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SAN JOAQUIN COUNTY LC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIS -ICN <br /> LOST '.*_SHEET FOR SITE CLOSURE EVALUATICH DATE j-j3 - ,V 2 <br /> NAME Of FACILITY e j�i Tvc< c krH SWEEPS CODE �rf 7lp <br /> -0OR a5 TANK ID 3 3 q - „)y7(a <br /> ANY SIZE jFUEL TYPE (,rile' <br /> GENERAL SITE HISTORY ••• <br /> is Dermlt current] Yes No Permit s <br /> Facility Status Code .SZ Dac.Sor l/GW Coni as No <br /> � j Age of Tanls(it available) Type of Tank Steel Fbrgl Sngl <br /> Hurber of Tanks at facility Dual <br /> I <br /> '1, TANK HISTORY <br /> Was Tank tested] Yes No Failed precision cess 7 Yes No if yes, give date(s) <br /> / <br /> if yes, what was repaired? <br /> / <br /> �uas a repair made to the tank system] Yes No <br /> IWere soil saaples anm lyzedT Yes No B1%E TPN•G TPH-DI Pb/E08 <br /> Was repair done under inspection? Yes No <br /> Type of failure/discharge catastrophic long-term leakage overfill unknown other: <br /> !V. RENCVAL HISTORY (ATTAC4 INSPECT REPORT FOR SITE DETAILS/COLLECT DATA FOR LEACHING POTENTIAL ANALYSIS) - <br /> / / Average Arcual Precipitation Aii 16 10-25 <br /> Soil SampLes Received Yes No epth to Grourd Water Yo' Ref/Year ! � 4� <br /> Cn-Site Wells) Yes No Number i Type Irr Dao IPub S Score S Score S Score <br /> Distance to VeIL(s) fres Tank ft; ft; ft C 10 pts C 9 pts C 5fpts <br /> 0 if 0 if 0 <br /> R condition R condition R condition <br /> V. Site Feature leeching Potential Analysis <br /> E is met E is met E is met <br /> Y0'�'3.L S <br /> Mi nimun Depth to groundwater fres the Soil Saeple (feet) - >100 51-100 25-50\1 <br /> Fractures in subsurface (applies to foothills or mountain areas) <br /> None Unknown Present <br /> Average Annual Precipitation (inches) xxxxxx <10 9 10-25 XxxxX%X 26-60%2 <br /> Man-Made conduits which increase vertical migration Unkin Present <br /> of leachate (i.e., septic system, water wells, pads) None 9 m <br /> q At least More than <br /> Unique site features: Recharge area, coarse soil, nearby wells. xxxxxx None / one one <br /> • y/ <br /> COLUMN TOTALS»>TOTAL POINTS C� t' <br /> sauple Result: (B T X OR E) RANGE OF TOTAL POINTS 69 pts or more 1 - 6a pts 60 pts or less <br /> B T X E 8 T X E � <br /> MAXIMUM ALLOYIIBLE B-T-X-E LEVELS (PPM) 1 50 50 50 .3 .3 1. 1. <br /> Sanple Result:ff <br /> GASOLINE 1000 100 10 <br /> (Yl MAXIMUM ALLOWABLE TPN LEVELS (PPM) <br /> TS-00 TPH DIESEL 10,000 1000 100 <br /> FOCTNOiES: ••'tf documentedsoil arid/ordor ground water contamination is present, <br /> analys do rot <br /> e leaching potential <br /> anelysis. (i.e.,, site is currently on UGT Contamination List for soil or ground water.) <br /> %I if depth is > 5 ft. and < 25 ft., score 0 points. If depth 4-5 ft., do not use table. <br /> %2 if precipitation is > 60 inches, store 0 points. <br /> \3 Levels for BTXSE are rot applicable at a TPN concentration of 10 ppm (gasoline) or Too ppm (diesel). <br /> VI. STAFF RECOMMENDATION/CONCLUSION <br /> 1. Are 3TX b E or TPN Concentratioru > Allow a Levels •Yes No <br /> 2. Recanmend Site Closure Yes No ✓ if Yes, Refer to Site Mitigation for Evaluation <br /> VII. REVIEW EVALUATION TO BE COMPLETED 8T A SUPERVi50R/SENIOR <br /> EEVALU!ATCR <br /> R V1TN STAFF RECCfgENDATICN FOR CLOSURE TES NO REFERRED TO SITE MITI WTION FOR EVALUATION YES NO <br /> / / DATE CLOSURE LETTER MAILED <br /> EH 23 30 (UGTWKSHT)\5/90 <br />