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20050872.pdfDATE RECEIVED PERMIT EXPIRES �. c CITY OF EDMONDSt IER *027 CONSTRUCTION PERMIT APPLICATIS 9 (�(' l 'SUITEiAPT# OWNER NAMEINAME OF B SIIN'ESS`Lk c IP IL vV1MEISUBDIVISION NO. LOT NO. LID NO. MAILINGADDRESS { � ��V/LID FEE $ 43 �/1//�'lRIGHT OF WAY PER OFFICIAL STREET MAP TESCP ApprovM/ ©. 1+ O ` (r tJ' �' -RW Permit Rertwred UStreet Use Permit Required 0CITY ZIP TELEPHONEG _ PROPOSED Inspection Sidewalk Requeod ED DEDICATION FT Underground OWmn r. mrodNAMSIZE LINE SIz� NO. OF FIXTU� PRV REQUIREDr/ YES NOI, z �/ �'wADDRESS S w ICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Z z w NAMES(� CB ENGIN ERING REVIEW BY ADDRESS l/ I -a1 i S CQ,rL 6 rr 14 p n5 , I AV Ac Iq iTA E LICE E NUMBE EXPIRATION D TE � ECKEO BY' VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA SA a �C- b 3 6 1 O� � / REQ'D COMPLE REAIPT OYES NO X 'ROPER TAX ACCO T A%RC�EL NO. %'� n I^ CA# � '^ D ZONE SIGN AREA HEIGHT D `+ � " 3 4 v I STUDY R O B r4 ALL�D PROPOSED ALLO 02 0 PROPOSED ❑ NEW ❑ RESIDENTIAL1:1PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.)) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR t7 rM ERCIAL COMPLIANCE OR �� N 0 �rrN &e.+ i ADDITION ❑ CHANGE OF USE z USE PARKING LOTAREA PLANNING REVIEWED BY DATE g ❑ REMODEL ❑ MULTIFAMILY ❑ SIGN REO'D PROVIDED / �-' ��✓1%i ivl Or6�25/0 5 CL GRADING FENCE �' ❑, REPAIR ElCYDS ❑ ( X FT.) REMARKS tTANK 1:1 OTHER iVV ❑GARAGE o RETAINING WALL FIRE SPRINKLER • . CARPORT ❑ ROCKERY ❑ FIRE ALARM (TYPE OF USE, BUSINES OR ACTIVITY) EXPLAIN: TYPE OF CONSTRUCTION CODE OCCUPANT �j, GROUP79t'2. C4*4k� NUMBER NUMBER OF .OF DWELLING SPECIAL INSPE TION CONSULTANTOCCUPANT STORIES UNITS LOAD DESCRIBE WORK TO BE DONE REQUIRED YES MA p .� [� HAL I REMARKS NR "" fYIAFiSHAL GEOTECH REPORT iviluej BY: CAP STRUCTURAL DESIGN BY: VALUATION Description FEE Description FEE ,ALMS —�"7 Plan Check O + Q1 State Surcharge HEAT SOU CE LOT SLOPE% VESTED DATE Building Permit �5� , �� City Surcharge r (� PLAN CHECK NO:G�� Plumbing Base Fee 14 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC E DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. e Engr. Review PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) L PERMIT LIMIT: SEE ECDC 19.00,005(A)(6) SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit#a70 , G Li IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF li E EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # C ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt, Due = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; THAT I AM THE.OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the THE OWNER. I EEY WITH CITY AND STATE LAWS REGULATING CONSTRUC• CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND 1 01 H . WORK THORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOL LABOR ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WO 'S OM SATION IN URANCE AND RCW 18:27. C OF L TU DAT y� NAT RE (0 ER O AG T): DATE ;GNE (42 S) �t %� %1 " n r (� if `J 771-0220. RELE ED BY ATE AT ' EXT. 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGI L -FILE • EL W - I PECTOR FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC1091 IBC110 1 IRC1101 PI. OWNER • D - ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES O owlm M m 0 co m0 O C mmi _ M mm Z p -I C z r = O �. mM ON e M S' CD ? Z� X I � D z 2 0 z O m i ZIP FIRER VIE ED BY • DATE tY w TELEPHONE CITY I AV Ac Iq iTA E LICE E NUMBE EXPIRATION D TE � ECKEO BY' VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA SA a �C- b 3 6 1 O� � / REQ'D COMPLE REAIPT OYES NO X 'ROPER TAX ACCO T A%RC�EL NO. %'� n I^ CA# � '^ D ZONE SIGN AREA HEIGHT D `+ � " 3 4 v I STUDY R O B r4 ALL�D PROPOSED ALLO 02 0 PROPOSED ❑ NEW ❑ RESIDENTIAL1:1PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.)) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR t7 rM ERCIAL COMPLIANCE OR �� N 0 �rrN &e.+ i ADDITION ❑ CHANGE OF USE z USE PARKING LOTAREA PLANNING REVIEWED BY DATE g ❑ REMODEL ❑ MULTIFAMILY ❑ SIGN REO'D PROVIDED / �-' ��✓1%i ivl Or6�25/0 5 CL GRADING FENCE �' ❑, REPAIR ElCYDS ❑ ( X FT.) REMARKS tTANK 1:1 OTHER iVV ❑GARAGE o RETAINING WALL FIRE SPRINKLER • . CARPORT ❑ ROCKERY ❑ FIRE ALARM (TYPE OF USE, BUSINES OR ACTIVITY) EXPLAIN: TYPE OF CONSTRUCTION CODE OCCUPANT �j, GROUP79t'2. C4*4k� NUMBER NUMBER OF .OF DWELLING SPECIAL INSPE TION CONSULTANTOCCUPANT STORIES UNITS LOAD DESCRIBE WORK TO BE DONE REQUIRED YES MA p .� [� HAL I REMARKS NR "" fYIAFiSHAL GEOTECH REPORT iviluej BY: CAP STRUCTURAL DESIGN BY: VALUATION Description FEE Description FEE ,ALMS —�"7 Plan Check O + Q1 State Surcharge HEAT SOU CE LOT SLOPE% VESTED DATE Building Permit �5� , �� City Surcharge r (� PLAN CHECK NO:G�� Plumbing Base Fee 14 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC E DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. e Engr. Review PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) L PERMIT LIMIT: SEE ECDC 19.00,005(A)(6) SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit#a70 , G Li IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF li E EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # C ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt, Due = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; THAT I AM THE.OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the THE OWNER. I EEY WITH CITY AND STATE LAWS REGULATING CONSTRUC• CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND 1 01 H . WORK THORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOL LABOR ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WO 'S OM SATION IN URANCE AND RCW 18:27. C OF L TU DAT y� NAT RE (0 ER O AG T): DATE ;GNE (42 S) �t %� %1 " n r (� if `J 771-0220. RELE ED BY ATE AT ' EXT. 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGI L -FILE • EL W - I PECTOR FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC1091 IBC110 1 IRC1101 PI. OWNER • D - ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES O owlm M m 0 co m0 O C mmi _ M mm Z p -I C z r = O �. mM ON e M S' CD ? Z� X I � D z 2 0 z O m I i, i I I I i UST Closure and Site Assessment Report November 5, 2005 Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington x Table of Contents Executive Summary adommoomes emonsomme*666 *assumed........ :...:... ....:. ..... ..:....:...1 1.0 Introduction ..........2 .............................................. ...... ...........................ease. .... .... It 1.2 Site Location and Description.........:........ . 2 2.0 Site Conditions ............... .............3 0 > .......... .. 0 2.1 Health and Safety ...:.......:.......... :. 4...00.6... 3 2.2 Utility location identification 3 . 3.0 UST Closure & Site. Assessment Activities —adds an ::..: ............. 4 3:1 Product Distribution Disassembly......... k' 3.2 UST Decommissioning and Removal... 4 3.3 UST Inspection ...................... C h v 1� ... .4 m 0 4.0 UST Site Assessment ......5 ''O n' 5.0 Summary & Conclusions... ••••••6 omegas C t> mz 6.0 Standard Limitations ••• ... 6 10 Mai C Z FIGURES 1z >;« Y I Sy I WEEN FIGURE 1 - SITE LOCATION MAP FIGURE 2 -UST SITE MAP a" 1 '� r. FIGURE 3 -SAMPLE LOCATION MAP ! t. FIGURE4 -PROJECT PHOTOGRAPHS - 3 SHEETS m E+: N TABLES i 0 TABLE.1 am SOIL SAMPLE ANALYTICAL RESULTS N "• i MTCA CLEANUP CRITERIA -METHOD A UNRESTRICTED LAN USE P M 0 k ATTACHMENTS ATTACHMENT A LABORATORY ANALYTICAL RESULTS . � L , LABORATORY CERTIFICATION j ATTACHMENT B - UST 30 DAY NOTICE : ; UST CLOSURE & SITE ASSESSMENT NOTICE it UST SITE ASSESSMENT CHECKLIST ATTACHMENT C - UST DECOMMISSIONING CERTIFICATION O1 t UST DECOMMISSIONING PERMITS - UST CLEANING & DISPOSAL CERTIFICATION rn PRODUCT TRIPLE RINSE DISPOSAL CERTIFICATION PROJECT PROFESSIONAL'S CERTIFICATIONId Ir . .. L Environmental Management Service, LLC Page ii z UST Closure and Site Assessment Report November 5, 2005 Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington Executive Summary .Environmental Management Services completed an. underground storage tank site assessment s as required by Washington administrative code (WAC) 173-360 during the decommissioning and closure of one (1) -12,000 gallon UST located at 23601 Edmonds Way, Edmonds, Washington z ..' The UST associated piping including the pump island was dismantled, excavated and removed m on October 4, 2005, The 12,000 gallon steel diesel fuel .UST was excavated and removed from the site for disposal on October 5, 20050 ca q vm Confirmation samples were collected from below the UST, from the perimeter of the UST m o excavation at 8 to 10 feet below ground surface (bgs), from the excavation floor