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3LE 11 -CHECKLIST OF REQUIREATA <br /> FOR NO FURTHER ACT14N REQUESTS AT UNDERGROUND TANK SITES <br /> SiteNameand Location: 3r MAKI I1Ir►4ScH.%L! SbyB "100 9L h1RA0o S;,2Eti', <br /> ii SAN -s"co u co-r+y <br /> 1. Distance to production wells for 91'U"nicipal, domestic, agriculture, industry and other uses within 2000 feet <br /> of the site; <br /> 2. rl Site maps, to scale, of area impacted showing locations of former and existing tank systems, excavation <br /> contours and sample Iocations, boring and monitoring well elevation contours, gradients;and nearby <br /> surface waters, buildings, streets,'and subsurface utilities; 2 TA <br /> 3. tJ Figures depicting lithology(cross'section), treatment system diagrams; <br /> it SoMf paoaucT sP .cco zo <br /> ; E! <br /> 4. `L Stockpiled soil remaining on-site or;off-site disposal (quantity); S-Oyd C.Rty -0 ,puRIftr_ ML-i" 6u. <br /> 5. Monitoring wells remaining ori-site,��fate; fjo we�4s AgAntr TV r"�ARc1� SS SO,yr1� �u li�ccpvnTft <br /> 6. Tabulated results of all groundwater elevations and depths to water; <br /> 7. PJ Tabulated results of all sampling and analyses: <br /> Detection limits for confirmation sampling <br /> is Lead analyses <br /> 8. Concentration contours of contami�6rits found and those remaining in soil and groundwater, both on-site <br /> E and off-site: ' <br /> Lateral extent of soil contamination `! ADvA-bo 19116 <br /> Vertical extent of soil co6tamk6tion y �5-­- Dem—w <br /> NJA Lateral extent of groundwater contamination <br /> Nf� Vertical extent of groundwater contamination <br /> 9. W4 Zone of influence calculated and assumptions used for subsurface remediation system and the zone of <br /> capture attained for the soil acid groundwater remediation system; <br /> 10. Reports I information <br /> I, Unauthorized Release Form (URF) ii/TZ VMS" us•r <br /> N QMRs(Dates) '( <br /> _ PAR <br /> FRP I <br /> _�j Other(report name) 919i� nbg 2Cs4L.Ts <br /> Well and boring logs 'x _ <br /> 11. Y ? Best Available Technology(BAT):used or an explanation for not using BAT;cx4eR ezx�n� Sa y2 w <br /> 12. rJ_ Reasons why*background*was/is unattainable using BAT; <br /> 13. 1J Mass balance calculation o#substance treated versus that remaining; <br /> 14. 711 Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15. Rationale why conditions remaining'at site will not adversely impact water quality, health; or other <br /> "!,;: <br /> beneficial uses; and CouNly''SJAT»hT #.�y + I'laalaen,�r�wy <br /> 16. WET or TCl_P results ►•.,,, g <br /> : Nadi bile cr <br /> i <br /> i <br /> Comments: 14 Doa,�cs Q Bim$ �.$ TP1a un $c*+ze.c <br /> I (a�,. •tS'4ec tgooe.,�,1�T�'. <5w, �+< 8s�zf'uY , <br /> I�FAk �'OtatAnu,lay-iib— LIMITeD VP-R-TK6L-�­/ AMD No7212-ti7A1-I-Y a <br /> By: JtQ 561L• amL7' - LOW Rlstc <br /> 91Date: F� q I <br /> 10 I <br />