HomeMy WebLinkAboutMiscellaneous - 785 TURNPIKE STREET 4/30/2018 (2)L
• Complete items 1, 2, and 3. Also complete A. NS'tureitem 4 if Restricted Delivery is desired. 13Agent
• Print your name and address on the reverse X'i ❑ Addressee
so that we can return the card to you. B. Received by (f' in d Nat) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits. i`
1. Article Addressed to:
Power Test Realty Company
o Getty Properties Corp.
%o Jericho Plaza, Suite 110
Jericho, NY 11753
D. Is delivery ad res diffe a ite
If YES, endelivery address below: o
I
OCT 3 0 2017 qwv
3. Service Type
❑ Certified Mail®
❑ Priority Mail Express'
❑ Registered
❑ Return Receipt for Merchandise
❑ Insured Mail
❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑ Yes
.2. Article Number �p14 2120 0000 8322 8529
(Transfer from service /a
PS Form 3811, July 2013 Domestic Return Receipt
UNITED STATES POSTAL SERVICE
First -Class Mail
Postage &Fees Paid
USPS
Permit No. G-10
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• Sender: Please print your name, address, and ZIP+4® in this box*
Town of North Andover
Health Department
120 Main Street
North Andover, MA 01845
III III I111f111#1lialii;,,liItIit111)1ItIIl:iIII,111,It1,!!111itiI
A Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
BP
785 Turnpike Street_
North Andover, MA 01845
A. Signature
X ❑Agent
13
B. Received by (PFin ed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail® ❑ Priority Mail Express'"
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
- 7 014 2120 0000 8322 8451
(transfer from service Iabe1J
PS Form 3811. July 2013 Domestic Return Receipt
' ;�l 'PIZ. Ffleklj
UNITED STATES POSTAl,Sk R'Rlbff
Y,
First -Class Mail
Postage & Fees Paid.
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box•
Town of North Andover
Health Department
120 Main Street
North Andover, MA 01845
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Certified Mail service provides the following benefits:
■ A Certified Mail receipt (this portion of the
mailpiece; include applicable postage to
Certified Mail label),
cover the return receipt service fee; and
■ A unique identifier for your mailpiece.
endorse the mailpiece "Return Receipt
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Regdested," or see a retail associate for
delivery.
assistance. For an electronic return receipt,
■ A record of delivery (including the recipient's
see a retail associate for assistance. To
signature) that is retained by the Postal
receive a duplicate return receipt, present
Service® for a specified period.
this USPS®-postmarked Certified Mail
Important Reminders:
receipt to the retail associate, who will
provide a duplicate return receipt for no
■ You may purchase Certified Mail service with
additional fee.
First-CI®ss Mail®, First -Class Package
Service , or Priority Mail service.
- Restricted delivery service, which provides
■ Certified Mail service is not available for
delivery to the addressee specified by name,
or to the addressee's authorized agent.
international mail. ,
Include applicable postage to cover the
■ Insurance coverage is notavailable for
restricted delivery fee and endorse the
purchase with Certified Mail service. However,
mailpiece "Restricted Delivery,' or see a
the purchase of Certified Mail service does not
retail associate for assistance.
change the insurance coverage automatically
■ To ensure that your Certified Mail receipt is
included with certain Priority Mail items.
accepted as legal proof of mailing, it should
• For an additional fee, you may request the
bear a USPS postmark. If you would like a
following services:
postmark On this Certified Mail receipt, please
- Return receipt service, which provides you
present your Certified Mail item at a Post
with a record of delivery (including the
Office- for postmarking. If you don't need a
recipient's signature). You can request a
postmark on this Certified Mail receipt, detach
hardcopy return receipt or an electronic
the barcoded portion of this label, affix it to the
version. For a hardcopy return receipt,
mailpiece, apply appropriate postage, and
complete PS Farm 3811, Domestic Return
deposit the mailpiece.
Receipt; attach PS Form 3811 to your
IMPORTANT: Save this receipt for your records.
Ps Form 3800, July 2014 (Reverse) PSN 7530.02.000.9047
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Certified Mail service provides the following benefits:
■ A Certified Mail receipt (this portion of the
mailpiece; include applicable postage to
Certified Mail label).
cover the return receipt service fee; and
■ A unique identifier for your mailpiece.
endorse the mailpiece "Return Receipt
■ Electronic verification of delivery or attempted
Requested," or see a retail associate for
delivery.
assistance. For an electronic return receipt,
■ A record of delivery (including the recipient's
see a retail associate for assistance. To
signature) that is retained by the Postal
receive a duplicate return receipt, present
Service® for a specified period.
this USPS® -postmarked Certified Mail
receipt to the retail associate, who will
Important Reminders:
provide a duplicate return receipt for no
■ You may purchase Certified Mail service with
additional fee.
First -Class Mail®, First -Class Package
Restricted delivery service, which provides
Service®, or Priority Mail® service.
delivery to the addressee specified by name,
■ Certified Mail service is notavailable for
or to the addressee's authorized agent.
international mail.
Include applicable postage to cover the
■ Insurance coverage is not available for
restricted delivery fee and endorse the
purchase with Certified Mail service. However,
mailpiece "Restricted Delivery," or see a
the purchase of Certified Mail service does not
retail associate for assistance.
change the insurance coverage automatically
■ To ensure that your Certified Mail receipt is
included with certain Priority Mail items.
accepted as legal proof of mailing, it should
■ For an additional fee, you may request the
bear a USPS postmark. If you would like a
following services:
postmark on this Certified Mail receipt, please
- Return receipt service, which provides you
present your Certified Mail item at a Post
with a record of delivery (including the
Office'" for postmarking. If you don't need a
recipient's signature). You can request a
postmark on this Certified Mail receipt, detach
hardcopy return receipt or an electronic
the barcoded portion of this label, affix it to the
version. For a hardcopy return receipt,
mailpiece, apply appropriate postage, and
complete PS Form 3811, Domestic Return
deposit the mailpiece.
Receipt attach PS Form 3811 to your
IMPORTANT: Save this receipt for your records.
DC __ aitnn Lrly OMA /Ou,mrcnl DCt,17GOMO.ROlLDOd9
North Andover Health Department
(ommunity and Economic Development Division
C� �!,%, :
10
Letter of Noncompliance — Notice of Septic System Failure
Order to Correct
October 26, 2017
RE: Septic System Failure
Power Test Realty Company
C/O Getty Properties Corp
Two Jericho Plaza, Suite 110
Jericho, NY, 11753
BP
785 Turnpike Street
North Andover MA. 01845
Dear BP Owner,
It has been brought to the North Andover Health Department's attention that the Septic System located at 785 Turnpike Street
North Andover MA, is in failure. It has been determined that your septic system is failing and the Health Dept. is obligated to
protect public health and the environment according to Title 5 of the State Sanitary Code.
Please be advised that you have town sewer available, on the street in front of your business. It is mandated that you tie into town
sewer as soon as possible. The North Andover Health Department can provide you with details regarding the local process.
You are hereby ordered to hire a septic hauler to pump your septic tank every week until you are connected to sewer. At the time
of hook up, the Health Department will come out and witness the Abandonment of your existing tank. You are hereby ordered to
hire a licensed contractor and submit a signed contract to the Health Department within 14 days of receipt of this order. The
Board of Health thanks you for your willingness to help protect the environment, the ground water and public health. Please do
not hesitate to call the Health Department office at the number below if you have any questions.
erely,
Vz
ichele Grant
Public Health Inspector
North Andover, MA.
