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0045 PIN OAKS DRIVE - Health
45 Pin Oaks Drive ' 279-063 Barnstable 4 6 f , ' * TOWN OF BARNSTABLE i LOCATION SEWAGE VILLAGE ASSESSOR'S MAP & LOT --0b3 INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY / CX3. rJ4/ LEACHING FACILITY:(type) / c/2 S (size) GGa �4 NO. OF BEDROOMS(,3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: I ) V" DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No AZ- i O '/�� zip sc- ' 1 o i('�Gyr i r. ASSESSORS MAP NO: ] 9 -7 PARCEL N0: d. ..... No. .. -- .... ..9� ....................... _ / THE COMMONWEALTH OF MASSACHUSETTS APPRMO BOAR® OF HEALTH 8' G===-3g TOWN OF BARNSTABL l/ d Appliration for Uwvaaal Work i TvnDtrurt' rmit Application is hereby made.for.a Permit to Construct ( ) or Repair P) an Individual Sewage Disposal System at: Pin Oaks Drive Barnstable --•............._....... . -.......Location ...ddr.e--................................... .......................................... or.Lot -----•---------....---•---------••••-•-------- Location-Address or Lot No. GildeA •.....................-----.................--""-----------.........--••---•--------------------- ..........--...................................................................................... Owner Address a .J.:.P.Macomb.r..&--Son...Inc.:-----....-"-----"--"--•-•-----•- ------"-•------------=----""--"-"----"-----...--- Installer Type of Building Size Lot Lot...........................Sq. feet V a Dwelling L No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ----------------"---"--- W Design Flow............................................gallons per person per day. Total daily flow............................................gal Ions. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter.-.-----.------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................--- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water..............--........ tz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..--.................... ----- .1 .r.s............................................................................................................... O Sand-""$c"""you ld e Descriptionof Soil...............................................................................=........................................................................................ x U --------------------•---•-•--••-•---•------••---------------......-•---------...-•-------•••-•-•----•------•---•------••--••--••-----•-------•-----••---------...........--------••--------------------. W U I�ature of Repairs Qr Alterations—Answer when applicable.1-1500" a lOri:__:tarik::: -I:� 'J:_,--a on LLeaching pits . "' --------------"-------------"--------------"----------------------"-------------------....-------------"-"---------------------------------•----------"-----"---------"--••••------------••---......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian e has ben i ue by the boo d of Ith. 11 0 Signed , 2 Application Approved BY --....----- ----------------------------------------- q .:;z Dace Application Disapproved for the following reasons- ----------- ----------------- ----------------- ----------------- --------- ---------------------------------- ----- - - -- ----------------------------------------- ------------------------------------------......---- .---...---------- ..------------.... _....----------------- - -- -- t-�- - Dare Permit No. / - �' ��. Issued ... L r'...------ ----------- Dare No._•-•- ^ .2�� 0 Fizz ...30.'.00... ,- THE COMMONWEALTH OF MASSACHUSETTS c� BOARD OF HEALTH TOWN OF BARNSTABLE-- Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: Pin Oaks Drive Barnstable f ................_................................................................................ --•--•-••--•-------•-•----•----•----------•-•-.... - - .......... Location-Address or Lot No. Gildea - - -----------...-......•................_...._.----•--- Owner Address W J.,P_.Macomb9r & Son Inc . ` a .....---- ......................................................Installer Addreess s;------------------------------------------- Type of Building Size Lot............................Sq. feet I—. - Dwelling)—No. of Bedrooms.........3................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------•----------------------•-----------•-----------------•-•--------------... WDesign Flow...........................4-_....:_......_.gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 0.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...................._-: �Z4 Test Pit No. 2.................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil..............Sand & BOLi.--deT s V W -----------------------_-----------------------------------------------•-•-•---------------------------•-•--•---------------•-----•-- ... .... 1-1500 gailon tanxcif.ga3-Tuly- U Leachi gpalpits Iterations—Answer when applicable. ------------------------------------------------------------------------------------------•-- -------••--•--------------------•-----•--------------------•------•------------•-------•....-•-------------...--------------------------•------•-•---•-----------••-•-------------•------._.......••--•- I Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI`"LE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. /d//� �8/11/92 ,— Signed � frl4AF9�=y k .... i................. ........................................Date Application A �_- ' ./ /J ..* PP Approved By ....----... .s... ----------------. --�------- ------------------------------------------ Application �J llare Disapproved for the following reasons: ...................................-----------Y- - - ----------- ---- ------------------------------ ------------------- --- ----------------------- --------------------------------- ----- ---......................- --- -----------. ................................. Dare Permit No. ..... '� � ✓ 1�.... Issued .. ......... Dare j t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed X J P Macomber Jr. g p y ) or Repaired' ' ) by .......�..-...�...................................................................................... ................................ Installer at ......Pin_-.Oaks Drive Barnstable. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..9.. ....... ----... dated -_, '` - .; f.- 47 Xi THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. t r� � •,� DATE 7ti ... f ll t Inspector l I ', ,/,. t�, -r l t e,t. r ----- ---- ---- ------------------------------------ -- ......... 1...- --- ...t . ---...!_--- --------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' G�No. TOWN OF BARNSTABLE FEE ...30.00 ``..�../ .. ................ Eiupsal Workii %Tnnitr uan nutit { J P Macomber .Jr. Permission is hereby granted.. '•.'---------------------- •---- to Construct (_ ) or Repair (Y ) an Individual Sewage Disposal System at No..-1'-in _Oaks Drive Barnstable ..--•.................•-•--------•------........-•---.......--•-------...------------------------------------•---•-----------•----•-----------------••---.......--•••- Street �+ y as shown on the application for Disposal Works Construction Permit N _ ". .? ated._ ?... M1 �- �..... sue, Board of Health DATE -----•---- �."-----------------•--•--. n' R �. FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS -a • -- From: Imagdeenplumbingcom Laura@Olsenplumbing,com Subject: Septicletter Date: May 26,2015 at 4:56 PM To: Susan Tyrrell seafaithful@comcast.net Thank you, - m3 Laura Edwards : �br i Olsen Plumbing&Heating Office Manager P:508-385-5290 F:508-385-6963 Laura@hokumrock.com IJ '1'63 E tf GKI01 ROCK C tJR MFa.3'6`WON:; To whom it may wevfnY Olsen Piumbing and Heating has inspected the Septic System In the back of the.propeny at the center of the house of as.Pin OAS t)cive,:grtttble,MA t1S30 4 Septic system;ls completely abandoned,. Sincerely, Ken Olsen .F BENNETTENVIRONMENTALAssOCI'ATES'o INC. - LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS 6.GEOLOGISTS. 6. ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA02631 6 508-896-1706 &.Fax 508-896-5109 0 www.bennett-ea.com BEA10-10230 June 29, 2010 Pat and Susan Tyrrell 45 Pin Oaks Drive Barnstable, MA 02630 RE: UST CLOSURE ASSESSMENT & LIM ITED REMOVAL ACTION COMPLETION STATEMENT Tyrrell Residence 45-Pin Oaks Drive Barnstable, MA Dear Mr. and Mrs. Tyrrell, Pursuant to our agreement dated May 26, 2010, BENNETT ENVIRONMENTAL ASSOCIATES, INC. (BEA) has prepared the following narrative as documenting regulatory compliance and remedial performance for the excavation of an estimated 6-8 yards (10.9 tons) of impacted soils as associated with minor leakage of an abandoned 550-gallon underground fuel oil storage tank(UST)at the subject property..The UST was discovered during recent renovations and. the release was identified at the time the tank was removed as permitted and witnessed by the West Barnstable Fire Department. End point sidewall and bottom of hole samples report petroleum hydrocarbons at the extent of excavation and below reporting limits (BRL)'as consistent with background conditions.. This work is consistent with the requirements 527 CMR 9.00 and the MA DEP Policy WSC-401-96 under 310 CMR 40.0000. The following narrative, and supporting .documentation, serve as a Limited Removal Action Completions Statement under the specific provisions of 310 CMR 40.0318 to,absolve Notification or fiuther Remedial Response liabilities specific to the former UST pursuant to the aforementioned,regulations and policies as governed under MGL c. 21 E. BACKGROUND ' On May 25,2010,BEA personnel were on site to oversee the removal of a 550-gallon fuel oil UST discovered during renovation activities at the property. Upon arrival at the property, BEA personnel were 'Met by the environmental contractor Tank Removal Services of Cape Cod(TRSCC), the Barnstable Fire Department'(Deputy'Chief, Frank Pulsifer), and the Barnstable Health Department (Cynthia Martin). The tank had already been pumped and removed from the ground . with the.tank grave remaining open for soil inspection. Inspection of the vessel showed substantial corrosion and scaling of the metal with"wetness"as indication of leakage. Upon removing scaling from the vessel,a 1/2"hole was observed on the bottom of the western end of the tank.. The bottom of hole-soils were discolored and a petroleum odor was noted [Refer to enclosed permits, field EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP Q SITE ASSESSMENT 0 PERMITTING 0 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE &WASTEWATER TREATMENT,OPERATION&MAINTENANCE JUNE 29,2010 TYRREL RESIDENCE:45 PIN OAKS DRIVE,BARNSTABLEBEAIO-10230 PAGE 2 OF 3 USTCL-LIMITED REMOVAL ACTION COMPLETION STATEMENT reports and photographic documentation]: Soil samples were collected from the sidewall and bottom of hole areas from within the tank grave. Dexsil PetroFlag analysis(EPA SW-846,Method 9074)reported concentrations