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Home My WebLink About0055 OLD MILL ROAD - Health 55 Old Mill Road Osterville A = 141 - 044 � 1 I 3f t TOWN OF BARNS.TABLE LOCATION 575'OLD /\h,11 �� SEWAGE# 9,010 -082; VILLAGE�5�-erU 1`� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. _4 }bO4.�" AAer SEPTIC TANK CAPACITY ILM HI AO LEACHING FACILITY:(type) (G 36 /ff, H—ap (size) //,X 2" NO.OF BEDROOMS OWNER /21IC PERMIT DATE: p/ D COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on . site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachin ility) Feet FURNISHED BY ,> 1N Y � OUT lZ0w6®r 5 Ar c tk �hF If-zo ,3 z( s 3 20 AfAlvksn► -12 3 i��►k,a D _ 3 l D Box �Vo �'23,3 `f TOWN OF BARNSTABLE SEWAGE # VILLAGES s /GL c-_, ASSESSOR'S MAP & LOT 'S NAME & PHONE NO. zu •� /V71� c a � f Soly SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COZIPL NCE ISSUED: t r ,�AD V QOv'� , � / / / / ��I /ter � � � I __ .. y: 1 �a v.� . I Ic- 6 .. a 3 . F�oo ,r LAN�'�S ,u Flom €ail A � � „ .� ,^k�r 3a '+�=�v-k .� �� ✓7y ,�s��y, ��d+� �v�� €fit- � o� �':�'»`��r7� ��h � .ti� v�� a nF m•ww^� v^,� 1t r� � q�, ,� ,�5 ��Q 'i 5owEgg m fl"f 1 f , I a r � r'jts�Mz s4�b. �`• m t s t k r w n,rws } +eG f �c +2 a na r a {a+r�,��idn .•.•� ,J `S&i� ��y+ t<,Y' �, �Zif t� � 8+� �+. 6 q bA r r R� fay:fE ea€:xistm_ and-1 Sexy,=l ft) Flo 10 /a VA let F-1,LA 4—b b� V. � �,c 5 � z r 4 55 OLD MILL ROAD, OSTERVILLE, MA RENOVATIONS Douglas and Christine Schofield trc= h r!,, *�- �'lk'�its•x.t�" ..n s��$� s .t sx z r'�`� ,+.� ..1,.:�'�r�` ad ��-.:..y ✓*�''Y{ ��.�wp#�- r..a;r- �-s-.�'.', �-� .&+A"<e+t. .^ d?uk A f ..#r .?.-2 (✓ � .s�xs�G'"`'*"y'sb-.�rz*� �w ' - `r'�'n-a�rgg sx7+�""t .•r '_t a� -�3L t � ,arar,`.�� :�. a`9`T y .�xa L,,a+i#"s�w :.s��•t 4 1• F.,,.�,�r� .Ww�,ai'ez�+� 3 Srr��'�'+$A-�r''N,,' y'u" 1`": ,� �n.�fi�: "'t.c iF h k%s .sr _ � 3 �"� v i/'1 1l!i� &. af'. -�a.3,•�1` S"��.a, �� fif �"'p� rh, (7Al � .� 1r- a •�� i'� '�,i 7'��.a� ^M,+,y's�' P�,'k �&� :��K ,-8'� Y Q " � E�`� 'I � �p►,�{� t j5�! "n'�.� 'F'tc r .9,ys^'1°r 9 ta"" fly q �t .: } FtF T' � sk 5 i'. ,. �T'♦ i t wg, 3� 'F+'k aye, .,�?Y'< ;awr,.-s i "•$ �� ce-t�.•v"�' i3 � k�.� a i:/V\�'<v��'� rwc-* •:u r L Ylt t'4� '��. x:. �r •mot.rys:.'�'t` ..�°` �w,�',�''�� v ��.ww �a 4 r' ��r.� �� E+,�, `... €�zear�.��.-r�x,��kay�u 35i��}��utieut��Pds;a�•� �x0�::f`a�-'s 4�} vi t'vk v,Al J o Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA D every page. Cityrrown Code Date a of i State 2ip Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. When filling A. General Information When filling out 1 forms on the computer,use 1. Inspector: . `f I only the tab key to move your DOUGLAS A BROWN cursor-do not . use the return Name of Inspector key. DOUGLAS A BROWN INC Company Name P.O. BOX 145 Company Address rem CENTERVILLE MA 02632 City/Town r=A. State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority & .—�aa_/=r° 4/25/12 Inspector's s gnature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. +sins•osioe rf � 59 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. City/Town 4/25/12 State Zip Code Date of inspection- B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM IS ONLY 2 YRS OLD B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•osios Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Officiel Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments lug 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. City/Town4/25/12 State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont,): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) .s ar p p ( ) a replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): i ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE every page. Cityfrown MA 4/25/12 State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is OSTERVILLE required for MA 4/25/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 god to 15,000 god. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '( 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is OSTERVILLE required for MA 4/25/12 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® - Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G 7 M a 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. Cdy/rown 4/25/12 State Zip Code Date of Inspection D. System Information Description: SYSTEM CONSISTS OF A 1500 GALLON H-20 TANK AN H-20 D-BOX AND 4 ROWS OF 5 ARC 36 H-C H-20 Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): Detail 2010--------------289 2011-------------278 Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments lug, 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. City/Town Zip Code Date of bate of 2 State Inspection D. System Information (cunt.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from-system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth, of Massachusetts 55 O9Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments LD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE every page. Cityfrown State MA Zip Code Date of Date of In Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: COMPLETE SYSTEM INSTALLED IN APR OF 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 H-20 Sludge depth: LIGHT/VARYING t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not'for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA Ciffown 4/25/12 every page. State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness LIGHT Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): WOODEN POLE Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09= Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M . ' 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. City/Town State Zip Code Date of bate of 2 Inspection D. System Information. (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '~ 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA /12 every page. Cityfrown 4-ate of State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0"" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): BOX LEVEL NO LEAKAGE Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: NO OBSERVATION PORTS t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA 4/25/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Type: ❑ leaching pits number: ® leaching chambers number: 20 ARC 36 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09108 Tifie 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments M 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is required for OSTERVILLE MA every page. 6i4rrown Date/12 State Zip Code Date of Inspection D. System Information (cunt.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments '( 55 OLD MILL RD Properly Address RILEY Owner Owner's Information is Name required for OSTERVILLE MA every page. City/Town 4/25/12 State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 r , Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments '( 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is OSTERVILLE required for MA 4/25/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high groundwater: GREATER THAN 5 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 4/25/12 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database explain: You must describe]how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 55 OLD MILL RD Property Address RILEY Owner Owner's Name information is OSTERVILLE required for MA 4/25/12 every page. Citylrown State Zip-Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page I of 1 TOWN OF BARNSTABLE , LOCATION_5-S' DOAUL 36 SEWAGE# ORS VILLAGE A der 1 r p ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) A_ f �—� (size) //r IX ls' NO.OF BEDROOMS OWNER- PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Suppty Well and LeachingFacility Feet ty(If any wells exist on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within Feet 300 feet of 1 ility) Feet FURNISHM HY a �1 Rcx-ab O r 5 Areou ik 3 v, 20 A BOX r"w odd-_ l l j7G s .8 r y c our.- QAoX _ �y D LOX — 2J16u 1 X17 z - DIY,� "f��►Y,� ://Www.town.bamstable.ma.us/AssessingINdisplaY.asp?mappar=141044&seq=2 4/25/2012 a� - No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftPlltAt10TY for M18p0sAY 6pBtPltt COttBtCULtI01Y PPrlltlt Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S 5'O 1 c)/ %jj; Owner's Name,Ad e s,and Tel.No. Obi-Cif it I-e Gdrrss/�s Assessor's Map/Parcel All I Installer's Name A ess,and Tel.No. Designer's Name,Address,and Tel.No. -b�slc.s t /��71�j0e S fey iNr r�j :y Type of Building: Dwelling No.of Bedrooms Lot Size u 54 he t r— sq.ft. Garbage Grinder( ) Other Type of Building h6obee No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 550 gpd Design flow provided 3 55, gpd Plan Date 1 ' Number of sheets Revision Date Title Size of Septic Tank /5-00 H"2.0 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �4"ft l/ 41xid Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o alth. t Date Application Approved by ® Date ' *414 Z Application Disapproved by Date for the following reasons Permit No.; Date Issued No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. 1 'PUBLIC HEALTH,DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTSItk Yes ! . application for Mispo%al bpstent eonstrUttkilt Vermit Application for a Permit to Construct O Repair(V11*`Upgrade O Abandon( ) ❑Complete System ❑Individual Components. Location Address or Lot No. -57S p 1 C) M A}j�J Owner's Name,Addre s,and Tel.No. ©5're+Utl 'e / / y elkl//e,5 12/ e Assessor's Map/Parcel Installer's Name Address,and Tel.No. Designer's Name,Address,and Tel.No. :> 1— FGWiJ1,AA SCc fay Ce3Ngfi �y�Nrrd" �5 �v/ .3 6 Type of Building: A Dwelling No.of Bedrooms Lot Size o 5 t A t!r' sq.ft. Garbage:.Grinder( ) Other Type of Building hie No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design low(min.required) gpd Design flow provided 3 S gpd Plan Date 2 -r /d Number of sheets . Revision Date Title Size of Septic Tank /1 QQ /V Type of S.A.S. 41,(k Description of Soil Nature bf Repairs or Alterations(Answer when applicable) 1A141-6�+/ IV?-id 5'a"I'C Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has-been issued by this Board of Hy�e�arlth. ? / Si e1 .1,li .f Date Application Approved by Q r Date f Application Disapproved by � � �� Date for the following reasons, Permit No" : f✓ F'� Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded Abandoned( )by 6�Ud t�, !v3 vr✓1 Nl ( ) at S l' Ole) AA; r) 6S fP(%?, )r has been cons�j c�ed in acc rdance with the provisions of Title 5 and the for Disposal System Construction Permit No.12 a ed r Installer J -, A 30WAl-1. J( Designer CN(/n/r p/r,vl i, k #bedrooms, Approved design flow '3 r gpd 11 The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date L) („�/J Inspector ( _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS MiSpoBal bpstem ConBtruttion permit Pe rmission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at /ild zf4 l /�� (�5 f• /,/t 11.E and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ; Provided:Construc.ionimust be co" leted within three years of the date of this permit. Date Approved by G � / ' Town of Barnstable P# y� Department of Regulatory Services . Public Health Division Hate 2 61, _ 200 Main Street,Hyannis MA 02601 Date Scheduled' S 0 U Time Fee Pd. C G Soil Suitability Assessment for Sewage sposal Performed By: �e � c—� f— Witnessed By: L;v+ jv. JL f LOCATION& GENERAL INFORMATION Location Address d ltk �-c ( T Owner's Name C kcq ck,2S ,`,V� a-2✓�J Address O b 2�5 Assessor's Map/Parcel: l�— !� y Engineer's Name c NEW CONSTRUCTION // REPAIR Telephone# --7`5-7 —1 Z CO T Land Use �225�\Ci �G« Slopes(3'0) ��— Surface Stones Distances from: Open Water Bally :�;P/ �V ft Possible'Wet'Area�f w ft Drinking Water Well I-r —oft Drainage Way . l SZ ft Property Line a! ___ft Other` Z ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) u I l ....LV Parent material(geologic) CL Depth to Bedrock (j ' �(1 Depth to Groundwater. Standing Water in Hole: ` t- Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE _ Method Used: Depth Observed standing in obs.hole: - _ _ in, Depth to soil mottles: `. Depth to weeping from side of obs.hole: �in, Groundwater Adjusttttent tt. Index Well# Reading Date: Index Well level Adj.factor A Adj.Groundwater Level,, PERCOLATION TEST ouie Z TIMO ,moo Observation t� Hole# 7 T Time at 0" Depth'of Pere,' Time at 6" p'1/1 Start Pre-soak Time @ /'�dl,(�� Time(9"-6") . End Pre-soak Zy cq �(,lti J Rate Min./Inch. 3- _ / Site Suitability Assesstnent: Site.Passed rX Site Failed. Additional Testing Needed'(YM) Original:Public Health Division Obsen4tion Hole Data To Be Completed on Back---------- ***If percolation test is to be.conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTICIPERCFORM.DOC DEEP.-OBSERVATION HOLE LOG Hole.# Depth from Soil Horizon Soil Texture Soil Color Soil ' Other ..Surface(in,) (USDA) (Munsell) Mottling (Structure„Stones;Boulders:;, t vl �u-1z0 DEEP OBSERVATION HOLE LOG Hole# Z' Depth from Soil Horizon Soil Texture Soil.Color Soil Other Surface(in.) (USDA) (Munsell) Mottling {Structure,Stones,.Bouldcrs. Consistency.% o F� mac_ . p f1-3� Co �� MS 30.-1 z) Z,5S DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling: (Structure,Stoncs,Boulders. Cgpsistenc�� e DEEP OBSERVATION HOLE.LO.G Hole# Depth from Soil Horizon Soil Texture Soil Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,:Stones;Boulders. t i Flood Insurance Rate Mav: Abope 500 year flood boundary No_ Yes f 'WiN 500;year boundary No_ Yes Within WO year flood boundary No Yes r Death of Naturally. Occurring Pervious Material Does at least four fet3t of naturall occurrin erviou material exist in all areas observed,throughout the, y gP area ro osed for the soil absorption system �S P ..P. If not,"at.is the depth of naturally occurring pe ious Certification I ce n / aT (date)I have passed the.soil evaluator examination approval by:the Department of Environmental Protection and that the above analysis was performed by me.consistent with the requir 'ning,expertise and experience described in 310 CNGG 15.0`17. / Date Signature Q:\S.EpT1C\PERCFORM.DOC y� ` ;�1� DATE:_ 9'/..6/95 . PROPERTY ADDRESS:__ 55 -01d Mill Road Osterville ,Mass , On the above date, I Inspected the septic system at the above addr _� This system consists of the following:- Q '( 1 . 1.1000 gallon leaching pit. The pit handles the laundry d RECEPiEO bath on the leftside of the house . 1�a 2. 2-61x8 ' block cesspools . Handles bath and kitchen on th ate SEP 1 8 1995 rightside of the house . Tl%1 MWW cQ Based on my Insr.*ction, I certify the following conditions: WAMWE 1 . This is not a title five -septlC' " t 2. .thj`�,wis `a "split -sewage -system. Th e system -il ' in proper 8 5 working order at the present time . SIGNATURP: IL Name: J. P.M'acomber Jr . Company: J. P_MacorUber & Son- Address:_•Bo-x-bb-----=I------- __Centerville LMass__02.632 Phone:---548�7��3338------- t THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY , JOSEPH P. MACOMBER & SON,. INC. Tar�krCssspoolrleachileIds Pump#d & Installed Town Sewer Connections P.O. Box 66' Centerville, MA 02632-0066 775-3338 775-6Al2 r S�a� sum, ale;' S?';^iACE DISY-06A.L SYSTEM AOdress Of Proper.�Y, 55 Old Mill Road Owner ' s nurse Jenniffer Jenny Date of Inspection 9/5/95 PART A C'1?'..CKLYBT Check if the following have been done : Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period . Large volumes of water have not been introduced into the system recently or as part of this inspection. --Z— As built plans have. b'een obtained and examined. Note if they are not available with N/A. _ZThe facility or dwelling was inspected for signs of sewage back-up. P . The site was inspected for signs of breakout._ All system components, cluding the SAS, have been located on the site. LtAo . Ar 4 eei; /Ieb� The manholes were uncovered, opened, and the interior of the k was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location' of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. _jZThe facility owner (and occupants, if di.fferent from owner) were provided with information on the proper maintenance '.of SSDS.' Recommendations . 1 . New tee must be installed in the cesspool on rightside of house. Present tee is broken and does not function. 2. New cover must be put on the leachung pit. Present cover is broken. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS: If residential number of bedrooms number of current rdsidents garbage grinder, ye-s or no 4LS-• laundry connected to system, yes or no -A�Q_ seasonal use, yes or no If nonresidential , calculated flow Water meter readings;. if available: 140,V-120"cu - a aPjQ Last date of occupancy GENERAL INFORMATION Pumping records and source of information: System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: , Type of system _0 Septic tank/distribution box/soil -absorption system _I Single cesspool Overflow cesspool Privy _A10 Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components . Date installed, if known. Source of inform tion: E- ------------ xp- Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK:4&1&47 (locate on site plan) depth below grade material of construction: concrete metal FRP other(explain) dimensions• sludge depth distance from top of sludge to bottom of outlet tee or baffle scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle Comments:. (recommendation for pumping, .condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet, invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: .(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc.) PUMP CHAMBER: (locate on site plan)• —d=�- pumps in working° order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, • recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, .but may be approximated by non-intrusive methods). If not determined to be present, explain: Type. rQ leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, cond .! io of vegetation, recommendations for ma 'nt nanc or repairs,etc. ) r ,� *&j0rRW5 ' �T ��s Tom_ y CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction CzJAXACTe indication of groundwater inflow (cesspool must be pumped. as part of inspection) �11� Comments: (note condition of soil; signs of hydraulic failure, level of ponding, c ndit 'on of vegetation: recommendation for maintenance pr re airs,etc. ) �. AL PRIVY: /1/D (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil, signs of. hydraulic failure, level of 'ponding, condition of vegetation,• recommendations for maintenance or repairs;etc. ) , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION CONTINUED Sketch of sewage disposal system; Includes ties to at least two -permanent references landmarks or benchmark Locate all wells within 100 i .I T - Depth to ground wa t ar •� G)Geoe_ /Yl /4 �'.G -_.. ---------- depth groundwater Method of determination or approximation -��--------------------------- ------------------------------------------------------------------------ 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined. .(Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) Backup of sewage into fa-,ility? _ Discharge or ponding of effluent to the surfa surface waters. ce. of the ground or i Static liquid level �N n the distribution box above outlet) invert? 8S Liquid depth in cesspool <6" below invert or available vo ' flow? me< 1/2. day .d11L Required pumping 4 times or more in the last year? number of times pumped d&f& Q Septic tank its metal? cracked? structurally unsound? substantial infiltration. substantial exfiltration? tank failure- imminent? "1 Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? _ within 50 feet of a surface water? within 100 feet of asurface water supply or tributary to a surface water supply? within a Zone I of a ,public well? Ae within 50 feet of..a bordering vegetated wetland or salt (cesspools and .privies only, not the SAS) ? marsh -.A20-- within 50 feet of a private water supply well? ..� less than 100 feet but greater than 50 feet from a private Water supply well with no acceptable water quality analysis? If the wellhas been analyzed to 'be acceptable, attach copy of� well water anal, for coliform bacteria, volatile organic compounds, ammonia nitro and nitrate nitrogen. gen I :r•rrrtry rrm•r--rs—l—rrr.:.--r_—ra--.r.::---rrr..•—re--n r_...s�r_�xar_--e.._ .�. .._ ._ .... _... _ — .. _—rrrrr�rr TOWN OF Barnstable BOARD OF HEALTH j SIJIISIRIFACF SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D— CERTIFICATION -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 55 Old Mill Road Osterville Mass ASSESSORS MAP, BLOCK AND PARCEL # OWNER s NAME Tanni ffar _Tanner PART D - CERTIFICATION r NAME OF INSPECTOR jose;jh P_ MPnnmhPr Tr COMPANY NAME J.P.Macomber & Son Inc . COMPANY ADDRESS Box 66 Centerville .Mass 02632 Street' Town or City Stat• Lip COMPANY TELEPHONE ( 508 1 775 - 3338 FAX (508 } 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate, and complete as of the time ofinspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience. .in the proper function and maintenance of on- site sewage disposal systems . Check one: XXXXU System PASSED The 'inspection which I have conducted has not found any information which indicates that •the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED# The inspection which I` have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 3.10. CMR 15 . 303 , and. as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Inspector Signature Date 9/6/95' One copy of this certification must be provided to the OWNER, the BUYER ( where applicable) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall u d he within one year of the date of the inspection, unless allowed ortrequiredm otherwise as provided in 3.16 CMR 15 . 305 . partd.doc f Cc^smonwea^r,cr Masscc#.Sens ' Execuuve Office cr Envuc=enics rttc;;s t a Department of 2 � F' Environmental Protection WoTer Ro uti n conTrol Tec.mcel Assuronce and Traning ,.ectOns wain F.w.w iTiodyCoOf 1 ' Thom"L Paw« - t f Jiunq�ormrwnw a, a f l W 06/12/95 ATTN: Joseph P. Macomber, ix s. .Joseph Macomber and San` 'PO:Sox 66 :Centerville, MA 026327 ' Dear'Joseph P. Macomber, Jr.., I am pleased to inform you ,that, you have attended training, . met the experience qual,ifications., and have passed the Title 5 System Inspector exam, .pursuant to• 310 CMR 15.340. The passing grade for the exam was 39/52 or 75%. This is an official notification'. that you are a Certified Department of .Environmental Protection System Inspector pursuant to 310 CMR IS,340.. You will receive a System Inspector certificate at a later date;, If you have any futher questions, please .write to me at the following address: Kimball Simpson D.E.P. Training Center 50 Route 20 Millbury, MA 01527 Thank,you very much for 'your time and consideration in this matter. Sincerely, - . • '° •fir,;� ;� � .-�;�.,� Kbipbal i" T T aSJ moson1 ring, or •cor, t lr •,• f• Watel• • ti.w tiw.." ' 1. C®ris'ervation SAVE Tips ME! • * • ' CHEGK FOR LEAKS ' Water Loss in•Gallons Due to Leaks i a` 'Leak this. Loss Per Day lass Per Month Size Z,l t 120 31600 • 693 20,790 s �1,200 36.000 1 i ;} 1,920 I 57,600 h, ,3,096 i 92,880 '•�' • , / ' I 5 4,296 29 .128,980 ® 6,640 - 199120Q .'1 s, . . 69.84 20Q520 r f� 8;424 252,720 .. '.