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HomeMy WebLinkAboutMP25-075 �QyC.4Ry DUI ti 11'VUY . 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrooknkg_ov TRUSTEES BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 19,2025 Harumi Yamano 54 Greenway Lane Rye Brook,New York 10573 Re: 54 Greenway Lane, Rye Brook,New York 10573 Parcel ID#: 129.84-2-43 As per the Certification letter from Enviroshield Inc. dated August 13, 2025, the removal of an underground oil tank under Mechanical Permit#25-075 issued on 5/28/2025 has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to LE BRnv�• O� tim � �O 19( BUILDING DEPARTMENT ❑0 BUILDING 1NSPI,-.43YIIt 6KMISTANT BUILDING INSPIi(:'1.'pit. VILLAGE OF RYE BROOK ❑CODE I'Mr-mcr UNT OrrICIM 938 King Street:• Itye Brook,NY 10573 (914) 939-0668 FAX (91.9) 939-5801 wwwA., ebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - DATE: 0 19 -1- o- Z ZcS BLOCK: LOT: _ LOCATION: OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ .FOUNDATION ❑ UNDI:RGROITNI-)hLCrMIZINc (VOTES ON INSPECTION: ❑ :ROUGH PLUMBING ❑ ItOU(:I3 FR.ANLING ❑ INSULATION ❑ Natural Gas 2 ,rH ogovd. a 00 u.a- .r ❑ Ut Gas &'FUEL TANK. ❑ FIRE SPRINKLER. We Uw 4m f�f Poll 0-I Q -2 6- ❑ FINAL PLUMBING T" �+ ❑ CROSS CONNECTION -- ❑ FINAL u� ❑ OTHERA L t. ` IC C(y�'1 �. gvv:PD7-d HYIHJ,() 0 Irvull 0 x 0 ANNOD N%,OHD 0 fiIj 0 ,)KINVIltl mmoll 0 f)mlt[]Kll!ld HfL)a()Il [I 90 L L D q. dt,,'N 1 N 0 Si f.1, K "ONXIBMId(lm(jq)xjL)-N)jtmjj 0 MOU'vomaod [] Iff)VNIVW([t)MjLootl I] oml.LO(),.l 0 MOIJLDAdSKIaH Gamma molly-MISMI YLUIS 0 —Sl"oAt-a"j, PION 1101VIOU ❑ Ich :107 i - - - - - - - - - --- -- - -- - - - - - - - - - - - - -- - ---- - - - - - -- ro 108!9-6C6(V16)'.I,-Vt:t W.M)-6V6('1116) CLSW .AN 100-41�119--J-X-$-rlS-im3l 8V6 MOO-dff ax-H tIO -tf9VTllA 0 d6i � I _ _ N.••�.a �.. � � - ' l ',t bb �, 1�lII wd q is r ,»:r •• ��'�y.'`+' 1� b• tip• �` '��. �. •, }, - ? 'ems'. •tY� - �.+Nxsa� l Ao ►�� lye Ln "o _ Ln 1 b � p O O a L Ln LO � ` Or W - Acn -o [••� bo L ca O "C M+� N U pp a0ON bC o v A F+i 04 �o '.o o o al WD O W s-� O � � �•+ � � '� C � o 'C W r h/ O w ,%4 PLOa W w y`p; u ~ 4J U r U � � o � op. � OW oo u'o w o a V = Z U Z °' n v+ 4 _ 11 47 W z a� R. Ayo • ►I--a--1 !�! O A G A a a 40. Ca = I� 00 O d 5 >1 0 5 ^o zv 1-4 _ w G4 0 El w � O o O E., �� p � � 4d I _ Ln �¢ .. o w x � � ub a D E C BUILD TMENT � 1 VIL E OF RY OOK MAY 2 l 2025 938 Knvc ET RYE BR NY 10573 I _p Iff/ VILLAGE OF RYE BROOK w e -:6 7 ov RLlit_OING DEPARTMENT Application for Permit to Remove or Abandon Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: - �J' 0 ! S Approval Date: 5- Z 'rr 2 Q 2 S' Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BIIILDING INSPECTOR.THE ADMINIST%XTIVE FEE FOR WORT:PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Application Completed by Bonded, Licensed Contractor. 2. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder) 3. Your contractor's valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3 /or NY State Workers Compensation Waiver) 4. Fee per Tank: Removal or Abandonment S 185.00 per Tank. 5. Dig Safely New York #(dial 81 1): t3S t a S - bit- `lrS 9 6. Inspection by Building Department fo remova or abandonment. 7. Submit all Manifests& Reports(after work has been completed). 8. Certificate of Compliance will be provided when all requirements are fulfilled. Application dated, MO-t 14.L-Z-G is hereby made to the Building Inspector of the Village of Rye Brook for a permit to remove or abandon a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s)will be emove r abandoned in conformance with all applicable Village,County,State&Federal laws,codes, rules and regulations. Indicate Permit Type: Removal (.f- Abandonment ( )/Above Ground ( ) • Buried in Ground (•�' I. Address: s4 W°'� ^�- SBL: I ag,0 4-3-" Zone: 2. Property Owner&Address: Phone#; g►y "-1v5 tia$S Cell#: email: 3. Contractor&Address: •2�S��t).o 1 -• Phone#: Cell #: email: 4. Applicant: c Sti+"La, Phone#: ��3 ` Sb```C Cell#: email: &-J6 5. Indicate Fuel Type: Fuel Oil�-<-L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: ?J 7. Exact Location(s)of each Tank:- i 6/l/2024 STATE OF NEW PORK,COUNTY OF WESTCHESTER ) as: U� opt. C�,c-c va ,being duty sworn,deposes and states that he/she is the applicant above named, (print name of individual signing ns the applicant) and further states that(s)hc is the Tank Installation Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein arc true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform}sire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this CS Sworn to before me this 1 day of 20 day of � ,20 ;?f5 Sign ture of Property Owner Signature of Applicant �tlltName of erty Owner _ Print 1qAme of Applicant Notary Public Mohammad Rahman Not Commission#olFA0032973 Notary Public State of Now York OARIELLY h.Iml_I-SANTOS My Commission Expiration:01/11/2029 Notary tnublic,Stale Ot Connecticut This application must be properly completed in its entirety and must incl no&i�MWi0n Expires May 27,2026 signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety anchor not properly signed shall be deemed null and void and will be returned to the applicant. z 6/1/2024 C� !