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24A-033
BLACKBERRY LN BP-2009-0533 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24A-033 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-0533 Project# JS-2009-000747 Est. Cost: $3000.00 Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 3920.40 Owner: WILLARD GEORGE E&MARY D TRUSTEES Zoning: URA(100)/ Applicant: WILLARD GEORGE E & MARY D TRUSTEES AT: BLACKBERRY LN Applicant Address: Phone: Insurance: 57 FIRETHORN LN NORTHAMPTONMA01060 ISSUED ON:3/30/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMOLISH GARAGE & FOUNDATION, REPLANT SEED POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 3/30/2009 0:00:00 $20.001546 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • , File#BP-2009-0533 APPLICANT/CONTACT PERSON WILLARD GEORGE E&MARY D TRUSTEES ADDRESS/PHONE 57 FIRETHORN LN NORTHAMPTON PROPERTY LOCATION BLACKBERRY LN MAP 24A PARCEL 033 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out le,‘Paid Typeof Construction: DEMOLISH GARAGE&FOUNDATION,REPLANT SEED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay , eof 3 3/ a _ Signature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. File#BP-2009-0533 APPLICANT/CONTACT PERSON WILLARD GEORGE E&MARY D TRUSTEES -7,,��0/ 4)111. r— ^ ADDRESS/PHONE 57 FIRETHORN LN NORTHAMPTON 1i/�J ,4 PROPERTY LOCATION BLACKBERRY LN (! ; / _ ��q/5 MAP 24A PARCEL 033 001 ZONE URA(100)/ jQ l� THIS SECTION FOR OFFICIAL USE ONLY: 6'8 7 J 37 5 PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Q/ f�.r�,� Fee Paid ��/'7 6Q /�D a'`� Typeof Construction: DEMOLISH GARAGE&FOUNDATION,REPLANT SEED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATIONSENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan )i e 46� Major Project: Site Plan AND/OR Special Permit With Site Plan OAK-51/7 ZONING BOARD PERMIT REQUIRED UNDER: § C 'v 5 Finding Special Permit Variance* � �c) Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management Demolition Delay //2,e5/0zqe_r Signature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. Department use only City of Northampton Status of Permit: (\ \ Building Department Curb Cut/Driveway Permit �r a u l____ -- 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability 2C 0 Northampton, MA 01060 Two Sets of Structural Plans Nw .\ 'Rhone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify 1 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office a 6 /a it ge M Ci Att 4/.e Map ;240 Lot t 33 Unit /Neil n6 Rif Overlay District / Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Recor : Cc Pvis e Mg e7 (,v//i j e, I R u c f S-7 Ft to 7)10,e,u x5 kve Name(Print) j ^ Current fling A dress: mil fif •�� //P / r e `V7IPP Telepho !%r'P1 1�44 yl /1 Gf Signature L1 --02 6-5' 2.2 Authorized Agent: /� p /?,91d (j1 / / f?� 1p `l c�lct"Sv4.c,c, frio" c , Name(Print) Current Mailing Address: ...„4/ cif — S S is 1: — 3?iT Signatu Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building G © D (a) Building Permit Fee 2. Electrical (b)Estimated Total.Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total= (1 +2+3+4+5) Check Number /sV 2 eon, ..... This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Cu uVot4 j w lThl T6A/Ast Y74 0PF(CP i Ft,4,.6„,), ( 4[( 00 3 i C Cak12-0 %\, ..I1 0% Le f-'- 41 QACi,5-p t 6 I c( a. Are.e 0,0 Poe 4,,, / Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ___ r. ....—. __ S Frontage q.ii. ..._ . . _.,..___ _....___� _ __. Setbacks Front _ ___i Side L ..,.L R: .5 L:I.. _. R: I 1 i Rear /$__-. Building Height 717 f_.__..] 