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APPEN Y B OF THE TRI•REGIONAL RECOATIONS <br /> CHECKLIST OF Rftb=D DATA FOR CLOSURE OF UN ERGROUND TANK SITES <br /> L�ta�N l�ry►F►��+ax���R.ter�SCy►�� <br /> CLOSURE DOCUMENT APPLICATION SITE: J2-5:5I E .1dA► t . T. qr�� -r� ,�,� <br /> 1. K\c> Distance to production wells for municipal, domestic, agriculture, industry and other uses within <br /> 2000 feet of the site; <br /> 2. No Site maps, to scale, of area impacted showing locations of 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 utilid6; <br /> 3. t-A 0 Figures depicting lithology (cross section), treatment system diagrams; • <br /> 4. —VL' Stockpiled soil remaining on-site or off-site disposal (quantity); GLk_a,� v"_smote, <br /> S. _ hLv--Monitoring wells remaining on-site, fate; <br /> 6. Tabulated data of all ground water elevations and depths to water; l05 +o i r p - <br /> 7. N1) Tabulated results of all sampling and analyses: <br /> Nlo Detection limits for confirmation sampling <br /> _b4 Lead analyses <br /> 8. --�= Concentration contours of contaminants found and those remaining in soil and ground water, both <br /> on- and off-site:PerrbaNirum •Ola9 lb-, loa.. rArte, .luil1 .i-btA.,... . <br /> No Lateral extent of soil contamination <br /> K6 Vertical extent of soil contamination <br /> _ e Lateral extent of ground water contamination <br /> _a Vertical extent of ground watet contamination <br /> 9. Zone of influence calculated and assumptions used for the subsurface remediation system and the <br /> zone of capture attained for the soil and ground water remediation system; <br /> 10. Reports/information <br /> Unauthorized Release Form (URF) <br /> QMRs (Dates) <br /> PAR <br /> �FRP <br /> Other (report name) 22.,nu C.lc�u re_)+r- <br /> _.t4u- Well and boring logs <br /> 11. _ 1Q Best Available Technology (BAT) used or an explanation for not using BAT; <br /> 12. NO Reasons why "background" was/is unattainable using BAT; <br /> 13. Mass balance calculation of the substance treated versus that remaining; �ea�cd 5O° `Gy S°`t <br /> 14. _tom Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15. --K-,, Rationale why conditions remaining at the site will not adversely impact water quality, health, or <br /> other beneficial uses; andr- d nc7t- e s t cdzi_-5 e,Oce- <br /> _ 16. K6 WET or TCLP results <br /> Comments: ONIXi I Y1"ci & IV-, V 10 <br /> By: — Y <br /> Date: <br />