Cc: Timothy Willett
Brian LaGrasse
Building Department
File
Page 1 of 1
North Andover Health Department, 120 Main Street North Andover, MA 01845
Phone: 978.688.9540 Fax: 978.688.9542
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor. not
use the return
key.
cc
' t�I
�V
T
J
RECEIVED
OCT 16 2017
Commonwealth of Massachusetts TOWN OF NORTH ANDOVER
City/Town of HEALTH DEPARTMENT
System Pumping Record NORTH ANDOVER
Form 4
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 390 CMR 15.351.
A. Facility Information
1. System Location:
Address
-16Z
CityrTown State Zip Cite
2. System Owner:
Name
Address (if different from location)
.State , Cade - -
��
Telephone Number
B. Pumping Record
1. Date of Pumping
3. Type of system:
❑ Other (describe)
Z� -1-7
Date' 2- Quantity Pumped: �—�"�•
Gallons
❑ Cesspool(s). Septic Tank ❑ Tight Tank ❑ Grease Trap
4. Effluent Tee Filter present? ❑ Yes P No
5. Condition of System:
6. System Pumped By:
Name —. —L�' ! `•-^� ..._, ._ —.. ___ ._ ..
W
If yes, was it cleaned? ❑ Yes ❑ No
— vehicle License Number
Company
7. Locatiort eCvjvnts were disposed:
�EB�Q ov18LgPWe
e ...-..._......
Od
Signa, U►tr„�,�-_._-----.--•-- ._
Signature`` of Receiving Facility �"t
mavemin vvvv rP
ae .. z6- ?$radforo, _Ma
Qin -
oate
'978) 374-2382
Date
t5form4.doc• 03/06 System Pumping Record . Page I of 1
RF
CEIVED
pC� 1.6 2017
�C\- Commonwealth of M assAacj usetts ?O0oft oEPAR R
City/Town of � �t o(/D � HEAD
System Pumping Record NORTH ANDOVER
Form 4
P has provided this form for use by local Boards of Health. Other forms may be used, but the
info ation must be substantially the same as that provided here. Before using this form, check with your
local and of Health to determine the form they use. The System Pumping Record must be submitted to
the loca oard of Health or other approving authority within 14 days froQ1 the pumping date in
accordan with 310 CMR 15.351.
A. Facilit nformation
Important:
When fining oui 1. System LOCat _
Corms on the
computer, use Af,
only the tab key Address /1 _
to cursor • do not
your �V - - • /'
A �
ca--••------- -- .. ..._. ..__.... _
Cit /Town _... ...... _..
use the return City/Town Zip Code � •
key. 2.
Owle
� Na—
mv` `. � ._ ..._._..__...... .�_...----._....._ -
_._ __..
Address (if different from location) "—'-"—"'— --- •
-..._—.. .....� . . _._ .. .._ _ ._.... . _�.
City/To•+vn State—-- --
Z-6001.
Teleph ne Number
B. Pumping Record
1• Date of Pumping ,• 7 %
P 9 o e. 2. uantity Pumped: Lallans
3. Type of system: cesspooi(s) Q Septic Tan ❑ Tight Tank ❑ Grease Trap
❑ Other (describe): __ .._. _.._.. _.....___.._. _...
4. Effluent Tee Filter present? ❑ Yes XNo If yes, wa it cleaned? ❑ Yes ❑ No
5. Condition of Sys
6. System Pu dBy
`7
Name I _ ...—.�...... ........._..._..._ .__.
Vehicl (license Number
W
7. Locap� �q corrl�j4t t�/�(r e,disposed:
111
(19 _ ?,
Signature of a
%98 Date "-
ignature of Receiving Facility Date -
15form4.doc• 03106 System Pumping Record - Page 9 of t
t
Important:
When filling out
forms on the
computer. use
only the tab key
to move your
cursor . do not
use the return
key.
IL
RECEIVED
Commonwealth of Massachusetts
' I 6 2017
City/Town of TOWN OF NORTH ANDOVER
System Pumping Record NORTH ANDOVER HEALTH DEPARTMENT
Form 4
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
__... KV1 •'�._. _
A dress � N (� ✓
CityfTown _... ... _.. _..
2. �Atem Owner:
sl_v_I__��e._.-
Name
State Zip Code
Address (if different from location) - --- - --
State--
Q� Zip Code
Telephone Numbero�__
B. Pumping Record
45 �- F- �� Date— 2- Quantity Pumped: Q• • •-
1. Date of PumpingA�o
Gallons
3. Type of system: ❑ Cesspool(s) F- 'Septic Tank ❑ Tight Tank !] Grease Trap
❑ Other (describe): - -• -_-- -
4. Effluent Tee Filter present? ❑ Yes LK No If yes, was it cleaned? ❑ Yes + No
5. Condition of System: G�
6. S stem Pumped B
NI
me
Company
7. Location where contents were disposed:
Signature of Hauler
Signature of Receiving Facility � -� �� --' "
VehicleQicel—eO4Nunber
Date - ._.... �Ps tjTP _
Date .....__ Cu1.M
A--
t5form4•doc- 03/06
System Pumping Record - Page 1 of 1
RECEIVED
Commonwealth of Massachusetts OCT T 6 2017
City/Town of
TOWN OF NORTH ANDOVER
System Pumping Record NORTH ANDOVER HEALTH DEPARTMENT
Form 4
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351,
A. Facility Information
Important:
when rifting out 1. Syste ovation: r
forms on the
computer. use
only the tab key Address
to move your
cursor - do not
use the return City/Town State Zip Code —
key-
Name
Address (if different from location)
Cit /Tov✓n ..._..._._.. __.. a .._._ ........ . _—_. — . __ _._
Tel hone Number
B. Pumping Record
1. Date of Pumping _�i•-.•-! 2. Quantit Pumped:
—
Date y p Gallons
3. Type of system: ❑ Cesspool(s) , Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes] No if yes, was it cleaned? ❑ Yes [1 No
5. Condition f. ystejn:
I t
6. System P ed By- ( Q
Name Vehicle Lfcen��Number
Company _
7. Locatiot ejo E� �Lre 146):
t�i'S`Pao
1paie
Signa of auer
Signature of Receiving Facility Date — – - -
15form4,doc- 03/06 System Pumping Record - Page t of 1
RECEIVED
Commonwealth of Massachusetts JUN 0 3 ?015
AM W City/Town of
ER
System Pumping Record NORTH ANPEARYEtI OW
Form 4
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351.
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
V
A. Facility Information
1. System Location:
Addre
OVeYZ
City/Town
2. System Owner:
Y / ,j6vat-, �
State
Name .a
Zip Code
Address (if different from location)
------
City(Town State Zip Code
M, jetephon Number _
B. Pumping Record
-'z-- .SZ0_
1s 2
1. Date of Pumping Date �----- _ - --I. 2. Quantity Pumped: Gallons ...
3. Type of system: ❑ Cesspool(s) 'Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other (describe): ----_ _ ._ . __. _..._. . _ .---
4. Effluent Tee Filter present? ❑ Yes 91141,
If yes, was it cleaned? ❑ Yes Q-46'
5. Condition of System:
v -d �
6. System Pumped By:
Wind River Environmental
I63 Western Ye.... - - --
-
Company
7. Location where contents were disposed:
Signature of Hauler
Signature of Receiving Facility
VehiclJLicense Number
Date
---_ ... — ............... -- -- -- -...
