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TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTF"R ACTION REQUESTS AT UNDE" ROUND TANK SITES <br /> Site Name and Location: �.�o�� r •l r �� -� r,� = r u -� =T , T ��, = r� x <br /> 1. ,.) Distance to production wells for municipal, domestic, agriculture, industry and other uses within 2000 <br /> feet of the site; <br /> 2. 'lid site maps, to scale, of area impacted showing locations of former and existing tank systems, <br /> excavation contours and sample locations, boring and monitoring well elevation contours, gradients, <br /> and nearby surface waters, buildings, streets, and subsurface utilities; <br /> 3. II?; Figures depicting lithology (cross section), treatment system diagrams; <br /> 4. QZ.� Stockpiled soil remaining on=site or off-site disposal (quantity); <br /> 5. L;, Monitoring wells remaining on-site, fate; I <br /> 6. L, Tabulated results of all groundwater elevations and depths to water, U4 <br /> 7. ,E,` Tabulated results of all sampling and analyses: <br /> `" r jj.S Detection limits for confirmation sampling <br /> AA Lead analyses <br /> 8. :_ Concentration contours of contaminants found and those remaining in soil and groundwater, both on- <br /> site and off-site: <br /> v�c -X_ <br /> Lateral extent of soil contamination IME <br /> J1­ Vertical extent of soil contamination > <br /> Lateral extent of groundwater contamination r : <br /> �> Vertical extent of groundwater contamination ­r!)'ry NI: <br /> 9. C)D Zone of influence calculated and assumptions used for subsurface remediation system and the zone <br /> of capture attained for the soil and groundwater remediation system; <br /> 10. ' J_�; Reports/ information <br /> les Unauthorized Release Form (URF)s, •? <br /> ays QMRs (Dates) <br /> i,LS PAR w es <br /> FRP <br /> 5 Other (report name) w�-u fFy ,a i- � i4g (off <br /> Well and boring logs <br /> 11. �)r Best Available Technology (BAT) used or an explanation for not using BAT;,y, nr <br /> 12. Reasons why"background"waslis unattainable using BAT; <br /> 13. ±:i'-�,5Mass balance calculation of substance treated versus that remainin` <br /> g' !fUr S <br /> 14. Assumptions, parameters, calculations and model used in risk assessments, and fate and transport ' <br /> modeling; ljPSorl� %iDrr <br /> 15. ,- Rationale why conditions remaining at site will not adversely impact water quality, health, or other <br /> beneficial uses; and <br /> 16. I WET or TCLP'results <br /> Comments: onea? Z7 z V'-5 <br /> (JPA2 �D l%'��,1�A.�(./'U =G�r)� s,,�✓�, . ._, ,�-i 9 1%� a:lJ��✓ 7` r / • <br /> � v � <br /> Date: ;J y <br />