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w . <br /> APPEND&t OF THE TRI-REGIONAL RECOMMIANDATIONS <br /> CHECKLIST OF REQUIRED DATA FOR CLOSURE OF UNDERGROUND TANK SITES <br /> rvp..64 L&440 `M-- SrAn o EJ <br /> CLOSURE DOCUMENT APPLICATION SITE: L vo <br /> 1. j- L5 Distance to production wells for municipal, domestic, agriculture, industry and other uses within <br /> 2000 feet of the site; <br /> 2. � 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 utilities; <br /> 3. e-5 Figures depicting lithology (cross section), treatment system diagrams; <br /> 4. Stockpiled soil remaining on-site or off-site disposal (quantity); (7oc V3 -ro <br /> 5. try Monitoring wells remaining on-site, fate; <br /> 6. � Tabulated data of all ground water elevations and depths to water; <br /> 7. (A e,5- Tabulated results of all sampling and analyses: <br /> � Detection limits for confirmation sampling <br /> Lead analyses ,,` <br /> 8. � Concentration contours of contaminants found and those remaining in soil and ground water, both <br /> on- and off-site: <br /> GS Lateral extent of soil contamination <br /> GS Vertical extent of soil contamination <br /> G Lateral extent of ground water contamination <br /> V5 Vertical extent of ground water 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. q&S Reports/information <br /> Unauthorized Release Form <br /> QMRs (Dates) t 1 Z " tO q <br /> es PAR <br /> rFRP <br /> Other (report name) <br /> 41-6 Well and borirg logs <br /> 11. — Best Available Technology (BAT) used or an explanation for not using BAT; <br /> 12, c. a Reasons why "background" was/is unattainable using BAT; II <br /> 13. Mass balance calculation of the substance treated versus that remaining; too rii-OKS l�twaved <br /> 14. Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15.1 Rationale why conditions remaining at the site will not adversely impact water quality, health, or <br /> other beneficial uses; and <br /> 16. WET or TCLP results <br /> Continents: <br /> By: <br /> Date: �/S <br />