Report Case Activity Listing 4/21/2008
CCEL/ 0
Case # BUP2007 -00445 2:55:20PM i
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
BUP1010 Application received 8/22/2007 None RECD BB 8/22/2007
BLD
BUP1020 Permit created 8/22/2007 None DONE BB 8/22/2007
BLD
BUP1030 Check for parcel 8/22/2007 None DONE BB 8/22/2007
tags /CWS BLD
BUPI280 Issue permit 8/22/2007 None DONE BB 8/22/2007
BLD
BUP1730 Case update (see note) 8/22/2007 None DONE JMT 8/22/2007 pump receipt received •
JMT
BUPI730 Case update (see note) 8/22/2007 None DONE JMT 8/22/2007 received environmental report from
JMT Hahn & Associates DEQ File No
34 -06 -1194
BUP 1740 Case finaled 4/21/2008 None DONE RB 4/21/2008
RB
BUP2299 Final inspection 4/21/2008 None PASS RB 4/21/2008 Septic Tank Pump Ticket dtd.
RB 6 -28 -07 attached.
Letter dtd. 4 -21 -08 acknowledges
removal of tank attached.
C�
C
Page 1 of 1 CaseActivity..rptLl
•t II'
f b Department Of Environmental Quality
, ` • ., , :. t I Northwest Region -East Side Office
• � ` � � 1550 NW Eastman Parkway, Suite 290
`.•. Gresham, Oregon 97030
The odoro R. Kulongoski, Governor �`
s s Au: , 2), 2007 (503) 667 -8414
Fax: (503) 674 -5148
C/O PREND & ASSOCIATES
1 805 SW BROADWAY STE 2070
PORTLAND, OR 97205 -3320
Re: Zimmler Development Llc
File No.: 34 -06 -1194
,: Dear c/o Prendergast & Associates:
The Department of Environmental Quality has received a report and Hahn a d Associates, fates, Inc
I;
certification concerning the heating oil underground storage tank (UST)
cleanup conducted at 11945 SW 70TH AVE, in Tigard, Oregon.
Hahn and Associates, Inc. was licensed to provide heating oil tank services and has certified that
the cleanup has met the Department's requirements. The Department has registered this report
and certification and closed its file on the project.
The decision to register the report and ts show that the project does no P omply the rules
longer apply if new or undisclosed fac
governing heating oil tank cleanups.
m
We recommend that you keep a copy of this information with the permanent property records.
4
Your efforts to comply with Oregon's environmental rules and regulations to ensure that your
1:
heating oil tank has been adequately addressed have been appreciated. Proper decommissioning
and cleanup helps ensure protection of the environment from future heating oil tank leaks and
l' ensures that the heating oil does not adversely impact human health or the environment. If you
have any questions, please feel free to contact me at (503) 667 -8414 ext. 55014.
Sincerely,
i t
1 1 Ed Druback, Manager
HOT Program
M cc: Contractor AUG 2 2 2007
1
.._ t.USt I-IoiS P. (ioC
1 it Is
r - tme - 2.0 6 4 - oo5q ( x kts
.., g t ( 5c4Sit, "W
N0 Mac (1-e-e. 4.4_, -4-4,4. c, a c)h-;evl I __..J.4
OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY
L•r
Underground Storage Tank Program
HEATING OIL TANK SERVICES
DEQ SERVICE PROVIDER REPORT CERTIFICATION
State o1Oregon
GENERIC REMEDY HEATING OIL CLEANUP REPORT FORM
Department
' Environmental
Quality July 3, 2001
Form No. HOT GRRep.2.070301
Complete this report and submit it to the DEQ NWR office within 'sixty (60) days from the date the release from a
residential heating oil tank is cleaned up. Completion of this report form satisfies the requirements of OAR 340-177 -
f 0055. Please read the Generic Remedy Heating Oil Cleanup Report Form Instructions (Form No. HOT- GRInst.2.070301)
before completing this report.
General Information
Property Owner Name:_ Dartmouth Square, LLC DEQ Cleanup File No.: 34 - - 1194
r ".' Property Address: 11945 SW 70 Avenue
City /State/Zip Code: Tigard, Oregon 97223 County: Washington
Owner Phone Number: 503- 223 -6605 (Prendergast and Associates)
Owner Mailing Address (if different):_ c/o Prendergast and Associates, 805 SW Broadway, 42070, Portland, Oregon
97204
Name of Person Reporting Release:_Matt Graves (no longer with Hahn and Associates, please contact Dennis Terzian for further
consultant information)
Phone Number (if different from Owner):_503- 796 -0717
06/28/06_ Date the release was originally suspected (e.g. water in tank) or confirmed (sight, smell, test).
