SCANNED

SCANNED
C
r
SCANNED
+& Thxj
LETTER OF TRANSMITTAL
MADEP - Northeast Region
To:
Date:
Job:
1
1
Date:
Description:
Immediate Resp nse Action Plan Completion Report
original IRA Transmittal Form
Remarks:
Copy To
AST Environmental
Baliotis Nominee Trust
Signed
CorpomteHeadquarters
69 Wexford Street
Needham, MA 02494
Tel (800) KNOLL26
(781) 449-1566
Fax (781) 449-1623
Email: [email protected]
RTN 3-13814
Subject:
Attention:
Copies:
June 8, 1999
Z
Massachusetts Department of nvironmental Protection
BWSC-105
Bureau of Waste Site Cleanup
Release Tracing Numeer
IMMEDIATE RESPONSE ACTJO4 (IRA)
TRANSMITTAL FORM
Pursuanttom3
3
CMR 40.0424 -40.0427 (Subpart 0)
13814
-
A. RELEASE OR THREAT OF RELEASE LOCATION:
Release Name: (optrona
458BOSTON STREET
SALEM
Ctyn-ow:
Street:
LocationAid:
ZIpcode
POPE STREET & BOSTON ST
01970
Check here if a Tier Ctassfication Suormtai has been provided to OEP fo this Release Traciang Numoer.
,D1104114.
S Ch-eheeif this locaion isAdequately Regulated, pursuantto 310CMR
Specify Program: El CERCLA
F-
HSWA Corrective Action
[]
Soli Waste Management
i
RCRA State Pnojrarn (21C Facilities)
Related Release Trackcing Numbers That This IRA Addresses:
B. THIS FORM IS BEING USED TO:
Submnit an
IRA Plan
(checx all that aply)
(complete Sections A, B, C, 0, E, H, 1,J and K).JU
E
9 T9
approved wntten IRA Plan. Date Submitt
Check here if this IRA Plan isan update ormodification ota previo
Submit an Imminent Hazard Evaluation (complete Sections A, B,C, F, H
I, J and K).
7A
'>3
I Sumit an IRA Status Report (complete Sections A. B. C,E. H, .J and
Suomit a Request to Termnate an Active Remedial System and/or Te nate a Continuing Response Action(s) Taken to Address an
Irnrninent Hazard (complete Sections A, 2, 3, 0, E. H, 1,J and K).
L
Submit an IRA Completion Statement (complete Sections A, S. C, 0. E,
-
. , J,J and K).
You must attach all supporting documnttin reqluired f each use of form indicaed, including copies or
cais required by 3113 CMR 40.1400.
any Legal Notices and Notices to Public
C. RELEASE OR THREAT OF RELEASE CONDmONS THAT WAR
Identify Madla and Receptors Arlected: (checK air that apply)
S
E
Air
_
7
7
Unknown
7
72 Hour Reportng condition(s)
Identify Oils and Nazaous Materials Released:
Others
Sutistaniial Reise
(cneck al that aopty)
Zone 2
F
Soil
Residence
Mig
on
E
j
2 tour Reporting Condritions)
E
Other Contion(s)
AN IMMINENT HAZARD
:l Chlonnated Solvents
Oils
II
Heavy Metals
(check all that appy)
1 Awwssment and/or Monitoring Only
F
DeployMent of Absorbent or Contanment Matenals
ExcavaTion at Contaminated Sods
E
Temoorary Covers or Caps
L
-
Re-use. Recycling or Treatment
Q
V
Store
:
On Site
Q
Ofr Site
E
Landfll
C>
Cover
0
Disposal Est. Vol.:
Est. Voi.:
-
cubic
_cubic
Removal of Drums Tants or Corainera
7
Structure Venting System
i
Product o NAPL Recovery
Q
Groundwater Treatment Systems
_
Air Soarging
1 TemporaryWater Suppies
Descinbe:
SECTION DIS CONTINUED ON
Revised 212495
renediation
Sol Vapor Extraction
c
Est. Vol.;
Off Site
On Site
Descnbe:
W
1
Sediments
Sbecit-
D. DESCRIPTION OF RESPONSE ACTIONS:
m
m
Surface Water
Public Water Supply
(chck aja appty)
ARSENIC IN SURFICIAL SOILS POSE
cescnbe:
E
Other SpecfY
Identify Conditions That Require IRA, Pursuant to 310 CMR 40.0412
7
7
ell
Wedrandive
Senool
NT IRA:
roundwater
X
E NEXT PAGE.
Supersedes Forms SWSC-005, 006, 010 (in part) and 011
Do Not Alter This r
Page I of 3
--N
Massachusetts Department c't Environmental Protection
r
BWSC-105
Bureau of Waste Site Cleanup
IMMEDIATE RESPONSE ACTO N (IRA)
TRANSMITTAL FORM Pursuant io310 CMR 40.0424 - 40.0427 (Subpart 0)
Reiease Tracking Number
:3
i 13814
D. DESCRIPTION OF RESPONSE ACTIONS (continued):
Removal of Other Contaminated Media
l Temporary Evacuation or Relocation of Residents
J
Specify Type and Volume:
Other Response Actions
L
Fencng and Sign Posting
Oescnbe: TEMPORARY COVE RING OF CONTAMINATED SOILS
Check here if this IRA involves the use of Innovative Technologies (D FPis interested inusing this information to aid in creating an innovative
Technologies Clearinghouse).
