31R BOSTON STREET RNF 11-23-21 V rt1a- ,r1-q neer1nq & ,6nmot rrena 567vice5, lnc, - - -
Land Survey, Civil Engineering and Environmental Services
Offices in Medford and Vineyard Haven,Massachusetts
www.vineyardeng.com
November 23, 2021 RECEIVED
City of Salem Mayor's Office DEC 01 2021
Salem City Hall
93 Washington Street CITY OF SALEM
Salem, Massachusetts 01970 BOARD OF HEALTH
RE: Commercial Property
31R Boston Street, Salem
DEP Release Trackinu Number: 3-37160
Dear Mayor,
Arsenic and lead were identified at 31R Boston Street, resulting in a 120-day Reportable
Condition under the Massachusetts Contingency Plan (310 CMR 40.0000). A Release
Notification Form BWSC103 (RNF) was submitted to the Massachusetts Department of
Environmental Protection (DEP) on November 16, 2021. In accordance with 310 CMR
40.1403(3)(h), a copy of the RNF is attached. Local officials have the right to request additional
Public Involvement Activities under 310 CMR 40.1403(9). No action other than the receipt of
this letter is necessary by your office.
Sincerely,
Steven T. Fleming, LSP, LEP
President
Attachment: BW SC 103 form
M. Salem Board of Health
Robert Adam
Vineyard Project File: 2936 ENV
17 Salem Street Martha's Vineyard
Medford,MA 02155 PO Box 458
Phone: 781.933.3330 Vineyard Haven,MA 02568
Fax:781.933.3334 Phone: 508.687.9437
lviassachusetts Department of Environmental Protection BWSC103-120 DAY
Bureau of Waste Site Cleanup
Release Tracking Number
RELEASE NOTIFICATION FORM assigned upon receipt and
LLI i Pursuant to 310 C_IR 40.0371(Subpart C) review by the Department
A.RELEASE OR THREAT OF RELEASE LOCATION:
1.Release Name/Location Aid: METALS RELEASE
2.Street Address: 31 R BOSTON STREET
3.City/Town: SALEM 4.ZIP Code: 019700000
5.Coordinates: a.Latitude:N 42.51793 b.Longitude: W 70.90795
B.THIS FORM IS BEING USED TO:
1.Submit a Release Notification for a 120 day reporting requirement
(All sections of this transmittal form must be filled out)
C. INFORMATION DESCRIBING THE RELEASE:
1.Date and time you obtained knowledge of the Release: 9/l/2021 Time: 08:00 .V AM r PM
mm/dd/yyyy hh:mm
2.Date and time release occurred,if known: Time: F.AM F-PM
mm/dd/yyyy hh:mm
3.120 DAY REPORTING CONDMONS
Check all Notification Thresholds that apply to the Release:
(for more information see 310 CMR 40.0315)
Fv` a.Release of Hazardous Material(s)to Soil or Groundwater Exceeding Reportable Concentration(s)
r- b.Release of Oil to Soil Exceeding Reportable Concentration(s)and Affecting More than 2 Cubic Yards
r- c.Release of Oil to Groundwater Exceeding Reportable Coneentration(s)
d.Subsurface Non-Aqueous Phase Liquid(NAPL)Equal to or Greater than 1/8 Inch(.01 feet)and Less than 1/2 Inch(.04 feet)
Revised: 10/11/2013 Pagel of 3
Massachusetts Department of Environmental Protection BWSC103-120 DAY
Bureau of Waste Site Cleanup
Release Tracking Number
RELEASE NOTIFICATION FORM
assigned upon receipt and
Pursuant to 310 CMR 40.0371(Subpart C) review by the Department
C.INFORMATION DESCRIBING THE RELEASE(cont.)
4.List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity(RQ)by the
greatest amount.
Check here if an amount or concentration is unknown or less than detectable.
O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable
if known Concentration (RCS-1,RCS-2,RCGW-1,
RCGW 2)
ARSENIC MA 43 MG/KG RCS-1
LEAD FM 300 MGIKG RCS-1
Check here if a list of additional Oil and Hazardous Materials subject to reporting,or any other documentation relating to this notification
is attached.
D.PERSON REQUIRED TO NOTIFY:
1.Name of Organization: K&R REALTY TRUST
2.Contact First Name: ROBERT 3.Last Name: ADAM
4.Street: 2 PENNY LANE 5.Title: TRUSTEE
6.City/Town: PEABODY 7.State: MA 8.ZIP Code: 019600000
9.Telephone: 978-852-7414 10.Ext.: 11.Email:
r- 12.Check here if attaching names and addresses of owners of properties affected by the Release,other than an owner who is
submitting this Release Notification(required).
E.RELATIONSHIP OF PERSON TO RELEASE:
I.RP orPRP E✓ a.Owner F b.Operator F c.Generator rN d.Transporter
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.21 E,s.50))
4.Any Other Person Otherwise Required to Notify Specify Relationship:
Revised: 10/11/2013 Page 2 of 3
RELEASE NOTIFICATION FORM assigned upon receipt and
Massachusetts Department of Environmental Protection BWSC103-120 DAY
Bureau of Waste Site Cleanup Release Tracking Number
:Pursuant to 310 CMR 40.0371(Subpart C) review by the Department
F.CERTIFICATION OF PERSON REQUIRED TO NOTIFY:
1.I, ROBERTADAM ,attest under the pains and penalties of perjury(i)that 1 have personally
examined and am`familiar with the information contained in this submittal,including any and all documents accompanying this transmittal
form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information
contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii)that I am fully authorized to make
this attestation on behalf of the entity legally responsible for this submittal.I/the person or entity on whose behalf this submittal is made
am/is aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,
inaccurate,or incomplete information.
2.By: ROBERT ADAM 3.Title: TRUSTEE
Signature
4.For: K&R REALTY TRUST 5.Date: 11/16/2021
(Name of person or entity recorded in Section D) mm/dd/yyyy
r 6.Check here if the address of the person providing certification is different from address recorded in Section D.
7.Street:
8.City/Town: 9.State: 10.ZIP Code:
11.Telephone: 12.Ext.: 13.Email:
YOU ARE SUBJECT TO ANNUAL CO_ TLJANCE ASSURANCE FEES FOR EACH BILLABLE YEAR FOR TIER
CLASSIFIED DISPOSAL SITES.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM
OR'DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU
MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE.
Date Stamp(DEP USE ONLY:)
Received by DEP on 11/16/2021 11:09:05
AM
Revised: 10/11/2013 Page 3 of 3