Date
15fofm4.doc• 03/06 System Pumping Record • Page t of 1
ti
❑commonwealth of Massachusetts JUL 0 3 2014
City/Town of T ANN OF NQti�tH X00 iM
pumping Record NORTH AND01/ =ALTNtJEP,4�lTl' �i'�
- _--� '�ster� P 9
Form-; 4
oards of Health.DEP has provided this form for use the local as that provided h Oe. Before using this form, check with your
information must be substantiallyRecord must be submitted to
loca; Board of Health to Healih or other approdetermine the ving inyrm taut ohey S ty within 14 day fromntghe pumping date in
the local Board of
accordance with 310 CMR 15.351.
A, Facility Information
importaWl 1 System Location:
When fining out y
forms on the 7�" 7 p,l
computer, use
onfv the tab key Address
to move your �/ ��c%v�✓ _._ .... .. State Zip Code
cursor - do not Cityrrown
use tie return
key. Z. System Owner:
Address (if different from location) _
-" State
Gode
City[Town _ J7� G.Y� 32 f,)--
p,
Ivyp, Pumping Record
__..... 2. Quantity Pumped: Ganons
U
'. Date of Pumping Date
Septic Tank ❑ Tight Tank ❑ Grease Trap
Type of system: ❑ Cesspool(s) [
❑ Other (describe): —
es, was it cleaned? f ❑ Yes ❑ No
4, Effluent Tee Filter present? ❑ Yes []-No iy
5. Condition of System:
6. System Pumped By:17
_._.
-Vehicle License um er
Name
_
Company
7. Location where contents were disposed:
pate
Signature of Hauler
-
Signature of Receiving Facility
System Pumping Record - Page r of t
15orm4.doc• 03106
MORiry w � + ) • �
302
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. .
Town of North Andover
o
`'•e,,, a :: HEALTH DEPARTMENT
,JSACMust4
CHECK #: DATE:
LOCATION:
H/O NAME: Ll�//-171
CONTRACTOR NAME:
r
Type of Permit or License: (Check box)
❑ Animal $
❑ Body Art Establishment $
❑ Body Art Practitioner $
❑ Dumpster $
❑ Food Service - Type: $
❑ Funeral Directors $
❑ Massage Establishment $
❑ Massage Practice $
❑ Offal (Septic) Hauler $
❑ Recreational Camp $
❑ Sun tanning $
❑ Swimming Pool $
❑ Tobacco $
❑ TrashlSolid Waste Hauler $
❑ Well Construction $
SEPTIC Sustems:
❑
Septic - Soil Testing
$
❑
Septic - Design Approval
$
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑ Title 5 Report $
0 Other (Indicate)
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
t
Town Of North Andover
Department of Weights and Measures
1600 Osgood St. Blg 20 Suite 2-64
North Andover 01845
Phone (978)688-9540
(Cell) (508)783-6403
TO:
North Andover Getty
785 Turnpike St.
North Andover 01845
INVOICE
DATE/ a 31()Z
FOR:
Testing and Sealing of Weights and Measures Devices
Fees and adjusting charges authorized by Section 56, M.G.L. Chapter 98 as amended.
V• ? TOTAL $240.00
Device
Legal Sealing Fees
Adjusted
Sealed
AMOUNT
Test And Seal Gas pumps
$15.00 per meter
16
240.00
RECEIVE
NOV 0 7 200
T
WN OF NORTH AND
VER
EALTH DEPARTME
4T
This is to certify that I have this day tested, adjusted, sealed or condemned the above described device in compliance with the
M.G.L., Chapter 98 as most recently amended. \
F—�
Inspector — se er o Weigh s and Measures
o
Date
Town Of North Andover
Department of Weights and Measures
1600 Osgood St. Blg 20 Suite 2-64
North Andover 01845
Phone (978)688-9540
(Cell) (508)783-6403
TO:
North Andover Getty
785 Turnpike St.
North Andover 01845
INVOICE
DATE 9/24/08
FOR:
Testing and Sealing of Weights and Measures Devices
Fees and adiustina charoes authorized by Section 56, M.G.L. Chapter 98 as amended.
Device
Legal Sealing Fees
Adjusted
Sealed
AMOUNT
Test And Seal Gas pumps
$15.00 per meter
16
240.00
TOTAL 1 $240.00
This is to certify that I have this day tested, adjusted, sealed or condemned the above described device in compliance with the
M.G.L., Chapter 98 as most recently amended. 1�),
Inspector 0
r of Weights and Measures
Date
ILE
V
J Z`
Town Of North Andover
Department of Weights and Measures
1600 Osgood St. Big 20 Suite 2-64
North Andover 01845
Phone(978)688-9540
(Cell) (508)783-6403
TO:
North Andover Getty
785 Turnpike St.
North Andover 01845
Fees and adjusting charges authorized by Section 56,
Test And Seal Gas pumps
This is to certify that I have this day tested, a
M.G.L., Chapter 98 as most recently amended
Daile
OW )x
"I'M
Cl
Of NORtq
�?0...°,1,�o a k
JO OA
o ; ; Town of North Ando
ver
�'+s •�'` HEALTH DEPARTMENT
$'fCNUStt
CHECK #: 6-1-1 7
DATE:
DATION: �S -
H/O NAS
ME:
CONTRACTOR NAME: ✓y L
T--,,—,eof Permit or License: /
❑ Antmal (Check box)
❑ Body Art Establishment $�—
❑ Body Art Practitioner $�
❑ Dumpster
❑ Food Service -$�
Type:
❑ Funeral Directors $�
❑ Massage Establishment $�
❑ Massage Practice $�
Offal (Septic) Hauler
❑ Recreational Camp
❑ Sun tanning $---
Swimming Pool $----
Tobacco $--�
Trash/Solid Waste Hauler
$
Well Construction 0
SEPTIC S $ e
est,:
❑ Septic - Soil Testing
11Septic -Design Approval
❑ Septic Disposal Works Construction (DWC)
❑ Septic Disposal Works Installers (DWI)
11 Title 5 Inspector
❑ Title 5 Report
❑—Other: (Indicate) �G�f
$
2675
Health Agent Initials
- Applicant Yelp Health P= Treasurer
Commonwealth of Massachusetts
_ w City/Town of NORTH ANDOVER,
System Pumping Record
�. Form 4
Important:
When filling out
forms on the
computer, use
only the tab keys
to move your
cursor - do not
use the return
key.