� r S � r 0 3���.-, f ----------- — - c c t �5 3 �sy s �xt�w�-, ��� k`Z+z pry,�y i ' � T . _ __ As��o�� 8 ;� ,� �PoG��� Clean, Preserve...Protect Environmental Specialists 5 August 13, 2025 Mr. Dominic Falcone IE Service Manager D Westmore Fuel Company 86 North Water Street AUG 18 2025 ID Greenwich, CT 06830 VILLAGE OF RYE BROOK Subject: Tank Removal,_August 7, 2025 BUILDING DEPARTMENT Yamano Residence 54 Greenway Lanc Rye Brook, New York Dear Mr. Falcone: On August 7, 2025, Enviroslueld completed the removal of one underground 300-gallon fuel oil tank located at the subject property. The former location of the tank and progression of the tank removal process is shown in Site Photographs enclosed with this letter. Prior to the removal of the tank, all remaining liquid, sludge sediment and rinse water were pumped and cleaned from the tank for disposal by Enviroshield, a State of New York licensed waste transporter at Safety-Kleen Systems, Inc., 120 Forbes Avenue, New Haven, Connecticut. Attached is a copy of the waste transport bill of lading. The top of the tank was exposed using an excavator and enough soil was removed from the excavation to pull the tank from the ground. The tank was thoroughly inspected for rust, cracks, holes, or other physical characteristics,which could have been cause for a fuel release. No evidence of a fuel release was observed. Soil samples obtained from the tank grave were screened using the Photo Ionization Detector (PID); the results of the field screening indicated no evidence of a fuel release. A soil sample was collected from the bottom of the excavation, in the area presumed to be most impacted, and submitted to a Complete Environmental Testing (CET), a State of New York certified environmental laboratory for analysis by STARS 8260 and 8270. Consistent with New York State — Department of Environmental Conservation (NYS-DEC) requirements, these are the required analyses for oil tank removal in New York State. As indicated in the attached Complete Environmental Testing (CET) report #251-10181, the reported results for the sample tested are below the laboratory detection limit for all the constituents tested; no petroleum was detected within the sample. CT Home Improvement Contractor HIC.0582591 — Westchester Home Improvement License WC-27310-H14 250 Moffitt Street, Stratford, CT 06615 (203) 380-5644 FAX (203) 378-8736 www.enviroshield.coin - info a,enviroshield.com Page 2 of 2 August 13, 2025 Yamano Residence 54 Greenway Lane Rye Brook,New York The tank was transported, cleaned, and disposed of at P.C. Metals, Inc., 270 Central Avenue, Bridgeport, Connecticut in a manner consistent with industry standards and in compliance with all Local, State and Federal Codes and Regulations. Attached is'Tank Disposal Ticket#605192. The tank grave was backfilled and brought to grade. Based on visual observations, PID field screening and laboratory analysis, Enviroshield found no indication of the tank system's failure. If you have any questions concerning any of this work, please do not hesitate to contact me at your earliest convenience at(203) 380-5644. Sincerely, Enviroshield S. lLon,id Bochicchio Senior Project Manager Enclosures cc: Village of Rye Brook Building Department via email 1petersen@ryebrook.org and jrook o ff; Permit#MP 25-075 5g��0 Site Photographs Enviroshield 300-gallon Underground Storage Tank(UST)Removal Yamano Residence,54 Greenway Lane, Rye Brook, New York -.-— .It � Photo 1 of 5.Location of 300-gallon UST;visible fill and vent piping. Site Photographs Enviroshield 300-gallon Underground Storage Tank(UST)Removal Yamano Residence,54 Greenway Lane, Rye Brook, New York 4. r- . Photo 2 of 5. Excavation to expose UST. Photo 3 of 5.Tank cut open and cleaned. i ■ ■ ■ 1 _ f _ :,. _•,, _ .��,. "t,. � sue`' - � Photo d of 5, 330 gl. UST out of ground. Photo 5 of 5.Tank grave backfilled to grade. $ - = 1 Clean, Preserve. ..Protect J- : ��► Environmental Specialists o �J � BI LL OF LADING DESCRIPTION: Check applicable waste ID' �(NA1993) Fuel oil /diesel /waste oil _ (UN1203) Gasoline (UN1223) Kerosene Off-Specification commercial chemical product fuel (applicable in CT only) _ Waste, NON-RCRA, Liquid, N.O.S. (Oil/Water mix) Non-Haz, None(applicable in NY State) Water only (no fuel waste). 0 Date: Total Quantity: gallons f r" Generator Name: Site Address: City: ( ! C State: Zip: ` Telephone: - W.O #: l Generator/Agent for Signature: Transporter: Enviroshield, Inc., 250 Moffitt Street, Stratford„.