Laserfiche WebLink
. ... <br /> _/'OR It Yt CWIURg <br /> T! <br /> •�+E`Or"fACtLtTY ^- SI �� G 'P. t71I cao-.. <br /> ,/ r <br /> tlORESS ! �f EPs;1 ANK 1D M <br /> ANK SIZE UEL TYPE 4 <br /> 11. GENERAL SITE HISTORY <br /> 1 <br /> Is permit current? es o ermit # " <br /> acitity Status Code oc.Soil/Gw Cont es ° <br />'4 umber of Tanks at facilityge of Tanks(if available) ype of Tank reel brgl mgt Dual <br /> 111. TANK HISTORY <br /> is Tank tested? es FFO ailed precision test ? es o <br /> if yes, give dates) <br /> as A repair mace to the tank system? es No f yes, what was repaired) <br /> As repair done under inspection? es o ere soil samples analyzed? es 10 TXE I PH-G PH-0 <br /> JEDO <br /> Ype of failure/discharge atastrophic long-term leakage verfill nown cher: <br /> t <br /> IV, REMOVAL HISTORY (ATTACH INSPECTION REPORT FOR SITE DETAILS/COLLECT DATA FOR LEACHING POTENTIAL ANALYSIS) <br /> oil 5amales Received es o epth to Ground water Y� of/Year �!� G verage Annual Precipitation = 4 10-25 <br /> Dn-Site Weil(s) es o umber 8 Type irr om ub <br /> istance to wetl(s) from Tank ft; ft; —ft C 0otS re C care S core <br /> P pts C i pts <br /> 0 f 0 if 0 :f <br /> R ordition Rcondition R ordition <br /> Site Feature - Leaching Potential Analysis E s met E is met E s met <br /> iniawm Depth to groundwater from the Soil Sample (feet) ��3 _ I '100 1-100 25-50\1 <br /> ractures in subsurface (appties to foothills or mountain areas) /U None Unknown resent <br /> verage Annual Precipitation (inches) l xxxx <10 9 10-25 Axxxxxx 26-40\2 <br /> ,)n-Made conduits which increase vertical migration <br /> f leachate (i.e., septic systems, water wells, ponds) i11�l <br /> None Unknown resent <br /> Iniwe site features: Recharge area, coarse soil, nearby wells. At Least 4ore than <br /> xxxx None one one <br /> COLUMN TOTALS»'TOTAL POINTS Z — ? <br /> ample Result: (B T X OR E) RANGE OF TOTAL POINTS9 pts or more I 41 - 48 pts 40 pts or Less <br /> S I T X E B T X ' <br /> MAXIMUM ALLOWAa3LE O-T-X-=_ LEVELS {?PM} T 50 50 50 .3 -3 1. 1. NA\3 <br /> ample Result: �IESEL <br /> 50LINE ]000 100 10 <br /> 3o U G AXIMUM ALLOWABLE TPH LEVELS (PPM) <br /> r� TPH 10,000 1000 100 <br /> FOOTNOTES; ***If documented soil and/or ground water contamination is present, do not complete the leaching potential <br /> analysis. (i-e., site is currently on UGT Contamination List for soil or ground water,) <br /> \1 If depth is > 5 ft. and t 25 ft., score 0 points. If depth <=5 ft., do not use table. <br /> \2 If precipitation is > 40 inches, score 0 points. " <br /> \3 Levels for BTX8E are not applicable at a TPH concentration of 10 ppm (gasoline) or 100 ppm (diesel). <br /> VI. STAFF RECOMMENDATION/CONCLUSION <br /> 1- Are BTX & E or TPH Concentrations > Allowable Levels Yes 1707 4;�/ct <br /> 2. Recommend Site Closure 1Y <br /> es o If Yes, Refer to Site Mitigation for Evaluation <br /> :')1. REVIEW EVALUATION - TO BE CCMPLETEO BY A SUPERVISOR/SENIOR <br /> -ONCUR WITH STAFf RECOMMENDATION FCR CLOSURE ES 0 �tEFERRED TO SITE MITIGATION FOR EVALUATION ES 0 <br /> ATE REFERRED / / )ATE CLOSURE LETTER MAILED <br /> AME OF <br /> .VALUATOR _5&7 � <br /> EH 23 80 (UGTWKSHT)\5/90 <br /> rH 29 80 <br /> :I <br />