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SAN JOACUIN COUNTY PURL 4EALTN SERVICES/ENVIRCNME4TAL HEALTH DIVESl,` <br /> UGST WORK,,:T FOR SITE CLOSURE --VALUATION v ATE i <br /> Z <br /> F FACILITY .n,rW'-� (.�T�LC' - EEPS COOE l <br /> S ANK IO <br /> !ZS <br /> lb DO UEL TYPE QLRLL` - to' <br /> HAL SITE HISTORY <br /> mi: current? Ias o ermit 4 acility Status Code pdc.Soik/GW Cont ITes to <br /> of Tanks at facility ge of Tanks(if available) ype of Tank reel �Fbrgl T ISngl I Duel <br /> K 41STORY <br /> ink lasted? es o ailed prat isim :est es o If yes, give date(s) <br /> repair made :o the tank system? lfes No f yes, what was repaired? <br />!pair clone uncer inspecticn7 I esI o � Here soil satoles analyzed? IT es I to TXE P4•G � PH-D I Fb/EDO <br /> of failure/discharge atastrochicl long-term Leakage pverfill I rwnm I I cher: <br />)VAL HISTORY (ATTACH INSPECTION REPORT FOR SITE 7ETAILS/COLLECT ^.ATA FOR LEACHING POTENTIAL ANALYSIS) <br /> iambLes Received es o corn to Ground Water I of/Year verage Annual Precipitation 4 10.25 <br />:9 'dot l(s) 1,es to )Lmber S Type (rr Dae Pub <br /> S cora S core S cora <br /> ice :o JeLl(sl fran Tank ft; ft; ft C 0 pts C9 PCs C pts <br /> 0 'f 0 Iif 0 if <br /> R ondition R condition R =rdl tion <br /> Ile Feature - Leaching Potential AlNly315 1S SMC E IIS MC E 3 •ML <br /> um 3eprh to grow dwater from the Soil Sade (feet) I >100 1.100 25.50\1 <br /> ares in subsurface (applies :o foothills or mountain areas) ( b 4dne Unknown resent <br /> ge Annual, Precipitation (inches) xxxx I <10 I 9 10-25 xxxxxx 26.40\2 <br /> ace conaui is which increase vertical migration <br /> acnace (i.e., septic systems, water wells, polls) None Unknown resent <br /> e size features: Recharge area, coarse soil, nearby wells. At Least are than <br /> xxxx None 9 ane I one <br /> COLUMN TOTALS>--TOTAL POINTS . 101 0136,L q <br /> e Result: (B T X 09 -c) RANGEOF TOTAL POINTS 9 pts or more Al :8 pts I 40 pts or Less <br /> ��Bu'PPt' S T X g T X E <br /> NAX IFIW ALLOWABLE 1-i•%•E LEVELS (PPM) 1 50 50 50 I .3 .3 1. 1. NA\3 <br /> e Result: FFLINE 7000 100 I 10 <br />— bDP�f'iPH ? IMUM ALLOWABLE TPH LEVELS (PPM) IESEL 10,000 1000 100 <br /> IOTES: •^If docu ntad sail and/or ground water contamination is present, do not coackete the leaching potential <br /> analysis. (i.e., site is currently an UGT Cantamimacion List for soil or ground water.) <br /> \1 If depth is > 5 ft. and < 25 ft., score 0 points'. If depth <=5 fc., do mat use table. <br /> \2 If precipitation is - :0 inches• scare 0 points. <br /> \3 Levels for STXAE are nor applicable at a TPH concentration of 10 pan (gasoline) or 100 Ppe (diesel). <br /> IFF RECO ME40ATTON/CONCLUSION y ,yl, L,,,, (;,,Q_(,_,,t>,;, IP-tlpmLtr TPH6nn�a <br /> Are 3TX L E or TPH Concentrations > Allocable levels Yes o Gn^•P�'f'T Lt�-t(�- > Len.�-tG��,Jt;,.erF. .ti^rr'L�-�P�+ <br /> Reccmeend Site Closure r�t/ilo i fin Yes, Refer to Si ce Mitigation for EwlustionG Y 01/ <br />:V[EU EVALUATION - TO gE COMPLETED gT A SUPERVISOR/SENIOR <br /> UR 'WITH STAFF RECOMMENDATION FOR CLOSURE IVES EFERRED TO SITE MITIGATION FOR EVALUATION Ir ES I Il0 <br /> { <br /> IEFERR EO `yx'E CLOSURE LETTER MAILED i / <br /> t <br /> 7 <br />