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i <br /> Tri Regional Recommendation Page 24 of 24 <br /> Appendix A <br /> TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> Site Name and Location:Arroyo' s Smog Shop 3012 East Waterloo Road, Stockon, CA <br /> 1. Distance to production wells for municipal, domestic, agriculture, industry and <br /> other uses within 2000 feet of the site; <br /> ❑✓ 2. Site maps, to scale, of area impacted showing locations of any 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: Figures depicting lithology(cross section), treatment system diagrams; <br /> ❑✓ 4. Stockpiled soil remaining on-site or off-site disposal(quantity); <br /> 0 5. Monitoring wells remaining on-site, fate; <br /> 6. Tabulated results of all9 roundwater elevations and depths to water,- <br /> ✓❑ 7. 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 <br /> and groundwater, and both on-site and off-site: <br /> ❑Lateral and Vertical extent of soil contamination <br /> ✓❑Lateral and In/ Vertical extent of groundwater contamination <br /> FFA-1 9. Zone of influence calculated and assumptions used for subsurface <br /> remediation system and the zone of capture attained for the soil and. <br /> groundwater remediation system; <br /> ED 10.Reports/information ❑✓ unauthorized Release Form NZ QMRs(Dates) <br /> ✓0 Well and boring logs ❑ PAR ❑FRP ❑✓ Other(report name) <br /> ✓❑ 11.Best Available Technology(BAT)used or an explanation for not using BAT, <br /> NA <br /> 12.Reasons why background was/is unattainable using BAT; <br /> ❑✓ 13.Mass balance calculation of substance treated versus that remaining; <br /> NA 14. Assumptions,parameters, calculations and model use d'in risk <br /> assessments, and fate and transport modeling; <br /> ❑✓ 15. Rationale why conditions remaining at site will not adversely <br /> impact water quality,health, or other beneficial uses;and <br /> NA 16. WET or TCLP results <br /> By. Comments: <br /> Date: <br />