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70-92 Boston Street - Phase 1 Initial SIte Investigation and Tier Classification - Submittal - January 2006 TRCIl Ark! 0 9 z 0 0 10 January 6, 2006 Ms. Joanne Fagan Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup Northeast Regional Office 205B Lowell Street Wilmington, Massachusetts 01887 RE: 120-Day Release Notification—Re-Submittal Phase I Initial Site Investigation & Tier Classification Submittal Former Flynntan Site 70-92 Boston Street Salem,Massachusetts RTN 3-24618, 3-16788 Dear Ms. Fagan: On behalf of the City of Salem (the "City"),TRC has prepared the following MCP submittals with the respect to the above-referenced Release Tracking Numbers (RTNs) 1. A revised Release Notification and Notification Retraction Form (RNF;Form BWSC- 103)for RTN 3-24618; and, 2. Phase I—Initial Site Investigation Report and Tier Classification submittal for RTNs 3-24618 and 3-16788. A brief discussion of these submittals is provided below: Revised RNF; RTN 3-24618 This RTN is related to a 72-hour release notification condition identified at the Former Flynntan Site (the "Site"), located at 70-92 Boston Street in Salem, Massachusetts, due to the -discovery of light non-aqueous phase liquid (LNAPL) on groundwater on December 28, 2004. This release was previously reported to the Department by telephone on December 30, 2004 and a prior RNF was submitted to the Department on February 28, 2005. On the previous February 2005 RNF, the City's Planning and Community Development Office, which is charged with managing this property, was listed as a Potentially Responsible Party (PRP) as the current Owner of the property. Based on TRC's subsequent discussions with you, we determined that the City should be listed as a"Municipality" rather than a PRP, 1 16 John Street, Boott Mills South 9 Lowell, Massachusetts 01852 Main: 978-970-5600 - Fax: 978-453-1995 www.tresolutions.com ww.trcsolutions.com. Former Flynntan Site Page 2 of 3 RTNs 3-24618 and 3-16788 11512006 given that the City took the property under tax foreclosure. The revised RNF attached to this letter serves to change the City's status with respect to this Site from PRP to Municipality. Pursuant to MGL c. 21E, the City qualifies for Municipality status with respect to this Site for the following reasons: • The City has taken ownership of the property for nonpayment of taxes. Included with the attached RNF is the Final Judgment from the Massachusetts Land Court regarding the City's foreclosure on the property. • No act of the City, its agents or employees caused or contributed to the releases at the Site, or caused the release to become worse than it otherwise would have been. • The City promptly notified the Department of the release of LNAPL discovered at the Site in December 2004 in accordance with the MCP. • The City will provide reasonable access to the Site to employees, agents and contractors of Department at the Department's request. • The City has taken steps to eliminate exposure of persons to oil and hazardous materials present at the Site. The areas of the Site where the releases have occurred are fenced and locked to prevent unauthorized access by the general public. The source of LNAPL at the Site is an existing 20,000-gallon No 6 fuel oil UST located beneath the paved parking area in the southwest portion of the Site. The City has undertaken an IRA assessment, using EPA Brownfields Assessment grant funds, to evaluate whether the separate phase No 6 fuel oil detected at the Site is significantly migrating from the property. Based on these IRA assessment activities, as described in the attached Phase I Report, significant off-site migration of separate phase No. 6 fuel oil is not occurring. Furthermore, no Imminent Hazard condition has been identified at the Site as a result of TRC's IRA assessment activities. EPA Brownfields Assessment grant funds are not longer available to the City for this Site; therefore, the City cannot continue with IRA assessment activities and/or removal of the existing 20,000-gallon UST. • The City does not intend to conduct any further investigative and/or remedial efforts at the Site. TRC understands