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PUBLIC WORKS Page 1 of 1 LTCP Checklist ® C£OTRA^_KCR XdAE 'a4'ATe i +4+ 1�` PUBLIC WORKS(TOBOTTO0319)-MAP THIS SITE OPEN-SUE AWEa MENT 1810 HAZELTON AVE E ACTIVITIES REPORT AN IPw STOCKTON CA 95201 SAN doAomry cooNTv Loa/LEAD/-cnsE r:nN1 SAN JDADUIN COUNTY PIR BPA CASEWJRNER:A /F fa KaW EAS M!XP'-SUPERwaPP:AOFIENNE ELLSAE55ER CENTRAL VALLEY RMCB(REGION 55)-CASE.:39(489 CASEwONNER:JAMLSIMaT -$uPERNBfw:Coucom N CUF Claim 1:11390 CUF Prom,AUIRmtl:D CUFNnourd la:]g CR She ID s:NOT SPECIFIED THIS PROJECT WAS LAST MODIFIED 9Y NUELNffAWj ON ON./1WIL52:3i 25 PM-tgI= THIS SITE HAS SUBMITTALS,CUCKI=TO OPEN A NEW WINDOW WITH THE SUBMITTAL APPROVAL MOE FOR TIIS SITE. CLOSURE POLICY THIS VERSION IS FINAL AS OF 41IM015 CNECKLIST INITMTED ONTnowu gLOgAEJ9414Ctl®TgH General CrKaria-The site satisfies the poficy genera/Criteria-CLEAR SECTION MIUSRS YEs a.Is the unauthorized release IMeled wnbm Me saMm ares of a Public waters tam'! Nm a Was,System: R YES r N D The unauMonced release consists Only of Petrdelm/jpyy. W YES r N c.The unauthorized(-pmna,,�release from me UST system has been stopped. R VES r N d.Free product has been removed to the maximum edea practicable knt& r FP Not Encountered R VES r N e.A conceptual aite model that assesses the nature,edent,and mobility of the release has been developedit,). G VES r N f Secondary source has bean removed to the extent Macticableif n(p). Or VES IT N g.Soil or groundwater has been tested for MTBE and results reported in accordance will Health and Safety Coda Section 25298.15. r Not Required w VES r N h.Does a nuisance exist as defined by Water de sexton 1'M r YES rA N 1.Media-Speoifk Criteria:GI011ndweter-The aontandmanfplume that exceeds waterquably,objectives is Stable or decreasing in areal extent,and meek all ofthe stltlitional NO characteristics of oro of the five Gasses of sites listed babes.-CLEAN SECTION ANseERs EXEMPTION-Soil Only Case(Release has not Affected Groundwater-1CM r YES r N Does the sae meet any a the Groundwater specific criteria scenarios? r YES r N ADDITIONAL QUESTIONS-Please indicate only those conditions that do not meet the policy cdteda: Mums Length(That Exceeds Water Quality Objectives): M a 100 Feet and<250 Feel r z 250 Feet and<1,000 Feet r a 1,000 Feet r Unknown Plume is Stable or Decreasing in AREAL Extent: r No r Unknown Free Product in Groundwater: C Yes r No IT Unknown Free Product Has Been Removed to the Maximum Extent Practicable: r No r Unknown For sites with free product,thed Plume Has Been Stable or Decreasing for SYeam(info): r No IT Unknown For sites with free product,owner Willing to Accept a Land Use Restriction(K requiretl): r No r Unknown Free Product Extends Offsite r Yes r Unknown Be roman Concentration r A 1,000 UW and�3,000( A M a 3,000 P8, IT untie. MTBE Concentration: G a 1,000 pgH r Unknown Nearest Supply Wall(From Plume Boundary): r s 250 Feet rho>250 Feet aM s 1000 Feet r Unknown Natural Sudece Water Body(From Plume Boundary): r 5250 Faet r>250 Feet and 51,000 Feet r Unknown 2.Media Specific Criteria;Petroleum Vapor Intrusion to Indoor Air-The site is Considered bw-thmat for the vapor-intrusion-lo-air pathway if site-specific Cordifions Saw, YES items 2a,2b,W 2C-cLEAR SECTION ANSMRs EXEMPTION-Active Commercial Petroleum Fueling Facility is YES r N 3.Media Specific Criteria Oimct Contectand Outdoor Au Exposure-The site is Considered low-threat for direct Contact and outdocrairexposure ifit meets 1,2,or3below. YES y, F�ICtl Ahs EXEMPTION-Tbupperl0feetmsoil isfreeofpetroleum coodamlnetion r YES rr N Dons the site mess any other Direct Contact and Outdoor Air Exposure criteria scenarios? Is YES r N 3.1-Maximum concentrations of petroleum Constituents in soil are less than or equal to those listed in the following sable JUN19 for Ne specified depth below ground sudace. R YES r NC Additlonal Information Shoal this case bB dose!in spite of NOT meatrg policy coterie? C VES r N Has this LTCP Chedtflst been UP1 fou FY ta/15? Is YES r N COFI r CHEM Save Form as Partially Completed Save Form es Com ale LODSaRD IN AS HENOERagM CONTACT GEOT https:Hgeotracker.waterboards.ca.gov/regulators/screens/closure_policy.asp?global_id=TO... 4/13/2015