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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): 7, Vod �d 3 <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): <br /> 2. Sand, pebble (medium permeability): <br /> 3. Gravel, cobble, rocks (high permeability): <br /> C. Mean annual precipitation (in): it. 2-Year 24-Hour (in): <br /> 1 <br /> D. Estimated separation between waste and groundwater (ft): o-- <br /> /NQ <br /> E. Is waste area within a 100 year flood plain? ( � Np <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 /> a 7. Surface water bodies and drainage patterns <br /> S. 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 /> Z-�/`� f" I � '�Cl ✓ Yy�rf!C ��.�C.0 .'^r a-. +W01 "'��w't ""A,w,. 4. t.1. <br /> 0 <br /> s Z r I-*., t�-rt S C't�x.•�-✓Z r .�.F.,.a- y�F` a r w r' Iv,_ W F a t{i^' %. ,:... -#4., <br /> �-G vf e C e a c `-L.t `".'`>a •!' ;, a" "fi"�`U,�r' .B In.�Q a...aE --a. EA <br /> f <br /> ,rt'.a4 <br /> � <br /> Page 1 of 4 <br /> CIWMB Closure and Remediation Branch (1/25193) <br />