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Home My WebLink About0040 WARREN STREET - Health 4OWARREN ., OSTERVILLE A=139.067—00 t o I I I a ,l it I � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street Property Address Spalding --- — — ---------- ------ — --—=— - Owner Owner's Name information is Osterville MA- 02655 — August 23, 2013 required for --- ---- State Zip Code Date of Inspection every page. City/Town Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: v only the tab key to move your Patrick M. O'Conneii ------ cursor-do not Name of Inspector use the return key. Septic Inspection Services Co.. ._. - ----- --- --.._...__...:_._....__....- -- -- ----..—=------- ------- Company Name r� PO Box 1487 -------- Company Address Marstons Mills MA 02648 enm City/Town -------- `State Zip Code ------ SI'12855 508.428.1779 ----- ---— 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 August 23 2013 Job# 13-76 Ins ector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of.1.0,000 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. Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 1 of 17 t5ins•3/13 W q (0l 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments'` �= 40 Warren Street M Property Address - —.— - ------ -- — Spalding -----Owner ------ ------------— ----------" Owner's Name information is required for Osterville MA 02655 Au ust 23, 2013 ------------ ---- �--- every page. City/Town 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: Tank was not in need of pumping at time of inspection. Leaching system showed no evidence of surcharge or saturation. _ 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. j 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); 15ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 2 of t7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal-System Form - Not for Voluntary Assessments 40 Warren Street Property Address Spalding Owner Owner's Name - --------- ---------------------------_---------- _ e information is required for Osterville MA 02655 August 23, 2013 every page. CityrTown State Zip Code Date of Inspection B. Certification (Cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. t B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced , ❑ Y ❑ N , ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N. ❑ ND (Explain below); ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N' ❑ ND (Explain below): ❑ obstruction is removed ❑ .Y _ ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further,evaluation by the Board of Health in order to determine if the system is failing to protect public health,, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3113 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 40 Warren Street Property Address Spalding Owner Owner's Name ---- ---------..------------------ -- --information is Osterville MA 02655 Au ust 23 2013 required for ------------- --------- ------- ---.. -�---' — — every page. City/Town State Zip Code Date of Inspection B. Certification (cont) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) ` determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the-SAS is within 100 feet of a surface water supply or tributary,to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has aseptic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**: Method used to determine distance:, ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen c,: 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 EJ ® Static liquid level in the distribution box above outlet irtvert due to an overloaded or clogged SAS or cesspool ; ® Liquid depth in cesspool is less than 6".below invert available volume is less than day flow il .!.11 15ins•3/13 Title 5 Official inspection Form Subsurf a Sewage Disposal System'•Page 4 of 17.:- .i e . . .. .. � � � _ f .� - e � � ., .. .�. s . i Commonwealth of Massachusetts Title 5 Official. Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street Property Address ----------- --_- _ ---_--- Spalding Owner Owner's Name ` information is Osterville MA 02655 August 23, 2013 required for — -- every page. Cityrrown 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.] I ❑ ® 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 facilitywith a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ 0 the system is located in a nitrogen sensitive area (Interim Wellhead Protection -Area 7IWPA)'or a mapped Zone Il,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. 15ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street _. Property Address Spalding Owner Owner's Name information is required for Oery g stille MA 02655 Au ust 23, 2013 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? r ❑ ® 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 examinpd? (if they were"not available note as N/A) ® ElWas 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 Systen= (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 1.5.302(5)) D. System Information Residential Flow Conditions: , Number of bedrooms(design): 3 --- Number of bedrooms (actual): 3 DESIGN flow based on 310"CMR 15.203 (for example: 110 gpd'x #of bedrooms),-. 330 t5ins-3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 6 of 17 . Commonwealth of Massachusetts Title 5 official Inspection Forml Subsurface Sewage Disposal System Form - Not-for Voluntary Assessments «., 40 Warren Street Property Address --_--- Spalding Owner Owner's Name information is 9 required for Osterville MA 02655 August 23, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspectfc ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 usage d N/A Irrigation 9 ( years. 9 (gp ))` system.' Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown 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? c ❑ Yes ❑ No �. Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: —--- 15ins•3/13 Title 5 Official Inspection Form.Subsurface sewage Disposal System•Page 7 of 17 L ,. Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street Property Address f Spalding P 9 Owner Owner's Name — ---information is Osterville MA 02655' 'August 23, 2013 required for = 9 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: " Date Other(describe below): General Information Pumping Records: , Source of information: None 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): 15ins'•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 8 of 17- i Commonwealth of Massachusetts - Title to f 5 ® facial InspectionForm rm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street Property Address Spalding Owner Owner's Name information is August Osterville MA _ 02655 Au 23, 2013 required for _ 9 every page. Cityrrown State. Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): Depth below grade: feet Material of construction.- El 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: 14" feet Material of construction; ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)' If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10.5' lon; x 5.8'wide- 1500 gal H2O load rated. Sludge depth: 2„ t5ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 9 of 17 s , i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . wM 40 Warren Street Property Address -- Spalding Owner Owner's Name --- -- information is g Osterville MA' 02655 August 23, 2013 required for ,b _ � every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) ` Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 13"- How were dimensions determined? 4 'Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition; structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.) Liquid level was found at bottom of outlet invert and tees were intact.v Grease Trap (locate on site plan): Depth below grade: feet t Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(ezp(ain): 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 5 Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 ®fficial Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 40 Warren Street Property Address Spalding _ Owner Owner's Name information is g required for Osterville MA 02655 August 23, 2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc..): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal. ❑ fiberglass ❑ polyethyiene ❑ 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 a t5ins-3113 Title 5 Official Inspection Form.Subsurfa,.:Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form p Subsurface Sewage Disposal System Form-,Not for Voluntary Assessments 40 Warren Street Property Address Spalding Owner Owner's Name information is .�required for Osterville MA'` 02655 Au ust 23, 2013 _ every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened).(locate on site plan): 011 Depth of liquid level above outlet invert 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.): No solids or high stains present. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No'' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc:): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on,site plan, excavation not required): If SAS not located;explain why: ` 15ins;3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•'Page.i2 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 40 Warren Street Property Address Spalding Owner Owner's Name information is Cisterville MA 02655 August 23, 2013 required for _ _ g every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: Three 500 gal. ® leaching chambers number. drywells. ❑ 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 pondin5, damp soil, condition of vegetation, etc.).- Leaching chambers showed no signs of saturation or surcharge. Chambers,were not excavated due to underground utilities in area. Cesspools (cesspool must be pumped as part.of inspection) (locate on site;plan); Number and configuration,, — Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow [' Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-.Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form Not for Voluntary Assessments, H 40 Warren Street Property Address — - Spalding Owner Owner's Name information is Osterville MA 02655 August 23, 2013 required for _ g every page. Cityrrown State Zip Code Dal!,,,of Inspection D. System Information (cont.) Comments (note condition of.soil, signs of hydraulic,failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan)': Materials of construction: Dimensions Depth of solids - Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition'of,vegetation, etc.): _ r ISins•313 Title 5 Official Inspection Form Subsurface Sewage Disposal System Page 14 of 17 • Commonwealth of Massachusetts q Title 5 Official Inspection Form IR Subsurface Sewage Disposal System Form Not for Voluntary Assessments a 40 Warren Street Property Address __....__. ...__ Owner _ _ Owner's Name information is required for Ostervllle MA 02655 August 23, 2013 every page. Cityfrown 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 440'!`` 5 Porch 3 6 35 66 X , 33 43 Warren Street • Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not_for Voluntary Assessments 40 Warren Street Property Address Spalding Owner Owner's Name information is g required for Osterville _ MA 02655 August 23, 2013 _ _ _ 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 ground water: 20+ , feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: - Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) " ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: All ponds in area are considerably lower in elevation than SAS. Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•'3/13 Title 5 Official inspection Form Subsurface Sewage Disposal System•Page 16of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Warren Street Property Address -- Spalding Owner Owner's Name information is required for Osterville MA 02655 August 23, 2013 every page. City/Town 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 Syster)s) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file ,p t5ins 3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 17 of.17 CENTERVILLE-OSTERVILLE-MARSTOAS MILLS FIRE DISTRICT 1875 ROUTE 28 CENTERVILLE, MA 02632 (508) 7130-23801FAXC(508) 790-2385 OILMAZARDOUS MATERIAL RELEASE FORM F.A.# a�- �' - O"I I LOCATION: ADDRESS DF RELEASE• AA. I-A)A&.QCc.,,� DATE OF RELEASE' /ri Iq1 PRODUCT RELEASED IL, ESTIMATED QUANTITY'.- ,,,-,._ CORRECTIVE ACTION TAKEN BY RESPONSIBLE P ARTY-474.0 i2a�p A-gg;4 :g� NOTIFICATIONS: FIRE DEPARTMENT YESk) NO(' ) D ATE: IC)- �°"� T IME: � r 25 NATIONAL RESPONSE CEO ER YESJ ) NO( ) DATE_4. TIME: %___ ,,. 4 DEFT.OF ENVIRONMENTAL PROTECTION YES( ) NO ) DAT�r�TlP'lgr I y e4 OIL SPILL COORDINATOR: YES( ) NO,� DATE TIME: - TOWN BOARD OF HEALTH: YE% ) N0('j DATE gip,. �, TIME;Ar=_ TOWN HARBORMASTER: YE� ) NO(, DATE:v—' TIME: w OTHER AGENCIES: t COMMENTS `l am IE if 4 rg'O� r r ♦ a e a irr a f e . .�_...,-., ♦ --v y v—r. .rV +w.'a vAi 4.� r G.».ice t—GSG.+ Ge'sr`i a i_i•� _•v -r+ i ii ae's�'s`!r9`9.9e !yr 1�ag g 1 r 6�r ro`� r..:�►f f►--e ■s 7 F REPORTffBY. ATE: , —t a -=3 WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.EP. PINK COPY-BOA,1}OF WrALTH C-O-MM FORM #58 COMMONWEALTH OF MASSA CHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 40 Warren StreetS I Osterville MA 02655 a Owner's Name: Scott Ruddrick t Owner's Address: Date of Inspection: Sebterirber 12 2008 Name of Inspector:(Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 `o Osterville,MA 02655-0049 t Telephone Number: (508) 862-9406 CERTIFICATION STATEMENT 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 N ds Further Evaluation by the Local Approving Authority Fi Inspector's Signature: Date September 17 2008 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 I0,000 . 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. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page I �V Dom' Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any'of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Answer yes,no or not determined(Y,N,ND)in the. 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with - approval of Board of Health): broken pipe(s)are replaced obstruction is removed 'distribution box is leveled or replaced ND explain: ` 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 obstruction is removed ND explain: 2 Ir Page 3 of 11 t OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 Warren Street Osterville, AM Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to detennine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 colifon-n bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: 3 Ir . Page 4 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 D. System Failure Criteria applicable to all systems: You must indicate either"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 ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] No (Yes/No)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 System:. To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. 