� OT 6615203-380-5644 Connecticut: CT-HW-495; New York: CT-095;"Westchester County,NY: WC-27310-1-114; Connecticut H.I.C. 0582591 Driver Signature: Destination/Facility: -- Tradebe Treatment and Recycling of Bridgeport, 50 Cross Street, Bridgeport, CT 06610 Safety-Kleen Systems, Inc., 120 Forbes Avenue, New Haven, CT 06512 Tradebe Treatment and Recycling Northeast, 136 Gracey Avenue, Meriden, CT 06451 Approval Code: (SEE BACK FOR HAZARD/SAFETY/RESPONSE DETAILS) FATemplateswlisc\Bill of Lad,ng Liquid docx CT Home Improvement Contractor HIC.0582591 — Westchester Home Improvement License WC-27310-H 14 250 Moffitt Street, Stratford, CT 06615 (203) 380-5644 FAX (203) 378-8736 www.env]roshield.com - info@enviroshield.com 80 Lupes Drive Tel:(203)377-9984 Stratford,CT 06615 Fax:(203)377-9952 e-mail:cetl@cetlabs.com CO MR 111 I NVIAGNMI NiAI 1I5)ING,I NG Client: Mr. Richard Louis Enviroshield,Inc. P.O.Box 1296 Stratford,CT 06615 Analytical Report CET# 25HO181 Report Date:August 13,2025 Project:Yamano,54 Greenway La,Rye Brook,NY PO Number: 30809 Connecticut Laboratory Certificate:PH 0116 New York N ELA P Accreditation: 11982 Massachusetts Laboratory Certificate:M-CT903 Pennsylvania Laboratory Certificate:68-02927 Rhode Island Laboratory Certificate: 199 Page 1 of 13 CET#:25HO181 Project:Yamano,54 Greenway La,Rye Brook,NY SAMPLE SUMMARY The sample(s)were received at 25.4°C. This report contains analytical data associated with following samples only. Sample ID Laboratory ID Matrix Collection Date/Time Receipt Date Tank Grave 6ft 25HO181-01 Soil 8/07/2025 11:45 08/07/2025 Analyte: Percent Solids ISM 2540 G) Analyst:AEP Matrix: Soil DataTimc Laboratory ID Client Sample ID Result RL Units Dilution Batch Prepared Analyzed Notes 25Ht1181-n1 Tank Grace 6ft 36 1.0 I B1150848 08/08/2025 08/1 U202513:05 Complete Environmental Testing,Inc. 80 Lupes Drive.Stratford.CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.ceLlabs.com Page 2 of 13 CET#:25H0181 Proiect:Yamano,54 Greenway La,Rye Brook,NY Client Sample ID Tank Grave 611 Lab ID:25HO181-01 Semivolatile Organics Analyst: MJH Method:EPA 8270E Matrix: Soil Result RL DatetTime Analyte (ug/kg dry) (ug/kg dry) Dilution Prep Method Batch Prepared Analyzed Notes Naphthalene ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Accnaphthylene ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Acenaphthenc ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Fluorene ND 120 1 EPA 3546 BB50834 08/08/2025 08/11/2025 16:28 Phcnanthrcne ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Anthracenc ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Fluoranthcnc ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Pyrene ND 120 1 EPA 3546 BH50834 08/08/2025 08/111202516:28 Bcnzo[a]anthraccne ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Chrysene ND 120 1 EPA 3546 BH50834 08/082025 08/11/2025 16:28 Bcnzo[b]fluoranthcnc ND 120 1 EPA 3546 BH50834 08/082025 08/112025 16:28 Benzo[k]fluoranthene ND 120 1 EPA 3546 BH50834 08/082025 08/112025 16:28 Bcnzo[e]pyrcne ND 120 1 EPA 3546 B1150834 08/082025 08/112025 16:28 lndeno[1,2,3-cd]pyrene ND 120 1 EPA 3546 BH50834 08/08/2025 08/11/2025 16:28 Dibenz[a,h]anthracene ND 120 1 EPA 3546 BH50834 08/082025 08/11/2025 16:28 Benzo[g,h,i]perylene ND 120 1 EPA 3546 BH50834 08/082025 09/11/2025 16:28 Surrogate:Nirroben_eue-d5 61.0% 30-130 BH50834 08/08/2025 0811112025 16:28 Sunngate. l-Fluorobiphenyl 69.2% 30-130 BH50834 08/08/2025 081111202516.18 Surrogate:Terphenvl-d14 82.0% 30-130 BH50834 08/082025 0811112025 16:28 Volatile Organics Analyst: FTR Method:EPA 8260D Matrix: Soil Result RL Date/Time Analyte (ug/kg dry) (ug(kg dry) Dilution Prep Method Batch Prepared Analyzed No Mcthyl-t-Butyl Ether(MTBE) ND 2,9 0.99 EPA 5035A-L BH50857 08/09/2025 08/092025 05:01 Benzene ND 2.9 0.99 EPA 5035A-L BH50957 08/092025 09/092025 05:01 Toluene ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 08/09/2025 05:01 Ethylbenzene ND 29 0.99 EPA 5035A-L BH50857 08i09/2025 08/092025 05:01 to-p Xylencs ND 5.8 0.99 EPA 5035A-L BH50857 08/09/2025 08/092025 05:01 o-Xylcne ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 08/092025 05:01 Isopropylbenzene ND 2.9 0.99 EPA 5035A-L BH50857 09/09/2025 08/092025 05:01 n-Ptopylbenzene ND 2.9 0.99 EPA 5035A-L 13H50857 08/09/2025 08/09/2025 05:01 1.3.5-Tiimclhyibenzene ND 2.9 099 EPA5035A-L BH50857 08/09/2025 08/09/2025 05:01 Complete Environmental Testing,Inc. 80 Lupcs Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 3 of 13 CET#:25HO181 Project:Yamano,54 Greenway La,Rye Brook,NY Client Sample ID Tank Grave 6ft Lab ID:25HO181-01 Volatile Organics Analyst: FTR Method: EPA 8260D Matrix: Soil Result RL t) tc%"lime Analyte (ug!kg dry) (ug/kg dry) Dilution Prep Method Batch Prepared Analyzed tert-Butylbenzene ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 08/0912025 05:01 1,2,4-Trimethylbenzene ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 W09/2025 05:01 sec-Burylbenzene ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 08/09/2025 05:01 4-Isopropyltoluene ND 2.9 0.99 EPA 5035A-L BR50857 08/09/2025 08/09/2025 05:01 n-Butylbenzene ND 2.9 0.99 EPA 5035A-L BH50857 08/09/2025 08!09/202505:01 Naphthalene ND 5.8 0.99 EPA 5035A-L BH50857 08/09/2025 0810912025 05:01 Surrogate:1.2-Diehloroe!hane-d4 107"1 70-130 B1450857 08/09/2025 0810912025 05:01 Surrogate:Tohiene-d8 99.7% 70-130 BH50857 08/09/2025 0810912025 05:01 Surrogate.4-BromoJluorohenzene 99 9"G, 70-130 BH50857 08/09/2025 0810912025 05:01 Complete Environmental Testing,Inc. 80 Lupcs Drivc,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetiabs.com Page 4 of 13 CET#:25HO181 