414 ESSEX STREET RNF+PSS 12-7-17 RECEIVED
19 National Drive
DEC 0 7 2017 Franklin, MA 02038
Phone: 508-966-600000
CITY OF SALEM Fax: 508-966-4861
IMP, C BOARD OF HEALTH www.nrcacom
December 4,2017
Mr. Paul Kirby, Chair
City of Salem Board of Health
93 Washington Street
Salem, MA 01970
RE., Release Notification Form and Permanent Solution Statement w/No Conditions
-Gal Property, 414 Essex.Stree4.ialem, MA 01970
Release Tracking Number(RTN)3-34189
Dear Mr. Kirby:
Pursuant to 310 CMR 40.1403(3)(f)and(h)of the Massachusetts Contingency Plan(MCP, 310 CMR 40.0000), NRC East
Environmental Services, Inc. (NRC)of Franklin, MA, on behalf Ms. Juana Inoa of Salem, MA provides this notification of the
submittal of a Release Notification Form(RNF)and Permanent Solution Statement with No Conditions for the referenced site.
As required,this notice includes a copy of the RNF and also reminds you of your right to request additional Public
Involvement Activities under 310 CMR 40.1403(9).
As outlined by the Permanent Solution Statement,A 275-gallon above ground storage tank(AST)located within the
basement of the residence developed a leak, resulting in an estimated 100 gallons of#2 fuel oil being released to a majority
of the concrete basement floor. Due to one or more penetrations in the floor, oil also migrated to and impacted underlying
soils. The release was reported to the Massachusetts Department of Environmental Protection(MassDEP),which approved
the collection of pooled oil,the deployment of absorbents,the excavation of impacted soil, and other actions. NRC
responded;collected oil from the floor and from the subject and a second, associated AST; used absorbents to clean affected
surfaces; and removed impacted debris and other items,thus eliminating the primary source of the release. Follow-on
activities have included the excavation and removal of impacted soil from beneath the basement space and the collection and
removal of#2 fuel oil and groundwater;groundwater was present at approximately 3 feet below basement grade.
NRC has determined the release area includes a portion of the basement space, and subsurface soils beneath this space,
measuring up to a total of approximately 50 feet long, 30 feet wide, and to 6 feet below basement grade. Groundwater had
been encountered within the excavation and although initial visual evidence indicated that this media had been impacted(at
least locally within the excavation itself)observations prior to backfilling/restoration indicated no fuel globules or other signs of
groundwater impact. Follow-on groundwater sampling and analyses indicates the presence of only a single contaminant at
minor concentrations within one monitoring well,essentially confirming that this media is no longer impacted. In NRC's
opinion, no further actions are necessary.
Select exposure point concentrations remain in soil but do not exceed applicable MCP Method 1 Standards or MCP Method 3
Upper Concentration Limits. Furthermore,a condition of No Significant Risk of harm to human health, public welfare, and the
environment exists at the site. A Critical Exposure Pathway,a condition of Substantial Release Migration, and/or an
Imminent Hazard does not exist at the site. A Permanent Solution has been achieved and one or more Activity and Use
Limitations are not required to maintain the level of No Significant Risk. A level of No Significant Risk to safety also exists at
the site and no further action is required at the defined disposal site with respect to this release.
•A complete copy of Permanent Solution is available to you through the Massachusetts Department of Environmental
Protection's(MassDEP's)Northeast Regional Office at 205E Lowell Street,Wilmington, MA. You may reach this office at
978.694.3200. Should you require any further information or have any questions relative to this submittal, please feel free to
contact the undersigned at the letterhead address at your earliest convenience.
Sincerely,
NRC
Richard R. LaMothe, LSP
Senior Project Manager
cc: MassDEP
FXCELLENCE IN ENVIRONMENTAL & EMERGENCY SOLUTIONS
Massachusetts Department of Environmental Protection
eDEP Transaction Copy
Here is the file you requested for your records.
To retain a copy of this file you must save and/or print.
Username: RICHARDLAMOTHE
Transaction ID: 927563
Document: BWSC103 Release Notification & Retraction Form
Size of File: 149.95K
Status of Transaction: In Process
Date and Time Created: 5/30/2017:5:38:48 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.
Massachusetts Department of Environmental Protection BWSC 103
*� h Bureau of Waste Site Cleanup
+Q RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
! RETRACTION FORM 34189
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: RESIDENCE
2.Street Address: 414 ESSE)(STREET
3.City/Town: SALEM 4.ZIP Code: 019700000
5.Coordinates: a.Latitude:N 42.51762 b.Longitude:W 70.90561
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 filled out unless otherwise noted above)
C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE (TOR):
1.Date and time of Oml Notification,if applicable: 4/11/2017 Time: 0622 r AM r PM
mm/dd/yyyy hh:mm
2.Date and time you obtained knowledge of the Release or TOR: 4/11/2017 Time: 06:15 r AM r PM
mm/dd/yyyy hh:mm
3.Date and time release or TOR occurred,if known: Time: r AM r PM
mm/dd/yyyy hh:mm
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
r 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
1/21nch(.04 feet) Reportable Concentration(s)
r" 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 r 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 new Water r d.Subsurface Non-Aqueous Phase
Supply Liquid(NAPL)Equal to or Greater than
1/8 Inch(.01 feet)and Less than 1/2 Inch
(.04 feet)
r e.Could Pose Imminent Hazard r" e.Substantial Release Migration
r• f.Release Detected in Private Well
r g.Release to Storm Drain
r h.Sanitary Sewer Release
(Imminent Hazard Only)
Revised:07/18/2013 Pagel of 3
LlMassachusetts Department of Environmental Protection BWSC 103
Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
RETRACTION FORM I'J 34189
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.
r Check here if an amount or concentration is unknown or less than detectable.
O or Hal Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable
if known Concentration (RCS-1,RCS-2,RCGW-1,
RCGW-2)
#2 FUEL OIL WA O 100 GAL INA
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:
3.Contact First Name: JUANA 4.Last Name: INOA
5.Street: 414 ESSEX STREET 6.Title: ONNER
7.City?own: SALEM 8.State: MA 9.ZIP Code: 019700000
10.Telephone: 978-9794533 11.Ext: 12.Email:
�- 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 hereto change relationship
r I.RP or PRP r a.Owner r b.Operator r c.Generator r d.Transporter
r e.Other RP or PRP Specify:
r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2)
r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.5(j))
r 4.Any Other Person Otherwise Required to Notify Specify Relationship:
Revised:07/18/2013 Page 2 of 3
Massachusetts Department of Environmental Protection BWSC 103
Bureau of Waste Site Cleanup
Release Tracking Number
RELEASE NOTIFICATION&NOTIFICATION
RETRACTION FORM [3:] 34189
Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C)
F.CERTIFICATION OF PERSON REQUIRED TO NOTIFY:
1.1,RICHARD R LAMOTHE ,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 not 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: RICHARD R LAMOTHE 3.Title: OVMIER
Signature
4.For: JUANA INOA 5.Date: 5/30/2017
(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.ZfP Code:
11.Telephone: 12,Ext: 13.Email:
YOU ARE SUBJECT TO ANNUAL COMPLIANCE ASSURANCE FEES FOR EACH BILLABLE YEAR FOR TIER
CLASSIFIED DISPOSAL SITES.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF TBIS 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 5/30/2017 5:34:59 PM
Revised:07/18/2013 Page 3 of 3