HomeMy WebLinkAboutApplication for Permit to Maintain an Existing/New Underground Storage Facility - Permits - 1 MASSACHUSETTS AVENUE 6/21/1989 FIRE bEPT• STATE USE ONLY CCRTIFICATloa
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SUbRT:ll.t:. 4..('y I
j LOCA1 FIRE DEPARTMENT t)ateFleceived
Notification is required by Federal law for all underground tanks that bare been 4. pipeline lacifirics (including gathering line~) regldaled under the Nal rai Gan
used to store regulated substances since.lanuary°1,1974,that are in the ground as of Pipeline Salo% Act of 196K or the liavard0ol Liquid Pipeline Sales.Act af 1971),ui
May,8,1986,or trial are brougfrt into use after May 8,1986.The information requested rk hich il all intnr%taue f iliclinc faclil.v leguLrted under State lim s:
is required by Section 9002 of the Resource Conservation and Recovery Act,(R(RA), S,stolace impourrdmeim.pill,ponds.or lagoons:
as amended. 6,storm hater or\\astc staler collection st%iems:
`I he primary'purpose of this notification program is to locale and esaluate anrder- 7.flote-through pI Itanks:
ground tanks that store or hair stored petroleum or ha/ardous substances. It is S.liquid III orrssociatedgatlwringfinerdirectlyreltucdtoaderagaasprcxhic(iunand ,
expected that tiro information you provide will be based our reasonable mailable gatheringoperationr:
recor(s.or.in the absence of such records.your kno"ledge,belief,or recollection. 9, Storrkl tzurks situated in an underground area (such as it basement. cellar.
roillmorkrirg;drift.shaft.or tunnel)il`the slorale tank is situated upon or above(he
Who Must Notify? Section 9002 of RCRA, as arnended, requires that, unless surface of the lloor.
exemd"igpted.
ated State orfun deagcrrci d tanks that%rule regulated subsNurccs must notify
1 g
s of Cite existence of their tanks Ovrner rrncalrs '0'ihalSSubstaunces Are Covered? Fire noolication icquirernems apply to� under-
(it) in the case. of ale underground stclagl tank in rise oil Nowniber 8, 1984,ter g g irks that coolant rlZnlated rribsla beer.�I hIs Includes anA'substance
brought into use after that date..an\"pelwn\M1)to mll an tmderground storage Lank (e'tlirC<I a% bat/ard OLIS in Se"ctitnl 101 (14) of Ilic Connprehemkc t o\irernnemal
used for the storage,use,or dispensing of regulated substances,and Response.Comperrsalion and Liabihti Act of 1980WERCLA).vtith theexception of
(b) in the case of any'UIRIC11,1,17e0nd storage tank in use:before Nme nber 8, 1984, those subrtitnccs regulated as ha/ardour vtaste under Sulrlitle('of RCRA. It ako
1 tat no longer in use on that date.any person Mro ovrned such Nlnk irmncdiately before includes petrolcunn e.g..crude oil or am I' Much thereof is liquid at Standard
I le di%C(1mirritation of its use, conditions of lennpcialrue and pressure tfdJ degrees Fahrenheit air(] 14.7 pounds per
What Tanks Are Included? L)ndeigiound storage tank is defined as airy one or square inch absolute).
combination of tanks trial(1)is used to contain an accumulation of"regulated sub- Where To Notify? Completed notification (orris should be sent to the address
st races."vend(2)%those rolunrc(including,connected underground pipuug)is 101`i or giwir it(the earn or this page.
more boreath theground.Sorne examples are underground tanks storing 1.gasoline,
used oil,or diesel fuel.and 2.industrial sokents,pesticides,herbicides or luniigarus. Ill To Notify? 1.0tuners of undergrotord storage tanks in rise or that lime been
taken out elf orelation after Jammu% I, 1974.but still ire tyreinrojord.must ncl by
What"Bunks Are f^.xctudecl? 'finks reamed from the ground are not subject to May 8,1986.2,Oyk net%voho bring underground storage tanks into use after fill 9.
notification.Other tanks excluded from notification are: 1986,trust nisi(¢within 30 days of bringing the tanks into rise,
1 fit rmorresideruiarltatiksol'I.100g,ariloncorlcsscaipacnyusedforstoringinotorluel
for noncormnerciai purposes: Penalties: Any owner ill knowingly fails to notify or submits false information
2.tanksusedforstoringtreatingoilforconsumpmerisearnthepreiniseswherestcl shall be subject to a civil penally not to exceed $10,000 for each tank for which
3.septic tanks: notification is not given or for which false information is submitted.
