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Corporate Office - 2055 Corte del Nogal - Carlsbad, CA 92011 - Tel: (760) 930-9966 - Fax: (760) 930-9974 www.mcconsultants.com
E X P E R I E N C E A N D I N N O V A T I O N S E R V I N G C L I E N T S N A T I O N W I D E
August 10, 2017 Via Email: [email protected]
Mr. David Godsey Nehalem Bay Health District P.O. Box 6 Wheeler, OR 97147 RE: Gound Penetrating Radar Report
Client: Nehalem Bay Health District Annex Building – Wheeler, Oregon MC File No.: A16-00942
Dear Mr. Godsey: MC Consultants, Inc. (MC) was retained on or about July 20, 2017 by Nehalem Bay Health District (Client) regarding the development of a Ground Penetrating Radar Report at the Nehalem Bay Health District Annex Building located at 278 Rowe Street, Wheeler, OR 97147 (Subject Property). The Ground Penetrating Radar Report was developed to determine the presence of Underground Storage Tanks (USTs) and related contamination that may be associated with the Subject Property. REPORT: Ground Penetrating Radar Report Please refer to the attached report prepared by ATC Group Services LLC a service partner to MC. LIMITATIONS The opinions contained in these reports are solely derived in accordance with current standards of professional practices in the community where the observations have been made. Except as otherwise described herein, MC’s opinions are based solely on visual inspections. Standard of care is time-dependent. The report has been prepared in accordance with the duty of care of MC environmental consultants as of the date on these reports. MC reserves the right to amend our opinions, if additional information comes to our attention, but we assume no obligation to do so. The services performed are solely for the use of our client, Nehalem Bay Health District. Therefore, no other person or entity other than our client may rely on the opinions contained in these reports without our prior written consent. Please do not hesitate to contact the undersigned should you have any immediate questions or require additional information. Thank you for this opportunity to be of service.
Respectfully submitted, MC CONSULTANTS
Tod R. Pettingill Northwest Regional Director of Environmental Services/Industrial Hygienist
ATC Group Services LLC. SW Westgate Drive Suite 123 Portland, Oregon 97221 Phone +1 971-319-6950 Fax +1 971-386-5918
June 21, 2017
Mr. Tod Pettingill Northwest Regional Director MC Consultants, Inc. 818 SW 3rd Avenue, 1182 Portland, OR 97204 MBL: 503.519.4887
EML: [email protected]
Re: Report for Geophysical Survey
Rhinehart Pharmacy
278 Rowe Street
Wheeler, Oregon
ATC Project No. NPMCC17009
Dear Mr. Pettingill:
At your request, ATC Group Services LLC (ATC) has prepared this letter presenting the results of a geophysical
survey conducted at 278 Rowe Street in Wheeler, Oregon (the Site). The purpose of this investigation was to evaluate
the potential existence of additional underground storage tanks (USTs) at the Site.
Pre-field Work Activities
It is ATC’s policy to ensure safe working conditions at all project sites. Therefore, prior to commencing the field
activities, ATC prepared a site-specific health and safety plan (HASP) for the Site. The HASP was used by members
of the project team, all of whom have completed 40 hours of Hazardous Waste Site Operations training and 8 hour
refresher courses as outlined in Title 29, Part 1910.120 of the Code of Federal regulations (29 CFR 1910.120). The
HASP provided health and safety guidelines for the geophysical survey investigation activities, and addressed key
safety issues and potential hazards associated with the project. The plan describes the scope of work, specifies the
appropriate personal protective equipment (PPE), discusses emergency procedures and contacts, lists project team-
member responsibilities, and outlines work zones and decontamination procedures to be used during this project.
All of ATC’s personnel and hired subcontractors were required to read and sign the plan prior to beginning work to
acknowledge they understand the contents of the plan and will abide by it. All ATC personnel and subcontractors
who entered the Site were equipped with the minimum PPE specified by the HASP (Level D - hard hats and steel toe
shoes at a minimum), and were required to sign the acknowledgment form. Following preparation of the HASP, ATC
mobilized to the Site to initiate field activities.
Page 2 Report for Geophysical Survey June 21, 2017
Geophysical Survey
ATC subcontracted Pacific Geophysics of Portland, Oregon, to conduct the geophysical survey. The survey was
completed on May 31, 2017 under the direction of Ms. Danielle Cook of ATC who was on site the entire time of the
survey and provided oversight of safety procedures. The area of the geophysical survey was determined by MC
Consultants and an aerial photograph was submitted to ATC with the area circled where the geophysical survey was
to be conducted (See attached Figure).
The survey was conducted using a magnetometer to collect magnetic data along survey lines that were on five-foot
centers. The magnetic anomalies were investigated using a Schonstedt Magnetic Gradiometer, an Aqua-Tronics
EMA6 Tracer, and a ground-penetrating radar (GPR) unit.
The Pacific Geophysics report states that three magnetic anomalies were identified. One of the anomalies is a
metallic object possibly located under a wooden cover that could not be removed for visual inspection. This anomaly
does not appear to be related to an UST. The second anomaly was detected east of the on-site shed. No three
dimensional object was detected using the Aqua-Tronics tracer; Therefore, this anomaly is unlikely to be an UST.
The final group of anomalies labeled as “C” on Pacific Geophysics’ figure appears to be associated with the rebar in
the parking curbs. No three dimensional object was detected in area “C.”
Conclusions
ATC’s subcontractor Pacific Geophysics has concluded, based upon their geophysical survey that additional USTs
do not exist in the area investigated. Furthermore, while preparing the work proposal for this project, ATC reviewed
the Oregon Department of Environmental Quality’s (DEQ) files for the Site. The DEQ files identified the Site as listed
within the DEQ Leaking Underground Storage Tank (LUST) database. According to the Oregon DEQ LUST Report,
in December of 1988 heating oil was discovered seeping into the basement and was reported to the Oregon DEQ.
The DEQ LUST Report form indicates that the tanks’ contents were pumped from the UST. However, the final
resolution was not given in this report.
Another heating oil release at the Site was reported to the DEQ on July 22, 1993. The Oregon DEQ Petroleum
Release Form indicates that the release was discovered on April 30, 1993. No other information is available regarding
this release.
In 1996, three USTs were decommissioned and removed from the Site. Also at this time the Site was converted to
natural gas as the fuel source. One 500-gallon diesel UST, one 8,000-gallon PS 300 UST (previously used to produce
steam), and one 4,000-gallon heating oil UST were removed from the Site. Only the 500-gallon UST was reported
by the DEQ as a regulated tank.
Based upon the removal of the three USTs associated with the former heating system for the building and the results
of the geophysical survey, ATC concurs that no additional USTs were discernable at the Site in the area surveyed.
If you have any questions regarding this project or if you need additional information, please do not hesitate to contact
ATC at 971-319-6950.
Page 3 Report for Geophysical Survey June 21, 2017
Sincerely,
ATC Group Services LLC.
Kelly A. Kline, R.G.
Senior Registered Geologist
Senior Project Manager
Dennis P. Firestone, REM, RG(MO,KY) National Program Director Direct Line +1 480 355 4612 Email: [email protected] CC: Ms. Dale Allison / National Client Management
Destiny S. Hazra National Project Manager Direct Line +1 925 804 2861 Email: [email protected]
Attachments: Pacific Geophysics Report DEQ Underground Storage Tank Information
Aerial Photograph of Proposed Survey Location
Kelly Kline Project: 170201 ATC Survey Date: May 31, 2017
Rhinehart Pharmacy 278 Rowe Street Wheeler, Oregon
A geophysical survey was conducted across the parking lot south and east of the south building of the facility located at the address shown above. The survey was conducted for Mr. Kelly Kline of ATC for the purpose of locating underground storage tanks (USTs). A known UST has been removed from an area north of the building but apparently the location of one tank is unknown. Two sets of product lines were seen in the boiler room; one set was reportedly connected to the known, removed tank. The location of the tank connected the other set is unknown. No other obvious surface evidence of USTs like vent pipes or fill ports was seen in the survey area. A shed that housed a generator is located near the southeast corner of the survey area. It is not known if a tank was used to fuel it. A Geometrics G858 cesium-vapor magnetometer was used to collect magnetic data along survey lines measured to be 5 feet apart, across the asphalt parking lot between the building and the street to the east, and the steep, berry-covered hillside to the south and the building to the north (figure 1). A Schonstedt Magnetic Gradiometer, an Aqua-Tronics EMA6 Tracer, and a ground-penetrating radar (GPR) SIR2000 control unit connected to a 400-MHz GPR antenna were used to investigate magnetic anomalies. A Radio-Detection TX3/RD8000PDL transmitter/receiver combination was used to trace product lines. The lines connected to the removed tank were traced to the north toward the area of the UST excavation. The location of this zone was verified with GPR. The strongest signal from the second set of product lines was traced to the north, up to the landscaped area near the building. No metallic object was detected in this area with hand-held metal detectors but the coverage was not complete due to the landscaping (figure 1). A second, weaker signal was detected in the south parking lot that was traced to the south, toward the southwest corner of the lot. Figure 2 is a colored magnetic contour map of the magnetic data, contoured at 250 nT (nanoTesla). Red contours are magnetic highs caused by ferrous objects on or below the ground surface (including USTs). Blue contours indicate magnetic values lower than the earth’s local background level and are generally caused by ferrous objects situated above the magnetometer sensor, carried at a height of about 3 feet. Fences, poles and buildings typically produce magnetic lows. Ferrous surface objects create magnetic interference that can hide the anomaly caused by buried objects of interest. The building, the shed, a dumpster, a parked trailer, rebar in parking curbs, and telephone pedestals in the southwest corner
created magnetic interference. Objects of interest buried near or under these features may have been missed. Three magnetic anomalies or groups of anomalies are labeled in figure 1:
A metallic object, possibly under a small wooden cover very close to the building wall, is causing magnetic anomaly A. We were unable to move this cover. The origin of this object is unknown but it is not believed to be related to a UST.
No three-dimensional object was detected with the Tracer in the area of anomaly B east of the shed.
Anomalies labeled C are interpreted to be caused by rebar in the parking curbs. No three-dimensional objects were detected with the Tracer in these areas.
No metallic object was detected along the length of the pipe traced toward the southwest. Nikos Tzetos of Pacific Geophysics conducted the survey on May 31, 2017. Ms. Danielle Cook of ATC was on site during the survey. This letter report was written by Nikos Tzetos and sent to Mr. Kline on June 8, 2017. Limitations The conclusions presented in this report were based upon widely accepted geophysical principles, methods and equipment. This survey was conducted with limited knowledge of the site, the site history and the subsurface conditions. The goal of near-surface geophysics is to provide a rapid means of characterizing the subsurface using non-intrusive methods. Conclusions based upon these methods are generally reliable; however, due to the inherent ambiguity of the methods, no single interpretation of the data can be made. As an example, rocks and roots produce radar reflections that may appear the same as pipes and tanks. Under reasonable conditions, geophysical surveys are good at detecting changes in the subsurface caused by man-made objects or changes in subsurface conditions, but they are poor at actually identifying those objects or subsurface conditions. Objects of interest are not always detectable due to surface and subsurface conditions. The deeper an object is buried, the more difficult it is to detect, and the less accurately it can be located. The only way to see an object is to physically expose it. Nikos Tzetos June 8, 2017 Pacific Geophysics
Appendix A. Geophysical Survey Methods Magnetometer Surveys Small disturbances in the Earth’s local magnetic field are called “magnetic anomalies”. These may be caused by naturally occurring features such as metallic mineral ore bodies, or from manmade features such as metal buildings, vehicles, fences, and underground storage tanks. The magnetometer only detects changes produced by ferrous objects. Aluminum and brass are non-ferrous metals and cannot be detected using a magnetometer. A magnetometer is an electronic instrument designed to detect small changes in the Earth’s local magnetic field. Over the years different technologies have been used in magnetometers. The Geometrics G-858 Portable Cesium Magnetometer used to collect magnetic data for Pacific Geophysics uses one of the most recent methods to detect magnetic anomalies. A detailed discussion describing the method this unit uses is available at Geometrics.com. This magnetometer enables the operator to collect data rapidly and continuously rather than the older instruments that collected data at discreet points only. The G-858 is carried by hand across the site. The sensor is carried at waist level. Typically individual data points collected at normal walking speed are about 6” apart along survey lines usually 5 feet apart, depending on the dimensions of the target objects. It is critical to know the exact location of each data point so that if an anomaly is detected it can be accurately plotted on a magnetic contour map. At most small sites, data are collected along straight, parallel survey lines set up on the site before the data collection stage begins. For very large, complex sites, the G-858 can be connected to a Global Positioning System (GPS) antenna which allows the operator to collect accurately-located data without establishing a survey grid. With GPS, data are collected and positioned wherever the operator walks. A limitation using GPS is that the GPS antenna must have line of sight with the GPS satellites. Data can be mislocated if the GPS antenna is under trees or near tall buildings. Data are stored in the unit’s memory for later downloading and processing. A magnetic contour map of the data is plotted in the field. Geographical features are plotted on the map. Magnetic anomalies appearing to be caused by objects of interest are then investigated on the site using several small hand-held metal detectors. If an object appears to be a possible object of interest, it may be investigated with GPR. Magnetic contour maps may be printed in color in order to highlight anomalies caused by ferrous objects located under the magnetic sensor. Usually, ferrous objects situated below the sensor produce magnetic “highs” and anomalies located above the sensor produce magnetic “lows”. Magnetic highs are of interest to the operator since most objects of interest are located underground. Depending on the orientation, shape and mass of a metallic object, a high/low pair of magnetic anomalies may be present. In the northern hemisphere the magnetic low is located north of the object and the magnetic high toward the south. The object producing the anomaly is located part way between the high and the low anomalies. Magnetometer surveys have limitations. Magnetometers only detect objects made of ferrous (iron-containing) metal. Large ferrous objects (buildings, cars, fences, etc.) within several feet of the magnetometer create interference that may hide the anomaly produced by a nearby object of interest.
Ground Penetrating Radar A Geophysical Survey Systems, Inc. (GSSI) SIR-2000 GPR system coupled to GSSI antennas of various central frequencies is used to obtain the radar data for our surveys. GPR antennas both transmit and receive electromagnetic energy. EM energy is transmitted into the material the antenna passes over. A portion of that energy is reflected back to the antenna and amplified. Reflections are displayed in real-time in a continuous cross section. Reflections are produced where there is a sufficient electrical contrast between two materials. Changes in the electrical properties (namely the dielectric constant) that produce radar reflections are caused by changes in the moisture content, porosity, mineralogy, and texture of the material. Metallic objects of interest exhibit a strong electrical contrast with the surrounding material and thus produce relatively strong reflections. Non-metallic objects of interest (septic tanks, cesspools, dry wells, and PVC and clay tile pipes) are not always good reflectors. Radar data are ambiguous. It can be difficult to distinguish the reflection produced by an object of interest from the reflection caused by some natural feature. Rocks or tree roots have reflections that appear similar to reflections from pipes. In concrete investigations reflections produced by metal rebar look exactly like those from electrical conduit or post-tension cables. Objects with too small an electrical contrast may produce no reflections at all and may be missed. Target objects buried below objects with contrasting properties that also produce reflections may be missed (e.g. USTs below roots, concrete pieces, pipes or rocks). If an object of interest like a UST is buried below the depth of penetration of the radar signal, it will be missed. In addition to interpreting ambiguous data, radar has several limitations that cannot be controlled by the operator. The radar signal is severely attenuated by electrically conductive material, including wet, clay-rich soil and reinforced concrete. The quality of the data is affected by the surface conditions over which the antenna is pulled. Ideally the antenna should rest firmly on a smooth surface. Rough terrain and tall grass reduce the quality of radar data. It is the job of an experienced interpreter to examine the GPR profiles and deduce if reflections are from objects of interest. A GPR interpreter cannot see underground, but can only interpret reflections based on experience. The only way to truly identify an object is to excavate. Hand-held Metal detectors Two small, non-recording metal detectors are used to locate suspect magnetic anomalies detected using the G-858 Magnetometer in order to determine the likely cause of the anomaly. First, the magnetic contour map and a Schonstedt Magnetic Gradiometer are used to locate the center of the magnetic anomalies. Once the anomaly is located an Aqua-Tronics Tracer is used to determine if the object producing the anomaly is a possible object of interest. Most anomalies are at least in part produced by features observed on the ground surface. Schonstedt Magnetic Gradiometer: This magnetometer has two magnetic sensors separated vertically by 10”. The magnetic field surrounding a ferrous object is strongest near the object and decreases rapidly as the distance increases. If the
magnitude measured by the sensor located in the tip of the Schonstedt is very high, and the magnetic field measured by the sensor located farther up the shaft of the Schonstedt is low, there is a large vertical magnetic gradient and the instrument responds with a loud whistle indicating the object is near the surface. If there is a small difference in the magnitudes measured by the two sensors, the object is deeper. The instrument responds with a softer tone. A discussion of this instrument is available at Schonstedt.com. Aqua-Tronics A-6 Tracer: The Aqua-Tronics A-6 Tracer uses a different method of detecting metallic objects. This instrument measures the electrical conductivity of a metal object. It is capable of detecting any electrically conductive metal, including non-ferrous aluminum and brass. The Tracer is capable of detecting three-dimensional objects as well as pipes. The Tracer consists of a transmitter coil and a receiver coil. In the absence of any electrically conductive material in the vicinity of the Tracer, the electromagnetic field around each coil is balanced. Basically the electromagnetic field produced by the transmitter induces an electric current into the area surrounding the instrument. Nearby conductive objects distort the EM field. The balance between the two coils is disturbed and the instrument produces an audible tone and meter indication. Radio Detection RD8000 PDL pipe and cable detector: This instrument may be used to detect buried, conductive pipes and utilities. It consists of a transmitter and a receiver and can be used in two configurations. The transmitter may be used to directly apply a small electrical current to exposed, electrically conductive pipes and utilities. The RD receiver is then able to “trace” the underground portion of the pipe or utility, under some conditions for several hundred feet. The transmitter can also induce an electrical current into buried pipes and utilities where direct contact is not available. The receiver can also be used alone. It has the capability to locate pipes and utilities by detecting the very small electrical currents induced into the features by nearby AM/FM radio stations. The receiver also has an AC power function that may be used to detect underground power lines.
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2/1/2017 UST Cleanup Program Database SiteSpecific Information
http://www.deq.state.or.us/lq/tanks/lust/LustPublicDetail.asp?lognumber=29880109 1/1
Leaking Underground Storage Tanks ( LUST ) Site Information
Home > Programs >LUST Program Information > LUST Database
(Use "Back" button on browser to return to previous search results) Leaking Underground Storage Tank (LUST) Site Information
Log Nbr: 29880109 Basic Incident Information Status: ACTIVE Site Name: HEATING OIL TANK Received Date: 12/12/1988 Address: 278 ROWE STREET City: WHEELER Zip Code: 97147 County: TILLAMOOK Site Type: Groundwater File Status: Heating Oil Tank (HOT): YES Regulated Tank:
Assessment Information 29880109 Cause: UNKNOWN Source: Not Reported Discovery: OTHER
Media Effected Contaminants Released >GroundWater >HeatingOil
Free Product Removed: Free Vapor Removed: CAP Requested: Delineate Groundwater: Groundwater Delineated: CAP Submitted: Delineate Soil: Soil Delineated: CAP Approved: Compliance Monitoring:
No Management Information For This Incident 29880109
Work Reported Information 29880109
Work Reported Reported By Reported Date Initial Response Data Conversion 2006 1/1/1901
This information may not reflect current status of site. For further detail, refer to the DEQ Regional Office file.
This page last updated: January 9, 2006 DEQ Online is the official web site for the Oregon Department of Environmental Quality.
2/1/2017 Profiler Site Summary Report
http://deq12.deq.state.or.us/fp20/FPDetail.aspx?siteid=11578 1/1
Oregon DEQ Facility Profiler 2.0 [Help] [Close Window]
Facility Summary Report
Return to Site Listing Print ReportMaps
Facility / Site Information for Location 11578
Facility/Site Name: NEHALEM BAY HEALTHDISTRICT
Address: 278 ROWE STREETCity State Zip: WHEELER OR 97147
Latitude: 45° 41' 11.4"Longitude: 123° 53' 3.12"Location Accuracy: HIGHLast Updated: 1/23/2003 8:09:00 AM
AliasesRINEHART HOSPITAL LUST
Geographic FeaturesTownship: T2NR10WS2 Congress Dist: 5 Forest Type:County: TILLAMOOK OR Senate Dist: 16 Vegetation: Sitka sprucewestern hemlock forestWatershed: NEHALEM OR House Dist: 32 Agricultural Land: N/ADrinking Water Source: N/A
Oregon DEQ Program InformationLeaking Underground Storage Tanks (LUST)
LogNumber Received CleanupInitiated
CleanupComplete Type Heating Oil Tank
USTFacilityID
Status DetailInformation1
29880109 NON_REGULATED HEATING_OIL_TANK REPORTED LUST Site
Report
1 Linked reports may be unavailable from 9:00pm to 7:00am PST due to system maintenance.2 DEQ does not maintain air discharge permit information for Lane County.
More Information on this locationOregon DEQ Neighborhood Info (by region/county)See wells in the same Township Range Section from the Oregon Water Resources Department Well logs ApplicationSee county's scanned assessor maps through ORMAP
[DEQ's Privacy Notice] [Contact DEQ] [Application Feedback]
Disclaimer:This product is for informational purposes, and may not be suitable for legal, engineering or surveying purposes.This information or data is provided with the understanding that conclusions drawn from such information are the responsibilityof the user.
* * * LUST REPORT * * *
Date Release 0 Lab Sample:
(Results: __________________________ , by RP Other{_
Date Release [] Control Compl { ______ , TYPE OF MATERIAL
OF RELEASE: Tank
Pipe Leak
EXTENT OF CONTM~INATION: POTENTIAL IMPAC'l'S:
y y
Product Y y
\ilater or Storm Dra Y Water { } Y
ASSESSMENT RESULTS: ____________ _ MANAGEMENT -RELEASE STOPPED: GUIDELINE:
PO SAL OF MA'rERIAL RE:HOVED: Free
CLEANUP ACTIVITY:
}
}
D or PRIORITY~
N % ? N ~
0 ? N ~ 0 ? N % ? N ~ 0 ? N % ?
Non-~iatrix 1
:_!_!_
Name: __ , ____________ __
PAPER TRAIL:
an
OUTGOING
*Confirmation Letter
*Compliance Agreement
Permit
*Other
Suspense Date
LOG NUMBER: ______________ ___
UST FAC. NUMBER: _________ _
* PETROLEUM RELEASE ITI1'G:: Q liK NL 'll FIT AH1".Y - ·INCIDENT INFORMATION· - -
FORM *
SOURCE OF RELEASE
SITE LOCATION:_x~~~~~~~~~~~~-L~~~ y N REGULATED UST: ADDRESS: -OCJ e.-
CITY: ~_)~~~-"'~Q.Q/r ZIP:----COUNT'f:·"ii (/a.,-}PHONE: _________ _
AST
OHC
HSRAF
OTHER
• • • • • • •MAIL TYPES• • •
SITE CONTAC}: ,. -~'~~---rr-7-LANK OIJNER: Name: LC?'%0 Name: _______ ~:--:----
RESPONSIBLE PARTY; . Name: C cr..-rtrf !!V\a~
Company: _ _,.....,..---.....:"------ Company: N. • -r; 0 · t·F. (:::, • Address:_..:.,,':i_·,.,..;'c;;...~:tr .... ~...;·...;/!l_ .. l_ . ..o·" ___ ~:;:_-_-_~_~--~~_7 Address: Po e (tz( I"'
Company: ··
City: Zip: City: &Jr~kt94,- Zip:Cf717'7
Address: _____________________ __
City: Zip: ___ state: ___ Phone: 3~'lf-~S:(( 2 State: ()(2 Phone: _____ _ State: ___ Phone: ,5D?r'!dc $f·S71"l
• ·SITE ASSESSMENT· • • • • • • • • • • • • • • A. •. ') '-::;?_,;-'1• cc:;'
DATE O!SCOVERED:f ~~ -;J;..~, ( 1 f DATE INVESTIGATED: _____ _ INVESTIGATED BY: ______ _
GALLONS RELEASED: ___________ __
INVEST. COMPLETED: y N RELEASE EXISTS:
CONFIRMATION METHOD: S I) Staff LD) Lab:DE.Q
H0\.1 DISCOVERED: RH) Routine Monitoring !C) Inventory Control
CAUSE OF RELEASE: TL) Tank Leak PL) Pipe Leak
MATERIAL RELEASED: UG) Unleaded Gasoline LG) Leaded Gasoline MG) Misc. Gasoline OS) Diesel
IMPACTS: Soil Groundwater Surface lola ter y
CLEANUP ACTIVITY: Date Release Stopped
PR lOR l TY =----------CLEANUP NECESSARY N OFFSITE MIGRATION:
LR) Lab:RP LO) Lab:OTHER
DC) Decommissioning SA) Site Assessment
0 F) Ove rf i ll SS) Surface Spill
""~-~..,. ~~~ating Oil
1.10) IJaste Oil FO) Fuel Oil BF) Bunker Fuel
".~J!.\(J_ Pump/Valve Leak ~)Unknown
LB) Lubricant OP) Other Pet. Dist. SV) Solvent CH) Chemical
N U Drinking Water y y y
N N N
N /!J'), N l.\l
Facility (Vapor) Facility (Free Product)
OT) Other
UN) Unknown
- - . - - - - - . - ~ - - - . Control Date: ______________ __
Cleanup Start Date: _____________ ___ Cleanup End Date;.=-----CLEANUP LEAD: ~ )State CLEANUP GUIDELINE: Matrix C.A.P.
