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SAN JCACUIN Co 'mTY PUSLTC 4EALTX SERVICSlENVIACNNEYTAL 4EALiN OTVISICH <br /> I ;T 'JCRKSHEEi FCR Sfic CLOSURE EVALUATICH IOATEI 2Z� <br /> INANE OF FAC.LIT", 44 S IS1tE°5 OMEN / <br /> ADCRESSI 'Q �U.1 / (TANK :13 <br /> TANK SIZE( //U O (FUEL 7P51 <br /> H. IENERAL SITE 4ISTCRY <br /> is =ereit carters[? Yell Noj IPsrmir tj �G Z� (Facility Status Code) �/ Oae.Sai l/GN C=LIYesI INoI <br /> Hiner of Tanks a2 facility) (Age of ianks(if available)( IType of TaniclsteeLl SLI IS'gLI Ou LI j <br /> ,•,. TANK HISTORY <br /> vas lank rested?(Yes INoI (Failed precision Last es! INC! [f yes, give date(s)I <br /> ':as a repair made rc :he tank sys;7iYZI ZI If Yes, ullat Was repairedtl <br /> :as repair done under irepecri antlYesl Na{ IYere sail samples analyzes? YesI I Ie I H-Gj�TPX]I IPb/EDBjtX <br /> 7yce of failure/disehar?el catasiraonicl (Long-cerin Leakage) averfi 111 l wj lather: <br /> j <br /> ;V. iE'!CVAL HISTCRY (ATTACi INSPE TCN REPORT FOR slim DETAILS/CCLLCT OATA FOR 1EAC3I101 POTENTIAL ANALISIS) <br /> �SaiL SaaeLes Raceivedl Yeas NoI (Depth :a Ground 'Jarerl vl Ref/Tearl ;E6IAversge Artival Preeipi[a[ianlA=l i4 I10-25 <br /> ICn-ii re vel L(s)IY"I 4,,fH0j IA mer i TypelIIrrl DCaI/1Puol <br /> S (Score S Score S Scare <br /> 'D•stance :o 'JeIL(s) frac tanK� Y. ,ft; ZT; 0 pcs C 9 pss C 5 pts <br /> O ref 6 if 0 if <br /> .2 �cNtion ldi i canditfan R condition <br /> iv. Site Feature - Leaching Potential Analysis is set l is ,nei C is get <br /> Minja Oeprh to groundwater from the Soil Saaole (feat) I l >70O j IST-iC0 1 I 5-50 <br /> IF^oc:_res in subsuraee (atop)ies ro foothills Cr aaarain arms) I j Nrne 1 q I Unu:am em <br /> IAverege Annual Pre_ ipi:atian (inches) IXoocsDcl <10 <br /> 'Man-Made conduits Which increase vertical aigration <br /> :of Leachate Ci.a., septic systass, Water xl Ls, pond) I .Norte I I (Present <br /> Unique sire features: Recharge area, coarse sail, reerdy ' eLts. f lzl <br /> AL Least '-' imam :hon <br /> )GLCOCcI .Yore Ona I one <br /> CCUA <br /> NM! iCTAL »TOTAL POINTS 0 <br /> Sa Le it"Utt: (3r OR _) RANGE OF TOTAL POINTS 149 Cr Imre l 41 - .a pts l t0 pis or Less <br /> MAXIMA ALLOYASLE 3-i-X-° !MELS <PPNJ I SO 513 50 I -3 I.3 ` t.l 1_ XA\.3 <br /> Saiole .ResulLtl: GASOLINE 1000 I ROD I 10 <br /> p <br /> / l D ,7PX MAXIMA ALLOYANLE TPX LEVELS CPPX) OIES< 10,000 I 1000 I 100 <br /> F•OOTNCT'cS. —If docmnted soil and/or around nater aniaminstim is were C, do not c.>mlete the leaching potential <br /> analysis. (i.e., site is : rwrty an UGT Contamination List for soil or grauld water.) <br /> \1 If depth is > 5 It. and < 25 ft., store 0 points. If depth =S ft., do not use table. <br /> j \Z If precipitation is > GO inches, score_ 0 points_ <br /> \3 Levels for 37X3E are not applicable at a IPM concentration of 10 ppm (gasoline) or 100 ppa (diesel). <br /> vT. STAFF .RECOMMENDATION/CONCLUSION <br /> I. Are 3TX 3 E or TPH Concentrations > All - le Lavets I"ft <br /> Z. Recoffierd site Closure+Tesl INej V1 �If Yes, Refer m Site Mitigation far Evat=z..Cnl <br /> 'lSI. 2E'/JEW EVALUATION - TO 3E CCMPLETD 3Y A SUPEZVISCR/SEMICR <br /> CNCIR 'JITH STAFF tE=ME'WATTCM(OR C.OSUREIYES1 Nei lRE=-UD TO SITE .MIT=TICN FCR =/ALUATICNIYESI INOI l <br /> DA-.= REFERRED! / Z 2/ z OATS CLOSURE La-TTER MAILS / / l <br /> NAME OF W ' <br /> E/AL'JATCR I <br /> EN 23 30 (CGTNKSNT)\5/90 <br />