•$i888 296,640 J ® 111324 339,720 P > r t i u y ^, 5 i.3 AL + t r s 12,720 1 381,600 rw , ' 14,052 i`448 560 aw zc r �. y•k.y'' h f( r } ,L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ufa Parcel q 7 Permit# P Date Issued Health Divisic►i ✓� Fee Conservation Division F%f� / �p aP`�tiv add-1 07 a0 SEPTIC SYSTEM MUST BE Tax Collector INSTALLED IN COMPLIANCE Treasurer WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address R J` O VQ W-w'—L" A� Village 0 - �� .M Owner Ghr�r-��-5 Address Telephone _ "� kQ LA Permit Request � i z� proposed 2nd floor:existing proposed Total new Square feet: 1 st floor: existing Valuation I 0 600 ZoningDistrict Flood Plain Groundwater Overlay Construction Type 000c� �rr}rnc Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 'Z new Half:existing new new Number of Bedrooms: existing �� Total Room Count(not including baths): existing First Floor Room Count � new 1 _ 5 Heat Type and Fuel: �Gas Q Oil ❑ Electric Cl Other Existing wood/coal stove: ❑Yes ❑No Central Air: ❑Yes $No Fireplaces: Existing New Pool:❑existing ❑new size Barn:❑existing ❑new size Detached garage:❑existing ❑new size Attached g rage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Proposed Use ' Current Use -- -- -- --. ---- -- BUILDER INFORMATION Telephone Number 3 1 SD Name License# C OI 5O y y Address' C 2 I"n(4 6454r r OZb3Z Home Improvement Contractor# Worker's Compensation.# O z F i&)a- I b Z5 ALL CONST N DEBRIS RESUL G FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE I Q, elnat� --�-� Q UNF.INtSHE2 ' b 4L r SEC0�4r).FLOOR PLAN a • 2.o itr74i.... - '—.. —_ F5" t-619i n . � - Cdustorn ►in�r��twoora � - &si ns ' f_a JOISTL g .. �c<.c.Su�Vy.cj <oq.ngm p t9y, Al . ae.e.v ea 1.1"stoKrl.iy.• ,i aat•R c.sto s+uncct' RIC,,n ELEVMc1.0 N . C lens ad 1a• urs e D a,•lo,rn• lose OI IM,1 cwr.w.rn'oo 3 ..... _. .,.. ._.r R n .. .. ..Y� Y.00. .. P !Y A!!Y othit ust n Srp Crr t 3a�o t - � I of I I V v! I I � I Cn MD�C[ [:t,3•• i j 1 I N` Tt 508.428-6191 o a eviin 11 I I� I o esigns wlo.s% sTL DIJIM � ..�.1 I ` O r npynght O 799T a I i i N An tgntr d er terora I 1 ,::r.�IG-1CaL I J i 4 Tl .CLNjC.UAP.1/6'14 ! I O I noCl.w u.. I I _.y �iTCN I P1TLk ll . Inc I 4 r. ILO 4 F- ..... . ... ._... .. 4nKA4E PLA 1,1 W I ' L Prel�minnry pr+n: Ana nr thrir rurrnmerl nmy Any nmrr u:r rt trnrlfy prnprpnr n\r4�v cu\tirus -• 1 i I / ta rrv...:_ _t L Li I �! R2lC E�V/T!oN 1fF* r;cyr.L0Ili srxc t>„t IITI1t� 608.418.6191 w �� -- - a eviin - @ustom c es igns cuy..- o ra � - All Ign(t 1nt•n tt-0 t 1 I t— I --C.triT-I N3^JifJS a J W 3 C - Y ple,m.naly plan$ Ana izyoutt by DC D dtt lot I—utt of tne, (Utt OMQlt only Any Otn(t Utf H ttrl(tly p.on,b•ta BOB FUGRO EAST, INC. ^ Sextant Hill•90 Route 6A Sandwich, MA 02563 Tel: (508)888-3905 Fax: (508)888-6689 November 3, 1994 16-23-3243 Chief Municipal Officer TOWN OF BARNSTABLE 367 Main Street Hyannis, Massachusetts 02601 RE: Response to Heating Oil Release Bevans Residence 55 Old Mill Road, Osterville Dear Sir: Pursuant to the Public Involvement Activities presented in the Massachusetts Contingency Plan, 310 CMR 40.1403, attached is a copy of the above-referenced report. Fugro East, Inc. has concluded that soil removal at the property has been successful in eliminating potential risk from fuel oil-impacted soils beneath the building of the site, and that a permanent solution has been achieved. Please do not hesitate to call with any questions or comments. Yours truly, FUGRO EAST, INC. AV - Joseph . Salvetti, LSP Senior Associate JPS/jtc Enclosure cc: Richard Clark A member of the Fug ro-McClelland group of companies with offices throughout the world. • 1 °Frt+e ram, The Town of Barnstable • BAM& LE, 9� '""M Office of Town Manager , ArEc '�" 367 Main Street, Hyannis MA 02601 Office: 508-790-6205 Warren J. Rutherford Fax: 508-790-6226 Town Manager TO: Thomas Geiler, Director, Department of Health, Safety and Enviromental Services r, a : _� t• 1 y FROM: Warren J. Rutherford; Town Manager f`I DATE: November 8, 1994 RE: Heating,Oil Release Report l ` Please find enclosed report from Fugro East Inc. and make available to the Health j Division. • j r"IECE 9 IVED -NOV 0 9 1994 � TOWN OF A4 iNSTAELE WEIGHTC A.40 MEA UPES x f r' . r E cmma 0 McCielgend a FUGRO EAST, INC. n 90 Route 6A-Sextant Hill Sandwich, Massachusetts 02563 Tel. (508)888-3905 FAX: (508)888-6689 16233243 RESPONSE TO A HEATING OIL RELEASE Bevans Residence 55 Old Mill Road Osterville,Massachusetts Release Tracking Number#3-10066 October 1994 Prepared for: OCEANSIDE, INC. 217 Thornton Drive Hyannis, Massachusetts 02601 r 5 �` 2 = d 1A., g. R 4, ek041 �.. h r � • � m y ;'V�� + g sw ems' � "', -mil ' r - _ '' - . � �:,_ �.r. ate. -�� .. � '• � ;k�r - _� w -`" a e GRG FUGRO EAST, INC.' o tRESPONSE TO A HEATING OIL RELEASE Bevans Residence t55 Old Mill Road Osterville, Massachusetts ' TABLE OF CONTENTS Page 1.0 INTRODUCTION................................. 2.0 SOIL REMOVAL ACTIVITIES ..................._................:. 3 ..................... 3.0 SOIL DISPOSAL/RECYCLING.....................................:. 4.0 HYDROGEOLOGICAL INVESTIGATION..................................................................... 10 5.0 SOIL AND GROUND WATER DISCUSSION................. 13 ' 6.0 RESPONSE ACTION OUTCOME................................................................................ 15 7.0 CONCLUSIONS, OPINIONS, AND RECOMMENDATIONS........................... 8.0 SERVICE CONSTRAINTS........................ ............................................... ................ 18 FIGURES ' Figure 1: . Locus Map Figure 2: Schematic Site Plan Figure 3: Soil Sampling Locations A ' Figure 4: -Excavation Locations TABLES tTable 1: Summary of TPH Concentrations, December 10, 1994 Table 2: Summary of Soil Sampling Analyses, May 3, 1994 ' Table 3: Soil HNU-101 Screening Results, June 2, 1994 Table 4: PetroRis Field Screening and Laboratory TPH Results, June 2, 1994 APPENDICES ' Appendix A: Release Notification Form Appendix B: Response Action Outcome t Appendix C: Activity and Use Limitation Appendix D: Laboratory Analytical Report Appendix E: Bills of Lading ' Appendix F: Boring/Monitoring Well Log t i Liao RESPONSE TO A HEATING OIL RELEASE Bevans Residence ' 55 Old Mill Road Osterville,Massachusetts Release Tracking Number#3-10066 1.0 INTRODUCTION This report is written to summarize and conclude response actions conducted as a result of a ' release of No. 2 fuel oil in the eastern portion of a residential building, located at 55. Old Mill Road in Osterville, Massachusetts (hereinafter referred to as the "Site"). Refer to Figure 1, Site ' Locus Map. Based on information available to Fugro, the date that knowledge of a release at the Site was sometime in November. Response actions at the Site were completed on September 26, ' 1994, as detailed below. The building has been unoccupied during response actions. The release occurred from a ' residential 275,gallon aboveground storage tank (AST) located in the crawlsP ace south of the basement (refer to Figure 2, Schematic Site Plan). The approximate 10' by 14' basement is ' accessed by stairs located in the northern part of,the basement. The oil-burning furnace was located within the basement north of the AST. According to information made available to ' Fugro, the AST apparently leaked for an unknown period of time. The former owner of the Site during the time the release occurred is deceased. The extent of oil migration was investigated ' throughout response actions and is detailed below. Fugro was retained by Oceanside, Inc. (Oceanside) of.Hyannis, Massachusetts to provide ' Licensed Site Professional (LSP) services to manage response actions conducted at the Sit e. In November 1993,Fugro responded to a threat of release at the Site. Analytical data which showed ' that concentrations of total petroleum hydrocarbons (TPH) at the Site exceeded the Reporting Category for Soils-1 (RCS-1) was made available,to Fugro on December 13, 1993. Response ' actions at the Site were conducted as a limited removal action (LRA) commencing in January 1994. LRA activities were delayed due to structural issues and'worker safety constraints at the ' Site. Based on information available to Fugro, the DEP was notified of a potential release by the Barnstable Board of Health. Fugro was then contacted by Cynthia Baron of the DEP in November 1993 for further information. At that time, there was no indication of a significant 1MR0 Response to Heating Oil Release o� release. Through further conversations with DEP, Fugro indicated that excavation ceased due to structural constraints and discussions with the client relative to the situation. During this period, evaluation of remedial options, costs, and feasibility were ongoing by the client. A monitoring well was installed in February 1994 and further assessment conducted in May and June 1994. Based on the results of the June assessment, an excavation plan was selected to minimize costs and impacts to the structure. Conversations with DEP indicated that the Site had been closed. It was recommended that a Release Notification Form (RNF) be submitted to DEP. A-copy of the RNF is included in Appendix A. This report has been prepared prior to DEP submittal of the RNF in order to satisfy a pending real estate transaction. Remediation and soil removal activities ' at the'Site were completed as of September 26, 1994. ' The objective of the activities detailed.herein was to remove fuel oil impacted soils from the Site and attempt to reduce TPH concentrations in soils to below the appropriate Method 1 Risk Characterization Standards. The Best Response Action Management Approach (BRAMA) standard, as specified in 310 CMR 40.0191, was employed throughout the response action to ' justify the amount of soils that were excavated and recycled. This report discusses the soil removal activities performed. In accordance with the Massachusetts Contingency Plan (MCP) 310 CMR 40.0446, a Response Action Outcome (RAO) Statement is being submitted with this ' report' In addition, due to concentrations of TPH in soils remaining at the Site, an Activity and Use Limitation (AUL) is being submitted with this report. Copies of both of these documents are ' included in Appendices B and C, respectively. 1 Bevans Residence, 55 Old Mill Road, Osterville,Massachusetts 2 a - Response to Beating Oil Release c� 2.0 SOIL REMOVAL ACTIVITIES ' Soil removal activities occurred at the Site intermittently over the period of time between December 1993 and September 1994. Soil removal and investigation was concentrated in the ' crawl space area from beneath the former AST south of the basement. An initial investigation conducted at the Site on December 10, 1993 identified concentrations of TPH as reported in Table 1 below. Refer to Figure 3 for soil sampling locations Borings were advanced and soil ' samples were collected using a stainless steel bucket auger. In order to avoid cross-contamination of soil samples, the auger was washed with a dilute Alconox soap solution followed by a potable ' water rinse between each borehole. The soil samples collected for laboratory analysis were collected into a 500 ml glass, laboratory supplied jar, capped with a Teflon-lined lid, stored on ice, ' and transported following chain-of custody protocol to Groundwater Analytical, Inc. (GAI) of Buzzards Bay, Massachusetts. The soil samples collected on December 10, 1994 were analyzed ' for TPH via . EPA Method 418.1 (modified). TPH concentrations ranged from 850 milligrams./kilogram (mg/Kg) to 10,000 mg/Kg. The laboratory analytical reports, chain-of- custody documentation, and laboratory Quality Assurance/Quality Control (QA/QC) statements are included in Appendix D. ' Table 1 SUMMARY OF TPH CONCENTRATIONS Samples Collected December 10,1994 .... agpte>dent�ticahoa Depth(£eet).;:. Concentration: (. ..... ..... SS-1 10 2,500 SS-2 10 1 10.000 ' SS-3 10 2,800 SS4 21 850 NOTES ' (1)All depths recorded from topographic grade. (2)All samples analyzed for TPH via EPA Method 418.1. ' Soil removal activities were conducted by Oceanside intermittently between January 27, 1994 and September 30, 1994. Removal activities consisted of removing the exterior foundation walls as shown in Figure 2, and various methods of excavation from within the affected area. A steel I- beam was placed under the southern foundation wall to provide structural support P pp during removal activities. Oceanside conducted preliminary excavation which consisted of digging by hand and Bevans Residence,55 Old Mill Road, Osterville,Massachusetts 3 -�SRO =Y Response to Heating Oil Release o� ' removal to an on-Site stockpile b hand. The soils were Y placed upon and completely covered by a 0.06-inch polyethylene plastic sheet until ultimate disposal. On May 3, 1994, Fugro conducted an inspection of excavation activities at the Site. Oceanside ' was conducting excavations using, square coffer dams constructed of 3/4-inch plywood. Four dams were constructed and labeled A, B, C, and D, as shown on Figure 3. Dimensions for the coffer dams are as follows: coffer dams A and D were 4' by 2.5', and B and C were 4' square. ' Soil removal from within the coffer dams was being conducted using a "Vactor" truck operated p ed by Energetics, Inc. of Cumberland, Rhode Island. The Vactor truck uses high pressure air suction ' to remove soils, sands, and small cobbles. ' Samples were collected from the bottom of the coffer dams at-various points of the excavation for field screening using an HNU-101 portable photoionization detector (IIlVU-101) and analyzed by GAI via EPA Method 418.1. The samples were submitted for standard two-week turnaround ' time following appropriate chain-of-custody protocol. Table 2 below summarizes thes e analyses. Samples were collected using a stainless steel trowel. The trowel was washed with a dilute ' Alconox soap solution followed by a potable water rinse before sampling and between each sample in order to avoid potential cross-contamination. Excavations were continued to the depths listed below, after which structural constraints related to the coffer dams restricted further digging. Table 2 SUMMARY OF SOIL SAMPLING ANALYSIS Samples Collected May 3,1994 :.:.: ample Appeoate D. HNiJ i01 Results TPH;(mg/I Ident�ficat�on Coffer Dam letter�n a> HS-1, SS-1 12'61.'/B 68 16,000 HS-2 10'8"/A 44 NA(3) HS-3, SS-2 12161'/C 42 13,000 SS-3 11'4"/A NA 16,000 ' HS-4 11'11"/D 59 NA HS-5, SS-4 12'6"/D NA 15,000 NOTES: ' (1) Approximate location of coffer dams and sampling points are included in Figure 3. Approximate depths recorded from floor joists above excavation. (Approximately one foot above topographic grade.). (2) HNU-101 results are in parts per million(ppm). ' (3) NA=Not analyzed. ' Bevans Residence, 55 Old Mill Road,Osterville,Massachusetts 4 Response to Heating Oil Release n� On June 2, 1994, Fugro conducted a limited subsurface investigation in order to further characterize soil quality remaining on the Site. The objective of the investigation was to obtain further soil quality data to assess the feasibility of soil removal options. The investigation ' included the collection of seven soil samples from nine boring locations on the Site proximal to where the AST had been located. The collected samples were field screened with an HNU-101 and field screened with the Petro Rapid Immunassay Screen (RIS). The samples were then submitted for laboratory analysis of TPH. The objective of the RIS field screening was to select soil samples for laboratory analysis to confirm soil TPH concentrations less than 10,000. Refer to Figure 3 for soil sampling locations. iA stainless steel bucket auger was used to create borings from which the soil samples were collected. Borings ranged in depth from approximately 15 to 19 feet below topographic grade. ' Cardboard and PVC tubing were set in place at the top of the borings to avoid cave-in of loose surficial sand. The auger was washed with a dilute Alconox soap solution followed by a potable ' water rinse before sampling and between each borehole to avoid cross-contamination of soil samples. ' Field screening was conducted with an -HNU 101 to determine the presence of volatile organic compounds (VOCs). The HNU-101 employs a photoionization detector to measure relative ' concentrations of VOCs in the headspace of sealed soil sample jars. HNU-101 readings cannot be directly translated to quantitative concentrations of organic compounds present, but are indicative ' of the presence and relative concentration of VOCs. The IM-101 was calibrated on-Site with an isobutylene standard read as benzene. All soil samples collected were grab samples taken from ' within approximately two inches of the recorded depths. At each soil sampling location and depth, soil was collected into a 250 ml glass jar, covered with foil, and then field scree ned with the HNU-101. Field screening was conducted using the procedure outlined in DEP policy i #WSC-94-400, "Interim Remediation Waste Management Policy .for Petroleum Contaminated Soils." Each soil sample was also field screened using the Petro RIS Soil Test System available from ' EnSys, Inc. This test method uses a differential photometer to detect petroleum products in soils at specific concentrations. The test,conducted at this Site was calibrated to detect No. 2 fuel oil at concentrations of 1,000 and 10,000 parts per million (ppm). Samples are extracted, diluted, Bevans Residence, 55 Old Mill Road,Osterville,Massachusetts � 5 -&IMRO =Y� Response to Heating Oil Release n ' treated, and then analyzed for color intensitywhich is related w e ated to petroleum content. Two laboratory prepared standard samples are also treated in the same manner. The two standard samples are compared using the photometer. A difference of more than a 0.20 reading (either + or -) between standards is out of the QA/QC for the test. The darker standard is then compared ' to the two other samples. If the samples are recorded as negative or equal to the standard, concentrations of petroleum hydrocarbons exist at that concentration. ' Soil samples were colle cted cted and transported to GAI following the protocol described above. TPH concentrations ranged from 150 to 8,600 mg/Kg. The laboratory analytical reports, chain-of- custody documentation, and quality assurance/quality control statement are included in Appendix D. Soil sampling VOC field screening results are presented in Table 3. Refer to Figure 3 for soil ' sampling,locations. ' Table 3 SOIL HNU-101 SCREENING RESULTS June 2,1994 t Sam le p P 1 pp g�mate bept6; . HNU 1U11..... . s ' SS-1 16'6" 20 SS-2 18'6" to 19' 34 SS-3 9'6" to 15'6" 40 SS4 11'6" to 16'6" 24 SS-5 8'6" to 14'6" 12 SS-6 9'6" to 16'6" 30 ' SS-7 10'6" to 17' 48 NOTES: ' (1) Approximate locations of sampling points are included in Figure 3. (2) HNU-101 results are in parts per million(ppm). The Petro RIS soil test system and laboratory TPH results are presented in Table 4. Refer to ' Figure 3 for soil sampling locations. Bevan Residence,55 Old Mill Road, Osterville,Massachusetts 6 ' �Qa6t0 Response to Heating Oil Release o� ' Table 4 PETRO RIS FIELD SCREENING AND LABORATORY TPH RESULTS(1) ' June 2,1"4 Sample Aplsrogimate Depth Standard fi 006 I0, RIS p 000 TI' ldenttficatinn X . .. .>..::., . b�fYei'eeces 3. .;.. : Standard t Standard mg/Kg SS-1 16'6" -0.18 -0.20 +0.06 640 ' +0.18 SS-2 18'6" to 19' -0.05 +0.16 +0.16 1,800 +0.04 ' SS-3 9'6" to 15'6" -0.19 -0.15 -0.05 NA(6) +0.19 SS4 11'6" to 16'6" -0.05 -0.05 +0.07 6,300 . +0.01 ' SS-5 8'6" to 14'6" -0.08 +0.11 +0.21 150 +0.02 SS-0 916" to 1616" =0.05 -0.01 +0.27 2,300 +0.27 SS-7 - 10'6" to 17' -0.06 -0.06 +0.35 8,600 +0.03 NOTES: (1) All samples analyzed using the EnSys Inc.Petro RISC Soil Test System. (2) Approximate locations of sampling points are included in Figure 3. (3) Differences within 0.20(+or-)are within QC limits for screening. (4) Negative numbers or 0 indicate presence greater than specified concentration of fuel oil#2. RIS Standard. Positive numbers indicate a lesser presence. (5) All samples analyzed via.EPA Method 418.1. (6) NA=Not Analyzed. Samples SS-1 and SS-2 are composite samples compiled from grab samples collected from the ' bottom of four borings. These four borings are located within the wooden coffer damns that were used during previous excavations. Samples SS-3 through SS-7 are composite samples collected from soils ranging in depth from discrete borings. All locations of samples and borings are included in Figure 3. ' Based on the analytical data collected yt co ected on June 2, 1994, Oceanside began to excavate soils to a depth of approximately 19 feet below topographic grade. Refer to Figure 4 for final excavation ' extent. Excavation at the perimeter of the contaminated areas was conducted by constructing steel coffer dams to support the excavations. The coffer dams were set up along the west, north, ' and eastern walls of.the Site area. The dimensions of the coffer dams are approximately 4 feet square. Upon completion of the excavations, Fugro conducted Site visits to verify depth of the Bevan Residence, 55 Old Mill Road, Osterville,Massachusetts 7 r =0� Response to Heating Oil Release o� ' excavation and soil removal. Each coffer dam was then filled with concrete or clean fill. Appropriate structural columns and supports were constructed along the south and eastern ' foundation walls. ' On September 15 through September 21, 1994, an excavator was used to conduct final excavation at the Site. The excavation was conducted in the center of the filled coffer dam walls ' to a depth of approximately 19 feet below topographic grade. The excavation extended horizontally approxmnely 2 feet south.of the southern foundation wall. Soils were collected into a container supplied by Waste Management, Inc. of Plymouth, Massachusetts. This final ' excavation concluded excavation activities for the Site. In order to reduce the potential risk of vapors from entering the house, Oceanside installed a passive vapor collection system in the final excavation within a layer of peastone approximately 6 feet below exterior grade and immediately below the basement floor. The vent for the passive ventingis located on the east i f side o the building. In addition, a polyethylene plastic vapor barrier was installed under the floor to further block vapors from entering the house. 