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i <br /> Ei <br /> i <br /> CENTRAL VALLEY REGIONAL WATER QUALITY CONTROL BOARD <br /> CASE CLOSURE CHECKLIST <br /> Leal iug Underground Storage Tank Program ' <br /> This checklist, CASE CLOSURE leaer, and the Linauthorized Release Report Form {URF} is to be <br /> retained by the Regional Board and Lccal Implernenting Agency`Ias documentation of release and', <br /> subsequent closure action. All files and reports will be placed on microfiche-for review. <br /> �s <br /> fj <br /> I. Case Information <br /> LLSTIS Case no. URF film date Closure date ! <br /> Site name/counry leve ,s Ae'v-91 /Sa� J'oa in ure <br /> Site address a7.5 Citv T,-z Zip' 9,57J-3Phone N/A <br /> Table I - Responsible Party Information <br /> Jr <br /> Responsible party Name Address, City, Zip Ph= <br /> Property owner Ohr1 e �A 533{c { ) M <br /> + T� Trust PO. 7.R - A/c9rlleGG a�J <br /> Operator 1 { ) <br /> Operator 2 <br /> Operatcr 3 <br /> II. Release and Site Characterization Information �ol;ne `CKs d Ur� r�aGon <br /> Tank size(s) A5-0 Sal u-a� oil re✓nOV&"'JFqueel tyge(s }! r or- o✓ �� /q7/. <br /> Chemical t ipe(s) and quandty(ies) reimsed �7d5ol r�� Ctrld COrisfr{�e�fS url how �a f� <br /> Table II - Lateral and Vertical Exner of Contamination <br /> + <br /> Environment Lateral (ft) I Ven"Cal (fr) Coninmi +hnt I Concentrarion Range <br /> Un 5&7Ur D x <br /> 3-7 7�uG 7o rizer» D_7,� D-3la0 • i <br /> ' <br /> SoilSrP 75X I 7--/01 /T G7Lef7� d � o .g� <br /> Groundwater 75 x 15ZI -y`a o `TPA mgil 1 <br /> Soil type at the sic-- Lcc��ri Cla y 7�a '--5'7t)dy <br /> Source of drinicing water under SWRCB POLICY 88-635 <br /> Were nearby wells (Domestic, Municipal, Ag, etc.) monitored? I Fes No <br /> Wells affected (Domestic, Municipal, Ag, etc.) NINE • E1. <br /> Highest and lowest depths to groundwater T 4� •Zola r-T �. <br /> Seasonal groundwater Brad-zent(s) and direction(s) D, 00a5- I - O. OQ35 �cl� <br /> Name of Regional Water Quality Control Plan (Basin Plan) aquifer affected (see attached) <br /> n �oac�c;�n fieriyr_,- Ir1 i �. <br /> Surface water impacted? Yes ` No ✓ I <br /> Name of surface water body affc=d NA <br />