15 ROBINSON ROAD AUL (002) RECEIVED
OCT 112022
CITY OF SALEM
BOARD OF HEALTH
GFS GEOLOGICAL FIELD SERVICES, INC.
October 4, 2022
Mayor Kimberly Driscoll
City of Salem
93 Washington St.
Salem,MA 01970
RE: Notice of Activity and Use Limitations Termination&
Notice of Activity and Use Limitations Recording
15 Robinson Road
Salem,MA 01970
RTN 3-26542
Dear Mayor Driscoll:
Enclosed is copy of the Notice of Activity and Use Limitation(AUL)Termination and a new
Notice of Activity and Use Limitations that have been recorded by 15 Robinson Road,LLC on
the above referenced property. The document was prepared in accordance with the
Massachusetts Contingency Plan(MCP) 310 CMR40.1074.
Should you have any questions,please contact me.
Sincerely,
GEOLOGICAL FIELD SERVICES,INC.
I .
Luke Fabbri
President,LSP
14 Hubon Street,Salem,Massachusetts 01970
Tel: (978)594-1376
Massachusetts Department of Environmental Protection
LmDEP Transaction copy
Here is the file you requested for your records.
To retain a copy of this file you must save and/or print.
Usemame: LFABBRI
Transaction ID: 1434460
Document: BWSC113 Activity&Use Limitation(AUL)Form
Size of File: 201.24K
Status of Transaction: In Process
Date and Time Created: 10/4/2022:3:08:08 PM
Note:This file only includes forms that were part of your
transaction as of the date and time indicated above. If you need
a more current copy of your transaction, return to eDEP and
select to"Download a Copy"from the Current Submittals page.
LlMassachusetts Department of Environmental Protection BWSC 113 12
Bureau of Waste Site Cleanup
ACTIVITY&USE LIMITATION(AUL)TRANSMITTAL,FORM Release Tracking Number
Pursuant to 310 CMR 40.1056&40.1070-40,1084(Subpart 1) 3 26542
A.DISPOSAL SITE LOCATION:
1.Disposal Site Name: A&H AUTO EXCHANGE INC
2.Street Address: 15 ROBINSON RD
3.Citp Town: SALEM 4.ZIP Code:
— 5.Check here if the disposal site that is the source of the release N'Tier Classified.Check the current Tier Classification
Category.
a.Tier I b.Tier 1D c.Tier Il
R.THIS FORM IS BEING USED TO:(check one)
1.Submit a Registry copy of a Notice of Activity and Use Limitation,pursuant to 310 CMR 40.1074_
2.Submit an Evaluation of Changes in Land Uses/Activities and/or Site Conditions after a Permanent or Temporary
Solution Statement has been tiled pursuant to 310 CMR 40.1080.
r 3.Submit a Registry copy of an Amended_Notice of Activity and Use Limitation,pursuant to 310 CMR 40.1081.
— 4.Submit a Registry copy of a Partial Termination of a Notice of Activity and Use Limitation;pursuant to 310 CMR
40.1083(3).
5.Submit a Registry copy of a Termination of a Notice of Activity and Use Limitation,pursuant to M 0 CMR 40,1083(1),
1-- 6.Submit a Registry copy of a Grant of Environmental Restriction,pursuant to 310 CMR 40.1071,
7.Submit a Registry copy of an Amendment of a Grant of F,nvironmental Restriction,pursuant to 310 CM R 40.108](3).
8.Submit a Registry copy of a Partial Release or a Grant of Environmental Restriction,pursuant to 310 CMR 40.1083(2).
9.Submit a Registry copy of a Release of a Grant of Environmental Restriction,pursuant to 310 CMR 40.1083{I)(d1•
10.Submit a Registry copy of a Confirmatory Activity and Use Limitation,pursuant to 310 CMR 40.1085(4).
11.Submit a Registry copy of a Deed,referencing a Notice of Activity and Use Limitation,following the recording or
registering of said deed conveying the record title for the property,pursuant to 310 CMR 40.1074(5).
(Section D and I I arc not required).
12.Provide Additional RTW
f a.Check here if this AUL Submittal covers additional Release Tracking Numbers(Rl"Ns).
b.Provide the additional Release Tracking Number(s) -
covered by this At;L Submittal.