beneath the Or O former. UST fill pipe area at 10 to 11 feet bgs, from the excavated soil stockpile, and one sample from under. each of the four fuel dispensers (Figure 3). Each sample was analyzed for diesel m range petroleum hydrocarbons (DRO) by method NWTPH-Dx. Samples were analyzed at c — z Freidman & Bruya, Inc. a Washington Department of Ecology (Ecology) accredited laboratory. Sample S1 -P11 was reported containing 8,700 .mg/kg diesel range, hydrocarbons (C10 -C25), �.' exceeding the Model Toxic Control Act (MTCA) Method A (MTCA-A) Cleanup Criteria of 2000 mg/kg. The remaining samples were reported by the laboratory below the MTCA-A cleanup m rn O N criteria. r 0 ro Approximately 10 cubic yards of petroleum contaminated soil (PCS) was excavation_ from the r Z north end of the former pump island. The soil was transported to Rinker Materials in Everett, f Washington a licensed disposal facility disposal. Additional samples were collected from the i � . excavation area immediately below the former northern fuel dispenser. Samples S14 and S15, ! collected from the north and south excavation floor at 48 inches bgs were analyzed by Friedman } z & Bruya for diesel range hydrocarbons and reported below the MTCA-A cleanup criteria. Z Following UST closure and site assessment activities, the excavation was backfilled using imported pit run. Imported pit run (medium to coarse grained sand with 2 inch minus rounded m gravel) was used to backfill the excavation from 10' bgs to the 6" bgs. Backfill was placed in 24 inch lifts and compacted. Crushed rock (5/8 minus) was used to top the excavation area. A dewatering well was installed on the excavation .during the backfill process extending from the 71 surface to 12 feet bgs. r is { � •. ., i ,.. Page Environmental Management Service, LLC rfj UST Closure and Site Assessment Report November 5, 2005 Ecology Site ID: 9046 23601 Edmonds Way s Edmonds, Washington ?; 1.0 Introduction 1. Environmental Management Services, LLC (EMS) has prepared this underground storage tank 01, (UST) closure and site assessment report on behalf of Laurelhurst Oil Company located at "' 7040-26Avenue NE Seattle, Washington 98115. ` Z' o r' UST closure and site assessment activities were completed in accordance with the following documents published by the Washington State Department of Ecology (Ecology) by an Ecology 1 licensed UST Site Assessor: Co. Relevant Publications: a m `t - rn a • Guidance for Site Checks and Site Assessments for Underground. Storage Tanks (Ecology -i00 F , O s' 02/1991);M. _ 1 • The Model Toxics Control Act Cleanup Regulation, Chapter 173-340 WAC (Ecology, m l 02/2001); C z • Collecting and Preparing Soil Samples for VOC Analysis- Ecology Memorandum Number 5, June 2004. ca t . f " _ 0 The P scope sco a was to provide. UST closure and site assessment services during the I ! . , decommissioning and closure of one -12,000 gallon diesel underground storage tank (UST). mFn �'. Soil samples were collected from the UST excavation side walls and excavation floor and C 0 col 4 excavated soil stockpiles following soil and groundwater remediation activities. r M !It<' I Each discrete. soil sample was submitted to Friedman & Bruya, Inc. under industry .standard' chain of custody protocols. All confirmation. soil samples were reported below the laboratory reporting limits for DRO and below the MTCA-A cleanup criteria. y z s 1.2 Site Location and Description Z f„ O The subject site, Ecology site number, 9046, is located at 23601 Edmonds Way, Edmonds P Washington. The area is developed for mixed commercial and residential use. The adjacent m properties to the north and south are commercially developed. The property to the east and west is developed for multi-family use. 1 Id (' 1 1 1. Environmental Management Service, LLC Page z 1: rp UST Closure and Site Assessment Report Novembers, 2005 Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington 41 2.0 Site Conditions The site has been operated as a commercial fueling station for the last 15 years. The UST was located near the center of the property. under a canopy and east of the pump island. Four fuel dispensers were located on the pump island. The developed area of the property is paved with z; areas of landscaping. There is an undeveloped area east of the UST. a The surface topography is sloped to the north. A storm water catch basin is located. on the m north end of the site, discharging stormwater into the City of Edmonds storm water conveyance N system. The remaining site utilities are located on the north end of the site. Water was o disconnected during the excavation activities. Power and telephone remains connected to the m O_ ; site's maintenance. shed, located west of the UST excavation area, p n 2.1 Health and Safety i rn z . i Asite-specific Health and Safety Plan was prepared in accordance with Chapter 296-62 of the > z t ' Washington Administrative Code (WAC) and 29 CFR 1910.120 (Code of Federal Regulations). The HASP identified potential physical and chemical hazards and specified personal protection O an t` and safety monitoring requirements. Site health and safety meetings were conducted during beginning of each workday to review aspects of the HASP, and to provide an �_ fieldwork at theg g Y opportunity for EMS site workers and contractor personnel to discuss health and safety issues p cern. or concerns. On-site personnel associated with the field activities were required to be familiar c CO with and comply with provisions put forth in the HASP. Subcontractors on-site were required to m n have their own HASP that identified potential physical and chemical hazards associated with �rt their own work activities. 2.2 Utility location identification z t Prior to implementing UST decommissioning .activities at the Site, the public underground P 9 , Utilities alert network was notified of intrusive excavation activities. The service contacted z appropriate agencies.or companies with underground utilities in the area. These agencies then . n marked the location of their utilities along the right-of-ways and easements of the property: rn 4 . Environmental Management Service, LLC Page 3 UST Closure and Site Assessment Report F November 5, 2005 z: Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington 3.0 UST Closure & Site Assessment Activities Laurelhurst Oil Company hired EMS to complete UST site. assessment activities and project , oversight during the decommissioning of 1-12,000 gallon diesel fuel UST. Saybr Construction, Inc. (Saybr) was hired as the UST decommissioning company. E, ( Y) 9 p Y z O t 3.1 Product Distribution Disassembly m The fuel system dispensers and associated piping were removed on October. 5, 2005. Each ` �q wn dispenser was drained and removed. Concrete covering the UST was removed and the soil rn fi covering the USTs excavated and stockpiled south the excavation area (Photo 10). The top of c m the UST was approximately three feet bgs and the piping was approximately twenty four inches bgs. The UST was prepared for removal by draining and disconnecting all associated piping O e z then removing the UST product piping. Temporary vent lines were installed on the UST to allow m m for proper venting during carbon dioxide inertion. C 3 z 3.2 UST Decommissioning and Removal r Saybr utilized a vacuum pump truck (Petroleum Reclaiming Services) to remove any remaining liquid from each UST. Once emptied, each UST was triple rinsed with water (Photo 05). The _ mm liquid was disposed of at Petroleum Reclaiming Service, a licensed local disposal facility. v Co Co Following UST triple rinsing activities each UST was interted. Saybr provided decommissioning n Fn C Ca oversight and used bottled carbon dioxide (CO2) to inert the UST. Approximately 2 pounds of CO2 was used for each 100 gallons. The UST was filled with CO2 until oxygen levels were r z below 6%. Following the UST cleaning and inertion, the UST was removed from' the excavation and transported to off site for disposal. All site activities were completed under the supervision of ` z Stephen Spencer; Ecology licensed UST Site Assessor and Mickey McAloon, Ecology Licensed UST Decommissioner. Z` .3.3 UST Inspection rn � rn The UST was inspected for signs of deterioration or evidence of a release following remove! from the excavation. The .UST was constructed of steel and appeared in excellent condition (Photo 09). UST tightness records were reviewed and showed the USTs and associated system to be tight. Page 4 Environmental Management. Service, LLC i UST Closure and Site Assessment Report November 5, 2005 ; Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington F 4.0 UST Site Assessment IT Confirmation samples were collected from below the UST at approximately 10 to 11 feet bgs, from the perimeter of the UST excavation at 8 to 10 feet bgs and from the excavated soil stockpile at three locations (Figure 4). Subsurface soil consisted of sandy loam with organics to 18 inches bgs. Medium to course grained sand was observed within the UST excavation area O .. from 18 inches bgs to a depth of 11 feet bgs. Extremely dense silty fine grained sand .with few � cobles was observed on the excavation sidewalls from 18 inches bgs and along the excavation PI floor below 11 feet bgs. -n Each confirmation sample was analyzed for diesel range petroleum hydrocarbons (DRO) by c m method NWTPH-Dx. In addition to the DRO analysis, sample. S1-PI1 was analyzed for volatile m O aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Samples were analyzed O C at Freidman & Bruya, Inc. a state accredited laboratory. m m 3 Z S Each confirmation sample with the exception of S1-PI1 was reported by the laboratory below y z the Unrestricted Model Toxic Control Act (MTCA) Method A Cleanup levels of 2000 mg/kg. rn Sample (S1-PI1) collected from below the northern pump island at 24 inches and sample S10- m PI1A collected from the same location at 30 rinches bgs were reported containing diesel range m hydrocarbons at 8,700 mg/kg and 18,000 mg/kg respectfully, exceeding the MTCA Method A m m (MTCA-A) Cleanup Level of 2000 mg/kg (Table 1). Additional excavation of this area was o in completed to a depth of 48 inches bgs, approximately 18 inches below the. original sampling c N depth (Photo 13). Impacted soil was transported to Rinker' Materials, .a licensed petroleum rn IT contaminated soil disposal facility, in Everett Washington. Impacted soil was treated by indirect r thermal desorption. Samples S14 -N and S15 -S were collected from the floor of the excavated area beneath the } Z former northern pump island. Each sample was analyzed for diesel range petroleum hydrocarbons and reported below the MTCA-A cleanup criteria. 0. No groundwater was observed during UST closure activities. n { rn . Soil sampling and analytical reporting for this project was based on the current MTCA UST: site assessment and soil sampling guidelines. : E Page 5 Environmental Management Service, LLC ( . UST Closure and Site Assessment Report November 5, 2005 Ecology Site ID: 9046 23601 Edmonds Way Edmonds, Washington Each discreet sample was analyzed for (Table 1): • Benzene, Toluene, Ethylbenzene & Xylene Range (BTEX-Volatile Aromatic - Hydrocarbons) - Method 8021B Sample (S1 -PI 1 Only) ° Diesel -range Hydrocarbons (DRO) - Method NWTPH-Dx z O Sampling protocol was derived from the "Guidance for Site. Check and Site Assessments for rn - Underground Storage Tanks, Ecology October 1992 and "Collecting and: Preparing Soil Samples for VOC Analysis (Method 5035) - Ecology Memorandum Number 5, June 2004".ca -+ t During the soil sampling activities, several field -screening techniques were utilized: m o 01. r , O Olfactory Observations c 1 =m. Visual Observations MZ • Sheen Test 5.0 Summary & Conclusions ''AA V/ q` 0� The UST and the associated piping was effectively decommissioned and closed according to Department of Ecology guidelines. Subsurface soil was characterized adjacent to and below rn m each UST location, from associated piping and fuel distribution equipment. Confirmation soil o N samples were collected from the excavation perimeter sidewalls, from the excavation floor, from c the excavated soil stockpile and from below each of the former UST dispensers (Figure 3). A N r Z n de-minimis amount of petroleum contaminated soil was confirmed and removed from below the -f northern fuel dispenser and disposed off site at Rinker Materials, a licensed disposal facility. 1 Additional soil samples were collected following the removal of the impacted soil and each were i -+ reported below MTCA-A cleanup criteria, No groundwater was observed during UST closure E. activities. Each discrete confirmation soil sample .was reported by the laboratory below the Model Toxic p Control Act method A cleanup criteria for unrestricted land use. No further action regarding this n UST system closure is warranted. M 6.0 Standard Limitations The findings and conclusions documented in this report have been prepared for the specific P. application to this project and have been developed in a manner consistent with that level of care and skill normally exercised by members of the environmental science profession currently f Environmental Management service, LLC. Page 6 f PXl t ItI IT c ,.� � 236th 'Street SW !)4Ill tit' ii , If I IN ,�fqT L;� i. 'C�`/ G tF k til• .•�jF {[?� a'a.• hiji ni' i' f1.Ifff I If 1 ' , r': 1 •''F l •1 4; r„ Concrete Curb w l� e VIP fiuck Extt i':• If P'l pI r,It ftIf If If I S CSW ry, yi 3r Yi a j i .Sr� ■ ff 1 f. t t eIdly. 's8 Sir 41At , lIf Tr it1•,1 ' +t F' '` J cr Y. n-('♦ T ,l a` 'a , r ' '~•' .. 1 NRIV IY ' -^ ' . •'�P,J d FI - 1:`y1 i A (yyj' •"t r c • S t{ I ; O _ YQ „�^�Y t , Sj • Zvi. 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Excavation area -North end of pump island Excavation area north end of pump island I n M `Photo.15 (Photo 16 T om m 0 -1 O O c t = m m Z y j• trk .• K C Z VVn k .jc = mm 0 Straw placed for erosion control Straw placed for erosion control 0 Cn U) Photo 1 Photo 8 r Z m ;1*4h D 1{ Z O y 0 - f 4 r r•dttn � ��r{y t m I �~R.,�_ '•,: 6KC �""f.�'3yy�'t 4pp\+31 ," x•/T tiit� l,.r Z'�' AV ..^ a .aG• 4jii� J , ' < •rot`s .. X . ,, fly,,�,i:ry'7`�+i�µ,►*,r�ti'i'.. ��,yt' [s:v[;i Excavation area following UST closure Excavation area following backfill placement .:.Ind lrr+fling __..,w...«_ Project Photographs Date: November 5, 2005 Fir�urr: lucf Completed: S.Spencer a UST Closure & Site Assessment P 23601 Edmonds Way Checked By: S.Spencer a.. Edmonds, Washington Environmental Services Stlecl t�.i Of 03 www.e rou llc.com i 'Environmental Management Services, 1_I_c i I. .. ti .. •.a,Ilk .. 'sa a 4t -'fi Un 1 -!.: 'r ^eK 'jN•4:fa+' fiMry^'t.^.xl -,C:. 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Y.'l.. r.. .. ..1 [> 1'�rA' 4+ItR'+rZS«YF`vrl 4r11�ii.tS.�N lri.T1R?ia^..'}}4�..ataid . P :^ tIlk {r. GAMES AAggg@ GASPAR f • j LT qy i ct. m ,, o • � R IiIY IRAN, til 10 0 T rnrn T N Ilk c r Co I t, - , 51 •. eli MIMI .. - m. t, 'P4M \i I 1 i 4 i y ,x f , Sample Date Diesel mg/kg Heavy oil mg/kg Volatile Aromatic Hydrocarbons (8021b) — Sample Number Sample Location Sample Depth Benzene mg/kg Toluene mg/kg Ethylbenzene mg/kg Xylenes mg/kg . 10/05/05 8700 1<250 <0.02 <0.02 1 <0.02 <0.06 S1-Pl1 Northern Pump Island 18" bgs 10/05/05 <50. <250 N/A N/A N/A N/A S2 -Floor West Excavation Sidewall 7-9 ft S3 -NSW North Excavation Sidewall 8-10' bgs 10/05/05 530 <250 N/A N/A N/A N/A S4-ESW East Excavation Sidewall. 8-10' bgs 10/05/05 <50 <250 N/A N/A N/A N/A. S5 -WSW West Excavation Sidewall 8-10' bgs 10/05/05 <50 <250 N/A N/A N/A N/A S61SSW South Excavation Sidewall 8-10' bgs 10/05/05 <50 <250 N/A N/A N/A N/A S7 -SP1 Stockpile Sample 1-2 ft 10/05/05 <50 <250 N/A N/A N/A N/A S8 -S!32 UST 3: excavation floor 10-12:ft 10/05/05 <50 <250 N/A N/A N/A N/A S9-SP3 UST 2: excavation floor 10-12 ft 10/05/05 65 <250 N/A N/A N/A N/A S10 -P11 Pump Island 01 30" bgs 10/06/05 18000 <250 N/A N/A N/A NIA S11 -P12 Pump Island 02 30" bgs 10/06/05. 190 <250 N/A N/A N/A N/A S12-1313 Pump Island 03 301f.bgs ; 10/06/05 30" bgs I 10/06/05 280 <250 N/A N/A N/A N/A 180 <250 N/A N/A NIA N/A S13-1314 Pump Island 04 f, MICA Cleanup Regulation 173-340-900 ' f Table 740-1 Footnotes: Method A Soil Cleanup Levels a Caution on misusing this table. This table has been developed for Unrestricted Land Uses.