1 Bldg. Square Footage 53J % `y1 Open Space Footage (Lot area minus bldg&paved 4(,/( 11111 parking) € i #of Parking Spaces ---= Fill: (volume&Location) _. _ _ ..... _.. A. Has a Special Permit/Variance/Finding ever been issued for/'on the site? NO Or. DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW 0 YES Q IF YES: enter Book ; Page: and/or Document# . B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES 0,40 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0/1 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, exca ton, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition [] Replacement Windows Alteration(s) n Roofing pi Or Doors El Accessory Bldg. El Demolition I /CI New Signs [DI Decks — Siding[CI] Other[Ell Brief Description of Proposed Work: IP/MIIJ/P EYr c/ 2: c4 f ric,,IZ Gi-i /C P /'1 tg-ST°9 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing,complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date �L///le , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. / .1 2tAZ.3 Print Name /0A-A f Sign of wner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor � , , , Not Applicable 0 Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No 0 11. — Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor.CMVIR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and L Zoni Laws a to of Massachusetts General Laws Annotated. Homeowner Signature The Commonwealth of Massachusetts Department of Industrial Accidents irt . ; Office bf Investigations 600 Washington Street Boston,MA 02111 ., www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaihly• Name(Business/Organization/Individual): D(.i/F, lii-r //le. EPfuA*7itif l/4/v/ ' 1 C Address: / ? /-7M'vv P.f,) ,A°-0 7 5,epvc.P /P/C City/State/Zip: f/a2f,,r/c-.P /R4 c/c)(p D.. Phone #: 1,1Co-"/' 77 Ale,yeu an employer?Check a appropriate box: Type of project(required): 1. I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 0 New construct}on 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 2-Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance. # 9. 0 Building addition required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions m self.[No workers'co right of exemption per MGL ycomp. 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 6 g4 r 4- ge42 1 Ic 4p City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi n r t e p ns and penalties of perjury that the information provided above is true and cor ect. Signature: Date: //,/CeA or Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner." The building department for the City of Northampton wants person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill). sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing&gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections.Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. me owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location 40.0 ft S 29'57" E -----...i -- - 39 6 of waY �15' wide rig In. favor of ECH Nominee Trust, I i / /"i / 1 f 1a> / i _ _ _ r _� ,_I ►� ,� a) ECH NOMINEE TRUST BOOK 6656, PAGE 233 MARY D. WILLARD i LIVING TRUST BOOK 8532, PAGE 61 PARCEL TWO (SECOND TRACT) -- 3,941± SQ. FT. W x 24A �, t 33 N) o f K) � i Z I ZtO J t 0 ____ ------ N 57'46'14" W 42.27' NORTH, N/F MASS ''TY ,R Toll Free: 1-866-662-2622 `� Facsimile: 413-787-2646 r. i rn January 26, 2009 1TI FE6 - 3 2009 , { i Frank Willard, Owner �---- —— - -—� 06 Duffy Willard Excavation & Paving, LLC CEP?pf P r "I ;-`CT1O'VS 157 Florence Road, P.O. Box 60137 Florence, MA 01062-0137 Sent Via E-mail: duffywillard(a�comcast.net RE: Assessment Letter 0 Blackberry Lane, N. Hampton, MA Dear Mr. Willard: At your request, Western Mass Environmental (WME) has completed this letter to document testing from an area of a former approximate 1,000 gallon gasoline underground storage tank (UST) at the above referenced property. WME personnel were present at the property on December 16, 2008, to oversee test pitting activities from the approximate location of