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j SAN "IAQUIN LOCAL HEALTH DISTRICT <br /> i UNDERGROUND STORAGE TANK PROGRAM <br /> CRITERIA FOR CLEAN -UP REFERRALS <br /> Situ's Address Evaluator <br /> �f0 hone : 209 - 466 - 6781 <br /> I . fruduct Identification <br /> Extremely Hazardous Substance 5 Points <br /> Hazardous Substance 3 -4 Points <br /> Designated Hazardous Substance 0 -2 Points <br /> II . Laboratory Analysis Results <br /> Extremely High ( Free Product ) 5 Points <br /> Be Hi h 3 -4 Points <br /> 9 <br /> `C . Points <br /> Moderate I <br /> 1 Point <br /> D . Low O <br /> E . Non -detectable <br /> III . Distance to Water Supply Wells <br /> A . 0 -50 ft . 5 Points <br /> Be 51 - 100 ft . m 4 Points <br /> Co 101 -200 ft . 3 Points <br /> D . 201 - 300 ft . 2 Points <br /> E . 301 - 500 ft . 1 Point FO <br /> Over 500 ft . <br /> IV . Documented Impact on Active Water Supply Wells <br /> A . Public Water Supply Well or two or more Domestic Wells 5 Points <br /> Be Active Water Well ( s ) : N� 200 ft . or off site 4 Points <br /> C . Domestae Wela site )) 3 Points <br /> 2 Points <br /> Nondomestic Well : 100 -200 ft . ( on site ) <br /> Nondomestic Well : se� 100 ft . ( on site ) 10 Point / <br /> F . No Active Well ( s ) Affected <br /> V . Depth of Groundwater <br /> 0 -25 ft . 5 Points �- <br /> 26 -35 ft . 4 Points <br /> C . 36 - 50 ft . 3 Points _ <br /> D . 51 -70 ft . 2 Points <br /> E . 71 -100 ft . 1 Point <br /> F . Over 100 0 <br /> VI . Soil Type ( Unified Soil Classification System ) <br /> A . Gravels - GW , GP , GM , GC 5 Points <br /> Be Sands on SW , SP , SM , SC 3 -4 Points <br /> Silts/ Clays ( Low Liquid Limit ) - ML , CL , OL 2 Points <br /> Tf - Omml Point <br /> Silts/ Clays ( High Liquid Limit ) - MH , CH , OH Ste Specific ) <br /> E . Organic Soils es PT <br />