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Home My WebLink AboutWell Inspection 45 Clinton Drive (2) STATE OF CONNECTICUT DEPARTMENT OF ENVIRONMENTAL PROTECTION cr, JgT`NES ureau of Waste Management, Oil and Chemical Spill Response Division rRAN* e LICIT Emergency Incident Report Case No.: 2007-03191 Staff Receiving Call: 207 GILMORE,PETE Assigned To: 917 EMANUELSON,BRIAN Date Reported: 05/22/2007 Time Reported: 8:30 Date of Release:05/22/2007 Time of Release:8:30 Town of Release: SOUTH WINDSOR State of Release: CT Location of Reported Release: 45 CLINTON DRIVE Reported By: DISPATCHER Phone: (860) 644-2551 Representing: SOUTH WINDSOR FIRE DEPARTMENT Responsible Party: Phone: Street Address: Town: State: Zip Code: Does the Responsible Party Accept Financial Responsibility? Release Type: PETROLEUM Release Substance: #2 FUEL OIL Media: GROUND SURFACE Total Quantity: 200 Gallons 0 Cubic Yards 0 Cubic Feet 0 Drums 0 Pounds Emergency Measures: REFERRED TO 937 Has the Release Been Terminated?: YES Type of Waterbody Affected: Name of Waterbody Affected: Total Quantity Recovered: 0 Total Quantity in Water. 0 Corrective Actions Taken: REFERRED Discharge Class: PRIVATE Cause of Incident: SEEPAGE Agencies Notified: Status: CLOSED (Printed on Recycled Paper) 79 Elm Street • Hartford, CT 06106-5127 An Equal Opportunity Employer Bureau of Materials Management& Compliance Assurance Emergency Response &Spill Prevention Division Emergency Response Unit Internal Referral Form Date of Referral: 05.24.07 Case#: 07-03191 J� z s- )T Ap6f3ving Supervisor's Signature Date TO: Jan Czeczotka BWPLR/REMEDIATION Name Bureau/Division/Program FR: BRIAN EMANUELSON MMCA/ ERSPD/ERU Name, Title Bureau/Division/Program When/if staff finds a potential or real violation or environmental problem,which falls under the responsibilities of another program within the Department,the matter will be referred in Purpose: writing on this"Referral Form" as soon as possible. Referrals will be directed to the appropriate contact person as provided on the attached list. In the case of an urgent matter,the referral will be made first by telephone to the recipient program. The attached case is being referred to you for: X Consideration for Action O Information O Other: Bureau of Materials Management&Compliance Assurance Emergency Response&Spill Prevention Division (ERSPD) Site Assessment&Support Unit O Drinking water impact O Free product present 0 Groundwater impact O High dissolved amount O Leaking UST O Potential vapor impact to building O Surface`water impact O Underground utility impact O Undetermined impact O Undetermined responsible party O Other Storage Tank Enforcement Unit O Commercial UST 0 Advised of mandatory 3-day written report estimating amount of product lost, location of release and leaking UST components to be sent to USTEP O Bare steel system components O CERCLA Chemical O Failure to conduct adequate leak detection (e.g., no automatic tank gauging (ATG) or inventory reconciliation O Heating fuel O Means of release discovery,ATG. IV-18-05 O Motor fuel O Waste Oil ERSPD/ ERU: Transmittal: Internal Referral Form 1/15/2007 Page 1 of 4 Bureau of Materials Management & Compliance Assurance Emergency Response & Spill Prevention Division Emergency Response Unit Internal Referral Form O Illegal disposal X Known GAA/GA area O LEP Hired X Public/private wells O Surface discharge O Underground piping failure X AST FAILURE 13 1 Voluntary Clean-up Program O Other Planning and Standards Division Programs O By-pass, upset or significant damage to an industrial wastewater treatment system O Discovery of a hazardous waste site O Fish kills 13 Illegal discharge§22a-430-3(k) O Illegal drains/pipes O Septage problem O Sewage overflows O Significant erosion problem 13 Surface water contamination O Threat to water supply O WWTP problem O Other Bureau of Air Management—Compliance& Field Operations Division O Air emission: chemical fire O Chemical