the former UST. A test pit was completed to approximately 10 feet an soil samples were collected. Samples were screened with a photoionization detector (PID) calibrated with isobutylene span gas standard "as benzene" and utilizing the Massachusetts Department of Environmental Protection (MADEP) "jar headspace" screening procedures. The samples were also inspected for visual and olfactory indications of petroleum impacts. Neither visual nor olfactory observation or PID readings were detected that would indicate any petroleum impacts. In an effort to be conservative soil sample was collected from the base of the excavation (ID: "TP-1"). The soil sample was submitted under chain of custody to Spectrum Analytical, Inc. in Agawam, MA for analyses of volatile petroleum hydrocarbons (VPH) and target gasoline parameters. The results indicated no concentrations in excess of laboratory method detection limits and thus were well below applicable reportable concentrations as outlined in the Massachusetts Contingency Plan (MCP). Therefore, in the opinion of WME no further action is required with regard to this UST. Copies of the analytical data are attached to this letter. Should you have any questions with regard to this letter please do not hesitate to contact the undersigned. Sincerely, West rn ass nvironmental z Kurt E lages Tec ical Ma er cc: E File • Arrange Hazardous Waste Transportation and Disposal 93 Wayside Avenue, West Springfield, MA 01089 • 24-Hour Emergency Spill Response 880 Rear Washington Street, Attleboro, MA 02703 • Site Remediation • Storage Tank Cleaning and Removal www.westernmassenv.com • Industrial Facility Maintenance i Waste Recycling Services Report Date: lJ Final Report 23-Dec-08 11:54 ' ❑ Re-Issued Report ❑ Revised Report J SPECTRUM ANALYTICAL,INC. • Featuring HANIBAL TECHNOLOGY Laboratory Report Western Mass Environmental 93 Wayside Avenue Project: 8 Blackberry Lane-Northampton,MA West Springfield, MA 01089 Project 2103 Attn: Kurt Klages Laboratory ID Client Sample ID Matrix Date Sampled Date Received SA88973-01 TP-1 • Soil 16-Dec-08 09:30' 17-Dec-08 14:35 SA88973-02 FB Methanol 16-Dec-08 00:00 17-Dec-08 14:35 SA88973-03 TB Methanol 16-Dec-08 00:00 17-Dec-08 14:35 I attest that the information contained within the report has been reviewed for accuracy and checked against the quality control requirements for each method These results relate only to the sample(s)as received. All applicable NELAC requirements have been met Massachusetts#M-MA138/MA1110 Authorized by: Connecticut#PH-0777 Florida#E87600/E87936 Maine#MA 13 8 � IN ACC%� New Hampshire#2538 p� QYoF New Jersey#MA011/MA012 < < , New York# 11393/11840 a ' O. = Hanibal C.Tayeh,Ph.D. Pennsylvania#68-04426/68-02924 President/Laboratory Director Rhode Island#98 USDA# S-51435 Technical Reviewer's Initial: Vermont#VT-I 1393 Spectrum Analytical holds certification in the State of Massachusetts for the analytes as indicated with an X in the"Cert."column within this report. Please note that the State of Massachusetts does not offer certification for all analytes Please note that this report contains 11 pages of analytical data plus Chain of Custody documen(s). When the Laboratory Report is indicated as revised,this report supercedes any previously dated reports for the laboratory ID(s)referenced above. Where this report identifies subcontracted analyses,copies of the subcontractor's test report is available upon request This report may not be reproduced,except in full,without written approval from Spectrum Analytical Inc. Spectrum Analytical,Inc. is a NELAC accredited laboratory organization and meets NELAC testing standards. Use of the NELAC logo however does not insure that Spectrum is currently accredited for the specific method or analyte indicated. Please