06/28/06_ Date the release was reported to DEQ. Name of DEQ person contacted: by form
Note: Confirmed releases must be reported within 72 -hours by the service provider or the tank owner who
performed the work.
06/28/06_ Date the tank wa removed r decommissioned in -place (circle one).
Approximate size of tank:_425 —_ gallons
If the tank was filled in- place, what type of inert fill material was used?
How much? gallons/lbs.
06/28/06_ Date cleanup started.
06/28/07 Date cleanup completed.
Residence has been demolished Approximate square footage of home on property where the release has occurred.
Initial Abatement Information (circle the appropriate answer)
1 ke, o A visual inspection of the release has been made and immediate actions taken to prevent any further release or
migration of heating oil into surrounding soils or groundwater.
2.re . No Any fire, explosion, and /or vapor hazards in soil or groundwater have been identified and mitigated.
G ® Yes 0 No ❑ NA Monitoring for hazards has continued beyond initial identification.
U ,.
Page lof3
''n.""mm".....'wm.."
HOT Generic Remedy Report Form
Initial Abatement Information (circle the appropriate answer)
F - Y o NA As much heating oil and sludge as possible has been removed from the tank.
Gallons removed: 195 gallons (emulsified oil and water)
Name of oil cycling disposal company (circle one) :_Oil Re- Refinering Compa
4e No Hazards posed y contaminated soil that has been excavated or exposed have been remedied.
Note: Contaminated soil cannot be stored on -site for more than 30 days without a permit from DEQ.
jY
5.Yes Free product has been observed in the tank pit and/or groundwater (circle any that apply).
�. Note: Any free product observed must be removed and properly treated/disposed. Use of the Generic Remedy for
Heating Oil Tank Releases is not appropriate if free product is present.
it• 6.Yes C� Groundwater has been encountered during tank decommissioning or cleanup actions taken to -date.
r Note: DEQ must be notified immediately when groundwater is encountered at any time
■ Yes No Water in the tank excavation was encountered and pumped out, but did not recharge after 24
hours.
? I of the Generic Remedy for Heating Oil Tank Releases is not appropriate if water recharges into the
excavation 24 -hours after initial pumping.
7. How was the release initially discovered? (Check any boxes that are correct)
® During tank decommissioning
❑ During a site assessment not associated with tank decommissioning (e.g. for property transaction, etc.)
F. ❑ Other. Describe:
ii
8. What observations were made about the tank condition when it was removed from the excavation or decommissioned in-
,. place? Describe: Evidence of impacted soil was observed in walls and floor of the UST wit. Tank was in poor condition
t with pitting and holes
9. How much contaminated soil was removed? _205 tons What was done with the contaminated soil?
(Check any boxes that apply)
® Disposed of at:_Waste Management Hillsboro Landfill, Hillsboro, Oregon (name of disposal company)
❑ Treated off -site at: (name of treatment company)
❑ Treated on -site. ATTACH copy of Solid Waste Letter of Authorization permit approv by DEQ.
❑ Yes ❑ No On -site treatment of contaminated soil is complete.
10. How was the cleanup conducted? Describe actions taken during cleanup and note any unusual circumstances:
Soil removal based on field screening and confirmation testing
1 I . Note highest TPH soil sample result prior to any excavation of soil: 46 500
mfg TPH -Dx
,': 12. The following information must be ATTACHED as part of this report (clearly label each attachment as listed below):
See Written Report
Label ID
Fig 2 Site map, drawn roughly to scale, showing the location of all buildings on the property and on adjacent properties and the
location of the heating oil tank. Include distances in feet between objects.
i.
;: Fig 3 Sketch of the property that clearly shows the sample locations and depths of all soil samples collected and identifies each
W <` location and sample with an unique sample identification code. An additional cross- section diagram may be necessary to
clearly show sample locations at- depth.
App C Copies of chain -of- custody forms for all soil samples collected.
