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Chevron #9-4054 May 2014 2103 Country Club Boulevard, Stockton Claim No: 12729 Has secondary source been removed to the extent practicable? ® Yes ❑ No Has soil or groundwater been tested for MTBE and results reported in accordance with Health and Safety Code Section 25296.15? ® Yes ❑ No ❑ NA Nuisance as defined by Water Code section 13050 does not exist at the ® Yes ❑ No Site? Are there unique site attributes or site-specific conditions that demonstrably increase the risk associated with residual petroleum ❑ Yes M No constituents? Media-Specific Criteria Candidate sites must satisfy all three of these media-specific criteria: 1. Groundwater: To satisfy the media-specific criteria for groundwater, the contaminant plume that exceeds water quality objectives must be stable or decreasing in areal extent, and meet all of the additional characteristics of one of the five classes of sites: Is the contaminant plume that exceeds water quality objectives stable ❑ Yes M No ❑ NA or decreasing in areal extent? Does the contaminant plume that exceeds water quality objectives meet ❑ Yes ® No ❑ NA all of the additional characteristics of one of the five classes of sites? If YES, check applicable class: ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 For sites with releases that have not affected groundwater, do mobile El Yes Li No ® NA constituents (leachate, vapors, or light non-aqueous phase liquids) contain sufficient mobile constituents to cause groundwater to exceed the groundwater criteria? 2. Petroleum Vapor Intrusion to Indoor Air: The site is considered low-threat for vapor intrusion to indoor air if site-specific conditions satisfy all of the characteristics of one of the three classes of sites (a through c) or if the exception for active commercial fueling facilities applies. Is the Site an active commercial petroleum fueling facility? ❑ Yes ® No Exception: Satisfaction of the media-specific criteria for petroleum vapor intrusion to indoor air is not required at active commercial petroleum fueling facilities, except in cases where release characteristics can be reasonably believed to pose an unacceptable health risk. a. Do site-specific conditions at the release site satisfy all of the ❑Yes ® No ❑ NA applicable characteristics and criteria of scenarios 1 through 3 or all of the applicable characteristics and criteria of scenario 4? If YES, check applicable scenarios: ❑ 1 ❑ 2 ❑ 3 ❑ 4 Page 4 of 15