Instructions for the Environmental Condition …

1 ECAF Instructions Page 1 of 14 STATE OF connecticut DEPARTMENT OF ENERGY AND Environmental PROTECTION BUREAU OF WATER PROTECTION AND LAND REUSE REMEDIATION DIVISION 79 ELM STREET, HARTFORD, CT 06106-5127 (860) 424-3705 Instructions for the Environmental Condition Assessment Form (ECAF) Rev. 11/4/10 Purpose: The Environmental Condition Assessment Form (ECAF) was developed by the connecticut Department of Energy and Environmental Protection (DEEP), as required by sections 22a-134a and 22a-133x of the connecticut General Statutes (CGS). An ECAF must be submitted simultaneously with every Property Transfer Program (CGS section 22a-134a(d)) and Voluntary Remediation Program (CGS section 22a-133x(a)) filing submitted to DEEP. The purpose of the form is to provide basic site information to DEEP and to the public regarding a site for which a filing has been submitted pursuant to the Property Transfer Program (CGS section 22a-134a) or pursuant to the Voluntary Remediation Program (CGS section 22a-133x).

2 The form is used by DEEP to determine whether DEEP oversight of the investigation and remediation at a specific site is necessary, or whether a Licensed Environmental Professional (LEP) may verify that site investigation has been performed in accordance with prevailing standards and guidelines and that site remediation has been performed in accordance with the Remediation Standard Regulations, sections 22a-133k-1 through 133k-3 of the Regulations of connecticut State Agencies (RSRs). In making a determination whether a LEP may verify the investigation and remediation of the site and in accordance with CGS Section 22a-134a(f), DEEP considers 1) the potential risk to human health and the environment posed by a release; 2) the degree of Environmental investigation at the site; 3) the proximity of the site to significant natural resources; 4) the land uses surrounding the site; 5) the complexity of the Environmental Condition of the site; and 6) any other factor the Commissioner deems relevant.

3 The information that DEEP staff need to consider and review in the determination process is included on the ECAF. The ECAF should not direct staff to refer to information in files or bound reports. The ECAF is to be a stand-alone document, with no reference made to, or inclusions of, attachments with the exceptions of site maps and receptor surveys. DEEP recognizes that, for some sites, some of the information requested on the ECAF might not be available at the time the ECAF is submitted. Gathering additional information to complete various sections of this form need not delay the transfer of the site or the filing of an ECAF. However, DEEP recommends that all available information be used to complete this form, as a complete Form is required by CGS section 22a-134a(d).

4 The following Instructions detail the requested information for each part of the ECAF. ECAF Instructions Page 2 of 14 Part I: Site Identification 1. Name and Address of Site - Provide the name of the site by the full, legal company/firm name. (If identifying a corporation or limited partnership registered with the Secretary of the State, fill in the name exactly as it is shown on the registration.) If identifying an individual s property, provide the full legal name, including title and suffix. Provide the full and exact street address of the location of the site. 2. Description in Property Deed - Provide the recorded information, including the page, volume, lot, block, and map numbers, as listed in the Town land records.

5 3. Site Details: Total Acreage - Include the total acreage of all contiguous properties that are referred to as part of this site. Acres Undeveloped - Include the total acreage that is not covered by pavement or structures. Latitude & Longitude Provide the latitude and longitude of the center of the site in decimal degrees for GIS purposes. Building square footage - Provide the sum of all building footprint square footage at the site. 4. Location Map - A figure, based on US Geological Survey quadrangles, delineating the limits of the property and an area extending at least -mile from the property line in all directions. The location map should include a title block listing the site name, street address, town, map scale, the date prepared or revised, names of the USGS maps utilized, and a reference to the ECAF to which it is attached.

6 Where applicable, the location map should also illustrate the location of sensitive receptors and off-site impacts. 5. Site Plan(s) - A figure(s) drawn to scale, which depicts the entire property and each of the site features listed, as applicable. Include a legend to define the abbreviations and map symbols used. Multiple site plans may be submitted to depict the site features listed below. Structures and Boundaries - Identify present and historical structures, roads, limits of pavement, process wells, underground utilities, septic systems, drywells, tree lines, fencing, property lines, right-of-ways, wetlands, and water bodies. Areas of Operation - Identify any area in which current and historical establishment operations occurred.

7 Hazardous Waste and Solid Waste Management Areas - Identify current and historical drum storage areas, chemical dispensing areas, degreasers, recycling stills, sumps, dumpsters, floor drains, leach fields, drywells, lagoons, pits, piles, landfills and any other relevant features. ECAF Instructions Page 3 of 14 Areas of Concern/Release Areas - Identify the location of features identified in the assessment and investigation of the site as having the potential for a release and delineate the limits of areas that have sample results, staining, or other indications showing present or former releases. UST and AST Locations - Identify all current and historical storage tanks; differentiate between above ground and below ground tanks.

8 Septic Systems and Water Supply Wells - Indicate the locations of any current and historical septic systems and water supply wells. Monitoring Wells and Water Table Elevations - Provide the locations of monitoring wells, contours for groundwater surface elevation, and the date that groundwater measurements were collected. The contours should be dashed where the location is being inferred beyond the monitoring well network. Limits of Groundwater Plume - Delineate the horizontal limits of groundwater that has been polluted by each release on-site. Dashed lines should be used to indicate the limits of an inferred plume. Areas Remediated - Indicate the extent of the areas that have had partial or completed remedial actions and provide a date for the remediation.

9 Sampling Locations - Indicate the depth and media at sample locations. Part II: Contact Information 1. Name of Business/Person - Provide the name of the business, person, or municipality submitting the ECAF, along with the full and exact mailing address of that entity/individual and his/her phone number. If a business is submitting the form, the name and title of the person who the business has designated as its authorized representative must be provided. The authorized representative listed here must sign and certify the ECAF at the end of the Form. For a corporation, the ECAF must be signed by a responsible corporate officer ( , president, vice president, secretary, or treasurer of the corporation) in charge of a principle business function, or any other person who performs similar policy or decision-making functions for the corporation.

10 For a partnership or sole proprietorship, the ECAF must be signed by a general partner or proprietor, respectively. For a LLC, the ECAF must be signed by a member of the LLC. 2. Primary Contact - Provide the name of the specific individual to whom DEEP's technical correspondence and inquiries regarding the ECAF should be directed. This individual may be the LEP of record. Include the full and exact mailing address, electronic mailing address, and phone number for that individual. If the Primary Contact information is the same as the individual listed in Part , specify same as in 1. ECAF Instructions Page 4 of 14 3. Parcel Owner - Provide the name of the property owner as recorded in the town or city land records, including the owner s full and exact mailing address, electronic mailing address, and phone number.