LUST CONTRACTOR: _____________________________ __ DISPOSAL • FlfEE PRODUCT: _________ _ Company: _____________________________ --______ __ DISPOSAL· SOIL: ____________ _ Address: __________________________________ ____
DISPOSAL • SLUDGE: City: _____________________________ Zip: __________ _ Disposal Location: __________________________ __. State: ________ Phone: _____________________ _
Removal Date=------------------------------
ENFORCEMENT ACTION: Y N Type: ___________ _ COST RECOVERY INITIATED: Y
COMMENTS: _______________________________________________________________________________________________________ __
CLUST Incident Number: ___ _ (Version 105, 27·JUN·91
(f) +-' (.) Q.) ........ 0 ,_ .
c.
> ,_ Q.)
> 0 (.) OJ
0:: +-' tJ)
0 (..)
PROJECT SETUP
PROJECT NAME
LOCATION: City------------
LEAD: Authority Fed ~ /"'
Division cC Section /ISTC- Staff M k3 PROJECT LIAISON: -----'--01~t:-~------
z1(zG, ?3 PROJECT START DATE
FUNDING SOURCE: __ Fed State
ECSI ID ----- log No.------ISAS, SRS, VCS)
PROJECT PHASES:
Phase Coda
Phase Start Date
Fund Code
7 (Z(o{i~ --
I I
(LUST)
Phase Lead
PROJECT ID PROJECT ABR __ _ TYPE STATUS BO # .. ·•·.••· .. · , ••.....• ·· ,.· ----.-:::::···
SITE SPEC•/
Mixed
(SAS, SRS and VCS only. UST Cleanup doea not complete this MC1ion.l
Cost Recovery Start Date I I
Non-ECD Charges - Authorization: ___ DEQlab ___ Region __ _ ___ DOJ ___ Other
PRP:
' .
Contact: Telephone:
Date: 7 1Z6 t2.S
PPD Date Entered: Date:
regan John A. Kitzhaber, M.D., Governor
April 21, 2000
Department of Environmental Quality Northwest Region
2020 SW Fourth Avenue Suite 400
Portland, OR 97201-4987 (503) 229-5263 Voice TTY (503) 229-5471
EUNICE MASSIE NEHALEM BAY HEALTH DISTRICT P.O. BOX 16 WHEELER OR 97147
Re: RINEHART HOSPITAL File No.: 29-88-0109
The purpose of this letter is to provide an update on your underground storage tank (UST) cleanup project, located at 278 ROWE STREET in WHEELER, Oregon, and to inform you of some changes to the DEQ's program. You are receiving this letter because you or your contractor reported a release from the UST system at this property and because the DEQ has not assigned your project to a project manager or closed out your file. File closure occurs when cleanup has met the appropriate requirements and the DEQ has reviewed the reports and issued a "no further action" (nfa) letter.
BACKLOGGED PROJECTS
The DEQ's first priority is to work on projects that pose the highest threat to human health or the environment. Due to staffing limitations, not all projects are assigned to project managers for review and are placed on DEQ's backlog of work needing to be completed.
To accommodate people who do not want to (or cannot) wait years for the DEQ to work down its list of priorities, the DEQ has set up a program by which responsible parties can request oversight. Filling out and signing a "cost recovery agreement" does this. By signing this document, the responsible party agrees to work with the DEQ in resolving the cleanup issues and agrees to pay the oversight costs which DEQ is required by law to collect.
Once a "cost recovery agreement" has been received for a project, DEQ places the project on a waiting list for assignment to the next available project manager. How long this takes depends on a lot of factors including current DEQ staffing and the number of high priority projects that need to be dealt with. In the past, it has taken up to two years for DEQ project managers to be assigned to a project. Currently the wait is about six months for more complicated projects. If there is an immediate need (i.e. a property transaction pending) for DEQ review, projects are usually assigned within two to four weeks.
DEQ·l
Backlog letter Page 2
NEW PROGRAM INFORMATION
In November 1998, revised rules went into effect for UST Cleanups. These rules included housekeeping items as well as rules governing low impact sites (LIP) and for developing generic remedies. These rules are available at the DEQ's website (http://www.deq.state.or.us/wmc/tank/200rules.htm) or can be obtained from the Northwest Region office.
Guidance for LIP sites was prepared in December 1998. Copies of this guidance are available at the DEQ's website (http://www.deq.state.or.us/wmc/tank/lisguid.htm) or from the Northwest Region office.
During 1999, DEQ developed a generic remedy for risk based assessments. The generic remedy and guidance document was finalized on September 29, 1999. Copies of this guidance are available at the DEQ's website (http://www.deq.state.or.us/wmc/tank/rbdm notice.htm) or from the Northwest Region office. This document replaces the DEQ's "Interim Guidance On Incorporating Risk Based Corrective Action For Petroleum Release Sites" (April 1996).
Another significant change is that the cleanup levels in Oregon Administrative Rules (OAR) 340-122-242 (4) have been replaced by the risk based screening levels in the risk based generic remedy.
The new rules and guidance apply to new releases and to cleanups that were not completed by the adoption date of the rules and guidance. If your cleanup was completed prior to these dates, or if you were operating under a DEQ approved corrective action plan, DEQ will apply the rules in place at the time of the cleanup when conducting our review.
If you have any questions or would like copies of the above referenced documents, please call Tina Leppaluoto at (503) 229-5472.
Sincerely,
Andree Pollock, Manager UST Cleanup and Compliance Section
Enclosures: Cost Recovery Agreement
(avp:AVP)
Environmental i Ground Water Consultants
Mark Yinger Associates 4865 Baseline Road, Parkdale OR, 97041 - 541-352-6015
~J::r';._~-[0~~,, September 8, 1997
Ms. Eunice Massie, Administrator Nehalem Bay Health District P.O. Box 16 Wheeler, OR 97147
Dear Ms. Massie:
This is a letter report concerning the excavation of petroleum impacted soils encountered during excavation for the installation of a drain pipe along a portion of the east side of your building (up hill side). The purpose of the drain is to prevent seepage into the basement during the wet season.
Deeply weathered basalt (saprolite) with a gray discoloration typical of petroleum hydrocarbons was encountered in the trench starting approximately 10 feet south of the corner of the patio and continuing to the south end of the trench. At approximately 20 feet south of the north end of the building fragments of a heavily corroded tank were discovered 6 to 8 feet beneath the surface and quite near the wall of the basement. Black soil with an odor very similiar to that of the water seeping into the basement was encountered in this area. Approximately 50 cubic yards of material was segregated and stockpiled on plastic sheeting. A sample of soil with the strongest odor and black discoloration was collected and analyzed. This sample contained the very low concentration of34 parts per million (ppm) total petroleum hydrocarbons (TPH). The same sample contained no detectable petroleum hydrocarbons in the diesel range. A composite sample (number 1819) ofthe stockpile contained only 15 ppm TPH.
One sample representing in situ weathered basalt contained 26 ppm and another contained no detectable TPH. The results of all the analyses were discussed with Andre Pollock of the DEQ (NW Region). He agreed that the 50 cubic yards of stockpiled soil could be used as fill on site.
There is no evidence that the excavation intersected the watertable. In the wet season percolating precipitation pools in depressions in the buried surface of the weathered basalt. Depressions for example such as that for the basement of the building and the excavation for removal of the old tank will fill with percolating precipitation during the winter months. The permeability of the weathered basalt, which has been altered to clays, is very low.
I did a small UST soil matrix cleanup in downtown Wheeler, and for that work I collected all the well logs within two miles, which amounted to one. That one well is located over a mile north of your site. Therefore, the threat that any residual petroleum might pose to a drinking water well appears to be nil.
MAY 97-102 page 1
I will forward a copy of this letter to the DEQ for inclusion in the file they have on the site. If you have any questions please do not hesitate to call on me.
Sincerely yours,
~~~ Mark Yinger, P.G. Hydrogeologist
attached: site map, laboratory reports and chain of custody cc: Andre Pollock, ODEQ-NWR
MAY 97-102 page 2
North-----•
Stairway to lawn Grass Lawn
Nehalem Bay Health District Building
1818, 8'
Concrete Patio
TPH418.1M: 34ppm , './
I Ditch to dry well
1820, 10.5' TPH418.1M: NO
legend
•
1820, 10.5': Sample number and depth TPH418.1M: Total petroleum hydrocarbons TPH-0: Total petroleum hydrocarbons diesel range ppm: parts per million NO: not detected
• Sample site in situ 0 Sample site excavated
0 10 Feet
20
Environmental & Ground Water Consultants
Mark Yinger Associates 4a65 Baseline Road, Parkdale OR, 97o41 - 541-352-6015
0
1817, 13.5' e TPH 418.1M: 26 ppm
TPH-0: NO ---------- 1 \~ ?j
Boundary of UST Cleanup pit excavated by PEMCO in February 1996
\ Boundary of excavation to Install a perforated drain pipe at approximately 2 feet below the basement footing, bottom of trench approximately 11 feet below grade.
Nehalem Bay Health District Wheeler, Oregon
Site Map
Wy 'East Environmental Sciences, Inc.
LABORATORY REPORT
Mark Yinger Associates 4865 Baseline Rd. Parkdale. OR 97041
PROJECT NAME/SITE: PROJECT NUMBER: EXTRACTION DATE:
Nehalem Health Dist. 97-102 9-4-97
OREGON DEQ TPH-418.1 MODIFIED Analvte: Total Heavy Oils I Diesel Quantification for soil
Field lD Lab ID mg1Kg (ppm) 1817 35113 26 1818 35114 34 1819 35115 15 1820 35116 ND
BLANK ND Detection Limit 10
REPORT NUMBER: REPORT DATE: PAGES:
19854 9-4-97 1 of 1
ND =Not Detected (below reporting limit or detection limit)
2415 SE 11th Ave., Portland, Oregon 97214 Phone (503) 231-9320 FA){ (503) 231-9344
From: Darren Blaine To: Don Butcher Date: 9/8/97 Time: 09:56:40
Wv 'East Environmemal Sciences, Inc.
?\lark Yinger Associates .f865 Baseline RcL Parkdale. OR 97041
LA BORA TORY REPORT
PRO.JECT NA .. tVIE/SITE: Nehalem Health Dist. 97-102
REPORT .Nl..T~VIBER: 19854A 9-8-97 PRO.JECT NUMBER:
EX:TR-\CTION DATE: 9-5-97
OREGON DEQ TPH-D /malyte: Diesel Range Hydrocarbons Quantification for soil
Field ID Lab ID
1818 3."114 BL....lJ\TK
REPORT DATE: PAGES:
mg.·Kg (ppm)
ND \:1)
Reporting Limit 20 Surrogate 1s o-T erphenyl ~1) Not Detected (belovv reporting limit or detection limit)
1 of 1
Surrogate Recovery 1_0 o)
94
Page 1 of 2
Environmental Sciences, Inc.
CHAIN OF CUSTODY
PROJECT# 17 ,_ j C/ 7,_
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1
ES 'Y~LEeTED BY J /c/Lie/
PRESERVATIVE USED? (HCI, etc.)
FIELDID
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Report Number: _________ _
119854 Research & Laboratory Services
2415 SE 11th Ave. • Portland, Oregon 97214 • (503) 231-9320 • FAX (503) 231-9344
~J~~Tr:.MEIS!JkJ!t £)· ·f STATE oK_ PURCHASE ORDER# I 'e. '/L .Ru-t 1 ? · t3
RE/'f AT~;ION '/: ~~~er- '1;4{:.~5!!!~ ~o1s- F~4J.~y;_2- §~f0 DATEI?Z3/l?7
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SAMPLES c;!!!;LED TO 4° C? . c~
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MEDIA CONTAINER VOLUME ETC ANALYSIS REQUIRED LABID
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RELINQUISHED B~ /1 ~. 1MzDAo/:?b~ RECEIVEDB~ -~. ~ Q_~J-r~D~TFfJJ~ ~ 1/~c/ ' .. , ~~AA 7• I I
RELINQUISHED BY / / I • DATE I TIMf! RECEIVED BtA:liB ., UCJ DATE!JfiME
REMARKS SHIPPED BY
Wy'East will return white copy to client -with laboratory report and keep yellow copy for files. Client keeps pink copy.
UST CLEANUP TELEPHONE USE REPORT
WITH:
6vof/ i\-TKJ ~t0 DATE: f-!£i:/AveVV'\ BAy i+£At:nf i>t;SJ: TIME:
CAL~O:
TELEPHONE NO: GlZ3>) ;3b'i_ 9t5
REGARDING: (Y/Of2e..-- ~M 1· n ATJO,_;>
FILE NO:
SUMMARY OF CALL
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9-3-71
PEMCO
March 7. 1996
Mitch Scheel DEQ- Northwest Region 2020 S.W. Fourth, Suite 400 Portland, OR 97201
RE: Nehalem Bay Health District File #29-88-1 09
Dear Mr. Scheel:
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6388
DEPT Or ENVIRONMENTAL QUAUiY RECEIVED
: MAR'1 1 \996
NORTHWEST REG\ON
Attached you will find a copy of PEMCO's 'UST Decommissioning and Environmental Clean Up Report for the Nehalem Bay Health District Located at Wheeler', Oregon dated March 5. 1996.
Please do not hesitate to call, if you have any questions.
Sincerely,
Bill Knutson,P.E. Environmental Manager
enclosure
cc: Carol May Nehalem Bay Health Dist1·ict
A Division of PEECO
PEMCO 437 N. Columbia Blvd. ~--
Portland, Oregon 97217 (503) 283-2151
UST Decommissioning and Environmental Clean Up Report for the Nehalem Bay Health District
Located at Wheeler, Oregon
prepared for:
Carol May Nehalem Bay Health District
278 Rowe Street Wheeler, Oregon 97147
March 5, 1996
PEMCO
Mrs. Carol May Nehalem Bay Health District PO Box 16 Wheeler, OR 97147
RE: UST Decommissioning and Environmental Cleanup Report Nehalem Bay Health District, 278 Rowe Street, Wheeler OR DEQ File #29-88-1 09
Dear Mrs. May:
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6388
This report presents the procedures, methods and results for the decommissioning of three underground storage tanks (USTs) at the Nehalem Bay Health District in Wheeler, OR and the subsequent environmental cleanup of contaminated soil at one of those UST locations. The three USTs consisted of 1-500 gallon diesel UST previously used to fuel a backup generator, l-8000 gallon PS 300 UST previously used to produce steam for heat. and 1-4000 gallon diesel UST previously used to fuel the facility's furnace. The facility has since been converted to natural gas.
The 500 gallon CST was a regulated tank and was permitted through the DEQ. The 4000 gallon and 8000 gallon USTs were not regulated tanks. All three USTs were decommissioned under the supervision of a DEQ licensed supervisor following all applicable DEQ rules for regulated tanks. Upon removal of the USTs, diesel contamination exceeding acceptable DEQ standards was detected in the soil beneath the 4000 gallon UST. The contaminated soil was excavated and taken to Marion County Soil Recycling facility in Woodburn. OR where it will be treated by thermal desorption and used as clean landfill cover. The site is in a rural residential area and currently meets DEQ Level 2 cleanup standards. Procedures. methods and results for the work performed by PEivlCO at the site are described in the following sections of this report.
Procedures
On February I, 1996, PEMCO decommissioned and removed from the site one 500 gallon. one 4000 gallon and one 8000 gallon USTs from the Nehalem Bay Health District in Wheeler, OR. The tanks were of single wall steel construction and were taken to Schnitzer Steel Products Co. for salvage after cleaning. The tanks were uncovered and degassed using a forced air venturi system prior to cutting holes in the tank tops with a pneumatic hammer to facilitate entry into the tanks for cleaning. The tanks were checked for explosive conditions using a Phd meter. When safe conditions existed, a PEMCO confined space entry person entered the tank and physically wiped the tank clean. The residual material was place in DOT approved 55 gallon drums pending disposal at an approved facility. When the tanks were sufficiently cleaned. PEMCO continued excavation activities necessary to remove the tanks from the ground.
Soil conditions were inspected around each tank by a DEQ licensed supervisor as they were removed from the ground. No visual or olfactory signs of contamination were observed at the 500 gallon or 8000 gallon UST locations during the decommissioning process. Obvious diesel contamination was dobserved in the soil around the 4000 gallon UST upon its removal. Soil samples were collected from beneath each end of the tanks in accordance with DEQ guidelines. The samples were taken to an independent laboratory for analyses of total petroleum hydrocarbons (TPH) using DEQ approved methodology. The results ofthe sampling performed at this time indicated that no detectable levels of TPH existed at the 8000 gallon UST
A Division of PEECO
location and levels ofTPH below the site's Level2 standard existed at the 500 gallon UST location. Results of soil samples collected beneath the 4000 gallon UST indicated elevated levels of diese I in the soil around the tank. Complete analytical results of the sampling beneath the tanks are summarized t•elow in Table I.
Pos*- TPH in the gasoline range is overlap from the diesel range ND- None Detected NT- Not Tested ppm- parts per million
NT '""'""""""""""'"'"''"'"'"""""""' .. ._"'--••••-•'!
- 90{~EET~: ___ _ NT
Due to the elevated levels of diesel contamination detected at the 4000 gallon UST excavatilm. PEMCO returned to the site on February 20. !996 to perform remedial excavation of contaminated c;oiL Approximately· 129.53 tons of diesel contaminated soil was removed from the exc:l\ation. stockpiled and covered with visquene aw·arting profiling for disposal and sample r·esults. A 2-inch P\"C 11arer line was encountered at this time and limited excavation along the west waH of the excavation. Tllis tine was under pressure and failed during the soil removal process. The water stream produced by the pre-;-;urized line appeared to wash out the remaining soil contamination along the basement foundation wall located at the west end ofthe excavation. The line was repaired and had to be supported over the open excavation.
Soil samples were collected from the four sidewaHs and bottom of the excavation subsequent to remedial excavation and prior to the failure ,,fthe 1vater line. These samples \vere analyzed !~1r TI'H by method 418.1 ~·loditied and no contamination \\'ilS detected. On February 26. 1996 PE\lCO returned to the site to remove the water perched in the 4000 gallon UST excavation and backfill the excavations. Cumaminated soil that had been washed off the west \val! during the water tine failure was removed from the excavation at this time. The water in the excavation was the result of a combination of surface nmoff and "mer from the \Vater line. The water \Vas tested tor B TEX for disposal purposes. ;\o groundwater \\as encountered at the site.
A soil sample was also collected from the backfill material of the 500 gallon diesel location and analyzed for PCB's, TCLP Metals and volatile organic compounds by EPA method 8240. Results of sampling conducted by PEMCO on this date are summarized below in Table 2.
2
*- Benzene-.54 ppb, Toluene- .85 ppb, Ethylbenzene- NO, Xylenes- .75 ppb NO- None Detected ppm- parts per million ppb- parts per billion
Complete certified analytical reports and chain of custody documentation t(!r all sampks collected and analyzed can be foun:l.Jn.Appendix I.
Subsurface Conditions
Native soil encountered at the site consists of a highly compacted silt hardpan from just below the surface to the total depth explored of 13.5 feet below surface. The backfill materia! used to bed the rormer liSTs appeared to be the same material in a disturbed form. No water was encountered durin:c. the removal of the USTs. Water entering the excavations after the removal of the tanks was the result ol' surface mnoff and the broken water line. No groundwarer was encountered during PEMCO's work at the site.
The excavation for the 4000 gallon UST was located adjacent to an eight foot foundatiLlll wall. The base of this foundation wall on the basement side of the wall had evidence of leakage of w8ter ~md :m oily type substance. The oily constituent in this leakage was possibly the result of the diesel con\i!m ination encountered directly on the opposite side of the foundation \Nail at the 4000 gallon L'ST excavation. Final excavation attempts to remove all diesel contaminated soil appears to have removed Clll\ source of contamination generated by the 4000 gallon diesel UST.
Waste Disposal
The three single wall steel tanks were taken to Schnitzer Steel Products Co. located at 3:2()0 N\V Yean Avenue in Portland. OR where they will be salvaged as scrap metaL A certification of r:ll1k disposal is attached in Appendix 2 of this report.
A total of 129.53 tons of diesel contaminated soil was removed from the site and taken w ".·!arion County Soil Recycling facility in Woodburn. OR where it will be treated by thermal desorpti<'l1 l'ri<\r to being used for clean landfill cover. Manifests for disposal of the soil can be found in Appendi~::: ,d.lhis report.
Approximately 3600 gallons of e~cavation water was removed from the site and taken w Oil Re-refining Co. in Po11land. OR where it was recycled. A bill of lading documenting the disposal ol this water can be found in Appendix 2 of this report. Two 55 gallon drums of tank residual remains at the site.
Condmions
One regulated and two unregulated USTs were decommissioned by PEMCO at the Nehalem Bay Health District Medical Facility in Wheeler. OR on 2/20/96. Soil sample results showed detectable levels ofTPH contamination at t\VO of the UST locations. A calculation ofthe site's Soil I'vlatrix Score indicate that this is a Level 2 cleanup site. Additional excavation was required at the 4000 gallon diesel excavmion to bring the site to within acceptable levels to meet the DEQ's standard of200 ppm for a Level 2 site.
The contamination encountered ar rhe 500 gallon diesel tank location was below rhe Level 2 cleanup standard of 500 ppm. Because the contamination at this site was in the heavy oil range, the soil was also analyzed for PCBs .. VOCs, and TCLP metals. No detectable levels of these contaminants were found.
A total of !29.53 tons of diesel contaminated soil and 3600 gallons of water were removed from the site during cleanup activities and were disposed of at permitted facilities.
3
The site has been cleaned up to within the site's appropriate DEQ Matrix Standard and no further investigative or remedial work is recommended at this rime. A Soil !\latrix Scoresheer ~md Checklist have been completed for this site and can be found in Appendix:::.
Please do not hesitate to call if;, cn1 have. any questions reg:trding the decommission in;,:: of the USTs or the subsequent clean up of contaminated soil at the site.