1 I Bevan Residence,55 Old Mill Road,Osterville,Massachusetts 8 f ' -fUGRO =Vw Response to Beating Oil Release o� 1 3.0 SOIL DISPOSAURECYCLING A Bill of Lading �OL) was prepared for the removal l of oil-impacted soils from the Site. Soils were transported to Bardon Trimount, Inc. (BTI) of Stoughton, Massachusetts for hot and cold 1 asphalt batching. Approximately 84 yards or 125 tons of soil were disposed at BTI under the BOL process. Soils were transported by dumpsters rented from Waste Management, Inc. Copies 1 of the BOLs and disposal receipts are presented in Appendix E. i i 1 1 1 i 1 1 1 it � 1 Bevan Residence, 55 Old Mill Road, Osterville,Massachusetts 9 ' GRo Response to Heating Oil Release ' 4.01 HYDROGEOLOGICAL IIWESTIGATION S In order to investigate potential impacts to ground water beneath the Site, Desmond Well ' Drilling, Inc. of Orleans, Massachusetts completed one soil boring and installed one monitoring well south and hydraulically downgradient of the Site on February 15, 1994. The soil boring was ' advanced using a truck mounted rotary drilling rig utilizing hollow stem augers. The soil boring was logged and the monitoring well installed under the direction and supervision of a Fugro geologist. The approximate location of the monitoring well (FM-1). is shown on Figure 2. ;The ' boring logs and well completion details are presented;in Appendix F. ' Before' arriving on-Site, the equipment used in: drilling was cleaned to remove, possible contaminants encountered during prior drilling work. All equipment coming in contact with the ' soil and water, including: augers, rods, water tanks, drill tools, pumps, and hoses was steam cleaned before drilling and between boreholes. No oil, grease, or other petroleum based products were used to lubricate augers or rods. Tn addition, care was taken to ensure that no oil, grease, or ' other lubricants entered the borehole from the drill rig. ' Standard penetration tests yielding split-spoon samples were conducted at approximate five-foot depth intervals within each soil boring. The split-spoon sampler was cleaned with potable wash ' water and Alconox detergent, and then rinsed with potable water-before each sample was collected. The soil samples were 'Visually classified and logged by a Fugro geologist, using a ' modification of the Burmister Soil Classification System(1958). Representative portions of each split-spoon soil sample were preserved in screw-top, eight-ounce, ' clear, glass jars. The soil samples were placed in the jars as soon as'they were collected to preserve the original moisture content. The jars were covered with aluminum foil and tightly ' capped. The well location number, sample number, depth interval, and number of blow counts per each drive increment wre recorded on each jar. In addition to soil sampling for textural characterization, each. split-spoon soil sample was ' headspace field screened for the presence of VOCs using an HNU Model 101 (BNU) photoionization detector. The HNU was calibrated in the field to an isobutylene standard read as ' benzene. The HNU provides qualitative indications of the presence of VOCs. The readings given Bevan Residence, 55 Old Mill Road, Osterville,Massachusetts 10 ' GRU Response to Heating Oil Release ' in parts per million (ppm) indicate the relative amount of VOCs present, but do not represent accurate VOC concentrations. A monitoring well was installed at the boring location. The monitoring well was constructed of ' schedule 40, two-inch diameter PVC casing, attached with flush-threaded joints to schedule 40, two-inch diameter, 0.010-inch factory slotted PVC well screen. The well screen was set to intersect the water table. Ottawa sand was used to backfill the borehole around and approximately one-foot above the screened section of the well to minimize the amount of fine soil entering the well. An approximate two-foot seal of bentonite-clay pellets was installed at a depth ' of nine feet below grade extending to 11 feet below grade. In addition, a one-foot bentonite. pellet seal was placed in the annulus at a depth of three to four feet below grade. A cement seal ' was installed around the curb box at the ground surface to minimize infiltration of surface water into the well. The well was completed with a standard steel curb box set slightly above grade to ' prevent tampering and protect.the well. ' Upon completion, the well was developed by surging the well with a disposable bailer and purging the well of at least three well volumes of water. ' In general, the soils' encountered in the soil boring consisted of topsoil overlying g n fairlysorted coarse to fine outwash sands: Coarse to fine-grained sands were encountered at shallow.depths grading to coarse to medium sands and gravel found in the vicinity of the water table. Detailed descriptions of the soils are shown on the boring log in Appendix F. The soils observed in the soil ' boring are consistent with USGS maps of the Cotuit quadrangle that indicate that the Site is underlain by Kame Deposits. No clay layers or other distinct low permeability layers were observed in the split-spoon soil samples that could affect the vertical migration of infiltration on- Site. No indication of oil impacted soils was noted from any of the soil samples collected. ' On February 24, 1994, Fugro collected a ground water sample from the above-referenced monitoring well (FM-1). Prior to sampling, the static water level and well depth were measured. ' The total volume of standing water in the well was calculated and the well was purged of at least three standing volumes of water in order to ensure that representative samples of gorund water were being obtained. The well was purged and sampled using one-time use, disposable, weighted, plastic bailers. A monitoring well sampling log is included in Appendix F. Bevan Residence, 55 Old Mill Road,Osterville,Massachusetts 11 II G6p0 Response to Heating Oil Release ' �1b ' After purging water from the well, a water sample was collected for laboratory analysis of TPH via EPA Method 418.1. There was no visual or olfactory evidence of oil or hazardous materials ' within any of the evacuated water. ' The sample was preserved appropriately, stored in coolers on ice, and hand delivered to GAL The laboratory analytical. report, chain-of-custody documentation, and laboratory quality asurance/quality control,(QA/QC) statement are included.in Appendix D. According to GAI, no ' concentrations of TPH were identified exceeding the reporting limit of the method used. ' It should be noted that this well was subsequently destroyed during excavation activities. 1 1 t Bevan Residence, 55 Old Mill Road,Osterville,Massachusetts 12 f 11GRG auuv� Response to Heating Oil Release oO� ' 5.0 SOIL AND GROUNDWATER DISCUSSION Fugro conducted research at the Centerville-Osterville-Marstons Mills Water District office in Osterville and the Barnstable Health Department in Hyannis on February 24, 1994 in order to ' determine the presence of private wells in the area. According to the water department, the majority of the Site area is serviced by the municipal system. However, some homeowners have ' private water supplies. Based on this information, a visual inspection of surrounding properties was conducted. Fugro observed what appeared to be a private water supply well south of the Site ' across the private way that forms the southern Site border. Further research and inspection indicated that this was not a well. Two private water supply wells were identified approximately 1,200 feet,southeast of the 'Site along Main Street. These were the closest private water supply wells identified. Based on a review of publicly available information, ground water flow direction y is inferred to be towards the south. Pursuant to the MCP, 310 CMR 40.0932, it is Fugro's opinion that ground water beneath the Site ' is defined as ground water category GW-I. According to Method I Risk. Characterization, the maximum concentration for TPH in GW-1 water is 1,000 parts per billion (ppb). According to ' ground water sampling conducted at the Site, no reportable TPH concentrations were identified in the ground water under the Site. Therefore, according to MCP Method 1 Risk Characterization, there is minimal risk from TPH impacts to ground water at the Site. The Method 1 Risk Characterization standards for TPH in soils is as follows: ' S-1/GW-1 = 500 µg/g(ppm) S-2/GW-1 = 2,500.µl/g(ppm) ' S-3/GW-1 = 5,000 µg/g(ppm) These TPH concentrations represent promulgated standards which, if met, reflect a level of no ' significant risk. In Fugro's opinion, all soils from under the footprint of the building are considered isolated subsurface soils and therefore fall into the S-3 soil category. Soils which are ' outside the structure along the east and south walls are considered to be accessible from 0 to 3 foot depths below grade, and therefore are classified as soil category S-1. Soils outside the structure at a depth from three to-15 feet are potentially accessible, and therefore classified as soil ' category S-2. All soils below 15 feet are considered. isolated subsurface soils and therefore classified in the S-3 soil category. ' Bevans Residence,55 Old Mill Road,Osterville,Massachusetts 13 66p0 , Response to Heating Oil Release The horizontal and vertical extent of excavations at the Site as shown in Figure 4 were determined ' using data collected in June 1994. Grade at the Site is considered to be approximately one foot below the top of the foundation wall. Soils which had concentrations of TPH,over 5,000 mg/Kg ' were excavated from the Site. The excavated areas are shown on Figure.4. .The vertical extent of excavation was determined by using data collected from within the four original coffer dams in ' June 1994. According to HNU screening and analytical data which had previously been Fcollected at the Site, the area of the coffer dams had the highest concentration of TPH at the. Site. Asa safety factor, all excavations were advanced to depths of approximately 18 feet below ' topographic grade. This method of excavation was used to ensure that,concentrations of TPH in soils remaining under the footprint of the building are well below the S-3 standard of 5,000 ppm, and that all impacted soils from outside of the footprint of the building are well within the specified concentrations as listed above. It is Fugro'.s opinion that the actions as detailed above ' have resulted in a conclusion that No.Significant Risk has been achieved at the Site. ' According to the MCP, 310 CMR 46.102 and 40.0923, an Activity Use Limitation (AUL) is required at any Site for which concentrations of oil and or hazardous materials exceeds the Method 1 S-1 concentration. As-noted above, the Method 1 S-1 concentration is 500 mg/Kg. ' According to the data, there are soils at the Site remaining which do exceed the:S-1 standard; however, as noted above, do not pose a risk to human or environmental exposure to its ' accessibility. Therefore an AUL is being implemented at the Site to ensure that the accessibility of these soils do not change for a foreseeable period of time. 7 Bevan Residence, 55 Old Mill Road,Osterville,Massachusetts 14 Response to Heating Oil Release �� ' 6.0 RESPONSE ACTION OUTCOME In accordance with,the risk characterization and the instituted AUL as detailed above, in Fugro s opinion current conditions at the Site meet set criteria as established in the MCP, 310 CMR ' 40.100 for a Class A-3 RAO. In support of this RAO, a background concentration feasibility study and demonstration of elimination of uncontrolled sources follows. Response actions at the Site have been conducted at the Site in response to a release of No. 2 fuel ' oil from an AST which was formerly located at the Site: The release resulted in *soil contamination which is detailed above. The AST was removed on November 2, 1993 by Enviro- Safe Corporation of Sagamore Beach, Massachusetts and .properly cleaned and disposed. Therefore, in Fugro's opinion, the formerly uncontrolled source of release has been eliminated. The incremental cost of conducting response the res action in order to achieve background P g concentrations at the Site would be exceedingly substantial, due to structural constraints and rworker safety issues that must be addressed. if further excavation were to be conducted. Additionally, the incremental risk of inflicting permanent damage to the building would aggregate ' severely sue to additional stress from supports which`would be necessary to conduct further excavations. Due to the inaccessibility and depths of the remaining contaminated soils, the 1 elimination of these soils would not result in an severe risk reduction. Therefore, according to the MCP, 310 CMR 40.0860' it is not feasible at this time with current technology to conduct a cost- effective restoration to background concentrations at the Site. Bevans Residence,55 Old Mill Road, Osterville,Massachusetts 15 y , ' ono Response to Heating Oil Release 1 ' 7.0 CONCLUSIONS, OPINIONS,AND RECOMMENDATIONS ' In Fugro's opinion,.a release of No. 2 fuel oil has occurred at the Site from a former AST. Response actions as detailed within this report have been undertaken at the Site. Based on the ' work performed during the soil investigation and removal activities detailed in this report, and subject to the service.constraints outlined in Section 8.0, Fugro offers the following conclusions: 1. The attached Class-3 RAO applies to the property located at 55 Old Mill Road in Osterville, Massachusetts, referred to in this report as the"Site". 1 2. Based on the remaining TPH concentrations in soils present beneath the basement floor and ' soils around the, exterior of the house, it is Fugro's opinion that the soil-removal activities have successfully removed fuel oil impacted soils from beneath the basement so that ' remaining soils are below the Method 1'Risk Characterization Standards as established in the MCP. Therefore, it is Fugro's opinion that a level of no significant risk to human health, ' public welfare, and the environment has been achieved. ' 3. The oil tank which formerly leaked at the Site has been removed from the Site; therefore, Fugro concludes that the formerly uncontrolled source of release of No. 2 fuel oil has been eliminated. 4. The incremental cost of conducting the response action in order to achieve background ' concentrations at the Site would be substantial, due to structural constraints, worker safety issues, and risk of severe permanent damage to the Site building which would have to be ' addressed if further excavation were to be conducted. In Fugro's opinion this cost outweighs the benefit of reducing concentrations of isolated and potentially accessible soil to background concentrations. 5. Due to the low concentrations of TPH detected in soils at substantial depths, and due to the ' analytical data collected from a ground water sample obtained from an on-Site monitoring well, it is Fugro's opinion that there is little likelihood for ground water impacts. No further ' subsurface assessment pertaining to this release is warranted at the Site. Bevan Residence,SS Old Mill Road,Osterville,Massachusetts 16 1 G6P0 Response to Heating Oil Release oY ' 6. A Notice of Activity and Use Limitation (AUL) has been included as part of response actions at the Site. Conformance with this AUL would ensure that oil contaminated soils ' beneath the Site shall not present a significant risk of harm to health, safety, public welfare, or the environment during any foreseeable period of time. Fugro accepts no responsibility as to enforcement of the ALL, or consequences which would result from non-compliance to AUL. ' 7. Fugro concludes that the soil removal has been successful in eliminating potential risk from fuel oil-impacted soils beneath the building of the Site, and that a permanent solution has ' been achieved. However, since soils remaining at the Site have concentrations above the Method l S-1 standard, it is Fugro's opinion that a Class A-3 RAO has been achieved at the Site. An RAO transmittal s ttal form and AUL are being submitted with this report, copies of 1 Which are located in Appendices B and C, respectively. 1 1 1 I Bevans Residence, 55 Old Mill Road,Osterville,Massachusetts 17 �sro Response to Heating Oil Release �� • o� ' 8.0 SERVICE CONSTRAINTS I. This report addresses the likelihood of a release or threat of release of it P o or hazardous materials on the Site as defined by M.G.L. c. 21E (March 1993) and 310,CMR 40.000, The ' MCP (October 1993). Much of the information provided' in this report is based upon personal interviews and research of all available.documents, records and maps held by the ' appropriate government and private agencies. This information is therefore subject to the limitations of historical documentation, availability and accuracy of pertinent records, and ' the personal recollection of those persons contacted. Unless otherwise indicated, any Site drawing provided within this report is not meant to be an accurate engineering drawing, but is used to present the general, relative locations of features of interest on and surrounding 1 the Site. ' II. An initial investigation took into account the natural and man-made features of the Site including any unusual or suspect phenomenon. These factors combined with the Site ' geology, hydrology, topography and past and present land uses served as a basis for choosing a methodology and location for subsurface exploration as well as ground water ' and subsurface soil sampling, if.any. III. The location and analyses of soil, ground water, and surface water samples, if any, were based upon the same considerations mentioned in I and II above. The samples were analyzed for those parameters unique to the Site as determined from the preceding Site ' evaluation. Where no testing was Iconducted, Fugro makes no certification or representation relative to soil or ground water quality. In addition, no representation.is ' being made regarding the potential for documented or non-documented releases of oil or hazardous materials migrating to the Site. . ' IV. The interpretations and opinions provided in this re port are based on governmental , regulations and policies in effect at the time of preparation of the report. Future changes in regulatory policy may render these'opinions obsolete or otherwise invalid. Fugro should be consulted regarding validity of conclusions and opinions before any use is made of this ' report outside of the time frame or;purpose of its preparation. Bevans Residence, 55 Old Mill Road, Osterville,Massachusetts - 18 o00 Response to Heating Oil Release s V. This report is designed to detect releases of oil or hazardous materials to the environment. It is not intended to be a complete environmental audit or industrial hygiene survey which ' would ascertain compliance with federal and state regulations other than those explicitly stated. Unless otherwise noted herein, this assessment did not include an evaluation of the presence of asbestos, lead paint, nor radioactive or infectious materials. I! I' Bevans Residence, 55 Old Mill Road,Osterville,Massachusetts 19 1 1 1 !I 1 1 1 1 1 1 1 1 1 1 1 '',,I -- O / n ! •-� I \��/, .I II i5h 'M6C y,.,, .� ` G7 - 'Q I,_7 EPHO ��L�� ;',.� f '' o HatCh ry f( • 0� — soGranberry��,f_v ��, ,.�� •SJ - ri' 1� �•• J O.. _N_ J •I/- 056 •0• : `�- r � ,28. ^ BM 6 ranb ry a QD ' '>,II rr• _ 4 an erry, 'North e " 0 Pond �,�0,.... I � �_.-�' 'o ` 9Wt. O 'a \1� es PondCr- !� P '%.1Cv�,. Bogs. Q J Gam— l . •o 0 0 O 6'..__ i — 'r,, do Micah� .�� , - ` Pond110 OrL In �„ IFo x.� p Josh `\ \ "01(= •'°�• ¢�`• e �._.� z_ 1 \�1 Pond ;4•�if�o' , r_ ail° ,ll' .Y• ----o- 0. • i . - - Islam' gJl /(/7� •� u •i o So, ` °_ 'ao POnd• Hi Iside.,. ' Marys @Ishein S c jl:`', •}� { 1 / Island and 1 i I tJ, -. ...11 ..,r�o,: v •:• •'VTakIOyihe' sue,• s' sT�';�` a z 6.. :v 1 , /e / % " ZCQti�'%• -� = East B y ' R Li •t a�,`�s��C�• :.,: ;' �,'�.,:'�; d •�.'�.';.., s I5I ' •( o\ `, ;\\_• :;, �•j�` f�lo} Y o� x Beach /a ubli Landin �, Q. a a;`�.'' 1.\�• ��\ •ti Ix n B Neck p a Parker •`„ rystal ! Pond:' `.. . c --�.9 �i� fit:::., �,r s W' G°[L_' —;.�• ♦ V /9 Qi course ianno ^r a r 1.: Io a •�.za' o /! 1 •:' • ►-. 1.,..�• - I•ICI 1 I ip ° ' -.nJ A EA VIEW „ -•� 9 /— Base Map Source: LOCUS MAP ' L MAss. U.S.G.S.Ouadrangles, Hyannis,MA (rev.1979) 55 Old Mill Road —�luii- and Cotuit,MA(1974). Osterville, Massachusetts Q 2000 4000 JOB#16233243FIGURE 1 APPROXIMATE SCALE IN FEET OCTOBERBER 1994 1994 RESIDENTIAL 1 FORMER ABOVEGROUND _ STORAGE N TANK ®FM-1 BASEMENT STAIRS—� SOILER/BURNER CHIMNEY ' — — HOT WATER TANK CAW :.;:; AREA OF INVESTIGATION ' BUILDING 1 ' SCHEMATIC SITE PLAN 55 Old Mill Road ' Osterville, Massachusetts NOTES: DRAWN BY: S.O. JOB#16233243 ' 1. All locations and dimensions of site and near vicinity features are approximate only. CHECKED BY: J.L. OCTOBER 1994 2. Figure derived from Fugro East,Inc.site observations. NOT TO SCALE FIGURE 2Tfi� -N- SS-6 ' 9'6"-16'6"/2,300 COFFER DAMS FURNACE CRIBBING ' SS-1 16'6"/640 SS4 18'6"-19'/1,800 I A • C SS-1 10'2,500 ' SS-5 SS-3 SS-7 8'6"-14"6"/150 9'6"- 15'6"/>10,000 ppm 10'6"- 1 T /8,600 D B • SS-3 SS-2 ® 1072,800 10710,000 SS-4 ' 21'/850 ' ®SS-4 11'6"-16'6" /6,300 FRONT OF HOUSE STEEL SUPPORT t LEGEND: SS-1 • SOIL SAMPLING LOCATIONS ' 16'6"/640 DEPTHIS/TPH CONCENTRATION IN mg/Kg (COLLECTED JUNE 2,1993) SS-1 ® SOIL SAMPLING LOCATIONS ' 102,500 DEPTHS/TPHCONCENTRATION IN mg/Kg SOIL SAMPLING LOCATIONS (COLLECTED DECEMBER 10,1993) NOTES: 55 Old Mill Road ' 1. All locations and dimensions of site and near vicinity features are approximate only. Ostervllle, Massachusetts 2. Sample depths are recorded from topographic grade. 3. Figure derived from Fugro East,Inc.site observations. DRAWN BY: S.O. JOB#16233243 ' SCALE: 2"=5' CHECKED BY: J.L. OCTOBER 1994 FIGURE 3 ' LEGEND: FOUNDATION WALLS(REMOVED) ' AREAS EXCAVATED W/BACKHOE OR EXCAVATOR EX.#3 COFFER DAM IDENTIFICATION EX.#3 EX.#5 EX.#7 EX.#4 EX.#8 EX.#6 EX.#2 EX.#1 ' EXCAVATION LOCATIONS NOTES: 55 Old Mill Road ' 1. All locations and dimensions of site and near vicinity features are approximate only. Ostervllle, Massachusetts 2. Figure derived from Fugro East,Inc.site observations. 3. All excavations conducted to approximately 16 below topographic grade. DRAWN BY: S.O. JOB#16233243 ' CHECKED BY: J.L. OCTOBER 19U NOT TO SCALE FIGURE 4Abann i i 1 APPENDIX A RELEASE NOTIFICATION FORM 1 1 1 i 1 1 1 1 1 1 1 � 1 1 Massachusetts Department of Environmental Protection BWSC-003 Bureau of Waste Site Cleanup HeWw Traddnq Wr6w.. OIL AND HAZARDOUS MATERIAL RELEASE ❑ ORELEASE NOTIFICATION FORM (pursuant to 310 CUR 40.0371110066 OR THREAT OF RELEASE (TOR) LOCATION: �trees: 55 Old Mill Road Location Aid: ity/rown: Ostervi l l a Zip code: 02655 - S. NOTIFIER INFORMATION: Estate of John .F.Bevaris,Jr. Lane of Organization: = _ tact Name: John F.Beyans , ILI Title: Executor vest %Richard"'�5-.Curle1,Esq. ,72 Pine Street ity/Town: _ �iydnnVs scats: MA zip Code: 02601 _ efepnone: 508 - 77 - 0346 End. RELEASE OR TOR AFFILIATION OF NOTIFIER (pursuant to M.G.L.c.21E§7 and 310 CMR 40.0331): heck onelspecify) Responsible Party(RP) Specify(circle one): Owner Operator Generator Transporter Other RP: Potentially Responsible Party(PRP) Specify(circle one): Owner Operator Generator Transporter Other PRP: Fiduciary/Secured Lender Agency/Public Utility on a Right of Way Other Person: Jonn F.Bevans,III ,Executor (heck ADDITIONAL INFORMATION ATTACHED: all that apply) Names and addresses of Contractor name 0 Licensed Site Professional ❑ Other: owners of all impacted and address (LSP)name and address properties(required) (optional) (optionao E. INFORMATION ON RELEASE OR THREAT OF RELEASE (TOR): (lease owledge of Release 11— /—03 / 93 — To Date: Time: am/pm(circle one) ® Check here if ReleaseITOR Date is Unknown or TOR Date — /— /_ - (it different): Time: aMpm(circle one) Check here if Release/TOR Time is Unknown trevious Oral Notification to DEP? [] No © Yes Previous Oral Notification to DEP Date: 11 / 03 /94 Time: amipm(circle one) Notification Thresholds(pursuant to 310 CMR 40.0311-15): ' 2 HOUR NOTIFICATION 72 HOUR NOTIFICATION 120 DAY NOTIFICATION (check all that apply): (check all that apply): (check all that apply): ❑ Sudden Release ❑ Subsurface Non-Aqueous Phase ❑ Release of Hazardous Material(s)to soil or groundwater Oil Sheen Liquid(NAPL) exceeding Reportable Concentration(s) El underground Storage Tank(UST) Release Detected in Private Well Release © Release of Oil to soil exceeding Reportable Imminent Hazard ❑ Release to Groundwater near Water Concentration(s)and affecting more than 2 cubic yards Threat of Sudden Release Supply ❑ Release of Oil to groundwater exceeding Reportable ❑ Release to Groundwater near Concentration(s) Release to Storm Drain School or Residence ( Sanitary Sewer Release ❑ Threat of UST Release (Imminent Hazard) aime and Quantities of Oil(0)and/or Hazardous Material (HM)Released: Reportable (If needed,attach a fist of additional OHM Substances.) Concentrations O HM CASt# Amount/ Exceeded ' OHM REPORTED: (check one) (if known) Concentration Units (if applicable) No. 2 fuel oil ® ❑ 10,000 mta/Kg 111-1 ❑ ❑ 500 mg/Kg U—ised00/93 This form is printed on recycled paper. Page 1 of 1 Massachusetts Department of Environmental Protection . BWSC-003 ' Bureau of Waste Site Cleanup. OIL AND HAZARDOUS MATERIAL RELEASE ReW—T-cf-VW.W, NOTIFICATION FORM (pursuant to 310 CMR 40.0371) . a' 10066 I F. ACTIONS TAKEN OR PROPOSED(IMMEDIATE RESPONSE ACTION,UTILITY-RELATED ABATEMENT ' MEASURE, RELEASE ABATEMENT MEASURE,PHASE I REPORT, LIMITED REMOVAL ACTION): Actions: Release Abatement Measure Oral Plan Approval Date: _ �_ �_ IRA Assessment Only: ® No ❑ Yes Was a Release Abatement Measure or Utility-Related Abatement Measure terminated due to discovery of a 2 hour or 72 hour release?