Table 6: Outline for Board Acceptable Site Assessment *

  1. Introduction
  1. General Information about the Dispensing Facility
  1. Address and geographic location of the Dispensing Facility, including the Universal Transverse Mercator (UTM) coordinates.
  2. A general description of the land use surrounding the Dispensing Facility including information obtained during site reconnaissance (see Table 3).
  3. Soil and groundwater categories defined by 310 CMR 40.0932.
  1. Description of Dispensing Facility
  1. Area locus map, based upon a U.S.G.S topographic or equivalent map, depicting an area 1/2 mile radius around the Dispensing Facility and a GIS.
  2. Site map depicting significant features of the Dispensing Facility (see Table 3 and 4), and property boundaries, and discussion of pertinent information within text.
  3. Types and uses of buildings or other structures which are present at the Dispensing Facility
  4. Indicate present or past federal/state environmental permits/regulations at the Dispensing Facility
  5. Hydrogeologic setting (see Table 1). Describe local site geology and hydrogeology which affect the potential for contaminant migration
  6. Summary of site reconnaissance information (see Table 3)
  1. History of Dispensing Facility (see Table 2)
  1. Ownership/lessorship (include information obtained from interviews, Table 5)
  2. UST System installation, usage, closure and information obtained from interviews, Table 5).
  3. Past operations at, and in the vicinity, of the Dispensing Facility
  4. Past buildings or structures which were present at the Dispensing Facility
  5. Historical oil and/or hazardous materials use and storage at the Dispensing Facility
  1. Evaluation of environmental conditions at the Dispensing Facility
  1. Summary of information obtained from publically available sources regarding existing environmental conditions at the Dispensing Facility (see Table 1).
  2. Summary of operations and chemical use, storage and management practices at the Dispensing Facility which could potentially impact soil and groundwater at the Dispensing Facility (include information obtained from interview, Table 5).
  3. Method and results of sample collection (see section 2.31)
  4. A description of the present conditions at the Dispensing Facility including a discussion of historical information and site sampling activities and results which provide an overview of the environmental conditions at the site.
  1. Conclusions
  1. Provide summary of data and information to substantiate that either: (1) there are no levels of Petroleum Product or conditions related to a release of Petroleum Product which require notification to DEP, or (2) there are levels of Petroleum Product or conditions related to a release of Petroleum Product which require notification to DEP using the following format:
Information Source Significant Findings/
Conclusions

Evidence of Contamination? (Yes/No)

Records
Hazardous materials/use storage
Potential release areas:
  • Petroleum Product UST System
  • Other USTs (waste oil, fuel oil)
  • ASTs
  • Bay drains
  • Oil/Water separator
  • Overfills
  • Accidents
  • PCB transformers
  • Septic
  • Surface releases
  • Other
Interview(s)
Site reconnaissance (visual)
Sampling Results
Other
  1. Provide conclusion that, based upon the records review, interviews, site reconnaissance, and site sampling activities: (1) there are no levels of Petroleum Product or conditions related to a release of Petroleum Product which require notification to DEP; or (2) there are levels of Petroleum Product or conditions related to a release of Petroleum Product which require notification to DEP.

Appendices:

  • Site Reconnaissance field notes and sketch
  • Supporting analytical documentation for groundwater and soil samples, as applicable.
* Note: In the event that levels of Petroleum Product or conditions related to a release of Petroleum Product are identified which require notification to DEP, then the Phase I (310 CMR 40.0480) and, if applicable, Phase II (310 CMR 40.0830) reports must also be submitted to the Board when completed, along with the most recent DEP response action submittal of site assessment, containment, and removal activities including any RAOs if achieved.