that the City intends to auction the property within the next few months and, thus, is acting diligently to divest itself of ownership of the property. Phase I Initial Site Investigation and Tier Classification Submittal; RTNs 3-24618 and 3- 16788 On behalf of the City,TRC prepared the attached Phase I - Initial Site Investigation Report and Tier Classification submittal to achieve MCP compliance for both Site RTNs. This work was done to aid the City in its marketing of the property to prospective developers as part of the City's efforts to act diligently to divest itself from ownership of the property, and maintain its status as a Municipality in accordance with MGL c. 21E. You should know that at the rac Former Flynntan Site Page 3 of 3 RTNs 3-24618 and 3-16788 - 11512006 time of the December 2004 release notification, TRC was not aware that RNT 3-16788 existed. This existence of this second RTN was discovered in March 2005 when TRC was given access to the EPA Administrative Record for the Site. Although the City is not listed as a PRP for this RTN, TRC prepared the attached Phase I Report to address both Site-related RTNs, again,to assist the City in their marketing of the property. As stated above, the City does not intend to conduct further response actions at the Site. It is TRC's understanding that because this information is being provided to you within the first year from the date of notification, the City will not be assessed annual compliance fees for either RTN associated with Site. Should you have any questions and/or comments regarding the above referenced information, please do not hesitate to contact Ms. Lynn Duncan at the City of Salem Planning and Community Development Office, or Mark Casey at TRC at (978) 656-3609. Sincerely yours, TRC Environmental Corporation Mark D. Casey, P.E., LSP Senior Program Manager Attachments .Form BWSC-103 Form BWSC-107 Phase I Initial Site Investigation &Tier Classification cc: Lynn Duncan—City of Salem Robert Lucci/MADEP Boston (w/o Attachments) 7JTC Massachusetts Department of Environmental Protection L Bureau of Waste Site Cleanup BWSC103 RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM 1fl - 24618 -�= -_—�� Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) A. RELEASE OR THREAT OF RELEASE LOCATION: 1. Release Name/Location Aid: Former Flynntan Site 2. street Address: 70-92 Boston Street 3. City/Town: Salem 4. ZIP Code- .01970-1421 B. THIS FORM IS BEING USED TO: (check one) © 1. Submit a Release Notification ❑ 2. Submit a Retraction of a Previously Reported Notification of a release or threat of release including supporting documentation required pursuant to 310 CMR 40.0335 (Section Cis not required) (All sections of this transmittal form must be filled out unless otherwise noted above) C. INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): 1. Date'and time of Oral Notification, if applicable: 12/30/2004 Time: 10:00 W] AM ❑ PM mm/dd/yyyy h h:m m 2. Date and time you obtained knowledge of the Release or TOR: 12/28/2004 Time: 1 2:00 _ ❑ AM [0 PM mm/dd/yyyy h h:mm 3. Date and time release or TOR occurred,if known: Time: ❑ AM ElPM mm/dd/yyyy h h:m m Check all Notification Thresholds that apply to the Release or Threat of Release: (for more information see 310 CMR 40.0310-40.0315) 4. 2 HOUR REPORTING CONDITIONS 5. 72 HOUR REPORTING CONDITIONS 6. 120 DAY REPORTING.CONDITIONS a. Sudden Release a. Subsurface Non-Aqueous q a. Release of Hazardous Phase Liquid(NAPE)Equal to Material(s)to Soil or ❑ b. Threat of Sudden Release or Greater than 1/2 Inch ❑ Groundwater Exceeding ❑ c. Oil Sheen on Surface Water ❑ b. Underground Storage Tank Reportable Concentration(s) (UST)Release b. Release of Oil to Soil ❑ d. Poses Imminent Hazard ❑ Exceeding Reportable ❑ e. Could Pose Imminent ❑ c. Threat of UST Release Concentration(s)and Affecting Hazard ❑ d. Release to Groundwater More than 2 Cubic Yards ❑ f. Release Detected in near Water Supply c. Release of Oil to Private Well ❑ Groundwater Exceeding ❑ e. Release to Groundwater Reportable Concentration(s) ❑ g. Release to Storm Drain near School or Residence d. Subsurface Non-Aqueous ❑ h. Sanitary Sewer Release ❑ f. Substantial Release