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TABLE I - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> Site Name and Location: i lct_ fVol HAwT yl" <br /> 1. 1441 Distance to production wells for municipal, domestic, agriculture, industry and other uses within 2000 <br /> feet of the site; <br /> 2. ✓ 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. !� Figures depicting lithology (cross section), treatment system diagrams; <br /> 4. A//A Stockpiled soil remaining on-site or off-site disposal (quantity); <br /> 8. _✓ 'Monitoring wells remaining on-site, fate; (7) <br /> 6. -z" Tabulated results of all groundwater elevations and depths to water; <br /> 7. ✓ Tabu4ated results of all sampling and analyses: <br /> _✓ Detection limits for confirmation sampling <br /> ✓ Lead analyses <br /> 8. Concentration contours of contaminants found and those remaining in soil and groundwater, both on- <br /> site and off-site: <br /> Lateral extent of soil contamination <br /> Vertica[ extent of soil contamination <br /> _✓ Lateral extent of groundwater contamination <br /> _✓ Vertical extent of groundwater contamination <br /> A141 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. ✓ Reports 1 information <br /> Unauthorized Rel ase Form (URF) r <br /> QMRs (Dates) 9S S 114 S/ n zlsy �Jyv_ rIC� 1l�/ —G;�a3 <br /> _✓ PAR 7/o/ <br /> ,(/ } FRP l <br /> i/ Other (report name) Hd of <br /> _✓ Well and boring logs <br /> 11, ✓ Best Available Technology (BAT) used or an explanation for not using BAT; <br /> 12. Reasons why "background" was6is unattainable using BAT; <br /> 13. Mass balance calculation of substance treated versus that remaining; <br /> 14. Oil Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15. �� Rationale why conditions remaining at site will not adversely impact water quality, health, or other <br /> beneficial uses; and <br /> 16. WET or TCLP results <br /> Comments: <br /> 0 <br /> By: <br /> Date: 17 -3 <br />