4 Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 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: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Tart C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 f Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 40 Warren Street Osterville. MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#'of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): n1a Is laundry on a separate sewage.system(yes or no): n1a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Weekend use COMMERCIAVINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): epd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: unavailable Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 5161'02-as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 40 Warren Street .Osterville. MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 BUILDING SEWER(locate on site plan) Depth below grade:. Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Commments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth.below grade: 16" Material of construction: ✓ concrete _metal fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confinned by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. H-20 Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 2" Distance froin top of scum to top of outlet tee or baffle: 6" Distance from bottoin of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.):. Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage. Recommend installing steel cover to grade on outlet cover so outlet filter can be cleaned/serviced. GREASE TRAP: None .(locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments (on pumping recorn mendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued) Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal fiberglass _polyethylene _other(explain): Dimensions: r Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Coimments(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.): The D-box was clean. No solids were present. The D-box is under the asphalt driveway, a camera was used for the inspection PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Coranents(note condition.of pump chamber,condition of pumps and appurtenances,etc.): { 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 40 Warren.Street Osterville, MA Owner's Name: Scott Ruddrick- Date of Inspection: September 12, 2008 SOIL ABSORPTION SYSTEM(SAS): . ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: / leaching galleries,number: 3-flow diffusers 11'x28'per as-built 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.): The flow diffusers were clean. There did not appear to be any signs offailure.A camera was used for the inspection CESSPOOLS: None (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: Dnnensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. 1 GArAgL /3 I , a y o a 3 1 33 3� ,S 0 a 33� &lo 3 y3` 3S t/ !o!o l S S '70 3 I 10 ' Page 11 of 11 OFFI CIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART.C SYSTEM INFORMATION(continued). Property Address: 40 Warren Street Osterville, MA Owner's Name: Scott Ruddrick Date of Inspection: September 12, 2008 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 20+/, feet Please indicate(check)all methods used to determine the high ground water elevation: t Obtained from system design plans on record-if checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Topographic and water contours snaps Checked with local excavators,installers-(attach documentation): Accessed USGS database-explain: You must describe how you established the high ground water elevation: . Using Barnstable topographic and water contours maps the maps were showing approximately 20'+/-to groundwater at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied relating to the septic system, the inspection, this report and/or any components of the septic systent which have not been located and inspected. 11 "00- ' u TOWN OF BARNSTABLE La)CATION 1 O WAf(e/\ ST SEWAGE# VILLAGE O MrV,L ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY a0 LEACHING FACILITY:(type) 3 Plow D I ZU ScU(size) N X a$ NO.OF BEDROOMS 3 .OWNER. Rug�tuk PERMIT DATE: 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 leaching facility). feet FURNISHED BY ^1l S t,�"Ci 0/1 F (J q h a lo? i i GArAgt,, .13 A_ Porch +� p yo a o A 13 3` a 33� yo S � ` S 3 y3 3 S 70.. 31 .(�J Ur`dP�IV TOWN OF B STABLE G+ a LOCATION NNf wrV i (OU 7. VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&`Q'P�HONE NO.�`3 V� �t SEPT C T AN CAPACITY 1 S O O OICA},g11-1 '\ -2=0� LEACHING FACILITY: (ty4- 9- Z ;ouI iatilSQ (size) NO. OF BEDROOMS ` ` n B LUDER OR OWNER.{ . Q, ! 1 Yr L PERMITDATE: ` {O ' O 2 + .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 leaching facility) Feet Furnished by f :&^Wag • '• ♦�.ems I t A] -vp DB 3 4 - 3`• e n�15 3.5 on tides • Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t/ es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppYication for ]h9po.0ar Opotem Conotruction Vertu Application for a Permit to Construct(Y)Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. V01Q 424 Be-V Sr Owner's Name,Address and Tel.No. os7—C Js c.c� , sZs et /'EC& .Ico.r,, T,ecc.sr- ap/Parcel �� Co 4 nz�W ST Assessor's M D C r-�2�/sCe E Qzlo 3� 3�hP�ar Po,e Hoar o< rx.a t i33 �'� ' 4 08' 7 ir�s�z Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. A. .ems, A-sso G', s�C' ?0 3&1C gwca J - l,�Q.eJ�I aGQ;� is'•a-��s r�-:3eE, �c s� oz6 so S� 3azS �3z Type of Building:"� 'VW Dwelling No.of Bedrooms 3 Lot Size 99-r' s`-*'C:' sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow d 1.0 PC-.e gallons per day. Calculated daily flow 33 D gallons. Plan Date ,1.3 La Number of sheets Revision Date Title scc'8-T&evAdc S�tJas� ��s�vaa� aa-iG.ci Size of Septic Tank iso�a Type of S.A.S. ta �D�E—��c somas Description of Soil a4i Ac-e--y 4- 7'-e 9368 Nature of Rep or Alterations(Answer when applicable) 6 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afo ed on-site sewage disposal system in accordance with the provisio f Title 5 of the Environmental Code and not t plac the em in operation until a Certifi- cate of Compliance has been i b s Bo d o th. �' 2 16 ,0 Signe Date Application Approved by Date Application Disapproved for the following reas s - Permit No. M1 "�_ Date Issued _ _411 No. ► + a "► Fee O / Fl COMMONWEALTH OF MASSACHUSETTS Ent redincompu;er: es PUBLIC HEALTH DIVISION -.TOWN OF BARNSTABLE,MASSACHUSETTS Ztpprication for ;Diopozar *pgtem �Conztructian Permit Application for a Permit to Construct(Y)Repair"(:.)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address oc Lot No. elflA Owner's Name,Address and Tel.No. QST`r"x'.rlr c.cE:�-�`-ram rt �'Eet .ilo�s•i. T.e4 sr Assessor's Map/Parcel Coy' , 19 Mary sT� Ce�P-e �/rc�E 6?—Z6 T * VCW �oerroti o� rr /39 6�-t)�� OVE, AP3- *V1= Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. e✓re-3ok f+sSo n, r�rC' ' � �ve �L�C�� pEs�lrsrxr'3'c�, srr�s 4s�30 Type of Building: `r rc fit Dwelling No.of Bedrooms 3 Lot Size 99-el V sq.ft. Garbage Grinder( ) Other TI pe of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures j Design Flow gallons per day. Calculated dailyllow U3 40 gallons. Plan Date Number of sheets / ` Revision Date Title Su 3 S fi,e�A[+E SEGcI<t 6� ��SF'o 5 C �E.�s iG�(r Size of Septic Tank /%I_0 O 9cl / Type of S.A.S. moils® s Description of Soil s� cots oa. ,P4AxI is 9348 Nature of Repairs or Alterations(Answer when applicable) �b ' Date last inspected:!. Agreement: The undersigned agrees to ensure the construction and maintenance of the afo fides �ed on-site sewage disposal system in accordance with the provisiof Title 5 of the Environmental Code and not t plat thetem in operation until a Certifi- rJcate of Compliah'ce has,den i b 's Bo Ad o 1 .� Signe Date Application Approved by n yf Date Application Disapproved for the following reas s t - R Permit No. "-- Date Issued THE COMMONWEALTROF MASSACHUSETTS t BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(L/ )Repaired( )Upgraded( ) Abandoned( )by Lf0 u5 I;;- at vf/f s% os7e-;e_0.e_r-dF baspleen constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NV. '� dated Installer Designer *. nt. cJr c sc 5� 14 s sc>n, .c'V The issuance of his p rmit shall not be construed as a guarantee that the sy m will fu tion as d i ned. Date -7122 ! Inspector - P. No. --------------------------Fee- v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Xigpogat *pztem Conotructton Permit Permission is hereby granted to Construct Repair( )Upgrade( )Abandon( ) System located at / ev-%(/ ST. asT�-ram y�c c- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. ' . Provided:Construction must be completed within three years of the date of this permit. Date: S. h Approved by �i✓ TOWN OF B STABLE rc- LOCATIONA A n L) SEWAGE #�,00 Yb VILLAGE ASSESSOR'S W & LOT i INSTALLER'S NAME&PHONE NO. SEAL TANK CAPAC ISO LEACHING FACILITY: (type y— fllnl (size) NO. OF BEDROOMS • SS ` r / /; �p Q i BUILDER OR OWNER:I11IJ Q. PERMITDATE: O 2— ' 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 leaching facility) Feet Furnished by l i j _33` ° 4 -iv l� i , #�ZCs • 'DB 3 Ru F rw S Vil - - AM CENT OST FIREDEPT 50879023E P.01 X4 rue Department retains original application and issues dup5cate as Permit a APPLICATION and. PP.RMIT Fep: for storage tank rerncynj and transportation to approved tank disposal yard in accordance with:the provisions of M.G.L. Chapter 1A8,Section 38A, 527 CMR 9.00, application is hereby made by: FQwner Silvia & Silvia Builders Tank 14arne(please print) X Address 44 Warren Avenue, Osterville, HA 02655 -- _ sr car SZare Co Name Advanced_Environmental Advanced Environments) nY Co.4:tadrvidual_ PAN FiYnr — P-0. Box 472, S. Dennis, MA PMtAddress -_-=- - Address Signature(Tap*ng atr:em-A). Signature(if applying fcr :errnk) 1 rt�fp--- r IFCi Certified = LSP# _ .other Tani:Location 44 Warren Avenue, Osterviile, MA 02655 Steer Aedrrss �� Tank Capacity(gaiicns: 275 Substance Last Store- #2 Fuel Oil Tank Oimen_gons(ifer-mer x length) Remarks: i Firm transpatingwaste Advanced Environmental State Lic. # HAV5083856100 Hazardous waste mane ? E.P.A. # Appruved tank ctlsposd_rard - J.G. Grant Tank yard# 03501__ Type of inert gas Tank yard address Readville.% MA •. . . Centerville 01920 City or Town; FDtD# Permit# Date of issue October 9, 1997 _ pate of expiration October 23, 1997 Dig safe appia nwbL— 974006506 Dig Safe Tdl'Free Tel.Number-860,102-4844 Signature!Title of Office'3anting permit After removals)'send Fcgm=?-290R signed by Local Fire Cept.to UST Regulatory Compliarx-s Unit,One AshbcroDn Place, Room 1310. Boston,,MA C2 08-1618. TOTAL P.01 COMMONWEALTH OF MASSACHUSETTS Y Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION . SOUTHEAST REGIONAL- OFFICE ARGEO PAUL CELLUCCI BOB DURAND Governor Secretary CI Y JANE SWIFT ® DAVID B.STRUHS Lieutenant Governor O e Commissioner May 0;.1999 : Mr.Floyd J. Silvia RE: BARNSTABLE—BWSC/ASM-4=14017 LIS Corporation 44 Warren Avenue, Osterville 619 Main Street NOTICE OF AUDIT%REQUEST FOR Centerville, Massachusetts 02632 '< INFORMATION/SITE INSPECTION NOTICE OF AUDIT,: This is an important.-Notice. Promptly respond to any requests,contained herein. - Dear Mr. Silvia: t' Massachusetts General Law Chapter 21 E requires the Massachusetts Department of Environmental Protection, Bureau of Waste Site Cleanup ("the Department"), to audit response actions not overseen or conducted by the Department at sites of releases of oil or hazardous material`to ensure that these actions are being conducted according to'M.G.L. c. 21E, the Massachusetts Contingency Plan ("the.MCP"), and other relevant laws and regulations. The MCP at 310 CMR 40.1100_establishes procedures for conducting such audits. The Department has randomly selected the site referenced above for an audit. The audit will be conducted by Department staff of the Southeast Regional Office in Lakeville. The audit will initially focus on the Class A-2 Response Action Outcome Statement(RAO)prepared on your behalf by Geoffrey R.May, LSP #5755 of McCulley, Frick and Gilman, Inc. Additional response actions'may„also be evaluated as appropriate. This Notice describes the scope of the audit and the type of audit activities the Department initially intends to perform along with your responsibilities and relevant deadlines. A fact sheet and flow chart, included in this Notice as enclosures one and two, describe the audit process. Note that, during an audit response actions can proceed as planned unless you are otherwise notified by the Department. a• _ x,;..�a�: +; '+ a s.Ww'+f3;,r m a.�,,.. ax^tt ,ee•.. .,�. ..v.. .. � ., ._ _ ., a r- .. J. .e. .. - i 20 Riverside Drive•Lakeville,Massachusetts 02347• FAX(508)947-6557•Telephone(508)946-2700 This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. DEP on the World Wide Web: littp://www.magnet.state.ma.us/dep is Printed on Recycled Paper 2 REQUEST FOR INFORMATION Pursuant.to M.G.L. Chapter 21 E §§ 2, 4, and 8, 310 CMR 40.0165, and 310 CMR 40.1120(1), the Department requires you to provide the information listed below. Y.ou must,prepare written responses to each item and deliver such responses to the Department within seven calendar days of your receipt of :this Notice.:t.Turthernibre your,response:must'contain:a-completed Certification;o..f.Submittal as specified in 310 CMR 40.0009. A copy of.the Certification is included as enclosure'three:; r' If you do not have any' portion.of the information,requested, in your possession, custody, or control, you must state this in your response and identify the person/s, if known to you, from whom the information can be obtained. You must follow the procedure described in 310 CMR 40.0165(3) if you claim any information submitted is a trade secret or otherwise exempt from public disclosure. DO NOT IGNORE THIS REQUEST. Failure to respond to this request or the submission of false or misleading information may subject you and your officers and employees to enforcement action by the Department'. .. r site.A copy of this request has also been sent to the LSP for o you s to You may consult with an LSP ur LSP are obligated to when preparing a response to this request. Note, however, that you, not .your g P P g P q Y Y respond to this request. Send your complete response and required certifications to this request to: Robert C. Murphy 20 Riverside Drive Lakeville, Massachusetts 02347 The'deadline given-for a fesponse to this request"is an "Interim Deadline" enforceable-under 310 CMR 40.0167. You may request an extension"of this deadline in writing to the Department auditor listed above. The Department, however, is not required to grant a request for an extension. 4 l provide the Department an Note that you are obligated under 310 CMR 0.0165(2)to promptly p o p y information relevant to this "Request for Information" and correct any errors in your response to this "Request for Information" at any time in the future when you discover such information or errors. The Department hereby requires the submittal of the following documents. Based upon the. Department's evaluation of these submittals, further audit actions may be indicated. 1. In compliance with 310 CMR 40.0318(3), documentation concerning the removal of the 500 gallon Underground Storage Tank (UST) should have been retained. Please submit copies of records documenting the proper removal of the UST and disposal of any remediation wastes associated with the removal. Submit a copy of the removal permit, UST disposal certificate and any manifests generated or associated with the UST cleaning. The copy of the Bill of Lading (BOL) enclosed in the Response Action Outcome (RAO) was unreadable and incomplete. Please submit a complete and legible copy of the BOL with all required signatures. 