776 DEP Report 12-19-19 ENVIRONMENTAL MANAGEMENT ASSOCIATES, INC.
P.O. Box 362,Erving,Massachusetts 01344-0362
Voice (413)498-2510 • § • Fax (413)498-2511
December 19,2019
EMA Document No. 19/000155
EMA Project No. 1910-354
MADEP RTN 1-20979 Via US Mail
City of Northampton,Health Department
212 Main Street
Northampton,MA 0. 060
Attention: Ms. Merridith O'Leary,RS
RE: . Notice of Submittal of Release Notification Form
776 North King Street,Northampton,Massachusetts
MADEP Release Tracking Number; 1-20979
Dear Director O'Leary:
This letter has been prepared in accordance with the Massachusetts Contingency Plan,specifically
310 CMR 40.1403 (3)(h). This section requires that the Chief Municipal Officer and the Board of
Health be:notifie&,of the right to request additional Public Involvement Activities pursuant to 310
tCMR 4O�r1:4,03(_9)carid upon Tier Classification pursuant to 310 CMR 40.1403(9).
On:;behalf-of-the-PRP,:(potentially.,responsible party), attached please find a copy of the Release
Notification Form flied with the MADEP under Release Tracking Number 1-20979. If you have
any questions,please do not hesitate to contact this office.
Sincerely,
Environmental Management Associates,Inc.
Dolores M.Branco,L.S.P.,P.G.
President,Senior Project Manager
DMB:db
Enclosure--,Release Notificatioin Form(4 pages)'•
ecc'+,,' .S;andfli.Realt ;
M>ADEP»WRO,//r
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Massachusetts Department of Environmental Protection
BWSC 103
Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number
RETRACTION FORM
20979 10
Pursuant to 310 iCMR 40.0335 and 310 CMR 40.0371(Subpart C)
A.RELEASE OR THREATI OF RELEASE LOCATION:
I.Release Name/Location Aid: SANDRI SUNOCO
2.Street Address: 776 NORTH KING STREET
3.City/Town: NORTHAMPTON 4.ZIP Code: 010600000
5.Coordinates: a.Latitu 1 e:N 42.36239 b.Longitude:W 72.63870
B.THIS FORM IS BEING USED TO: (check one)
r 1.Submit a Release Notificl tion
1— 2.Submit a Revised Release Notification
r 3.Submit a Retraction of a Previously Reported Notification of a release or threat of release including supporting documentation
required pursuant to,310 C1 IR 40.0335(Section C is not required)
(All seen I ons of this transmittal form must be filled out unless otherwise noted above)
C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE I(TOR):
i
1.Date and time of Oral Notificatign,if applicable: 10/30/2019 Time: 11:oo V AM rPM
I mm/dd/yyyy hh:mm
2.Date and time you obtained knowledge of the Release or TOR: 10/30/2019 Time: 10:45 r.AM r PM
mm/dd/yyyy hh:mm
3.Date and time release or TOR occurred,if known: 10/30/2019 Time: 10:40 r AM rpm
mm/dd/yyyy hh:mm
Check all Notification Thresholds Ithat apply to the Release or Threat of Release:
(for more information see 310 CMI�l 40.0310-40.0315)
4.2 HOUR REPORTING CONDITIONS 5.72 HOUR REPORTING CONDITIONS 6.120 DAY REPORTING CONDITIONS
I
jv—.. a.Sudden Release r a.Subsurface Non-Aqueous Phase J a.Release of Hazardous Material(s)to
Liquid(NAPL)Equal to or Greater than Soil or Groundwater Exceeding
1/2 Inch(.04 feet) Reportable Concentration(s)
r' b.Threat of Sudden Release r b.Underground Storage Tank(UST) r b.Release of Oil to Soil Exceeding
Release Reportable Concentration(s)and
Affecting More than 2 Cubic Yards
J c.Oil Sheen on Surface Water (" c.Threat of UST Release j"' c.Release of Oil to Groundwater
Exceeding Reportable Concentration(s)
17 d.Poses Imminent Hazard r, d.Release to Groundwater near Water r d.Subsurface Non-Aqueous Phase
Supply Liquid(NAPL)Equal to or Greater than
1/8 Inch(.01 feet)and Less than 1/2 Inch
(.04 feet)
" e.Could Pose Imminent Hazardr e.Substantial Release Migration
J- f.Release Detected in Private Well
r, g.Release to Storm Drain
r h.Sanitary Sewer Release
(Imminent Hazard Only)
Revised:07/18/2013 Pagel of 3
r
Massachusetts Department of Environmental Protection $WSC 103
Bureau of Waste Site Cleanup
RELEASE NOTIFICATION&NOTIFICATION �Release Tracking Number
RETRACTION FORM E=::1 -,26979
_.. Pursuant to 310 CMR 4Q0335and 310,CIMR 40.0371-.(Subpart C) -, -. _.., _ .•
an f....,r{. ;" -• .-: ,,r.l;',^ .,r.-. <:;-""`i.'^:':• Tii•'. ..:'•,1 P r•ti.,',':'' :. .l 1.:�•_� •s
C.INFORMATION DESCRIBING THE RELEASE'OR TfIREAT OF RELEASE(TOR):(cont:)
,(^.r.; `, 'S)•iInr• '.Q 4 :i.:' ':fT�:'F�rl;:'G ,,.,9�; :.2.4" .. �:?` -;.'I'i al,'u .i
7.,Lisfbelow,the;0ils:(0).or.Hazardous.Materials(IIIv1)ahat,exceed their,Reportable Concentration=(RC);or•Reportable quantity;(RQ);by}the
greatest,amount. ,...
