 57 n.Indoor Air r-o.Air r=p.Soil Gas r q.Sub-Slab Soil Gas r r.Critical Exposure Pathway r's.NAPL r t.Unknown r r.Others Specify: 2.Sources of the Release or TOR:(check all that apply) r a.Transformer 1—b.Fuel Tank c.Pipe r d.OHM Delivery r e.AST r f.Drums r g.Tanker Truck r h.Hose r i.Line r-j.UST Describe: rV k Vehicle r 1.Boat/Vessel r in.Unknown r n. Other: MECHANICAL LIFT 3.Type of Release or TOR:(check all that apply) F_a.Dumping r-b.Fie I—c.AST Removal r-d.Overfill r e.Rupture 170 f Vehicle Accident g.Leak h.Spill i.Test failure r-j.TOR Only r k.UST Removal Describe: r 1.Unknown N m Other: MECHANICAL LIFT 4.Identify Oils and Hazardous Materials Released:(check all that apply) V a.Oils 17 b.Chlorinated Solvents r c.Heavy Metals r d. Others Specify: D.DESCRIPTION OF RESPONSE ACTIONS:(check all that apply,for volumes list cumulative amounts) r 1.Assessment and/or Monitoring Only r 2.Temporary Covers or Caps r 3.Deployment of Absorbent or Containment Materials r-4.Temporary Water Supplies W 5.Structure Venting System/HVAC Modification System r 6.Temporary Evacuation or Relocation of Residents r 7.Product or NAPL Recovery rVe 8.Fencing and Sign Posting r 9.Groundwater Treatment Systems r 10.Soil Vapor Extraction 11.Remedial Additives r 12.Air Sparging 13.Active Exposure Pathway Mitigation System 14.Passive Exposure Pathway Mitigation System Revised: 11/14/2013 Page 2 of 6 1 L71Massachusetts Department of Environmental Protection BWSC 105 , Bureau of Waste Site Cleanup Immediate Response Action (IRA) Transmittal Form Release Tracking Number Pursuant to 310 CMR 40.0424-43.0427(Subpart D) K - 26151 D.DESCRIPTION OF RESPONSE ACTIONS:(cont.) r 15.Excavation of Contaminated Soils. r a.Re-use,Recycling or Treatment ` i.On Site Estimated volume in cubic yards ii.Off Site Estimated volume in cubic yards iia.Receiving Facility: Town: State: iib.Receiving Facility: Town: State: iii.Describe: r b.Store r i.On Site Estimated volume in cubic yards ii.Off Site Estimated volume in cubic yards iia.Receiving Facility: Town: State: iib.Receiving Facility: Town: State: r c.Landfill r i.Cover Estimated volume in cubic yards Receiving Facility: Town: State: r ii.Disposal Estimated volume in cubic yards Receiving Facility: Town: State: r 16.Removal of Drums,Tanks,or Containers: a.Describe Quantity and Amount: b.Receiving Facility: Town: State: c.Receiving Facility: Town: State: r7 17.Removal of Other Contaminated Media: a.Specify Type and Volume: NAPL+WATER IN EASEMENT(3775 GAL),WASTEWATER-FRAC TANK CLEANING(350 GAL). W 18.Other Response Actions: Describe: GROUNDWATER MONITORING r 19.Use of Innovative Technologies: Describe: Revised: 11/14/2013 Page 3 of 6 Massachusetts Department of Environmental Protection BW�C 105 Bureau of Waste Site Cleanup , R Release Tracking Number Immediate Response Action (IRA) Transmittal Form Pursuant to 310 CMR 40.0424-40.0427(Subpart D) [4 I - 26151 E.LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form,including any and all documents accompanying this submittal.In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisionsof 309 CMR 4.02(2)and(3),and 309 CMR 4.03(2),and(iii)the provisions of 309 CMR 4.03(3), to the best of my knowledge,information and belief, >if Section B of this form indicates that an Immediate Response Action Plan is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000, (ii)is(are)appropriate and reasonable to accomplish thepurposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders,permits,and approvals identified in this submittal; >if Section B of this form indicates that an Imminent Hazard Evaluation is being submitted,this Imminent Hazard Evaluation was developed in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,and the assessment activity(ies)undertaken to support this Imminent Hazard Evaluation comply(ies)with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000; >if Section B of this form indicates that an Immediate Response Action Status Report and/or a Remedial Monitoring Report is(are)being submitted,the response action(s)that is(are)the subject of this submittal(i)is(are)being implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal; >if Section B of this form indicates that an Immediate Response Action Completion Statement or a request to Terminate an Active Remedial System or Response Action(s)Taken to Address an Imminent Hazard is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal. I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 4303 2.First Name: DAMD C 3.Last Name: BENNE Fr 4.Telephone: 508-896-1706 5.Ext: 6.Email: 7.Signature: DAVID C BENNEIT 8.Date: 8/30/2016 *n/dd/yyyy) 9.LSP Stamp: ; Eye\�1h Of JET Electronic Spa -ante 1p l Revised: 11/14/2013 Page 4 of 6 Massachusetts Department of Environmental Protection BWSC 105 Bureau of Waste Site Cleanup , Release Tracking Number ' y-. Immediate Response Action(IRA) Transmittal Form KI Pursuant to 310 CMR 40.0424-40.0427(Subpart D) - 26151 F.PERSON UNDERTAKING IRA: 1.Check all that apply: r a.change in contact name r-b.change of address N c.change in the person undertaking response actions 2.Name of Organization: HOLLY MANAGEMENT&SUPPLY COMPANY 3.Contact First Name: STUART 4.Last Name: BORNSTEIN 5.Street: 297 NORTH STREET 6.Title: OWNER 7.City/Town' HYANNkS 8.State: MA 9.Zip Code: 026010000 10.Telephone: 508-775-9316 11.Ext 12.Email: G.RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON UNDERTAKING IRA: I— Check here to change relationship r 1.RP or PRP r a.Owner r.b.Operator r c.Generator r.d.Transporter r e.Other RP or PRP Specify Relationship: r- 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50)) 1— 4.An Other Person Undertaking Response Actions: Specify Relationship: Y g P P fY P H.REQUIRED ATTACHMENT AND SUBMITTALS: r 1.Check here if any Remediation Waste,generated as a result of this IRA,will be stored,treated,managed,recycled or reused at the site following submission of the IRA Completion Statement.If this box is checked,you must submit one of the following plans,along with the appropriate transmittal form. r a.A Release Abatement Measure(RAM)Plan(BWSC106) rb.Phase IV Remedy Implementation Plan(BWSC108) .r- 2.Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s)and/or approval(s)issued by MassDEP or EPA.If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. .W 3.Check here to certify that the Chief Municipal Off cer and the Local Boardof Health were notified of the implementation of an Immediate Response Action taken to control,prevent,abate or eliminate an Imminent Hazard. r 4.Check here to certify that the Chief Municipal Officer and the Local Boardof Health were notified of the submittal of a Completion Statement for an Immediate Response Action taken ro control,prevent,abate or eliminate an Imminent Hazard. 1= 5.Check here if any non-updatable information provided on this form is incorrect,e.g.Release Address/Location Aid.Send corrections to BWSC.eDEP@state.ma.us. r 6.Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised: 11/14/2013 Page 5 of 6 - � Massachusetts Department of Environmental Protection gWSC 105 Bureau of Waste Site Cleanup r` Release Tracking Number Immediate Response Action (IRA) 'Transmittal Form -ti4 Pursuant to 310 CMR 40.0424-40.0427(Subpart D) - I26151 I.CERTIFICATION OF PERSON UNDERTAFENG ERA: 1.I, STUART BORNSTEIN ,attest under the pains and penalties of perjury(i)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 the/those individual(s)immediately responsible for obtaining the information,the material information contained herein is,to the best of my knowledge,information and belief,true,accurate and complete;(iii) that,to the best of my knowledge,information and belief,I/the person(s)or entity(ies)on whose behalf this submittal is made satisfy(ies)the criteria in 310 CMR 40.0183(2);(iv)that I/the person(s)or entity(ies)on whose behalf this submittal is made have provided notice in accordance with 310 CMR 40.0183(5);and(v)that I am fully authorized to make this attestation on behalf of the person(s)or entity(ies)legally responsible for this submittal.I/the person(s)or entity(ies)on whose behalf this submittal is made is/are aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. 2.By: STUART BORNSTEIN 3.Title: OWNER 4.For: HOLLY MANAGEMENT&SUPPLY COMPANY 5.Date: 8/30/2016 (mm/dd/yyyy) 17 6.Check here if the address of the person providing certification is different from address recorded in Section F. 7.Street: 8.City/Town: 9.State: 10.Zip Code: 11.Telephone: 12.Ext 13.Email: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 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:) Received by DEP on 8/30/2016 5:12:54 PM Revised: 11/14/2013 Page 6 of 6 Massachusetts Department of Environmental Protection BWSC105 -A Bureau of Waste Site Cleanup IRA REMEDIAL,MONITORING REPORT Release Tracking Number , r Pursuant to 310 CMR 40.0400('SUBPART D) of° � - 26151 '► Remedial System or Monitoring Program: 1 ( 1 A.DESCRIPTION OF ACTIVE OPERATION AND MAINTENANCE ACTIVITY: 1.Type of Active Operation and Maintenance Activity:(check all that apply) a.Active Remedial System:(check all that apply) r i.NAPL Recovery ii.Soil Vapor Extraction/Bioventing I iii.Vapor-phase Carbon Adsorption r-iv.Groundwater Recovery v.Dual/Multi-phase Extraction ;,vi.Aqueous-phase Carbon Adsorption T_vii.Air Stripping r viii.Sparging/Biosparging r ix.Cat/Thermal Oxidation r x.Other Describe: r-b.Active Exposure Pathway Elimination Measure Active Exposure Pathway Mitigation System to address(check one): r i.Indoor Air r ii.Drinking Water r-c.Application of Remedial Additives:(check all that apply) r-i.To the Subsurface r-ii.To Groundwater(Injection) r iii.To the Surface r-d.Active Remedial Monitoring Program Without the Application of Remedial Additives:(check all that apply;Sections C,D and E are not required;attach supporting information,data,maps and/or sketches needed by checking Section G5) r-i.Reactive Wall r ii.Natural Attenuation r iii.Other Describe: 2.Mode of Operation:(check one) r-a.Continuous r b.Intermittent r c.Pulsed r d.One-time Event Only r e.Other: 3.System Effluent/Discharge:(check all that apply) r a. Sanitary Sewer/POTW f-b.Groundwater Re-infiltration/Re-injection:(che-.k one) r i.Downgradient ii.Upgradient r-c.Vapor-phase Discharge to Ambient Air:(check one) r-i.Off-gas Controls r-ii.No Off-gas Controls r d.Drinking Water Supply f-e.Surface Water(including Storm Drains) 1v f. Other Describe: RETURNED TO BASEMENT. B.MONITORING FREQUENCY: 1.Reporting period that is the subject of this submittal: From: 6/10/2016 To: 7/20/2016 (mm/dd/yyyy) (mm/dd/yyyy) 2.Number of monitoring events during the reporting period:(check one) W a.System Startup:(if applicable) r i.Days 1,3,6,and then weekly thereafter,for the first month. W ii.Other Describe: DAYS 1,2,3, r b.Post-system Startup(after first month)or Monitoring Program: i.Monthly ii.Quarterly r iii.Annually r iv.Other Describe: WO 3.Check here to certify that the number of required monitoring events were conducted during the reporting period. C.EFFLUENT/DISCHARGE REGULATION:(check one to indicate how the effluent/discharge limits were established) "1.NPDES:(check one) r a.Remediation General Permit r b.Individual Permit r c.Emergency Exc_usion Effective Date of Permit: (mm/dd/yyyy) W 2.MCP Performance Standard MCP Citation's): 310 CM 40.0045 3.DEP Approval Letter Date of Letter: (mm/dd/yyyy) 4.Other Describe: Revised: 11/13/2013 Page 1 of 3 Massachusetts Department of Environmental Protection BWSC105 A Bureau of Waste Site Cleanup IRA REMEDIAL MONITORING REPORT' Release Tracking Number Pursuant to 310 CMR 40.0400(SUBPART D) 1 Remedial System or Monitoring Program: , ! of I I 1. (26151 D.WASTEWATER TREATMENT PLANT OPERATOR: (check one) r 1.Required due to Remedial Wastewater Treatment Plant in place for more than 30 days. a.Name: b.Grade: c.License No: d.License Exp.Date: (mm/dd/yyyy) P7 2.Not Required r'3.Not Applicable E.STATUS OF ACTIVE REMEDIAL SYSTEM OR ACTIVE REMEDIAL MONITORING PROGRAM DURING REPORTING PERIOD:(check all that apply) 17 1.The Active Remedial System was functional one or more days during the Reporting Period. a.Days System was Fully Functional: 4 b.GW Recovered(gals): c.NAPL Recovered(gals): d.GW Discharged(gals): 36772 e.Avg. Soil Gas Recovery Rate(scfm): f.Avg. Sparging Rate(scfm): t-2.Remedial Additives:(check all that apply) T a.No Remedial Additives applied during the Reporting Period. b.Enhanced Bioremediation Additives applied:(total quantity applied at the site for the current reporting period) r-i.Nitrogen/Phosphorus: r-ii.Peroxides: Name of Additive Date Quantity Units j Name of Additive Date Quantity Units iii.Microorganisms: —r iv.Other: Name of Additive Date Quantity Units Name of Additive Date Quantity Units r c.Chemical oxidation/reduction additives applied:(total quantity applied at the site for the current reporting period) r i.Permanganates: r ii.Peroxides: Name of Additive Date I Quantity Units Name of Additive Date Quantity Units �. ui.Persu ates:ar iv.Other: Name of Additive Date Quantity Units Name of Additive Date Quantity Units Revised: 11/13/2013 Page 2 of 3 Massachusetts Department of Environmental Protection BWSC105 -A ` Bureau of Waste Site Cleanup IRA REMEDIAL,MONITORING REPORT Release Tracldng Number � Pursuant to 310 CMR 40.0400(SUBPART D) 4 - I26151 Remedial System or Monitoring Program: Ll1 ' of �j ( i E.STATUS OF ACTIVE REMEDIAL SYSTEM OR ACTIVE REMEDIAL MONITORING PROGRAM-DURING REPORTING PERIOD:(cont.) d.Other additives applied:(total quantity applied at the site for the current reporting period) Name of Additive I Date I Quantity (Units I Name of Additive jDate Quantity jUnits. l� h e.Check here if any additional Remedial Additives were applied.Attach list of additional additives and include Name of Additive,Date Applied,Quantity Applied and Units(in gals.or lbs.) F.SHUTDOWNS OF ACTIVE REMEDIAL SYSTEM OR ACTIVE REMEDIAL MONITORING PROGRAM:(check all that apply) 1.The Active Remedial System had unscheduled s`utdowns on one or more occasions during the Reporting Period. a.Number of Unscheduled Shutdowns: b.Total Number of Days of Unscheduled Shutdowns: c.Reason(s)for Unscheduled Shutdowns: W 2.The Active Remedial System had scheduled shutdowns on one or more occasions during the Reporting Period. a.Number of Scheduled Shutdowns: 3 b.Total Number of Days of Scheduled Shutdowns: 13 c.Reason(s)for Scheduled Shutdowns: SYSTEM OPERATED DURING DAY UNDER SUPERVISION. 17 3.The Active Remedial System or Active Remedial Monitoring Program was permanently shutdown/discontinued during the Reporting Period. a.Date of Final System or Monitoring Program Shutdown: 7/20/2016 (mm/dd/yyyy) 171 b.No Further Effluent Discharges. I—c.No Further Application of Remedial Additives planned;sufficient monitoring completed to demonstrate compliance with 310 CMR 40.0046. rV d.No Further Submittals Planned. r—e.Other: Describe: G.SUMMARY STATEMENTS:(check all that apply for the current reporting period) WO 1.All Active Remedial System checks and effluent analyses required by the approved plan and/or permit were performed when applicable. Wo 2.There were no significant problems or prolonged(>25%of reporting period)unscheduled shutdowns of the Active Remedial System. W 3.The Active Remedial System or Active Remedial Monitoring Program operated in conformance with the MCP,and all applicable approval conditions and/or permits. 