Descrbe Technologies:
E. TRANSPORT OF REMEDIATION WASTE:
(if Reiearation
ste has been sent to an off-site facility, answer the folwing questions)
Name of Facility:
Town and State:
Quantity of Remouiation Waste Transported to Date:
F.
IMMINENT HAZARD EVALUATION SUMMARY:,
(check a e of the follomng)
S Based upon an evaluation, an Imminent Hammr exists in connection
ah this Release or Threat of Release.
1 Based upon an evaluation, an imminent Hazard does not exist inconn
on with this Release or:Threat of Release..
FT Based upon an evaluation, it is unknown whether an Imminent Hazard
in connection with this Release or Threat of Release, and further
assessment acttvities will be undertaken.
Based upon an evaluationt.
t is unknown whether an Imminent Hazard i in connection with this Release or Threat of Release. However,
response actions will address those conditions that could pose an Immi lent Hazard.
G, IRA COMPLETION STATEMENT:
rn
Check here if future response actions addressing this Reiease or Th
of Release will be conducted as part of the Response Actions planned
Tracing Number, or a Site that is identified on the Transiton List as
described in 310 CMR 40.0600 (1,e., a Transition Site, which includes es with approved Waiers). These additional response actions must
occur according to the deadlines applicatble to the earier Release Tracki g Number (i. e., Site ID Number).
for a Site trat has already been Tier Clas sifted under a different Ref
State Release Tracking Number (. e., Sit e 10 Number) of Tier Clasis
If any Remediation
Site or Transition Site:
Waste wit$ be store d. treated. mnanaged. recy
Statement. you must submit either a Release Abatemaet Measure (
appropriate transmittal form as an at=
or mused at the site following submission of the IRA Completion
) Plan or a Phase IV Remedy Implernentation Plan, along with the
t to the IRA Completion Slatement.
H. LSP OPINION:
I attest under the pains and penalties of perpury that Ihave personally examin and am familiar with this transmittal form, including any and all
documents accompanying this submittal. In my professional opinion and judg em based upon application of (J)the standard of care in 309 CMR
4.02(1), (ii)the applicable provisions of 309 CMR 4.02(2) ano (3), and (il) the ruvisions of 309 CMR 4.03(5), to the best of my knowledge.
information and beliet,
if Secon B of this frm inafcates mat an ImmedIate Response Acton Pla is being subnittad, the response action(s) that is (are) the subject of
this suomttal (i) has (have) been developed In accordance withtheapcable rowsions of M.G.L c. 21E and 310 CMR 40.0000. (ii) is (are)
aepropnare and reasonable to accomplish the purpose of such response acti; (s) as set forth in the applicable provisions of M.G.L c. 21E and 310
rits, and approvals identified in this submittal;
CMR 40.0000 and (iii) compiesty) with the identified provisions of all orders,
> if Secton B of this florm idicatesthat an Imminent Hazard Evaluatian is
accordance with the applicable provisions of M.G.L c. 21 E and 310 CMR 40.
Imminent Hazard Evauaton complies(y) with the applicatle provisions of MG.
ing submitted, this Imminent Hazard Evaluation was developed in
. and the assessment activity(ies) undertaken to support this
c.21E and 310 CMR 40.0000;
> if Secdon 8 of this krm noicates thar an immedke Response Status Re rt is being submtted,the response action(s) that is (are) the subiect
of this submitta; (i) is (are) being implemented in accordance with the aoplicable provisions of M.G.L c. 21 E and 310 CMR 40.0000. (ii) is (are)
approoriate and reasonable to accomplish the purposes of such response actio (s) as set forth in the -aplicableprovisions of M.G.L. c. 21 E and 310
CMR 40.0000 and (lii) complies(y) with the identified provisions of al ormers,
its, and approvals identified in this submittal;
I
> if Secton 8 of tis orm indcates that an Immediate Response Action
System andar Terminate a Continuingr Response Action(s) Taken to Ad
that is (are) Me subject of this submittal (i) has (have) been developed ano impi
and 310 CMR 40.0000, (ii) is (are) appropriate and reasonable lo accomplish
provisions of M.G.L c. 21E and 310 CMR 40.0000 and (iju)conolies(y) with the
this subtrttal
SECIONI is CDNITlNU
2124/95
Revisec 2(24/95
Revisea
plationSttement or a Request to Terminate an Active Remedial
an Imminent Hazard is being subritted,the response action(s)
ented in accormance with the appticable provisions of M.G.L. c. 21E
purposes of such resoonse action(s) as set forth in the appicable
dentified provisions of ail orders, permits, and approvals identified in
ON THE NEXT PAGE
Supersedes Forms BWSC-0o4. 006, 010 (in pan) arid 011
Do Not Alter 'FisForm
Page 2 of 3
Page 2 of 3
Massachusetts Departmen of Environmentaj Protection
BWSC-105
Bureau of Waste Site Cleanu
IMMEDIATE RESPONSE AC ON (IRA)R
TRANSMITTAL FORM Pursu nt to 310 CMR 40.0424 - 40.0427 (Subpart D)
Trackng Number
3
13814
H. LSP Opinion (continued):
I am aware that significant oenalties may result, including, but not limit
false, inaccurate or-matenadly incomplete.
