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SAN JOAQUIN Ct NTY ENVIRONMENTAL HEA 'H DEPARTMENT UST WORK EET FOR SITE CLOSURE EV wo UATION I. FACILITYITANK INFORMATION DATE: SITE/FACILITY NAME: Levand Family Trust STATUS CODE: ADDRESS: 47 East 11th Street CITY: I Trac! FA#: 21941 PR#: 0538004 TANK # 39— Q� TANK SIZE:gal FUEL TYPE: Leaded gasoline 11 rPC\ICOAI 01TC U10Tr%0V 11. vLnLlv'1L VIAL 11vv� Is Permit Current? ❑ Yes ❑ No X- NA —not o erating Documented Soil/GW Contamination?*** ❑ Yes X No Number of Tanks at Facility 3 I Age of Tanks (if available) 1900-1950s Type of Tank X Steel X Single TANK HISTORY 2 M. 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 LlNo X BTEX X TPH-G ❑TPH-D X LEAD L3 EDB X OTHER_ oxygenates Type of Failure/Discharge: ❑ Catastrophic ❑ Long-term Leak ❑ Overfill X Unknown ❑ Other IV. KtMUVAL IIID l v1[ r I,MLLOW I me Soil Samples Received? X Yes ❑ No Seasonal High Depth to GW ft bgs Year/ Reference �,h Z Onsite and/or Nearby Well(s)? ❑ Yeslo S S ❑ Irrigation: # Distance to Tank ft 10 if C Score 9 points if 0 Score 5 points if ❑ Domestic: # Distance to Tank ft ❑ Public: # Distance to Tank ftn FEc is 0 condition is R condition is met Emet E Drw l� W, ,• 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) (p None Unknown Average Annual Precipitation (14 inches for SJC area) -------- <10 9 10-25 ----- 26- 402 Man -Made Conduits which Increase Vertical Migration None Gr Unknown Present i.e. septic sstems, 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 `b + 'J(o + _ Sample Results for BTEX: Range of Total Points 49 Points or More 41 — 48 Points 40 Points or Less B 0, 2�1-� T 5 I�, Maximum Allowable BTEX B T E X B T E X NIA3 Levels (ppm) 1.0 50 50 50 0.3 0.3 1.0 1.0 E 3$, 2 X ample Results for TPH: Maximum Gasoline 1,000 100 10 `{/ 1 �' Allowable TPH Diesel 10,000 1,000 100 Levels (ppm) *** If documented soil and/or groundwater contamination is present, do not complete leaching potential analysis (i.e. site is already on the contamination list). Lootnotes: 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? X Yes ❑ No 2. If No, Is Site Closure Recommended? ❑ Yes )4No Completed By: e4n Date Referred to Site Mitigation Unit for Final Actiont Reviewed By: I Concur with Staff Recommendation ❑ Yes ❑ No 1All Cases are Referred to Site Mitigation for Final Action Date Closure Letter Mailed EH 23-0080 (Rev 11/14/08)