F(_—A
5ACHUSETTS
DEP has provided this form for use by local Boards of Health. The S
be submitted to the local Board of Health or other approving authoril
A. t-acimy Information
JUL 19 2006
1. System Location: TO1N .51 OF NORTH ANDOV� ;
HEALTfJ DF_PA.RTPy1ENT
Address �J--------'—._ .__
------
City/Town State
2. System Owner:
Name
Address (if different from location)
City/Town - ' —
B. Pumping Record
1. Date of Pumping
3.) Type of system: ❑
❑ Other (describe):
Zip Code
State
Telephone Number
Zip Code ----
1� -2. Quantity Pumped:Date --
Gallons
Cesspool(s) _[�J-<eptic Tank ❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
6. Sy em Pumped By:
Name ---
Vehicle License Number
Company
7. Location where contents
®were disposed:
Si ature of Haul - y ------------ —
http://www.mass.gov/dep/water/ provals/t5forms.htm#inspect
Date -
t5form4.doc• 06/03
System Pumping Record • Page 1 of 1
9
Of MO oTN � � w
O w
9
• Town of North Andover
`,�'•�,; ;; :. HEALTH DEPARTMENT
,sSACHUStt
CHECK #:
LOCATION:
H/O NAME:�'S�
CONTRACTOR NAME: G'Of�/✓-fY
Type
of Permit or License: (Check box)
$
❑
Animal
$
❑
Body Art Establishment
$
❑
Body Art Practitioner
$
❑
Dumpster
$
❑
Food Service - Type:
$
❑
Funeral Directors
$
❑
Massage Establishment
$
❑
Massage Practice
$
❑
Offal (Septic) Hauler
$
❑
Recreational Camp
$
❑
Sun tanning
$
❑
Swimming Pool
$
❑
Tobacco
$
❑
Trash/Solid Waste Hauler
$
❑
Well Construction
$
SEPTIC Sustems:
❑
Septic - Soil Testing
$
❑
Septic - Design Approval
$
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
®%O her (Indicate) u.✓ `� // / $�*;+
1836l�
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
..
" Town Of North Andover
Department of Weights and Measures
1600 Osgood St. Blg 20 Suite 2-64
North Andover 01845
Phone(978)688-9540
(Cell) (508)783-6403
TO:
North Andover Getty
785 Turnpike St.
North Andover 01845
OCT 13 2006
INVOICE
)0`'ER DATE I b (51610
FOR:
Testing and Sealing of Weights and Measures Devices
Fees and adiustinq charqes authorized by Section 56, M.G.L. Chapter 98 as amended.
Device
Legal Sealing Fees
Adjusted
Sealed
AMOUNT
Test And Seal Gas pumps
$15.00 per meter
16
7 qb --
TOTAL f Z %4 o `"
This is to certify that I have this day tested, adjusted, sealed or condemned the above descri ed device in compliance with the
M.G.L., Chapter 98 as most recently amended.
Inspector — Se( le of Weights and Measures
10 5 bV
to
9
Lincoln Environmental, Inc.
June 3, 1998
Sandra Starr
Board of Health Administrator
30 School Street
North Andover, Massachusetts 01845
RE: Getty Station 30561
785 Salem Turnpike
North Andover, Massachusetts
MADEP RTN 3-16677
Lincoln Project Number RGT8180
Dear Ms. Starr:
15 Park Drive
Westford, Massachusetts 01886
(978) 392-7971
(978) 392-7926 FAX
Other Offices:
Glastonbury, Connecticut 06033
Portsmouth, New Hampshire 03801
Smithfield, Rhode Island 02917
The purpose of this letter is to inform you that a Response Action Outcome (RAO) Statement has
been filed with the Massachusetts Department of Environmental Protection (MADEP) for the above
referenced site in accordance with the Massachusetts Contingency Plan (CMR 40.0000). This
document is available for review at the MADEP Northeast Region Office in Wilmington or a copy
may be obtained from Lincoln for the cost of duplication and mailing.
This notification has been provided in accordance with 310 CMR 40.1403(3)f. If you have any
question regarding this correspondence, please contact the undersigned at (978) 392-7971.
Sincerely,
LINCOLN ENVIRONMENTAL, INC.
Richard A. Adams Jr.
Environmental Scientist
RAA/blc -
cc: ": Jarfies Stewart = Getty Petroleum_ Marketing,- Inc. :
•Massachusetts Department of Environmental Protection - .
C:\OFFICE\WPWIN\WPDOCS\GETTY\RGT8180\RAOIRARA. WPD
JUN -- 4
Consulting Engineers and Geologists • Remediation Contractors
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
M
Metropolitan Boston - Northeast Regional Office
ARGEO PAUL CELLUCCI
Governor
Getty Petroleum
P.O. Box 1590
Portland, ME 04104
Attn: James Stewart
Dear Mr. Stewart:
TRUDY COXE
Secretary
DAVID B. STRUHS
MAY2 91998 Commissioner
juN 3 RE: NORTH ANDOVER
785 Salem Turnpike
RTN #3-16671
F RELEASE NOTIFICATION &
NOTICE OF POTENTIAL
RESPONSIBILITY; MGL c.
21 E & 310 CM R 40.0000
On April 7, 1998 at 3:00 p.m., the Department received oral notification of a
release/threat of release of oil/hazardous material at the subject location. The Department
has reason to believe that the release/threat of release which was reported is or may be a
disposal site as defined in the Massachusetts Contingency Plan (MCP), 310 CMR 40.0000.
The Department also has reason to believe that you (as used in this letter "you" refers to
Getty Petroleum) are a Potentially Responsible Parry (PRP) with liability under Section 5A of
M.G.L. c. 21E. This liability is "strict" meaning that it is not based on fault but solely on your
status as owner, operator, generator, transporter, disposer or other person specified in Section
5A. This liability is also "joint and several", meaning that responsible parties are liable for all
response costs incurred at a disposal site even if there are other liable parties.
The Department encourages parties with liabilities under M.G.L. c. 21E to take
prompt action in response to releases and threats of release of oil and/or hazardous material.
By taking prompt action, you may significantly lower your assessment and cleanup costs and
avoid the imposition of, or reduce the amount of, certain permit and annual compliance fees
for response actions payable under 310 CMR 4.00. Please refer to M.G.L. c. 21 E for
complete description of potential liability.
GENERAL RESPONSE ACTION REQUIREMENTS
The subject site shall not be deemed to have had all the necessary and required
response actions taken unless and until all substantial hazards presented by the site have
This information is available in alternate format by calling our ADA Coordinator at (617) 574-6872.
205a Lowell St. Wilmington, MA 01887 • Phone (978) 661-7600 •
Fax (978) 661-7615 • TDD # (978) 661-7679
Q Printed on Recycled ecyGed Paper
Getty Petroleum
Page -2-
been eliminated and a level of No Significant Risk exists or has been achieved in compliance
with M.G.L. c. 21 E and the MCP. In addition, the MCP requires persons undertaking
response actions at disposal sites to perform Immediate Response Actions (IRAs) in response
to "sudden releases", Imminent Hazards and Substantial Release Migration. Such persons
must continue to evaluate the need for IRAs and notify the Department immediately if such a
need exists.
You must employ or engage a Licensed Site Professional (LSP) to manage, supervise
or actually perform the necessary response actions at the subject site. In addition, the MCP
requires persons undertaking response actions at a disposal site to submit to the Department
a Response Action Outcome Statement (RAO) prepared by an LSP in accordance with 310
CMR 40.1000 upon determining that a level of No Significant Risk already exists or has been
achieved at a disposal site or portion thereof. [You may obtain a list of the names and
addresses of these licensed professionals from the Board of Registration of Hazardous Waste
Site Cleanup Professionals at (617) 556-1145.]
