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SAN JOAQUIN Ct NTY ENVIRONMENTAL HEA H DEPARTMENT UST WORKU..,EET FOR SITE CLOSURE EV. ,.,,iJATION I. FACILITYITANK INFORMATION DATE: SITE/FACILITY NAME: Levand Family Trust STATUS CODE: ADDRESS: 47 East 11h Street CITY: I Tracy FA#: 21941 PR#: 0538004 TANK#j 39– TANK 9–TANK SIZE: 000 gal FUEL TYPE: Leaded gasoline II. GENERAL SITE HISTORY Is Permit Current? ❑ Yes ❑ No X- NA – not operating I Documented Soil/GW Contamination?*** ❑ Yes X No Number of Tanks at Facility 3 Age of Tanks (if available) 1900-1950s Type of Tank X Steel X Single III TANK HIST(1RY Was Tank Tested? ❑ Yes ❑ No X -NA Failed Testing? ❑ Yes ❑ No If Yes, Provide Dates: Was Tank System Repaired? ❑Yes ❑No X -NA If Yes, Describe Repair: Was Repair Done Under Permit? ❑Yes ❑No X -NA Were Soil Samples Analyzed? X Yes ❑ No X BTEX X TPH-G ❑ TPH-D X LEAD ❑ EDB X OTHER_ oxygenates Type of FailurelDischarge: ❑ Catastrophic ❑ Long-term Leak ❑ Overfill X Unknown ❑ Other Soil Samples Received? X Yes ❑ No Seasonal High Depth to GW ft bgs Year/ Reference Onsite and/or Nearby Well(s)? ❑ Yes �(No LJ Irrigation: # Distance to Tank ft � Score 10 � Score 9 � ❑ Domestic: # Distance to Tank ft 0 points if 0 points if 0 Score 5 points if ❑ Public: # Distance to Tank ft R condition is R condition is R condition is met E met E met E V. SITE FEATURE – LEACHING POTENTIAL ANALYSIS Minimum Depth to Groundwater from Soil Sample (feet) >100 51-100 25-501 Fractures in Subsurface (applies to foothill or mountain areas) (v None Unknown Present Average Annual Precipitation (14 inches for SJC area) -------- <10 9 10-25 -------- 26-402 Man -Made Conduits which Increase Vertical Migration None Unknown Present i.e. septics stems, water wells, ponds Unique Site Features: Recharge Area, Coarse Soil (coarse sands, �� None At Least One More Than One gravels), nearby wells Column Totals Total Points u + + Sample Results for BTEX: Range of Total Points 49 Points or More 41 – 48 Points 40 Points or Less Fart —r j gT► �S T 057 Maximum Allowable BTEX B T E X B T E X NIA E 3 4 1-71-1 Levels (ppm) 1.0 50 50 50 0.3 0.3 1.0 1.0 X Sample Results for TPH: Maximum Gasoline 1,000 100 10 Diesel 10,000 1,000 100 �YI–N 13TI —S Allowable TPH 3 1 to Lo lAbo Levels (ppm) Footnotes: *** If documented soil and/or groundwater contamination is present, do not complete leaching potential analysis (i.e. site is already on the contamination list). I If depth is >5 feet and < 25 feet, score 0 points. If depth is <=5 feet, do not use table. 2 If precipitation is > 40 inches, score 0 points. 3 Levels for BTEX are not applicable at a concentration of 10 ppm for TPH—Gasoline or 100 ppm for TPH-Diesel. VI. STAFF RECOMMENDATION/ REFERRAL/ REVIEW 1. Are BTEX or TPH Concentrations > Allowable Levels? XYes ❑ No 2. If No, Is Site Closure Recommended? ❑ Yes )�II'No Completed By: TRAKk Date Referred to Site Mitigation Unit for Final Actiont Reviewed By: Concur with Staff Recommendation ❑ Yes ❑ No Date Closure Letter Mailed tAll Cases are Referred to Site Mitigation for Final Action EH 23-0080 (Rev 11/14/08)