0EVEMEN
Please type or print in Ink all iteins except"signature"in Section V.This form must by Completed for Indicate number of
each location Contouring tmderground'storage tanks If snore than 5 tanks are owned at this location. � continuation sheets
photocopy the reverse skit.,and staple continuation sheets to this form. attache((
o a 0 m a
Owner Narne(Corporation,Individual,Public Agency,or Other Entity)
(If same as Section 1,mark box here )
PATOB REALTY TRUST Facility Narne or Company site Identifier,as applicable
Street Address
1-3 MASS. AVENUE MERRIMACK VALLEY OIL CO.
street Address or State Road,as applicable
ESSEX 1-3 MASS. AVENUE
City State ZIP Cade county
NORTH ANDOVER MA 01845 ESSEX
Area Code Phone Number City(nearest) state ZIP Code
NORTH ANDOVER MA 01845
Type of Owner (Mark all flint apply[ }
El Private or Indicate Mark box here if tank s
Current State or Local Gov't Corporate ( )
p number,of are located on land within �y
El
Farmer Federal Gov't Ownership tanks at this 6 an Indian reservation or ti J
(GSA facility Y.D.no. uncertain location on other Indian trust lands
Name(if same as Section I,mark box here } Job I itle Area Code Phone Number
WILLIAM D. O'BRIEN 508-683-3131
a
1 ,mt Mark box here only if this is an amended or subsequent notification for this location.
I certify under penalty of lave that I have personally examined and am familiar With the information submitted in this and all attached
documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the
submitted information is true,accurate,and complete.
.Name and official title of owner or owner's authorized representative _I -
forrnnal p Date signed
WILLIAM D. O'BRIEN �, I C F.P. 290 Part 2 Pagel
.rrz>:r Maui,-(IroIII Section I)- Location(Isom Section II) _� _—_- -__— _ Page No. _ aI I�Uges
IdoWific:ation No.(c>.g.,AUC;-M),or `tal+k Na. Tank No. T arlk No. Tank No. Tank No.
i
;i..:bkrrnrily r s3it rse:d Sec{uetttlat Number(e.g.,1,2,3...) 6
{ i 15latcas of Tank Currently in Use
{Melk all 111al apply tg7) fern ac�r rril Out of Use
f Y
f'ermrano illy Out ofUsf>
B
0r0ugI II into use,aIfor 5/8/86
--
Estimated Aga Years)
i ;,I,Estimated Total Capacity(Gallons)
f�"a4er#al of d canstacrction Steet
Concrete
f Fiberglass Hointorce;d Plastic
f Unknown
F
Other,!'tease Specify -- - - - _- - ----- ---- - - -- -.... ------
Internal Protraction �
? ff ath.rill 1WI apply DO) Cathodic;Protection
hiterior Lining(e_( .,opoxy resins) [_W 1 F 771
None
Unknown C- T] �� C� F-1 C
i
Ott)er.P erase Specify -
---_- ...........__
r:.. 1w;�terraral f'rotec;tioll
Cathodic Protection C ] [—� C � �] I- -A
tM arh all that apply M) ,
i ainted(e g.,asphaltic)
1=iherrtias s Reiraforcr-d Ptra;tic Coated
None
Unknown
Other,Re<.ase Specify
t iping Wire Steel FX�
{Perk all thief apply LX3} Galvanized Steel _
Fiberglass Roinforceci€'Iastic
t Cathodically Protectoci
I
Unknown
Other,Pletase specify
t ,�ubs€arace:Currently or Last Stored ca. Em f — -- __.-- --
fn€_:rcatc:,f G]uErn€lty by�eltsrtas? p y �-._---� C--� �� L .--1 [---._._�
b. VPtr(flcalaM
"Mark all that apply0) Diesel
Kerosene
C�asoline(including��aicphol bteruis
usvrl oil
Othor, I'lotrse Sl�c`c:ily
_• <:. hfaz.rrrtfnrs Stahl€anr;e• [ _-] L ---��]
f
Ir,rse Inds c:;ato Noma of I'I'rwipM GF IICLA Srihstant;e -
OR
Chnnic,rl rlhslrcica:service (CA >) No.
� Mark box!hit lank stores rt n)ixh.rro of substances
d. UnknoL^ett
Additional Intornaation(tear tanks permanently
taken out of S('rvice)
a. FstiimWt d crate last used (rno/yr) —---
ta. E.S11H1,itt:d[tuantiiy Of St}lasttarace rt,mi4ining (qaL)
c. 10.ar k i;ox(A if lank was hiled with inei t matorial
(e o., sand,concrele) C--_�
oil! Tntmintuirat'a"I .1 Tf
P E`1 R M I T Jut ie 21 1
w
TO MAINTAIN AN EX ST'�[NC/NEW UNDERGROUND STORAGE FACILITY
In accordance with the provisions of 527CMR9.24 this permit to maintain an
existing/new underground storage gt facility is granted ed to:
1. t „ y .. .a. .�:._._.�.. nue Lc]�,at;irr «r� �r"(r'�rt; _...,.-��� 3 ���a��a, ��rr _.�.„_�.....__...w.......�..�..�.w�� �c�.)�.__... .. .�,�..��.��..w.....w..�
st;rec�C rucicfress
Owner of propert.y:._.. .Sac;C�1w�.. r�� ���..k. ..._....._ ._.. ......_mm
F"K:i�i n<ai�a of person, firm or corporation
Restrictions:--,-., irinst be_wrenewed
Fee Paid:.$ 10 . 00 (M.G.L.ft. Chapt;a. 148 Sec. 10A)
Forvi
r��rt R � TE't'i`S permit will 4.x.7ir�c ['r��t�; � � � li�p4.. ear �ptxtruatrutrtt �it ,i
Si,n�aturt, c�6 iier tl of !is e^ &' �� F
l (Owner' s Copy to be posted at the storage facility with F.Pd290 Partin 3)V 11y, of ffla
r
gli �Add X. � . a
w „ D(��rar�t�l��rent; o Ptiblicw Sa,fet ....__-_Divisim). o J:il .ro : r:ev� c �itiofl
i f r j <. 1010 Cold MC)NWI�ALTI.I AVI',., 13C)S'I`C1N
.'myr g Sri' N
...�.o�..�W.Ar7c3.c�avar................�t'StT
(My or Town) (raAO
T y ' ' ..lairs, irr nuTor„dance �.����rdal�r the
This r;; to certify t,h<rt.,....... :'�.�r;4.�<C�l�...}fat,'�.1.t.�...'.i'.1:1,1.C,9a..........,.W..,.,.
preaVions of Chapter 148, Wetbn 13, of the (:"xc funal barn, hied rvRh ine a c er•tiiic<rtc of re istratieari set-
ting fort tli4:rtl���',�a � .c:al:a.. tr�.<�a..�M�. °I".a�::�i.,:a:t�. .........................................—i's the holdeb° of t.}ace licaeme j"Yarited
�Jt.z�l ,.f r ................ �.,,...`rt:3j;G ... for the l,'rwAd use of they IarriWin (s) or other~ strirc,ture(s)
�Jq Ave . ,
" . i .1,."'" J I4r,4,�p7 W
�trttr�rtcc:t car t.ra lair srt,r.r.r#;cScl :xk.................. ......... ....„..., ........ .,. ..,.,..,,,,......,,..,,,. . .,.........,...........,....,.,.,..,..�,..,,,
(ftitree! and iV�:Gn�wrra°r�)
a., rr, atcd to the 11,E 11`tt:�; STORAGE, t1�A�t`�li11��"e1C'fi.ff OR. SALE', O r l� � �� is�" f t�)3 Pt OSI`�ES
. , ,, ,ram
110, 000 uncle;�t�roi.rnC.i f ue:l. ca:S„t. � � Cat°'.a�� �� ........ .......aa
i w �i
Now A c"liAwe of rer,islradwi umm be (ulyd on t,ru„ fmrore Aixrit 300 or each year,
(1111S Bh:(;rS'C`(`(A"t`1(:1N 1n1tJM, ('ONSi`'[f:tfOC.1SC...' ' 1'O`,s'I'ED M 'ME r'rtr AU,:EV)
t l
r
DEPARTMENT OF PUBLIC
:a
( � North Andover,, MA € i0
C.
W(City❑ 7'aF°ruj, Ir�ss4s)
r LIC4
I � � Y
lr€ nctasrcla€nee with !l€e lrrovisinnx of Citapltr 1 6� of it€r [.irnrrnl ��r4, n litertsLj l7erelrY ft`t€ntecl t use tl€e lsnd
hc;rci€t described for tbn lawful rrse of the buildilrt;.. , ot~ otlrei strite#rtre.... tiehieb is/are or is/are to be aitr€ated tlrerewk,
and as described on tilt: plot pl;€rt filed with the ipplieation for tlii:, license.
Location of hind .....I� 3 ."'ass. Ave. , R!A� jovc z Nearest ero.&.s street .......1.nLer,st ri.e �r�:�... ............ ............
(T31r et �i Rumt,er) 1-3 Masp Ave.
Owner of land .........T� t:a}�, Rejl�.t.y..•:G't;t�,�.k• ...Address .......................I...... ..,..................................... ......
...
Number of buildings or, Other structures to which this license applies U.).........•................................•...........•..............
Occupar€ey or bse of sBucb buildings office & sea'vic.. area; ..•storage............•.......... ,•
I I.Q,QQU f 1:I. ot1s
ToUd capacity Of tar7k5 in gallons:�AbG�eryrnund. ......••............................... 1iT dergrot�tad
li•s€sal of fluid to be Stored in tttirks fuel oil
Ftc'.tr•ictions— If [illy: ...................................•.................................................................................•.•.. ,....•.,..,.•....�„1,....,
E...•...•.....•.•...•l.•........•................................
"' ❑ature of flcvnslug AIIWQVIIp)
�It i�� _ic: w�a; —6 pmQT-9s ATQ n) ce�F�Y r;1,f .�mr-upt" mum L)_uy
p0,;€r_D IN A_PROTECTED P AC.C. ON THE LAN13 FOR WHICH Cr If's�GRANTF-D