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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UST WORKSHEET FOR SITE CLOSURE EVALUATION I. FACILITYITANK INFORMATION DATE: 12-6-2019 SITE/FACILITYNAME: I City of Trac STATUS CODE: ADDRESS: 729 N Central Avenue CITY: I Trac FA#:0024559 PR#:054284 TANK # 39- TA0520845 TANK SIZE: —100 gallons FUEL TYPE: Unknown II. GENERAL SITE HISTORY Is Permit Current? ■ Yes ❑ No ❑ NA Documented Soil/GW Contamination?` ❑ Yes ❑ No N/A Number of Tanks at Facility 1 Age of Tanks (if available) N/A Type of Tank ESteel ❑Fiberglass ❑Single ❑Dual III. TANK HISTORY Was Tank Tested? ❑Yes ■No ❑ NA Failed Testing? ❑ Yes ❑ No ■ NA If Yes, Provide Dates: N/A Was Tank System Repaired? ❑Yes ❑ No ■ NA If Yes, Describe Repair: N/A Was Repair Done Under Permit? ❑Yes ❑ No In NA Were Soil Samples Analyzed? ❑ Yes ❑ No ❑ BTEX ❑TPH-G ❑TPH-D ❑ LEAD ❑ EDB ❑OTHER ❑OXYGENATES Type of Failure/Discharge: ❑ Catastrophic ❑ Long-term Leak ❑ Overfill ■ Unknown ❑ Other IV, REMOVAL HISTORY Attach File Soil Samples Received? ■ Yes ❑ No Seasonal High Depth to GW _90_ ft bgs Year/ Reference 2015 Onsite and/or Nearby Well(s)? ❑ Yes ■ No ❑ Irrigation: # Distance to Tank ft C Score 10 C Score 9 C LJ Domestic: # Distance to Tank ft 0 points if 0 points if 0 Score 5 points if ❑ Public: itDistance to Tank _ ft R condition is R condition is R condition is met V. SITE FEATURE — LEACHING POTENTIAL ANALYSIS E met E met E Minimum Depth to Groundwater from Soil Sample (feet) >100 9 51 - 100 25 - 501 Fractures in Subsurface (applies to foothill or mountain areas) None 9 Unknown Present Average Annual Precipitation (14 inches for SJC area) <10 9 10 - 25 -------- 26 - 402 Man-Made Conduits which Increase Vertical Migration None 9 Unknown Present i.e. septic sstems, water wells, ponds) Unique Site Features: Recharge Area, Coarse Soil (coarse sands, None 9 At Least One More Than One gravels), nearby wells Column Totals Total Points 0 + 45 + 0 =45 Sample Results for BTEX: Range of Total Points 49 Points or More 41 — 48 Points 40 Points or Less B <0.0050 mg/kg T <0.0050 mg/kg Maximum Allowable BTEX B T E X B T X N/A3 E <0.0050 mg/kg Levels (ppm) 1 .0 50 50 50 0.3 0.3 0 1 .0 X <0.0050 mg/kg Sample Results for TPH: Maximum Gasoline 11000 100 10 TPH-g - <1 mg/kg Allowable TPH TPH-d- 1 .6 to 2.7 mg/kg Levels m Diesel 10,000 11000 100 Footnotes: *** If documented soil and/or groundwater contamination is present, do not complete leaching potential analysis (Le, site is already on the contamination list). 1 If depth is >5 feet and < 25 feet, score 0 points. If depth is <=5 feet, do not use table. 2 If precipitation is > 40 inches, score 0 points. 3 Levels for BTEX are not applicable at a concentration of 10 ppm for TPH—Gasoline or 100 ppm for TPH-Diesel. VI. STAFF RECOMMENDATIONI REFERRALI REVIEW 1 . Are BTEX or TPH Concentrations > Allowable Levels? ❑ Yes ■ No 2. If No, Is Site Closure Recommended? ■ Yes ❑ No Completed By: E. Manzo Date Referred to Site Mitigation Unit for Final Actiont _N/A Reviewed By: y✓I T N41 al Concur with Staff Recommendation 64eS ❑ No Date Closure Letter Mailed: December 6, 2019 tAII Cases are Referred to Site Mitigation for Final Action EH 23-0080 (Rev 11/14/08)