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y .
<br /> B zi 1,eaAlk uv,._.tc l at site, ?`u:: has not :neer .u,_ _rr,ed.
<br /> .r t :. c pensomil_ e.r-r "x. o" .i 'Sit, As,—'s-,ams"-,e___ n -s �; w ect iu p r-re
<br /> ,. .. _ du a _ _ ��i €2p4xtegrmmd
<br /> >,... .Lc_,_., - - at Wx o.,0 _.._F Road, water has been, _i a x,-L hC r,zattced as a re_...._., -of the __pease_
<br /> €2U o e _� form .� o,u .,vis e � c .g.:rtAwma S. r I ell= - implementation of workplan.
<br /> zs incal r�c s.._ z_, tx,. y.,. jsv ,v whether _ € -i �?. - _-__2.=.e PWO __ in the .,cam_ of _`idly
<br /> :e CES royr; t..a G ¢: of the .,«at Of th.,s rep;3.t_ ,1. tas_x, of oct.,.__ t ._ wd trowd wMer and awes--:ng
<br /> ifapa
<br /> on surface 1>r _ uwater_
<br /> F € c at > . rrcdwat upia. , <_ �uetea a _��� 1. rg term;
<br /> To .,:c :a pursoast to Heallh and SaNty core Section remediation a toms, trcposal- and impleman:,atio schedule for appropriate
<br /> �1,,. . ;;_s .d ;>.n <__:j 3»e €,t=., form_ a ___-s b_tcoi, _.....xs ate____ af,im2s also >.,v,m.Mtsd_
<br /> e pose a „ r sir f,remnedlatian plan-
<br /> Kgniliva;V, to r<., that not;fica:ion S in Froriojic ground Sauer or other
<br /> rn-onitorimg at srte, as nycessary, o verify and;lar r eva uatm effe......dE_...SS
<br /> of remedial <sti tiez'
<br /> f-ase r`losE'C regimal board and local agency in concurrence that no
<br /> t':qmmn waSex, end eJdrecs, indicate which p .rty you further work is necessary at ths site,
<br /> U-IPORTANT: I9E iNFO?R'IAT ON aROV ,g.E. ON THTC r. U-1 S INT DED FOR GENERAL
<br /> __
<br /> _ LLS: .3RPOSES ONLY AND 1S NOY, _O BE D _MMD AS REPRESENTING THE
<br /> x_. name Lwnber, ewMacz person, and address o ug 3FFICIfid, POSITION 'i" ANY G ' RNt-1.14T r AGENCY
<br /> s. c � d _._ . ly w �t e _a
<br /> po he
<br /> REt T>IA1 ._ l(ti
<br /> nli
<br /> _.._._,
<br /> indicate *& ch action have been used to clean-up or rerediava las leak,
<br /> SIZE r �;t
<br /> __ ??. �_..._ tes _.=,:tioss,csf npt>cns follow
<br /> Enter :z.kezcc.ae tan-K favi iity. At, a
<br /> the ,<." ... <, -1 E;u'Lr�^�,s. Qm Sine - install horizontal impermeable layer to red ce ram al
<br /> i.nfilwzat`.v:.
<br /> outain es Q Jmrri:;€ - instaL. -vertical dike to black horizontal m ve-ment o`,
<br /> E"A; U.M0 of ...w 140 „ . .y and Wster Qua-ity Control board _ _ ca t eninant.
<br /> E a¢aaty a=id t3. ;:tae - remove corttas;;i.axed soil and dispose is approved
<br /> site,
<br /> .'.p;-r,a';at ard'Trs-at .E3€"ave, contaminated Soil and treat ncludesre `ing'
<br /> the - ..,_ _. tLe .. .. _. -.___ _,ubst s._. o .ca, Roo._ or land far=ing),
<br /> v __. ., _u, :;xt svt t.... if a; _. if mwe t:_a_ nowLLIMe ixtcl.uct re_._ tie floating product from nater table,
<br /> o su'.,_,*a.nces «...r., tn, of 3" , t -___'e_.. for _ 0y a€.-_t Tryw f" F3Ur gW:ru:-, My empicyed to rea—care dissolved
<br /> coma ls.ora3s.
<br /> use Of -0 a,ail=Lle -eeh"o a P-_,.:3*
<br /> r_..., . _.r-, € .d abat_n . of: he leak. bacterial ixl _r m a. sit i o€ of Cuptaminants.
<br /> all.ernative water supply to affected parties-
<br /> inVaLl w=ave_ reat_..a._ devices at each dwelling 01
<br /> awatc .,."_ .os ._a:_ Check �,_,x".e„ Endi<__rng ase of peak_ aver zinc of use,
<br /> a
<br /> bac xtk wnvct we pays ar blowers to draw -a through c
<br /> Cal Vert JC_-, bare holes in smi . to allow volatilization of contaminants
<br /> in0cato _._.._ case type aawjwy to, ____ 10k. Check one Des. only. Case Eo %s.t.ion icsy±red incident is minor. reniring no remedial action,
<br /> resource affected. Forpl if
<br /> s T:"S Jae this :ace to elaborate on ar.P aspects of the incident-
<br /> . ��__ ,,a is : � Lazo ..a cted, ease t-y,e s ,-_ be round � g
<br /> Water". in0cove "Dr4nkyg Water" on ne or tors iil or
<br /> d-me,tic water w, Hz hav6 awtuaM been affected, Al "G-round `Fater°' SIAILMf - Sign the form in the space provided,
<br /> 3„v o Cy that '-!n. _.__„ted water _a=.,.._ be, or is _,t,
<br /> ,.
<br /> wed , d_., s g - a that water sells .ars no yet keen� I3l5ii:ISCTIUT
<br /> a`_fec::aK it to tinde _„mud that case type hay charga upon further if the fora . completed ley the. tack owner or iia: tort, retail: the rust copy
<br /> inves tl.;,.td:,n, _ _ and forward Am reinalming copies intact to your localtan Permitting agency
<br /> for. dis.r4bi:tion.
<br /> URIEU ITA77M ._, t" a€n>i - al. Took Agenry
<br /> Indicate the ,z ategc_ .._ 'he_?, i,xscm-fh�, ti;e c vr- er_t
<br /> - states of the , sa 0 x giMai Water (Pali r _;
<br /> bc..<Y<,eoan:s:
<br /> C'laca, ._ebox only, _ic na _� relatve to thecase type. For _ .. si Health Officer ad County Twar
<br /> . of _ mss__. o their d_s
<br /> ag'iee
<br /> camplp, if c z. `-rixnd .. aggert S, should refer rVqixe sro,sition 65
<br /> to the s : of the g nd > ur or cleanup, as Opposed to pa
<br /> +sir_ of sail.. Des nn )f_ ol:
<br /> c Actio>s rat: .. No a.t,_m has been t --n by responsible party i3e y -..d
<br /> iNUal ruponn of inak,
<br />
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