©No❑Yes ' If yes,provide relevant Release Tracking Numbers: Additional information relevant to the release or Threat of Release attached: ❑ No ® Yes If yes,check all that apply: ❑ Response Action Outcome Statement ❑ Immediate Response Action Completion Statement ' ❑ Other See attached letter dated / 7/94 G. SIGNATURE AND CERTIFICATION: 1 certify under penalties of law that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this certification, and that, based on my inquiry of those individuals immediately responsible for.obtaining the information.the material information contained herein is,to the best of my knowledge and belief,true,accurate and complete. I am aware that ' there are significant penalties,including,but not limited to,possible fines and imprisonment,for wilfully submitting false.inaccurate.or incomplete information. Signature: �• Date: `0/� < Name of Perso lint): John F. Bevans,Jr. ,Executor ' Addresses: ' Estate of John F.Bevans ,Jr. Z ).hn. F..Bevans, III,.Executor Mr. Richard Clark Richard L. Curley, Esquire Oceanside, Inc. ' 72 Pine Street 217 Thornton Drive Hyannis, MA 02601 Hyannis, MA 02601 1 Joseph P. Salvetti , LSP Fugro East, Inc. , 90 Route 6A Sandwich, MA 02563 1 1 1 Revised 10t1193 This form is printed on recycled paper. Page 2 of 2 1 I - 1 APPENDIX B RESPONSE ACTION OUTCOME II I� I Massachusetts Department of Environmental Protection " BWSC-004 Bureau of Waste Site Cleanup pelaaaa Tracking Number: RESPONSE ACTION OUTCOME (RAO) STATEMENT (pursuant to 310 CMR 40.1056) 4 ' 10066 A. RELEASE OR THREAT OF RELEASE LOCATION: Release Name if Previously Assigned(classified sites only): Street 55 Old Mill Road Location Aid: City/rown: Ostervi l l a Zp Code: 02655 _ Additional Release Tracking Numbers Addressed in this RAO: Provide a clear and accurate description of the location of the site or the location and boundaries of the disposal site or portion of the disposal site to which the RAO applies,as specified in 310 CMR 40.1003(4)with this submittal. Is a site or disposal site map or survey attached to this RAO Statement? ❑ No ® Yes Does this RAO apply to a portion of a disposal site? ® No ❑ Yes If yes,attach a statement regarding the relationship of the RAO Statement to any other RAO Statements that have been filed for the disposal site,if applicable,together with a statement as to whether any additional response actions are needed for any other portions of the disposal site. B. PERSON SUBMITTING RAO STATEMENT: Name of organization: Estate of John F. Bevans, Jr. Name of Contact John F. Bevans, III Title: Executor Street c/o Richard L. Curley, Esquire, 72 Pine Street City/rown: Hyannis MA 02601 _ State: Zip Code: Telephone: 508 — 775 — 0346 Ext. C. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON SUBMITTING RAO STATEMENT: (check one/specify) ❑ RP Specify(circle one): Owner Operator Generator Transporter Other FIR ❑ PRP Specify(circle one): Owner Operator Generator Transporter Other PRP: ❑ Fiduciary/Secured Lender ❑ Agency/Public Utility on a Right of Way ® other Person: John F. Bevans, III, Executor D. RESPONSE INFORMATION: RAO Status: Z1 First ❑ Revised Was initial notification oral? ❑ No ® Yes Date: 11 03 �93 Is a Release Notification Form(RNF)attached? ❑ No ❑ Yes Was a RNF previously submitted? ® No ❑ Yes Date: — /— Is a RAO Compliance Fee attached? ❑ No ® Yes A fee is required 120 days after Release Notification and prior to Tier classification. E. RAO INFORMATION: RISK CHARACTERIZATION GROUNDWATER SOIL. RAO CLASS: METHOD: CATEGORY: CATEGORY: ❑ A-1 ❑ B-1 © 1 ® GW-1 ® S-1 . ❑ A-2 ❑ B-2 ❑ 2 ❑ GW-2 ® S-2 ® A-3 ❑ C ❑ 3 ❑ GW-3 x❑ S-3 Was contamination reduced to background level(s)at a disposal site? 9 No ❑ Yes Is this RAO based upon the implementation of an Activity and Use Limitation? [:] No In Yes If yes,indicate the type of Activity and Use Limitation implemented at the disposal site: Notice of AUL Date filed with Registry of Deeds: _/_ /_ Registry or Court Location: Book/Page Number(or other identifier): Attach to this RAO Statement a copy of any and all Activity and Use limitations which have been implemented under 310 CMR 40.1070 and an Activity and Use Limitation Opinion pursuant to 310 CMR 40.1056(2xg). Will Post-RAO Operation and Maintenance(0&M)be conducted at the site pursuant to 310 CMR 40.0896(for Class C RAOs only)? x❑ No ❑ Yes If yes,check one: ❑ Active O&M ❑ Passive 0&M Attach to this RAO Statement a description of any operation,maintenance,and/or monitoring that will be required to confirm and/or maintain those conditions at the disposal site upon which the RAO is based. vised 10/1/93 This form is printed on recycled paper. Page 1 of 3 1h; Massachusetts Department of Environmental Protection BWSC-004 ' Bureau of Waste Site Cleanup Release TrarJcinp Nur�ber: RESPONSE ACTION OUTCOME (RAO) STATEMENT �_ 1 ORO :'Traci', (pursuant to 310 CMR 40.1056) F. RESPONSE ACTIONS COMPLETED: ' (Check all that apply) COMPLETION STATEMENT TYPE OF PREVIOUSLY ' RESPONSE ACTION: YES NO ATTACHED SUBMITTED DATE OF DOCUMENT Immediate Response Action' ❑ ® ❑ ❑ — �— �— Release Abatement Measure' ❑ ® ❑ ❑ Utility-Related Abatement Measure' ❑ rX_1 ❑ ❑ �— Phase 1 ❑ ® ❑ ❑ Phase II ❑ 0 ❑ ❑ — �— �— Phase III ❑ ® ❑ ❑ —�— �— Phase IV ❑ ® ❑ ❑ —�— �— , Phase V ❑ ❑ ❑ ❑ _ �— �— 'If multiple actions were completed at a disposal site,provide an attachment stating the date of the Completion Statement for each. ' G. DESCRIPTION OF RESPONSE ACTIONS: Provide details on attachments,as warranted. ' (Check all that apply) REMOVAL OF REMEDIATION WASTE: OTHER RESPONSE ACTIONS: ❑ Contaminated Water ❑ Drainage Controls ' Contaminated Soils ❑ Berms/Dikes/impoundments (check all that apply): ❑ Temporary Covers/Caps ®Excavate ' • ❑ Waste/Product Recovery X1 Store ❑ Temporary Evacuation/Relocation of Residents ❑Treat ❑ Temporary Water Supplies ❑Re-use ' ❑ Vent System ®Recycle Actual Volume: 84 cubic yards ❑ Groundwater Treatment Systems ❑Landfill Actual Volume: cubic yards _❑ Other: ❑ Drumsaanks/Containers ' ❑ NAPL ❑ Other: ❑ ASSESSMENT ONLY H. FINDINGS AND CONCLUSIONS: ' Except where previously submitted and specified,submit all documentation, plans, and/or reports necessary to support the RAO to the Department,including,without limitation,the following: ' ♦ For all Class A RAOs,information documenting the extent to which levels of oil and/or hazardous material in the environment have been reduced to background,and for all Class A-2 and A-3 RAOs,the results of the feasibility evaluation conducted pursuant to 310 CMR 40.0860 demonstrating that the achievement of background is not feasible. ' ♦ For all Class A and Class B RAOs,information supporting the conclusion that a level of No Significant Risk has been achieved or exists. ♦ For all Class A RAOs and where applicable to Class C RAOs,a demonstration that all uncontrolled sources,as specified in 310 , CMR 40.1003(5)have been eliminated or controlled. ♦ For all Class C RAOs,information supporting the conclusion that no substantial hazards remain at the disposal site. ♦ For all Class C RAOs,a copy of the plan,as specified in 310 CMR 40.0861(2)(h),which presents definitive and enterprising steps to be taken toward achieving a Permanent Solution at the disposal site. ' Revised 10/1/93 This form is punted on recycled paper. Page 2 of 3 ' r .. Massachusetts Department of Environmental Protection DWSC-004 Bureau of Waste Site Cleanup Release Tracking Nurdber: RESPONSE ACTION OUTCOME (RAO) STATEMENT (pursuant to 310 CMR 40.1056) �4 - 10066 1. LSP OPINION: Name of Organization: Fugro East, Inc. LSPName: Joseph P. Salvetti rtie: Sr. Associate Telephone: 508 — 888 — 3900 Ext. I attest that I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this attestation,and in my professional judgment,the response action(s)that is the subject of this submittal complies with the provisions of M.G.L. c. 21A. §§ 19-19J. 309 CMR, M.G.L c. 21E, 310 CMR 40.0000.and all other laws, regulations,orders, permits, and approvals applicable to such response action(s). I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I wilfully submit information which I know to be false,inaccurate or incomplete. ►��.44 a� r vevatr H M Signature: �c Seal: �1��OF '9`SS,q�r Date: to.L JOSEPH cyG license Number: 9546 P. a 00 SALVETTI C-/4) A ,9No. 9646 v S ASl1E PR��`Sa�a J. CERTIFICATION OF PERSON SUBMITTING RAO STATEMENT: I certify under penalties of law that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this certification,and that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained herein is,to the best of my knowledge and belief,true,accurate and complete. I am aware that there are significan penalties,including,but not limited to,possible fines and imprisonment,for wilfully submitting false,inaccurate,or incomplete information Signature: Date:// 2 I Name of Per (print): John F. Bevans III xecutor �evised 10/1/93 This form is printed on recycled paper. Page 3 of 3 t APPENDIX C ACTIVITIES AND USE LIMITATION If R GISTER RECEIPT # : 1994 28172 BARNSTABLE COUNTY REGISTRY OF DEEDS RG170R INTED : THU 10/ 13/94 12:45 :40 BATCH : 966 C STOMER : N/A PAGE : 1 BOOK-PAGE : 9403 189 RECORDING FEE : 18 . 00 STRUMENT # : 60363 POSTAGE : . 29 RECORDING DATE : THU 1994- 10- 13 12 : 38 MARGINAL REF FEE : . 00 RESS : 55 OLD MILL ROAD COPY FEE : . 00 INSIDERATION : . 00 COUNTY EXCISE : . 00 TAL AMOUNT DUE : 18 . 29 STATE EXCISE : . 00 PAID BY : CHECK 0705 J-E-E-/G--T-O-R-G--R-O-U-P-: --O-O-I------------------------------------------------------------ TOWN : -------------- TOWN : BARN BARNSTABLE STRUMENT: N NOTICE OR CAVEAT ANTOR : GRANTEE : DESCRIPTION : OLD MILL RD MARGINAL REF BOOK-PAGE : GIANTORS : MASSACHUSETTS COMMONWEALTH OF (DEP &0) BEVINS JOHN F (AS EX &0) G�ANTEES : NONE RECORDED ------------------------------------------------------------------------------ TURN ADDRESS : FUGRO EAST INC 90 ROUTE 6A SEXANT HILL SANDWICH MA 02563 JANTEE ADDRESS : NONE RECORDED SCRIPTION : NONE RECORDED ---------------------------------------------------------.--------------------- ' 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION E,P:ii� i_r -t11��'� ' �}-1iJ-1:� 1�:_8 �F,ii363 40.1099: continued Form 1075 ' Disposal Site Name: 55 Old Mill Road Osterville,Massachusetts DEP Release Tracking No(s).4-10066 ' NOTICE OF ACTIVITY AND USE LB41TATTON M.G.L.c.21E,§6 and 310 CMR 40.0000 PURSUANT TO CHAPTER 21E OF THE MASSACHUSETTS GENERAL LAWS,AS AMENDED(Chapter 21E") ' and THE MASSACHUSETTS CONTINGENCY PLAN, 310 CMR 40.0000, AS AMENDED ("MCP"), NOTICE is hereby given by John F. Bevans,III. Executor of Barnstable County,Massachusetts,being the owner(s)in fee simple of that certain [vacanf]land located in Osterville,Barnstable County,Massachusetts,with the buildings and improvements thereon,pursuant to a deed recorded with the Barnstable County Registry of Deeds in Book 649, Page 519 said land being more particularly bounded and described in Exhibit A, attached hereto and made a part hereof, and being shown on a plan entitled, "Sub- Division of Lot"A"",dated October 1937,prepared by Bearse&Kellogg,recorded with Barnstable County Registry of Deeds as Book 56,Plan 65 on file with the Land Registration Office of Barnstable, County Registry District("Property")as Lot Al and the westerly portion of Lot A2 and that part of said twelve-foot right of way adjoining the westerly portion of Lot A2. ' THAT SAID PROPERTY, OR A PORTION THEREOF, IS A DISPOSAL SITE AT WHICH THERE HAS OCCURRED A RELEASE TO THE ENVIRONMENT OF OIL AND/OR HAZARDOUS MATERIAL,SAID DISPOSAL SITE BEING DESCRIBED IN EXHIBIT B,ENTITLED, "RESPONSE TO A HEATING OIL RELEASE," DATED OCTOBER 14, ' 1993,PREPARED BY FUGRO EAST, INC. ATTACHED HERETO AND MADE A PART HEREOF, IN ACCORDANCE WITH THE MCP. Said response action is based upon the limitation on human access to and contact with oil and/or hazardous material in soil and the limitation on certain activities occurring in, on, upon, through, over or under the (select one) (Pr pe Xrt ] as set forth in an Activity and Use Limitation Opinion ("AUL Opinion") dated t S prepared by the undersigned Joseph P. Salvetti, holder of a valid license issued by the Board of ' Registration of Waste Site Cleanup Professionals pursuant to M.G.L. c. 21A, §§ 19 through 19J(any holder of such a license hereinafter referred to as an"LSP"),said AUL Opinion Died with the Massachusetts Department of Environmental Protection ("DEP"),at its Southeast Regional Office,under Release Tracking No(s).4-10066,a copy of which is attached hereto as Exhibit D and made a part hereof. The activity and use limitations set forth in said AUL Opinion are as follows: ' 1. Activities and Uses Inconsistent with the AUL Opinion. Activities and uses which are inconsistent with the AUL Opinion,and which,if implemented at the(select one)g!ropertv , may result in a significant risk of harm to health, safety, public welfare or the environment,are as follows: 1. no excavation within the area of the outline of the dwelling; 2. no disburbance of the basement floor resulting in penetration,cracks, fissures, or other route of vapor entry of ' underlying soils into basement ambient air,and 3. lack of notification to an LSP prior to any such activities or uses listed as Item 1 or 2. 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 40.1099: continued ' 2. Permitted Activities and Uses Set Forth in the AUL Opinion The AUL Opinion provides that there exists for any foreseeable period of time a condition of No Significant Risk to health, safety,public welfare or the environment(such condition being defined in 310 CMR 40.0000) so long as any of the ' following activities and uses occur on the(select one)[Pro [Disposal ; ' 1. Existing residential use and/or other use/activity that is not inconsistent with the above;and 2. Such other activities or uses which, in the Opinion of an LSP, shall present no greater risk of harm to health, safety,public welfare or the environment than the activities and uses set forth in this paragraph. Any such Opinion shall be set forth in writing, signed and sealed by an LSP, a copy of which is to be filed with DEP at its Southeast Regional Office under Release Tracking No(s).4-10066 within 30 days of its date of execution. 3. Obligations and Conditions Set Forth in the AUL Opinion. ' If applicable, obligations and/or conditions to be undertaken and/or maintained at the (select one) Property] [Dispesal as set forth in the AUL Opinion in order that a condition of No Significant Risk may be maintained shall include the following: ' Not applicable. 4. Proposed Changes in Activities and Uses Any proposed changes in activities and uses at the(select one) ro rt which may result in higher levels of exposure to oil and/or hazardous materials shall be evaluated by an LSP who shall render an Opinion,in accordance with 310 CUR 40.0000,as to whether the proposed changes will present a significant ' risk of harm to health, safety,public welfare or the environment. Any and all requirements set forth in the Opinion to ensure a condition of No Significant Risk in the implementation of the proposed activity or use shall be satisfied before any such activity or use is commenced. 5.0 Violation of a Response Action Outcome. If the activities,uses and/or exposures upon which an Activity and Use Limitation field with DEP is based change at any ' time to cause a significant risk of harm to health,safety,public welfare,or the environment due to exposure to oil and/or hazardous material without the prior evaluation by an LSP in accordance with 310 CRM 40.0000,and without additional response actions, if necessary, to achieve or maintain a condition of No Significant Risk, the owner or operation of the (select one) (Proper<yl subject to such Activity and Use Limitation at the ttime that the activities,uses and/or exposure change,shall comply with the requirements set forth in 310 CMR 40.0000. 6. Recording,Filing,and Publication Requirements ' In accordance with the requirements set forth in 310 CMR 40.0000,this Notice of Activity and Use Limitation shall be: h 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 40.1099: continued ' (i)recorded and/or registered with the appropriate Registry of Deeds and/or Land Registration Office,within 14 days of its date of execution,and marginally referenced on the deed into Owner at the time of recordation and/or registration; (ii) incorporated either in full or by reference into all deeds, easements, mortgages, leases, licenses, occupancy agreements,or any other instrument of transfer,whereby an interest in and/or a right to use the Property or a portion thereof is conveyed; (iii)a copy shall be filed with the following municipal offices within thirty(30)days of its date of execution: (1) The chief municipal officer of the community(ies) in which the (select one) 1Pro2erty] [Disposal Site] [Peffien of the Disposal Site]is located; 2 The health officer/department ent of the communit ies in which the select one o O epartm y( ) ( ) [Pro perty] {Di:pesal-$ite} [Peftien of the Disposal Sitel is located; ' 3)The zoning official of the community(ies)in which the(select one)fPro ] Disposal Site}is located;and ' 4)The building code official of the community(ies)in which the(select one) ro of the Disposal-Site]is located;and (iv)published as a legal notice,in a form prescribed by DEP,within 14 days of its date of execution,in a newspaper ' which circulates in the community(ies) in which the(select one) [Pro ] [Disposal Sitel [PeAiea of the Disposal &te}is located. Owner hereby authorizes and consents to the filing and recordation and/or registration of this Notice of Activity and Use ' Limitation to become effective when executed and sealed by the undersigned LSP; and recorded and/or registered with the appropriate Registry(ies)of Deeds and/or Land Registration Office(s). WITNESS the execution hereof under seal this 13 day of t) C.( , 1994. 1 6hwner , COMMONWEALTH OF MASSACHUSETTS Then personally appeared the above-named ld_-'�Anoevand acknowledged the foregoing to be ' free act and deed before me. ' N Public: My Commission Expires: The undersigned LSP hereby certifies that he executed the aforesaid Activity and Use Limitation Opinion attached hereto ' as Exhibit D and made a part hereof and that in his Opinion this Notice of Activity and Use Limitation is consistent with the terms set forth in said Activity and Use Limitation Opinion. 1 Date: C b* A'k4 ' J SP LS c 1 JOSEPH P. Q SALVETTI y e No. 9546 y �ell_��a/sTE�`�`�o�! ' 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION ' 40.1099: continued ' COMMONWEALTH OF MASSACHUSETTS Then personally appeared the above-named Joseph P. Salvetti and acknowledged the foregoing to be his free act and deed before me. Notary blic: My Commission Expires: 94 1 ' 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION ' EXHIBIT A DEED 1 ' I Ek.L3: R. CRCSRY, widow of the late Ralph N. Crosby, 649 of Barnstable (Osterville), Barnstacle County, ::asse.c usetts, 519 ' fcr consideration paid, rrant to RAL?H R. CRCSBY, of Runford, Rhode Island, pith 7i�°'.".':TY CC':3(P1:?S, the land in Barnstable (Osterville), Sarnstable County, Massachusetts, boded and t ' described as follows: j Northerly by Scudder Ho.d, one hundred tan (110) feet; ' Easterly by land of Dr. McDonald, about one hundred forty- Easterly (145) feet; Southerly by ;teck ?ond, one hundred fifty-five (135) feet, more or less; and by lnad of John Leos�er, one hundred fifty-five s,?Wosteilp lese� - - (155) feet,=Q:- Ar . ----•— ' Befne Lot #3,•Block F, as shown on'plan entitled "".'ianno j Estates, Osterville, '-:ass. July 1926. =•spinwail and Lincoln, t( C,E,", duly filed in the Barnstable County Registry of Deeds. ss may beoinnforcenandeefectiandf ap li able.and l restric- tions as may � j For my title, see will of Raloh 'Y.of°rcbatCrosby, duly filed in the -arnstable ounty Registry Nominal consideration. - ... 1 46. -� ;7ITa hand and s"eg,—this eighth.day of bsy, 9 �3S my t... CO!•`}.;.:':Jr OF tu+ss.czvs�TTs Vay 8, 1946 Barnstable as. Than personally appeared the above named Ellen R. Crosby e, sad acknowledged the foregoing instrument to he �tree�act '' tl deed,-Before, � t,,, , � �" '�• _ .-'��i.�� " `,�„�` „"• M101 "s �1^"_.,i' .4 .�"'c,-k, 'TE �llas�,.;-I i�a,. ';,� rt0001"� �'.-•4'-.`.1;4 x, ,.gnrastable, eg.t eve j ti• F ' ' :err`•v.rr r�'+'?ni'�d�I.QF b�Z` SL.'-tipn•Yi,;,i:°1,6.i'48.' i�i�3-b= * t M.� g t a s '_•aye.. L ty M�sxiehnxen, `Z rvil16 __a. for considendon pvd.grant< - hue)hnd and of=�sr .`. '.• t f -� �... with quarter cawouts as Qste�v114��rastable ust9, 4 • that art of gaI•natable wa_ _ f• <- the laud ia.._ D_-.- 1x .• r:: ,fit.;VZ =,•^� .. f s: hessachusetts, with the Mlinges thereon, westerly of the Town Road 4) 649 known as the Old bill Roadp bounded and described as follows:- -7 _T96 --- ' by land now or,.formerIV__of one-Beaumont, one hung,re 2/1J0 (l13. 72�teet;-ih'est�rly by land believed to be -- --- owned by the Horticultural Society, one hundred (100) feet; 'Northerly.:�9 by land now or formerly of Lindqui at, one hundred forty-five, and ' 89/100 (145.89) feet; Easterly by land of A. John 3sacquade and Ritaa b. VacQuede, ninet four and 8 100 ) 1' Y- / (94.08 feet, more or leas. , -f-� Said premises are hereby conveyed together with ai right of x ` v over a twelve-foot right-of way to and from said Old Mill Road as shown on a plan hereinafter mentioned. y�' SaSd lend is shown`as Lot A-Land the'westerly portion of Lost - - _t ; /►-2 and'tha6 part of said twelve foot rot of way adjoining--the westerly portion of Lot A-2,_ cn plan of Subdivision of Lot October 193 , Hearse and Bello i gg, Civil Engineers, as filed with ` ' Book 56, Plan 65, in said Barnstable Deeds. cony remises same -•- . . ,__,�� —. p eyed to me by deed of A. John F' 0acquia_ rind".Rita A. Mac%;ue.de, dated December 8, 1945 and recorded = - •r with Bdmst�ble Deeds Bock 638,3 Page 112. . - Said premises are conveyed subject to taxes for 1946. ' FF Said premises are also conveyed subject to incumbrances 6 • • , , of record. I � v, � a � o — '�'— kr of said grantor, release to said grant ee ail nigh;s of dower and other interests therein. Pit—.-.our— hands and seals this='1`I_e ty--F_Qu.FU-of_=,Lune_..----. 1946-- t _......... .. --- .............._._ . ..- - ' L_ _.--- �I}r am�maassrra(2� of Maeaa.c1n nn — t 'and acknowledged the icreguing instrument to be—hi 9" ...'.Cec act and�1,beiore me ,t,,5 . i Barnstable, ss., Received June 25, 1946, and is recorded. . .. .... ;:�,�-.. - -- __ _:- .-•.: _.- ,--'•'�,>-- See_--- -��, JOkm F. Bevans Pnr a c or .Ha_IDSLBhle—County. Maesaehueetta, W Q s.4 a rol-ll a, ... --- -- of .-..... -nin for consideration paid, grant to the G n i SECURITY FEDERAL SAVINGS AND LOAN ASSOCIATION OF BROCN. _ x - United States corporation doing business in Brockton,Plymouth County, Massaehasetta with !SORT- m iA G to secure the payment of..--..._....-...._-.._..__------------ AGE COVENANTS "_- - - ^T.h13'tY'S'd4-•-fiLwdTP�-.SIId_ ./ .�..