refer to our"Quality"web page at www.spectrum-analytical.com for a full listing of our current certifications and fields of accreditation.States in which Spectrum Analytical,Inc. holds NELAC certification are New York New Hampshire,New Jersey and Florida.All analytical work for Volatile Organic and Air analysis are transferred to and conducted at our 830 Silver Street location(NY-I 1840, FL-E87936 and NJ-MA012). Headquarters: 11 Almgren Drive&830 Silver Street•Agawam,MA 01001 • 1-800-189-9115 •413-789-9018•Fax 413-789-4076Page I of 1 l www.spectrum-analytical.com *, '.I„ , 1,11 11011,11u11. I vi. I til,lll,lnl,l 1 I I., III I,It ,i,. 1{,s CHAIN OF CUSTODY R I �,( 1( )R I ) . ` , , - III 1 1 1 y• ,,,•,,1 I Iin i i„.:.: .. ...: ... .. „ , , , : ,u in SPECTRUM ANALYTICAL,IN('. Page Of •n11111,{, ,IL," l , I,,. ,:,.. 1• Featurleg 1IANI AI.TECIINOI(H 1 Ill',HI I,t III '1‘, ,, 'I .,t • Rep t To: Invoice To: I'rujr(•I N . , .,,,,/I s / ff / S/91�E SiteNl1111,': y !AA,t 4lX,rt, J., • i pisic/ /J7 / I ` Project Mgr.: Mier' /fC 9-er P.O.No.: RQN: 1=Na2S2O3 2=HCI 3=H2SO4 4=HNO3 5=NaOH 6=Ascorbic Acid Containers: .\mil\',,. , ►' 7=CH3OH 8=NaHSO4 9= 10= DW=Drinking Water GW=Groundwater WW=Wastewater 4,1 ,11. hi,i , t '' O=Oil SW=Surface Water SO=Soil SL=Sludge A=Air cq , i 1 III, XI= X2= X3= a' •~ l7 i; iy rt ,tI t, , . , . 1 , ,. ` 'r ' �1 I' 1 1 II 1 1 G=Grab C=Composite 1 I t 1 , �, i 1 % It. Fi• FI tt r Lab Id: Sample Id: I)ale: Tinto: 1 '. �`` II II II ,I #- 'A ';,-^'1 ')( y j' ' /' /2, " AK ,'S{' e: ,,Ic / / X ( `1(, t -1 .f ._ _/o' /'.-it I -�- 6 't ( ��# VI .a I# If I c T�' _ 7 1 X • i t Relinquished by: Pl. , it,1 I i f {1,., ❑ Fax results when available to( ) AE-mail to,,eivn e i)com e.Ne�-- '\- �.._. { g'i 4 EDD Format 31 (.,,-t() 1I 1 i -Condition upon receipt: ❑ Iced ❑Ambient 0°C f, 0 11 Almgren Drive•Agawam,Mas achusetts 01001 •413-789-9(118• Fax•I I I '/II" lit 0 6 1,,, ,,,,,,, ,,,,1 I,, ,t,,:i„ CASE NARRATIVE: The samples were received 1.0 degrees Celsius,please refer to the Chain of Custody for details specific to temperature upon receipt An infrared thermometer with a tolerance of+/-2.0 degrees Celsius was used immediately upon receipt of the samples MADEP has published a list of analytical methods(CAM)which provides a series of recommended protocols for the acquisition, analysis and reporting of analytical data in support of MCP decisions "Presumptive Certainty"can be established only for those methods published by the MADEP in the MCP CAM. The compounds and/or elements reported were specifically requested by the client on the Chain of Custody and in some cases may not include the full analyte list as defined in the method According to WSC-CAM 5/2004 Rev.4,Table 11 A-1,recovery for some VOC analytes have been deemed potentially difficult Although they may still be within the recommended70%-130%recovery range,a range has been set based on historical control limits See below for any non-conformances and issues relating to quality control samples and/or sample analysis/matrix. +MADEP VPH 5/2004 Rev. 1.1 Spikes: 8121518-MS1 Source:SA88967-01 The spike recovery was outside acceptance limits for the MS and'or MSD. The batch was accepted based on acceptable LCS recovery. 