Migration Phase Liquid(NAPE)Equal to (Imminent Hazard Only) ❑ or Greater than 1/8 Inch and Less than 1/2 Inch Revised:06/27/2003 Page 1 of 3 Massachusetts Department of Environmental Protection LL Bureau of Waste Site CleanupBWSC103 RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM 3 - �24618 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) C. INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR):(cont) 7. List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity (RQ)by the greatest amount. O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if if known Concentration Applicable(RCS-1,RCS-2, RCGW-1,RCGW-2) ❑ 8. Check here if a list of additional Oil and Hazardous Materials subject to reporting is attached. D. PERSON REQUIRED TO NOTIFY: 1. Check all that apply: ❑ a.change in contact name ❑ b. change of address ❑ c. change in the person notifying 2. Name of Organization: City Of Salem, Massachusetts 3. Contact First Name: Lynn 4. Last Name: Duncan w 5. Street City Hall Annex - 120 Washington Street 6.Title: Director-of Planning 7. City/Town: Salem 8. State: MA 9. ZIP Code: 01970-0000 10. Telephone: (978) 745-9595 _ 11.Ext.: 310 12. FAX: (978) 740-0404 13. Check here if attaching names and addresses of owners of properties affected by the Release or Threat of Release, ❑ other than an owner who is submitting this Release Notification (required). E. RELATIONSHIP OF PERSON TO RELEASE OR THREAT OF RELEASE: ❑ 1. RP or PRP ❑ a. Owner ❑ b. Operator ❑ c. Generator ❑ d. Transporter ❑ e. Other RP or PRP Specify: 0 2. Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2) ❑ 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21 E,s.50)) ❑ 4. Any Other Person Otherwise Required to Notify Specify Relationship: Revised:06/27/2003 Page 2 of 3 l Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC103 RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM 3❑ _ 24618 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) F. CERTIFICATION OF PERSON REQUIRED TO NOTIFY: 1. I, Lynn Goonin Duncan attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this transmittal form, (ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I/the person or entity on whpse behalf this submittal is made am/is aware that there are significant penalties, including,but not limited to, possible i s and imprison lent,for willfully sub rp g false, inaccurate,or in omplete information. 2. B 3. Title: Director of Planning Signature City of Salem, Massachusetts 4. For. _ _ 5. Date: (Name of person or entity recorded in Section D) mm/dd/yyyy 6. Check here if the address of the person providing certification is different from address recorded in Section D. 7. Street: 8. City/Town: _ 9. State: 10. ZIP Code: 11. Telephone: 12.Ext.: 13. FAX: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE. YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE Date Stamp(DEP USE ONLY:) Revised:06/27/2003 Page 3 of 3 Dec 19 05 11:10p DPCD 9787400404 p.2 OXOWNWEALTR OF HUSACRUSETfS LAND COURT DEPARTMENT OF THE TRIAL COURT Case No. 119646 T.L. # FINAL JUDGMENT IN TAX LIEN CASE 1 - City of Salem i j Vs. Salem Realty LLC JIMC YiENT :i _S This case came on to be heard and was argued by counsel, and thereupon, upon consideration thereof, it is ADJUDGED and ORDERED that all rights of redemption are forever foreclosed and barred under the deed given by the Collector of Taxes for the City of Salem, in the County of Essex, and said . Commonwealth, dated October 20, 1989, and duly recorded in Book 10197, Page 184; excepted from this judgment is that portion of the preuises at 70-92 Boston Street identified- as Parcel A in a deed dated September 4, 1996, from John Flynn S Sons, Inc. . to Salem Realty LLC, and regis t ered'with the Essex County (Southerrt District) Registry District of the Land Court as Document No. 323113, i Transfer Certificate of Title No. 67231. By the Court (Breuer, Deputy Recorder) Attest: Charles W. Trombly, Jr. Recorder Dated: June 19, 2002 A - A TRUE CQPY ATTEST: a 1 REWRMR Massachusetts Department of Environmental Protection BWSC107 Bureau of Waste Site Cleanup Release Tracking Number TIER CLASSIFICATION TRANSMITTAL FORMILI _ �24618 Pursuant to 310 CMR 