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PUBLIC WORKS — Page 1 of 2 11./ .fir - LTCP Checklist A Fdo GEOTRACKER HOMENJINAGE PROJECT6ftEPORT6 SfARCHLOGONr PUBLIC WORKS(70607700379)-MAP THIS SITE OPEN-SITE ASSESSMENT 1610 HAZELTON AVE E ACTIVITIES REPORT SgNJ OVERSIGHTUIN AGENCEgO)-CASEC 1191 SAN JOA N,CA 95201 CASEWORKER:BNGEL CLOP A SANOOVAL MARIN-SUPERMSOR:ADRIENNE ELLSAESSER SAN JOAOUIN COUNTY PUBLIC WEBPA CENTRALVALLEYRYIVCB(REGION 55)-CASE/:3&489 VIEW LE CASE SUMMARY FOR THIS SM CASEWORKER:JAMES BARYON-SUPERNSOR:CORI LONDON CUE CMlm e:11390 CUE Floras Assigned;D CUFAmourePaial THIS PROJC-CT WAS LAST MODIFIED BY ANGr31CA SANDOVAL Apo ON it/ifl2(11310:43:3a AM-hASTPM 716 SITE HAS SUBMITTALS.CLICK HERE TO OPEN A NEW WINDOW WITH THE SUBMITTAL APPROVAL PAGE FOR THE;SITE. CLOSURE POLICY-FY 12f13 THIS VERSION IS FINAL AS OF 711112013 CHECKLISTTNmATEU ON 7n1yz0f3 CLOSURE POLICY III NOTE:CHANGES CAN ONLY BE SAVED FOR FY 13114 LTCP CHECKLISTS-CLICK HERE TO VIEW OTHER LTCP CHECKLISTS General Criteria-The Site satisfies,the policy general cdteds-CLEAR 6E0TON ANSWERS NO a.Is the unauthorized release located within live service area of a Public water S stem? NamaWWater System: [Canister is VES r NO b.The unauthorized release consists only of petroleum jMf2j. r VES r NO c.The unauthorized('primary)release from the UST system has been slopped. Is VES r NO d.Free product has been removed to the maximum extent practicable im. r FP Not Encountered R VES r NO a A conceptual site model that assesses the nature,extent,aM mobility of the release has been developed jja(gj. re YES r NO I.Secondary source has been removed to the extent practicable info. Impediment to Removing Secondary source(Cheek all that Apply): F Remediation Has Net Been Attempted F Remediation Was Designed incorrectly r VES r NO F Remediation Was Shut OR Prematurely F Pow Remedied..MM Father - ISVE,xioltailwaluationispandnc, g.Soil or groundwater has been tested for MTBE and results reported in accordance with Health and Safety Code Section 25296.15. C Net Required Is VES r NO h.Does a nuisance exist,as defined by Water Code section 13050. r VES r NO 1.Media-Specific Criteria:Groundwater-The contentment plume that exceeds water quality objec0ves is stable or decreasing in areal extent,and NO meets all offing additional characteristics of one of the five classes of sites LEAR sa fisted below.-CcnoN ANSWERS EXEMPTION-Soil Only Case(Release hasgot Affected Groundwater-info) r VES le NO Does the site meet any of the Groundwater specific criteria scenarios? r VES Is NO ADDITIONAL QUESTIONS-Please indicate only those conditions that do not meet the policy criteria: Plume Length(That Exceeds Water Quality Objectives): X t 100 Fast and 1250 Feet r 1250 Feet and 11,DOO Fast r t 1,000 Feet r Unknown Plume is Stable or Decreasing in AREAL Extent r No r Unknown Free Product in Groundwater: r Yes C No C Unknown Free Product Has Been Removed W the Maximum Extent Practicable: r No r Unknown Forsites with free product,the Plume Has Basin Stable or Decreasing for 5-Years(Info): r No r Unknown For sites with free Product,owner Willing to Accept a Land Use Restriction(it required) r No r Unknown Free Product Extends OBaite r yes r Unknown Benzene Concentration C z 1,000 pg/l and<3,000 pgll (e z 3,000 pg/I r Unknown MTBE Concentration: is z 1 000 pg/I r Unknown Nearest Supply Well(From Plume Boundary) r 5 250 Fact (- >250 Feet and 51,000 Feet r Unknown Nearest Surface Water Body(From Plume Boundary): r s 250 Feet r>250 Feet and s 1,0DO Feet r Unknown 2.Media Spe fic Criteria:Petroleum Vapor Intrusion to Indoor Air-The site is considered AD -thraat for the vapor-lnWsion-Ro alrpathwaYNsito- specific conditions satisfy item 2a,2b,Or 2C-CLEAR eECTK)N ANSWERS NG EXEM PTION-Active Commercial Petroleum Fueling Facility r YES r NO Does the site meet any of the Petroleum Vapor Intrusion to Inclon r Air specific criteda semadoe? r YES r NO https:Hgeotracker.waterboards.ca.gov/regulators/screens/closure_policy.asp?global_id=T... 11/19/2013