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SAN 4CACUIN =INTT AISLiC :iEALTN SaVICS/EWUMNMENTAL .45-41.71 a(VISMN 3- /'C <br />gapT'4CRKSNE=T :-CB Si1c =SIRE '/ALIATTCN A ICATEI <br />INANE OF : AGILITY ! 2' - ..��//� � �� � ,,C-/ // jamas C E1�J �j� JJ/' / //. <br />iAOCRESSI / D / W GLi(i(� /� © Jae 01-j SJ/TJJ/(j ITARK ill t1 (/O <br />BANK SIZES 1%,IB�'D lFUE1. TTPEI �u�J <br />[I. O4NE.iAL SITZ 3ISTCRY <br />[s :emit �•rc- V! I INaI IPermft S, - l�a�ility ictus C.:del lcce.Soi L/C.I CSntl Yes! INaI <br />VL'I[tef of Tanks at faeiLiyl IAge of Tanks(if avai [ante) (Type of Tarric;Seeeil 1Pbr3ll ISngtl Ouatl <br />;(I. TARK NISTCRY <br />Vas lank :estad?IYesl INoI IFai led precision cast ?Iyes I INoI 1 E yes, Sive =Ce(s)I <br />:,;as a re^rair ❑aide :0 rhe ardc sys:ee<l ITesl Vol i[f yes. 'mat was : ire�- <br />':as recair cons ::neer inseection7lYeel In.; lUefe sail salmlee alnlyzea?l7ee1 iMa{ IT=: 'T7N-Gl ITPM JI IPb/DBI I <br />Cype of failure/disc-.ar;el I tatastrepinicl Itleakage! laverfiIq i I IaCer: <br />711. MMOVAL VISTCRT (ATTAM [NSPZ-IMN 3EPMT --JR SITEEOEFAlLS/C '=-C' TATA A= GLEAMING POTBiTIAL ARAL•SIS) <br />(Sail Samples .ieceivedjy <br />sl jMj <br />laeorh ;O O.eune Vatnrj?D IRef/'fearl�'/ ; (Average Ahzllui Prxfpi:aciandA=116 <br />w <br />110 -SI <br />ICn-Sita Velt(sllTeel <br />iNal INurmer L Typel <br />Ilrrl lo -I IPudl <br />l <br />fI <br />S <br />C <br />I SecreS <br />is pts <br />C <br />S=-- <br />9 .--=C <br />S <br />SqR <br />5 pts <br />!O,S-.WCe :0 vel-L(s) frxs Tared ^. <br />a <br />R <br />- <br />iT <br />`Q+ei tics+ <br />lis net <br />a <br />.i <br />' <br />if <br />Q+di tion <br />is nee <br />a <br />R <br />I - <br />if <br />aoxlf tion <br />is net <br />V. Site Pea care - Leaching PosantiaL Analysis <br />Minimus Dept- :n ?rcuncwater 4T --he Sail Sacate (feeearl <br />l j >IW <br />l ;51-I.a I <br />l v -i0\1 <br />IF -:c^ -,res in s—ul=ace Caepties :a -'wcsitLs or ro. xstain areas) <br />I j Vox <br />I na,a, l <br />(Proem <br />average Annual PreciOitati= (ilxhesl <br />lxa0�szl <br /><VO <br />l 9 l is-� ice) <br />Z5 -<a\2 I <br />'4an-'fade =MC!Ults •wniei mase •ertiat aigrsctan <br />of tas=ara (f.a., septic systas¢, wail vel Ls, pons) <br />I Vane <br />-to I - <br />Presort <br />I�Uni Ne site 4eat'.)res: ie=srne 313, ccerse 3eit, .near' -'y fe <br />I <br />I At lN1tj <br />ishan <br />�� <br />7LLiCIX .Varve tI <br />ox <br />(Mare <br />acre <br />�'�.n �����yct, //�+' <br />xyyvi/ �T ALA7>iCf,1L <br />POINTS <br />SameLOe .tesuL:: (9 T X OR i) <br />.TANGE CF TOTAL PQLMTS149 <br />pts w mere I +) - :.d pts l <br />:a pis or less l <br />1k <br />`JI'll <br />-MI <br />T� i. I <br />I f <br />MAXIMM ALLONAW-- 3 -T -X -j ISVELS CP <br />it <br />;"a� ;-a} Sa .� ;.` <br />MA\3 <br />Saaole .resin:: uA50LiNE <br />IMAX <br />•1000 I 100 I <br />SO <br />IMINI TPR LEV S PM) <br />r K;2w ALWAIIIA CP <br />10,100 I 1000 l <br />Sao l <br />c+i r> M IIf[ IOIES� <br />PS)TMCTES. —If do=m=ed soil and/or 3rmad eater ahtamimcion is p esin C, do net ctaetecs rhe Leacning potentfat <br />analysis. Cf.e., site is currlrcty on Wr Contamination List !ar sail or, ground weter.) <br />\1 If deaffi is > 5 f--. a-& < 25 ft., save 0 Points- If encs --i ft., Ga nos use cele. <br />I \2 If precipitation is > to inches, snre 0 poincs- <br />I U F.&Yets for 3TXSE are not e:PL i=te at a iPR ca I=Otfart Of Ta pica CSaseLim) or TOO ppa (dfeset). <br />i <br />VI. STAFF 3EC=MMEVOATTCM/CX=ICN <br />T. Are VX 3 E or SPM C=c2neratias > ALLwecte Levels I^es' IMai L-�7� �/1✓ L6 �J2�� <br />l?. iec=MOM site Ct Oara•ei Teel IM0I)<1�If Yee, .1efer to Site Mitfgacm it _"LMM'n <br />'111. REVIEW 'IALUATICN - TO 3E CWLEM 37 A SUMRVISCR/SENICR <br />CCIIMR VITN STAFF q9C=4MEWATTCM M ..=MIYESIINaI IRE -MED TO SITE i I ATiOM FM =VALUA-,ICXl YESI INaI I i <br />IDAc RE. ViRDI / / IDAT'e .MMURE L01ei MAIL- <br />NAME OF <br />E4ALUATCRI <br />S3 T3 30 (L'GT'rXSMT)\5/g0 <br />