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I « 14U jun 1b .` b 11 :19 No -022 P .06
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<br /> APPENDIX R OF THE TRX-REGIONAL RECOMM N ATlONS
<br /> CHECKLIST OF REQUIRED DATA FOR CLOSURE OF UNDERGROUND TANK SITES
<br /> t4ok-C.a-r. i1C, 60-AG,C f&P..-x' JI
<br /> CIAKSURE IIOCUMRNT APPLICATION SIM 1500 C. vii yr..
<br /> 1. U r,5 Distance to producticm wells for municipal,domestic, agriculture,industry and other uses within
<br /> `t AXV feet of the site; lG j7.e(13 A-�ftg T
<br /> 2. r-'u Site: maps, to scale, of area impacted showing locations of farmer and existing tank syslGms.
<br /> excavation contours and sample locations, boring and monitoring well elevation contours,
<br /> gradients, and nearby surface waters, buildings, streets, and subsurface utilities;
<br /> ?l. L° Figums depicting lithology (cross seelion), treatment system diagrams;
<br /> 4. .i Stockpiled soil remaining on-site or off-site disposal (quantity); ,s/I_g 1, t ,l=s. ',',,. it r( t
<br /> 5. -'4-'� Monitoring wells remaining on-site,fate; f,,kW ti -it-ii 5)-1 YJ t NO Di i t t
<br /> 6. Tabulated data,of all ground water elevations and depths to water;
<br /> 7. o Tabulated results of all sampling Arid analyses:
<br /> _1 Detection limits for confirmation satmpling(tal�I.
<br /> o Lead analyses
<br /> 8. L a Concentration contours of containinants found and those remaining in soil and ground water, both
<br /> on- and off-site:
<br /> --q c_� Lateral extent of soil contamination
<br /> _f1c Vertical extent of soil contamination r,w A leu{f•t,
<br /> Lateral extent of ground water contamination
<br /> „00_ Vertical extent of ground wider contamination
<br /> 9. _1 D, Zone of influence calculated and assumptions used for the subsurface remcdiation system and the
<br /> zone of capture attaincd for the soil and ground water ramediaation system;
<br /> 10. 4�` Repnmfinformaiion
<br /> e Unauthorized Release Form (URF
<br /> 4 QMRS (Dates) -
<br /> ' P' PA
<br /> P* FRP
<br /> _144.3.Mer (report natne) 0's",e-C. (?..e_e�� .i t�A . LJ P _
<br /> Well and boring logs
<br /> 11. i4t.5 Best Available'!'ethnology (BAA) used or an explanation for not using BAT; if.(ro P
<br /> 12. c.r Reasons why "background" waslis unattainable using BAT; owf�c tae"rn rJ" �` 3
<br /> 11. A0 Mass balance calculation of the substance treatul Ycnus that remaining;
<br /> 14. O o Assumptions,parameteirs, calculations and model used in risk assessments, and fate and transport
<br /> 15. �- Rationale why conditions remaining at the site will not adycrsely impact water quality, health,or
<br /> -other beneficial uses; and (;orky('ria uti 5i•m j yttice tj t..1 s 4 +fn,,,,1.(t? ip,"Ix'
<br /> 16. Ov WET m TCJ_P results a ''j rte! �11 s �;. .,, I u{14 r)a^ tit.;4 I.,1 i r ti's.L ..,.t
<br /> Y
<br /> ..lLyL Jy
<br /> i,ti,lf Cb., 1 AlQ A"•!t .'4 l.•,
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<br /> Daft
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