HomeMy WebLinkAboutUnderground Tank Removal - Oil Tank Removal - 15 FURBER AVENUE 11/27/2019 '
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|ostaK&UoU | Mniote00000 | Removal
November 27, 2D10
Fire Prevention
North Andover Fire Department '
705Chiokeriny Road �
�
North Andover, MA01845
Re: UndenynzundTmnkRemnove[—
IS Furhwr Avenue, North Andover, K0A
�
Dear Fire Prevention: |
�
On November 19, 2019 CommTank removed an underground storage tank (UST)at the above �
referenced address. Please note that the tank was discovered hobea 2.0OO gallon tank, and not �
a1.00O gallon tank am originally indicated. Enclosed im the removal permit, the tank disposal |
receipt and the hank closure report following the nynnove|of the UST at the above-referenced |
add/mos.
Should you require any further information on this please contact us at 617-628-8260.
Sincerely,
'
�
Margie Leven
�
Administrative Assistant
--�o
Make application to local fire department. C n f r ]r
Fire department retains original application and Issues duplicate as permit..
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goa90M�a1&�w C�ri>vuicea @ e 6 ri QAr, �ia�
APPLICATION and PERMIT
for steel underground storage tank removal and transportation to approved tank disposal ya rd in accordance
wish the provisions of M.G.L. Chapter 148, Section 38A,527 CMR 9.00, application Is hereby made by.
Tank Owner Name(please print) r X
Address Finr'7QC:�Ci.lCr SlpnaWro(llepptyl�pforpormlr}
51roq Clry
State lay
7Address
� x
Company Name 4rY1 n _ P�� -L4n C ia€
Addresa_\j(�,� , _("�tRPY�
Print
Signature (If applying for permit) Signature(If applying for permit)
icy IFCI"Certified Other oA IFCI'Certlfled E*LSP# Other
Tank Locaflon
• recta 1( -
Y
Tank Capacity(gallons) n 5 Substance Last Stored
Tank Dimensions(diameter x length) ,� r
Remarks:
Flrm Trwnsporting Waste 0,0`a en m 'fa n K ' ?' State Lie.tf_ ._r l a c?o
Hazardous Waste Manliest# O 912-51 C r!v I-.P.A.# MAPD00 5 0 R 7 (p
Approved Tank Disposal Yard / O 5
/9f o Tank Yard# Q/ � _
Type of Inert Gas CEO Tank Yard Address
City ar Tawn FDID# Permit#
Date of Issue -7 Date of Expiration
Dig Safe approval number. 4 7 Trenching Permit#__. 0(J-
0l SWo Tdl Free Tel,Number-00o.3y j ----
Signature/Title of Officer granting perrnit
Alter removal(s) (`consumptive use'fuel oil tanks exampled)s nd Form FP290 or Form FP-29OR signed by the local fire department to
MassDEP,Bureau of Waste Prevention UST Program, PO Box 120.0166,Boston,MA 021 1 2-01 55.
'Intemational Fire Code Institute
FP-292(revised 3110)
RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK
FORMERLY CONTAINING FLAMMABLE LIQUIDS
NAME AND ADDRESS OF APPROVED TANK YARD: �.LC _-
coQ
Approved Tank Yard Number:
Tank Yard Ledger plumber 1,527 LIAR 1.00:66.21.7.8.2):
I certify under penalty of law that I have personally examined the u erground s(e�s rage tank delivered
to this"approved tank yard"by(firm,corporation or partnership)
and accepted same in conformance with 527 CMR 1.00.66.21.7.7 Provisions forApproving Underground
Steel Storage Tank Dismantling Yards.A valid permit was 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:
SEgna re: Title: ��SE _ Date signed:
TANK DATA: TANK REMOVED FROM:
Gallons: No.and Street: � s
Previous contents: - r21 y — City and Town:
Diameter: ...L.1 1 Fire Dept. Permit
Length: Notes:
Date Received: �
Serial#(i€available):
Tank I.D.#(Form FP-200):
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 must be returned to the head of the local fire department.
