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Report (693) : ►�� • =z.rf — i3 ' 2c66— c HAHN AND ASSOCIATES, INC. ENVIRONMENTAL CONSULTANTS August 3, 2007 Mr. Ed Druback Oregon Department of Environmental Quality HOT Cleanup Program 1550 NW Eastman Pkwy., #290 DEQ File No. 34 -06 -1194 Gresham, Oregon 97030 HAI Project No. 7317 SUBJECT: Certification and Documentation of Heating Oil Tank Cleanup Activities, 11945 SW 70 Avenue, Tigard, Oregon Dear Mr. Druback: Hahn and Associates, Inc. (HAI) has completed heating oil tank cleanup activities at the above referenced property. Enclosed are the following Oregon Department of Environmental Quality (DEQ) forms and other documents: • Certified Report Cover Information • Cleanup Checklist • Generic Remedy Heating Oil Cleanup Report Form • Project Cost Summary • The $200 filing fee If there are any comments or questions regarding the report, please contact the undersigned. Sincerely, Dennis M. Terzian, .G. Project Manager dennist @hahnenv.com enclosures c: Mr. Pat Prendergast, Prendergast and Associates 434 NW 6th AVENUE, SUITE 203 • PORTLAND, OREGON 97209 -3651 y f 503- 796 -0717 Telephone • 503 - 227 -2209 Facsimile HAHN AND ASSOCIATES, INC. ENVIRONMENTAL CONSULTANTS CERTIFIED REPORT COVER INFORMATION August 3, 2007 HAI Project No. 7317 DEQ File No. 34 -06 -1194 Tank Owner Name: Dartmouth Square LLC Tank Site Address: 11945 SW 70 Avenue, Tigard, Oregon Type of Project: Tank Decommissioning / Generic Remedy Cleanup Hahn and Associates, Inc. has performed heating oil tank services at the above property and certifies that the work performed meets the appropriate requirements of OAR 340- 122 -0205 through 340 - 122 -0360 and OAR Chapter 340, Division 177. Based on information and belief formed after reasonable inquiry, the heating oil tank services performed under this certification were conducted in compliance with all applicable federal, state, and local laws. Hahn and Associates, Inc. is currently insured as required by OAR 340 - 163 -0050. • Signed b : •_� L2*r &Le 3 9 Y �,� Date: � /0 Roger E.`Brown Vice - President Licensed Service Provider Company Name: Hahn and Associates, Inc. Service Provider License Number: 16487 Expiration Date: March 15, 2008 434 NW 6th AVENUE, SUITE 203 • PORTLAND, OREGON 97209 -3651 503 - 796 -0717 Telephone • 503 - 227 -2209 Facsimile OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY Underground Storage Tank Program HEATING OIL TANK SERVICES DEQ SERVICE PROVIDER REPORT CERTIFICATION State of Department on CLEANUP CHECKLIST Department of Envlronmental Quality July 3, 2001 Form No. HOT CuCkIst.2.070301 This checklist is divided into five sections. Section A must be completed for all cleanup projects. Complete Sections B, C, D, or E as appropriate for the type of cleanup option selected. The checklist must be filled out as completely as possible and any exceptions noted for the certification to be valid. GENERAL INFORMATION Tank Owner Name: _Dartmouth Square, LLC Tank Site Address: _11945 SW 70 Avenue _Tigard, Oregon 97223 DEQ Cleanup File Number: 34 -06 -1194 Date Release Reported: 06/28/2006 Licensed HOT Service Provider Company Name: Hahn and Associates, Inc. _16487 _03/15/08 License Number Expiration Date ✓ Check each item as complete and correct. By checking any of the boxes in this checklist, you are indicating that the statement applies to this project. If there are any exceptions to the statement, please note them in the comment area provided at the end of the checklist. If the statement does not apply, please do not check the box. NOTE: TPH = Total Petroleum Hydrocarbons as diesel by method NWTPH -Dx Note: The submittal of this checklist does not replace a final cleanup report • This checklist MUST be signed and dated on page 4 Page 1 of 4 HOT Cleanup Checklist Form SECTION A - ALL CLEANUP PROJECTS O Al. The release of petroleum was reported to DEQ (OAR 340 -163- 0020(4)). ❑ A2. No free product is present or was removed during initial abatement actions. ❑ A3. Water is present at the site and DEQ was notified. Please note the name of the DEQ Staff person notified and the date of notification ® A4. A site sketch, drawn approximately to scale, is included in the report (OAR 340 -122 -0345) which clearly shows: © The location of all buildings and other key features, both man -made and natural; ® The names of adjacent streets and properties; • The location of all excavations including those that were for the removal of tanks and associated piping as well as those that were strictly for the removal of contaminated soils; El The location of all identified underground storage tanks, including those that were decommissioned as well as those that remain on the site in the vicinity of the cleanup; El All soil and water sample locations including sample depths and analytical results; and ® Location of remaining contaminated soil (for risk -based decision making and generic remedy only). ® A5. All soil and /or water samples have been properly collected, coded, stored, shipped, and analyzed as required, and chain -of- custody forms have been filled out (OAR 340 - 122 -0218, 340 - 122 -0340 and 340 - 122 - 0345). CHECK EITHER A6a or A6b, NOT BOTH A6a. Petroleum- contaminated soil has been removed from the property and properly handled, disposed of, or treated. Amount of soil taken off -site for treatment/disposal: 205 tons Disposal/treatment location: Waste Management Hillsboro Landfill, Hillsboro, Oregon ❑ A6b. No petroleum- contaminated soil removal occurred. ® A7. A report has been prepared which includes a detailed description of everything that was observed and performed at the site and contains all of the information required by (check one): ®. OAR 340 -122 -0360 and OAR 340 - 177 -0055 DEQ's "Heating Oil Tank Generic Remedy Guidance Document" (January 24, 2000) ❑ DEQ's "Risk -Based Decision Making for the Remediation of Petroleum- Contaminated Sites" (September, 1999) For Soil Matrix cleanup project, complete Section B. For Generic Remedy cleanup project, complete Section C. For Risk -Based cleanup project (simple, soil- only), complete Section D. • Complete Section E for: All sites where groundwater is encountered and soil matrix standards for closure are not met. All sites where heating oil tank constituent concentrations exceed the risk based concentrations in Appendix A of the DEQ's "Risk -Based Decision Making for the Remediation of Petroleum - Contaminated Sites" (September, 1999). Page 2 of 4 HOT Cleanup Checklist Form SECTION B - SOIL MATRIX CLEANUP ❑ B8. No contaminated soil exceeding the soil matrix level established for this site remains onsite. If a pocket of contamination exceeding the man level remains, use the appropriate checklist in Section C, D, or E instead. CHECK EITHER B9a or B9b, NOT BOTH ❑ B9a. TPH concentrations were all below 100 mg/kg. ❑ B9b. TPH concentrations greater than 100 mg/kg remain in the soil and a Matrix Score Sheet has been completed. Supporting documentation for the matrix evaluation is included in the report. This project is a (check one): ❑ Level 2 site (500 ppm TPH) ❑ Level 3 site (1,000 ppm TPH) ❑ B10. Groundwater was encountered, but no benzene, toluene, ethylbenzene, and total xylenes (BTEX) or polynuclear aromatic hydrocarbons (PAHs) were detected in water above risk -based concentrations. No BTEX was detected in soil samples collected from the soil /water interface pursuant to OAR - 340 - 122 -340. SECTION C - GENERIC REMEDY ® C8. Contamination is limited to soil only, and the remaining contaminated soil is a minimum of feet above the seasonal high groundwater level. © C9. The magnitude and extent of contamination has been clearly delineated both horizontally and vertically to at least 500 mg/kg TPH. © C 10. The volume of contaminated soil remaining in the subsurface above 500 mg/kg TPH is less than 65 cubic yards. Volume calculations are included in the cleanup report. ® C1 1. Any contaminated soil left in place is deeper than 3 feet below ground surface. a C12. The maximum heating oil TPH concentration remaining in the soil is less than 10,000 mg/kg. The maximum TPH concentration detected remaining in the soil is _2,047 (mg/kg). ❑ C13. Contaminated soil left in place is greater than 2,500 mg/kg TPH. A representative soil sample was collected from the most contaminated soil remaining at the site and analyzed for benzene. No benzene was detected in the soil in excess of 0.1 ppm. SECTION D - SOIL ONLY RISK -BASED EVALUATIONS ❑ D8. Contamination is limited to