4.Indicate any Operational Problems or Notes: r 5.Check here if additional/supporting Information,data,maps,and/or sketches are attached to the form. Revised: 1/13/2013 Page 3 of 3 i Massachusetts Department of Environmental Protection BWSC105 -B Bureau of Waste Site Cleanup w �- IRA REMEDIAL MONITORING REPORT a Ps. * ; MEASUREMENTS Release Tracking Number - J Pursuant to 310 CMR 40.0400(SUBPART D) 126151 Remedial System or Monitoring.Program: ,�j of I; !— For each Point of Measurement,related to concentration indicate the`highest concentration detected during the reporting period,of each oil,hazardous material and/or remedial additive. For each Point of Measurement for pressure differentials,indicate the lowest pressure differential detected during the reporting period. Point of Date Contaminant, Influent Midpoint (check one) Check Permissible Units within Measurement (mm/dd/yyyy) Measurement and/or Concentration Concentration here,if Concentration Permissible Indicator Parameter (where (where NDBD or Pressure Limits? applicable) applicable) �'Discharge Differential (Y/N) Groundwater Concentration Pressure Differential INFLUENT 07/66/2616 BENZENE �� 1000 UG/L ES INFLUENT 07/06/2016 C5-C8 ALIPHATI 1� 3000 UG/L ES INFLUENT 07/06/2016 C9-C10 AROMATI �� 4000 UG/L YES 'INFLUENT 07/06/2016 C9-C12 ALIPHATI �— 5000 G/L YE INFLUENT 07/06/2016 ETHYLBENZENE r F r 15000 UG/L YES INFLUENT 07/06/2016 FEE r 50000 G/L YFS INFLUENT 07/06/2016 APHTHAL.ENE I r 1700 G/L S INFLUENT 07 6/2016 O-XYLENE rV 3000 UG/L 1 r S - INFLUENT 07/06/2016 /M-XYLENE 3000 G/L S INFLUENT 07/06/2016 TOLUENE 40000 UG/L YES EFFLUENT 07/20/2016 2-NMTHYLNAPH P 2000 UG/L YES EFFLUENT 07/20/2016 CENAPHTHENE �� 10000 G/L YE EFFLUENT 07/20/2016 JACENAPH=F ���� 40 FUZE YES EFFLUENT 07/20/2016 CENE � l� 30 UG/L YES EFFLUENT 07/20/2016 ENZO(A)ANTHR F iy 1000 G/L figs- ---- --- - �f r EFFLUENT 07/20/2016 BENZO(A)PYREN � 500 EFFLUENT 07/20/2016 BENZO(B)FLUOR �—�� 400 UG/L YES EFFLUENT 07/20/2016 ENZO(GHI)PER EFFLUENT 07/20/2016 BENZO(K)FLUOR F 100 UG/L YES EFFLUENT 07/20/2016 Cl 1-C22 AROMA 207 5000 UG/L l Y EFFLUENT 07/20/2016 C19-06ALIPHA F F W 50000 UG/L YES EFFLUENT 07/20/2016 C9-C 18 ALIPHATI �� 9v 5000 UG/L I r ES EFFLUENT 07/20/2016 gj�YSENE 1✓ 70 UG/L YES EFFLUENT 07/20/2016 DIBENZO(A,H)A �— 40 UG/L l i ES EFFLUENT 07/26/2016 UORANTHENE 200 G/L YES p- Check here if any additional BWSC105 B,Measurements Form(s),are needed. Revised: 11/17/2013 Page 1 of 1 i Massachusetts Department of Environmental Protection BWSC105 -B Bureau of Waste,Site Cleanup ~;...y IRA REMEDIAL MONITORING REPORT � MEASUREMENTS Release TrackingNumber-q � Pursuant to 310 CMR 40.0400(SUBPART D) 4 26151 Remedial System or Monitoring Program: h of , For each Point of Measurement,related to concentration indicate the highest concentration detected during the reporting period,of each oil,hazardous material and/or remedial additive. For each Point of Measurement for pressure differentiaNs,indicate the lowest pressure differential detected during the reporting period. Point of Date Contaminant, Influ=nt Midpoint (check one) Check Permissible Units Within Measurement (mm/dd/yyyy) Measurement and/or Concentration Concentration here,if Concentration Permissible Indicator Parameter (where (where 1✓Discharge r NDBD or Pressure Limits? applicable) applicable) Differential (Y/N) Groundwater 1" Concentration Pressure Differential EFFLUENT 07/20/2016 UORENE 40 G/L S EFFLUENT 07/20/2016 INDENO(1,2,3-C 57 100 G/L EFFLUENT 07/20/2016 APHTHALENE � 7 G/L00 S EFFLUENT r 1✓ 10000 G/L YF.S EFFLUENT 07/20/2016 JPYRENE F 1W 20 G/L S INFLUENT 07/06/2016 2-METHYLNAPH �y )w 000 G/L YES INFLUENT 07/06/2016JACENAPHTHENE 1y 10000 G/L S INFLUENT 07/06/2016 CINAPHTHYLE 40 UG/L YES INFLUENT 07/06/2016 CENE I '1v 30 G/L YES INFLUENT 07/06/2016 INZO(A)ANTHR FV 1000 UG/L YES INFLUENT 07/06/2016 ENZO(A)PYREN �� ry 500 G/L S� FLUENT 07/06/2016 1v 4 ENZO(B)FLUOR 00 G/L YES IN INFLUENT 07/06/2016 BENZO(GHI)PER r 20 UG/L YES INFLUENT 07/06/2016 �BENZO(K)FLUOR 100 UG/L YES INFLUENT 07/06/2016 ICI 1-C22 AROMA 284 5000 G/L YES INFLUENT 07/06/2016 C19-C36 ALIPHA 6280 F-- r 50000 UG/L YES INFLUENT 07/06/2016 C9-C18 ALIPHATI 5000 G/L YE� � INFLUENT 07/06/2016 CHRYSENE 1✓ 70 G/L I Y INFLUENT 07/06/2016 IBENZO(A,H)A r- rv- 40 UG/L I T INFLUENT 07/06/2016 LUORANTHENE r,,- b0 INFLUENT 07/06/2016 LUORENE 40 UG/L YES INFLUENT 07/06/2016 ENO(1,2,3-C r r w 100 UG/L YES INFLUENT 07/06/2016INAPMEALENE F_ r 700 G/L YES INFLUENT 07/06/2016 IPBENANTHRENE F 116666 UG/L YES INFLUENT 07/06/2016 YRENE F r,,- 20 G/L YES r— Check here if any additional BWSC105 B,Measurements Form(s),are needed. Revised: 11/17/2013 Page 1 of 1 8/30/2016 eDEP-MassDEP's OnlineFiling System r MassDEP Home I Contact I Privacy Policy ICU- 9 MassDEP's Online Filing System Usemame:DAVIDBENNETT + fl Nick-name:BENNETTDAVID 71 Receipt Forms Attach Files Signature Receipt 'Summary/Receipt ' print receipt Exit 'Your submission is complete. Thank you for using DEP's online reporting ;system. You can select "My eDEP" to see a list of your transactions. DEP Transaction ID: 853667 I :Date and Time Submitted: 8/30/2016 5:12:54 PM i 'Other Email Form Name: BWSC105 Immediate Response Action Transmittal Form i 'RTN: 4-26151 !Location: FORMER CAR DEALERSHIP Address: 268 STEVENS STREET, HYANNIS, !Person Making Submittal !HOLLY MANAGEMENT & SUPPLY COMPANY !STUART BORNSTEIN 297 NORTH STREET ;HYANNIS, MA 026010000 !LS P 'LSP#: 4303 ILSP Name: DAVID C BENNETT Person Making Certification MOLLY MANAGEMENT & SUPPLY COMPANY !Stuart Bornstein 1BWSCRMRA Remedial Monitoring Report( ) 11BWSCRMRB Remedial Monitoring Report( ) !BWSCRMRB Remedial Monitoring Report( ) Ancillary Document Uploaded/Mailed IBWSC-105 Q.1302 - IRA Plan - Uploaded (BEA16-10824A IRAP 8.4.16.pdf) BWSC-105 Q.B04 - Imminent Hazard Evaluation Doc - Uploaded (IHE lreference.pdf) i My eDEP MassDEP Home Contact i Privacy Policy MassDEP's Online Filing System ver.12.25.3.0© 2016 MassDEP https://edep.dep.mass.gov/Pages/PrintReceipt.aspx 1/1 r "Environmental Solutions of the 21st Century" 823 Pleasant Street • Norwood,MA 02062 781/769-9310 Fax 781/769-9775 SOUTHERN MIDDLESEX INDUSTRIES, INC. c CA V �a L November 23, 2016 Town of Hyannis Board of Health Attn: Health Inspector 200 Main Street Hyannis, MA 02601 RE. 268 Stevens Street, Hyannis Dear Health Inspector, Please be advised that Southern Middlesex Industries, Inc. will be engaging in window abatement activities at the above referenced project. This work will commence approximately on December 7, 2016, and end approximately on December 9, 2016. All appropriate state and federal agencies have been notified. If you should have any questions, please do not hesitate to contact this office. Yours truly, Sandy MacKinnon Bid Coordinator 4 � ENN]ETT ENVIRONM]ENTA]L AssOCIAT7Es9 NCO LICENSED SITE PROFESSIONALS O ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS ® ENGINEERS 1573 Main Street- P.O. Box 1743, Brewster, MA 02631 508-896-1706 Fax 508-896-5109 www.bennett-ea.cc1—R G7 BEA16-10824A-� August 12, 2016 , Dan Crafton, Section Chief �- MA DEPARTMENT OF ENVIRONMENTAL PROTECTION (MA DEP) ' Southeast Regional Office (SERO)Bureau of Waste Site Cleanup (BWSC) 20 Riverside Drive Lakeville, MA 02347 RE: NOTICE OF LSP TERMINATION RTN 4-26151 268 Stevens Street(Bornstein/Holly Management) Hyannis, MA Dear Mr. Crafton, In accordance with the provisions of 310 CMR 40.0169(2), and as consistent with the licensing requirements of 309 CMR 4.03(4), BENNETT ENVIRONMENTAL ASSOCIATES, INC. is providing notice that they have suspended professional services, inclusive of LSP Oversight. This Notice of Termination shall absolve me personally and BENNETT ENVIRONMENTAL ASSOCIATES, INC., collectively, from any and all remedial response performance under the MA Contingency Plan, 310 CMR 40.0000. Should you have any questions, or need additional information,please contact me directly. Respectfully yours, BENNETT ENVIRONMENTAL ASSOCIATES, INC. *dnt tt, LSP Encl. BWSC-126 Miscellaneous Document Transmittal Form cc: Stuart Bornstein, Holly Management-Property Owner/PRP Thomas McKean, Director—Barnstable Health Division Fire Prevention Officer/Lieutenant John Cosmo—Hyannis Fire Department Mark S. Ells—Barnstable Town Manager EMERGENCY SPILL RESPONSE & WASTE SITE CLEANUP 6 SITE ASSESSMENT 6 PERMITTING 6 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE & WASTEWATER TREATMENT,OPERATION&MAINTENANCE 8/12/2016 eDEP-MassDEP's OnlineFiling System _t -� MassDEP Home i Contact I Privacy Policy 117=k ! MassDEP's Online Filing System USemame:DAVIDBENNETT Nickname:BENNETTDAVID Receipt Forms Attach Files Signature Receipt (Summary/Receipt i print receipt Exit our submission is complete. Thank you for using DEP s online reporting system. You can select"My eDEP" to see a list of your transactions. i IDEP Transaction ID: 856514 'Date and Time Submitted: 8/12/2016 4:27:47 PM 'Other Email : i Form Name: BWSC126 Miscellaneous Document Transmittal Form i I I IRTN: 4-26151 Location: FORMER CAR DEALERSHIP Address: 268 STEVENS STREET, HYANNIS, IPerson Making Submittal i f I LS P 3 jLSP#: 4303 ILSP Name: DAVID C BENNETT Person Making Certification I Additional Forms Submitted lAncillary Document Uploaded/(Mailed BWSC-126 Ques.B3 - Resign as LSP-of-Record My eDEP MassDEP Home i Contact i Privacy Policy MassDEP's Online Filing System ver.12.24.5.0©2016 MassDEP https://edep.dep.mass.gov/Pages/PrintReceipt.aspx 1/1 Massachusetts Department of Environmental Protection e® P Transaction Copy- Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: DAVIDBENNETT Transaction ID: 856514 Document: BWSC126 Miscellaneous Document Transmittal Form Size of File: 144.78K Status of Transaction: In Process Date and Time Created: 8/12/2016:4:28:09 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy"from the Current Submittals page. Massachusetts Department of Environmental Protection BWSC 126 - �- Bureau of Waste Site Cleanup • Miscellaneous Document Transmittal Form Release Tracking Number 4 � - 26151 A.DISPOSAL,SITE LOCATION: 1.Disposal Site Name: FORMER CAR DEALERSHIP 2. Sheet Address: 268 STEVENS STREET 3.City/Town: HYANNIS 4.Zip Code: B.THIS FORM IS BEING USED TO: (check all that apply) r 1. Correct typographical errors and/or make corrections that do not materially affect the nature or complexity of the response actions.If changes are materially significant,then a revised or modified submittal must be made to the Department.List the report/form that is being corrected that is associated with the above Release Tracking Number (RTN).Attach an errata sheet containing a description of the errors and/or corrections. Form/Report Submittal Transaction ID Date(mm/dd/yyyy) r 2. Submit other documents associated with this RTN hat cannot be submitted to the Department using any other BWSC transmittal form.Do not submit documents that are of a time-critical nature and/or that require a direct response from the Department and/or that require an LSP Opinion pursuant to 310 CMR 40.0015.(Section C is not required). Description of Submittal 17 3. Resign as LSP-of-Record for the above Release Tracking Number(RTN).Attach a copy of the LSP resignation letter. (Section D,E,and F are not required). r 4. Submit copies.of Public Notices required pursuant to 310 CMR 40.1400:(check all that apply) (Section C is not required) a.Tier I Classification 7 Check here if submitting a copy of a legal notice r b.Tier II Classification Check here if submitting a copy of a legal notice r c.Immediate Response Action(IRA) r d.Release Abatement Measure(RAM) e.Downgradient Property Status(DPS) r7 f.Utility-related Abatement Measure(DRAM) r g.Comprehensive Response Actions r h.Activities related to r Check here if submitting a copy of a legal notice recording/registering an Activity and Use Limitation(AUL) T'i.Permanent or Temporary Solution (All sections of this transmittal form must be filled out unless otherwise noted) Revised:09/17/2013 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC 126 L7' Miscellaneous Document Transmittal Form Release Tracking Number 4 - 26151 B.TIIIS FORM IS BEING USED TO(cont.): check all that apply) ( ): � PP Y) 5. Submit Public Involvement Petition documents.(check all that apply).(Section C is not required). r a.Submit a Public Involvement Petition r b.Submit a Public Involvement Petition Retraction r c. Submit a Positive Public Involvement Petition Designation Letter r7.d.Submit a Negative Public Involvement Designation Letter r-e. Submit a Draft Public Involvement Petition Plan f. Submit a Revised Public Involvement Petition Plan g.Submit a Final Public Involvement Petition Plan 1 h.Submit a Notice of Public Cormnent Period Date of Close of Comment Period: (mm/dd/yyyy) i. Submit a copy of a Public Involvement Petition legal notice j.Submit a Notice of Public Meeting Meeting Date: (mm/dd/yyyy) k.Submit other Public Involvement Petition related documents not specified above: Describe: 6. Submit a RCRA Contained-In-Determination to document that soil and/or groundwater is no longer considered a hazardous waste pursuant to state(310 CMR 30.00)and federal(Title 40,Chapter I,Part 261 of the Code of Federal Regulations)hazardous waste regulations. r'7. Submit notification and documentation of Reclamation Soil Reuse pursuant to 310 CMR 40.0031(2). C.LSP SIGNATURE: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form, including any and all documents accompanying this submittal.I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 4303 2.First Name: DAVID C 3.Last Name: BENNEfT 4.Telephone: 5088961706 5.Ext.: 6.Email: 7.Signature: DAVID C BENNETT 8.Date: 8/12/2016 (mm/dd/yyyy) Revised:09/17/2013 Page 2 of 4 Massachusetts Department of Environmental Protection BWSC 126 • � Bureau of Waste Site Cleanup Miscellaneous Document Transmittal Form Release Tracking Number ?� 4 - 26151 � { . D.PERSON MAKING A SUBMITTAL: 1.Check all that apply: r a.Change in contact name r b.Change of address 1-c.Change in person undertaking, response actions 2.Name of Organization: 3.Contact First Name: 4.Last Name: 5.Street: 6.Title: 7.City/Town: 8. State: 9.ZIP Code: 10.Telephone: 11.Ext.: 12.Email: r 13.Check here if the person is a Public Involvement Petitioner E.RELATIONSHIP TO SITE OF PERSON MAKING SUBMITTAL: r Check here to change relationship 1.RP or PRP r a. Owner r b. Operator r c.Generator r d.Transporter r 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.21E,s.50)) l�4.Any Other Person Undertaking Response Actions Specify Relationship: F.CERTIFICATION OF PERSON MAKING SUBMITTAL: 1. I, ,attest under the pains and penalties or perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmitt-,l 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.I/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties, including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. 