40.0500(Subpart E) El A. DISPOSAL SITE LOCATION: 1. Disposal Site Name: Former Flynntan Site - 2. street Address: 70-92 Boston Street 3. City/Town: Salem 4. ZIP Code: 01970-1421 B. THIS FORM IS BEING USED TO: (check all that apply) ❑ 1. Submit a new Tier Classification Submittal for a Tier I Site,including a Numerical Ranking Scoresheet(BWSC107A) (check one). A Tier I Permit Application must also be submitted. ❑. a. Tier IA ❑ b. Tier IB ❑.c. Tier IC © 2. Submit a new Tier Classification Submittal for a Tier II Site,including the Numerical Ranking Scoresheet(BWSC107A) and the Tier 11 Compliance Hist6ry(BWSC107B)_ © 3. Submit a Phase I Completion Statement as per 310 CMR 40.0480. If previously submitted,provide date mm/dd/yyyy ❑ 4. Submit a Phase 11 Scope of Work as per 310 CMR 40.0834. If previously submitted,provide date mm/dd/yyyy Q 5. Submit a Phase II Conceptual Scope of Work supporting a Tier Classification Submittal. 6. Submit a Tier II Extension Submittal for Response Actions at a Tier II Site including the Tier If Compliance History ❑ (BWSC1076).. ❑ 7. Submit a Tier II Transfer Submittal for a change in person(s)undertaking Response Actions at a Tier II Site including the Tier II Compliance History(BWSC107B)and the Tier II Transferor Certification(BWSC107C). Proposed effective date of transfer, mm/dd/yyyy ❑ 8. Submit a Revised Tier Classification Submittal,including a Numerical Ranking Scoresheet(BWSC107A). A Major Permit Modification may also need to be submitted. If this revised submittal is re-classifvinq the site check the new classification. ❑ a. Tier IA ❑ b. Tier IB ❑ c. Tier IC ❑ d. Tier II 9. Submit a Notice that an additional Release Tracking Number(s)is(are)being linked to this Tier Classified Site (Primary RTN). Future response actions addressing the Release or Threat of Release notification condition associated with.additional Release Tracking Numbers(RTNs)will be conducted as part of the Response Actions planned or ongoing at the Primary Site listed above. For a previously Tier Classified Primary Site,if there is a reasonable likelihood that the addition of the new secondary RTN(s)would change the classification of the site,a Revised Tier Classification Submittal must also be made. Provide Release Tracking Number(s): a•© " 16788 b•❑ - �� All future Response Actions must occur according to the deadlines applicable to the Primary RTN. Use only the Primary RTN when making future submittals for this site unless specifically relating to response actions started before the linking occurred. Revised: 02/10/2004 Page 1 of 4 Massachusetts Department of Environmental ProtectionL7-1 BWSC107 Bureau of Waste Site Cleanup TIER CLASSIFICATION TRANSMITTAL FORM Release Tracking Number Pursuant to 310 CMR 40.0500 (Subpart E) 0 - 24618 C. LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form, including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and 309 CMR4.03(2),and (iii)the provisions of 309 CMR 4.03(3),to the best of my knowledge,information and belief, > if Section B of this form indicates that a Tier I or Tier 11 Classirication Submittal including the Numerical Ranking System Scoresheet is being submitted,.this Tier Classification Submittal has been developed in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000 and,the response action(s)that is(are)the subject of this submittal(i)has (have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii) is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and(iii)complies(y)with the identified provisions of all orders, permits,and approvals identified in this submittal; > if Section B of this form indicates that a Phase I Completion Statement is being submitted,the response action(s)that is(are) the subject of this submittal(i)has(have)been developed and implemented in accordance with the.applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal; > if Section B of this form indicates that a Phase 11 Scope of Work is being submitted,the.response action(s)that is(are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders, permits,and approvals identified in this submittal; > if Section B of this form indicates that a Tier 11 Extension Submittal or a Tier H TransferSubmittal is being submitted,the response action(s)that is(are)the subject of this submittal(i)is(are)being implemented in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000, (ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and(iii)complies(y)with the identified provisions of all orders, permits, and approvals identified in this submittal. am aware that significant penalties may result, including, but not limited to, possible fines and imprisonment,if 1 submit information which I know to be false,inaccurate or materially incomplete. 