2,2,4-Trimethylpentane Benzene Methyl tert-butyl ether Samples: SA88973-01 TP-1 The VOC preserved soil sample is not within the 1:1 weight to volume ratio as recommended by SW846 methods 5030 and 5035 but may be within the 1:1 volume to volume ratio.This variance may affect the final reporting limit This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 2 of II Sample Identification Client Project# Matrix Collection Date/Time Received TP-1 SA88973-01 2103 Soil 16-Dec-08 09:30 17-Dec-08 CAS No. Analyte(s) Result Flag Units *RDL Dilution Method Ref Prepared Analyzed Batch Cert. Volatile Organic Compounds VOC Extraction Field extracted N/A 1 VOC Soil Extraction 17-Dec-08 17-Dec-08 8121482 VPH Aliphatic/Aromatic Carbon Ranges me Prepared by method VPH-EPA 5030E Initial weight:19.12 g C5-C8 Aliphatic Hydrocarbons BRL mg/kg dry 0.645 50 +MADEP VPH 5/2004 18-Dec-08 18-Dec-08 8121518 Rev.1.1 C9-C12 Aliphatic Hydrocarbons BRL mg/kg dry 0.215 50 ' C9-C10 Aromatic Hydrocarbons BRL mg/kg dry 0.215 50 ' Unadjusted C5-C8 Aliphatic BRL mg/kg dry 0.645 50 ' Hydrocarbons Unadjusted C9-C12 Aliphatic BRL mg/kg dry 0.215 50 ' Hydrocarbons VPH Tarot Analytes vclo Prepared by method VPH-EPA 5030E Initial weight:19.12 g 71-43-2 Benzene BRL pg/kg dry 43.0 50 ' 100-41-4 Ethylbenzene BRL pg/kg dry 43.0 50 ' • 1634-04-4 Methyl tert-butyl ether BRL pg/kg dry 43.0 50 ' 91-20-3 Naphthalene BRL pg/kg dry 43.0 50 ' 108-88-3 Toluene BRL pg/kg dry 43.0 50 " 179601-23-1 m,p-Xylene BRL pg/kg dry 86.1 50 ' • 95-47-6 o-Xylene BRL pg/kg dry 43.0 50 ' Surrogate recoveries: 615-59-8 2,5-Dibromotoluene(FID) 101 70-130% ' 615-59-8 2,5-Dibromotoluene(PID) 94 70-130% ' General Chemistry Parameters %Solids 95.9 % 1 SM2540 G Mod. 17-Dec-08 17-Dec-08 8121480 This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 3 of 11 • - Sample-Identification Client Project# Matrix Collection Date/Time Received TB SA88973-03 2103 Methanol 16-Dec-08 00:00 17-Dec-08 CAS No. Analyte(s) Result Flag Units *RDL Dilution Method Ref. Prepared Analyzed Batch Cert. Volatile Organic Compounds VPH Aliphatic/Aromatic Carbon Ranges Prepared by method VPH-EPA 5030E C5-C8 Aliphatic Hydrocarbons BRL mg/kg wet 0.750 50 +MADEP VPH 5/2004 18-Dec08 18-Dec08 8121518 Rev.1.1 C9-C12 Aliphatic Hydrocarbons BRL mg/kg wet 0250 50 ' C9-C10 Aromatic Hydrocarbons BRL mg/kg wet 0.250 50 ' Unadjusted C5-C8 Aliphatic BRL mg/kg wet 0.750 50 ' Hydrocarbons Unadjusted C9-C12 Aliphatic BRL mg/kg wet 0250 50 ' Hydrocarbons This laboratory report is not valid without an authorized signature on the cover page. * Reportable Detection Limit BRL=Below Reporting Limit Page 5 of 11 - Sample Identification Client Project# Matrix Collection Date/Time Received FB SA88973-02 2103 Methanol 16-Dec-08 00:00 17-Dec-08 CAS No. Anulyte(s) Result Flag Units *RDL Dilution Method Ref Prepared Analyzed Batch Cert. Volatile Organic Compounds VPH Aliphatic/Aromatic Carbon Ranges Prepared by method VPH-EPA 5030E C5-C8 Aliphatic Hydrocarbons BRL mg/kg wet 0.750 50 +MADEP VPH 5/2004 18-Dec08 18-Dec-08 8121518 Rev.1.1 C9-C12 Aliphatic Hydrocarbons BRL mg/kg wet 0.250 50 ' C9-C10 Aromatic Hydrocarbons BRL mg/kg wet 0250 50 ' Unadjusted C5-C8 Aliphatic BRL mg/kg wet 0.750 50 ' Hydrocarbons Unadjusted C9-C12 Aliphatic BRL mg/kg wet 0.250 50 ' Hydrocarbons This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 4 of 11 Volatile Organic Compounds-Quality Control Spike Source %REC RPD Analyte(s) Result Flag Units *RDL Level Result %REC Limits RPD Limit Batch 8121518-VPH-EPA 5030B LCS Duo(8121518-BSD1) Prepared&Analyzed:18-Dec-08 Unadjusted C5-C8 Aliphatic Hydrocarbons 236 mg/kg wet 280 84 70-130 0.5 25 Unadjusted C9-C12 Aliphatic Hydrocarbons 96.4 mg/kg wet 84.8 114 70-130 0.6 25 Benzene 19.2 pg/kg wet 20.0 96 70-130 7 25 Ethylbenzene 20.4 pg/kg wet 20.0 102 70-130 5 25 Methyl tert-butyl ether 20.8 pg/kg wet 20.0 104 70-130 14 25 Naphthalene 21.8 pg/kg wet 20.0 109 70-130 3 25 Toluene 20.1 pg/kg wet 20.0 100 70-130 6 25 m,p-Xylene 42.2 pg/kg wet 40.0 105 70-130 8 25 o-Xylene 20.0 pg/kg wet 20.0 100 70-130 7 25 2-Methylpentane 18.5 pg/kg wet 20.0 92 70-130 13 25 n-Nonane 22.9 pg/kg wet 20.0 115 70-130 9 25 n-Pentane 18.9 pg/kg wet 20.0 94 70-130 9 25 1,2,4-Trimethylbenzene 21.5 pg/kg wet 20.0 108 70-130 3 25 2,2,4-Trimethylpentane 19.4 pg/kg wet 20.0 97 70-130 3 25 n-Butylcyclohexane 