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SAN MAMIN C )NTP PURL:C YEAL`H AEMC:S/ENVIRCNMENTAL HEALTH 01VISICH <br /> f. _ 'SRKSHEE-i :-0R Sl—,c CLOSURE :VALUATION OATE7j <br /> !NAME CF .AC:LIT'! <br /> AOCRESSI CS�Q , - '�-y/ZS ITANK iD 1-13 <br /> ITANK SIMI a Do-G IFUEL <br /> II. 'CEHEiAL SITE HISTCRY <br /> Ifs .ermit a.•rrent?iyesI X INa! iPerait :1 - IFacitia SactS CadelG Oce_SaiC/G7 Cstl7esl INaI <br /> Yulcer of Tanks at 12eilic/I IAge Ti Tanu(if avaitaote) iiype of Tan)clSteell IForgtl ISngll O.LI ! <br /> ..,. TAHK 'iISTCRY <br /> aas Tank tesced7I Yesl No! IFai led pr-eisim zest ?ITes1 IMo! /1 If yes, give rnce(s) <br /> e^„ a <br /> :as a rair wade the tartk Sys-.M? Yes No II' w yes, ac '+as,epairec? <br /> :.'Jas repair -acne urder insaee_ion7 l Yesl INo; l4ere sail sa®les �l•/Lea.I Yesi INa1 IBTX--I ITPH-•;i IT?N-)I !Pb/SSI I <br /> 'ype of 'ai lure/disehare! Icata t.r icl Ilaq-cerm leakage! averfi Lll Iunkrra+n! Iac-ert <br /> IV. 7E'!OVAL iISTCR7 (A ACI IN MMCH REPORT =M SITE ]Ei AILS/CML:CT DATA POR I_:.ACiING MTc)TIAL ANALYSIS) <br /> lSotL SanoLes iecei vea�Yesl INa1 10,0M .s Craraxi 'Jaterl IRef/7earl (Average Annual Tree ipi tacimlA=!il It0-SI <br /> !Cn-Sita 'JeLL(s)I Yes! INaI 19l L Pypei Zrrj 10=1 IP•s! <br /> SScareS Ser_ i Scor- - <br /> 1Oistanr_ to 'JeLL(s) 2rm Tard: rt; C TO pts C 9 -aG C 5 acs <br /> O if 0 if 0 if <br /> 3 ctci:Tan 7 CSdi Lim .R c i:ion <br /> IV. Site --azure - Leaching Potential Analysis �is met I _ is ser Iis set <br /> Mi ni man OMLh to gr•]IJnOAcer rrtmIre Sail Sade (reet)J(. .41-TDD <br /> =^ct•Jres in suosurface Ca=t ies -a faaCri l is or souncain areas) Yore I I 'lnkno+n+ I �Presertt ! <br /> [� <br /> I Average Annual Precipitation (irrcies) IXK% i e10 I 9 I IQ-S Iii <br /> '..4an-Sate ::n its '<(r1Gh InCeiae vertT Gl nigratiw <br /> 'af LeBCidt- (i.e., SeDtTc sy%t . Miter Yet Ls, pnnna) I I Harte ( i 'hrla:arer (J IPresertt <br /> Unfwe size festures: Recharge area, parse sail, nesmy Yetls_ i Ac least Mara _hon <br /> I.LLL�CI 4me I I mel me ! <br /> / n <br /> I CCL1961 TDTAL9»aTAL MINTS <br /> IS:ImIIeie ieSUL-: (9 T X OR E) RANG-e OF TOTAL MI)4T3#L9 ata or mere i •i - Ga pts I 4 acs or less <br /> NAKI.'4101 ALLCWBL_ 3-T-1-. !=VELS (Pa!17l 31 5Q� 4Q1 50 I I i.I 1 NAV <br /> 'Saoni'1ie Resulc: � GtSCL:AE 1000 I 100 ! iD <br /> MAXIMRI ALLC"-'C"-' TPN L-VE'S (PPM) ! <br /> oil = /f`fm ' Tax DIES` tQ,�aQ ! taaQ too <br /> ;•CTMOTES-, "".f dar�merrted soil and/or grana Yater =roainetion is aware, m not �Lete teaiering po <br /> amlysis. (i.e., site is carrsretY an UGT CmizaWmcim List for mit or grand water.) <br /> \1 if deOe)a is > 5 ft_ am < S ft., sere 0 point- If ja= <=5 ft_, do net use Cole- <br /> \Z if precipitation is > 60 inches, sore O Points- <br /> \Z L evets for n=E are nac aM0caoLe at a 74 azar --= of 10 p® Cguso(ine) or TOO pea Cdiesei). <br /> VI. STAFF .2Er EIOATICN/CI31C0SICN pp <br /> 1. Are 3TX 3 ° or 74 Canceffa elms > Allaweoie Lavets ^est Na! <br /> ?_ lecsoee+d Site Ctosurel TM Na! ',-If Yes, .4efer TO Sita NTtigatim far Evaluat:ml(.t'Q.StJ: C r <br /> 0,t< S_ C-K�o. le40 <br /> VIl. 2E9IE/ EVALUATICV - 10 3E =K--M W A SWRVISCR/SERICR b //yr '>Lo <br /> CCVC;R 'JITH STAFF RE02M01E40ATTCM FCA ^Im<IYES! INC) !RE=PRE] M Siic YITTGAT-,CM .CR 2/ALUATICNITESI 1NQl I fr)ye <br /> OAT< la-ERRED / / OAT'e .^L=M __T—e.•L MAIL.MI <br /> NAME CF <br /> E/ALUATCRI <br /> EH T3 30 (UGTYKSHT7\./90 <br />