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HomeMy WebLinkAboutBuilding Miscellaneous 2014-2-6 '' .x,�: Sr R-3007 J ... c C M1FZAs_T4 J L ES ` DATE • DEMOLITION • ENVIRONMENTAL • SI-FEWORK 2/6/14 ' 65386 Hwy 99 S • P.O. Box 7515, Eugene, OR 97401 CUSTDMEA (541) 726-9422 « FAX (541) 726-9837 - -' Sold City of Springfield, Attn: Matthew Ruettgers Old to SALESMAN Billing Address 225 Fifth Street, Springfield, OR 97477 Robert DeSpain Job Name 3/// TERMS • Location Franklin Blvd FOR/CONTRACT Job Description Heating oil tank removal DATE HOURS RATE TOTAL 1/17/14 ITank removal as per bid • $2,185.00 LU 2/6/14 Drum disposal, includes lab, labor,travel,,drums and disposal fees 2 325 $650.00 L3 a®` TOTAL INVOICE • $2,835.00 • • r++ • Please submit a copy of this invoice with your payment. Thank you! • ALL ACCOUNTS ARE DUE ON THE 10TH OF THE FOLLOWING MONTH.A FINANCE CHARGE OF 2%PER MONTH IS ASSESSED TO ALL ACCOUNTS PAST DUE (ANNUAL PERCENTAGE RATE 24%). PURCHASER AGREES TO PAY REASONASLE ATTORNEY'S FEES AND OTHER COSTS INCURRED FOR COLLECTION. (XE#O 371 SIGNED • • • • • • &MTON t .D. "IIPAN:fIE DEMOLITION • ENVIRONMENTAL SITEWORK 85386 HWY 999 Heating Oil Tank Service Provider PD. BOX 7515 EUGENE, OR 97401 Certification Letter (5411726-9422 FAX (5411726-9837 CCB NO. 03371 2/6/14 TANK OWNER: City of Springfield 3/// TANK SITE ADDRESS: )QO' Pranklin Blvd Glenwood,OR • DEQ CLEANUP FILE#: NONE TYPE OF PROJECT: CLEAN TANK REMOVAL Staton Companies 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. • Staton Companies is currently insured as required by OAR 340-163-0050. Sincerely, DATE SIGNED • RD L-Ht- 2/6/14 Robert beSpain, Supervisor/Project Manager Soil Matrix Cleanup Supervisor License 13489 Decommissioning Supervisor License 13148 Heating Oil Tank Supervisor Services License 18397 Staton Companies Heating Oil Tank Service Provider License 16477,Expires 02.15.2014 Yf:¢ /hit C¢ Dem9( YVi La Smarter. Faster. Safer. • s C0IM PAN II]ES DEMOLITION ENVIRONMENTAL SITEWORK 85386 HWY 995 P.O. BOX 7515 EUGENE. OR 97401 (541) 726-9422 FAX (541)726-9837 COB NO. 03371 Clean Tank Removal Report City of Sprinjreld 3// / ,3OOrFranklin Blvd. Glenwood, OR 97477 Prepared by: Robert DeSpain 2/6/14 "74e 4rf ZDernotttaoro" Smarter. Faster. Safer. • • Introduction This report is to document the activities and findings during the tank removal at 3007 Franklin Blvd, Glenwood on January 17, 2014. Tank removal and soil sampling Staton Companies removed a 740 gallon heating oil tank under the permit and inspection process of the City of Springfield. The tank measured 45" in diameter by 9' in length. The top of the tank was 48"bgs (below ground surface). The tank was in bad shape. The western end of the tank was collapsed,presumably damaged by utility trenching activities at some previous date. The south side of the middle of the tank was also dented inward,presumably from the installation of the power pole. The tank was inerted with CO2 gas. Internal tank atmospheric readings with a CGI (combustible gas indicator) showed that Oxygen level was at 3%, and LEL (Lower Explosive Level) was at 0%. With two legs of the fire triangle eliminated, the tank was safe to cut open. There was no evidence of any product release or overfilling around the fill spout. There was 4"of water in the tank at the time of opening, along with significant infiltration of dirt from the hole in the damaged end. The water was pumped and later disposed through ORRCO of Eugene on January 24. The dirt was drummed,removed, and later disposed on February 5 at Short Mtn. Landfill, as slightly contaminated