Project:Yamano,54 Greemvay La,Rye Brook,NY QUALITY CONTROL SECTION Batch BH50834-EPA 8270E Result RL Spike Source %Rec RPD Analyle (ugikg) (ug"kg) Lcvcl Result %Rec Limits RPD Limit Notes Blank(BH50834-BLK1) Prepared:8/8/2025 Analyzed:8/11i2025 Naphthalene ND 100 Acenaphthylene ND 100 Accnaphthcnc ND 100 Fluorene ND 100 Phenanthrene ND 100 Anthracenc ND 100 Fluoranthenc ND 100 Pyrene ND 100 Benzo(a]anthraccne ND t00 Chrysene ND 100 Benzo[b]fluoranthene ND 100 Bcnzo[k]fluoranthcnc ND 100 Benzo[a]pyrene ND 100 Indeno[1,2,3-cd]pyrene ND 100 Dibcnz[a,h]anthraccne ND 100 Benzo[g,h,i]perylene ND 100 Surrogate:Nitrobenzene-di S0.2 30-130 Surrogate:2-Fhmmabiphen0 86.9 30-130 Surrogate:Terphenrl-d14 86.7 30-130 LCS(BH50834-BSI) Prepared:8/8/2025 Analyzed:811 U2025 Naphthalene 3380 l00 4.000.000 84.6 40-140 Acenaphthylene 3720 100 4,000.000 92.9 40-140 Acenaphthene 3890 100 4,000.000 97.4 40-140 Fluorene 3940 100 4,000,000 98.5 40-140 Phenanthrene 3930 100 4,000.000 98.2 40-140 Anthracene 4010 t00 4,000.000 100 40-[40 Fluoranthene 4020 100 4,000.000 101 40-140 Pyrene 3980 100 4,000.000 99.6 40-140 Benzo[a]anthracene 3910 t00 4,000.000 97.8 40-140 Chrysenc 4050 100 4,000.000 101 40-140 Benzo(b]fluoranthene 3870 100 4,000.000 96.7 40-140 Benzo[k]fluoranthcnc 4290 100 4,000.000 107 40-140 Benzo[a]pyrcnc 4080 100 4,000,000 102 40-140 Indeno[1,2,3-cd]pyrene 4240 100 4,000.000 106 40-140 Dibcnz[a,h]anthraccne 4260 100 4.000.000 107 40-140 Bcnzo[g,h,i]perylcnc 4190 l00 4,000.000 105 40-140 Surtgate.Ninvbem_ene-d5 88.2 30-130 Surrogate.2-Fluorobtphenvt 93.6 30-130 Staragate:Terphenc1414 981 30-130 LCS Dup(BH50834-BSDI) Prepared:8/8/2025 Analyzed:8/1 li2025 Naphthalene 3400 100 4,000.000 85.1 40-140 0 615 30 Acenaphthylene 3710 100 4.000.000 92.8 40-140 0.0730 30 Accnaphthcnc 3790 100 4.000.000 948 40-140 2.69 30 Fluorene 3960 100 4,000.000 99.0 40-140 0.461 30 Phenanthrene 3780 100 4.000.000 94.5 40-140 3.84 30 Anthraccnc 3980 100 4.000.000 99.5 40-140 0.761 30 Complete Fnvironmcntal Tcsting,Inc. 80 Lupes Drive,Stratford,CT 00615-Tel:203-377-9984-Fax:203-377-9952-www.cctiabs.com I Page 5 of 13 CET#:25HO181 Project:Yamano,54 Greenway La,Rye Brook,NY Result RL Spike Source %Rec RPD Analyte (ugtkg) (ug/kg) Level Result %Rec Limits RPD Limit Notes LCS Dup(BH50834-BSDI)-Continued Prepared:8/8/2025 Analyzed:8/11/2025 Fluoranthene 4250 100 4,000.000 106 40-140 5.60 30 Pyrene 4250 100 4,000.000 106 40-140 6.53 30 Benzo[a]anthracene 3960 100 4,000.000 99.1 40-140 L31 30 Chry•sene 4020 l00 4.000.000 101 40-140 0.669 30 Benzo[blfluoranthene 4130 100 4.000.000 103 40-140 6.41 30 Benzo[klfluoranthene 4170 l00 4,000.000 104 40-140 2.98 30 Benzo[a]pyrene 4320 l00 4,000.000 108 40-140 5.81 30 ►ndeno[1,2,3-cd]pyrene 4580 100 4,000.000 115 40-140 7.78 30 Dibenz[a,h]anthracene 4620 100 4,000.000 116 40-140 8.05 30 Benzo[g,h,i]pery•lcnc 4630 100 4,000.000 116 40-140 9.96 30 Surrogate.Nitrobenzene-0 88.0 30-130 Surrogate:2-Fluorobiphertvl 91.2 30-130 Surrogate:Terphenvl-dl4 89.4 30-130 Complete Fnvironmental Testing,Inc. 80 Lupcs Drive,Stratford,CT 06615•Tcl:203-377-9984•Fax:203-377-9952•www.cetiabs.com Page 6 of 13 CET/1:25HO181 Project:Yamano,54 Greenway La,Rye Brook,NY Batch BH50857-EPA 8260D Result RL Spike Source %Rec RPD Analyte (ug/kg) (ug/Itg) Level Result %Rcc Limits RPD Limit Notes Blank(BH50857-BLKI) Prepared:8/8/2025 Analyzed:8/8/2025 Methyl-t-Butyl Ether(MTBE) ND 2.5 Benzene ND 2.5 Toluene ND 2.5 Ethylbenzene ND 2.5 m+p Xylcnes ND 5.0 o-Xylene ND 2.5 lsopropyl benzene ND 2.5 n-Propylbenzene ND 2.5 1,3,5-Trimethylbenzene ND 2.5 tert-Butylbenzene ND 2.5 1,2,4-Trimcthylbcnzcnc ND 2.5 sec-Butylbcnzcnc ND 2.5 4-1sopropyltoluene ND 2.5 n-Butylbenzene ND 2.5 Naphthalene ND 5.0 Surrogate:1.1-Dichloroethane-d4 101 70-130 Surrogate:Toluene-d8 99.9 70-130 Surrogate:4-Bromolluorobenzene 102 70-130 LCS(BH50857-BSI) Prepared:8/8/2025 Analyzed:8/8/2025 Methyl-t-Butyl Ether(MTBE) 51.2 2.5 50.000 102 70-130 Benzene 50.3 2.5 50.000 lot 70-130 Toluene 51.7 2.5 50.000 103 70-130 Ethylbenzene 52.8 2.5 50.000 106 70-130 m+p Xylencs 104 5.0 100.000 104 70-130 o-Xylene 53.0 2.5 50.000 106 70-130 lsopropylbenzene 54.3 2.5 50.000 109 70-130 n-Propylbenzene 53.5 2.5 50.000 107 70-130 1,3,5-Trimethylben7ene 53.6 2.5 50.000 107 70-130 tert-Butylbenzene 53.8 2.5 50.000 108 70-130 1,2,4-Trimethylbenzene 51.2 2.5 50.000 102 70-130 sec-Butylbcnzcnc 53.8 2.5 50.000 108 70-130 4-Isopropylloluene 53.3 2.5 50.000 107 70-130 n-Butylbenzene 52.8 2.5 50.000 106 70-130 Naphthalene 52.2 5.0 50.000 104 70-130 Surrogate:1.1-Dichloroetlmne-d4 98.6 70-130 Surrogate:Toluene-d8 98.8 70-130 Surrogate:4-8romojhrorobencene 101 70-130 LCS Dup(BH50857-BSDI) Prepared:8/8/2025 Analyzed:8/8/2025 Methyl-t-Butyl Ether(MTBE) 47.2 2.5 50.000 94.4 70-130 8.11 20 Benzene 47.9 2.5 50.000 95.8 70-130 4 87 20 Toluene 48.0 2.5 50.000 96.0 70-130 746 20 Ethylbenzene 48.9 2.5 50.000 97.8 70-130 7.77 20 m+p Xylenes 96.6 5.0 100.000 96.6 70-130 7.22 20 o-Xylenc 49.2 2.5 50.000 98.4 70-130 7.51 20 lsopropylbenzene 50.0 2.5 50.000 100 70-130 8.17 20 n-Propylbenzene 51.0 2.5 50.000 102 70-130 4.69 20 1,3,5-Trimethylbenzene 