1. LSP#: 5319 2. First Name: Mark 3. Last Name: Casey (978) 656-3609 (978) 453-1995 4. Telephone: 5. Ext.: 6. 'FAX: 7. Signature: 01/05/2006 8. -Date: 9.LSP Stamp: mm/dd/yyyy Revised: 02/10/2004 Page 2 of 4 Massachusetts Department of Environmental Protection BWSC107 Bureau of Waste Site Cleanup Release Tracking Number TIER CLASSIFICATION TRANSMITTAL FORM _ 24618 Pursuant to 310 CMR 40.0500(Subpart E) D. PERSON MAIGNG SUBMITTAL: 1. Check all that apply. 11 a.change in contact name b.change of address c. change in the person undertaking response actions 2. Name of Organization: City Of Salem, Massachusetts 3.. Contact First Name: Lynn 4. Last Name: Duncan 5. Street: City Hall Annex - 120 Washington Street 6.Title: Director of Planning 7. cityrrown: Salem - s. State: MA . 9. ZIP Code: 01970-3523 10. Telephone: (978) 745-9595 11. Ext.: 310 12. FAX: 978 740-0404 E. RELATIONSHIP OF PERSON MAILING SUBMITTAL TO DISPOSAL SITE: 1. RP or PRP a. Owner b. Operator ❑ c. Generator d. Transporter Q e. Other RP or PRP Specify: ❑✓ 2. Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2) 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.C.21E,s.50)) 4. Any Other Person Making Submittal Specify Relationship: F. REQUIRED ATTACHMENT AND SUBMITTALS: . 1. Check here if the Response Action(s)on which this opinion is based, if any,are(were)subject to any order(s), permit(s) and/or approval(s)issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. ® 2. Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the submittal of any Phase Reports to DEP. 3. Check here to certify that a Legal Notice of a Tier Classification or Re-classification Submittal has been or will be made Q✓ according to 310 CMR.40.1403,and a copy of the notice sent to DEP,the Chief Municipal Officer and the Local Board of Health. o 4. For a Tier II Extension Submittal,check here to certify that a statement summarizing why a Permanent or Temporary 'Solution has not been achieved at the Disposal Site is attached. 5. For a Tier 11 Transfer Submittal,check here to certify that a statement summarizing the reasons for the.proposed change ❑ in person(s)undertaking the Response Actions is attached. All Response Actions must be completed by the deadline applicable to the person who first filed either a Tier Classification Submittal for the Disposal Site or received a Waiver of Approvals. 0 6. Check here if any non-updatable information provided on this form is incorrect;e.g.,Site Name or Street Address. Send. corrections to the DEP Regional Office. 7. Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised: 02/10/2004 Page 3 of 4 Massachusetts Department of Environmental Protection BWSC107 Bureau of Waste Site Cleanup Release Tracking Number ;' TIER CLASSIFICATION TRANSMITTAL FORM Pursuant to 310 CMR 40.0500(Subpart E) G. CERTIFICATION OF PERSON MAKING SUBMITTAL: 1. I, Lynn Goonin Duncan , attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this transmittal form, (ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete, and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I/the person or entity on whose behalf this submittal is made amlis aware that there are significant penalties,including, but not limited to, possible fines and imprisonment,for willfully submitting false, inaccurate,or incomplete information. If submitting a Tier II Classification, Extension or Transfer, I also attest under the pains and penalties of perjury that(i)I/the person(s)or entity(ies)on whose behalf this submittal is made has/have personally examined and am/is familiar with the requirements of M.G.L.c.21 E and 310 CMR 40.0000; (ii)based upon my inquiry of the/those