soil. Soil sample results are discussed below. Documentation for disposals are enclosed. Water marks on the inside of the tank (shown in the attached photos) indicate that water levels have fluctuated over the years. In addition to soil sample PCS of the tank contents, two soil samples were obtained from 12"beneath both ends of the tank at 8' 9" feet bgs, and delivered to the lab on ice that day. The samples were collected by hand, and packed into 8 oz. wide-mouthed soil jars with Teflon-lined caps using a latex gloved hand to avoid further contamination. The samples were stored on ice and delivered by Robert DeSpain, Project Manager for Staton Companies, under Chain of Custody procedures to APEX LABS for analysis. Sampling methodology and QA/QC procedures are described in those lab reports, enclosed. No groundwater entered the pit at any time during the operation. The pit was backfilled and compacted with crushed rock that same day. The tank and product lines were recycled at Schnitzer Steel. The tank liquid contents were recycled at Oil Re-Refining Co. of Eugene. The tank solid contents were disposed at Short Mtn. Landfill. • • Sample results Sample PCS (petroleum contaminated soil) in the lab report represents the solid materials in the tank. Samples TE1 and TW I were from the east and west ends, respectively. Results of sample PCS were 488 ppm diesel and 134 ppm heavy oil range product. Lab notes indicate anomalies in the chromatograph, likely indicating the weatherized breakdown and separation of diesel oil (or heating oil) into other components. Sample results indicate both samples under the tank were non-detect,meaning no petroleum product was detected in the soil samples. No contaminated soil was encountered in the environment under the tank. Summary and Conclusions Approximately 20 gallons of oily water were pumped and recycled at ORRCO of Eugene. Two drums weighing a total of 1,640 pounds were disposed at Short Mtn. Landfill. The tank and associated piping were recycled through Schnitzer Steel of Eugene. This tank is assumed to be an old heating oil tank from a previous residence at the site. It is assumed to be heating oil and not gasoline, because the soil sample of the tank contents did not show any detection in the gasoline range of product. Heating oil tanks are not registered tanks in the DEQ(Dept. of Environmental Quality) record keeping systems. If contamination were encountered beneath the tank, if would then have been reported to and registered with the DEQ as a cleanup. No record of this work has been submitted to the Oregon DEQ because there is no requirement to do so for clean soil situations. 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'^ .l -Z` ,° '�{ .� x.- 'tr417•V r,V a..• d 'e- f' ' a` '.` v..,l'�2"$` `' -.. ;.' rr . "^y4 ` - art' "' f... n_ ,�.. "� -x4 14.E s°" ,v.'' , ,"fr s w4V% rx " ?i33. . .v «_7._'�a� _ .du+ n.. 3 > e,T. •.,;.� n • • Attachment C Lab Report • • • • • Apex Labs Tigard,S.W.Garden Place Tigaard,OR 97223 7223 503-718-2323 Phone 503-718-0333 Fax Wednesday, January 22, 2014 Robert DeSpain Staton Companies PO Box 7515 Springfield, OR 97475 • RE: Springfield/ 1/17/14 • Enclosed are the results of analyses for work order A4A0404, which was received by the laboratory on 1/17/2014 at 1:40:00PM. Thank you for using Apex Labs. We appreciate your business and strive to provide the highest quality services to the environmental industry. • If you have any questions concerning this report or the services we offer, please feel free to contact me by email at: DAuvil(a�apex-labs.com, or by phone at 503-718-2323. Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of custody document. This analytical report must be reproduced in its entirety. Darrell Auvil,Project Manager Page 1 of 11 • • Apex Labs Tigard,OR Garden Place • Tigard,OR 97223 503-718-2323 Phone 503-718-0333 Fax • • Staton Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 • ANALYTICAL REPORT FOR SAMPLES • • SAMPLE INFORMATION • Sample ID Laboratory ID Matrix Date Sampled Date Received PCS A4A0404-01 Soil 01/17/14 09:45 01/17/14 13:40 TE1 A4A0404-02 Soil 01/17/14 11:20 01/17/14 13:40 TW1 A4A0404-03 Soil 01/17/14 11:25 01/17/14 13:40 • • • • • • • • • Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of [j) custody document.This analytical report must be reproduced in its entirety. G / ( Darrell Auvil,Project Manager Page 2 of II • • • Apex Labs Tigard,S.W.Garden Place Tigard,OR 97223 7223 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 ANALYTICAL SAMPLE RESULTS Hydrocarbon Identification Screen by NWTPH-HCID Reporting Analyte Result MDL Limit Units Dilution Date Analyzed Method Notes PCS (A4A0404-01) Matrix: Soil Batch:4010379 Gasoline Range Organics ND --- 24.7 mg/kg dry 1 01/18/14 00:02 NWTPH-HCID Diesel Range Organics DET --- 61.7 " " A-Olb Oil Range Organics DET --- 123 Sudogate:o-Terphenyl(Surr) Recovery:90% Limits: 50-150% • • • • • • Apex Laboratories The results in this report apply to the samples analyed in accordance with the chain of custody document This analytical report must be reproduced in its entirety. • Darrell Auvil,Project Manager Page 3 of t1 • • • 12232 S.W.Garden Place Apex Labs Tigard,OR 97223 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project: Springfield PO Box 7515_ Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 ANALYTICAL SAMPLE RESULTS Diesel and Oil Hydrocarbons by NWTPH-Dx Reporting Analyte Result MDL Limit Units Dilution Date Analyzed Method Notes PCS (A4A0404-01) Matrix: Soil Batch:4010422 Diesel 488 --- 25.0 mg/kg dry 1 01/21/14 20:45 NWTPH-Dx A-01 Oil 134 --- 50.0 " " F-03 Surrogate:o-Terphenyl(Sun) Recovery:84% Limits: 50-150% TE1 (A4A0404-02) Matrix: Soil Batch:4010422 • Diesel ND - --- 25.0 mg/kg dry 1 01/21/1421:21 NWTPH-Dx Oil ND --- 50.0 Surrogate:o-Terphenyl(Sun) Recovery:67% Limits: 50-150% a TW1 (A4A0404-03) Matrix: Soil Batch:4010422 Diesel ND --- 25.0 mg/kg dry 1 01/21/1421:39 NWTPH-Dx Oil ND --- 50.0 Surrogate:o-Terphenyl(Sun) Recovery:50% Limits: 50-150% Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of 0 I j/ custody document This analytical report must be reproduced in its entirety. ('..^'.'y.,-V Darrell Anvil,Project Manager - Page 4 of II • • 12232 S.W.Garden Place Apex Labs Tigard,OR 97223 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project: Springfield • PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 ANALYTICAL SAMPLE RESULTS Percent Dry Weight Reporting Analyte Result MDL Limit Units Dilution Date Analyzed Method Notes PCS (A4A0404-01) Matrix: Soil Batch:4010378 %Solids 80.9 --- 1.00 %by Weight 1 01/20/14 10:10 EPA S000C • TEl (A4A0404-02) Matrix: Soil Batch:4010438 %Solids 74.4 --- 1.00 %by Weight 1 • 01/22/14 09:39 EPA 8000C TW1 (A4A0404-03) Matrix: Soil Batch:4010438 %Solids 74.2 --- 1.00 %by Weight 1 0122/1409:39 EPA 8000C • • • • Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of custody document This analytical report must be reproduced in its entirety. LIVI Page 5 of 11 Darrell Auvil,Project Manager • • •Apex Labs Tigard,S.W.Garden Place Tigard,,OR 97223 7223 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 QUALITY CONTROL(QC)SAMPLE RESULTS Hydrocarbon Identification Screen by