COMPLIANCE INFO 1992-2014 - Laserfiche WebLink

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k il. TANK HISTORY Was Tank tested? SAN IOAOUIN C PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTJt,;tI VISION No NO Failed precision test t Yes WORKSHEET FOR SITE CLOSURE EVALUATION • DATE yes, give date(s) NAME OF FACILITY iIs permit .- �� l% C 41G47 SWEEPS CODE No 2:56 S Permit a - C�.!� Status Code TANK ID @ '76/ 19/ ADDRESS Number of Tanks at facility ��,� _ Age of Tanks(if available) , (TANK SIZE (./ FUEL TYPEHISTORY r, catastrophic Sngl Dual if condition is met overfill r unknown V. Site Feature - Leaching Potential Analysis k il. TANK HISTORY Was Tank tested? Yes TES No NO Failed precision test t Yes Ref/Year No If yes, give date(s) 14 iIs permit current? Yes If yes, what was reps ired7 No Yes Permit a - Facility Status Code � Doc.SOiL/GW Cont Yes No No Number of Tanks at facility TPH•G _ Age of Tanks(if available) , Type of Tank Steel H Fbrgl catastrophic Sngl Dual if condition is met k il. TANK HISTORY Was Tank tested? Yes TES No NO Failed precision test t Yes Ref/Year No If yes, give date(s) 14 Was a repair made to the tank system? Yes No If yes, what was reps ired7 Was repair done under inspection? Yes umber S Type No Irr Were soil saaples analyzedt Yes No BTXEI Score 10 pts TPH•G Score 9 pts TPH-D Score 5 pts if Pb/EDB ft; ft; ft Type of failure/discharge catastrophic if condition is met long-term Leakage if condition is met overfill condition is met unknown V. Site Feature - Leaching Potential Analysis other: by Dtrnvil NtCTnaY (ATTACH INSPECTION REPORT FOR SITE DETAILS/COLLECI UAIA ruK LtAlntnu rw1cn11 . ,..... " Soil Samples Received Yes TES No NO Depth to Ground Vater 7,�. Ref/Year `;.;� Average Arn:aL Precipitation A= 14 10.25 On -Site '4ell(s) Yes DATE CLOSURE LETTE)�ILED Na umber S Type Irr Z1�� Dom Pub S C Score 10 pts S C Score 9 pts S C Score 5 pts if Distance to Wells) frac Tank ft; ft; ft 0 R E if condition is met 0 R E if condition is met 0 R E condition is met V. Site Feature - Leaching Potential Analysis Minimum Depth to groundwater from the Soil Sample (feet) >100 51-100 S 25-50\1 Fractures in subsurface (applies to foothills or mountain areas) None Unknown Present xxxxxx <10 9 10-25 xxxXxxx 26.40\2 Average Annual Precipitation (inches) Man -Made conduits which increase vertical migration None Unknown present of leachate (i.e., septic systems, water wells, ponds) Unique site features: Recharge area, coarse soil, nearby wells. GG At least More than one xxxxxx None / one �'J + Z/ + e5t;' a L Z COLUMN TOTALS>>>TOTAL POINTS Sample Result: IS T X OR E) RANGE OF TOTAL POINTS 49 pts or more 4 48 pts 40 pis ar less MAXIMUM ALLOWABLE B-T-X•E LEVELS (PPM) B 1 T 50 X E 50 50 B .3 T X .3 1. E --1 NA\3 I�/,1_2 Saeple Result: GASOLINE 1000 100 10 - 0- 100 MAXI MIM ALLOWABLE TPH LEVELS (PPM) TPN DIESEL 10,000 FOOTNOTES: •--If documented soil and/or ground water contamination is present, do not complete the leaching potential analysis. (i.e., site is currently on LOT Contamination List for soil or ground water.) \1 If depth is > 5 ft. and < 25 ft., score 0 points. If depth <=5 ft., do not use table. \2 If precipitation is > 40 inches, score 0 points. applicable at a TPN concentration of 10 ppm (gasoline) or 100 ppm (diesel). \3 Levels for BTX3E are not VI. STAFF RECOMMENDATION/CONCLUSION 1. Are BTX 8 E or TPH Concentrations > Allowable Levels -Yes 2. Recommend Site Closure Yes,-- No •if Yes, Refer to Site Mitigation for Evaluat VII REVIEW EVALUATION - TO BE COMPLETED BY A SUPERVISOR/SENIOR CONCUR WITH STAFF RECOMMENDATION FOR CLOSURE TES L/ NO REFERRED TO SITE MITIGATION FOR EVALUATION YES N DATE REFERRED / / DATE CLOSURE LETTE)�ILED NAME OF EVALUATCR Z1�� EH 23 30 (UGTWKSHT)\5/90 Z"