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TAE. 1 -CHECKLIST OF REQUIRED Duk <br /> FOR NO FURTHEeCTION REQUESTS AT UNDERGROUND TANK SITES <br /> � IN EST S1dClcTp.1 SA.-f <br /> Site Name and Location: R2cv SySo lb V r7 FR��owfi <br /> 1 ka Distance to production wells for municipal, domestic, agriculture, industry and other uses within 2000 feet <br /> of the site; <br /> 2. Site maps,to scale, of area impacted showing locations of former and existing tank systems, excavation <br /> contours and sample locations, boring and monitoring well elevation contours, gradients, and nearby <br /> surface waters, buildings, streets, and subsurface utilities; p20 pucT 4rNCr a PGaApr <br /> 3. Figures depicting lithology(cross section), treatment system diagrams; <br /> 4. Stockpiled soil remaining on-site or off-site disposal (quantity); 3S D�S P�sc l F1 I+-w E n n.ahr <br /> 5. Y Monitoring wells remaining on-site,fate; l IM W <br /> - 6. Tabulated results of all groundwater elevations and depths to water; 12/f3 6s <br /> 7. Tabulated 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-site <br /> and off-site: <br /> r <br /> y Lateral extent of soil contamination f1ptipaU %Av I-0 36C DW-61kb Q <br /> _�L Vertical extent of soil contamination vis•An,,y ar-maut-v <br /> N Lateral extent of groundwater contamination <br /> Vertical extent of groundwater contamination <br /> g. 01k Zone of influence calculated and assumptions used for subsurface remediation system and the zone of <br /> capture attained for the soil and groundwater remediation system; <br /> 10. Reports 1 information <br /> Unauthorized Rele se Form (URF) 1695 s��ass <br /> QMRs(Dates) 9 q'7 <br /> PAR 3�q�_ <br /> PAR <br /> FRP <br /> Other(report name) <br /> Well and boring logs <br /> 11. _ Best Available Technology(BAT) used or an explanation for not using BAT; avertcxcR�a�+•,, <br /> 12. N Reasons why"background"wasfis unattainable using BAT; <br /> 13. Mass balance calculation of substance remaining; 6--14'3 c-o#471 4""+"'&7-rn -$°'� <br /> 14. 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 Dn ,�.2 b��l +�anu+`i'7 s�r>^��r�� r/mum scne-t,. <br /> Comments: Low fZ i=of- To Crz o­rrn wooer S T C t D[E�tCcT p&(, c e9k <br /> tJbdl r �rucliNre � <br /> By: J t f3 <br /> Date: S -1-`3 r1 <br />