�i-- - ,;-i; _ _ _ pars with interest from the date hereof.as provided tn.=-DUFnote of even date: e land,with the bnpdings thereon,situated in that part of Barnstable known as Oster- ville, Barnstable County, westerly of the Toys Road known as the Old 11 Road; bounded and described as follows:- t ? Southerly by_land now or formerly of one Bea=ont, one hundred i yr i `' ;�` 'a:'^ :• ';,yam -:fe t 1esterly by�1. ad believed tb be ' }' ii 1` +'�`3�,:• : t_ thirteen.ezat},j2tlod.(113..'J2),. Q a i $ 'ti �.Y •7i1 /1 �'3 i. r a v T 9r �fs� ;j _ <^"�'~�:ii<14 x4 .a ti„e,.c to a a•'L:aitini s4}u w try t ♦ s ed by. tbe: HoFticultural Society, one htmdred (100f teeE,'Norts J t`•,.�'. ,: - y ,r- w '.=:fig,>•.. a y'"..}:..-.r^= a• - �i' „i �- p f 1� i _ F quiet, onb hundred forty=five pad*s910o dud- ' formerly of Lino �''•.. y�►Y,7dL7N A r..„ ..r },�s�_ ..ti a1eyY-idr'y„'•�`. 7+t�`'F_�i'4�.r i set, ead Bsaterly by land former Y�of A ' 08 feat pore 0 Zee LAa�gnde, ninety our $/io0��9t ) , 5� - t-. �,:. s• �:. v; o- rr••• .•°.sf }. .mot- + J rl�, "3 #•��,'�- af OII9B`N.+�+4;tr1^g thei'lf�th a,SSghri O� 0�@ hs e c 8e r _ x.are ye see by: . Said.37t'BIIfi '.�• n t< .�, 14 ,• LZ' , .t riw twel foot hz o o an8 7�om said Oldjlill Road A i a; w Y Fyn yeti 77. 4 M ,,�,r..*�•'C'�v'�''^'� }e1r' ' <1 .1 � I n'ylea'her@in atte men ..t ZitT u•.9. -5>;0.....,y�.x< ,. :c,,;�cr�- .,� ='h ,?�. .4. J V!: Z R' ��tln - �- i_,��._•y,. :v�'.Yr�.::..?YGa at ��l-.;:,..aad thfnes q@Steryl q .C•�Y'i s.(•�. .^'�.e-Y��'2+'•'S}i•.1`.l '. r of said ve`foot right of way edjoiaing t A-2, en plan of --- ---_ -� er 1937, E �9 _ _" i Boo Plan 65, ellogg, Civil Sngia as- a - . .-art•s�i.aa�_._-mar.=. is said Barnstable Deeds. Being the same premises conveyed to us by deed of James 1i. Bundy, ' of even date, and to be recorded herewith. ix z: Aftffw=I_ t s pti ' as a of the realty an Pastabla or sectional bnildings heatfn�aDD�at� Dlnmbtna.rantrs. 649 mane rw soars and windows, o� barnan. ;at and e0 sad eledzie Sztuze4 teraena.screen soar.. } Lam at z, D�dthaeino apyars1 and other en fixtures of whatever kind and nature an a prunism er the I yrfae to the inn Payment and dlaebarg.of this mortgage+ ' 622 came mw be had real or Personal DrW ; and the mortgagor(a)covenants that none of said properly is or will be on eonditiond contract ef aala !rapt with the ascent of the mortgagee The mortgagor farther covenants and agrees: _.. -- - L To make equal monthly Payments (estimated by the mortgagee)to the Association tontemporaaa- ry, y with Payments on the note sufficient to Pay an taxes,assessments,public liens. - i.l` ham dun _._. +w.: --tea• - 2 To insure in era Ao$egaYee and for the benefit o1 ths,m, , --- now or hereafter Lad against Are and such.hazards.pW _ aattters ia�N. .d Mortgagee nny dtra# _Wd aD such Insurancepolkies th0 ma r�0. S me4e[ "° That i sae shad loreva �Im ae J •`. on w a ha.from sA hi�ht titii,sad Snterest is sod to+ny and all card' ' t �upon the head ee by hta mortgage at the 4ime of.such [aB thtd Zo sue: }remh�s on oLothar*iaei aed ilia mortgagor� theme ' . cla6m.bis 9r, to"sip ini.of'Wd a,ir►esiae�af 'sf�ala�And present value thereof on t "tip.',..-.�}.`i" ! S r3 a•-F '�''r Y -"�k-* t�-. w� x'it Yr,�i:. "�'� t:u.:. WS ' �' 6r� yr•d .ry-_-a ��`�-'�' ,..L'�,'Si'�'��- ts��- �'cf ,a?� s6-r�.�i:..•.'�'�.w'?9,:�` `- s c h e`d.. Thar the wsZi Pay on demat►d:to the.TmortS�a��r „}nortRageaW1 . •'r then due,:any smut idvsnoed'ar the' tom, add ak of whati ai, a®a,.advaneed of y�aid.'-whether„bafors'�ae ' default.of whatevet�nata:q,by the mortgagor.ae.any. default..f*t&xe% Improvements, awrance.on the mortgagcd:prop4z4,4� :a pledged as eollsternl secure.the mortgage:loan,a any enure paid bbpy.t6q,�: a fees,in defending or intervening to any.kgal aMIND itable roceediay RfierdII ��deems auy hts crated by thL mortgage are a '' 6. That m the event the ownership of the mortgaged premises,or any part tbrseot.becomes vested'. ' In a person other than the mortgagor,the mortgagee may,without notice to the mortgagor.deal with successor or sucoeeeors in Interest,with reference to the mortgage and the debt hereby secured in the. same manner as with the mortgagor,without in any way vitiating or discharging the mortgagor's liabrlttyj l hereunder or upon the debt hereby secured'or at the option of the mortgagee the entire mortgage debt__ shall become due and payable on demand.This clause shall not applyto mortgages written under,the 8ervi ca _ } men's Readjustment Act of 1944. That this MORTGAGE is upon the STATUTORY CONDITION fox any breach o1 whichh, or for breach of any other condition or covenant herein contained,or contained in the note which this m :. -r-_—gage secures the terms whereof are made a part hereof, or for the breach of any requirement of Sher -- laws of this Commonwealth or of the laws of the United States of America the MORTGAGEE tban have''. " the STATUTORY POWER OF SALE. ?'' husband sad: i t Reve_nn_------wife e _�ier+t�yn� ssitr� a ha tenancy by the curteay release to the mortgagee all rights of dower and homeatead other interests in the mortgaged premises :,_ r '` •�. ..'} —...bands and seals this.-Th .-Kurt ... of -one----.---=-19L�rr." 1� ... .............��...�lff ..................... F � p&=MV=rR4 of 111a888Iiplart1b Plyu.cuth-ea. --Brockton.:.3Lnss..FJune..2L .19..L5.� Then personally appeared the above named......._.--••---...._J.Qbn_f'---.BeyeX1s-----......... ------- - -- - ...............................-._...---..... -- ----------------_----------------- - - - -- - — _al;a-uth, � —. pert of acsi9, ` or 1.115 feet, the f ,r-8i: c rveya, on .aid Tdlc'. - - =nd ar. is on- + ^, ,1 rr • ,.ly Of FG'E�6.: ilnV:lTai`i1:0`y dis- t-.._e ^r r.S fee', "lie ?.i e ..d Joir. ng ^t'� t� b- Lon Firms lo�c_ted Ccr:e-s Of t:�o pereel t_s_e ir. .onve�eQ; o* ?er:�� 'Ys'i�bt, et ux, a distance or j t- deedvi`d7;� ; .Countr' _ 1938, and r :cor.lcfl r.ith cnc Y n�1 T G.T•,nrt husben3' LJT, 9�FrAz6 ; ( Bts+ie t i �L T !. 1 �If 1. L �S� o rlrM t- t �� xa>r '+-; f 0« $9�y s #. .��-i•.b' �_ p"�1�}' 1+ s* teztnc^d bpi tic ou��tesysnd ot?or '�ntareetseeixt ' ' �� Ca- may"' i7 0121' hands and Deu2e Z},f8 i8th 'c$a x K F G c r � .- ', a � .• -_ „µ 1`�it'-.1. 1' yam--^ f,,,. r„- a, �,�.*,� �y �F- � �� '•=� P r� ,� ; z-''i �. `I' �"`...F-' r '"fi?,�� -sl'' ,��'.��ad�.-'�.1 �'�.t y • 1,Rl�rt`'1 T�'.¢rAV _'Elf '- ;.�•a��i �: � k�.c�.�-��..pp� >.`•`z• �`i•-' ,fir a•.:+.: � '�� r '��. ,� "- �-tY.,�� ;� �3 ..e� a• �'. �'+��,? ` r b.� r.,�R. i0a,. .?�..v'3S.u"'e�Y''i*`'. al't�+ i w {: i`TR. l4•� •.,¢- e r"`� ` ;;., .. .L. >'- • �1 0 > 1 Yi >>f��;/� �T' > - �i -.�,'�•t♦w -La(.�1'w.�.....,I.- _Ny I td�•, �{� �".��" ..rn' .�ct�r .N r,'n �. lI ♦t�w7 �}Vy iF'. W� �/��j �� .�� 7liW LY/4Y. `I 6. —y,�./y�4Y '�lL`'�"�'�—`�{ ,�,�_.� „� - _ y , :1'cs."ARtBbe� as - ' Louiae A nr ` t Persca�ally apkeare4 the alac,va Cle e cor C } be her 'rea � � an�2_d�nd beSore� ^` � � ..the .ore...�.ng. I � ' r+J - .._.. •ice-:�nr�, ' 310 CUR: DEPARTMENT OF ENVIRONMENTAL PROTECTION EXHIBIT B RESPONSE TO A HEATING OIL RELEASE ' OCTOBER 1994 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION ' ExmBIT D ACTIVITY AND USE LINIITATION OPINION ICI ' EXHIBIT D ACTIVITY AND USE LEMTATION OPMON ' Disposal Site Name: 55 Old Mill Road Osterville DEP Release Tracking No.: 4-10066 Date of Preparation: October 12, 1994 In accordance with the Massachusetts Contingency Plan (MCP), 310 CMR 40.1056(2)(g) and ' 310 CMR 40.1074(b), this Activity and Use Limitation (AUL) Opinion is being submitted to the Massachusetts Department of Environmental Protection (DEP) in support of the Class A-3 Response Action Outcome(RAO) statement prepared for the above-referenced disposal site. In my opinion, due to the presence of No. 2 fuel oil-impacted soils remaining beneath the basement of the residential structure, Notice of an AUL is appropriate to maintain a level of no significant risk. This is appropriate because the remaining No. 2 fuel oil-impacted soils beneath the basement exist due to the fact that further excavation would have resulted in potential ' structural impacts, loss of use of the dwelling, and the need for elaborate shoring to support the dwelling.' ' The AUL shall prohibit the following: 1. no excavation within the area of the outline of the dwelling; 2. no disturbance of the basement floor resulting n penetration,enetration cracks fissures or other , route of vapor entry of underlying soils into basement ambient air; and ' 3. lack of notification to an LSP prior to an such activities or uses listed as Item 1 or 2. P Y ' Permitted activities shall include existing residential use and other use/activity that is not inconsistent with the above. Name of Organization: Fugro East, Inc. Seal: ►w�v LSP Name: Joseph P. Salvetti � 110 OF, JOSEPH yN� 6 � � P. SALYETTI No. 9546 ' Signature: m ell- Date: �Fc 0 tob 2, 94 °,ysF,6'/SITE P pE�s` License Number: 95 '►.��PRO ' APPENDIX D LABORATORY ANALYTICAL REPORT 1 I 1 1 GROUNDWATER Groundwater Analytical, Inc. 228 Main Street ANALYTICALBuzzards Bay, MA 02532 Telephone (508) 759-4441 FAX(508) 759-4475 ' December 13, 1993 ' Mr. Joseph Salvetti Fugro-McClelland (East) , Inc. P.O. Box 1840 90 Route 6A Sandwich, MA 02563 Dear Joe: ' Enclosed are Total Petroleum Hydrocarbons Analyses performed for the Oceanside project, number 16233243, sampled on 12-10-93. This project was processed for Rush turnaround. A brief description of the Quality Assurance/Quality Control procedures employed by Groundwater Analytical , and a statement of our state certifications are contained within the report. This letter authorizes the ' release of the analytical results and should be considered a part of this report. Should you have any questions concerning this report, please do not hesitate ' to contact me. Sincerely, Jonathan R. Sanford Vice President 1 JRS/cac ' Enclosures I GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-1 Lab ID: 6607-01 Project: Oceanside/16233243 Batch ID: HI-0439-X Client: Fugro-McClelland Sampled: 12-10-93 Cont/Prsv: 500mL Glass/Cool Received: 12-10-93 ' Matrix: Soil Percent Moisture: 4 % Extracted: 12-13-93 Analyzed: 12-13-93 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 2,500 30 ' BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis ' of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-2 Lab ID: 6607-02 Project: Oceanside/16233243 Batch ID: HI-0439-X Client: Fugro-McClelland Sampled: 12-10-93 Cont/Prsv: 500mL Glass/Cool Received: 12-10-93 ' Matrix: Soil Percent Moisture: 4 % Extracted: 12-13-93 Analyzed: 12-13-93 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 10,000 290 ' Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA ' EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-3 Lab ID: 6607-03 ' Project: Oceanside/16233243 Batch ID: HI-0439-X Client. Fugro-McClelland Sampled: 12-10-93 Cont/Prsv: 500mL Glass/Cool Received: 12-10-93 1 Matrix: Soil Percent Moisture: 2 % Extracted: 12-13-93 Analyzed: 12-13-93 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 2,800 30 i ' n weight.BRL Below Reporting Limit. Calculations based dry y sample ht. Method Reference: Method 418.1 le p g (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA; EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). ' GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) ' Field ID: SS-4 Lab ID: 6607-04 Project: Oceanside/16233243 Batch ID: HI-0439-X Client. Fugro-McClelland Sampled: 12-10-93 Cont/Prsv: 500mL Glass/Cool Received: 12-10-93 t Matrix: Soil Percent Moisture: 4 % Extracted: 12-13-93 Analyzed: 12-13-93 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 850 30 ' Method 418.1 = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: BRL p g Y P (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis ' of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). iR �AT � MaMet (�OIL MON- 1S1M REWID 0 j" Buzzards Bay, MA 02532 ANALYTICAL Telephone(508) 759-4441 AND WORK ORDER FAX (508) 759-4475 Project Name: Firm: TURNAROUND ANALYSIS REQUEST F.4 �- MG�I�I I^ I Volatllea semivoleules PPeat/HerbMetale Ce ooze N:r� Other per- sf T'1 a ❑ STANDARD(10 Business Days) Project Number: Address: ❑ PRIORITY(5 Business Days) r 90 eT 6 R RUSH (RAN- 355 ) o o�O m o a JW L W W 00 . 2.p7; = Sampler Name' City(State Zip: (Rush requires Rush Authorization Number) u m o v u 22� a V V yy m E 3- t' • o J2wf f 2 ar3 a.r- o. rS3N r-0 N 'u T £fZ tw 1 " Please FAX ❑ YES ❑ NO ❑ ❑❑ ❑ ❑ o❑❑❑ ❑ ❑❑ a E �� 07 5 63 FAX Number: BLA, 6/ad9 ¢ E a Project Manager' Telephone: a ,y ry $N o a o ` ❑ r Joe SR�VL-f' i 8� 8gg-6� � BILLING to o s r_ c oo C00 $ LL E q ❑ ❑ m C E O INSTRUCTIONS: Use separate line for each container(except duplicates). Purchase Order No: 1 156/4 c ❑ 8 92 z Sampling Matrix Container(s) Preservation Filtered $ $ ' m ^ ° p g = m m ° $ J c, ❑ ❑ ❑ ❑ ❑ ❑ ❑ a caa aQ � g ❑ � > m m' LABORATORY J _ x = g a z Z -, N a S arb m w SAMPLE ¢ W W o y g a NUMBER r t IL J ago Q G J C m 1 J In a a000 vQ� - � ❑ o w w IDENTIFICATION J In J g E g E N o tS v, (Lab Use Only) E as $ $ g b $ $ Cr a O a > $ o' $ m U Z w w O o F= 3 m 3 z x x 3F U > Z o: 00 ❑ ❑ ❑ El ❑ ❑ ❑ ❑❑❑ ❑ _ C � 3 LZ l04 11: 7� SS-1V1 w tt:3� 55 - 2- tt;z s- 3 'a m L.ob J Q Z Q O TFIT REMARKS SPECIAL INSTRUCTIONS PROJECT SPECIFIC MATRIX CHAIN-OF-CUSTODY RECORD SPIKES and DUPLICATES NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof.. Shipping/Airbill Number: Many regulatory programs and EPA methods require project specific matrix Relinquished by Sampler: Date Time Received by: p leVF- 0�5 s�"f A"S spikes and/or duplicates.Each requested r matrix spike(MS),matrix spike duplicate 1 2 -3./� a3 blE � Mw,►�►y 12-0193 (MSD)and sample duplicate should be Date Time Received by: Custody Seal Number: A�S I listed above as a separate sample.Each a inqui d by: r MS,MSD and sample duplicate requires an additional sample aliquot. ❑YES.Please perform a project specific MS,MSD or sample duplicate as Relinquished by: Date Time Received by Laboratory: requested above. Cooler Serial Number: ❑NO.Please do not perform a project �o� specific MS.MSD or sample duplicate analysis for this project. Method of Shipment: ❑ GWA Courier ❑ Express Mail ❑ Federal Express 0 UPS ;0 Hand 0 GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE QA/QC Program Statement tGroundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and Specifications for Preparing ' Quality Assurance Project Plans, US EPA QAMS-005/80 (1980) , and Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (Revised 1992) . 1 Quality Control protocols include Standard Operating Procedures (SOPS) developed for each analytical method. SOPS are derived from US EPA methodologies and other established references. Equipment and facility maintenance conform to Good Laboratory Practices (GLPs) . Standards are prepared from commercially obtained reference materials of certified purity, ' and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of ' one calibration standard, one method blank, one laboratory control sample, and one matrix spike and one sample duplicate for. each sample batch. All samples, standards, blanks, laboratory control samples and matrix spikes are spiked with internal standards and surrogate compounds. GC/MS systems are tuned to ' BFB ion abundance criteria daily, or for each 12 hour operating period, whichever is more frequent. ' Quality Assessment protocols for most inorganic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, one matrix spike and one sample duplicate for each sample batch. Standard curves are derived from one reagent blank and four concentration levels. Curve ' validity is verified by standard recoveries within plus or minus ten percent of the curve. Batches are used as the basic unit for Quality Assessment. A Batch is defined ' as twenty or fewer samples which are analyzed together with the same method sequence and the same lots of reagents and with the same manipulations common to each sample within the same continuum of time within a 24 hour period. ' Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliqot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank ' contamination. Laboratory Control Samples are used to assess the accuracy of the analytical ' method. A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with a group of target compounds representative of the method analytes. Accuracy is defined as the degree of agreement of a measured value with the true or expected value. Percent Recoveries for the Laboratory ' Control Sample are calculated to assess accuracy. Surrogate Compounds are used to assess the effectiveness of the method in ' dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to organic analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are calculated for each Surrogate Compound. 1 GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE Laboratory Control Sample Recovery Category: EPA Method 418.1 (Modified) ' Batch ID: HI-0439-XL Matrix: Soil Units: mg/Kg Laboratory Control Sample SPIKE SPIKED PERCENT QC ' ANALYTE ADDED RESULT RECOVERY LIMITS Fuel Oil No. 2 940 1,100 115 % 80-120 1 1 ' All Calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE Method Blank Category: EPA Method 418.1 (Modified) ' Batch ID: HI-0439-XB1 Matrix: Soil PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons BRL 30 BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE State Certification CONNECTICUT Certificate Number ' Department of Health Services PH-0586 Potable Water, Wastewater/Trade Waste, Sewage/Effluent, and Soil: Purgeable Halocarbons, Purgeable Aromatics, Pesticides, Phenols, Oil and Grease, Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium-T, Chromium-VI, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Cyanide, TDS, Ammonia, TKN, Nitrate, Ortho-Phosphate, Alkalinity, Hardness, Chloride, Fluoride, pH, Conductivity MAINE Certificate Number ' Department of Human Services N/A Reciprocal certification in accordance with Massachusetts certification for drinking water parameters. MASSACHUSETTS Certificate Number Department of Environmental Protection MA103 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel , Selenium, Silver, Thallium, Nitrate-N, Nitrite-N, Fluoride, Cyanide, Calcium, Total Alkalinity, Total ' Dissolved Solids, pH, Langelier Index, Trihalomethanes, Volatile Organic Compounds, 1,2-Dibromoethane, 1,2-Dibromo-3-chloropropane. Non-Potable Water: Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium, Cobalt, Copper, Iron, Lead, Manganese, Mercury, Molybdenum, Nickel, Selenium, Silver, Strontium, Thallium, Titanium, Vanadium, Zinc, pH, Specific Conductivity, Total Dissolved Solids, Total Hardness, ' Calcium, Magnesium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Ammonia-N, Nitrate-N, Kjeldahl-N, Orthophosphate, Total Cyanide, Oil and Grease, Total Phenolics, Volatile Halocarbons, Volatile Aromatics, Chlordane, Aldrin, Dieldrin, DDD, DOE, DDT, Heptachlor, Heptachlor Epoxide, Polychlorinated ' Biphenyls (Water), Polychlorinated Biphenyls (Oil). MICHIGAN Certificate Number Department of Public Health N/A Drinking Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Cyanide, Fluoride, Lead, Mercury, Nickel, Nitrate, Nitrite, Selenium, Silver, Sodium, Sulfate, Thallium, Total Trihalomethanes, Regulated and Unregulated Volatile Organic Chemicals. ' NEW HAMPSHIRE Certificate Number Department of Environmental Services 202791-A/B Drinking Water: Lead, Selenium, Silver, Thallium, Trihalomethanes, Volatile Organics, Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Mercury, Nickel, Fluoride, Total Filterable ' Residue, Calcium, Alkalinity, pH, Corrosivity, Total Cyanide, Vinyl Chloride, DBCP and EDB. Wastewater: Arsenic, Beryllium, Cadmium, Cobalt, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, pH, Total Hardness, Calcium, Sodium, Potassium, Total ' Alkalinity, Chloride, Fluoride, Nitrate-N, TKN, Orthophospates, Total Phenolics, Oil & Grease, PCBs in Oil, Pesticides, Volatile Organics, Titanium, Total Cyanide, PCBs in Water. RHODE ISLAND Certificate Number ' Department of Health A54 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate, Nitrite, Fluoride, Turbidity, Chlorine, Total Filterable Solids, ' Calcium, pH, Alkalinity, Sodium, Corrosivity, Sulfate, Cyanide, Trihalomethanes, Chlorinated Hydrocarbon Pesticides, PCBs, Herbicides, Volatile Organic Compounds (EPA 524.2 and 504) and PAHs. Non-potable and Waste Waters: Aluminum, Arsenic, Beryllium, Cadmium, Cobalt, Chromium, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Vanadium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, Titanium, pH, ' Conductance, TDS, Hardness, Calcium, Magnesium, Sodium, Potassium, Alkalinity, Chloride, Fluoride, Sulfate, Ammonia, Nitrate, Orthophosphate, TKN, Total Phosphorous, Cyanide, Non-filterable solids, Oil and Grease, Total Phenolics, Chlorine, PCBs in Water, PCBs in Oil, Chlorinated Hydrocarbon Pesticides, ' Volatile Halocarbons, Volatile Aromatics, Acid Extractables and Base/Neutral Extractables. ' Groundwater Analytical, Inc. GROUNDWATER ANALYTICAL Buzzards Main Street Buzzards Bay, MA 02532 Telephone(508) 759-4441 ' FAX (508) 759-4475 .MAR 11 1994 ' March 10, 1994 /4 - A3 - 3--),,13 ' Mr. Joseph Salvetti Fugro East, Inc. P.O. Box 1840 ' 90 Route 6A Sandwich, MA 02563 Dear Joe: ' Enclosed is the Total Petroleum Hydrocarbons Analysis performed for the Beveans project, sampled on 02-24-94. This project was processed for Standard Two Week turnaround. ' A brief description of the Quality Assurance/Quality Control procedures employed by Groundwater Analytical , and a statement of our state certifications are contained within the report. This letter authorizes the t release of the analytical results and should be considered a part of this report. ' Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, 14wk Jonathan R. Sanford Vice President JRS/sb Enclosures r GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 ' Total Petroleum Hydrocarbons (IR) Field ID: BW-1 Lab ID: 7053-01 Project: Beveans/16233243 Batch ID: HI-0426-F Client: Fugro East Sampled: 02-24-94 Cont/Prsv: 1L Glass/H2SO4 Cool Preserved: 02-24-94 ' Matrix: Aqueous Received: 02-24-94 Extracted: 03-02-94 Analyzed: 03-03-94 PARAMETER CONCENTRATION REPORTING LIMIT ' (m9/L) (m9/L) Total Petroleum Hydrocarbons BRL 0.5 t ' BRL = Below Reporting Limit. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-19-020, Revised (1983). 1 GROUNDWATER NALY�ALTER QUALITY ASSURANCE ' Project Narrative I Project: Beveans Lab ID: 7053 Client: Fugro East Received: 02-24-94 IA. Physical Condition of Sample(s) This project was received by the laboratory in satisfactory condition, with the following non-conformances(s) : 1. Sample 7053-01 for analysis by EPA Method 418.1 was not received in duplicate containers. - 2. Sample 7053 Ol for analysis by EPA Method 418.1 was not received preserved with H2SO4.. The sample was preserved by the laboratory upon receipt. 1 B. Project Documentation This project was accompanied by satisfactory Chain of Custody documentation. All sample container label (s) agreed with the Chain of Custody. C. Analysis of Samples) No analytical anomalies or non-conformances were noted by the laboratory during the processing of these samples. All data contained within this report is released without qualification. i 1 1 1 1 GROUNDWATER Zzo Buzzards t N. STM RETWD 1 Bay, MA 02532 N9 .666 Telephone(508) 759-4441 AND WORK ORDER ANALYTICAL FAX(508) 759-4475 Project Name: Firm: TURNAROUND ANALYSIS REQUEST Other �ZI $ fir Volatlbs samivotstlbs I Pest/Herb Metals Wut. BC,��.v.