2. Information`contained in the RAO includes reference to soil screening conducted during the UST removal. Submit copies of all soil screening results generated to date in association with the release. 3 3. The site schematic included in the RAO did not include specific soil collection points to include the location of soil samples S-101 and S-104. Submit a site schematic with the " 1ocafion,of all soil sample collection-points , J ' 'The"extent of,th&e area,subject to::the RAO-was novdelineated �,The�ektent..ofAhe.:area subject to the'RAO shouldtbe,delineated on:the:Site'schematic:,,.y, In addition to the above; please submit anyadditional documentation associated with the'response actions performed at the site not previously submitted to the Department which you would like to be included as part of the audit. Any submittal made in response to this Notice.must contain the enclosed certification of submittal per 3 1 0CMR40.0009. REQUEST FOR SITE INSPECTION Pursuant to M.G.L.c. 21E §§ 2,4, and 8, 310 CMR 40.0166,'and 310 CMR 40.1.120(1) employees,' agents, and contractors of the Department may enter any site or vessel to investigate, sample, or inspect any documents, conditions, equipment, practice, or property as part of the audit. The.Department requests an appointment to inspect the site on May 26, 1999,at 1:00 p.m.,to discuss issues relevant to this audit. The inspection will be conducted by Mary Ellen Smith and Bob Murphy of the Audit and Site Management Section. Your LSP is requested to attend. Please call Bob Murphy within seven (7) days of receipt of this Notice at(508)946-2788 if you will need to arrange an alternative date or time. w At the completion of this phase of the audit, the Department may; Issue,a`Notice:of Audit Findings.,that,may.include a;statement of violations,gr deficiencies and steps to:correct-those violations or deficiencies.,,µa ra. 17, (2) Request"a meeting with you,.and if you,choose, a representative,to discuss:response actions and other supporting evidence to demonstrate compliance and then issue a Notice of Audit' Findings. (3) Conduct further site investigations and then issue a Notice of Audit Findings. (4) Issue a Notice of Audit Findings that sets an Interim Deadline to correct violatiais or . deficiencies or to prepare an Audit Follow-up Plan. (5) Initiate enforcement actions listed at 310 CMR 40.1140(2) if violations of M.G.L. c. 21E or the MCP have been identified. If you have any questions regarding this Notice or any of the requirements contained in it, or believe that you cannot comply .with its requirements, please contact Bob Murphy at (508) 946-2788. The Department appreciates your anticipated cooperation in this matter. Very truly yours, Mary Ell S ith,Branch Chief ' ;c t ui*v. e,.,c, `.+'�..i., . .,. .>_. .. ""°., .:Audit and Si Management..Sectiijon , 1. MES/RCM/ka } 4 CERTIFIED MAIL NO.Z 539 134164 RETURN RECEIPT REQUESTED Enclosures: (1) Fact Sheet (2) Flow Chart (3) Certification of Submittal cc: Board of Selectmen Town Hall 367 Main Street Hyannis, Massachusetts 02601 Board of Health Town Hall 367 Main Street . Hyannis,Massachusetts 02601 McCulley,Frick and Gilman 500 West Cummings Park, Woburn,Massachusetts 01801 ATTN: Geoffrey R.May,LSP DEP-SERO ATTN: Data Entry DEP-Boston ATTN: Tom Potter I M providing environmental 500 West Cummings Park. consulting and Suite 1050 Woburn,MA 01801 p engineering services 781/937-0500 Fax: 781/937-0578 G \. McCulley Frick 8c Gilman,inc. November 3, 1998 MFG Project No. 5539(l 1) Board of Health Town of Barnstable PO Box 534 Hyannis, MA 02601 RE: Response Action Outcome Statement 44 Warren Avenue Osterville, Massachusetts RTN 4 - 14017 Attention;'=Board':'of Health '' h"t Y}' .Orisbelalf of our client;LIS Corporation, McCulley, Frick, & Gilman,.Inc. (MFG) is providing this notice that a Class A2 Response Action Outcome Statement has been filed with the Southeast Regional Office of the Massachusetts Department of Environment Protection. t Asper 310 CMk 40.1403(3)(f)we are providing this notice to you. If you would like to receive a copy of the Response Action Outcome Statement, you may contact us at the letterhead address. If you have any questions please do not hestitate to call,us at 781-937-0500. Very truly yours, McCulley,Frick,` Gil' n,Inc: fre May,.P..G:, L.S'.P: Senior Geologist rE:- P.i:t-' I ° C,� tCdF a Po Ei ..fi, fr? Ffr. +.l o!i `Cf. i,: ky,� r� 1EvF_ ra , r• 7:1f�{ A a cc.MA0EP'/SV7"','. '} LIS Corp. ``Barnsthbl'e�BOH''�_`r`�•`_�� ' �c9 ecyct d Albuquerque,NM•Austin,TX•Boston,MA•Boulder,CO•Missoula,MT•Port Lavaca,TX•San Francisco,CA•Seattle,WA•Wallace,ID o-`P' ea L__ f COMMONWEALTH OF MASSAC1 USETTS G F EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE V ARGEO PAUL CELLUCCI TRUDY COXE GovernorC OPY Secretary DAVID B.STRUHS Commissioner URGENT LEGAL MATTER: PROMPT ACTION NECESSARY:` CERTIFIED MAIL: RETURN RECEIPT REQUESTED September 2, 1998 LIS Corporation }. RE: ` BARNSTABL-BWSC ' 619 Main Street 44 Warren Avenue Centerville, Massachusetts 02632 RTN# ,4-14017 u. ?'- NOTICE-, OF- RESPONSIBILITY .y. M -G- L. c . 21E 310 CMR w40 0000 ATTENTION: Floyd J. ^Silvia{ On June 24, 1998, the Department of Environmental Protection (the "Department" ) -. received. a Release Notification Form ("RNF" ) which indicates that _ a ' release of oil , and/or hazardous- material has occurred at the location referenced above . The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan (the "MCP" ) , 310 CMR 40 , 0000, . require ..the performance of response actions to prevent harm to health,, safety, public welfare and. the environment which may result, from this .release and/or threat of release and govern the conduct of such actions . The purpose -•of---this• -notice --is , to- nform you of your legal, responsibilit-ies, -under - ..State, law.-., fora assessing and/or remediating the release at' this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and :phrases ' by; the MCP unless the context. clearly indicates otherwise 20 Riverside Drive•Lakeville,Massachusetts 02347• FAX(508)947-6557•Telephone(508)946-2700 This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. DEP on the World Wide Web: http:/twww.magnet.state.ma.us/dep ��Printed on Recycled Paper 2. The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as .defined*, by the M.C. P. The Department also has reason to believe that you (as used in this letter, "you". refers to LIS Corporation) are a Potentially Responsible Party (a "PRP") with V liability under M.G.L. c.21E §5, for response- action costs . This . liability is "strict" , meaning that it is'' not' based onfault, but solely on your status as owner, operator, generator, transporter,, disposer or other person specified in - M.G.L. c.21E §5 . This liability is also "joint and several meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties . The Department encourages parties with' liabilities. under,,- M.G.L. c .21E to- take prompt and appropriate actions in -response to releases and threats of release of oil and/or -hazardous- materials. By taking prompt action, you may significantly- -lower your assessment and cleanup 'costs and/or ' avoid liability for costs incurred by the Department in . taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit. and/or annual compliance assurance fees payable under ° 310 CMR 4 .00 . Please refer to M.G.L. c..21E' for a complete description of' .- potential liability. For your convenience, a summary_. of liability , under M.G.L. c.21E is attached to this notice. You should be aware that :you may have claims against third parties for damages, -including claims for contribution or reimbursement for the costs, of cleanup. —Such claims do not. exist indefinitely but are governed by laws ' which establish the time allowed for bringing ;litigat 'on The Department encourages you to take any action necessary to protect - any such claims you, may have against third parties,. SITE INFORMATION Information on file with the Department, indicates the . following contaminant (s)� were detected "in soil. samples collected from the site at a concentration which exceeded the Reportable Concentrations for Soil Category 1 (RCS-1), per 310 CMR 40 . 1600 . CHEMICAL CONCENTRATION RCS-1 s _ C5-C8 Aliphatics �, 2, 190 mg/kg 100 mg/kg Specific approval is required from -the Department for the implementation 'of all Immediate Response. Actions' ("IRA") , and Release Abatement Measures (RAMS) pursuant .to 310 CMR 40 . 0420 .and 310 CMR 40 . 0443, respectively. Assessment activities, the _ .ter•, 3 ` construction of a fence and/or --,the posting of signs are actions that are exempt from this approval. requirement . This site shall not be deemed to have had all ', the necessary and required response actions taken unless and until- - all substantial hazards .presented by -.the release and/or threat' of release have been eliminated and a ' level of No Significant Risk exists or has been achieved: in compliance with M.G.L. c.,2lE and the MCP. y. Unless otherwise provided by the Department, potentially responsible parties ( "PRP' s" )have one year from the initial date of notification 'to the Department of a release or threat of a release, pursuant to 310 CMR ` 40 . 0300, or. from the date the Department issues a . Notice of Responsibility, -whichever occurs earlier, to "file _`with the Department ' one of, .the following submittals : (1) a completed Tier Classification Submittal; (2) a Response . Action Outcome. Statement. � . or, . if -applicable, Downgradient Property- Status. The deadline for either of the first two submittals for this disposal site is ` June . 24, 1999 . If required. by the MCP, a completed- Tier I Permit Application must , also accompany a Tier Classification Submittal... The MCP requires that a fee of $750 . 00 be. submitted to the'-, Department when a Response Action Outcome (.".RAO")` -statement ' if '-!filed 'greater ' than 120 days from the date of notification. You must employ or engage a Licensed. Site . Professional ( "LSP" ) to manage, supervise or. actually perform the necessary response actions at this `site Attached' .is, a ' copy of. the Department' s guide to hiring a Licensed Site Professional . If you have any questions relative to this. notice, please contact Tyson Rose-at the letterhead address or at (508) 946-2743 . All future communications regarding this release must reference the following Release Tracking Number: 4-14017 . Very truly yours, . Richard F. Packard, Chief Emergency Response / Release Notification Section P/TLR/cb CERTIFIED MAIL NO. Z 598 884 632 RETURN RECEIPT REQUESTED 4 Attachments : Release Notification Form; BWSC-103 .and Instructions Summary of Liability under M.G.L. c.21E Department' s guide to hiring a Licensed Site Professional . CC: Board of Health PO Box 534 Hyannis, MA 02601 Board of Selectmen 367 Main Street Hyannis, MA 02601 •Fire Department.. , .. 1875 Falmouth Road' Centerville, MA 02632 . l CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Falmouth Road,Rte.28 SST Emergency Number: Centerville,MA 02632-3117. 9-1-1 `Business:508-790-2375 John M.Farrington Facsimile:508-790-2385 Chief of Department 1976 "Commitment to Our Community" August 22,2001 Town of Barnstable Board of Health 367 Main Street Hyannis,MA 02601 Dear Mr.McKeon: Our Department has a record of tank removal for 44 Warren Avenue, Osterville(which served as their shop and office). The date of removal was October 14, 1997, the size of tank 275 gallons, fuel type was heating oil. We have.no other records for 44 Warren or 49 Warren Avenue, Osterville. If you hav-_any questions,please contact me at(508)790-2380. Thank you, Craig E.Whiteley eputy Chief ' -O-MM Fire D' is r a r � fTM r e ��c.`.. � -der 3 fat .w'^� < ' �3T' d;+.'.' I � ��Y_ �''�#, - :,., i ��vya a' �`3r�. •f'�•^� � �r�57 `'$E.d c' w'-d-r,. x;F s t. _33'—` •,-. o-"�.. ,.^ �� r�` -rat,...f..- i�LL. i�F} a�.Ya .?-i'a.-. '�,.q�--��"'s � �y .}C�t•:;, �r,.:s'�'�` .� -._s�,j'ro � ,F; 4: sY�rlJ�ryn��fin),,"�i'" '" i .2' ,r i.$*7 h��'�';ry"`j"w3 a .y�=�3y_b CEiUERY W.E-OSTE�Y fLLE-WI tSTO�S P�fLL$, FEE 4 CEN/ER @O�L.L f A kl1i�D6 A.: •r r l56 ,��4.90 2i8d it-, (►iB O f 'k f � 15 4 �AL RELEASE FoRm!. f4 r � Y �A > - � L LOC T a..f..'Y,� §• C1 ADDRESS OF RELEASE x,•.� s�^�'' _ e°a pP/`t '' �Qi�ie F b'�i� ' �� !1r �oeia°`ai ., ` p. DATE'O RELEASE PRODUCT RELEAS Mee, A ,. I c... f ESTIMATED QUANTITY CORRECTNE ACTION TWEEN'BY RESPONSIBLE PARTY==, —L2,; �. NOTIF � C F IRE EP ARTMENT NO( ) DATE �-G TIME "l NATIONAL RESPONSE.. _YE ) NO(`,) DATE�a�+ TIME` )�!►.` DEPT.OF ENVIROtNTAL PROTEaION ^ §.. OIL SPILL:COORDINATOR AS( ) DATE TlE ' TOWN BOARD OF HEALTH YE :) ��:) . D#TE �,' �� T JOWN HARBORMASTER: :=YES ) N *�` ) DATE.• ` 'TIME 'OTHER AGEWIES �� e ei -r /d�{tlr7� rsrg� r-�'�19r v e .vQss>�ve�s+� ,," Y s .- -••^''->.:-r {,i v -1 M�+'� (/V/r•'i 4 '1 i i1L/O V i. i' - - •�'r'r+�IdE }',i. - F"G ',;a-•,r.','f. - G r.N F :�.. - .'kd :r'. .:�� s�oe•:� +w--i�--�lBr��) ink iw � �� e � a se a o � ��G:rs it i e e i• � •�o ��+r+r ee��e��e-1 i i i ��s1 e�1 i!+di�_e��yr r.,�.trs►—•e n a�� -�' r ^27IJiA � - REPOR *.v B L�<, " �! y�1� a L�'�l��1� SATE I'r _i n WHITE COPY-FIRE DEPARTMENT` YELLOV COPY-D.E.P. P i,COPY,'BOARD OF I#��1LTH C-O-MM FORM #58 ' Health Complaints 24-Feb-98 Time: 3:00:00 AM Date: 10/9197 Complaint Number: 1056 Referred To: JEROME DUNNING Taken By: L.S. Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Artio le X Detail: Business Name: Number: 44 Street: WARREN AVENUE Villager OSTERVILLE Assessors Map-Parcel: Complaint Description: LEAKING OIL TANK AT RESIDENCE Actions Taken/Results: Investigation Date: Investigation Time: 303 l y T III o h e 1,o?:�.ino-TE—al t h Of 1,as s a.a:(lus.t SAv I� _ III 0r f I c e of the Chief" of the Dist-_,-t 01J.c S J.C.%` rhos 8. Ali e I� 3a1'T' table Junes e 2� 1�2 i �� PER ' ! 1 - � I I ! i a�CO�'da2l.GP -f i t11 a,'. gprQ ,,Sjs 1 rr � 01 Q= ��0 �. A. ` ' 0f 1904; q =and a�.ei�,�seilts t'rla;,eto J Miry " e_'e:oy } s - ys n gl Dante i. tQ in a �Diliel rcthe-'s tO c0rdu:t or i a i t �ia. g -.-______, y �aJe 0_^ the th 'C? ti12,S:5 s ai:d Keep o store volatlie Inflammable -r j o d � { y' I ii in LQ �1(,f; 0- t,Clp.�eYJ e.t .I { the vi17.a. evvi81110 in COl��Oi'??=ty With the ulat I 0?:8 ;I f t' Detective y T ,^e 1' pect 0-11 Depcml tlment of the Distric—u OliCB s 2nr1 of- Jtu?v '7 1,92 0o '1 i.I! 6 E(1 C i27 T C_' c? �'L c1t1 Q=^. +�f, n ;mod Oi a p .. n. SG'yG('t .a xPiY'eJ �'�I'E8 Lr)3 ;92 a� y1 i G?'.A'_ie .'_9:3 1Q2 0, ?ven..Vi lred 7a1d is re�Qr�'e^ � �.u 111 1..._Q .^ II of the Tl o pi'�� f ✓2SI1s 4u-?l7?F!' Q1 TO.! 1 I . NA,,IE LOcAT IO\T Marney & Lahteire T,l ianno,. Mass (Orin -- b- :-Daniel Bro= I:. ) --=- -- ----- --_ - --- cQ -- - .- Date Lic. Granted: 303 - 6-28-20 . lu' 1966 .