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SAN JOAQUIN C( NTY ENVIRONMENTAL HEA 'H DEPARTMENT <br />UST WORK..MET FOR SITE CLOSURE EV DATION <br />I. FACILITYITANK INFORMATION DATE: <br />SITE/FACILITY NAME: I Levand Family Trust STATUS CODE: <br />ADDRESS: 47 East 11th Street CITY: I Tracy <br />FA#: 21941 PR#: 0538004 TANK <br />TANK SIZE: oo gal FUEL TYPE: Leaded gasoline <br />II. GENERAL SITE HISTORY <br />Is Permit Current? ❑ Yes ❑ No X- NA — not operating Documented Soil/GW Contamination?*** ❑ Yes X No <br />Number of Tanks at Facility 3 Age of Tanks (if available) 1900-1950s Type of Tank X Steel X Single <br />III. TANK HISTORY <br />Was Tank Tested? ❑ Yes ❑ No X -NA <br />Failed Testing? ❑ Yes ❑ No <br />If Yes, Provide Dates: <br />Was Tank System Repaired? ❑Yes ❑No X -NA <br />If Yes, Describe Repair: <br />Was Repair Done Under Permit? ❑Yes ❑No X -NA <br />Were Soil Samples Analyzed? X Yes ❑ No <br />X BTEX X TPH-G ❑ TPH-D X LEAD <br />❑ EDB XOTHER_oxygenates <br />Type of Failure/Discharge: ❑ Catastrophic ❑ Long-term Leak ❑ Overfill X Unknown ❑ Other <br />■VMN9iv, MIP/_1■:113/ .-V91±1 I W M <br />Soil Samples Received? X Yes ❑ No <br />Seasonal High Depth to GW ___&_L ft bgs <br />Year/ Reference I <br />Za r'2 <br />Onsite and/or Nearby Well(s)? ❑ Yes i*No <br />Ll Irrigation, # Distance to Tank ft <br />� <br />Score 10 <br />� <br />Score 9 <br />� <br />❑ Domestic: # Distance to Tank ft <br />0 <br />points if <br />0 <br />points if <br />0 <br />Score 5 points if <br />❑ Public: # Distance to Tank ft <br />R <br />E <br />condition is <br />met <br />R <br />E <br />condition is <br />met <br />R <br />E <br />condition is met <br />V. SITE FEATURE — LEACHING POTENTIAL ANALYSIS <br />Minimum Depth to Groundwater from Soil Sample (feet) <br />>100 <br />51 —100 <br />25-501 <br />Fractures in Subsurface (applies to foothill or mountain areas) <br />None <br />Unknown <br />Present <br />Average Annual Precipitation (14 inches for SJC area) <br />-------- <br /><10 <br />9 <br />10-25 <br />-------- <br />26-402 <br />Man -Made Conduits which Increase Vertical Migration <br />None <br />CT <br />Unknown <br />Present <br />i.e, septic sstems, water wells,ponds) <br />Unique Site Features: Recharge Area, Coarse Soil (coarse sands, <br />None <br />At Least One <br />More Than One <br />gravels), nearby wells <br />Column Totals Total Points <br />+ <br />+ <br />= `io <br />Sample Results for BTEX: <br />Range of Total Points <br />49 Points or More <br />41 — 48 Points <br />40 Points or Less <br />$-n--N 6[3 s <br />B 0, 016 p , q -a <br />TMaximum <br />d 14L5 a <br />Allowable BTEX <br />B <br />T <br />E <br />X <br />B <br />T <br />E <br />X <br />N/A3 <br />+ <br />E . <br />a'S1 - <br />Levels (ppm) <br />1.0 <br />50 <br />50 <br />50 <br />0.3 <br />0.3 <br />1.0 <br />1.0 <br />X <br />Sample Results for TPH: <br />Maximum <br />Gasoline <br />1,000 <br />100 <br />10 <br />E)Y3— tJ IP, T3 —S <br />Allowable TPH <br />Diesel <br />10,000 <br />1,000 <br />100 <br />l 2 q 0 <br />Levels (ppm) <br />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). <br />1 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. <br />3 Levels for BTEX are not applicable at a concentration of 10 ppm for TPH—Gasoline or 100 ppm for TPH-Diesel. <br />VI. STAFF RECOMMENDATION/ REFERRAL/ REVIEW <br />1. Are BTEX or TPH Concentrations > Allowable Levels? XYes ❑ No <br />2. If No, Is Site Closure Recommended? ❑ Yes,&VNo <br />Completed By: yl <br />Date Referred to Site Mitigation Unit for Final Actiont <br />Reviewed By: <br />Concur with Staff Recommendation LJYes LlNo <br />Date Closure Letter Mailed f <br />tAll Cases are Referred to Site Mitigation for Final Action <br />EH 23-0080 (Rev 11/14/08) <br />