Laserfiche WebLink
CENTRAL VALLEY REGIONAL WATER QUALITY CONTROL BOAR® <br /> CASE CLOSURE CHECKLIST <br /> Leaking Underground Storage Tank Program <br /> This checklist, CASE CLOSURE letter, and the Unauthorized Release Report Form (URF) is <br /> to be retained by the Regional Board and Local Implementing Agency as documentation of <br /> release and subsequent closure action. All files and reports will be placed on microfiche for <br /> review. <br /> I. Case Information <br /> LUSTIS Case no. URF filing date Closure date <br /> Site namelcounty "eed vK&1%T_ 4IA"4"' 6-e/u SA-N J'0 A-4-,)U/>s' <br /> Site address 777 7 W f rL 57-City _�MLU Zip S6-3 76 Phone_,a z �s+do <br /> Table I•Responsibte Party Information <br /> Responsible party - Name Address,City.Zfp Phone <br /> Property ownerell we-rw�49"I((C{ 3 r^ST7-vY"'Z 13 J, ple"J-4. <br /> !v <br /> Operator t { ) <br /> Operator 2 <br /> Operator 3 <br /> t ) <br /> II. Release and Site Characterization information <br /> <w e> Tank size(s) a 1166" Fuer type(s) CA-1,w c,, v� <br /> Chemical type(s) and quantity(ies) released T�irt-� 03T� <br /> Table{i_lateral and Vertical Extent of Contamination <br /> Environment Lateral(n) varticai(ft) Cortaminarn Concernratron Range <br /> soa F4 r 13 rAF A G r( <br /> 1" m4+kg <br /> Groundwater As%C/x <br /> Alp <br /> Soil <br /> mryl <br /> Soil type at the site SJ-7— <br /> Source <br /> JtSource of drinking water under SWRCS POLICY 88-63 lYxv <br /> Were nearby wells. (Domestic, Municipal, Ag, etc.) monitored? Yes No X <br /> Welts affected (Domestic, Municipal, Ag, etc. ! vT <br /> Highest and lowest depths to groundwater <br /> Seasonal groundwater gradient(s) and direction(s) <br /> Name of Regional Water Quality Control Plan (Basin Plan) aquifer affected (see attached) <br /> Surface water impacted? Yes No <br /> Name of surface water body affected_ ��} <br />