Sincerely.
fl! /(,.4-Bill Knutson, P.E. Environmental ~tanager
4
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Vicinity Map m PEMCO
Nehalem Bay Health District Date: 3/6/96
278 Rowe Street PrQject: #7Q20 Wheeler, Oregon
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y ... y y ..,. y ... y y y y y y y y ... v y y y y y y y v v ... y v y ... v ... v y y y y y y y y y y y y y ... y y y y y y y y y y y y y v y y y y v v ~ y ...
y y y y y y y y y y ... y y y y y y y y y y ... y ... y y v y y y y y ~ y y y y v y y y y v y y y y y y v y v y y y y y y y y y y ... y y ... y y v y ¥
y y y y y y y y y y y y y y y y y y y y y v y y ... y v ... ... y v v y y ... y y v y y y y y y y v y v y v y v v y ... y v v v v ... y ... y v y y y v v v
y v ... y y y y y y y y y v y v v v y y v y y y y ... y v y y y v v ... v ¥ y v y y y y v v y y y y v y y y v y y y y y y y y v y y v ... ... y y y y y
... --~
y y v y y y v y y v y y y y v y v y v v y y ... .... ... y y .... y y y y y y v _y v y v v y ......... y y ....... y y y .... y ... y ....... y ... ... y v y .... y ... y y v v y
\
VYYYVVYVYYVYYYVYV YVYV~'YVYVYVYV Y YYYYYY ..,'' YY Y Yv'Y' YY vyv Y vyv'•., YYY YV YV Y v -edJV'v Yv v Y VV 'l"v .,.Y v v "''., ....... "".,. ... .,.,., • ., ""•/' 'Y
YYYYYYYYYVVYVYYYYY 'YYVYYYYVVVVYY .... y ... ... y y y y v y y ... ... ... y ... ... ... y y y y y y y ... y ... y y
Y v v ., v v v v Y Y Y Y v v v v v y L"' S,.., Jf") • v v v v v v v v ·~ v v v Y
!YYVYYVYYYYYYYYYYY IV~ ._. ... ,,.,_.._ • .,.., • .,,._.YYYV
YYYYYYY'YYYYYYVYYYY ~~o...,yyyy•,•-.•.,•YYYVY"' ... v y ... ... ... ... v y y v ... v ... v ... ... ... y y ... y y y y ... v v ... v ... y ... ... v
... y ... y ... y ... ... ... y y y y v y ... y y y ... y ... ... v y ... y y y y y y ... y ... y y y y ... y y ... ... y y ... y y y y y y y y y ~ y ... y y y y y y y v y y ~ y
¥ y y y ... y y y y y y y ¥ y y y y ¥ y y y .... ... ... y y y v y y y y y v y v y ... y y y y ... y ... v y y ... y y ¥ y v y y ... v y y y y ... ... y ¥ v y ¥ y v
jv v v y v v v .,. Y v Y .,.. v v v v v y v .., .,. v v v ... v ., • .,. .,_. ... •.• v ... .., "' v . y y y y y y y y y ¥ y v y y ¥ y y y y v v ... ... y ... y y v y y v y y y y
y y y y y y v y y y v y v ... y y y y y ... y y ... y ... y ... y y ... ... y ... ... y y y y y y v y y y y ... v y y y y y y y y y y y y ... y y ... y ... ... y v ... y y
... y y v ¥ v v y y y y v y v y y y y y ... y y y y y y y ... y ... ... y y y y y y y v y y y y y y y y y y y y y y y y ... ... y ... y ... y y y y y y y ¥ v y
v v y y y y v y ¥ y y ... y y y y v y y ... ... y ... y ... y y y y y ... y y y v y y ... ... y y y y v v y y y y y y y y y v v y y y ... ... v y ... y v ... y ... y v
y y y ... y y y v v y v y y v v v y y y y y v y v ¥ y y y v ... v v v y v y y y y y y v y y y v ... y y y y y y y y y y y y v y y y y y y y y ¥ y y
y y y y v y ... v y y ... y y y v y y y ... ... y y y y y y y y y y y y y y y y v v y y y y y y v v y y y v y y y y y y y y y y y y y y y y ... y y y y
v v y v y y y y y y v y ¥ y y y y y y v y y y y y y v v y y ... y ... y y y v y ... ... v y y y v y v y y y v y y y y y y y y y y y y v y y y y y y y
y y y y ... y y y y y v y v y y y y v y y y y y y y y y v y y y y y ... y y y y y y v y y ... y y ... y y y y y y y y y v y y y ... y y y y y y y y y y
y y v y y v y y v y ... ~ y y y y y v y y y ... y y y y y y y ... y v y v y ... y y y y y y y y y ~ y v y y v y y v y y y y v y y y v y v v y v
------------•Y...;Y...;,Y...;Y...;Y...;Y...;Y;..;V;.,.Y;...Y;...Y.;.. ;' Y Y Y y '\• y y y y y v y y V y '1-' ~· \' v y .,.. ...,
Appendix 1
- Chain of Custodv Documentation .,;
- Ce1iified Analytical Repo1is
-~~
437 H. COLUMBIA IH.VD. \ PEMCO P.O. BOX 11569 CI-IAIN OF \CUSTODY
PORTLAND, OR 97217 {503) 283-2151
PROJ. NO. PRMCT N&£: SAt-lPLER
11A.&NAt..t..711 81Y !lttXJt..--17/ Y~' -;r. f-n;;vG l{oD20((p 702o RDDRU!i ~
27? R.ow~ >r. wfl~t.~ OR. 9/F-17 /""\_ /""'.. ,.....,_ ..-.. "'0 /""'.
/'liKe£ I: 0 u . ..,. +' 0 0 0
f.l~i:wcr f} --: 0 ~ .n" 88 (1, 41 0 )::0
'IT I: .-
~ m N E E _v. gs o~ If) ~ 1- u D c. ro ~xg ti> n..~ (f)O N
g w SAMPLE LOCATION I I I v 1>.1 ro ~N o<SC) 00 t4) moo -~ co .... ......, X
fi! (!) ::r: '-" ~v (L "-" 0 0 SAH=>LE d w
~ nEnll I ::t: v I-"'- U"- .VI
.. .-DATE TIH£ Cl c. TANK SIZE :l: a... (L <mN :!{ Of'- rom D.. 5..- 00 a.. ·-0 1-- :;) a.. 1-- 1- l 1-- '-' 8'-' _J ...J o....m -o (_) ~ M..t-13ER -<( ~
11. 0 u 0 -<( (I) ~ TANK PRODUCT f- ld \,!) £L u G<.D 0
): 1- 1- \,!) > a.. f9 a.. 1-- w G:
2~ tf:c;o X X ?CZVG/It_ U'71 (c?,cy
K / I 'lb P> '3o0 /VOIZOI Sc?rTD-'" -
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"5dVfil B o 171.:::xr1
3 I !:2s- ~ y 1/QO(> J5q( #TG Oi' L {})' fr:r- ~ .~
(:;-n71 S.oTT0/7 X 7' /I: JS lX X
//COO (";aJ.L. )/T G_ OIL U'21 tf'!-1 IX \
t...-ve"" 7 .,- 8 oTJ??rt
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6 ;;:'Is ~ ~ 5'oo{;;.JL. V/C::~;-L- U7r 7r:::_-r X y') I ?0Vl71 M/7D./J]
7 //:!)' x ~ 4coo-c;d_6. ,CLr. ~ Q/C u 4r jr::r
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'}
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f~6}ih,/rc:rL., f= Urw;z; ANAl I- V77C4 !-),
~»b*-- ?/Jh?· II(;()
~n~~-~ p ..-:;. -4. (( ll9')D ~~~ -.ol # Pt(J 02 [l({p » a-7-~ /; -=-- / ,·
'{ ..._--
~NORTH = CREEK
-= 2 ANALYTICAL
February 12, 1996
PEMCO P.O. Box 11569 Portland, OR 97211
Attention: Bill Knutson
RE: JOB # 7020 P.O.#
18939 120th Avenue N.E., Suite 101 • Botr \ 98011-9508 (206) 481-9200 • FAX 485-2992
East 11115 Montgomery, Suite B • Spokan~ • .VA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
PROJECT- NEHALEM BAY HEALTH DIST.
Enclosed are test results for your samples received in this lab on Feb. 02, 1996. For your reference, these analyses have been assigned our NCA # P602016.
Solid samples are reported on a dry weight basis except for Oregon DEQ Fuels Methods and where otherwise noted.
This report will be accompanied by a separate Quality Control Data Report, unless omitted by client request.
Please call if you have any questions.
Respectfully,
~~~ Laboratory Manager
~NORTH -= CREEK 18939 120th Avenue N.E., Suite 101 • Bothe• 38011-9508 (206) 481-9200 • FAX 485-2992
E1 ANALYTICAL East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
TPH-HCID per Oregon DEQ Results In mg!kg (ppm)
Client: PEMCO NCA Project #f- P602016 Project: NEHALEM BAY HEALTH DIST. Matrix: soi I
Sampled: 02/01/96 Received: 02/02/96
Date Client ID lab ID Analyte Results MRL Prepared
#1-8000 GAL PS 300/NORTH P602016-1 Gasoline NO 20 02/02/96
Diesel NO 50 Heavy/Oil NO 100
#2-8000 GAL PS 300/SOUTH P602016-2 Gasoline NO 20 02/02/96
Diesel NO 50 Heavy/Oil NO 100
#3-4000 GAL HTG OIUEAST P602016-3 Gasoline 30 * 1 20 02/02/96
Diesel 4300 50 Heavy/Oil NO 100
#4-4000 GAL HTG OIL/WEST P602016-4 Gasoline NO 20 02/02/96
Diesel 160 50 Heavy/Oil NO 100
#5-500 GAL DIESEUNORTH P602016-5 Gasoline NO 20 02/02/96 Diesel NO 50 Heavy/Oil 110 100
#6-500 GAL DIESEUSOUTH P602016-6 Gasoline NO 20 02/02/96 Diesel NO 50 Heavy/Oil 130 100
#8-8000 GAL PS300 UST P602016-8 Gasoline NO 20 02/07/96 Diesel NO 50 Heavy/Oil NO 100
MRL NO
Method Reporting level · None Detected at or above the method reporting level · See CommentSection at end of report *
Date Analyzed
02/02/96
02/02/96
02/03/96
02/03/96
02/03/96
02/03/96
02/07/96
. Page 2 of 5 ·
~NORTH -= CREEK 18939 120th Avenue N.E., Suite 101 • Bothe )8011-9508 (206) 481-9200 • FAX 485-2992
- :§ANALYTICAL East 11115 Montgomery, Suite B • Spokane, vvA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
TPH-418.1M per Oregon DEQ Results In mg/kg (ppm)
Client: PEMCO NCA Project #: Project: NEHALEM BAY HEALTH DIST. Matrix:
Sampled: Received:
Client ID lab ID Analyte Results
#3-4000 GAL HTG OIUEASTP602016-3 TPH
#5-500 GAL DIESEUNORTH P602016-5 TPH
#6-500 GAL DIESEUSOUTH P602016-6 TPH
MRl NO *
Method Reporting Level · · None Detected at or above the method reporting level· See Comment Section at end of report
MRL
2000
100
100
P602016 soil 02/01/96 02/02/96
Date Date Prepared Analyzed
02/07/96 02/07/96
02/07/96 02/07/96
02/07/96 02/07/96
Page 3 of 5
~NORTH -= CREEK 18939 120th Avenue N.E., Suite 101 • Bothe l8011-9508 (206) 481-9200 • FAX 485-2992
:E ANALYTICAL East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
SURROGATE RECOVERIES (%)
Client: PEMCO _,..,0-
....---.::-" NCA Number: Project: NEHALEM BAY HEALTH DIST. Received:
Sample Name Analyte Result
TPH-HCID per Oregon DEQ
#1-8000 GAL PS 300/NORTH 1-Chlorooctadecane 92
#2-8000 GAL PS 300/SOUTH 1-Chlorooctadecane 99
#3-4000 GAL HTG OIUEAST 1-Chlorooctadecane 77
#4-4000 GAL HTG OIUWEST 1-Ch I orooctadecane 114
#5-500 GAL DIESEUNORTH 1-Chlorooctadecane 103
#6-500 GAL DIESEUSOUTH 1-Ch I orooctadecane 107
#8-8000 GAL PS300 UST 1-Chlorooctadecane 100
. MRL NO *
Method Reporting Level . . None Detected at or above the method reporting level See Comment Section at end of report
P602016 02/02/1996
Control Limits
50-150
50-150
50-150
50-150
50-150
50-150
50-150
Page 4 of 5
:iNQRTH -= CREEK
..::: =ANALYTICAL
Client: PEMCO Project: NEHALEM BAY HEALTH DIST.
18939120th Avenue N.E., Suite 101 • Both . 98011-9508 (206) 481-9200 • FAX 485-2992
East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
COMMENTS
NCA Number: Received:
P602016 02/02/1996
1. Detected hydrocarbons in the gasoline range appear to be due to overlap of diesel range hydrocarbons.
Page 5 of 5
~NORTH = CREEK
-= =ANALYTICAL
February 12, 1996
PEMCO P.O. Box 11569 Portland, OR 97211
Attention: Bill Knutson
Re: Quality Control Data JOB# 7020 P.O.#
18939 120th Avenue N.E .• Suite 101 • Bothe 38011-9508 (206) 481-9200 • FAA 485-2992
East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAA 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAA 644-2202
PROJECT- NEHALEM BAY HEALTH DIST.
NCA project number P602016.
Note: Surrogate Recoveries are included in the final report.
QUALITY CONTROL DEFINITIONS
METHOD BLANK RESULTS
The method blank is an analyte-free matrix which is carried through the same analytical process as the samples. It is used to document contamination that may result from the analytical process.
SURROGATE STANDARD
A surrogate standard (i.e., a chemical compound not expected to occur in an environmental sample) is added to each sample, blank, and matrix spike sample just prior to extraction or processing. The recovery of the surrogate standard is used to monitor for unusual matrix effects, gross sample processing errors, etc. Surrogate recovery is evaluated for acceptance by determining whether the measured concentration falls within accepted limits.
~NORTH -= CREEK 18939 120th Avenue N.E., Suite 101 • Both€ 98011-9508 (206) 481-9200 • FAX 485-2992
= s ANALYTICAL East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
Accuracy is measured by percent recovery as in:
% Recovery ~ (Measured Concentration) (Actual Concentration)
X 100
Precision is measured using duplicate tests by relative percent difference.
RPD = (Result of Test 1 - Result of Test 2) x 100 (Result of Test 1 + Result of Test 2)/2
If you should have any questions concerning this report, please contact me.
Sincerely,
Page 2 of 4
~NORTH = CREEK 18939 120th Avenue N.E., Suite 101 • Both < 98011-9508 (206) 481-9200 • FAX 485-2992
- g ANALYTICAL East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 {509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton, OR 97008-7132 (503) 643-9200 • FAX 644-2202
Client: PEMCO
BATCH QUAliTY CONTROl RESUlTS TPH-HCID per Oregon DEQ
_.,.~--··
NCA Project#: P602016 Project: NEHAlEM BAY HEALTH DIST. Received: 02/02/96
METHOD BlANK Batch# FA96009e Results In mg/kg (ppm)
Compound
Gasoline Diesel Heavy/Oil
Date Prepared Date Analyzed
Surrogate Recovery (%)
1-Chlorooctadecane
METHOD BlANK Batch # FA96010a Results In mglkg (ppm)
Compound
Gasoline Diesel Heavy/Oil
Date Prepared Date Analyzed
Surrogate Recovery (%)
1-Chl orooctadecane
Result
NO NO NO
02/07/96 02/07/96
Result
99
Result
NO NO NO
02/02/96 02/02/96
Result
98
MRL
20 50 100
Control Limit
50-150
MRL
20 50 100
Control limit
50-150
Page 3 of 4
~NORTH -= CREEK
a ANALYTICAL 18939 120th Avenue N.E.. Suite 101 • Bothe , 98011-9508 (206) 481-9200 • FAX 485-2992
East 11115 Montgomery, Suite B • Spokane, WA 99206-4776 (509) 924-9200 • FAX 924-9290
9405 S.W. Nimbus Avenue • Beaverton. OR 97008-7132 (503) 643-9200 • FAX 644-2202
BATCH QUAliTY CONTROL RESULTS TPH-418.1M per Oregon DEQ
~--~·
Client: PEMCO Project: NEHALEM BAY HEALTH OIST.
METHOD BLANK Batch # FB96007b Results In mg/kg (ppm)
Compound
TPH
Date Prepared Date Analyzed
DUPLICATE Batch # FB96007b Results In mglkg (ppm)
Compound
TPH (ap)
Result
NO
02/07/96 02/07/96
Sample Cone
NO
NCA Project#: P602016 Received: 02/02/96
MRL
20
Duplicate 10 P602057-1
Oup Cone
NO
RPO QC Limit RPO
50
(ap) RPD is not reported for sample concentrations less than 5 times the MRL.
LABORATORY CONTROL SAMPlE Batch # FB96007a Results In mglkg (ppm)
Compound
TPH.
True
125
Found % Rec
101 81
QC Limit % Rec
30-134
Page 4 of 4 ·
tl"~ T t''l ·l .,
... ~
JlEMCO 437 N. COLUMBIA lli.YD.
P.O. DOX 11569 PORTLAND I OR 97217
(503) 203-21~1
CliAIN OF CUS'TODY
PROJ. NO.IPROJCT NAVE: It! PI, CL{L,-r, flct '1 If t:1a/ /-J, Du frtc -1
5/\tvlPLER
/J!c j-)/1lf?;7(
0 ~ ~ ~ f- Q '·"" 00 0 -v'O' . o8
SAH'LE "' 0 ~ SAMPLE LOCATion o 0 o ·c "' N ;;; tf: ~ @ ~ ~ E g .<: S ';t :£ ~ r~ER DATE TIHf 6 ~ B § 61 TAHK SIZE IIErlll T J J ~ '¢ ~ g !'lo N,; S oo "'-~ g .ll g &I tn Sl w -«
0
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ft.. ~- nuto
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,----------1 I I ------ ~01 II l!lllnqulshad by: o.$.1!3- z.L/
\
ANALYSIS REPORT
c l Bill Knutson I PEMCO E P.O. Box 11569 N Portland OR 97211 T
Project #7020(9A) Project - Nehalem Bay Health District Sample Type - Soil
Lab Number Client Identification
5218 #1 4K UST Bottom #2 4K UST West
5219-0up #2 4K UST West 5220 . #3 4K UST North
5221 #4 4K UST East 5222 #54K UST South
Lab Blank
NO = None Detected
Detection Limit = 20 mg/Kg
2/21/96
QC Information: Spike, 87 % Recovery
Date Received: 2/21/96 Date Analyzed: 2/21/96 Date Reported: 2/22/96
Job Number: 5218-24 Page: 1
Total Petroleum Hydrocarbons Analysis - TPH 418.1 (mod.)
Results mg/Kg (ppm)
ND
57
ND
NO
\' Reported By --"-"~""--'.:1~L'=""""'-"""J _s=......, ... '---_
QA Check ________ _,(;~~,_"-:--:,._ Laboratory Manager
Am Test Inc.
Professional
Analytical
Services
9205 SW Nimbus Ave.
Beaverton, OR
97008
Tel 503 626 7424
Fax 503 643 1460
ANALYSIS REPORT
c l Bill Knutson
PEMCO E P.O. Box 11569 N Portland OR 97211 T
Project #7020(9A} Project - Nehalem Bay Health District Sample Type - Water
Lab Number
5224 5224
Lab Blank
Client Identification
W-1 4K UST EXC. W-1 4K UST
2/21/96
Detection Limit
NO = None Detected
QA Check G-() ----------------------
Benzene
0.54
NO
0.5
Mlli::sT
DateHeceived: 2/21/96 Date Analyzed: 2/21/96 Date Reported: 2/22/96
Job Number: 5218-24 Page: 2
Am Test Inc.
Professional
Analytical
Services
9205 SW Nimbus Ave.
Beaverton, OR
97008
Tel 503 626 7 424
Fax 503 643 1460
Analysis - BTEX (EPA Method 602) ug/L(ppb)
Toluene Ethyl benzene Xylenes Surrogate* %Recovery
0.85 NO 0.75
NO NO NO 77
0.5 0.5 0.5
Laboratory Manager
c L I E N T
AM.:sr ANALYSIS REPORT
Bill Knutson Date Received: 2/21 /96 PEMCO ~"-- Date Analyzed: 2/27/96 P.O. Box 11569 Date Reported: 2/29/96 Portland OR 97211 Job Number: 5218-24
Page: 3
Analysis - Toxic Characteristic Leaching Procedure (TCLP- 8 Metals) Project #7020(9A) Project - Nehalem Bay Health District Sample Type - Soil
Lab Sample Number 5223 5223-Dup #6 500 gal. Diesel #6 500 gal.
Stockpile Diesel Stockpile Client Identification Metal mg/L (ppm) mg/L (ppm)
Arsenic ND ND
Cadmium ND ND
Lead ND ND
Selenium ND ND
NO = None Detected
fi~ QA Check
Detection Digestion Limit Blank
mg/L (ppm) mg/L (ppm)
0.01 NO
0.02 NO
0.4 NO
0.01 NO
~·Ckt Greg Bolt Laboratory Manager
Blank Spike
%Recovery
103
92
104
98
Am Test Inc.
Professional
Analytical
Services
9205 SW Nimbus Ave
Beaverton, OR
97008
Tei 503 626 7424
Fax 503 643 1460
Matrix Spike
% Recovery
111
89
100
96
ANALYSIS REPORT
c L Bill Knutson I PEMCO E P.O. Box 11569 N Portland OR 97211 T
Analysis - PCBs (EPA Method 8080) Project #7020(9A) Project - Nehalem Bay Health District Sample Type - Soil
5223 Laboratory Sample Number Client Identification #6 500 gal. Diesel Stockpile
PCB's mg/Kg (ppm)
Arochlor 1016 NO
Arochlor 1232 NO
Arochlor 1248 NO
Arochlor 1260 NO
Surrogate Recovery % 88
NO = None Detected
QC Information: Spike (Arochlor 1248), 116 % Recovery
Reported By
QA Check
Lab Blank
Date Received: 2/21 /96 Date Analyzed: 2/27/96 Date Reported: 2/28/96
Job Number: 5218-24 Page: 4
Detection Limit
mg/Kg (ppm) mg/Kg (ppm)
NO 0.2
NO 0.2
NO 0.2
NO 0.2
76
Laboratory Manager
Am Test Inc.
Professional
Analytical
Services
9205 SW Nimbus Ave.
Beaverton, OR
97003
T2l 502 626 742-+
Fax 503 6..\3 1..\60
, ANALYSIS REPORT c L Bill Knutson I PEMCO E P.O. Box 11569 N Portland OR 97211 T
Analysis - GC/MS Volatiles (EPA Method 8240)
Project - Nehalem Bay Health District #7020(9A) Laboratory Sample Number 5223 Client Identification #6 500 gal. Diesel Stockpile Compound
Chloromethane
QC Information: Surrogate Recovery %
ug/Kg (ppb)
NO
ND None Detected
Date Received: 2/21 /96 Date Analyzed: 2/27/96 Date Reported: 2/28/96
Detection
Job Number: 5218-24 Page: 5
Limit Blank ug/Kg (ppb)
30 ug/Kg (ppb)
ND
(04-1 ,2-Dichloroethane) 102 97 (DB-Toluene) 95 94
(4-Bromofluorobenzene) 95 94
~fhc-reg)l!t Reported By
OA Check Laboratory Manager
Am Test Inc.
Professional Analytical Services
9205 S'-IV Nimbus Ave.
B<~averton, OR
97008
Tel 503 626 7424
Fax 503 643 1460
Appendix 2
- Tank Certificate of Disposal
- Contarninated Water Disposal Receipt
-Matrix Scoresheet
- Matrix Checklist
- Soil Manifests
_:;;o
r
PEI\~{:0
CERTIFICATION OF TANK DISPOSAL
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6388
JOB NUMBER: -; tl ? CJ
LOCATION FROM WHICH REMOVED: ;t/'-(///Ji -.e~ !l4x
QUANTITY SlZE. LAST KNOWN PRODUCf
~ ~
I c;-oo !) ;'e<i I
t fl/;ao?' fl e/1'1.<4 /)(!;- [);'e;; I
( CG lootJ /) ?--i-<-tw~.v ~
li-L-t (A/ )...e i/J-TRANSPORT DRIVER:-----------
A Division of PEECO
I.
.. "'" .• ~HT Bill OF LADING ORIGINAL - NOT NEGOTIABLE
e;l;,','J/o-''
Street
FR Sh
Street
llrt~?f'C:O fl/o~5
II
Shipper's No.
Carrier's No. !' ' 7 r ' t~-1
l!::q. [.1.,
RemitC; .. <?·:·D· .to: COD C.O.D. FEE: TOTAlCHARGES: A~d~ess:~~i . . 1 PrepaidD $ $ C1ty. ;:1s'l~'' State: Z1p: Aml. ;~ Collect 0 FREIGHT CHARGES NOTE • Where the rata is dependent on value, shippers are required lo state specifically in writing SubJKt to Se(.t!Oll 7 ol the coo4•Mns, It this shipment " be dl!livef~ o th• coosogn$e without l«<ll""
the agreed or declared value of the property. The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding $ ~ Per
0 Mo•l :ftk Oft ..... 1<;1 ~It Heta•~ Mot~t•kd 111 d,.tl.,e4 W. fl"t At tl M.• ctdt tl hdt.,lllltovlotl.,.,, G~d•n~ foo,..p<orlooi<o" ol Houlfd<>ut M.ott.•lolt. Tt1t uot of thl, Colu"'n ll on opticw>"' -flood .t oi.-.lf"CC.W.f "-•••'*- -••rialt.., t.illt •' lo.fH>o "'' t•tlloA ln.:lOt .... d 111.10itbl df tt.• ••ov'ollotlt ll<>"•'"lng lh• tro~p<~rtot...., of wd• ..,.,,.,..,1 •.
;::~\--1 O-BLS-A3 (Rev. 8/92)
\ \
--~ •;;)'
- ' MATRIX SCORE SHEET
1. Cepth to Gra.In:lwater < 25 feet (10) 25 - 50 feet ( 7) /O 51 - 100 feet ( 4) > 100 feet ( 1) - - .
2. Mean Annual Precipi tatian I >45 in::hes (10) I
20 - 45 inches ( 5) ID <20in::hes ( 1)
3. Native Soil Typ: . Coarse sarrls, gravels (10)
/) Silts I fine sa.rrls ( 5) Clays ( 1)
4. Sensitivity of UJ:::p=nrDst Aquifer Sole scurce (10) current Potable ( 7) 4 Future Potable ( 4) N'on-pJtable ( 1)
5. Potential Receptors Many, near (10)
6 Medium ( 5} F€!11, far ( 1)
I 'I'OI1U. SCORE =
I 3LJ
I
Cleanup Level in :f.'Pil TfH Matrix Score
I.ev'el 1: I.ev"el 2: I.ev'el 3:
UST Cleanup Manual · Matrix Scoresheet
> 40 pts. 25 - 40 pts.