of TPH at 1,827 ppm in the bottom of hole area in the western portion of the tank grave (WBOH@4') as i indicating significant soil impacts above the applicable RCS-1 Reportable Concentration of 1,000 mg/Kg. BEA instructed the operator to excavate the impacted soils observed in the western portion of the bottom of hole area to a depth of 8' below grade surface (4-8' bgs). The impacted material was stockpiled on polyethylene sheeting (6 ml) and covered with the same. Samples from the excavation were recollected and screened in the field with a Thermo Environmental Equipment 580 B organic vapor meter(OVM). Results of the field screening subsequent to soil removal operations reported no concentrations of organic vapors or TPH above the method detection limits Hof the instruments used: Based on the field-testing results reporting no concentrations of organic vapors or TPH above the detection limits,the excavation was considered complete. Due to property and safety issues,the excavator lined the excavation with plastic sheeting and backfill the excavation. Endpoint soil samples were field preserved and sent to a MA certified laboratory for confirmatory analysis of Total (TPH) and Extractable Petroleum Hydrocarbons (EPH)with target compounds. Contaminated soils generated by the Limited-removal Action were transported under a fully executed and approved Bill of Lading for off-site recycling at Aggregate Industries South Dennis asphalt batching plant on June 11, 2010. Receipts from Aggregate Industries are enclosed as documentation of appropriate remedial waste management [Refer to enclosed Bill of Lading]. RISK CHARACTERIZATION. The analytical results for endpoint soils samples were reported on June 7, 2010. This data was internally validated as reporting all TPH,EPH and target PAH analyte concentrations as Below Reporting Limits (BRL). In all cases; the reporting limits of the analyses conducted were significantly less than the applicable RCS-1 Reportable Concentrations and the most restrictive S- 1/GW-1 Method 1 —Risk Characterization standards [Refer to enclosed analytical results]. The S- 1/GW-1, Method 1 _ Risk Characterization standards are consistent with the RCS-1 values as a measure of significant risk in consideration of ingestion, inhalation and dermal contact exposures, environmental impacts to sensitive receptors and as a measure of potential leaching to groundwater. As such,the endpoint sampling showed that there was a finite area of soil impact at least 40' above the groundwater interface and that the removal of some 8 yards of impacted soils in'the western end of the tank grave achieved background conditions in all areas. Based on the physical testing conducted relative to the RCS-1 reportable Concentration and S-1/GW-1,Method 1 —Risk Characterization standards noted, a condition of No Significant Risks to humans and the environmental resources, inclusive of groundwater, is documented. ' JUNE 29,2010 TYRREL RESIDENCE:45 PIN OAKS DRIVE,BARNSTABLEBEA10-10230 PAGE 3 OF 3. USTCL-LIMITED REMOVAL ACTION COMPLETION STATEMENT CONCLUSIONS The removal of the former 550-gallon fuel oil UST at the subject property,as witnessed by the Barnstable Fire Department and Barnstable Health Department personnel,indicated that a minor release of fuel oil had occurred. BEA-was subsequently engaged to provide technical support, oversight and to document the removal of contaminated soils under a Limited Removal Action (LRA) in accordance with the provisions of 310 CMR 40.03 18. Confirmatory end point sampling reported all concentrations of TPH, EPH.and target analytes as BRL wherein the reporting1imit concentrations were significantly below the most restrictive RCS-i and S-1/GW-1 standards. The tank and waste fuel were removed and disposed of at approved facilities by Tank, Removal Services of Cape Cod in accordance with permits issued and receipts provided. Impacted soils excavated were transported off-site under an'approved Bill of Lading to an appropriate and licensed recycling facility. As such,the removal of some 10.9 tons of contaminated soils,remedial waste management, and post-excavation environmental testing represented herein, document regulatory compliance-and remedial performance in accordance with the governing regulations. Such work absolves any Notification or further Remedial Response liabilities specific to the location of the former UST pursuant in accordance with the provisions of 310 CMR 40.0000 as regulated under MGL c.21 E. Copies of this report are being provided to the Barnstable Fire Department and Barnstable Board of Health as part of,the public record towards documentation of regulatory compliance and project closure. i If you have any questions or need additional information,_please contact me directly at your earliest convenience. Sincerely, B TT ON TAL ASSOCIATES,INC. Jo D. a ema S nior Project Manager Encl. Reference Maps: Topographic.Quadrangle/MassGIS 2 1 E Overlay Tank Removal Permit/Waste Fuel Manifest Barnstable Fire Department Barnstable Health Department Notes to the File , BEA Field Log/Site Sketch Plan/Photographic Documentation Aggregate Industries Receipt/Soil Recycling Submittal/BWSC-12 a,b, c Bill of Lading Laboratory Analytical Report [GWA Lab ID 133473 (6/18/10)] Cc. Deputy Chief Francis Pulsifer, Barnstable Fire Department Cynthia Martin, Barnstable Health Department David Bennett,LSP [internal] 45 Pin Oaks Drive 1°43-21%70°20.25' _ _ 41 4 yt ' S an :.:•:;viA...I y•_[ '.:ice ........ ..l:..;:'I .,.. ... ............. ... .. ._. .,... .... .:.is♦....i.. ......,.. ..:....._ ..... .... [ ...:;:`.;ram n••: �5: ,.o;,;�;,-••&- 1 I I S ::,-:, a-. !�:?�ti_ r:�Y...i8:,t., .xl_ ;:>itr ram:. .:::.::... ..,.a•._.i:?!^::%•:::'�i'• +•2 [�.� •ti••yr .. J Isla � �r'B E [y `— �.:: .. Kiscl? stu e` 2 6 -Sy9 AJ Nz - - •L'A�-� •o Ems• t L. — Locus - _ X, \_ --_ ��[>�ti •,�� � o o'o�; ,� \ C -Jam. CI 09 s° 1,1•l.c�`—V'P .1�`�0 (f°\1 (dl\' Inl r1"%- UnH"W %l' 11417T 70°20B'NAD83 ' ' 41°4137-,70°17'23" MN a in l nr<s 16%• ton^ s low 7me ssos .aoo RMT PmMamTOM DIM Wi1d0MWft&CWW(www. soN Figure 1: Subject property locus is shown at 45 Pin Oak Drive in Barnstable Village off Route 6A. The property is entirely upland as located at elevation 60' +/- NGVD. The depth to groundwater(EL 11' NGVD) is estimated as 45-50' below grade surface. I F F F F 9.1 J. ► ), I j t I* t I- I t. It: rt - t -1- -t t I, t I I t 1' + I I t I. t ZIA I t 11 V T . 2 . 1 . 1 1 1 1 1 1 -t I :1—11 1 f I' T A*Tk ldcf III I I I I 1 A4 t 11c _I F 'F 4 1 x j r-1 90*1 fbwf-I V. L I cCOIEIBS VILLA A� Al I f .7. Locus C10L1C0JRT �iiABLE #,QND RNS ABLE, F fdf�,f fit L I I CA PE! tn. ► t CA Ar, Figure 2: The subject property at 46 Pin Oakes Drive in Barnstable Village is shown relative to identified resource areas. Although the property is located within a potential drinking water source area, there are no know private well within 500' of the property and the property is not within the Zone II protective Radius for any municipal public water supply wells. I Fire Department retains ariginaf application and issues duplicate as Permit. r RECEIVED JA �y 2 6 L-'eia��(iin.�r�a�C?��ri��e�a�iced— �aair�c�i��ril�e ✓'�ru�n�iz APPLICATION 'and PERMIT Fee: for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: 0 Tank Owner Name(please print) LEti 711ICES X gnature apuymg crperm4) Address Street � State ZIP • • • a Company NameulC, 4rEtrt�y� S£dNl Co.or Individual_ Print Print Address �� 1/MI�iAIV 1��� o- Address Pnnt Signature(if applying for vuN.�1n� 1 lea Q�, j i Signature(if ap ying for permit) O IFCI Ce '' d Other `p iFCI Certified ❑ LSP# Other N . Tank Location l xn> F Z + Steet Address city . Tank Capacity(gallons) _ 11 000 UST. Substance Last Stared Tank Dimensions(diameter x length) Remarks: Firm transporting waste State Lic:# 7— Z Hazardous waste manifest# E.P.A,# ^ Approved tank disposal yard s MCF.'J't SWX-(- Toank yard# C. l.F _ y ,e>. Type of inert gas Tank yard address I=t.'l City or Town J czus FD10# Permit# Date-of issue nS'-OS—i o Date of expiration . OS'-3 Dig safe approval number:?—C) C�( CJCi Dig Safe Toil Free Tet..Number-800-322-4844 Signature/Title of Officer granting permit After removal(s)send Form FP-29OR signed by Local Fire Dept.to UST RegulatOo-cvt RR nce unit, One Ashburton Place, Room 1310,Boston, MA 02108-1618< �gSN�EnREv\,G• c023�� 'P-292(revised 91961 Notes to the File Date: May 25, 2010 Tyrrel Residence 45 Pin Oaks Drive Barnstable,MA Cynthia Martin, PHD Deputy Fire Chief Pulsifer, Barnstable Fire Brian Clarke,Bennett Environmental Services A five-hundred and fifty gallon underground oil storage tank was discovered when the home owner was removing rhododendron bushes. Tank Removal Services was contacted . for its removal,upon lifting it out of the ground the tank was found to have two holes in it. There were approximately one-hundred and fifty gallons of oily water still in the tank.' Tank Removal Services contacted Bennett Environmental Services to determine the extent of the leak. The field TPH tests on two soil samples revealed the following: there were no TPH hits from the sample taken at eight feet below the tanks location,but there was a hit from the sample taken four feet below the tank location. It was decided that soil would be removed to a depth of eight feet. The hole would then be back filled with the clean soil on site. Contaminated soil was placed on plastic,sheets until removal from the site. Should lab results on the soil samples indicate contamination at eight feet further work would be required. Page 1 of 1 John Tadema-Wielandt From: Francis Pulsifer[FPulsifer@barnstablefire.org]- Sent: Wednesday, June 02, 2010 3:55 PM To: jtadema-wielandt@bennett-ea.com Subject: UST REmoval Pin Oaks Drive Responded to 45 Pin Oak Drive, Barnstable for a UST removal. Met contractors from Tank Removal Services on site with 550 gallon steel UST on the'North West corner of the property directly behind the structure. The tank was un-earthed and prepared for removal. The tank had approximately 150 gallons of product removed prior to my arrival that was a mixture of water and fuel oil. The tank was found during some site excavation and removal of plantings. An opening was made in the top of the tank and the tank ' was cleaned. I observed the tank being removed from the grave. The grave has a slight odor of fuel oil present from the grade level. The underside of the tank 180 degrees from top has two holes visibly present. One hole is approximately one foot from the.West end of the tank and is approximately 2-3 inches in rough diameter. The second hole is approximately 2-.3 feet East of the 1st hole and is approximately 1/2 inch rough diameter. The soil does not appear,to be wet but slightly discolored around the area of the larger hole. Tank Removal Services had already notified an LSP to respond. I had Fire Alarm contact the Town of Barnstable Board of Health for a response. The owner, Ms. Susan Tyrell 508-362-3997, was on site and briefed of the status of the operation. LSP Brian Clarke 508-896-5109, from Bennett Envirnmental Associates, Inc arrived-on location and was briefed of the incident. TOB Healt Agent Cynthia Martin 508-8624644,.arrived on location and was briefed of the incident. No hazards noted for the fire department to mitigate. Scene turned over to the LSP and TOB Health Department. Mr. Clarke will forward a copy of the LSP report to the fire department upon completion. C-210 cleared w/o incident. 