There are several other submittals required by the MCP which are related to release
notification and/or response actions that may be conducted at the subject site in addition to
an RAO, that, unless otherwise specified by the Department, must be provided to DEP within
specific regulatory timeframes. The submittals are as follows:
(1) If information is obtained after making an oral or written notification to indicate that
the release or threat of release didn't occur, failed to meet the reporting criteria at 310
CMR 40.0311 through 40.0315, or is exempt from notification pursuant to 310 CMR
40.0317, a Notification Retraction may be submitted within 60 days of initial
notification pursuant to 310 CMR 40.0335; otherwise,
(2) if one has not been submitted, a Release Notification Form (RNF) [copy attached]
must be submitted to DEP pursuant to section 310 CMR 40.0333 within 60 calendar
days of the initial date of oral notification to DEP of a release pursuant to 310 CMR
40.0300 or from the date the Department issues a Notice of Responsibility (NOR),
whichever occurs earlier;
(3) unless an RAO or Downgradient Property Status Submittal is provided to DEP earlier,
an Immediate Response Action (IRA) Plan prepared in accordance with 310 CMR
40.0420, or an IRA Completion Statement (310 CMR 40.0427) must be submitted to
DEP within 60 calendar days of the initial date of oral notification to DEP of a release
pursuant to 310 CMR 40.0300 or from the date the Department issues an NOR,
whichever occurs earlier; and
(4) Unless an RAO or Downgradient Property Status Submittal is provided to DEP earlier,
a completed Tier Classification Submittal pursuant to 310 CMR 40.0510, and, if
appropriate, a completed Tier I Permit Application pursuant to 310 CMR 40.0700,
must be submitted to DEP within one year of the initial date of oral notification to
Getty Petroleum
Page -3-
DEP of a release pursuant to 310 CMR 40.0300 or from the date the Department
issues an NOR, whichever occurs earlier.
(5) Pursuant to the Department's "Timely Action Schedule and Fee Provisions",
310 CMR 4.00, a fee of $750 must be included with an RAO statement that is
submitted to the Department more than 120 calendar days after the initial date of oral
notification to DEP of a release pursuant to 310 CMR 40.0300 or after the date
the Department issues an NOR, whichever occurs earlier, and before Tier
Classification. A fee is not required for an RAO submitted to the Department within
120 days of the date of oral notification to the Department, or the date the
Department issues an NOR, whichever date occurs earlier, or after Tier Classification.
It is important to note that you must dispose of any Remediation Waste generated at
the subject location in accordance with 310 CMR 40.0030 including, without limitation,
contaminated soil and/or debris. Any Bill of Lading accompanying such waste must bear the
seal and signature of an LSP or, if the response action is performed under the direct
supervision of the Department, the signature of an authorized representative of the
Department.
If you have any questions relative to this notice, you should contact the undersigned
at the letterhead address or (617) 932-7600. All future communications regarding this release
must reference the Release Tracking Number (RTN #3-16671) contained in the subject block
of this letter.
Sincere ,
Kin ey Ndi
Chief, Notification Branch
Emergency Response
KN/fc
cc: Board of Health, Town Building, N. Andover, MA 01845
Fire Headquarters, 124 Main St., N. Andover, 01845 .
Attachment: Release Notification Form; BWSC - 103
DEP data entry/file
Lincoln Environmental, Inc.
August 8, 1997
Sandra Starr
Board of Health Administrator
30 School Street
North Andover, Massachusetts 01845
RE: Getty Station 30561
785 Salem Turnpike
North Andover, Massachusetts
DEP Case Number 3-4434
Dear Ms. Starr:
15 Park Drive
Westford, Massachusetts 01886
(508) 392-7971
(508) 392-7926 FAX
Other Offices:
Glastonbury, Connecticut 06033
Portsmouth, New Hampshire 03801
Smithfield, Rhode Island 02917
AUG 12 1997
The purpose of this letter is to inform you that a Response Action Outcome (RAO) Statement has
been filed with the Massachusetts Department of Environmental Protection for the above referenced
site in accordance with the Massachusetts Contingency Plan (3 10 CMR 40.0000). For a small fee,
a copy of the RAO can be provided.
This notification has been provided in accordance with 310 CMR 40.1403 (3)f. If you have any
questions regarding this correspondence, please contact the undersigned at (508) 392-7971.
Sincerely,
LINCOLN ENVIRONMENTAL, INC.
,�J. r-PX17 �-
Edna E. Dripps
Project Geologist
EED/blc
cc: James Stewart - Getty Realty Corp.
Massachusetts Department of Environmental Protection
C:\OFFICE\WPWIN\WPDOCS\TS6072\RAO.LET
Consulting Engineers and Geologists • Remediation Contractors
I
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This formis used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law
regulations or requirements. ,
****************Applicant fills out this section*****************
� R.J. Snyder and Decker & Company, Inc. for,
✓APPLICANT: Poor Test Realtv o ---an
Phone 413-243-4083
LOCATION: Assessor's Map Number 98D
Parcel 9
Subdivision _
Lot(s)
,8'Ereet 785 Turnpike Street
St. Number 785
Use Only************************
7REC9MMENDATIONS OF TOWN AGENTS:
Conservation Administrator Date Approved
Date Rejected
Comments
Town Planner Date Approved
Date Rejected
Comments
Food Inspector -Health Date Approved
Date Refected
Septic Inspector -Health Date Approved
Date Refected
Comments
Public Works - sewer/water connections All&
- driveway permit
,fire Department
Received by Building Inspector
Date
DECKER & CO., INC.
P.O. BOX 258
LEE, MA 01238
PHONE: 413-243-4083 FAX: 413-243-4088
TO: Town of North Andover
Health Dept. - Septic Insp.
North Andover, MA 01845
i
LETTER OF TRANSMITTAL
DATE: February 21, 1995
ATTENTION: Sandra Starr
RE: Getty - North Andover
785 Turnpike Street
GENTLEMEN: WE ARE SENDING YOU ATTACHED G UNDER SEPARATE COVER VIA O
THE FOLLOWING ITEMS:
XEROX COPY O PRINTS O PLANS Q FINALS O SPECIFICATIONS O
COPY OF A LETTER 0 COMPUTER WORK O PRELIMINARY WORK O OTHERS O
# OF COPIES
DESCRIPTION
1
Site Plan
1
Form U - Lot Release Form
APPROVED AS NOTED
O RESUBMIT FOR OUR USE
O AS YOU REQUESTED
O
RETURNED FOR CORRECTIONS
O RESUBMIT WITH CORRECTIONS
THESE HAVE BEEN TRANSMITTED FOR THE REASON(S) CHECKED BELOW:
OFOR YOUR APPROVAL
O
APPROVED AS SUBMITTED
O RESUBMIT FOR APPROVAL
OFOR YOUR USE
O
APPROVED AS NOTED
O RESUBMIT FOR OUR USE
O AS YOU REQUESTED
O
RETURNED FOR CORRECTIONS
O RESUBMIT WITH CORRECTIONS
O FOR REVIEW do COMMENT
O
O
REMARKS: If You have
any questions or comments,
please feel free to
contact me. Also,
could
you please sign -off
on Form U - Lot
Release Form. Thank you,
R.J. Snyder
IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CONTACT US AT YOUR NVENI
I�
SIGNED: �'1
William F. Weld
Governor
Daniel S. Greenbaum
Commissioner
Co►nmonweaffh of Massachusetts
Executive Office -of Environmental Affairs
Department of
Environmental Protection
Metro Boston/Northeast Regional Office
June 16, 1993
James Stewart RE: N. ANDOVER - Getty Station
Getty Petroleum Corp. <785 Turnpike Road-
Massasoit Ave. & Dexter Rd. DEP Case #3-4434
E. Providence, RI 02914 RELEASE CATEGORIZATION
Dear Sir:
This Office has been notified that a "release' of a
petroleum product or hazardous chemical has occurred at the
location referenced above. (In some cases a "release" refers to
a recent spill, in other instances it refers to the discovery of
historical contamination.) Your name was recorded in our log
book as a person who has knowledge of and/or responsibility for
such a release.