23.0 pg/kg wet 20.0 115 70-130 3 25 n-Decane 23.6 pg/kg wet 20.0 118 70-130 0.2 25 Surrogate:2,5-Dibromotoluene(FID) 57.4 pg/kg wet 50.0 115 70-130 Surrogate:2,5-Dibromotoluene(PID) 55.0 pg/kg wet 50.0 110 70-130 Duplicate(8121518-DUP1) Source:SA88967-01 Prepared&Analyzed:18-Dec-08 C5-C8 Aliphatic Hydrocarbons 0.940 J mg/kg dry 1.07 0.953 1 50 C9-C12 Aliphatic Hydrocarbons 0.289 J mg/kg dry 0.356 0203 35 50 C9-C10 Aromatic Hydrocarbons 1.45 mg/kg dry 0.356 1.49 2 50 Unadjusted C5-C8 Aliphatic Hydrocarbons 0.940 J mg/kg dry 1.07 0.953 1 50 Unadjusted C9-C12 Aliphatic Hydrocarbons 1.74 mg/kg dry 0.356 1.69 3 50 Benzene BRL pg/kg dry 71.1 BRL 50 Ethylbenzene BRL pg/kg dry 71.1 BRL 50 Methyl tert-butyl ether BRL pg/kg dry 71.1 BRL 50 Naphthalene 75.0 pg/kg dry 71.1 81.7 9 50 Toluene BRL pg/kg dry 71.1 BRL 50 m,p-Xylene BRL pg/kg dry 142 BRL 50 o-Xylene BRL pg/kg dry 71.1 BRL 50 Surrogate:2,5-Dibromotoluene(FID) 48.9 pg/kg dry 50.0 98 70-130 Surrogate:2,5-Dibromotoluene(PID) 48.7 pg/kg dry 50.0 93 70-130 Matrix Spike(8121518-MS1) Source:SA88967-01 Prepared&Analyzed:18-Dec-08 Benzene 31.8 QM7 pg/kg dry 20.0 BRL 159 70-130 Ethylbenzene 23.9 pg/kg dry 20.0 BRL 120 70-130 Methyl tert-butyl ether 31.0 QM7 pg/kg dry 20.0 BRL 155 70-130 Naphthalene 19.5 pg/kg dry 20.0 1.3 91 70-130 Toluene 25.8 pg/kg dry 20.0 BRL 129 70-130 m,p-Xylene 45.1 pg/kg dry 40.0 BRL 113 70-130 o-Xylene 20.8 pg/kg dry 20.0 BRL 104 70-130 2-Methylpentane 25.9 pg/kg dry 20.0 BRL 129 70-130 n-Nonane 24.5 pg/kg dry 20.0 BRL 122 70-130 n-Pentane 25.9 pg/kg dry 20.0 BRL 129 70-130 1,2,4-Trimethylbenzene 20.6 pg/kg dry 20.0 BRL 103 70-130 2,2,4-Trimethylpentane 31.6 QM7 pg/kg dry 20.0 BRL 158 70-130 n-Butylcyclohexane 23.8 pg/kg dry 20.0 BRL 119 70-130 This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 7 of 1 I Volatile Organic Compounds-Quality Control Spike Source %REC RPD Analyte(s) Result Flag Units *RDL Level Result %REC Limits RPD Limit Batch 8121518-VPH-EPA 5030B Blank(8121518-BLK1) Prepared&Analyzed:18-Dec-08 C5-C8 Aliphatic Hydrocarbons BRL mg/kg wet 0.750 C9-C12 Aliphatic Hydrocarbons BRL mg/kg wet 0.250 C9-C10 Aromatic Hydrocarbons BRL mg/kg wet 0.250 Unadjusted C5-C8 Aliphatic Hydrocarbons BRL mg/kg wet 0.750 Unadjusted C9-C12 Aliphatic Hydrocarbons BRL mg/kg wet 0.250 Benzene BRL pg/kg wet 50.0 Ethylbenzene BRL pg/kg wet 50.0 Methyl tert-butyl ether BRL pg/kg wet 50.0 Naphthalene BRL pg/kg wet 50.0 Toluene BRL pg/kg wet 50.0 m,p-Xylene BRL pg/kg wet 100 o-Xylene BRL pg/kg wet 50.0 2-Methylpentane BRL pg/kg wet 50.0 n-Nonane BRL pg/kg wet 100 n-Pentane BRL pg/kg wet 100 1,2,4-Trimethylbenzene BRL pg/kg wet 50.0 2,2,4-Trimethylpentane BRL pg/kg wet 50.0 n-Butylcyclohexane BRL pg/kg wet 50.0 n-Decane BRL pg/kg wet 50.0 Surrogate:2,5-Dibromotoluene(FID) 50.8 pg/kg wet 50.0 102 70-130 Surrogate:2,5-Dibromotoluene(PID) 48.7 pg/kg wet 50.0 97 70-130 LCS(8121518-BS1) Prepared&Analyzed:18-Dec-08 C5-C8 Aliphatic Hydrocarbons 122 mg/kg wet 140 87 70-130 C9-C12 Aliphatic Hydrocarbons 62.8 mg/kg wet 55.2 114 70-130 C9-C10 Aromatic Hydrocarbons 34.2 mg/kg wet 40.0 85 70-130 Unadjusted C5-C8 Aliphatic Hydrocarbons 235 mg/kg wet 280 84 70-130 Unadjusted C9-C12 Aliphatic Hydrocarbons 97.0 mg/kg wet 84.8 114 70-130 Benzene 18.0 pg/kg wet 20.0 90 70-130 Ethylbenzene 19.4 pg/kg wet 20.0 97 70-130 Methyl tert-butyl ether 18.0 pg/kg wet 20.0 90 70-130 Naphthalene 21.1 pg/kg wet 20.0 105 70-130 Toluene 18.9 pg/kg wet 20.0 95 70-130 m,p-Xylene 39.0 pg/kg wet 40.0 97 70-130 o-Xylene 18.7 pg/kg wet 20.0 94 70-130 2-Methylpentane 16.3 pg/kg wet 20.0 81 70-130 n-Nonane 20.9 pg/kg wet 20.0 104 70-130 n-Pentane 17.3 pg/kg wet 20.0 86 70-130 1,2,4-Trimethylbenzene 20.9 pg/kg wet 20.0 105 70-130 2,2,4-Trimethylpentane 20.0 pg/kg wet 20.0 100 70-130 n-Butylcyclohexane 