(All sections of this transmittal form must be filled out unless otherwise noted above)
C.AUL INFORMATION:
L Document(per Section 13)Recording and,or Registration In Formation:
a.dame of Registry of Deeds andfor Land Registration Office: souTH ESsIX
b.Book and Page Number and/or Document Number: 412281462
c.Date of recording andior registration- 11114/2022
nnniddiyyyy
2.Is the address of the property subject to AUL different from the disposal site address listed above?
4 a.No i`b.Yes If yes.then fill out address section below.
3.Street Address:
4.City/Town: 5,ZIP Code:
Revised:08/27.12015 Page i of 5
,
`71Massachusetts Department of Environmental Protection SWSC 113 12
Bureazi of Waste Site Cleanup
ACTIVITY&USE LIMITATION(AUL)TRANSMITTAL FORM Release Tracking Number
Pursuant to 310 CMR 40.1056&40.1070-40.1084(Subpart 3) 3 - 26543
D.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 Ch1R4.03(2),and(iii)the
provisions of 309 CMR 4.03(3),to the best of my knowledge,infornation and belief;
>if Sectinn 8 indicates that a Notice of Activity and Use Limitation has been registered armllor reworded.the Activity and Use
Limitation that is the subject of this submittal(i)is being provided in accordance with the applicable provisions of M-G.L.c.21 E and
310 CMR 40.0000 and(ii)complies with 310 CMR 40.1074;
>?/'Section B indicates that art Evaluation of Changes in Land Uses/Activities and/or Site Conditions after a Permanent or
Temporary Solution is being submitted,this evaluation was developed in accordance with the applicable provisions of-M.G.L.C.
21 E and 310 CMR 40.0000 and(ii)complies with 310 CMR 40.1080;
>?j'Secrion B indicates that an Amended Novice of Activity and Use Limitation or Amendment to a Grant of Environmental
Restriction has been registered andfor recorded,the Activity and Use Limitation that is the subject of this submittal(i)is being
provided in accordance with the applicable provisions of M.G.L.c.21 F and 31 ft-MR 40.0000 and(ii)complies with 40.1091;
>iif Section B indicates that a Termination or a Partial Termination of a Native of Activity and Use Limitation,or a Release or
Partial Release of a Grant of Environmental Restriction has been registered and-nr recorded,the Activity and Use i,imitation that is
the subject of this submittal(i)is being provided in accordance with the applicable provisions of M.G.I..c.2 1 E and 310 CMR
40.0000 and(ii)complies with 310 CMR 40.1083;
>ff Section B indicates that a Grant ofEnvironinental Restriction has been registered andlor recorded,the Activity and Usc
Limitation that is the subject oftW%submittal(i)is being provided in accordance with the applicable provisions of M.G.L.c.21 F and
310 CMR 40.0000 and(ii)complies with 310 CMR 40.1071;
>if Section B indicates that a Confirmatory Activity and Use Limitation has been registered ant or recorder}.the Activity and Use
Limitation that is the subject of this submittal(i)is being provided in accordance with the applicable provisions of M.G.L.c.21 E and
310 CMR 40.0000 and(ii)complies with 310 CMR 40.1085(4);
1 am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit
information which I know to be false,inaccurate or materially incomplete.
1.131?4: 9988
2.First Name' LUKE A 3.Last Name: FABBRI
4.Telephone: 9785941375 5.Ext.: b.Email:
7.Signature: LUKEAFABBRI 8.bate: 1 01412 0 2 2
tnm!dc yyyy
9.LSP Stamp:
R y
r:• ��j��,1C^s ' ;,i
? r-j
Revised:08/27/2015 Page 2 of 5
`7jMassachusetts Department of Environmental Protection BWSC 113 12
Bureau o,f Waste Site Cleanup
Release Tracking 1\umbcr
ACTIVITY&USE LIMITATION(AUL)TRANSMITTAL.FORM
Pursuant to 310 CMR 40.1056&40.1070-40.1084(Subpart 1) 3 - 26542
E.PERSON SUBMITTING AUL TRANSMITTAL FORA:
1.Check all that apply: f—a.change in contact name I—b.change of address c.change in the person
undertaking response actions
2.Name of Organization: 15 ROBINSON ROAD LLC
3.Contact First Name: MICHAa 4.Last Name: WOW
5.Street: 27 FARM AVE 6.Title: MANAGER
7.City/Town: PEABODy 8.State: MA 9.ZIP Codc: ot960oo0o
10.Telephone: 9785357200 11.Exl.: 12.Email:
13.Is the person described in this section the owner of the property?
a.Yes Z—b.No,if checked then Section 11 must be filled out by at least one owner unless submitting a Dm-d
referencing a Notice of Activity and Use Limitation in accordance with 310 CMR 40.1074(4).
f e.Check here if providing names and addresses of any additional owners in an attachment.
