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CIRCLE-K#1205 Page I of 2 <br /> LTCP Checklist � GEOTRALKER HOMEIMANAGE PROJECTG IBEP.QB.Ta 15Eb8ffiI1,gggSII <br /> CIRCLE-K#1205(70607700822)-MAP THIS SIZE OPEN-VERIFlCAnON MONITOPoNG Lr�[ <br /> 1647D CAMBRIDGE RD v I, \�11 <br /> ACTIVITIES REPORT SA CASEWORKER: <br /> A LIN LEAD)-SUPERVISOR, <br /> , <br /> LANJOA CA COUNTY <br /> CASEWORKER:MCB(REGIOOLL-S)-CASE ,3 ADRIENNE ELLSAEssER <br /> SAN JOAOUIN COUNTY PUBLIC WEEPAGE CENTML VALLER;dMa (REGION SS)-CARVFSOR.BRI <br /> VM PRINTABLE CASE SUMMARY FOR THIS SITE CASEWORKER:JAMES BARNN-SUPEFNSOR:BRIAN NEWMAN <br /> CUP Cielm a:19820 CUP Priority Assigned;D CUP Amount Paid:18 <br /> THIS PROJECT WAS LAST MODIFIED BY MARLIN KNOLL ON 8/25.20133:33:30 PM-11)STORV <br /> T M SITE HAS SUBMITTALS.CUCKIIEBB M OPEN A NEW WINDOW WITH THE SUBMITTAL APPROVAL PAGE FOR THIS SITE. <br /> CLOSURE POLICY THIS VERSION IS IN PROGRESS AS OF 512812013 CHECKLIST INITIATED ON W"13 CLOSURE POLICY HMTJNO <br /> General CFRarla-The Site Satisfies the policy general Ontario-CLEAR SECTION ANSWERS YE <br /> a.Is the unalMor¢etl release located within the service area of ublic water s stem? <br /> Nameaf Wader System: Cityof Latrop /' VES r <br /> b.The unauthorized release Consists only of petroleum jl)r flit. (S YES r <br /> c.The unauthorized("primary)release from the UST system has been stopped. R YES r <br /> d.Free product has been removed to the maximum extent practicable Lfg). G FP Not Encountered r YES r NO <br /> e.A Conceptual site model that assesses the nature,extern,and mobility of the release has been developedif nfpl. A- YES C NO <br /> L Secondary source has been removed to the extant practicable IM (a YES r NO <br /> g.Soil ort groundwater has been tested for MTBE and results reported in accordance with Health and Safety Cede Section r Not Required! G YES r NO <br /> 252%.15. <br /> In.Does a nuisance exist,as darned by Water Code section 13050. r VES IS NO <br /> 1.Media-Specific Criteria:Groundwater-The contaminant plume that exceeds water quality objectives is stable or decreasing in asset extent,and NO <br /> meets all of the additional Characteristics of One of the five Classes of sites fisted below.-cuEAR BECTON ANSWERS <br /> EXEMPTION-Soil Only Caw(Release has nP3 Affected Groundwater-Loi r YES is NO <br /> Does the site meet any of the Groundwater specific criteria scenarios? r YES to NO <br /> ADDITIONAL QUESTIONS-Please Indicate only Nose conditions that do not meet the policy criteria: <br /> Plume Length(That Exceeds Water Quality Objectives): <br /> r is 100 Feet and<250 Feel G>-250 Feet and<1,000 Feet r x 1,000 Feet r Unknown <br /> Mums is Stable or Decreasing in AREAL Extent <br /> r No r Unknown <br /> Free Product in Groundwater <br /> r Yes r No r Unknown <br /> Free Product Has Been Removed to the Maximum Extent Practicable: <br /> C No r Unknown <br /> For sites with free product,the Plume Has Basin Stable or Decreasing for 5-Years(info): <br /> r No r Unknown <br /> Il For sites with free product,owner Willing to Accept a Land Use Restriction(lfrequired): <br /> C No r Unknown <br /> Free Product Extends Offsite <br /> r Yes r Unknown <br /> Benzene Concentration <br /> r z 1,000 pgg and<3,000 pgll r z 3,000 pgn r Urdmown <br /> MTBE Concentration: <br /> r e 1,000 pgl r unknown <br /> Nearest Supply Well(From Plume Boundary): <br /> r s 250 Feet G>250 Feet and s 1,000 Feet r Unknown <br /> Nearest Surface Water Body(From Plume Boundary): <br /> C s 250 Feet r>250 Feet and s 1,000 Feel r Unknown <br /> 2.Media Specific Criteria:Petroleum Vapor Intrusion to Indoor Air-The site is considered low-threat for the vapor-intrusion-lo-airpathway ifsiie- YES <br /> specific condition satisfy items 2a,2b,or 2c-CLEAR SECTION ANSWEPS <br /> EXEMPTION-Active Commercial Petroleum Fueling Facility r YES G NO <br /> Does the site meet any of the Petroleum Vapor Intrusion to Indoor Air specific criteria scenarios? R YES r NO <br /> 2a-Scenario 4 axamclel:Direct Measurement of Soil Gas Concentrations YES <br /> I.Soil Gas Sampling Locations-No Bioadenuation Zone: YES <br /> -Beneath or adjacent to an existing building:Soil gas Sample is collected at least 5 feet below the Whom of the buiking foundation. r• YES r NO <br /> 1 -Future construction:The soil gas sample shall be collected from at least 5 feet below the ground surface lugs). (a YES r NO <br /> ii.Soil Gas Sampling Locations-with Bioattenuation Zone:The criteria in Column A in the Soil Gas Criteria table(page 5 of the Policy)apply R the <br /> following requirements for a bioattenuation one are satisfied: <br /> -Minimum of 5 feel 0 soil between the soil vapor measurement and the foundation of an existing or ground surface of future construction. r YES r NO <br /> I <br /> \ 4ttps://geotracker.waterboards.ca.gov/regulators/screens/closure—Policy.asp?global_id=TO... 6/27/2013 <br />