__ 1967 ---- 1968_ __19b9 ------- .1970 _ 1971 19 ..... ---------------- .. ' —_—_ r CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE& EMERGENCY SERVICES l 1875 Falmouth Road,Rte.28 Emergency Number: 111 Centerville,MA02632.3117 9-1-1 Business:508-790-2375 John M.Farrington Facsimile:508-790-2385 Chief of Department 1926 . "Commitment to Our Community" August 22,2001 . Town of Barnstable Board of Health 367 Main Street Hyannis,MA 02601 Dear Mr.McKeon: Our Department has a record of tank removal for 44 Warren Avenue, Osterville(which served as their shop and office). The date of removal was.October 14, 1997, the size of tank 275 gallons,fuel type was heating oil. We have no other records for 44 Warren or 49 Warren Avenue, Osterville. If you have any questions,please contact me at(508)790-2380. Thank you, Craig E.Whiteley eputy Chief f� -O-MM FjDic 0 139074 s �t, ��9 �,"g p�� "�rrxta .f� flWn �t)� f St,'• I ��y'a`� B4, Faf Pafcel ufnbe 139074ental Business Narne �`' ITC n }� 9369r 99-599 ? ,: Foie/PeYrmt No issC Dates f r 3 :. 09/14/1999 ` I €is of$ep}��• s, ape/ ize oI S7i 60x4x2 LT 1500 UNIT D-99-600, 1500 ST,60X4X2 LT,9/14/99 K. ma pp 139074 v✓ ,° PECK,ALBERT TR fo 49 WARREN STREET a��/ y nno�ative�AMerrat�e'technoio`g�'Sept1 ys e � E y -�� in [e of 9 'a.. hey ?�• `' � ,y i 1 ' � 'Y: {�i�° r"iN""fir ,w •� t,c fr.'. c a °.�}- `j,'',�- 4 -s�'� � _. e •ic.Y ap. -Yf '.,�6 »y >ke"+ x v: w k6`U �f✓ d x' S. }4- L;$' ?' _.a,{ , --,'F'3 ,..�h:..`,'�v.•,a�r ay,� &,,yar '�' ...,` .3,..a ,�,$ '" y AS '�" '••i�" 4,x �,K r ', L Fr[F d ,f a xy F3 ti t- ar�Fry f >v i I ,y �t.;F .Sky �.ar'?'�f iK k'� �•�,v� C.r t+•S "V,�+�'A,�E.ts.r#R, �i r� x.=c �. a � i:��,-r?.J�'y,�x.+ �.rr� ��-0�{ •€i' 'G'r :"t+s ,,„t x '� i; i. 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'fi-..;,n .. e -.:'�'f''r ...� ° 4 "Ly `^"`, 1",: �''�'^E a ,.:� .x ,'• `'i ,> � :;'ts`' _i-'= LOCATION: � � h ABM' r,•.��{. �� ,�, ,J�(w] °='Ga ` r : '� r- '. �%d��w`,r#Lx t fdiW �i'S 'fir F /�/D� W �RE 7C �^�l�g�}�.{�+�fv��' "� 1 •"'.L {, � Y�y,�jG MA �-•� �+�,g� t.�«•��y�a�*�h DATE OF RELEASE PRODIXT RELEASED cEST < I`1ATED�• ANT ITY• r . CORRECTIVE ACTIM TAKEN BY RESPOFlSIBLE PARTY• p, jh4 j2. r HK 3- , NOTlF�ATffi r�z �4 i sx x u t F F�tE DEPARTMENT id0( x ";DATE TIVIE �NATIMALRE§PONSE YE ) ::l ) DATE �i TI!' —r; ... .;" r� a61 DEFT OF ENVIR N AL PRE TE ¢) NQf ') DATI I-OIL SPIL COORDIhIATOR:' YES{ ) '; DATE TCIE r TOWN i�ARD OF HEALTH� a � -YE ) N ew)., DATE; C+ T PTO HRMASTER 4 t< ` YEs�(' ) IAIr)t DATE•" Tlh1E IRCRyl7i7G1Y1. -�x`��.+z '•r� „J s� .� .^.a • ,� <" r k g t,3-k s rpj *ly�P'jys �� ,a, .. d `i-s�;.. y,:. - i s v, ,-n�•2,.'=as'�i T4+e - r 1fI �C?'�i"'.';�3t�'" •s„�� +� `�`, yr� `�"� -:r �"�T. FF1;;5��:-n.�'�<r_'�`-k.3, .�`!.- :.v;�. `F�`��'">•#�t3.x^.i G3�`2':,. i`.: °5 x a Ft 2 �, I" �•i�a'§'t` -�``s.. ti �'�r�f7+�- ."+-aay�"�.r;; �FJSL9!«"' i `a # 4 �,�'f'�'iG� t C w�. �,Ylk�w'w`•.- a��."y. � � �_ r t L a - """'�me ri��i�e+`� .r f��+hB � ImR e1e� �t-aaa+c .o• •t. '�^•F•a a,�ie��3''�'"�+• 3m,i� � �' 9. k f:+�� r }I�'ya ui!.}; �� 4 �x^. ��1G �e�` r• `� �7r ,.}., -� "eR�g�4.��,:,�. e.r r-� ��.� - r • ....may " - p 4 .. ... S: t-�_ ii ;F' ffi" PAwnk �s(�+�e . .: v(��v' ��.:ees ve 9 �-• r� . ...�►> vu�+'Lla�rTi-�. � e 1 �E-FDrcitt�ist� - 4"" I��#� SATE'- - Ei WHITE COPY—FIRE DEPARTMENT' YELLOW COPY—D.E.P. MCOPY—SOA,RD OF l6 TH `Y C-O+1M FORM #5$ k j \) Health Complaints 24-Feb-98 Time: 3:00:00 AM Date: 10/9/97 Complaint Number: 1056 Referred To: JEROME DUNNING' Taken By: L.S. . Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE . Article.X Detail: Business Name: Number: 44 Street: WARREN AVENUE Village: OSTERVILLE Assessors Map-Parcel- Complainant's Name: CENTERVILLE-OSTERVILLE Address: Telephone Number: Complaint Description: LEAKING OIL TANK AT RESIDENCE Actions Taken/Results: J Investigation Date: Investigation Time: i i o. i "�a chi o��MapJP reel 1 90 �•^ own qm�abf ;;�� . �, Bus Hess Name , UNIT B o df,Co ,fn, = o { '/�N � *'� �Ar@q � a U".a{�@ � � � s'E',a'z �C1T'lfgmi q11 R@I✓< a i p o``e f 000 � 7751442 � t "�+S�oT 4Tn P�8 � � Y F i@/fg. tfii NO" H p9368 99-597 ry. is�hran@�6ate� �� 09/14/1999 �s i�ereof�p jM pe%Size o „S: 2-500 cham in 12x25x2"LT � r tqq� t 1500 w Unit A-99 598=1500 st,2-500 cham in 12x25x2 LT,9/14/99 _ iapp� 139067 O PECK ALBERT TR 44 WARREN STREET � R 3 .,.t.5; rnnovafiv@`Alt@KratiueTeUzi noiog S@pticS sfernsm � 5ii�gle or " u � gC�Csa t ; i - m 6) 3 F;U 707710722. POUDREAU LAW LAW OFFICES OF PIULIP M. P,()I.?D AI tiT I C vM A SS. CT[;3E1 i S t.l60 e ..o TCiCA1\;ISOS, BoUdkesqu ip Pit ij�AV(,hael 3aUdr-,2u Hbudieau `1A TE.EE , �C or this le ter is not x. to f9111--)v•`via the U.,S,_ po.q - To! hjt�p M-Gh:3ei -r-'oud,-eat3 =8q. Date. dRc, J u t 1. t•. Novem_ber"�� ' c1tT StclNa�'d:`:�LpF,31� ` Total P. FOR S-F-`s ';F-AIENT IDISCUSSj0,4�-01N7LV iff response to Va.tt orre on p dcnce �l I No yemr 1 17, I w uid off'r t e`o11a;�tag: 1. vi� clients mill av ee that each of the r esidencs on the ncirth side of 4ay�ren try a �votrid be Omited to 4 00 sou�7re t?et of i- y e-a-ble area, plus aP�tta. cY ;yVU car f�i,�. e. lst�tn i?(I.r7+� w�-,uf also be limiter]t4 iliie� i3?rlr�, m , Tl1C resideilUf,-on t-1 je S.011til SidC of Warren Sty ec-t would b� limited to ?.54{j gr F:.et of li;eahlp ate<� lus , •�� usr� y P fl t�� a lrcci m.o car garage; and it wouid�� limited to . . fc:ur iiedthoiits. J. � l three pauses could be of ctne l�drsrRr cedar roa s117 Ztl arch trt1ra� grade car red. : . tT1tsy shingl,,.sid,t�,a.ils (clapi_ioa�rdti optional on the !r , - �t underground utilities: 4 � ,0n0 and • -Within the l:ra12'ie4L'Ork c};•' .� t ,des- , Can; Y! t �. my clients are enen td n�o,� wit s r6s ect t►.etails on design .arid A! uld he d� llin7 to iri;,l� p ' su "ti.�nw - side additio 'a] rcasonablt.sPee ications as Proposed conditions to a,,;s, Varian ce.a3Jrlot accept as a Vo_ditiu the rnequircment t rla^.s be.'7na!,.Zed r]d triads a fl BULTRE k! I AT "7`of h ; y, iical o��L��_}�sy'T�Ps3C1•`i.�� ddr ;[tio ;r an -allbuy1'to irnake evti rr.nor iro'j' rt;ff wct to 5 e of Awl tanks,=7 +IIG ice: � t 9 iHr�+iti, Floyd =t12orZTis r;.e SUilrth Ede of 4� r� 'i` � e..l1e_-Ltr er W)?en the,.purch;-,sed V5�, I !"'proximately fifteen`v`i, ??{i, A tfi ati r S tree =- S r t_na iiS. the ,1 ! tarn on the ,i- sin f rr t ti.�x �°r��-ed i� ?y��a I cton'��:rtoc�r - nt.;_.r: �.� �s k�-�;.rl t-• L'vhy th r� would h no t-e,>nrd at Lie local art i^� r 7 t } }( _ _ tP� e d� t 0 'd af�l) 4e�15 e �lffi t :n both.Ir1Sta}ICCS tl ire lz a - - - 1 - .. a.r4 }C�rt L, �5 ,e di2ring :_ :.c_I'L�Presentative ��lttv�l. _ t back to zne,vVtiei7 you have t1i h$u'.'a t� d cL1C t£j v `✓_y-,, � vii`}1 the 4.LiOvc y0i;t �.. `'inc7G rely, t'�•�1�ii1Ca f �ii�4�-.i�d'`1�4�� it I- " I i �Til'N. .I,L D. rf`-RD, 'ESQL'1�F AT LA IAT ' /? .J t.-L'L 1. P. O. 1�1_l'K W 4 0- EMAIL nl. tesq,@.-',o, eccd.. � V�LN tiO '-i:aIaX F,-d Old i FrUtil �`�%ctaw.I Fc�Y d Old v, Peck et ' 2,00 ��' lla•; `�'CfIP �uTi a*1'@1i?�Tlt.wl.kxl5lli'13�iii?C1115 d1()tl i1C�i11ZS )1�: SV2�.C4�' 011Siy'3T�,i� o �. t;,, t,ce 3t ti.a t'- ?iGi3t� are r�:��Li.7 ec1 tC�Le r�1110 y'e?d?:c� l ate than 'lie elnd of'anUal-y ?.001. i Ti-Vel: th 1l Lans1.I; r.haJ 1. G1t:atra that vole VF'Uuld egret witliout fill} i'eyilir:t?_;eni Uii the boats,�•a531tI31E Wa 1'OL' hr�tll t?t~� ttlat tli_.ti 1S S,i:t�fact01;°. 1'was cable t.0 �=.01--vitlee tbe•Ttl tllat, r,a trial,1 1T11`�T.11t be able tC -ais?it-e boat issue-vv- il-v} v ou.ld prejudice their J ght to the !-111d IU.till--r.il:3.at If w 2 etwm t0 th Bij'a2 1. � .�l)ll-�a1's t0 ina")lerrient.thP,settle ill.-'nt,the Vail mCes tiv Ill ch Ii oat hC.SLi aght ilia) 6 a, -C Q the l-)oaf storm v Issue, y i e v)e,t tilC ran':.r«'Or '•�lti' icy 7 l t t0 il? settlement `rl'll'_ LAC forwardedtU }t?i1 w-,thin th i" ILCsir �,ti Gv�1 t • 9 , Inc. Silvia & Silvia Associates, 1 ' August 2, 1999 Joseph F. Kowal, Chief Audit & Site Management Section ' SERO/DEP 20 Riverside Drive Lakeville, MA 02347 ' RE: Barnstable - BWSX/ASM 4-14017 44 Warren Ave. , Osterville Response to Notice of Audit Findings and Noncompliance ' NON-SE-99-3A-036 (our file 2 . 0601. 1) ' Dear Mr. Kowal; Attached please find our response to your -June 24, 1999 Notice of Noncompliance cited above. We received your notice on June 28, 1999. I anticipate that you will have received this response with the 45 days allotted. t The response has been prepared with the assistance of my LSP, Geoffrey R. May, P.G. , L.S.P. of McCulley, Frick & Gilman, Inc. Based on his advice., we believe this transmission will provide all t the information you have requested. Should, however, you continue to have questions, please don't hesitate to contact Mr. May or myself. Based on your instructions, only copies of requested documents except for the Certification of Submittal are. being provided to you. The originals will be kept in a secure location on the ' subject premises. You are being provided with the original of the Certification of Submittal which is attached to this cover letter. ' Sincerely; LIS Corporation Floyd J. Silvia, Treasurer cc: Geoffrey R. May, P.G. , L.S.P. 619 Main Street, Centerville,Massachusetts 02632 (508) 775-1442 Fax 771-7626 Attachment C CERTIFICATION OF SUBMITTAL(310 CMR 40.0009) This certification must be included with your response to any request for further information or ' documentation I attest under the pains and penalties of perjury, (i)that I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this 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 willfully submitting false, inaccurate or incomplete information. Name(Print): F-/ OV.D �}. S'/ v A, y Position or Title: 1 Signature: Date: A?d /I 1 1 1 1 f 1 1 S 1 ��7 1 - -- providing environmental 500 West Cummings Park consulting and Suite 1050 Woburn,MA 01801 F engineering services 781/937-0500 ' Fax: 781/937-0578 G ' McCulley Frick & Gilman,ins. July 26, 1997 ' MFG Project No. 5539-11 ' Mr. Bob Murphy Department of Environmental Protection Southeast Regional Office ' 20 Riverside Drive Lakeville,MA 02347 RE: Response to Notice of Audit Findings 44 Warren Avenue Osterville, MA ' RTN 4-14017 Dear Mr. Murphy: On behalf of LIS Corporation,MFG, Inc. is providing the attached information is response to your request as outline in your letter dated June 24, 1999. The following information is included is this submittal and should complete the information requested by the Department. ' The Site Plan prepared by MFG now includes the RAO boundaries(the limit of excavation)and the location for soil samples S 101 and S 104. A letter by Advanced Environmental Services (AES) indicated that the original composite soil samples were collected at a depth of fourteen ' feet. Please refer to the letter prepared by AES to A.M. Wilson Associates,Inc. (AMW)dated June 2, 1999. According to AMW,AES could not provide any additional information regarding their sample locations. ' Permit for Removal and Receipt of Disposal of UST. P ' Copy of the Bill of Lading prepared by AES,the Individual Load Sheet(BWSC-012B) and the Summary Sheet(BWSC-012C)were not filled out, however the gate receipts from Bardon Trimount are included documenting receipt of the contaminated soil. • Memo from AES documenting head space screening results, and documentation of site activities by AMW. t California • Colorado - Idaho • Massachusetts • Montana • New Jersey • New Mexico • Pennsylvania • Texas • Washington �•�ed ' Information from the Board of Health and Water Department obtained by AMW regarding drinking water wells(the lack there of)within a 500'radius around the site. According to AES a manifest for the tank contents was not generated because the fuel was transferred to the new tank. Please refer to the letter from AES to AMW dated July 8, 1999. MFG be levies that the attached information completes the request for information. Signatures required ' for the individual loads in the Bill of Lading could not be provided, however additional proof of disposal is provided. If you have any questions please do not hesitate to contact this office. Very truly yours, ' MFG Inc. ' ;enior e ay,P.G.,L. Geologist ' cc. Floyd Silvia,LIS Corporation Arlene Wilson, A.M. Wilson Associates,Inc. PROPERTY LINE TYP. , i taN 3 0 �� o` �� \\ MW-2 j TPC=102.60 GRASS PVC=102.09' GRASS BASEMENT =84.31' (5/26/98) APPROXIMATE LIMITS BULKHEAD �� OF EXCAVATION a,,,,O 10 APPROXIMATE LOCATION OF FORMER TANK I MW-3 __T TPC=98.72' B1� MENT =9 .44' \ 84 \IGW=-84.30' (5/26/98) j wood \ N. WORKING \ f SHOP ASN kLT I GARAGE PAVEMEPgT ANNEX \ f T MW-1 ASSUMED WELL EL.=100' 44 WARREN GW 83.54" (5/26/98) STREET LEGEND j FIGURE 2 GROUNDWATER SITE PLAN CONTOUR INTERVAL' SILVIA & SILVIA ASSOCIATES 0.1 FEET OSTERVILLE, MASSACHUSETTS GROUNDWATER FLOW McCulley Frick & Gilman, Inc. 500 lea! Cu-inter Pmrk. Smile 1050 DIRECTION Iob., Xaaa�ehusella 01801 SCALE: 1"=20' . . --- ---- - - it 1 1 1 1 1 1 1 _ . _ _ 1 1 1 1 1 - - - - - 1 1 � 1 — a � � _ _ � _ �� a f A.M.Wilson Associates Inc. ' TO: Floyd J. Silvi Geoff May t FROM: Arlene Wilson RE: 44 Warren Ave. , Osterville (Our File No. 2 .0601. 01 ' DATE: 8/02/99 ' In accordance with your request, we have undertaken various tasks to assist in compliance with the DEP Audit Notice of 5/10/99 for. 1 the 21e work at the Silvia and Silvia woodworking shop located at 44 Warren Ave. , Osterville. Those tasks have included: file research; coordination with consultants and contractors who worked on the project; additional research with local agencies as ' required by DEP and provision of letters and memos. Attached, please find copies of documentation and correspondence igenerated to date as follows: Permit for Removal and Receipt of , Disposal of UST; Request to Advanced for Bill of Lading signed by Bardon ' Trimount; Bill of Lading with trucking receipts; Memo from Advanced on head space screening; ' Memo from my notes on head space screening and sketch of excavation; Information from Board of Health, C-O-MM Water Dept. , and Assessing Records relative to water service/onsite well permits and development status for properties within 500 ' of the Site; Memo from Advanced Environmental relative to tank ' contents; Bill of Lading, Sec. L; Receipt for recyclable soil from Bardon Trimount. ' Insofar as originals are available, Mr. Silvia will bring them to the site visit Thursday, 6/03/99. at 1 PM. Where originals are not available, he will bring copies. Please let me know if we can be of any further assistance. ' 699AW01 cs / P i PA. Box 486 508 375 0327 3261 Main Street 508 428 1450 Barnstable, MA 02630 FAX 375 0329 1 1 1 1 1 I 1 1 1 1 1 1 ✓ Silvia & Salvia Associates, Inc. 1 1 May 17, 1999 ' Robert C. Murphy transmitted by fax SERO/DEP 20 Riverside Drive ' Lakeville, MA 02347 ' RE: Request of Information Barnstable - BWSC/ASM-4-14017 44 Warren Ave. , Osterville 02655 ' Dear Mr. Murphy; ' I have just received your "Notice of Audit/Request- for Information/Site Inspection" letter dated 5/10 99. That letter asks that I provide several pieces of information within 7 ' calendar days of my receipt of the letter. It also provides that, should I need more time to obtain and transmit. that information, I may request,an extension in writing. It *appears. that it will take-.me some time to retrieve the informationyouu .have requested- from the various contractors who worked on the 44 Warren Avenue site. In addition, .as you should ' _-by=now-_be_aware as-=a=result=of-a -callfrom -the-project-LSP "-"--1�- requesting rescheduling of your r site visit, -_I_-have_some _health .and ------ - --personal-matters-which'_must be taken care of in the next couple of ' weeks. =would:-a - Y gr ppriciate -it-if � ou -could" a tome an extension. of time submit written responses and .additional-.:_information: to-. date of =e"scheduled -site visit.. the - Thank ys�u=forgour. cons-iderata*.on=in -this -matter - Sincerely; LIS CORPORATION Floyd .J.