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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 Ar—co S�rvtcc. 'z- w2.6) } t`i( I C-OLSI- Yr-,,S-ryK S <br /> -t v c 4e /I�rtvti}ecc� <br />' i Distance to production wells for municipal, domestic, agriculture, industry and <br /> other uses within 2000 feet of the site, P ci 3 <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, 1:�,IL��b t Q 2 <br />' ❑ 3 Figures depicting lithology(cross section), treatment system diagrams 6i C h yx-e� f- D <br /> ❑ 4 Stockpiled soil remaining on-site or off-site disposal(quantity), N 14 <br />' E� 5 Monitoring wells remaining on-site, fate, F--) <br /> 0 6 Tabulated results of all groundwater elevations and depths to water, Te,L,6e S 1 - 3 <br /> 7 Tabulated results of all sampling and analyses <br /> ❑"Detection limits for confirmation sampling '�`TF -la l-�'' <br />' a&ad analyses a � ' Z <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 ❑Vertical extent of groundwater contamination <br /> 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 />' 10 Reports/information ❑ Unauthonzed Release Form ❑ QMRs(Dates) <br /> ❑ W 1l and boring togs ❑ PAR ❑FRP ❑ Other(report name) <br /> A-14c c to,-m--F T> <br />' 11 Best Available Technology(BAT)used or an explanation for not using BAT, 7 fi PQges I—,+ <br /> 12 Reasons why background waslis unattainable using BAT, d 'p <br />' 0 13 Mass balance calculation of substance treated versus that remaining, A-I-inn <br /> 0 14 Assumptions,parameters, calculations and model used in nsk 1 <br /> assessments, and fate and transport modeling, N ` <br />' 15 Rationale why conditions remaining at site will not adversely <br /> impact water quality, health, or other beneficial uses, and <br /> Ea16 WET or TCLP results n/ <br />' By Comments <br /> Date <br />