22.3 pg/kg wet 20.0 112 70-130 n-Decane 23.7 pg/kg wet 20.0 118 70-130 - Surrogate:2,5-Dibromotoluene(FID) 55.7 pg/kg wet 50.0 111 70-130 Surrogate:2,5-Dibromotoluene(PID) 53.6 pg/kg wet 50.0 107 70-130 LCS Dup(8121518-BSD1) Prepared&Analyzed:18-Dec-08 C5-C8 Aliphatic Hydrocarbons 114 mg/kg wet 140 81 70-130 7 25 C9-C12 Aliphatic Hydrocarbons 61.1 mg/kg wet 55.2 111 70-130 3 25 C9-C10 Aromatic Hydrocarbons 35.3 mg/kg wet 40.0 88 70-130 3 25 This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 6 of I I • Volatile Organic Compounds-Quality Control Spike Source %REC RPD Analyte(s) Result Flag Units *RDL Level Result %REC Limits RPD Limit Batch 8121518-VPH-EPA 5030B Matrix Spike(8121518-MS1) Source:SA88967-01 Prepared&Analyzed:18-Dec-08 n-Decane 25.4 pg/kg dry 20.0 0.8 123 70-130 Surrogate:2,5-Dibromotoluene(FID) 50.6 pg/kg dry 50.0 101 70-130 Surrogate:2,5-Dibromotoluene(PID) 48.5 pg/kg dry 50.0 97 70-130 General Chemistry Parameters-Quality Control Spike Source %REC RPD Analyte(s) Result Flag Units *RDL Level Result %REC Limits RPD Limit Batch 8121480-General Preparation Duplicate(8121480-DUP1) Source:SA88973-01 Prepared&Analyzed:17-Dec-08 %Solids 96.0 % 95.9 0.06 20 This laboratory report is not valid without an authorized signature on the cover page. *Reportable Detection Limit BRL=Below Reporting Limit Page 8 of 1 I Notes and Definitions QM7 The spike recovery was outside acceptance limits for the MS and'or MSD. The batch was accepted based on acceptable LCS recovery. VC10 The VOC preserved soil sample is not within the 1:1 weight to volume ratio as recommended by SW846 methods 5030 and 5035 but may be within the 1:1 volume to volume ratio.This variance may affect the final reporting limit BRL Below Reporting Limit-Analyte NOT DETECTED at or above the reporting limit dry Sample results reported on a dry weight basis N R Not Reported RPD Relative Percent Difference J Detected but below the Reporting Limit;therefore,result is an estimated concentration(CLP J-Flag). A plus sign(+)in the Method Reference column indicates the method is not accredited by NELAC Laboratory Control Sample(LCS): A known matrix spiked with compounds)representative of the target analytes,which is used to document laboratory performance Matrix Duplicate: An infra-laboratory split sample which is used to document the precision of a method in a given sample matrix Matrix Spike: An aliquot of a sample spiked with a known concentration of target analyt4s). The spiking occurs prior to sample preparation and analysis. A matrix spike is used to document the bias of a method in a given sample matrix Method Blank: An analyte-free matrix to which all reagents are added in the same volumes or proportions as used in sample processing. The method blank should be carried through the complete sample preparation and analytical procedure The method blank is used to document contamination resulting from the analytical process Method Detection Limit(MDL): The minimum concentration of a substance that can be measured and reported with99% confidence that the analyte concentration is greater than zero and is determined from analysis of a sample in a given matrix type containing the analyte Reportable Detection Limit(RDL): The lowest concentration that can be reliably achieved within specified limits of precision and accuracy during routine laboratory operating conditions For man} analytes the RDL analyte concentration is selected as the lowest non-zero standard in the calibration curve. While the RDL i_approximately 5 to 10 times the MDL,the RDL for each sample takes into account the sample volume/weight,extract'diaestate cleanup procedures and, if applicable,dry weight correction. Sample RDLs are highly matrix-dependent. Surrogate: An organic compound which