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Super Center Mart March 2014 <br /> 701 East Charter Way, Stockton <br /> Claim No: 12741 <br /> Has secondary source been removed to the extent practicable? ® Yes ❑ No <br /> Has soil or groundwater been tested for MTBE and results reported in <br /> accordance with Health and Safety Code Section 25296.15? ® Yes ❑ No <br /> Nuisance as defined by Water Code section 13050 does not exist at the ® Yes ❑ No <br /> Site? <br /> Are there unique site attributes or site-specific conditions that ❑ Yes M No <br /> demonstrably increase the risk associated with residual petroleum <br /> constituents? <br /> Media-Specific Criteria <br /> Candidate sites must satisfy all three of these media-specific criteria: <br /> 1. Groundwater: <br /> To satisfy the media-specific criteria for groundwater, the contaminant plume that <br /> exceeds water quality objectives must be stable or decreasing in areal extent, <br /> and meet all of the additional characteristics of one of the five classes of sites: <br /> Is the contaminant plume that exceeds water quality objectives stable ® Yes ❑ No ❑ NA <br /> or decreasing in areal extent? <br /> Does the contaminant plume that exceeds water quality objectives meet <br /> all of the additional characteristics of one of the five classes of sites? ® Yes ❑ No ❑ NA <br /> If YES, check applicable class: ❑ 1 ® 2 ❑ 3 ❑ 4 ❑ 5 <br /> For sites with releases that have not affected groundwater, do mobile <br /> constituents (leachate, vapors, or light non-aqueous phase liquids) ❑ Yes ❑ No ® NA <br /> contain sufficient mobile constituents to cause groundwater to exceed <br /> the groundwater criteria? <br /> 2. Petroleum Vapor Intrusion to Indoor Air: <br /> The site is considered low-threat for vapor intrusion to indoor air if site-specific <br /> conditions satisfy all of the characteristics of one of the three classes of sites (a <br /> through c) or if the exception for active commercial fueling facilities applies. <br /> Is the Site an active commercial petroleum fueling facility? <br /> Exception: Satisfaction of the media-specific criteria for petroleum vapor intrusion ® Yes ❑ No <br /> to indoor air is not required at active commercial petroleum fueling facilities, <br /> except in cases where release characteristics can be reasonably believed to <br /> pose an unacceptable health risk. <br /> a. Do site-specific conditions at the release site satisfy all of the <br /> applicable characteristics and criteria of scenarios 1 through 3 or all ❑Yes ❑ No ® NA <br /> of the applicable characteristics and criteria of scenario 4? <br /> If YES, check applicable scenarios: ❑ 1 ❑ 2 ❑ 3 ❑ 4 <br /> Page 5 of 13 <br />