2.By: 3.Title: Signature 4.For: 5.Date: (Name of person or entity recorded in Section D) mm/dd/yyyy r 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.State: 10.ZIP Code: 11.Telephone: 12.Ext.: 13.Email: Revised: 09/17/2013 Page 3 of 4 a Massachusetts Department of Environmental Protection BWSC 126 L Bureau of Waste Site Cleanup Miscellane®us Document'Transmittal FormRelease Tracking Number [4] - 26151 ,r Check here if any non-updatable information provided on this form is incorrect,e.g.property address. Send corrections to BWSC.eDEP@state.ma.us 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): Received by DEP on 8/12/2016 4:27:47 PM Revised:09/17/2013 Page 4 of 4 July 24, 2011 To: Town of Barnstable Health Dept. &Hyannis Fire Department E I am writing this letter as a concern citizen. About 18 months ago or so I complained about improper dumping of contaminated water into the storm drains at the dealership located at the corner of north& Stevens street across. from Mr. Perry's building. They have moved to another location but after a physical check by me and my concern people as of July 23, 2011 the water is still being pumped into the storm drain and then into the bay. -- This condition also adds to the flooding of that area on severe rain conditions causing another issue. The water now is a rusty color and has an odor. We are requesting that an inspection be done, water samples taken and they be ordered to stop pumping ASAP. I am very sad that this condition has been left to continue. Man will destroy this beautiful earth. One last concern, after checking there are no permits, permission granted for that location which is owned as you know by Mr. Bernstein to attach any pipes to that storm drain. It is also noted that years ago it was disconnected by the town. Take a ride to the location; look at the drain located at the beginning of the driveway On Stevens street and you will see the flow of water into the drain. Hundreds of gallons an hour never stopping. a We will be monitoring this condition and others in the area as a concerned citizen group, co . : Trying to keep Cape Cod Beautiful w Lo C �.L r� x co N � � s � V 0 s t Message Page 1 of 1 Martin, Cynthia F o Martin, Cynthia _. Sent: Thursday, August 04, 2011 4:05 PM To: McKean, Thomas Cc: Malkus, Karen Subject: RE: Storm drain Tom, FYI On July 28th DPH received another anonymous complaint letter regarding this on going issue. Karen verified the water flow on August 1st, she did not mention whether odors were present. At 3:00 pm today I inspected (4) storm drains, one at the corner of North and Stevens, one at the corner of North and Michells Way and the two on the 268 North Street property. The basin on the property, nearest Michells Way was bone dry. The other three storm drains did in fact have water in them. The two nearest the corner of North and Stevens Street had a very steady flow of water through them. However, the water was absolutely clear, there was no "oily" sheen, and no odors of any kind from any of the four storm drains. Cindy -----Original Message----- From: McKean, Thomas Sent: Wednesday, August 03, 2011 11:41 AM To: Perry Sr, Michael Cc: Malkus, Karen; Martin, Cynthia Subject: Re: Storm drain Thank you. We will have someone look at it From: Perry Sr, Michael To: McKean, Thomas; Malkus, Karen Cc: Kadunc, Wilhelm Sent: Wed Aug 03 11:37:35 2011 Subject: Storm drain Tom the storm drain right next to the old dealership on the corner of North and Mitchells way is pipe out into the Stewart creek area we will not block it up because this will create a flooding situation on both roads. A private property owner is pumping into our basins they should be ordered through you to stop because we do not know what they are pumping apparently there has has been a strong smell of sewage coming from that basin Sounds like a board of health issue. Michael Perry General Foreman Barnstable Highway Department 382 Falmouth Rd. Hyannis Ma.02601 Phone#508-790-6330 Cell#774-836-7908 Fax#508-790-6343 Email-Michael.Perry@town.barnstable.ma.us 10/25/2011 i_ ,_ �� i � � I � � � � � , � j I � I � � I I � � I � I i I � � � �. � I I � I � I � � � � � � � � � � i � � � ��� � , I � i � I � � � y � f � � � � ; j � I i ' ) � � i I i � i I I � i ! �. � � II , j � � , � � � I � I � ; � � i � G I i � i � i ! I � I �, � � i ! � I # y � � � I � �. � , I � �� � t I I - � - -t - - - - - -� ----� ---+ - � - - � +- � �_ � � � r �- � # �- t I � I � j 1 � � � � ' j i j � � I f 1 � ` i � �� � � � � �-. I I �, � � � � f I � I � I • ,; j � � � ;7 � f •,.. - � � .� � � � I � , � { � � � ( � . � I I I � � - - � 3 r f, t• a� .Y.. �. .•u�_"°'"�'�ear � � t n � -. In 8 f7- N Via. ��,,• x�. d U 0 4- /2>A C-Cpt-v CJ2-� e-\ Y • Y .�- t�y a #Tti � K � .ate�4�iT. Y C#� y q, A biz• :, � ! y.,�y, �. ■+.a °Y r.< Y r `� #. > x m '�y ry"K�. f'+�'"�,s t'�' �.�y.'S y���'" .a� iar ?bP-w .. 6 yy " *�, •'� 3 �, kr.. . IZ Malkus, Karen From: Martin, Cynthia *� Sent: Tuesday, March 23,2010 12:27 PM To: Malkus, Karen Subject: Phone Hey Karen, Thanks for the email regarding Balise Hyundai, I'm sure the past few rain events added to the existing six inches of water in the basement. Perhaps I didn't update you but FYI: Balise had New England Environmental Technical Services empty out the basement of all water damaged items and skimmed the standing basement water of any oily substances. I was provided a copy of the waste manifest for this removal. In addition, alise was going to place oil booms in the bermed area of the oil tanks as a precaution. The storm drain at the base of the drive (Stevens St side) is the drain that is allegedly "tied in"to the towns system. This is also the drain that is/was receiving the water being pumped from the basement of the Balise building. Thanks for your assistance in this matter. Are you keeping the shared work phone in a different spot on your desk? I've needed it since my return and have used my personal phone in the mean time. Enjoy! Cindy Hazardous Materials Specialist Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Tel: 508-862-4645 Fax: 508-790-6304 1 FI C� N N j r. }�j F i '� `t,� ���i1i.s�^ 6 ,,.r t'''*•.v r �c"`j�'�'...�es��t' _s;,. ` � � v " a '�� ,f 1 �j rStt•Y atw�tA7;Mfi 5 We �ezJp ¢ ���� ?r 1 �`''f�-s�l,pr�t�..l��{♦ - ,Cv ��ly�}' y+ - t.;,� try � k�. y�y`.'�,,(.,.•r�`w"�- ;�� �' � �. ,, "� 'k. Al�y{7�, ,�'"' t�'i,`� f-•e � I 'ia�fi".��}ai.`- 'try �yg . y r Syr y r ii y `rSY 9 ✓,; r -r ' t '' n' y w r pp r a w� =h. t - P? r-_ ✓. ! v ++: ' < - � g l t a p E " a � • e � r , • n n � 'e �Y IZ tr ` a _ 9Or- �. _ , . Aunt Betty's Pond ��,•.' :, '� .. '� � ,I „ r r / 4t t �� � � �-/� �/���M� 0 ��� �� ��� ����� G t IL Fm— Ho �� I ��„—. a" -� � �� � - _ _._ R r� F � ' ,� ,.! .. t , il T �, t ti 's i' - � � �, - � ` � ,� E� [ -.�.,, A �.Mr: �. C � , �. S �' k ' e � ' �;� � .a' E ''� � = �_ c r .� ;s g�pg� � � Y �f. a t1' E Z\ y � n+ R 1 ,.t- � � y , F k w. A�+,yam J t. , Malkus, Karen From: Lovell, Bob Sent: Monday, March 29, 2010 7:04 AM To: Burgmann, Bob; Malkus, Karen Subject: RE: Catch Basin on Stevens Street at North Street I apologize for the confusion. Yes it does appear there is a pipe going directly from the building into our catch basin. Sometime ago the Hyannis fire chief and I went there and checked out the problem, they were pumping out the basement into the street creating ice on the road. We ordered them to stop and they did. We checked out the basement and saw at least 2 sump pumps in the floor. At that time they had a truck come in and pump the basement. The problem there is ground water coming right up into the basement it will not stop until the water level goes down. -----Original Message----- From: Burgmann, Bob Sent: . Friday, March 26,2010 8:50 AM To: Lovell, Bob Subject: FW: Catch Basin on Stevens Street at North Street Bob, Have you be able to figure this one out? Bob Robert A. Burgmann, P. E. Town Engineer 230 South Street Hyannis, MA 02601 508-862-4070 508-862-4711 fax -----Original Message----- From: Malkus, Karen Sent: Friday, March 26, 2010 8:39 AM To: Burgmann, Bob Subject: RE: Catch Basin on Stevens Street at North Street Hi Bob, I haven't heard back from Bob Lovell, he has probably been busy. Cindy Martin, who is charge of hazardous materials, wrote the following to me: "Thanks for the email regarding Balise Hyundai, I'm sure the past few rain events added to the existing six inches of water in the basement. Perhaps I didn't update you but FYI: Balise had New England Environmental Technical Services empty out the basement of all water damaged items and skimmed the standing basement water of any oily substances. I was provided a copy of the waste manifest for this removal. In addition, Balise was going to place oil booms in the bermed area of the oil tanks as a precaution. The storm drain at the base of the drive(Stevens St side) is the drain that is allegedly"tied in"to the town's system. This is also the drain that is/was receiving the water being pumped from the basement of the Balise building. " When I talked to the manager of Balise, they said their lease was almost up and they plan to move. I have also received a complaint about car washing water running down their back West parking lot to the creek. I did not find evidence.of water reaching the creek, but the last aerial pictures of the area do show water moving down the back lot. Is there a map of the town's storm water system in this area. I would be interested to know where the pumped basement water and the carwash excess ends up. Any help with this matter would be greatly appreciated. Thanks, Karen 1 Malkus, Karen From: Burgmann, Bob Sent: Friday, February 05, 2010 2:10 PM To: Lovell, Bob Cc: Malkus, Karen Subject: Catch Basin on Stevens Street at North Street Hi Bob, Karen Malkus in .the Health Department has had a tip that there is a connection from a catch basin at the former Nissan dealer at the corner of Stevens Street and North Street out to one of our catch basins on Stevens Street. Would you please contact Karen (508-862- 4641) and set up a time for a crew to meet her out there and pull the catch basin grate so that she can look to see if she can verify that there is a connection. Thanks, Bob Robert A. Burgmann, P. E. Town Engineer 230 South Street Hyannis, MA 02601 508-862-4070 508-862-4711 fax 1 Karen Malkus Coastal Health Resource Coordinator karen.malkus@town.barnstable.ma.us 508-862-4641 -----Original Message----- From: Burgmann, Bob Sent: Friday, February 05, 2010 2:10 PM To: Lovell, Bob Cc: Malkus, Karen Subject: Catch Basin on Stevens Street at North Street Hi Bob, Karen Malkus in the Health Department has had a tip that there is a connection from a catch basin at the former Nissan dealer at the corner of Stevens Street and North Street out to one of our catch basins on Stevens Street. Would you please contact Karen (508-862-4641)and set up a time for a crew to meet her out there and pull the catch basin grate so that she can look to see if she can verify that there is a connection. Thanks, Bob Robert A. Burgmann, P. E. Town Engineer 230 South Street Hyannis, MA 02601 508-862-4070 508-862-4711 fax I 2 i Hazapdops Materials Inventory Sheet Checklist .3'v a ate Physical Street Address-Check database to ensure it exists v7 Working Phone Number �c--- Actual Amounts ( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials-no blanks) �torage Information -location of storage, how long is storage for? If none, note that. L Disposal Information -where and who? If none, note that. L.— Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and plain it Attach the Business Certificate with your sign off and comments **The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. 11 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME`in t e Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 13t FI., 367 Main St., Hyannis, MA.02601(Town Hall) and get the Business Certificate that is required by law. o 13 Fill in please: DATE Ni APPLICANT'S YOUR NAME/CORPORATE NAME fdiV.flr tl + BUSINESS TYPE:_ BUSINESS YOUR HOME ADDRESS: t�' 10 s- TELEPHONE # Home.Tele hone Number NAME OF NEW BUSINESS {-{r ^3t1j1 " 47--ti & C-AleS EIN: Have you been given approval from the building division. YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER d� When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Towh of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — cor( ner of Yarmouth Rd. & Main Street) to. make sure you.have the appropriate permits and licenses required to legally operate in this town. your business. 1. BUILDING CO Aa�)��en4n ER'S O ICE O/- 1 This indivi ua m d an per it re uirements that pertain to this type of business. /� I A thori�ed.Signatur J^Q COMMENTS: 0 2. BOARD OF HEALTH '-+ fl This individual hash infor d o' mit uirement hat pertain to this.type of business. 1�2;0CD Authorized S' ture** COMMENTS: 3. CONSUMER AFFAIR (LICENSIN UTHORITY) w This individual h en inf m t o lice in e r m hts tha e ain t this p of business. Author Signa' e COMMENTS: i l r3 TOWN OF BARNSTABLE Date: I v l 3 D TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: V 46!6', s M41%.,n oN �-tj CgV S BUSINESS LOCATION. _ a � R S , Wd i a wn,`t INVENTORY MAILING ADDRESS: a l too.t� el Mti 14 rcauwrs, M ul o TOTAL AMOUNT- TELEPHONE NUMBER: So 8- '115- 9 314 CONTACT PERSON: s 4va.41 -BoVKS f%,- 1 EMERGENCY CONTACT TELEPHONE NUMBER: S'oS -`1-75= 9 31(,q MSDS ON SITE? TYPE OF BUSINESS: Av --o S4 I-es - U Sgl INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: '�r�„�,tr_ Last shipment of hazardous waste: Name of Hauler: C leu,1 Destination: (� 'P c c (� Waste Product: 0 .11 Licensed? e� No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) CD Miscellaneous Corrosive ANEW WISED 0 Cesspool cleaners tS Automatic transmission fluid O Disinfectants b Engine and radiator flushes O Road salts(Halite) 1 Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides YNEW ❑ USED (insecticides, herbicides, rodenticides) 6 Gasoline, Jet fuel,Aviation gas 0 Photochemicals (Fixers) (� Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) �-1 - 21,fis lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Q Printing ink o Degreasers.for driveways&garages Wood preservatives (creosote) 6 Caulk/Grout Swimming pool chlorine D Battery acid(electrolyte)/Batteries Lye or caustic soda 0 Rustproofers 0 Miscellaneous Combustible Q Car wash detergents Leather dyes d Car waxes and polishes Q Fertilizers d Asphalt&roofing tar PCB's d Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, a Lacquer thinners (including carbon tetrachloride) L1d'NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers d hydrochloric acid, other acids) v Miscellaneous. Flammables Other products not listed which you feel d Floor&furniture strippers may be toxic or hazardous (please list): dj Metal polishes Laundry soil &stain removers Q (including bleach) Spot removers &cleaning fluids (dry cleaners) Q Other cleaning solvents 0 Bug and tar removers a q. Windshield wash �.. 1. WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staff's Initials I N 3 e 11Q sl ♦IW 250 SGIE IN FEET 0® \ 252 _ /' i +l 036 nw3oe\ \ v nor 'r II yi -- / • \ \\/ 042 \ re \ —3 41 020 tt172 13l 130 WI03 2e 7 J sa ° / 1.269 261 1 30B a .. �fMP3 03 ` � 01 63- 1 M' 'r ne ; j l �1 Vx •� m f d\ /� 16 \ Illllll \, 0 2702 / M,P r391 . iniuuini /ii/ n � r, 273-03w01 I"45 '� \ICI 61 008 /e ' 30] eur rur3m Ss 'vs 049 - nw '�'� IRIS^ •-� �rclsm � o � rw2 i i 1 v ' /�t\e 28 \ \ 0 4z 0� � / ray 0\ nw 3m e A \\ • ) i ess 1 nw J 14 T Z i \-00 \` 8 0 002 , w3 00� 2 �,w / 1 I 65ve 00 t 716 n / � Y4V3 r5W I \)\\p- 1 II i i� 1 143 _ Li 8 a IR5 \ n nw 8 144 11 ' w O -• Illlli � � 1 ,:-lnw3w i•I `7 i'0""P — - nw 3m,���nv3m,� 080 556 Yarmouth Rd.HYUnDm FACTORY GENUINE PARTS Hyannis, Massachusetts 02601 HYUNDAI AUTOMOBILE PARTS ARE COVERED BY A ONE YEAR WARRANTY 508-957-71 91 FROM DATE OF PURCHASE, 20% RESTOCKING FEE ON ALL RETURNED ITEMS www.baliseauto.com IN ORIGINAL PACKAGING, NO RETURNS AFTER 30 DAYS. NO RETURNS ON ELECTRICAL ITEMS,SPECIAL ORDER PARTS,OR KEYS. NO CASH REFUNDS. ENTEREDDATE YOUR ORDER NO. DATE 6H[FPFL) INVOICE DATE INVOICE NUMBER 20585 0 **QUOTE**ACCOUNT NO. H PAGE 1 OF 1 L I D p T T 0 O SHIP VIA SLSM. TERMS T4VAlqMTR . MA ORD. SHIp:: B.0'. PART ;NUMBER IIESCR3PT10'N LtST'. NET AMOUNT.::";::: 1 0 OIL2 .4- 5- SYNTHETIC 7 . 