Laserfiche WebLink
SAN JOACUIN C&MVIt PUBLIC HEALTH SENVICES/ENRIRO#KRTAL REALhwWIVIStON <br /> 1. UST WORKSHEET FOR SITE CLOSURE E ALUATtON ATE <br /> AME OF fACILiTY # ENS CdE' <br /> DGRESa ARK IG <br /> ANX SIZE � t TYPE <br /> 11< GENERAL SITE HISTO Y <br /> E prt rr d i n t i ty Sstas C' SSI#fGtt cont as 0 <br /> r` f Tsas ftlizy Ss '7 lcstif sysitsdtT Tse rt rt Dual <br /> 111� TANK HISTORY <br /> 'as Tank test it d pre isi Nt T a if yes, give date(s) <br /> as s repair fas t syst s N f `les, fat ass repa Ir <br /> as repair r i spa i T Es yrs s it s is sraslytsd s a0 TXE P1t-G Par- b/Et111 <br /> Y`#� fsittta' /disr`N stsstrsi t •tura tsksSs vrfait �, drz <br /> ly. AEM VAL HISTORY (ATTACH INSPECTION REPORT FOR SITE DETAILS/COLLECT DATA FOR LEACHING POTENTIAL ANALYSIS) <br /> rail sohptes R verege Arrival'Precipitation 4 0-25 <br /> -Site W ltt s Tye Irr <br /> S core S cors S care <br /> istance to wettts t ft; ftt fC 0 pts C pis C pts <br /> 0 `f C if C f <br /> R ondition R anditiort R ondition <br /> Site feature • Leaching Potentfat Analysis E s met E Is met E s t <br /> tram Depth to groundwater from the Snit timple (fest) >100 1.100 S- 1 <br /> rs tures in subsurface (applits to foothitts or mountain areas) Nome <br /> Lark r prat <br /> ,veroge Anmuot Precipitation tt hes} xxxxx <10 9 10-25 Kxxxxxx 26-40\2 <br /> a -made its Witch increase rti sl migration, <br /> I leachate (i.e., septic systems, dater wells, ponds) None Unknown rft rat <br /> Imiquo site features: Recharge area, coarse soil, nearby wells. At Cast ors then <br /> xxxx Raw one one <br /> COLUMN T0TAL$>>ioTOtAL POINT + 2 <br /> ar is Rssvtta IS T A OR EI RANGE OF TOTAL POINTS 9 pts or r 41 48 pts 40 pis or its$ <br /> S T X E S T X <br /> MAXI ALL tASLE B-T-X-E LEVELS (PPM) 1 50 30 Y3 1.' 1, :N:A\:3 <br /> �,aavle Result: AS LINE 100 100 I <br /> ycio AXI M ALLOWABLE TAN LEVELS (PPM)TAN iEL 10, 0 1000 100 <br /> 00TROTES; ***If documented sent and/or ground anter contamination is present, do not complete the teaching pot tint <br /> s, lysis. (i.e.. site to currently on LIGT Zontamination Li t�for, soil or ground water.) <br /> 11 If depth is S ft. and < 25 ft., score 0 points,. If depth <=5 ft., do not use table. <br /> \2 If precipitation is > 40 inches, score C points. <br /> Lsvts fcir STXSE ars t spptisLats s s TP1i t srarstt of 1G Isslatt�a1 r IdiEst). <br /> V l, STAfF'RECOWENDAT ION/ ONCLUS ION <br /> 1, Ari RTX S E TPN C rstrAti � Atlaastal Lvets Yes cr �' <br /> R rxd SSte lsLar Rs f Yds, RsfEr to Sits MitSsti 'fC` Evdt i <br /> 11. PIVIEW EVALUATION - TO BE COMPLETED BY A: SUPERVISOR/SENIOR <br /> TO SITE MITIGATION FOR <br /> EVALUATION E 0 <br /> ET7!7= <br /> / <br /> 7 <br /> EH 23 C ItIGTWKSHTtt3/ C <br /> EH 29 8 <br />