Release Notification Form

(1) Written notification of releases and threats of release required under 310 CMR 40.0333 shall be submitted to the Department on a form established by the Department for such purposes and shall include, without limitation, the following: (a) the location and address where the release or threat of release occurred; 1. the street number, city or town, and zip code, where applicable; and 2. the location coordinates; (b) the time and date when the release or threat of release occurred; (c) the time(s) and date(s) when the person(s) required to provide the notification to the Department pursuant to 310 CMR 40.0331 obtained knowledge that the release or threat of release met one or more sets of notification criteria established in 310 CMR 40.0311 through 40.0315; 40.0371: continued (d) the time(s) and date(s) when oral notification of the release or threat of release was made to the Department, if applicable; (e) the set(s) of notification criteria met, as specified at 310 CMR 40.0311 through 40.0315; (f) the names and amounts of oil and/or hazardous material released or threatened to be released; (g) the names and mailing addresses of the owners of all properties impacted by the release or threat of release; (h) the name(s) and address(es) of the person(s) providing the notification of the release or threat of release; (i) the affiliation of the person(s) making the notification to the site of the release or threat of release, as described in 310 CMR 40.0331; (j) a signed and dated certification statement from the person(s) reporting the release or threat of release attesting to the truth and accuracy of the information provided, as specified at 310 CMR 40.0009; and (k) such other information as the Department may from time to time determine is necessary and useful in the fulfillment of its statutory obligations under M.G.L. c. 21E and 310 CMR 40.0300. (2) Persons required to notify of releases or threats of release to the Department under 310 CMR 40.0300 shall make reasonable efforts to obtain and preserve the information required in the Release Notification Form described in 310 CMR 40.0371(1), in order to furnish same to the Department. (3) Persons providing notification of a release(s) or threat(s) of release(s) shall also provide a copy of the Release Notification Form to the Chief Municipal Officer and the Board of Health in accordance with 310 CMR 40.1403(3)(h). SUBPART D: PRELIMINARY RESPONSE ACTIONS AND RISK REDUCTION MEASURES