49.7 2.5 50.000 99.4 70-130 7.61 20 tert-Butylbcnzcnc 49.6 2.5 50.000 99.2 70-130 8.14 20 1,2,4-Trimethylbenzene 49.0 2.5 50.000 98.0 70-130 4.47 20 Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 7 of 13 CET#:25HO181 Project:Yamano,54 Greenway La,Rye Brook,NY Result RL Spike Source %Rec RPD Analyte (ug/kg) (ugikg) Level Result %Rec Limits RPD Limit Notes LCS Dup(BH50857-BSDI)-Continued Prepared:8/8/2025 Analyzed:8/8/2025 sec-Butylbenzene 50.3 2.5 50.000 101 70-130 6.71 20 4-Isopropyltoluene 49.3 2.5 50.000 98.6 70-130 7.86 20 n-Butylbenzene 50.2 2.5 50.000 100 70-130 5.07 20 Naphthalene 47.9 5.0 50.000 95.8 70-130 8.50 20 Surrogate:I.2-Diehloroelhane-d4 Mn 70-130 Surrogate.:Toluene-dg 101 70-130 Sw-rogate.4-BromoJluaahen_ene 102 70-130 Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 8 of 13 CET#:25H0181 Project:Yamano,54 Greenway La,Rye Brook,NY T 80 Lupes Drive Tel:(203)377-9984 Stratford,CT 06615 COMR111 1NVIRONMINiAl TOINC,INE Fax:(203)377-9952 email:cetl@cetlabs.com Quality Control Definitions and Abbreviations Internal Standard(IS) An Analyte added to each sample or sample extract. An internal standard is used to monitor retention time,calculate relative response,and quantify analytes of interest. Surrogate Recovery The%recovery for non-target organic compounds that are spiked into all samples. Used to determine method performance. Continuing Calibration An analytical standard analyzed with each set of samples to verify initial calibration of the system. Batch Samples that are analyzed together with the same method,sequence and lot of reagents within the same time period. ND Not detected at or above the specified reporting limit. RL RL is the limit of detection for an analyte after any adjustment made for dilution or percent moisture. Dilution Multiplier added to detection levels(MDL)and/or sample results due to interferences and/or high concentration of target compounds. Duplicate Result from the duplicate analysis of a sample. Result Amount of analyte found in a sample. Spike Level Amount of analyte added to a sample Matrix Spike Result Amount of analyte found including amount that was spiked. Matrix Spike Dup Amount of analyte found in duplicate spikes including amount that was spike. Matrix Spike%Recovery %Recovery of spiked amount in sample. Matrix Spike Dup%Recovery %Recovery of spiked duplicate amount in sample. RPD Relative percent difference between Matrix Spike and Matrix Spike Duplicate. Blank Method Blank that has been taken through all steps of the analysis. LCS%Recovery Laboratory Control Sample percent recovery. The amount of analyte recovered from a fortified sample. Recovery Limits A range within which specified measurements results must fall to be compliant. CC Calibration Verification Flags: H- Recovery is above the control limits, L- Recovery is below the control limits B- Compound detected in the Blank P- RPD of dual column results exceeds 40% #- Sample result too high for accurate spike recovery Connecticut Laboratory Certification PHOI 16 New York NELAP Accreditation 11982 Massachussets Laboratory Certification M-CT903 Rhode Island Certification 199 Pennsylvania NELAP Accreditation 68-02927 Complete Environmental Testing,Inc. 80 Lopes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 9 of 13 CET#:25HO191 Project:Yamano,54 Greenway La,Rye Brook,NY All questions related to this report should be directed to David Ditta,Timothy Fusco,or Jeffrey Smith at 203-377-9984. Sincerely. This technical report was reviewed by Jeffrey Smith IV144i *4 David Ditta Project Manager Laboratory Director This report shall not be reproduced except in full,without the written approval of the laboratory Report Comments: Sample Result Flags: E-The result is estimated,above the calibration range. H-The surrogate recovery is above the control limits. L-The surrogate recovery is below the control limits. B-The compound was detected in the laboratory blank. P-The Relative Percent Difference(RPD)of dual column analyses exceeds 40%. D-The RPD between the sample and the sample duplicate is high. Sample Homogeneity may be a problem. - The Surrogate was diluted out. *C I-The Continuing Calibration did not meet method specifications and was biased low for this analyte. Increased uncertainty is associated with the reported value which is likely to be biased low. *C2-The Continuing Calibration did not meet method specifications and was biased high for this analyte. Increased uncertainty is associated with the reported value which is likely to be biased high. *F1-The Laboratory Control Sample recovery is outside of control limits. Reported value for this analyte is likely to be biased on the low side. *F2-The Laboratory Control Sample recovery is outside of control limits. Reported value for this analyte is likely to be biased on the high side. *I-Analyte exceeds method limits from second source standard in Initial Calibration Verification (ICV). No directional bias. All results met standard operating procedures unless indicated by a data qualifier next to a sample result,or a narration in the QC