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Home My WebLink AboutMiscellaneous - 17 MASSACHUSETTS AVENUE 4/30/2018 (2) ` }�{-�ASSACHUSETISdVFIJIIF ril 1000.0 2 /002 .0 0040-00 + ---- - l i I E f i I EarthTech 196 Baker Avenue P 978.371.4000 Concord, MA F 978.371.2468 A tq=International ltd.Company 01742 www.earthtech.com EX IVED May 4, 2006 Ms. Susan Sawyer MAY 10 2006 Director, Health Department,Town of North Andoverr TOWN OF NORTH ANDOVER 120 Main Street HEALTH DEPARTMENT North Andover,MA 01845 Subject: Board of Health Notice under the Massachusetts Contingency Plan g Y Response Action Outcome 17 Massachusetts Avenue,North Andover,MA MADEP Release Tracking Number: 3-25209 Dear Ms. Sawyer: The purpose of this letter is to notify you, pursuant to the Massachusetts Contingency Plan (MCP-310 CMR 40.0000), that Leona and David Hollins have prepared a Response Action Outcome (RAO) for the above referenced,site: A release-of petroleum hydrdcarb'ons`to the,envir6n—ment was=detected in a small area (approximately 0.1 acres) in the southwestern portion of the property. The release was determined to have resulted from the accumulation`"of°petroleum products from surface runoff, and potentially occasional discharges, into the sump of*a leaching catch basin, which was abandoned. Approximately eight tons of soil and sediment was removed from the base of the structure. However, excavation was discontinued prior to removal of all contaminated soil due to concerns about undermining the integrity of an adjacent diesel underground storage tank. After excavation, residual petroleum hydrocarbons were detected in soil at the base of the leaching catch basin and in groundwater at a downgradient monitoring well. A Method 1 Risk Characterization was conducted that determined that there is No Significant Risk to human health, safety, public welfare, or the environment due to the release. The result was the submission of a Class A-2 Response Action Outcome (RAO) Statement for the above referenced site. No further MCP response actions are required. The RAO report is available for review at the Massachusetts Department of Environmental Protection's Northeast Regional Office file storage facility in Wilmington. Should have any questions regarding this notice,please contact me at(978) 371-4124. Sincerely, Earth Tech,Inc. Ivh liael. . Clerk;P.E:,L SP ` ; 8eriior,Pr6gram'1Vlana'ger cc ' 1VIr.Mark Rees,Town'1Vlanager,Town of North Andover Mr. and Mrs. David Hollins DEP BWSC NERO i WOW TECHNICAL DRILLING.:SERVICES INC.,.. P.O.Box 10 + Sterling;MA 01564 �a A?Yaodl !!F?!F5i! idld? id i ??d id.c!ldddtdddi !?e d?iFttill 4 `1 Massachusetts Department of Environmental Manf9ement p�q Office of Water Resources (l00 O/_0 / 143966 TYPE OR PRINT ONLY Well Completion Report w 1.WELL LOCATION GPS (OPTIONAL) LATITUDE LONGITUDE_° DATUM Ui'd Address at Well Location: &S JT1Cl77M' Property Owner/Client: Eo- rth TO CA Subdivision Name: S GSI Mailing Address: no ° City/Tovdo: D/th AY�o%YU. Citylrown: Assessors Map Assessors Lot#: NOTE:Assessors Map and Lot# mandatory if no,streetPaddress-available Board of Health permit obtained: Yes ❑ Not Required ® Permit Number Date Issued 1 2. VIIORK PERFORMED 3. PROPOSED USE ,� 4. DRILLING METHOD C New Well ❑ Abandon ❑ 94mestic ❑ Irrigation ❑ Cable ,p--; ❑ Auger ElDeeped, El Recondition ) Ml, onitoring ❑ Municipal El Air Hammer erect Push EJRe lace ElOther ElIndustrial ElOtherx` ElMud;Rota ❑ Other 5.WELL LOG Water Unconsolidated"" Consolidated 6.SITE SKETCH (use permanent landmarks with distances) ... N .