* for specific purposes. It is intended to provide conservative cleanup levels for sites undergoing routine cleanup actions or for Hazardous Substance CAS Number Cleanup Level sites with relatively flew hazardous substances, •and the site qualifies under WAC 173-340-7491 for an exclusion from Arsenic 7440-38-2 20 mg/kg conducting a simplified or site-specific terrestrial ecological evaluation, or it can. be demonstrated using a terrestrial fj 1 Benzene 71A3-2 0.03 mg/kg ecological evaluation under WAC 173-340-7492 or 173-340- d 7493 that the values in this table are ecologically protective for Benzo(a)pyrcne 50-32-8 0.1 mg/kg the site. This table may not be appropriate for defining cleanup Cadmium 7440-43-9 2 mg/kd. levels at other sites. For these reasons, the values in this table should not automatically be used to define cleanup levels that Z Chromium must be met for financial, real estate, insurance coverage or Q n Placement, or similar transactions or purposes. Exceedances of Chromium VI 18540-29-9 19 mg/kg the values in this table do not necessarily mean the soil must be O l Chromium 111 16065-83-1 2 000 mg/kg' restored to these levels at a site. The level of restoration depends M f : on the remedy selected under WAC 173-340-350 through 173 DDT 50-29-3 3 mglkgg 340-390. T h b Arsenic. Cleanup level based on direct contact using Equation ' Ethylbenzenc 100414 6 mg/kg 740-2 and protection of ground water for drinking water use N { Ethylene dibromide (EDB) 106-934 0.005 mg/kg' using the procedures in WAC 173-340-747(4), adjusted for C rn natural background for soil.p Lead 7439-92-1 250 mg/kgi c Benzene. Cleanup level based on protection of ground water for MQ s Lindane 58-89 9 0.01 mg/kgk drinking water use, using the procedures in WAC 173-340- C, 747(4) and (6). -i .� Methylene chloride 75-09-2 g/k t d Benzo(a)pyrene. Cleanu level based on direct contact using _ i' 0.02 m gP fTl f -: ? Equation 740-2. If other carcinogenic PAHs arc suspected of M Z [ Mercury (inorganic) 7439-97-6 2 mg/kg°' being present at the site, test for them and use this value as the stotal concentration that all carginogenic PAHs must inset using concenZ l MTBE 1634-04-4 0.1 mg/kg D the toxicity equivalency methodology in WAC 173-340-708(8). 1— Naphthalenes 91-20-3 5 mg/kg° a Cadmium. Cleanup level based on protection of ground water for drinking water use, using the procedures described in WAC 0) PAHs (carcinogenic) See 173-340-747(4), adjusted for the practical quantitation limit for Q =1 i bcnzo(a)pyrened soil. II PCB Mixtures I mg/kgP ft Chromium VI. Cleanup level based on protection of ground Tetrachloroethylene 127-18 4 0.05 mg/kgy water for drinking water use, using the procedures described inM M WAC 173-340-747(4). p N Toluene 108-88-3 7 mg/kg` 1`2 Chromium 111. Cleanup level based on protection of ground Q water for drinking water use, using the procedures described in 0 m Total Petroleum Hydrocarbonss WAC 173-340-747(4). Chromium VI must also be tested for C and the cleanup level met when present at a site. M.N [Note: Must also test for and meet cleanup levels for other petroleum DU'1'(dichlorodiphenyltrichloroethane).Cleanu Icvel based t 171 n components --see footnotes!] g P �. on direct contact using Equation 740-2. Gasoline Range Organics h Ethylbenzene, Cleanup level based on protection of ground water for drinking water use, using the procedures described in Gasoline mixtures 100 mg/kg WAC 173-340-747(4), without benzene andi Ethylene dibromide (1,2 dibromoeth ane or EDB). Cleanup D' the total of ethyl level based on protection of ground water for drinking water use, F. Z: benzene, toluene and using the procedures described in WAC 173-340-747(4) and xylene are less thanadjusted for the practical quantitation limit for soil. 1% of the gasoline d j Lead. Cleanup level based on preventing unacceptable blood mixture lead levels. Z All other gasoline 30 mg/kg k Lindane. Cleanup level based on protection of ground water for mixtures drinking water use, using the procedures described in WAC 173- 340-747(4), adjusted for the practical quantitation limit. M Diesel Range Organics 2,000 mg/kg I Methylene chloride (dichloromethane). Cleanup level based 2,000 m *g1kg on protection of ground water for drinking water use, using the t Heavy Oils procedures described in WAC 173-340-747(4). j Mineral Oil 4,000 mg/kg m Mercury. Cleanup level based on protection of ground water ` for drinking water use, using the procedures described in WAC (,(,(.Trichloroethane 71-55-6 2 mg/kg 173-340-747(4). u n Methyl tertiary -butyl ether (MTBE). Cleanup level based on i Trichloroethylene. 79 U1 6 0.03 mg/kg protection of ground water for drinking water use, using the Xylenes 1330-20-7 9 mg/kg° procedures described in WAC 173-340-747(4). o Naphthalenes, Cleanup level based on protection of ground water for drinking water use, using the procedures described in WAC 173-340-747(4). This is a total value for naphthalene, I- `• methyl naphthalene and 2 -methyl naphthalene. p PCB Mixtures. Cleanup level based on applicable federal haw (40 C.F.R. 761.61). This is a total value for all PCBs. Page 233 February 12; 2001 r r 173-340400 MTCA Cleanup Regulation q Tetrachloroethylene. Cleanup level based on protection of See Table 830-1 for the minimum testing requirements for ground water for drinking water use, using the procedures mineral oil releases. described in WAC 173-340-747(4). t 191,1 Trichloroethane. Cleanup level based on protection of r Toluene. Cleanup level based on protection of groundwater for ground water for drinking water use, using the procedures drinking water use, using the procedures described in WAC 173- described in WAC 173-340-747(4): 340-747(4). u Trichloroethylene. Cleanup level based on protection of s Total Petroleum Hydrocarbons (TPH). ground water for drinking water use, using the procedures TPI -1 cleanup values have been provided for the most common described in WAC 173-340-747(4). v . Xylenes. Cleanup level based on protection of ground water for petroleum products encountered at contaminated.sites. Where there is a mixture of products or the product composition is drinking water use, using the procedures described in WAC 173- !' unknown, samples must be tested using both the NWTPH-Gx 340-747(4). This is a total value for all xylenes... i and NWTPH-Dx methods and the lowest. applicable TPH t cleanup level must be meta • Gasoline range organics means organic compounds measured I using method NWTPH-Gx. Examples are aviation and auto - Z motive gasoline. The cleanup level is based on protection of r ground water for noncarcinogenic effects during drinking water r use using the procedures described in WAC 173-340-747(6). m `- Two cleanup levels are provided. The lower value of 30 mg/kg can be used at any site. When using this lower value, the soil must also be tested for and meet the benzene soil cleanup level. 71 The higher value of 100 mg/kg can only be used if the soil is tested and found to contain no benzene and the total of ethyl N benzene, toluene and xylene are less than 1% of the gasoline C Tf1 i mixture. No interpolation between these cleanup levels is m0. C allowed. In both cases, the soil cleanup level for any other carcinogenic components of the petroleum [such as EDB and Q C EDC], if present at the site, must also be met. Also, in both j . cases, soil cleanup levels for any noncarcinogenic components "° 171 [such as toluene, ethylbcnzcne, xylenes, naphthalene, and m MTBE], also must be met if these substances are found to !0 exceed ground water cleanup levels at the site. See Table 830-1 C Z j for the minimum testing requirements for gasoline releases. • Diesel range organics means organic compounds measured _ using method NWTPH-Dx. Examples are diesel, kerosene, and ? NF1 and #2 heating oil. The cleanup level is based on preventing the accumulation of free product on the ground water, as described in WAC 173-340-747(10)1 ,The soil cleanup level for any carcinogenic components of the petroleum [such as benzene m and PAHs], if present at the site, must also be met. Soil cleanup 4 111 levels for any noncarcinogenic components. [such as toluene, " ethylbenzcne, xylenes and naphthalenes], also must be met if C these substances are found to exceed the ground water cleanup levels at the site. See Table 830-1 for the minimum testing t i7 requirements for diesel releases. Heavy oils. means organic compounds measured using NWTPH-Dx. Examples are #6 fuel oil, bunker C oil, hydraulic oil and waste oil. The cleanup level is based on preventing the i accumulation of free product onthe ground water, as described in WAC 173-340-747(10) and assuming a product composition similar to diesel fuel. The soil cleanup level for any carcinogenic components of the petroleum [such as benzene, PA -Hs and PCBs], if present at the site, must also be met. Soil cleanup levels for any noncarcinogenic components [such as toluene, ethylbenzene, xylenes and naphthalenes], also must be 0 met if found to exceed die ground water cleanup levels_ at the '1 site. See Table 830-1 for the minimum testing requirements for m ` heavy oil releases. • Mineral oil means non -PCB mineral oil; typically used as an insulator and coolant in electrical devices such as transformers and capacitors, measured using NWTPH-Dx. The cleanup level is based on preventing the accumulation of free product on the ground water, as described in WAC 173-340-747(10). Sites using this cleanup level. must also analyze soil samples and meet the soil cleanup level for PCBs, unless it can be demonstrated that: (1) The release originated from an electrical device that r .