--Silvia 619 Main Street,Centerville,Massachusetts 02632 (508) 775-1442 Fax 771-7626 T• .. ...� _ _�__ .. '�_ .. .. _ ,. _ . . .�_._.._ _._>_. ___.. _ , .... � v .. a ., _ __. r ,^� � .. _. _ , . r .. ,, ,.�. . . . .. i � . S _ ,` .. ., '.. � .. 1 _, .. .. �,, 1 -. _, _ -•-- _' :. ,. ,., .. . - � .. ^iLr =k'Jc !iI ADVAN C EM ENVIRONMENTAL SERVICES ' BCC/974/43CO (508) 385/61 C0 FAX (508] 385/6622 February 2, 1998 Silvia & Silvia Associates, Inc. c/o A.M. Wilson Associates Inc. ' P.O.Box 486 Barnstable, MA 02630 I ' Project Location: Silvia � S & Silvia Bldg. 44 Warren Ave. ' Osterville, MA Dear Ms. Wilson, ' Enclosed please find copies of your Permit and Receipt of Disposal of Underground Steel Storage Tank. The original Receipt of Disposal has been sent to your Fire Department for their records, we will also keep.a ' copy in our files. The copies enclosed are for your records. We want you to know we appreciate your business and we hope that we may serve you with your environmental needs in the future. - :Sincerely; Denise Mowles Office Manager Advanced Environmental Services enc. P.O. 8ox 472 • South Dennis, MA 02SEO-0472 IWaKe 3p�111Gauw, w wc3i rare ucr� ..,.�.,•. re Cecartmerit retains original application and issues durtiC,te as Permit. F � / ��j•2ic(:YILBIZC�'G�'r'/cB -xvic2P. — :v'cCLJ a`�4Gr? i=3?:2Y•'CC:?•: ``�- - '� 1i ��r� ✓/ nc. 10.00 APPLICATION and PERMIT iF ' for storage tank retmcval and transportation to apt:;oved tank disposal yard in accordance with the previsions or M.G.L. Chapter 1=8_ Section 38A, 527 CMR 9.GC, apolication is hereby made by: Tank Owner Name(pi��print) Silvia & Silvia Builders X 1fit aauw.U;r, Address 44 Warren Avenue, Osterville, MA 012655 / /%/ /✓/ strew G',q six@ Zo ' � .iiiritti 1[=,r .it •-�=-z'�itt-ll''1 � I Advancet Environmental Company Name Advanced Environmental I C;..or Individual ' air Address P.O. Box 472, S. Dennis, MA Andress Pnnr i re 7f Signature (if appiving:-r=ermit) Signature (if acciyinc cr=ermit) rdn� C r _:FC!Cerified _ __ _ _ Other i i 1 Tank Location 44 Warren Avenue, Osterville, MA 11.2655 _ ' ! sieei AQareai _ I Tank Capacity(aailcm: 275 _ubstance Last Store-- #2 Fuei Ci: I Tank Dimensions(dip- x length) ' I Remarks: I' . I Firm tmnspordng waste Advanced Environmental _State Lic. # MAV5083856100 Hazardous waste manf._—n�, _E.P.A. Approved tank disposeal•card J.G. Grant _Tank yard T 03501 IType of inert gas Tank yard address _F.eadville, MA . Centerville' FDID# 01920 City or Town Permit: Date of issue October 9, 1997 Date of expiration October 23, 1497 - -.. Dig safe approval numix-- 974006506 _ Dig Safe Tall F:se Tel.Number-E00-3 Signature/Title of 0ffim—=wting permit I: �After removal(s)send F—_=?-290A signed by Local Fre O,pt.to UST Regulatory Compliant-Unit;One Ashburt:;-t P!ace, Atom 1210, Boston.MA 3-161 G. ' 3_wz 4saviean OESi:I 1 -Y ?T OF DIS20SnL OF UNDERG rT'� STE E STORAGE `�ME AND ADDRESS J OF 28l^ a (`ran c-��— 6�' 7APPROVED TANK YARD E�. J/ APPROVED TANK YARD NO. Tank. Yard Ledger 502 CMR 3.03 (4) Number: La I certify urrier penalty of law I have personally e-Kanined the under7rcund s�jU�NIC' torage tank delivered to this "approved tank yard" .by fian, corporation or partnership L,`/!7 and accepted sane in conformance with Massachusetts Fire Prevention Regulation 502 C R 3.00 Provisions for Approving Urxierground Steel Storage Tank dismantling yards. A valid permit was issued by LOCAL Head of Fire De^rarzmnent FDIDi .2 G to transport rius tank to this yard. ;sane and official title of approved tank yard owner or owners aurhorized representative: /�- -1 3--9 7 ' IQA7JRE ♦ TITIZ DATE SIGNED Ilus signed ipt of disposal must be returned to the local head of the fire department rolDi �►1 p2 d pursuant to 502 C 3:00. (EACH TANK KIST HAVE A RE�IPT OF DIS:C�AL1 ' FORM F.P. 291 (rev. 11/95) (QVtR) ASS F.TRE l9ARgiAL'S CFFIM 1 ' Tank Data Tank Removed From: Gallons_ ( No. and.Street ) Previous Con tents. ( City or Town ) ' Diameter Length Date Received_ Fire Dept. Permit # Serial # (if available) ' Tank I.D. # (Form FP-290)_ . Owner/Operator to mail revised copy of Notification Form(FP-290, or Fp- 290R) to: UST Compliance, Office of the State Fire Marshal, 1010 ' Commonwealth Avenue, Boston, Ma. 02215. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I � a A.M.Wilson Associates Inc. TO: ARTHUR McCORMACK ADVANCED ENVIRONMENTAL SERVICES , I FROM: ARLENE WILSON , ' RE: 44 WARREN AVE. , OSTERVILLE 21E AUDIT INFORMATION (our file 2. 0601. 1) rDATE: 5/26/99 .-T. Thanks for your 'letter of 5/21/99. It, has been very helpful. Unfortunately, I need a couple of additional items. DEP said they now want a sketch to show where the samples came from that are cited in your report on the site. They also want to know whether the samples were composites and at what depth those samples were taken. Lastly, I 'm having a lot of trouble getting the signed bill of lading. Bardon-Trimount said that they would have been sent back to Vargo. We have been in touch with Vargo's office but they are not being very helpful despite the fact that we have told them the information is for a DEP audit and we have a deadline of Friday. ,(5 I was hoping that you might be able to light a fire under someone up there for me. We need the page(s) that were signed by Bardon and the. trucker. I think its page "L" of the form. Please feel free to. fax the, information - (508) 375-,0379. Thanks for your help. ' 599aw39 ' P.O. Box 486 508 375 0327 3261 Main Street 508 4281450 Barnstable, MA 02630 FAX 375 0329 t .� 1 l om TICKET N0. -� - Souih Dennis ^1 U`66�.h -DATE TIME TRUCKER NO: :TRUCK..1 C �_IL 'JCT TLLE-41, WAPFEN P — POUNDS . . TON! RE v SOIL C I L GROSS t 't •TRUCKING RATE - ' TARE. TAX NET — TOTAL DUE ' ~ CIL e re lave a se er o any I I Ity or personal In�Ury or property DEPART JOB WAITING TIME "WEIGHTMAST .damage when delivery is made be and carCa line -y-0ur-ba9inea9ln Waiting time irl:ezcess:c Received by: 1/4 dour will be ch ed current prices w" - 5/95)BT 25 CUSTOMER COPY CONTROL NO. 2"" 6 2 8 7 t 1 _ r I' Massachusetts Department of Environmental Protection BWSC-012.A Bureau of Waste Site Cleanup Release flecking NUMDeV ' BILL OF LADING (pursuant to 310 cAIR 40.0030) ❑ LRA A. LOCATION OF SITE OR DISPOSAL SITE WHERE REMEDIATION WASTE WAS GENERATED: Release Name(optional): Woodwork Shop Street: 44 Warren Avenue y Location Aid: City/Town: Osterville 0265:5 10 17 97 10118 9 7 Zip Code: — Date/Period of Generation: _ /_ /_ to /_ Additional 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. B. PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL OF LADING: ' name of Organization: LI)S Corporation . %ame of Contact: Floyd Silvia Title: Partner Street: 619 Main Street ' Cityfrown: Centerville -State: MA. 'Zip Code: 02632 Telephone: 508 - 710- - 1442 Ext. C. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON CONDUCTING RESPONSE ACTION ' ASSOCIATED WITH BILL OF LADING: (cneck one/specify) =J RP Specify(circle one): Owner Operator Generator Transponer 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: if an 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.if known. ' D. TRANSPORTER/COMMON CARRIER INFORMATION: Transponer/Common Carrier Name: _Robert Beyilaqua Trucking Contact Person: _Robert Beyilaqua Owner ' Street: 152 Kiahs Way Title, Cityfrown: Sandwich MA. 02563 508 State: Zip Code: — Telephone: — — Ext. �.� E. RECEIVING FACILITY/TEMPORARY STORAGE LOCATION: Operator/FacilityName: Bardon Trimount , Inc Cdntacl Person: Barry Powers Manager Street: 230 Great Western Road Title: Cgy/rown: SOuth Dennis MA. 02660 _ ' 508 398 State: Zip Code: Telephone: _ _ 886 Ext. Type of Facility: ® Asphalt Batch/Cold Mix - (cneck one) ❑ Landfill/Disposal ❑ Incinerator ® Asphalt Batch/Hot Mix ❑ Landfill/Daily Cover ❑ Temporary Storage ❑ Thermal Processing ❑ Landfill/Structural Fill ❑ Other. Division of Hazardous Division of Solid Waste waste/ClassAPermitq: S-95-042 Management Permit#: EPA identification a:MAD985286384 ' Aclual/Anticipated Period of Temporary Storage(specify dates if applicable): _ /_ /_ to / Reason for Temporary Storage(if applicable): / ' Revised 10/7/93 Thrs form is.printed on recycled paper. Page t of 2 i Massachusetts Department of Environmental Protection BWSC-012A Bureau of Waste Site Cleanup Release Trauunp Numper: BILL OF LADING (pursuant to 310 CMR 40.0030) E. RECEIVING FACILITY/TEMPORARY STORAGE LOCATION (contInued): Temporary Storage Address: Street: _ Cityrrown: 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 2 Oil #4 Oil #6 Oil Waste Oil ' Kerosene Jet Fuel Other: Estimated Volume of Materials: Cubic Yards: 30 Tons: 45 Other: Contaminant Source(check one/specify): ❑ Transportation Accident ® Underground Storage Tank ❑Other: 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 n Sampling_and Analytical Methods and Procedures 2 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 DEP. G. LICENSED SITE PROFESSIONAL (LSP) OPINION: Name of Organization: Vargo & Associates, Inc. LSP Name: Patrick 0. Vargo Title: President ' Telephone: — /98 — Ext. _ I 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 I if I wilful) submit information which I know to that significant penalties including,but not limited to,possible fines and imprisonment may resu t y , be false.inaccurate,or materially incomplete. ' Signature: - Seal: Date: �- 2955 ' License Number: H. CERTIFICATION OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS ' 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 ' cluding.but not limited to, possible fines and imprisonment, for wilfully submitting false, inaccurate. or incomplete informa ipn Signature: Date:. l� �� 77 ' Y/A Name of Person(p ' )OrL 0 Revised 10/1/93 This form is printed on recycled paper. Page 2 of 2 1 R.. 1 Massachusetts Department of Environmental Protection BWSC-1012A :'J1S1-.;4 Y aulreaU 91i`I. GF �a::INra Ip�rw;ai:t:D cN:q so_OoJq) ' �. wklYEDai�iG X'f:t.f+,i'i'�;TE1d>�C'e1AR1f STotiiaua r...:,r,7if(11u !,-n�►inuflydj: �� &•'1NCJ:^.1.��.:OrOa^,n.Art.•ifP55! I Cityflown -...--- F< DESCRilPTION' OF•RE&MMATION WASTE: II cheCK 311 trot orply1 1 ii A•_��) �.;: !aailrn,nn:aa;fee0d McCla(circe al: hBF Fly): Sal C.rrnr'„nnnn�w+ratMlrnt 1Naica;l1o3 C0'.:312Vf Coon (ci rcit,dii it.ai ec;@w!u.aG�r•e:f�•�—an c -`_-u r-,.u:: ._.....�----__.. i F.n:;crcan;Materials Otnsr. U(icorrainerizod Waste c,r;:le aii;n p' 1- - .` ;_! C ir —_.-----_-• --- ; 1- nn Wart.fr,rcle all trial apply)- lA.11K b•Jllp'tlb ..,f -f; ;n�inatlrcaJ L•1:lyuunOmGn1S Vltlur:, _ __ _. _ _,_,_ i tiiat;DC:. 3j.p y,: laaSUii:'� :,:i;el°U it r':il e (,1.t ,h < +..-_. _cE:1. _iuma:c vxu re cl M;t ial, �u�i; .�!r.s 30 7 ' :,:'ird,ihf:an•�c'rce ICheCY Dpe/SUBCA' r Tran Oflulipn AC%+:iitt r S r^:'i:yyi :':,. (,�Uu•d, ridCVJlt:q:,:.ion ASSC.0 ter,Ymn D11' if t.avu:l,�•�1.n,.io•�....i ------ .:oaia,uyl,; ' � ... , .I,..,^• F-:�t olti ), I,: ..lt - +�<un.,•iJ:iv`,�.ra��":J`:._1—�.!_. ._-1-rQ,'1ti�F�Ye%i`SCUf1$G.°_�'-_'._ .... Ciner(scec,tv': ' 1 Aen•e:,,.:.or:•+'aste Ctlarac{i+rizetiun S-uppor.Dacumenta:,On a:'-:mziiL•u. !X1 'arr�p!inO and Ar•a:nicai MOIf�Cs: f'fOCe:% '( i_7C".t3IG:'y'(id -� :'It!'y:r.�nii'.0 f'•i.(% 11 ! �(�^ -•:.,� :Inr:,ma!t!aUon Is not aucardac •^viAir hIT!H^I ;r l ' ( ,Ct-;':•�. r. do o{I3C i 51 Jiln.� +c .7 r,:.e )n•• ... ,.D".C.^_..�. Y:'r• •�:'13• .,i+•::i+T�.'•.. ;�.^n ,nlcitn4ti •,wat prtrviousiY s4:bm,twd io Uc' r. G. sLiCENSED SITE PROFESSIONAL(LSP) OPINION; � ' I MameclOtganizatior,: yarQO & Associates, Inc. i ! �:.�'••"rM'Ti:: PF•t_i.�T1: �, �C?C`�r1 ----- --_'--- - - - t'l•Es;y��C:l{. I i lalepnt ntr. we Ext rsvc pc:UL4ta;y tixanii:,cu u:�d.T.1:t;;tiia, with tho ir-1c.":�::.a:❑lir:n:r:Cn:+"n^.•t ^?+n',«•i1h:h!^ I IJpiruon inat the Lusting iwo adoquale to it it .°i1l (�41h S(,1.i)30 d• a Iaci4y or locatitm can a:.epi refned,atlon:vastcs itiit;l ule cl:.lfaCli uji•i S v i:::' am award t th&(& rulican ri pill ;ci' • .y � „;; a crt„- ar au �.n i •.v. l:io"Q 1 ld line � _ �u.r, f ,y.i 1.JIiS n1 Ow:C be Wse.+na CU m8 erlaJly i„ „3. PATR ICK �ig:iat•Jr,. _..... VARGO `n i.iate. / No•2956 ' I H. CERTIFICATION OF PERSON CONDUCTING RESPONSE AC T ii N A=OCUTED-tq!TH THIS I BILL OF LAD1M!2! I I Y L d,e:0,low ii C t:@:i`Jflil;i/ei•.Uit'1:1C+d nisi an:iain:i+u1 wni'�;i,..-�..-:.:.:.. ... ._... . �ih,+t• _ ranee��C�•rY�n.,inn Rule ro IA,**__n - - hill h+�c ♦ Y• �n(Orl�tet n� � art,;n't-r�;n:�,nr�a:{I;t75H�!rb1,:u!,�IC'.:'^ =;t;; -..^.i::918 ti'OCl I c me rnatdnat fitotm:uon ccn:ulne:Lc:c!,,s,t to,t_ ,,r rr: P,r.::: �'•; Y l a ntrr� ' I n,ai there ale .1 anc c n:�.•za 1 r C4 ,a'1„�;.�. '.IG:7.7• L•J.7C:I r'tl t'8 ..' ;r% l:c( i :c:v ,...<•,,1r.;a,:n;J i4!CR ,:.a;Ccra1C•e. i Z If 7 i kev,sec+ 1 C,1153 7nrs'crrn --1 s Frm ec cnr.,rc,:rr�a;ce'•r. y _t ' Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Release Tracking Numoer: ' BILL OF LADING (pursuant to 310 CMR 40.0030) ❑_ L SUMMARY SHEET OF K. SUMMARY OF SHIPMENTS: ' DATE OF SHIRMENT: DATE OF RECEIPT: NUMBER OF LOADS SHIPPED: DAILY VOLUME SHIPPED(CU.YDS.rfONS): - ----------- --------------- -------------- ---------- ------------ ----------------- �� K3 '--------- --------------- -------------- ----------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- --------------- --------------------------- ----------------------------- ---------------- --------------- --------------------------- ----------------------------- r• ---------------- --------------- --------.------------------- ----------------------------- ----"----------- --------------- ---------------------------- ----------------------------- _------.-------- ------------- --------------------------------------------------------- r --------------- --------- -- ------ --------------- --------------------------- 1 ---------------- --------------- --------------------------- ----------------------------- �• -------.--------- --------------- --------------------------- ----------------------------- ------- .--------- ---------------- ----------------------------- ----------------------------- -------.--------- --------------- --------------------------- ------ --------------- ---- . _---_—.---------- --------------- ---------------------•------- ------------------------------ --------------- ------------- ---_------------ ------- --------------------------- ---------------- --------------- -------------------- --_--- ----------------------------- ------.---------- --------------- --------------------------- ----------------------------- ----------- ' SUMMARY SHEET TOTAL SHIPPED: BILL OF LADING TOTALSHIPPED(only it different): ' Rewsed 1011t93 This form is printed on recycled paper. Page 1 of 2. Massachusetts Department at Environmental Protection BWSC-012C Bureau of Waste Site Cleanup ' I - ;:d�6sia kacMmy N�rroa� BILL OF LADING (pursuant to 310 CUR 40.00301 SUMMARY SHEET -f ' L. ACKNOWLEDGEMENY.OF RECEIPT OF REMEDIATION WASTE AY RECEIVING FACILITY OR TEMPORAKY STORAGE LOCAT1,00; Reconnng Faci.14yrfemporary ilia. ' Location raepresentaliva(print): ___..._. w Signature. Date:.M.ACKNOWLEDGEMENT OF SHIPMENT AND RECEIPT OF REMEDIATION WASTE BY PERSON ' CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS BILL OF LADING: I ceruiy wider ponalties of law that I have personally examined and am familiar min the intormauon contained in th13 3uamnlal.Lnctud,n3<rny and all documents accompanrng this certitication,and that, based on my inquiry of those-ndivrduals immediately responsible for oolairung the niwmanon,the material informalion contained h8rmn ts,to the best of my knowledge and behel,true,accurate and complete, i am aware ' mat there are 51gnrfiCant penaltie ine ding,but not!united to.possrbie fines and urCrisonment, for wilfully 5ubmiaing tai;e,inaccurate, or .rt`nrnsNete rnlonnatton, �rynature _T --- Date to d Silvia 1lante of F'Erspn(pnnta: Y •_. ,— IIi I r I 1 t navtseo 1011193 This/arm rs printed on ree tiedFOPer. Page 2 of. o� TJ�ount TICKET NO. South Dennis MA 02660 :TIME r:+ TRUCKER N0: TRUC PiJ.