NWTPH-HCID Reporting Spike Source %REC RPD Analyte Result MDL Limit Units Dil. Amount Result %REC Limits RPD Limit Notes Batch 4010379-NWTPH-HCID(Soil) Soil Blank(4010379-BLKI) Prepared:01/17/14 14:24 Analyzed:01/17/14 20:05 NWTPH-HCID Gasoline Range Organics ND --- 18.2 mg/kg wet 1 -- -- --- --- --- --- Diesel Range Organics ND --- 45.5 " Oil Range Organics ND --- 90.9 Surr: o-Terphenyl(Surr) Recovery: 101% Limits: 50-150% Dilution: lx • • • • • • • • Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. • Darrell Auvil,Project Manager Page 6 of 11 • • • • 12232 S.W.Garden Place • Apex Labs Tigard,OR 97223 503-718-2323 Phone 503-718-0333 Fax Staten Companies Project: Springfield • PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 QUALITY CONTROL(QC)SAMPLE RESULTS Diesel and Oil Hydrocarbons by NWTPH-Dx Reporting Spike Source %REC RPD Analyte Result MDL Limit Units Dil. Amount Result %REC Limits RPD Limit Notes Batch 4010422-EPA 3546 (Fuels) Soil Blank(4010422-BLK1) Prepared:01/21/14 09:02 Analyzed:01/21/14 20:45 NWTPH-Dx Diesel ND --- 25.0 mg/kg wet 1 --- --- --- -- --- --- Oil ND --- 50.0 " Surr: o-Terphenyl(Sun) Recovery: 89% Limits: 50.150% Dilution: Is LCS(4010422-BSt) Prepared:01/21/14 09:02 Analyzed:01/21/14 21:03 NWTPH-Dx Diesel 115 --- 25.0 mg/kg wet 1 125 --- 92 76-115% --- • Surr: o-Terphenyl(Surr) Recovery: 94% Limits: 50-150% Dilution: Is • Apex Laboratories • The results in this report apply to the samples analyed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. Darrell Auvil,Project Manager Page 7 of It • • • Apex Labs • Tigard,S.W.Garden Place V Tigard,OR 97223 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project Springfield PO Box 7515 Project Number: 1/17/14 - Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 QUALITY CONTROL(QC)SAMPLE RESULTS Percent Dry Weight Reporting Spike Source %REC RPD Analyte Result MDL Limit Units Dil. Amount Result %REC .Limits RPD Limit Notes Batch 4010378-Total Solids(Dry Weight) Soil Duplicate(4010378-DUP3) Prepared:01/17/14 14:17 Analyzed:01/20/14 10:10 QC Source Sample: PCS (AMA0404-01) EPA 8000C %Solids 79.7 --- 1.00 %by l --- 80.9 --- -- 1 20% Weight • No Client related Batch QC samples analyzed for this batch. See notes page for more information. Batch 4010438-Total Solids(Dry Weight) Soil No Client related Batch QC samples analyzed for this batch. See notes page for more information. • • Apex Laboratories The results in this report apply to the samples analyed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. Darrell Anvil,Project Manager Page 8 of 11 • • • 12232 S.W.Garden Place Apex Labs Tigard,OR 97223 503-718-2323 Phone • 503-718-0333 Fax Staton Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 SAMPLE PREPARATION INFORMATION Hydrocarbon Identification Screen by NWTPH-HCID Prep:NWTPH-HCID(Soil) Sample Default RL Prep Lab Number Matrix Method Sampled Prepared Initial/Final Initial/Final Factor Batch: 4010379 A4A0404-01 Soil NWTPH-HCID 01/17/14 09:45 01/17/14 14:24 10.01g/10mL 10g/l0mL 1.00 Diesel and Oil Hydrocarbons by NWTPH-Dx . Prep: EPA 3546 (Fuels) Sample Default RLPrep Lab Number Matrix Method Sampled Prepared InitiaUFinal • InitiaUFinal Factor Batch: 4010422 . A4A0404-01 Soil NWTPH-Dx 01/17/14 09:45 01/21/14 09:02 10.98g/5mL l0g/5mL 0.91 A4A0404-02 Soil NWTPH-Dx 01/17/14 11:20 01/21/14 09:02 11.24g/5mL l0g/5mL 0.89 A4A0404-03 Soil • NWTPH-Dx 01/17/14 11:25 01/21/14 09:02 11.23g/5mL I0g/5mL 0.89 Percent Dry Weight Prep:Total Solids(Dry Weight' Sample Default RL Prep Lab Number Matrix Method Sampled Prepared InitialFinal Initial/Final Factor Batch: 4010378 