• was manufactured after July 1, 1979; or (2) oil containing PCBs i was never used in ti equipment suspected as the source of the ? release; or (3) it can be documented that the oil released was ` i recently tested and did not contain PCBs. Method B must be I used for releases of oils containing greater than 50 ppm PCBs. Page 234 February 12, 2001 UNDERGROUND STORAGE TANK FOR OFFICE USE ONLY Site ID #:---------------- 30 DAY NOTICE Owner ID WASNINO TON SIAIE . a[ r A A I Y I N 1 0 f E C O L O G Y See back of form for instructions Please ✓ the appropriate box: X Intent to Close s z Site Information Owner Information o (This form will be returned to this address) Site ID Number: 9046 UST Owner/Operator: LAURELHURST OIL CO INC ee ee (Available from Ecology if the tanks are registered) Site/Business Name: LAURELHURST OIL CO INC. Mailing Address: 704026th Avenue NE Street Orn Site Address: 23601 Edmonds Way m 00, ) F . tl City/State:Edmonds, Washington City/State: Seattle, WA 98155 O C Zip Code: 98026 Telephone: (360) 683-9522 Zip Code: 98134 Telephone: 206-523-4500 m � Q � k; a-z Tank Installation. Company (if known): Fill out this section ONLY if tanks are being installed.ca r Service Company Contact Name ____ Address' Street -- P.O. Box rn. _ — Telephone (_) — _ m City — State Zip Code 00 C_� icY. Tank Permanent Closure Company (if known). Fill out this section ONLY if tanks are being closed. k z Service Company: Environmental Management Services, LLC Contact Name: Stephen Spencer i Address: 652 8th Avneue Street ) Fox Island Washington 98333 Telephone (253) 921-7059 City State Zip Code ! N z Tank Installation: o Tank Closure Information Information m Fill out this section ONLY if tanks are being closed, Fill out this section ONLY if tanks are being installed. Is There i Projected Product In If No, Date Closure Tank Substance Date Tank the Tank Tank.Was Approx. Tank ID Date Capacity Stored Last Used (Yes/No) Pumped Tank ID Install Date UST 1 June. 15, 2005 12000 Gallons Diesel Unknown No March 2005 ' To receive this document in an alternative format, contact the TOXICS CLEANUP PROGRAM at 1-800-826-7716 (VOICE) OR (360) 407-6006 (TDD). . ECY 020-95 (Rev. 3-01) Instructions Please Read Carefully Check the appropriate box for tank closure, tank installation, or both. Site and Owner Information Fill in the.site and owner information. Please include the Ecology site number for tank closures; also, besure to provide telephone numbers so that any problems can be resolved quickly. Confirmation of receipt of this form will be returned to the owner. z O is Tank Installation Company 0 List the installation company, if known. Upon receipt of the completed form, Ecology will validate it and return 604 9 it to the owner. This validated forallows you to receive a one time drop of product, for UST system testing m t, purposes only. To dispense product and receive additional deliveries, you must complete the Master v m Business License registration and obtain your Tank Tag from Ecology. The registration information. m v must be submitted to the Department of Licensing within 30 days of installation to receive a Master n Business License with the appropriate tank endorsement(s). mZ Tank Permanent Closure Company - z - y List the closure company, if known. Upon receiving a completed 30 day closure form, Ecology will stamp the r date received on the form and return a copy to the owner. O 'n 71 Contact your local fire marshal and planning department prior to tank closure to find out if any additional permits are required by county or other local jurisdictions. Compliance with the State Environmental Policy Act rn rn Co (SEPA) Rules, Chapter 197-11 WAC, maybe necessary. o �rn Closure may proceed 30 days after the date stamped on the form. A"site assessment is required at the time of closure. Contamination found or suspected at the site must be reported to the appropriate Ecology regional t z o office within 24 hours. If the contamination is confirmed, a site characterization report must be submitted to the regional office within 90 days; if contamination is not confirmed, a site assessment report must be submitted to M the above address within 30 days. z Please note: Individuals performing UST services MUST be certified by the International Fire Code Institute (IFCt), or have passed another qualifying exam approved by the Department. in z Tank Information o List tanks to be installed or closed. Please report tank ID number(s) for tanks to be closed and assign new tank n m ID number(s) to tanks being installed. Do not use existing numbers from closed tanks. The following tanks are exempt from notification requirements: ❖ Farm or residential tanks, 1,100 gallons or less, used to store motor fuel for personal or farm use only. The fuel must not be for resale or used for business purposes. : ❖ Tanks used for storing heating oil that is used on the premises where the tank is located. ❖ Tanks with a capacity of 110 gallons or less. ❖ Equipment or machinery tanks such as hydraulic lifts or electrical equipment tanks. ❖ Emergency overflow.tanks, catch basins, or sumps. i waft UNDERGROUNDSTORAGETANK Closure and Site Assessment Notice WASNIN610A 5141E 0 f P A A I N F A F O F _ See back of formfor instructions ECOLOGY Please ✓ the appropriate box(es) ❑ Temporary Tank Closure ❑ Change -In -Service X Permanent Tank Closure X Site Check/Site Assessment `: i= Site Information Owner Information (This form will be returned to this address) Site ID Number: 9046 UST Owner/Operator: Laurelhurst Oil Company p (Available from Ecology if the tanks are registered) Site/Business: Laurelhurst Oil Company Mailing Address: 7040 - 26th Avenue NE t7 rn Street Street "n Site Address: 23601 Edmonds Way P.O. Box N City/State: Edmonds ashi City/State: Seattle, WashigntonC rn y Zip Code h e (206) 5 -4 0 Zip Code 9 115 Telephone (206) 523-4500rnl O O Owners Sign u e _ __✓—f— — -- -- ----- --- --_ = m I Tank Clo ICh nge-ln-Service Company p c_ I, Service Company: Saybr Contractor ' Certified Supervisor: Micke loon to , Supervisor's Signature: Date O Mn I` Address: 12115 Canyon Road Street. P.O. Box mmEll ' Puyallup Washington 98373 Telephone (253) 531-2144 ©� O , City State Zip Code r C I mo Site Check/Site Assessor Certified Site Assessor: Stephen M. Spencer ;0' Address: 652 8th Avenue. i Street P.O. Box Fox Island Washington 98333 Telephone (253) 921-7059 ► z City State Zip Code. Contamination Present z0 < at the Time of Closure Tank Information n Tank ID Closure Date Closure Method Tank Capacity Substance Stored . X : rn UST 01 October 5, 2005 Removal 12000 Gallons Diesel Yes No Unknown Check unknown if no obvious: ;. contamination was observed and sample results have not yet been received from ro analytical lab. j I; X ° Yes No 1, If contamination is present, - has the release been reported – — to the appropriate regional office? To receive this document in an alternative format, contact the TOXICS CLEANUP PROGRAM at 1-800-826-7716 (VOICE) OR (360) 407-6006 (TDD). ECY 020-94 (Rev. 6-99) i I 11 d Please Read Carefully This form is to be completed by the tank owner and submitted to Ecology within 30 days of tank closure. Mark the appropriate box(es) for temporary tank closure, permanent tank closure, change -in-service, or site assessment. Permanent Closure and Change -In -Service require a site assessment be performed. P z Site and Owner Information o Fill in the site and owner information. Include the Ecology site number, if known; also, be sure to provide m telephone numbers so that any problems can be resolved quickly The tank owner MUST sign this form. Tank Closure/Change-In-Service Company and. Site Check/Site Assessor v m co List the closure company and fill in the site assessor information for permanent closure or change -in-service. p Ask to see the closure company supervisor's IFCI Certification and make sure that the certified supervisor signs O C this.form. rn g m Please note: Individuals performing services MUST be certified by the International Fire Code Institute c _ (IFCI), or other nationally recognized association by which they demonstrate appropriate knowledge pertaining to USTs or have passed another qualifying exam approved by the Department. Tank Informo ati n and Contamination Present at Time of Closure i m m Please fill in the tank information requested using tank ID numbers previously reported to Ecology. In the pFn .