F.RELATIONSHIP TO DISPOSAI.SITE OF PERSON SUBMITTING AUL TRANSMITTAL FORM:(check one)
Check here to change relationship
r 1.RP or PRP f—a.Owner I b.Operator f—c.Generator r d.Transporter
io e.Other RP or PRP Specify: aJGlBLECMVER+OPERATOR
1 2.Fiduciary,Secured Lender or Municipality with Fxempt Status(as defined by M.G.1..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 Submitting AUt. Specify:
Revised:08/27/2015 Page 3 of 5
Massachusetts Department of Environmental Protection BW5C 113 12
Bureau o f Waste Site Cleanup
ACTIVITY&USE LIMITATION(AUL)TRANSMITTAL FOR.NI Release Tracking NumberLI
J _
Pursuantc4.. to 310 CMR 40,1056 40.1070-40.1094(Subpart J) 3 26542
G.REQUIRED ATTACHMENT AND SUBMITTALS:
T 1.Check hereto certify that notice of the proposed Activity and Use Limitation(ALL)was given to all record-interest holders.
if any,via certified snail,in accordance with 310(:M R 40.1074(1)(d)or 310 CMR 40.108I(4)(c)fir a Notice of AUL or
Notice of Amended AUL.
f a.Check here if there were no record interest holders. b.Date of certified mailing:
mmiddryyyy
e.Check here to certify that names and addresses of all record holders notified i,attached.
* 2.Check here to certify that within 30 days of recording and.`or registering the AUL,including amending-releasing or
terminating the AUL,a copy of the AUI,w-ds/will be provided to the Chicf Municipal Officer,the Board of[Health,the Zoning
Official,and the Building Code Enforcement Official in the cornmunhy(ies)where the the property subject to such Activity and
Use Limitation is located.
* 3.Check here to certify that within 30 days of recording and'or registering the AUL.including amending,releasing or
terminating the AUL,a Legal Notice was will be published in a newspaper with circulation in the eommunity0cs-)where the
property subject to the AUL is located.
IV 4.Check here to certify that within 7 days of publishing a Legal Notice in a newspaper with circulation in the community(ics)
where the property subject to the AUL is located,a copy of the notice was will be submitted to DEP.
1— 5.If an AUL Compliance Fee is required for this AUL,check here to certify that an Al;L Compliance tree was submitted to
DEP,P.O.Box 4062.Boston,7%1A 02211.
6.Check here if any non-updatable information provided on this form is incorrect,e.g.Site Address/Location Aid.Send
corrections to bwse.cdep@statc.ma.us.
FV 7.Check here to certify that the LSP Opinion containing the material.facts,data,and other information is attached.
H.CERTiFIC:ATiON OF OWNER OF PROPERTY,IF NOT PERSON SUBMITTING AUL TRANSMITTAL
FORM:
1, 1, .attest under the pains and penalties of perjury that I am the owner of
saidproperty(ies),subject to the AL;L
2. 3.date:
Signature mm%dd'yyyy
4.Natnc of Organization:
5.Contact First Name: 6. Last'Name:
7.Street: S.Title:
9.City/Town: 10.State: I I.ZIP Code:
12.Telephone: 13.Ext.: 14.Email:
Revised:007.12015 Page 4 of 5
L1. Massachusetts Department of Environmental Protection BWSC 113 12
Bureall of Waste Site Cleanup
ACTIVITY&USE LIMITATION(ALL)TRANSMITTAL FORM Release Tracking Number
Pursuant to 310 CMR 40.1056&40.1070-40.1084(Subpart J) 3 - 26542
1.CERTIFICATION OF PERSON MAKINC SUBMITTAL:
1. 1, MtCHAEL WEBS .attest under the pains and penalties of perjury(i)that I have personally
examined and aim familiar with the information contained in this submittal,including any and all documents accompanying this
transmittal form,(ii)lhat,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 10 make this attestation on behall'of the entity legally responsible for this submittal.Itthe 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.