soil only. The magnitude and extent of heating oil contamination (as TPH), has been clearly delineated vertically and horizontally (OAR 340 - 122 - 0240). Note: It is often a site -by -site decision on the adequacy of this determination. Contact the Department if there are questions on this issue. ❑ D9. A sample representative of the most contaminated soil remaining at the site was obtained and analyzed. No BTEX or PAHs were detected in the soil in excess of any risk -based concentration in DEQ's "Risk -Based Decision Making for the Remediation of Petroleum Contaminated Sites" (September 1999) guidance document. Page 3 of 4 HOT Cleanup Checklist Form SECTION E - GROUNDWATER AND COMPLEX RISK -BASED EVALUATIONS Note: These certifications are complex and may require Department involvement. Please contact the Department for assistance as appropriate. ❑ E8. The magnitude and extent of heating oil contamination as TPH in soil, and BTEX & PAHs in groundwater, have been clearly delineated vertically and horizontally (OAR 340 -122- 0240). Note: It is often a site-by-site decision on the adequacy of this determination. Contact the Department if there are questions on this issue. ❑ E9. A mass balance calculation for vapor intrusion into the structure of benzene was performed using the Screening Model for Volatilization from Soil to Indoor Air at Heating Oil Tank Sites posted on the Department's web page at www.deq.state.or.us/wmcitank/volscreen.htm. ❑ E10. A detailed risk based evaluation has been conducted and the site has been found to be in compliance with OAR 340 -122- 0205 through 340 -122 -260. A detailed report documenting the finding has been prepared. General Comments: • • SIGNATURE Licensed HOT Supervisor Name: Dennis M. Terzian (please print) _20230 10/27/2007 License Number Expiration Date Check the correct box for each section completed in this checklist: Section A AND O Section B OR 121 Section C OR O Section D OR O Section E "By my signature below, I state that the information contained in this checklist is true and complete to the best of my knowledge." « Supervisor Signature: Date: �.. Note: If more than one supervisor was involved with the project, please add a second sheet with the license information and a signature block. Page 4 of 4 OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY P.411141 Underground Storage Tank Program HEATING OIL TANK SERVICES DEQ SERVICE PROVIDER REPORT CERTIFICATION State otOregon GENERIC REMEDY HEATING OIL CLEANUP REPORT FORM Department of Environmental Duality 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- 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 -06 -1 194 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, #2070, 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 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 w re moved 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 es No 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. (1ees No Any fire, explosion, and /or vapor hazards in soil or groundwater have been identified and mitigated. ® Yes 0 No ❑ NA Monitoring for hazards has continued beyond initial identification. Page 1 of 3 HOT Generic Remedy Report Form Initial Abatement Information (circle the appropriate answer) .Yes 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 oily et ycling disposal company (circle one):_Oil Re- Refinering Company 4' No Hazards posed by 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. 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. 6.Yes No Groundwater has been encountered during tank decommissioning or cleanup actions taken to -date. 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. Use 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.) ❑ Other. Describe: 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 pit. Tank was in poor condition 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 approved 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 11. Note highest TPH soil sample result prior to any excavation of soil: 46,500 mg/kg 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. Fig 3 Sketch of the property that clearly shows the sample locations and depths of all soil samples collected and identifies each 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. 