95 7 . 95 7 . 95 1 0 ,00232 190..12 �n�ATF-SP III. 9 .36 9 36 936 >1 0 00232 460.00 LONG LIFE 37;39 29 BUIc�c 1 0 !B670:0 P/S FLUSH' 4522 32 .9:5 32.. 95 1 2 0 B5902 COOLANT FL 38 . 11 29 . 95 29 . 95 0 B6600 TRANS. SER . 36,. 98 29 95 29 95 GMC l 0 B 110 P4 9 9 5 9 9 5 1 O 'B203; CARBON FI 1369 9 95 9 9;5 1 1 0 00232-19047 FUEL SYSTE 19 . 19 19 . 19 19. 19 0 00232 12180 CLEANER KI 34 . 01 34 . 01 34 . 01 0 75W90 75W 90 SY 18 >95 1-8 95 18 95. Q :;U O T E DO NO PAY **** HoxDA PARTS SUBLET TOYOTA FREIGHT (�® , SALES TAX ® � ! :::TOTAL'. oPvng I ;: ....._.... .:.;. c. -- ---- -------- -------- -------- --------- ----------_C-US-T-OMER CQPY CUSTOMER SIGNATURE OFFICE COPY BALISE HYUNDAI OF CAPE COD X $231 .48 556 Yarmouth Rd. FACTORY GENUINE PARTS Hyannis, Massachusetts 02601 508-957-7191 HYUNDAI AUTOMOBILE PARTS ARE COVERED BY A ONE YEAR WARRANTY www.baliseauto.com FROM DATE OF PURCHASE, 20% RESTOCKING FEE ON ALL RETURNED ITEMS IN ORIGINAL PACKAGING, NO RETURNS AFTER 30 DAYS. NO RETURNS ON ELECTRICAL ITEMS, SPECIAL ORDER PARTS,OR KEYS. NO CASH REFUNDS. INVOICE NUMBER 20585 0 **QUOTE**ACCOUNT NO. H PAGE 1 OF 1 L I D P T T O 0 SHIP VIA SLSM. B/L NO. TERMS F.O.B. HYANNIS MA ORD. SH9P, B.O;: PARf;NUMBER DESCRIPTION....:... LISS NET .". AMOUNT 1 0 OIL2 SYNTHETIC 7 . 95 7 . 95 7 . 95 1 Q.. 00232-19012 ATF-:S:P ILI _9:..36 .;;. 9 .;36 9. 3.6 0? 0023:2-06000 LONG ';LIFE;: 37<. 39 29 .27 2927 1 0i`B6.7.00. P f S FLUSH 45!.22 32 . 95 32 95 1 O B5902 COOLANT FL 38 . 11 29 . 95 29. 95 _, 1 O.: B6600 TRANS. SER. 3,6. 98 29.95 29:..9,5. 1 0; B110 MOA 12 . 08 9.9'5 9 95 0! B203' CARBON FI 13>'.69 9 . 95 9 95 l 2 0 00232-19047 FUEL SYSTE 19 . 19 19 . 19 19 . 19 1 2 . 0 00232-121 80 CLEANER KI 34 . 01 34 . 01 34 . 01 1 0:! 75W90 75W�9'0 SY 18 95 18 . 95 1895 ** ;TEDO ;NOT PAY *:.**** O PARTS 231.48 SUBLET FREIGHT 0 . 00 SALES TAX 0 . 00 To ALS231.481 .1PIt 100 1 C.PV,'.ghl 2000 ADP,I-, PARTS INVOICE 2-UP-P13Cl t 06 CK\ TOWN OF BARNSTABLE Date: / / J' TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY /NAME OF BUSINESS:__ s�LlS� / y uNd A-! OG(/S�PC (�oD BUSINESS LOCATION: 2?-Atl S>����s S /-1yAA1.ycs INVE TORY MAILING ADDRESS: -2' l/o r S7- A-NNIS T-CMAL AMOUNT- TELEPHONE NUMBER: ���' S' - /a0 © S o 4AtjoR/s CONTACT PERSON: UUU A16E�S0A1 am _ o EMERGENCY CONTACT TELEPHONE NUMBER:94J3 `,J-IV ���oZ. MSDS ON SITE? TYPEOFBUSINESS: AbIzD S/fGL� 4-NA SOU/C.E yES -ovi OGbA-7E INFORMATION/RECOMMENDATIONS:�� /-KTl Pr - aJ+/s F:0asr Fire District: AIW;3 �Ocs A044M&S (/QW 6 POST L'a'U"AAe7JcZ Pl-5€XV14C- r//z' //V 4A"V/,S DUT dF DATE /745 CX774401 11F&WSaz)GIPD,Q 7wc- A13117S BOO/< ®PROS//l�E i 75 !c 771C 2>/5P0541- Of ARTS e1--- Af47,; WASTE A N b W,+S rE—614 /1-- A A0c/G4134--). 00 L Z W 4DEASTC OIL [.A b b Vs")7E'G vt_A-rW R 6T_Yc L4&.r k 47aV&j_"I"'U SCb OIL RLE,i "LTaX ' W'?' Waste Transportation: //IM> -73/V01, Last shipment of hazardous waste: Name of Hauler- S dal Destination: _ Waste Product: W'g- ©1L/W1QS7,-1i icensed? a No 1-/&V id NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division, LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum e-or-eu-puc A-c-naAjs S'3 .tam�5 wcle� Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive �H�' t3 NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants �6 Motor Oils Pesticides � dlou ,5-/ NEW / U S E D (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers 3 Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED - Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, �W-Ica-=F_q 42c Misc. Flammables iM T?tE -4?- />t-PT hydrochloric acid, other acids) Floor & furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers /6 a&LQAJS 0� L lXZ-A—M&W75 (including bleach) i{�l�777a,v�4� �i/oJ�S;dP/lam /LIAR ,4�E i4��/t�f�3 Fog Spot removers & cleaning fluids S PI L'r,Scoves i4A� 13/0 6 AV*)LMZ 3 T14 (dry cleaners) Ft��lr HAS 6 INC1}�� of S1AN aG Gf�aunJ®inlR P�ITS LAC L-,*nLL `x TL Other cleaning solvents /,y Wr G?,AP4r -n4r c.C_-kLA1"4 FtrS Arm FLiLL_CAUS(N4- w/krE-►t -M c,va2- Bug and tar removers ° y PLAS-� T-A-9K I Al C,kRAt c SHUT i)OL4JAJ OF SuHPS ks Gvc7 _2 "W oA1 it/OITrN S7-. Windshield was 0M cokZR�r Z�'dif OV&R. WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS S . . .�._.._.� n �� 3. �� � � � � �� ::� �� �, .. I ,_ITS '%. r ' r �� I � � i l�. �, b � ; ,, �' ii � �� ' -. J I � ---- -� i � � i v i '!V I �� I�, � io C ,.J 4 � l I i f �: � : � � � � y +.�� r- yr' .`". • .+'�''; ���' � . a �'s,. ti/ i r►.�� °�\�, r'- �-.fig Y t.� vv�c N I � J Q co t� 'I j i f i� 1 -y T7 Moe r- - - ^� i' J �� "cJ ' �`:i i` C'� -\1 E� ._ i -::: � � � i + � �. �,i LPG' 1 .i VVI(3 C , e r' --�-�—=r''�- i ,� i �� s �� r� .� � \J 1` �I �" I - v—M/21/2010 09:48 5087714552 BALISE NISSAN PAGE 02 VF Rease pint or Iwo,(I=des'ned IW taso on,elate 2-olch)*Uwrftrl) Farm!e2!Ld,OMB No.2050MU UNIFORM HAZARDOUS.: 2-Page WAW MANIff-ST 5. ift', 74 FLE MUR 4W18NI"'Ut SNM U.S.EPA 90 Number I.Ia.ERA 41 Number ft~Focally Nome and 3ft Address UI&EPA to Numw ga. 9b.U.S.DOT Des VW6 VAukpcdq PmW anpMnq plan,Mv FM and PadbV C—sp Cff-y)) iI.Totpi 12.Urit 13.Waals Co&o No. Cmanoly WIM. 2. LU E Ov'i"we OIL ON 4, 14,"1 Ha-d 1rq Inouctioris and A00MgM5M—� wm �' 01B Mitt., t5. MAN% 1���MNI�IhWoby osdare ttistft cuft is of this consignment are Aft and e=rsidy OMGKW abft by ft p"of Sh"Rama,wxIw;ho&d,packaged, e6 carded,and of 1fla1MPw;ffi?n p.;...dom for ftrepcdvqwmwQ toapplIcalse Inlem2fiDa and naftWpvwmrft1regulations. lam ft pftwy or v q rTty 9WRW gu uw*Wgratm) (b Id om w.4 GWMWMWEii�PMWIT)*WaM VM vay Year Ia.inwna§cAoKWftriwft rf"` tar WC2 Ono, 17.TmWaW Admowledgmitt or Receipt of Mz*rbms Twguvar I PonUKVTyped Marr* tum *nth Day ear 414LY—&&A4 -.;. 4 Z 7*4pwz PMfladffypEffl Name [a cc usy year Va,Ploopricy Indcation Space R991d. ❑Partial RWd. OFJR411M _MmniFwzRefW!vm Nunn Go"orator) W, V.5.EPA 10 Number IV 0 H C w1b U I VA g w Resort w I 10 F M M t Method (t.e.,mdes tar hszsydou;rvmsW twImoK dqml,and nKyding systems)12. 4. 110i .. L . 7 1 20.Dw4naisd Fed r Omw or Operator,Cotfipdm of rac*of h=IdVj Mfthi covered try the m&gsd except so TOW In km lap Nwm M" Day Year EPA Form 8700-22(Rey,M em 013001616. GENERATOR'S INITIAL COPY Z--Z -/0 - 0 0, It, ly soclbj `3a Fs- ai A * Oi922 13 MAI 11/21/2006 001 A261220 0 ❑ Change NFIRS - 1 ' „�. State Incident Date Station Incident Number Exposure ❑ No Activity Basic I B Location I Check this box to indicate that the address for this incident is provided on the Wildland Fire Module in Section B"Alternative Loce' n Specification". se only for ildl nd fires. Census Tract 40 ® Street Address al d I I TREET,;®`') ST ❑ Intersection LJ u El In front of Number/Milepost Prefix Street or Highway Street ype Suffix ❑ Rear of JHyannis / I MA 02601 ❑ Adjacent to Apt./Suite/Room C1ty � J° �Statee Zip Code ❑❑ Directions Hyannis nissan Dealership Cross street or directions,as applicable «w. Incident Type E1 Dates&Times *4ht is 0000 E2 Shifts&Alarms 400 (Hazardous condition, other Local option Incident Type Check boxes if Month Day Year Hour Min dates are the ALARM alwa s required u still �J p Aid Given Received I same as Alarm v Date. Shift Alarm l 1 21 2006 14:3 8 1 platoonr No Of AlarmOistrict 1 ❑ Mutual aid received I I ARRIVAL required,unless canceled or did not arrive 2 ❑ Automatic aid recv. U ® Arrival I O1 OS 1904 14:41 E3 Special Studies 3 ❑ Mutual aid give Their FDID Their g State Local Option CONTROLLED optional,except for wildland fires y 4� ❑ Automatic aid given Controlled 5 ❑ er ai given ❑ u u " I � N ® None I I LAST UNIT CLEARED,required except wildland fire Special Special Their Incident Number ® Last Unit Study ID# Study Value Cleared 01 05 .1904 14:58 uuuu Actions Taken G1 Resources G2 Estimated Dollar Losses&Values Check this box and skip this section if an 1. LOSSES: fires if known. Optional for non fires. t 43 �Hazardous materials spill control and ( Apparatus or Personnel form is used. Required for all ;Primary Action Taken(1) Apparatus Personnel None Property ❑ Suppression 1 4 Contents I I ❑ tAdditional Action Taken(2) EMS u I 0 PRE-INCIDENT VALUE: optional a:I I Other L 0 �0� Property I ❑ :I I Additional Action Taken(3) Check box if resource counts include aid ❑ received resources. Contents ❑ Completed Modules H1 Casualties ® None H3 Hazardous Materials Release Mixed Use Property N❑ None El Fire-2 Fire Deaths Injuries NN® Not mixed ❑Structure-3 Service I n I n 1 ❑ Natural gas:slow leak,no evacuation or HazMat actions 10 ❑ Assembly Use ❑Civilian Fire Cas.-4 u 2 ❑ Propane gas: <zt lb.tank(as in home BBo grill) 20 ❑ Education use I 3 Gasoline:vehicle fuel tank or portable container .33 n I 4 ❑ Medical use ❑Fire Serv. Casualty-Civilian �Q U ❑ 40 ❑ Residential use EMS-6 ❑ Kerosene:fuel burning equipment or portable storage 51 ❑ Row of stores ❑HazMat-7 5 ❑ Diesel fuellfuel oil:vehicle fuel tank or portable storag 53 ❑ Enclosed mall El Detector 6 Household solvents:Home/offiices ill 58 ❑,Business&residential Wildland Fire-8 H2 Required for confirmed fires. ❑ p cleanup only II Apparatus-9 7 ❑ Motor oil:from engine or portable container 5e ❑ Office use 5 i 1 ❑'Detector alerted occupants 8 Paint:from pant cans totaling< 5 gallons 60 ❑ Industrial use Personnel-10 ❑2❑;Detector did not alert them 0 ® Other:Special HazMat actions required or spill>55 gal., 63 ❑ Military use65 El Farm use U ElI Unknown Please complete the HazMat form 00 ❑ Other mixed use y:gg Property Use Structures P 341 ❑ Clinic,Clinic Type infirmary 539 ❑ Household goods,sales,repairs 131 ❑ Church,place of worship 34 ❑ Doctor/dentist office 579 ❑ Motor vehicle/boat sales/repairs 3 ❑ Prison or jail,not juvenile 571 ❑ Gas or service station 161 ❑ Restaurant or cafeteria 419 ❑ 1-or 2-familydwelling 599 162 Bar/tavern or nightclub 9 ❑ Business office 162 ❑ Elementary school or bndergart. 429 ❑ Multi-family dwelling 615 ❑ Electric generating plant 215 ❑ High school or junior high 439 ❑ Rooming/boarding house 629 ❑ Laboratory/science lab 241 ❑ College,adult rjued. 449 ❑ Commercial hotel or motel 700 ❑ Manufacturing plant 311 ❑ Care facility for the aged 459 ❑ Residential,board and care 819 ❑ Livestock/poultry storage(barn) 331 Hospital 51199 ❑ FFo d and beverage sales 891 ❑ Warehouse tial parking garage Outside 936 ❑ Vacant lot 981 ❑ Construction site 124 ❑ Playground or park 938 ❑ Graded/cared for plot of land 984 ❑ Industrial plant yard 655 Crops or orchard 669 ❑ � ❑ Lake,river,stream Forest(timberland) ❑ 951 ❑ Railroad right of way 807 Outdoor storage area 960 919 ❑ Dump or sanitary landfill ❑ Other street Look up and enter a Property Use 931 ❑ Open land or field 961 [1Highway/divided highway Property Use code only if 960 ❑ 962 ❑ Residential street/driveway Property Usyou have e checked a box Street,other ` NFIRSI Rev'sun03N1199 281220 - EXP 0, 1112112006 PAGE 1 OF 2 t:- HYANNIS FIRE DEPARTMENT - MFIRS REPORT KPerson/Ent!ty Involved 1 Local Option (Hyannis Nissan I I508-771-3636 Business name(if applicable) Phone Number ;taChe k this box if same address as �J (Nicholas I U IMilione I L� incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address lines. I I INORTH I ST ST r Number/Milepost Prefix Street or Highway Street Type Suffix (Hyannis Post Office Box Apt./Suite/Room City MA I 02601 State Zip Code ❑More people Involved? Check this box and attach Supplemental Forms(NFIRS-1S)as necessary. Owner ❑Same as person involved? Then check this box and skip Local Option the rest of this section. I Business�lica le I I Phone Number ❑ Check this box if I I I LJ I u same address as u incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three I I u u duplicate address III lul lines. Number/Milepost Prefix Street or Highway Street Type Suffix Post Office Box Apt./Suite/Room City State Zip Code Remarks: Local Option il4 ITEMS WITH A I MUST ALWAYS BE COMPLETED! ® More remarks?Check this box and attach Supplemental Forms (NFIRS-IS)as necessary. M Authorization II I 11 Lj1j 1 2006 Officer in charge ID Signature Position or rank Assignment Month Day Year .,C,reck box if same as "officer in "charge. ® 197702 (Roger E Cadrin I I Lieutenant I I Suppressionj 1 11 21 2006 ' -�•• Member making report ID Signature Position or rank Assignment Month Day Year A261220 - Exp 0, 1112112006 page 2 of 2 HYANNIS FIRE DEPARTMENT- MFIRS REPORT L_01922. 1 1 MAI 1 11/21/2006 1 1 001 1 A261220 u ❑ Delete NFIRS - 1S Change SupplementaJIF State Incident Date Station Incident Number Exposure I ❑ UIb KPerson/Entity Involved 1 Local Option (Hyannis Nissan I I508-771-3636 I Store lvlanaaer Business name(if applicable) Phone Number ❑ Chec address as k this box if same INicholas I II Lnlione I �� incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address lines. � I NORTH I ST I ST 1� Number/Milepost Prefix Street or Highway Street Type Suffix I I I Hyannis Post ,*,Of c Box Apt./Suite/Room City 02601 State Zip Code a: t Person/Entity Involved IDeversified Auto I I617-719-5440 a Local Option Business name(if applicable)6J Phone Number m1) oyee r `El Check this box if I I John l _] I Odonnell I �� same address as incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address 100 I Terminal Street lines. Number/Milepost Prefix Street or Highway Street Type Suffix I I I I Charlstown I Post O�ffi�cee Box I Apt./Suite/Room City u I State Zip Code KPerson/Entity Involved 3 I Cyn Environmental 1781-341-0269 Local Option I Business name(if applicable) Phone Number Check this box if I I u I I u same address as LLJI incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address s•{:`.,: lines. s ;, Number/Milepost Prefix Street or Highway Street Type Suffix � IIBraintree Post Office Box Apt./Suite/Room City Ma State Zip Code NFIRSI1 RWWW 85r98 A26122n - Fxn n_ F.S<' <<,FCr 1112112nn6 HYANNTS FTRF DFPT_ r'a(7P 1 nf 1 Li j 01922 1 1 MAI 1 11/21/2006 1 1 001 1 A261220 0� ❑ Delete NFIRS - 1S ♦ ,� I State Incident Date Station Incident Number I Exposure I [I Change Supplemental K2 Remarks NORTH STREET We received a call Via BPD reporting a hydraulic oil spill in the area of the Hyannis Nissan Dealer on Stevens St. caused by a car carrier having a blown line. We responded with E-823, upon arrival we found an obvious spill on Stevens Street next to the dealer entrance, the car carrier had already left the scene, the spill had already been covered with speedi dry by the auto dealer. We covered the spill with additional speedi dry and in doing so found the the nearby drain had not been ffected by the spill. ;Lt. Cadrin spoke with the service manager Mr. Milion and informed him that the spill needed to be cleaned lup, he stated that the transport company who caused the spill will pay for cleanup. Transport company name is Diversified Auto, contact person is John Odonnell. Lt. Cadrin spoke with this company and instructed them to notify this department when the cleanup is complete. The spill involved approximately 10 gallons of hydraulic oil, Lt Cadrin advised the TOB Board of health of the situation so they would be aware what took place. F2 r+ rz 'ii t: t 4 A261220 - EXP 0, 1112112006 HYANNIS FIRE DEPARTMENT MFIRS REPORT PAGE 1 YOU WISH TO OPEN A BUSINESS? EForYour Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town whichu must do by M.G.L.