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SR0083415_SSNL ADDENDUM
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SR0083415_SSNL ADDENDUM
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Last modified
2/24/2022 1:21:10 PM
Creation date
2/23/2022 5:06:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL ADDENDUM
RECORD_ID
SR0083415
PE
2602
FACILITY_NAME
88 MARKET & GRILL
STREET_NUMBER
21850
Direction
E
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
CLEMENTS
Zip
95227
APN
02120024
ENTERED_DATE
3/16/2021 12:00:00 AM
SITE_LOCATION
21850 E LIBERTY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Drinking Water Source Assessment and Protection (DWSAP) Program <br /> Transient Noncommunity System Ground Water Source <br /> Possible Contaminating Activity (PCA) Inventory Form <br /> Water system name: tqe M&j�cq—'4 G� ID No. <br /> Source Name: Wil ID No. <br /> Inventory date: lu - 21 - 2Q Inventory conducted by. <br /> Transient Noncommunity Water System PCA Inventory-Ground Water Source <br /> PCA (Risk Ranking) PCA in Zone? * Comments <br /> Y, NorU <br /> Automobile-Gas stations (VH) <br /> Chemical/petroleum processing/storage (VH) <br /> Dry cleaners (VH) /J <br /> Metal plating/finishing/fabricating (VH) <br /> Plastics/synthetics producers (VH) <br /> Sewer collection systems (H) <br /> Airports -Maintenance/fueling areas (VH) /y <br /> Landfills/dumps (VH) <br /> Septic systems- high density (>1/acre) (VH) <br /> Wastewater treatment plants (VH) <br /> Septic systems—low density (<1/acre) (H) <br /> Lagoons/liquid wastes (H) <br /> Agricultural Drainage (H) <br /> Fertilizer, Pesticide/ Herbicide Application (M) <br /> Sewage sludge/biosolids application (M) <br /> Underground Injection of Commercial/Industrial Discharges (VH) <br /> Historic gas stations (VH) <br /> Historic waste dumps/ landfills (VH) <br /> Injection wells/dry wells/sumps (VH) <br /> Known Contaminant Plumes (VH) <br /> Military installations (VH) <br /> Mining operations -Historic(VH) <br /> Mining operations—Active (VH) <br /> Confirmed leaking Underground storage tanks (VH) <br /> Grazing (> 5 large animals or equivalent per acre) (H) <br /> Concentrated Animal Feeding Operations (CAFOs) (see Note 1) (VH) <br /> Animal Feeding Operations (See Note 2) (VH) N <br /> Other Animal operations (H) <br /> Risk Ranking of PCAs: VH = Very High Risk, H = High Risk, M = Moderate Risk, L = Low Risk <br /> *A contaminant potentially associated with this PCA has been detected in the water supply <br /> Transient GW forms 2-2003.doc <br />
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