'�y Note: Chain -of- custody forms should include the date, time, and location of each sample collected; the name and company
of the person collecting the samples; a description of how the samples were collected, stored, and shipped to the laboratory;
it .-. and note any problems encountered during the cleanup or sampling process that may have affected sample integrity. Forms
,vks:' . should clearly state the address of where samples were collected as a unique identifier.
App C Copies of all laboratory data reports. Test methods used, including method reporting limits, must be included. Include data
` .. for all samples, even if data is not used in summary (question #13).
fw
a. f= Page 2 of 3
r'if HOT Generic Remedy Report Form
41
App B Copies of all receipts or permits related to the disposal of any oil / sludge, free product, water pumped from the excavation,
i
i
o
{ contaminated soil, and /or decommissioned tank and tin (circle all that apply). This data has been previously
` piping t; ( PP Y)
submitted to DEQ in the previously completed Heating Oil Decommissioning Report for the site completed Jul 1
2007. p y 16,
` App A Any photographs taken at the time of the heating oil tank decommissioning and cleanup that depict major activities (e.g. tank
' : as it is removed to note presence or absence of pits or holes, contaminated soil handling, excavation, tank /excavation in
relation to home, unusual circumstances, etc.)
;,;,,
1. 13. Provide a summary of the concentrations measured in the FINAL round of soil samples from each sample location that
clearly show the extent and magnitude of the contamination.
•
Note: Write in the specific unit of measurement for each contaminant if different. Write in "N /A" if sample was not •
analyzed for Benzene. Use additional pages as necessary to report final summary results.
Sample ID Location ID
TPH-Dx Conc. Benzene Conc.
008__ Base 18' bgs <34 mg/k8 N/A
PPm ,
<32.3 bgs .
009 E Wall 15-15.5' b < mg/kg N /A
PDm
010 E Wall 5 -5.5' bgs <34.7 mg/kg N/A
PPm
01 1 S Wall 15 -15.5' bgs 582 mg/kg N/A
ppm
r . 012 S Wall 5 -5.5' bgs <37.4 mg/kg N/A ppm
013_ W Wall 15 -15.5' bgs 2,047 mg/kg N/A
ppm
014 W Wall 5 -5.5' bgs <35 mg/kg N/A
1) PPm
t 015 N Wall 15 -15.5' bgs <32 mg/kg N/A
ppm
_,. 016 N Wall 5 -5.5' bgs <33.8 mg/kg N/A
ppm
L ip Final Report Checklist and Signature
_" All of the following boxes must be checked indicating that the action has been taken and /or procedures followed correctly.
Completing this information does not substitute for service provider checklist certification requirements in OAR Chapter 340,
Division 163. The person signing this report must ensure that this information is correct. "Guidance" refers to the Heating Oil Tank
Generic Remedy Guidance Document.
® The cleanup project is for a release from a residential underground heating oil tank (a tank used primarily for single - family
dwelling purposes; OR
.: ❑ The cleanup project is for a commercial underground heating oil tank. On a separate attachment, describe why use of the
generic remedy for residential tanks is appropriate to use for the commercial tank.
® A report of the discovery of contamination from a leaking heating oil tank was made to the appropriate DEQ regional office.
® The underground tank was decommissioned following the procedures in Appendix 4 of the Guidance.
1' 10 A site assessment was conducted and the magnitude and extent of the contamination was determined in accordance with the
4. procedures outlined in Appendix 3 of the Guidance.
® All samples were collected in accordance with methods described in OAR 340 -I22 -0345.
• ® This project meets all of the Qualifying Criteria set forth in Section 1 of the Guidance.
® This project meets Remedial Action Alternative 1 of the Guidance; OR
❑ This project meets Remedial Action Alternative 2 of the Guidance.
"By my signature below, I state that the information contained in this report is true and complete to the best of my knowledge."
Name of person preparing report Dennis M. Terzian ® Licensed Cleanup Supervisor?
( f ,
k / ase . t) (if box)
t Signature:
a— Date: �3 �J l—
Supervisor License No.: 20230 Expiration Date: 10/24/2007
v r.
Licensed Heating Oil Tank Service Provider Company: Hahn and Associates, Inc
Company License Number: 16487 Expiration Date: 03/15/08
❑ Yes ® No Additional information is included. If yes, write in attachment label(s): _See written report
i i .
Page 3 of 3