-it does-not give you permission•to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL.[367ain Street, Hyannis, MA..02601 [Town Hall) Uml, OGTE• C= �.. n• Fill in lease: Zn - - �.,,,;.r s:_.... a• APPUGANT'S YOUR NAME_ V �7 S �c Sr.L1 rn « .. 9USINESS co YOUR HOME ADDRESS: Al VoL&O TELEPHONE # ome Telephone Number Iq fG m 7} ME NAME OF IVEVN BlJ31IVESS1 S.1lJ� y�� I�C/Qo-4 OF SINES v d �.Cr IS THIS A HOME OCCUPATION? YES Np.. T1�P BU S: CD Have you been given afsproval frbrn the buildanq:divisiori? YI=S NO ADDRESS OF BUSINESS rrdn�5 _� �h :MAP/#PARCEL NUMBER When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assistyou•in obtaining the information you Rd. &-Main Street) to make sure you have the a y nay need-. You MUST GO TO 200 Main St. — (corner of Yarmouth appropriate permits and licenses-required to legally operate your business in this town. 1. ��BUILDING'COMMISSI ER'S OF ICE C This individ�l ha - �n irffo'r .e.•o ermit requir en -pertain to,this type of business. 1 ' COMMENTS: Au t 1 prized-Sign ure* - - . 2. BOARD OF HEALTH This individual has been i me p equirements that pertain to this type of business. Authorized Signa ure** COMMENTS: . MUSTCOMPLY WITH ALL 3: CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.* COMMENTS: YOU WISH TO OPEN A BUSINESS? For Y ur I ormation: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town ( hic 'you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's ffic , Vt FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. y� DATE: 1/30/08 's Fill in please: APPLICANT'S YOUR NAME: Frl Kardan , Manager BUSINESS YOUR HOME ADDRESS:6 Nnrce pines Drive as k �?1-3F - East .0,nud ,�irh , MA 02517 TELEPHONE # Home Telephone Number: 774 41 -3-g268 NAME OF NEW BUSINESS Cape Hy, Inc . d/b/a Balise Hyundai o1rYPE OF BUSINESS Auto . dealership IS THIS A HOME OCCUPATION? YES NO X Cape Cod Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS 268 Stevens Street , Hyannis MAP/PARCEL NUMBER 308/017 When starting a new business there are several things you must do in order to be incompliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 2. BOARD OF HEALTH This individual has bee�xformed of the per '''requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements the'p j&t�o this type.of business. Authorized Signature** COMMENTS: , (� ewm . 4-4 HYANNis NISSAN 820: Hazardous Waste Contingency Plan The following is our written contingency plan, designed to prevent and minimize hazards to public health or to the environment from fires, explosions, spills or any other unplanned release of hazardous waste to the air, soil, surface or ground water. The plans will be administered by the Emergency Coordinator, who is the Owner/General Manager or Service Manager. FIRE RESPONSE Use of Fire Extinguishers. In the event that a fire does start, associates may respond with ABC-rated dry chemical fire extinguishers if the fire is small and they can approach it without endangering themselves. In such cases one associate should call the Fire Department(911)while others try to contain the fire. If associates are alone, they are instructed to call the Fire Department --not to fight the fire. If associates determine that they can use the fire extinguishers without endangering themselves, they should remove the pin of the fire extinguisher,point the nozzle at the base of the flames, squeeze the handle and direct the output to sweep back and forth at the base of the flames. During this operation it is important to be alert so that the fire does not cut off the associates' escape route, and that their lives are not threatened by smoke inhalation. If either of these conditions seems possible, they are instructed to get out fast, and leave the fire fighting to the Fire Department. Generally, water is not effective in fighting flammable and combustible liquid fires. Gasoline and oil float on water, so pouring water on this type of fire may actually spread the fire. Natural Gas Line. There is a gas line coming into a shut off and meter located in the outside of the building as shown in the"Evacuation Plan". In the event of fire or leaking gas the Emergency Coordinator should close this valve if it can be done without endangering themselves. Otherwise they should alert Fire Department and Gas Company workers. SPILL PREVENTION AND RESPONSE Initial response and reporting spills. If there is a leak, immediately stop the discharge if it can be done quickly and without risk. Notify the Hazardous Waste Emergency Coordinator at once(phone numbers for the Emergency Coordinator are under"Emergency Phone Numbers"). Whenever the Emergency Coordinator determines that there is an imminent or actual emergency which could threaten public health, safety, welfare or the environment, they shall immediately: 1. Activate internal facility alarms or communications systems to notify all personnel. 2. Notify local agencies with designated response roles if their help is needed. 1 Gasoline, Solvent and Oil Spills. If flammables are present, use only non-flammable tools and eliminate all sources of ignition. If the smell is very strong evacuate the area. Windows and doors may be opened to reduce odors, but do not turn on fans or other electrical equipment, unless they are explosion proof when flammables are involved. If there is a fire, don't open windows and doors, since the air will make the fire burn faster. For small spills pour ground clay(e.g. Speedi-Dri) around the spill,building a dike to prevent its spread. Pour additional ground clay on top of the spill. Remove or stop the source of the spill. Often this involves transferring material to an approved non-leaking container, such as DOT specification 17E closed head drum. In some cases it may be possible to tip a leaking drum on its side so that the hole is on the top. After the spill is stopped and absorbed, shovel the ground clay into an approved container, such as DOT specification 17H open-head drum with a Hazardous Waste label filled out. Acid Spills. Electrical storage batteries are a potential source of sulfuric acid spills if dropped or otherwise damaged. Spilled acid from batteries is hazardous waste because it is corrosive, and also may contain toxic substances including lead and arsenic. WARNING: SULFURIC ACID CAN CAUSE SEVERE SKIN BURNS, AND BLINDNESS IN THE CASE OF EYE CONTACT! In case of contact with acids, first rinse skin for at least 5 minutes (15 minutes for eyes) with cold running water then go for medical help. There is an eye wash flushing station at each dealership. If someone else is present, then get medical help while rinsing continues. Large acid spills (more than a quart) can be confined by pouring a dike of ground clay around the spill. The subsequent clean up of a large spill should be left to professionals. Small acid spills can be neutralized with sodium bicarbonate (baking soda) or sodium carbonate (soda ash). Wear protective clothing including eye goggles since there will be bubbling and splashing. Apply soda by sprinkling the powder, or an aqueous soda solution, on the aid spill gradually. The neutralization process is exothermic (gives off heat). Diluting strong acid solutions with water also generates heat that can cause boiling and splashing. The bubbles of carbon dioxide gas evolved during neutralization are not flammable but acids coming in contact with some metals including zinc generate flammable hydrogen gas. Always make sure that there are no sources of ignition at any acid spill and that flammables are kept separate. When enough soda has been added to neutralize the acid, the bubbling will stop even if more soda is added. Neutralization should be checked by dipping a piece of pH paper in the liquid and comparing the color of the paper with the chart on the package of paper. A pH of 7 is completely neutral,but a reading of 6 or above is acceptable. Clean up the neutralized spill with a mop and place in approved labeled Hazardous Waste containers. A DOT specification 17H drum is acceptable if a heavy duty polyethylene liner is put in the drum first. Rinse the area with mop and water. The first rinse water should go into the drum also. If you are certain that the spill area has been fully neutralized (use pH paper as described above) subsequent rinses may be poured into the sewer. HAZARDOUS WASTE CONTINGENCY PLAN EMERGENCY PHONE NUMBERS Fire and Police Department or Ambulance: 911 Hazardous Materials Emergency Coordinator: Fixed Operation Manager Alternate Hazardous Materials Coordinator: Parts Manager Hazardous Waste Consultant: John W. Furrh Associates, Inc. 135 Washington Street Taunton, MA 02780 508-824-4939 Reg- MA 04-108 Hazardous Waste Transporter Advanced Liquid Recycling, Inc. Spill Contractor: 14 West Main Street Meriden, CT. 06451 1-800-582-5906 EPA Transporter#CTD021816889 Emergency Coordinator will call one of the numbers below to report a release, spill or leak which may threaten human life or the environment: ■ EPA National Response Center 800-424-8802 • EPA Hazardous Waste Super Fund Hot-Line 800-424-9346 ■ Nights &Weekends, Hyannis Fire Department 50�--'5w-'5�p0- ADDITIONAL HYANNIS NISSAN PERSONNEL TO BE NOTIFIED: Work Cell Home Richard Covington Dealer Principal 508-771-3636 508-737-2980 508-775-5912 Nicholas Millione Fixed Ops Manager 1 508-771-3636 508-802-0580 508-775-6256 HAZARDOUS WASTE CONTINGENCY PLAN EQUIPMENT LIST Item Description I✓ocation $ , Fire Extinguishers various Fire Blanket Service Area Eye Goggles Issue Baking Soda Parts Storage Rubber Gloves Tool Room Rubber/Plastic Apron Tool Room pH Paper Service Manager Office First Aid Kit Service Area Hazardous Waste Labels Service Manager Office DOT 17E & 17H Drums Service Area Polyethylene drum liners Parts Storage Flash Light Service Manager Office Ground Clay Service Area Drum Wrench Tool Room Brooms Tool Room Non-Sparking Shovels Tool Room Hazardous Waste Management and Disposal Procedure g p ocedu e Purpose: To assist with the proper management and disposal of hazardous wastes. Definitions: Accumulation Area-Clearly delineated area where hazardous wastes are stored prior to being picked up for disposal. Hazardous Waste Manifest-The approved form used as a shipping document To identify the quantity, composition, origin, routing, and destination of hazardous wastes from the generation site to the disposal, treatment, storage or use site. Satellite Accumulation Area-Area at the generation site where hazardous wastes are accumulated. Procedures: STORAGE 1. All hazardous wastes, including oil, must be placed in containers that are labeled as Hazardous Wastes. Labels must have the words "Hazardous Wastes", the associated hazard, and the waste type. 2. Accumulation start dates must be on the container label. The Accumulation Area must be labeled with the words "Hazardous Wastes" in at least 1" high capital letters. The Accumulation Area must be clearly marked off with paint, tape or some other identifying marker. 3. Drums must be removed by the authorized hazardous waste hauler when containers are full or the allotted time limit has been reached. INSPECTION Hazardous Waste Accumulation area inspections must be conducted once per week and documented on the approved form. DISPOSAL 1. The Hazardous Waste Manifest must be used whenever waste is shipped offsite by the waste hauler. 2. Eight(8) copies of the each manifest are generated with the waste shipment. 3. The person signing the manifest is responsible for ensuring the information is accurate, correct and that the proper EPA Registration number is used. 4. The manifest will be signed by the trained representative and the waste hauler will receive three copies, including: Copy 6 -Destination State, this must be sent by the generator to disposal facility's state. Copy 7 - Generation State, this must be sent to the waste generator's state,(Massachusetts) and Copy 8 - Generator, this copy must be saved for you facility's records. Regulatory References: 310 CMR 30 Hazardous Waste Storage Area Inspection Checklist Location: Inspector: Date: Area . Inspection Items Yes No Comments Hazardous Waste Are the Hazardous Wastes Labels Visible? Containers Are the Hazardous Waste Labels Complete?(Include the words"Hazardous Wastes,"The type of wastes, the hazard associated with the waste,and the accumulation start date). Has the 180 day accumulation start date for SQG or the 90 day accumulation start date for LQG been exceeded?Note Date: Are containers in good condition?(not leaking or deteriorating). Are containers compatible with the waste? Are containers tightly closed?(Bungs and seals secured). Containment Is there evidence of spills,leaks or corrosion? Is secondary containment in good condition? (Not necessary for Satellite areas). Accumulation Is the area clearly delineated with visible markings on Area the ground? Is there a sign above the area with"HAZARDOUS WASTE" in at least 1" letters? Is the waste accumulated in a manner protective of public health and the environment? Is a fire extinguisher and spill equipment adjacent to the area? Good Are drums of waste products stored outdoors? Housekeeping If yes-are they covered? Are waste product drums labeled with the product and potential hazard? Are waste product drums stored in an orderly manner? Are storage areas clean,neat,spill free,no speedy dry on ground? Other Comments =N Passe Date: /D / /�-/ ���"• TOWN OF BARNSTABLE &*afed TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: INVENTORY MAILING ADDRESS: ➢� '� TOTAL AMOUNT- TELEPHONE NUMBER: 5V8-77 f —�314?3 n Jelo' CONTACT PERSON: /VIGGI 61V.f ZV/ Id-NI P EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON ITE? TYPE OF BUSINESS: /j INFORMATION/RECOMMENDATIONS: E, Fire District: easte Transportation:��s Last sh ment of hazardous.waste: Name of Hauler- l�2 , Destinatio Waste Product: Licensed Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the Genera Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW 2V USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid_ (including brake fluid) Refrigerants � Motor Oils Pesticides 339 NEW ]USED (insecticides, herbicides, rodenticides) Ib Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED 03 Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's i� Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers %�P � , ._ /A- Gd/,t l�dYIS (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Hyannis Nissan Peugot LTD. v Fax: Corp Name: Mailing Addres . Location: 268 Stevens Street,Hyannis Street: P. B 957 mappar: 308-017-000-000 City: Hy is Contact: Nicholas Milione,,Team Leader State: a Telephone: '508-771-3636 Zip: 02601 _ Emergency: Person Interviewed: O.V.Martin Business Contact Letter Date: Category: VehicleMaintenance Inventory Site Visit Date: _. Type: Automobile Dealers r 1,v� Follow Up/Inspection Date: V" d❑ water public p ❑� indoor floor drains outdoor surface drains ❑d license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc W currently licensed W town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/d ell - � ex it p El on-sitesewage Elindoor on-site syste El outdoor outdoor onsite system date: CRT 800-833-8278 W.BRID. Picks up used oil filters-80/barrels. compliance: PAINTS INPAINT STORAGE ROOM SPRAY BOOTH-FILTERS CHANGED incomplete 4 HYDRAULIC LIFTS&1 WLWCTRIC LIFT. MSDS&MANIFESTS KEPT IN UPSTAIRS OFFICE(PER DALE). MUST SHOW PROOF OF /) N O CERTIFIFCATOIN FOR FREON WORK-SEE ATTACHED MUST HAVE �J /N1 �/� SECONDRY CONTAINMENTS FOR TANKS&DRUMS IN BASEMENT. ALSO,30 GAL GEAR OIL,10 GAL BATTERY ACID,5 GAL CAR WASH. NO SECONDARY CONTAINMENT FOR OIL.REMARKS: 3/5/98- MAD059731406. MSDS kept in central file 4 hydraulic,1 electric lift. Lt m 4-eO �• Safety Kleen parts+brake washer. New Pan America Env.Oil/waterI �� saPaFatW=:..may dsV,kv. drams 613104 0"Ite Sinventory. Waste.od,coilectionand containmentsystem in basement,. car wash run-off collection and containment system in basement-both have 110%catchment. All new and waste products stored in proper barrels/tanks. MSDS onsite. ORDERS: Need manifest/hauler info, 1 Aw remove obstructions from haz mat storage areas(ladders,rugs,shop items cluttering storage area),label waste drums properly,are MSDS 1 fY1OY �� current?,move oil filter dumpster inside/off of gravel/dirt surface, a�. � tQy ala remove large tire pile out back(disease and fire hazard).