Licensed Site Professional(s) employed or engaged to render Professional Services for the disposal site which is the subject of this Transmittal Form and of the person(s)or entity(ies)on whose behalf this submittal is made,and my/that person's(s')or entity's(ies')understanding as to the estimated costs of necessary response actions, that/those person(s)or entity(ies)has/have the technical,financial and legal ability to proceed with response actions for such site in accordance with M.G.L. c.21 E,310 CMR 40.0000 and other applicable requirements; and(iii)that I am fully authorized to make this attestation on behalf of the person(s)or entity(ies)legally responsible for this submittal. I/the person(s)or entity(ies)on whose behalf this submittal is made is aware of the requirements in 310 CMR 40.0172 for notifying the Department in the event that I/the person(s)or entity(ies)on whose behalf this submittal is made learn(s) that it/the i re unable to proceed with the necessary sponse actions. 2. B 3. Title: Director of Planning /ignature 4. For: "� I 5. Date: Oo" amElP person or entity recorded in Section D) mm/dd/yyyy 6. Check here if the address of the person providing certification is different from address recorded in Section D. 7. Street: 8. City[Town: �, _ __ __ _ 9. State: 10. ZIP Code: 11, Telephone: _ 12.Ext.. _ 13. FAX: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE. YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP.MAY RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY): Revised: 02110/2004 Page 4 of 4 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC107A NUMERICAL RANKING SYSTEM (NRS) SCORESHEET Release Tracking Number Pursuant to 310 CMR 40.1511 (Subpart O)L73 - 24618 A. NRS SCORESHEET SUMMARY SECTION: 1.Classification Submittal: (check one) a. Initial NRS Score ❑ b. Revised NRS Score 2. Disposal Site Score: _ II III IV V VI Total 60 101 15 20 0 196 3. Disposal Site Classification: (check one) Fla. Tier IA ❑ b. Tier IB ❑ c. Tier IC 0 d. Tier II B. DISPOSAL SITE INFORMATION(NRS SECTION I): 1. UTM Coordinates: a. UTM N: 4709253 b. UTM E. 343094 2. Check which, if any,of the Tier I inclusionary criteria are met by the Disposal Site,pursuant to 310 CMR 40.0520(2): ❑ a. Groundwater is located within an Interim Wellhead Protection Area or a Zone II,and there is evidence of groundwater contamination by an Oil or Hazardous Material at the time of Tier Classification at concentrations equal to or exceeding the applicable RCGW-1 Reportable Concentration set forth in 310 CMR 40.0360. ❑ b.An Imminent Hazard is present at the time of Tier Classification. C. EXPOSURE PATHWAYS(NRS SECTION II): 1. Exposure Pathways,and Oil and Hazardous Material(OHM)Sources: For A.through D.,score according to 310 CMR 40.1512-Exposure Pathway Designation Criteria and NRS Table H. ForE.,score using NRS Table II.E. Score A.Soil(includes sediment) 15 B.Groundwater 20 C.Surface Water(includes wetlands) 0 D.Air 0 E.Number of OHM Sources 25 Total NRS Section II Score(15-700) 60 2.Was Section G(NRS Section VI)used to amend the score for this Section of the NRS? ❑ a.Yes b. No Revised: 02/10/2004 Page 1 of 5 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC107A NUMERICAL RANKING SYSTEM (NRS) SCORESHEET Release Tracking Number Pursuant to 310 CMR 40..1511 (Subpart O) � - E246:1:8::—1 3. Summary Rationale for Exposure Pathway Values,A.through D.,and Phase I Report References: A. Soil - VPH/EPH, PAHs in soil, see Table 4; Site is fenced (see page 6-1 of Ph. 1) B. Groundwater - VPH in groundwater, see Table 5,no drinking water wells, see Figure 2 and page 6-1. C. Air - Not anticipated. VPH approx. 6 feet below grade at SB-31MV-3, and D. Potential Sources - 20,000 gallon No. 6 Fuel Oil UST "4-car garage" area with evidence of volatiles. D. DISPOSAL SITE CHARACTERISTICS(NRS SECTION 111): 1. Oil and Hazardous Material(OHM)Toxicity Score(NRS Section III.A.): a. List the Four Highest OHM Toxicity Scores from NRS Table III.A.: OHM Scored Concentration and Media Toxicity Score(1-80) No. 6 Fuel Oil (as C11-C22 Aromatic) NAPL 65 C11-C22 Aromatics 1,500 ug/g= Soil 25 C19-C36 Aliphatics 3,500 ug/g- Soil 20 C9-C18 Aliphatics 2,700 ug/g - Soil 20 b. Score using NRS Worksheet III.A.1 to determine the OHM Toxicity Score for OHM not listed in NRS Table 111.A.: OHM Human Health-based Concentration Concentration Toxicity Toxicity Value (Soil-ug/g) (Water-ug/1) Score Benzo(a)pyrene 44 3.6000 20 .Benzo(a)anthracene . 