� BearingT m m ca Other Rock Type From(ft) To (ft) Zonecoo Z m Material Description ` RECEIVED, EB 2 S 200 V - , U E LTH DEPARTM-\JT 7.WELL CONSTRUCTION 8. CASING Total Depth Drilled From ft To ft Casing Type and Material Size I.D. (in) Well Seal Type // Date Complete rr �i T 9. SCREEN From (ft) To (ft) Slot Size Screen Typf and Material Screen Diameter U 10. FILTER PACK/GROUT/ABANDONMENT MATERIAL 11. ADDITIONAL WELL INFORMATION From (ft) To (ft) Material Description Purpose Developed? E-1 Yes El NoFracture .,, k Enhancement? El Yes ❑ No �l Method Disinfected? ElYes ElNo 12.WELL TEST DATA(ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) 13. STATIC WATER LEVEL(ALL WELLS) Yield Time Pumped Drawdown to Time to Recover Recovery to Depth Below Date Method (GPM) (hrs& min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) P-3/06 14. PERMANENT PUMP(IF AVAILABLE) 15.NAMEIADDRESS OF PUMP INSTALLATION COMPANY Pump Description Horsepower Pump Intake Depth (ft) Nominal Pump Capacity (gpm) 16. COMMENTS 17. WELL DRILLER'S STATEMENT This well was drilled, altered, and/or abandoned under supervision, according to applicable ,O ruleand regulations, and thisire ort is plete and o rect to the best of my knowledge. l/ (� Driller: 4 r Supervising Driller Signature: Registration #: �J j Firm: h v / TR Date: Rig Permit #: i NOTE. Well Completion Reports must be filed by the registered well dril r within 30 days of well completion. i 'i BOARD OF HEALTH COPY EarthTech on Baker Avenue P 978.371.4000 Concord, MA 01742 F 978.371.2468 A Tyco International Ltd.Company www.earthtech.com September 16,2005 RECEIVE® Susan Sawyer, Director SEP 2 0 2005 North Andover Board of Health Health Department TOWN OF NORTH ANDOVER 400 Osgood Street HEALTH DEPARTMENT North Andover, MA 01845 Subject: Board of Health Notice under the Massachusetts Contingency Plan Release Abatement Measure Plan 17 Massachusetts Avenue North Andover,Massachusetts MADEP Release Tracking Number: 3-25209 Dear Ms. Sawyer: The purpose of this letter is to notify you, pursuant to the Massachusetts Contingency Plan (MCP-310 CMR 40.0000), that David and Leona Hollins will be conducting a Release Abatement Measure (RAM) to remove hydrocarbon-impacted soil at the above referenced Site. A RAM Plan has been prepared and submitted to the Massachusetts Department of Environmental Protection. Should have any questions regarding this notice please contact the undersigned at Earth Tech(978- 371-4124). Sincerely, Earth Tech,Inc. Michael P. Clark, P.E.,LSP Principal cc: DEP BWSC NERO H:\data\Projects\17 Massachusetts Avenue\PubNotice-BOH.doc Town of North Andover f t40RTH OFFICE OF ��O`t a o O L COMMUNITY DEVELOPMENT,AND SERVICES p 146 Main Street North Andover,Massachusetts 01845 WII LIAM I SCOTT 9SSACHuse Director TOWN OF NORTH ANDOVER TOBACCO SALES PERMIT DATE: July 25 , 191 1.6 FEE: $2 .' 00 This is to certify that North Andover Shell 17 Massachusetts Ave North Andover, MA 01AAg Address IS HEREBY GRANTED A TOBACCO SALES PERMIT This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires July 1 , 1997 unless sooner suspended or revoked. July 25, 19 96 Gayton sgood, Chairman << >�ancisP. MacMillan, M.R., Member John S Rizza, D.M.D.,Mern,kier 1, BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 T O W N O F N 0, R T H A N D 0 V E R BOARD . OF HEALTH TOWN HALL ANNEX 146 MAIN STREET NORTH ANDOVER, MA 0184. 5 TELEPHONE # (508) 688-9540 TOBACCO SALES PERMIT APPLICATION Date 7- Establishment Name Business Address Mailing Address (if different) Telephone # Applicant' s Name and Title ✓�� GXD Applicant's Address Owner of Establishment (if different) Corpoz%tion Name _ Corporation Address Emergency Response Person Telephone # ((/ �� 17-1(0 l� Business # Y7 ' /Z69 6 . 1 Yd TOWN OF NORTH ANDOVER a` Q BOARD OF HEALTH ` 384 OSGOOD STREET NORTH ANDOVER, MA 01845 TELEPHONE # (978) 688-9540 TOBACCO SALES PERMIT APPLICATION Date:-9-1?/ Establishment Name: Business Address: ZZ Ct S S -hc-e— Mailing Address (if different): Mo • ,4 do u,q� Telephone: W —6,3 7— 2616 Applicant's Name& Title: �V-,915� Applicant's Address:?. D . 