Laserfiche WebLink
CENT <br /> VALLEY REOIONA.L WATER QUALITY CONTROL BOARD <br /> CASE CLOSURE CIIECKLIST <br /> Leaking Underground Storage Tank Program <br /> This checklist, CASE CLOSURE letter, and the Unauthorized Release Report Form (URF) is to be <br /> Th Agencyas documentation of release and <br /> retained by the Regional Board and Local Implem-1 be laced on microfiche for review. <br /> subsequent closure action. All files and reports will be p <br /> I. Case Information 7A rA Closure date <br /> LUSTIS Case n �o. Ot X10 URF filing date <br /> V1% ja <br /> Site name/county 2��Z4 Zi phone <br /> Site address 4'4q( W-`Dur kQA'^'' Ctty� G p <br /> -erv✓ <br /> Table I - Resr>orsible PartY information <br /> Responsible parry Nana <br /> Address, City, Zip Phone <br /> L44al GM i-er� R (ZD�t �3S^SSS <br /> Property owner L(Q vu i-Z <br /> Operator l { <br /> operator 2 ( ) <br /> Opera_or 3 <br /> II. Release and Site Characterization Information <br /> Tank sizes) f�J o ?�-- -.14_d06-�Jcs' - Fuel rype(s) <br /> Chemical type(s) and quantity(ies) released 0- Z � ( bared a"rfesr.+ l`daf <br /> Table II - Lateral and Vertical Extent of Contamination <br /> l Environment Lateral (ft) Vertical (ft) Contaminant Concentration Range <br /> 60A em"Uf n.16j+ 4i<- �jY'A ff10-0-6e9-6e1 `7P# <br /> 20 -toW,006 rngixg <br /> Groundwater © nudiuf 10-�t-4ttc mg/1 <br /> Soil type at the site SI40 Sm o Sg,, �-zj m L <br /> Source of drinking water under SWRCB POL CY 88-63 <br /> Were nearby wells (Domestic, Municipal, Ag, etc-) monitored? Yes �_ No <br /> Wells affected (Domestic, Municipal, Ag, etc.) AMUS- urn-s�-4e c� ¢dH_Z t4*6yi-d-,-,4Li,�-IJ <br /> t,sr�fe� <br /> to �u�f mre� wer o►A 4ew4 �e c <br /> Highest and lowest depths o groundwater g� I '4z - lc�w v S c�2 <br /> Seasonal groundwater gradient(s) and direction(s) 0, 00 1 4.r <br /> Name of Regional Water Quality Control Plan (Basin Plan) aquifer affected (see attached) <br /> Sa^ To (fov <br /> Surface water impacted? Yes No <br /> Name of surface water body affected <br />