� column entitled "Closure Method," indicate what manner of closure was used, such as closure in place or c removal. Check the appropriate box(es) indicating if contamination is present and has been reported. N Contamination found or suspected at the site must be reported to the appropriate Ecology regional office within r Z 24 hours [see below for telephone numbers]. If contamination is confirmed, a site characterization report must be submitted to the regional office within 90 days., if contamination is not confirmed, then this form, a site assessment checklist, and a site assessment report must. be submitted to the above address within 30 Z days.Miss Central Eastern Southwest Northwest Z - O (509) 574-2490 (voice) (509) 456-2926 (voice) (360) 407-6300 (voice) . (425) 649-7000 (voice) n (509) 4544673 (TDD) (509) 458-2055 (TDD) (360)407m (TDD) (425) 649-4259 (TDD) m The following tanks are exempt from notification requirements: ❖ Farm or residential tanks, 1,100 gallons or less, used to store motor fuel for personal or farm use only. The fuel must not.be for resale or used for business purposes. :. Tanks used for storing heating oil that is used on the premises where the tank is located. + ,> ❖ Tanks with a capacity of 110 gallons or less, i or machine tanks such as hydraulic lifts or electrical equipment tanks. f. Equipment machinery ❖ Emergency overflow tanks, catch basins, or sumps. For more information, call toll free in the state of Washington 1-800-826-7716 (Message). UNDERGROUND STORAGE TANK Site Check/Site Assessment Checklist V1 ASNIN 6101 SIAIE OFfAR141N1 OF ECOLOGV s; When a release has not been confirmed and. reported, this Site Check/Site Assessment Checklist must be completed and signed by a person .certified by IFCI or a Washington registered professional engineer who is competent, by means of examination, experience, or education, to perform site assessments. The results of the site check or site assessment must be included with this checklist. This form must be submitted to Ecology at the address shown below within 30 days after completion of the site check/site assessment. Z SITE INFORMATION: Include the Ecology site ID number if the tanks are registered with Ecology. This number may be found on >' r the, tank owner's invoice or tank permit. m v TANK INFORMATION: Please list all tanks for which the site check or site assessment is being conducted. Use the owner's tank _ ID numbers if available, and indicate tank capacity and substance stored. m ' 1 ca-.� REASON FOR CONDUCTING SITE CHECK/SITE ASSESSMENT: Please check theappropriate item. C rn { m g Underground Storage lank Section j CHECKLIST: Please initial each item in the appropriate box. Department of Ecology 0 n ' i PO Box 47655 C SITE ASSESSOR INFORMATION: This information must be signed by the registered Olympia WA 985047655 m M. c : ( site assessor who is responsible for conducting the site check/site assessment. p :— CZ i' SITE OR • Site ID Number (Available from Ecology if the tanks are registered): 9046 'On s; Site/Business Name: Laurelhurst Oil Company Mm Site Address: 23601 .Edmonds Way v ca Street O m Edmonds Washington C N i City Siate Zip Code iJJ r m Each item of the following checklist shall be initialed by the person registered with the Department of 0M Ecology whose sign a ears below. YES NO 1. The location of the UST site is shown on a vicinity map. X icV) 2. A brief summary of information obtained during the site inspection is provided, X (see Section 3.2 in site assessment guidance) 3. A summary of UST system data is provided. (see Section 3.1.) X 4. The soils characteristics at the UST site are described. (see Section 5.2) X 5. Is there any apparent groundwater in the tank excavation? X 6. A brief description of the surrounding land use is provided. (see Section 3.1) X 7. Information has been provided indicating the number and types of samples collected, methods used to collect and analyze the samples, and the name and address of the laboratory used to perform the X analyses. 8. A sketch or sketches showing the following items is provided: - location and ID number for all field samples collected -groundwater samples distinguished from soil samples (if applicable) FX -samples collected from stockpiled excavated soil Pea Gravel PID Samples Collected - tank and piping locations and limits of excavation pit - adjacent structures and streets X - approximate locations of any on-site and nearby utilities X is 9. If sampling procedures different from those specified in the guidance were used, has justification for O using these alternative sampling procedures been provided? (see Section 3.4) NA 10. A tableis provided showing laboratory results for each sample collected including; sample ID number, constituents analyzed for and corresponding concentration, analytical method and detection limit for X that method. 11. Any factors that may have compromised the quality.of the data or validity of the results are described. XX M C My 0 0 c mz ;.• f D Z t I. Each item of the following checklist shall be initialed by the person registered with the Department of 0M Ecology whose sign a ears below. YES NO 1. The location of the UST site is shown on a vicinity map. X icV) 2. A brief summary of information obtained during the site inspection is provided, X (see Section 3.2 in site assessment guidance) 3. A summary of UST system data is provided. (see Section 3.1.) X 4. The soils characteristics at the UST site are described. (see Section 5.2) X 5. Is there any apparent groundwater in the tank excavation? X 6. A brief description of the surrounding land use is provided. (see Section 3.1) X 7. Information has been provided indicating the number and types of samples collected, methods used to collect and analyze the samples, and the name and address of the laboratory used to perform the X analyses. 8. A sketch or sketches showing the following items is provided: - location and ID number for all field samples collected -groundwater samples distinguished from soil samples (if applicable) FX -samples collected from stockpiled excavated soil Pea Gravel PID Samples Collected - tank and piping locations and limits of excavation pit - adjacent structures and streets X - approximate locations of any on-site and nearby utilities X is 9. If sampling procedures different from those specified in the guidance were used, has justification for O using these alternative sampling procedures been provided? (see Section 3.4) NA 10. A tableis provided showing laboratory results for each sample collected including; sample ID number, constituents analyzed for and corresponding concentration, analytical method and detection limit for X that method. 11. Any factors that may have compromised the quality.of the data or validity of the results are described. XX 0 0M icV) e MO Z' is O MollM M C My 0 0 c mz ;.• D Z t 071 M rn vN 0 •- •- • Stephen M. Spencer Environmental Management Services z Person registered with Ecology Firm Affiliated with } _ Business Address: 652 8th Avenue Telephone: (253) 921-7059 0) Street Z 0 Fox Island Washington 98333 City State Zip Code .0 , 1 hereby certify that I have been in responsible charge of performing thesU'e.check/site assessment described above. Persons sub►nitting false information are subject to penalties unde►;,Chzipter 173"6b -Cl.; November 5, 2005' z ��...� Date Signature o iaers r Register with Ecology ... �T Ecologv is an equal opportunity employer Page 2 i 0M icV) e MO •- •- • Stephen M. Spencer Environmental Management Services z Person registered with Ecology Firm Affiliated with } _ Business Address: 652 8th Avenue Telephone: (253) 921-7059 0) Street Z 0 Fox Island Washington 98333 City State Zip Code .0 , 1 hereby certify that I have been in responsible charge of performing thesU'e.check/site assessment described above. Persons sub►nitting false information are subject to penalties unde►;,Chzipter 173"6b -Cl.; November 5, 2005' z ��...