Form FP-291(Rev.5.1.2017)
COIY MTANK,FINc 84 N>cw SAI M S�k�]C r WAKCCIEI I1 MA
. T AN: IC CLOSUitk REXORT
PM: 3 , t Z CREW: DATE: �/ r
JOB NAME: r- pA,q jitriio,,t,CUSTOMER PHONE#
SITE ADDRESS:
CITY: -ti , d o & STATE: ZIP CODE:
Within 24 hours after the removal of a UST the oivner/operator shall measure for the presence of a release of ail or hazurrlujis materials to the
envirotunent Inhere contamination is most likely to be resent on the site.
HOMEOWNERMUSINESS OWNER QUESTIONS
T
YPE oI�sr 1
FAMILY RESIDENCE MULTI-FAMILY RESIDENCE BUSINESS -TYPE
❑ UST AGE: YEARS OLD YEAR INSTALLED
®'/UST SIZE ;2 0oC) _GALLONS
®1-1U51' tUC4r E Xk'I±_{�CIRCLE ONE)
Q2 FUEL OILS GASOLINE OTHER
❑ IS THE TANK IN USE?(ClRCL1-:ONQ
YES NO HY?
❑ HAVEE BEEN ANY ERRATIC CHANGES IN YOUR USAGE OR BILL?
NO ) YES.EXPLAIN
❑ LAST FILL DATE _AMOUNT OF LAST FILL GALLONS
❑ HAS YM5ANK EVER BEEN RELINED?
NO YES WHY?
❑ HAVE THERE BEEN ANY SPILLS IN THE PAST?
o DATE DESCRIBE
❑ IS THP OT14ER FLAMMABLE OR HAZARDOUS MATERIALS STORED ON-SITU?
NO
O ES LIST:
❑ NOTES:
EACH BOX MUST BE CHECKED BEFORE REMOVAL OF THE UST
[ ,—TANK PERMIT FORM#FP-292
CYDIGSAFE #j (j/ 9 i -qp !z,?mn DATE OBTAINED DIGSAFE9 1-800-322-4844
❑ TANK INFORMATION : FIBERGLASS STEEL IVY
CYLINDRICAL TANK
Formula For a CYLINDRICAL TANK
=D� 2 x 2 x 3.1464 L
231 gallons
L D» Inches L» inches
a UST SIZE 9 ()0 GALLONS
o [ GALLONS OF OIL EMPTIED FROM TANK
o GALLONS OF WATER EMPTIED
o INCHES OF OIL IN TANK INCHES OF WA'I'Lli
- I -
❑ IS THEY STRESSED VEGETATION OR DISCOLORED PLANTS IN THE AREA?
o Ga%
/IS
o YES DESCRIBE:
THERE ANY BROKEN OR PATCHED PAVEMENT AROUND OR NEAR THE(CIRCLE IF YES)
'TANK FILL PIPES PUMPING ISLANDS OTHER
�IS THERE ANY STAINING ON/AROUND/ABOVE THE(CIRLCE IF YES)
/TANK FILUVENT PIPES LINE AREA OTHER
0 FILL MATERIAL- GRAVEL NATIVE F[LL OTHER
❑ DEPTH TO TOP OF TANK- FEET
EACH BOX MUST BE CHECKED DURING THE REMOVAL OF THE UST
❑/FD PERSONNEL ON-SITE :NAME TITLE
� ON THE TANK IS'THERE ANY VISIBLE SIGNS OF:
0 HOLES/BREAKAGE DESCRIBE
o RUST/CORROSION DESCRIBE
0 STAINS DESCRIBE -
0 OTHER DESCRIBE
i1 1N THE EXCAVATION IS THERE ANY VISIBLE SIGNS OF:
0 SOIL STAINING DESCRIBE
0 OTHER DESCRIBE
(GROUNDWATER EVALUATION:
IS THERE GROUNDWATER IN THE EXCAVATION?
