Site Cleanup Transmittal Forms

Making sure that the Waste Site Cleanup forms are filled out and submitted correctly involves a coordinated effort between Waste Site Cleanup program staff and EEA Information Technology staff.  By directing your question to the people with the right expertise, we'll be able to help you faster & better.

• For questions relating to how the BWSC forms work on eDEP (e.g., what forms you need to fill out, why the forms ask certain questions), please email the BWSC program staff at BWSC.eDEP@state.ma.us.
   
• For problems, changes or corrections to DEP data systems (e.g., LSP Change of Address, LSP Proof, WSC data corrections, Resource Maps, Site Files), please email BWSC program staff at BWSC.eDEP@state.ma.us.
   
• For eDEP hardware/software problems (e.g., slowness, availability, attachments not uploading, blank screens) please email the EEA Service Desk at EEA.ServiceDesk@massmail.state.ma.us or call (617) 626-1111.

BWSC103:  (2/72 hr) Release Notification and Retraction Form

Notification to MassDEP of a release or threat of release of Oil and/or Hazardous Material is required under the regulations established by the Massachusetts Contingency Plan (MCP) at 310 CMR 40.0300. 

This Form is for use by a person who wants to:

• Provide DEP with written notification of a release or threat of release of Oil, Hazardous Material or both for 2 and 72 hour releases, or
• Revise a previously submitted oral or written notification of a release or threat of release, or
• Retract a previously submitted oral or written notification of a release or threat of release.

BWSC103: (120 day) Release Notification & Notification Retraction Form

This second version of the BWSC103 Release Notification and Notification Retraction Form is to be used to submit the BWSC103 to MassDEP when the Release Tracking Number (RTN) has not yet been assigned by the regional office.

This form is to be used for 120 Day releases only.

BWSC104:  Permanent or Temporary Solution Statement Transmittal Form

Revised April 2014
Formerly the RAO transmittal form.

This form is used to submit documentation that the cleanup has achieved a Permanent or Temporary Solution.

BWSC105: Immediate Response Action (IRA) Transmittal Form

This form is used to submit an IRA Plan, Imminent Hazard Evaluation, Status Report, Remedial Monitoring Report, IRA Completion Statement, Plan for Application of Remedial Additives, or  to terminate a Response Action taken to address an Imminent Hazard.

BWSC106:  Release Abatement Measure Transmittal Form

This form is used to document progress of a Release Abatement Measure (RAM), including the initial and modified RAM Plan, Remedial Monitoring Reports and RAM Completion Statements.

BWSC107: Tier Classification Transmittal Form also includes several additional forms used in specific cases:

• BWSC107B: Tier Classification Compliance History
• BWSC107C: Tier Classification Transferor Certification
• BWSC107D: Eligible Person, Eligible Tenant or Other Person Transmittal Form

BWSC108: Comprehensive Response Action Transmittal Form & Phase I Completion Statement

This form is used to submit any one of a number of documents associated with the implementation or completion of MCP Response Actions, including:

• Phase I Completion Statement
• Phase II Report & Completion Statement
• Phase III Remedial Action Plan and Completion Statement
• Phase IV Remedy Implementation Plan, and
• Phase V Completion Statement

For a full list of documents submitted using this form, see the checklist in Section B of the form itself.

BWSC111: Audit Follow-up Plan Transmittal Form & Post-Audit Completion Statement

The initial BWSC112 Bill of Lading ("BOL"), which includes the LSP Opinion and Remediation Waste Characterization, must be submitted electronically through eDEP. Follow-up documentation, including:

• BWSC112A Summary of Shipment Sheet 
• BWSC112B Summary Sheet Signature Page 
• Transport Log Sheet 

may be submitted through eDEP or using the paper forms below.

BWSC113: Activity & Use Limitation (AUL) Transmittal Form is used to submit any one of a number of AUL-related documents, including:

• Registry copy of a Notice of AUL
• Registry copy of a Termination of a Notice of AUL
• Registry copy of a Confirmatory Notice of AUL, and
• Registry copy of a Deed referencing a Notice of AUL

For a full list of documents submitted using this form, see the checklist in Section B of the form itself.

BWSC115 & 115A: Downgradient Property Status Transmittal Forms

When a Downgradient Property Status ("DPS) submittal addresses more than one RTN, please submit a separate BWSC115 Downgradient Property Status Transmittal Form for each RTN addressed in the Downgradient Property Status.

BWSC119: Utility-Related Abatement Measure (URAM) Transmittal Form

This form is used to document progress of a Utility-Related Abatement Measure (URAM), including the initial notification, submittal of Status Reports, Remedial Monitoring Reports and URAM Completion Reports.

BWSC120: Homeowner Certification Form

This form is used by a homeowner to document that they are eligible for reduced fees.

A Homeowner is an owner occupant of a residential one to four family structure used exclusively as a one to four family residence throughout his or her ownership, and where the owner's unit is the owner's principal residence for 6 or more months of the year and the owner is conducting response actions at the residence.  (see 310 CMR 4.02 for more details)

BWSC121: Notification of Delay in Compliance with Response Action Deadlines Transmittal Form

Note that, except in the case of Force Majeure,  providing this notice does not forgive a Responsible Party's, Potentially Responsible Party's or Other Person's noncompliance with response action deadlines in 310 CMR 40.0000, nor does it extend those deadlines.

BWSC122:  Informational Notice to Property Owners

This form is used to provide notice that a property falls within the boundary of a disposal site.

Revised June 2014
Note: This form is not available through eDEP.

BWSC123: Notice of Environmental Sampling is used to let a property owner know that sampling will/has been conducted at a property or to provide the results of sampling on the property.

Revised May 2014
Note: This form is not available through eDEP.

BWSC124: Informational Notice About Immediate Response Actions  (IRAs) is used to provide information to potentially affected parties about an IRA that is/has been/will be conducted, or to provide notice that the IRA is now completed.

Revised June 2014
Note: This form is not available through eDEP.

BWSC125: Notification of a Non-eDEP Submittal is used to accompany a CD, DVD or thumb drive containing documents that are too large to be submitted using eDEP, but which are required to be submitted electronically.

Revised June 2014
Note: This form is not available through eDEP. This form must be completed when making a non-eDEP electronic submittal. Non-eDEP electronic submittals will not be accepted by the regional offices without the BWSC125 form and any other required attachments. See the BWSC125 Notification form for more detailed instructions.

BWSC126: Miscellaneous Document Transmittal Form is used to submit documents, letters, reports or other material for which there is not a form specified by the Department.

BWSC127:  Activity & Use Limitation (AUL) Property Ownership Update Form

This form is not available through eDEP.

This form is for updating property ownership information for disposal sites with Activity & Use Limitations where the most recent property transfer occurred prior to June 20, 2014.  Where the property was conveyed to a new owner on or after June 20, 2014, this form should not be used to update property ownership information.

Instead, a copy of the deed must be submitted to MassDEP to meet the requirements of the Massachusetts Contingency Plan at 310 CMR 40.1074(5) using the online transmittal Form BWSC 113 (see BWSC113 Activity & Use Limitation (AUL) Transmittal Form).