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State of California—California Environmental Protection Agency AGREEME Y <br /> ^� AGREEMENTS <br /> Water Boards Request for Agency Oversight Application <br /> ❑ Phase 1 Environmental Assessment <br /> ❑ Phase 2 Environmental Assessment <br /> ❑ Human Health Risk Assessment <br /> ® San Joaquin County Environmental Soil 11/4/2020 <br /> Health Inspection <br /> El <br /> 11. Is there currently a potential for exposure of the tenants, community or workers to <br /> hazardous substances, pollutants, or contaminants at the Site? <br /> Yes ® No ❑ If yes, then explain.Direct contact with impacted soils by <br /> workers <br /> 12. Provide a brief summary of removal or remedial activities that have been <br /> undertaken or completed at the Site, if any. None <br /> List relevant available cleanup reports, if applicable: <br /> Cleanup Report Name Author/Consultant Media Addressed Date <br /> N/A <br /> 13. Provide a description of known or possible water quality impacts at the Site. <br /> Also, provide information about the type(s) of water supply for the Site and, if <br /> known, any information on municipal, domestic, agricultural, or industrial water <br /> supply wells that are either on the Site or within a 1-mile radius of the project <br /> area. <br /> Unknown, only soil impacts identified so far <br /> 14. Are any federal, state, or local regulatory agencies currently involved with the <br /> Site, or have any been previously? Yes ® No ❑ If yes, provide details below. <br /> Agency Involvement Contact Name Phone Number <br /> San Joaquin Site inspection and soil sampling John Alaniz (209)616-3053 <br /> County <br /> Environmental <br /> Health <br /> 15. Is a change of regulatory agency being requested for this Site? Yes ❑ No® <br /> If yes, please explain the need for the change: <br /> 16. Do you have a preference in which regulatory agency providing oversight? <br /> Yes ® No ❑ If yes, please name the preferred agency and state a reason. <br /> DTSC Form 1460-Revision July 19 2018 <br /> Page 4 <br />