< 25 pts.
Gasoline Diesel
40 100 80 §.22.
130 1000
July 1991
__ ,
Matrix Olecklist
/ 1. 'The release of petroleum has been reported to the Department of Env:irorJm::ntal Quality (220}.
v/' 2. 'The Matrix score sheet attadled to this checklist has been ccanpleted for this site, l.mless the site is beir:q cleaned up to the nost st.rinqent cleanup level (320).
~ 3. If th:e clE:-:.:.:.~-? level USE'.~. fc::: t.~ site is one of t:l"l..e three diesel cleanup levels, a hydrocarbon identification (HCID) test has been pe..:..--:Eo:rmed which proves that the soil contamination is not from gasoline (335(3)).
V 4. A sketc.'l has been made of this site (345(1)). 'IT.is sketch clearly sho;vs:
--1L" a. 'The location of all buildings arrl other key features, both man-made arrl natural;
~b. 'Ihe names of adjacent streets arrl properties;
__ V c 'Tt:P 10CZ'tic:J of a:!.l e--:c:::'",,.'2ticns includ.i.~ t.";.ose that were for ::.:> . .:- :.z:~·c-~~~ (:± t:1:l;.~·.:.s ee-l ~i.e..>··:.:-· 1---:_;.i..~ c.2 well as those t:-;.:..--:- ·;;."T'.::::-e s"-::ic'-.. Jy fer the rerroval of cont.a.--ni..r"Jated soils;
~d. 'The location of all prcduct. storage tanks, lines a:rrl dispensers, including those that were decarmnissio:ne:i as well as those that remain en the site; arrl
V e. 'Ihe locations from which all soil arrl water samples were collected •
~ 5.
...k. 6.
_L' 7.
If a:trf contaminated soil in excess of matrix limits bas been left on site, the reason for leavin:f this soil has been explained arrl the requ.ireme:rrt: of 355(4) have been met •
If water was present in the tank pit, the Cepartment was notified, the water was pumped from the pit, arrl the requirements of 340(4) have been met.
All soil anJjor water samples have been collected, o:xied, stored and shif:ped as specified in the rules, ani proper chain-of-custody forms have been filled rut (345) •
~ 8. All final confinnato:ry soil samples have been analyzed using the Irethcxls require1 by the Department (350) •
.N/4 9.
__k(1o.
If a tank was decannd s.sioned in place, the Cepartment gave prior approval for a site-specific sampling plan (340(5)).
A J:e!X)rt has been prepared which contains all of the Wonnation required by the :rules (360).
55
Project Manifest
Job# Gen # Dare In Number
0259 i'JEH259 2/27/96 03 I 1 d.
c-;~c. '-~~ i"JEH2::S·
.-.,.-..,-,,,....,,-.. L.' L_t.:,, :::..'0 03715
0259 0lEH2.S9 2./22/96 037"16
0259 NEH259 2129/96 03718 Q"JC::~ "- .. /d NEH259 2125i96 03720
0259 i'JEH259 2/27/96 03723
0259 NEH259 2l22/96 03760
PEMCO 'vlarion County Soil Recycling Facility
Job 259 - Nehalem Bav
T ransoorter Grass lb. PEivlCG 83,200 PEi·1lCC 74,460 PE:·;1CC 75.800 PEi·;iCO 64,340 PE:'llCO 61,900 PEMCC 74.820 PEi·1iCO 33.500
L!..68.020
Tare lb. 32.800 30.680 32,540 30.520
_.:-'~
30,560 30.700 20.360
208.160
Net Net lb. Tons
50,<100 25.20 43,780 21.89 43,260 21.63
-"'"'' .. 33,820 16.91 31,340 15.67 .:14,120 22.06 13.140 6.57
259.860 129.93
FACILITY SOIL l\1ANIFEST
P . "f"~h i roJect spec1 1c generator num er: NEH259 Date of shipment: "---..__ I • ~ ___-/ 'J ~ 7 •; C::
2126/1996 ~number: _, ..__ J.. v
" T011ECO&II'IETE111JYCYIRI'Oll..t'1.£1/E,fDQI.Mil11!1lS"i,· .• '·:, l ·:~' ·:.~ • 1i. :~.;. ;::;f":.~· "'.:":;~:: :.~t~~:.'!f.~··")'~,:~;,;-£~1~~:-~7 ;.·:·i.-,"P. :• »;·;~'.'?·:.; G.!ncrntor information Site of ;:enerntion
COMPANY NMH€ ACll,/TYHA~€.
NEHALEM e.AY HEALTH DISTRICT NEHALEM BAY HE..t.,L TH OISIRICT snu:ETna o. a ox TREET AODRE.S:.:
278 ROWE ST. 278 ROWE ST CifYI:TAf£/ZJP IPEMCO •CCOUHf • TYt;TME/ZJP
W.-1E::Lt:R. OR I 1M-<==: =~ OP CONT"-CT Pr!RSON \TEL.EhiONE HUMBER Transporter infomwtion
.-AO,....._f I v "" ,. "'2CC !:' ~,. n fOMP~Nr NAMe:
Consultant information v C::Aicn CQMP.A.N't' loi<I•M€ ~nu;;a!P o aox
oc:: ,...,..,
STR££Tn-.O iiOX TYI:T.AfEIZJP \PEM<:O •CCCV"' •
,.,.,..,. ~' ,....,..,, I !HP!A PI"'"' ..
CJfYtsT.4fC/ZJP IPEMCO •CCOUHf o ONUGT~RSOH ITEJ..EP"'OJ.i£ HUMBER
0,..,0.,.1 ~"1"\ 1""10 CONTACT nRSOH I TEJ..EI'"MOHE HUftlfBER Soil information r check the appropriate boxes I
.. -·-- -~·--. --· - ·-. Destination infurma~tToii-- Type of conramrnaoon I Cause c.~ cJnrar.-::r.a:iJr: ..... I Manon Countv Soil Recycling Facility 0 Gasoline n Leakmg ~_1 S7
l-J•' :;rREi;T!~>t;. 3Q.t
I 17827 VVhnnev Lane N Q Diesel 'I ' . . .--~- l...! ~-::2:-t.::;; ...... ,::;
=;rY.o:;r.o~t£..=:."'
I ,:x
0 Waste Oil ,-:
Cther !s;;ecify;: Woodburn. Oregon 97071 L.J
CONf ..~ocr ~RSOH TELEPHON( HVM6£R 0 Kerosene
0 Other: ' ..
Weichts Load in~pcclion $.1"tCTOR StGH4TURE
Gross wetgnt
Tare weight
Net weight
I -/ Certifications
Generator's and/or consul!ant's certification
1/W~ cerujy that tlu: soil rcferaJct:d herem is Ja.Jcen t:ntircly from thou soils desert bed in tht Soil Data and Acceptance document compl~red u.nd curified b~· mcms for rl1c (;~_•tJUutlolf Sire shnwn abO\'C und
nothinK has ban added or dont! to such soil that would aiur U in an.v wa\".
I,..., co•oeo our
7'ransporter'~ certification
IJJVe acknowlftig~ recetpt of the soil describ«i abov~ and certih tha.J. such soil is bang ddivered in cmaly tit~ same condition as wlrm rtet:iv~. 1/W~ further certify thut thi.'i soil is hr:ing dircclly
transport~ from th~ Gm~ation Site to the Dui~natfti Facili(Y without off-Joadinr:. addin~ ta. su.btnu:tin~ from or irhzny wav detavin~ delivuy to such silt.
I ac.knowledte r«npt of the soil ouJiintd;.;, this document ucqn as described b-tlaw.
··~ // //YI 1.-,]A Vl-~ r.: F.· I...£.//// ~L/.r;; / ' ..t
I
.. Fiu:ility cmi{ica.rion/
/ I /
/
PEMCO ACCOUNTING (INVOICE)
PEMCO HeaOQuaners
Aodress
<37 N. COLUMBIA BLVO.
P 0. BOX 11569 PQRTl..ANQ, OR 97211 (503)2::!-21$1
FAX (503121:!-6388
Date of shipment: ms11sss Manif~st number: Q 3 716 , ·' ::1 i il I ' ' I ' ~ I ' 1 I :~ :t.'.J..
Generator information Site of generntion
NEHALEM BAY HEALTH DISTRICT NEHALEM BAY HEAL Tw DISTR!C7 ST>1(ETIP.O. SOX TR££T ,A.QQRES::.
278 ROWE ST. 278 ROWE ST
\NHEELER. OR WHE:CLER. OR :OiHI.A.Cf Pt:RS.OH
rFLEPHOHE HUMBER
f========~m:'·=P=~~'ca~~=!·~~v==============~=======~=:~==·~~:ic~o=Z~=·=•2n================~'Jpu~~~ ~~Me Consultant information
Tr6nsportcr infonnatiun
STRE.£TIP.O llOX
A"-7 ~I t"'r")f I IMP IA :ll \/n ::rrr.:t,.rE.IZJP
Destination infom1ntion
Marion Countv Soil Recvciing Facility
17627 \Nhitnev Lane N.S.
Woodburn. Oregon 97071
~TREUJP':J BO.t A-: __,I ?"'f-.)
Soil infom1alion 1 cht"ck the ;q:propriatc bnxcs 1
0 Gasoirne
D.x D1t:sei
0 Waste Oil
0 Kerosene
0 Other·-------
.. - ·. .~ ;.: ..... t· ~}i; ·:,:. ; .. .:·m-,:~·~;}.~~~;.;~~~~~~?§~~4;t~~~~~~~:~ ... .
Wei(!hts II / Loart-1nspcttJUn
'/ - 8"(,yj NsP'fCtOR SJGHArtJj;tf
/ .·.
Gross we1ght \ /. ' / i "\(j / ; OltiM!Hf$
/-ij_Jt/!f.~~~~-" ' -- <"' 0 Tare weight , __ 8 ._j I ( J -· _,
43C)?;n " / ,• Net weight ,/ -- '-'
SCAU HOUSI! liGHAfiJRf
15~. ·. '
\ / Certi!ications - Generator's and/or consultant's cenification
{IW~ cmify that the soil r~fermcni hi!TI!in is taktn CJtireiy from thou soils desaibeti in the Soil Data and Acuptance document compi~eti and cmiji~ by mc1us for tire Generation Site slrown above and
nothin1t has bun addt:d or done to sudr soil that would aJJer iJ in an.v wa_v. .. ,.., L:..... A'r-'VE A/ RIC k..c IT_~ I'KINA'!:Lo,/(rrt>-17 If(~ rATE .2 I l. 8 I Cil~ I""' <o•oEo our
Transponu'f czni(ictnion ..., /IWt- acknowit:dgt: receipt oflh~ soil ducribai 11.boo;e and certify that such soil is beint deliwred in uactiy the same cotiditi011 ijhm ric~«L 1/Wt juRher cutifo. that this soil is beinr: dir«t(v '
<dfi h G . s· 'h D · ~ ·r / ff..J • ..ad· suJ>t · Ji /,/ /I l.u. 1 /.u 1'0.1 . / / runsport rom t e ent:ration tie tot e tst~nat acl. uv w1t ottt o oa.dm~. Ut~ to. racttnt: rom or anywa_9 VIII~ e vcy to.sa.c •szll!. ..... I lv.dC:
,-,0::::_:/
lmHA~ l;tJY Jl_.· I om ._. I ~~ ' .•
.~ A,~ ., -~'".,... ./ ..:../:: "Sf! / ;h I Facill:y cinipEation 1.1-' /
I I uc:knowlcdt:~ r«cipf of the soil outlinfti in this docummt ucevt as describai bdow. / '
,. .....
///~ /:v/:J?JJ/ , ............ // /-.4/_/v £:1,7?'----- r.,· .~ ... i~,.l~ /. - ' " . . . i' ·-· ',.-.-:;r::;, • 'j ~
'-ACJUTY CQ~Hts
/ . ' - // I /' ·"
'
PEMCO 437 N. COlUMBIA Bl.\10. P 0. BOX 11S6D PQR'I1.NIO. OR 9n1 1 (.503} 2.e3-2151 FAX (SQ3J 2113-6388
.
-~ ' . ·'"='":;-
MARION COUNTY SOIL RECYCLING FACILITY
A PEECO COMPAt"Y ~\ . I\. ; , I
SOIL MANIFEST
~-· Project specific generator numher. _.::::~:..:l::..:>-l;:;2:.6:::;a=---- Date of shipment: 21:21:11 aal: ---'==::.=..;;:.;;;..-
-:; ....... , Manifest numher. U ...J { ..;.. 4
Generator information COMP.AHY 1'/AM€
NEHAL!':M BAY HEALTH DISTRICT
278 ROWE ST.
Consultant information
STREET If" 0 a OX
Destination infommtion
l~<1ancn County Soil Rec:·_;:::tng F=aciiity
\782.7 Wnitney Lane N.=:
Woodburn. Oregon 9707~
· .~ ~~}.f;~rt'l~~,~ :t:~!~,:~}~ { fl'. ~~- ·: !. ·~ · ~ ~:--. ~
Weichts
Gross weight x~)(~(/
Tare weight ~8 xrJ; Net weight £)C14(l)
~ SCAU HQIJ$ll SICHATUitf
I ,s;~ i'\ )' I ' "-... -- --
Site of ~cnerntion ACUJTYNA.*E
NEHALEM BAY HEALTH DISTRICT
278 ROWE ST.
WHEELER. OR
Transporter information
'. j,:'/-;V' (/
1RfEUI' 0. llOZ IV 1T'fi$1A1En;ZI"
Soil information I check the appronriate boxes)
Type of conraminarion Cause of :;onramrnarion
0 Gasoline
Qxoiesel
0 Waste Oil
0 Kerosene
0 Other:
'1DB£~ATFACIUII': ·· : . •
I HS'!CTOR SIGI'IAT~
._/. - .. ~
Certifications
Generruor's and/or consullant's certification
[J... <_:aK:r,g L.:SI
0 <_eaking ASI
0 ·:ther (spe':ify):
.. -~ ~ .. ; 1~~-:t!.f:~~:.:~~..;~~~~~;t~~t;)·~~:%~~~:·~~~~~~~ _,Load inspection
----,( t./:.. r:_..-- __
' ...._
//We certify that th~ soil refeuiu:ed ll<rnn is takm <rfllreiy from those saris dLScn'Md in tht: Soil Da:a anti Acceptancedor:umcnt compif!tt:d and ccrttjied hy m<IUS forth~ Ccm:ration Siu shown abo•< and
nothin~ has been added or done to such :.oil that wouJ.d ailtr it 1n any wov. HA ...
WAYNE IJ. ~ )(t' C.T!~ I'"'""URJ~ J\:} , h!~9t ,JOAr• }}/ I TIJ.E !.OAUO our
) f /'" . I J r.l 11:-.-~ /":.';~ , -" _-.!:. "'f'ir:nsponu's certi{iCIJiion J ..
1/W~ acknowlcdg~ r«eipt of tltc soil dacribt:ti abovt! and certifr.tha.t such soil is Mng ddifu:rrd in cmaly th~ SIUIItr co:.dUion as whm re.f:a,f!d. 1/Wefurthu c~nify thuttllis so1l is being dir«tiy
I. . ')/1" :, -1 transporuri from the GcnD"ation Siu 10 the Dui~natl!fi Facilit'! without o[f../cxuiinr:. addin~ to. subtraain'(jrom o/.,in an~.,twfr:, dt:ltzyin~ deiiYt:ry·tD,ruch silt:. / HA..,
(lvJJ <'" '-........._ ' ' ~---- !f' / {ji--<f. 1/ C" -, ;: .. .--;' ~~-~ / )- I / ~r(P I I /:.A', ...!...... _·....,roO}'-. ":>!, d .'/ '·~ - F acilily cmifiClltion
I acknowi«lr:c rr:cap1 o(rlle soil outlined in this document uceptus dccribai bdow. J
HAM!
J 11orn'(' 1..,_27. ~ . ' l ..,.,-0""'........._.. ~ACIUf'T COitW/eiiT::S y
PEMCO ACCOUNTING liNVOICEI
IDA.fl! ?- •· '2.
_., /
PEMCO
-·
- :.:?/ I .,_
•37 N. COLUMBIA BLVD.
P.O. BOX 11!>\1;
PORT!»>I. OR 9721t (:103)283-2151
FAX (:103)2113-6384
lV1ARI9N couNTY soxr..: RE.CY:<xiNG FACILITY
S 0 IL l\ILL\NIFEST
N!:H259 Date of shipment: --=21.:;;2;:;,:.61..:..19!!=6~ Manifest number: 0 3 718 II I !I ~,'J..
C.,nerator information
NEHALEM BAYHEALTH DISTRICT
b==;..27:...;9:...:...:R.::.O.;..W,;..:E::....::.ST.;...;...._ _______ ~=~=-:--------r·;;;";~WE ST. CJTYr.:t.A.TEIZJP iP£M:O.o.c:ovur ~ !TI!Yt:it..ot.c:t.:;P
SfREETIP.O, aoz
WHEELER. OR .I WHE::u:::?-. OR
I TEI..(PMONC HUMBER
f====="'=A~O=n=·d!~v~======='===~;::;,"±;;' ·=="'~"'=<l..~~=' =' ;;;,O========ill -M""' (;~ A" "" n Consultant information Y 1 /f v 1 r_..;......;
STRf.ETh"'.O. iOZ
Dl 111"'1
Site of generation
Tr::tnsporter information
CONTACT ?'ERSOI>f Soil information I check the appropriate boxes)
Destination informnt.ion C2use of conrammarion
Manon County Soil Recycling Facility
1782.7 Whitney Lane N.!::.
Woodburn, Oregon 97071
Gas:'i.-.:
QXDiese.
0 Was:e Oil
011 Kercse::e
0 Othe:· ____ _
C:L Leaking USI
0 Le:=king AST ·
0 Other (speciiy):
.. ~:. :'· ·.::"-'-.;:~:· .. ~· ·}~-~~ 77r·~~;~:I4·~~~~:~~;~:;~:~!~"~~;t~~~~Jr~:ti~~-:;)1;~a~?!:~1;!k~~~~~1:?.;{-&;;r.f~~}~~~~~=~i..:t;!;·~; .. ··' Wcichts H r. Lo~d insncction
{a-LL~LJ() I>HSPfCOP,O;OHATU'f . --.-::-! -/ r/ _, .:~ ,:;:. -.. ~·~ Gross weight . /; r~ _, /.// -.P/-" /.·- '· , .-:-
~I ,~.,.'-./ "' /
Tare weight ~ \:::-J (} Netweigh~~
"' ' '-" $CA<J! ...... ~:.IOHAltH<7 ~ ~ ) )
\ / Certifications
Generator's and/or consultant's cem(ication
1/Wt: cmijy that tlrt: soil r~umced hn-cin is taken ~ntirciy from thou soils dacribed in 1h~ Soil Daza and A.cuptance docu.rnmt complettd and cmific:J by mC'tUS for tlr~ Gcrruauon Site .shown above and
nothin~ ha.s bem addl!d or done to mch soil that would aUer ii in any waT. HA ...
'vVAY;Vf:- N. 12 K.-k.ET!£ J'"'"TuJlNI. h H~f" J J) ~/Ct'" 1. tUolll!: t.OA0£0 our
Transporter's certification I
JJW~ ackncmictigt receipt of the soil desaiiH:d above and ~mify that sudt .soil is bting deiiv~red in aactiy the SIJ.me condition as whm r«nved. //We further ct:rtih thal this soli is being dir«:iy
rransponed from th~ Gor.t!ration. Sit~ to th~ Dai'lna.ud Facility wit how offloadin~. addin~ to. subtractin~ fram or in.dnv wa:v dtl.aYin~ deiiYtry to sudt sill.. H ....
J.J.f, }vj;\--C.. {~ \l(...- H \f:- 1"~)1;;-;;]... : \.Vin/ 1~5f:JJ ~T~/v:t/90 I F acilily certification _
I acJcnow.f~r«&ipt of th~ .soil ouJiinui in rhis document uccpt as desuiiHd below. _ .. _.--., ,' / --... ) / s:-w 1:7/s ~P.:Y c 17 P/ , .............. , / ,/ / IOAft
X :;==;-....,..-_ -:~ .'J:~:-:/1 /", • n///. ~../ -;/' .., .:::;.. -96 < . ...-:.- - _.., ,ACJUrT CQMIIIII!!Hrs _...
' > ·'
_ _...,_,- /
PEMCO 437 N. COI.UMBIA BLVO. Po. aox nM• POR'Tl.ANO. OR 97211
(503) 2S3-2JSI FA)( (503J283-63Sll
co-la.
A rs:CO COMrA,\:Y
--MARION COUNTY SOIL RECYCLING FACILITY
S 0 IL lVlAl"'[IFEST
Project specific generator numher: __ N_E_H_'2_S_~ __ Date nf shipment: __ 212_L_s_n_s_s_s_ Manifest number. 0 3' 7 2 0 C,ncrator infonnation Site of generation
NE-iALEM BAY HEALTH DISTRICT Sl"'EFfiP.O. GOZ
278 ROWE S7. Clrt~TA.ff./Z;,.
Wrlt:::LER. OR
Transporter information I rn.£PHON€ NuM8E,: I
CAROL ~V\ Y ~ 1 ~3CS..3 ~ 1 ~ .... ._ .......... ~ F===========================C=n=n=s=u=l=ta=t~l=t=j,=,f=o=rn==,=a=ti=o=n========================~ll f> ·~ ;\1 <=_.c:>
PSMCO STR££'TIPQ. liOZ
437 N. COLUMBIA BLVD. c:rYt:t.~ore;z.;,.
PORTLAND. OR
l
lfl..iP,..ON( HU~><BE:t
~~-~'1v":'C''·~-;.~:...~
Soil infonnation I check the appropriate boxes)
Destination infonnatinn "!'yoe of c:nramnarion Cause of contamination
i 7227 Vv'httney Lane N =.
Wocct:urn, Oregon S707i
'~ L: Gaso11<1e
' ' ....,. ' lJX '..·!eset
LJ IN2s;e Oil
Q Kerosene
n ·Cther: -----'---'
IJ~ Leaking UST
U- Leaking AST
0 Other (specify):
·~· · -~ : ... ~~-~; _:.:;:.< ... ;~ .. ,=.- . : M ... ~~¥ ;:~~,~~~=!:_.~~~~~1t~!",..~~~~r~~·~~ti~~~~ fl,~~ - · ~ ~_;:~~~:::.~~~~;;.;t:~:.;t·:~.;r~.;~\"'~:~1.;f:~: ~~: )·:r:.· ... -~·~=:r:. ;f;;; ~: · Weichts il L<lad inspection
~ ;q (I 0 !'""'ceo• ""'•fUR<
' /
Gross we1ght / CO~}'I'fS / / .~ '(/ (/ ~ o.S.o 0 , . '/ // ·4-· d. Tare weight . /?:/·. ,.,/Z!/.
13 LJ() / /.
Net weight '?, I / _,
lc.tU I'IOUU ~~VAt
L)J._ Certi!ic::ltions
Generator's and/or consuilanrs certificatwn
/lll"l.!' cutift. that the soil refurnced hcrt:'itt is ta.ktn entrrciy from thou soils dccnhffi in the Soil Data and Acupr.ance dowmmt campiatd and certified by mel us for the Gcnutzlion s;u shown above and
nothint has bnn. added or done to ruch soil lhtzl would atur il in an:'l wa\". ""' I H-
\ .. 0PHNF N l<\lk~n~ ,,~ .. ru•< ' '~ . k-dl,f" J } ~~t.o.coe.oour
(l.-Q.\ !"~-'-VJ ,\,c, '. /1, l- 'lin I ,...,
I" '-;
Trairsporrer's cmi;icaJion I I 1/Wor ac.krtawicdge r«eipt ojth11 soil d~cnbed abot~c and unify that such sorl is Mtnr: dcilvern:i in exactly the same condition as whm r«nvui. l/We junher certify that til is soU is beint: dirrctiy
I" lransr~of'f«i from tire Gmeration Silt! to the D~trnated Facilitv without off·loo.din~. addin~ to, :uhtractmr: from or iir arrY 119'GY deUniltt..ddi•trtto such nu.
HA~ u .---1\AA- c. Q._ LT C!-t \ ;s, ~~~·· 2:i. V/7()..(_ --(~;1;~-J lOA'§ I' J.-;;;r/? ......... jJ,
' I I ~ d.,.(:.
Facilit:v certification l
I acknowlnit:~ ~pt of th~ soil oudi.nt:d in this docum~nt ur:cpt as d~scrtbfti btiow. !
HA ...
!u/Y} I ?- \SIGHATVAt <?1. " ,; ~ IQAIE ,/. , . . .<' / ::~/("": :, . ....->.# I / • ~-;; ...;'// t. ..~. r::./' ,;/,/;--;:..-.-.-. ! / . .