NO YES
IF YES IS THERE:
[ FREE PRODUCT DESCRIBE
SHEEN DESCRIBE
TABULATE
DATE TIME SAMPLE ID SAMPLE DEPTH PID YID 13AC ppM)OUND SAMPLER NO ES
(M/DD/YY) (0:00 AM/PM) I EE'I) (PPM)
SIDEWALL 1 rj 0,0
SIDEWALL 2 �4 CO
Z; t� SLDEWALL 3 G
SIDEWALL 4 S Q,O
Z, PIT BOTTOM Q• c C C�
PIPING AREA
NOTES:
❑ ARE THERE PETROLEUM ODORS IN:
o NEARBY STORM SEWERS- PID READING ppm
o DRAINAGE DITCHES-PID READING___o ,pprn
0 BASEMENTS-PID READING pm
0 WETLANDS-PID READING 17pf
❑ HAS THE TANK BEEN CLEANED?
0 OUTSIDE
a INSID
2 -
Gth !benzene 80 500 0.7 4
X tenes total 500 500 6 6
Total Petroleum Hydrocarbons('1'Yk!) 200 2000 0.2 1
Samnlin-a Loctioll� <ri
1�'iil Pipe
fl ��
vj rF.
Cs
if �r`�I 11 L•_:.l�J�'� _�5_'�_�cf'L_.r.. t.�1T.�.r_ .-.SLF- � 1..�
l;
rr
S.11llllli'ever)' 20 I"2A
•tip '�e ��t•
SIDEWALLS u
�1
PIT BOTTOM
'I Ids figure depicis Ills l4te mid II1111$l),3r1 0l U Ixli'+I ICII III UST IQUk:1Itd JWU Hlial ON POSOW IM IIRYII}s.
RP-5iciucll SO Cont 011lilltltloll
` G�solille!�il.nrs
I
p i
J4tf lr',i rt- is 4 s Y71}7 S t
4j1`�Y1 tir Y ' Y{ 1fj1°t 1t,f 't �Y �tyt.
���f'Il�,thl��tS�Lj��Sy�'oi�t'�'91'r<114i�3illt(��i tt��,jr(r t i l t 1Lr6y
Frr:,-- floot ing IYaluct
GrouWmnter Flow
- 5 -
❑ BACKFILL MATERIAL- GRAVEL LOAM SAND WILLPAC OTHER
❑ EXCAVATION (CIRCLE ALL THAT APPLY
0 LINED WITH POLY
0 COVERED WITH POLY
0 FENCED IN WITH: SNOW FENCING CHAIN LINK FENCING CAUTION TAPE
❑ ##OF PHOTOGRAPHS TAKEN; PIPING LANK EXCAVATION
❑ ##OF DRUMS LEFT ON SITE: CONTENTS:
❑ LOCATION OF DRUMS: (DRUMS CAN NOT BE LEFT ON GRASSY AREAS)
❑ #OF TOTES OR FRAC TANKS; CONTENTS:
❑ NOTES:
SITE SKETCH:
Npli"I'it
Q
PLEASE INDICATE: L The location of the UST
2.The UST piping
3.Field screening points&laboratory sample collection
4.General observations
NOTES:
ATTACHCU DOCUMENTATION
❑ WITHIN 72 HOURS OF CLOSING THE UST,PILOVIDE RECEIPT"I'O THE LOCAL FIRE DEPAR:fMENT'FOR DELIVERY OF UST'ro THE
DISPOSAL SIT'r DESIGNATED ON PERMIT
Ll WITHIN 30 DAYS OF REMOVING THE UST,SEND NO'l'ICE'I'O DPS"I'O CHANGE REGin'RA'1'ION INFORMATION FOR THE UST.FP-
290R
0 BILLS OF LADING(BOL)OR HAZARDOUS IYASTE MANIFESTS USED TO TRANSPORT CONTAMINATED MEDIA OFF-SITE,A
COPY MUS'r BE ATTACHED.
