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SAN .OACUIN CCUNTt ',C HEALTH SERVICES/EHVIRCNMEYTAL HEALTH Ot �'CN <br /> ucsr �.�S4E:T FCR SITE CLOSURE EVALUATICH teas ATE I 9/p—3 Lq <br /> £ OF FACILITY I NO G)q�L_ EEPS CODE / 'L' D-s_ <br /> TRESS 2g3S /UGLt/ Or�v� �7 G� n TANK 10 S - D / <br /> +r SIZE j 2Df 000 UEL TYPE ,pf65 l <br /> :EHERAL SITE HISTORY <br /> permit currenc7 as o ermit 4 - /� acitity Status Code 99' x.Sot /Ga Conc es o <br /> ,;neer of Tanks at facility ge of Tanks(if available) Wa yrsIType of tankIS teel I Orbrgl ngtIV Dual <br /> TANK HISTCRY <br /> as Tank tested? eso ailed precision tesci7 es oV It yes, give daces) <br /> ,as a repair made to the tank system? as No f yes, what was repaired? <br /> as repair done under inspection? es o Idere sail samples analyzed? as I P tdj TXE I IrPH-G IPH-D b/EDB <br /> 'Pe of failure/discharge �atasprophic long-term leakage verfill nknown cher: <br /> REMOVAL 4ISTCRY (ATTACH IHSP TION REPORT FOR SITE DETAILS/COLLECT DATA FCR LEACHING POTENTIAL ANALYSIS) <br /> foil Samples Received fileso epth co Ground later Q of/Year 7 ; verage Annual Precipitation = 4 0-25 <br /> an-Site WellCs) es o unber 3 Type Irr I cm I ub <br /> S Score S Score S core <br /> istance to Vett(s) from Tank ft; ft; ft C 10 pts C 9 pts C pts <br /> 0 if 0 if 0 f <br /> R ondition R ondition R :and ition <br /> Site Feature - Leaching Potential Analysis E is met E is met E s met <br />;tinimtm Depth to groundwater from the Soil Sample (feet) to r_le'0 >100 1-100 25-50\1 <br />=ractures in subsurface (applies to foothills or moLntain areas) None Unknown resent <br />>vcrage Arcual Precipitation (inches) KXXXXX <10 9 f0-25 xxxxxxx 25-40\2 <br />,-tan-made conduits which increase vertical migration <br />>f leachate (i.e., septic systems, water wells, ponds) None ( Unknown Dresent <br />;nique site features: Recharge area, coarse soil, nearby wells. At leas t ore than <br /> xxxx None one one <br /> CCLUMN TOTALS>>>TOTAL POINTS * + I <br /> rzmote Result: (B T X CR E) RANGE OF TOTAL POINTS 9 pts or more 41 - 48 pts I 40 pts or less <br /> B T X L510 <br /> B JT X E <br /> MAXIMALLCWABLE 3-T-X-E LEVELS (PPM) 1 50 I50 .3 .3 1. 1. HA\3 <br />_.mple Result: ASOIINE 1000 100 10 <br /> AXIMlM ALLOWABLE TPH LEVELS (PPM) <br /> TPN IESEL 10,000 1C00 100 <br />'CGiNOTES: ***If docu•nented soil and/or ground water contamination is present, do not complete the leaching potential <br /> analysis. (i.e., site is currently on UGT Contamination List for soil or ground water.) <br /> \1 If depth is > 5 ft. and < 25 ft., score 0 points. if depth ­5 ft., do not use table. <br /> \2 If precipitation is > 40 inches, score 0 points. <br /> \3 Levels for BTXZE are not applicable at a TPH concen ration of 10 ppm (gasoline) or 100 ppm (diesel). <br /> STAFF R£CCtWENOATI0N/CCNCLUSI09Pae- pr94lam <br /> i Iork lel c_.r' ,f <br /> 1. Are 3TX L. E or TPH Concentrations > All able Levels Yes o <br /> Recoamend Site Closure as o V If Yes, Refer to Site Mitigation for evaluation <br /> REVIEW -cVALUATICH - TO 3E CC14PLETED BY A SL'PERVISCR/SENICR <br />.CNCUR WITH STAFF RECCNMENOATICH FCR CLOSURE IES 0 EFERR£O TO SITE MITIGATION FOR EVALUATICH �ES O <br /> i;ATE REFERRED / / Z v ATE CLOSURE LETTER MAILED <br /> '/J%L OF <br /> _t 23 80 (VGr%-xSHT)\5/90 <br />