F'ACIUNC~Hn
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PEMCO
·.:. ' '
•l7 N. CCI.UMBIA et.VO. P.o. acx 115159 PORT1J-HC, OR 91211 <=I 253-2151 FAX (SOli2B3-6388
_______ ..;.._;;;..;.. __ .;.;.;-;;;-=----~·-·---- --- ··-
-=--co' MARI01'i COUNTY SOIL RECYCLING
FACILITY m ~ .~. ?:0:~0 COMPANY ~ SOIL :MANIFEST
. ~/ P
. .1• Efi25Jl
roJect speC! JC genera . -------212!if1ggs
Date of shipment: ------ Manifest number: J 3 7 2 3 ~4~ Jt;ri ::0~;.'~~~~~:;-•t;h~t:~t: • ~.;.J~,:(;~.~ l~: :;:r.: ~: . ~ ·'
.. : ~ 1DIIECOAfi'IElEDBrCORl'Dil.t'IE111W14!l'-illrER$. ~ . ' ,,
C'..enerntor information Site of generation
co""''"'"'11EHALEM BAY HEALTH DISTRICT •c''i<IE'H1QEM BAY HEALTH DISTRICT
""m~o 'z78 ROWE ST. I '"'2'igoft0WE ST.
:::rrt:; ... :E,.z:"'VVHEt:.LER~ OR l""""'o •cccu•r •
I ITY'WA"EELER. OR
::.~-o:A-<;: Pf;<";:;,N l fEL.EP'-fQN£ ~UM8£R Transporter infonnation CAROL MAY 54 i-368-51 i 9 rv- AllY NAMI:
Consuit.ant infonnation .P'?/VfcO :::..M~AI'< ~ 'lA!,'£ , ... fRE£1'11".0, SOX
?:::MCO
:rill£,. .. .,.-; acx llTYISfAT£/ZJ,. l""""'o •ccou.r • 437 N. COLUMBIA BLVD.
::r•.-:;:..ort,:,? 1"-"'0 •CCCu•T o I OHfJtCT Pf!R$0H Tfi....EI'WON€HVM!AEII
OGRTLAND, OR
::::;,..:.~.-;- ?f?!:::;: .. I ffl.£Pt-IONE IWiofdER
I Soil infonnation r check the appropriate no xes) :?.!~L. KNUTSON 503-283-2151
Destination lnfoml:.llion Type of conraminadon I Cause of conrammaoon ........ :
'.<::~·::n C::;un:·; S::li C::e:·:::::~:; i"adity ;: ~ ii- " : ;:; : ~
- '-//hJtn':y L3r:s :\J =. --' -.: .- .. ~: :.
'/J;-;::::urn. OreGon ~7:7;
:::•. ~ .;.;::- .:o:::~; :;~.- rer..EPkONE HUM8Eif
Gress we!gnt
Tare weight
0 Gasoline
I [}Xoi~sel
I 0 .. Waste Oil
0 Kerosene
0 Other.
PEMCO ACCOUNTir-JG (INVOICE)
0v ~.
0 0
PEMCO
leaking USI
Leaking ASI
Other (soecify):
<37 N. COLUMBIA BLVO. P.o. aox 11~v PORTI.ANO. OR 97l11 (503)2113-2151 FAY. (5031283-CU
l!'tl\1co MARI01~ COUNTY SOIL RECYCLING -r,s,-, ;:::;;:;)
FACILITY =
L:~~-:4
-~~ z,:·
SOIL l\1ANIFEST A PEECO COMPANY
Project specific oene~~ t).. JS""t[ Date of shipment· b . '' '
Manifest number: 0 3 7 8 0 I J I J 1''1' ''
, ... Generator information I Site of ?enerntion
.oi.ClUTYHAME oo-••' ":;)4 fi /t f..-1_ ({\ ;2, A-r A 1-h JY' -~ f-f· r1' '-1' rt. I r-;-1 I..J:l.. I I ··A-" (/_ /Vl /),,4--, j.{z:. "'--r-r-1 fi. <:·-· ... ,, ·-;-::,;P£ETQ.O. BO:t
ce--;-TRE£1' .400R.C.S 0
J.--Jx An,£_ >-;y R-r..J -::-c..,.-c:rrt:rArE.IZJP 'PEMCO ACCOUNr>
ITYI$TAIE/ZJP
'' \ -~ 1.- I t}l(_ r/L i ) \ +·t: e,.. J 4Z;1 1"vf ':~ ... ocr PER::CH - - I TCLEP~ONE NlJ!t$ER Tr.ffisporter inforn1ation
. ( ~Wi) =?r. _...., _..
/ej /-.: t-...~ 01 ;;'1--\ ..at:/\ \1' - (' f-'-'IW"AN H.AIMC /hd CO'Q6ult.ant information I ' !.?/\'vi rv-.. r. :z-.t,..,..,,.ME' /I TRE.ETifi.O • .iO:t LJ--vj }1/' c~ 1
\ .. /I u Ptk V\(l /) /\ I \ l)f'·J.r}'
:rREi71PO. aox TYIST.AIE/ZJP ( JJ r-~ ~}-y- IPEIHCO ACC'OW<r •
LI--t ,.... ) (' ,...., I____., fr"'A,r. ';,'T'I'.!Sf.4TE./:;P \..,; I 1""""0 ACCOUNf ' FONT ACT POt$0H - I I TELEPHONE HUIWBER ,--:
f~A-;; '1 :n I J(\ CC~- -< s:::-... '-. ' :...;./ ' J ' ' __-fA__...,_ --.., •, ""'.--::··I ::;. .. r ... c: P"f~so"" ~ I rELii.hiOHE HUMIJER Soil information fcheck the approprintc boxes l
.! ...... ' ( V,._l,1 -- ' -:it .., - \ I ' !.~"~ " .... ' I Destination information Type of conramrnanon I Cause of conramination
1 .. ~ :.-~~aricn County Sci! Rec:;c!irc~ ~aci!ity I D
,..-. Gasoline U leaking US!
;.·;;.:c""; ac1
I ~ 7827 'lv'httney lane N.E. _Q_ Diesel D leaking AST ::rt."::..on:.;::,..
D Waste Oil D Other (specify): 'Noodburn. Oregon S707i
:=~o~tAC~ J>!ff'SOH r'f!LEPHOHE H1Jitl8f:R 0 Kerosene
0 Other.
;'~sf~:t'*~;.~:~~::\r:;~;,:: i :~~, -.:; ~ : ~ · ', .... . :" ( ., msscoMI'££1EDArFAnlJJT: ·:~ · . .:. ;.. .... ~ ... ~ ~:~:?J'~~~;~fi;~:~:~:~?~~~~~~~~~l:~~~r-;r~: ,, -:..r " '
Weights II U>ad insrcction
-=i .c;r;ln ~PfCTOR $JGHAfVRf. /
Gross weight --:::< a __-;. .. /..-~~,
;}t---~{-,n r:oy -
!are weight
Net weight /-3 )L/fl SCA,U M)U.st: ~IGNAI1HU!
(~~ "-..._ / CertifiCltions
Generalor's and/or CJJnsuitant's certification
l{W~ cuufy that the soil rt!Jurnc«i hu~tn is uzkm mtirc1y from those sails di!Scribed fnihe Soil.Dar~arld .h~~J;. d~cummt compieted and cmifid bv m.:Jus for tit~ Genera/ion Site shown abov~ and . ' .. .!VtUV .)../ ·. ·
nolhint has b~m added or ~ne to such .WI that wouid a1Jer il in any way. ·r:.. r ' ~ I I ""'. I ' I ..... (_~ J.. ;Jc:: ~.-('17 /! 1 .. ., ... ,_ :11/ )/ ~ / IDA" ~ /v- t/""jt I""" •o•o•o our
. tf., :,. _,._.,.,-...~ •• 4./-;-_!(;/:.--; .n - Transporter's certification /I
1/lV• ac!r.nowl<dg• r..:erpt of the soil describ<d abo., and certify thtU sucir soil it h<inr ddi•ur:ti in cr.aal_v the SIUn< coftdilion as whm·r•ceiv<d. IllY• furrh<r certify that this soil it h<ing dinctly /
ran.soorrt:d from the G<neratioJI Site 10 the Dtsi~a~aciliry witHout aff-.loadint:. lllidinf!! ttl. subtractin~ from o/;J:Jr, .4v deia/in~'~eiivn-y to £en site. / ' I ..... ( J~~ ~. !/ ,.,.,...-- · /{/! / /;' ~ 1 uj I OAT< ) I 1 "'j£11 (C' / r'! .. ;. ~-!.,/ / 7 -:-;-j---:- (T I r,
I Facility cimificalion ~
I adnowiaic:~ r«npt of the soil outlined in this document uccpt as dncribt:d bdow. # ...... L --rt; Cl,.. "' .0 r-:o '~ - .
F<lCI:Ur'r~Htl'
?
PEMCO ACCOUNTING (INVOICE)
I I
f" 7 -c.:.-:{
PEMCO
-:::; / -·
437 N. COLUM61A 81. VO.
P.O. SOX 11561 PORll.ANO. OR 97211 (~3)21ll-2151
FAA (50llll13-<1348
PEMCO
DEPARTMENT OF ENVIRONMENTAL QUALITY USTPROGRAM 811 S.W. 6TH AVENUE PORTLAND, OREGON 97204
- l
REGARDING: DEQ I.D.#--"A4f>;;..oo;..;;..w...;..:~=Q;....._t;~.....)l~u.;n.:.-_____ _
FACll..ITY NAME t-ti~~?<c\..~M 'eP~-::( ~~=!\-\ t)\~\· ADDRESS 2 "7<a ~Ob\~ §"'l
H,\\t;if\&p. 01'2.
FROM:
Enclosed please find:
___ New tank permit
___ 30 day notice
V Change in service report
___ Installation checklist
___ 30 day notice of intent to close/decomminsion tanks
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX ( 503) 283-6388
~ C..Ol\;.5 \-\a...vliJ 'Qi=:~...,. .S~"'\ 'To ~~fit o-\.Jt-lWO.'f\. "f"<> -hb~ ~t) ~~-To 'i'o101•
Please call if you have any questions.
Regards, PEMCO
Project Manager ,,.,.
DEPT OF ENVIRONMENTAL QUfl~LITY RECEIVED
MAR 1 2 1996
NORTHWEST REGION
A Division of PEECO
QIJAI.ITY Ill
Ill
.II ~~1)ERGROWWSTOJ'Gf~Ai~~~~=i~=~~~2E CHANGE REPORT I DEQ FAcri:..ITY NuMBs-q_: #I DATE: "''i' r~ 6
FACILITY ADDRESS: 27'13 12~t<. S""
?HONE: '3(, ~ · ,('(l'\
T"ne following informa.tion ,\fUST be submitted by the underground storage tank owner, operator or licensed DEQ Supervisor within 30 days following completion of the tank decommissioning or changing tank contents to a non-regulated substance. (OA.R 340-150-001 though -150)
T"::;e :.~ttached supplemental checklist should be prepared by the person performing the decommissioning. The checklist should be provided to DEQ and the tank owner to demonstrate that all required practices were followed.
Crdinar..ly the checklist is filled out by the DEQ licensed Service Provider or Super1isor. 0'Nners who wish to persona!!:: :::o:comrmssion a t.ank must follow all DEQ and other applicable standard.s. The owner should contact the DEQ Regional Office prior :o st.arting the decornrrussioning to receive currenc copies of underground storage tank regulations.
A. DATES:
:::>ecommissioning/Service Change Notice - Date Submitted: \/, 1o {<A. C. (30 days before work starts)~ y..\b..l\)\::b v~-n. -::r, .... tv\6.,~
Work Start Telephone Notice- Date Submitted: \l-<."\("'-1. 01-J.. \{\1./"!J.
(3 working days before work stares)
DEQ Person Not!fied: "::r-=...:..IM,__,___M!..:....;.=o:,_,~""'J.=\..\,___ ________ _
Date Work Started: \h-. {., <:.
~ote: Provide the followmg information if any soil or water contamination is found during the decommissioning. Contamination must be ;-eported by the US7 owner or operator within 24 hours. Tne licensed service provider must report contamination within 72 hours after discovery unless prev10usly reported.
Date Contamination Reported: 1 I':> 1-.' By: '\:1,1..\.. · ~ ..... ..;T !><> 14
DEQ Person Notified: t-AI\l<\rl.. ~c.~"L
Backfill Telephone Notice- Date C:llled: Z/z. \ fc:.rr., (before backfilling)
DEQ Person Notified: "-"'1\t-lol. 't..l,.l;U-1-
B. PERMITS:
Note: DEQ pennits or an addendum to the UST permit(s) may be needed where soil or D.l:iR'b-Qr
DEQ Water Discharge Permit#:------ Date:------
Disposed to (Location):------:~/ ___________ _
DEQ Solid Waste Disposal Permit#: -~.Z'------ Date:------
July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report Page 1 of 4
B.~fiTS (Continu~)
UST Soil Treatment Permit Addendum - Type: ------ Date: _.-...... ____ _
' Soil Disposal or Treatment Location: Mt..tt.\ol>-\ t-o.., .... 1'i.~so•'- i2.i--:'((.,\..\l-(l. ';~"''L.ir'"(
C. TANK INFORMATION: 11-li::.Q.f:~~I'}.L ""'f~E:A'TV\~T
:Tank \ j
DEQ Tank Size uST in
Permit (Gallons)
Product: Gasoline, I Closure or Ser?ice Change?iTank to be~ Diesel, used Oil, Other?\1-------,-----.,------,1 Renlaced?::\
Tank I ClosureCIJ j New CIJ i - ;l Present I 1 Removal Inplace jProduct I Yes*! No 1
''\) !! . \ i II soo lv-
I 4ooo I u~,\~~. 011- I 1 s ooo 0\\.. I..- I
L _ _j
"' Where decommissioned tank(s) are replaced by new underground storage tanks the CST 0w11er or o~rator mu.st submit a new permit application containing information on the new tanks 30 days before placing them in service.
a:: Submit a wil sampling plan to the DEQ regional office and receive plan approval prior to starting work if 1) tank is to be decommissioned in-place, 2) tank contents are changed to a non-regulated substance, or 3) tank contains a regulated substance other than petroleum.
D. DISPOSAL INFOR."\1ATION:
: ':'ank' Tank & Piping Disposal Hethcd I Disposal Locatio~ of Tank Cc r.::. e r.. t s * I
Scrap\Land-~Other\Identi!y Location .I '
.I ' fill j& Property Owner I..iquids i Slud;es ' '
:~1 I I I !, ~:.>~,~1\~tt. .s·n.e.1. ?O.~<>·.H~ .. ' I
I v \)O~r:) 0~ 'I '\\.:..:..~ ,,...., " I 'V \;;.,-~'\) '"" (.
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I v I I~ ... 1-\'""\'''l"t~ 6~a<,L ~tl,b,.o~~l ~o~\..~~ OoQ. I \ I \
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~on.\\.~~ Ott !
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* Note: The tank contents, the tank and the piping may be subject to the requirements of Hazardous Waste regulations. If you have questions, contact the DEQ Hazardous Waste Section at (503) 229-5913 or DEQ regional office hazardous waste staff.
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July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report P:tge 2 of 4
~)
r
r E. tONTAl'vnNATION ~ORMATior
IT;nk Ground* Product!Product Number Laboratory water odor in\staina of (Name, City, State, Phone)
I in pit? soil? in soil? Samples I
I i I ~ I ~0 I 3 A'r-\ ~ 1-··en~.- A\.....
i t--\~ .N.o~l,l, <:..2-E:.t\-..:
7. I ~'0 I "{~ I "{ "'"!> 3 I ~ "'-A'-1 e:.n \ <l ......\ <>R C,£.\1; ""{(_oQ : I
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3 ~0 t-l-"0 ~Q I~ I
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• Note: Sampling is required if groundwater is encountered. See cleanup rules.
F. SITE SKETCH: (Show location of adjacent roads, property lines, structures, dispenser, & all USTs) (Sbow North; general direction of ground slope and soil sa.mple locations. Sketch does not need to be drawn to scale. You may attach a separate drawing.)
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July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report Page J of 4
G. W'JRK RERFORMED BY:
DEQ Service Providl!rls LiceL J: \'1...1-\C..O
Name: ?~c,o
Construction Contractor.
Telephone: S"O~· '7.'6'3 · 'Z.\(1
DEQ Decommissioning Supemsor's License#: \l\~7 C.
Name: f'-1\'~'- IAVW'\'QE."'LJ"
Telephone: ;Lo'l · 'Z \Q') • "'l.-\l I
DE Q Soil Matrix Service Provider's License #: \ <-l\"t. \
Name: \>t::t-J\<-0
Telephone: "l.~J·'L\S""I
DEQ Soil Matnx Sup<:rvisor's License #: l '"U"':ro
(If applicable)
(If applicable)
Name: 'ih\...\.. '(;:1--\v\JO>-\
Telephone: Z.8'1~ 'l. \.11
H. ATIACR"I\1£:-ITS TO THIS REPDRT:
l. Attac~ a ;;opy of the labor:uor; re;x>rt showing the results of ail tests on ail soil and water samples. Tne laboratory report must identif; sample collection meiliods, sample loc;J.tJOn, sample depth, sample type (soil or water), type of sample container, sample temperature during trdllsportation. types of tests, and copies of analytical laboratory reports, illcluding QA/QL illformation. Include laborator; name, address and copies of chain-of-<:ustody forms.
:. If contamination is detec~ed and a Le•;el 2 or Level 3 soil matrix cle;mup standard 1s selected attach a copy of the soil matrix analysis for the site including methods of determining soti type, depth to groundwater, and sensitivity of uppermost aquife:-.
I. REPORT FILING:
T:'lis 'eport, signed by the tank ov.-ner or operator. compiere with all applic::~ole attac:unents must b<: filed with :JEQ beadqu.arte:-s wnbin 30 days after the excavation 1S backfilled or change-LD-ser;ice is complete. ContJ.ct the DEQ reg1onal orfic:: pnor to filing this report ·wbe:e special c;rcumst.'1nces exist at the site (such as water ill pit, re::naming pockets or contamin::~tion, etc.).
NOTE: If contamination was found during site assessment at decommissioning or change-in-service and reported to DEQ re<Jional o!Tice, this report may be submitted with either the tirst interirn cleanup report or the tina.! cleanup report, whichever is first.
Return Completed Form to: Department of Environmental Quality UST Program - Decommissioning Re;x>rt 811 S. W. Sixth Ave. Portlane, Oregon 97204
I have personally reviewed this report and the attachments and find them to be true and complete;
Signature: ---------------- Date: --------(Owner or Operator)
For information: (503) 2:29-5733 or Toil Free in Oregon l-800-452-4011
July 1, 1991 Oregon DEQ
~~ ---------------------------------~~ -----
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437 lL COLUMlHA :BLVD. . .. ' . ' _- ·- -. . . --· PEM ' .l'~Q_(BOX 1!569' - ----~-,\;~~r~_~i;::_;,: .. · .. _':. '"_., __ ,. __ , __ ,___ . CO.. PoRTI..ANn o'R 91ii1 - cH_AIN oF cuSTODY
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-~ SAMPLE LOCATION §, - TANK SIZE -' ·- TANK PRODUCT
XI J>CX:Oc;Ac U5-r J ro.?, JX' p > 3 oO ,IUJfL-(7.1 8.<? -rTD- >
I( ;1 ?a .. :o U- P5 'Suo LiS! i /O,c-r~~;1 /--.j 5c?vflJ Bo-rrc:o.r--: t 1 /
YI-Y-oo6 .611C. _j/rG o/L.4 f'~r fY OJ71 f!.o1/00 ' / l
X I -V'?=V't?u&C- ff'G eve_ u?j d;> pr lJ.; l L-ve- -$1 E oi!V.r-r I · '
... .__,.L- l
........ I ,_...._ :L -:: 0
o 0
~ ~ ..... "":(!) N-.a.-..oA""4- o>OO 91 (D - X 0 :;:: 0... - w 0 E E •::0 0 - -.;r :r: ~ ....- jW (0 '--"' ';:o N -:,.$ ~ I)) M _:-" 0 \f) C• N o... v-
1t- --..... ...- ..,- 0 -~ '-' ro (!) • m ro
1- '-J < ,ro N :r: -o ,.._ m ill a.. a.. u '- '- ......._ ~• ::r: 0...1 0 < }-'--/ Q'--" .J ..J o_(l) 0 -· o.. w: \Oo..l uJ uu o:cou 1- f I 1- r- ---~ u -n g
-u ,......1 I 0 0 I ::L ~ l
D •
~ Clxj 0- o, ro 2 t-1
< "' o...,!!. w lJ...
' rX n-I I
l I ! i l
s /1::; c) xl I
6 I I J I : II _II. -~-i ;
'1b j r, .y • ',, !
~.y (. ' D /(;!';: eT- LJ '?- .- ' ;:;' I I XI
/.0 I
'X.v' K / ~_ooG;;c. j;Vc-1<;---c u~ L2L:c...f \/
! ?c:x.A71 W7/D./'7] I 1\ 'I ' I
7 i Lio:??-64~ :ItT(_, ,pc. u 4-T' ! I JC'J ~ < 50-'"<=- ? 7VC..k P/ L.£
}J Y.l J>C<?0(21£- i. ?s :ko us 7 - .'L._ :..:..~· ••• ... • ' •
5&-c. . STOCk W l-<5- c_
sllnqu~hajl by;// I , ;, ;; 1 1";:::;"7" -- -,.. _y--I UIII B
l-t,~~J?~./_p-- :J(/;Y(;. '-"' y~L-_r<-· r-
._, 0 "-"'I .;-'I o"; ; ' ) ~--·- '"'--' .. ~c:~~"--
1.p,· JJ?f, ! I -I ~ ~ ~: . -- ,_
:::;'/y-'76- PC.t:?;J5'C /re-.x.::> 5~---?.c.;::st:::t- / 'tf ""'.F" r=on.. l"">->H/.s~ F Urt.->'.l.f' .A.--v,q' 'r'"/7c.,{ <-).
nusn:@o
J·-· -· -··------·--·-··-
JJ -1
I I
0 JJ rn ~ D z D r -< -1
f'o D r
-1 0
(Jl 0 (,j
~} tD w (Jl w tD w
•;·
' .... Ul Ul Ol .• -
(5) 1\) I ... w
... ... .. w (5)
~ "" (Jl ~J N
ll ,__. I.> I
,. '1
:;
.. '
Lt. 't· \ " "' .. Jl·' !i '!\':; ''.
FP.:Ot'-1 ! NORTH' CREE>< Rt~I=\L YT I CP' TO 603 283 6388 11!31RM ~522 P.14 ,I' , i: ·~NORTH.
~-·-r=_CREEI< i ,
,. I '· i I
18839 1?oth Avnnue N.L .. tiulw 101 • Elotli~ll, w,, ~M11·Hfrtla .. ·(ZOO) 4UH:!2UU • FAX:1BG Z<J~? 1
.§%·~.ANALYTICAL fosl 1111 G Mo"tll'""wy, ~u•1~ B• e~kano, ;vfiQD200.4771\ .. (film) 1124 u~uu •I M 0?~·9290 ·(.·,~: ..
g~os sw N1n11"'~ AvO!lliO • flcavc!lc.n, OR R7Mil·7\~2 · (503) 643-ll20tl •I·M tl~4·??ff.• t
.. {·~ 'L ·,J , J·.: ) ,,
~ f : ( • ' ),
;; j,
'f' I
:J "··
'fqpruary, 12, 1996 ' ·: t ' ' ' .. , . ·. I
. PEMCO i ;. r:o. Box 11569
, Portl~ndJ OR 97211 . ·t . :L; ~·" .. f:
Attention: Bill Knutson -:.·~ - _:_-
J' ·~ \ :t -~
RE: fl
· .. ( i
JOB# 7020 P'.O.#
:r
... ,. PROJECT- ~~EHALEM BAY HEAL lH DIST.
!' ..
:: 7,
u ,. I
:Ir ·,
\:· ,, i!
i! i
'i
. ,·'~ ; l<>•J.
E!Kiosed are test results for your samples received In this I<IIJ on feb. 02, 1996. f:or your reference, these nnnlyses have been assigned our !'-;(A tt PG02016.
Solid samples are rcpOrtl.':d on a d1y weight basis except for Oregon DrQ Fuels Methods and where otherwise noted,
1 his report will be Clccompttnied b/' a sepamte Qul11ity Control Data Report, unless omitted by client request.
Please call If you huve any questions.
Rcspec\(ully,
/!J?J~r;J f-Lr~-t,tf!lf'L-q Philip Kierenberg )..--"' Laboratory Manager <=-
/'I ,, I ~-
FEE-13-1996 11:26 +1-50J-6..J3-7213 P.Ol..J
. ;
'· ::. '
'· ..:.