05/25/2010 17:44:55 fpulsifer Francis M. Pulsifer Deputy Fire Chief Barnstable Fire Department 508-362-3312 i 6/2/2010 PAGE 1 OF 2 FLOGBEA10-10230 FIELD RESPONSE LOG Tyrrell ResidenceBEA10-10230 Limited Removal Action' Potentially Responsible Party: Pat and Susan Tyrrell., 220 20' St. South#1711 Arlington,VA`22202 Property Location: 45 Pin Oaks Drive Barnstable, MA 02630 Remedial Response: 05/25/2010 11:30 am Mobilize from Bennett Environmental Associates office. 12:00 pm Arrive on Site. Previously unidentified 550-gallon UST discovered during renovation work at subject property-.' Deputy Chief Frank Pulisfer of Barnstable Fire Department on Site along with John (machine operator, Bortolotti .Construction), Rick Mahoney (Tank Removal Services. of Cape Cod), and Cynthia Martin of the Barnstable Health Department. +/- 1 '/2"hole in the bottom of the west end of the UST. a Collect worst-case sample at the west end of the bottom of the tank grave and.also remaining sidewalls and bottom of hole. West end of bottom of tank grave has odor,.but no TOV readings. Sample with results as: Location PID Dexsil NSW: V-4' 0 0 ESW: 1'-4' 0 0 SSW: 1'-4' 0 0 WSW: l'-4' 0 0 f PAGE 2 OF 2 FLOGBEAIO-10230 EBOH @ 4' 0 0 WBOH @ 4' 0 1827 BOH @ 8' 0 0 Have John (Borolotti) take the western end of tank grave,to +/-8'bgs (4' below bottom of UST),and retest as follows: Location PID ' Dexsil . NSWxl: 2'-8' 0 0 ESWxl: 2'-8' 0 0 SSWxl: 2'-8' 0 0 WSWxl: 2'-8' o 0 BOHxl @ 8' 6 0 Have John square off excavation to 8'x8'x8'. Stockpile is approximately,15'-x 6' x 4', on top of poly sheeting. Set plastic over the terminus of dig. 2:30 pm Depart Site to get more rolls of ploy sheeting at Home Depot. 3:30 pm Arrive back on Site. John has backfilled with clean soil to grade to protect the frost wall as no gutters and the excavation is immediately adjacent to the cinder block . foundation wall. Cover the stockpile with poly sheeting and secure with rocks. Photo document Site. 4:30 pm Depart Site. ` L Submitted by: BENNETT ENVIRONMENTAL ASSOCIATES, INC. This Field Response Log is a compilation of field observations, interviews with individuals familiar with the project and a review of public record. As such, it is intended to be an accurate and complete record of pertinent information. j However, based on the reliance on third party and hearsay information included, no guarantee or warranties of the accuracy and completeness of that information is expressed or implied. I . SITE SKETCH PLAN now 4 e(y1c, / t � 4 .''JQ0 LUST � s . THIS SITE PLAN WAS NOT PREPARED FROM t ANY INSTRUMENT SURVEY AND UNDER NO CIRCUMSTANCES SHOULD THE DISTANCES, BEARINGS AND/OR FEATURES SHOWN BE r USED TO ESTABLISH PROPERTY LINES: r . Hole observed in western portion of bottom of UST. •��, t Nye R",�, •A •�;• yNfs. ��A +�iifL.. r �b Contaminated soil stockpiled generated from Limited Removal Action. RECEIVED JUN' 2 2 A10 AGGREGATE June 18, 20T0 INDUSTRIES Dave Bennett Bennett Envir. PO Box 1743 Brewster,Ma 02631 Re: Soil, Tyrell Residence-- Pin Oaks Dr Barnstable, Ma Release Tracking#LRA Recyclable soil from the above referenced project has was last received at our facility on June 1 lth, 2010. A total of 10.90 tons was received. I assume that shipment is complete and have attached a copy of the BOL, along with an original form 12C to close out the project. Thank you for recycling at Aggregate Industries. Regards, William R. Reinhardt Manager, Environmental Services AGGREGATE INDUSTRIES NORTHEAST REGION 1101 Turnpike Street Stoughton,MA 02072 Telephone (781)344-1100 Facsimile (781)341-5523 www.aggregate-us.com An Equal Opportunity Employer An AGGREGATE INDUSTRIES company - I SOIL RECYCLING SUBMITTAL Revised 3/12/99 AGGREGATE INDUSTRIES 1301 Turnpt ke-nm eet toyu}itn_,n MAdlz072� Te �78,7)3.41 55ti �� x�{j7$3)°?�g41 244U § Site Information: NAME Tyrrell Residence CoNTACr Pat Tyrrell STREET 45 Pin Oaks Drive PHONE 508-362-3997 Crry/TOWN Barnstable s`rAreiiiP MA 02630 Generator Information: N;kME Tyrrell Residence CONTACT Pat Tyrrell STREET 220 20th St.South#1711 PHONE 202-354-7447 crryrTowN Arlington STATE 123P VA. 22202 . Consultant Information: :. NAME Bennett Environmental Associates,.inc. Jahn Taderna-Wielandt corrTACT sTR & P.O.Box 1743 PHONE 6{3tS 896-17UEi CITTITOwN Brewster - MA..02631 'STATE/ZIP Estimated Soil Quantity: T©Ns 12 CUSICYARDS 8 Soil :conbminants(gasoline,diesel fuel,motor oil,etc.) No.2 Fuel Oil Analyses Performed(check all that apply) wh ED AS R14 Reactivity(5,C N) PCBs, Flash Cr Pb TCLP(metals)if required VOCs . Cd 0 H9 " 1,,.i based on total levels other ((� Ali the above tests ==k ✓ Laboratorryy analytical �Screening Data I _} werd performed t V data attached Attached. Instrument Used and Constituents Found Thermo Environmental OVM 5808 .. n NVg,a.v��'`«...a=9Si Environrnental Services.Revised 3/12/99. page I of 3 . i Description / Source of Release: UST Yes DATE OF RELEASE 'Historic OTHER,DESCRIBE Soil Description PHYSICAL DESCRIPTION(SAND,GRAVEL,SILT,ETC.) Sand CLASSIFICATION METHOD USCS Check it the following materials are present(check all that apply) ❑CLAY CONSTRUCTION DEBRIS OTHER DELETERIOUS MATERIALS(PLEASE LIST) COAL VEGITATIVE MATTER E3 ASH Soil Characterization Methodology Sampling Method BIA ED SAMPLES GRAB COMPOSITE (E.G.HE DSPACE SCREENED,VISUALLY CONTAMINATED) CONSTITUTES OF CONCERN NO.2 Fuel Oil Site History CHECK IF EXTRA SHEETS ATTACHED CURRENT USE Relsdentlal PAST USE Res'de tl I I,the generator,having used 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 anthropogenic contaminants. I,the generator,realize that due diligence shall consisit of a search of information and records reasonably available to the generator of the contaminated soil and sufficient to make the determination.Such records and information may include, but are not limmited 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. All samples for VOC analysis were collected according to DEP policy#99-415. SIGNATURE OF GENERATOR DATEIV w c GENERATOR PRINTED NAME Pat Tyrrell "a��an _ N -wJ.* 8.c�'�` r $ 6 4 r'# - .:3 x ''� r7xY fir.G`x'r� r -.4 r_,!>.� n.`a�.e 4 "`F"y EM 3u+:1'i a X.,.....gt,,,n__r". Q,r36w�.Uetx�..`w..�aa,-}-3 ,.:.,.44�,..iu. r,_..f�n..nT v_...i..st. u... ,. .S:I.- ir_.spzs ar,u±w.a. irccxi$3._.. AGGREGATE Environmental Services.Revised 3/12/99. page 2 of 3 wourrnrcs t A site diagram is.rouired indicating any major structures or roads,excavation areas and stockpile locations. All sampling locations must be noted. CHECK IF DIAGRAM ATTACHED Site Diagram ; I 4 NAME I i A E OF INDIVIDUAL PREPARING DIAGRAM: saa.v.,"" s""=„msr"a +Y ':" z ..,.X. ,.£ g'seaaa •--1�, �—:ac,..�...,k - ,� ma..+<. r� 3'ki.�. i'SZ.:. e'.S44tttt'J �?,'�?!4.i AC"C-RELATE Environmental Services(BTE5/900)128197.Revised 3r WS. page 3 of 3• :�buran Town of Barnstable Geographic Information System June 8, 2010 279063001 #0 279083 #62 279091 #74 279090 #2874 I W J t e+ 1 046 Q�F�eI 0►0 UST 279070 g `. #39 #30 k a t"—. 27900$ #2870 a 279062 #33 279002 �_ '_-: 279009 810 #2858 lJ 32 Fe tt 279093#8 'm DISCLAIMERS:This map Is for planning purposes only. It is not adequate for legal Map:279 Parcel:063 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel Owner:TYRRELL,PATFtICK J&SUSAN H Total Assessed Value:$1212600 { 1"=100'may not meet established map accuracy standards. The parcel lines on this map .. are only graphic representations of Assessor's tax parcels.They are not true property Co-Owner: Acreage:1.08 acres Abutters .: '•. 11�iR'°;a+=' boundaries and do not represent accurate relationships to physical features on the map Location:45 PIN OAKS DRIVE Such as building locations. Buffer ':' Massachusetts Department of Environmental Protection BWSC-012A Bureau of Waste Site Cleanup Release.Tracking Number" "o BILL OF LADING (pursuant to 310 CMR 40.0030) El.E= A. LOCATION OF SITE OR DISPOSAL SITE WHERE REMEDIATION WASTE WAS GENERATED: Release Name(opftonal): Tyrrell Residence Sheet 45 37in Oaks Drive Location Aid:.Assessors Map 279 Parcel',063 Cityfrown: Barnstable ZIP Code: 02630� y I Date/Peried of Generation: 5/25/10 to: 5/2 5/10 Additional Release Tracking Numbers Associated with this Hill of Lading;. 'Abte: If this Bill of Lading is the resuk of a limited Removal Acton(t W taken prior to NotrrcaSon, a Release Trac/dng Number Is not need. B. PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL OF LADING: Name otOrganization: Tyrrell Residence NameofContact: Pat Tyrrell Title: Pro perty,Owners Sheet 220 loth St.. South #1711 City/Town: Arlington State VA ZIP Code: 22202 Tel hone: (202) 354-7447 - Ext.: a. C. RELATIONSHIP TO RELEASE OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH BILL.OF LADING: RP or PRP Specify: .O,vner Operator Generator Transporter tattier RP of PRP Fiduciary,Seared Lender or Municipality with Exempt Status(as defined by M.,G.L.G 2112 s.2) Agency or Public Utility on a Right of Way(as defined by M.G.L.Q 21E.s.50)) �. Qther.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,inckidfng any area code aid extension;for each,if known. 0. TRANSPORTER OR COMMON CARRIER INFORMATION: } Transporter/Common Carrier Nam. Bortolott' Contact Person: Bob Bortolot:ti Title: President Sheet 95 industry Road Cityfrosvn: Marstons Mills Slate: MA ZIPCode: 02648 Telephone: ( 0.8) 771-9399 Ext.: E. RECEIVING FACILrryrrEMPORARY STORAGE LOCATION: Operator/FaaTityNare: Aggregate Industries Contact Person: William Reinhardt Title: General Manager Environmental Safety _ Street 230 Great Western Road South Dennis MA ZIP Code: 02660 Cityfrown; State: Telephone: 7 81-3 41-5 5 0 0 ExL: Type of Facility: © Asphalt BaWCold Mix Landtil*.sposai rj incinerator L_.: Temporary Storage (check one) Asphalt Bak"ot Mix Landfi]VD*COm 'Other, Q Thermal Processing 0 .taridfiluswoturatk, MAD985286384 EPA Identification;�: S-61-627 Division of Hazardous Waste/Class A Permit#: DiYrsion of Solid Waste Management Permit# ` Actual/Anticipated Period of TerTorary Storage(spedfy dates if applicable): -SI.25./10 present to:.p Reason for Temporary Storage: Need to prepare paperwork for proper transport and disposal of:.impacted material. Revised IM/94 Page lof 3 ' I -� Massachusetts Department of Environmental Protection 13VV5C-012A Bureau of Waste Site Cleanup Release Tracking Number* '.e. BILL OF LADING(pursttant to 310 CMR 40.0030) � t E..RECEIVING FACILttYfIEMPORARY STORAGE LOCATION(continued): Temporary Storage Address: Street: 45 Pin Oaks Drive CitylTown: Barnstable State: :MA ZIPCode: '02630-0000 F. DESCRIPTION OF REMEDIATION WASTE: (check all that apply) Contaminated Media(check all that apply): ,Soil � Groundwater 0 .Surface water 0 ;Other: Contaminated Debris(check all that apply): i) vegetation or Organic Debris {'} Demolition/Construction waste O Inorganic Absorbant Materials Q Other ElNon-hazardous Uncontalnerized Waste(check all that apply): 0 Nor:.