Pursuant to 310 CV1R 40,1074(1)(c).I also hereby certify under penalties of perjury.that either I(if person sitbimirting the AUL
Transmittal Fonn is the property owner),or
2.dame of Property Owner
am/is identified on the Notice of AUL as the owner of the property subject to the AUL,owned such property on the date that.the
Alit was recorded and/or registered
3.By: MICHAELWEISS 4.Title: MANAGER
Signature
5.For: 15 ROBINSON ROM LLC 6.Date: 1014l2022
(dame of person or entity recorded in Section E) mntiddlyyyy
- 7.Check here if the address of the person providing certification is different from address recorded in Section E.
8.strcct:
9.City/Town: 10.State: 11.ZIP Code:
12.Telephone: 13. Ext.: 14.Finail:
YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE.FEE OF LIP TO$10,000 PER BILLABLE
YEAR FOR THIS DISPOSAL SITE.YOU MUST LEGIBLY COMPLETE A].1.REI.FVANT SECTION'S 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 10/4/2022 2:52:58
PM
Revised:08/27/2015 Page 5 of 5
�I I�I�I III�I�II���Ill�liflfIlN�I I�
SO, ED 4192 Bk;41228 Pg,452
1010412G22 01_39 TRM Pq 112
Form 1084C
TERMINATION OF NOTICE OF ACTIVITY AND USE LIMITATION
M.G.L. c. 21 E. � 6 and 310 CM 40.0000 f,310 CMR 40.1083(1)(bZ)
Form 1084C Is Used When the Notice of Activity and Use Limitation Is Being Substituted
by a New Notice of Activity and Use Limitation
Disposal Site Name: 15 Robison Road
DEP Release'Tracking No.(s)3-26542
WHEREAS, a Notice of Activity and Use Limitation has been
recorded with the Essex South District Registry of Deeds in Book 37237 Page 237,
(said Notice of Activity and Use Limitation and any amendments thereto are
collectively referred to herein as "Notice"
WHEREAS, said Notice sets forth limitations on use and activities,
conditions and obligations affecting certain land situated in Salem, Essex County,
Massachusetts [with the buildings and improvements thereon], said land being
more particularly bounded and described in Exhibit A attached hereto and made a
part hereof("Property"); and
WHEREAS, said Notice is being terminated so that it may be
substituted with the Notice of Activity and Use Limitation given by15 Robinson
Road, LLC, dated October 6, 2022, and recorded and/or registered immediately
hereinafter;
NOW, THEREFORE, I, of Michael Weiss Manager of 15 Robinson
Road, LLC of Salem, Essex County, Massachusetts, being the owner of said
Property, do hereby terminate said Notice and substitute the same with the Notice
of Activity and Use Limitation given by by 15 Robinson Road. LLC,dated October
6.2022,and recorded and/or registered immediately hereinafter.
15 Robinson Road, LLLC authorizes and consents to the filing and recordation/and or
registration of this Termination of Notice of Activity and Use Limitation,said Termination
to become effective when recorded and/or registered with the appropriate Registry of
Deeds and/or Land Registration Office.
WFINESS the execution hereof under seal this 411 day of October, 2022.
15 Robinson Road,LLC
A Massachusetts limited liability company
F�
1
Mie el Weiss, lqa6ger and not individually
(hereunto authorized)
Form 1084C: continued
COMMONWEALTH OF MASSACHUSETTS
Essex, ss October 4, 2022
On this 41h day of October,2022,before me,the undersigned notary public,personally
appeared Michael Weiss,Manager of 15 Robinson Road,LLC, proved to me through
satisfactory evidence of identification, which was a driver license to he the person
whose name is signed on the preceding or attached document, and acknowledged to
nee that he signed it voluntarily for its stated purpose.
tVotary Public:
My Commissio!e re
Upon rccording,rctut'��ip�
OF
The Panos Law Group 14;iIj,,,Ftii 0%'
246 Andover Street, Suite 301
Peabody,MA 01960
Attn: Jason A. Panos, Esq