F""'XOt·l I NORTH CREEl< RNf=<L YT I CRL TO
~NORTH ·· .= CREEK
1§ s ANALYTICAL \
•,
503 2:33 6388 ' l:"<96.1Zl2-l3 llt31RM ~522 P.lS
109:19 lZU\11 A'1cnue N.l., Suite 101 • Bothell, v.11 RR011·H~OU (200) 4tl1·Vi'O(J • FAX 48S 2')')~
rax! 1111~ Munlyomcty, Suite B ~·SpoklnO, WA 09~06-4776 (bU9j U24 U<UU • FAX 974-8/fl\1
9dO~ ~:.w. !~iutuus Av~nuo • BcJvcdon. OH ~7000· 7132 \5\J3l64;J· l);ttlU • 1/\X 644<'?0?
TPH·HClD per Oregon DEQ Results In mg/kg (ppm) '
Client: PEMCO NCA ProJect#: P602016 soli 02/01/96 02/02/96
ProJect: NEHALEM BAY HEAI.TH DIST.
·< i• ' '
~. ; I,·,
I' .. • I f
J 1:
# 1·8000 GAL PS 300/NORTH
I #2-8000 GAl. PS 300/SOUlH ·
,. ··I , 'I 1
#3-4000 GAL 1-rl G OIUEAST
#4·4000 GAL HTG OIL/WFST
lab 10
P602016·1
P602016-2
1'602016-3
f>G020 16·4
#5-500 GAL DIESF.l/NORTH PGO:l016-5
#6-500 GAL DIESEUSOUTH P60201 &-&
.:.!i' • ..
,#8-8000 GAL PS300 USl P602016-6 - '·
Annlytc
Gasoline Diesel He«vy/011 ·
Gasoline Diesel Hoavy/011
Gasoll ne Diesel lleavy/Oil
Gasoline Di r.sc:l Heavy/Oil
Gasoline Diesel Heavy/Oil
Gasoline Diesel HeRvy/Oil
Gasoline Diesel I ieavy/Oil
Matrix: Silmplcu: : Recoived: ; , ·
'I
Results MRL
ND ND ND
ND NO NO
30 • 1
4300 ND
NO 160 NO
NO ND 110
NO ND 130
NO ND ND
20 50 . 100~'
20 50 100
:w 50 100
20 50 100
20 50 100
:w so 100
20 50 100
MRL NO •
Method Rcporti ng Level None Detected at or above the method reporting level See Comment Section at end of report
FEE-13-1996 11:26 + t-so:::-t:.<43-':' 213
Dille Prl'parcd
',.02/02/96
~.~t.:::~:
02/02/96
Date Analyzed
0210'21%
02/0'1./%
02/02/96 02/03/96
02/02/96
02/02/96
02/02/96
02/07/96
. ' ~· • I
~ .
02/03/%
02/03/96
02/03/90
~·:1~ I
02/07/96 .:In: .I:
~I!_, I
~ /j ! :
'
.t•,
P<1gc 2 of !i
.. li•.
P.Ol5 ~ dl) ' ~
1: <: \.' I'
' F'ROI"I I NORTH. CREEl-< RNI=IL YT I r .• . TO
,; -==NORTH ;i'
503 283 6388 ,•
',1 '
lll32RM "522 P.15
,, -· · L= CREEi{ . . 1A010 i?l\lh Al'nt>lln Ill r ~IIIIP 101 'HnlltrJL WI\ RM11·A~O!l '12061481·9700. ~1\X. 48~ Z!J(J? . ' .,, '
@_§:ANALYTICAL F.1~1 11115 Montgomnry, (iulte IJ .~ ~p~~kur~~;WII ~9~nll:~77n (~OH) ~24-~i:!UU • FAX 92.\ 0200
~ \O!i :i.W. Nhnllus Avunue • Beaverion. OR 07000· 71,1? {1\0:l) 61:! u;•uu •I AX 644·??02
"· ' t TPH-418.1M per Oregon DEQ
Results In mg./kg (ppm) .:
PtMCO . II
Client: :; Project: I NEHALEM ~A Y HEALTH DIST.
1\ .'i Lt. I'• r .. •] l' .. ,.
,,
Cllenl ID lab ID
#3-4000 GAL I lTG OIUfASTP602016-3
#5-500 GAL DIESl:UNORTH P/)02016·5
Ana lyle
lPH
TPH
#6-500 GAL DIESEUSOUTH P602016-6 TPH
NCA ProJ~cl #: Malrlxr i.
Smnpl<.'d: : 1\ccclvcdl '
Results MRl
7,900 2000
220 100 .. •L
330 100
MRL ND •
Method Reporting Level None Detected at or above the method reporting level Sec Comment Se~:tlon at end of report
FEB-13-1 9'35 11: 27 +1-503-6<43-7213
P602016 soil 02/01/%
'. 02/02!96
Date Prepared
02/07/96
;",;02/07/96 :f.!,](
02/07/96
Dale AnJlyzctl
02/07/96
02/07/96
02/07/%
l.t! ith II "'·I
l,'
"•/!<;'·
' . '
Page 3 of 5
P.Ol6
F"ROt'-1 : NORTH CREE>< RNI=IL YT J r TO t.=03 283 6388
-=NORTH r -:;,02-13
i f,
11: 32Rr·t>· 1:1522 P. 17
;.:E -cREEl< ==-="§ANALYTICAL
1HU3U 121)111 fwon.;c N.E, Suit~ 101 • 8cth~ll. WA ili\011-0~Ua (~06) 481·9)(11) • FAX •ln:i·?~l12
~u,l 111 1 b M011ll)on10ry, S\rit~ A • $(r~k~nn. WA 99206·4771$ (bll'J) u:•4 0?00 • FAX ~?·l·A?AO
9405 S 1'1. t<in·,bu~ 1\vcrwo • Ro~v~rinn, OR 0700U··t13Z (~0~) 043 Q200 • r Ax C.4J.,O?
~ . ' SURROGATE RECOVER! ES (%) :~
Cllenl: f'EMCO Project: NF.HALEM BAY HEALTH DIST.
c· Sample Name' Analyte
1 ' TPH-HCID per Oregon D[Q
r ' 11 , I•
#1-8000 GAL PS 300/NORTH 1-Chlorooctadecane
#2-8000 GAL PS 300/SOUTH 1-Chlorooctadecane
#3-4000 GAL HlG OIUEAST 1-Chlorooctadecane
#4-4000 GAL HTC OIUWEST 1-Chlorooctadecane
#5-500 GAL DIESEL/NORTH
#6-500 GAL DIESEl /~OUTH i ...
#£HJOOO GAL PS300 UST )
l
1-Chl orooctadec;me
1-Chlorooctadecane
1·Chl orooct;1decane
NCA Number: . Received:'
Result
92
99
77
114
103
107
100
MRL Method Reporting Level ND None Detected i'lt or above the method reporting level • See Comment Section at end of report
FEB-13-1 '3'36 11: ~7 +l-503-6...\3-7213
."·l
~.I·'
P602016 02/02/1996
J Control iii limits •
I! I'
50..150 1:
5()..1 so 50-150
50-150
!i0-150
5()..150
50-150 .
Page 4 of 5
P.Ol7
;.
i. PROI·1 : NORTH ' CREE>< I=<NI=!L YT I C'0 ' • TO
-=NORTH. i-== CREEK
C!?!? !§ANALYTICAL
Clienh Project!
PEMCO NCI1ALEM BAY HfAITH DIST.
503 283 6388 11:32RM ij622 P.l8
lU<JJ~ l:!Uih Avenue N.E .. Suite 101 • Bothell. Wfl 9M11·Rf,on (l'UGl ~01·~200 •I M 48J·(99<'
Lttc•l 11\1 ~ Monlgom~ry. $vile B • SpokMt;, WI\ 09~00·H76 (609) g;•1-IJ2UU • ~AX U:!4 nuu
ll,llb S W. tJimbu~ fwMuA • I'IAaVMOit Of1 97000·7132 (5031 G43·9?()Q • ~AX ~44 ~~ll<
COMMENTS
NCA Number: Re<elved:
P602016 02102/1996
1. Detected hydrocarbons in the gasoline range appear to be due to overl<lp Q( diesel IC\11ge ilyUtOGHl.HmS.
1.·
Page 5 of s
FEB-13-1996 11:27 +1-503-643-7213 P.Ol8
A. SAFETY EQl3IP~:U ON JOB SilL:
C0mbustioie Gas De~:or: :.iodel: ~UD
Mode:: ---L~.:..:\.\-'-"'2'---------
E. DECOM?TfLSSO~lNG: All 7m..k:3: (T:c.i:. = 7~-n.'::.o\l.CJ, ~/A= ~ot .-i.pplic:;.ole) (C..1eck Appropriate Box)
5. ~an1r..J gs..s lir:e.s off or ci.:sconnec:ed?
9. R.:lln ware: nmo ff direc.ed t.o tre.:J.tme:: t ::l.r"'~?
10. Drained and coUec:ed produc: from lines?
1 L Removed prociuc~ and residual from t:mk?
1:2. Oe:med tank?
13. Exwvated t.o top of tank?
14. Rernoved tank fixrures? (pumps, lci cie~tion equip.
15. Re::noved pnxiuc~, fill and ve::lt lines?
16. Sampling plan approved by DEQ?
Dace: DEQ St.aff: -----------
July 1, 1991 Oregon DEQ
UST Decoiil.!Il.issioo.io.g Cheddist
C:Uiorauon Dace: \ [y ''" G,
I/
I i i ~I v' I I
I I I
i :I
/ I :I " I I
I I I I
I I ~lit)
i' I ./ I I I I (/ I
[/ I I I I I
[/ I I I I ·-·""' I I I
I I / I I • I I 1/
I [/ I I I I I
I L/ I I I 1\ I
II \vI) . :-:::-.. -:-::.· .... _.
Page l of 3
B . . DECO?Yr?Yil.SSIONING: AJl T:rr (T.Jnk:.= Unk::::o\'!lll, N/A = NotApplio.ble) (C.ned:: Appropriate Box)
17. Gnt.amimuion concerns fully resolved?
D. TA.-'"1--:K REMOV . .\.L:
20. P.Jrged or ventilat..'Od t.:mk to pre·;enc c:-:?iosion? Method. used: ;/ c"1.".f r;. / ;t •
I
'2~. lank labc~ed before le..1ving sise?
-:· -------------------------su~: -------------------------
~~e: ----------------------------------
.~Gd~: ----------------------------------
32. Disposal or recyc:.ing loc:1cion of re:::::.oveci t:mk(s) and associated piping.
Name: 't ~ t-\ 11""2-~f't 5:\~ \..
Address: ~i.Oc '"""-"'-\ '1.-i.tl\--\ A'-H=-·
33. If t.ank(s) are intended to be reused, ide::;.tify new tank: site.
I Yes
p; [T/
f/ v
I I I i/ I I I [/ I
I i l [/ I i // I
Da~: ----------------
Address: ---------------
Purp-ose of Re:.ISe: -----------------------.,
July l. 1991 Oregon DEQ
UST Decommissioning C:!c:ck!ist
i
I No \
Uu.k I N/A I
;I
/
I I I vi I
I I I I
I
I I I !
I
I I
I I
I l ! I
I I I ,j
II I I I I I I 'I
I I I ':I !
Page 2 of 3
,, :F. WORK P£.RFOR1v£ED BY:
DEQ Sen-ice Provider's LiC!:'J..Se it: \ 'Z.-'1 'Z--'0
E. CHECKLIST FIIJNG:
Name: ? If;~ ~o Te~e:Jhone: S'o~ · 'Z.S3 • 7.-\S"'\
L. ?:ov1de G:ipy of c::~k:.ist :0 the LST ow--ce:- anci o~tor ..
:\'OTE: If c::mt:J..rnin:J.r:ion was found durir...g decnrnm.issioniiJ!6 and n;;::-cr~ to DEQ ~anal office, t.'lls re?f)rt may be SllbmitW:i ,..-[r.h e.i the- tbe firs• inte......;..m C:e:l.J1U(J t"e?'Jf't or the frnaJ cle:mu(J n;port, whicheYe:::- is firs-._
::::; ~:J.r:::::le::c of c::vi."""nrr:e::ca.i G~i'! -... ~S7 ?:-og:-~ - De:..:Jm;~ssioci.::g C..1~k.!.!s~
~:: S.'(/. Slx:h .A.ve.
For information: (503) 2:29-5559 or Toil Free in On::gon l-8()()...452-4011
July 1, 1991 Oregon DEQ
UST Decommissioning C.1eddist P3.ge 3 of 3
PEl\1.~0
CERTIFICATION OFT ANI DISPOSAL
-±37 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-21.31
FAX (503) 283-6388
DATE: J /; /9(/ JOB HUMBER: ((I/ 0
LOCATION FROM WHIQI REMOVED: ;t/-ci/-/]t y'~ !lc.-:/
QUANT1TI SIZE LAST K.:"'fOWN PF.ODUCT
~
t
j 1
~
c;;?;C_~
l!fr"o c:)
q,oOO
()its/
fleJil.-<4 ;_'i r'T"cf/- [);·c;;· I
o~..._/jf' (2
/1-- ) -< i/ I-TRANSPORT DRIVER:__:__· _l--t_v'-' ________ _
RECEIVING SV..APY ARD: NAME: ---------,------' --, ,_-,.,· ~--···~~~i\~·,r~:~ ( .. \:,; ... ~--~-. l.. - ~
• ': • I ,I.:
ADDRESS ...... ~...:.;.··._·' ·_· . ..,.~.1-...,...'.; • .....,;. _y_c: __ -.:·..:.... ::..:.::.....; __ .....;;;,' .... ._.· . .) .. . ~ ,- "·-
-;;·:_L· ;;?' , RECEIVED BY:------~--------
A Division of PEECO
A. SAFETY EQuLP~1ETI ON JOB .::u.r..:
C::nncustioie G:l.S De:.::c:cr:
--:- :-T.e: S c: .z.A3...XJ.~C.....::..___:'Z=-o.:.......:t.:-=-:O'-----
\fc.c::i: '? \.\ \)
B. DECO?YC\flS'S:0:--·<"10G: ,.:._:__: -:.":U:.:C:: ~:;::£:. = ·_·r::.:::::c·;.-:;, :.i/A = :.ict A;:;piiwoie) (C:eck ·"'·??rcpri:;te l3ox)
Department of Environmental Quality
~'~~ 10. Drained and ccile::ed prociuc: frow. lines?
11. Removed produc: and residual from t:mk? usr 12. Oe:med t.ank:?
1:3. Exwvated to to? of t.:m.k?
14. Removed tank fix:ures? (pumps, lci cie:.e::~icn equi?.
15. Removed produc:, fill and Ve:It lines?
C. TAc."lK ABAl.'IDONMLu lli-PLACE:
16. Sampling pian a?proved by DEQ?
Date: DEQ Staff: -----------
July 1. 1991 Oregon DEQ
UST Decommissioning Caeddist
i i
!
I
I I
II
Giiorarion Date: \ ( -z.c. !-H
Giioration Date: \ h<f"'l
·yes I ~0 I Unk I
":JIA !\ I I
I
/
I I I il v I
/ I I i i [/ I
! i I
/ I
i I :I ~ I I
i I i ·I v I !
I I I / 'I I i I I
I
:I ?-/.• I
I I I I :I
" .• I i I :\ I
/ i I I 1\ j/ I I
z,/ I I I I
/ I I I I /I I I
I \
/I I I I I
I I I I
v I I
I I I / I I
P'lge l of 3
B·l'JECOlYThflSSJ:ONl:NG: All Tm' '1Jnk. = Unk:nown, N/A = Not Applicable) (Check Appropriate Box)
I I
I
I II Yes No
I Unk NIA
17. Cont.amination c::m~rn.s fully resoiveci?
I V"\ I I :I v- I I I I
I
D. TA-''11( REMOVAL: I
I c·'J- I !. il( (,; '!' 1/)-f)$} il,f------c---~----'----
20. P·-1rged or ve:::i.laced t.mk to preve~t explosion? 1 f· ~r·f (} ,._,: V,r! f Method u..<:eci: !..;_,.._'.;..'":..c·t:;;.,rt ___________ Me~:- re:u::iing: /~ "' '"' ' 1
', 1, ':
I :?.~. No c=:ains or s-.eel wales wrapped :rround tank for removal? i
I 22. TJ.ci: re::novec::. sec on gTOund, blocked :a pre·re:1t ::nove::ne~t? I
i ii I
II
.:::y: ------------IY=:·~ Sb.ff: ------------
~~e: -------------------------
32. DiS"\X)sal or :"e!:yc!ing !oc:J.tion of re::::~oveci tank(s) md a.ssoc::ued piping.
Address: 0'2. o" ~-......\ '( '6-Q\=1 ,c..;~
Po~Si "O'Q
33. If t:mk(s) are inte:1ded to b<! re~. ide:1tify ne•)l tank site.
Nillne: -----------------y---Ad~: ---------------~~~~---------
Date: ---------
l'"??>e of ?..e=7::._ ___________ _
July l, 1991 on:5ou DEQ
UST Decommissioning O:led:Jist
I I I i,/ I
/
I I I t/ ' I '
V'/ I I I i : I
/ / v
l/' ' ' ' !/"'
·v/
V" i/
P:rge 2 of 3
i ;I
/
., ,, :F. W0;RK PERFOR.\fED BY:
DEQ Se:vio:: Provider's Lc:'!!J.Se !1: ------
N~e: -------------------------
T e!ephone: --------------
DEQ Decomrnissiouing Supe::-visor's Lice:J..Se #: t if c;,-7(..
N~e: ;V/.h c:: /h?~b .,.. r ~ . . /.~ ..., \ --, ,-.-t f i '1('-('-1 e!epn~ne: {_' {.'" . ' ~- '7 ·· ... -' • . ;; _--:;,
l. ?:ovide copy of c::ecrlist to t.he UST owner a.nci ope::;.r.cr.
?'iOTE; If c:ont..aminarion was found during dea)mmissioning and re;xJrtd to DEQ re.sional office, this rep-on: may be SlJ.bmict..<>d with e!the:r the first inte...>-im. de::mu9 rep-ort or the tll'.al c.!e:mup r"e!JOrt, whic.heYe:r is first.
D~ar:me:.t of :E::r\.:1:-cn=e::t::..l C~~ry l.}.S7 ?:0g:-..u::: - D~l'"'"' ....... ;ssioci.:.g C.J.~k:is~ 81: S.''tl. SL~:b. .~\·e.
For information: (503) 229-5559 or Toil Fr= in Ore-gon 1-S00-452-4Dll
juiy 1, 1991 Oregon DEQ
UST Decolllillissiooing C.'leddi.st Page 3 of 3
PEl"i~O
CERTIFICATION OFT ANX: DISPOSAL
437 N. Columbia Blvd. P.O. Box 11569
Por'"Jand, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6383
DATE: -'-]"-'-'--/-'-;_/_CJ_(/ __ JOB NlJMBER: lo ;J (}
LOCATION FROM WHICH REMOVED: !11-c;/-/}i Yt-,_- /7;-/
QUANl"ITf SIZE LAST KNOWN PRODUCT
~ ~ ----:~
c:;-2;C; () - I i t:'7 I
t lfL,/? {) C:) ;-/ eTi ~" /I ;7'-:J/ - f) v / / c-7 /
I
c:j,oOO /7
() ~IA-t .. ,:p fil \...--
/1-- j ~ /;-TRANSPORT DRIVER: --...:._IA_v_'-' ________ _
RECEIVED BY: -----~-r _____ _ A Division of PEECO
·••••• '(············ ··•·•· < :•······················ •.•...•••. <···········. ·}···································· Qregva>· TJ~parlcient of. E1liir&l1riterita.l Qllal i ty<:•••·•· .. · ... ·····>· < /··················· .. ><··············· .. ······ .... / <••••••••<· .•• iJN])ER.GROUNJYSTOAAGE TANK b"Ecd:MMISsioNfNGJSERviCE CHANGE/REPORT .. .. ·······•·•••• 111'11>···················
. DEQ FACrLITY .. NUMBER.: ~ _•: _.....;._--:
········••··········•·•.••·•·~&2~ITY.·N~=·•· ···~t\:\•••;:(d.ri;..·•· . . .. .• .· .. . .. . ;.;.;.:,...:.::;;.;!...L;.:;....==..;,;,;...--=~..L.;..---1...:.::=Q...I~
.•.••.. FAcrifr..;.•••i\l)£~ss:•••·· i';Z~···········:I2~t• ··.·····rr··.··
. ·<.:::::·· :?:/::::>~:::c;::~::::~>::.;:\~ <r ::::;~;::::.~.< . >· : :><~>: ._. .
·dl~:: ~~i~f~fi··········
. ":>:.+~/:::>:·:::>:.: :·.·· :-.. :-··
Tne following information MUST be submitted by the underground storage tank owner, operator or licensed DEQ Supervisor within 30 days following completion of the tank decommissioning or changing tank contents to a non-regulated substance. (OAR 340-150-001 though -150)
The attached supplemental checklist should be prepared by the person performing the decommissioning. The checklist should be provided to DEQ and the tank owner to demonstrate that all required practices were followed.
Ordinarily the checklist is filled out by the DEQ licensed Service Provider or Supervisor. Owners who wish to personally decommission a tank must follow all DEQ and other applicable standards. The owner should contact the DEQ Regional Office prior to starting the decommissioning to receive current copies of underground storage tank regulations.
A. DATES:
Decommissioning/Service Change Notice - Date Submitted: \A f. I""-C.
Work Start Telephone Notice- Date Submitted: \l-t"\1'\~
(30 days before work starts) .. Wb..''-' \Ct) fli:1l -::r,..., N\6.'fN"
Q loA. \{\lo ,,,~, (3 working days before work starts)
DEQ Person Notified: -'-:f~'M"--"--'""'c.-..;.::o:::;;.;w"""""~"----------
Date Work Started: 1. h~ {~f.
Date Work Completed: S>iF'"'~Hio\lo
Note: Provide the following information if any soil or water contamination is found during the decommissioning. Contamination must be reported by the UST owner or operator within 24 hours. Tne licensed service provider must report contamination within 72 hours after discovery unless previously reported.
Date Contamination Reported: 'I':./~' DEPT. OF ENVIRONMENTAl QUALITY
RECEIVED: DEQ Person Notitied: """'\c,\}.. ~(..""\...
Backfill Telephone Notice - Date Called: Z. {"t- \ fctr.. (before backfilling)
DEQ Person Notified: ....::\o.A.;;;.;;..:.''t':...."-'-'"-'--...::'...:;c....:;;\o\:..::M-=\..'------- MAR ytf996 B. PERMITS: /j;,
ENVIRONMENTAL (I; UP DIVISION Note: DEQ permits or an addendum to the UST permit(s) may be needed where soil or water cleanup is required.
DEQ Water Discharge Permit #: ------Date: ----
Disposed to (Location): ----:::,.,.c"'------------DEQ Solid Waste Disposal Permit #: -.,e./:__ ___ Date: ____ _
July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report
DEPT OF ENVIRONMENTAl QUALITY RECEIVED
MAR 12 1996
NORTHWEST ~le 1 or 4
' :B. PEJrnrrs <Continued)
UST Soil Treatment Permit Addendum- Type: __ . --·-· ___ Date: _:-_: _._· __ _
'- .Soil Disposal or Treatment Location: HA.tt,\o\4, c.-o..,~'1,.p·1·o,'- ~ii'Cc..\..\~&. ~~"'t.:.\1"( ·
C. TANK INFORMATION: "1\.-l~tZ.~~L -rn.~A\V\-~,_-
Tank DEQ Tank Size Product: Gasoline, Closure or Service Change? Tank to be I UST in Diesel, Used Oil, Other? Replaced?
.\
"t.
~
Permit (Gallons) Tank Closu;reoo New CXl
Present New Removal Inplace Product Yes* No
- Soo t> \f:.~E\... V"" v I "-UI. 4ooo I .,/"' ,/
u~~'.,4'" 0\\ ...
NC.. ~ 000 ~E,e .. ~\..u. 0\\.. ..,....,.- V"'"
'
* Where decommissioned tank(s) are replaced by new underground storage tanks the UST owner or operator must submit a new permit application containing information on the new tanks 30 days before placing them in service.
co Submit a soil sampling plan to the DEQ regional office and receive plan approval prior to starting work if 1) tank is to be decommissioned in-place, 2) tank contents are changed to a non-regulated substance, or 3) tank contains a regulated substance other than petroleum.
D. DISPOSAL INFORMATION:
~ Tank & Piping Disposal Method Disposal Location of Tank Contents *
Scrap Land- Other Identify Location fill & Property Owner Liquids Sludges
\ v s. 'l.~~\"t"E.12.. .S'\:U.\. ?tUQ ... ~"{~ I ?O~c:) 0"'- I ''\)~""'~'<;,..\!,. \>~;)>>-~.l.
