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SAN,JAQUIN LOCAL HEALTH DISTRICT <br /> UNDERGROUND STORAGE TANK PROGRAM• <br /> CRITERIA FOR CLEAN-UP REFERRALS <br /> Situs Address Evaluat <br /> Ste/ Phone: 209-466-6781 <br /> I. Product Identification <br /> A. Extremely Hazardous Substance 5 Points <br /> B. Hazardous Substance 3-4 Points <br /> C. Designated Hazardous Substance 0-2 Points <br /> II. Laboratory Analysis Results <br /> A. Extremely High (Free Product) 5 Points <br /> B. High 3-4 Points <br /> C. Moderate 2. Points <br /> D. Low 1 Point <br /> E. Non-detectable 0 <br /> III. Distance to Water Supply Wells <br /> A. 0-50 ft. 5 Points <br /> B. 51-100 ft. 4 Points <br /> C. 101-200 ft. 3 Points <br /> D. 201-300 ft. 2 Points <br /> E. 301-500 ft. 1 Point <br /> F. ' Over 500 ft. 0 <br /> IV. Documented Impact on Active Water Supply Wells <br /> A. Public Water Supply Well or two or more Domestic Wells 5 Points <br /> B. Active Water Well (s) : -% 200 ft. or off site 4 Points <br /> C. Domestic Well (on site) - 3 Points <br /> D. Nondomestic Well : 100-200 ft. (on site) 2 Points <br /> E. Nondomestic Well : e- 100 ft. (on site) 1 Point <br /> F. No Active Well (s) Affected 0 <br /> V. Depth of Groundwater <br /> A. 0-25 ft. 5 Points <br /> B. 26-35 ft. 4 Points <br /> C. 36-50 ft. 3 Points <br /> D. 51-70 ft. 2 Points <br /> E. 71-100 ft. 1 Point <br /> F. Over 100 0 <br /> VI. Soil Type (Unified Soil Classification System) <br /> A. Gravels - GW, GP, GM, GC 5 Points <br /> B. Sands - SW, SP, SM, SC 3-4 Points <br /> C. Silts/Clays (Low Liquid Limit) - ML, CL, OL 2 Points <br /> D. Silts/Clays (High Liquid Limit) - MH, CH, OH 0-1 Point <br /> E. Organic Soils - PT (Site Specific) <br />