-aqueous Phase Liquid .Other.. Non-hazardous Contar"rierized waste(check all that apply). Tank Bottoms/Sludges 0 Containers tD Drums: Q Engineered impoundments Other: , Type of Contamination(check all that apply): Q Gasoline Diesel Fuel *2 Oil E] :#4 Oil #6 Oil F1 Waste Oil Kerosene Jet Fuel 0 Other. Esti mat ed Volume of Materials Cubfc Yards: 8 Tam: 12 Other Contaminant Source(check one)specily): Transportation Accident © Underground Storage Tank Other. Response Action Associated with Sill of Lading(check one): ❑ Immediate Response Action Release Abatement Measure Utility-Related Abatement Measure Q Limited Removal Action Comprallensive Response Acticri nOther ` Remediation waste Charcterization Supporl Documentation attached: Q Site History Information 0 Sampling and Analytical Methods and Prcceduires © Laboratory Data ® field Screening Data If supporting dotun:entatlon 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: 13M*TEITT EWIRONMMAL ASSOCTATSS :1I4C.. LSP Name: David C: Bennett Tiller President:, LSP Telephone: 15081 89`0,1706 Ext.: ' I attest under the pains and penalties of perjury that t have personally examined and am familiar with this submittal,including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of - (i)the standard of care in 309 CMR 4.02(1), (ii)the applicable provisions bf 309 CMR 4.02(2)and(3),and (tit)the provisions of 309 CMR 4.03(5), to the best of my knowledge,information and belief,the assessment actions undertaken to characterize the Remediation Waste which is(are)the subject of this submittal ptance' facility identified in this subnitlal comply with the applica i e.visions of 310 CMR 40.0000,and such facility is permitted to acept Rekediatich 4ste having the characteristics dacribed in this sub at significant penalties may result. including,but not limit to,pos 'b ± nd imprisonment,if I submit inbrmation which I to or materially incomplete. DAMID LSP Signature: Seal: O C. U BENNETT Date: r No. . 3 t License Number: 4303 F,�S OTC!S TBR�� SITE PROF Revised 1013194 Page 2 of 3 I Massachusetts Department of Environmental Protection BWSC-012A Bureau of Waste Site Cleanup Release Tracking Number* BILL OF LADING (pursuant to 310 CIVIR 40.0030) El 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,inGu limited t pos ible fi and impris ent,for willfully submitting false,inaccu�riatef r the plete information. Signature: Date: L Name of Person(print): P Ty re 11 f 4 Revised 10/3/94 Page 3 of 3 Massachusetts Department of Environmenta Protection BWSC-012B Bureau of Waste Site Cleanup. BILL OF LADING (pursuant to 310 CUR 40.0030) Release Tracking Number 1 SUMMARY SHEET OF E_I / LOAD INFORMATION: Si ature of Tr er R resentative: ReveivingFacility/Temporary Storage Representative: ) ' Load 1: �.. ,r I ^`�'�r' S�f ,�,1�r• k,� Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: circle one ( I�/P m 4•/.��w O�y /• (circle on'q am PM Truck//Tractor Registration: Trailer Registration (if any) ��G�� ✓ s Load Size(cu.yds/tons):!D•i Load 2: Signature of Transporter Representative: Reveiving Facility/Temporary Storage Representative: 77 Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/pm (circle one)am/pm Truck/Tractor Registration: Trailer Registration(if any) Load Size(cu.yds/tons): Load 3: Signature of Transporter Representative: Reveiving Facility/Temporary Storage Representative' t Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (cireie one)am/pm (circle one)am/Pm Truck/Tractor Registration: Trailer Registration(if any) Load Size(cu.yds/tons): Load 4: Signature of Transporter Representative: Reveiving Facility/Temporary Storage Representative: Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt. (cirrk onel am/pm (circle onci,am/Pm Truck/Tractor Registration: Trailer Registration(if any) Load Size(cu.yds/tons): Load 5: Signature of Transporter Representative: Reveiving Facility/Temporary Storage Representative: Date of Shipment: Time of Shipment: Date of.Receipt: Time of Receipt: (circle one)am/pm (circle one)am pm Truck/Tractor Registration: Trailer Registration (if any) Load Size(cu.yds/tons): Load 6: Signature of Transporter Representative: Reveiving Facility/Temporary Storage Representative: Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: (circle one)am/Pm Icircle one)am/Pm Truck/Tractor Registration: Trailer Registration(if any) Load Size(cu.yds/tons): J.LOG 89 T VOLUME INFORMATION: Total Volume Recorded This Page(cu.yds/tons) - Total Carried Forward(cu.yds/tons) Total Carried Forward and This Page(cu.yds/tons) Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup BILL OF LADING(pursuant to 310 CMR 40.0030) Release Tracking Number ki SUMMARY SHEET 1 OF 1 K. SUMMARY OF SHIPMENTS: Daily Volume Shipped Date of Shipment: Date of Receipt: Number of Loads Shipped: (cu.yds./tons): 6/11/10 1 10.90 Summary Sheet Total Shipped: 1 10.90 Bill of Lading Total Shipped (only if different): Revised 1013/94 Pagel of 2 Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup BILL OF LADING(pursuant to 310 CMR 40.0030 Release Tracking_Number SUMMARY SHEET ONLY COMPLETE ONE COPY OF THIS PAGE AND ATTACH TO THE FINAL COPY OF THE SUMMARY SHEET. L. ACKNOWLEDGMENT OF RECEIPT OF REMEDIATION WASTE AT RECEIVING FACILITY OR TEMPORARY STORAGE: Receiving Facilitylremporary Storage Representative(print): William R Reinhardt Title: Mngr Env Srvcs Signature: �% -""" Date:- 6/18/10 ' M. ACKNOWLEDGMENT OF SHIPMENT AND RECEIPT OF REMEDIATION 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 th' ification,an t,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contaiMi=ited .. of rry knowledge and belief,true,accurate and complete, I am aware that there are significant penalties,including,but nos and imprisonment,for willfully subrfffng false,inaccurate,or incomplete information. Signature: Date: tu Name of Person(print): T7api d C BPnnattpresident BENNETT ENVIRONMENTAL ASSOCIATES, INC. For Pat Tyrrell, Homeowner Revised 10/3194 Page 2 of 2 GROUNDWATER t 'ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GUID Field ID: NSW 2-8' Matrix: Soil Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-1 QC Batch ID: EP-3110-M Sampled: 05-25-10 16:00 Instrument ID: GC-9 Agilent 6890 Received: 05-26-10 15:45 Sample Weight: 15 g Extracted: 05-27-10 13:00 Final.Volume: 1 mL Analyzed(AL): 05-29-10 12:50 %Solids: 95 Analyzed(AR): 05-29-10 13:34 Aliphatic Dilution Factor: 1 Analyst: KM Aromatic Dilution Factor: 1 EPH Ranges _ ' Concentration ';', Notes' Units,! ;Reporting Limit `" n-C9 to n-C18 Ali phatic H drocarbons t BRL mg/Kg 31 n-C19 to n-C36 Ali phatic H drocarbons t BRL mg/Kg 31 n-C11 to n-C22 Aromatic Hydrocarbons t0 BRL mg/Kg 31 Unad'usted n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 31 CAS Number• Analyte '• Conc- tretio M e o l ;`,' Notes' ,. t _;Units` - Reporting Limit" 91-20-3 Naphthalene BRL mg/Kg 0.51 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.51 85-01-8 Phenanthrene BRL mg/Kg 0.51 83-32-9 Acenaphthene BRL mg/Kg 0.51 QC Surrogate Compound Spiked''. Measured v 'Recovery �'QC Limits . � -•` Fractionation: 2-Fluorobiphenyl 2.7 2.4, 89 % g 40-140% 2-Bromonaphthalene 2.7 2.4 87% 40-140% Extraction: Chloro-octadecane 2.7 1.7 61 % 40-140 ortho-Terphenyl 2.7 2.1 75 % 40-140% QA/QC Certification, „ 7. 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards forthe required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1?` No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis.. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n.C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. x - Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 4 of 20 GROUNDWATER ANALYTICAL Data Certification Project: Tyrell/BEA10-10230 Lab ID: 133473 Client: Bennett Environmental Associates,Inc. Received: 05-26-10 15:45 a`» °JMA'DEP Corrip`endium of An_alytical Methods",,`k •° ,{ a „„T x-, ,ri,b Project Location: n/af MA DEP RTN: n/a This Form provides certifications for the following data set: MA DEP EPH: 133473-1,-2,-3,-4,5 Sample Matrices: Groundwater ( ) Soil/Sediment (X) Drinking water ( ) Other ( ) ;. MCPSW-8.46'., pf.„�.'# 8260B ( ) 8151A ( ) 8330 ( ) 601013 ( ) 7470A/1A ( ) Methods Used r_ ' 8270C ( ) 8081A ( ) VPH ( ) 6020A ( ) 9012A2 ( ) As specified in MA DEP 8082 ( ) 8021 B ( ) EPH (X) 7000 S3 ( ) Other ( ) `!Compendiumof Analyti6i,V j.:List.Aelease Tracking Number(RTN),if known. r � e am Methods 1 ` 2. SW 46 Method 901.2A(Equivalent to 9014)or.MA DEP Physiologically Avail6fe,cyanide(PAC)Method a s'. is.(check all that apply) ,�; 3. S-.SW-846 Methods 7000 Series:,List individual method and analyte j,,,.;, ,s* . An affirmative response to questions A,B,C and D is required for"Presumptive Certainty"status. A. Were all samples received by the laboratory in a condition consistent with / that described on the Chain-of-Custody documentation for the data set? Yes f B. Were all QA/QC procedures required for the specified analytical method(s) included in this report followed,including the requirement to note and discuss in a narrative QC data that did not meet appropriate performance / standards or guidelines? Yes C. Does the analytical data included in this report meet all the requirements for"Presumptive Certainty,"as described in Section 2.0 of the MA DEP / document CAM VI A,Quality Assurance and Quality Control Guidelines for the Acquisition and Reporting of Analytical Data? Yes D. VPH and EPH methods only: Was the VPH or EPH method run without / significant modifications,as specified in Section 11.3? Yes A response to questions E and F below is required for"Presumptive Certainty"status. E. Were all QC performance standards and recommendations for the specified methods achieved? Yes F. Were results for all analyte-list compounds/elements for the specified method(s)reported? No All No answers are addressed in the attached Project Narrative. I,the undersigned,attest under the pains and penalties of perjury that,based upon my personal inquiry of those responsible for obtaining the information,the material contained in this analytical report is,to the best of my knowledge and belief,accurate and complete. Signature: Position: Operations Manager Printed Name: Eric H.Jensen Date: 06-07-10 Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532page 3 of 20 GROUNDWATER ANALYTICAL Sample Receipt Report Project: Tyrell/BEA10-10230 Delivery: GWA Courier Temperature: 3.3°C Client: Bennett Environmental Associates,Inc. Airbill: n/a Chain of Custody:' Present Lab ID: 133473 Lab Receipt: 05-26-10 Custody Seal(s): n/a Lab ID Field ID Matrix Sampled