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y y <br /> Tri Regional Recommendation Page 24 of 24 <br /> Appendix A <br /> TABLE 1 - CHECKLIST OF REQUIRED DATA <br /> FOR NO FURTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> Site Name and Location:STOC N WARB OU INC; AND INDUSTRIAL CENTER, LLC, 4696 FAST WATERLOO ROAD, <br /> x 1 1. Distance to production wells for municipal, domestic, agriculture,industry and <br /> other uses within 2000 feet of the alta; <br /> ❑ 2. Site maps, to scale, of area impacted showing locations of any former and existing tank systems, <br /> excavation contours and sample locations, boring and monitoring well elevation contours, <br /> gradients, and nearby surface waters, buildings,streets, and subsurface utilities, <br /> 0 3.Figures depicting lithology(cross section), treatment system diagrams; <br /> �A 4. Stockpiled soil remaining on-site or off-site disposal(quantity); <br /> 5. Monitoring wells remaining on-site, fate; MONITORING WELLS REMAINING ON AND OFF SITE WILL BE DESTROYED <br /> M 6. Tabulated results of all groundwater elevations and depths to water, <br /> 7. Tabulated results of all sampling and analyses: <br /> ❑Defection limits for confirmation sampling <br /> ❑Lead analyses <br /> © B. Concentration contours of contaminants found and those remaining in soil <br /> and groundwater, and both on-site and off-site: <br /> ❑Lateral and ❑Vertical extent of soil contamination <br /> ❑Lateral and In Vertical extent of groundwater contamination <br /> 0 9. Zone of influence calculated and assumptions used for subsurface <br /> remediation system and the zone of capture attained for the soil and <br /> groundwater remediation system; <br /> 10.Reports/information ❑x Unauthorized Release Form x❑ QMRs(Dates) <br /> ❑ Well and boring logs ❑ PAR ❑FRP ❑ Other(report name) <br /> 0 11.Best Available Technology(BAT)used or an explanation for not using BAT; <br /> 12.Reasons why background wesris unattainable using BAT; <br /> x❑ 13.Mass balance calculation of substance treated versus that remaining; <br /> 14. Assumptions,parameters, calculations and model used in risk <br /> assessments, and fate and transport modeling; <br /> 0 15. Rationale why conditions remaining at site will not adversely <br /> impact water quality, health, or other beneficial uses;and <br /> E3 16. WET or TCLP results <br /> By., Comments: <br /> Date: <br />