•� STANDARD(10 Business Days) Project Number: Address: ❑ PRIORITY(5 Business Days) m o o r� r� ❑ RUSH (RAN- ) 2 m to w m o C5 s o s (Rush requires Rush Authorization Number) d p v u m E o ❑ r Sampler Name: City State Zip: O 0 0 Lou F 0 0 $0 0 F �; o o C Please FAX BYES ❑ NO °° ° ° ° °°°° ° V; FAX Number: 0° `3 0 � o Project Manager: Telephone: w „ N < a �S'w.sl77 T9oo BILLING y o 0 0 o as a 2 Purchase Order No: € ° INSTRUCTIONS: Use separate line for each container(except duplicates). 1 0 0 D o Sampling Matrix Containers) =Presor"tlon o 0 0 0 0 0 0 0 0 X a o C7 ii 8 ❑ F s ` u�jBORATORY W a = r w g ] NUMBER H $ o V SAMPLE Q w `� 3 8 S3 a W IDENTIFICATION I"P 3 ; = J b Use Only) Q n ❑ o S n o 0 0 0 0 0 0 o ne J -O W /a' v I J Q 2 t;7 Q O REMARKS SPECIAL INSTRUCTIONS PROJECT SPECIFIC MATRIX CHAIN-OF-CUSTODY RECORD SPIKES and DUPLICATES NOTE:All samples submitted subject to Standard Terms and Condllions on reverse hereof. $hipping/Afrbill Number: Many regulatory programs and EPA methods require project specific matrix Relinquished by Sa ter: Date Time Received by: spikes and/or duplicates.Each requested matrix spike(MS),matrix spike duplicate 1�sr/ ;•/O (MSD)and sample duplicate should be Date Time Received by: Custody Seal Number: listed above as a separate sample.Each Relinquis d'by: MS,MSD and sample duplicate requires an additional sample aliquot. ❑YES.Please perform a project specific Relinquished b Date Time Re e y laboratory: MS,MSD or sample duplicate as q y requested above. ial Number: ❑NO.Please do not perform a project YJ 3.1[ b specific MS,MSD or sample Method of Shl ment: ❑ 'WA Courser ❑ Expr ss M ' F eral Express duplicate analysis for this project. p 0 UPS Hand ❑ -- GROUNDWATER ANALYTICAL QUALITY ASSURANCE ' QA/QC Program Statement Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the ' guidance provided by Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980) , and Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (Revised 1992) . ' Quality Control protocols include Standard Operating Procedures (SOPS) developed for each analytical method. SOPs are derived from US EPA methodologies and other established 'references. Equipment and facility ' maintenance conform to Good Laboratory Practices (GLPs) . Standards are prepared from commercially obtained reference materials of certified purity, and documented for traceability. ' Quality Assessment protocols for most organic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, and one matrix spike and one sample duplicate for each sample batch. All samples, standards, blanks, laboratory control samples and matrix spikes are spiked ' with internal standards and surrogate compounds. GC/MS systems are tuned to BFB ion abundance criteria daily, or for each 12 hour operating period, whichever is more frequent. ' Quality Assessment protocols for most inorganic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, one matrix spike and one sample duplicate for each sample batch. Standard curves ' are derived from one reagent blank and four concentration levels. Curve validity is verified by standard recoveries within plus or minus ten percent of the curve. ' Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples which are analyzed together with the same method sequence and the same lots of reagents and with the same manipulations common to each sample within the same continuum of time within a 24 hour period. ' Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliqot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. ' Laboratory Control Samples are used to assess the accuracy of the analytical method. A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with a group of target compounds representative of the method analytes. Accuracy is defined as the degree of agreement of a measured value ' with the true or expected value. Percent Recoveries for the Laboratory Control Sample are calculated to assess accuracy. Surrogate Compounds are used to assess the effectiveness of the method in ' dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to organic analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are ' calculated for each Surrogate Compound. GROUNDWATER i ANALYTICAL QUALITY ASSURANCE ' Laboratory Control Sample Recovery Category: EPA Method 418.1 Batch ID: HI-0426-FL Matrix: Aqueous Units: mg/L Laboratory Control Sample ' SPIKE SPIKED PERCENT QC ANALYTE ADDED RESULT RECOVERY LIMITS Fuel Oil No. 2 20 20 100 % 80-120 1 1 ' All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 GROUNDWATER ANALYTICAL QUALITY ASSURANCE Method Blank Category: EPA Method 418.1 Batch ID: HI-0426-FB1 Matrix: Aqueous 1 PARAMETER CONCENTRATION REPORTING LIMIT (mg/L) (mg/L) Total Petroleum Hydrocarbons BRL 0.5 1 1 1 . 1 1 1 1 i 1 ' BRL = Below Reporting Limit. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE State Certification CONNECTICUT Certificate Number ' Department of Health Services PH-0586 Potable Water, Wastewater/Trade Waste, Sewage/Effluent, and Soil: Purgeable Halocarbons, Purgeable Aromatics, Pesticides, Phenols, Oil and Grease, Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium-T, Chromium-V1, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Cyanide, TDS, Ammonia, TKN, Nitrate, Ortho-Phosphate, Alkalinity, Hardness, Chloride, Fluoride, pH, Conductivity MAINE Certificate Number ' Department of Human Services N/A Reciprocal certification in accordance with Massachusetts certification for drinking water parameters. MASSACHUSETTS Certificate Number SDepartment of Environmental Protection MA103 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate-N, Nitrite-N, Fluoride, Cyanide, Calcium, Total Alkalinity, Total ' Dissolved Solids, pH, Langelier Index, Trihalomethanes, Volatile Organic Compounds, 1,2-Dibromoethane, 1,2-Dibromo-3-chloropropane. Non-Potable Water: Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium, Cobalt, Copper, Iron, Lead, Manganese, Mercury, Molybdenum, Nickel, Selenium, Silver, Strontium, Thallium, Titanium, Vanadium, Zinc, pH, Specific Conductivity, Total Dissolved Solids, Total Hardness, ' Calcium, Magnesium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Ammonia-N, Nitrate-N, Kjeldahl-N, Orthophosphate, Total Cyanide, Oil and Grease, Total Phenolics, Volatile Halocarbons, Volatile Aromatics, Chlordane, Aldrin, Dieldrin, DOD, DDE, DDT, Heptachlor, Heptachlor Epoxide, Polychlorinated ' Biphenyls (Water), Polychlorinated Biphenyls (Oil). MICHIGAN Certificate Number Department of Public Health N/A ' Drinking Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Cyanide, Fluoride, Lead, Mercury, Nickel, Nitrate, Nitrite, Selenium, Silver, Sodium, Sulfate, Thallium, Total Trihalomethanes, Regulated and Unregulated Volatile Organic Chemicals. NEW HAMPSHIRE Certificate Number Department of Environmental Services 202791-A/B Drinking Water: Lead, Selenium, Silver, Thallium, Trihalomethanes, Volatile Organics, Antimony, ' Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Mercury, Nickel, Fluoride, Total Filterable Residue, Calcium, Alkalinity, pH, Corrosivity, Total Cyanide, Vinyl Chloride, DBCP and EDB. Wastewater: Arsenic, Beryllium, Cadmium, Cobalt, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, pH, Total Hardness, Calcium, Sodium, Potassium, Total ' Alkalinity, Chloride, Fluoride, Nitrate-N, TKN, Orthophospates, Total Phenolics, Oil & Grease, PCBs in Oil, Pesticides, Volatile Organics, Titanium, Total Cyanide, PCBs in Water. ' RHODE ISLAND Certificate Number Department of Health A54 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel , Selenium, Silver, Thallium, 'Nitrate, Nitrite, Fluoride, Turbidity, Chlorine, Total Filterable Solids, ' Calcium, pH, Alkalinity, Sodium, Corrosivity, Sulfate, Cyanide, Trihalomethanes, Chlorinated Hydrocarbon Pesticides, PCBs, Herbicides, Volatile Organic Compounds (EPA 524.2 and 504) and PAHs. Non-potable and Waste Waters: Aluminum, Arsenic, Beryllium, Cadmium, Cobalt, Chromium, Copper, Iron, Mercury, Manganese, ' Nickel, Lead, Selenium, Vanadium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, Titanium, pH, Conductance, TDS, Hardness, Calcium, Magnesium, Sodium, Potassium, Alkalinity, Chloride, Fluoride, Sulfate, Ammonia, Nitrate, Orthophosphate, TKN, Total Phosphorous, Cyanide, Non-filterable solids, Oil and Grease, Total Phenolics, Chlorine, PCBs in Water, PCBs in Oil, Chlorinated Hydrocarbon Pesticides, Volatile Halocarbons, Volatile Aromatics, Acid Extractables and Base/Neutral Extractables. i ' Groundwater Analytical, Inc. GROUNDWATER 228 Main Street ANALYTICALBuzzards Bay, MA 02532 ' Telephone (508)759-4441 FAX (508) 759-4475 ' May 10, 1994 SAY 121994 ' Mr. Joseph Salvetti Fugro East, Inc. 90 Route 6A ' Sandwich, MA 02563 Dear Joe: Enclosed are the Total Petroleum Hydrocarbon Analyses performed for the Beveans/Csterville project, number 16-23-3243, sampled on 05-03-94. This project was processed for Rush turnaround. A brief description of the Quality Assurance/Quality Control procedures employed by Groundwater Analytical , and a statement of our state certifications are contained within the report. This letter authorizes the ' release of the analytical results and should be considered a part of this report. Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, Jonathan R. Sanford Vice President JRS/adw Enclosures I ' GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) ' Total Petroleum Hydrocarbons (IR) ' Field ID: SS-1 1216" Lab ID: 7628-01 Project: Beveans Osterville/16-23-3243 Batch ID: HI-0505-X Client: Fugro East Sampled: 05-03-94 Cont/Prsv: 500ml Glass/Cool Received: 05-04-94 ' Matrix: Soil Percent Moisture: 7 % Extracted: 05-09-94 Analyzed: 05-10-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 16,000 310 Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA 1 EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). r GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-2 1216" Lab ID: 7628-02 Project: Beveans Osterville/16-23-3243 Batch ID: HI-0505-X Client: Fugro East Sampled: 05-03-94 Cont/Prsv: 500ml Glass/Cool Received: 05-04-94 Matrix: Soil Percent Moisture: 5 % Extracted: 05-09-94 Analyzed: 05 10 94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) Total Petroleum Hydrocarbons 13,000 300 i 1 1 1 1 1 1 1 _ 1 Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). ' GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) ' Total Petroleum Hydrocarbons (IR) ' Field ID: SS-3 11'4" Lab ID: 7628-03 Project: Beveans Osterville/16-23-3243 Batch ID: HI-0505-X Client: Fugro East Sampled: 05-03-94 Cont/Prsv: 500ml Glass/Cool Received: 05-04-94 ' Matrix: Soil Percent Moisture: 6 % Extracted: 05-09-94 Analyzed: 05-10-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) Total Petroleum Hydrocarbons 16,000 300 1 I 1 Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA ' EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). f GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-4 12'6" Lab ID: 7628-04 Project: Beveans Osterville/16-23-3243 Batch ID: HI-0505-X Client: Fugro East Sampled: 05-03-94 Cont/Prsv: 500ml Glass/Cool Received: 05-04-94 Matrix: Soil Percent Moisture: 6 % Extracted: 05-09-94 Analyzed: 05-10-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) Total Petroleum Hydrocarbons 15,000 310 1 1 ' Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, Is EPA ' EPA-600/4-79-020, Revised 119831. Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ANALYTICAL QUALITY ASSURANCE Project Narrative ' Project: Beveans/Osterville/16-23-3243 Lab ID: 7628 Client: Fugro East Received: 05-04-94 A. Physical Condition of Samples) This project was received by the laboratory in satisfactory condition. The ' sample(s) were received undamaged in appropriate containers with the correct preservation. B. Project Documentation This project was accompanied by satisfactory Chain of Custody documentation. All sample container label (s) agreed with the Chain of Custody. C. Analysis of Sample(s) No analytical anomalies or non-conformances were noted by the laboratory during the processing of these samples. All data contained within this ' report is released without qualification. 1 1 GROUNDWATER 228 treet� ■NAi�CUP%y R&IROM M Buzzards Bay, MA 02532 N° .. 8627 Telephone(508) 759.4441 A ANALYTICAL ND WORK ORDER FAX(508) 759-4475 TURNAROUND ANALYSIS REQUEST Project Name: Firm: Ria Volatlles I Semivoletlles I Post/Herb Metals� Other fuE/tNs f OsTrQus b �v6 2 0 earoena Waata ❑ STANDARD(10 Business Days) Project Number: Address: ❑ PRIORITY(5 Business Days) rR 40 o o r € LL 0 1t5- 23- 32y3 90 llbct7E d � Aq RUSH (RAN- ) o 3w W w C5oo o City(State/Zip' (Rush requires Rush Authorization Number) a p U U $ 0 O O U. U. Sampler Name: ° ❑0 0 0 ❑ ❑ 0000 0 Please FAX AY YES ❑ NO E F 1= L ANO R`/ SANOLrCCtI FAX Number: &&° -b L % -- m < a ❑ Project Manager: Telephone: a N m Q8 P- ❑ 2�-t �+ V) aD J C� $ o I 8d6 3Svp BILLING y o o ❑ o ❑❑ o❑❑ I` > ,TO� Al,U 1�-rT-T ❑ INSTRUCTIONS: Use separate line for each container(except duplicates). Purchase Order No: 0 0 k Sampling Matrix Container(s) Preservation Filtered a 3 ^.g a o zn ❑ n00 ❑ ❑ ❑ ❑aa ❑ Qig ❑ o r� a $ to 2 W LABORATORY QQ g y NUMBER w tl1 2j t ��j ❑ L' V Qw w IDENTIFICATION �" Q�SAMPLEof $JpF a pQE `9x' o ° w m (Lab Use On a J OL$ ' g g S m Yj J 1n Z S = S V y = S ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 600 ❑ ❑ ❑ 1- ❑ 7�28- sl3 /V-0 SS- -r-2, ' owl /� CZ W s l3'os SS-2 r ,� 03 } S ly'2o SS _ / `� m tzr6 `' S J Q Z_ (7 Q O REMARKS SPECIAL INSTRUCTIONS PROJECT SPECIFIC MATRIX CHAIN-OF-CUSTODY RECORD SPIKES and DUPLICATES NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof. Shipping/Airbill Number: Many regulatory programs and EPAWb Date Time Received by: methods require project specific matrix spikes and/or duplicates.Each requestedrc— matrix spike(MS),matrix spike duplicate3 ��J (MSD)and sample duplicate should beDate Time Received by: Custody Seal Number: listed above as a separate sample.Each MS,MSD and sample duplicate requires an additional sample aliquot. ❑YES.Please perform a project specific Relinquished b Date Time R slued b Laboratory: MS,MSD or sample duplicate as 4 y G requested above. (L�� / p/n ( (/IG�J� Cooler Serial Number: bf-W.Please do not perform a project lc l��CC..ff(t v� specific MS,MSD or sample Method of Shipment: ❑ GWA Courier ❑ Express Mail ❑ ederal Express duplicate analysis for this project. P 0 UPS 0 Hand 0 GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE ' QA/QC Program Statement Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and Specifications for Preparing it Assurance Project Plans US EPA AMS-005 80 1980 and Test Methods Quality J Q l ( ) , for Evaluating Solid Waste, US EPA SW-846, Third Edition (Revised 1992) . Quality Control protocols include Standard Operating Procedures (SOPs) developed for each analytical method. SOPS are derived from US EPA methodologies and other established references. Equipment ui ment and facility maintenance conform to Good Laboratory Practices (GLPs) . Standards are prepared from commercially obtained reference materials of certified purity, and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, and one matrix spike and one sample duplicate for each sample batch. All samples, standards, blanks, laboratory control samples and matrix spikes are spiked ' with internal standards and surrogate compounds. GC/MS systems are tuned to BFB ion abundance criteria daily, or for each 12 hour operating period, whichever is more frequent. ' Quality Assessment protocols for most inorganic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, one matrix spike and one sample duplicate for each sample batch. Standard curves ' are derived from one reagent blank and four concentration levels. Curve validity is verified by standard recoveries within plus or minus ten percent of the curve. Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples which are analyzed together with the same method sequence and the same lots of reagents and with the same manipulations common to each sample within the same continuum of time within a 24 hour period. ' Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliqot of ' sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. ' Laboratory Control Samples are used to assess the accuracy of the analytical method. A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with a group of target compounds representative of the method analytes. Accuracy is defined as the degree of agreement of a measured value ' with the true or expected value. Percent Recoveries for the Laboratory Control Sample are calculated to assess accuracy. Surrogate Compounds are used to assess the effectiveness of the method in ' dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to organic analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are ' calculated for each Surrogate Compound. ' GROUNDWATER ANALYTICAL QUALITY ASSURANCE ' Laboratory Control Sample Recovery Category: EPA Method 418.1 (Modified) Batch ID: HI-0505-XL Matrix: Soil Units: mg/Kg Laboratory Control Sample SPIKE SPIKED PERCENT QC ANALYTE ADDED RESULT RECOVERY LIMITS Fuel Oil No. 2 940 830 88 % 80-120 All Calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. I GROUNDWATER ANALYTICAL QUALITY ASSURANCE ' Method Blank Category: EPA Method 418.1 (Modified) ' Batch ID: HI-0505-XB1 Matrix: Soil PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) Total Petroleum Hydrocarbons BRL 30 ' BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1183), Adapted for solids by Method 3140 ' (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE State Certification CONNECTICUT Certificate Number Department of Health Services PH-0586 ' Potable Water. Wastewater/Trade Waste. Sewage/Effluent, and Soil: Purgeable Halocarbons, Purgeable Aromatics, Pesticides, Phenols, Oil and Grease, Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium-T, Chromium-VI, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Potassium, ' Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Cyanide, TDS, Ammonia, TKN, Nitrate, Ortho-Phosphate, Alkalinity, Hardness, Chloride, Fluoride, pH, Conductivity MAINE Certificate Number Department of Human Services N/A Reciprocal certification in accordance with Massachusetts certification for drinking water parameters. MASSACHUSETTS Certificate Number ' Department of Environmental Protection MA103 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate-N, Nitrite-N, Fluoride, Cyanide, Calcium, Total Alkalinity, Total ' Dissolved Solids, pH, Langelier Index, Trihalomethanes, Volatile Organic Compounds, 1,2-Dibromoethane, 1,2-Dibromo-3-chloropropane. Non-Potable Water: Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium, Cobalt, Copper, Iron, Lead, Manganese, Mercury, Molybdenum, Nickel, Selenium, Silver, Strontium, Thallium, Titanium, Vanadium, Zinc, pH, Specific Conductivity, Total Dissolved Solids, Total Hardness, ' Calcium, Magnesium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Ammonia-N, Nitrate-N, Kjeldahl-N, Orthophosphate, Total Cyanide, Oil and Grease, Total Phenolics, Volatile Halocarbons, Volatile Aromatics, Chlordane, Aldrin, Dieldrin, ODD, DDE, DDT, Heptachlor, Heptachlor Epoxide, Polychlorinated Biphenyls (Water), Polychlorinated Biphenyls (Oil). ' MICHIGAN Certificate Number Department of Public Health N/A ' Drinking Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Cyanide, Fluoride, Lead, Mercury, Nickel, Nitrate, Nitrite, Selenium, Silver, Sodium, Sulfate, Thallium, Total Trihalomethanes, Regulated and Unregulated Volatile Organic Chemicals. NEW HAMPSHIRE Certificate Number ' Department of Environmental Services 202791-A/B Drinking Water: Lead, Selenium, Silver, Thallium, Trihalomethanes, Volatile Organics, Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Mercury, Nickel, Fluoride, Total Filterable ' Residue, Calcium, Alkalinity, pH, Corrosivity, Total Cyanide, Vinyl Chloride, OBCP and EDB. Wastewater: Arsenic, Beryllium, Cadmium, Cobalt, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, pH, Total Hardness, Calcium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Nitrate-N, TKN, Orthophospates, Total Phenolics, Oil & Grease, PCBs in Oil, Pesticides, Volatile Organics, Titanium, Total Cyanide, PCBs in Water. RHODE ISLAND Certificate Number ' Department of Health A54 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate, Nitrite, Fluoride, Turbidity, Chlorine, Total Filterable Solids, Calcium, pH, Alkalinity, Sodium, Corrosivity, Sulfate, Cyanide, Trihalomethanes, Chlorinated Hydrocarbon Pesticides, PCBs, Herbicides, Volatile Organic Compounds (EPA 524.2 and 504) and PAHs. Non-potable and Waste Waters: Aluminum, Arsenic, Beryllium, Cadmium, Cobalt, Chromium, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Vanadium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, Titanium, pH, ' Conductance, TDS, Hardness, Calcium, Magnesium, Sodium, Potassium, Alkalinity, Chloride, Fluoride, Sulfate, Ammonia, Nitrate, Orthophosphate, TKN, Total Phosphorous, Cyanide, Non-filterable solids, Oil and Grease, Total Phenolics, Chlorine, PCBs in Water, PCBs in Oil, Chlorinated Hydrocarbon Pesticides, Volatile Halocarbons, Volatile Aromatics, Acid Extractables and Base/Neutral Extractables. i 1 GROUNDWATER Groundwater Analytical, Inc. ' 228 Main Street ANALYTICALBuzzards Bay, MA 02532 Telephone (508) 759-4441 ' FAX (508) 759-4475 ' June 17, 1994 JUN 2 p 199 ' Mr. Joseph Salvetti Fugro East, Inc. 90 Route 6A Sandwich, MA 02563 ' Dear Joe: ' Enclosed are the Total Petroleum Hydrocarbon Analyses performed for the Beveans/Osterville project, number 16-23-3243, sampled on 06-02-94. This project was processed for Standard Two Week turnaround. ' A brief description of the Quality Assurance/Quality Control procedures employed by Groundwater Analytical , and a statement of our state certifications are contained within the report. This letter authorizes the release of the analytical results and should be considered a part of this report. Should you have any questions concerning this report, please do not hesitate ' to contact me. Sincerely, ' Jonathan R. Sanford Vice President F JRS/adw Enclosures p GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-1 10' Lab ID: 7880-01 ' Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06-02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 ' Matrix: Soil Percent Moisture: 5 % Extracted: 06-10-94 Analyzed: 06-14-94 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 640 30 1 BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised 11983), Adapted for solids by Method 1140 ' (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-2 12'-1216-1 Lab ID: 7880-02 ' Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06-02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 ' Matrix: Soil Percent Moisture: 6 % Extracted: 06-10-94 Analyzed: 06-14-94 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 1,800 30 ' BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 ' (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) Field ID: SS-4 5'-10' Lab ID: 7880-03 Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06-02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 ' Matrix: Soil Percent Moisture: 5 % Extracted: 06-10-94 Analyzed: 06-14-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 6,300 150 III I Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-19-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) ' Field ID: SS-5 2'-8' Lab ID: 7880-04 Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06 02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 t Matrix: Soil Percent Moisture: 3 % Extracted: 06-10-94 Analyzed: 06-14-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 150 30 1 1 1 1 BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis ' of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). t GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) Total Petroleum Hydrocarbons (IR) 1 ' Field ID: SS-6 3'-10' Lab ID: 7880-05 Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06-02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 ' Matrix: Soil Percent Moisture: 4 % Extracted: 06-10-94 Analyzed: 06-14-94 ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 2,300 30 I ' BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 I p 9 ` (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis f ' of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL EPA METHOD 418.1 (Modified) ' Total Petroleum Hydrocarbons (IR) ' Field ID: SS-7 4'-10'511 Lab ID: 7880-06 Project: Beveans/Osterville/16-23-3243 Batch ID: HI-0524-X Client: Fugro East Sampled: 06-02-94 Cont/Prsv: 500ml Glass/Cool Received: 06-03-94 ' Matrix: Soil Percent Moisture: 8 % Extracted: 06-10-94 Analyzed: 06-14-94 PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons 8,600 150 I, 1 Elevated reporting limit due to required sample dilution. BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA ' EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (1986). GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE Project Narrative ' Project: Beveans/Osterville/16-23-3243 Lab ID: 7880 Client: Fugro East Received: 06-03-94 ' A. Physical Condition of Sample(s) This project was received by the laboratory in satisfactory condition. The ' sample(s) were received undamaged in appropriate containers with the correct preservation. ' B. Project Documentation This project was accompanied by satisfactory Chain of Custody documentation. ' All sample container label (s) agreed with the Chain of Custody. C. Analysis of Sample(s) No analytical anomalies or non-conformances were noted by the laboratory during the processing of these samples. All data contained within this report is released without qualification. E� M �in sty H/IWF-@WODVftCCW M M NAM2701=1 Buzzards Bay, MA 02532 ANALYTICAL Telephone (508) 759-4441 AND WORK ORDER FAX(508) 759-4475 Project Name: Firm: TURNAROUND ANALYSIS REQUEST I'UG Z O Vblatllsit Semivolatlles PesUHerb Metals �„p.s Wy s6 Other 1�FuEi►NS lossERvrt.