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; and note any problems encountered during the cleanup or sampling process that may have affected sample integrity. Forms 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). Page 2 of 3 HOT Generic Remedy Report Forni App B Copies of all receipts or permits related to the disposal of any oil / sludge, free product, water pumped from the excavation, contaminated soil, and /or decommissioned tank and piping (circle all that apply). This data has been previously submitted to DEQ in the previously completed Heating Oil Decommissioning Report for the site completed July 16, 2007. 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.) 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/kg N/A ppm 009 E Wall 15 -15.5' bgs <32.3 mg/kg _N /A ppm 010 E Wall 5 -5.5' bgs <34.7 mg/kg N/A ppm 011 S Wall 15 -15.5' bgs 582 mg/kg N/A ppm 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, _ /A ppm 015 N Wall 15 -15.5' bgs <32 mg/kg _ /A ppm 016 N Wall 5 -5.5' bgs <33.8 mg/kg _ /A ppm 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. CO The underground tank was decommissioned following the procedures in Appendix 4 of the Guidance. ® A site assessment was conducted and the magnitude and extent of the contamination was determined in accordance with the procedures outlined in Appendix 3 of the Guidance. ® All samples were collected in accordance with methods described in OAR 340 -122 -0345. IS This project meets all of the Qualifying Criteria set forth in Section I of the Guidance. IS This project meets Remedial Action Alternative I 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? (. -ase . 'nt) (if yes, 9heck box) Signature: / Date: /3 ' >1 Supervisor License No.: 20230 Expiration Date: 10/24/2007 Licensed Heating Oil Tank Service Provider Company: Hahn and Associates, Inc Company License Number: 16487 Expiration Date: 03/15/08 0 Yes ® No Additional information is included. If yes, write in attachment label(s): _See written report Page 3 of 3 • OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY Underground Storage Tank Program HEATING OIL TANK SERVICES DEQ SERVICE PROVIDER REPORT CERTIFICATION State otOregon PROJECT COST SUMMARY Department of Environmental Duality July 3, 2001 Form No. HOT- Cost.2.070301 This form must be completed by the licensed service provider for each certified heating oil tank project submitted to DEQ. This summary must be included with the project certification cover sheet, checklist, and decommissioning or cleanup report. Upon receipt, DEQ will separate this form from the report and compile the project cost information for future reference. This form is used to record general information only and is not part of the individual file for any specific project. Complete the following information for Questions 1 through 5: 1. Date the heating oil project was complete: _06/28/07 2. County the tank site is located in: Washington 3. Project cost (what did it cost to perform the services listed below): _$18,000 4. Type of certification category (check one): ❑ Decommissioning only ❑ Soil Matrix Cleanup © Generic Remedy Cleanup ❑ Risk -Based Cleanup 5. Rate the general complexity of the project as compared to other similar projects of the same category that your company has worked on: © Normal No unusual circumstances ❑ Moderate Some difficulties encountered ❑ Difficult Problems encountered that caused increased work or other complexities Page 1 of 1 HAHN AND ASSOCIATES, INC. 25808 Check # : 25808 Vendor ID: D227 Department of Environmental Quality Date : 08/07/2007 Check Amount : 200.00 Invoice # Date Invoice Amount Gross Payment Discount Net Payment Proj. 7317 08/03/2007 $200.00 $200.00 $200.00 • 25808 HAHN AND ASSOCIATES, INC. WEST COAST BANK 434 NW SIXTH AVENUE, SUITE 203 LAKE OSWEGO, OR 97035 PORTLAND, OR 97209 -3651 96 (503) 796 -0717 CHECK NO 0 O DATE AMOUNT 08/07/2007 $200.00 th PAY THE SUM OF TWO HUNDRED DOLLARS 00/100 ONLY TO THE Department of Environmental Quality TWO SIGNATURES REQUIRED OVER $5000.00 ORDER Attn: Business Office VOID AFTER 90 DAYS FROM ISSUE DATE OF 811 SW 6th Avenue Portland, OR 97204 -1390 LL wp AUTHORIZED SIGNATURE II " 2 580811' I : L 2 3 2000881: 0 3 9000 4 7 2 911• •