Laserfiche WebLink
SAH ,CACU!X CQ)HTT NHEALTH SERV LCE S/EVVIRC4MEH faL HEALTH DIV{ I FATEUGST 4l `:ci FCR SITE CLOSURE EVALUATICH ��� <br />FACILITT I &4 <br />X SIZE o 00 <br />GENERAL SITE HISTORY <br />permit current? es <br />neer of Tanks at facility <br />IO s <br />-mit s acili ty Status Code oc.Soit/GV Conc ttes T <br />�ae of Tanks(if available) i ype of Tank tee( IF rql Out <br />TAHX 4lSiCHT <br />s Tank tested7 eso ailed precision <br />test 7 es <br />I repair made to the Cank system? as <br />repair done under inapecCion7 es �la <br />No f yes, chat was repaired? <br />Jere sail samples snalyaed? 4as o TXE N -O PH -0 b/ 08 <br />.e of failure/discharge <br />atastrophic <br />long-term leakage <br />verfill <br />nown <br />Cher: <br />Samples Received I es <br />a epth <br />flu <br />Site Wetl(s) 4as I <br />EAGVAL 417TCRT (Al IALA <br />...... .... _.._ -- <br />L <br />= MG 0-25 <br />'l <br />to Oravrd 'lacer 0 of/Tear <br />r' ; p�t <br />verage Arnual Precipitation <br />i <br />Samples Received I es <br />a epth <br />flu <br />Site Wetl(s) 4as I <br />o <br />ureter S Type Irr pp° <br />b <br />S <br />pcore <br />i <br />S <br />C <br />care <br />0 pts <br />S <br />C <br />core <br />7 PCs <br />if <br />C <br />O <br />Ck Pcs <br />ref <br />to "ell(s) from Tank ft; fp h <br />.tante <br />0 <br />E <br />if <br />:ordition <br />is :net <br />0 <br />R <br />E <br />condition <br />is met <br />R <br />E <br />ondi tion <br />s met <br />Site Feature • Leaching Potential Analysis <br />?Lasmo Oepch to graur+d++ater trap the Sail Saop(e (feet) <br />>100 <br />I - <br />1-100 <br />I ,l <br />1 25.50\1 <br />cures in subsurface (applies to foothills or mountain areas) <br />I Rine <br />I (" <br />Unknorn <br />present <br />xxzz <br /><IO <br />I 9 <br />IO•ZS <br />xxxz <br />126-40\2 <br />rage ArnuaI Precipitation (inches) <br />-made conktits .hicah increase vertical migration <br />/ <br />(, <br />Hone <br />Unknown <br />resent <br />leschace (i.e., septic systems, water wells, Ponds) <br />( <br />cue site features: Recharge area, coarse soil, nearby wells. <br />I ry <br />At least) <br />are than <br />one <br />xxxa <br />Hine <br />7 <br />ane <br />' <br />\ <br />CCLLIM TOTALS>>>TOTAL POINTS <br />C <br />m e .Result: (9 T X OR E) <br />RA)IGe' Of TOTAL 7019TS <br />9 pts <br />or .more <br />GI <br />48 pts <br />I GO pas or less <br />3 <br />T <br />X <br />I5 <br />3 <br />I.3 <br />T <br />X <br />1. <br />E <br />I. <br />HA\3 <br />X f� <br />f iM !� ✓N, <br />4AXIXLM ALLCVABLE 3-T•X-E LEVELS (PPR) <br />1 <br />50 <br />50 <br />.3 <br />It Result: <br />CLINE <br />1000 <br />100 <br />10 <br />10,000 <br />1000 <br />I 100 <br />�AXIH.N ALLGm:A9lE TPH LEVELS (DPN) <br />IESEI <br />TPH <br />NOTES: •'<1f documented sail and/or grand water contamination is Present, do not complete Che leaching potential <br />sralysis. (I.e., site Is currently on UOT Contamination Lisa for soil or grovd water.) <br />\1 If depth is > 5 ft. and < 25 ft., scare 0 points. If depth <=5 ft., do not use cable. <br />\2 If precipitation is > GO inches, score 0 paints. <br />of to Ppm (gasoline) or 100 ppn (diesel). <br />\3 Levels for 3TUE are not applicable at a TPH concentration <br />1AFF RECCFWENOATICH/CONCLUSION <br />_71t3 9.E or TPH Concentrations > Allowable Levels Yesl o <br />Site Closure as o I �If Tes, Refer to Site mitigation for Evaluation <br />.1EVIEV EVALUATICH . TO 3E CCNPLETED 3Y A MVEAVISCR/SENICR <br />GR WITH STAFF AECCHMENOATICH FCR CLOSURE i4 EES �70 I �E:EAREO TO SITE MITIGATICH FOR EVALUATICH <br />E .TEF_RR E0 I / / ATE CLOSURE LETTER MAILED I i / <br />+e A <br />I UAIT <br />aCR <br />23 30 (UGR.'XSHT)\5/90 <br />