to. possible fines and imprisonment. if I submit information wfich I know to be
7
, if any, are (were) sJO ect to any order(s), permrt(s) analor appmval(s) issued
t identifying the applicable provision
Check here if the Resoonse Action(s) on which this opinion is ba
by OEP or EPA. Ifthe box is checkea. you MUST attach a
KEVIN A. DOHERTY
LSP Name:
781-449-1566
Telephone:
LSP #:
Stamp:
Ex:
78l-449-1623
FAX: (optional)
7M9
Signature:
A
Date:
1. PERSON UNDERTAKING IRA:
BALIOTIS
Name of Orgasnoatio
Name of Contact:
'
NOMINEE TRUST
GEORGE BALIOTIS
TRUSTEE
Tine:
stret: 12 GREENWAY ROAD
cayrrown:
SALEM
State: MA
Teieohone: 781 -932-9500
Check here
i
Ex.:
ZIP Code: 01970
FAX:, (optionat)
there has been a change in the persn undertWn th
eRA.
IRA:
PR
arP:
J.RELATIONSHIP TO RELEASE OR THREAT OF RELEAS -OF PERSON UNDERTAKING
RP or PR P
Speeytr, aC
Owne
t Opentor
n
tt
Generata
Fisuciary, Secured Lener or Municipatoty vth Exempt Stats (ade
or
Other RP
Transporter
Ma
. 21E,
(Check one)
sn
Agency or Pulic Utility on a Right of Way (as defined by M.GL c. 2 E. s. 5(i)
Any nther Person Undertaing IRA
Specify Relationship:
K. CERTIFICATION
OF PERSON
GEORGE BA LIO TIS UNDERTAKINt
frA
, tes
ner th =pains and Penalties of Dequry (i) that Ihav" personally exaine ano am
familiar with the information contaned in thrs submittal, including any and acuments
cl
accompaninrg this transmittat form, (ii)that. based on my mnquiry
af those indivduals immediatety responsible for obtining The information. ta matenial informanen contained in this suDrMI is. mothe best of my
knowledge and berief. true, accurate anti complete, andi (0iithat t am fullya ard
to m-axe this attestation on behalf of"th entty lega~yretoonsible for
this submittai. I/the persoin or entity on whose behalf this submittai is made am/1is aware (hat there are significant penalties. including, but not limited to,
possible fines and implnsonmrent, for wilfully submitting false. inaccurate, orincomoliete information.
nr
B:(3ignature)
.
For BALIOTIS NOMINEE TRUST
Re:
TRUSTEE
Date:
2.9"
(pnnt name of person or entity recorded in Section 1)
.Enter
address of the
person
providing certification, if different from address -eorded in Secuon
1:
Street:
Telephone:
7JP Code:
State:
cilyfrowen:
E.:FAX:
(optionai)
THIS FORM OR DEP MAY RETURN THE DOCUMENT AS
FORM, YOU MAY B3E PENAUZED FOR MISSING
A REQU1R D DEADUINE.
YOU MUST COMPLETE ALL RELEVANT SECTIONS 0
INCOMPLETE. IF YOU SUBMtT AN ENCaMP
Revised 2/24195
Superseces Forms BWSC
5. 006, 010 (i part) and 01f
Do Not All r This Form
Page 3 of 3
SCANNED
IMMEDIATE RESP NSE ACTION PLAN
COMPLETI N REPORT
45 BOSTO
SALEM,
STREET
A 01970
RELEASE TRA KING # 3-13814
PREPA ED FOR:
MR. GEOR
BALIOTIS N
12 GREE
SALEM
E BALIOTIS
MINEE TRUST
WAY ROAD
MA 01970
PREP RED BY:
KNOLL ENVi ONMENTAL, INC.
69 WEXF RD STREET
NEEDHAM H IGHTS, MA 02194
rporateHeadquarters
*Wexford Street
edham, MA 02494
Tel (800)KNOLL26
(781) 449-1566
(781) 449-1623
,raiI lmoflem'@a"olcorn
Jun 7, 1999
imediate Response Action Compleon Reporl
Baholis Nominee mst
Preparatio of Report
This Immediate Response Action Completion Re )ort was prepared by Knoll Environmental, Inc.
(KNOLL) at the request of Mr. George Baliotis o EBaliotis Nominee Trust. This report was
prepared by Mr. Kevin A. Doherty, Professional lydrogeologist and Licensed Site Professional
(LSP # 7890).