13 —'�'J•�r�c%-t �/8y1 Owner of Establishment (if different): Corporation Name: Corporation Address: Emergency Response Person: 7p A/7 7 e�19- Telephone:2 21 6 72, /T06 Business: 6,?2- 0`/ 6 Revision: 8/5/98 Enclosure i a THE COMMONWEALTH OF MASSACHUSETTS 1 { TOWN OF NORTH ANDOVER BOARD OF HEALTH Date: September 4, 1998 Fee: $20.00 This is to certify that: NORTH ANDOVER SHELL, 17 MASSACHUSETTS AVE., NORTH ANDOVER, MA 01845 IS HEREBY GRANTED A TOBACCO SALES PERMIT This permit is granted in conformity with the statutes and ordinances relating thereto, and expires July 1, 1999 unless sooner sus ded or rev ked. �j Francis P. MacMillan, M.D., Member John S. Rizza D.M.D. Member : SO 1 , I 1 t 4. i THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTHANDOVER BOARD OF HEALTH Date: October 10, 1997 This is to certify that NORTHANDOVER SHELL, 17 MASSACHUSETTS AVE., NORTH ANDOVER, MA 01845 IS HEREBY GRANTED A TOBACCO PERMIT This permit is granted in conformity with the statues and ordinances relating thereto, and expires JULY 1, 1998 unless sooner suspended or revoked. _ Gayton Osgood, Chairm , r Francs J��Mach Aft' ' ' 1VI�e ber-�q wt, John Sizza, D.M.D., Me TOWN OF NORTH ANDOVER BOARD OF HEALTH TOWN HALL ANNEX 146 MAIN STREET NORTH ANDOVER, MA 01845 TELEPHONE # (508) 688-9540 /�' TOBACCO SALES PERMIT APPLICATION Date Ca ec 9 7 Establishment Name /V0i2 f ,90Ut12 J Business Address �77A S S AClE /I,��,") /9N1)0 ()6 � Mailing Address (if different) Telephone # q6- Applicant' s LApplicant' s Name and Title la-3 601?6c F v � Applicant's Address ` �J Owner of Establishment (if different) g Corporation Name Corporation Address Emergency Response Person Telephone # -52) Y ' 61 f7- 10 C Business # Z `,6 0 7 2 tl,(, T O W N OF NORTH ANDOVER BOARD OF HEALTH TOWN HALL ANNEX 146 MAIN STREET NORTH ANDOVER, MA 01845 TELEPHONE # (508) 688-9540 c TOBACCO SALES PERMIT APPLICATION Date Establishment Name f'7/.1 /? /r1C1021e,(, 'S/�� Business Address /7 7026SS &e - Mailing e -Mailing Address (if different) Telephone # Applicant's Name and Title Applicant's Address Owner of Establishment (if different) Corporation Name�/,� Corporation Address Emergency Response Person 31 4' 2. �/ /J/` Telephone # '�� 7- %(o Business # NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS TOWN of NORH ANDOVER This is to Certify that North Andover Shell NAME 17 Massachusetts Ave. , North Andvoer, MA 01845 ADDRESS IS HEREBY GRANTED A PERMIT For Tobacco Sales Permit This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires July 1 , 1996 unless sooner spe d or reyOked. Jam• February 1.3, -. -19_26 FORM 451 H&W HOBBSB WARREN TMva.r�.. i✓ ti� Town of North AndoverZof NORTN IA., OFFICE OF 3� "I '6,, �1 COMMUNITY DEVELOPMENT ANIS SERVICE ° ., F 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT QSSACFHUS"- Director (978)688-9531 Fax (978) 688-9542 Establishment: Address : 17 Telenccne: Date: 0 Person Spoken With: T_ur_" c g4A'^ Owner: /{ .��, On this day an, inspection was made of your waste receptacle area. Your waste receptacle area was found clean 1, dirty and the cover of your waste receptacle was found _min good repair in poor repair and kept closed P/ not kept dosed°. Other Comments: �- �� E�Yufw c9'vl 410 . 600 Storage of arA - Garbage/Rubbish shall be stored in watertight receptacles with 1 ��-•- tight-fitting covers . Said receptacles and covers shall be of metal or of r durable, rodent-proof materia . 410 . 6,0 1ollection c Gar ge and rubbish - The owner of any dwelling shall be responsible for the final ` I� collection or ultimate dis=posal or incineration of garbage and rubbish by means . of a regular collection system approved by the Board of Health. 410 . 