-..s: .. ....:.: .. . . .., OA .... DS ACOUM.At ,.0 `c J - i - ADVANCED ENVIRONMEitTAL SERVICE SOIL/uSTERVILLE-44 WARREN 15 ATLANTIC AVENUE ' SOUTH DENNIS MA 02660 P _ J POUNDS T GROSS RELY SOIL OIL TRUCKING RATE TARE TAX NET MAEX ` - TOTAL DUE @ lrge I@ 8 8 Se @r 0 any I 1 Or persona In)Ury or property flEPART JOB WAITING TIME WEIGHTh '+x uri-Wai+�+ .`vt-°xts. damage when llve ismade-beyond the curb hne Your business is greatly valued. Driver: Waling time imezce 1/4 hourill be chat Received by: ��/. �i7ylfy Zv current Prices 1 �' CUSTOMER COPY CONTROL NO. 259 2 88 ��r✓�� jrr�c,r/Y or environmental ,protection BWSC-012q Bureau of Waste Site Cleanup Reiaese fraoun0 Numow BILL OF LADING (pursuant to ato c1uR 40.0030) ' A. LOCATION OF SITE OR DISPOSAL SITE WHERE REMEDIATION WASTE WAS GENERATED: Release Name(optional): Woodwork S11A Street: 44 Warren Avenue City/Town: OstervilIe Location Aid: _ Date/Period of Generation: 10 17 9 7 10 18 9 7 ZiP Code: 2 6 55 Additional Release Tracking Numbers Associated with this Sill of Lading: ' *Note: It this all/of Lading is the result of a LJrnifted Removal Action Notification, a Release Tracking Number Is not need( J taken prior to ' d. S. PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL OF LADING: Name Of Organization: LIIS Corporation Name of Contact: Floyd Silvia ' Street: 619 Main Street title: Partner Cilyfrown: Centerville Telephone: 508 - 775 - 1442 State: MA•__ Zip Code: 02632 _ C. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON CONDUCTING ASSOCIATED WITH BILL OF LADING: RESPO N'SE ACTION (check one/specity) ' ❑ RP Specify(circle one �-t ) Owner Operator Generator Transporter Other RP: fl PRP Specify(circle one): Owner Operator Generator Transporter Other PRP: ❑ Fiduciary/Secured Lender ' ❑ Agency/Public Utility on a Right of Way ❑ Other Person: II an 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.if known. D. TRANSPORTER/COMMON CARRIER INFORMATION: ' Transporer/Common Carrier Name: Robert Bevila ua Trucking Contact Person: Robert Bevf la ua Street: 152 Kiahs Way Title: Owner Ciloown: Sandwich ' Telephone: - - State: Zip Code: 02563 _ Ext. E• RECEIVING FACILITY/TEMPORARY STORAGE LOCATION: Operator/Facility Name: Barden Trimount Barr Inc' Contact Parson: y Powers Street: 230 Great Western Road T;,,c: Manager ' C,,yfrown. South Dennis Tetepnone: 508 _ 398 _ 8 6 State: MA. 02660 Zip Code: E. Ext. __ ---- — Type of Facility: ® Asphalt BatcNold Mix C (check one) ❑ Landfill/Disposal ❑ incinerator ® Asphalt Batch/Hot Mix ❑ Landfill/Da,ly Cover ❑ Temporary.Storage ❑ Thermal Processing ❑ Landfill/Structural Fill Division of Hazardous ❑ Other: ' Waste/Class A Permit p: S—9 5—04 2 Division of Solid waste Management Permit ii: MAD 9 8.5 2 8 6 3 8 4 Actual/Anticipated Period of Tempura EPA Identification a:: ry Storage(specify dates if applicable): Reason for Temporary Storage(if applicable): to ,. %+awed t0/t/93 ` This lorm is printed on recycled paper. Page 1 of 2 Massachusetts Department of Environmental Protection BWSC-012A ' Bureau or Waste Site Cleanup Release iracwnQ Number. BILL OF LADING ❑' LRA ' (pursuant to 510 CM 40.00S0) E. RECEIVING FACILITY/TEMPORARY STORAGE LOCATION (continued): Temporary Storage Address: ._Street: Cityrrown: 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 Olhe'r: Non-hazarcous Containerized Waste(circle all that apply): Tank Bottoms/Sludges Containers Drums ' Engineered Impoundments Other: Type of Contamination(circle all that apply): Gasoline Diesel Fuel 2 Oil xa Oil #6 Oil Waste Oil ' Kerosene Jet Fuel Other: Estimated Volume of Materials: Cubic Yards: 30 Tons: 45 Other: Contaminant Source(check one/specity): ❑ Transportation Accident ®.Undergreund Storage Tank ❑Other: ' 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 Suppon Documentation attacnec: Site History Information E] 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: Vargo & Associates , Inc. LSP Name: Patrick 0. Vargo rue: President 508. Telephone: — — Ext. ' I 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 including.but not limited to,possible lines and imprisonment may result if I wilfully submit information which I know to be false,inaccurate,or materially incomplete. Signature: Seal: Date: ' License Number: 2955 H. CERTIFICATION OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS 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 cluding, but not limited to, possible lines and imprisonment, for wilfully submitting false, inaccurate,or incomplete Ofarma' n n ' Signature: Date: Name of Person(p FL y T fl Yl~ I � Revised 10/1/93 this form is printed on recycled paper. Page 2 of Massachusetts Department of Environmental Protection BWSC-',,1 2A, ' ! �_ ..BILL U;; "DINC; jp.1Hl;4;;Z*Z 1C CAPA A10.0039) '144POW11 7F. 1D)ESC;1j'PTIOX0F REMIMATION WASTE. !check at.,,rat orply) klecla icirve bil:;A&I apply)! Soil Gl,:.�.,no-wrtt swilaco wafer :;'chef.Ctecris'(Urr.10 44 wa310 AOSC:Cant Matettals olnw: Uncowalnerizoo wave(Cirwrd ali mat acp;yy NZ.1.11-LIQuirv,,: W-Ilt-qve all In at ap;)io lAhk .4 ve.0.1 Vivv!Oil 7.ji;i re Ct Malalaii1s. 30 ' I ..v':'ai0x:9n.Soxce icheci L ASsc-zaai:;Ye.in Vil'41 L;Sljt,;Ij -Nasie;.harp cwilglion�Eupper.D(xumenurt.jon X*4::ilu-,.;. K;;-ory;14CrMz;.Qr1 �arripp!ng Ftocti is not aquarloce. _aiAg an icaclwnwii :;wtwf :NT C101%mr...?r.1 !4.,7n inictmatsm wa-%orvvio"y ZUQM1%Ldd io G. LIG9USEZ)SITE PROFESSIONAL(L3P) OPINION; -7 Nivite,;1I Oigzrnattor: Varqo & Associates, Inc. patz-F- ?;:r4..;i low. 71--—01 r xt o!.r. �asec cn!r,;.-'nto-r�,,:2n i-s my -41r v.ith the ini�:7,—= Oc:ruon inat tte Lesting�U:O as"o'-swilen,ac!ions VACQ*l1i44?n 0<1`0 acoczu*we m chai-&:ioeize 310 ' '�::ri 3C.iX 3C. d.Ing-�!,-Fvfi Q,10cation Can efr4datior,wastos oi.n. tne am aware ini not -t— "! *Zvi:'. be;a!5e.-1r. ma erta,Iy 1. 0. E;ate. .-IV4,j H. CERTIFICATION OF PERSON CONDUCTING RESPOH5F ACT a0f-1 AZZOCIA TED;!TH'THIS BILL OF LAAMMS! oi iw,li-41 1'14-0V prX,;iana:;j ai-i%;all: !mt-m-tiai znc,u�nnq any :wi ;,t it; -;p uw e:;v'-I*:Ole v octainmi.i Me Material x1lotma.,jon c=airia.';.C.a n.a 1:-w -)t 'o JIN4(there a,e .-y-fic.;r! 41- %,lo. -2nr L-21 Ac:I I'llof C,C., 0. 7 -rl7-- 7-- rhis'CrM lscmwc Massachusetts Department of Environmental Protection BWSC-012C ' Bureau of Waste Site Cleanup Release Tacking Number: BILL OF LADING (Pursuant to 310 CMR 40.0030) ❑_ SUMMARY SHEET OF LRA ' K. SUMMARY OF SHIPMENTS: DATE OF SHIPMENT: DATE OF RECEIPT: NUMBER OF LOADS SHIPPED: I DAILY VOLUME SHIPPED(CU.YDSJTONS): 1 -------------- ------------------------------------------- --------------------------- 1 ___:____________ _______________r---------_----------------- ____________________________ ________________ _______________ ________________________________________________________ i _______________ ____________________ -_ ----_------_--_--_-_----__-- _________ _______________r-----_____________________- ---------------------------- -------------- --------------------------- ----------------------------. i ---------------- ------&V------- --------------------------- ---- ------------------------ ---------------- ---= -------- T ------=------------- ------------------------------ ------_ __ ____-r-__________________ ___---_ _____ ________________ 1 ----------- ------------- --------------- ---------- ------------------- -------_ i ----- ---------- --------------- --------------------------- ----------------------------_ 1 --------------- --------------------------- ----------------------------- _______________ ___________________________ ____________________________- 1 ---------------- --------------- --------------------------- ----------------------------- 1 _____________ _______________ ________________________ ____ _______________ ___________________________ _____________________________ 1 ---------------- --------------_ ---_--__------------ --_-__ -------_--------------------- ________________ _______________ ___________________________ _____________________________ 1 ----------- ----- ___________________________ _________________________ ___ _____________________________ SUMMARY SHEET TOTAL SHIPPED: 1 BILL OF LADING TOTALSHIPPED(only it diHerent): Revised 10/1/93 This lorm is printed on recycled paper. Page 1 of 2 Massachusetts ,pea rtment Of rrvrr,arrmental Protection BWSC-012C Bureau ct Waste Sitf: cleanup FULL OF LADING (pursusnt to 310 CUJJ 40.D03al _., ''xesa rrwju,y qy�, SUMMARY SHEET -------- L. ACXNOWLEOGEME1t+IT.OF RECEIPT 'TEMPORARY STORAGE LOCATION. REMEDlATIt3N WASTE AY RECEIVING FACILITY.OR nccemn9 Facility/Temporary ' Location Hepresenta0ua(print): Srgnaiure. rtlC. Da JW.ACKNOWLEDGEMENT OF SHIPMENT AND RECEIPT OF REMEDIATIOH WASTE BY PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS 13ILL OF I ceruiy under O�N127ti8s Of law that I have personal) LADING: t]!r Jnd�fl documents y examined and am Iamiliur vain the iniprraallon contained in!►u;sucnNual-rntrvdln3 ally 1 the nicvrnauon.the rrtater ong tt+rs ctrrtificayon.and µme,based on m m mtation contained h9r01 rs.to the best Of my kr ow edge and bellLI,true,accurate and compre[e. i am aware rnaf there are Sign cant penaeiG Incr wrunediat resvons,bie for ontanmg i •rrntnt�fefe nlormatfort. �nB•but net lunuetl ro. possrdle fines anu nrnorisonmrn t tar wrlfutly Submitting tarse, ❑naccurale. or Kjnra[ure __T Aan +ni FWsWr(pant): 1 Opd S 11 V l a -- Date 1 ' I _ 'vrsec M/1193 0115 larva rs printed on fucWed{caper. ' Page d of L, " r t 1 , f Massachusetts ^ , sachusetts Department of Environmental Protection swsc-oi2C Bureau of Waste Site Cleanup ®ILL OF LADING R.r.,.&xlcinpttunber: (puraunnt to 310 CMR 4t1.0030) �— r SUMMARY SHEET L. ACKNOWLEDGEMENT OF RECEIPT OF REMEDIATION WASTE AT RECEIVING FACILITY OR TEMPORARY STOR1iGE LOCATION: Receiving FacillityrTemporary Location Represerttative(print): bavid hl. Peter Title; Mandger-JyEn]7. Services ' signature: -.r' _ Date: � ' l CS-! r M. ACKNOWLEDGEMENT OF SHIPMENT AND RECEIPT f]F FiEMk— TION WASTE BY PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS BILL OF LADIN O: I certify under penalties of law that I have personally examined and am lamillar with the informaflon contained In this submittal,Including any and all documents accompanying this cortm,caWrt, and that,baaad an my Inquiry of those individuals Immediately responsible for obtaining the Information,the mate ai information eantalnad herein Is,to the hest 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 sul trnftng false, inaccurate, of incomplete information Signature: - Date: flame of Person(print): Revised 1011 rt34 _ rim m rs PHINGUM rMywwjPaper. aga2of 2 8aninn (nmeiunl,Inr.. - ' 1 101 rurnpiI p.Strrer r Sloughton Massacnusems 0.'O7J Tel: 617•.144-1100 E FAX:817-:141-1>"o Deccmbcr 15, 1997 AR1'HUR MCCORMACK ' AF)VANCFD FNvlrzc�NMFNTAL . P.U. BOX 472 SO. DEWS, NIA 026tif) Re; soil. LEIS Corporation 44 Warnmi Ave. (7sterville, MA )Release'1•racking #: l.RA 1 The recyclable soil from the above address was received at our facility on December 11, 1 tM. Attached are the shipper's lag of soil rec.ipts xjrhich total 49.<)8 torts along; with the Billy ot'Lading and ether receipt documentation. We will issue ,s Certiltc;cle at Recycling"upon request after Prlacessing,. Thank you for recycling soil at our So. Dennis facility. Yours truly, Pe��t David M. Peter, Manager Environmental Services n aln:aniry m LLnrnnn UmIq',Inn. BPRDON TRIHOUNT ENVIRONMENTAL SERVICES 1101 TURNPIKE STREET, STOUGHTON, NIA 02072 PHONE (617) 341-5500 , FAX ( 617) 341-2440 1 SOIL RECYCLING SUBMITTAL Site Information: Game . wood S hop Contact : Ronald,. Silvia ' Street , 44 Warren Avenue Phone 508-•771-1442 C=ty/Town : Osterville State/Zip : MA. 02655 ' Generator informaJ2116: Name ; TLIS Corporation Contact : Ronald, Silvia ' S= rzer : 619 Main Street p 50'fi'-775-1442 _ hone F ' City/Town: Centerville State/Zip : MA. 02632 Consultant Information: i `tame : Advanced Environmental Svcs . .Contact':• Arthur J., McCormac'.{ Street : PO Box 472 ,i 1 Atlantic Ave . phone n : 508=385-6100 ' City Town: South Dennis - / State/Zip : IN fA- 02600 Estimated Soil Quantity 45, Tons 30 Cubic Yards Soil Contaminants ' (gasoline, diesel fuel , motor oil , etc. ) No. - 2 -Fuel Oil Analyses Performed (check all that apply) X . TPH, X VOCs , X- Flash, ' X PH, X Reactivity (S, CN) , X PCBs , As , Cd, Cr, Hg, Pb, TCLP (metals) , if required based on total .levels All the above tests were performed - Other Total RCRA 8- Metals Laboratory Analytical Data -Attached X h ' Screening Data Attached , Instrument Used and Constituents Found * _ r _ age J CL J Site ' ± L8 diaCraiTl i S required indicating any Major s rIuc!:'_es Cr roads e:ccavaticr. z:eas znd stockpile locations . Ali samglin5 locations must be ' noted . • Check is diagram attached. SITE DIAGRAM i i i i E Mo'i" -f•o Sc.A �L arias Name of individual pre ' P g diagram: ' Page 2 Description/Source of Release _ UST _ Other, Describe is cluding date of release Release found during removal of UST on 10/9/97 . Soil Description Physical Description (.sand, gravel , silt , etc . ) Tan fine to medium sand w/some gravel Classification Method Modified Burmeister Check if the following materials are present ; clay, — construction debris , _ vegetative matter, _ ash, _ coal , otI.jer deleterious materials ( list) ' Soul Characterization Methodology Sampling Method Grab 'X. Composite _ Biased samples (e .g. headspace screened, visually contaminated) Constituents of' Concern No . 2 fuel oil Site History ( _ check if. eatra sheets- attached) Current Use Woodworking shoo Past Use Woodworking shop . I , the generator, having .=ed due diligence determined that there is no reason, 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 anthropegenetic contaminants . I , the generator, realize that due diligence shall consist of a s.earch of information and records reasonably available to the generator of the ' contaminated soil sufficient to make the determination. Such records and information may include, but are not limited to, those of the generator; location of generation. (i .e.. facility if not the generator) the Department's Bureau of Waste Site Cleanup and the municipality (i . e. Board of Health, Fire ' Department) within which the site is located. ' •Xi;g at-ure of Generator ••.Generator - Printed Name n bo i 1 1 1 1 1 1 1 1 1 1 1 1 ' _ _ 1 1 1 1 - I�`�:_ 1 r:3Y 11RCNMEN TAL SERVICES ' 800/974/4300 . (508)398/2400 FAX (508) 398/2441 May?1, 1999 ' A.M.Wilson Associates P.0.Box 486 Barnstable, MA 02630 RE: Silvia and Silvia Inc. ' Woodworking Shop 44 Warren Ave. Osterville, MA ' Dear Ms. Wilson, ' As per our phone conversation ofMay 18, 1999 in regards to head space screening during the soil excavation process done on October 17`'and 180', 1997. I checked my field notes and.recorded the f�il��v;n_ ' S y ft 70 ppm 12ft 50 ppm 7ft 85 ppm 13ft 40 ppm ' 9ft 85 ppm - .14ft 30 ppm 11ft 60 ppm Any further questions please contact me at our So. Dennis office. t - Arthur McCormack . President Advanced Environmental Services " P.O. Box 472 • South Dennis, MA 02660.0472 nn',k -' - _ ... ' r_ £ __• r ..