1
Licensed Site
# 7890
innnediale Response Acmon Completion Reporl
HaholAt Nomfinee Trust
TABLE OF CONTENTS
1.0
INTRODUCTION
.
.
.
.
.
.
.
.
1
1.1
Background
.
.
.
.
.
.
.
.
1
1.2
Project Objectives
.
.
2
1.3
Location Information
.
.
.
.
.
2
.
.
.
.
.
.
2.0
IMMEDIATE RESPONSE ACTION.
.
.
.
.
.
.
3
3.0
IMMINENT HAZARD EVALUATION
.
.
.
.
.
.
4
4.0
PROPOSED SCHEDULE
.
5
5.0
PREPARATION OF IRA PLAN
.
5
,
.
.
.
.
.
.
.
.
.
.
.
FIGURES
Figure 1: Topographic Site Map
Figure 2: Site Plan
Figure 3: Detailed Site Plan
TABLE
Table
Table
Table
Table
Table
Table
1:
2:
3:
4:
5:
6:
Summary
Summary
Summary
Summary
Summary
Summary
of Ground Water An
of Ground Water An
of Soil Analytical D
of Soil Analytical D
of Soil Analytical D
of Water Level Data
lytical Data - VOCs
lytical Data - Metals
ta - TPH and VOCs
ta - Metals
ta - Metals
APPENDIX
Appendix A: IRA Plan and Status Rep rt Transmittal Form
4
d%
Jmmieidite Responte Action Completion Report
Halo/ts Nominee Trut
1.0
Page I
INTRODUCTION
This Immediate Response Action (IRA) Complet on report is submitted to the Massachusetts
Department of Environment Protection (MADEP to document the outcome of an Immediate
Response Action (IRA) conducted at 45 Boston treet in Salem, Massachusetts in accordance
with 310 CMR 40.0427. This report is submitte in conjunction with the Immediate Response
Action Transmittal Form BWSC- 105 that is copi d in Appendix A. This IRA was conducted by
Mr. George Baliotis, Trustee, Baliotis Nominee rust, 12 Greenway Road, Salem, MA 01970,
telephone (617) 932-9500. This Immediate Res onse Action (IRA) Completion Report is
submitted for Massachusetts Department of Envi onment Protection (MADEP) approval,
pursuant to 310 CMR 40.0420(4), and is designe to ensure the elimination of an imminent
hazard and a substantial release mitigation as de ned in 310 CMR 40.0321(2)(b) and 40.0413(2).
Specifically:
+
1.1
a release to the environment indi ated by the measurement of concentrations of
hazardous materials within 500 f et of a residential dwelling, school, playground,
recreation area or park.
Background
The Site is located at 45, 59-61 Boston Street d 21 Proctor Street, in Salem, Massachusetts as
shown in Figure 2, Site Plan. The Site is locate within an industrial and commercial area within
the city of Salem and borders a residential area, nd is serviced by municipal water and sewage.
The site is located on the city of Salem Assesso Map No. 15 and includes lot 319, lot 320, lot
321, lot 322 and lot 324. The site is occupied b three structures as shown on Figure 2, an auto
repair shop (45 Boston Street), a former leather finishing company (Ideal Finishing Company)
and a private residence (21 Proctor Street. Top graphically the Site is located at an elevation of
approximately 10 feet above mean sea level, at pproximately 423 1'05" latitude and 70 54' 35"
longitude and at the Universal Transverse Mere ture coordinates 3431 OmE and 4708875 mN.
The Site is located along the North River appro imately 50 feet directly across Boston Street.
Refer to Figure 1, Topographic Site Map, Figu 2, Site Plan and Figure 3, Detailed Site Plan, for
Site details.
In February of 1995 Haley & Aldrich, Inc. (H A) conducted a Phase I Environmental Site
Assessment and in April of 1995 conducted a hase II Environmental Site Assessment. The
results of the Phase II assessment revealed low levels of VOCs in the ground water, elevated
levels of arsenic and mercury in ground water, and elevated TPH concentrations in site soils.
In December of 1995 and May of 1996, Envir nmental Science Services (ESS) conducted a
subsurface investigation of site soils and gro d water. The results of the subsurface
investigation revealed levels of arsenic in surfi ial and subsurface soils and ground water
contamination containing arsenic and mercury
4
Page 2
lrnmediate Response Action Completion Repor
Iazko/A Noninee Mst
On May 23, 1996, Mr. George Baliotis submitted
Hazard Notification". The "open soil area" conta
accessible and was fenced in as an interim measu
1996, Mr. Baliotis submitted a Release Notificati
Tracking Number issued at this time was 3-1381
a letter to the MADEP reporting an "Imminent
ning the elevated levels of arsenic was directly
e to prevent access to the soils. On July 19,
n form to the Department. The Release
.
