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CENTRAL VALLEY REGIONAL WATER QUALITY CONTROL BOARD <br /> CASE CLOSURE CHECKLIST <br /> Lealdng Underground Storage Tank Program <br /> This checklist, CASE CLOSURE letter, and the Unauthorized Release Report Form (URF) is to be <br /> retained by the Regional.Board and Local.Implementing Agency as documentation of release and <br /> subsequent closure action. All fies and reports will be placed on microfiche-for review. <br /> I. Case Information <br /> LUSTIS Case no. 24:3 L'RF filing date Closure date <br /> Site namelcounty Ve/ov> Cpb Cv SAN S;� IAJ <br /> Site address Z?-10 CoNu+rq 0,4h BI✓d. City 5ryCi*7-% Zip q52O Phone Z R31-8600 <br /> Table i-Responsible Party Information <br /> F <br /> onsible part+ N'ataeTp,,,, DWiCIS Addr=, Ciry, Zip Phone <br /> erty ownerr <br /> To D,rw ie l s PC--8c)( 4003 570ck4cN)CA . (209 ) q 3i `8601 <br /> t operator 1 ( ) <br /> LOperator 2 ) <br /> Operator 3 ( ) <br /> II. Release and Site Characterization Information <br /> Tank size(s) Z, 000- AA//oN Fuel type(s) 67p SCI <br /> Chemical type(s) and quandry(ies) released T PP. i ET�iyt g--,v z wf, Xy ENEs <br /> LTable II -Lateral and Vertical Extent of Corztamination <br /> Environment Lateral (ft) I Vertical (ft) I Contaminant - Concentration Range <br /> Soil L30/ /2/ 1S�bs - TPl*-g. aw z1PWz c X /ears Zf0.00570.ea mglkg <br /> Groundwater _ d 11Z7bsTPN- F7H yL Benl?F. n►rs /. 0 048'10.0, mgo/I <br /> Soil type at the site _CIA.leN $w,)d <br /> Source of drinking water under SWRCB POLICY 88-63 <br /> Were nearby wells (Domestic, Municipal, Ag, etc.) monitored? Yes No <br /> Wells affected (Domestic, M�.taicipal, Ag, etc.) M01 r <br /> Highest and lowest depths to groundwater C14nytJ7 lk th AfekeXim4cl1z' <br /> Seasonal groundwater gndient(s) and direction(s) Ilk�rtl► ��ttl�ensr i,�smnc�alET_ <br /> Mame of Regional Water Quality Control Plan (Basin Plan) aquifer affected (see attached) <br /> Surface water impacted? Yes No <br /> Name of surface water body affected NA <br /> E! <br />