-�.li,�. rSv.s .,.a...+a++"N-+• �y F �u.w'!.:se n -'+-.: =t ray#'.++, 4 .— i I A.M.Wilson Associates Inc. ' TO: GEOFF MAY FROM: ARLENE WILSON RE: 44 WARREN AVE. , OSTERVILLE 21E AUDIT ' DATE 5/28/99 Based on my notes, the following test results were obtained in 10/17/99, the first day of work. ' A composite sample was taken from the .west face of the:'hale.:.71n strata of dark-stained, damp, fine to very fine sand cccurring ± 6-8 ' below grade. This fine layer extended to the east .beyond the ' excavation. Where it was not stained, the color was pale : yellow-gray (5Y 7/1) . The reading was ± 85 ppm. A second sample was taken from the bottom at the west wall interface + 10 ' down ' which was below the stained material. The reading here was ± 55ppm. At + 13 ' below grade a sample from the bottom read + .30ppm. ' A sample from .the east end of the north face about 10 ' 'down was ± 50ppm. ' At + 14 ' there were two west face samples of ± 3ppm and 0. The north and east walls were ranging between 25 and 50ppm at this elevation On 10/18/99 the samples from the hole bottom at 14 ' were ± 25ppm. At ± 16 ' "clean samples had been obtained from all 4 side walls based on information from the machine operator. These were done while I was off site. He also said they has hand augered to ± 22" ' in the hole bottom and had still had a reading of + 17ppm. tl ' P.O.Box 486 508 375 0327 3261 Main Street 508 4281450 Barnstable, MA 02630 FAX 375 0329 s Bo'Ir'C5"N. 7_.co 1 V E . _- a Soo -75.00 ca a 1 I� 0o ra O -- �\�� W JEANETTL._ 8EAR3E Ln N 80 14 08 E 150.00 SQ. FT_ 5�1-+ �Ala ,.•ice�. :;.% AV 61 375.39 �• w.. � _ is S�..a��? °4 FREEMAN ADAMS I. I • >`y,y� i`ram r,';_ I.Sa0 27 381N 7 S.OQ 1 z I �•_ - � c t • ,• .• '. � ..w...,mv�...r w .aa rw n rn u. m�r � r :m ,:_v.l•'r: nm.ir:F:M:r�+SM.. +. wa'd3.'1R:x rt- - .e , aYF � 4 7 a ..._.. _.,., _............._...a,._...»..__-_�.._..,..��........._..��:......._�....._.....w....«.—...,.,-.....�.r.w......,.,w x+m¢..�iJw.zk✓*n,xnur. �^ .....,.rri.:rw - I 1 ► G i 1 A.M.Wilson Associates Inc. FAX NUMBER (508) 375-0329 1 1 DATE TO: , COMPANY/DEPARTMENT: 1 �- Number of pages (including title page): G-- COMMENTS: /f, -v - ..r v. i 7Z, /" -7 ' l i 1 . ' FROM: IF COMPLETE DOCUMENTATION IS NOT RECEIVED, PLEASE CONTACT US AT (508)•375-0327. 1 doc:FAZFORM ' P.O.Box 486 508 375 0327 3261 Main Street 508 4281450 Barnstable, MA 02630 FAX 375 0329 1 . . ECO/G74/4000 (5M) 3E=/E1CC FAX [SL- 3fi!5lEE�= Dec=ber 12. 1997 ! It1r c:c i son f � � •.'''',� J� rA- NL Wu-sox Asscc rs,lric. P. Q. Box 486 Barnstable, Massachusetts 02630 ' RE: Alternatives Analysis Silvia&Silvia Property A4 Warren Stre Usterrille, Massaciusetts Ucar Ms. Wiisca: Advanc-a environmental Services, Inc. (Advanced), in conjunction with Patrict- U. Var n. LSP of Vargo &Associams. has prepared a revie-N ot'viabie clean-IM alte-native ' for a rcl. sc of No. 2 fuel oil at the above referenced property in Ostcrrille, MassachwsetL4(hereinafter the"site). ' BACKGROUND On 0mober 17, 1 M Advanced removed a 500 gallon underground fuel oil storage tank ' (UST) at the site: Upon removal a release of fuel oil was discov=d. Advanced excavated oily soil and stockpiled in on-site: On OctoDer,18, 1997 Advanced excavated additional oily soil to a depth of approximately 15 feet, and stockmiled it on-site. Composite soil samples were collected from each sidcwall and the excavaron bottom as well as a hand augered soil boring through the bottom of the excavation to a depth of approximately 20 feet (the approximate depth of the groundwatedsoil interf=. ' Laboratory.analysis of the samples collected indicated concentrations of TPH in the sidewalls to range from 12 au76grams per kilogram (mg/Kg).to 834 mg/Kg).. The laboratory repotted a concxntt ation of TPH at the bottom of the excavation(15 feet)to be ' 3,020 mg/Kg. Laboratory analysis. of the sample collected at 20 feel indicated a 'I'PH concentration to be 105 milligrams per lulogmm(mglKg). In the opinion of Advanced the concentration of fuel oil at the gmundwater intcxtsce ' indic:ates a strmag possibility of an imp=to groundwamr. 41 i s - F.D. Eox 'Ea 472 • 2h Derntis,MA 02S60<472 x, ,:' :�i�lIRDNMFITAL �� 1IiC�� . a / 385! 1 CC FA'NX (506) C85i 6E22) ECDl�.4,,4�C� t�C@) :FACSI LE COVER STREET TO: , t g cr -7 a3z 1 FROM: DATE: t ?-� 1'7� MME; PAGE-sc. NOT PiCLUDING THIS.PAGE If you have any-Aj ieWty receiving any of the folio ring pages, please concact sender at(508)3854104. co { ,+i ^-►u d �4-�t P.B.•Box 472 • South Dennis. MA 0266O C472 � . R.I. f�n ;cal 5rceraiaa in Em*rnmenr j Sennctm CERTIFICATE (31'' ANALYSE Advawzd Enviro==1 Serxta Date Rimed: 11/13197 Atm: Mr. Tcay Baticr ! Daft Repartxd: 11/14197 � P.O. Box 472 I P.U. 7 One Atiamic Avemc Nark(3etler P. 5i 11-0 Moll" South De:mis, MA4?bot) i 1 DESCREMON: ONE SOIL SAN01Z 1 ' Subjea sammle(s)basibave be=analyzw by m=Wommu ry with the a=cbcd results. Reft-tree: All par =c=w=and yzed by U.S.Ea4 approved mcd odalopa. The q=jl3o meawdologies are listed in the ' methods column of the Cart&AM of Aralpsis If you bane this work,or if,we maybe of fu cV=assistance, please contact us. t Vii=plika Quality C==1 1 ` ' of Custody ' RL,1r I k= A pinta fie.Warwick m otB88,Hw aw= Far wn m--s= t ' A.A.Wilson Asscc,atzs Inc. FAY NUMBER (508) 375-0329 DATA: Num:e: c= pages (including title page) : 3 COIF-NTS: Le� lo. T�f?T �S//F L✓/d S s//LG ✓�LcZj� / /.��r 1 _ FROM: t IF COMPLETE DOCUMENTATION IS NOT RECEIVED, . PLEASE 'CONTACT US AT ' (508) 375-0327. Idoc:FAY_ORM P.O. 8cx 486 508 375 0327 3261 Main Street 508 428 1450 8arnstabie. MA 02530 FAX 375 0329 &r3 & C ECO/974/42CO r/SICC FAX iECEI 2EE/Son- MUM D=mbox 12, 199 7 Arlcnc Wilson Il. M.. WMSON A-sectATz-s,INC. P. 0. Box 486 Barnstable, Ivlassac=e= 02630 ' RE: Alternatives Analysis Silvia&Sihiia Property 44 Warren Street i Usterrillc,Massac7usetts Dcar Jets. Wilson: Adv-ane--d Environmental Services, Inc. (Advanced), in conjunction with Patrick 0. ' Fargo, ►SP of Vargo &Assuciates. im prcpared a review o1'viaole clean-up slteztat vcs for a rcl=sc of No. 2 fuel oil at the aoove referenced property in Ostcrri ile, MiLssachm ewN(heminafler the"sin). ' BACKGROUND On OLlober 17, 1.997 Advanced roved a 500 gallon undergmund fuel oil storage tank (U-371� at the sites Upon romoval a release of fuel oil was discov=d. Advanced excavated oily soil and swckpiled in on-site. On October 18, 1997 Advanced excavated additional oily soil to a depth of approximately 15 fee:, and stockpiled it on-site. ' Composite soil samples were collected from each sidcwall and the excavation bottom as well as a hand augered soil boring through the bottom of the excavation to a depth of approximaLely 20 fact (the approximate depth of the groundwater/soil interf=. ' Laboratory analysis of the samples collected indicated coaccairadans of TPH in the sidewalk in range from 12 au7Ggrains per kilogram (mg lKg) to 884 mgfKg). The laboraft ry reported a concentmticn of TPIi at the bouom of the excavation(15 feet)to be ' 3,020 m9ag. laboratory analysis of the sample collected at 20 feet indicated a TPH concentration to be 106 milligrams per kiiog=n(mg/Kg). In the opinion of Advanced the concentration of fv.ei oil at the groundwater intcrike ' indicates a strong possibility of an impact to groundwater. P.C. Sox 472 • ScuthDennis, MA 025v C60472 124) . " r J - � c c uruuci jai 5u�.�23500� P. 01 NPED:'�i1i�IIt;t�NIVIiUTAI. S �VICc� . .SCO��?4f�3Cir '(5C6) 3fi5i 61CO ::-�< (�OSJ r8�f6c2? ...'FAC$1-MILE COVER STREET 1 TO: 1 FROM: LYL12:•, , DATE: I z t'7 I -7 TIME., PAGES: C) NOT INCLUDING THIS.PAGE If you hive sny:difliculty rerriving any of the,following plages, plen.se contact sender U(40813854100:' . COMI�2'��'Sc- ' -•�•A-2.��ri �u� ��--A ' P.O. Box 472 • South Dennis.MA 0266C 0472 i c v, - n - rc g A.M.Wilson Associates Inc. ' TO: Geoff May FROM: Arlen e Wilson RE: Water Service/Onsite Wells 44 Warren Ave. , Osterville ' DATE: 6/01/99 ' Attached please find a list of properties within 500 ' of the 44 Warren Ave. , Osterville site. We have consulted with the Centerville-Osterville-Marstons Mills Water Dept. and the ' Barnstable Board of Health. We have also checked the Town Assessor's list. Noted for each property is whether there is a list of municipal water service. The Water Department keeps its records by payee. Several of these properties are in trusts with third party payees, some of which do not correspond to tax records. Other properties ' front on more than one street and the Water Department seems to use an address different from that used by the assessors. We have cross checked the Water Service List against the Board 'of Health ' records for Onsite Well Permits. The Assessors records have been used to see whether buildings exist on the properties. The Board of Health shows no onsite drinking water wells permitted ' for any of the properties. The C-O-MM records show water service to all properties with dwellings except two. one of these appears to have water service which 'is billed to the owner at his primary ' residence in Oyster Harbors: The other at 35 Fourth Ave. (Assessors Map 139/70) may billed through a third party not in the tax records. There is no external evidence of a well at this site. ' 699AW0 2/csp ' P.Q. Box 486 375 3261 Main Street 508 0327 508 375 0327 Barnstable, MA 02630 FAX 375 0329 i ' A.M. WILSON ASSOCIATES, INC. eoe 3261 Main Street P.O. Box 486 SHEET NO. OF BARNSTABLE, MA 02630-0486 CALCULATED BY ' (508) 375-0327 DATE ' FAX (508) 375-0329 CHECKED BY DATE SCALE .............__._....... .... v� JAG... .. .` ... ! ......................:.......CO ... �5770 J .9 .................... . 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A /I 1 J a' ~• p 66 a V E►`'t 4�i° " '• SL 'IMP*1 OL es �l r a = P a� cr I 1 3 3 aai E .. 3 mo N1040000 �a. � I 1 .o l I Y 1 1 1 1 1 1 1 1 1 1 1 f I aLDV&NCEDEW'RGNMENTAL SERVICES ' 800/974/4300 (508)398/2400 FAX 508( ) 398/2441 July 8, 1999 ' A.M. Wilson Associa tes P.O.Box 486 tBarnstable, MA. 02630 Dear Arlene, As per your.request, I am sending along.the Bill of Lading with David.Peter's ' signature along.with the"Certificate of Recycling" You also wanted a manifest for the tanks contents which I do.-not have because I the fuel was transferred to the new tank. I think that will do it..... Good Luck; Arthur McCormack P.O. Box 472 • South Dennis, MA 02660.0472 . Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup Reisew TrscUng t%znber. BILL OF LADING (pursuant to ato CMR 40.0030) _ SUMMARY SHEET ' L. ACKNOWLEDGEMENT OF RECEIPT OF REMEDIATION WASTE AT RECEIVING FACILITY OR TEMPORARY STORAGE LOCATION: ' Receiving Facility/Temporary Location Representative(print): David M. Peter Title: Manager—Env Services Signature: Date: �L I L!�-12 ' M. ACKNOWLEDGEMENT OF SHIPMENT AND RECEIPT OF REME IATION WASTE BY PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS 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. 1 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: ' Name of Person(print): � r Revised to/l/94 7 nis rorm is prrn e recycled paper. Page 2 of 2 t3ardon Trimount,Inc. 1101Turnpike Street � itoughton Thfiz Flmt Aassachusetts )2072 fel: 617-344-1100 =ax:617-341-2440 December 15, 1997 tARTHUR MCCORMACK ADVANCED ENVIRONMENTAL P.O. BOX 472 ,. SO. DENNIS, �,.-n 02660 Re: Soil, LDS Corporation r 44 Warren Ave. Osterville, MA Release Tracking#: LRA The recyclable soil from the above address was received at our facility on December 11, 1997. Attached are the shipper's log of soil receipts which total 49.98 tons along with the Bills of Lading and other receipt documentation. We will issue a "Certificate of Recycling" upon request after processing. 'Thank you for recycling soil at our So. Dennis facility. '.. Yours truly, David M. Peter, Manager Environmental Services 1. V '3 subsidiary of ardon Group,Inc. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ' 1 I 1 11 Town of Barnstable P Department of Health,Safety,and Environmental Services ' ' Public M611th Division Date 367 Main Street,Hyannis MA 02601 jo 7Jf MA89. '. .: RNSTABIA i63g6 \� Q Cam' rtuMx+� Date,Scheduled (J Thne tee Pd. 16o Soil Suitazbility Assessment for Se wage Disposal Pe formed By: c ( < Witnessed By: �+ .tvu.I OG Sx�A : & G lei ZN O ON � Locatlon Addressrresi Owners Name Silvia SiVt.- b�4°rws,tRa, _ Address E.0: VYlc.i 54 t:c.�•.le.rui01� Assessor's Map/Parcel:.*4to /%c.. Engineer's Name 3AKT'tr-as 0Ye , /k/C. _. NEW CONSTRUCTION l� REPAIR Telephone# ,..} -Cj Land Use CbMinctrck..'A 1, ..,� Slopes(%a) t= 2. Surface Stories ---- Distances from` Open Water Body R Possible Wet Area R Drinking Water Well R w Drainage Way fl Property Line Il Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 46 FN LP, . 27.6 "26-4 28.3 N80'14'13'E - x?0.2 x 18.4 O y2 >^ N80' ND. OFF. . 275 - 200AO'. 22.3 - : .20.g, - - .,.. 1�-�-1-i /2s.e 19.2 Z o I o ;0x 21.5�. I 23.3 2Ef 2 - o OLIVE FIELD. 20.6 26.I 24.0 ... '2 J6- 118:8 0ckode 23.5 23 2 - 1g_2 _ .ice 23.4 - 20.8 ^ i82 u.24.8 / i 19 18.8 22,,I 9aroge .existing building a\2a 5 18.f v w a .4 - j building Ef el. 23 9' a 20.i 18.2 N''. 0 aI .23.4 - ec r1 18 1 - o f 23.9. 23.4 ?2Zy28 22.J .,C,4''91�199j `19.1 18.0 17.7 I - 16.1 eG�1O/NC .22.9 21.L. deck "�'gy ! E]17 _183 18? `23.1- y�#44©20 -19.8 19.6 aJ / 17�, r- r -:/1923a-..•0 172 .`7500`., . . 3.8 berm _ _ .0 '21y 21 p8 ✓,5801r7; .19s 1. 72`>r= - �'J.4_ 18.6 - 22 i - 4 f441�`'7 �e . AR EN, 'STREET - 17.36" 7, 7 7. I7,5 PRIVATFFn•WAX` 40'WIDE . '.. 1722 rlb�lo`1cdok .. 22.0 .. 216. 21:1- 196 \497 educe 0f�8.8 po ement � 1.74_: 17J _ .-?07 % - ■171 �i7 -"174 20,7 19 B,2g2 5 +, i 21.7 C.8. 201.,. 19.9 _ C.Q FND.OF ti'• ',�"1g'8 .N80-15'45'E/ µ FND. .OFF .. ' Parent material(geologic) C�Ic� rt Clu�cra.*fit Depth to Bedrock Depth to Groundwater; Standing Water in Hole:` Weeping from Pit race Estimated Seasonal High Groundwater -�- `:` >:`. DxEX�tATI( N + n SASCINXX ALT'UVA ' ' 'A .> ..::.:;: Method Used: Depth Observed standing In obs.hole:''. in. ,Depth to soil mottles: in. Depth to Weeping from side of obs hold: In: GroundwatecAdJustment ft, Index Well# Reading Date;— Index-Well level Aill.factor Adj.Groundwater Level_ b '`lfdr .: ...< l Observation I'iolc I< _ Time at 9'- N Depth of Pere ` e Time at 6 �i Stan Pre-soak Time Du IG':?o Time(9"-6"). v End Pre-soak VSe _ l city �m �)✓C,54Pa(0 Rate MIn./Inch :�y�nth tutu 50 Site Sultability Assessment: Site Passed Site railed: Additional Testing Needed(YM) ' n Original: Public Health Division Observation Mole Data To Be Completed on Back j �Q` f Depth from Solt Horizon Soil Texture Soil Color Soil Other Surface(id.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes, Consistency.%Graven r- 1,, f�> x, y i.lv jam' t .. I ULEP'OBSLRVA'PXON HOLD LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,noulderes. Consistency.%Gravel) . I .....