From June of 1996 through September of 1996, P Engineering (SP) conducted additional site
investigation activities consisting of the samplin of surficial and subsurface soils, ground water
sampling, the removal of an oil/water separator a d 500 gallon waste oil UST, the removal of
two 1500 gallon #2 fuel oil UST's, and the remo al of a 6,000 gallon #2 fuel oil UST. During
the removal of the UST's, the excavation and d mming of soils and water was conducted in two
areas; the waste oil tank and separator system, d the 1500 gallon #2 fuel oil UST located inside
the on-site building (Refer to Figure 2). These a tivities are presented in a report titled " Chapter
21-E Site Investigation Conducted at Ideal Finis ing" and dated July 1996.
In October of 1996, George Baliotis contracted r. Kevin Doherty, a professional
hydrogeologist and Licensed Site Professional ( 7890) of Knoll Environmental, Inc. (KNOLL),
to review site information to date and to prepare the necessary response actions as required by
the MADEP in the Massachusetts Contingency lan, 310 CMR 40.000. An IRA plan, which
served as both an Immediate Response Action P an and Status report as requested by Mr. Roger
Chu in verbal correspondence conducted by tele hone on Friday, October 11, 1996, was
submitted on October 14, 1996. The objective f the IRA was to perform an Imminent Hazard
Evaluation to satisfy the requirements of the M P and to further assess site conditions to define
the area(s) requiring remediation. This data an the current data collected to date were utilized
for the completion of IRA Activities in accorda ce with 310 CMR 40.0426.
On June 2, 1999 a Phase II Comprehensive Site Assessment report and a Phase III
Comprehensive Remedial Action Plan was sub itted to the MADEP in accordance with the
required timelines outlined in the MCP. The P ase It report documents the site contaminants in
the soils and ground water throughout the prop rty and the Phase III report outlines the remedial
alternatives to cleanup the localized areas of so 1 and ground water contamination.
2.0
IMMEDIATE RESPONSE ACTION ACTIVITIES
In accordance with 310 CMR 40.0427, the I
consultant, Mr. Kevin Doherty, a Licensed Sit
hydrogeologist of Knoll Environmental, Inc. (
Massachusetts 02494, telephone (781) 449-15
was implemented by Mr. George Baliotis'
Professional (LSP # 7890) and professional
NOLL), 69 Wexford Street, Needham Heights,
6.
The objective of the IRA was to further assess
define the area(s) requiring remediation. The
ground water (arsenic, cadmium, mercury) an
water were quantified through the implementa
water observation well exploration program.
arsenic is surficial and subsurface soils and to
xtent of arsenic and associated metals in soils and
petroleum related compounds in soils and ground
ion of a comprehensive soil sampling and ground
Immediate Response Action Completion
Page 3
Report
1iaotis Nominee Trust
The current analytical data for soils and ground water conducted by H & A, ESS, and SP
Engineering are summarized in tabular form that ompares the chemical concentrations to the
MADEP "Reportable Concentrations" and "MCP Method 1 Standards" for the soil categories of
S-I /GW-2, S-2/GW-2, and the ground water cate ories of GW-2 and GW-3. The following
tables summarize the analytical data collected to ate:
D Table 1: Summary of Ground Water A alytical Data - VOCs
D Table 2: Summary of Ground Water
nalytical Data - Metals
" Table 3: Summary of Soil Analytical
ata - TPH and VOCs
" Tables 4&5: Summary of Soil Analyti at Data - Metals
C Table 6: Summary of Water Level Da a
Referring to Tables 1 and 2 summarizing ground water quality, TPH exceeds GW2 Method 2
Standards in the area of the former waste oil US" (HA2/MW2). Volatile organic compounds are
low and not exceeded and semi-volatile organic ompounds are not quantified. In addition,
arsenic and mercury exceed GW3 Method 1 standards in HA2, 1 A3 (MW-B3) and MW-B4. In
addition, cadmium exceeds GW3 Method 1 stan lards in MWl (HA1) and MW2 (HA2).
Referring to Table 3, TPH in site soils exceed S-1/GW-2 standards at HA2-S4, Soil under Fuel
Tank, Soil Under Waste Oil, and Soil Under Ins de Tank. Volatile organic compounds and semivolatile organic compounds are not quantified a- these locations.
Referring to Tables 4 & 5, arsenic in site soils e ceeds the Upper Concentration Limits (UCLs)
at the 2-foot to 4-foot interval in boring B-2, an the 6-foot to 10-foot level at boring B-4. The
UCLs are approached at the 0 to 4-foot level of orings B-5 and B-7, and the 5-foot to 8-foot
interval at boring B-9. Borings HA3-S5 and B- 11 are the only boring locations that do not
exceed Method 1 Standards. The principal area of arsenic in surficial soils has been covered
with 12 inches of clean fill and fenced off to pr vent direct access.
Figures 2 and Figures 3 depict the observation ell and boring designations and locations
throughout the site. Referring to the Figures, t e principal areas of environmental concern
relative to this IRA condition are the following
Page 4
Inmediate Response Action Completion Report
BaliotisNominee TrusI
Sthe surficial and subsurface fill materi Is in and around the present auto repair garage
contain arsenic in areas, which exceed UCLs. Some soils will require removal and
those areas exceeding reportable cone ntrations yet below Method I Standards may
be eligible for an AUL.