reaction O Dump fire O Gasoline in sewers O Unregistered or malfunctioning equipment O Other Bureau of Natural Resources O Fish kill O Other Bureau of Outdoor Recreation O OTHER: Attached you will find: O Copies of case documents— MAP, PHOTO'S Specify: X Emergency Incident Field Report ERSPD/ ERU: Transmittal: Internal Referral Form 1/15/2007 Page 3 of 4 Connecticut Department Of Environmental Protection Bureau of Materials Management& Compliance Assurance _ Emergency Response and Spill Prevention Division—Emergency Response Unit 79 Elm Street Hartford, CT 06106 1/15/2007 EMERGENCY INCIDENT FIELD REPORT INCIDENT INFORMATION Case#: 2007-03191 Date Reported: 05.22.07 Time Reported: T Assigned By: 937 Reported by: DISP Representing: FIRE DEPT. Phone#(s) 860 644 8551 Assigned to: 917 Additional ERC's On-scene: NA Location of Reported Release: Address: 45 CLINTON DRIVE Town,ST Zip SOUTH WINDSOR Property Owner: Name 1: KAREN STEELE Address: 45 CLINTON DRIVE Town,ST Zip SOUTH WINDOR Phone#(s): 860 644 9999 Contact Name: KAREN STEELE Did the release affect more than one property? If yes,complete next section: Name 2: NA Address: NA Town, ST Zip NA Phone#(s): NA Contact Name: NA Name 3: NA Address: NA Town,ST Zip NA Phone#(s): NA Contact Name: NA Responsible Party Information Is the Responsible Party Known? YES If"No",explain in Narrative section of this report RP: SAA Address: SAA Town,ST Zip SAA Phone#(s): SAA Contact Name: SAA Financial Responsibility Accepted? YES Date accepted: Time Accepted: Responsibility Accepted or Denied by Whom: I KAREN STEELE Release Information Release Substance: #2 FUEL OIL Date of Release: 05.21.07 Time of Release: Historic On-going Release Status On Arrival: Terminated X No Release Other: (Explain) ERSPD-ERU-E1FR, 115/2007 Page I of Environmental Clean-Up Contractor Information State Licensed Contractor Retained Y/N? YES Name of Contractor Retained: ENVIRONMENTAL SERVICES,INC Hired by Whom(Who actually called the contractor): R.P. Date&Time Requested: 05.22.07 AM Date&Time Arrived: 05.22.07 AM Sea/Sorbent Boom Sorbent Pads X Sweeper #of Vac Trucks 1 Speedy Dry Level A Mitigation Equipment Boat Hand Tools X Level B Overpack/Drums Roll-Off X Level C Excavation Equipment X I Other Agencies Involved And Reports Available On Scene Report On Scene Report Local FD X Local FMO Local PD State FMO Agencies Involved CSP FBI Local Health X State Health EPA USCG Consultant(Name) Other DEP employees on-scene(name&phone ft Na Evidence Available On This Incident Photographs of Scene?Y/N YES Taken by: EMANUELSON Submitted?Y/N YES Video Tape of Scene?Y/N Taken by: Submitted?Y/N Sketch of Scene Submitted YIN Invoice Submitted Y/N Map of Scene Submitted Y/N Samples Taken? Y/N YES Taken By: ESI Analytical Results Attached?Y/N PEN Date Taken: 05.22.07 PENDING Samples Laboratory Performing Analysis? PHOENIX LABS Chain Of Custody?Y/N YES Split Samples:Y/N NO Spilt With Whom: _T Analysis Required: Cost Recovery Information Spill Fund Authorized?Y/N NO I Authorized bTF7 I Date&Time: Release Letter Received: Whom did you give the"RP Handout"to? KAREN STEELE Was there a witness? Y/N YES I If yes,Name&Phone#of Witness(s): FIRE,DEPT. Whom did you Fax the"RP Handout"to NA Fax Transmission Submitted Y/N Explain any statements made by RP as to the assumption of responsibility: R.P.SECURED ESI AFTER BEING GIVEN LIST OF CONTRACTORS Explain efforts by DEP to have RP perform clean up(include dates,times,DEP staff,party contacted,witness(s) if any): SAA Do you know of any violations,negligence,or intentional acts that may have contributed to this incident? 7NO If yes, Explain: ERSPD-ERU-EIFR. I'15/1007 Page 3 of DEP-ERU Case # 07-03191 All Photographs taken by: 45 Clinton Drive,South Windsor Emanuelson, Brian # 917 1 of 3 05.22.07 275 AST Failure 2 of 3 e; Hole in AST with srew i .;'ect to stop leak 3of3 from leaking AST Referral Copy Excava a area =Mre removal of 30 culyds of oil impacted soil was removed .