-Follow up in S Iea """" �CG�r 30 drays. G tit GC)• 6 Lr t a.b e Gi / r,U G�+` l� (j,p�j�`I i'H•,IGt�.� __@ 300 �o ►fit w ' Ln1a►�Y JC� 4,cYS j BL.c'�'► ®t'over rem o�`z'� w-o:Q UL C i`i I nw owS n .�.wb-I-I'c ol�, eL Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals 0 gty's 111 gals or more 7 q _.unit,of measure misc.petroleum products:grease,lubricants ( 26.5 gallons __...._...............-..._...._._.____..__...__......_.....__-....._.._...___......_.._.___....._....._.___.__._._._ other cleaning solvents 7.25 Gallons Mineral Spirits ( 0.25 gallons Sealant € 1 gallons .............._.._..._........................................_... .._.._.. ....._................._ .._._...._._...___.-................._..._.._...._..._.............._..._.............._...-............._........._... Misc.Poison 4.25 gallons refrigerants E 0.5 gallons bug and tar removers 3 gallons Adhesives 0.5 gallons A ..__......._____._.___...._..._......................___._-._ _ _ ..... ______..._---....... ..._.._......._...____.._._.__.... _..__ _........_...........____...._.......___.....__._._._._._..._..............._..._.. automatic transmission fluid 124 gallons hydraulic fluids .._..__.. (including break fluid)....... ..............._.._......._...._._............_.._..............__........ Windshield Wash ` 225.5 gallons Batteries [ 78.75 gallons _..._._..._..__..........................__.._.__.__..._._....__.........._......___._..______.____...__...._.._._._-------.____. _....__......._._......_.._....---_..._._....._._.. Solvents 20 gallons aste oil 300 gallons _..__...-___...._........................_.. __........_.._..._..._............._..................... car wash detergents } 18.25 gallons _.._.._...._._.................__.__..-...__..__.-_..__..........._................._...__....._.................._..._...._......_..._..............�_.__.__.__..._..._..._..........____...._....__._.__...._........_.__..._.._..__.-_ Misc.Corrosive 12 gallons Sealant 3 gallons Mis_c.Flammable _ _ __ .._._....... w__ 3 gallons ce.Melt 3 gallons .............._.._.._._ ---_ _.._.__...... ......................_._ ste•antifreeze 110 gallons paint,varnishes,stains,dyes 5 gallons new lacquer thinner _ 2 gallons _ car waxes and polishes 10 gallons _� __ ._ _. _..._.... _... . ..__..____..__ ...__.___.._......_...___.___ antifreeze(for gasoline or coolant systems) 44lgallons Waste Transporter: Fire District: ;Hyannis _.... Last HW Shipment Date: Waste Hauler Licensed: No OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE b 30000� j ANITFREEZE ' O�G�t� GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF Jb 6�'7`.7 HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GE SE/ LUBRICANTS) o/ M FREON ACETYLENE CAR WASH CAR WASH PAINTS/ J , / WAX / DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID 5y FERTALIZERS WASTE SOLVENT � MSDS /a le ou�"oov MANIFESTS 1 wr • � Town of Barnstable Regulatory Services o Thomas F. Geiler,Director G' ` '"M .g Public Health Division i639• �0 1 ArFO MA'S A Thomas McKean,Director ^' 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 608-79p 6304 • c» Application Fee: $100.00 c�v r ' ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS R FULL NAME OF APPLICANT R S ( (_(: SS- K < be, F 4Nt'c t WlS. RMS&K NAME OF ESTABLISHMENT &ba- ADDRESS OF ESTABLISHMENT abR S�77 1kE ,RN w S M ft- 0601 TELEPHONE NUMBER SOLE OWNER: YES ')C NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: T cNoSQ IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O1Q� STATE OF INCORPORATION �(1 BSc RCt t� ETC FULL NAME AND HOME ADDRESS OF: . PRESIDENT -�?,�Ci-tp4kb \-- CAy sty � TREASURER CLERK SIGNATURE PLICANT RESTRICTIONS: HOME ADDRESS �tNty�E'g c ��� c_ Sa,Ntct� m oa53°� HOME TELEPHONE# Haz.doc/wp/q .'p�+a,� +aye+' 'as 3A d"1 r;�S ¢,�"'• �W a 5. 'a's� 8 aka �' k m�� �. � �..�.. ... �r'r.wn x.SM a1 � `'`�� ':�' . r.. � + ' to lop VEM TZ « uw+ t,"�z1\�:•+ ru.p�T 9 ., ¢* t e"r,rry„ ex �k. 'r �`!L„r'""",y�# ,?''�... ,. .� s� ?3 a3 k,�� . ����� rya t ,,��a �r g,,.-w•t� E + ry €a ' r� m lk W n ` '� �;��� �A.�, ik,�'�?� �,�+'"* y�,{t';�r,� j "�k''���„ �. y, '�t - ,� a '►�'i.+e B{�•'�, a'R� �w� .�^�a1`���,�f" a°@s.� k,4 .. t+a` ,��' r41Yp' a x .r.•ce/'�[IDa "4€'.�'"� x s '�y r 1rM�,� 3�+. r p'rb, � _a y"!t �'. ��i' �� �cery� �"'9i1 irk" �<' '�y 00,5 y + rs�: rya r�r4' �T�. '�l.k� ,^ � �py� �'•rrk �+' +.,�ry gy:+,s,j�'t-Z,s'�r':t+y.�t� ' '% _ 4F" R',�,,; # � .�4` '^b',o°;e�, i SS"4-- — 'Pulp o Ce S 5 W A , I p 5 II `�l ��III �I ,•r *r r I` Ar: I � f 1 x. s, ' � t:. r tY i ,J4 �, ✓r�'� !'fry�,f.,k 4� '�,''a, `�''�,+ y s y �� Sri ���,W if°�^an" +�� G�^"�+..�'y3(•�'� �1 R '#`�'�.� 4 '� `�� t�d: J b` s K� rotF f Town of B s� cr;;,7 6 ._2,/—v THE t Regulatory Services ' : Thomas F. Geiler,Director Public Health Division BAxxsrAB Thomas McKean,Director MASS. 200 Main Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: health(a)town.barnstable.ma.us Fax: 508-790-6304 J e Office Hours: M-F 8:00 5:00 June 4,2004 l� bL� ' Hyannis Nissan Attention: Nicholas Milione 268 Stevens Street Hyannis,MA 02601 Q Dear Mr. Milione: Thank you for your time and cooperation during the hazardous materials inventory and site visit on June 3,2004. This letter contains information from that visit that will help Hyannis Nissan, become compliant with Article 39 of the Town of Barnstable Ordinance: The Control of Toxic and Hazardous Materials (copy enclosed). Also enclosed is a copy of the Toxic and Hazardous: Materials On-Site Inventory form from the visit to your business. Please note the problems and, :i." their corresponding recommendations listed below: Problem: The hazardous waste drums in the shop area of Hyannis Nissan are not labeled"Toxic" and k "Hazardous Waste." The drums are not easily accessible because they are obstructed with ladders,rugs, shop machines or pieces of equipment stored in the hazardous material storage area. Order/Recommendation: Please remove the above mentioned items and provide a clear and accessible hazardous waste storage area in the service shop. This will prevent workers from bumping into or tripping on things while trying to dispose of hazardous waste. Label ALL hazardous waste drums,tanks and ' containment with the words "Toxic"and"Hazardous Waste." Problem: There was a spill pan(black plastic collection pan)of antifreeze on the top of a waste antifreeze drum. It was full and not poured into the drum nor contained properly. Order/Recommendation: Please make your staff aware that when they take hazardous waste to the hazardous waste storage drums,they should pour this material into the appropriate container immediately to avoid improper storage, spills/releases, contamination or a possible human health exposure. Antifreeze is especially toxic and can cause irreversible health problems or death. Problem: M The used oil filter dumpster is located outside on a dirt/gravel surface. Recommendation: Although the dumpster is appropriate storage for the drained oil filters (which are ready for .. proper disposal), it should be relocated inside the shop so it can rest on an impervious surface(the shop concrete floor). CC Problem: There is a large used tire pile in the back of the service shop at Hyannis Nissan. This pile is a potential health hazard(water accumulation attracts insects,particularly mosquitoes, which in turn carry West Nile Virus). It is also a potential fire hazard. Order/Recommendation: The used tire pile should not accumulate to this size. As soon as possible, a waste hauler must be called for a pick up to remove the tires from outside the shop. If used tires are stored for disposal/recycling,please attempt to store small amounts indoors. The Toxic a azgrd us Materials On-Site Inventory from the June 3rd shows that you have approxim ly ga ons of toxic and hazardous materials being used, stored,generated and disposed fat Hyan � Nissan. The Board of Health has determined that the using, storing, generating and disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual license. The license for Hyannis Nissan should be purchased after the expiration date of your current license: July 21,2004. Please refer to the enclosed license application for more information on how and where to purchase a license. Why are these recommendations being made for Hyannis Nissan? • This information is intended to educate you, a business owner in the Town of Barnstable; in order to keep your business operations in compliance with local, state and federal toxic and-hazardous materials laws so that you can avoid future regulatory problems. • Complying with the Control of Toxic and Hazardous Materials ordinance(Article 39)can + prevent contamination of Barnstable's existing and future drinking water supply,prevent environmental contamination which can bankrupt site owners,lower or destroy land values,drive out residents and industry,depress local economies and endanger public ,health:."•.�.� `. As a follow up to the site visit and inventory completed on June 3, 2004,a representative from the Public Health Division will re-visit your business during the next thirty days to further advise you on your compliance and complete your annual inspection. If you have any questions about these problems and/or their recommendations, or you need further information,please do not hesitate to contact me at the Public Health Division. Sincerely, o7 n 6� pe Thomas A. McKean,RS, CHO Director of Public Health h enc. On-Site Inventory (copy) Article 39 (copy) COPY Date• (o-3-Ot/ TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: i 5 " BUSINESS LOCATION: 26 5+. MAILINGADDRESS: �� '� INVENTORY TELEPHONE NUMBER: TOTAL AMOUNT: SD$ - -7-71 - 3G36 CONTACT PERSON: -70, �j� d. EMERGENCY CONTACT TELEPHONE NUMBER: 1=t�E Dl S�RI�' TYPEOFBUSINESS: z4hc,+o of eaifek, <S?ic.✓�C� OTHER INFORMATION: l. r 'o-n s/a-col Pit 4,o L`or e�kt ' •s �,v�.,ui�M 505� or1 �if�• •s s ��- MaAma cs "ce ti.�faq ,,WOAt 31 -6 Waste Transportation: Name of Hauler: C,,r Destination, Waste Product: wre a crit •s Licensed Yes No � wCt,a,�lre-Qirvi; ��- %n LIST OF TOXIC AND HAZARDOUA MATERIALS a�r�4� eez� The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume.'. NOTE: UST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): ✓ Antifr-eeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners /ZZ .!wAutomatic transmission fluid Disinfectants Engine and radiator flushes .: 3 Road Salt Halite _Va-e "f- u.l Hydraulic fluid (including brake fluid) • A Refrigerants ✓ Motor oils Pesticides 50 B NEW �USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel.fuel, kerosene,#2 heating oil NEW USED 2�0.- Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal Printing ink Degreasers for drivewaYs&garages Wood preservatives (creos ote) Battery acid*(electrolyte), bmbk�e..a_ Swimming pool chlorine Rustproofers Lye or caustic soda 15• 2-s Car wash detergents . Jewelry cleaners / Car waXes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, Z -NEW USED (inc. carbon tetrachloride)- - Raint&varnish removers, deglossers - Paint brush cleaners `'i•Z S Any other products with 'poison' labels Floor-&furniture strippers (including chloroform,formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers&cleaning fluids 1*n7014-t slQ.,'wt s , 2 S'ba.t Misc.: Seo„tu,,.,•,� �.�. cuett (dry cleaners) . 2 S ther cleaning solvents •n 'pAa1 Wqa.4% 22-T-. S cA a,{ 3 g�ac Bug and tar removers Jam, Za Aca Cow v e_ / z_ r� Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY SITE VISITS 0,13A: Hyannis Nissan Peugot LTD. Fax. 7 Corp Name: Mailing Address • _.._. ........... 3 , Location: 268 Stevens Street,Hyannis Street: P.O Box 957 v mappar: .308-017-000-000 City: Hyannis e Contact: .Dale Martin State: Ma Telephone: 508-771-3636 Zip: 02601 �f Emergency: Person Interviewed: O.V.Martin ✓ °v1 r CS�h2 Business Contact Letter Date: 5/28/2004 Category: VehicleMaintenance Inventory Site Visit Date -6 �a Type: . Follow Up/Inspection Date: ❑� public water indoor floor drains outdoor surface drains ❑d license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc currently licensed ❑d town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - - - El on-sitesewage El indoor on-site syste El outdoor 7/21/2004 outdoor onsite system ----- ------ - CRT 800-833-8278 W.BRID. Picks up used oil filters-80/barrels. compliance: PAINTS INPAINT STORAGE ROOM SPRAY BOOTH-FILTERS CHANGED Unsatisfactory 4 HYDRAULIC LIFTS&1 WLWCTRIC LIFT. MSDS&MANIFESTS KEPT IN UPSTAIRS OFFICE(PER DALE). MUST SHOW PROOF OF CERTIFIFCATOIN FOR FREON WORK-SEE ATTACHED MUST HAVE SECONDRY CONTAINMENTS FOR TANKS&DRUMS IN BASEMENT. ALSO,30 GAL GEAR OIL,10 GAL BATTERY ACID,5 GAL CAR WASH. /_ 5 NO SECONDARY CONTAINMENT FOR OIL.REMARKS: 3/5/98- 4-7 MAD059731406. MSDS kept in central file 4 hydraulic,1 electric lift. Safety Kleen parts+brake washer. New Pan America Env.Oil/water separator. Speedy dry in drum. Z5 f �' � All- �,, � j ��� � � � , ti 1 � �'" I r Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials gty's>25 Ibs dry or 50 gals liquid but less than 111 gals qty's 111 gals or more description "' ""' "qty:, :_unit of measure, antifreeze(for gasoline or coolant systems) 220 Gallons .. .. ... ._...�_. . ____ _.._... __.._..._ _ ___ _ . _. __._ _............ hydraulic fluids(including break fluid) 3 Gallons paint,varnishes,stains,dyes 25�Gallons motor oil 900`Gallons Waste Transporter: Fire District: Last HW Shipment Date Waste Hauler Licensed: It- 45 /V VV Ili , 'ce , .. sue, "V cvy�ce. -Cr s C� I 'k 1 � � i i 4 . � �.. I i h alGv-ar�5 i (N i V • � i f Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: Location: Date: 6 -3 -oy Physical Features to Inspect: 1. 