The Department of Environmental Protection (DEP) is the
state agency that is responsible for ensuring that all releases
of oils and hazardous materials are properly assessed and cleaned
up. At this point in time, DEP is trying to determine if any
further assessment or cleanup work needs to be done at the above
location. If further work is in fact required, DEP needs to
decide which set of regulations must be followed. To accomplish
this task, this Office has developed a short form, which is
attached to this letter. This release categorization form m%st
be filled out and returned to our Office within 90 days. '
The purpose of this form is to record, for our files,
conditions at this location and document what steps, if any, have
been taken to assess and clean up released materials. You do not
need to be an engineer or scientist to fill out this form, but
you should consider retaining persons with expertise in the
environmental engineering/testing field if you do not understand
the questions that are being asked. If you had previously
retained a testing/cleanup firm to respond to the release, you
should check your records to see what documents they provided
that demonstrate the completeness of testing or cleanup actions.
You should refer to these documents when filling out the form,
and provide copies of whatever is appropriate to document the
information you provide on the form.
A
10 Commerce Way • Woburn, Massachusetts 01801 • FAX (617) 935-6393 • Telephone (617) 935-2160
N. Andover
Page 2
Imulications of Release Categorization:
DEP is attempting to determine whether the reported release
constitutes one of the following: a "Confirmed Disposal Site", a
"Location to be Investigated (LTBI)", or a "Spill/Leak". These
distinctions are important, because they dictate the regulatory
status of the release, and consequently, the statutory process
under which future response actions must be taken.
Response actions taken at Spills/Leaks, Disposal Sites, and
LTBIs are subject to Massachusetts General Law Chapter 21E (MGL
c. 21E), the "Massachusetts Oil and Hazardous Material Release
Prevention and Response Act", and the regulatory process
established in the Massachusetts Contingency Plan (MCP), 310 CMR
40.000. The response action process for Disposal Sites and LTBIs
is outlined in Subpart E of the MCP. Subpart E involves a long-
term, phased assessment and cleanup process which is subject to
the oversight and approval of the Bureau of Waste Site Cleanup's
Site Management Branch.
Situations that meet the definition of Spills/Leaks are not
subject to Subpart E of the MCP. However, DEP may require
certain response actions be taken at these types of releases,
including confirmatory testing to document the effectiveness of
response actions.
DEP's Bureau of Waste Site Cleanup provides specific
guidance on differentiating Disposal Sites from Spills in its
policy
#WSC-100-89.
Responsibility to Provide Required Information:
Pursuant to the Department's authority to perform
information -gathering activities and investigate, sample and
inspect records,' conditions, equipment, practices or property
under MGL c. 21E Sections 1,4 and 8, you are directed to complete
the attached "Release Categorization Form" and submit it, along
with copies of the supporting documentation, to DEP within 90
days of the date of this letter. This information, along with
the previous notification and any other applicable DEP records,
will be evaluated by this Office to determine whether the release
is a Spill/Leak or whether it falls under the Subpart E of the
MCP as a Disposal Site or LTBI.
If you should fail to submit the "Release Classification
Form" and supporting documentation to DEP within the specified
timeframe, or if the submittal is determined to be deficient or
incomplete, the location may be placed on DEP's annual public
N. Andover
Page 3
list as a "Location to be Investigated (LTBI)". The most common
submittal deficiency is the lack of "confirmatory" sampling data
that demonstrates the effectivenesssoilsthathave beenremovedfrom
oeos
ting
data on wastes or contaminate
a site does not provide information on the extent or
effectiveness of cleanup, nor the degree of "residual"
contamination that may have been left at the site.
Once listed as an LTBI, the site may be required to proceed
through a long-term, phased assessment and cleanup process
described in Subpart E of the MCP; at a minimum, a Preliminary
Assessment (310 CMR 40.541) must be completed within a year of
the listing. Therefore, it is to your advantage to provide the
most detailed information possible on the Release Categorization
Form in order for this Office to accurately categorize your
release, and for you to avoid unnecessary additional assessments.
Policies Pertaining to Release Categorization:
Please note that this release is considered to be a serious
matter. All response actions taken at the release location must
conform with applicable DEP regulations, policies and guidelines.
These policies include, but are not limited to:
#WSC-401-91, "Policy for the Investigation, Assessment,
and Remediation of Petroleum Releases", provides
guidance and criteria related to releases of petroleum
products.
#WSC-400-89, "Management Procedures for Excavated Soils
Contaminated with Virgin Petroleum Oils", is applicable
if you have excavated or plan to excavate soil
contaminated with petroleum oils. These soils are
considered to be a hazardous waste. If you fail to
adhere to this policy you may be in violation of 310
CMR 30.000 and MGL c. 21C, the "Massachusetts Hazardous
Waste Management Act".
#WSC-130-90, "Short Term Measures Policy", contains
guidance on notifying DEP of the existence of an
imminent hazard; submitting appropriate documentation
in support of a proposed Short Term Measure; and
evaluating the appropriateness and effectiveness of
Short Term Measures.
#WSC-131-90,
category of
Locations to
Sites.
"Interim Measures Policy", describes a
Interim Measures that may be implemented
be Investigated and Confirmed Disposal
at
N. Andover
Page 4
Failure to adhere to applicable regulations, policies and
guidelines may result in DEP rejecting submittals and/or taking
enforcement actions.
Statutory Liabilities
As stated earlier, the contamination reported at this
location constitutes a release of oil and/or hazardous materials.
The prevention and/or mitigation of such a release is governed by
MGL c. 21E. (Please note that c. 21E was amended on July 20,
1992, with some provisions taking effect immediately). Chapter
21E defines "Potentially Responsible Parties" to include owners
or operators of a site at which there has been a release. Such
parties are liable without regard to fault, and the nature of
this liability is strict, joint and several. If you have any
questions or concerns about your legal liabilities in this
matter, you should refer to c. 21E and consider contacting an
attorney.
Finally, if you believe that this letter was sent to you in
error, or that you have already provided the requested
information, please contact this Office immediately, so that we
can re -check our records.
Your cooperation in this matter is appreciated. Please send
the completed form and supporting data to the attention of the
"Site Management Branch", at the letterhead address. If you have
any questions, please contact the undersigned at (617) 935-2160
or the letterhead address.
Very truly yours,
Chris A. Coolen
Environmental Geologist
Ida Babroudi
Environmental Engineer
IB/ae
Enclosure:
cc: DEP, BWSC, Boston, Attn: Jeff Krukonis
N. Andover Board of Health
y
William F. Weld
Governor
Daniel S. Greenbaum
Commissioner
Carl111i:v1 IV�wC_.i�li I C.�i IY14vJ',a..I iUSt-.. �.J
Executive Office of Environmental Affairs
Department of
Environmental Protection
Metro Boston/Northeast Regional Office
James Stewart
Getty Petroleum
Massasoit Ave.
