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IAULt 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTF' ` ACTION REQUESTS AT UNDEF ROUND TANK SITES <br /> :„Site flame and Location: N <br /> 1. 6 Distance to production wells for municipal, domestic, agriculture, industry and other uses within 2000 <br /> feet of the site; <br /> 2. = Site maps, to scale, of area impacted showing locations of former and existing tank systems, <br /> f excavation contours and sample locations, boring and monitoring well elevation contours, gradients, <br /> and nearby surface waters, buildings, streets, and subsurface utilities; <br /> 3. �Io Figures depicting lithology(cross section), treatment system diagrams; <br /> 4. L� Stockpiled soil remaining on-site or off-site disposal (quantity); IcQaw” <br /> 5. �L5 Monitoring wells remaining on-site, fate; rrv.)- i <br /> 6. s Tabulated results of all groundwater elevations and depths to water, %I' <br /> 7. �ljS Tabulated results of all sampling and analyses: <br /> Lee Detection limits for confirmation sampling <br /> Lead analyses <br /> 8. ? o Concentration contours of contaminants found and those remaining in soil and groundwater, both on- <br /> site and off-site: <br /> iris Lateral extent of soil contamination Cc;.� UotS✓,_'r, ,, � <br /> ! s Vertical extent of soil contamination i o' <br /> Lateral extent of groundwater contamination tv r <br /> .[ 45 Vertical extent of groundwater contamination rr <br /> 9. La Zane of influence calculated and assumptions used for subsurface remediation system and the zone <br /> of capture attained for the soil and groundwater remediation system; <br /> 10. ib Reports/information <br /> L 6 Unauthorized Release Form.(URF) t -i <br /> QMRs (Dates) ) tgj <br /> PAR <br /> r �rS FRP � I D3 u C tL�c�v <br /> hf Other(report name) qs Inv, 7! <br /> 2� Well and boring logs <br /> 11. IJ16 Best Available Technology (BAT) used or an explanation for not using BAT; <br /> 12. 1 to Reasons why"background"was/is unattainable using BAT; <br /> 13. T Mass balance calculation of substance treated versus that remaining; 1m "' 1�1r.56 <br /> 14. t„* Assumptions, parameters, calculations and model used in risk assessments, and fate and transport <br /> modeling; <br /> 15. OL) Rationale why conditions remaining at site will not adversely impact water quality, health, or other <br /> beneficial uses; and <br /> 16. i Ifs WET or TCLP results <br /> Comments: Z 1,( <br /> t <br /> + arLSefl <br /> By:` <br /> Date: }�� <br />