report. For Percent Solids,if any of the following prep methods(3050B,3540C,3545A,3550C,5035 and 9013A)were used for samples pertaining to this report,the percent solids procedure is within that prep method. Complete Environmental Testing is only responsible for the certified testing and is not directly responsible for the integrity of the sample before laboratory receipt. ND is None Detected at or above the specified reporting limit Reporting Limit(RL)is the limit of detection for an analyte after any adjustment made for dilution or percent moisture. All analyses were performed in house unless a Reference Laboratory is listed. Samples will be disposed of 30 days after the report date. Complete Environmental Testing,Inc. 80 Lupes Drive.Stratford.CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.ectiabs.com Page 10 of 13 CET#:25H0181 Project:Yamano,54 Greenway La,Rye Brook,NY CERTIFICATIONS Certified Analyses included in this Report Analyte Certifications EPA 8260D in Soil Methyl-t-Butyl Ether(MTBE) CT,NYPA Benzene CF,NYPA Toluene CT,NY,PA Ethylbenzene CT.NYPA m+p Xylenes CT,NY,PA o-Xylene CT,NYPA Isopropylbenzcnc CT,NYPA n-Propylbenzene CT,NYPA 1.3.5-Trimethylbcnzene CT,NYPA tert-Butylbenzene CT,NYPA 1,2 a-Trimethylbenzene CT,NYPA sec-Butylbenzcnc CT,NY,PA 4-Isopropyltoluene CT,NYPA n-Butylbcnzenc CT,NYPA Naphthalene CT NYPA EPA 8270E in Soil Naphthalene CT,NY,PA Acenaphthyfcne CT,NYPA Acenaphthene CT,NY.PA Fluorene CT.NI;PA Phenanthrene CT,NYPA Anthracene CT,NYPA Fluoranthene CT.NY,PA Pyrene CT,NYPA Berzo[a]anthracenc CT,NYPA Chrysene CT,NY.PA Benzo[b]fluoranthene CT,NN.PA Benzo[k]fluoranthcnc CT,NYPA Benzo[alpyrene CT,NYPA lndcno[1.2.3-cd]pyrene CT.NYPA Dibenz[s0]an1hracene CT,NY,PA Benzo[g,h,i]perylene CT,NYPA SM 2540 G in Soil Percent Solids CT Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 11 of 13 CET ft:25HO181 Project:Yamano,54 Greenway La,Rye Brook NY Complete Environmental Testing operates under the following certifications and accreditations Code Description Number Expires CT Connecticut Public Health PHOI 16 09130/2026 NY New York Certification(NELAC) 11982 04/01/2026 PA Pennsylvania DEP 68-02927 05/31/2026 Complete Environmental Testing,Inc. 60 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 12 of 13 N 310N ' I M I.NOO d0 4 lV1Ol co 3 < r LL N o m� E Q O N "o �; Y t t9 ui 0 0) Q r ¢ ¢ 9 td In U U dlol y Z a dldS to u atUjQeiL jell,ipla$4 w '� ti �� IJ Z -o w O (( Q O I a> m PaAlossl0 • a J a U c U y H U � m Q slgleW Sl d33010 a c io I H a m cx m O slelaW El'clod qJOud I C E in SIMRA 9 VHOH 3 L 00� a Q CO Hd1310 W f 11 �. o sopio!gJBH ,J .y w ~ S U saP10490d L � d LL s80d U > n HVd/sVNd OLZ9 O ao salve&OalReloA'! SOLZO Z 09ZB auex010 j UI y Q sua601eH 09Z9 d o S.g r o j« = soiJewwV osze LLJ d m o 2 E U solue610 al!leloA 09ZR °z a L) I O n ¢ I tt ...PiePueyg 7 � 0 E at .Aep, _LLo C v �L /a0 om_L zca AG(I ixaN c W (ep awes > cu r- Q �? v1 r N c C ar7,3o3�J� o 0 m U ee O w m in m m CL _ W I o`ou`Vi E E p g W W >� W �� E ; �. Q'p� O O 0 to w w I S' y d d !I �� al 0 ^ U L a ¢�-� UPI ¢ w r Z ���� co m m O RJ O 0 3 c vN 0 U `�� Z 0 3 '� ❑ 3 ,� N N ul Z ?, C C y N a S ,•ten w a G 0 'o w rn r \ C '✓� Q m p z O _ E a Q 0 m 0. J T rn n C Cl r E U d G E n T 7 ? a n C U-A I com E cc U W v N N o a m m' m o rn a ®V1 > H o ff! W >- �N OU Q C H CIO w� o o t ro _ NJoo U) r W ON EL — N Z N Oy a ,1 �JO QO WZ > G GI h ao Z vi � ¢ : UtW Z O NC a a SCALE PURCHASE TICKET PC Metals, Inc 270 Central Avenue Bridgeport, CT 06607 203-367-9328 Ticket: 605192 Weigh In: 08/07/2025 14:28 Customer: 1034 Weigh Out: 08/07/2025 14:56 ENVIRO SHIELD Bridgeport, CT RED DUMPTRUCK Commodity Gross Tare Net Price TOTAL$ UN TANK 11460 10500 960 /GT Buyer: 0 I hereby certify that I have the right to possess and sell this scrap. This is a Bill of Sale to the above described scrap. I hereby acknowledge payment in full. Customer Signature Please do not lose this ticket. Ticket required for payment. E xw STATE OF NE bL' ORK,COUNTY OF WESTCHESTER ) as: l,- ^ O t c�r<<�v being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing av the applicant) and further states that(s)lie is the Tank Installation Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance witli the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable!aws,ordinances and regulations. . ti Swom to before me this 0� Sworn to before me this I'D day of r 1A .20 2-0 da of m 20 Sign re of property Gorier Signature of Applicant rant Name�of p rzy Owner Print me of Applicant I` 'i'�ice,-I�✓1"A'l M���, Notary Public Mobunu d Rtrlmm Not. P otI Cary Public S de ofN w Y KIDAINIELLY 1`IOVOLI-SANTOS Notary Public Berate of New YorkMy Commission Expiration:01/17/2029 ry Public,Stato Of ConnecocutThis application must be properly completed in its entirety and must inclRMISSlon Expires May 27 2026 signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided.Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. r 6/1,2024 BUILDING DEPARTMENT VILLAGE OF RYE'$IROOK �J MAY 2 7 2025 �II 938 KING STREET RYE BROOK,NY 10573 _ �J 3ROOK N1MN'.rJ SOOkDV.QO'- Application for Permit to Remove or Abandon Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE: USE ONLY: PERMIT N: /-1Pc, —C7J Approval Date: 2 ' 2 4:25' Permit Fee: S t J '' 06 Approval Signature: _ls�z_,A fA ���� Other: Disapproved: (fees are non-refundable) rwwrwr}afawaawa•aarraf•w#frarrfwwawf•r•ww#•rr••wawr.a.rwwwr♦rwrarr•waw:awawr•wra♦aaawfa•:rr•:frrrwawaaa DO NOT START WORK or CONSTRt1CTION I"NTIL %PERMIT I AS BEEN ISSUED BY THE BUILDING INSPECTOR THE ADMINISTRATIVE FEE FOR WORK PR04RESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750 00 REOUIRVVIFINTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Application Completed by Bonded, Licensed Contractor. 2. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder) 3. Your contractor's valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3 /or NY State Workers Compensation Waiver) 4.Fee per Tank: Removal or Abandonment S 185.00 per Tank. 5.Dig Safely New York#(dial 81 1): _0'a►► c%S - Dot- its`li 6. Inspection by Building Department tip removal or abandonment. 7.Submit all Manifests& Reports(after work has been completed). 8.Certificate of Compliance will be provided when all requirements are fulfilled. rwwr}f*w}•**}w}#ffrrra***}a*a4faar♦a#fwaa#r•wf lw#far•f#wfa•f**}wR#a#w#•*a•♦♦#r4♦**4*wwffw*waf}flfrRfa4 Application dated, MD'-% I5,Zv LS ,is hereby made to the Building Inspector of the Village of Rye Brook for a permit to remove or abandon a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s)will be cmvl c r abandoned in conformance with all applicable Village,County.State& Federal laws,codes, rules and regulations. aaaafff*fafaa}a#*raa#f*faaaffafafaaf}aaaraa}}}aaaaafwrfaaa#ra}ffawfaaf}of}**fa*fafaaafff}*}*aafra#}*** Indicate Permit Type: Removal Wf•Abandonment( )/Above Ground( )• Buried in Ground(y' I. Address: 54 G,u,W°." U:,.,;- SBL: /a9,0,q"'.)-73 zone: pub 2. Property Owner&Address: f'n K l,C04Jm; �41,-n P. o Phone#: 9"-716� ` etSs Cell : __ __email 3. Contractor&Address: Phone#: a°3 a�g+o J(.4+,t Cell a email: 4. Applicant. oz a Z'X- - - - Phone#: 'Z-3-3 Cell#: cma it: Z,I<o��/"'�aeyl.,.ttp•Co-r. ----- 5. Indicate Fuel Type: Fuel Oil(+,<*L.P.Gas( )•Gasoline( )•Other( }: 6. Number and Capacity ofeach Tank: 7. Exact Location(s)of each rank I 61 1/2024 �,�l� �u••y � cr,k p v^,v j ytxb' y F#`�Xot / � �. _ v+f i �.. !i, �y;y �i. \gt$9" —7,- 'L�€t t r `�.-�. yy�y ,--- "iat•�''1,�"C�p _� {:.lXy�+s. �� +4•'t 4�,�yNY ;1 t_,i+�I ,�_ {tirr`•) ¢,� 'Sit +.� .Ip�' r� _ m,y,'^. TT`.. r• y �^ '� .�� l2ey. `�/r •.1 f :� a F'' f r, St•.•5v'{r{{lQ! r��'i'ri•Jrrr t � �. .M1 �Sa , },tip • .'k�' . 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I^Y,.'i�r' ,� rn 7('r'',G > +'"nb "' _yK.F,,Y^•�4+`�!�`�'+ ,�' v.; ! !n � � •`d IT'S ENVIINC-01 JSILVA ACORO" �-- �� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 12/4/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mary Tomaselli OWrle Group PHONE - 70 Essex Road �ta.Mc�._No.Eat) (860)399-2838 I FAX Westbrook,CT 06498 IwFtlkSS:mtomaselli@risk strategies.com -- . INSURER(S),AFFORDING COVERAGE_ B liu1;Y.ERA:Nautilus Insurance Company INSURED Ht19URER8:Great Divide Insurance-Company _ 25224 Enviroshield Inc.and E.G.Kost Rental,LLC PO Box 1296 iNsuRER c _-_ 250 Moffitt Street INSURER D: Strafford,CT 06615 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN-WLTR TYPE OF INSURANCE 'AD O i UY Wv RI POLICY NUMBER j POLICikl"DM21M (MMMY YY LIMITS A 1 X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE - S __ 1,000,000 CLAIMS-MADE X OCCUR ECP01521982-25 12/1/2024 12/1/2025 OAMAGETORENTED 100,000 X Pollution Liability � PBEMIR SiEa-occurrence)__ S _ -—_ MED EXP A(_n oy-%On),— i 5,000 X Professional lab - ----';---- I- PERSONAL&ADV INJURY S 1,000,000 _GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,066 I POLICY O'Pea- CJ LOC ! PRODUCTS=COMP/OP AGG S 2,000,000 OTHER 1 _ -- B AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT 1,000,000 --- (Ea.A�Odfnj) ANYAUTo BAP1521979-25 12/1/2024 12/1/2025 BODILY-INJURY lPsrpera0n S L.- AUTOS ONLY X AED AUUTTOS�'EO --- BODILY INJURY Per accident ,S �RE��� ooNN..ppyyyy��EEpp p 3_X- A�70S ONLY X AUTOS ONLY (P eIO cRkiTYx� AMNGE ._........-- $ X MCS-90 Endl - A UMBRELLA LIAB XFOCCUR 1,000,000 -J __ .EACH OCCURRENCE__—„_ _S-__ X 'Excess LIAR Ms MADE IFFX 2036752 13 12/1/2024 12/1/2025 --- AGGREGATE S 1,000,000 DED I X I RETENTIONS 10,01 -- B WORKERS COMPENSATION X PER OTH- 'AND EMPLOYERS'LIABILITY WCA 1szlsso 24 121/2024 12/1/2o2s _sTeTuaE—L :AOoNY51RIMI EMTBOE 1 EXCLUDED?ECUTNE YIN E,L..EACHACCIDENT_-.,. 