0 COPY OF FORM FP 292(PERMIT FOR REMOVING UST AND FOR TRANSPORTATION TO'rANK YARD)
❑ COPY OF FORM 291 (RECEIPT OF THE UST A'I'DISPOSAL FACILITY,INCLUDING ST'AT'E LICENSE NUMBER OF FACILITY).
-3 -
0 Within 24 hours after the removal of the UST,measure for the presence of contamination at locations where it is
most likely to be present,as required by 527 CMR 9.07(K)(4). Steps 13 through IS describe DEP and DPS
recommendations for fulfilling this requirement.
TABLE 1:Summa of Follow u Procedures to Heads ace Screenin
RESULT ACTION
Readings> 100 ppmv I. Notify the DEP within 72 hours
the r--1 1z"r)1-T
Reading Obtain arnininiusnof one sample for lab wiaiysis
Readings<or=to ambient air Gasoline only Assume"clean"
Fuel oil Only I composite sample for lab
Other contaminates I composite sankple for kno%yrdsuspceted contaminates
>Greater than
<Less than
'fable 11: Anktl}'lhntl NWILAS fur Khikurn Vriod uds
citisol;rlc and vocs 8020,8240,S260,or Dr PATH
Products mcdlo&
Fuel Oils(No.2,4,5%,6) Vocs 6020,8240,8260,or DEP-NOPH
Diesel,Lubricotaig Oils and Atnikir 111calod.,
uwciulll prolmns 8270,oi'DEP-014
PAN nledlo&
GCIFI D or 418.1
TPH
U41ltI)o%yll peivolcura Product vocs 6240,8260,or DEP-NIPH
mcdio&
PAH 8166,S270,or DEP-EPH
nicthod'
1 7PI-I
GCYFID
The DEF his designed two methods for&-icniiiniog die %mccnUntions orlp%trolcu'll hydiuk-jitxm in
%%nicrmidsoil nPirmich lo maltmic lit,[tin',IV011 lum"ilsil"d
jilay rtt3ult from c-xpo5urc to such cQmpouads, The hiciliod for die Detcrallulalioll of Exviemblc Ilctrokunl
Hydpjcjjboris (111`14) collectively 1)1a)iuj)ci die concentrUtbFIS of CX1P-1C13bL- UliPlItItiC 41%CI aronln"C
hydrtxnrlNln;, uml individual collocnaitiosis of PAHS. The NICIttOct for the D'-wrillirutioll Of Vubtile
11cuolcuni Hydrccalbolls 11rasti-5 culleetiie wneella,,1[jotir of vollij- al;plintic and uwaintic
III: SUHHUAl'y WWI'1t4!Pj;rjkjj;ie CufflU110111 MAI 11CLIU11TILIVILIS for
NuMeadmitt,IMP
Contuflon
0%LEL 2 hour
Rcle,�o?gjcajcr ditin 10 gallona'in 24 hours 2 ILIDUM
Heads piacc-pircri�-rdian MppnlY 72 h:-tirs
72 blUrS
NAPL at goratcr than ortqLMI to 112"
Concel?IM!ions Prkmitcrti-on RCs in Lrcuachv.vwwidi;n 40)fi orpubli:%ilticr-uil][y or K-) 72 halos
ft of prmm-mittrsupply d SLI&LC=>-5 njol--,vidiin 30 1`1 of 72 h:)urs
VOCs in grcu1K1%%,k1erQt IS fk IV lGXYj2'rYU n
scljoojJ4�ccupied icsidcotiol viucrure
N
Q0%
(7011CCninlions in$oil Amicrtlun Rcv,
Notificntion to DEP may not be 1-"7L1;1Cd if Limil"I Removal Action Call be inLen.
Table IV: MCP RCDortable Concentrations for Selected Petroleum Constituents
ANALYTE SOIL WATER
(rug/kg) in /L
RCS-1 RCS-2 RCCW-1 RCGW-2
Benzene 10 100 0.005 2
roluene 30 300 1 4