Method ' ;x ,,:. + Notes; 133473-1 NSW 2-8' Soil 5/25/10 16:00 MA DEP EPH with 4PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1270772 250 mL Glass n/a n/a None n/a n/a n/a Lab ID Field ID Matrix Sam ied Method " :' Notes P a 133473-2 SSW 2-8' Soil 5/25/10 16:00 MA DEP EPH with 4PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1270775 250 mL Glass n/a n/a None n/a n/a n/a l Lab ID Field ID- _ Matrix q ,Sampled- Method '} t" ;' Notes 133473-3 ESW 2-8' Soil 5/25/10 16:00 MA DEP EPH with 4PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep ' Ship C1270773 250 mL Glass n/a n/a None -n/a n/a n/a Lab ID Field ID_ Matrix i Sampled Method `� �� 'Noted: 1334734 WSW 2-8' Soil 5/25/10 16:00 MA DEP EPH with 4PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1270771 250 mL Glass n/a n/a None n/a n/a n/a t r = Lab ID Field ID Matrix„ Method Sampled'' " - ',�, �,w.» ,Notes 133473-5 BOH 8' Soil 5/25/10 16:00 MA DEP EPH with 4PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1270774 250 mL Glass n/a n/a None n/a n/a n/a Lab ID Field ID Matrix Sampled Method F, Notes= 133473-6 Disposal Comp Soil 5/25/10 16:00 TPH by GC ASTM D3328-00 Mod L L Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1270776 250 ML Glass n/a n/a None n/a n/a n/a r Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532 Page 2 of 20 GROUNDWATER Groundwater Analytical,Inc. ANALYTICAL1200 P.O.Box 2532 228 Main Street Buzzards Bay,MA 02532 Telephone(508)759-4441 FAX(508)759-4475 www.groundwateranalytical.com June 7, 2010 Mr. David Bennett Bennett Environmental Associates, Inc. P.O. Box 1743 Brewster, MA 02631 LABORATORY REPORT Project: Tyrell/BEA10-10230 Lab ID: 133473 Received: 05-26-10 Dear Dave: Enclosed are the analytical results for the above referenced project. The project was processed for Priority turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this report. This report contains a sample receipt report detailing the samples received, a project narrative indicating project changes and non-conformances, a quality control report, and a statement of our state certifications. The analytical results contained in this report meet all applicable NELAC or NVLAP standards, except as may be specifically noted, or described in the project narrative. The analytical results relate only to the samples received. This report may only be used or reproduced in its entirety. I attest under the pains and penalties of perjury that, based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the best of my knowledge and belief, accurate and complete. Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, Erin H.Je sen Operatio s Ma ager EHJ/elm Enclosures Page 1 of 20 r GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GUID Field ID: SSW 2-8' Matrix: Soil Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-2 QC Batch ID: EP-3110-M Sampled: 05-25-10 16:00 Instrument ID: GC-9 Agilent 6890 Received: 05-26-10 15:45 Sample Weight: 15 g Extracted: 05-27-10 13:00 'Final Volume: 1 mL Analyzed(AL): 05-29-10 14:18 %Solids: 95 Analyzed(AR): 05-29-10 15:02 Aliphatic Dilution Factor: 1 Analyst: KM •• Aromatic Dilution Factor: 1 EPH Ranges , 3 '- "' M; Concentration " _«fi,'Notes r. Units Reporting Limit; n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 31. Unadjusted n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 31 , - CAS Number • 'Analyte _ _r=. i >=Concertration ,Notes Via'.' ;Uni#s r'Re'poitmg Simi}i. 91-20-3 Naphthalene BRL mg/Kg 0.52 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.52 85-01-8 Phenanthrene BRL mg/Kg 0.52 83-32-9 Acenaphthene BRL mg/Kg 0.52 QC Surrogate Compound Spiked Measured Recovery ,1QC Limjts r=_,. _.. Fractionation: 2-Fluorobiphenyl 2.8 2.4 86 % 40-140 2-Bromonaphthalene 2.8 2.5 89 % 40-140 Extraction: Chloro-octadecane 2.8 1.7 61 % 40-140 ortho-Terphenyl 2.8 1.8 65 % 40-140 QA/QC Certification r„ 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. Report Notations:. BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 5 of 20 GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GC/FID Field ID: ESW 2-8' Matrix: Soil Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-3 QC Batch ID: EP-3110-M Sampled: 05-25-10 16:00 Instrument ID: GC-9 Agilent 6890 Received: 05-26-10 15:45 Sample Weight: 15 g Extracted: 05-27-10 13:00 Final Volume: 1 mL Analyzed(AL): 05-29-10 15:46 %Solids: 95 Analyzed(AR): 05-29-10 16:30 Aliphatic Dilution Factor: 1 Analyst: KM Aromatic Dilution Factor: 1 `EPH'Ranges a1"'°;- Concentration =•� a ,,.Notes _ Uniti o Reporting Limit n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 31 Unadjusted n-Cl1 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 31 CAS Number Anelyte Concentration" Notes Uniti". Rep-orting Limit 91-20-3 Naphthalene BRL mg/Kg 0.52 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.52 85-01-8 Phenanthrene BRL mg/Kg 0.52 83-32-9 Acenaphthene BRL mg/Kg 0.52 QC Surrogate Compound'':;.:.' Spiked Measured`. -'Recovery QC Limits ? ` Fractionation: 2-Fluorobiphenyl 2.8 2.4 88% 40-140% 2-Bromonaphthalene 2.8 2.5 91 %, 40-140% Extraction: Chloro-octadecane 2.8 1.6 58 % 40-140% ortho-Terphenyl 2.8 1.8 64 % 40-140% QA/QCCertification.. 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 6 of 20 i GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GC/FID Field ID: WSW 2-8' Matrix: Soil' Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-4 QC Batch ID: EP-3110-M Sampled: 05-25-10 16:00 Instrument ID: GC-9 Agilent 6890 Received: 05-26-10 15:45 Sample Weight: 15 g ` Extracted: 05-27-10 13:00 final Volume: 1 mL Analyzed(AL): 05-29-10 17:14 %Solids: 96 Analyzed(AR): 05-29-10 17:58 Aliphatic Dilution Factor: 1 Analyst: KM Aromatic Dilution Factor: 1 �^-EPH Ran es w— , .:.._ C oncntton fi _No -te - ° nits Reporting Lim,it.,,;. n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg •30 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 30 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 30 Unadusted n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 30 CAS Number Analyte _ Concentration ..,sA_ Notes, 'JUnifs Reporting Limit" 91-20-3 Naphthalene BRL mg/Kg 0.51 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.51 85-01-8 Phenanthrene BRL - mg/Kg 0.51 83-32-9 Acenaphthene BRL mg/Kg 0.51 ,QC Surrogate Compound', Spiked-# Measured.., Recovery, a; 4r' *. ? QC Limitsi t�<''.'• Fractionation: 2-Fluorobiphenyl 2.7 2.4 90% 40-140% 2-Bromonaphthalene 2.7 2.5 94 % 40-140 Extraction: Chloro-octadecane 2.7 1.6 60 % 40-140 ortho-Terphenyl 2.7 2.0 72 % 40-140 QA/QC Certification .� � ,, f 7 -• 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. s :Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 7 of 20 GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GC/FID Field ID: BOH 8' Matrix: Soil Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-5 QC Batch ID: EP-3110-M Sampled: 05-25-10 16:00 Instrument ID: GC-9 Agilent 6890 Received: 05-26-10 15:45 Sample Weight: 15 g Extracted: 05-27-10 13:00 Final Volume: 1 mL Analyzed(AL): 05-29-10 18:42 %Solids: 94 Analyzed(AR): 05-29-10 19:26 Aliphatic Dilution Factor: 1 Analyst: KM Aromatic Dilution Factor: 1 "EPH Ranges ' °". '_`' `; . _ Concentrafiorir Notes Units {Iteportiog Limit ,' n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-C19 to n-C36 Aliphatic Hydrocarbons t. BRL mg/Kg 31 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 31 U ad'us ed n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 31 CAS Number,,' A.nalyte, Concentration' Notes bUnits Reporting Limit 91-20-3 Naphthalene BRL mg/Kg 0.52 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.52 85-01-8 Phenanthrene BRL mg/Kg 0.52 83-32-9 Acenaphthene BRL mg/Kg 0.52 QC Surrogate_Compound,: "_ Spiked r>"Measured + ,,y .Recovery;, T,.., QC,Limits Fractionation: 2-Fluorobiphenyl 2.8 2.4 86% 40-140 2-Bromonaphthalene 2.8 2.5 90% 40-140 Extraction: Chloro-octadecane 2.8 2.1 76% 40-140% ortho-Terphenyl 2.8 2.4 84% 40-140 _ ._QA/QC Certification J ,. 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 page 8 of 20 GROUNDWATER ANALYTICAL ASTM Method D3328-00(Modified) Hydrocarbon Fingerprint by GC/FID Field ID: Disposal Comp Matrix-' Soil Project: Tyrell/BEA10-10230 Container: 250 mL Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 133473-6 QC Batch ID: HF-3093-M Sampled: 05-25-10 16:00 Instrument ID: GC4 HP 5890 _ Received: 05-26-10 15:45 Sample Weight: , 16 g , Extracted: 05-29-10 12:00 Final Volume: 1 MIL Analyzed: 06-03-10 11:54 Dilution Factor: 5 Analyst: MB %Solids: 92 - ;:Qualitat6eldentification,,,. This sample has GC/FID characteristics that are similar to: 1. Petroleum products in the Fuel Oil range: Analyte, r-•, .� ,concentration',N -:,:> • ''Notes �" a UpltS�i Reporting L_imit` Total Petroleum Hydrocarbons 1,700 mg/Kg 310 ..,. g Q QC Surirog'ate Compound Spiked Measured_ Recovery x, C Limits, ,,, ortho-Terphenyl 2.8 1 n/a d 60-140% Method Reference: Comparison of Waterbome Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). ' i Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions:Reporting limits are adjusted for sample size and dilution. d Surrogate recovery not measurable due to required sample dilution. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 9 of 20 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00(Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID: 133473-06 Hydrocarbons Laboratory ,.o 0.s 0.6 0.4 0.2 JL)k 0 5 10 15 20 25 30 35 40 45 Retention Time (Minutes) Page 10 of 20 ��-,//L� k 'y5`�; w2_.�cc•.•Sa✓_•S:»y,,Q-r��H.�'.•i'1:a'�dr-.�•"r�'.r t-�"..vR,,'r7+s.+*,8,�' :•;�N!��:;,•,�i !' f'.- ''I' 4' C .+.N-.'.►w J�.}wK.�','S ,!�•"T:7 ,.i'1_'t.4't*-,t om '.S-.-e` sM '-3w.d^wGrY AF ?r.: 1.-.-•..r_Tte_,—V L�_ye .. �.J•ad' y,.,n .ilF T ..t.. _ 'q,o:. �sn:tAt,.".T.� � _ , � •'r -'?'� 5:= 'S�rzi:.• .. _.r ., e..+• _ ..,':csk:: �yyy.rlaMak,'srreer-Ro.eca;2so .•yJ*' . ' r TODY RECORD`.' y• `sa r- �x • . _ _IAr ;.^ {. aTER'a'F,,,`el�arda 6ev�MA,02532:-a''` "�R'+' 't-7- ``'r' ",,,,-.iCHi41N OF=CU$ M" y ,P�• :..: -`� +� •k q t -,s -i +r• ":r`. ^fY .� # r7RQUN�,{N, k -`Telepho�(�)759-4497'•FAM508)7594475;f `-AND�WORK ORDER � �11�tI"►� �I.�M�..r*, R;wyvw.groutsdwateranaljAical.com' 3r- - i - ••• :,»r -x.<• _ p ;1, wh - 4 r. aFiRn+ `TURNAROUND ,A «+ ,Pro)ed Noma ` NALY "'. omt°at Nti L t IS REQUEST MS b 1,(•�a Days " r' ": �"' ,1. ' ,t `; s '•r_ 3 a` P rat•- ,•t 1 r. i BStrslnese r t � - uuu"1 11t cl N �-5. uslnessDaya� •ct + .� �.� � �� � .� n � i r. t J ,.p:°RUSH(RAN, d r� . -- '.❑` r '" ❑o❑ i, r o.❑ q -w �g g,. tit teWbe°RmhAUOmeea?nNwn° t a xc r l i yi sy t h 9 f-❑ E 7 t �y� p BSe tOstate/. erNa . ` Z K ; ❑ ' . . i ., ..e +; pw SS "p p3j BILLINQ r. i i s 3(� t.a x i. ° q I ❑ ❑ ,, ❑ S ❑ ❑o ❑ ❑ , c � " ',, Project Manager: .Telephone :1��J O a ° L ❑" i � � q1 .urchaae Order Na• 0 gT� r >S E A ❑ ' ,� •:�c(/ IV �G p-Thlyd Party Billing::' -n' .• �a �!e tif $ ❑ 'INSTRUCTIONS:Use separate'Ilne for;each cont®mer(excePl'replldates). p'GWA Ouote:^ a''_ .