E. Providence,
Dear Sir:
June 2, 1993
w � �1 $I
4r
RE: N. ANDOVER - Getty Station
Corp. 785 Turnpike Road
& Dexter Rd. DEP Case #3-4434
RI 02914 RELEASE CATEGORIZATION
This Office has been notified that a "release" of a
petroleum product or hazardous chemical has occurred at the
location referenced above. (In some cases a "release" refers to
a recent spill, in other instances it refers to the discovery of
historical contamination.) Your name was recorded in our log
book as a person who has knowledge of and/or responsibility for
such a release.
The Department of Environmental Protection (DEP) is the
state agency that is responsible for ensuring that all releases
of oils and hazardous materials are properly assessed and cleaned
up. At this point in time, DEP is trying to determine if any
further assessment or cleanup work needs to be done at the above
location. If further work is in fact required, DEP needs to
decide which set of regulations must be followed. To accomplish
this task, this Office has developed a short form, which is
attached to this letter. This release categorization form must
be filled out and returned to our Office within 90 days.
The purpose of this form is to record, for our files,
conditions at this location and document what steps, if any, have
been taken to assess and clean up released materials. You do not
need to be an engineer or scientist to fill out this form, but
you should consider retaining persons with expertise in the
environmental engineering/testing field if you do not understand
the questions that are being asked. If you had previously
retained a testing/cleanup firm to respond to the release, you
should check your records to see what documents they provided
that demonstrate the completeness of testing or cleanup actions.
You should refer to.these documents when filling out the form,
and provide copies of whatever is appropriate to document the
information you provide on the form.
10 Commerce Way • Woburn, Massachusetts 01801 0 FAX(617)935-6393 * Telephone (617) 935-2160
N. Andover
Page 2
Implications of Release Categorization:
DEP is attempting to determine whether the reported release
constitutes one of the following: a "Confirmed Disposal Site", a
"Location to be Investigated (LTBI)", or a "Spill/Leak". These
distinctions are important, because they dictate the regulatory
status of the release, and consequently, the statutory process
under which future response actions must be taken-.
Response actions taken at Spills/Leaks, Disposal Sites, and
LTBIs are subject to Massachusetts General Law Chapter 21E (MGL
c. 21E), the "Massachusetts Oil and Hazardous Material Release
Prevention and Response Act", and the regulatory process
established in the Massachusetts Contingency Plan (MCP), 310 CMR
40.000. The response action process for Disposal Sites and LTBIs
is outlined in Subpart E of the MCP. Subpart E involves a long-
term, phased assessment and cleanup process which is subject to
the oversight and approval of the Bureau of Waste Site Cleanup's
Site Management Branch.
Situations that meet the definition of Spills/Leaks are not
subject to Subpart E of the MCP. However, DEP may require
certain response actions be taken at these types of releases,
including confirmatory testing to document the effectiveness of
response actions.
DEP's Bureau of Waste Site Cleanup provides specific
guidance on differentiating Disposal Sites from Spills in its
policy
#WSC-100-89.
Responsibility to Provide Required Information:
Pursuant to the Department's authority to perform
information -gathering activities and investigate, sample and
inspect records, conditions, equipment, practices or property
under MGL c. 21E Sections 1,4 and 8, you are directed to complete
the attached "Release Categorization Form" and submit it, along
with copies of the supporting documentation, to DEP within 90
days of the date of this letter. This information, along with
the previous notification and any other applicable DEP records,
will be evaluated by this Office to determine whether the release
is a Spill/Leak or whether it falls under the Subpart E of the
MCP as a Disposal Site or LTBI.
N. Andover
Page 3
If you should fail to submit the "Release Classification
Form" and supporting documentation to DEP within the specified
timeframe, or if the submittal is determined to be deficient or
incomplete, the location may be placed on DEP's annual public
list as a "Location to be Investigated (LTBI)". The most common
submittal deficiency is the lack of "confirmatory" sampling data
that demonstrates the effectiveness of cleanup actions. Testing
data on wastes or contaminated soils that have been removed from
a site does not provide information on the extent or
effectiveness of cleanup, nor the degree of "residual"
contamination that may have been left at the site.
Once listed as an LTBI, the site may be required to proceed
through a long-term, phased assessment and cleanup process
described in Subpart E of the MCP; at a minimum, a Preliminary
Assessment (310 CMR 40.541) must be completed within a year of
the listing. Therefore, it is to your advantage to provide the
most detailed information possible on the Release Categorization
Form in order for this Office to accurately categorize your
release, and for you to avoid unnecessary additional assessments.
In this case additional information that will address the
following questions will be required before this office considers
your submittal complete enough to categorize this release as
requested. Please submit the following:
- Quality assurance/quality control information for all
samples taken.
- Explanation of the large gap between the results of the
Total Petroleum Hydrocarbon analysis Method 418.1 and
that of the GC finger print.
- The results of additional investigation and analysis of
the horizon that produced 887 mg/kg.
- Address the potential for this contamination to be coal
tar related.
Policies Pertaining to Release Categorization:
Please note that this release is considered to be a serious
matter. All response actions taken at the release location must
conform with applicable DEP regulations, policies and guidelines.
These policies include, but are not limited to:'
N. Andover
Page 4
#WSC-401-91, "Policy for the Investigation, Assessment,
and Remediation of Petroleum Releases", provides
guidance and criteria related to releases of petroleum
products.
#WSC-400-89, "Management Procedures for Excavated Soils
Contaminated with Virgin Petroleum oils", is applicable
if you have excavated or plan to excavate soil
contaminated with petroleum oils. These soils are
considered to be a hazardous waste. If you fail to
adhere to this policy you may be in violation of 310
CMR 30.000 and MGL c. 21C, the "Massachusetts Hazardous
Waste Management Act".
#WSC-130-90, "Short Term Measures Policy", contains
guidance on notifying DEP of the existence of an
imminent hazard; submitting appropriate documentation
in support of a proposed Short Term Measure; and
evaluating the appropriateness and effectiveness of
Short Term Measures.
#WSC-131-90, "Interim Measures Policy", describes a
category of Interim Measures that may be implemented at
Locations to be Investigated and Confirmed Disposal
Sites.
Failure to adhere to applicable regulations, policies and
guidelines may result in DEP rejecting submittals and/or taking
enforcement actions.
Statutory Liabilities
As stated earlier, the contamination reported at this
location constitutes a release of oil and/or hazardous materials.
The prevention and/or mitigation of such a release is governed by
MGL c. 21E. (Please note that c. 21E was amended on July 20,
1992, with some provisions taking effect immediately). Chapter
21E defines "Potentially Responsible Parties" to include owners
or operators of a site at which there has been a release. Such
parties are liable without regard to fault, and the nature of
this liability is strict, joint and several. If you have any
questions or concerns about your legal liabilities in this
matter, you should refer to c. 21E and consider contacting an
attorney.
N. Andover
Page 5
Finally, if you believe that this letter was sent to you in
error, or that you have already provided the requested
information, please contact this Office immediately, so that we
can re -check our records.
Your cooperation in this matter is appreciated. Please send
the completed form and supporting data to the attention of the
"Site Management Branch", at the letterhead address. If you have
any questions, please contact the undersigned at (617) 935-2160
or the letterhead address.
