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SAN JOAQUIN Ct"&NTY ENVIRONMENTAL HEAL-I DEPARTMENT UST WORKSHEET FOR SITE CLOSURE EVALUATIOAI I. FACILITYITANK INFORMATION DATE: 7130109 SITEIFACILITY NAME: Ff in J STATUS CODE: ADDRESS: 1501 Jack Tone Road, Ripon CITY- FA#:0006672 I PR#:0505254 TANK# PIA TANK SIZE: MIA FUEL TYPE:Diesel IL GENERAL SITE:HISTORY Is Permit Current? x Yes ❑ No Documented Soi11GW Contamination?* ❑ Yes ❑ No Number of Tanks at Facility 7 Age of Tanks(if available) Type of Tank❑Steel ❑Fiberglass ❑Single ❑Dual Ill. TANK HISTORY Was Tank Tested? ❑ Yes LINo Fowled Testing? LIYes L3No If Yes, Provide Dates: Was Tank System Repaired? ❑ Yes ❑ No If Yes,Describe Repair: Was Repair Done Under Permit? ❑Yes ❑No Were Soil Samples Analyzed? ❑Yes ❑No ❑BTEx❑TPH-G❑TPH-D ❑LEAD ©EDB❑OTHER Type of Failure/Discharge: ❑Catastrophic ❑Long-term Leak ❑Overfill ❑Unknown ❑Other IV. REMOVAL HISTORY lAtInh File Salt Samples Received? x Yes ❑No Seasonal High Depth to GW 10-7-M ft bgs Year/Referenoe Onsite and/or Nearby Well(s)? ❑Yes L]Na Irrigation: # Distance to Tank ft C Score 16 C Score 9 C L3 ❑Domestic:# Distance to Tank ft O points if O points if 0 Score 5 points if ❑Public: # Distance to Tank ft R condition is R condition is R condition is met V. SITE FEATURE-LEACHING POTENTIAL ANALYSIS E met E met E Minimum Depth to Groundwater from Soil Sample Depth(feet)' >100 51-100 25-501 Fractures in Subsurface(applies to foothill or mountain areas) S None Average Annual Precipitation(14 inches for SJC area) ---- <10 9 10-25 26-402 Man-Fade Conduits which Increase Vertical MigrationNone 6t Unknown Present i.e.septic sstems,water wells,ponds) —-- —` Unique Site Features: Recharge Area,Coarse Soil(coarse sands, None At Least One More Than One gravels),nearbX wells Column Totals Total Points 10 + 0 _ 7p Sample Results for BTEX: Range of Total Points 49 Points or More 41-48 Points 40 Points or Less ND Maximum Allowable BTEX B I E I X B T E X N/A3 Levels m 1.0 50 50 50 0.3 0.3 1.0 1.0 Sample Resuh,for TPH: Maximum Gasoline 1,000 100 10 v g� [V�J' PA% lL,tea sle(ppT mH Diesel 10,000 1,000 100 Footnotes: ***if documented soil and/or groundwater contamination is present,do not complete leaching potential analysis(i.e.site is already on the contamination list). T if depth is>5 feet and<25 feet,score 0 points. If depth is a=5 feet,do not use table. 2 If precipitation is>40 inches,score 0 points. 3 Levels for BTEX are not applicable at a concentration of 10 ppm for TPH-Gasoline or 100 ppm for TPH-Diesel. VI. STAFF RECOMPAENDATIONJ REFERRAU REVIEW 1. Are BTEX or TPH Concentrations>Allowable Levels? Yes ❑No 2. If No; Is Site Closure Recommended? ❑Yes ❑No Completed By: Al, Vp r Date Referred to Site Mitigation Unit for Final Actiont 'LS Reviewed By: Concur with Staff Recommendation ❑Yes ❑No tAll Cases are Referred to Site Vitipton for Final Action Date Closure Letter Mailed *Subtract soil sample depth from groundwater depth to determine distance be sample depth and groundwater EH 23-0480(Rev6/4/2007)