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SAN JOAOUIN =NAWOAC HEALTH SERV? WENVIRGIMENTAL MEALt OH <br /> lNs'ST BEET FCR SITE CLOSURE EVALUATION � ATE 2, <br /> ►+E OF fACtItTY �� ,'�'�� Z'- EPS CODE !S <br /> RESS C l' ,, t%NK IO x —� <br /> K SIZE wU IFWL TYPE <br /> GENERAL SITE HISTORY <br /> permit current? If eso rmit a aciticy Status code ac.Soit/GW Cent as <br /> r of Tanks at facitity ge of Tanks(if available) ype of Tank cost brgl t Dust <br /> . TANK HISTORY <br /> s Tank tested? lga acted precision test t Ires o if yes, give dace($) <br /> as a repair made to the tank system? as No f yes, what was repaired7 <br /> as repair done under inspeotiont es o ere soil samples analyzed?IYes to TICE PH-G PM-0 EDO <br /> ype of faiture/discharge acastrophic tag-term Leakage verfill nown cher: <br /> REMOVAL HISTORY CATTACH INSPECTION REPORT FOR SITE DETAILS/COLLECT DATA FOR LEACHING POTENTIAL ANALYSIS) <br /> it Samples Received es I o th to Ground Vater of/Year t7 verage Annual Precipitation i A 0-25 <br /> -Site Vett(s) es o r b Type trr am <br /> S t S rt S ore <br /> iscance to Vett(s) from Tank ft; ft; ft C 0 pts C pts C pts <br /> 0 f 0 if 0 f <br /> R Ician R condition R ondition <br /> Site Feature - Leaching Potential Analysis E a mac E is met E s met <br /> inimum Depth to groundwater from the Soit Sample (feet) 3,100 1-100 25-SOM <br /> ractures in subsurface Capplies to foothitls or mountain areas) CiJ Nona Unknown resent <br /> verage Anxial Precipitation (inches) KXX= <10 9 10-25 xxxx= W40\2 <br /> -Node conduits which increase vertical migration <br /> I teachace Ci.s., septic systems, water wells, ponds) None Unknown Present <br /> iow site features: Recharge area, coarse, snit, nearby watts. At tease gore than <br /> KXXXXX Mont ane one <br /> COLUMN TOTALA»TOTAL POINTS + 27 • <br /> law** Result: (B T_X.OR E) RANGE OF TOTAL POINTS 9 pts or more 41 - 68 pts °60 pts or tee <br /> c�•6� e,.5 ppb <br /> JE <br /> )C. MAXIMM ALLOUABLE 3•T-X-E LEVELS (PPM)18 SO So So .3 .3 t. i. NA\3 <br /> s Result: CNE 1000 100 10 <br /> 4AXtXUN ALLMMLE TPM LEVELS CPP") <br /> 00 TPH r"SEL 10.000 1000 100 <br /> ?NOTES: ***If documented soil and/or ground water contamination is present, do not comotote the teaching potential <br /> anslysis. (i.e., site is currancty an UOT Contamination List for snit or ground water.) <br /> \1 if depth is 3, S ft. and < 25 ft., score 0 points. If depth "S ft., do not use table. <br /> \2 if precipitation is v 40 inches, score O points. <br /> \3 Lewts for BTXU are not applicable at a TPN concentration of 10 ppm (gasoline) or 100 ppw (diesel). <br /> STAFF RECONOMTION/CONCLUStON <br /> t. Are 3TX E; E or TPM Concentrations > Attoweblt Lewis es _ <br /> 2. Reeasaiend Site Closure es if Yes. Rater to Site Mitigation for Evaluation <br /> . REVIEW _VALUATION - TO N CO PLETEO 8Y A SUPERVISOR/SENIOR <br /> WITH STAFF RE0000"TION FOR CLOSURE S140 1 1 ItIEFERM TO SITE MITIGATION FOR EVALUATION E5 <br /> ATE REFERRED i ; a[F. CLOSURE LETTER MAILEII <br /> i <br /> �JJ'LUAT ru <br />