`g II s ❑ p ❑ ❑ "# ❑. .,,Matrix. .Type I Contelrror(s)_ _.r,.. .Preeerve8on;=.. _ , - ,� r•F. r: b' '�� a S.;' �:=.�❑ 0:1 Sampling gg g e �. LABORATORY b � � .$ ' � 8 SANPLE. '!3 < 'e t � r t:en.uea coif .I`.X.Xi IDENTIFlCAT:ON. � :,. g _r,. ='�g a e a e a ( r t i'� l;i�'; 6 x Y m y $ g b m. at 13 10 Iz E?'.'a .'z. °'t" - y '�?fi.=h,ls+'E'k,X•.0 ''r -X y -< > • isa "" `r ,, +"�^� �'��pI r'�'.� �:�':#tk',a;kk v,'r#, , D .. Xa ..f •t f Y ,' " #"'C'.kz.'r Y•'t•�" •'-- °'..9: LR7�''"''''{'�'o.:.a.. '�'+, F 4l {• tiw r s Y ,, t "i- } �y 4 .p�s.+c".';i ,�':"P* x.7 T 7x pp 1- ("- 7 I� r CHAIN-OF-CUSTODY fi ,i DATA OUALITY OBJECTIVES REM S I SPECIAL INSTRUCTIONS ` m protect Specific OC NOTE-All samples submitted sub eU ro Standard Terms and Conditions on reveres hereof. - re Ned .s1o"p RecelptrempernWre ` Ulet O P Tmo; Re R9 e red. 9 ry Det n S❑NO MCP Data Certification requl ter. �i 'SI Merry regulatoryro tams end EPA methods require project in by Same O t, 3 • ❑YES p NO MCP Drinking Water Sample tnduded. State Standard. Dallverebles' oje 9 ❑m❑aarisorooa specific OC.Pro)ectspecMo-OCIncludes Semple Duplicates, (Volatile analyses require duplicate collection and Tip.Blanks). p CT %(MCP GW-t/S-t ❑PWS'Form MaMx'Spikes,and/or Matrix Spike DuPlh:eles.Laboratory OC Is r.1 V Da Trims _ q C�telrrer Came: 't' not project specific unless prearranged.Project specific OC RNinq ned by:- - pAnayze Duplicates,and Tips Blardat ony Il positive results. p ME O MCP GW-2fS-2 ❑MWRA whiplessre charged on a.per sample basis.Each MS,MSD: - s �TYl R.MA ❑NY STARS ❑' end Sample'Dupllcate requires an additional sample aliquot. ,ShippingfAirbis _ ❑NH ❑ ishetltry: .Drinking Water Oata•. Time Roue :by story. elf - Number. ❑YES❑NO CT R eta tion p NY ❑Wastewater project Spechic OC Required 9elecaen or OC Sempto - x Pteesauaesam a - Signature: ❑RI Of Waste Disposal - ❑Sample pfk a ❑ _ R Number ' Method of Shipment: WACaMor•❑Express Mall p Federal Express. Nurrdrer. ❑VT ❑Dredge Material ❑Matrix Spike ❑UPS O Hand❑ A. "' ,p—- ❑ , O Matrix Spike Duplicals - - .�i i GROUNDWATER ANALYTICAL Project Narrative Project: Tyrell/BEA10-10230 Lab ID: 133473 Client: Bennett Environmental Associates,Inc. Received: 05-26-10 15:45 A Documentation and Client Communication The following documentation discrepancies,and client changes or amendments were noted for this project: 1 . Samples 133473-1 through 4 were reported with a depth of"2-8"'not"0-8",per Brian Clarke,6-8-10. B.Method Modifications,Non=Conforrnances and Observations The sample(s) in this project were analyzed by the references analytical method(s),and no method modifications, non-conformances or analytical issues were noted,except as indicated below: / 1 . MA DEP EPH Note: Samples 133473-1 through-5. Samples were analyzed for only carbon range analytes and CDC,cke A 01� four Fuel Oil No.2/Diesel Fuel PAH analytes,as requested by client. 2 . TPH by GC/FID Non-conformance: Sample 133473-6. Sample did not have measureable surrogate recoveries due to required sample dilution. Jp6jtjd 3 . TPH by GC/FID Note: Sample 133473-6. Sample was diluted prior to analysis. Dilution was required due to ViQ�il1�Cil ap presence of non-target analyte interference. J Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Stet, Buzzards Bay, MA 0253N 9e 11 of 20 GROUNDWATER ANALYTICAL Quality Assurance/Quality Control A.Trogram Overview`. Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980), and Test Methods for Evaluating Solid Waste, US EPA;SW-846, Update III (1996). Quality Control protocols include written Standard Operating Procedures (SOPS) developed for each analytical method. SOPS are derived from US' EPA'methodologies and other established references. Standards are prepared from commercially obtained reference materials of certified purity, and documented for traceability. ` Quality Assessment protocols for most organic analyses include a minimum of one laboratory control sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. . All samples, standards, blanks, laboratory control samples, matrix spikes and sample duplicates are spiked with internal standards and surrogate compounds. All instrument sequences begin with an initial calibration verification standard and a blank; and excepting GC/MS sequences, all sequences close with a continuing calibration standard. GC/MS systems are tuned to appropriate ion abundance criteria daily; or for each 12 hour operating period,whichever is more frequent. Quality Assessment protocols for most inorganic analyses include a.minimum of one laboratory control sample, one method blank,one matrix spike sample, and one sample duplicate for each sample preparation batch. Standard curves are derived from one reagent blank and four.concentration levels. Curve validity is verified by standard recoveries within plus or minus ten percent of the curve. B'. Definitions Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples of the same matrix which are prepared together for the same analysis, using the same lots of reagents and the same techniques or manipulations,all within the same continuum of time, up to but not exceeding 24 hours. Laboratory Control Samples are used to assess the accuracy of the analytical method. A Laboratory.Control Sample consists of reagent water or sodium sulfate spiked with.a group of target analytes representative of the method analytes. Accuracy is defined as the degree of agreement of the measured value with the true or expected value. Percent Recoveries for the Laboratory Control.Samples are calculated to assess accuracy. Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliquot of sodium sulfate. Method Blanks are taken through all the appropriate . steps of an analytical method. Sample data reported is not corrected for blank contamination. Surrogate Compounds are used to assess the effectiveness of an analytical method in dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to the target analytes of interest in chemical behavior, but which are not normally found in environmental, samples. Percent Recoveries are calculated for each Surrogate Compound. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 13 of 20 GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Samples LCS LCSD Category: MA DEP EPH Method Instrument ID: GC-9 Agi lent 6890 Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-3110-M Extracted: 05-27-10 13:00 Extracted: 05-27-10 13:00 Matrix: Soil Analyzed(AL): 05-28-10 16:21 Analyzed(AL): 05-28-10 17:49 Units: mg/Kg Analyzed(AR): 05-28-10 17:05 Analyzed(AR): 05-28-10 18:33 Analyst: KM Analyst: KM CAS.Number .: Analyfe ;, LGS°, n :1. .LCS Duplicate' QC Limits Spiked,Mea:urea •Recovery,g Spiked Measured s;Recovery RPD"'s _ .Spike RPD 111-84-2 n-Nonane(C9) 3.3 1.8 55 % 3.3 1.7 52 % 5 % 30-140% 25% 124-18-5 n-Decane(C10) 3.3 2.1 64 % 3.3 2.0 60 % 5 % 40-140% 25% 112-40-3 n-Dodecane(C12) 3.3 2.3 69 % 3.3 2.2 66 % 5 % 40-140% 25% 629-594 n-Tetradecane(C14) 3.3 2.3 71 % 3.3 2.2 67 % 5 % 40-140% 25% 544-76-3 n-Hexadecane(C16) 3.3 2.5 76 % 3.3 2.4 74 % 3 % 40-140% 25% 593-45-3 n-Octadecane(C18) 3.3 2.8 84 % 3.3 2.7 82 % 3 % 40-140% 25% n/a n-C9 to n-C18 Group 20 14 70 % 20 13 67 % 4 % 40-140% 25% 629-92-5 n-Nonadecane(C19) 3.3 2.9 87 % 3.3 2.8 84 % 4 % 40-140% 25% 112-95-8 n-Eicosane(C20) 3.3 2.8 85 % 3.3 2.7 82 % 3 % 40-140% 25% 629-97-0 n-Docosane(C22) 3.3 2.7 80 % 3.3 2.6 78 % 3 % 40-140% 25% 646-31-1 n-Tetracosane(C24) 3.3 2.7 82 % 3.3 2.6 79 % 4 % 40-140% 25% 630-01-3 n-Hexacosane(C26) 3.3 2.7 80 % 3.3 2.6 77 % 4 % 40-140% 25% 630-02-4 n-Octacosane(C28) 3.3 2.6 79 % 3.3 2.5 76 % 4 % 40-140% 25% 638-68-6 n-Triacontane(C30) 3.3 2.6 79 % 3.3 2.5 75 % 5 % 40-140% 25% 630-06-8 n-Hexatriacontane(C36) 3.3 2.4 72 % 3.3 2.2 68 % 6 % 40-140% 25% n/a n-C19 to n-C36 Group 26 21 81 % 26 20 78 % 4 % 40-140% 25% 91-20-3 Naphthalene 3.3 2.2 66 % 3.3 2.1 63 % 5 % 40-140% 25% 91-57-6 2-Methyl naphthalene 3.3 2.3 71 % 3.3 2.2 68 % 4 % 40-140% 25% 208-96-8 Acenaphthylene 3.3 2.5 76 % 3.3 2.4 73 % 4 % 40-140% 25% 83-32-9 Acenaphthene 3.3 2.5 75 % 3.3 2.4 72 % 3 % 40-140% 25% 86-73-7 Fluorene 3.3 2.6 79 % 3.3 2.5 77 % 2 % 40-140% 25% 85-01-8 Phenanthrene 3.3 3.0 90 % 3.3 2.9 88 % 2 % 40-140% 25% 120-12-7 Anthracene 3.3 3.0 90 % 3.3 2.9 89 % 2 % 40-140% 25% 20644-0 Fluoranthene 3.3 3.1 93 % 3.3 3.0 90 % 4 % 40-140% 25% 129-00-0 Pyrene 3.3 3.1 93 % 3.3 3.0 90 % 3 % 40-140% 25% 56-55-3 Benzo[a]anthracene 3.3 2.9 88 % 3.3 2.8 85 % 3 % 40-140% 25% 218-01-9 Chrysene 3.3 3.0 91 % 3.3 2.9 89 % 2 % 40-140% 25% 205-99-2 Benzo[b]fluoranthene 3.3 2.9 88 % 3.3 2.8 85 % 3 % 40-140% 25% 207-08-9 Benzo[k]fluoranthene 3.3 2.9 87 % 3.3 2.8 85 % 2 % 40-140% 25% 50-32-8 Benzo[a]pyrene 3.3 3.0 92 % 3.3 2.9 89 % 3 % 40-140% 25% 193-39-5 Indeno[1,2,3-c,d]pyrene 3.3 3.0 92 % 3.3 3.0 89 % 3 % 40-140% 25% 53-70-3 Dibenzo[a,h]anthracene 3.3 3.0 91 % 3.3 2.9 89 % 2 % 40-140% 25% 191-24-2 Benzo[g,h,i]perylene 3.3 3.0 90 % 1 3.3 2.9 87 % 3 % 40-140% 25% n/a PAH Group 56 48 85 % 56 47 83 % 3 % 40-140% 25% QC Surrogate Corripound, Spiked Measured ,.Recovery, .Spiked ,Measured.; Recovery QC Limas Fractionation: 2-Fluorobiphenyl 2.7 2.2 81 % 2.7 2.1 78 % 40-140% 2-Bromonaphthalene 2.7 2.3 85 % 2.7 2.2 81 % 40-140% Extraction: Chloro-octadecane 2.7 2.2 81 % 2.7 2.1 78 % 40-140% ortho-Terphenyl 2.7 2.4 89 % 2.7 2.3 85 % 40-140% "Fractionation Breakthrough7baluationi QC Limits 91-20-3 Naphthalene I LCS 0 % LCSD 0 % 5% 91-57-6 2-Methyl naphthalene I LCS 0 % LCSD 0 % 5% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Method modified by use of microwave accelerated solvent extraction technique. Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. The LCS and LCSD are prepared from separate source standards than those used for calibration. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532Page 14 of 20 GROUNDWATER ANALYTICAL Quality Control Report Method Blank ' Category: MA DEP EPH Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-3110-M Extracted: 05-27-10 13:00 Matrix: Soil Analyzed(AL): 05-28-10 19:17 Analyzed(AR): 05-28-10 20:01 Analyst: KM EPH Ranges_., _„ ;" u :. Coricentratiori .r ,`,-` Notes m., Units•. Repomngumu; _ n-C9 to n-Cl8 Aliphatic Hydrocarbons t BRL mg/Kg .30 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 30 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg • 30 Unadjusted n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 30 CAS Number;+ �a Analyze ;_ Concentration =a _Notes Unit;{ ,`.;ReporLng Limit 91-20-3 Naphthalene BRL mg/Kg 0.50 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.50 85-01-8 Phenanthrene BRL mg/Kg 0.50 . 