602 Maintenance of areas free from Garbage and Rubbish (A) - The owner of any parcel of land, vacant or otherwise, shall be responsible for maintaining such parcel of land in a clean and sanitary condition grid free from garbage, rubbish or other refuse. The owner of such parcel of land shall correct anv condition caused by or on such parcel or its appurtenance which affects the health or safety, and well-being of the occupants cf and dwelling or of the general public. ,- .. 17 MASSACHUSETTS AVENUE JS-2004-1097 IS Proiect Detail Report Printed On:Fri Jun 04,2004 Project Name: GIS#: 22 Project No: JS-2004-1097 Owner of Record HOLLINS,DAVID B&LEONA M Map: 002.0 Date Submitted: Jun-04-2004 12 HAMILTON ROAD Block: 0040 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Work Location: 17 MASSACHUSETTS AVENUE Zoning: Proposed Use: District: land Use: 334 Proposed Use Detail Subdivision Description RAM Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2004-0079 5/21/004-Release Abatement notice received from EnviroTrac;781.769.5005. This is regarding Excavation and removal of impacted soil. GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 1 of 1 0 Environmental Services May 19, 2004 Ms. Susan Sawyer, Director _ Town of North Andover Health Department TOWN OF NORTH AfVGb"tIk/ ' North Andover Town Hall BOARD OF HEALTH 120 Main Street North Andover, Massachusetts 01845 MAY 2 1 ?rn ; Mr. Mark Rees, Town Manager I Town of North Andover " North Andover Town Hall 120 Main Street J North Andover, Massachusetts 01845 Re: Availability of Release Abatement Plan Former Shell Service Station 17 Massachusetts Avenue - North Andover, Massachusetts MADEP RTN 3-22983 Dear Ms. Sawyer and Mr. Rees: In accordance with 310 CMR 40.0447(1), notification is hereby made that a Release Abatement Measure (RAM) Plan was completed for the above-referenced location. The RAM Plan is required to accommodate the removal of potentially impacted soil. Potentially impacted soil and groundwater encountered during excavation activities will be managed and removed (if impacted) from the site. , Work is'scheduled to begin in April 2004. Excavation and removal of impacted soil will take approximately one month. A copy of the report can be obtained at the Massachusetts Department of Environmental Protection Northeast Regional Office in Salem. If you have any questions please call the undersigned at(781)769-5005. Sincerely, EnviroTrac Ltd., Eric D. Simpson, P.G. Project Manager cc: MADEP NERD J:, D.Weeks, Motiva Enterprises LLC .,... ..J.�� •' '; .T t i.-ft'..' •.r. ..f. ,t� A .. .�•7 . t ,.•, t .... ,w 1.>t,'•:i;. ?.f 1400 Providence Highway, Suite 2100, Norwood, MA 02062 (781) 769-5005 Fax: (781) 769-9345 0 June 30, 2004 Environmental Services Ms. Susan Sawyer, Director Town of North Andover Health Department RECEIVED North Andover Town Hall 120 Main Street North Andover, Massachusetts 01845 JUL - 9 2004 Mr. Mark Rees, Town Manager Town of North Andover TOWN OF NORTH ANDOVER North Andover Town Hall HEALTH DEPARTMENT 120 Main Street North Andover, Massachusetts 01845 i Re: Availability of Release Abatement Measure Completion Report Former Shell Service Station tr1:7.Massachusetts Avenue North Andover, Massachusetts MADEP RTN 3-22983 Dear Ms. Sawyer and Mr. Rees: In accordance with 310 CMR 40.0447(1), notification is hereby made that a Release Abatement .Measure (RAM) including the excavation of 213.15 tons of petroleum impacted soil was completed for the above-referenced location. All work was conducted using Level D (the lowest level) of personal protective equipment. The RAM Completion Report was submitted to the MADEP. A copy of the report can be obtained at the Massachusetts Department of Environmental Protection Northeast Regional Office in Salem, Massachusetts. If you have any questions please call the undersigned at (781)769-5005. Sincerely, EnviroTrac Ltd., Eric D. Simpson, P.G. Sr. Project Manager cc: MADEP NERO D.Weeks, Motiva Enterprises LLC RAM C Report Submittal Package I 1400 Providence Highway, Suite 2100, Norwood, MA 02062 (781) 769-5005 Fax: (781) 769-9345