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SAN JOACUIN COUNTY PUBLI' SALTH SERVICES/ENVIRCNMENTAL HEALTH OIVISI <br /> UGST WORKSv: FOR SITE CLOSURE EVALUATION r,,,. ATE <br /> F FACILITY (7 n 6, �^ YQQ EEPS CODE �-y �� <br /> S1 ANK 10 4t <br /> ! CT- �)� UEL TYPE <br /> Z <br /> ,RAL SITE HISTORY LL <br /> Tic current? es o ermic 3 icy Status Code yoe.SOil/GW ConC es Jo <br /> of Tanks at facility ge of Tanks(if available) IType of Tank teal brgl 6ngl I Duall <br /> 'K HISTORY l <br /> ink tested? as a ailed precision :est ? es a If yes, give date(s) <br /> reoair .made t0 the tank system? IY es No f yes, what was recairedf <br /> !Pair done under inspection? es 01 Mere soil samples analyzed? es !o ixE PN•G �T PN-0 Pb/EDD <br /> :f Failure/discharge atastroahicl long-term Leakage wer`ill I mown crier: <br /> .'lAl 'HISTORY (ATTACH INSPECTICN REPORT FOR SITE OETAILS/COLLECT :ATA FOR LEACNIHG POTENTIAL ANALYSIS) <br /> y <br /> Samples Received 4es �0 eoth to GranId Water 115 of/TearI 0� verage Annual Precipitation > 4 10.25 <br /> r. Wel l(s) es 0 umber 3 Type Irr Dan p <br /> S core SScore S core <br /> ice :o uell(s) from Tank ft; ft; ft : 0 pts C 9 pts C PCs <br /> O �'f 0 Iif 0 'f <br /> R condition R ordiIion R ordition <br /> ite Fea Cure - Leaching Potential Analysis lis met E lis met �is •met <br /> um Oepth -a 3rourdwater from the Soil Sample (feet) I >100 1.100 I 25-50\1 <br /> ures in subsurface (applies to foothills or nountain areas) .None Unknown present <br /> ge Annual Precipitation (inches) zxzx 1410 9 10-25 zxxxxx 126-40\2 <br /> ade corauits which increase vertical migration n <br /> acnace (i.e., septic systems, water wells, ponds) None Unknown resent <br /> e site features: Recharge area, coarse sail, nearby wells. At least More than <br /> xxxx None -Z-7 <br /> 'J one I aro <br /> COLUMN TOTALS»>TOTAL POINTS I ' ' L-/ <br /> e Result: IS T X OR E) RANGE OF TOTAL POINTS 9 acs or more l 41 - 48 PCs l 40 pts or ss <br /> �0•� 3 T x E 3 T x =_ <br /> 'l MAXI" ALLOWABLE 3-T-X•E LEVELS (PPN) 1 50 SO 50 .3 .3 1. 1.I I <br /> NA\3 <br /> e Result: &SOLNE 1000 100 10 <br /> AXIMUM ALLOWABLE TPH LEVELS (PPM) <br /> �N1 [E SEL 10,000 1000 100 <br /> ICT--S: ***If documented soil and/of ground water contamination is present, do moC cam)leCe the Leaching potential <br /> analysis. (i.e., site is Curren Cly an UGT Contamination List for $Oil or grand water.) <br /> \1 If depth is > 5 ft. and < 25 ft., score 3 points. If depth <:5 ft., do not lase cable. <br /> \2 If precipitation is > 40 inches, scare 0 points. <br /> \3 Levels for 3TXEE are not applicable at a TPN concentration of 10 POR (gasoline) or 1GO x m (diesel). <br /> 1FF RECOfME.VDAttON/COL.CCLUS ION (,�� ,{n13--Q.//C. Cq <br /> Are 3TX 3 E or TPM Concentrations > All9wable Levels Yes 0 / � /l wn,... okQ0 r-J5\� <br /> Recomrctd Site Closure es 0 I plf Yes, Refer t0 Site Mitigation far Evaluation <br /> :VIEW EVALUATION . TO 3E COMPLETED SY A SL;PERVt SCR/SENIOR <br /> .LIR WITH STAFF RECOMMENDATION FOR CLOSURE YES EF"ERRED TO SITE MITIGATION FOR EVALUATION ICN 4ESI hJ0 l l <br /> : REFERRED ArE CLOSURE LETTER MAILED i / `` <br />