� Date Signature o iaers r Register with Ecology ... �T Ecologv is an equal opportunity employer Page 2 i h Online Government Information i Services Snohomls County4* washingtoin x R F A LProperty Information County Quick Info Directory. Departments Employment Calendar Questions Search County Home links: --- ; Common Assessor Home Treasurer Home Information on which Department to contact links: .. Z Please view Disclaimer If you have questions, comments or suggestions, please Contact Us. a Daterrime:5/10/2005 1.02:08 PM Answers to Fre_yuently Asked Questions about Parcel Data (opens as new window) C7 M. Return to Prop "rt End page Parcel Number 00463300300401 Prev Parcel Reference 46330030040106 N Mo -__ 0..I n O C ;, Links to property information below r M 0. General Information Names & Addresses, Property Legal Description 'C Z 4 .. • Treasurer's Tax. Information Total Current Year's Taxes and other information r— • o Assessor's Property ,Values Market Values, Current Use Values (if any) 'n • Assessor's Property Characteristics Tax Code Area, Use Code, Parcel Size ril m • Assessor's._Structure(s.) Data Data related to the structures on a parcel ! i • Assessor's Property Sales Sales recorded since 7/31/1999 C N �. • Cal Assessor's Mapping Information Traditional and Interactive maps, Neighborhood '14, M nr General Information � Taxpayer Name ii Address .(contact the Treasurer if you have questions) MARIER & MARIER LLC 7040 26TH AVE NE - - - SEATTLE, WA 98155 z 4 If the above mailing address is incorrect and you want to make a change, see the information on Name and Address Changes ca Owner Name li Address (contact the Assessor if you have questions) MARIER & MARIER LLC 117040 26TH AVE NE - - - SEATTLE, WA 98155 O Street (Situs) Address (contact the Assessor if you have questions) • 0 23601 EDMONDS WAY - - EDMONDS, WA 98026 m Parcel Legal Description S, r HANBURYS SOUND VIEW TRS BLK. 003 D-01 - THAT PART TRACT 4 LY N & E OF CO RD LESS ST HWY Go.to_top.of page j Treasurer's Tax Information Taxes For answers to questions about Taxes, please Contact the Treasurer's office (opens as new window) 2005 Taxes for this parcel $1,696.81 j 1, (Taxes may include Surface Water Management and/or State Forest Fire Patrol fees. LID charges, if any, are not r included.) To obtain a duplicate tax statement, either download our Tax Statement Request form or call 425-388-3366 to }, request it by phone. ? Go to top of page Assessors Property Data Characteristics and Value Data below are for 2005 tax year. Please contact the Treasurer's office for answers to questions about Taxes (opens as new window) ' For questions ONLY about property characteristics or property values NOT taxes please contact the Assessor's Office (opens as new window) ? Z: ; .. Property Values do not reflect adjustments made due to an exemption, such as a senior or disabled persons =1` n r' Values exemption. M V alues _ ; Reductions for exemptions are made on the property tax bill. Tax Year 2005 Market Land $123,000 Market Improvement $32 300 Market Total _� � J $155,300 _ Go to top of page - — ® mC Id Property Characteristics p j. Tax Code Area (TCA) 00227 View Taxing Districts for this Parcel (opens as new window) 0 C ' ', psi suse Code 553 Gasoline Service Stations m Z Size Basis ACRE Size 0.24 a 10 Go. . top_of.page z,.' Property Structures L` O'n ' No structures found for this parcel i Go to top. of page. L L ; M M L; 1ca Ca Property Sales since 7/31/1999 r nR, . C to f ' f••A\ Explanation of Sales Information (opens as new window) j[ r Z v0'I Sales data is based solely upon excise affidavits processed.by the Assessor. —1 4 M Transfer Receipt Sales Excise DeedOther j Date Date Price Number Type Grantor (Seller) Grantee (Buyer) Parcels ? 8/4/1999' $0 362390 QC THOMAS&CAROLE;FRANK&CAROL MARIER & No ;) Z t;,-.• MARIER MARIER LLC {" Go_to_top_ of _page Property Maps Township/Range/Section/Quartcr, links to maps Neighborhood .5601000 Explanation of Neighborhood_Code (opens as new window) 1OT11 - - ; Township 27 Range 04 Section 31 Quarter SW Find_parcel maps for this.Township/Ran_ge/Section i View Map of this parcel (opens as new window) Idi . r C 3 S w r . ,.,� :.; .....'F",Ila W t+. ...M ;, �•'tl�rJ`''Jft.�'H,^3'r •t +It.: {. ELe .w. :. r0s.r,✓1i f et i`: + , yl'.' 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'__. k .. i414 �1 Environmental Management Services, LLC May 2, 2005 Revised: June 15, 2005 s, Laurelhurst Oil Company` UST Closure Work Plan 23601 Edmonds Way Edmonds, Washington Z `.: 0 M Environmental Management Services, LLC (EMS) will be managing the closure and removal of T one 1. 12,000 gallon diesel underground stora a tank UST located at 23601 Edmonds Wa ,10 O 9 .9 9 ( ) Y �_ Edmonds, Washington. This work plan detailed the closure activities and project responsibilities v M during the UST decommissioning project. m O -�l n j;: The tasks included in this work plan are presented below. Z M Task 1 — Pre-Construction Activities ID -1 �. CZ Pre-construction activities will include the following tasks: •mn 0 Preparation of site specific Health and Safety Plan; �t • A lication for UST Decommissioning permit through Edmonds / King County Fire � PP Department; Mn Notification of proposed UST closure activities to the Department Of Ecology (Ecology); " v N • Submittle of UST Closure Bid to select contractors. n N The decommissioning contractor will be responsible for physically preparing the site for z n upcoming work and deliver needed personnel, machinery, and supplies to the worksite will be --I the responsibility of the selected contractor. Work activities in this task include: �. • Oversee the mobilize excavation equipment and supplies to the site; Z • Install temporary security fencing where necessary (location for fence shown on site map attached); i • Install silt fencing, straw bails and other storm water management best management zo practices. (BMP's) around the work area perimeter (BMP Placement shown on site map attached); n • Install signage (e.g. "Keep Out No Trespassing", "Emergency Phone Numbers etc.) rn Task 2 — Surface Demolition Activities The decommissioning contractor will be responsible for the following items: ,. Concrete and asphalt covering the underground storage tank and the pump island area will be removed and disposed of off site at a local disposal or recycling facility by the contractor. Dust Environmental -Management Services$.LLC 1n 0 9 333 f Washington n 8 I 652 8 Avenue Fox Island, W g Phone: (253) 921-7059 Fax: (253) 369-6228 ems@emsgroupllc.com r UST Closure and Site Assessment Work Plan & Cost Proposal April 4, 2005 Laurelhurst Oil Company UST Closure } 23601 Edmonds Way Edmonds, Washington control will be provided as necessary using water. No water will be discharged from the site during demolition activities. Straw bails or silt fence will be placed on the down gradient side of the excavation area. Any water accumulating on the northern end of the site will be pumped, transported off site and disposed at a local disposal facility. s: Trucks entering the property site will enter from the south bound lanes of Edmonds Way. The trucks will leave the site from the north entrance/ exit on to 236'' Street to the east through the intersection and south along Edmonds way to 1-5 Flagging use exitinq the site to 236th is not anticipated as the total truck traffic will be limited to four loads of import and one load of export. -i PCS transport off site isnot anticipated. n M Task 3 - UST Closure Activities =i ca EMS will be responsible for permitting through the City of Edmonds or King. County. This c' m process will be required for the UST closure activity. The permitting process can take several rn 0 Weeks, A 30 day notice will be required by the Department of Ecology. This notice is to be 80 C by the UST decommissioning company or the project environmental. consultant. It is not uncommon for Ecology to wave the 30 day notice if the closure schedule can be expedited. m M .. to r The decommissioning contractor will be responsible for the following items: a Upon receipt of the proper permitting, decommissioning activities will be started. Each 1 dispenser and piping backflow devises will be dismantled to allow all gasoline to be drained .0,�'�; back into the USTs prior to any excavation activity. Each dispenser pump will be drained and --I removed from the pump islands. The UST will be pumped of all existing contents and triple m m 61 10 rinsed to remove any residual contents. UST contents will be disposed at a local recycling o facility. All associated product piping will be exposed by excavation and inspected. by the UST c N Site. Assessor prior to removal. t m CA .o n The UST be excavated exposing the top of the UST and associated piping. All piping will be ,-Zi location will be plugged removed only after it is inspected by the UST Site Assessor. Piping I p gg X with the appropriate sized plugs. A vent will be erected on. each UST to allow for venting of the E UST during the inertion process. ` Z t Following the UST. inertion and cleaning process, each UST will be excavated and removed under the supervision of a State of Washington certified UST Site Assessor and an IFCI certified Z UST decommissioner