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APPEh .,a B OF THE TRI-REGIONAL REC6rKMENDATIONS <br /> P, CHECKLIST OF REQUIRED DATA FOR CLOSURE OF UNDERGROUND TANK SITES <br /> CLOSURE DOCUMENT APPLICATION SITE: <br /> 1. _ Distance to production wells for municipal, domestic, agriculture, industry and other uses within <br /> 2000 feet of the site; <br /> 2. _ Site maps, to scale, of area impacted showing locations of former and existing tank systems, <br /> excavation contours and sample locations, boring and monitoring well elevation contours, <br /> gradients, and nearby surface waters, buildings, streets, and subsurface utilities; <br /> 3. _ Figures depicting lithology (cross section), treatment system diagrams; <br /> 4. _ Stockpiled soil remaining on-site or off-site disposal (quantity); <br /> 5. _ Monitoring wells remaining on-site, fate; <br /> 6. _ Tabulated data of all ground water elevations and depths to water; <br /> 7. _ Tabulated results of all sampling and analyses: <br /> _ Detection limits for confirmation sampling <br /> Lead analyses <br /> 8. _ Concentration contours of contaminants found and those remaining in soil and ground water, both <br /> on- and off-site: <br /> Lateral extent of soil contamination <br /> Vertical extent of soil contamination <br /> Lateral extent of ground water contamination <br /> Vertical extent of ground water contamination <br /> 9. _ Zone of influence calculated and assumptions used for the subsurface remediation system and the <br /> zone of capture attained for the soil and ground water remediation system; <br /> 10. _ Reports/information <br /> _ Unauthorized Release Form (URF) <br /> _ QMRs (Dates) <br /> _ PAR <br /> _FRP <br /> Other (report name) <br /> _ Well and boring logs <br /> 11. _ Best Available Technology (BAT) used or an explanation for not using BAT; <br /> 12. _ Reasons why 'background" wasAs unattainable using BAT; <br /> 13. _ Mass balance calculation of the substance treated versus that remaining; <br /> 14. _ Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15. _ Rationale why conditions remaining at the site will not adversely impact water quality, health, or <br /> other beneficial uses; and <br /> 16. — WET or TCLP results <br /> Comments: <br /> ey: <br /> Date: <br />