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SAN ,=JJIN- ­%ITY ?USLiC 4EAL74 ScZVIGS/EtVIRCNMe#TAL :ffn' -'! OIVISICH <br /> i. GST 'CRKSHE�7 FCR S[1 c LCSURE EVALUATION i OAi c+ <br /> NAME OF FAC:L?i' j " I SWF:--ZS CODE <br /> IADORESSI S ' iTANK <br /> lTANK SIZE!1 G�L�C�C.� I`UE= E1 4-- <br /> rr. 3ENE..RAL SITE' AISTORY <br /> jrs permit current? Yes Na jPernit :` - �FaeiLity Status rade; �Dae.S.iilC.i Cantfyesj Ncl <br /> I <br /> 1 Nt.^cer of Yanks at `aci U-zy Lige of Yares(i f avai(acle)� Type of Yank l Steei l j Fbr7d I s.gt j 3uat� I <br /> iir. TANK A1STORY <br /> iVas Yank ;este.?iYes� VINO; Failed orecision :est ?fyes� INoj !rf yes, give cz(s)� <br /> !Was a repair ,nate :o t/h�e ;ank systewtiYes} Not �rf yes, +ihat was repair--071 <br /> i <br /> 'Was re:air done under insaectian?iYesf INoi !Were saii samples analyzeC?lYes� HolISTXE; fTP4-6i !TP!t-•31 IPb/E781 I <br /> t <br /> jTyce of 4ailure/disclarge� Icatast:aonic� !Lang-term teakagef laversittl 1,.ima.. f.tater: <br /> rV. ZEMOVAL 4ISTCRY (ATTACH iNSPECTICN 1EZCRT FOR 31ic OETAIL3/CZL'_` DATA i:M 'r.aCi1NG POTENTIAL ANALYSIS) <br /> Soil 3.tes leceivedlYesi 1N.1 10.pm :a .:round Vater! Ref/Year !Average Arcual Pr claitati.nlA=j 14 �TII-S i <br /> ion-Site Weli(s)IYesi !No} iNuwer k TYpel Irrri local 'Pt=1 i <br /> I <br /> S Scars � S �Sc:r-_ i i !Scare <br /> !Distance ;o VeLL(s) from Yank} ft; t C 10 pts C �9 pts E C 35 pts <br /> Q if 1 Q if <br /> a Cartoon! 2 (condicicrs a (condition <br /> jV. Site =eature - Leareiing P?t nvfaL Analysis _ (is .Tier I d �is art = Iis ret <br /> Minimim Oeoth :a grauncwater .raw tie SoiL 3ampte ('e•t) ! j >10II t ;Si-i0O j � I S-:C\1 <br /> � r <br /> r.e:ures in su:suraea (acafies ;a =aaLtiitLs or .xc-stain areas) � f C � Acne ! j !lnzrawn � ;Pr_se.1t 1 <br /> I <br /> ;Average Annual ?recipitation (rotes) j=c=1' -IC r 10-25 j ocxxxl a-40\Z <br /> !Man-mace cartdui is wn i c�t inc.--ase ver—tical .ai grab cct <br /> I� I <br /> !of :qac:^.ate C'.a_, septic ;ystesrts, water 'yetis, xnrs) t� j xarte Unknow c ;?resent <br /> IUnicue size 4ear'res: aecharge area, coarse soil, Hearty vet Ls. f I At Less-,I tM.re -Ilan <br /> JOCr= .-ware j ane} l one <br /> n�a+�t`,�L>»-,orA.10 NNTTs ` k �i' 3 k <br /> ISarcote AesuL;: (3 Y XOR ?) RANGE'' CF NOTAL P9tNTS144 pts or ;nor_ =: - L3 pts :0 pts or less <br /> = �� 3 <br /> X -7 3 yv <br /> MAXI" ALLOWABLE 3-T-X-; ';JE=T <PPIM) S1 :tl� StlE SA 3 '.3 i .� 1. ! NA\. <br /> Samofa Resutt: G.LSu^LIAE 1000 100 .D <br /> n MAXII�IDM ALLCYABL= YPH L_EM S (PPM) <br /> i YPH fOtcSe— 10,000 i 100017100 <br /> OCT40TES: if doamentzd s.it and/or graatd water Cantaminatian is present, da not caaotete ate Leacning potential <br /> analysis. 0.a., site is :rrrentty at UGT Cantamination List far s.iL or ground water.) <br /> \1 rf deoth is > : ft. and < 25 ft., scare 3 points_ If depth —5ft., do riot Ise aisle. f <br /> \2 rf precipitation is > 40 incites, ware 0 points. <br /> j \a Levels for 3TXEE are not applicadte at a -PH =tcattrar'on of TO ppa (gasoline) or 1130 X= (dieset). <br /> VT. STAFF 3E_—IMME14DATION/COMMUSiCM 13 T,�:)` CG7'17' C/ / ' 4rtG r� %�a % TK a AK <br /> 1. Are 3TX b = or TPN Concentrations > ALLowaote Levets }'Yes{�imol <br /> 2- lecormwmd Site Ctosur_jYe51 ENof X L`-If Yes, defer to Site Mitigation for _valuation) <br /> e <br /> Vt i. 1£1/I£T4 EVALUATION - 70 3E �UTTIM 3T A SUPE2VISCR/SaI(3R <br /> =Nr-JR 'a1TH STAFF RE+.�.'MMER)ATiCN =-CR CL=R£1YE51 iRE.=ERRM 70 Si,c AITIGATICN FOR _VALLLATICNIYES11 I <br /> OA-.'a .2£72RED / / 'DAT= CLOMIR£ 1—CI—M.- MAIL-M1 <br /> NAME OF 11 <br /> EVALUATOR! <br /> -H 235 30 (UG`7.XSHT)\5/E'0 J <br />