> the ground water in the vicinity of H 2, HA3, MW-B3, and MW-B4 exceeds GW3
standards for mercury and/or arsenic nd exceeds arsenic UCLs in some areas and
will require removal/treatment.
This IRA was limited in scope and complexity, ad involved placement of a cap of clean fill one
foot thick overlain by 6 inches of crushed stone i areas where surficial and subsurface soils
contain arsenic which exceed reportable concent ations and UCLs.
4.0
FINDINGS AND CONCLUSIONS
The Immediate Response Actions taken by KN LL have assessed Imminent Hazards at the site
and contained and prevented future exposure to rsenic contaminated soils. The capping of these
soils has accomplished necessary stabilization o site conditions and controlled Imminent
Hazards to health, safety and public welfare. Ar Imminent Hazard Evaluation will be
continually evaluated as part of Phase II-IV Co prehensive Response Actions in accordance
with 310 CMR 40.0400 or 40.800. Until Comp ehensive Response Actions are conducted to
address areas of environmental concern, the perimeter fence and soil cap will be maintained.
5.0
LICENSED SITE PROFESSIONAL
PINION
I attest that I have personally examined and am amiliar with the information contained in this
submittal, including any and all documents ace mpanying this attestation, and in my professional
judgment, the response action(s) that is the subj ct of this submittal complies with the provisions
of MGL c. 21A, 19-19J, 309 CMR, MGL c. 21 , 310 CMR 40.0000, and all other laws,
regulations, orders, permits, and approvals appl cable to such response action(s). I am aware that
significant penalties may result, including but ot limited to, possible fines and imprisonment, if
I willfully submit information which I know to be false, inaccurate or incomplete.
Kevin
. Doherty
Director Envi onmental Services
Licensed Site rofessional 4 7890
A
C
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A
Iunediate Response Action Completion Report
aIativ Nominee Trust
Appeodix A
IRA Completion Repbrt Transmittal Form
Massachusetts Department of En ironmental Protection
Bureau of Waste Site Cleanup
SWSC-105
Release Tracang Numoer
IMMEDIATE RESPONSE ACTION (IRA)
TRANSMITTAL FORM Pursuantto 3101CMR 40,0424 - 40.0427 (SubpartO)
3
13814
A. RELEASE OR THREAT OF RELEASE LOCATION:
Releese Name: (optiona
Streer
45 B&STON STREET
SALEM
cityrrown:
Submittat has been provided to OEP for tt is Release Tracnrg Numoer.
.
Check here
E
Check here if this location is Adequately Regulated, pursuant to 310 CMR
E
Specify Program:
0970
IP Code:_
if a Tier Ctassificaion
POPE STREET & BOSTON ST
Locadon Aid:
fl
CERC LA
HSWA Correctve Action
.0110-0114
lid Wase Management
]S
j
RCRAr Stae Prgram (21C Faciliies)
Related Release Tracking Numbers That This IRA Addresses:
B. THIS FORM IS BEING USED TO:
0
H, 1,J and K).
Subnt an IRA Plan (complete Sections A. B, C., 0.
0
7
(check all that aoplv)
ChecK
here
ifthis IRA Plan is an update or modification of a previousy pproved written IRA Plan.
Date Submrtte.:
Submit an invinnent Hazard Evaluation (compiete Sections A. B, C, F. H, 1,J and K).
I Suomit an
iRA Status
Report (complete Sections A, S. C, E. H. .J and K),
Suomit a Request to Terminate an Active Remedial Systern andlor Tem nate a Continuing Response Actionisi Taken to Address an
Inminent Hazard (complete Sections A, 2, C, 0. E. H,
1, J ano K).
X
Submit an IRA Completion Statement (conolete Sections A, 8. C. 0. E, G. H.J. J and K).
You must attach all supporting docunetation requied fci each use of form indicated, incluing copies of
any Legal Notices and Notices to Public Of its required by 310 CMR 40.14D.
C. RELEASE OR THREAT OF RELEASE CONDITIONS THAT WAR1
Identify Media and Receptors Affected: (check all that apply)
7
Paved Surface
Stan, Orain
Weland
Identify Conditions That Require IRA. Pursuant to 310 CMR 40.0412:
72 Hour Reportng Condition(s)
Desncrbe:
7
Private Wa
L
m
Surfce Water
Public Water Supply
I
Sediments
Zone 2
.
