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E . A2 104 oe <br /> ATTACHMENT 3 <br /> SITE ASSESSMENT DATA FORM <br /> (Attach additional description or explanation as needed <br /> or include in comment Section VII.) <br /> I. DISPOSAL SITE CHARACTERISTICS <br /> A. Waste Area(s) Dimensions <br /> 1. Area and Volume (acre and yd3): <br /> 2. Estimate Maximum Depth of Waste (ft): <br /> 3. Estimate Average Depth of Waste (ft): <br /> B. Soil Type (check appropriate soil type) <br /> Native Cover <br /> 1. Clay, silt, loam (low permeability): u^'e <br /> 2. Sand, pebble (medium permeability): uN� <br /> 3. Gravel, cobble, rocks (high permeability): �y <br /> C. Mean annual precipitation (in): /2 2-Year 24-Hour (in): <br /> D. Estimated separation between waste and groundwater (ft): <br /> E. Is waste area within a 100 year flood plain? (Y/N): - <br /> F. Show the following items on a site map(s): <br /> 1. Property boundaries <br /> 2. 'Haste disposal area(s) boundary <br /> 3. Structures on or within 1000 ft. of waste <br /> 4. Topographical Contours <br /> 5. Access points and roads <br /> 6. Site security systems <br /> 7. Surface water bodies and drainage patterns <br /> 8. Monitoring and control systems <br /> 9. Areas where landfill gas migration was detected <br /> 10. Areas where leachate migration was detected <br /> G. Provide a chronological list of enforcement actions for the site <br /> Page 1 of 4 <br /> CIWMB Closure and Remediation Branch (1/25/93) <br />