Laserfiche WebLink
SAH :CAtX)IN C=NTY <br /> �, ` HEALTH SSRVIC_S/ENVIRCHMENTAL HEALTH OIV I <br /> I)GS; 'tLHE_; FCR SITE CLCSL'RE _VALUATICH ATE <br /> p :E=PS CCOE <br /> of FACMITY <br /> �Q C ` �✓ I ANX 10 Y <br /> _SS <br /> t SizS UEl TYPE <br /> NERAL SITE HISTCRY <br /> a- acility Status Code oc.soit/GJ Cant es o I <br /> cr:pie eurrent7 es o ermit S <br /> r of Tanks at facility g <br /> e of Tanks(if available) ype of Tank �teel brgl ngl Oual <br /> Aqx HISTCRY <br /> nk tested? leg o ailed precision test ? es <br /> o If yes, give dates) <br /> system? es No V yes, what was repaired? <br /> repair ,Wade to the tank <br /> pair done under inspection? f es a Mere soil samptes analyzed? as o TXE PH-GI PH-0 b/ED8 <br /> if faiture/discharge atastraphic long-term leakage verfitt sown cher: <br /> :VAL HISTCRY (ATTACi IHSPEC ICH REPORT FOR SITE OETAILS/COLLECT DATA FCR LEACHING POTENTIAL ANALTSIS) <br /> lamples Received les o epth to Ground 'later bn of/Tear <br /> verage Annual Precipitation <br /> trr cm ub <br /> to 'lett(s) Fes I o umber i Type S core EEE <br /> care S core <br /> ft, <br /> ft C 0 pts pts C pts <br /> ace to 'lell(s) from Tank ft: 0 f if 0 E <br /> R onditim cnditicn 2 ondi tion <br /> ;ite Feature - Leaching Potential Analysis E is met is met E s net <br /> sun Depth to grouridwater from the Soil Saapte (feet) <br /> >too , 1-100 ( � 25-50\1 <br /> :tures in subsurface (applies to foothills or mountain areas) <br /> MoneI Unknotin resent <br /> -age Arnual Precipitation (inches) xzx;cxs 26-40\2 <br /> <t0 + 9 10-25 <br /> -Hade conduits which increase vertical migration � UnknownAt least ore than <br /> we site features: ► resent <br /> leachate (i.e., septic systems, water welts, ponds) NOAe <br /> IRecharge area, coarse soil, nearby wells. xxxz None17- We one <br /> -� <br /> CCLL'1'xt TOTALS»>TOTAL POINTS + �—L <br /> pole Result: (B T X CR E) ,URGE OF TOTAL POINTS 9 pts or more 41 - 48 p 40 pts or less <br /> 3 TX 3 IT X E <br /> FWI".LM ALLCJABL: 3-T-X•E LEVELS (PPM) 1 50 <br /> 15o 15 I .3 .3 1. 1. NA\3 <br /> nple Result: CLIME 1000 100 10 <br /> AXI" ALLOWABLE TPH LEVELS (DPN) <br /> TPH IDiESEL 10,000 loco 100 <br /> 31NOTES: If documented soil and/or ground water contamination is present, do he teaching potential <br /> er.otysis. (i.e., site is currently on UGT Contamination List for soil or round water.) <br /> \1 If depth is > 5 ft. and < 25 ft., score 0 points. If depth <=5 It., do not use tl*1 <br /> . <br /> \2 If precipitation is > 40 inches, score 0 points. <br /> \3 Levels for 3TX&E are not applicable at a TPH cencentraticn of la -M (gasoline) ar 10 ppm Cdiesel). <br /> STAFF RECCMENOATICH/CCUCLUSICU <br /> Are 3TX 3. ° or TPH Concentrations > Altowabi _wets Yes <br /> 2e^-ommerd Site Closure es o If Yes, Refer to Site Mitigation for :valuation <br /> tE'/I"c'1 EVALUATICH - TO 3E C04PLETED 3Y A SL'PERVISCR/SENICR <br /> YCJR WITH STAFF 2ECCHY.E40ATICH FCR CLOSURE YES I 0 I �IEFEARED TO SITE MITICAT(CM FCR :VALUATICH ttES I 0 <br /> REFERRED / / ATE CLOSURE LETTER MAILED I f / I <br /> c ..F <br /> wLUATCR <br /> 23 30 (UGTt.XSHT)\5/1;0 <br />