« r @�, STANDARD(10 Business Days) Project Number: Address: m= ❑ PRIORITY(S.Business Days) 0 -o a 2 r - 50 r7mt,h 6 ❑ RUSH (RAN- ) a w w w 8 o°r r �-' 21 g m Celt if !Zip: (Rush requires Rush Authorization Number) n U f Z<u (. m E o.'s_[ ❑ Sampler Name: _ Y P o 2 w� 2 $a a a 3 2 c o ievi L Al"PRy a SAvvOvscw M a aP_a 3 Please FAX IKYES ❑ NO ❑G❑❑ ❑ ❑ ❑❑❑❑ ❑ co g" .m y r FAX Number: 8 Q 4 ' 6 6 1 #1 o' Project Manager: Telephone: < N N c a a .e o 0_ 3 N H s $ a 3 BILLING o N m 8 o a JoE Sacuf/>s f�SoF � 8fcfs ' 34oa v, ❑ ❑ ❑ ❑ G❑ ❑G❑ > 2 INSTRUCTIONS: Use separate line for each container(except duplicates). Purchase Order No: c o a € N e w Sampling Matrix Container(s) Preservation Filtered a. e a o o = m _ ❑ ❑ ❑ ❑ ❑ ❑ G ❑ Ga`a n ¢ ❑ � 2 O > ryn i LABORATORY _ x a g n m SAMPLE ¢ w rtI, n NUMBER « tri. J o t O u, d a o F w IDENTIFICATION a a E ag a c3 i y w w ° (Lab Use Only) u $ $ $ 8 $ m C N $ o I g 3 ° 3 z 9 d d S z x x x" o z a ❑ G G n G ❑ o n n ❑ nn❑ G n ❑ [� riz II:SO SS- I I n I K t �/X n:is u-L '- n I U3 6�2 t?:to S S-S .2 f I f 6( IC" SS-� I- r if 0 REMARKS/ SPECIAL INSTRUCTIONS PROJECT SPECIFIC MATRIX CHAIN-OF-CUSTODY RECORD SPIKES and DUPLICATES Many regulatory programs and EPA NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof. Shipping/Airbill Number: methods require project specific matrix li q shed Sampl r: Date Time Rr ived by: spikes and/or duplicates.Each requested 6' matrix spike(MS),matrix spike duplicate �• I� (MSD)and sample duplicate should be listed above as a separate sample.Each elt q ished by: Date Time Received by: _ Custody Seal Number: MS.MSD and sample duplicate requires 6 an additional sample aliquot. �b j U YES.Please perform a project specific MS,MSD or sample duplicate as Re inquishe by: Date Time Received by Laboratory: requested above. f�NO.Please do not perform a project Cooler Serial Number: specific MS,MSD or sample duplicate analysis for this project. Method of Shipment: ❑ GWA Courier ❑ Express Mai eder 1 Expre ❑ UPS 0 Hand ❑ f GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE QA/QC Program Statement ' Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the t guidance provided by Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980) , and Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition (Revised 1992) . 1 Quality Control protocols include Standard Operating Procedures (SOPS) developed for each analytical method. SOPs are derived from US EPA methodologies and other established references. Equipment and facility maintenance conform to Good Laboratory Practices (GLPs) . Standards are ' prepared from commercially obtained reference materials of certified purity, and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, and one matrix spike and one sample duplicate for each sample batch. All samples, standards, blanks, laboratory control samples and matrix spikes are spiked with internal standards and surrogate compounds. GC/MS systems are tuned to BFB ion abundance criteria daily, or for each 12 hour operating period, whichever is more frequent. Quality Assessment protocols for most inorganic analyses include a minimum of one calibration standard, one method blank, one laboratory control sample, one matrix spike and one sample duplicate for each sample batch. Standard curves are derived from one reagent blank and four concentration levels. Curve ' validity is verified by standard recoveries within plus or minus ten percent of the curve. Batches are used as the basic unit for Quality Assessment. A Batch is defined ' as twenty or fewer samples which are analyzed together with the same method sequence and the same lots of reagents and with the same manipulations common to each sample within the same continuum of time within a 24 hour period. ' Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliqot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. Laboratory Control Samples are used to assess the accuracy of the analytical ' method. A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with a group of target compounds representative of the method analytes. Accuracy is defined as the degree of agreement of a measured value with the true or expected value. Percent Recoveries for the Laboratory Control Sample are calculated to assess accuracy. Surrogate Compounds are used to assess the effectiveness of the method in dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to or anic anal tes of interest in chemical behavior, but 9 Y which are not normally found in environmental samples. Percent Recoveries are calculated for each Surrogate Compound. GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE Laboratory Control Sample Recovery Category: EPA Method 418.1 (Modified) ' Batch ID: HI-0524-XL Matrix: Soil Units: mg/Kg ' Laboratory Control Sample SPIKE SPIKED PERCENT QC ' ANALYTE ADDED RESULT RECOVERY LIMITS Fuel Oil No. 2 940 925 99 % 80-120 I 1 1 All Calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or ' alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 f GROUNDWATER ' ANALYTICAL QUALITY ASSURANCE Method Blank 1 Category: EPA Method 418.1 (Modified) ' Batch ID: HI-0524-XB1 Matrix: Soil ' PARAMETER CONCENTRATION REPORTING LIMIT (mg/Kg) (mg/Kg) ' Total Petroleum Hydrocarbons BRL 30 BRL = Below Reporting Limit. Calculations based on dry sample weight. Method Reference: Method 418.1 (Spectrophotometric, Infrared) - Petroleum Hydrocarbons, Total Recoverable, Methods for Chemical Analysis of Water and Wastes, US EPA EPA-600/4-79-020, Revised (1983). Adapted for solids by Method 3540 (Modified) - Soxhlet Extraction, Test Methods for Evaluating Solid Waste, US EPA SW-846, Third Edition ' (1986). GROUNDWATER ANALYTICAL ' QUALITY ASSURANCE State Certification CONNECTICUT Certificate Number Department of Health Services PH-0586 ' Potable Water. Wastewater/Trade Waste. Sewage/Effluent, and Soil: Purgeable Halocarbons, Purgeable Aromatics, Pesticides, Phenols, Oil and Grease, Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium-T, Chromium-VI, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Potassium, ' Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Cyanide, TDS, Ammonia, TKN, Nitrate, Ortho-Phosphate, Alkalinity, Hardness, Chloride, Fluoride, pH, Conductivity MAINE Certificate Number Department of Human Services N/A Reciprocal certification in accordance with Massachusetts certification for drinking water parameters. MASSACHUSETTS Certificate Number Department of Environmental Protection MA103 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate-N, Nitrite-N, Fluoride, Cyanide, Calcium, Total Alkalinity, Total ' Dissolved Solids, pH, Langelier Index, Trihalomethanes, Volatile Organic Compounds, 1,2-Dibromoethane, 1,2-Dibromo-3-chloropropane. Non-Potable Water: Aluminum, Antimony, Arsenic, Beryllium, Cadmium, Chromium, Cobalt, Copper, Iron, Lead, Manganese, Mercury, Molybdenum, Nickel, Selenium, Silver, Strontium, Thallium, Titanium, Vanadium, Zinc, pH, Specific Conductivity, Total Dissolved Solids, Total Hardness, ' Calcium, Magnesium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Ammonia-N, Nitrate-N, Kjeldahl-N, Orthophosphate, Total Cyanide, Oil and Grease, Total Phenolics, Volatile Halocarbons, Volatile Aromatics, Chlordane, Aldrin, Dieldrin, ODD, DDE, DDT, Heptachlor, Heptachlor Epoxide, Polychlorinated Biphenyls (Water), Polychlorinated Biphenyls (Oil). ' MICHIGAN Certificate Number Department of Public Health N/A Drinking Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Cyanide, Fluoride, Lead, Mercury, Nickel, Nitrate, Nitrite, Selenium, Silver, Sodium, Sulfate, Thallium, Total Trihalomethanes, Regulated and Unregulated Volatile Organic Chemicals. NEW HAMPSHIRE Certificate Number ' Department of Environmental Services 202791-A/B Drinking Water: Lead, Selenium, Silver, Thallium, Trihalomethanes, Volatile Organics, Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Mercury, Nickel, Fluoride, Total Filterable ' Residue, Calcium, Alkalinity, pH, Corrosivity, Total Cyanide, Vinyl Chloride, DBCP and EDB. Wastewater: Arsenic, Beryllium, Cadmium, Cobalt, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, pH, Total Hardness, Calcium, Sodium, Potassium, Total Alkalinity, Chloride, Fluoride, Nitrate-N, TKN, Orthophospates, Total Phenolics, Oil & Grease, PCBs in ' Oil, Pesticides, Volatile Organics, Titanium, Total Cyanide, PCBs in Water. RHODE ISLAND Certificate Number Department of Health A54 Potable Water: Antimony, Arsenic, Barium, Beryllium, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Selenium, Silver, Thallium, Nitrate, Nitrite, Fluoride, Turbidity, Chlorine, Total Filterable Solids, ' Calcium, pH, Alkalinity, Sodium, Corrosivity, Sulfate, Cyanide, Trihalomethanes, Chlorinated Hydrocarbon Pesticides, PCBs, Herbicides, Volatile Organic Compounds (EPA 524.2 and 504) and PAHs. Non-potable and Waste Waters: Aluminum, Arsenic, Beryllium, Cadmium, Cobalt, Chromium, Copper, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Vanadium, Zinc, Antimony, Silver, Thallium, Molybdenum, Strontium, Titanium, pH, Conductance, TDS, Hardness, Calcium, Magnesium, Sodium, Potassium, Alkalinity, Chloride, Fluoride, Sulfate, Ammonia, Nitrate, Orthophosphate, TKN, Total Phosphorous, Cyanide, Non-filterable solids, Oil and Grease, Total Phenolics, Chlorine, PCBs in Water, PCBs in Oil, Chlorinated Hydrocarbon Pesticides, Volatile Halocarbons, Volatile Aromatics, Acid Extractables and Base/Neutral Extractables. 1 � 1 ' 1 1 ' APPENDIX E ' BILL OF LADING 1 1 1 i i i i 1 r r i Massachusetts Department of Environmental Protection BWSC-012A Bureau of Waste Site Cleanup Release Tracking Number*: BILL OF LADING (pursuant to 310 CMR 40.0030) a- 10066 LOCATION OF SITE OR DISPOSAL SITE WHERE REMEDIATION WASTE WAS GENERATED: Release Name(optional): tt 56 Old Mill Road.Ostervi 11 a Location Aid: — aown: Os Zip code: 02655 Date/Period of Generation: 2 /0111 / 94 to _ s/-QL /qIt _ Itlonal Release Tracking Numbers Associated with this Bill of Lading: *Note: If this Bill of Lading is the result of a Limited Removal Action(LRA)taken prior to Notification,a Release Tracking Number is not needed. . PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL OF LADING: e of Organization: S eofContact: Estate of John F. Beavans Title: nwner street: 52 Old Mill Road frown: Ostervi l l e _ State: MA Zip Code: 02655 phone: 508 — 477 — 2011 Ext. C. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL OF LADING: ( one/specify) RP Specify(circle one): Owner Operator Generator Transporter Other RP: PRP Specify(circle one): Owner Operator Generator Transporter Other PRP: Fiduciary/Secured Lender ❑ Agency/Public Utility on a Right of Way itOther Person: owner and/or operator is not conducting the response action associated with the Bill of Lading,provide on an attachment the name. contact person,address and telephone number,including any area code and extension,for each.ff known. t RANSPORTER/COMMON CARRIER INFORMATION: porter/Common Carrier Name: Waste Management Contact Person: Title: t: 264 Nicks Rock Road, P.O. Box 1610 kk frown: Plymouth .,. .... State: MA Zip Code- 02362 T phone: 800 — 262 - 5633 ` Ext. RECEIVING FACILITY/TEMPORARY STORAGE LOCATION: Operator/Facility Name7 Bardon -Tri mount tact Person: William Reinhardt Title: t: 1101 Turnpike Street cityrrown: Stoughton State: MA Zip Code: 02072 Tlphone: 617 — 221 - 8400 Ext. Type of Facility: ® Asphalt Batch/Cold Mix ❑ LandfilVDisposal ❑ Incinerator (check one) ® Asphalt Batch/Hot Mix ❑ Landfill/Daily Cover El Temporary Storage ' ❑ Thermal Processing El ion Fill ❑ Other: Division of Hazardous Division of Solid Waste Waste/Class A Permit#: Management Permit#: S-90-020 EPA Identification#:MAD998121-1R 31 Alal/Anticipated Period of Temporary Storage(specify dates if applicable): — /_ /_ to Reason for Temporary Storage(if applicable): evind 10/1/93 This form is printed on recycled paper. Page 1 of 2 Massachusetts Department of Environmental Protection BWSC-012A ' Bureau of Waste Site Cleanup Release Tracking Number: DER.. 1 BILL OF LADING (pursuant to 310 CMR 40.0030) a- 10066 ' E. RECEIVING FACILITY/TEMPORARY STORAGE LOCATION (continued): ' Temporary Storage Address: Street: Cityfrown: State: Zip Code: F. DESCRIPTION OF REMEDIATION WASTE: (check all that apply) ® Contaminated Media(circle all that apply): Soil Groundwater Surface Water Other: ❑ ' Contaminated Debris(circle all that apply): Demolition/Construction Waste Vegetation/Organic Materials Inorganic Absorbant Materials Other: ❑ Non-hazardous Uncontainerized Waste(circle all that apply): Non-aqueous Phase Liquid Other: ' ❑ Non-hazardous Containerized Waste(circle all that apply): Tank Bottoms/Sludges Containers Drums Engineered Impoundments Other: — Type of Contamination(circle all that apply): Gasoline Diesel Fuel 42 Oil #4 Oil #6 Oil Waste Oil ' Kerosene Jet Fuel Other: Estimated Volume of Materials: Cubic Yards: 60 Tons: 90 Other: Contaminant Source(check one/specify): ❑ Transportation Accident ❑ Underground Storage Tank Q Other: Residential AST ' Response Action Associated with Bill of Lading(circle one): Immediate Response Action Release Abatement Measure Utility-Related Abatement Measure Limited Removal Action(LRA) Comprehensive Response Action ' Other(specify): Remediation Waste Characterization Support Documentation attached: ' ❑ Site History Information ❑ Sampling and Analytical Methods and Procedures (A Laboratory Data ❑ Field Screening Data If supporting documentation is not appended, provide an attachment stating the date and in connection with what document such information was previously submitted to DER G. LICENSED SITE PROFESSIONAL(LSP)OPINION: ' Name of Organization: Fugro East, Inc. LSP Name: Joseph P. Sal vetti Title: Sr. Associate ' Telephone: 508 — $$g - iqnQ_ Ext. 1 have personally examined and am familiar with the information contained on and submitted with this form. Based on this information,it is my Opinion that the testing and assessment actions undertaken were adequate to characterize the Remediation Waste,in accordance with 310 ' CMR 40.0030.and that the facility or location can accept remediation wastes with the characteristics described in this submittal. I am aware that significant penalties includin but not limited to,possible fines and imprisonment may result if I wilfully submi i th I know to be false,inaccurate,or materially i complete. OF Signature: r� qua Seal: G" JOSEPH yG Date: I °`� / P. T SALVETTI License Number: 9546 No. 9546 ' a/STEQ`�� Fo sS � H. CERTIFICATION OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WIW ' BILL OF LADING: I certify under penalties of law that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this certification,and that, based on my inquiry of those individuals immediately responsible for obtaining ' the information,the material information contained herein is,to the best of my knowledge and belief,true,accurate and complete. I am aware that there are significant penalties, including, but not limited to, possible fines and imprisonment,for wilfully submitting false,inaccurate,or incomplete information. Signature: '^, F. l Name of Person nt): -J O ff`T' G ' Revised 10/1/93 This form is printed on recycled paper. Page 2 of 2 . 1 I Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Release Tracking Number: BILL OF LADING (pursuant to 310 CMR 40.0030) �- /0064 ( SUMMARY SHEET ACKNOWLEDGEMENT OF RECEIPT OF REMEDIATION WASTE AT RECEIVING FACILITY OR TEMPORARY STORAGE LOCATION: Fe'viFacility/Temporary M er-Env. Services ng ation Representative(print): David M. Peter / Title: Manager—Env.g c, Signature: Date: ACKNOWLEDGEMENT OF SHIPMENT AND RECEIPT OF REMEDIATION WASTE BY PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS BILL OF LADING: tta rtify under penalties of law that I have personally examined and am familiar with the information contained in this submittal,including any ail documents accompanying this certification, and that, based on my inquiry of those individuals immediately responsible r obtaining for information,the material information contained herein is,to the best of my knowledge and belief,true,accurate and complete. 1 am aware there are significant penalties, including, but not limited to, possible fines and imprisonment, for wilfully submitting false, inaccurate, or incomplete informatio Alm Date: o ( nature: 4�� Name of Persprint): J E'1 r'. vP`N S vised 10/1/93 This form is printed on recycled paper. Page 2 of 2 i ' BARDON ENVIRONMENTAL SERVICES PETROLEUM CONTAMINATED SOIL RECYCLING SUBMITTAL ' This cover sheet should accompany all requests and submittals concerning the transport and recycling of petroleum contaminated soils , as governed by DEP policies . SITE LOCATION CITY/TOWN : Osterville IF KNOWN: ' ADDRESS: 55 Old Mill Road _ DEP SPILL # : 4 10066 ' DEP CASE ' CONTACT PERSON FOR THIS SUBMITTAL NAME : Joseph P. Salvetti PHONE NO . : (508) 888-3900 THE FOLLOWING ARE NECESSARY FOR RECYCLING ' 1,. A Completed Soil Profile 2 . A Completed Bill of Lading with Original Signatures 3 . Analytical data from a DEP Certified Laboratory LICENSED SITE PROFESSIONAL STATEMENTS ' All soil samples were obtai ned fined in a manner that accurately and adequately characterize contaminant levels in the ' stockpile/soil mass under evaluation, as specified by DEP policies , and is in conformance with standard and accepted industry practices and procedures . ' Based upon site history information, the analytical data obtained, and an evaluation cf all other pertinent and available information, there is no evidence or reason to ' believe that this soil is contaminated with any RCRA Characteristic Hazardous Wastes or RCRA Listed Hazardous Wastes as from time to time amended . Pursuant to 310 CMR 40 . 0000 , I have personal lY- examined this submittal and am familiar with the information contained in ' this document and all attachments and that , based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the information is ' true, accurate, and complete . I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment . ' �(j 9 PRINTED NAME Joseph P. Salvetti L I TURE DA E AFFILIATION Fugro East, Inc, ' BTE /17A BARDON ENVIRONMENTAL SERVICES ' Petroleum Contaminated Soil Profile ' Generator's Name/Address : Estate of John F. Beavans Old Mill Road, Osterville Site Name/Address : 55 Old Mill Road Osterville, Massachusetts Current Use of Property: Residential ' (home, factory, etc. ) Past Use of Property: Residential (site history) Consultant 's Name/Address: d seph P_ Salvetti , Fugro East, Inc ' 90 Route 6A, Sandwich, Massachusetts 02563 Soil Contaminant : Gas , X No. 2 , Diesel , No. 4 , No. 5, ' No. 6, other, please describe ' Estimate of Quantity: 90 tons 60 cubic yards Source of Contamination: Underground Storage Tank, If other please describe: Residential aboveground storage tank release Soil Type: Sand (sand, gravel , etc. ) Printed Name Joseph P. Salvetti Sign u e Affiliation Fugro East; Inc. ' BTES/15 08-18-94 12:37PM FROM BARUON TRIMOUNT TO 915087752848 P004/004 ' BARDON ENVIRONMENTAL SERVICES PETROLEUM CONTAI+II1mATED SOIL ORNERATOR STATEMENTS ' FOR LIMITING OF ANALYTICAL REQUIREKENTS The fojllowing is required for any waiver of analytical testing based on ' D;epartment of Environmental Protection permits and policies. 1 . The source of the release of the petroleum contamination must be known. The petroleum and hazardous constituents of the petroleum released must be knorem. 3. The below items are required and must be certified by the generator. T, the generator, having used due diligence determined that there is no r;eason; to suspect or believe that the petroleum contaminated soil has been ' impacted by any releases of oil or hazardous materials other than that of the known source or I have identified the additional oil and hazardous materials that are suspected or known to be present in the soil , in addition to those associated with the known release, including any anthropogenetic ' c ontaxinants. ' 1 i, the generator realize that due diligence shall consist of a search of nforation and records reasonably available to the generator of the ' vonta19inated soil sufficient to make the determination. Such records and are not limited to, those of the generator, Information may include, but location of generation (i.e. facility if not the generator) the Departments ' Hureati of Waste Site Cleanup and the municipality (i .e. Board of Health, Fire Department) within Which the site is located, the generator have included sufficient information justifying the limits ' of this analytical requirements as part of the Site History Information accompanying the 21.E Bill of Lading or Material Shipping Record. This includes as a minimum, the following: ' the 1 analytical parameters selected; any screening analytical data (i.e. total data for TCLP, headspace data) ; the laboratory analytical data; a description of the release; ' a physical description of the soil including the classification method :used ' a description of the site location with regards to current and 'former :usage;; ,I T � '1 Gener.at r - Printed Paine '! 