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TAE ' 11 - CHECKLIST OF REQUIRED D'—A <br /> • �' FOR NO FURTHEft;(CTION REQUESTS AT UNDERGRtwiND TANK SITES <br /> Site Name and Location: ft'1u4L.ar(, 9. VA% .Ti4c CO,,,PANy , 1119 RooseUc.T Sr, S j-ocic7oy SA-4 ,Yn. N <br /> 1. Ir, Distance to production wells for municipal, domestic, agriculture, industry and other uses within 2040 feet <br /> of the site; WELL 54(?Vky N' YMuNlrlpp� 5uPp" We"" wlrN.'.► l r.,ILt- <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, buildir �treets, and subsurface utilities; <br /> 3. yo Figures depicting lithology(cross section),treatment system diagrams; SA,-DY -%wr <br /> 4. vl-� Stockpiled soil remaining on-site or off-site disposal (quantity); <br /> -- S 6A+ 'rgwr- <br /> 5. 4Pr Monitoring wells remaining on-site,fate; R�n�o�ea X988 <br /> 6. Tabulated results of all groundwater elevations and depths to water; <br /> 7. Tabulated results of all sampling and analyses: G u-+ <br /> Detection limits for confirmation sampling <br /> _.1 Lead analyses <br /> 8. Concentration contours of contaminants found and those remaining in soil and groundwater, both on-site <br /> and off-site: <br /> Lateral extent of soil contamination ysI P)D. <br /> `f Vertical extent of soil contamination ze `D P-A63 56Lijw •r <br /> Lateral extent of groundwater contamination <br /> N Vertical extent of groundwater contamination <br /> 9. MSA- 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. ye, Reports/information <br /> Unauthorized Release Form (URF) (,/z.-i /ri <br /> QMRs (Dates) f <br /> _ PAR <br /> FRP <br /> 1y Other(report name) iFHAsE Z SITE AssrssMC's-r-, Nou 9s- ant F',#-t R'r- SJc epD <br /> .5 Well and boring logs <br /> 11. N Best Available Technology(BAT) used or an explanation for not using BAT; <br /> 12. Reasons why background'wads unattainable using BAT; <br /> 13. N Mass balance calculation of substance treated versus that remaining; <br /> 14. �J 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 Co•.141.7ANTS CaNc143-,.-I 1�ARl7c,n�+On <br /> 16. WET or TCLP results <br /> Comments: Se.tiL Bc0fN(z ND a 4of 1PH j (Nlr-)r MTBE PePon-reo AT 714 Ik <br /> G.". So - NoT s ED LIL1lT ro.w„ c A� Apia <br /> NFA2 <br /> Z-ow i21rx. <br /> By: Ifd <br /> Date: Z S WY 9' <br />