A4A0404-0I Soil EPA 8000C 01/17/14 09:45 01/17/14 14:17 IN/A/IN/A IN/A/IN/A NA Batch: 4010438 A4A0404-02 Soil EPA 8000C 01/17/14 11:20 01/21/1415:44 1N/A/IN/A IN/A/IN/A NA A4A0404-03 Soil EPA8000C 01/17/14 11:25 01/21/14 15:44 1N/A/1N/A 1N/A/IN/A NA • • • Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of • custody document.This analytical report must be reproduced in its entirety. iii,,J,, Darrell Auvil,Project Manager Page 9 oft 1 • • Apex Labs 12232 OR Carden R 97223 7223 Place Ti O 503-718-2323 Phone 503-718-0333 Fax Staton Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43. Notes and Definitions - Qualifiers: A-01 Detected fuel pattern resembles jet fuel or a similar product. A-Olb The response in the diesel range appears to be kerosene or a similar product. F-03 The result for this hydrocarbon range is elevated due to the presence of individual analyte peaks in the quantitation range that are not representative of the fuel pattern reported. Notes and Conventions: DET Analyte DETECTED ND Analyte NOT DETECTED at or above the reporting limit NR Not Reported dry Sample results reported on a dry weight basis. Results listed as'wet'or without'dry'designation are not dry weight corrected. RPD Relative Percent Difference MDL If MDL is not listed,data has been evaluated to the Method Reporting Limit only. wmsc Water Miscible Solvent Correction has been applied to Results and MRLs for volatiles soil samples per EPA8000C. Batch Unless specifically requested,this report contains only results for Batch QC derived from client samples included in this report. All QC analyses were performed with the appropriate Batch QC(including Sample Duplicates,Matrix Spikes and/or Matrix Spike Duplicates)in order to meet or exceed method and regulatory requirements.Any exceptions to this will be qualified in this report.Complete Batch QC results are available upon request. In cases where there is insufficient sample provided for Sample Duplicates and/or Matrix Spikes,a Lab Control Sample Duplicate(LCS Dup)is analyzed to demonstrate accuracy and precision of the extraction and analysis. Blank Apex assesses blank data for potential high bias down to a level equal to'''/the method reporting limit(MRL),except for conventional Policy chemistry and HCID analyses which are assessed only to the MRL.Sample results flagged with a B or B-02 qualifier are potentially biased high if they are less than ten times the level found in the blank for inorganic analyses or less than five times the level found in the blank for organic analyses. For accurate comparison of volatile results to the level found in the blank;water sample results should be divided by the dilution factor, • and soil sample results should be divided by 1/50 of the sample dilution to account for the sample prep factor. Results qualified as reported below the MRL may include a potential high bias if associated with a B or B-02 qualified blank.B and B-02 • qualifications are not applied to J qualified results reported below the MRL. --- QC results are not applicable.For example,%Recoveries for Blanks and Duplicates,%RPD for Blanks,Blank Spikes and Matrix Spikes,etc. *** Used to indicate a possible discrepency with the Sample and Sample Duplicate results when the%RPD is not available. In this case, either the Sample or the Sample Duplicate has a reportable result for this analyte,while the other is Non Detect(ND). • • Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of ((//�� ff r /11,-247 custody document This analytical report must be reproduced in its entirety. Darrell Anvil,Project Manager Page 10 of 11 • S Apex Labs Tigard,S.W.Garden Place Tigardrd,,OR 97223 503-718-2323 Phone • 503-718-0333 Fax Stators Companies Project: Springfield PO Box 7515 Project Number: 1/17/14 • Reported: Springfield,OR 97475 Project Manager: Robert DeSpain 01/22/14 15:43 e 4r a ,a R31 .