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NAME aF FACILIT <br />SAN 1CAG1[H`a191TY 7URCiC :1EAL:A SE2VICSlE4V[RCO)MEiTAC ifa� JCYCS:CN <br />UGST 'aIRKSNE=t :-aR ii is GCSURE _/ALUAi TCN <br />u)-.1 ->533_0 <br />fI. !-e.VEiAL iITc 4I STaR7 <br />els permit rlrrent?lyes{ INoI IPerait tI - [Facility States Cam{ ICoc <br />,vtaaer of Tanks at faeilityl Age of ianks(if availaLe)l IType of Tarek I Steell <br />TANK 4ISTCRY <br />'Jas Tank t&Sted?l YeslkZltal IFai Led precisian :as-. ?i Yesl XINo} IIf yes, give mie(s)l// / <br />':as a rerair made :o :.'te :aNL sys:e>r/l7el Na} lIf yes, vnac was 'mat refill v <br />Vas :ecair done 's+cer irtspee:ianl}Yes Nal {here soil sa®les a LYEs?jyes} 11101 13 -WI <br />"yce of failure/discharge[ Ieatnzr�tticl horn[ -^term leakagel laver.'i lL, luuawtetl IaCert Nl, <br />!Y. 10OVAL AISTCRT (.AT --AM I)4SPE-rid UPMT .1:'N. Slie IEAILSIC 'l-•r'3AiA Rm i-EmCiima MI2NTIAL AN <br />/ tr% / <br />IhlllC <br />PWMS <br />Sail SaaCiea .gecei vedl Yes <br />Nal <br />IOeorn :o «Mata 'Jaserl�'t'�Ref/:'ear1 <br />1-00: (Average Amtnl 71-eeipi tation1A=I iL 110-251 <br />ICn-Sita Wei LCS)YesI� INaI INu®er 3 } <br />llrrl IOea} �Ps� <br />i Stlm <br />C to pcs <br />S <br />C <br />scar_ <br />9 pes <br />S <br />C <br />Scare <br />Pts <br />!Oistanee :a 'Jell(s) frme 'wKR <br />ao ": f'; <br />a if <br />3 ICZCfC 4m3 <br />is met <br />a <br />l -c <br />if <br />a910i Ciao <br />is me <br />a <br />2 <br />E <br />if <br />i <br />CTd{Sian <br />is me <br />V. Site Fenture - Leaching PaCerWial Analysis <br />'IMT <br />nimuo OepCt :a 3rOtat0iater from 7Ie Sail Samle (fees[ 1 <br />l >1W <br />l <br />151-iW <br />i c'e..-5a\i 1 <br />lF^�c^.res in stksuraee (amlies -3 f, =iLls Jr �Cain arms) 1 <br />.vane <br />I <br />i <br />1 'lemmtn I <br />[Present <br />[Average Annual ?rnCipitaC:an (inoses) 1 <br />'ar� <br /><10 <br />I <br />1 10-:5 Ixaoco=1 <br />L-4\2 I <br />Man -Mede �it 'which InG-m ver"cat sigraxim <br />l Tarte <br />I <br />I{ <br />l2Rfvsr^ <br />iPresmc <br />:of lescmate (l.e-, sepiie 7WIMe, vacr'xtLs, pends) <br />f <br />Sunt Cole site TCm=rea: .ieClarge arms, c7rse sail, nearoy 'eel Ls- I <br />( <br />At Leas% <br />(Mare :tan <br />AXXXXK versa <br />an e <br />=0 <br />r Rion - A) r) �•I iQfAt9�26fAL 7QINTs I <br />` - <br />I <br />- ! <br />(� <br />ke 7esult: (s T X d D .UN,Q OF TOTAL VIXnjjq <br />pts ar mre <br />f `i - (a ;es 1 as Pis or Less I <br />Is, <br />ll3D <br />i I X I= <br />3 T X <br />MAXIMLsI , rxuare 3 -T -z-_ LNE+S (pPM)I <br />t) :al Tat is <br />I 3'S I t.' 1_ NAV <br />. saoele ,tesut t: rrASOLIRE <br />'IOW <br />1 1W 1 is <br />,. t n,aa a I'm L_e4Ps (PPM) <br />A II Nb .TPM inlWE— <br />tame <br />1 IWC 1 1W 1 <br />? ' NCTSS: "e1.f racmeteed soil and W staid "tw omrtosimcion is preseeet, do nee glees rhe leataing potwmiaL <br />analysis_ (i -a., site Is=a-ranttY an (DOT CanCaminesim List for mit or grautd atMr.] <br />\1 If di!ptll is > 3 ft,- and < g ft., score 0 points_ If mpas =5 ft., do nae use sole. <br />\Z If ;r ,'pitacim is > LO irudses, scan 0 pains_ <br />l\2 Levels for 3i>;iE are raC app[Comte ac a TPM o=wCrwZ!m of to IPPR (gasoline) or iW PW (diesel)_ <br />i.AFF .3EC34ME?ICATId/CIX=STd si feDo Aso <br />3� <br />1. Are 3i JI S _ or TPM Cmics M -mans > ALLa to Levels l^e} IMa} 1 <br />1 ?- 3ecaametm site C;osurcl Tel lNa} '11!f Yes, Safer Ca sits Mitigation �r 3val ati m1 <br />/ti. 2EYIEIi S/ALUATICH - Ta 3E C7Br---T0 3T A 21PS-'1YISCIUSE9Id <br />G.VGR 'JITH STAFF .gEr...7' @eMnd FCD( =X=Elmj I (MOI IRF -=-:um m s -.—m .vITIGArcm FCC ?/Al1)ArdlTEsl {Ma <br />CA—,z e 3E-Sit)[0I / / IOATe CGSIWE L---Im MIL -3 <br />NAME OF ✓I i <br />ii 23 30 (UGTL'KSHT)\V/SG <br />