Very truly yours,
Chris A. Coolen
Environmental Geologist
Ida Babroudi
Environmental Engineer
IB/ae
Enclosure:
cc: DEP, BWSC, Boston, Attn: Jeff Krukonis
N. Andover Board of Health
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APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
785 ike St. No. Andover . I will install this system in ac-
cordance with all the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover,
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 196 until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. I will install a con-
crete septic tank of in size. A manhole (s) permitting easy cleaning
will be provided with removable cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series.of trenches, the bottom of which will pro-
vide a minimum of lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/8" to 1/41, (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE January 3, 1973
John Lay Si n' ture of A
40 embrook
I hereby issue the above permit for Board of He h of the
Andover, Massachusetts.
DATE
CV6
Rd., Nod Andover, Ma.
Town of North
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
785 Turnpike St., No. Andover . I will install this system in ac-
cordance with all the laws of the Commonwealth of Massachusetts -and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1/ until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. I will install a con-
crete septic tank of in size. A manhole (s) permitting easy cleaning
will be provided with removable cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE January 3, 1973
Joh( J { McLay ` , i Mature of Appplilant
4� Pembrook Rd. �p No. Andover, Ma.
I hereby issue the above permit for the,Board of Health of the Town of North
Andover, Massachusetts.
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
,--- — — -- , - --a-_ — j
114
McLay Nursery
_ALRt.l14' Turnpike
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
__ Rt. A . I will install this system in ac-
cordance with all the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1/ until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2106. I will install a con-
crete septic tank of 750 as'- in size. A manhole (s) permitting easy cleaning
will be provided with removable' cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of 130 lineal (s) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
That may be attached to the permit. Plot Plans must be submitted with application.
DAT (v
Signature of A plicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE
Sifatfire of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
r
Signatur of Inspecting Officer
Percolation Test 5 min. Soils Sandy -clay
Garbage Grinder No
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
'D�ST�'8�er/dN Qd,Y
c 1"RNk- _
15'71
zo LIS
/
%G R N pile e ST. - RTC-, 1/LI.
1. NAME �' HAI Alfa y DATE
2. ADDRESS j �— hI" XNDe� 9R A
m l� g ®0 k R �� LOfi NO �$ , TEL.
3. NO. OF BEDROOMS A16 A/ E . DEN YES NO t/
4. GARBAGE GRINDER YES NO
5. SHOW DIMENSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIMENSIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC.
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS
SEWAGE DISPOSAL
DATE July 3, 1964
NAME OF APPLICANT McLay Nursery
LOCATION Rte. 114, Turnpike Street
Address of lot no.
BUILDING: Dwelling Other Nursery Business
SYSTEM: New X Repair
GENERAL DESCRIPTION OF LAND high
SUBSOIL: Clay Gravel SandY Clay
PERCOLATION TEST 5 minutes per inch.
MINIMUM INSTALLATION RECOMMENDATIONS
CONCRETE SEPTIC TANK
750
gallon
capacity.
LEACH FIELD 130
lineal
feet of
drain pipe.
William J. Dr s oll, Engineer
Board of Healt
Town of North Andover , pCRT►y
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES41
.:
146 Main Street +�
.;
North Andover, Massachusetts 01845
WILLIAM J. SCOTT 9SsncHUS
Director
MEMORANDUM
TO: Licensing Commissioners
FROM: Sandra Starr, R.S., Health Admi s
RE: Class H License - 785 Turnpike Street
DATE: April 2, 1997
The Board of Health has no objection to the issuance of a Class II license for this
establishment.
If you have any questions, please do not hesitate to call the Board of Health Office at the
number below.
SS/cjp
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Y. d/c"�—
OFFICE OF
LICENSING COMMISSIONERS
NORTH ANDOVER, MASSACHUSETTS
Memorandum
To:
Building Inspector
Board of Health
Fire Department
Police Department
'Commission on Disability Issues
From:
Jant aton,
Asses nt Town Clerk
Date:
March 27, 1997
Subject:
Class II License
785 Turnpike Street
MAR 3 1 199T
Please review and submit your recommendation to me by Friday,.
April 11, 1997 on the attached application for a Class II License from Roger
G. Feghali at 785 Turnpike Street formerly owned by Fardi Mansour.
attachment
THE COMMONWEALTH OF MASSACHUSETTS
OF
APPLICATION FOR A LICENSE TO BUY, SELL, EXCHANGE
OR ASSEMBLE SECOND HAND MOTOR VEHICLES
OR PARTS THEREOF
I, the undersigned, duly authorized by the concern herein mentioned, hereby apply for a ..............
class license, to Buy, Sell, Exchange or Assemble second hand motor vehicles or parts thereof, in accordance with
the provisions of Chapter 140 of the General Laws.
1. What is the name of the
....................
e
_ Business address of concern. No.. n1. 5.. LA `u� :1,, , , ," , , , , , , , , , , , , , , , , , , , St.,
..... � .�.•. � .. l� .....(�.1.. u.Y.1 : A:. . .......................City —Town.
2. Is the above concernan individual, co -partnership, an association or a corporation? ..............
........�.... ...... . ........................................................
3. If an individual, state full name and residential address.
....................................................................................
4. If a co -partnership, state full names and residential addresses of the persons composing it.
....................................................................................
5. If an association or a corporation, state full names and residential addresses of the principal officers.
President .1R.o Q. az ....C°'..... �� �? �' ...`'r"l'il`�!1% ; J i!!
Secretary......l...................................................&:A:.i2184A
Treasurer............................................... .......................
6. Are you engaged principally in the business of buying, selling or exchanging motor vehicles? '� ....
If so, is your principal business the sale of new motor vehicles? ....................................
Is your principal business the buying and selling of second hand motor vehicles? ...1.0 .................
Is your principal business that of a motor vehicle junk dealer? ./.Vq ................................
�'eCvesT/A) 4� yeh/ c%S
FORM 53 HOBBS & WARREN, INC., PUBLISHERS - REVISED
7. Give a complete description of all the premises to be used for the purpose of carrying on the business.
....�... ............. ..a ... �.s .... .... .
�......................................................
....................................................................................
....................................................................................
,t 8. Are you a recognized agent of a motor vehicle manufacturer? ..... V . • • • • • • • •
(Yes or No)
If so, state name of manufacturer..........................................................
...........................................................................
9. Haveou a signed contract as required b Section , Class 1? .......... .
y �' 9 y Sti58(Yes or No) , .... .
/J
10. Have you ever applied for a license to deal in second hand motor vehicles or parts thereof?
(Yes or No)
If so, in what city — town.............................................................. .
Did you receive a license? .......................... For what year? ................
(Yes or No)
11. Has any license issued to you in Massachusetts or any other state to deal in motor vehicles or parts
thereof ever been suspended or revoked? ...... / • v :.......
(Yes or No)
....................................................................................
....................................................................................
........................... � .. ..... ....
Sign your name in full.� •� 1,�� —
J'
e. aut nrrd to epres the concern here n mentioned)
Residence ....:..
/110 A
IMPORTANT
EVERY QUESTION MUST BE ANSWERED WITH
FULL INFORMATION,. AND FALSE STATEMENTS
HEREIN MAY RESULT IN THE REJECTION OF
YOUR APPLICATION OR THE SUBSEQUENT
REVOCATION OF YOUR LICENSE IF ISSUED.
NOTE: If the applicant has not held a license in the year prior to this application, he must file a duplicate of
the application with the registrar. (See Sec. 59)
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