65 WASHINGTON STREET - DEP RECEIVED
MAR`2 5 819
z CITY OF SALEM
BOARD OF HEALTH
March 20, 2019
Dr. Jeremy Schiller
98 Washington Street, 3rd Floor
Salem, Massachusetts 01970
Attention; Salem Board of Health
Reference: RTNs 3-35398; 65 Washington Street, Salem, Massachusetts
Notification of the submittal of a Release Notification Form
Dr. Schiller:
Pursuant to the Massachusetts Contingency Plan, 310 CMR 40.1403 (3) (h), you are hereby
notified of the submittal of a Release Notification Form (RNF) to the Massachusetts
Department of Environmental Protection for the above referenced location, a copy of which
is attached. Release conditions include; a sudden release, threat of sudden and the
presence subsurface non-aqueous phase liquid equal to or greater than 1/2 inch. Release
conditions are as defined by M.G.L. c. 21E. Response actions at this site are being
conducted on behalf of 65 Washington Street, LLC, and has employed Thomas J Fennick,
LSP of McPhail Associates, LLC to manage response actions in accordance with the
Massachusetts Contingency Plan (310 CMR 40.0000).
We trust that the above is sufficient for your present requirements. Should you have any
questions concerning the above, please call us.
Very truly yours,
McPHAIL ASSOCIATES, LLC
Thomas J Fennick, L.S.P.
N:\Project Documents\6424 -65 Washington Street\RNF\6424_RNF Notice_HD_3-20-2019.docx
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cc: 65 Washington Street, LLC
GEOTECHNICAL AND GEOENVIRONMENTAL ENGINEERS
2269 Massachusetts Avenue
Cambridge, Massachusetts 02140
(617)868-1420
Massachusetts Department of Environmental Protection BWSC 103
. Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
RETRACTION FORM '135398T
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: FOR&IERCOURTWOUSEPROPERTY
2.Street Address: 65 WASHINGTON STREET
3.City/Town: SALEM 4.ZIP Code: 019700000
5.Coordinates: a.Latitude:N 42.52288 b.Longitude:W 70.89529
B. THIS FORM IS BEING USED TO: (check one)
r 1.Submit a Release Notification
r" 2.Submit a Revised Release Notification
r 3.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 C is not required)
(All sections of this transmittal form must be Sited out unless otherwise noted above)
C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR):
1.Date and time of Oral Notification,if applicable: 1/14/2019 Tm= 10:47 AM r PM
mm/ddlyyyy bh:mm
2.Date and time you obtained knowledge of the Release or TOR: 1/14/2019 T��: 09:00 r,AM r PM
mm/dd/yyyy bh=n
3.Date and time release or TOR occurred,if known: Time: r AM r PM
mm/dd/yyyy bh.- mn
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 CONDMONS 5.72 HOUR REPORTING CONDITIONS 6.120 DAY REPORTING CONDITIONS
rv- a.Sudden Release r: a.Subsurface Non-Aqueous Phase r a.Release of Hazardous Material(s)to
Liquid(NAPL)Equal to or Greater than Soil or Groundwater Exceeding
1/2 Inch(.04 feet) Reportable Concentration(s)
17 b.Threat of Sudden Release r b.Underground Storage Tank(UST) r b.Release of Oil to Soil Exceeding
Release Reportable Concentration(s)and
Affecting More than 2 Cubic Yards
r c.Oil Sheen on Surface Water ri c.Threat of UST Release r c.Release of Oil to Groundwater
Exceeding Reportable Concentration(s)
r d.Poses Imminent Hazard r', d.Release to Groundwater near Water r d.Subsurface Non-Aqueous Phase
Supply Liquid(NAPL)Equal to or Greater than
118 Inch(.01 feet)and Less than 1/2 Inch
(.04 feet)
r e.Could Pose Imminent Hazard r e.Substantial Release Migration
r £Release Detected in Private Well
r g.Release to Storm Drain
r h.Sanitary Sewer Release
(Imminent Hazard Only)
' Massachusetts Department of Environmental Protection $WSC 103
Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
RETRACTION FORM 3 '�35398
Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C)
C.INFC:IM.'ITO*:DESCRMING TUE RELEASE OR THREAT OF RELEASE(71 OR): (cunt.)
7.List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity(RQ)by the
greatest amount.
r Check here if an amount or concentration is unknown or less than detectable.
O or EM Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable
If known Concentration (RCS-1,RCS-2,RCGW-1,
RCGW-2)
42 FUEL OIL O 10 GAL N/A
#2 FUEL OIL O 24 Plgi N/A
- 1
r 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.Check all that apply: r a.change in contact name r b.change of address r c.change in the person notifying
2.Name of Organization: 65 WASHWTrON STREET LLC
3.Contact First Name: JEFFREY 4.Last Name: HRSCFI
5.Street: 55 BENTSTREET 6.Title:
7.City/Town: CANBRDGE 8.State: MA 9.ZIP Code: 021410000
10.Telephone: 617-868-5558 11.Exk: 12.Email:
r 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: r Check here to change relationship
r 1."or PRP r a.Owner r b.Operator r c.Generator r d.Transporter
F-0 e.Other RP or PRP Specify: NONSPECIFED PRP
r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2)
r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.56))
r 4.Any Other Person Otherwise Required to Notify Specify Relationship:
Massachusetts Department of Environmental Protection BWSC 103
Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
A RETRACTION FORM -135399
Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C)
F.CERTIFICATION OF PERSON REQUIRED TO NOTIFY:
1.I,JSHRSCHI ,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.lithe 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: Jl4HRSCHI 3.Title:
Signature
4.For: 65 WASHINGTON STREET LLC 5.Date: 3/14/2018
(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 COMPLIANCE ASSURANCE FEES FOR EACH Rn L ARr E YEAR FOR TIER
CLASSIFIED DISPOSAL SrM YOU MUST LEGIBLY C0NNIZ E ALL RELEVANT SECTIONS OF TRLS FORM
OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IFYOU SUBNIIT AN INCOMPLETE FORM,YOU
MAYBE PENAL UED FOR MUSSING A REQUIRED DEADLINE.
Date Stamp(DEP USE ONLY:)
Received by DEP on 3/15/201911:22:31
AM