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Tri Regional Recommendation Page 24 of 24 <br /> Appendix A <br /> 0 TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> Site Name and Location FAG C4r-/ QfEVrR f?JV, GYZj CAPZ+61 4veAvt I L oa j c-A <br /> 1 Distance to production wells for municipal, domestic, agnculture, industry and <br /> other uses within 2000 feet of the site, <br /> E02 Site maps, to scale, of area impacted showing locations of any former and existing tank systems, <br /> excavation contours and sample locations, bonng and monitoring well elevation contours, <br /> gradients, and nearby surface waters, buildings, streets, and subsurface utilities, <br /> 3 Figures depicting lithology(cross section), treatment system diagrams, <br /> Z) 4 Stockpiled soil remaining on-site or off-site disposal(quantity), <br /> © 5 Monitonng wells remaining on-site, fate, <br /> 6 Tabulated results of all groundwater elevations and depths to water, <br /> 0 7 Tabulated results of all sampling and analyses <br /> ❑✓ Detection limits for confirmation sampling <br /> BLead analyses <br /> 8 Concentration contours of contaminants found and those remaining in soil <br /> and groundwater, and both on-site and off-site <br /> Lateral and Vertical extent of soil contamination <br /> FDLateral and F�rVertical extent of groundwater contamination <br /> 9 Zone of influence calculated and assumptions used for subsurface <br /> remediation system and the zone of capture attained for the soil and <br /> groundwater remediation system, <br /> P-110 Reports l information Unauthonzed Release Form QMRs(Dates) <br /> WrWelland bonng lags PAR aFRP ❑ Other(report name) <br /> 0 11 Best Available Technology(BAT) used or an explanation for not using BAT, <br /> �12 Reasons why background was<s unattainable using BAT, <br /> 13 Mass balance calculation of substance treated versus that remaining, <br /> EaM Assumptions, parameters, calculations and model used in nsk <br /> assessments, and fate and transport modeling, <br /> Q15 Rationale why conditions remaining at site will not adversely <br /> impact water quality, health, or other beneficial uses, and <br /> 16 WET or TCLP results <br /> By Comments <br /> Date <br />