Guide Site Cleanup Transmittal Forms

MassDEP requires that the cleanup of contaminated property be documented so that there is a complete record of what is known about the contamination and what was done to clean it up. These documents are submitted to MassDEP (usually electronically) accompanied by standard Transmittal Forms that allow the information to be entered into our data systems.

There are transmittal forms for each specific type of document, plus one to use for miscellaneous documents (letters, reports, etc.)

BWSC103: (2/72 hr) Release Notification

Used for 2-Hour and 72-Hour Notifications
29,243 Number of 2 & 72-Hour Release Notifications through FY16

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.

Key Actions for BWSC103: (2/72 hr) Release Notification

Additional Resources for BWSC103: (2/72 hr) Release Notification

BWSC103: (120 day) Release Notification

Used for 120-Day Release Notifications
11,646 Number of 120-Day Notifications through FY16

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.

Key Actions for BWSC103: (120 day) Release Notification

Additional Resources for BWSC103: (120 day) Release Notification

BWSC104: Permanent or Temporary Solution

34,233 Permanent & Temporary Solutions Filed through FY16

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.

Key Actions for BWSC104: Permanent or Temporary Solution

Additional Resources for BWSC104: Permanent or Temporary Solution

BWSC105: Immediate Response Actions

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.

Key Actions for BWSC105: Immediate Response Actions

Additional Resources for BWSC105: Immediate Response Actions

BWSC107: Tier Classification

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

Key Actions for BWSC107: Tier Classification

Additional Resources for BWSC107: Tier Classification

BWSC108: Comprehensive Response Actions

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.

Key Actions for BWSC108: Comprehensive Response Actions

Additional Resources for BWSC108: Comprehensive Response Actions

BWSC111: Audit Follow-up

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

Key Actions for BWSC111: Audit Follow-up

Additional Resources for BWSC111: Audit Follow-up

BWSC112: Bill of Lading

The initial BWSC112 MUST be submitted through eDEP.

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.

Key Actions for BWSC112: Bill of Lading

Additional Resources for BWSC112: Bill of Lading

BWSC113: Activity & Use Limitations

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.

Key Actions for BWSC113: Activity & Use Limitations

Additional Resources for BWSC113: Activity & Use Limitations

BWSC115 & 115A: Downgradient Property Status

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.

Key Actions for BWSC115 & 115A: Downgradient Property Status

Additional Resources for BWSC115 & 115A: 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.

Key Actions for BWSC119: Utility-Related Abatement Measures

Additional Resources for BWSC119: Utility-Related Abatement Measures

BWSC120: Homeowner Certification

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)

Key Actions for BWSC120: Homeowner Certification

Additional Resources for BWSC120: Homeowner Certification

BWSC121: Notification of Delay

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.

Key Actions for BWSC121: Notification of Delay

Additional Resources for BWSC121: Notification of Delay

BWSC122: Notice to Property Owners

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.

Key Actions for BWSC122: Notice to Property Owners

Additional Resources for BWSC122: Notice to Property Owners

BWSC123: Notice of Environmental Sampling

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.

Key Actions for BWSC123: Notice of Environmental Sampling

Additional Resources for BWSC123: Notice of Environmental Sampling

BWSC124: Notice About IRAs

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.

Key Actions for BWSC124: Notice About IRAs

Additional Resources for BWSC124: Notice About IRAs

BWSC125: Non-eDEP Submittal

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.

Key Actions for BWSC125: Non-eDEP Submittal

Additional Resources for BWSC125: Non-eDEP Submittal

BWSC126: Miscellaneous Documents

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.

Key Actions for BWSC126: Miscellaneous Documents

Additional Resources for BWSC126: Miscellaneous Documents

BWSC127: AUL - Ownership Update

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).

Key Actions for BWSC127: AUL - Ownership Update

Additional Resources for BWSC127: AUL - Ownership Update

Image credits:  Boston Light (Paul W. Locke)

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