'Hazardous waste generation sittees-(production/manufacturing areas): 2. Waste storage areas: 3. Satellite accumulation points throughout: 4. HazMat stored outdoors - CHECK OUTSIDE: 5. Shipping and receiving areas: LA 6. Run down of shop activities: 7. Housekeeping practices: i v 'r r HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: �iSSr.Z Location: Z S,, s S� Site visit date: • Hazardous Waste Manifests: • Employee training documentation (if required): • Hazardous substance spill control and contingency plan: • MSDS on site? 4 _r • HazMat Inventory records (if applicable): t • HazMat Waste Shipping documentation: • Spill records (if applicable): o� , Malkus, Karen From: Martin, Cynthia Sent: Thursday, April 15, 2010 4:45 PM To: Malkus, Karen Subject: Balise Karen, A quick note. As you know the pumping of the basements water has been stopped. Doug Anderson reported that a tanker truck hauled away some basement water earlier today but as you can guess the water in the basement continues to rise . The oily booms, pads and debris were removed and placed into Haz Mat labeled barrels and are awaiting pick up. New booms have been laid in the basement and Doug is working on getting the above ground oil and waste oil tanks pumped out as a precaution. I did not get a chance to call Bob Murphy after my site visit this pm. I'll touch base with him on Tuesday. Enjoy, Cindy Hazardous Materials Specialist Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Tel: 508-862-4645 Fax: 508-790-6304 1 � � ;- . � � :4 . , � ., � � . �_ � ��� .�,�� ,y y ;. �� _� . �. ►�'-~_�.'. its.: � { � iaAi t �� � !1 {yg� � � �1��� � ��_Ma A jaa A c�' �4 � � i '-' � ✓- `- 1 �. m �L ' \ ~� Q ,��� . ,:.>� . r� �i t .. � ::� 'f� . �_•3 fir._ r\',r', � � .� i� � _ q _ a : _ ,. h.. �'1:YJL+lA;.�C' ...►i �, .'#"fit. ....:'L" tin. . _ •. w� i-. . \.� ,� �.1.�.,. f _� .ol � �l ��'" ',r ,� .� raw f�y; .�..]� n _ o ��� , � 1MI r�` r �. �"4�' � �.RT .�, L. '7= �, __. u t ,� �� �, ��„. hi�x ` � # o { rMI, D V 4 . � � � � ~ � �f � �3 � ^��\ \ � \ \\\ � , / s - . » \ \ y� � r �{ 2 � i � � � }�� ` Z � \ . ��\ y , . a . , � � � , : � �§ . \��� � � � i%�\ � ° � . . , :� \� \ � � , ° -� z � �;� � / ` \ ! , 2 a � ,_w\ � % \ � � � � ` �{\ \� � \ � . 2�� `� \ . . } 2 �f . a g \ } } » \\ {\ � �(7/ � . _ 6 ���� - / . � �w � \\ �Z \�� \�` \ �§ � . � � � � ^ � � � .}� j| r � � .}:\ }: ' � , � ` , � �. , ` .d� . . . ^ \ { \� \ { ) y � . \ , <�% r ti �T' 41 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA OFFICE OF THE BOARD OF HEALTH sAaasTAEL o OF THE 9�O MASS.i639 TOWN OF BARNSTABLE, MASS. �^J SEWAGE DISPOSAL PERMIT VO y ri1 ar fir. 4 J Permission is granted to __�1' .. '_�_. = ___, � t ______ _______ to construct Sketch Upon t e Pre sef�l�,r, �^�r;Q".�E.-Lb�� l�,� SUCH r - P -- y� P In the illage o� 100 or more feet from any source/of water supply 20 feet from building , 10 feet from property line .Jr fArt� ---- .-- — �—`Health Officer. i' No.— ;�- S 5— THE OFFICE OF THE BOARD OF HEALTH OF THE = MMMSTAM, % TOWN OF BARNSTABLE, MASS. MA86. 0 9oOprF039•p`g�' �A ------ 19 '7.�,.r MAY - - '/a--- --- SEWAGE DISPOSAL PE� 114I�'' I. Permission is granted to ---�?�,`- ------ '-------------- to construct -"'- f � --- - �?-=- `z2C " c�l -- 4;� Upon the Premises of � � (X�D"?Jt�.r�� '4 { SketchOA -�'—Z' In the villa a t 100 orrr ore feet from any source of water supply 20 feeKfrom building V 10 feet from property line - ----- t Hea h Officer. ,K � ��,..,. . =a-+ ;. .,. � � '• . � � .,o�.... _ 1 �°goo,.�r..dw✓ 1�1 � +y� � �,���� `A R� V r; f 1 � ?IIII y A!Y �r,� -.; %�. <<<, rj ;f� ;� ,` L `J ¢ ,.. ., --r .. 'f, ._ k s_ i �� �^ � P + � r� h '�y, p A i f _ ' ,\'�JM'ET'�. V /�.�" �^ ,� ��, � � �� �. {::. ,�� �w i �._, �l UI ,I �' G' 1 _ • i • 4� 69 SA �L 4i r� � ,, ;t, '� „r it 1' � u7 i i I I �,I � � ra -i r� `.,; c ', C. PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 308 017- - Account No: 219864 Parent : Location: 268 STEVENS ST Neighborhood: HY09 Fire Dist : HY Devel Lot : Lot Size : 1 . 01 Acres Current Own: HYANNIS IMPORTED CARS LP State Class : 330 297 NORTH STREET No. Bldgs : 1 Area: 8250 Year Added: HYANNIS MA 2601 Deed Date: 100195 Reference : 9907/166 January 1st : HYANNIS IMPORTED CARS LP Deed MMDD: 1095 Deed Ref : 9907/166 Comments: Values : Land: 162000 Buildings : 249700 Extra Features : 7300 Road System: 268 Index: 1535 (STEVENS STREET ) Frntg: 218 Index: 1032 (MITCHELL'S WAY ) Frntg: 197 Control Info: Last Auto Upd: 052596 Status : C Last TACS Update : 031596 r Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date: 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ J Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [308] [018] [ ] [ ] [ ] I TOWN OF BARNSTABLE 40MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY Ni�tN `S)CMEe5H iP (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Sal Ye-0 tyo2 n SI , Class: 1 7. Miscellaneous c3Cv� QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS kround Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) x transmission/hydraulic Synthetic Organics: degreasers x Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 6�y3l_tA_ `�� �`-�S\�.S S�Q QS _XTown Sewer Public 0-VCLk \ O On-site OPrivate 3. Indoor Floor Drains YESNO O Holding tank,,-MDC_ O Catch basin/Dry well L-`O kQ MrV 1aA0 _2, l On-site system 4. Outdoor Surface drains:YES N0,/ ORDERS: O Holding tank:MDC % S?= V 1 O Catch basin/Dry well 054Q_� cj6X\QCAt OrN d� TI O On-site system 5.Waste Transporter Narne of Hauler I)esfination Waste od •d NO 1. n AVI S M 2, 1 t\ t% O Person s) nterviewed rispector Date ,J i Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUS INESS: '+A o/\INi S N%s5ni'J BUSINESS LOCATION: ©ZO MAILINGADDRESS: .S�"rne Mail To: TELEPHONE NUMBER: 09 -77/— j0h Board of Health CONTACTPERSON: W �A� k , co V i 46- o� Town of Barnstable P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES 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: ►V 1 I� 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 Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED — Cesspool cleaners LAutomatic transmission fluid —' Disinfectants i 4 Engine and radiator flushes Road Salt (Halite) CI-t Hydraulic fluid (including brake fluid) Refrigerants vo (;rl Motor oils _ Pesticides NEW USED (insecticides, herbicides, rodenticides) G<F� Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED 53 C14L Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED '76'CANsDegreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda S6-&( Car wash detergents Jewelry cleaners �—62ft Car waxes and polishes — Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) 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 (dry cleaners) 64- Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS t ozDate: — c TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBU_SINESS: ` " tgNm 5 N% SIS�Vlj BUSINESS LOCATION: tJPf�IS S' �1\1 iq f0l IS IY Ift OC2bO MAILINGADDRESS: A me Mail'To: TELEPHONENUMBER�, %Arcl KoE -27I 3�3b Board of Health I_ 1 Town of Barnstable CONTACT PERSON �,:. r 0 V i �l00"i P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPE OF BUSINESS: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES 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 Y address: ADDRESS: j TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that th6following 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; I Quantity Quantity �n GAY) Antifreeze(for gasoline orcoolantsystems) Drain cleaners NEW USED __. _.4" _Cssspool cleaners R Automatic transmission fluid Disinfectants r4g5 Engine,and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Q 1b� Refrigerants Of I Motor oils Pesticides NEW USED ' (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene,#2 heating oil NEW USED E 53 CAL Other petroleum products: grease, Photochemicals.(Developer) :Y i lubricants, gear,oil _ NEW USED 75-5- -sDegreasers for engines and metal Printing ink s —" Degreasers for driveways-& garages -- Wood preservatives (creosote)" 4 Battery acid (electrolyte) Swimming pool chlorine'" Rustproofers Lye or caustic soda SAC Car wash detergents , , ---' Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's E Lacquer thinners Other chlorinated-hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde,, . '! Floor& furniture strippers Metal polishes hydrochloric acid, other acids) s Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) L Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS - r TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair O satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops � unsatisfactory- 4.Manufacturers COMPANY; ?�%�i'l /6'Il S* Ov o& O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �d�o Class: _ 7-Miscellaneous '/"��UANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR TERIALS DrumsAbove Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age .Test t Fue4A lVe eY; Heavy Oils: waste motor oil (C) "U Ate/ new motor oil (C) .d 5 �� transmission/hydraulic Synthetic Organics: degreasers 64 "e Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. ater Supply O Town Sewer Public A a On-site 0Private U 3. Indoor Floor Drains YES_j,-'NOh Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES_f/NO ORDERS: _ O Holding tank:MDC Catch basin/Dry well O On-site system 5.Waste TransporterName of Hauler Destih.ation Waste Product "IS Licensed?' 2. ..mot t/ Person(s) Interviewed nspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops �j O unsatisfactory- 4.Manufacturers COMPANY �f� �``d .. (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Z4�'P 929". SST Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Di-e-seh,-Ivroseue,-#2 (B) Heavy Oils.Ot' waste motor oil (C) f� new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply ,01'Town Sewer Public . . 0 On-site OPrivate 3. Indoor Floor Drains -ES P'NO- 0 Holding tank:MDC Y 0 Catch basin/Dry well LI��/ 0 On-site system 4. Outdoor Surface drains:YES--!/—NO ORDERS: 0 Holding tank:MDC � f� Catch basin/Dry well ° On-site system .r�J 5. W ste Transporter YES NO 1.2. 'A rAA vV � --�.�, `',i%Z� ! gym►-jc.� -- �.� i Person(s) Interviewed or Date /,rr z TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH 0- satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY /�`f�-kit SsSa,ti (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS _Z(Y -rA y"-j SJre vt Class: 7.Miscellaneous 4Y°`^"'"3 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: 373 Y. waste motor oil (C) new motor oil(C) 4 T F transmis 'on/hydraulic � 7 Gj Synthetic Organics: degreasers Miscellaneous: '�� pC htM/ Q.Gl C WvS l.ac,I Od 1 1 2 Ss' Oc Lc C U.c""a.. I e1 pC DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply M A b '7 JN 0 -, ,✓t ds-n Fd r ATown Sewer APublic L4 (� e,,,Lc ( t. +c P J On-site 0P.rivate. k"114 -e ril Ek 3.Indoor Floor Drains YES- NO J,; O Holding tank:MDC .0 wSA? 40 O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well g On-site system 5.Waste Transporter Name of Hauler 1 • ' � �uc NO 2. Cykj, / el � r Person (s) Interviewed Insp ctor Date s l Z-/1--9 7 A4f P" I-*,- zo �✓ a She. C9,` l l,� �:�, h� ,,d r .a� d k G (".eV. Z"1 Glr s dc"k/ V� 4,1271 > al,- e 1"-"/ loot.(- -A�aK dv k(� s/7 h L �� obi /a,, q O-CCP-SJ C7 S4-1/ To ZZ, c47ya t — — — — . C(o dEd a.l e4- Sew. r I E I � ! i I I f II i { i i I i ► 1 � � i i l i � � � i I , ` � � � ! I � � � � 4 � � i � i � � � � i I I I ► � i � l l � i , � � i � � � � � � � � � � � � 1 • OMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair �'(un PrintersShops 0 (see"Orders") 5. Retail Stores 6. Fuel Suppliers 7. Miscellaneous i AMC WON ( ise lets , ,lhums k� Above Tanks> Under��nund Tanks MONSOON , 1 1 mmmmmmmm mommmomm mmmmmmmm Immommomms , 1 1 I I old • . - - off • WE- Vol 1 1 VINAWY_ mm s "m 00 Wi RUN, AN Name of Hauler " lle5t�nation� �_` Waste Product Licensed? g.: 3 �WAr ��►IBM �. .f •:. .z � 1� / /� ' % �fit.%r! �' � ► t►� TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Q satisfactory 2.Printers BOARD OF HEATH 3.Auto Body Shops Os unsatisfactory- 4.Manufacturers COMPANY p (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDAl N7SS �� Class' 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATER S Case lots 1 ove . x. IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) .e ils. aste motor oil C ) new motor oil(C 1� transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: fV, � . p� oox ' ����� DISPOSAL/RECLAMATION REMARKS: �N) 1. unitary Sewage 2. ater Supply -1uh<5 lwalffib6:, 1U Town Sewer Public On-site O Pr' ate � r E :I 3. Indoor Floor Dr YESNO rV O Holding tan DC s O Catch basin/Dry wel �f\l % � a�� (l O On system o � 4. Outdoor Surface drains:YESXNO ORDERS: O Holding tank:MDC / =C�ouav6re__a�apgrr O Catch basin/Dry well 16 W rf O On-site system 0 5.Waste Transporter Name of Hauler V 16 c� Destination Waste Product E YE NO 1. 2. r0A a a Person(s) Interviewed VICtor, TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY C (see"Ord rs") 5.Retail Stores 6.Fuel Suppliers ADDRESS C� 4 Class• 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS 1 ,• - und IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: a l DISPOSAURECLAMATION REMARKS: m 1. nitary Sewage 2, ater Supply 6/ id kOxILZ9Eaz22-)-)5 Town Sewer 'ublic - - - Q On-site OP 1 to 3. Indoor Floor DnMD YESNO O Holding tan - O Catch basin/Dry well a O On-site system o 4. Outdoor Surface drains:YES NO O Holding tank: MDC O Catch basin/Dry well S 6 / O On-site system P_a A /L, y�t� !f � /c. (! J 5.Waste Transporter Destination WasteProduct Name of Hauler 1. P/V S NO 2. Person (s) Interviewed Ins cto Date NIS (OaD V) . TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD p,OF H ALTH O satisfactory 2•Printers MY& 3.Auto Body Shops 5 A 8 unsatisfactory- 4.Manufacturers C (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 6 I/ Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MA Case lots. Drums Above Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) e motol•oil (C)' Q new motor oil (C) transmissio ydraulic S Organics: degreasers Miscellaneous:rdA 3 J b [,\411' r DISPOSAL/RECLAMATION R.EMAR.IKS: 1. Sanitary Sewage 2. ater Supply Town Sewer Public On-site O ri to W _ r 3. Indoor Floor Drains YES NO7 O Holding tank: MDC O Catch basin/Dry well O On-site system O C& 4. Outdoor Surface drains:YESNO O D S• o ® 0 4. Outdoor Surface drains:YES_X_O Holding tank:MDC It- V `�j O O Catch basin/Dry well � � RrN O On-site system �` 5. Waste Transporter Name of Hauler Destin altion Waste Product 1C 1. rYlv. OZL U / / V XDate 2. ,6 b, S lrl6 IVIVA�tff� Person (s) Interviewed I4pe :. -It kw 'v TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM HYANNIS NISSAN PEUGEOT LTD. Mail To: NAME OF BUSINESS: STEVENS & NORTH STREETS Board of Health P.O. BOX 957 Town of Barnstable MAILING ADDRESS: HYAA NIS, T. "^'"' TELEPHONE NUMBER: S0d- 77/-3&_?& P.O. Box 534 CONTACT PERSON: 1)A« MgeT/,1 Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in u ntities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES 4 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: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health.has determined that the following products exhibit toxic or hazardous characteristics and must be registered v�heord •, ..c� � `- id Vo• - Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants —< Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine �Y Car wash detergents Lye or caustic soda f\ Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (includingbleach Other rod n listed ) products of which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business &1/)Z� STEVENS AND NORTH STREETS an .