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r e <br /> r ? ITS CLEA N V P rC,-r C711CA), <br /> ��---- OUTLINE OF HYDROGEOLOGICAL ASSESSI-4ENT REPORT <br /> Text <br /> I. IDENTIFICATION OF FACILITY AND IMPOUNDMENT <br /> r A.a p 60 4. aetAl °.,t_ FZA <br /> B. RCRA identification number, if applicable <br /> C. Qwner fait I . <br /> ItyJ <br /> 1.". Corporate (or personal ) na <br /> 2 !' owner`s mailing addre s <br /> D. �ratar�r faG i1,? y c1] f r f�4��ow :. : F, <br /> 1., perator`s' name <br /> 2: Oporator's mailing addre <br /> E. L �catior� ,of faci.lt`"y Pz1. (,i <br /> County-- - �� . <br /> 2. =.,Lgcal mai I i n address: (street ad res's, p ; to fox r4u e etc - <br /> 3. Distance and di r�ectt®n from major , road intersection; or <br /> ..applicable, tow shi - - b , <br /> prangy, sects o , and l ocatt t t i n sec t o 6�ZC� <br /> . :_ <br /> F. Specific location of impoundment within facility <br /> G. Local identification of impoundment (e.g., Pond No. 2, West Pond) <br /> II. PREPARATION OF REPORT <br /> A. ;tdam o ffirm�Eepar�rig ro ealo ica ssessmen PZG <br /> B. Mailing address of firm preparing HAR <br /> C.". Fdame and title of Qualified Person responsible for preparation of the PJG <br /> NAR <br /> D. Professianal license number (CEG. RG, or RCE) of Qualified Pers@ (� <br /> :responsible for preparation of the HAR <br /> III. WASTE CHARACTERISTICS <br /> A. Identification o jdivtdual hazardous constituents contained w�trs' <br /> `the ,impoundment �.�-�,.��., m_ <br /> ajv-m- vi kAAJ2.r( 0 0 1 <br /> W K& <br /> It ct,t <br />