83-32-9 Acenaphthene F BRL mg/Kg 0.50 QC Surrogate Compound Siked eRecoveryp ` QC Limits Fractionation: 2-Fluorobiphenyl 2.7 2.3 86 % 40-140% 2-Bromonaphthalene 2.7 2.2 83 % 40-140% Extraction: Chloro-octadecane 2.7 2.3 85 % 40-140% ortho-Terphenyl 2.7 2.4 89% 40-140% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532Page 15 of 20 GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Sample Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC4 HP 5890 QC Batch ID: HF-3093-M Extracted: 05-29-10 12:00 Matrix: Soil Analyzed: 06-02-10 03:44 Units: mg/Kg Analyst: KM Analyte a '- '` Spiked : ' `�Meaiuied .1 Recovery _QC Limits Fuel Oil No.2 130 98 1 75 % 60-140% QC Surrogate Compound' 'F ;, 4 Spiked,w. :; Measured Recovery QC Limits�`,t, -> ortho-Terphenyl 2.7 1.9 73 % 30-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5alphaandrostane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. a. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532Page 16 of 20 GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: ASTM D3328-00 Mod Hydrocarbon_ Fingerprint Instrument ID: . GC4 HP 5890 QC Batch ID: HF-3093-M Extracted: 05-29-10 12:00 Matrix: Soil Analyzed: 06-02-10 02:49 Analyst: KM Analyte .. �! �, ti.� °' 'c' .'^ {COOCOntrdtlo0 �' ws �,�''Notes . °•-�UnItS"Z r.,Reporhng Limif'. Total Petroleum Hydrocarbons BRL mg/Kg 60 _QC Surrogate'Compound I'Spiked y' Measured ` ,j>Recovery: :z QC Limits ortho-Terphenyl 2.7 1 2.3 85 % . 60 140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5alphaandrostane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532Page 17 of 20 GROUNDWATER ANALYTICAL Certifications and Approvals Groundwater Analytical maintains environmental laboratory certification in a variety of states. Copies of our current certificates may be obtained from our website: http://www.groundwateranalytical.com/qualifications.htm CONNECTICUT Department of Health Services,PH-0586 Potable Water,Wastewater,Solid Waste and Soil http://www.ct.gov/dph/I ib/dph/envi ronmental_health/environmental_laboratories/pdf/Out_State.pdf MASSACHUSETTS - Department of Environmental Protection, M-MA-103 Potable Water and Non-Potable Water htt :// ublic.de .state.ma.us/labcerOabcert.as x I P P P P Department of Labor, Asbestos Analytical Services,Class A Division of Occupational Safety, AA000195 http://www.mass.gov/dos/forms/la-rpt_list—aa.pdf NEW:HAMPSHIRE Department of Environmental Services, 202708 Potable Water,Non-Potable Water,Solid and Chemical Materials http://www4.egov.nh.gov/DES/N HE LAP NEW YORK -.. , Department of Health, 11754 Potable Water,Non-Potable Water,Solid and Hazardous Waste http://www.wadsworth.org/labcerVelap/comm.html RHODE ISLAND Department of Health, Potable and Non-Potable Water Microbiology,Organic and Inorganic Chemistry Division of Laboratories, LA000054 http://www.health.ri.gov/labs/outofstatelabs.pdf U.S. DEPARTMENT OE AGRICULTURE USDA,Soil Permit, S-53921 Foreign soil import permit VERMONT Department of Health, VT-87643 Potable Water http://healthvermont.gov/enviro/ph_lab/water—test.aspx#cert Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 Page 18 of 20 • 1 GROUNDWATER ANALYTICAL Certifications and Approvals MASSACHUSETTS. "' "` ".` Depa'rtment"of.Ehyironmental Protection,`M-MA-103 Groundwater Analytical maintains MassDEP environmental laboratory certification for only the methods and , analytes listed below. Analyses for certified analytes are conducted in accordance with MassDEP certification , standards,except as may be specifically noted'in the project narrative. Potable Water(Drinking Water) Non-Potable Water(Wastewater) - Analyte Method Analyte Method 1,2-Dibromo-3-Chloropropane EPA 504.1 Antimony EPA 200.7 1,2-Dibromoethane EPA 504.1 Antimony EPA 200.8 Alkalinity,Total SM 2320-B Arsenic EPA 200.7 Antimony EPA 200.8 Arsenic EPA 200.8 Arsenic EPA 200.8 Beryllium EPA 200.7 Barium EPA 200.7 Beryllium EPA 200.8 Barium EPA 200.8 Beta-BHC EPA 608 Beryllium EPA 200.7 Biochemical Oxygen Demand SM 5210-B Beryllium EPA 200.8 Cadmium EPA 200.7 Cadmium EPA 200.7 Cadmium EPA 200.8 Cadmium EPA 200.8 Calcium EPA 200.7 Calcium EPA 200.7 Chemical Oxygen Demand SM 5220-D Chlorine,Residual Free SM 4500-CL-G Chlordane EPA 608 Chromium EPA 200.7 Chloride EPA 300.0 Copper EPA 200.7 Chlorine,Total Residual SM 4500-CL-G Copper EPA 200.8 Chromium EPA 200.7. Cyanide,Total Lachat 10-204-00-1-A Chromium EPA 200.8 E.Coli(Treatment and Distribution) Enz.Sub.SM 9223 Cobalt •EPA 200.7 E.Coli(Treatment and Distribution) NA-MUG SM 9222-G Cobalt EPA 200.8 Fecal Coliform(Source Water) MF SM 9222-D Copper EPA 200.7 Fluoride EPA 300.0 Copper EPA 200.8 Fluoride SM 4500-F-C Cyanide,Total Lachat 10-204-00-1-A Heterotrophic Plate Count SM 9215-B DDD EPA 608 Lead EPA 200.8 DDE EPA 608 Mercury EPA 245.1 DDT EPA 608 Nickel EPA 200.7' Delta-BHC EPA 608 Nickel EPA 200.8 Dieldrin EPA 608 Nitrate-N EPA 300.0 Endosulfan I EPA 608 Nitrate-N Lachat 10-107-04-1-C Endosulfan II EPA 608 Nitrite-N EPA 300.0 . Endosulfan Sulfate EPA 608 Nitrite-N Lachat 10-107-04-1-C Endrin EPA 608 pH SM 4500-H-B Endrin Aldehyde, EPA 608 Selenium EPA 200.8 ,, Fluoride EPA 300.0 Silver EPA 200.7 Gamma-BHC EPA 608 Silver EPA 200.8 Hardness(CaCO3),Total EPA 200.7 Sodium EPA 200.7 Hardness(CaCO3),Total SM 2340-B Sulfate EPA 300.0 Heptachlor EPA 608 Thallium EPA 200.8 Heptachlor Epoxide EPA 608 Total Col iform(Treatment and Distribution) Enz.Sub.SM 9223 Iron EPA 200.7 Total Col iform(Treatment_and Distribution) MF SM 9222-B Kjeldahl-N Lachat 10-107-06-02-D Total Dissolved Solids SM 2540-C Lead EPA 200.7 Trihalomethanes EPA 524.2 Magnesium EPA 200.7 Turbidity SM 2130-8 Manganese EPA 200.7 Volatile Organic Compounds EPA 524.2 Manganese EPA 200.8 Mercury EPA 245.1 Non-Potable Water(Wastewater) Molybdenum EPA 200.7 Analyte Method Molybdenum EPA 200.8 Nickel EPA 200.7 Aldrin EPA 608 Nickel EPA 200.8 Alkalinity,Total SM 2320-8 Nitrate-N EPA 300.0 Alpha-BHC EPA 608 Nitrate-N Lachat 10-107-04-1-C Aluminum EPA 200.7 Non-Filterable Residue SM 2540-D Ammonia-N Lachat 10-107-06-1-B Oil and Grease EPA 1664 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 19 of 20 GROUNDWATER ANALYTICAL Certifications and Approvals MASSACHUSETTS'. = ` : Department of Environmental Protection; M-MA-103 Groundwater Analytical maintains MassDEP environmental laboratory certification for only the methods and analytes listed below. Analyses for certified analytes are conducted in accordance with MassDEP certification standards,except as may be specifically noted in the project narrative. Non-Potable Water(Wastewater) Analyte Method Orthophosphate Lachat 10-115-01-1-A pH SM 4500-H-B Phenolics,Total EPA 420.4 Phenolics,Total Lachat 10-210-00-1-B Phosphorus,Total Lachat 10-115-01-1-C Phosphorus,Total SM 4500-P-B,E Polychlorinated Biphenyls(Oil) EPA 600/4-81-045 Polychlorinated Biphenyls(Water) EPA 608 Potassium EPA 200.7 Selenium EPA 200.7 Selenium EPA 200.8 Silver EPA 200.7 Sodium EPA 200.7 Specific Conductivity SM 2510-B Strontium EPA 200.7 Sulfate EPA 300.0 SVOC-Acid Extractables EPA 625 SVOC-Base/Neutral Extractables EPA 625 Thallium EPA 200.7 Thallium EPA 200.8 Titanium EPA 200.7 Total Dissolved Solids SM 2540-C Total Organic Carbon SM 5310-13 Toxaphene EPA 608 Vanadium EPA 200.7 Vanadium EPA 200.8 Volatile Aromatics EPA 602 Volatile Aromatics EPA 624 Volatile Halocarbons EPA 624 Zinc EPA 200.7 Zinc EPA 200.8 M-,v . CiA o -....A 4— Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 20 of 20 I Notes to the File Date: May 25, 2010 T M Tyrrel Residence 15 Pin Oaks Drive Barnstable, MA Cynthia Martin, PHD Deputy Fire Chief Pulsifer, Barnstable Fire ` Brian Clarke, Bennett Environmental Services A five-hundred and fifty gallon underground oil storage`tank was discovered when the home owner was removing rhododendron:bushes. Tank Removal Services was contacted for its removal, upon lifting it out of the ground the tank was found to have two holes in it. There were approximately one-hundred and fifty gallons of oily water still in the tank. Tank Removal Services contacted Bennett Environmental Services to determine the, extent of the leak. The field TPH tests on two soil samples revealed the following: there were no TPH hits from the sample taken at eight feet below the tanks location, but there was a hit from the sample taken four feet below the tank location. It was decided that soil would be removed to a depth of eight feet. The hole would then be back'filled with the clean soil on site. Contaminated soil was placed on plastic sheets until removal from the site. Should lab results on the soil samples indicate contamination at eight feet further work would be required. . lit E .Town of Barnstable r# Department of Regulatory Services * j Public Health Division 200 Main Street,Hyannis MA 02601 Date - b Date Scheduled 7 / Time— Fee Pd: Soil.By: Suitabili A �. ty sseSSMent for Sewage Disposal Perfotrned td -----�r�4 •`moo.,, � ,. Witnessed By; Location Address / Lo CATION& GENERAL IORMATION 7 11'-� �/h •5 �,�R Owner's Name Address Assessor's Map/Parcel; Y �. Engineer's Name NEW CONSTRUCTION ` �.:_ RE AIR' Telephone# � ()(� � p,,.�,3 Land Use t S Slopes(%) Distances from; n Surface Stones Open Water Body G 1 v ft possible Wet Area t p ��`,' , /� �ft Drinking Water Well -LL/.�ft > Drainage Way Ott Property Line p Other I ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate well . t ands in proximity to holes) To t fop k5 ✓ Parent material(geologic)--SS- r- th Bedrock roc k Dep Depth to Oroundwatec Standing Water in Hole: ill Ot.� ,t3 Weeping from Pit Pace ` �Y Estimated Seasonal High Groundwater__ a ------ DETERMliNATION FOR SEASONAL HIGH WATER TAB Method Used: S t V Depth Observed standing in obs.hole: a Depth to weeping from side of obs.hole: In. Depth to soil mottles: Index Well# in, Groundwater AdJusimeAt in, Reading Date: Index Well level� It. AdJ•flactor _ Adj.tlroundwater Level EinJ PERCOLATION TEST Date Thne �_ 3' Tuna at 9" . ltr; ..7 3 t� Time at 6" _k lime @ � � o • 'Time(9"•6")� ' �� �ch _ _. Site Suitability Assessment Site Passed V Stte'Fatied: Additional Testing Needed(Y/N) ' Original:Public Health Division ' Observation Hole Data To Be Completed on Back ***If percolation test is to be conducted. within 100'of wetland,you must first notify the { Barnstable Conservation Division at least one(1)week prior to beginning, Q:ISEPTICIPERCFORM.DOC, DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sdil Color Soil then Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. ConsistencL%Grityell A. S1r \o�{It 3/L GON►C9tiG�•�r7 Vttvt r ' c 0th.'tpaC-V, V- . - -e,- t00%% C' comyAe- S z L- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil they Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% t1l,1. Co— 'Po r L S o ��NCS— Lam` vsrst_�f. C. Go 10 to w ST'tn-�t�t► DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C i St_ �c`.{tG AIL LrLta L Ca+•�l.PI�.G'rtd..d t� Z DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. o ' 0--c Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes . Within 500 year boundary No- Yes Within 100 year flood'boundary No Z Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviou material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervtous material? -. Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in�10 CMR 15.017. • Signature Date 3-1"%�0� , Q:\S,EpTIMERCFORKDOC 4� r4 COMMONWEALTH OF MASSACHUSETTS 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: 45 Pin Oaks Drive(Main House) Barnstable, MA 02630 Owner's Name: Edward Gildea Owner's Address: c') Date of Inspection: October 31, 2005 o Name of Inspector: (Please Print) James.M. Ford Company Name: James M. Ford ,. Mailing Address: P.O.Box 49 co Oster_ville,MA 02655-0049 Telephone Number: (508)862-9400 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 Needs Further Evaluation by the Local Approving Authority Fai s Inspector's Signature: Date: November 7, 2005 The system inspector shalyia of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. 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 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(Main House) Barnstable. MA Owner: Edward Gildea Date of Inspection: October 31, 2005 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 . Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 3 L 2005 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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria 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: I 3 i Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gddea Date of Inspection: October 31 2005 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 Ilof 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 f Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 Check if the following have been done: You must indicate" es"or"no"as to each of the followin : 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 Part 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 INSPECTIO N FORM PART C SYSTEM INFORMATION Property Address: 45 Pin Oaks Drive(Main House) Barnstable AM Owner: Edward Gildea Date of Inspection: October 31 2005 RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design): 4+ ' Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 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: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd 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: Installed in approximately 1992-per information on file 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 DISPO SAL SY STEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward G Idea Date of Inspection: October 31 2005 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: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 15" Material of construction: ✓ concrete _metal fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no : certificate) ) (attach a copy of Dimensions: _ 1500 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: _ MeasurinQ 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.): Cement tees were present. The li uid level was even with the outlet invert. There did not a pear to be any signs o leaka e. 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 recommendations,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: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 11 2005 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: Capacity: allons Design Flow: allons/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 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.): The D-box was level and clean. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: _ 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2-6'x 6'(1000 gal.) leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil, condition of vegetation, etc.): One leach pit(#4) was dry and clean. The bottom to grade was 9' The other pit(#5) was dry and clean The bottom to grade was 9. There did not appear to be anv signs o ailure. — 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: Dimensions 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: j 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: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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. A ❑ QA�k ;L � 8 a y 3 aq i� 3 3 39 ya 3 39 �16 y yq -7(o (3 10 i Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(Main House) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/_ feet Please indicate(check)all methods used to determine the high ground water elevation: 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:_tonoQranhic and water contours tnaos Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable to o ra hic and water contours maps..the maps were showin a roximatel 30'+/_to round water at this site. This report has been prepared and the systettt inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the systent will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the'inspection and/or this report. 11 . COMMONWEALTH OF MASSACHUSETTS 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: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA 02630 Owner's Name: Edward Gildea Owner's Address: c Date of Inspection: October 31 2005 c Name of Inspector: (Please Print) Janes M. Ford Company Name: JaesM.Ford "' m Mailing Address: P.O.Box 49 m Osterville,MA 02655-0049 rn Telephone Number: (50 P 862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the in 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 Nee Further Evaluation by the Local Approving Authority Fail F Inspector's Signature: Date: November 7 20)5 The system inspector shall sub i a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the.approving authority. Notes and Comments **"This report only describes conditions at the time of inspection and under the conditions of use time. T at that 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 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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" lease explain. p 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 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(System for bathroom in basement. Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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 CAM 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 i 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria 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 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Pin Oaks Drive(Sint--for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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 %2 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 now 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 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 Check if the following have been done: You must indicate" es"or"no"as to each of the followin : 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 backup? ✓ — 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 detennined 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 Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]: 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 45 Pin Oaks Drive(Nvsteni for bathroom in basement) Barnstable AM Owner: Edward Gildea Date of Inspection: October 31 2005 RESIDENTIAL FLOW CONDITIONS ' Number of bedrooms(design): n1a Number of bedrooms(actual): - DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 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): La [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: Unknown I COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd 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 detennined? 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: Unknown Were sewage odors detected when arriving at the site(yes or no): No 6 1 i Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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 Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: . 7' Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no certificate) no): (attach a copy of Dimensions: _ 2- 1000 gal Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 1" -- Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: _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.): This system has 2 tanks in series. Both were T below f,rade. Both tanks have steel covers 1'below rade. Just t in the basement goes to this s stem. he bathroom GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete(explain): _metal, _fiberglass _polyethylene _other 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 recommendations;inlet and outlet tee or baffle condition,structural integrity,as related to outletegrity,liquid levels invert,evidence of leakage,etc.): q 7 a f Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(_ Sv� Stem for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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: ' Capacity: _ allons Design Flow: allons/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.): 4 DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) I 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.): The D-box was 7'below grade. Unable to locate. A video camera was used or the ins ection. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 4 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA - Owner: Edward Gildea Date of Inspection: October 31 2005 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: leaching trenches,number, length: leaching fields,number,dimensions: ✓ overflow cesspool,number: 1 -4'W x 7'T x 10'bottom to rade Innovative/alternative system Type/name of technology: Conunents (note condition of soil,signs of hydraulic failure, level of ding,damp s etc.): oil,condition of vegetation, The cesspool was dry, The cover was 2'below rade. There did not a'---- 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: Dimensions 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: 45 Pin Oaks Drive (Systemm fior bathroom in basement Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 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. A aAvk 0 . c«k i 3 aq �� s 3 39 ya y a aa- 1 e6 y S�1 Sy 3 39 4l 6 G3 (�-7 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Pin Oaks Drive(System for bathroom in basement) Barnstable MA Owner: Edward Gildea Date of Inspection: October 31 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- feet Please indicate(check)all methods used to determine the high ground water elevation: 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: topogranhic and water contours mans Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: UsingBarnstable to o ra site. hic and water contours ma s the tna s were showin a roximatel 30'+1-to round water at this . i This report has been prepared and the system 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 system, the inspection and/or this report. 11 �. TOWN OF BARNSTABLE `LOCATION ra yS Pji1 OAks Dr. SEWAGE # -VILLAGE u/a(/ISTA�O�.c ASSESSOR'S MAP & LOT01-7 1 O�3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /SUb f a ' ? LEACHING FACILITY: (type) o'L /CW P177 Z tj (size) NO.OF BEDROOMS y BUILDER OR OWNER f. G-�d�A PERMITDATE: 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 tIr T 61 C= w 10 pwk CvAf4 t, ] -o DO' P a a D:l To A 8 3 39 ya 3 1 aq sr, 3 y a as �� y SC) Sy 3 39 ��6 y yq -7( G3 G7