28 4.7000 10 Benzo(b)fluoranthene 28 5.1000 10 0 c. Use the Highest OHM Toxicity Score from either NRS Table III.A. or Worksheet III.A.I.: OHM Scored Toxicity Score No. 6 Fuel Oil (as C11-C22 Aromatic) 65 Revised: 02/10/2004 Page 2 of 5 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC107A NUMERICAL RANKING SYSTEM (NRS) SCORESHEET Release Tracking Number FL711 0 _ 24618 Pursuant to 310 CMR 40.1511 (Subpart O) 2. Multiple OHMs(NRS Section III.B.): Was the Toxicity Score of more than one OHM greater than or equal to 30? ❑ a. Yes(30) © b. No(0) 3.OHM Mobility and Persistence(NRS Section III.C.): Score according to 310 CMR 40.1514-OHM Mobility and Persistence a.OHM Scored b.Score (0-50) No. 6 Fuel Oil 20 4. Disposal Site Hydrogeology(NRS Section III.D.): Site Hydrogeology Score(2-20) Score according to 310 CMR 40.1515-Soil Permeability, and NRS Table III.D. 16 5.Total NRS Section III Score: A. B. C. D. Total for Section III (3- 180) 65 0 20 16 101 6. Was Section G(NRS Section VI)used to amend the score for this Section of the NRS? ❑ a.Yes Q b. No E. HUMAN POPULATION AND LAND USES(NRS SECTION IV): 1. Human Population(NRS Section IV.A.): Residential Population Institutions On-site Population within 112 Mile within 500 Feet Workers Score(0-40) Score using NRS Table IV.A. 15 0 0 15 2.Aquifers(NRS Section IV.B.): a.Sole Source Aquifer: ❑ i.Yes(25) ii. Name: iii. No(0) b. Potentially Productive Aquifer: ❑ i. Medium or High(15) RI ii. No(0) 3.Water Use(NRS Section IV.C.): Proximity to Persons Served by Private Water Alternate Public Water Score using NRS Table IV.C. Public Drinking Public.Drinking Supplies Water Supply Use Score Water Source Water Supply within 500 Feet Available (0-125) 0 0 0 0 0 4.Total NRS Section IV Score: Total for Section IV A. B. C. (0-205) 15 0 0 15 5. Was Section G(NRS Section VI)used to amend the score for this Section of the NRS? ❑ a.Yes ® b. No Revised: 02/10/2004 Page 3 of 5 L71Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC107A 1 NUMERICAL RANKING SYSTEM (NRS) SCORESHEET Release Tracking Number Pursuant to 310 CMR 40.1511 (Subpart O) - 24618 F. ECOLOGICAL POPULATION(NRS SECTION V): 1. Environmental Resource Areas(NRS Section V.A).- Score using NRS Table V.A. Area of Critical Species of Special Concern, Wetlands,Certified Vernal Environmental Environmental Threatened or Endangered Pool,or OutstandingFish Protected pen S Resource Area Habitat O pace Concern Species Habitat Resource Water Score (0 - 150) 0 0 0 20 0 20 2. Environmental Toxicity Score(NRS Section V.B.): Score only if Environmental Resource Area Score is greater than or equal to 30. a. List the Three Highest Environmental Toxicity Scores from NRS Table V.B.: OHM Scored Concentration and Media Toxicity Score (0-35) 0 0 0 b. Score using NRS Worksheet V.6.1.to determine the Environmental Toxicity Score for OHM not listed in NRS Table V.B. See 310 CMR 40.1516 for Environmental Toxicity Values for each OHM. OHM Environmental Concentration Concentration Environmental Toxicity Value (Soil-ug/g) (Water-ug/1) Toxicity Score 0 0 0 c. Use the Highest Environmental Toxicity Score from either NRS Table V.B.or from Worksheet V.13.1.. OHM Scored Toxicity Score 0 3.Total NRS Section V Score: A. B. Total for Section V (0- 185) 20 0 20 4. Was Section G(NRS Section VI)used to amend the score for this Section of the NRS? El a.Yes n b. No Revised: 02/10/2004 Page 4 of 5 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC107A NUMERICAL RANKING SYSTEM (NRS) SCORESHEET Release Tracking Number Pursuant to 310 CMR 40.1511 (Subpart O) a - 246 $ G. MITIGATING DISPOSAL SITE-SPECIFIC CONDITIONS(NRS SECTION VI): 1. Disposal site-specific conditions that warrant amending the site score. Changes directly related to NRS Sections or Subsection scores may not reduce the score more than the relevant lsubsection value assigned for the disposal site in that subsection. Section VI must reference specific pages of the Phase I. Section VI may not exceed plus or minus 50 points and may be scored only in 5-point increments. 