is similar to : _e:a_-:alytc(s)in chemical composition and behavior in the analytical process,but which is not normally found in environ_r e- These compounds are spiked into all blanks,standards,and samples prior to analysis. Percent recoveries are cal:_ each surrogate. Validated by: Hanibal C.Tayeh,Ph.D. - - - = _:-.n authorized signature on the cover page. BRL=Below Reporting Limit Page 9 of 11 e , • MADEP MCP ANALYTICAL METHOD REPORT CERTIFICATION FORM Laboratory Name: Spectrum Analytical, Inc. -Agawam, MA Project#: 2103 Project Location: 8 Blackberry Lane-Northampton, MA MADEP RTN t: This form provides certifications for the following data set SA88973-01 through SA88973-03 Sample matrices: Methanol Soil O 8260B 0 8151A 0 8330 0 6010B 0 7470A/1A MCP SW-846 0 8270C 0 8081A Pf NTH ❑ 6020 ❑ Methods Used 9014M z ❑ 8082 0 8021B 0 EPH ❑ 7000S 3 ❑ 7196A 1 List Release Tracking Number(RTN),if known 2 M-SW-846 Method 9014 or MADEP Physiologically Available C__ P_AC;Method 3 S-SW-846 Methods 7000 Series List individual method and any An affirmative response to questions A,B, C:71 D is required for "Presumptive Certainty"status Were all samples received by the laboratory in a cc-:-__- consistent with that described on the A Chain of Custody documentation for the data set E1 Yes 0 No Were all QA/QC procedures required for the _--a .tical methods) included in this report B followed,including the requirement to note and __a narrative QC data that did not meet Ef Yes 0 No appropriate performance standards or guideline:.- Does the data included in this report meet all the a __::requirements for"Presumptive Certainty",as described in Section 2.0(a).(b).F` : ::--_he MADEP document CAM VII A, "Quality Assurance and Quality Control Gu_?::_-:: ____-..quisition and Reporting of g Yes 0 No Analytical Data"? U VPH and EPH methods only: Was the\T _- -__- ,-....nducted without significant g( Yes ❑ No modifications(see Section 11.3 of respec-'-• A response to questions E anu F _ r "Presumptive Certainty"status E Were all analytical QC performance star.----- : _ - --_ .a -:Ls far the specified methods Yes ❑ No achieved? F Were results for all analyte-list com^:-_-__: -- - _ "__ 7_II:_d s'reported? 0 Yes P1 No All negative responses are _ — : page of this report. I,the undersigned,attest under the pairs -_ -^ : - -____ _ -- my personal inquiry of those responsible for obtaining the informa* .- - - -_ :a. rer:ort is.to the best of my knowledge and belief,accurate and S ^F The following outlines the condition of all VPH samples contained within this report upon laboratory receipt Matrix Soil Containers Er Satisfactory ❑ Broken ❑ Leaking Aqueous 16 N/A ❑ pH 2 ❑ pH>2 Comment: (acid-preserved) Sample Preservative Soil or ❑ N/A ❑ Samples not received in Methanol or air-tight container ml Methanol/g soil Sediment g( Samples received in Methanol: Er covering soil/sediment ❑ 1:I +/-25% Ef Other: 0 not covering soil/sediment ❑ Samples received in air-tight container. Temperature Cal Received on ice ❑ Received at 4=2=C Er Other: 1.0 °C Were all QA/QC procedures followed as required by the V?- --hed' Yes Were any significant modifications made to the VPH met1-_::as s-ec:fted in section 11.3? No *see below Were all performance/acceptance standards for required QA r cedures achieved? Yes *Yes,if PID and FID surrogate recoveries are listed as'fa,then that s----;_ _-_:is GCMS using all QC criteria specified in the method I attest that based upon my inquiry of those individuals km-- _: -_sponsible for obtaining the information the material contained in this report is,to the best of my knowledge and belief :emplete. Authorized by: Hanibal C.Tayeh, Ph.D. President/Laboratory Director • �• - �. :max. ,.--otoitamosillowpatfairtmam Adr m Page 10 of 11 4 _ �+ by ai