�.-t f�Js l 9 c --'I - C' ti r y 3 3 I 0 1 Y, m o s.' a a. a ii c o "- lelaaacrwoa ! • �..n' Pad Sete uoa j I U q , tad,'Laoa E II a 0 •HYd YES OEM i H u n'l 3 sapn aaLS a v Y s o_ V sae OleN(Thu 1 I ' d c O E xaln MLO i MZ l'"djiauMA ■flu - xarauua _ _ j n]NNdII/V X C c ~ � U IC▪ a go Eyye g . P. n rn v1� -. I8 12 &`c}V L. i c n i ▪ t 3ti.a, 5 .. 1 S ; p�-1J r J o e, °c ct e ivc r- ,� ' z p -. b' a ac r- S ry r . M Y a P :OIBP1 l2 O 3 �acJ - < D • s w \ u m N a o 8 n v x a x m �t o• g s p C . n m 8 A .' iulq = u :7 tag f 1 - Li it; f§ g e N t ¢ Apex Laboratories The results in this report apply to the samples analyzed in accordance with the chain of custody document. This analytical report must be reproduced in its entirety. (((/ G, (A.,7-:-(2 Darrell Auvil,Project Manager Page II of II • • Attachment D Disposal Receipts • and Documents i I . • SCHNITZER STEEL PRODUCTS-EUGE111111 Highway 99 North Eugene,OR 97402(541)69• ‘. (3\--/�(� \ 1 STATON COMPANY Date: 1/27/ Q Vendor # STAT32 Check No: X154952 TICKET# SHP DATE COMMODITY GROSS TARE NET VEHICLE ID PRICE UM Flit-EX-T TOTAL AMT TIHFXT 01/27/14 #1 & #2 HMS UNPREPARED. 68200 42640 25560 STATON 230.0000 NT 0.00 2939.40 VENDOR STAT32 TOTALS (Pounds): 25560 ,� TOTAL DUE: S 2939.40 /: n c • • • • • ■ i 1 0 `I, I n i 0= 1 3n_o I'I I I _ 1 y t" _▪ e C hl _ �. T f- Lrc 3.o I I f i � �5- wu I ' O °N V I I I- U ji Z - ° F-J - I n c2 ;° Q I,...i 0 - a I _ a_ (. RD- O L.a0 0 O I u J r" I 1 C H • i -rrInr-N•ca� ssaaPPd 6uiiiig (4- c ,9 2- i. I PQnNPJNN . I rN 'U3 - - P ONp O 1 ONPO-PN0 I I I I CLL !!�� _ J - O O O '.:� CA-, O 1 °°co°°o^°°°fo r 1 IJ 1 031:1_ 0 m oQP=V,PT= • j O s..-=• 000073 ter: .r I I s 1=��.c: I O C U QQQQQQQQ �. ::c2.-- n r''',1 4 1 _T as a a aaaa E ouco• • o{ C D ( I cc > '0o ic' aO3 O✓-.1 i I - nm n_, I rc 0Tu3 rw ■ ,� 2 23(1;2 a vE 2-0 t.7 ;{mbl 1 CI I _. S mo.n'r . n O U V Cn 2 -'k JI 1 J •\ `2 wIYYEZVmVI CJi" I_. 1-- 3 0 • = I ('‘,11; ; a a-0,1e I tII • 0 VI E 0 o_u� U° — `5' _ ELI ' s = 'm c u ti �4 1` I , c� c m 5-- - •I S' ' r ` Lo o /tR9_Y I' 0 --1, • T P L m y Nn13 O I o a o O J T • DI DI I k 'I t2 I \ a 3 ,r0 • C• r0 t& -1' L .. 1 o f^mwuo r m I L u 0 O . co X11 4\I ? 1 g I ` \\. ` `-8 O 0 0 ' I E= ° ❑ O ; ° o I=U-3g 2 0 3 ' - cox 1TZ c i m n O s.0 - i� Z o . o r...-J U N o i i x o a I- w Joaeauap 'uogpodsuel d 1 I a o^O O U w • • J.I i Disposal Application I, L., I I PETROLEUM CONTAMINATED SOIL • ao„s , Office Use Only • PERMIT FEE RECEIVED ($25 ) .0 PRICE PER TON PERMIT# C 0000 DISPOSAL TO BEGIN APPROVED QUANTITY FEE TYPE ACTUAL TONS HAULED FINANCIAL LIMIT ACCOUNT NUMBER ❑ ACCEPT AS COVER • ❑ ACCEPT FOR DISPOSAL EXPIRATION DATE • SIGNATURE / y/ APPROVAL DATE GENERATOR C t f1 G1- SP""t�`�cc ,�1 (l q MAILING ADDRESS 1-�a�,c�.J(.� ET-%-C IAN_ S``r•ee-t CITY Sp 1 • ZIP 17`{17 CONTACT PERSON (NLttL 'fRVttlws PHONE 136- 163> FAX SITE ADDRESS (IF DIFFERENT) 3 p 6 7 Fvro.---V.t.” titsd CITY S rrld CONSULTANT S ttio w+ c ..,_1 6."-tom /� I1I� ADDRESS ��\ ?O ?dot 1 J Nb CITY-r5�`ctSiCXri ZIP 4:11 72E1 J • CONTACT tl�o A-- .L �Q S-aa. PHONE rZ(o' 4L(2LFAX-1126-`1 831 TRANSPORTER S \011-*� 0`^- CU 1N^"-LDO V% PHONE 12-10-�iiZn'Z FAX i Zb -q8 37 ADDRESS ? O INdlc. 1.S-1%;-- S 117 CITY .Sp-RA ZIP Ti Li 1, 1 ,«CC FAILURE TO COMPLETE THIS SECTION WILL RESULT IN RETURN OF yTH/IS APPLICATION FOR COMPLETION<C«< WHO WILL ARRANGE PAYMENT OF FEES TO LANE COUNTY? ❑GENERATOR Y`S CONSULTANT ❑l TRANSPORTER ESTIMATED TONS FOR DISPOSAL USE(1.25 TONS/CUBIC YARD) a- i� T-F,, _aar j o"�R4 C6`..