'Signature of Generator Date ' i18TES.':17B Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Release Tracking Number BILL OF LADING (pursuant to 310 CMR 40.0030) ( SUMMARY SHEET_._ OF_� � - /006 K. SUMMARY OF SHIPMENTS: DATE OF SHIPMENT: DATE OF RECEIPT: NUMBER OF LOADS SHIPPED: DAILY VOLUME SHIPPED(CU.YDSJTONS): -------------- ------i3 A y --------- -------------------------- -------- F-/ ------------ -------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ----------------------------- -------------- ---------------- ----------------------------- ----------------------------- -------------- ---------------- ----------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- --------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- --------------- --------------- --------------------------- ----------------------------- --------------- --------------- --------------------------- ----------------------------- --------------- --------------- ---------------------------- ----------------------------- --------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- --------------- -------------------------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- --------------- --------------- --------------------------- ----------------------------- SUMMARY SHEET TOTAL SHIPPED: J V BILL OF LADING TOTALSHIPPED(only if different): �evised 10/1/93 This form is printed on recycled paper. Page 1 of 2 Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Release Tracking Number BILL OF LADING (pursuant to 310 CMR 40.00301 SUMMARY SHEET_ OFR-1 SUMMARY OF SHIPMENTS: DATE OF SHIPMENT: DATE OF RECEIPT: NUMBER OF LOADS SHIPPED: DAILY VOLUME SHIPPED(CU.YDS.rTONS): ----= ------ --- � �y--- -----------/---- -------- -------a- , ----------- ------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- - ------------- ------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- - -------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- f------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- ------------- --------------- --------------------------- ---------------------------- ---------------- --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ------------------------=---- ---------------- --------------- --------------------------- ----------------------------- ------------ --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- ------------- --------------- --------------------------- ----------------------------- ---------------- --------------- ---------------------------- ----------------------------- - ------ - --------------- --------------------------- -------=--------------------- -=------------ --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- -------------- --------------- --------------------------- ----------------------------- ------------- --------------- --------------------------- ----------------------------- SUMMARY SHEET TOTAL SHIPPED: 1ILL OF LADING TOTALSHIPPED(only if different): used 10/1193 This form is printed on recycled paper. Page 1 of 2 Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Release Treckmg Number. BILL OF LADING (pursuant to 310 CMR 40.0030) a- /00 6 i SUMMARY SHEET_ OF SUMMARY OF SHIPMENTS: DATE OF SHIPMENT: DATE OF RECEIPT: NUMBER OF LOADS SHIPPED: DAILY VOLUME SHIPPED(CU.YDS./TONS): -1 ------ -� �� y-- --------- ------------- ------ 6�� ------------ - ------------- --------------- --------------------------- ----------------------------- ------------- --------------- --------------------------- ----------------------------- __ _____________________________ i_------------- --------------- --------------------------- ----------------------------- ________________ _______________ ___________________________ _____________________________ _______________ ___________________________ _____________________________ - ----------------------------- ---------------- --------------- --------------------------- ----------------------------- ________________ _______________ ___________________________ _____________________________ ______________ _______________ ___________________________ ____________-____________-___ ______ _______________ ___________________________ _____________________________ ----------------------------- ----------------------------- ______________ _______________ _______________________-___ -_____-_____-_______________- ________________ _______________ ___________________________ _______________ _____ _ -------------- ——————————————— —————————————————— _— --_ _--_------------------_------ ________________ _______________ ___________________________ _____________________________ ______________ _____________________________ _______________ _________-__-___________--_ ______________ _______________ ___________________________ _____________________________ SUMMARY SHEET TOTAL SHIPPED: !bF ILL OF LADING TOTALSHIPPED(only if different): vised 10/1/93 This form is printed on recycled paper. Page 1 of 2 Massachusetts Department of Environmental Protection 13WSC-012B Bureau of Waste Site Cleanup — Release Tr OW19 Numoer: BILL OF LADING (pursuant to 310 CMR 40.00301 U d I LOG SHEET OF ' I. LO NFORMATIO t t LOAD Signature of Tr sCjereresentative: e� i g a iry orary Storage Representative: r ' Date of ipm t: Time of Shipment: Time of Receipt: /-2--/ /22�A 1L*1 (circle one)am/pm — / / / gy �� :�•S Trur:k/Tractor Registration: Trailer Registration (if any): i ��C jl./� (circle one)a Load Size(cu.yds. ons �� J/V LOAD 2: Signature of Transporter Representative: Receiving Facility/Temporary Storage Representative: t t ' Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: /_ /_ (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): i (circle one)am/pm Load Size(cu.yds.Aons): LOAD 3: Signature of Transporter Representative: Receiving Facility/Temporary Storage Representative: r t ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm i _ /— /— Truck/Tractor Registration: Trailer Registration(if any): (circle one)am/pm 'r Load Size(cu.yds.Aons): ' LOAD 4: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: t t Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: ' (circle one)am/pm 11 Truck/Tractor Registration: Trailer Registration(if any): i (circle on am/pm t ' t Load Size(cu.yds.Aons): r LOAD 5: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: t t ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: t (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): t (circle one)am/pm t Load Size(cu.yds.Aons): LOAD 6: Signature of Transporter Representative: I Receiving Facility/Temporary Storage Representative: t E t ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: t (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): t (circle one)am/pm t Load Size(cu.yds.Aons): LOAD 7: Signature of Transporter Representative: Receiving Facility/Temporary Storage Representative: t ' Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/pm - t Truck/Tractor Registration: Trailer Registration(if any): (circle one)am/pm Load Size(cu.yds.Aons): J. LOG SHEET VOLUME INFORMATION: Total Volume This Page(cu.yds.Aons): Total Carried Forward(cu.yds.Aons): Tctal Carried Forward and This Page(cu.yds.Aons): ' Revised 10/1/93 This form is printed on recycled paper. Page 1 of Massachusetts pePartrnerf of £iWironrr]E»tai Prote*r:iorr B1NSty i2S 8ureau of Was#,Q Site Crearup �t MTl�! LA BIl<.L ofi' ( LOo SH£ETOF — -- 1. LOAD ittroRMAT10N: Fe par S Drape Agpr.ranrstive: , p rst�CtrP1r'taFrasAn:atr+e: �i' _..__ ' i Titre sJ E�eCe�pr ' p prnsrt rme of Shipment t C y 4/o ye mio one%arnhote l /--. J-- /� (]� ioaele ate) Tn.o,/rrreter Rsgiltnati�M Tiy7or Asqtrtratian �jt anyk j /-Y / 7 rJ ' � Rrioe�j FxiGylfernPr+►rW Rtaae�e Aeyesa�exiw►. t.oae J! gVaw e d Tr2n9Portor a.a►esenmdvw. i Cate e!Sector at>occipc Gate d SKvnem Time of Shiprrr.+t + •t ! J�- —/...�. /.._. (curse one)ar:dprn i (c:icle ono)&..+lpm Try. /mc:cr registratian: Regislraw.(if Wyk t toad Site(cu,yesJb"k LOAD 2s S•tgnaltrre d TMMporter Pev"wt-tine: {= Fect g paciEtylTan parary StompReFreattr>tatd+a ' Date at sftif:ncrtC Time ct i oao at►,acaict Tema et Asc.-ict (circle oft)amlPm t --/, J— -- ' 7Nc1VVffaCter aegisua8an: Tr:)lu Regtsiravan(rt tV+yr _ (�;relo one)antiF*n i L cad Sae("ydJtan4 LOAD 4: Slgnaar9 of TrWU;U er R¢prss mm dvct ± Racoivirsq f�i YITf F'��'!= afr!�'"p`o+tatsttrK t ' OSIs OI Shtprtt2nt; Tune a(�ti,'Xr+nnL' Qite of Receipt Tr ru Ot R�4ip (circle ere)ar.Vprn + (tie-is oral am" Trt�rl+rac:a tiec satian: TrJ;at RegivaDiott CHI 3nyr ` . Load Sftr;c..pe:lnrn): 1 LOAD S: Signature of-,ramsPatter R.prss.ntadve: i Rotoiving FaciiitylfE+nPersry Staape RsFreseerKathre: r + I ante a)5lnpntstla i rna of St, mr+�t i oats ad Rec:�t Tum of F*Ni t ' t —./� J� _../� /_ •�-.._ (�lo ono)t:eNpm tru�kRraalor FegisDr�Cn: Tra1C 4egi my-oft(a arlO (txcla one}arnfpdt Load sae(W.yds J m+ .. ' LOAD 6t StgAMwe of Trinapmter Rep:esentaire: i F4pe'ving P=7ayrf ry sage Ft►Xe+ : t Onto of St�eent: Tfe,.of SF:pnena Oa a of iieeaGe Time of RYCiiot: /- /_... (Chia otro)mlPm /-- ' Tnr<Wi?ataa Re�istraBctr TWO Pec44-A +(it ArV? ; {c�cJa am)attttpm Lead Sire(t tL yda.ilDms LOAD 7: Stgrmttvre of Transports mepamyurivct lteetyFrlrrg facNty/Tar»pocary 9lorege Repreaentatt�e' ' t t>s a d A"0c nets d Plece0c Date d Sf>tvR+erd: Tune e(sh+tr.:ent: , --•-- TnrWreeta d'iEgtWBUW: Trailer ReQw9an kit wyk {cfrcie a?�rtfpm Lwd Ste(cu.Ykft-,lP-qSX d. LOG SHEET VOLUME]ItFORIHFJiT10N: .ad V4Wum DO Pap(au.YdsAW0 Tatal Carmen Fptwam(csds yAtms): _ - +ew r.wead ry wsm sort rNa%ge(t:vydszan*r fiEY�52d 101 i193 i 1ys form is Arn,teC o:+mcyt►a0 Aa?af- tat ' TOTAL P.05 Massachusetts Department of Environmental Protection BWSC-0128 Bureau of Waste Site Cleanup Release Tradknp Numear. ' BILL OF LADING (pursuant to 310 CMrt 40.00301 i LOG SHEET OF ' I. LOAD INFORMATION: r r 1%0AD 1: Sid ture f Ttansporter resentative: r . ' ing cif' em or Storage Representative: � �EI✓]� ' Date of Shipment: Time Time of_Shipment: r of t: Time of Receipt: T � 1A /� � ��/h � (circle one)am/pm i g/QZ(��/ppqq� r 4,' -/O ` 3/ (circle ru.k/Tractor Regl tration: Trailer Registration (if any): r ( 'cle one)am� Load Size(cu.yds ons): -Z 3 1 45S LOAD 2: Signature of Transporter Representative: i Receiving Facilityrremporary Storage Representative: t r ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm _ /_ /_ Truck/Tractor Registration: Trailer Registration(if any): i (circle one)am/pm Load Size(cu.yds.Aons): LOAD 3: Signature of Transporter Representative: Receiving FacilityfTemporary Storage Representative: r r t Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/pm TruckfTractor Registration: Trailer Registration(if any): (circle one)&Wpm t ' r Load Size(cu.yds.Aons): LOAD 4: Signature of Transporter Representative: i Receiving Faciti /Temporary Storage Representative: 9 P P 9 ty r I ' Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/pm i _ /_ /_ Truck/Tractor Registration: Trailer Registration(i(any): i (circle one)am/pm r ' r Load Size(cu.yds./tons): LOAD 5: Signature of Transporter Representative: i Receiving Facilityfl'emporary Storage Representative: I t . Date of Shipment: rime of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm TrucWractor Registration: Trailer Registration(it any): i (circle one)am/pm r ' Load Size(cu.yds:Aons): LOAD 6: Signature of Transporter Representative: i Receiving FacilityfTemporary Storage Representative: I ! ' Date of Shipment: Time of Shipment: i Date of Receipt: rime of Receipt: r • (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): I (circle one)am/pm ' Load Size(cu.yds.Aons): LOAD 7: Signature of Transporter Representative: Receiving FacilityfTemporary Storage Representative: r ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm I Truck/Tractor Registration: Trailer Registration(it any): (circle one)am/pm Load Size(cu.yds.Aons): J. LOG SHEET VOLUME INFORMATION: Total Volume This Page(cu.yds.Aons): ' Total Carried Forward(cu.yds.Aons): Tctal Carried Forward and This Page(cu.yds.Aons): ' Revised 10/1/93 This form is printed on recycled paper. Page 1 of A)-M ' Massachusetts Department of Environmental Protection EWSC-0126 Bureau of Waste Site Cleanup Release Tradung Nurnaer. ' BILL OF LADING (pursuant to 310 CMR 40.0030) ( LOG SHEET=OF ' I. LOAD INFORMATION: r r LOAD is Sign t of Traspoe Repreentaive: i ' F ili orage Representative: Dates of Shipment: Time of S pment: r D Receipt: Time of ecei t: (circle one, pm Tnrr:k/TractgG Registration: Trailer Registration (if any): (circle an a m Load Size(cu.yd ons ' LOAD 2: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: t r Date of Shipment: Time of Shipment: Oats of Receipt: Time o1 Receipt: (circle one)am/pm _ /_ /_ Truck/Tractor Registration: Trailer Registration(if any): i (circle one)am/pm Load Size(cu.yds./tons): LOAD 3: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: r ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm It _ /_ /_ Truck/Tractor Registration: Trailer Registration(if any): (circle cne)am/pm t i Load Size(cu.yds.hons): LOAD 4: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: r ' r ' Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/pm rr _ /_ /_ • Truck/Tractor Registration: Trailer Registration(if any): i (circle one)am/pm r ' Load Size(cu.yds./lons): LOAD 5: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: r ' t Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): (circle one)amlpm ' i Load Size(cu.yds.Rons): LOAD 6: Signature of Transporter Representative: i Receiving Facility/Temporary Storage Representative: t i ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): r (circle one)am/pm r ' Load Size(cu.yds./lons): LOAD 7: Signature of Transporter Representative: Receiving Facility/Temporary Storage Representative. r ' Date of Shipment: Time of Shipment: i Date of Receipt: Time of Receipt: (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any): (circle cne)am/pm Load Size(cu.yds.Rons): J. LOG SHEET VOLUME INFORMATION: I Total Volume This Page(cu.yds./tons): ; ' Total Carried Forward(cu.yds.hons): Tctal Carried Forward and This Page(cu.yds.hons): ' Revised 1011193 This form is printed on recycled paper. Page 1 of ' APPENDIX F ' BORINGIMONITORING WELL LOG I SHEET r OF MONITORING WELL SAMPLING LOG CLIENTS DATE(S) z/Zy LOCATION �f� �J i� n f psr �•�-�� JOB NUMBER 33 Z V 3 MEASURING POINT SAMPLER GROUNDSURFACE O .O.0 ELEV.OF TOTAL STANDING WATER WELL REFERENCE DEPTH OF DEPTH TO WATER WATER TABLE STATIC' VOLUME HNU NUMBER POINT WELL HEIGHT ELEVATION VOLUME PURGED _101 COMMENTS FEET (FEET) (FEET) ( ) (FEET) (FEET) (GALLONS) (GALLONS) 1 _ OTES: �_•/�- / 'V st =n r2 h (7.48) WHERE: V= Volume in gallons r =inside well casing radius in feet h =standing water height in feet i ' o=o ® McClelland BORING / MONITORING WELL LOG BORIN G G NO. FM-1 ' SHEET 1 OF 2 Project Fuel Oil Assessment 16-23-3243 Ground Elev. N/A Location Off Old Mill Road Job Number Top of Casing Elev N/A ' Osterville,Massachusetts Boring Location 10'south of release site Ground Water Level Readings Geologist T.Bauer DATE DEPTH Drilling Contractor Desmond Well Drilling 2/15/94 N/A ' Driller T.Desmond Date(s) DRILLING METHOD ABBREVIATIONS ' Casio Hollow Stem Auger F-Fine F/C-F to C TR-Trace,0-10%g 1 1/4"x 24"Stainless Steel Slit S M-Medium V-Very LI-Little, 10-20% Sampler Split C-Coarse (+)-More SO-Some,20-35% F/M-F to M (-)-Less AND- 35-50% ' E SAMPLE GEN. FIELD INSTALLATION o e No. PenJRec. Blows/6' DESCR.SOILS SAMPLE DESCRIPTION TESTING LOG s 2'Black loam F/M SAND. Flush mounted 1 ' 1 - Topsoil 1'Brown M SAND,SO Silt BDL curb box set in 2 _ — (descril2tion off auger) cement 2 3 - Outwash 6"Brown M SAND,SO Silt, 4- S-1 24"/20" 4,2,4,5 12"Tan M/C SAND. BDL 1'Bentonite seal ' 5 - Outwash 2"ID PVC riser Cobbles at 6'.(difficult drilling) flush threaded 6- in natural ' 7 baddill. 8 - 9- S-2 24"/15" 14,17,17,22 1"Tan C SAND and GRAVEL, BDL ' Outwash 6"Tan F SAND LI M SAND, 10_ 8"Tan F/M SAND(stone in 2'bentonite seal. 11- split spoon). ' 12- 13- S-3 24"/18" 4,5,6,7 14- Outwash 18"Tan F SAND,intermittant 0,2 iron staining,SO moisture ' 15- 16- 17- ' �8- S-4 24"/14" 6,6,7,9 14"Tan M/C SAND,LI F SAND, BDL Outwash intermittant iron staining. 20- ' 21- 22- 23 2"ID PVC well ' 24 S-5 24"/16" 6,7,10,11 16"Tan M/C SAND. Sample wet BDL screen(2o slot) Ouwash at leadingedge of split spoon. 25- g P Po 10'long in No. 2 sand pack. 26- 27- 28- NOTES: ' 1.HNU results represent total volatile organic vapor concentrations(referenced to an isobutylene standard read as benzene)measured in the headspace of sample jars with an HNU-101 photoionization detector. Results are in parts per million(ppm). 2.BDL=Below Detection Limit of 0.1 ppm. awn U McClelland BORING NO. FM-1 BORING / MONITORING WELL LOG JOB NO- 16-23-3243 SHEET 2 OF 2 D SOIL N F SAMPLE GENS SAMPLE DESCRIPTION T. FIELD INSTALLATION 0 P T TESTING LOG K H No. PenJRec. Blows/6" DESCR. s ....... ....... ..... ...... 29- Outwash 15"Gray-tan C SAND,SO Gravel, BDL 30- S-6 18"/15" 822,30 wet. Sampler stuck at 18". Sand ....... ...... \heaving into annulus. .. . ....... 31- End of boring at 33'. Well set at 31'. X ..................... ...... .... xxxx ...... .... .............. .... ...... 32- ...................... ....................... 33- 34- I' NOTES: Annulus collapsed approximately Tabove screen level at ll'below surface. r, ? N --101--EXISTING CONTOUR CD o F ® X 1oo.98 EXISTING SPOT GRADE 52 21A' o � -G;-H•4V-UNDERGROUND WIRES 56 PG' PG• 0 Qa k �� -W-EXISTING WATER SERVICE g�(. 10082 01 P -G-EXISTING GAS SERVICE PL BYC Sect' x 127,5 TEST PIT EOOoth'(n ZZ LOCUS o BENCHMARK / d Main St LEGEND s 127,02 0 O ul /0•N 0 0 127.13 Wionno Rd '�9 Ave ' LOCUS MAP +-i27.2 NOT TO SCALE ', in9 _ �G fN126,96 x 127,2 Benchmark Set of <e PK. NAIL SET ON TOP edge TN EVENT : / OF LIGHT POST a' �EPL PSEME w EL.=123.30 (Assumed) +'125,55�o� `�\\ u.P. c000 P coo 4: 1 �126.55 24.87• �; :... u,12.520:'�.,. ._ .. // 126,89 123.8 ' d r a :.: r a23,33 .. 1 122r9.6: ` ..: GARAGE I H \ cn 1 12.2:,47 122.62 PROPOSED . . 2�,43 :�:.:..:. .;.., SEPTIC TANK cD W .'stone wall 12 4.3 5 �\� o t.,..: rT f` O M 121,33 121.49 124.28 0 �,2 ..121,47 , . SHR. x x -_ 10 21.28 \ � 1�26,54 121.1 Mop 141 1 :_ O : x 7.2OjQ Porcel 44 -12 F 121.30 1 0.54 Ac.±Msessor) `��` w \ 12r2.55 , r 12 L` j �i --. -.az �\ --72 T -DECK ,, j. • _ .-®`� _. ��..�- ::� �_ . .-; - :120,1 I ` x I 21' i - _ -7 120,8 71 f jL2.79 EXISTING ' _ % •�-2 ` HOUSE(#55) ` _ -', + T.O.F.=121.75f 12516 _7 ICLI61 I ( C --:�F 12,5'.15 85 t 125.10 , 01, \ x 123.5 I �. ` �� NOTE: WATER, GAS AND ELECTRIC SERVICES c` ENTER FROM FINGER LANE. -�-1-23------ x 123.1 94.08',•(DEED) - _ _ - - FENCE TINE (APPROX.) GENERAL NOTES: iz �� EXISTING CESSPOOLS 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ TO BE PUMP D & FILLED BOARD OF HEALTH AND THE DESIGN ENGINEER. U) W/SAND AN ABANDONED 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS Q Q I L I OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE W LOCAL RULES AND REGULATIONS. 1�� I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE y J. DESIGN ENGINEER. 3 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ui I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN > ENGINEER BEFORE CONSTRUCTION CONTINUES. p 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 0 ~I F THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. N I 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S. ,I 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE + DIRECTED BY THE APPROVING AUTHORITIES. 118.98 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING O O CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AND FOR 5' ON ALL SIDES OF la c�Q�\a OF MASS9Cy REPLACE WIIITTHB CLEAN HSAND AS SPECIFIED IN 3110 MRTHE 255(3).S. AND G PETER T. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE O I O McENTEE - INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. O (b o� CIVIL cn 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 35109 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. } I a) 'EGIST PROPOSED SEPTIC SYSTEM UPGRADE PLAN 118.02 E 55 OLD MILL ROAD, OSTERVI LLE, MA 2y-'7 1 l � G Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. CHARLES E. RILEY Engineering Works, Inc. 1"=20' P.T.M. 1.11-10 55 OLD MILL ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. OLD MILL ROAD OSTERVILLE, MA 02655 (508) 477-5313 2/27/10 P.T.M. 1 Of 2 I I NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:117.83 „ FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL H-20 RISERS, FRAMES & COVERS OVER INSTALL WATERTIGHT RISER & INSTALL INSPECTION PORT OVER END UNIT WITH T.O.F. INLET & OUTLET AND SET TO FINISH GRADE. COVER SET TO 6" OF GRADE PROTECTIVE METAL COVER SET WITHIN 3" OF F.G. (secure covers to prevent unauthorized access) F.G. EL 120.8(MAX.) CHARCOAL � EXISTING � F.G. E'�L.=121.Ot � F.G. EL: 120.8t /MAINTAIN VENT 2% GRADE MIN. OVER S.A.S. 11 BIAXIAL GEOGRID-BX TYPE INSPECTION L = 52'(MAX.) L = 2T L = 8'(MAX.) EXTEND 1 FT. BEYOND S.A.S. PORT ® S=1% (MIN.) 4"SCH40 PVC ® S=1% (MIN.) @ S=1% (MIN.) 12„ PLACE 4"SCH40 PVC 4"SCH40 PVC COUPLER 6"13._ AT END 10"I TO I 14" 6 10.38 T MANIFOLD VENT INV.=118.15 48" LIQUID INV.=1 17.37 LEVEL ADD 4 ROWS OF 5 UNITS AT 5.0'/UNIT = 25.0' GAS BAFFLE INV.=117.62 PROPOSED INV.=117.45 INV.=117.90 D-BOX Am d'm (4 OUTLETS) SOIL ABSORPTION SYSTEM (PROFILE) PROPOSED SEPTIC TANK MODIFY INTERIOR PLUMBING TO EXIT BIAXIAL GEOGRID / BX TYPE BUILDING AT, OR ABOVE, INV.=118.70 PRODUCED BY TENSAR CORP. ATLANTA GEORGIA RESTORED DRIVEWAY SURFACE COMPACTED, CLEAN GRAVEL BACKFILL BACKFILL WITH CLEAN PERC SAND 18" TOTAL COVER (MIN.) F_TP, TOP OF CHAMBERS BREAKOUT=TOP NOTES: TOP ELEV.=117.83.37 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=117 INVERTS, PRIOR TO INSTALLATION. 12" 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND BOTTOM ELEV.=116.50 I TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 5' MIN. SEPARATION 310 CMR 15.221(2). TO HIGH GROUNDWATER EFFECTIVE WIDTH=11.3' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE NO GROUNDWATER, EL=110.5 - MATERIAL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. USE 4 ROWS OF 5-ADS Arc 36HC UNITS PER ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE SEPTIC SYSTEM PROFILE UNITS MUST BE STAMPED H-20 TYPICAL SECTION N.T.S. SOIL LOG DATE: FEBRUARY 25, 2010 (REF.#12,842) SOIL EVALUATOR: PETER MCENTEE. (SE#1542) DECK WITNESS: DAVID STANTON-HEALTH AGENT f, Elev. -TP-1 Depth Elev. TP-2' Depth - H U7 T 7NG 5) 120.5 0" 120.5 0,. 'T.0.F.=121.75f FILL FILL 119.8 B g' 119.8 B 8' MED. SAND MED. SAND 1OYR 5/4 10YR 5/4 ENTRY 118.0 30" 118.0 30" C PERC C 42" C4 MED. SAND MED. SAND U' 2.5Y 6/4 2.5Y 6/4 C. FEW BOULDERS FEW BOULDERS I ------ 1 T P POSED A.S.i I I I 110.5 120" 110.5 120 S.A.S. LAYOUT I---25'--�1 PERC RATE <2 MIN/IN. ("C" HORIZON) NO GROUNDWATER OBSERVED 63.25" 16„ 34.5" DESIGN CRITERIA Al TOP VIEW' NUMBER OF BEDROOMS: 3 BEDROOMS 60" SOIL TEXTURAL CLASS: CLASS I END CAP END CAP DESIGN PERCOLATION RATE: <2 MIN/IN FRONT.VIEW SIDE VIEW END CAP DAILY FLOW: 330 G.P.D. REAR/TOP VIEW DESIGN FLOW: 330 G.P.D. NOTE: UNIT CONFIGURATION AND AVAILABIUTY SUBJECT SIDE VIEW TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY GARBAGE GRINDER: NO DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY H-20 4640 TRUEMAN BLVD Are 36HC DETAIL ( ) HILLIARD, OHIO 43026 H-20 RATED WITHLL1111JUM" PROPOSED DISTRIBUTION BOX: 4 OUTLETS MINIMUM ADVANCED DwvwiGE SMEMS,INC.. 18" MINIMUM COVER LEACHING AREA REQUIRED: (330) = 445.9 S.F. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 74 55 OLD _ MILL ROAD, OSTERVILLE, MA USE 4 ROWS OF 5-ADS Arc 36HC UNITS PER ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) Engineering by: SCALE DRAWN JOB. NO. (Arc36HC Units) 20 UNITS x 5.0 LF x 4.80 SF/LF = 480.0 SF Engineering Works, Inc. NTS P.T.M. 111-10 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74(480.0 S.F.) = 355.2 G.P.D. (508) 477-5313 2/27/10 P.T.M. 2 Of 2