Soil
Residence
R
(check al
itapply)
Substantial Reose Migr on
2
2 Hour Reorting Condition(s)
[
Other Condition(s)
ARSENIC IN SURFICIAL SOILS POSED AN IMMINENT HAZARD
S
Chlorinated seivents
Assessment an/or Monitoring Only
7
Cepkiyment of Absorbent or Containment Materials
Excavation of Contaminated Soils
Q
Temoorary covers or Caps
L
5
Bioremediadon
Identify Oils and Hazardous Materials Released:
: Others
Oils
1crieck all that apply)
Heavy Metals
(checxall that apply)
Re-use. Recycang or Treatment
> On Site
Q
Orr Site
ESt Vol.:
culIic verds
Soul
Vapor Extracdon
Describe:
| Stmcture Venting System
F
Store
:
On Site
5
Landflit
Q
Cover
Q
j
Off Site
Est. Vol.:
Disposal Est Vol.:
Removal of Drums. Tanks or Containers
Describe:
iI
Soecfy-
0. DESCRIPTION OF RESPONSE ACTIONS:
OI
NT IRA;
Grounawater
other SpciY
uniknown
Seinoo
Air
cubic y
r
Product or NAPL Recovery
Groundwater Treatment Systems
cubic yErds
I
Air Soarging
5
Temporary Water Suppites
SECTION D IS CONTINUED ON THE NEXT PAGE.
Revised 21
5
Supersedes Forms BWSC405, 04, 010 (in par) and 011
Do Not After This im
Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Waste Site Cleanup
BWSC-l 05
Retease Tracing Numoer
IMMEDIATE RESPONSE ACTION (IRA)
f-
TRANSMITTAL FORM
'3
Pursuant to 10 CMR 40.0424 - 40.0427 (Subpart D)
.
13814
D. DESCRIPTION OF RESPONSE ACTIONS (continued):Removal of Other Contaminated Media
E
Temporary Evacuadon or Relocation of Residents
Specify Type and Volume:
7
Fencing and Sign Posting
Other Response Actions
Describe: TEMPORARY COVERING OF CONTAMINATED SOILS
Check here if this IRA involves the use of Innovative Technologies (DEF- is interested in using this information to aid in creating an Innovave
Technologies Clearinghouse).
Describe Technologies:
E. TRANSPORT OF REMEDIATION WASTE: (if Remediation W ase has been sent to an off-site facility, answer the following questions)
Name of Facility:
Town and State:
Quantity of Remecianon Waste Transported to
Date:
F. IMMINENT HAZARD EVALUATION SUMMARY:
(checX on ef the following)
0
Based upon an evaluation, an imminent Hazard eiasts in connection with this Release or Threat of Release.
H
Based upon an evaluation, an Imminent Hazard does not eist inconne on with this Release or.Threat of Release.
7
Based upon an evaluation, it is unknown whether an Imminent Hazard :2sts inconnecton with this Release or Threat of Release, and further
assessment activities will be undertaken.
Based upon an evaluation. it is unknown whether an Imminent Hazaru:is
in connection with this Release or Threat of Release. However,
response actions will address those conditlons that could pose an Immir ent Hazard.
G. IRA COMPLETION STATEMENT:
r
Check here if future response actions addressing this Release or Threat of Release will be conducted as part of the Response Actions planned
for a Site that has already been Tier Classified under a different Release Tracilong Numoer, or a Site iat is identified on the Transition List as
described in 310 CMR 40.600 (. e., a Transition Site, which includes S tes with aoproved waivers). These additional response actions must
occur according to the deadlines applicable to the eartier Release Trackt g Number (i. e., Site 10 Number).
State Release Tracking Number (L
e., Site ID Number) of rw Classified Site or Transition Site:
if any Remediation Waste ill be stared,. treated. managed. recycle or mused at the site following submission of the IRA Completion
Statement, you nust submit either a Release Abatement Measure (R W) Plan or a Phase IV Remedy Imoternentation Plan. along with the
appropriate tranrniati form as an attacIanent to the IRA Completion Statement..
H. LSP OPINION:
I attest under the pains and penalties of perqury that I have personally examineI and am familiar with this transmittal form, incauding any and all
documents accompanying this submittal. in my professional opinion and judg ent basea upon application of (I) the standard of care in 309 CMR
402(1), (11)
the aputicable provisions of 309 CMR 4.02(2) and (3), and (iii) the prcsions of 309 CMR 4,03{5). to the best of my knowledge,
information and belief.