-4 . cue1 v\eC 0....-\5-i- .. t.-- CONTAMINATED SOIL IS FROM: la-UST REMOVAL PROJECT ❑ACCIDENTAL SPILL ❑ MONITOR WELL DRILLINGS OTHER SOIL IS CONTAMINATED WITH: ❑ GASOLINE $ DIESEL!HEATING OIL ❑ WASTE OIL ❑ SOLVENT OTHER ARE THE CONTAMINATED SOILS A HAZARDOUS WASTE? ❑ YES ONO HAS THE SOIL BEEN EXCAVATED? J&'YES ❑NO IS THE DEO INVOLVED IN THIS PROJECT? ❑ YES(LIST CONTACT PERSON) NO THE FOLLOWING DOCUMENTS ARE ENCLOSED: TA.TEST RESULTS if-SAMPLE CHAIN OF CUSTODY ❑MAP OF SAMPLE LOCATIONS Certification of Accuracy of Information I hereby certify under penalty of perjury under the laws of the State of Oregon that to the best of my knowledge the above described waste is properly identified and is not a RCRA or Oregon State hazardous waste, and that the information given is true and complete. I have read the instructions on the reverse of this form governing disposal of petroleum contaminated soil and understand my responsibilitie51/� �� C 5M-- NAME(PRINT) U"�c'�� `�/�7—i.�,<�-\1��Pl TITLE S"r""�'r • COMPANY lL G SIGNATURE c +-�"< 1✓c-�1✓,P�' DATE ( - 2.1 - j I Return to:Lane County Waste Management Division,3100 E. 17th Ave.,Eugene,OR 97403 FAX:(541)682-2353 h/spec waste/pcsapp Regional Fax Server 1/27/2014 12 : 03 : 12 PM PAGE 2/002 Fax Server CONSO• I III III IIIII IIII III IIIII!IIIIIIIIIIIIIIIIII 11111 111111111111 Permit No. CS003679 Contaminated Soil ': Fees paid via Fee group CONSQIL Permit:expired; 4128/14`' Prepayment App raved amt 2 00 ion Penttlifee ? $25 00 recelved• (PeS only?? Application received _,Approved by Larry Gibbs Appoval date 1128114 Waste type: Contaminated Soil Waste description: Petroleum Contaminated Soil- UST- Heating Oil • • Source: Underground Storage Tank-Heating Oil Special instructions: Consultant: Staton Companies Robert DeSpain • • Site address: City of Springfield 225 Fifth st. Springfield,OR 97477 a Generator;' p77637�< Cit of S rtn field <Mailing address Contact :- Phone Hauler t}77014 , Stators Companies: <Maihng address p O 8ox7515 N \ Contadt Phone: 1541)7269422 Fat {541)72C9837 IMPORTANT INSTRUCTIONS Call Short Mt. Landfill at 726-3047 to schedule an appointment to dump your waste. Petroleum contaminated soil is accepted MONDAY THROUGH FRIDAY ONLY. Depending on conditions at the landfill,we will reserve the right to • limit the amount of soil accepted at the landfill per day. Be specific when you call for an appointment. Bring a copy of this permit with you when you go to the landfill. If you are using multiple trucks to haul your waste, be sure that every driver either has a copy of the permit or at least knows the permit number. • Failure to follow these procedures may result in long waits at the scales for your trucks or inaccurate billing. Remember,these procedures are for your protection as well as ours. • • • Page 1 of 1 1/27/14 • c� 7 of 5z a« Lane County Public Works Waste Management Division 3040 North Delta Highway • Eugene, OR 97408-1996 Site 02 Short Mt. SMScale Ticket: 7022270044 Temp: 13 Permit: 03003573 Operator: 5777 Date: 02/05/2014 In: 10:55AM Out: 11:04AM Customer: Staton Companies Account: 077014 Card: 010 In County: Yes Secured: Yes Driver: Truck: Volume: Load Gross- Wt:• 7.26 Tare Wt: 6.44 Net Wt: 0.82 Gross IBS: 14520 Tare LBS: 12880 Net L8S: 1640 Fee Tyre Description ,_- Qty Rate Fee_ 41286 Moil TN 0,82 67.00 54.94 Total Fee: $54:94 Signed -------'------- -- Lane County Ordinance 1-99 System benefit Fee Calculated at $26.45 per ton • • Attachment