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TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS-AT UNDERGROUND TANK SITES <br /> Site Name and Location'. <br /> i <br /> _ <br /> Distance to production wells for.municipal, domestic, agriculture, industry and other uses wvith rt 2000 <br /> feet of the site; <br /> 2. Site reaps, to scale, of area impacled showing I-cations of former and existing tank systems, <br /> excavation contours and sample locations, boring and monitoring well elevation contours, gradients, 1 <br /> and nearby surface waters, buildings, streets, and subsurface utilities; <br /> 4 <br /> 3. r Figures depicting litl70109y (cross suction), treatment system diagrams; <br /> 4. Stockpiled soil remaining vn-site or off-site disposal (quantity); <br /> 5. Monitoring wells remaining on-site, fate; <br /> 6_ ^_ i abul.atsd results of all gra-undwater elevations.and depths to grater; <br /> 7. _ Tabulated results of all sampling and analyses: <br /> Detection limits [or confirmation sampling r <br /> Lead analyses <br /> 13. Concentralion contours of contaminants found and those remaining in soil and €groundA-wer, both on- <br /> site and off•siie: <br /> _ Laieral extent of soil contamination <br /> _ Vertical extent of soil contamination <br /> Lateral extent of groundwater contarniration <br /> Vertical extenl of groundwater contamination <br /> 9 _ ?a-ie of influence calculated and assumptions used for subsurface remedialion system and the zone <br /> of rapture attained for the soil and groundwa?er remed,ation system; <br /> 10- Reports J information <br /> _ Uriautitorized Release Form (URF) <br /> C1MRs (dates) <br /> _ PAR <br /> _ FRP <br /> Other (report rtarne) <br /> r_ ►!'.veli and boring Ids <br /> I;. Bes: Available T echnol.pgy (BAT) used or an explantation for not using BAT-, <br /> 12. _ Reasons why "background'wasfis unallairta<t le Using BAT, <br /> 13. hllass balance calculation of substance treated versus that remaining: <br /> 14, Assumptions, parameters, calculations and model used in risk assessments, and fate and transpar! <br /> modeling; <br /> Rationale wviy conditions remaining at si3e will not adversely'impact water quality, health, or other <br /> benefociaa uses; and <br /> 15, 1N=T or TGLP resutts <br /> Corhments; <br /> By: <br /> Date: <br /> M <br /> . F <br />