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CENTRAL VALLEY REGIONAL WATER QUALITY CONTROL BOARD <br /> CASE CLOSURE CHECKLIST <br /> 'l Leaking Underground Storage Tank Program _ <br /> This checklist, CASE CLOSURE letter, and the unauthorized Release Report Form (URF) is to be <br /> retained by the Regional Board and Local Implementing Agency as documentation of release and <br /> subsequent closure action All files and reports will be placed on microfiche for review <br /> I Case information <br /> LL'STIS Case no a s-v URF filing date / Closure date / <br /> Site name/county r...�y r'-hAr/�p t SenK.,ar G'�+�iy.r /�}/cP-�S'��T !Jl?�8��.� a.-�sr�i. <br /> Site address .y. �.c -L�« City o Zip Phone <br /> Table I - Responsible Party Information <br /> RPsnonstble pam Name Address Cir, Zip Phone <br /> v t.— P D $ax S7;po y y <br /> -Prop--M owner <br /> Operator 1 ( ) <br /> Oor-ator <br /> Operator 3 <br /> II. Release and Site Characterization Information <br /> Tank size(s) Ztiale- -tea 43-2o_ateIka s:!� 4r Fuel type(s) <br /> Chemical type(s) and quannty(ies) released <br /> Table II- Lateral and Vertical Extent of Contamination <br /> Environment Lateral (ft) Vertical (ft) Comxninant Conceni.ration Range <br /> $oil �f�—9� aop <br /> Sb /.s r,SV � <br /> � � - $¢..7�.�c — o oa31— i6o rnglkg / <br /> Groundwater -p n//,4 �•s�y,r 60— Gr, acw w <br /> Soil Type at the sitere 4 r_/�5, J r, rc✓�lc. cc� <br /> Source of drinking water under SWRCB POLICY 88-53 <br /> 'Were nearby wells (Domestic, Municipal, Ag, etc ) monitored Yes ?Jo <br /> Wells affected (Domestic, Municipal, Ag, et; )_ WA <br /> Highest and lowest depths to groundwater <br /> �iP a� iD/26/Qz � <br /> Seasonal groundwater gradient(s) and air--ction(s) 4ZEZ ig <br /> ?game of Regional Water Quality Control Plan (Basin Plan) aquifer affected (see attached) <br /> SD- a a.o v n rc,. (S7$ <br /> Surface water impacted? Yes No <br /> Name of surface water bodv affected -- ._ ^ <br />