'2. v , ... ~'""'"'t~.s't"~ ~""'~"~ \ \
\"OCC'\\.. ...... \) Oft ,.._\-\U.'\t IE~ ::~,~·~11 ~ ~ 3 .r ~·a..~\. .. ~
I I I I
LJ * Note: The tank contents, the tank and the piping may be subject to the requirements of Hazardous Waste regulations. If you have questions, contact the DEQ Hazardous Waste Section at (503) 229-5913 or DEQ regional office hazardous waste staff.
I
I
July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report Page 2 of 4
,.,
r , E. COt"ITAMINATION INFORMATION
. '
Tank Ground* Product Product Number Laboratory # water odor in stains of (Name, City, State, Phone)
in pit? soil? in soil? Samples
l. ~'0 ~ ""-0 3 WoOM"\.\ c:.:e~'-\-(. A\o-\~\-'•{\t'-' ....._\....
'2. ~'I) -<~ """~ 3 'B.~"E:,.(\.\<IIo"\ 6'n.., C.t.{'Jr ""(coo
'3 ~0 t-\"0 ~Q ~
* Note: Sampling is required if groundwater is encountered. See cleanup rules.
July l, 1991 · Oregon DEQ
UST Decommissioning/Change-in-Service Report Page 3 of 4
G. WORK PE!U'ORMED BY: ';6
DEQ Service Provider's License , ; \'7..\.\l-0 Construction Contractors _ ~ .:nse #: '-\ '3 ··p\ v Name: ~~"o
Telephone: so~· ~'63 · "2.\ (I
DEQ Decommissioning Supervisor's License#: \t\!''1 (,
Name: t-1\\\-(.t:. ~'-''tA'\lC.'\t.-1"
Telephone: ;ro'l . C. "b1 • -z..\S" \
DEQ Soil Matrix Service Provider's License#: \""l.""'t\
Name: '\>E;t-1\c.,O
Telephone: t.~"l·1...\S'"'I
DEQ Soil Matrix Supervisor's License #: l "'l£'::ro
(If applicable)
(If applicable)
Name: 'lh\.\... '\-c"'"'v"\~oloo-\
Telephone: t!.fS"l .. 't. \J1
H. ATIACHMENTS TO TillS REPORT:
1. Attach a copy of the laboratory report showing the results of all tests on all soil and water samples. The laboratory report must identify sample collection methods, sample location, sample depth, sample type (soil or water), type of sample container, sample temperature during transportation, types of tests, and copies of analytical laboratory reports, including QA/QL information. Include laboratory name, address and copies of chain-of-custody forms.
2. If contamination is detected and a Level 2 or Level 3 soil matrix cleanup standard is selected attach a copy of the soil matrix analysis for the site including methods of determining soil type, depth to groundwater, and sensitivity of uppermost aquifer.
I. REPORT FILING:
This report, signed by the tank owner or operator, complete with all applicable attachments must be filed with DEQ headquarters within 30 days after the excavation is backfilled or change-in-service is complete. Contact the DEQ regional office prior to filing this report where special circumstances exist at the site (such as water in pit, remaining pockets or contamination, etc.).
NOTE: If contamination was foWld during site assessment at decommissioning or change-in-service and reported to DEQ regional office, this report may be submitted with either the first interim cleanup report or the final cleanup report, whichever is first.
Return Completed Form to: Department of Environmental Quality UST Program - Decommissioning Report 811 S.W. Sixth Ave. Portlane, Oregon 97204
!have perso.J:la,~Y review~ this report and the attachments and find them to be true and complete;
Signature: C~. \.~ ·"j''·~) ;(·~.:_jl·jl{,~ 7 .... ·· J:)ate: __ ··· ""-"'".....:.--"-~ (Owner or Operator) ./·/-·
For information: (503) 229-5733 or Toll Free in Oregon 1-800-452-4011
July 1, 1991 Oregon DEQ
UST Decommissioning/Change-in-Service Report Page 4 of 4
··-----~---~··------
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SN"FLEI DATE lnH£ .~ ~ o g §.- TANKSIZE DEP'lH iE ~ g: ~ tJ~~ ~ ~C ~e ~ ~ ~~ .§c;t; m :gjt-! . Ml'-BER i loo:; ~ iiJ -1·. TANK PRoDUCT- " t- . a.;wr- gal w ~ ~ ... ;.g B..og if~ .
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" Ji _, r· . Enclosed are test results for your samples received In this lab on Feb. 02, 1996. For your reference, these analyses have been assigned our NCA # P602016. · . · , '"i:· '
Solid samples are reported on a dry weight basis except for Oregon DEQ Fuels Methods and where otherwise noted. , · ·
i h1s report will be accompanied by a separate Quality Control Data Report, unless omitted by cl.ient request. · : · •
Please call If you have any questions. ;· '> .;
Rbspcctrully,
f!/,J,.,!lj/tM~ Philip ~erenberg )./"" Laboratory Manager .-:>
)'1 ,,
FEB-13-1996 11:25 +1-503-643-7213 P.Ol4
,• I
FROt--1 I NORTH CREEt< 1=\NI=IL YT 1 D-' TO
'; .i:NORTH 503 283 6388 ; 111311=\t--1 1*522 P.lS
I
}.:i§ CREEK· . ···;s 5 ANALYTICAL
10A:I9 lZUth A1cnue N.L, Suite 101 r BC>lllcll, WI\ jlR011·1l~Oll \2\Jtl) 4tl1·~i''IQ • FAX 48!:. 2W~
fa~11111b Munlgomct~, Suit~ B ~ 1 Spokano, WA 'tm?nfi-4776 (~U!J) !!24 U<'UU • FAX 9?4-B?ilO
!l40!'i HW. Ni1111Jus Avenue • BcavCtlon: OH A7000·7132 1503) 643·\.Jn>O •lAX 644-:'?0?
TPH·HCID per Oregon OEQ Results In mg/kg (ppm) .·;
'i PEMCO NCA Project t#: roo2016
soli NEHALEM BAY HEAI.TM DIST.
'f ~· : fc # 1 ~8000 GAL PS 300/NORTH ! .
~ .. J~ 2 j:;·l~ #2·8000 GAl. 'ps 300/SOU1 H ·• !
K . ~d:<))1 4d-4000 GAL Hl G OIL/EAST· -H , '. _,'~~-·
';
'i
Lab ID Anlllytc
P602016·1 Gasoline Diesel
~ Heavy{Oit '·
P602016-2 Gasoline Diesel Heavy/Oil
. 1'602016-3 Gasoline Diesnl Heavy/Oil
fl4·4000 GAL HTG Oll/WFST 1>602016·4 Gasoline
;ji .<·
#5-500 GAL DIESF.I/NORTH PG02016·5
-~> .L
#6·500 GAL biESEUSOUTH P60201 &·6
c\1· L· ·;~~-8000.GAL PS300 USl l·, .)!
P602016·6 ':!· "
.•!,.•
,,. '.1:
Diose! Heavy/Oil
Gasoline Diesel Heavy/Oil
Gasoline Diesel Heavy/Oil
Gasoline Diesel lieavy/Oil
.,.;!,,
M<ltrix: ( ·. SamJJicd: ~ · ·• 02/01/96 Rec(lived: .~" , . 02/02/96
lk_:. ,. :t ' ,.. ;: f. ·;: i '\ l,: Dale r
Results MRl '· Prepared ''i 5
ND ~g i r!:~ ,p21o2/96 ND ND 1 oo\t :8:·r~·
-~ } . .:~~· '. . . i.'
"I ... 20 ··:·' •' \
02/02/96 NO NO 50 ·;
. ·~. . ND 100
·• ·l •. ~! j .. ~ : i .. ' .. :. ''\~ ; I
30 "'1
. I
·;o2/02/96 :w 4300 50. NO 100
ND 20 . 02/02/96 160 50 ND 100 .
NO 20 'o2fot.t9b NO 50 " 110 100
.;l
NO :w 02/02/96 NO 50 130 100 L ND 20 0/.{07/% Nb 50 ND 100
r: ; '\
MRL ND ..
Method Rcporti ng Level None Detected at or above the method reporting level See Comment Section at end of report
•·.
FEB-13-1996 11:26 +1-503-643-7213
Date Analyzed
\
02/0'2/')6
~ '.~
02/02/9&
01./03/96
02/03/96
02/03/96
02/03/96
' r~~~' .,
02/07/96 ~~D :' .i i •.!
;~;: ·J :· . ! ~ ~·
'
Pi!gC 2 of 5
p .815 ~I[!; ' !
TO
·:1 ;/}
503 :283 6388.',•, l'
I' c ' ··02;..13 ll132RM: !*5:2:2 P.l6
·-f -,\l,J ,:;:, : . \ ti
1A010 i?rlth Allnnnn N r ,::IIIIP 101 t Hnlltrdt: WI\ (IR011·A!!OO '1206l461·9?l>\l HAX ~8b 2\!0? ' •tl '
FM.I 11115 Montgomary, $ulte ll ~~ Sp<Jkur~~.~WII99~0G;-IJ71l {~09) 1124-9l!OU • FAX 924 0200 A Wi s.w. NlrniJus Avunue • t:leaverton: (111 Oi000-71:1? (1i03) 613 u:•uo •I IV< 644-??02
•.'.! 'I
TPH-418.1M per Oregon DEQ Results In rnglkg (ppm) ,.:;
l'tMCO NEHALEM OAY HEALTH DIST. ~·', J .
CllenliD r lab ID Analyte
#3·4000 OAliiTG OIUfASTP602016-3 TPH
#5-500 GAL QIESt:UNORTH P€102016·5 TPH . ·~
#6·500 GAL DIESEUSOUTH P602016-6 TPH
,J.
NCA ProJ~cl th P602016 Matrlxr r .. ·• ·. soli Sampled: , . 02/01/96 Rccclvcd1 : · . '' 02/02/96
Date Results MRL rre(Jated
71900 2000 02/07/96
220 100 :1•\:o'J./o7/'J6 "''t; i'lhl~l'
330 100 02/07/96 ··:
,.
MRI. . Method Reporting level ND None Detected at or above the method reporllng level • Sec Comment Se(;tlon at end of report
FEB-13-19~6 11:27 +1-503-643-7213
I f i
~:
li.. !
i
ll f· 'li
Date Analyzed
02/07/%
02/07/96
02/07/CJ(,
( l.t! I ah . ;I " .... , I
~·\\~1 i ;r > I' ·;· '! r· I
~!I);. ::1 :;• li
Page 3 of 5
P.016
:i
,· l
! I ;
) ., • , FRO!"I 1 I NORTH CREE>< RNI=IL YT I C' TO
. ·=NORTH f . .:C. CREEl< = -;i ANALYTICAL ·
503 283 6388 l' 02-13
1UU3U 12Uih AvomJO N.E .. Suit~ 101 • BotMII, WA RA011-Il!>Oll
!::u·•l 1111 b Montl)omory, $1ril1,1 R • Stll'lk~nn. WA 99206·477tl t\40!> $.W. Nimbu~ f\vcnuo • flo~vonori,'OR Q700U·7132
SURROGATE RECOVERIE~ (%) ::
':,~~~: PEMCO Client;
ProJect: NEHALEM 13A Y HEALTH DIST.
Analyte ·[' ·!· . ,··.
TPH-HCI,O per Oregon DEQ ~· J!t. r· , . ~
#1-8000 .GAL PS 300/NORlH 1-Chlorooctac.lecane
NCA Number: . Received: r
·;
:.r· <.' • '~ " 'I ' l(esult , ..
' ,';, !~ <·· . <.
·;·
92
lll32RMrH622 P.l7
ii (206) 481·9~(11) • Ffi:X .\nr,.?g;l2
(ou") 024 9?00 • FAX ~~~·1·M~n I'
(&O~) <H 3 n20o • r A{< G4 J. ??O?
I!
i! P602016 l: 02/02/1996
.,
. 5';;;\';'1 ~ :jl ,j
#2·8000 GAL PS 300/SOUTH 1·Chlorooctadecane '. ~···-·-···· ... 99 ,C;',~. . ~ ;: :,::
50.150 ':
5(}150 .I ~~
#3-4000 (jAl Hl G OIUEAST ' •,
#4·4000 CAL HTG OIUWEST
#5-500 CAL DIESEl/NORTH
1#~-SOO d~L .DI,~SEI/SOUTH ,,, .,;; J #0·0000 CAL PS300 UST
" ' '· --
.. <·
·:J !
- " t''
1·Chlorooctadecane
1·Chl orooctadecane
1·Chlorooctadccane
1-Chlorooctadecane
l·Chlorooctadecane
MRL Method Reporting Level ND None Detected at or above the method reporting level • See Comment Section at end of report
FEB-13-1996 11:27 +1-503-643-7213
77
114
103 ,.
.107
100
5(}150
SD-150
50-150
50-150
50-150 i !
r !I
Page 4 of 5
P.017
t ·'\
,, ,, (.
t~ c>' ;j,
FRO!•! : NORTH' CREEK RNRL YT I r TO
:1 "· .a NORTH t; ~~ .
3 -=-CREEK .· ,.;;; -iANALYTICAL
I'
Clienh Project!
PEMCO NEHALEM BAY HEAlTH DIST.
603 283 6388. ;!·:
v >.02-13'
lUoJ\J 12Uth Avenue It E .. Suite 101 • aothc:ll, WI\ 9fl011•1lfi011 (2U6)4UH1200 •I AX 46~·?99~'
Lttsl 1111 ~ Monti)OOl~rt. Suite B .• Sj>(lkO~O. WI\ OO~M-~7.7S' (609) 9:'1·11~UU • ~AX 1124 nuu !)4llb s.w. IJimbu~ fiVMIIA. l'lMVMOil, on 97000·7132 . (503) 643·9?00' ~AX 1;144 22U2
COMMENTS
NCA Number: Re<:elved:
P602016 01./02/1996
1, Detected hydrocarbons In the gasoline range appear to be due to overlap of diesel range hydrocarbons,
FEB-13-1996 11:27 +1-503-643-7213
I, 1,•:
Page 5 of 5
P.018
A. SAFETY EQl:JIPMENT ON JOB SITE:
Fire Extinguisher. Type/Size: /).~(.. 20 (...'\>
G:lmbustible Gas Detector: Model: fU-'D
Oxygen Analyzer. Model: h·\'2
B. DECO?'riMISSIONlNG: All Tanks: (Uci:. =Unknown, N/A = Not Applicable) (Check Appropriate Box)
1. All e!ec:rical equipment grounded and e;,:plosion proof?
2. Safety equipment on job site?
3. Overhead elec:rical lines located?
-t. Subsurface elec:ricallines off or diSCDnnec:ed?
5. Natural gas lines off or disconnected?
6. No open fires or smoking !IUlterial in area?
7. Vehicle and pedestrian traffic controlled?
8. Excavation material area cleared?
9. Rainwater runoff directed to tre:J.tment area?
10. Drained and collected product from lines?
11. Removed product and residual from t.ank?
12. Oeaned tank? (~
13. Excavated to top of t.ank?
14. Removed tank fixtures? (pumps, leak detection equip.
15. Removed product, fill and vent lines?
C. TA.i"1K ABANDONNIENT IN"-PLACE:
16. Sampling plan approved by DEQ?
Date: DEQ Staff:----------
July 1, 1991 Oregon DEQ
UST Decommissioning Cheddist
Recharge Date: \ { .f { <1 It
Calibration Date: \ { 'U, { litl.
Calibration Date: \.['lf.{e, t,
I I
I Yes No
I Unk N/A
I v I I I t/ I I I I 1/\ I I v/l I I
I I 1/1 /I I
I
I I t/~ I I I I I t/l I I I t/ I I I I t/ I I I t/ I v I Y\ I V\ I v I I
! \v II
;.:z-.,.":"=;' ... _. - ..... ·-
Page 1 of 3
E .•. m;:CQ:i\11'YITSSION1NG: All Tan' Unk.= Unknown. N/A = Not Applicable) (Cb.eck Appropriate Box)
17. Contamination concerns fully resolved?
D. TANK REMOVAL:
19. Tank pia~ment area cleared, chocks placed?
20. P"urged or ventilated tank to prevent explosion? Method used: II evv[ 'I:J .if X • Meter reading: ---+---'--'-
/
21. No chains or steel cables wrapped around tank for removal?
22. Tank removed, set on ground, blocked to prevent m.ovement?
23. Tank set on truck and secured v.rith strap( s )?
24. Tank labeled before leaving site?
E. SITE ASSESSMENT:
25. Site assessed for contarniru.tion? See OAR 340-122-340
26. Soil samples taken and analyzed?
27. Decoii1IIlissioning/0...ange-in-Service re?<Jrt sent to DEQ?
23. Was contamination found? Date/Time:-------
29. Was contamination reported to DEQ? By:-----------Date/Time: DEQ Staff:-----------
30. Was b.az.ardous waste determination made for tank contents (l.iquids/sit.idges)?
31. Disposal location of tank(s) contents.
Name: --------------------- Date: Y~o '~ f?
Add~: --------------------
Attach disposal re:e.i pt.
32. Disposal or recycling !OC:J.cion of removed tank(s) and associated piping.
Name: '- \ \h..\ \T"U:.n. S\~ \.
Add~: ::noo \'-\.""'\ 'i~o~ .O."ii·
Attach disposal receipt.
33. If tan.k(s) are intended to be reused, identify new tank site.
Date: ---------
Ad~: -------------------------
Yu:rpose of Reuse: --------------
July 1, 1991 Oregon DEQ
UST Decommissioning Checklist
l I
Yes No
-I
~ I
VI I vj I
I J I VI
I l I I
Unk NIA. I v
I
I I I I I I
I I jv I I~
Page 2 of 3
( ;I
(
•-/ I•
I '
F. V\:'9RK PERFORMED BY:
DEQ Service Provider's Lic..onse #: \ "2.."\ "l--"0
Name: '?""'~ t:,.O
Telephone: S"o~ • ZSl· "2...\$"'"\
DEQ Decommissioning Supervisor's License#: btl.t77& Name: /11//<e {h,~-< .. J~.vr
' Telephone: (;-o)) 7-'7"'-R -!1-/t:;-.;---. )
E. CHECKLIST FILlli G;
1. Provide copy of checklist to the UST owner and operator.
2. Send completed checklist to the DEQ headquarters within 30 days after the excavation is backfilled.
NOTE; If. cnnt.arnination was found during deo:>mmissioning and repo~ to DEQ regional offi~, this rep<>rt may be submitted with cither the first interim cleanup !'"ep<lrt or the final cleanup report, whicheYer is first.
Send Completed Form to: Department of Environmental Quality UST Program - Decommissioning Checklist 811 S.W. Sixth Ave. Portland, Oregon 97204
For information: (503) 229-5559 or Toll Free in Oregon 1-800-452-4011
July 1, 1991 Oregon DEQ
UST Decommissioning Checklist Page 3 of 3
CERTIFICATION OF TANK DISPOSAL
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6388
DATE: } I I /9(/ JOB NUMBER: r !/ ;) ()
LOCATION FROM WHICH REMOVED: ;t/--ctJ-qt -.?~--v- /Jc; x
QUANTIIT SIZE LAST KNOWN PRODUCT
~- $']~ - I
c;?OO 0/e-;/
t fdoue/ t}_ e /! , ':!;£. /ltF(- [);'c;;·/ ' f
I
l q c;OtJ /} (r~A-{...'P e
1'1--!..-t vv- )...e i/ ;-TRANSPORT DRIVER:--'-----------
RECEIVING
SCRAPYARD: NAME: - ... -.. -p,---,r-,.,-,-1-(-\-1-_ .,....., ...... , .• -1 . .-. -. ---...t1
ADDRESS; . !;;'~~:~;)- ;.;_· \:~ ~ .. 'i'E C· ~.: ~ ~·-::~. ·' ,, _.~:; ·~ ~ ~\r· ... ~ :::;: ;.;., t.~.~ ('. ~ ··i"'"' (l . .,. ~ · ~. :'
-'"~-~~~%
RECEIVED BY:------~--------
A Division of PEECO
A. SAFETY EQUIPMENT ON JOB SITE:
Fire Extinguisher: Type/Size: A'{) C... "Z o l-ll
Combustible Gas Detector: Model: \> \.\1)
Oxygen Anal yZJ;r: Model: j> ~J>
B. DECO?vfl\1ISSION1NG: All Tanks: (Uci:. =Unknown, N/A = Not Applicable) (Check Appropriate Box)
1. All electrical equipment grounded and e:-:plosion proof?
2. Safety equiprne:Jt on job site?
3 . Overhead electriw..l lines 1 0C:lted?
4. Subsurfac-e e!ec~-iwl lines off or disconnec::ed? .
5. Natural gas lines off or disconnected?
6. No open fires or smoking material in area?
7. Vehicle and pedestrian traffic controlled?
8. Excavation material area cleared?
9. Rainwater runoff directed to treatment area?
10. Drained and collected product from lines?
11. Removed product and residual from tank? l·~ (l 12. Cleaned tank? 7 _ . / 1996
ElfVIRONA,f ~ 13. Excavated to top of tank? :4! C'L l
Nt)p DIIJISION 14. Removed tank fixtures? (pumps, leak detection equip.
15. Removed product, fill and vent lines?
C. TA.Nl( ABANDONI\1E.NT IN-PLACE:
16. Sampling plan approved by DEQ?
Date: DEQSm~-----------------------------
July 1, 1991 Oregon DEQ
UST Decommissioning Checklist
Recharge Date: \[~tbr.
Calibration Date: \ f-t<l"'t
Yes J No I I
Unk I
N/A I
v"' I I I VI I I I V/i I I I
I I I I /1 I I I
c/j.fl\ I I v/ I I I v' ... I I I I /I I I I v'~ I I I I ~I I I I /I I I I /I I I v l I I /I I I I
\VII ~ .. ":':: ...... _ .. ·- ...... ··· ·- ··.
Page 1 of 3
B •. DECOI\11\1ISSIONING; All Tan' 1Jnk.= Unknown, N/A = Not Applicable) Yes No Unk NIA (Cll.eck Appropriate Box)
17. Contamination concerns fully resolved?
1~1 I I I 18. Fill Material? Type: c:::n.·.n~Ct.l) '\'to~
D. TANK REMOVAL:
19. Tank placement area cle:u-ed, chocks placed?
20. Purged or ventilated tank to prevent explosion? Method used: 1/.ewh;ey • Meter reading:-----
21. No chains or steel cables wrapped around tank for removal?
22. Tank removed, set on ground, blocked to prevent movement?
23. Tank set on truck and secured with stra:p(s)?
24. Tank labeled before leaving site?
E. SITE ASSESSMENT:
25. Site asses.sed for contamination? See OAR 34D-122-34D VI I I I 26. Soil samples taken and analyzed? i/1 I I I
29. Was contamination reported to DEQ? By:-----------Date/Time: DEQ Staff: -----------
30. Was b..az:lrdous waste determination made for tank: contents (Liquids/sludges)?
I I I I I
.1/j I I II
I v I l l II it
v// I I I
27. Decommissioning/Change-in-Service report sent to DEQ?
28. Was CDntamination found? Date/Time: I J }iJ /tty
31. Disposal location of tank(s) contents.
Name: ---------------------
Address: ----------------------
Attach disposal receipt.
32. Disposal or recycling location of removed tank(s) and associated piping.
Name: ~ ll..~\\!l't-n .S"f'D\. Date: ....:~::..t...b:-L/"l....LJ!!!. ____ _
Address: '3"Z.o~o ~H 'fC.m-l ~\:
~0~1) '(:l'tt_ Attach disposal receipt.
33. If tank(s) are intended to be reused, identify new tank site.
Name: --------------------.r---Address: ------,.-:2:~---
Date: ____________ ___
Purpore of Reure7::;._ ________ _
July l, 1991 Oregon DEQ
UST Decommissioning Checklist Page 2 of 3
( ;I
/
F. W<;lRK PERFORMED BY:
DEQ Service Provider's License#:-----Nxme: _______________ __
Telephone: ----------------
DEQ DecDmmissiooing Supervisor's Lie!!n.se #: l 4 $~{(/
E. CHECKLIST FILING;
Nxme: ,N! /fr '!!:- !tt·'-~le.vr Teleph~ne:{jpt) ;zc;-u -I 1-/!7S-
1. Provide copy of checklist to the UST owner and operator.
2. Send completed checklist to the DEQ headquarters witbin 30 days after the excavation is backfilled.
NOTE; If. contamination was found during decnmmissioning and reported to DEQ regional office, this report may be submitted with either the first interim cleanup report or the final cleanup report, whicheYer is first.