E • . City Permit • i . I. • • SPRINGFIELD - 225 Fifth St• , , CITY OF SPRINGFIELD Springtield,OR 97477 I'}q �;.r Phone: 541-726-3753 i;Ce.. otEGoN Building / Commercial Permit Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00092 wwwspringfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued - ISSUED: 01114/2014 EXPIRES: 07/13/2014 STATUS DATE: 01/14/2014 APPLIED: 01/14/2014 SITE ADDRESS: 3007 FRANKLIN BLVD,Eugene,OR 97403 SCOPE: Tanks ASSESOR'S PARCEL NO: 1703343300700 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Tank removal OWNER: CBS OUTDOOR INC Phone Number: ADDRESS: PO BOX 404 BROADWAY NJ 08808 l CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone • General Contractor STATON COMPANIES CCB 3371 03/21/2014 541-726-9422 INSPECTIONS REQUIRED Inspections 8480 Tanks(install/remove) By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.I further agree to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the permit card is located at the front of the property,and the approved set of plans will remain on the site at all times during construction. , Owner or Contractor Signature Date n • O ex,- fc„ Tr -), Q\�\t\ \C3 In�i lVut--t} i`t ` t ,> (�I;1 IlL rcfr r1, I., isI i . 5p•/ \`\`+` l..is I t\r 0 F. , t) number `,Or the Oley .: ,,r. ., t �ry v' ��S`` ��� n ) Center i5 �' ti`y:\r Q(�'\-\ CO� Q�\S Q• .`.c\\,,.,,, ' /G:00 0--•O 1, p\ t. Q ?:fir ,'':'' 0;� G1 , \ n FC ' • Springfield Building Permit 1/14/2014 9:26:52AM Page 1 of 1 • • Attachment F Credentials 1. � . 4 • 6 o I ,�: Oparhnent of Environmental Quality :�{, ` ` . •�� Land Quality Division v'i +� 311 SW Sixth Avenue 1a e John.4 iQtrluber,MD,Governor Portland,OR 97204-1390 (503)2_9-5696 FAX(503)229-6977 May 23, 2013 TTY 711 Robert L. DeSpain 70 Box 7515 Sorinafieeld OR 97473 RE: UST Supervisor License • You are licensed by the State of Oregon to supervise regulated underground storage tank services while employed by a licensed UST Service Provider. Your license(s) to supervise specific regulated activities are valid until the expiration date(s) below. Licensed Services Lic Nbr Expiration Decommissioning 13143 06/27/2015 Heating Oil Tanks 14397 09/16/201: Soil Matrix Cleanup 13439 05/27/2013 • Your license(s) are issued under the provisions of OAR? 340-160-005 through 340-150-150 and OAR 340-152-005 through 340-162-150. The identification card below serves as Proof = e current licensing and must b available for inspection when performing UST Supervisor activities. must _ If you have questions concerning your license please contact Steve Pal.;ko at (503) 229-5652 cr toll free (in Oregon) (800) 452-4011. Sincerely, D vCc&LCv&tt -cod' - David Livengood UST Program Manager Land Quality Division Robert L. DeSpain • • _O Box 7515 Springfield C4 47'.Z_-c . LICENSED SE?VICEsc zts. ;WIC 4 EXPIRES Decom^issionirq _ .....::0413143 O5/27/2+)15 Heating Oil Tank '` t 1333 09/15/201 Soil Ma- ea ;4i- 13439 05/27/20013 • • Supenror Siataes_ • C 4 STAB, • p 01 'Cl bL 4 I a • CD O r ° m M h n• b, r n a m n ro -- n r- n H 3 G m c c r Y L I Y tut Cr rr- t< ±i 0-I te- a a s c =. ° J CD - y 0 l- C' o 0 . CD m m rt a4 4t n G CD ® • r r m G• N 0 0 0 III! M9 r te a., N N 0 & £ .cy 0 01 CD A A Z x O CD La :� � a P Lo .n CD te fQ • a n a f o M rn Cr ', 1 (1-r m 2 ti N co - _ !A r O 0 _ Pi N N rat . 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N 3 a - B CD o m) 3 O c7)•0 3 m ^ A Po ii Z1 ti bm 1 go .� i A 3 Q z o • O Pi C N f. fil- W Q C co OW - • O A O if IL - r: -...-._..«- ..:�. ,.0 .. .r..�� ..-.2-n, m.x--t,...: ..,.: ,.. .._� ,.a,.:.<c- .-.:xr.,raa... •+a:--;�,w..-.,c�t..c.�.- e. - •