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SAN :OACUIN =NTY P C HEALTH SEdVIC_S/EVV l0.CNMEH TAI `ZEAL TH Olv .4 <br /> UGST -.JbaeREET FCR SITE CLOSURE E'/ALUAT!CN AT£ <br /> J ,'.r� <br />.+rE CF FACILITY I l'. 9,z, i �.e - :EEPS CCOE /=rel <br />(ORES"a ANX ID3Y <br /> ANX SIZE UEL TYPE - <br /> GENERAL SITE HIST16Y <br /> s permit currenC7 as o ermit J <br /> acility Status Code oc.Soil/GU Canc as o <br /> user a( Ranks at (acility ge of Tanks(if available) ype of Tank teal brgl ngl Dual <br /> . TANK HISTCRT <br /> as Tank tested? as a ailed Precision as <br /> If yes, give date(s) <br /> o <br /> +s a repair ,made to the tank system? es 40 f yes, a r ired? <br /> +s repair done under inspection? as o ere soil samples ana as o TXE PH-G PH-0 b/ED3 <br /> ,re of failure/discharge acastrophic Img-tenm leakage verfill own cher: <br /> A£MOVAL HIST0RY (ATTACH INSPECTION REPORT FOR SITE DETAILS/COLLECT DATA FOR LEACHING POTENTIAL ANALYSIS) <br /> oil 5ampt es Received as a epth to Ground Water 50 LIPi of/Year C4 ) verage Annual Precipitation 4 0-25 <br /> rSite 'Nell(s) 'Yes I o umber L Type Irr pa° ub S care S care S core <br /> stance to Wells) from Tank ft; ft; ft C 0 pts C Pt, C PCs <br /> 0 if 0 if 0 f <br /> C R andi[ion R mdition R arditi an <br /> Site Feature - Leaching Potential Analysis �,5 r = J l Es �nec E is met E 's mac <br /> nimtm Dench to groundwater frau the Soil Sanpte (feet) <br /> ,100 1-100 25.50\1 <br /> Hone I CI' Unknown resent <br /> li <br /> ac-,Ures in subsurface (applies to foothills or motncain areas) / <br /> crage Arcual Precipitation (inches) xxxz <10 9 10-25 zszxxs 26•G012 <br /> rc <br /> n-made conduits 'which increase vertical migration Hone Unknown J resent <br /> teschace (i.e., septic systems, water wells, ponds) <br /> Leas'.leare than <br /> itt:e site features: Recharge area, coarse sail, nearby wells. At one j one <br /> xzxx None <br /> CCLL,?N TOTALS»,TOTAL POINTS 7 1 b -37 <br /> mole 0.esul t: (9 i X OR E) RANGE OF TOTAL POINTS 9 PCs or more 41 - 48 pts 40 pts or less <br /> 3 T X E 3 T X E <br /> MAXIMLH ALLCUA3LE 3-T-X-E LEVELS (PPM) 1 50 50 50 .3 .3 1. I. HA\3 <br /> Rple Result: II ASOLINE 1000 100 10 <br /> f1AXI`L'M AILCUA3lE TPH LEVELS (PPM) TOG <br /> ACI /V � TPH II IESEL 10,000 1000 <br /> JINOTES: „•If documented soil and/or grovel water contamination is present, do not ccmplett the teaching potential <br /> aralysis. (I.e., site Is currenCly an UGT Contamination List for sail or grovel water.) <br /> \1 if depth is > 5 ft. and < 25 ft., score 0 points. If depth <=5 ft., do not use cable. <br /> \2 If precipitation is > 40 inches, score 0 points. <br /> \3 levels for 3TXLE are not applicable at a TPH concentration of 10 ppm (gasoline) or 100 ppm (diesel). <br /> STAFF RECCW.ENOAT ION/CCNCLUSION <br /> Are SIX I. E or TP4 Concentrations > Allowable Levels Yes o <br /> Reeaomerd Site Closure It;es �10 If Yes, Refer to Site Mitigation for Evaluation <br /> REVIEW EVALUATICH - TO SE CCiPLETEO 3Y A SUPERVISCR/SENICR <br /> )NCUR WITH STAFF RECCHHENOATICN FCR CLOSURE �Ei 0 EFERAED TO SITE MITIGAT ICH F00. EVALUATICH HES 0 Z—k-� <br /> LTE REFERRED / / �AIE CLOSURE LETTER MAILED <br /> ."E OF ^ / <br /> 'A LUAICR <br /> 23 10 (UGTGXSHT)\5/90 4 <br />