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SAN ,CACUt.4 C=NTT N C 4EALTH SE3VICES/ENVtAC8HE41Al 4E,lUH DIV{ I A(c <br /> UCST ,L jEET FCR SITE CLOS RE ?VALUATICN <br /> CF FAC;LITY <br /> �E PS <br /> i YANK !0 a lfJL- O <br /> RSSS I �, , ✓rA" <br /> SIZE <br /> E4EUL SITE :i "CRT <br /> permic CurrtMCT Ies O ermiC s <br /> &CW I:Y Sta eui Cote oe.Soiltva Cont ez o I <br /> r of Tanks at fatiliry �g <br /> e of "anks(if available) I yp4 of Tank Pteet �Fhrt rqt Ouat <br /> IAN% 41STCRY <br /> Tank tested? as f to sited pceeision test 1 yes a [f yes, give date(sI / / <br /> a repair .node to the tank system? ez I Yo f yes, what was repaired? <br /> rPH <br /> epair done under inspection? yrXE <br /> es �7o I Mere soil saaoles analytedT es o <br /> of failureldischarge I racastraphie long-term leakage erf Tll I n Cher: <br /> `.OVAL :it STCRY (ATTACH tHSPEvicii AEPCRT FOR SITE DETAILS/COLLECr DATA FCR LEACHING POTENT UL ANALTSIS) <br /> nverage Ar al Precipitation iA. PG 0-25 <br /> L Sannles Received � es ✓ o I �epth ce Crotrd Water I ��-�ef/Year � 6 I <br /> ice 'Jett(sI yes I o t.t r L Type Ilrr Pao 'b I ecar- <br /> S peace S core S <br /> tame co Velt(s) from Tank I fe; ft; ft C ��Irci <br /> 0 pts 0 if <br /> C0 Pfpts <br /> 0 tion Site Feature - Leaching PotentlaI Aro Lys is <br /> s .met E is met "c s net <br /> iaxua Oeph to grausdwater from :he Sait Saople (feet) >AO <br /> I51.100 I j' I25•i0\t <br /> to <br /> cures in sucsurfaee (applies foo chills or mourttain areas) <br /> (� I None I Unkm,n I �rezene <br /> age Arcual Precipitation (inches) <br /> 410 I 9 I0-25 �Czzazss 126.6012 <br /> Hade :ordji Z$ which increase vertical nigration Nene ( I Unknown eresent <br /> leachate Ci.e septic systems, water wells, ponds) <br /> At teas. • lore than <br /> F. <br /> site features: Reahare area, coarse soil, nearby wells. Nene one one <br /> CCLL" TOTALVWOTAL P014TS iU * I -/ I S Z <br /> to RRessu-/x ltdA <br /> : (RT1 XX Ct U RANCc" Of TOTAL POINTS 9 pes or more 41 48 pts ,I 40 PCs or tens <br /> c';/.L1 <br /> Z M HAXf.'!LIi ALLCVABIE 3•T•X-E LEVELS (PPM) 1 50I 50 SO I .3 .3 X. <br /> E <br /> t. �, NA%3 <br /> to deny <br /> �to p m�p� CLINE t000 I 100 10 <br /> I Pim , IKA ALLCUABLE TPH LEVELS VPH) I 100 <br /> N ��1 -a, IESEL Io,Oao loco <br /> MIES: ..-If dxunenced seit and/oc ground water eonemmimcion is present, do roe a the leach ung potential <br /> analysis. (t.e., site is currently on UGT Contamimcien List for soil or grand water.) <br /> %I If depth is > 5 ft. and < 25 ft., score 0 Points- If depth <a5 it., do not use cable. <br /> \2 I} precipitation is > GO inches, scare 0 paints. <br /> L3 Levels for 3rXSE are not applicable at a TPH comentraticn of 10 ppm (gasoline) or 100 ppo (diesel). <br /> rAFF AECCMMENOAT ICY/CCNCL'US ICN <br /> Are 31X C, E or TPY Concentra ti arts > Atlowabit Levels yes <br /> Aea°mmerd Site Ctoswe Yea IX �7o If Yes, Refer to Site Mitigation for Evalwtion <br /> EVIEV EVALUATICU - TO 3E CCSIPI.:TED 3T A "Cly?SCR/SEHICR <br /> C'R VITH STAFF AECCHMENOATICN FOR CUS'RE ESI I PEFE3RE0 TO SITE 41TICATICH FOR E'/ALUATICN AYES <br /> E .T:FERREO / / PAIS ::OSURE LETTER MAILED Y / <br /> E Cf . <br /> LUArCR <br /> 23 d0 (UG.%SRTM4/90 <br />