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Tri R4gional kecommendation Page 24 of 24 <br /> Appendix A <br /> TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> Site Name and Location: STP(I brx V\.:Aed Se'-.1 % [.e- �'{�� � , I oaf v► S'�+�-Pe� r � "1 <br /> 1. Distance to production wells for municipal, domestic, agriculture, industry,and <br /> other uses within 2000 feet of the site; <br /> 2. Site maps, to scale, of area impacted showing locations of any 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 results of all groundwater elevations and depths to water, <br /> 7. Tabulated results of all sampling and analyses: <br /> ❑X Detection limits for confirmation sampling <br /> ❑Lead analyses <br /> ® 8. Concentration contours of contaminants found and those remaining in soil <br /> and groundwater, and both on-site and off-site: <br /> ©Lateral and ®Vertical extent of soil contamination <br /> ❑� Lateral and F91 Vertical extent of groundwater contamination <br /> © 9. Zone of influence calculated and assumptions used for subsurface <br /> remediation system and the zone of capture attained for the soil and <br /> groundwater remediation system; <br /> © 10.Reports/information ❑ Unauthorized Release Form © QMRs(Dates) <br /> ❑X Well and boring logs ❑ PAR ❑FRP ❑ Other(report name) <br /> © 11.Best Available Technology(BAT)used or an explanation for not using BAT,- <br /> El12.Reasons why background wasrs unattainable using BAT; <br /> 13.Mass balance calculation of substance treated versus that remaining, <br /> © <br /> 14. Assumptions,parameters, calculations and model used in risk <br /> assessments,and fate and transport modeling; <br /> © 15. Rationale why conditions remaining at site will not adversely <br /> impact water quality, health, or other beneficial uses;and <br /> 16. WET or TCLP results <br /> Comments: <br /> Date: <br />