5 1,000,000 (Mandit.,rm NHS EXCLUDED? MIA E.L.DISEASE-POLICY LIMIT 1,000,000 - If yes,describe under DESCRIP ION OF OP RATIONS below � i _ _ S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addltlonal Remarks Schedule,may bs attached If more space Is required) Village of Rye Brook is listed as Additional Insured for General Liability where required by written contract. I� l CERTIFICATE HOLDER _ __ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook AUTHORIZED REPRESENTATIVE _ 938 King Street ( i e Brook.NY 10� ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address of Insured(Use street address only) Ib.Business Telephone Number of Insured (203)394-2268 Enviroshield,Inc. Post Office Box 1296 lc.NYS Unemployment Insurance Employer Stratford,CT 06615 Registration Number of Insured Work Location of Insured (Only required if coverage is 1d.Federal Employer Identification Number of Insured specifically limited to certain locations in New York State, i.e., a or Social Security Number Wrap-Up Policy) 060319014 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Commerce&Industry Insurance Company 3b.Policy Number of entity listed in box"Ia" BAP1521979-25 Village of Rye Brook 938 King Street 3c. Policy effective period Rye Brook,NY 10573 12/1/24 to 12/1/25 3d. The Proprietor,Partners or Executive Officers are ■ included. (Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "T' insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"T'. The Insurance Carrier will also notes the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c",whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Vincent M. Falcigno (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Vi.+1.ae,+vf-M. 11/25/2024 (Signature) (Date) Title: Managing:Member Telephone Number of authorized representative or licensed agent of insurance carrier: (203)745-0078 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Friday, August 1, 2025 11:07 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 08/01/2025 11:07 To: VIL RYE BROOK PRIMARY Transmitted: 08/01/2025 11:07 00009 Ticket: 08015-000-805-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 54 To: Name: GREENWAY LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WE ARE REMOVING AN UNDERGROUND OIL TANK LOCATED UNDER THE PATIO IN THE REAR OF THE HOUSE. THE ARBORS NearSt: BRUSH HOLLOW CLOS & BRUSH HOLLOW LN Means of Excavation: EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: TANK REMOVAL Estimated Work Complete Date: 08/06/2025 Depth of excavation: 6 FEET Site dimensions Length 6 FEET Width 5 FEET Start Date and Time: 08/06/2025 07:00 Must Start By: 08/20/2025 ------------------------------------------------------------------------------ Contact Name: LEONARD BOCHICCHIO Company: ENVIROSHIELD Addri: PO BOX 1296 Addr2: City: STRATFORD State: CT Zip: 06615 Phone: 203-380-5644 Fax: Email: len@enviroshield.com Field Contact: LEONARD BOCHICCHIO Alt Phone: 203-380-5644 Email: len@enviroshield.com Working for: PROPERTY OWNER ------------------------------------------------------------------------------ Comments: THE SITE IS MARKED IN WHITE FLAGS Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CONED SUEZ WTR WESTCHESTER 1 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday,July 7, 2025 9:38 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 07/07/2025 08:14 To: VIL RYE BROOK PRIMARY Transmitted: 07/07/2025 09:37 00001 Ticket: 07075-000-379-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 54 To: Name: GREENWAY LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: THE SITE IS THE ABRORS. WE ARE WORKING IN THE REAR OF THE UNIT, THE TANK IS UNDER THE STONE/BRICK PATIO. NearSt: BRUSH HOLLOW CLOS & BRUSH HOLLOW LN Means of Excavation: EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: OIL TANK REMOVAL Estimated Work Complete Date: 07/10/2025 Depth of excavation: 6 FEET Site dimensions: Length 6 FEET Width 5 FEET Start Date and Time: 07/10/2025 07:00 Must Start By: 07/24/2025 ------------------------------------------------------------------------------ Contact Name: LEONARD BOCHICCHIO Company: ENVIROSHIELD Addrl: PO BOX 1296 Addr2: City: STRATFORD State: CT Zip: 06615 Phone: 203-380-5644 Fax: Email: len@enviroshield.com Field Contact: LEONARD BOCHICCHIO Alt Phone: 203-380-5644 Email: len@enviroshield.com Working for: PROPERTY OWNER ------------------------------------------------------------------------------ Comments: THE AREA IS MARKED WITH WHITE FLAGS Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK 1 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday, May 19, 2025 12:03 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 05/19/2025 11:51 To: VIL RYE BROOK PRIMARY Transmitted: 05/19/2025 12:03 00018 Ticket: 05195-001-459-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 54 To: Name: GREENWAY LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: REMOVING AN UNDERGROUND OIL TANK LOCATED UNDER A REAR PAVER PATIO NearSt: GREENWAY CIR & BRUSH HOLLOW CLOS Means of Excavation: EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: OIL TANK REMOVAL Estimated Work Complete Date: 05/22/2025 Depth of excavation: 6 FEET Site dimensions: Length 5 FEET Width 5 FEET Start Date and Time: 05/22/2025 07:00 Must Start By: 06/06/2025 ------------------------------------------------------------------------------ Contact Name: LEONARD BOCHICCHIO Company: ENVIROSHIELD Addr1: PO BOX 1296 Addr2: City: STRATFORD State: CT Zip: 06615 Phone: 203-380-5644 Fax: Email: len@enviroshield.com Field Contact: LEONARD BOCHICCHIO Alt Phone: 203-380-5644 Email: len@enviroshield.com Working for: PROPERTY OWNER MR. HARUMI YAMANO ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR i