HomeMy WebLinkAboutUnderground Storage tank removal application CommOTank, WI Now E3aleiti St Pir,0_/]'h8E3,26157 Emnii:tE�(uti:c:ornutUmk.t:um
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Installation I Maintenance I Rentoval
May 20, 2021
North Andover Fire Department
Fire Prevention
795 Chickering Road
North Andover, MA 01845
Re: Underground Tank Removal—
79 Chickering Road, North Andover, MA
[dear Fire Prevention:
On March 8, 2021, CommTank removed one (1) underground storage tank (UST)at the above
referenced address. Enclosed is the tank closure report and disposal receipt following the
removal of the UST at the above-referenced address.
Should you require any further information on this please contact us at 617-628-8260.
Sincerely,
Mary Breda
Project Coordinator
;.S COMNITANI
• SALC
Pm: SUiltc, t�ro�tr;.
CREW:
DATE:
JOB NAME:
CUSTOMER PHONE It
SITE ADDRESS:
CITY: �1y
STATE:Within 24 hours u ZIP CODE:after the rernuvrrl of rr UST the owner/operator shall rrleasnre fur the presence of a release of oil or hazardous environment where contarrtirratiol, is u,uS1like! to be resent on the site nrrrterials to the
HOMEOWNER/BUSINESS OWNER QUESTIONS
❑ TYPE OFSITE (C(RCLE ONE)
SINGLE FAMILY RESIDENCE (MULTI-FAMILY RESIDENCE BUSfNESS - I'YPE
ElUST ACE: ----•- YEARS OLD
y YEAR I•4STn LED
❑ US I Si[E � }��_GALLONS
I+� UST FUEL TYPE CIRCLE ONE)
#2 FUEL OIL GASOLINE OTRER
❑ IS THE TANK IN USG? (CIRCLE ON
YES I O WI[Y? — c�-C CeV
❑ HAVE THERE SEEN ANY ERRA NC ES IN YOUR USACL' OR [SILL?
NO YES EXPLAIN
❑ LAST FILL DATE ANIOUNT OF LAST FILL
❑ RAS YOUR TANK EVER BEEN RELINED? GALLONS
NO YES WFIY?
❑ HAVE THERE BEEN ANY SPILLS IN THE PAST?
o DATE DESCRIBE
❑ IS THERE ANY OTHER FLAMMABLE OR HAZARDOUS [MATERIALS STORED ON-SITE?
0 NO
0 YES LIST:
❑ NOTES:
EACH BOX MUST BE CHECK>ED BEFORE REMOVAL OF THE UST
El PERMIT FoRIvI # FP-292 /
❑ DIGSAFE # �Q 2 ,��/ DATE OBTA[NED� �s(� �i DIGSAPE# 1-800-322-4844
❑ TANK INFORMATION : FIBERGLASS STEEL
1 CYLINDRICAL TANK
Formula for a CYLINDRICAL TANK
1 Q 2 x 2 x 3.4464 L t
S r
231 gallons
�— L
D= inches L= inches D �
0 UST SIZE GALLONS
GALLONS OF OIL EMPTIED FROM TANK
o GALLONS OF WATER EMPTIED
o INCHES OF 0[L IN TANK_���INC[IES Ol'Wti I'Glt
❑ IS THERE ANY STRESSED VEGETATION OR DISCOLORED PLANTS IN THE AREA?
o NO
o YES DESCRIBE:
❑ IS THERE ANY BROKEN OR PA'CCEIED PAVEMENT AROUND OR NEAR THE(C(RCLE IF YES)
TANK FILL PIPES PUMPING ISLANDS OTHER
❑ IS THERE ANY STAINING ON/AROUND/ABOVE THE(CIRLCE IF YES)
TANK FILL/VENT PIPES LINE AREA OTHER
❑ FILL MATERIAL - GRAVEL NATIVE FILL OTHER
❑ DEPTH TO TOP OF TANK- FEET
EACH BOX MUST BE CHECKED DURING THE RE,MOVAL OF THE UST
D PERSONNEL ON-SITE : NAME _TITLE
❑ ON iuF"TANK IS THERE ANY VISIBLE SIGs S OF:
HOLES/BREAKAGE DESCRIBE
RUST/(JORROSION DESCRIBE
0 STAINS DESCRIBE
0) OTHER DESCRIBE
❑ IN THE EXCAVATION IS THERE ANY VISIBLE SIGNS OF:
0 SOIL STAINING DESCRIBE
o OTHER DESCRIBE
G ROUND WATER EVALUATION:
IS THERE GROUNDWATER IN THE EXCAVATION?
NO YES
IF YES IS THERE:
FREE PRODUCT DESCRIBE
SHEEN DESCRIBE
I
� TAfiULA'1'E
j DATE i'tmE SAMPLE [D SAMPLE oEtTti P[D PID BACKGROUND SANIPLER S
€ (M1DDIYY) (0;00 MvtfflM) FEE'€'} (PYM) (pPtvt) ((NI'C€ALS)
SIDEWALL 1 2 b,joLr-- /
SIDEWALL 2 �C), P c
a:
j v ��^ M SIDEWALL 3 0 k
r o y SID1aWALL 4 '
d r PIT BOTTOM d-
4 K PIPING AREA ° c�
NOTES:
❑�ARE'I'HERE PETROLEUM ODORS IN:
O NEARBY STORM SEWERS--PID READING ppm
O DRAINAGE DITCHES - PiD READING Plan
0 BASEMENTS- PID READING_ !!f2 ppm
o WETLANDS - PID READING / ppm
0/1""I'IAS THE TANK BEEN CLEANED?
0 OUT ,[Dr-
0 NStDE
- 2 -
r
aACKFILL MATERIAL- GRAVEL LOAM SAND 1 WILLPACK ; OTHER
❑ EXCAVATION (CIRCLE ALL THAT APPLY) t
0 LINED WITF[ POLY
0 COVERED WITH POLY
0 FENCED IN WITH: SNOW FENCING CHAIN LINK FENCING
�#01-PHOTOGRAPHS TAKEN: `— CAUTION TAPE
PIPING TANK EXCAVATION
C� # OF DRUMS LEFT ON SITE: _—CONTENTS:
54-�, LOCATION OF DRUMS: c�
(DRUrIvIS CAN NO-F BE LEFTON GRASSY AREAS)
0 # OF TOTES OR rRAC TANKS: CONTENT'S: Q (� 0, ft, '
❑ NOTES:
SITE SKETCH:
NORTH
(� 1
PLEASE INDICATE: 1.The location or the UST
2. The UST piping
3. Field screening points& laboratory sarnpic collection
NaI�cS: 4-General observations
I
i
ATTACNCD DOCUMENTATION
❑ wrrum 72 HOURS OI CLOSING TUE UST,PROVIDE RECEIPT TO THE LOCAL FIRE DEPARTMENT FOR DELIVEILY OF UST TO THE
DISPOSAL SITE DESIGNATED ON PERMIT
❑ WITHIN 30 DAYS OF REyIOVtNG*mr- UST,SEND NOTICE TO DPS TO CHANGE REGISTRATION INFORMATION FOR THE UST, f P-
290R
❑ BILLS OF LADING(BOL)Olt IIAZ..kItUOUS 1VASTE i'VIANIFUL'S USED"rO'rRANSPOItT CONTANIIYATED,MEDIA OFF-SITE,A
COPY iIUS'r BE ATTACUED.
❑ COPY OF FORM FP 292(PEIUMIT FOIL REMOVING UST AND FOR TRANSPORTATION TO TANK YARD)
❑ COPY Or FORM 291 (RECEIPT OF THE UST AT DISPOSAL FACILITY, INCLUDING STATE LICENSE NUMBER OF FACILITY).
- 3 -
❑ Within 24 hours after the removal of the UST, file'as for the presence of contatilination at locations fvttere it is
"lost likely to be present, as required by 527 CMR 9.07(K)(4). Steps B through IS describe DEP and DPS
recommendations for fulfilling this requirement.
is ;�`�?.�:�a;{fr :i,�r: 1;:::?It', 1;l:;ti,isril,:>•:`-r>•i:TiC�4:'1i�:'r`1'•" .i:�
w'ra4 ° '.c-r iT.,f�l• !]rt SjA2r� •.l�r. .�•I�t•,.,+•:��i •al'1�tli'.y'i- +'•,r'•�£" �.rr. -L�.1•v„>: rcr
.ra,'. ::t:n^;'-1.�(„ :.y., ..f.�e'?.g�: :�I a:i•' ,.p,. .:;:ml:..-5. -
%`�;.•.11 !.. .5.: �TAB t >4..,�5 rr.. C;:•, .l-
f Fo(Eow�u`vProcedures to,Heads•'ace.� •., --� ^''`�w"`�''-•"Screenin
RESULT ACTION
Readings > too ppmV !. Notify the DE P within 72 hours
2. Noti!y die local Fire Dc t.
Reading <1.00PPMV, but>ambient air Qbtain a minimutu of one sample for lab analysis
Readings <or =to ambient air Gasoline on1
Y Assmue"clean"
Fucl oil only l eomposiIC sample for tab
Other contanlinales l cvrnpositc sample for kno+vn/suspected conlanlinalts
>Greater than
Lcss than
'L•nble II: Analylicll llcthndsrur Irl•IMILUM Product
Pctrulcual Ihutiuct Saitt€r Watcr�rstrix �
Atlt1'Icc lrtnhiical�reihartr T
GaSo6c and 5imilaril+ci:ht ��ocs S020.S2-10,5360,orDEP-%--Kl
Produ'!m mcdiad,(xl'webelutw
Fuc1 0113(N0.27a.:.G} VOCs S020,6240. ),ur DEP-\•7'H
Dic-rcl,Lubrimtin 0ils;lndsimilar tncdlod,
1'•?GI IL P(vdtA:(S
S100.S270,or DEI'-EPH
PA It mctllod'
GCIVID ar dt S.I
TPH
Unt noxn Pcttul llm Product \"OCs S240•8?60,or[)'Ep-vpjj
medtod'
PAH SI00,8270.or DEP-EPFd
nitd)od'
TPH
GCJE ID
` T'h`DEP Ins dcsi„ncd h+o nlethcds ror.ktcnniaiw,dtc c��nocntmtions of pelrulcunt lFJdrnr€6ans in l+atcrntld�otl to-111 lclonitand support dr-tmicological:tpprcncll to cvaluatchuulnu trald!(uzlnis that
mayrcJ.tltFrvmetposurcto such compounds. The`IclhoJ for dicDctcrniinatiunofErnnccA(IcI'cbukvnI Hydroc-trbons (EPII) collcclnrly mclsurc dlc concentr.AtUns of cstracr_�lbly aliphatic art 1 arumun
Irjdtucuit-NDrts,and 6dividunl cortxnontiotts of PAHs. The Meth d For the Dctcmliarrtion of Vohlile
Pctiolctim HydiuQmbutU rl>casUMS cullceti+c cnnocntnitioas of +olatil: ahp iatic and nrumntic
IrjdrucaA'oas,such as BTE,�(0cnzsnc,Toluene.Eiii),Ittitucttc,Vylcnc).
M. SttmntAry of\tCP Repurtahle Con(litiuna alit(ltect"h-aucctts for
Notification w I)gl,
Clindltion 'linicrraltic
` GreaL-rthnn t 0%LEL
o- Rckasc of l;rcatcr dvin l0 s allow in 31 hours 2 hours
I Heads ncc_rcarrthan 100 nls 2 haun
MAP at,raXerthna ore'u71 to Il'2" 7?72 blurs
hours
Cori entntions crxs€terthan RCs in grcunduatcr+yidlin�C3 EtorpuGli_+later wllyor5CQ 73 hours
ttof rivaL-mjtcrsu l{
OCs in crccutcll+alcrat IS 1l bcluly!round attrkLc->S mtVl.u•idurl3l)ft of o
schoolecccu icd rc.Mcn6al vtueturc 721>_'7t€rs
COIICCntm.t.tom in soil r;rtatcrdnn RCO
l20 c111's
`Notifi�ttion to DEP tnay ttot be Mui rcd ii a Limited Rctiloval Acttim can L-r<lkcn.
I'
Table IV. MCP Re ortable Concentrations for Selected Petroleum( Constituents
ANALYTE SOIL WATER
(nlg/kg} ut /L)
TICS-t Res-2 RCGW-I RCGW-2
Benzene 10 too 2
Toluene 30 300 ( q
_ 4
Elt> (benzene 80 500
` X lenes{tataf) 0.7 4
500 500 b G
Total Pctrofeum k f drocarbons(TPi-0 200 2000 0.2
i
5a� �t�lir�
Fill E51pe 1f�a'r
f1
'�� ��:��:��,�+���_�li��j:tYsr:��.?;7t:p'lT*'^� •�4 r,���,�f•��1���
'ii ?'`ri ar Si �,-ix3i�'it�,t§.ilt1 `�.i�L 9��•ac.�� '. .5
r J
l vet..2(j tcc;t
S1DEWALLSs
,..
ICU PIT BOTTOM
Yhk Eivure depicls Eha Il:ntd tt�nsporl of a Nulticutu 11Sf lank and E1SklruEi:+1 a-Xlrac tre p:Ultwa}�.
i Crinkino lit ht er t�1+�l1 e
Rl Soil Cont ominat ion
Gasollnel,l {
i
i
�L-7���i.3,/!yk '�F'-i11�hN•:sir 4�a`�ri"�k5..
loll
2u` ; +��•:>�{Fi4i
c..,v tle;%•iii alp n5iui�, FF:+
Fr e,•f l0D t il1g RQd uct
GF011tl:A'1t8f FIO';v
- s -
311112021
The Commonwealth of Massachusetts
North Andover Fire Department A
755 Ctilckudnej Road
Nu Rh Anduvur,MA 01845
Underground Fuel Storage Tank Removal
Permit
Oaie issued:Mash 11,2021 Permit No. 68608
TOir Ix un v•pmaii4 To lua=n rnw ,u,a�ll vtls eounau of gall 11U7 � �•'•'
This permit is granted to
Mary Breda
GommTank, Inc.
for storage tank removal and transportation to approved tank disposal yard
from the following address
78 CNICKERING ROAD
In accordance with the provisions of M.G.L. Chapter 148, Section 38, 527 CMR 1.00 Section 1,12.8,40,
5
FDID II:
Dig safe Approval It: 2021 0806845
Trenching Permit it:
Expiration Date: William McCarthy, Fire Cnief
i
i
1
i
112
9
�IJe ft a� it eir��`t� raze veii�ucr e6 — &I alaw aega e a-o
RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK
FORMERLY CONTAINING FLAMMABLE LIQUIDS
NAME AND ADDRESS OF APPROVED TANK YARD:
Approved Tank Yard Number:
Tank Yard Ledger Number(527 CMR 1.00:66.21,7,8.2):
I certify under penalty of law that I have personally examined the underground steal storage tank delivered
to this"approved tank yard"by(firm, corporation or partnership) Dry--) Xl TC n �,
and accepted same in conformance with 527 CMR 1.00:66.21.7.7 Provisions forApproving Underground
Steel Storage Tank Dismantling Yards.A valld permlkwas issued by the head of the LOCAL.fire
department FDID#
to transport this tank to this yard.
Name and official title of approved tank yard owner or owners authorized representative:
— (�L Signature ; Title: l � i� Date signed: `t1
TANK DATA,. TANK REMOVED FROM:
Gallons: No. and Street: :. 1,�C`',y�(
Previous contents: City and TownA\,\• },r�= Q '(A_ —u
Diameter: Fire Dept. Permit fR:
Length: Notes:
Date Received:
Serial#(if available):
Tank I.D.V(Form PP-290):
EACH TANK MUST HAVE A RECEIPT OF DISPOSAL
Owner/Operator is responsible for notifying the Department of Environmental Protection:
Department of Environmental Protection
Bureau of Waste Prevention- UST Program
Boston, MA 02112
This signed receipt of disposal mast be returned to the head of the local fire department.
Form FP•291(Rev.6.1.2017)