per Ecology decommissioning requirements set out in WAC 173-360. O Each fiberglass. UST will be disposed' of. through a local demolition debris disposal company. The UST excavation area will be backfilled with pit run material following the UST closure and m site assessment activities: Backfill will be compacted to meet 95% proctor or as specified by the project engineer. The excavation area will be capped with 5/8recycled or better gravel backfill. c i Environmental Management Services, LLC I 652 8i' Avenue Fox Island, Washington 98333 2 Phone: (253) 9214059 Fax: (253) 369-6228 ems@emsgroupllc.com t UST Closure and Site Assessment Work Plan & Cost Proposal April 412005 Laurelhurst Oil Company UST Closure 23601 Edmonds Way Edmonds, Washington Task 4 - Sampling, Closer Report Preparation and Submittal UST Site Assessment activities will be completed as outlined in the Washington Administrative Code (WAC) 173-360 and new Ecology sampling method 5035 by a licensed UST Site Assessor provided by EMS. Soil samples will' be collected from below the UST, from each excavation sidewall, from the excavated soil stockpile, from below the UST system piping at 100 ' foot intervals and from below each UST dispenser. Up to 12 samples are anticipated. If groundwater is encountered during excavation activities, representative samples (2) will be ZO collected from the excavation. Each sample will be analyzed for diesel range petroleum --� hydrocarbons by method NWTPH-Dx. Sample analyses will be complete by an Ecology m accredited laboratory. Following UST closure and sampling activities, a UST Site Assessment and Closure Report will co i be completed detailing the closure activities, site conditions and sample analytical results: v P 9 P cr Mo Site assessment and report preparation time can vary depending on conditions encountered n during the decommissioning process, Total time on site is anticipated not to exceed 8 hours. In the event unanticipated services are required, additional time and expense beyond this scope r=m et " Z will be accrued only after prior client approval based.on the attached rate sheet. p -i CDZ �.,. The following field screening techniques will be used on each sample collected: r • Olfactory Observations f . • Visual Observations _ i • Photoionization Detector (PID) — As necessary I my . Sheen Test n ml i, Task 5 - Petroleum Contaminated Soil Management.. N10 t mn Z �. Petroleum Contaminated Soil (PCS) exceeding.the Model Toxic Control Act (MTCA) method A . cleanup limits (MTCA WAC 173-340), will be staged onsite for later disposal. A PCS staging area, will be completed using hay bails or other appropriate storm water management BMP's: All PCS will be placed on and covered with 6 millimeter plastic. It is not expected that PCS will t z be encountered during this project. _ Task 6 - Test Pit Sampling o Following the closure of the UST system, EMS will complete up to five test pit excavations to a m" M of 10 to 12 feet bgs using the onsite contractor's excavation equipment: Soil samples will be collected from each test pit at 4 to 5 feet bgs and 10 to 12 feet bgs. Each sample will be analyzed for total petroleum hydrocarbons by method HCID (Hydrocarbon Identification Scan). EMS will complete a separate report detailing the sample collection process and analytical results along with recommendations. ilki d r , Environmental Management Services, LLC 652 8th Avenue Fox Island, Washington 98333 3 h Phone: (253) 921-7059 Fax: (253) 369-6228 ems@emsgroupllc.com I ` UNDERGROUND STORAGE TANK FOR OFFICE USE ONLY Site ID #:-----------------------,,' 30 DAY NOTICE Owner ID #:---------------------- NA 5N 1N 010N S A[t 0[ P A N 1 Y I N C 0 f ECOLOGY See back of form for instructions Please ✓ the appropriate box: X Intent to Close Site Information Owner Information (This form will be returned to this address) Z . 3' Site ID Number: 9046 UST Owner/Operator: LAURELHURST OIL CO INC (Available from Ecology if the tanks are registered) ot M,c: Site/Business Name: LAURELHURST OIL CO INC Mailing Address: 7040 26th Avenue NE Street _ i.. Site Address: 23601 Edmonds Way m OM City/State:Edmonds, Washington City/State: Seattle, WA 98155 }t M Zip Code: 98026 Telephone: (360) 683-9522 Zip Code: 98134 Telephone: 206-523-4500 Ort; F; M x Tank Installation Company (if known). Fill out this section ONLY if tanks are being installed. c z Service Com an _� Contact Name ----------- --- P y _--_-------- Address _-------- --- ------ -- -- (A Street ---- P.O. Box 0 y _ Telephone (--) ---= City ------ State Zip Code m Fn Tank Permanent Closure Company (if known). Fill out this section ONLY if tanks are being closed. ch 311I W t rn Service Company: Environmental Management Services, LLC Contact Name: Stephen Spencer 7�- Address: 652 8th Avneue Street I . Fox Island Washington 98333 Telephone (253)921-7059 City State Zip Code I Z Tank Installation Cn Tank Closure Information Information o Fill out this.section ONLY if tanks are being closed. Fill out this section ONLY if —I' tanks are being installed. (7 Is There M Projected Product In If No, Date Closure Tank Substance Date Tank the Tank Tank Was Approx. Tank ID Date Capacity Stored Last Used (Yes/No) Pumped Tank ID Install Date UST 1 June 15, 2005 12000 Gallons Diesel Unknown No March 2005 i ---------- -----' -- ------ --- --------- - -------- -------- ------ -- 1 f td .-------- ---'- ----�_-.-- --- r-- -- ----'- To receive this document in an alternative format, contact the TOXICS CLEANUP PROGRAM at 1-800-826-7716 (VOICE) OR (360) 407-6006 (TDD). ECY 020-95 (Rev. 3-01) Instructions Please Read Carefully Id Check the appropriate box for tank closure, tank installation, or both. Site and Owner Information Fill in the site and owner information. Please include the Ecology site number for tank closures; also, be sure to provide telephone numbers so that any problems can be resolved quickly. Confirmation of receipt of this form will be retumed.to the owner. Z O Tank Installation Company M r List the installation company, if known: Upon receipt of the completed form, Ecology will validate it and return ' it to the owner. This validated form allows you to receive a one time drop of product, for UST system testing Cn purposes only. To dispense product and receive additional deliveries, you must complete the Master v rn 4: Business License registration and obtain your Tank Tag from Ecology. The registration information e v M must be submitted to the Department of Licensing within 30 days of installation to receive a Master -� n Business License with the appropriate tank endorsement(s). e ` =m m Tank Permanent Closure Company A AZ List the closure company, if known. Upon receiving a completed 30 day closure form, Ecology will stamp the r -4 z date received on the form and return a copy to the owner. ca Contact your local fire marshal and planning department prior to tank closure to find out if any additional f permits are required by county or other local jurisdictions. Compliance with the State Environmental Policy Act rn rn (SEPA) Rules, Chapter 197-11 WAC, may be necessary. O Closure may. proceed 30 days after the date stamped'on the form. A site assessment is required at the time of ra closure. Contamination found or suspected at the site must be reported to the appropriate Ecology regional E M n office within 24 hours. If the contamination is confirmed, a site characterization report must be submitted to the �n regional office within 90 days; if contamination is not confirmed, a site assessment report must be submitted to the above address within 30. days. Please note: Individuals performing UST services MUST be certified by the International Fire Code } z Institute (IFCI), or have passed another qualifying exam approved by the Department. Tank Information o List tanks to be installed or closed. Please report tank ID number(s) for tanks to be closed and assign new tank rn ID number(s) to tanks being installed. Do not use existing numbers from closed tanks. The following.tanks are exempt from notification requirements: ❖ Farm or residential tanks, 1,100 gallons or less, used to store motor fuel for personal or farm use only. The fuel must not be for resale or used for business purposes. ev Tanks used. for storing heating oil that is used on the premises where the tank is located. ••• Tanks with a capacity of 110 gallons or less. 1 Equipment or machinery tanks such as hydraulic lifts or electrical equipment tanks. ❖ Emergency overflow tanks, catch basins, or sumps.. • u ,.., .. .. i .. or to r. 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