``.: ::AIa1 (� 3LItVATONY.IC :0 Depth from Soil Horizon SoII.Texture Soil Color Soil 01he.r Surface(in,),. (USDA) (Munsell) Mottling (Structure,Stones,Uoulderes. Consistency,%Gravel) .DI±,P OBSERVATIONIOL Depth from Soil Horizon Soil Texttire Soil Color Soil Other Surface(in,) (USDA) (Munsell)_ Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No _/_ Yes Within 100 year flood boundary No %/ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious.material exist ill all.areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? . Certification 1 certify that on p, L `` ! (date) I have passed the soil evaluator exatninatiodapproved by the Department of En uronmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described'in.310 CMR 15.017: f° Date 1/2"-y INLET & OUTLET COVERS TO BE �.- _2_ LE TEST z 1/r' ES HO LE O L E #2 BROUGHT TO 6" OF FiN1SH GRADE. � i � I , ! �K. '�-�,_- (,�•,t L?o� �'� I ]! 1�••"-=]* 1. CONCRETE - 5000 P51 MIN ' A' A STRENGTH 0 28 DAYS BAXTER & NYE INC. BAXTER & NYE INC. ��'''' 11'-O" ___:-_ s" �n 1/23/02 FIOUSC FOOTPRIN r 3/18/99. 3/18/99 ► f�-"-- - t0'-0" COVES r 2. STEEL REINFORCEMENT - P-9368 P- � -AS TM 1 36 � oT A 6 5 GRADE }9 8 nE so �..:,:. .. . . .. . .. . _ , ! l tJSE FOOTPI�ItIT FAt A M 24" DIA. MANHOLE COVE R t'-o". I r 1 j _ = 18.5' ELEV. = 26.9' _ 7 2 HOUSE FOOTPRINT- ELEV. , --- 2:00' , • 3 COVER TO STEEL - 1".MIN. � HO 6" PLOW P F f- �_ � /r • " 0 S " ZABEL FILTER L! n 2 O i OUTLET TEEW/EXTE SION 2 B 1 1-1 I - /_ ' I 4i• INLET q•_1" i lI III ,,, - .� �. PLAN VIEW M � �-�=- 1�poch I � ; I AP SANDY LOAM 10YR 2 2 AP SANDY LOAM 10YR 5 1 d :•;; TEE 1n a / / LIQUID DEPTH 6" M1N, 3/4" TO 1-1/2"STONE �\ f�oy III :.`•: 5" DIA, KNOCKOUT 5" DIA. KNOCKOUT i TYP Y 3.5 0 T P PRECAST CONCRETE SEPTIC TANK BATTOM ON LEVEL STABLE BASE e.P ( REINFORCED WITH STEEL i 28.l00' �. B SANDY LOAM 10YR 4 6 ANY M 1 r� CROSS SECTION VIEW / B 5 D LOA 0YR 5/6 PLAN VIEW _ Tf NOTES 3) INLET AND OUTLET TEES TO BE CAST IRON 0 f' Crystn! / i -6" -20" 1) SEPTIC TANK TO WITHSTAND H-10 LOADING OR SCHEDULE 40 PVC. a 3" LOCUS TEES TO BE CENTERED UNDER MANHOLE COVERS. g" PLAN VIEW I // UNLESS UNDER PAVEMENT, DRIVES, OR TRAVELED 6" 7 1/" i 0.^:fErvirlry I't, C7 Q WAYS, WHERE BY H-20 LOADING SHALL APPLY. .' • ..., i f(_ ~ - �e; I 17 Q 2) ALL PIPE CONNECTIONS AND CONCRETE CON- NO, OF GALLONS: 1500 C MEDIUM SAND 10YR. 7/4 STRUCTION TO BE WATERTIGHT. / f I Q v SECTION A-A SECTION B-B o I Q SEPTIC TANK DETAIL DISTRIBUTION BOX DETAIL / 5° r�� 11 C MEDIUM SAND 10YR, 6/6 e Q Q DB -J W/ BAFFLE ELEVATION 20.30 MAX. D -60' PERC TEST Q NOT TO SCALE - NOT TO SCALE - 18.1 / I V Q INLET & OUTLc7 COVERS TO BE BROUGHT TO © Q WITHIN 6" OF FINISH GRADE FINISH GRADE 2% MINIMUM FINISHED GRADE OVER LEACHING AREA 2" PEASTONE C INVERTS 16.80 3 FLOW DIFFUSERS L=18 S-2% � 18.1' MIN. 20.3 MAX. I Q Q 4" PVC SCH. U�' 17.3' (TYP.) ' t L-2 S-1,5% FIRST TWO FEET TO 17.3 . o LOCUS�l IVI / 1 I ~) I aaaaaoa aoaaaiacl aaaaaaa I -120" NO WATER (ELEV.-8.5") -120" NO WATER (ELEV,=16.9'") BE LAID LEVEL -` �2.00 PERC RATE <2 MIN/IN 19.5' A 19.22' 19.05' o a o q o a o a N A 1' STONE: UNDER _ _ 14,8' NOT TO SCAf_E. 21.0' 500 GAL. 16.80' y 3 SEPTIC TANK :? 19,25' 14.8' I MAP 139, PARCEL 67 -3/4"-1 1/2" DOUBLE WASHED STONEI FOUNDATION W LEACHING 3 FLOW DIFFUSERS I I zTO BE INSTA Eq N A SYSTEM P R O I L E 3.5' STONE SIDES. 2' ENDS, 1' UNDER LL 0 LEACHING DETAIL DESIGN ANALYSIS LEVEL & STABLE BASE TEST PIT #i 8.5 NOT TO SCALE NOT TO SCALEN,. I DESIGN FLOW: aIA j C1vlr_ , Zone : I \ 1- ,I � i ': 3 BR x 110 GPD/BR=330 GPD _ No. MINIMUM AREA 43,560 S.F. MINIMUM FRONTAGE 20' l N F � SEPTIC TANK . REQUIREMENTS: _._.__- '��/��, %�' -,_.._._ _. _._.._ _.__.__-________.._ BENCHMARK: / 2 DA x 330 GPD OR _ SETBACKS: NAIL TO BE SET IN MARILYN C. WILBURN & PHILIP L. CHASE - _,- .__-_-____.____ Project 11fle FRONT: "30' TREE, ELEV. 23.00oQ�iALTMIN.� SIDE: 15' X27.6 � REAR: 15' 275 PRIMARY LEACHING FACILi fY { LOT WIDTH: 125' S 6527'08" W Ida x25.3 ,�' E' REQUIREMENTS: _; .` 2` ((28,0' x 11.0')+2x(28.O' + 11,0') x 2) , Lot 4 4-A I _ ___ �,��_�__.� __ o f �A -- __ --- - -- __ ;• x0.74 GAL/(FT 2 - DA_) � 343 GPD 0 v e r I a y District : r 9,9 7 7 S. F. ,t _ - _ ,. - --- W(,AP - AQUIFER PRO"iECTION DISTRICT �r ' II �/ ^� / P r 0. 23 Acres / � LEACHING FACILITY PROVIDED AS SHOWN ON PLAN ENTITLED I "REVISED GROUNDWATER PROTECTION 27.2 / / I 3-FLOW DIFFUSORS _ { OVERLAY DISTRIC75' - APRIL, 1993 / ,� i 2' STONE ATND 3 -AT siDCs AN1?_ UNDER I TP fin; �i ti .� RESERVE 2'Hx2.67'Wx66'L-330 GPD I SCREENED �, � / o e)r. //e Flood Zone : C � I' F')RCH o i Io y N �jw 21. 21.5 �i� N `,..1 Tl.S y C O M M U N,I T`( P'A N E L NO, � y� ---- � V l ��1 #250001 0016 C x26.9 26 I LIMIT OF 5 , - �' c AUG. 19, 1985 --y` 1. UNLESS OTHERWISE NOTED, ALL CONSTRUCTION o REMOVAL METHODS AND MATERIALS SHALL CONFORM 'TO _,.. - , I. I 1 C NM I N w I I TITLE V OF THE STATE ENV R J ENTAL CODE AND-- (SEE N 0 rE) I I ;_... _.. PSI TOWN OF BARNS i AE.°:I_E RULES A�•,ID f?P::rl.li._A1';LCiNs. I I_.,_ rn b " I rl l C o rl r I I 16.7' �1 P OSED 2. GROUT TO BE USED AT ALL POINTS Wo-iFRP r'II E:S j y b U t o n N/� F GARAGE �' ENTER OR LEAVE ALL. CONCRETE STRUCTURES IN I NANCY A. !WHITE TR. �� 23,3 Zone : I �BEDiOOM DWELLING I ON SLAB ORDER TO PROVIDE A WATERTIGIiT SEAL. x2f NOT WITHIN ZONE. 3. ALL SH{PLAP JOINTS IN SEPTIC TANK SHALL, BE f' I _,� Prepared f^or' TOP OF FND.-23.0 SEALED WITH NEOPRENE GASKETS OR ASPHALT CEMENT TO PROVIDE_ A WATERTIGHT SEAL_, R e f e re n c e V. 22,`j 4. PRECAST CONCRETE SEPTIC TANK, DISTRIBUTION PECK NOMIN1-E 1`RUSFE I BOX AND LEACHING FACILITY TO WITHSTAND H--10 2_18 ALTAMONT AVENUE „ / < .� LOADING UNLESS UNDER PAVEMENT DRIVES OR � I SITE PLAN OF EXISTING CONDITIONS AT 44 P o z TARRYT-OWN, NEW YO K 10591 I # I < o � TRAVELLED WAYS WHEREIN H-20 LOADING �>HAL_I_ WARREN STREET IN (OSTERVILLE) BARNSTABLE, ° r APPLY. MASS", FOR PECK NOMINEE TRUST, PREPARED , 23 5 23.4 / < � r SHALL AREA SHOWN, ALL UNSUITABLE MATERIAL (A & B / / S' / \ ) 5. ALL 4" PVC PIPES IN THE SYSTEM SHALL BE BY BAXTER & N1 E -DATED FEB. 8, 1999. / RCH J , in S _. HORIZONS) TO BE REMOVED AND REPLACED WITH SOIL I C Ml/�/`1.) SCHEDULE 4Q. 31(>1 Main Street CONSISTING �S � Domstoble, MA MATTER AN OF CLEAN GRANULAR SAND, FREE FROM ORGANIC � 1 � FW � 6, WASHED CRUSHED STONE SHALL FREE OF ALL 02r:;30 MATTER AND DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS "PLAN OF LAND LOCATED IN OSTERVILLE I < DIRT,, TAN IN OF DIFFERENT CLASSES OF SOIL SHALL NOT BE USED. THE FILL I D DUST D FINES, (BARNSTABLE) MA. PREPARED FOR PECK � I -= < � .,:.. ,,. ,,,,,. T, •�r ,' ,: : SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A NOMINEE TRUST PREPARED BY YANKEE I < EXIS77 c. lcb/Nc "� 7. AT ALL_ POINTS of INTERSECTION F wATyrLINES SIEVE ANALYSIS, USING A ##4 SIEVE, SHALL BE PERFORMED ;`� ❑ 1 0 . i I !� ); 0 0 WATER , ON A REPRESENTATIVE SAMPLE OF THE FILL. UP TO 45% Y W I HT SURVEY CONSULTANTS, REVISED DATE OF MAY �! GARAGE o < (TO E R ZED) a I AND SEWER LINES, BOTH PIPES SHALL BE CON- B E G I `'' cv �.: iO,P�E RAZED N OF !, , .. ; OF THE FILL SAMPLE MAY BE RETAINED ON THE #4 SIEVE. 21 , 2001. �i ( ) 8 1L WG I ( STRUCTED OF CLASS 150 PRESSURE PIPE AND ARE TO SIEVE ANALYSES ALSO SHALL BE PERFORMED ON THE FRACTION OF i / (TO E AZED) (TO BE IN BE PRESSURE TESTED TO ASSURE WATERTIGHTNESS. A. M. WIIson Assoc*otes Inc, R THE FILL SAMPLE PASSING THE #4 SIEVE, SUCH ANALYSES MUST DEMONSTRATE THAT THE MATERIAL MEETS EACH OF DEED . BOOK 11026 PAGE 324, ,�� `� 8. SEPTIC TANK, DISTRIBUTION BOX, ETC. SHALL BE < MANUFACTURED BY ROTONDO OR AN EQUIVALENT 508 375 0327 / FAX 375 0329 < 10'_IMIN. 10' NIIN, / ( MANUFACTURER. _ THE FOLLOWING SPECIFICATIONS; � _-F / EFFECTIVE % THAT MUST ) Y 23.9 SIEVE SIZE PARTICLE SIZE PASS SIEVE vq 23.4, 228 < Drawing Title I 5 ��-,11.• 9. EXCAVATE ALL UNSUITABLE MATERIAL IN LEACHING ## 4 4.75 MM �100% Ow n e r/A I�'� I I c c n t . I ° T' AREA AND BACKFILL WITH MATEFZIAI, AS DESCRIBED 100 0.30 MM 10% 100% PECK NOMINEE TRUST �' 22.9 0 S < ,' ON PLAN. 0.15 MM 0% - 20% � � ## 200 0,075 MM 0% - 5% rr 218 ALTAMONT AVENUE _ - - _ TARRYTOWN, NEW PORK 10591 Q �-- _.. - - - - _ z 2'H x 2.67'W x 166'L RESERVE �� / 10,HEAVY EQUIPMENT SHALL, NOT BE ALLOWED TO L - - - - - - - -' - - - - -- - - - - - -` � x1��.6" OPERATE OVER THE LIMITS OF THE SEWAGE DIS- o x23. I e 22.6 U /�7 i� I`n POSAL SYSTEMS DURING THE COURSE OF CON- DECK a I / /� ":� STRUCTION OF THE SYSTEMS. L / /h / / / fu C�' k 22 6 x 2P-__ C_.J (..�1 / INVERT ELEVATIONS Notes : w. / � ! SHELL � � 11, N(� FIELD MODIFICATIONS TU THE SEWAGE DISPOSAL I z i 1. PROPERTY LINES SHOWN HEREON WERE COMPILED - ��` -_--� / DRIVE / SYSTEM UHALL F3E MADE WITHOP.JT PRIOR WRIT-1 F_N APPROVAL OF THE ENGINEER AND THE LOCAL. � �-y FROM PLAN OF RECORD AND DO NOT REPRESENT AN - _.__-,,a S652600 W ,�_� - t�'' IT'�•�------� �, - �".'.� ``! ��`�'� 4" INVERT AT BUILDING 21.0' ACTUAL SURVEY 01� `SHE GROUND, •�' ,-'`r 1 0.0 / BOARD OF HEALTH. r � EDGE Of PA Vi�'IUENT � o 4" INVERT AT 1500 GAL. TANK IN `-` 20.6 \,�/ 5' 12.THIS SYSTEM SHALL BE INSPECTED AS REQUIRED BY (}� C), ( ) 1�'•5 2. EXISTING SITE CONDITIONS 5F10WN HEREON WERE ____ ____ � ..-,� --- � - COMPILED FROM PLAN OF RECORD ANDDO NOT / LIMIT OF • 22.1 i� 21.9 21:4 _ __ __ __.. i ,� REMOVAL 4 INVERT AT 1500-GAL- T-ANK _(-OUT) 19 25 REPRESENT AN ACTUAL SURVEY ON THE GROUND. (SEE NOTE) -- � ' 13.A CERTIFICATE OF COMPLIANCE AS REOUIFZF:D BY TITLE V AND AN AS--BUILT PLAN �; 4" INVERT AT DIST, BOX (IN) 19,22' 3. ELEVATIONS ARE BASED ON N:G.V.D. ,�o :� OF THE SYSTEM MUST BE OBTAINED BY THE W A F R NI PUBLIC WAY - 40'' WIDE S T R E T 7 CONTRACTOR UPON COMPLETION OF T1 IE ABOVE WORK, Y 4" INVERT AT DIST, BOX (OUT) 19.05' 4. LOCATIONS OF UTILITIES SHOWN HEREON ARE APPROXIMATE ONLY AND ARE TO BE VERIFIED IN THE /�� , i - 14. TIAIS SYSTEM IS NOT DESIGNED FOR A GARBAGE INVERTS AT LEACHING FACILITY: FIELD. �/ i x\\ / DISPOSAL UNIT. 4" INVERT AT BEG. ,x220 x21.1 / 18. 15.AL.L UNDERGROUND UTILITIES SHOWN WERE COM - LEACHING FACILITY 16.8' �� I� 19.9 19.T - ,1 PILED ACCORDING TO AVAILABLE RECORD PLANS Q�/ EDGE OF /�A VEMEN T 21��' ____ .,,,,1r24.7 !' x----: �' "' 4" INVERT AT END -_ 22 --- --- -- -x "� -" `~ _ i __ ___ I AND ARE APPROXIMATE ONLY, SEE CHAPTER 370, -- -- ACTS OF 1963, MASSACh-IUSETTS GENERAL_ LAWS. LEACHING FACILITY N/A \ 207 1�9 / WE ASSUME NO RESPONSIBILITY FOR DAMAGES W _ _,✓ INCURRED A A RESULT' T t I '"=� " U ED S OF UTILITIES �MM T I I-. OR L ELEVATION AT BOTTOM 1 �.� INACCURATELY SHOWN. THE APPROPRIATE PUBLIC Date Sept. '3, 2001 OF LEACHING FACILITY 14.8' �� „ ENGINEERING DEPARTMENT SFiALP.. BE:: COhITACTE:L`) A5 I Drowing No. Scale: 1 = ( ) E)esi' r1 A.M.W. �h WELL AS DIG SAFE PH, NUMBER 1--800--32.2--4844 . OBSERVED GROUND WATER ELEVATION (MOTTLES) 8.5 Check A.M.W, �!t J1 ,.r......, 0 5 10 15 20 25 FEET Drawn J.V.B, 2,0601;3 TP#1 � _ _ j Job. No. last Rev 1/25/02 of I 7601-1,rPTiC.dwg PURPOSE OF PL.A11! { Os ER al'Ll�' _ I. ' LOTS :� 4 & PORTION OF 5 (PLAN 451109) IS TO BE DI VY-DED INTO LOTS' "AY' & „B" AM. 139/69 la'F'' \ BI>rUCE s OLD PRESENT 0 TPAT AL)F,7-?T PECA, Tf:' Polw CB/DII ! ` (FIID OFF) A.M. 13.9170 1,/ / ATLANTIC N%F MARIL171,T C XILBIIRN r. Y7A.NN0 OCEA.Ar i' a & PHILIP L CHASE ' .� A.1LI. 139/6B BEACH j 00.00 �00 00 OLr�MELD _- / - _-- - ----- FOR REGISTRY USE 2 LOCUS MAP � \ PLAN RF;_F• \o LOT B �, ;; 451109, 2171153 & I 1 \ AREA=9,974� S.F ///, 057129 (1972 LAYOUT) BARN !!\\ E \r //�/ { !%i i%✓!i,`y ,2�'0 ,z oa\a BUILDING MI DH DEED .REF. 110261324 ZONING. % N65 \� (FN OFF) RPOD- RESOURCE PROTF,CTION 0 0 \ w_ !!/;: !, O VERI,A Y DISTRICT too- (2 ACRE MIN..) GROUNDWATER PROTECTION \ �f \ -1 r w 0 VERLA Y DISTRICT- 'AP" \ �'� L O T A f \\ / \ 1 5 0 0 �\ PASESSO6S MAP 139 AREA=9 977E S.F. 1 (FWD OFF;J � MIN. LOT-BE UIRF,�I C ENT, . ARE'A_ FRONTAGE I X7DTH 43,560SF. -- 20' I 125, SETBA_CKS.. /„! BUILDING , - FM S1D ONT ES RL'AR r o . 70 BE RAZED ! �--- -- �—_._ A.M. 139/90 \ \a !//!!!.( )// ////!/ �0 30 1 15 1. 15 NANCY A. WHITE, TR. \ �� /!!!//!;///!/!;!!///! /!!!!// 1\ it !!!,BUILDING/1/ !//////!//!!/!/!///!/ \ 20 (TO BE RAZED)! GARAGE/1 -15 \ 0 _ D AN OF LAND ;y \ �0 Npl 00 T65'26 � KAYO \ \ t � f I 2 LOCATED IN Iy7 \ OS T� VILLE (40 .Aj RNS T , JIM, / I.F' (FND) �,- PREPARED FOR.- PTICA' NOA1,11XI-1, ,' TR, UST 7 MARCH 1, 2001 5 00 ' APPRO VAL NOT REQUIRED RE 11 MA Y 21, 2001 UNDER THE BARNSTABLE 1 , Ek : VISION CONTROL LA W i il>H it(FAD OFT) ------------- ----- GRAPHIC SCALE r ------------- ------ 20 0 10 20 40 80 Z11 RIM UTMOn� i•Ki$. 'arxirsli`""`• 3 ':i''.1`>a. ( ) I CE'I�TIF'Y THAT THIS PLAN r'IAS BEEN PREPARED IN FEET------------------ -----1 1 inch = 20 ft. I IN CONFORMITY Y�7TH THE RULES AND REGULATIONS ___-- _ _ OF THE REGISTRY OF DEEDS OF THE COA1fAfON#TALTTl - - 1 l OF MASSACHUSETTS. -- _- -- - _-- ANKEE SUlI. V Y CONSYULTANTS � UNIT 1, 40 IN.D U��'TI-�'Y ROAD �{ I CER77FY THAT THIS SURVEY AND PLAN WERE MADE ��` or y NO I)ETER�IILVATION AS TO COMPLIANCE WITH 7IIE p 0. BOX 265 r ZONING- ORDINAACE REQUIREMENTS HAS BEEN FADE f S°TONS MILLS, MASS. 02648 IN ACCORDANCE #= THE PROCEDURAL AND TECHNICAL , Q PAuI sG STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN OR INTEND-AD BY THE AEO VE EPIDORSEMENi THE--4'OMMONWEALTII OF AlASSACHUSE= �o+ TEL: 428_-1 055 FAX 420-5553 32098 PA VI, A. MERITHEN; P.L S. ATE i J# 52665 GAI, I 4 ,( TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM dha NAME OF FIRM: -ri 4 aNr-r a- MAILING ADDRESS: Alxl s TELEPHONE NUMBER: 41 1-c4 (,g 7l CONTACT PERSON: CosboRNr 1= 01 nl?iv.4r Does your firm-;store:-any-;of-the.toxic:.or hazardous mat=erials listed==b.el v-;. . either for sale or for your own use, in quantities totalling, at -any, time, more than 50 gallons liquid volume or 25 pounds dry weight? YES P..� NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink tom- Gasoline, Jet fuel i/ Wood preservatives i L__1 Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, ! Swimming Pool chlorine i lubricants Degreasers for engines and metal Lye or caustic soda Jewelry cleaners s! Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro- ✓ Asphalt & roofing tar carbons, (inc.carbon V Paints, varnishes, stains, dyes tetrachloride) � Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers . hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers (including bleach) Other products not listed Spot removers & cleaning fluids which you feel may be toxic or hazardous please (dry cleaners ) Other cleaning solvents R E E I V E ® list. :: HEALTH DEPT. Bug and tar removers TOWN OF BARNSTABLE Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants MAY 1 8 1981 Road Salt (Halite) TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF OXIC AND JAZARDOUS TE IA,LS INSPECTION SHEET FIRM-' ADDRES Major typejdmateri als: 1) 2) 3) J I. Description of material(s) use: - II. Storage (denote product by number listed above) A. Containers metal o glassAl paper plastic cans,bottles,jars drums,barrels aboveground tanks `p underground tanks' fir . bags,boxes open,loose,uncovered inadequate labelling = B. Storage Facility for # Remarks/Recommendations 1. Indoor. a) separate, contained room b) stored in general work area -i)=_-inadequate-vent-il.ation ii)_-floor-drains,- iii:)'--inadequate=fire protection- 2. Out door a) uncovered, exposed to weather b) ;pesw3ousLssuzEd efacatch*basins r III. Disposal s' A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler b) address or disposal site v Person(s) Intervie e` _ i �°;� Inspector. Date - - -