� HYANNIS, MASSACHUSETTS 02601 NISSAIl O SSAN CCCC1111 TEL. (617) 771-3636 UGOT �O NN A Z //c�/9G7}f T,/f/•/i'E'� 7tarc.J Tows+ �F .Z3/�2J✓'T/t�cF HE��T7� D61r'"T 3G� /`7/��r.► f T EN CL o✓&--p Af THE pleat o F of- EY�TYF/i CE'2Tfi-1ev TFcHN/C16j If /7'2sl.r7e-J TrC H"k-/41i Ja/.ftj /Yl l?ra z/d vk/ ES THRU RVICE" TOWN OF_BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printerssatisfactory POAR10"m0F H ALTH 3.Auto Body Shops n C-1 unsatisfactory- 4.Manufacturers COMlANY (see Orders ) 5.Retail Stores 0� c, e 6.Fuel Suppliers ADDRESS J C7 �� (;jggg; 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS " Case lots Drunis Above Tanks UnOrground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel Kerosene #2 (B) LA waste.motor oil (C) Cnew motor oil(C) ) _transmission hydraulic ' " Xx Sy_nMetic�Organics: degreasers. —Y, C Miscellaneous: \J Ap qN b DISPOSAURECLAMATION REMAIWS. 1. Sanitary Sewage 2. #ater Supply ko b v 1i U)t Town Sewer Public / J _ J On-site Q rijate VAilW17,' r G �4 J c �(. 3. Indoor Floor Drains YES NO �1 �- O Holding tank:MDC rL �r 'L ( c/ Ai, ` u, O Catch basin/Dry well ® `�,�� 1 (^ c:7L -� , O On-site system 4. Outdoor Surface drains:YES NO IRD S` S`T =? + ° _X_ > = O Holding tank: MDC S 20® -� < J O Catch basin/Dry well O r42,E N P O On-site system colvaldInaltP, r 5.Waste Transporter Name of Hauler Destination Waste Product 1 rYA1. 01Z__, 6VAf)rC- * AIV 1 YEM NO &,/v i' i Person (s) Interviewed Inspecto Date ` .; ...: r: &• •� . V �� 'srt'�"Se �(' 'n"�t 3.:wr,, .�,... '�;�. e.# - :4Y11r'.'�� �.ytL t-'_'.see" il�fl Y 4 Sr L♦F.® tSeh�T. A� 4- "dK+.bwd �'r^� �'.f- b �� • , '�., Y 7' �Y4K.+{ 'Y�1 M1 a a '4 4`tF'r� ��{ .43"�� r•�tH' 'A+. o« KISR F��rlFs? �, •;y4', �`�pitr�¢" , "�f• 4 � ! � S•-. .: � �'�;�� � M1'!`.W� rolt'l � F A , M�. a� - � i .ar'.Yb ,.�i + ^�'�M1+'�. ' ''kl�_`��.�+sZ'�.�{' d�'S%_,1 '�'�.I, :+u�� .,,�.t.a�F+``�.��._3 ,•,41,v f?"T-'�f «,•q. ,�x. �4 �•�..+��s� +'�!w� �2'��R ��� "�._ ,�'� i�'.��.✓t rn.- ?k' �- �. ycy „x....m grY � � �l`��`t�'�c� 'L'�•.t2"'�i^,;'�'�^'S,t�a' s�: .L: �{`" "5r' �:,v-'i�•f? �,.�= � _ - - ants ^�'_ r �l',. y Y�f-..4 ,�P9'�,6 - •" Yr w \����`'*� � y+ .lfk�.���--sa•..�'��'�,.��cJ. '-�..)�+ .�.ZE_r'��.... .•►3a � .. Ts1,}v+�r : atibmt l 4lttAifr)r 1 r :I^R Lj �! IF ARM fava mv i �e- it kno wi! that has ticccs�fully pawthe examinatiow and awt the experience requirement prescrib; i by ate National jjut4ute al Aut i?ueHcrtce and is awarded this CERTIF TATE in cAdcnee of CO'Ni�E" i .in the serAm Om listed below: M W AUTOMO 1 � ;TECHNICIAN ARF.M OF DEMO"T�Id�T O'1Yt�E rEl�C ",� E1iQINZ REPA>jit` % a� JllE1�QI 94$ `_y ': ut F t ACTIMT C f�y �,� �t DRiN1", TRAIN' AND � 199A ;F SWENSIGN A)W,3'-TMIl10 BRAKES -tip• YRICAL"SMEl9S -PU'I'Ito Its ITIQ1�121Mg> i 9 i ''` �1ME'' l.R1FI>di1�11L�E :. .JIICY �„�����, r fi� ,�` y� '�+ yy� y�� �Ip.� rx t��' _ y�p� yam• ;,) .'r�f :.r ic5,�,,�e" _r .t ,Z F ,. ;�F� lOf_,y a 7�Js. efiF • �W 7of Jim.' � I fL w '�7� .• .� rr; ,• .hP 1 St 'y: a q•., e k •, � 3� _ TM nll'Yr 0�►� 19l3, � MERi�OM, YItRaZiitltx"' �: �, � �.. 1 e `• � • t1E6340474�25iROZI /���� --- -� ,. .''�; �x y�M +� '� �� wa }n[v}:FlCnt�oHi91Y>�.' .��' • _ p�"v�R;ryi+e.1 ��� Date: (o-3 -at/ TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: H a-►w - i S BUSINESS LOCATION: 2 6 u54-e y e-n s .MAILING ADDRESS: �� �� INVENTORY TOTAL AMOUNT: TELEPHONE NUMBER: SD$ - -7-7 / - 36 36 CONTACT PERSON: /Vvc k4>_&a, EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOFBUSINESS: _ Azvto a(eai eP�� 17WE Dt57�ICT" OTHER INFORMATION: aA*a44-Wd -6,4w"L _ �.c�cinrLi s r�vr'f-l. 'o-n s/o-t al Pits -i-y v e 's �,,vvtar .M S�5 oe7 5ife" (�cr Pit itx l-s ac qv,** 3`t' 0b Waste Transportation: Name of Hauler: �R�c. Destination, Waste Product: &v ,.Ae oarit -s. Licensed Yes" No 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. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): t✓ Antifreeze(for gasoline or c oolantsystems) Drain cleaners NEW ZIAA0 USED Cesspool cleaners /2_/` Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite)/2"c-e. 177e-t t Hydraulic fluid (including brake fluid) Refrigerants ✓ Motor oils 3av Pesticides 6-0 SB NEW _ppA USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) .Diesel.fuel, kerosene, #2 heating oil NEW USED 26o.r 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) 5-Battery acid'(electrolyte).) Swimming pool chlorine Rustproofers Lye or caustic soda 1`d• 25 Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, Z.aaA NEW USED (inc. carbon tetrachloride)' Paint&varnish removers, deglossers Paint brush cleaners `� s'L Any other products with p poison° labels (including chloroform,formaldehyde, Floor&furniture strippers hydrochloric acid, other acids) 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 /ncne4a t s��,u*- P g Misc.: 5 eov P,4A� CLC&t (dry cleaners) '7arJbther cleaning solvents W;,1044L tod VjaA,4,% 22T. S mat t`�Bug and tar removers Zo NO. _??�i DATE /-- o RECLIVED FROM DOLLARS Account Total $ wi Amount Paid. $ Balance Due $ Signature CoPttight 2000 A P,Inc. CHECK'.; 7771 ISSUED BY: enise HVANNi, 02601 M PAGE 1 CONTROL NO. Murray,Yi HYANNIS MA 2607 IfVU{}I� <' INVAQI A O h T/ ET Nl H a . V Ql STOCK T ORDER W. . . 061604 ANNUAL PERMI -HAZARDOUS MATERIALS 100.00 7771 20200 100.00 HA -MAT-PERMIT 4803 100.00 n � $ � V �j �� lov 00, ol CA TOTAL 20200 100.0 DETACH AT PERFORATION BEFORE DEPOSITING CHECK REMITTANCE ADVICE f Town of Barnstable °FtHVE T Regulatory Services � y Thomas F. Geiler,Director ` H" MASS.`� S. ` Public Health Division y MASS. 1639. ,0� '°'Fv► •+°' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office- 508-862-4644 Fax: 55-08-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT _ Q a Z:: ;1,��C t,1 A1{ a ADDRESS OF ESTABLISHMENT k�\j,'N \sue A—Ca>a( TELEPHONE NUMBER SOLE OWNER: YES__)�_NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: ;fib 1�Wu"q_7- 11Oa S\ i IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. C 3 -5`)9- IL STATE OF INCORPORATION n)ASS4CHUS�T\� FULL NAME AND HOME ADDRESS OF: PRESIDENT g� cC FAEZD (:�OV INC• Gg 3 \Rti11�lNlE li �l �_ _ty11Lo51C�1 VY1A OaS312 TREASURER ` CLERK OF APPLICANT RESTRICTIONS: HOME ADDRESS 1,,����t wav E_SAti�w�eN, VY�P,G253l HOME TELEPHONE# agFsd xaz.aoc/wp/q MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc). In addition,please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7)working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check . must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 Town of Barnstable • °FtHE T�� Regulatory Services Thomas F. Geiler,Director H" MASS. Public Health Division i639• ♦0 '°TEc 39 Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 ax: 508-790-6304 Application Fee: $100.00 ) � Pp �r ,rF� o yfq Ae e �oo� ASSESSORS MAP AND PARCEL NO. v 01- DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT IIYAN ti/,' 1"11',"1r'9'.j- -ZW c' NAME OF ESTABLISHMENT yYANN/t a(9s= ADDRESS OF ESTABLISHMENT fT'FvsN s r7--r, ffY9NN/f, /1'J/� 0 2(soJ .. ... . `j + �t'� f [!,.`r�'.�,, s,ue�g , #:• ��" .,, ,ry y t4 ,� °�...,� s�t� -�'ci ....:.L. oy, _`•R" �. A x TELEPHONE N[TMBER =�7 f✓ j k'F etiaYK 1 i) ^" x� n. k#� i � �' "� � j 8 �b,�''4�°i.• � ���-� rC a �`� r� x,._ r F 4�YEit S t "'yrN x. O✓,,.�, y" R c ,3 r r 2i'-ag'.,t^ckx a•ti'S'r�"s�7.1 u y P�1 r � y F'} x Y Eb �ks SOIWNRY na4 i,•r'�GY.IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. D't STATE OF INCORPORATION M'grrrfl C'HW'F37r FULL NAME AND HOME ADDRESS OF: PRESIDENT PAuc Zo1z^/✓7wPJ TREASURER CLERK AU A) SIGNATURE 0-1VAPPILWANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q l TOWN Or E3ARNSTAE3LE COMPLIANCe: CLASS; 1. tlarine,Gas Stations,REpai.r � ' -n � Q satisfactory 2. ers g. PputotP.od Shops llanufacturers t, / r. � •• / Qunsatisfactory- 5• Retail Stores COMPANY %l % �/ J (see"Orders") / !'f 6. Fuel Suppliers r °1 ADDRESS . f� :•}` ilk �Y=�'• y �� .11+ Class[ ! t 7.. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT-outdoor. 1fAJOR IUITERIALS Case lots Drums AbOveTanks Undetgrohnd Tanks I� )l OUT— a R gallons 9ge EW Fuels: • Gasoline, Jet Fuel (A) Diesel, Kerosene, Mz (B) Heavy Oils:__ waste motor oil - (C) - f pY�` i •�t r' new "motor oil (C) transmission/hydraulic Synthetic Organics: degrea//s�1e/rtls// W • . *Miscellaneous: D12 c)pry r—A l © lei CL-6'AA16��. DISPOSAL REC[, flAT ON REMUS: 1. sanitary Sewage 2. Water Supply *�� 4 Town Sewer ®� Public Alk,4 (-(41�'��/{t •,� , —_ ._ � On-site O Private 3. Indoor Floor Drains: YES) NO I 1�1V M 0 O [folding tank: MDC %.�T'.�11�1/I���(?,�r�.�"I(Lt�tf1 ("I,+` r rr Catch basin/Dry well On-site system ,Z� .f/�/� �'�/ 4. Outdoor Surface drains:Y E S NO /{(/A/ �/�+�/1� �/1 f /�/J} /j 0 O Holdin;; tank: MDC t - Catch basin Dr well %��K '! t� t _ _ _/ '� -- / y C; � OOn-sites stem L S. Waste Transporter .�. Q- icensed? �IiQ""aular- t .Destine iori i 1 r 1(/ast`ePi:bdur.L c:+(j YESI 2_ rjtep-��rT(�_- v -err ��� � i - 1 � n�,,�., ,� 1 +t ' r u. 21 , erson s Int.erview`e +" ;Inspector Date T NOF QARNsTAa�.E COMPLIANCE: CLASS. 1. Marine,Gas Stations,REpalr " 2. Printers "R D OF IICALTH �satisfactory 3, nuto Body Shops ; �r r � r. r unsatisfactory- 4. tfanufacturers '' J tf., see"Orders" S. Retail Stores COMPANY r ". r � � ( ) 6. Fuel Suppliers j r,: i �i �C18ss i ADDRESS t. �� _ � r,, . + 7. Miscellaneous QUANTITIES AND STORAGE (IN=111doors; OUT-outdoor. lfAJOR MATERIALS • Case -lots Drums AboveTanks Undetgrohnd Tanks IL in 8 ge l tons 9m Et-U Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, 02 (B) . Heavy Oils: 'waste •motor oil (C) new motor oil (C) - transmission/hydraulic `•Synthetl.c Organics:. degreasers • 'Miscellaneous: lT r pe,r L f l(. "w L1i Ji .a'V j(,- 60 . t 1 r� 0 I— 'j,NC DISPOSAL RECf, b�AT ON' � 1. Sanitary Sewage 2. Water SupplyF7. � V Town Sewer 0�Public tlrC it r)c C) On-site Private �, �'�l<'E �,� � 1' t f �✓�✓ �(- tr +/�` ' u ra { . 3. Indoor Floor Drains: YES N0 Q [folding tank: MDC Y ( ✓�;r`�,7N el OCatch basin/Dry well , ',(�/��/ ��� � b._. !/Ir�`� -- '•---.� _...__. �...._.�. - On-site system 4. Outdoor Surface drains:YES NO O lfoldinL tank: MDC ell V Catch basin/Dry well 11 U- '��1 -' �?_+!�`I_:. Jy ✓ 7*1r O On-sites stem S. Waste Transporter -''-''` -OV4.' t + - Licensedi 11s2m �i1a1:1�� 1?stina inn ,j rr, _wnstigr`Product _ r. u H luPerson(s) Interviewed Inspeftor Date SENDER: 'o ■Complete items 1 and/or 2 for additional services. I also wish to receive the y ■Complete items 3,4a,and 4b. following services(for an H ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. ai j ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Addre',ss permit. d ■Write'Return Receipt Requested'on the mailpiece below the article number. 2, ❑ Restricted Delivery rn r ■The Return Receipt will show to whom the article was delivered and the date a C delivered. Consult postmaster for fee. 0 v 3.Article Addressed to: 4a.Article Number w c d2Zc P3,3q TV 74/' E 7. 4b.Service Type c°+ QiG/{2fs �04� /, ❑ Registered Certified ¢ , (AlN (� p �a ❑ Express Mall ❑ Insured G �1`"C/V-�1,3 � � 7 ¢ 9 c,�� ❑ Return Receipt for Merchandise ❑ COD 7.Da Del' Ad z p 5.Received By:(PrintName) 8.Address e's Address(Only ifrequest W and fee is paid) r W t— g 6.Signature: (Addr ee or 0 X 0 N PS Form 38 , cember 1994 1 1 i i i Dom tie Return Receipt UNITED STATES POSTAL SERVICE First-Class MailPostage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box • Pobft Health DidiSlan Town of Barnstable P.O.Box 534 Hyannis.Massachusetts 02601 P 339 578 701 US Potal Service Receipt for Certified Mail No Insurance Coverage Provided. .Do not use for International Mail See reverse Sent Sye�t&. u bar PJ $ Certified Fee Special Delivery Fee Restricted Delivery Fee U. Return Receipt Showing to Whom&Date Delivered Q Return Receipt Showing to whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees $ �, �9 07 Postmark or Date E o Cl- /Z12 2 Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the Q) f return address of the article,date,detach,and retain the receipt,and mail the article. uO 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gumme!'ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the C addressee,endorse RESTRICTED DELIVERY on the front of the article. M 5. Enter fees for the services requested in the appropriate spaces on the front of this E receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. �`8L 6. Save this receipt and present it K you make an inquiry. a �I - z ...., yAIA- ,� i • 0' I ' i 7 i C.^. .� � I , �' o I L i ` y i i 1 BELTED M,E1. � l l yS ov S�S�I co s s I f.j. . . s s ' Town of Barnstable Department of Health, Safety, and Environmental Services * BAMSPABLE ' ,m� Public Health Division �fDN1A'�A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health December 17, 1999 Mr. Dale Martin Hyannis Nissan Peugot LTD. 268 Stevens Streets, Hyannis MA 02601 Jr ORDER TO COMPLY WITH THE BOARD OF HEALTH FLOOR DRAIN r 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. c> 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 �' acKe!' Thomaa�s Director of Public Health Enc. Board of Health Floor Drain Regulation cc: Ed Jenkins, Town of Barnstable Plumbing Inspector Ir � II BARNSTABLE, REFERErE MA PLAN TIED "SUBDIVISION PLAN OF LAND IN HYANNI5, m 13ARN5TAE, MASS" PREPARED BY DAVID H. GREENE, LOCUS 5URVEYOIDATED NOVEMBER 1 961 -TOWN O5ARN5TABLE A55E550K5 MAP 305 PARCEL O 17 Pleasant Hill Ln N 3 IiEc�e// < No��gt NOTE: TH 517E PLAN WA5 NOT PREPARED FROM ANY Sway IN5TRUME 5URVEY AND UNDER NO CIRCUM5TANGE5 SHOULD T DISTANCES, BEARING AND/OR OTHER FEATURES R �ar5t 5HOWN E U5ED TO E5TA13Ll5H PROPERTY LINE5. ALL W Main St South 5t LOCATIONAPE APPROXIMATE. o10 Pie KEY MAP LEGEND ID CATCH BASIN s 0 Q MONITORING WELL O I IT AREA OF DISTURBANCE 6 I RESIDENTIAL i (FRESH SAND) S I STIFEL NICOLAUS INVESTMENTS 1, rn � �" -- --—-- WATER TREATMENT SYSTEM (SEE DETAIL) _ 7z_ FO,�p MFR IJST Cl o MW-I EXTERIOR RAMP _ _n m rn MW-2 RESIDENTIAL r SLAB I '�-10 \ i ^- rn VILLAGE MARKET PLACE -- _ SUMP z RESIDENTIAL APARTMENTS � II I ^ ' 1 I N-G I LIVING HOPE FgMILY z 0 CHURCH I cn Q i W > HOLE/FRACTURE IN ' =Q ��D FIRST FLOOR SLAB MW-3 Q FULL I � 00 BASEMENT rn .. M W 4 Q n. 1 8,000 GALLON WEIR TANK I MW-5 GAC I GAC 2 I G7 m LOCUS -Q 2G8 5TEVEN5 STREET FIRST FLOOR O RETURN TO BASEMENT J Ov BASEMENT � / 00 TRASH PUMP SAMPLE PORT 7FLOW METER WCHELL'S WAY (EFFLUENT) -_ 50w MR. PERRY'S TUX PROJECT COMMERCIAL BEAUTY SALON SUMP PUMP CAPE WIDE TELEPHONE UQDEVELOPED GRIP 4-SHAFT MASTER \ 1 (WATER INTAKE) I LA CHEZ PATRICE 1 .) 18,000 GAL. WEIR BAFFLED OPEN-TOP FRAC TANK 2.) PUMPS FROM WEIR TANK TO 2 x 2000 Ib GRANULAR I � .// ACTIVATED CARBON VESSELSPROGRESS PRINT 3.) CLEAN EFFLUENT RETURNED TO BASEMENT RESIDENTIAL I I [TfN 4-26151 ' 1- / Project: HYANNIS IMPORTED CARS, LP. PROCESS FLOW D I AG RAM C/o HOLLY MANAGEMENT & SUPPLY CORP 297 NORTH STREET-HYANNIS,MA 02601 NOT TO SCALE Title: IMMEDIATE RESPONSE ACTION PLAN 268 STEVENS STREET-HYANNIS, MA 02601 BENNETT ENVIRONMENTAL SKETCH PLAN BED; ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS, GEOLOGISTS,ENGINEERS 0 50 100 150 1573 MAIN STREET, P.O. BOX 1743,BREWSTER, MA 02631 PHONE:(508)896-1706 www.bennett-ea.com FAX:(508)896-5109 SCALE 1 "=50' DATE SCALE BY CHECK JOB NUMBER 08/04/16 As Noted SRF TME/DCB BEA16-10824A