Send Completed Form to: Department of Environmental Quality UST Progr.illl - DecDmmissioning Checklist 811 S. W. Sixth Ave. Portland, Oregon 97204
For information: (503) 229-5559 or Toll Free in Oregon 1-300-452-4011
July 1, 1991 Oregon DEQ
UST DecDmmissioning Cheddist Page 3 of 3
PElvi~O
CERTIFICATION OF TANK DISPOSAL
437 N. Columbia Blvd. P.O. Box 11569
Portland, Oregon 97211 Office (503) 283-2151
FAX (503) 283-6388
JOB NIJMBER: 7 o ;;J 0
LOCATION FROM WHICH REMOVED: ;r/'-c!l/Jt ~&v- !J:rx
QUANTITY SIZE LAST KNOWN PRODUCT
~· ~
c;-oo 0/e<?/
t fdf.?uc? tf.e/1·~ !Itt!- [)··c;;·! 'f I
t CG, c;OO I
1}?<-k!-'P e
It-{A <A-- j ...e i/ I-TRANSPORT DRIVER:-----------
RECEIVING SCRAPYARD: NAME:-----~--~
ADDRESS: ·;;:;c;;• \:;: L~~c',.'~'·:~ . •' 0
..... -:'J· ..... ~~\:·K., ~---~;)_::c~.···:..-"~ 0..,. ~~ ~.-:-
r·;;z·~L- %
RECEIVED BY: ____ _;_A_~------
A Division of PEECO
UST CLEAL'WP TELEPHONE USE REPORT
CALLBTO: DATE:
WITH: TIME:
TELEPHONE NO:
REGARDING:
FILE NO:
UST CLEAl'WP TELEPHONE USE REPORT •
CALL FROM/TO: \N PY....t ha R, ~IJ-r DATE:
WITH: NRh..nUu, ~I ~D{#-. TIME:
c ) sG8- stf :t ' '~ TELEPHONE NO:
REGARDING: 4 s l /::be c C) Kt J1..1...
FILE NO:
SUM.lA"...ARY OF CALL
• !
UPDATES:
~ETBQ~~-:~~::.::2 · Please Check All That Apply ----
.,. MORE ON BACK •
-------------------------------------------------IN CtDENT INFO RMA TIO N-----------------------------------
LOG NBR:"'---.- . ___,_ RECEIVED BY: · ::::::;; 4- V1J UST FAC NBR: /IS7 ~ . DATE REPORTED: A.- I ...... c:z. ;s
~ REGULA TED UST
0 NON-REGULA TED UST
SITE NAME: 1\ (Q h9 lR ~ B ~ .... ) Hew.... li~ (J, s+ I' I e- J.. SITE ADDRESS: ¢_ '7 8 '[2:a k.e ,<;;_£
0 HEATING OIL TANK
SITE CITY: \..{'( ~ ~-Q__{ 4',? V ZIP: q 7 l4l SITE COUNTY: 7tl/AIIhOc.d(PHONE: --------
PROJECTMANAGER=---------------------------
FUNDING
pt, LUST 0 OHC
0 HSRAF 0 FINANCIAL ASST
0 INVOICE START LTR. AGR. DATE: _____ _
0 INVOICE STOP " 0 NFA SENT
-----------------------------------------,--------------------MAIL C 0 NT ACT$------------------------------------------------------
REPORTED BY
NAME: \ f\-/0.' J' f\..{ /(_( fZ--/ce f../-p COMPANY:./V~hl~Le~ [S;: I~ Jj'J 0: s t ADDRESS: ________________________ '---------------------
CITY: --------::---. ZIP: --::--::::------:::-
STATE: HONE: (:S03') ?68- $1/1
INVOICE CONTACT ::::::7' NAME: ---------f7<-..::::......f~-.i.> __ / __ , COMPANY:-----------------------------------------
ADDRESS: _______________ ~-------------------------------CITY: ______________ ZIP:-----,-'----
STATE:---PHONE:-----------------
RESPONSIBLE PARTY
NAM~ ~ coMPANY: {\Ieh g,le ~ i?a..,, lJe"' IP\ t:J( ') ADDRESS: ;t;.'J g l2o u,...p 7 Sf., CITY: \Nl...iu?~ ZIP: 17/C/7 STATE: CJ'JZ. PHONE:-------------------
OTHER CONT ACT{SI
NAME:----------------------------------------------COMPANY: ______________________________________ ___
ADDRESS:------------------.,-------------------CITY: __________________ ZIP: ______ _
STATE: ___ PHONE:-----------
---------- ------------------SITE ASSESSMENT------
DATE DISCOVERED: ~2---·,_/_-_.._?_, __ 0 EMERGENCY RESP.
CONFIRMATION:
0 Sll STAFF 0 LDI LAB:DEO 0 LR} LAB:RP
0 ENFORCEMENT
0 LO) LAB:OTHER ';if RR) RP REPORT 0 CN) CONTRACTOR ::J OTl OTHER-----
DISCOVERY:
0 RM} ROUTINE MONITORING 0 DC) DECOMMISSIONING 0 CP) COMPLAINT 0 ICl INVENTORY CONTROL !J SAl SITE ASSESSMENT 0 TTl TANK TEST 0 OTI OTHER------
rf FURTHER CLEANUP REO.
0 NO FURTHER CLEANUP REO.
0 OFFSITE MIGRATION
---- LLP.S. SCORE (Region)
CAUSE:
~ TU TANK LEAK 0 PU PIPE LEAK 0 OA OVERFILL 0 SS} SURFACE SPILL 0 PV)PUMP!VALVELEAK 0 on OTHER------0 UN! UNKNOWN
------------------------------------------CONTAMINANTS - IMPACTS---------------------------·--
CONTAMINANTS:
0 UG) UNLEADED GASOLINE 0 LG) LEADED GASOLINE 0 MGI MISC. GASOLINE jl( OS} DIESEL 0 FOl FUEL OIL 0 WOI WASTE OIL 0 LSI LUBRICANT
0 SV) SOLVENT 0 SF} BUNKER FUEL 0 OPI OTHER PET. DIST. 0 CHI CHEMICAL 0 HOI HEATING OIL 0 UN) UNKNOWN 0 on OTHER-------
MEDIA/IMPACT:
~SLl SOIL 0 GWI GROUNDWATER 0 SW) SURFACE WATER 0 OWl DRINKING WATER
· 0 FYI FACILITY {VAPOR) 0 FP} FACILITY (FREE PROD)
--<f-+-_C!:J __ C>_O __ Q~-( __ {~-~--SITE- SOIL MANAGEMENT---------~·--RELEASE STOPPED: ;;,. -/ -? ~ CLEANUP STARTED:----------
REMEDIATION COMPLETED: --------
NO FURTHER ACTION: ----------...-
SWLA PERMIT NUMBER: _____ ;..._ ___ _ DATE ISSUED:---------
AMOUNT OF SOIL (yds3) TREATED ON SITE: -------
AMOUNT OF SOIL !yds3) TREATED OFF SITE: --------
AMOUNT OF SOIL !yds3l DISPOSED OF: ------0 TREATED
FINAL DISPOSITION OF SOIL: 0 ONSITE 0 LANDFILL
TREATMENT METHOD:
0 UNTREATED
0 ROAD BASE
0 AREATION 0 THERMAL 0 BIOLOGICAL 0 OTHER~--------
0 ·oTHER---------
NOTES/COMMENTS: ______________________________________________ _
This Space Provided Fbr Regional Use
!LUST1 06/26-AUG-94)
.. · Oregon Department of Environmental Quality NOTICE OF UNDERGROUND STORAGE TANK PERMANENT DECOMMISSIONING/SERVICE CHANGE
FACILITY ~~on ofTanks) (c..o.<C2.t: c~~) Name: t--\ E:.\\ ~\..<fw-, "t!>!i..'( Ui A\..j\1 Q\~m'"~
Address:_.;;,;....;.....;;.._-==-=;;,..;;;;.--=~-----
Phone:
DEQ Facility LD. Number: ·...,-~'"-'1:;.._-,~-t-
TANK OWNER
Name~ t-\~i.:.\-\o..\..~~'\ ~b..-1 U~J>.\;,."\\:\ tH~\.
Address: 2"7 8 '2-o\-\~ · S\'"
~\\e.'C.L.eQ. 1 0~ ~~ \4 7
Phone: S03· 3'-~· $\\"'\
Work To Be Performed By: --;·-p':::·=I£M;;:... ·.;...;·. :..::·t..~c?"-;-,.----;-::;--,..---;:;-~..,....,~ · .·... · · · ·· (Owner or Licensed Service Provider)
License# \ 'Z.K "Z.O
Phone:· 'Z~"l· "Z.\$'"'\ p Mobile Phone:------------
FORM MUST BE SUB.MITTED BY UST OWNER OR OPERATOR 30 DAYS BEFORE START OF WORK
YOU MUST CONTACT YOUR LOCAL DEQ REGIONAL OFFICE 3-DA YS BEFORE STARTING ANY DECOl\fMISSIONING WORK. (Phone numbers are listed on reverse)
Will tank removal or potential cleanup affect adjacent property or Right-of-Way property? Yes __ No ~
Date deCommissioning is scheduled to begin: \ f '7-"1 (q v
[J DEQ Tank Size Product: Gasoline, Closure or Service Change? Tank to be UST in Diesel, Used Oil, Other? Replaced?
\
Permit (Gallons) Tank Closureco New m
Present New Removal Inplace Product Yes*
----- J: Ot> t> \'6~6\.. "' '
* If decommissioned tank(s) are to be replaced by new underground storage tanks you must submit a new permit application containing information on the new tanks 30 days before placing them in service.
co Submit a soil sampling plan to the DEQ regional office and receive plan approval prior to starting work if 1) tank is to be decommissioned in-place, 2) tank contents are changed to a non-regulated substance, or 3) tank contains a regulated substance other than petroleum.·
Signature:
I. , ..
No
;(
July 1, 1991 Oregon DEQ
Notice of UST Permanent Decommissioning/Service-Change . _ , _ . .. .. _ _ Page 1 of 2 'i:.J.~~;'l/~g~"--""'·~'-'"~~·d .. ~:-... ~~•.,.,J,t .~~"~---~ ···~·/
January 26, 1996
Facility ID No.: 11579
Dear Tank Owner/Permittee: DEPARTMENT OF
ENVIRONMENTAL
We received a decommissioning notice on January 19, 1996 for 1 underground stor<ifgM\kkk"(()) located at:
Nehalem Bay Health District 278 Rowe Street Wheeler, OR 97147
Checking our records, it appears the tanks are registered, permit fees are current, and the contractor is licensed. You are required to confirm the date of removal with the appropriate regional office (see below) at least 72 hours prior to tank removal. If you have any further questions about your permit fees, facility information or DEQ Licensed Contractors please call Steven Paiko at (503) 229-5733.
An assessment must be conducted at all tank sites and contamination must be reported within 24 hours of discovery. OAR 340-122-301 through 340-122-360 contains the sampling requirements necessary when decommissioning underground storage tanks. As soon as contamination is identified in any manner, including observations of visible staining or odors, it must be reported. If obvious signs of contamination are present in the excavation, DO NOT wait until you receive the sample results to report the contamination.
If you need to report contamination or have any general questions regarding site cleanup or UST compliance issues, please contact the regional office at the number listed below.
*** REMINDER: The UST Decommissioning/Change-In-Service Report form and the UST Decommissioning Checklist form must be submitted within 30 days after completion of work.
Sincerely,
Jj;4;P Steven Paiko Office Specialist UST Compliance/Emergency Response Section Waste Management & Cleanup Division
cc: Northwest Regional Office - 229-5263
811 SW Sixth Avenue Portland, OR 97204-1390 (503) 229-5696 TDD (503) 229-6993 DEQ-1
JRN-17-1996 14:05 FROM PEMCO
PEMCO
F A X C 0 V E R
DATE : \ h-, I fi1"'
TO 2296945 P.001/002
4:)7 N. Coltnnbiil Blvd. P.O. B<)X 1156~
Portland, On:·gon LJ72Il Office (503) ?.r;J-2151
FAX (503) 28J-6388
L E T T E R
TIME: ______________________ __
WE ARE TRANSMITTING 2.. PAGE{S), INCLUDING THIS PAGE
TO:
FIRM: O~Q ATTN:~,...,. M A.:n.r H
PHONE: ________________ _
FROM: t:/'h kc.;; Wa~'"'\ PEMCO, PORTLAND, OREGON
COMMENTS:~~~~~~~--------------------------------------------------
A Division of PEECO
JAN-17-1996 14:06 FROM PEMCO TO 2296945 P.002/002
.. .. . . .· Oregon I>el'artment of Environmental Quality NOTICE OF UNDERGROUND STORAG~ TANK PERMANENT DECOM.MISSlONING/SERVICE CHANGE
FACIUTY (U.xadon ofT~) . • . · : . . )
N~=·· ;t;~~~G~·~~4··ij~~ei¥\riii;:q Addres$: · • i~~· :::S&~J~:·::·~;;r : .. :.:.·: .
Y-\Wiijn. . ~··. t:\-1. '.,, l
TANK OWNER.
Name: t'\G.\j ~~~'\ 'ie...-1 ~~A>-\.-··n=\ t)\~\.
Addr~s: 2..., 8 12-0"'-\ 1iL · ~ \
k4\\aaL.E.<4. OQ. ~~ \41
Phone: .>03 • .3'-S· $\1.8\
DEQ.Facility to.·N~mber:.·.·:~~\liP p9s.
Work To Be Performed By;<' : ···~~ ~9 License II \ ~ C. o ·· .. · •·· .. ·:: .. , .. > .. :....;-.:::·-. (~Owu~.;..;~.:.::r Qo'r ,...U.,..'ce_n_sed-:--::-Sc-·rv_,..ice-·-=Pro:--Vl..,-,d-:-e'"""r}~
· Phone: '2 ~'l· 'i·\ _t., : <'·:I' • ' ··, '· .·. .. Mobile Phone: ------------
FORM MUST BE SUB.MITTED BY UST OWNER OR OPERA TOR 30 DAYS BEFORE Sl ART OF \VORK
YOU MUSI' CONTACT YOUR LOCAL DEQ REGIONAL OFFICE 3-DAYS BEFORE STARTING ANY DECOMMISSIONING WORK. (Phot~c t~umbers are listed on reverse)
Will t.a.nk: removal or potential cleanup affect adjacent propc::rty or Right"'()f-Way property? Yes __ No v--._ Date decommissioning is scheduled to begin: \ ( "l-j {1 (,
Tank CEQ Tank Si~e Product: Gar;wline, Closure or Service Change? Tank to be
# UST in Diesel, Used Oil, Other? Replaced:? Permit (Gallons) Tank. Closure!,)j Ne..., co "'
Present New Removal In place Product Yea• No .. , ... , ... .. -'
\ &" CIC) '0 \ f,~ ...... ~ -·•li"H"I•
__ .... ,,.-
··-- -- ,.,.,_
.. .. .. "'" ___ ,. ·-""' If decommissioned tank(s) are to be replaced by new underground storage tanks you must submit a new permit application co!ltaining information on the new tanJ,.:s 30 days before placing th~m in service.
co Submit a soil sampling plan to the DEQ regional office and receive pll!Jl approval prior to starting work if 1) t.a.nk: is to be da:commissioned in-place, 2) tank contents are changed to 11 non-regulated subslam:c, or 3) tank contains a regulated substance other than petroleum.
July 1, 1991 Oregon DEQ
Notice of UST PelliiAnent Decommissioning/Service Change Page 1 of 2
JAN-16-1996 10:31 FROM PEMCO TO
PEMCO
To:. :;r,W\ \V\.
Company:_~...:::..J!!e"-'Q~------------Phone: '2'1..,. sa.~
2296945 P.001/002
Fax: 'l.'l.~· Gt'14S 0-----·-----------
From:~~~·k~~~~~~~~~~------------Company:----!V:...::k;.;_""_:.",;;.,;a:;.__~--·-···· .. o--··-o-.·---------------------------
Phone: __ ~~•~l·-~~'~s~'-------------------------------------F ax: --='Z:....;f6:::...'3_·_,3~~'J_fl-"8...._
Date :____;\-=-/...:..:t~!t.l.{.....z."'l'-2-'---.... ·-······o··-.. o--------------
Pages including
cover: _ ___..Z.."""'-------o-............ o·o ........... o .................... ----·-------
Comments: ::::3' \M I .............................................. 0.,.,,,,,,0. -··----......... ., ......... ,, •. _0'"o"o'""""''''"' 'O'"'"'''O'"'"''"'''_'_, ______ _
~\l u 1!!-\'W!I t:.\l.&.la.~!:.~ .• :irl ~111.\l ~on...---------··-· ... A. !~U: 't:os "'t"'~~ .roo {s.a ... \.o..J 1)\'fl.~a\.r "\o...L~, _________ _
"'\'"\"''-'!" ~u~ t'1? =r~·"'\'"' "\IJ.lf'L l!e-"£ Iii:. ets .... \,.
.l:laYJ~\\,. .. 1:12"! I
""'~i-1) 0~~·
---------------~~~~=~~~~.-----------------------------------L-~U4-----------------------------·······'"""'''''""'""'''"""'"'''''"----· l'E?>:(CO 437 N. Columbia Blvd. P.O. Box ll.%9 Pon.!;md, 0 R 972ll
Office (50::\) :&J-215 \ F.->..X (503) 2S'J-<'i::nlS
JAN-16-1996 10:31 FROM PEMCO TO 2296945 P.002/002
NEll QOI.D"'•-f ..,.,.._ ,,
Oregon Department of Environmental QualiL. 811 SW Sixth Avenue i'
( Portland~ Oregon 97204·1334 i Y=b 1 • 229-~~, &f!d In Oregon 1 ·800·462-401 1 I
PERMITIEE
/
NTCHD H.E. R.inehatt: Memorial Hospital 278 Rowe P.O.Box 16 Yhocler, OR 97147
UNDERGROUND STORAGE TANK PRbGRAM TEMPORARY PERMIT
AFAGE
13·MAY·89 _ . .,..~--.-, .........
2
:--, ....... ··:
The Department of Environmental Quality iS&ues this temporary permit with the underotandlng that the Permfttee is to comply with the condlllons on the reverse side of this temporary permit.
Fred Hansen Director I Deportment of Envi>"OnmentAI tlity
I
··--··-· -- ·---"-' ---- ·-''"""""'"_ .. ____ _ 368-'1162 P. DCI2
NORTH Til .\MOOK COUNTY HOSPIT~ ~DISTRICT
dba: H.E. RINEHART MEMORIAL HOSPITAL NEHALEM VALLEY CARE CENTER
July 22, 1994
Environmental Cleanup Division Mike Zollitsch, UST Cleanup Specialist 811 s. w. 6th Portland, OR 97204
RE: Heating Fuel oil Tanks
Dear Mike:
278 Rowe Street P.O. Box 16 Wheeler, Oregon 97147-0016 Phone: (503) 368-5119
JUL 2 6
ClEANUP
As discussed with you this date, the District Board and I have become aware of an old heating oil tank that needs to be reported. This tank is located behind the hospital building, directly placed against the old section of the building. Neither the Board or myself where aware this tank existed until I noticed this past spring in the basement maintenance area on the West end of the building what I believed where some water seepage problems. (We had been having some problems with leaking roofs). Upon inspecting the area from time to time, I noticed a residue on top of the water. I had this inspected and consulted with the Chevron dealer in Rockaway. The Board and I had the residue cleaned up. The problem continued. We searched the area and the outside areas and found this tank. It appears to be a rather large tank, but I am not sure as to the exact size. My best guess-1000 gals. We determined there was some material still in the tank, had it pumped out and disposed of by a heating fuel company to eliminate further seepage into the basement maintenance area. This seepage came through the concrete wall onto cement floor and basically was self-contained. We have had no further problem since the tank was pumped dry and the area in on the basement cement floor cleaned up. The Board only meets once a month, so action on their part takes time, however I for reporting purposes approximately April 30, 1993 was when we fully understood the problem. I am sorry for the delay, but it has taken a while to handle the situation, also I had a head injury in May and that has slowed me down.
We have no funds to remove the tank at this time, nor an 8000 gal. empty, cleaned, sandblasted tank of the front lawn of the hospital building which had leakage problems in 1988 and was reported. I had been informed by the
"EQUAL OPPORTUNITY EMPLOYER"
NORTH TI: .\MOOK COUNTY HOSPIT. ""DISTRICT
dba: H.E. RINEHART MEMORIAL HOSPITAL NEHALEM VALLEY CARE CENTER
Page 2 Mike Zollitsch, UST, ECD Heating oil fuel tanks
278 Rowe Street P.O. Box 16 Wheeler, Oregon 97147-0016 Phone: (503) 368-5119
previous maintenance staff that this tank had been placed on a removal list with the State, due to the financial difficulties of District and the closure of the hospital.
The Board has no plans to sell this property, nor are there any prospects. Long-range plans are to remove the north end of the hospital building and this would have to include the removal of the (just found) tank, if the State could not do it on a cleanup list. The 8,000 gal empty tank on the front lawn had been placed on a removal list to the best of my knowledge, by either your agency or EPA.
I hope that this addresses all of your concerns and will not create further problems for the District. The District is still struggling to pay past debts and repay a bonded debt issue. Funds are not available to handle the above situations and are not likely to become available in the near future.
I will respond to the letter and report you will be sending the District and if I have any questions, I certainly will call you.
Thank you for all your advice and help. I wish to commend all the employees I contacted at the Department of Environmental Agency which include yourself and Julie Berndt for their helpfulness and team cooperation.
cc: Board
Sincerely,
Carol L. May Administrator
"EQUAL OPPORTUNITY EMPLOYER"
STATE OF OREGON
DEPARTMENT OF ENVIRONMENTAL QUALITY INTEROFFICE MEMORANDUM
DATE: August 21, 1992
TO: File
FROM: Northwest Region
SUBJECT: Heating Oil Underground Storage Tank Cleanup
The following heating oil UST cleanup has been referred to the Environmental Cleanup Division's UST Cleanup Section for further oversight.
File No. Z.(p - S~ - Joe,
File Name: R_ I YJ (. h<Xr--\- ho5 ,; I )"'- \
Since the Northwest Region does not anticipate conducting any further work on this site, our file has been administratively closed.
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STATE OF OREGON
DEPARTMENT OF ENVIRONMENTAL QUALITY
TO:
FROM:
SUBJECT:
File
Andree Pollock, NWR
Rinehart Hospital File No. 29-88-109
INTEROFFICE MEMORANDUM
DATE: July 9, 1992
This file was returned to the Northwest Region because it was a low priority for the program. Additional follow up needs to be conducted to determine the status of the project and to evaluate the current financial status of the hospital. If they still indicate that they are financially unable to pursue the project, an ability to pay analysis needs to be requested.
The site has a site ranking of 344 due to the reported presence of PS-300 in the building. The current occupancy of the building, or if vapors are present in the building, is unknown.
STATE OF OREGON
DEPARTMENT OF ENVIRONMENTAL QUALITY INTEROFFICE MEMORANDUM
DATE: July 24, 1990
TO: Michael Fernandez, ECD UST Cleanup Section
FROM: Andree Pollock, Northwest Region
SUBJECT: Rinehart Hospital
During December 1988, PS-300 heating fuel was found leaking into the basement of Rinehart Hospital in Wheeler, Oregon through cracks in the foundation. Investigation was conducted and the hospitals underground heating fuel storage tank was found to have holes in it.
No site assessment or cleanup has been conducted due to the hospitals financial difficulties. I spoke with Carol May (368-5119) on July 16, 1990. She indicated that the hospital is no longer in operation and that they have gone through bankruptcy. No funds are available to conduct any investigation or cleanup.
Since it does not appear that Rinehart Hospital will be able to conduct additional work, the Northwest Region is forwarding the file to you so that you can evaluate the site and include it with the list of sites that will require State involvement.
cc: Carol May, Rinehart Hospital
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Department of Environmental Quality NEIL GOLDSCHMIDT
GOVERNOR 811 SW SIXTH AVENUE, PORTLAND, OREGON 97204-1390 PHONE (503) 229-5696
DE0-1
Mr. Archie Buchanan Rinehart Hospital 278 Rowe street Wheeler, Oregon 97147
Dear Mr. Buchanan:
July 12, 1990
Re: UST-Tillamook County Rinehart Hospital
The Department .has not received any reports concaning the underground storage tank deconn:nissioning and contaminated soil cleanup conducted at your facility located at 278 Rowe Street in Wheeler, Oregon. The contamination was reported to us on December 12, 1988.
Oregon Administrative Rules (OAR) 340-122-225 (2) and OAR 340-122-230-(2) outline the rules for interim reporting. In addition, OAR 340-122-360 outlines final reporting requirements. A copy of these rules is enclosed for your information.
Please submit a final report, and any interim reports that may have been prepared, on the investigation and cleanup conducted at your facility by July 30, 1990. The report(s) will help us complete our review of the site. If cleanup has been completed according to our requirements, the report ( s) will help us close our file on the site.
If you have any questions concaning this matter, please call me at (503} 229-6923.
Sin~ly, ~\\ on() h 0\"/,"&/\ r ~ 0'-Dz IL /
Andree Pollock Leaking UST Specialist Northwest Region
cc: Environmental Cleanup Division, llJST Section