T✓'Check heie'if an amount'or concentration is unknown or less than detectable:'
O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable
if known Concentration (RCS-1,RCS-2,RCGW-1,
RCGW-2)
DIESEL 0 10 GAL N/A
r Check here if a list of additional Oil and Hazardous Materials subject to reporting,,or any other documentation relating to this notification
is attached. . .. - -
D.PERSON'REQI)HtED'TO'NUTIFY
1.Check all that apply: P a.change in contact name-' ± b°ch°arige'of address '' c.cliaiige in the person notifying
2.Name of Organization: . SANDRI REALTY INC
3.Contact First Name: MICHAEL 4.Last Name: BEHN
5.Street: 400 CHAPMAN STREET 6.Title: PRESIDENTICOO
7.City/Town: GREENFIELD 8.State: MA 9.ZIP Code: 013010000
10.Telephone: 413-772-2121 11.Ext: 12.Email:
ly.
13.Check here if attaching names and addresses of owners of.properties affected by the Release or Threat of Release,other,than an
owner who is submitting this Release Notification(required).
E.RELATIONSHIP OF PERSON TO RELEASE OR THREAT OF RELEASE: C Check here to change relationship
r 1.RP or PRP P-'a.Owner r—b.Operator lr c.Generator r d.Transporter
I—e.Other RP or PRP Specify:
r2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2)
r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50))
r-4.Any Other Person Otherwise Required to Notify Specify Relationship:
" "`Revised:07/18/2013 ` "' 'Page`2`of 3
Massachusetts Department of Environmental Protection
BWSC 103
Bureau of Waste Site Cleanup
RELEASE(NOTIFICATION&NOTIFICATION Release Tracking Number
RETRACTION FORM 2097,9
Pursuant to 310 CMR 40.0335 and 310 CMR 40;0371(SubpartC) t,a;
I
F.CERTIFICATION OF PE ON REQUIRED TO N.O,TIFY:
1.I,MICHAEL V BERN ( attest under the pains and penalties of perjury(i)that I have personally ;; r
exam ried'arid dm'familial With,tH6 jnformation dont'ained•in'this-sulimiital,iricluding.'any and-all•dociftn nts accoinpanymg this'transmittal
form,(ii)that,based on my inquiry!of those individuals immediately responsible for obtaining the information,the material-iniffibirrinaition
contained in this submittal,is,to the best of my-know.ledge and belief,tote,accurate and complete,and,(iii)that I am fully authorized to make
this attestation on behalf of the entity legally responsible for this submittal.I%the person or entity on whose behalf this submittal is made
am/is aware that there are significant penalties,including,-but not limited to,possible fines and imprisonment,for willfully'submitting false,
inaccurate,or incomplete information.
2.By: MICHAEL V BEHN I 3.Title: PRESIDENT/C00
Signature
4.For: SANDRI REALTY INC 5.Date: 12/18/2019
(Name-of person of entity recorded in Section D)' - mm/dd/yyyy
1— 6.Check here if the address of the person providing certification is different from address recorded in Section D.
7.Street:
8.City/Town: 9.State: 10.'ZIP Code:
11.Telephone: �::_ 12:Ext.: '., 13.Email:
_.,.-_._•„__,._YOUARE SUBJECT TO ANNUAL COMPLIANCE ASSURANCE FEES,FOR EACH BILLABLE YEAR FOR TIER•__,.••,_,..,_•
CLASSIFIED DISPOSALSITES.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS:OF,THIS FORM
OR DEP MAY RETUPJ i THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU
i;`=i a:>n:>:.; s•ri: ce,MAYBE'1'ENALIZED,EORMISSING A REQUII2EDDEADLIIVE.,
Date Stamp(DEP USE ONLY:)
Received by DEP on 12/18/2019 7:20:58
PMI
;:';:Revised:07/1'8/2013 _...._...... ..__.._....._ _---..._._..._......__.._._..... ..........._..._
RTN 1-20979
776 North King Street,Northampton,Massachusetts
Additional Property Owner for BWSC-103
Commonwealth of Massachusetts
Highway District 2 Office
811 North King Street
Northampton,MA 01060