if Secton 8 of this fbrm idicates Mar an Immediate Response Action Pft is being sunnitedt, the response action(s) that is (are) the subject of
this suomrttal (i) has (have) been developed in accordance with the asplicable rovisions of M.G.. c. 21E and 310 CMR 40.0000, (ii) is (are)
appropnate and reasonable to accomptish the purposes of such response actil n(s) as set forth in the appdicable provisions of M.G.L c. 21E and 310
CMR 40.0000 and (Ui)complies(y) with the identified provisions of all orders, p nrits, and approvals identified in this submittal:
> i Secion B of this orm urdicates thar an ImminerrtHazard Evaluation is Iing submirted, this Imminent Hazard Evaluation was developed in
accordance with the applicable provisions of M.G.L c. 21E and 310 CMR 40. 10. and the assessment activity(ies) undertaken to support this
imminent Hazard Evalanon compli(y) with the applicable provisions of M.G. . 21 E ard 310 CMR 40.0000;
.fSczdon a of this ibrm indcates that an Immediate Response Stats Re
tis being subntted the response actionts} that is (are) the subaect
at this submittal (i) is (are) being implernented in accordance with the sopficabi- provisions of M.G.L c, 21 E and 310 CMR 40.0000, (ii) is fare)
approonate and reasonable to accomplish the purposes of such resoonse actic (s) as set forth in the aoplicable provisions of M.G.L. c. 21 E and 310
CMR 40.0000 and (iii) compliesty) with the identified provisions of all arers, p frnits, and approvals identified in this submittal:
> if Secdon 8 of this form incates that an Immediate Response Action C paeion Statement or a Request to Taminatean Active Remedial
System and/or Terminate a Condnuing Response Action(s/ Taken to Ade 'rss an Imminent Hazard is beig subrtfud, the response action(s)
that is (are) the su4ect of this submittal (I) has (have) been developed ani impi aented in accordance with the applicable provisions of M.GL C.21 E
and 310 CMR 40.0000, (i) is (are) appropriate and reasonable to accomplish ti purposes of such resconse action(s) as set forth in the appicable
provisions of MGL c. 21 E and 310 CMR 40.0000 and (Iii) cornoles(y) with th identified provisions of all orders. permits, and approvals identified in
this submittal.
SECTION H IS CONTINUE 3 ON THE NEXT PAGE.
Revisea 2/24t95
Supersedes Forms SWSC-O , 006, 010 (in part) and 011
Do Nat Altr This Form
Page 2 of 3
S
i
Massachusetts Department o Environmental Protection
BWSC-1 05
Bureau of Waste Site Cleanup
IMMEDIATE RESPONSE ACTION (IRA)
TRANSMITTAL FORM Pursuant so 310 CMR
Release Tracxing Number
40.0424 - 40.0427 (Subpart 0)
3
13814
H. LSP Opinion (continued):
I am aware that significant oenalties may result. including, but not limited t . possible fines and imansonment. it I submit informatuon whtci knew to be
false. inaccurate armaterially incomplete.
fl
Check here if the Resoonse Action(s) on which this opinion is based. i any, are (were) suoiect to any orders), permrtls) anworaprova(s) issued
by DEP or EPA If the box is checkea. you MUST attach a statement deintving mhe applicable provision I
KEVIN A. DOHERTY
LSP Name:
Telephone:
781-449-1566
FAX: (optionai)
stamp:
tSPt
F.:
11
781-449-1623
Signature:
oats:
L. PERSON UNDERTAKING IRA:
Nae
f rgnuno.BALIOTIS NOMINEE TRUST
GEORGE BALIOTIS
Street 12 GREENWAY ROAD
ciyrrown: SALEM
Name of Contact
The'
state
Teieohone: 781-932-9500
E
EX&:
Check here if there has been a change in the person undetaiting the
TRUSTEE
MA
ZIPCcde:
FAX (Dotionat)
RA.
J. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON UNDERTAKING IRA:
,I
RP or PRP
Spectr C.: Owner
Q
Operator
Q
01970
Generator
Q
(check one)
Transoorter Ciher RP or PRP:
Figucary, Secure Lener or Murucality with E n:pt Status (as defaby M.GL c. 21 E, s.2)
F
Agency or Puolic Utlitty on a Right of Way (as defined by MG.L c. 21
Any Cther Person Underting IRA
. a. 50)
Specify Reiationship:
K. CERTIFICATION OF PERSON UNDERTAKING IRA:
1.
GEORGE BALIOTIS
,. aet umW
t
cam -onafies of qery Q)that I have personullye mned an am
familiar with the information contained in this subrnittal. including any and all aocunents accompanying this transmittal form, (ii) that, based on my mnquiry
of those individuals imrnediately responsible for obtaining the nformation. th matenal information conmined in this suomittal is, to the bet of my
knowledge and bedef. true. accurate an conplete, and (iii) that I am fuily athoned to maxe this attestation on behalf of the entity legally resonsible for
this subrmttai. I/the person or entity on whose oehalf this submittal asmade is aware that there are significant penalties. including but not limited to.
possible fines and impnsonment, for wilfully subritting false, Inaccurate, or incomolete information.
(signature)#I
i-
A.
Fr BALIOTIS NOMINEE TRUST
TRUSTEE
Date:
(pnint name of person or entity recorded in Section t)
Enter address of the oerson providing certification, if different from address recorded in Section 1:
Street:
City(Town:
Telephone:
State:
Ext.:
ZIP
Code:
FAX- (optonal)
YOU MUST COMPLETE ALL RELEVANT SECTIONS CF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS
INCOMPLETE. W YOU SUBMIT AN INCOMPU M FORM, YOU MAY BE PENAIZED FOR MISSING
A REQUIR cD DEADLINE.
Revised 224/95
Superseces Forms SWSC-005. 006, 010 (in parr) and 011
Do Not Alter This Form
Page 3 of 3
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