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State of California-California Environmental Protection Agency Department of Toxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> AREA OF CONCERN DATASHEET <br /> Instructions:Complete the following questions in detail for EACH release or suspected release identified in Section III FACILITY WALK- <br /> THROUGH INSPECTION-SPECIFIC AREAS or SECTION IV FACILITY WALK-THROUGH INSPECTION-OTHER AREAS and any <br /> other known or suspected releases. Do not include areas that have been or are being remediated under the oversight of an appropriate <br /> agency. <br /> If answers to questions are not known,then state"unknown". <br /> 1. Facility name: grew l e-✓ Fl ✓V t 5 (A l hl t <br /> tt <br /> 2. This sheet is being completed.for a: N 0—E"�{.\a <br /> Known release Suspected release tr �C 7 VO,v\/I"k 7 (7Q J <br /> 3. How was this release or suspected release discovered? _ I <br /> During the walk-through inspection? Previously known release? Iv I tP' <br /> What checklist question(s)are related to this release(section/question) <br /> 4. When did the release occur? N 1A <br /> 5. What was released and how much? <br /> N �a <br /> 6. What caused the release? <br /> 7. Indicate the approximate area of the release(e.g.3 feet in diameter,5 feet X 4 feet.) <br /> 8. Was the release remediated? If YES,explain how.(Note: A datasheel need not be completed to]- <br /> releases remediated or being remediated under the oversight of an appropriate agency. <br /> 9. Were samples collected?If yes,what were the results? <br /> NJO <br /> 10. List any environmental reports or studies performed on the area of concern and attach copies or summaries of <br /> the reports not submitted to the Department. <br /> Name of preparer: A k) J CL N LR Z� �7 C <br /> Title of preparer: <br /> Date: <br /> DISC 1151(06/99) Please indicate total number of pages S of <br />