2. Check here if additional pages are provided in an attachment. Total Score Section VI 3_ Disposal Site Amendment (Not to exceed plus or minus 50 points): O Revised: 02/10/2004 Page 5 of 5 O L- O t� N Lf) LO0000LO L000 O + W N N CV N N T T T T T .x O H � 3 � O = > Q ¢ qt < < < < < ww < C Z Z � ZZ .ZZ ZNN Z c>s � E 'x O CD _ ~ C .r_ N rnU co Q c a N O r o OD O u A ❑ ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ v a � a zzTZzz zzz zo t° x � =N N� cc cQ O to U1 ch O Z Q CO a Cl) 3- = F- C7 V aiE � a� .r_ CO _ coo o C � � C\j E T 0 � 0 n — Q � 0 M Y J (D I..L tm U Q C C LL N H ti ` rn � c cm OZ .« C O O O O O CD L= U E O 'i n Q O CO 0 0 0 C) O h r Cp '0 cz O O. V z Lo M T f� Lf) I N Lo T C Q N �O T T CM. M O U N = (� Y O :> cz N :p C) O c .< O O O cZ 0 � N Q O N O L U 4- cv co U U � Q U cn = O O O N '- '- � _ C N x T Q r v O v v V v N O O a) ❑ � U U d L cu C ++ p+: '++ C (J Q O O O O O 0 L M CU` LU 4) M C o CLCLC. E � � � � Z -0 o � a 0 O .ICL a. a. ._ p O c.� o 0 0 U 0 N OII *Q E N N r r T— Q O D OE N O p Z CCUZ �.,Ox 'x U U C.) O O OO � F- FU-- - njmCD r C p ❑ Q II II II Z Z Z T N co O CL� W Z O > /4) T C Oyti w .N N N O N_ N 0. N N U U cr. C Z 4 W � co o � Q ai a ° E "got LO (1) N T O N O O Ci a Cn ct) N lQ 4+ i- C a) _ O O co 0O U ccl LL QO .V � O N f`-- > L ° CO Ln cn O O O L t- C 7 E U +r ++ CO N N N N O ° E ° Cl) v co ESE U1 LL m Z •° O Y .y o c o a �` o ai cc > �. a _ X C) B U CO ~ c j_ CL ° 4- Y L O — O 0 E L co L a) a) N 2 LL Q Q Q < .Q u- Q O � O -0 co cl, .— Q O D U U U Q C Z r 0) E cu O oU U o _Wj � � ZO Massachusetts Department of Environmental Protection BWSC107B Bureau of Waste Site Cleanup Release Tracking Number TIER II COMPLIANCE HISTORY 30 _ 24618 Pursuant to 310.CMR 40.0540(Subpart E) A. DISPOSAL SITE COMPLIANCE HISTORY SUMMARY: 1. Check here if a Tier II Compliance History of the person listed in BWSC107,Section D,was previously submitted,and ❑ there has been no change in that person's compliance history. If this box is checked,this section does not have to be completed. 2. List all permits or licenses that have been issued by the Department that are relevant to this Disposal Site: Program Permit Number Permit Category Facility ID a. Air Quality NA b. Hazardous Waste(M.G.L.c.21C) NA c. Solid'Waste NA d. Industrial Wastewater Management NA e. Water Supply NA f. Water Pollution Control/Surface Water NA g. Water Pollution Control/Groundwater NA h. Water Pollution Control/Sewer Connection NA i. Wetland&Waterways NA 3. List all other Federal,state or local permits,licenses,certifications,registrations,variances,or approvals that are relevant to this Disposal Site: Issuing Authority or Program,or Documentation Type Identification Number Date Issued mm/ddlyyyy NA 4. Check here to certify that,if needed,a statement further describing the Compliance History of this Disposal Site is attached. This statement must describe the compliance history of the person or entity named in BWSC107,Section D with the following: (1)DEP regulations;and(2)other laws for the protection of health,safety,public welfare and the environment administered or enforced by any other government agency. Such a statement should identify information such as: (1)actions relevant to the Disposal Site taken by the Department to enforce its requirements including,but not limited to,a Notice of Noncompliance(NON),Notice of Intent to Assess Civil Administrative Penalty (PAN),Notice of Intent to Take Response Action(NORA),and an administrative enforcement order; (2)administrative consent orders;(3)judicial consent judgements; (4)similar administrative actions taken by other Federal,state or local agencies; (5)civil or criminal actions relevant to the Disposal Site brought on behalf of the DEP or other Federal,state,or local agencies;and(6)any additional relevant information.For each action identified,provide the following information: (1)name of the issuing authority,type of action,identification number and date issued;(2) description of noncompliance cited;(3)current status of the matter;and(4)final disposition,if any. Revised: 02/10/2064 Page.1 of 1