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Tri Regional Recommendation 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 <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 Ethology(cross section),treatment system diagrams, <br /> ❑ 4 Stockpiled soil remaining on-site or off-site disposal(quantity), <br /> ❑ 5 Monitoring wells remaining on-site,We, <br /> 6 Tabulated results of all groundwater elevations and depths to water, <br /> ❑ 7 Tabulated results of all sampling and analyses <br /> ❑Detection limits for confirmation sampling <br /> ❑Lead analyses <br /> 8 Concentration contours of contaminants found and those remaining in soil ,a <br /> and groundwater, and both on-site and off-site r ; ` .r' r r. <br /> ❑Lateral and ❑Vertical extent of soil contamination <br /> ❑Lateral and ❑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 /> ❑ Well and boring logs ❑ PAR ❑FRP ❑ Other(report name) <br /> ❑ 11 Best Available Technology(BAT)used or an explanation for not using BAT, <br /> ❑ 12 Reasons why background ways unattainable using BAT, <br /> ❑ 13 Mass balance calculation of substance treated versus that remaining, <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 /> By Comments <br /> ate <br />