\

# • DE Q

Stat e ofOregcsf

i Oop^itmBxi t

c d Quattt y 

## US T PETROLEU M RELEAS EFOR M INCIDEN T INFORMATION DAT EREPORTED : (today' s date ) (Thi s Sectio n fo r DE Q Us e Only ) LO GNUMBER : RECEIVE D BY : DATEDISCOVERED : SIT ENAME : SIT EADDRESS : SIT ECITY : ZIP : REGULATE D US T & FA C NBR: . NON-REGULATED US T SIT ECOUNTY : PHONE : REPORTE D B Y (required , perso n reportin g thi s releas e t o DEQ ) NAME : ;^.^- ^ :::••/>.•;. • •"• ' ' " •' • ':^!-^---' - -MAI LCONTACTS RESPONSIBL EPART Y (required , perso n responsibl e fo r remedia l action ) NAME : •• ' • -•'/-' " ' • • ' •'' • - • ' • • • '•• ^•• " • • •'• ' •

• • • : COMPANY : ADDRESS : _ CITY : ZIP : COMPANY : ADDRESS : _ CITY : ZIP : STATE: . EMAIL : PHONE : STATE : EMAIL : PHONE :

INVOIC ECONTAC T (required , ma y b e sam e a s responsibl e party ) NAME : OTHE RCONTACT(S ) (Optiona l Information ) NAME : •': • - •'• • • hMPANY : ADDRESS : _ CITY : ZIP : COMPANY : ADDRESS : _ CITY : ZIP : STATE : PHONE : STATE : PHONE : -SIT EASSESSMEN T (Fo r Caus e an dSourc e Description s - Se e Nex t Page ) DISCOVERY : (chec k

one ) CAUSE : (chec k one ) DECOMMISSIONIN G• OVERFIL L ROUTINEMONITORIN G• SPILL COMPLAIN T • CORROSIO N LEA K DETECTIO N • INSTAL LPROBLE M SITEASSESSMEN T • PHYSICAL/MECHANICA LDAMAG E TIGHTNES S TES T JZ ] OTHE R OTHE R• UNKNOW N SOURCE : (chec k one ) • TAN K • PIPIN G • DISPENSE R • TURBIN EPUM P • DELIVER Y PROBLE M • OTHE R CONFIRMATION : (chec k one ) • CONTRACTO R • R PREPOR T • STAFFDE Q • LA B DE Q • LABR P • LA B OTHE R • OTHE R

• HEATIN GOIL• UNLEADE D GASOLIN E • DIESELMOTO RFUEL• WAST EOIL • OTHE RPET . DIST . • CHEMICA L -CONTAMINANT S (Selec t on e o r more ) • LEADE D GASOLIN E • LUBRICAN T • MTB E • MISCELLANEOU S GASOLIN E • SOLVEN T • UNKNOWN p ~ | DRINKIN GWATE R GROUNDWATE R IMPACTE D MEDI A (Sielec t on e o r more ) SURFAC EWATE R SOI L VAPOR S FRE EPRODUC T -SITE-MANAGEMEN T (Thi s Sectio n Departmen t Us e Only) - RELEAS ESTOPPED : _ ANU PSTARTED : NQTES/COMMENTS : » FINA LREQUES T INVOIC EDATE : N O FURTHE RACTION : May200 7 Page l of 2 DEQ-05-LQ-091 AX CAUS EO FRELEAS EDESCRIPTION S y

Overfil l - Us e thi s caus e whe n a n overfil l occurs . Fo r example , overfill s may occu r fro mth e fil l pip e at th e tan k o r whe n th e nozzl e fail s t o shu t of f a t th e dispenser . Spil l - Us e thi s caus e whe n aspil l occurs . Fo r example , spill s ma

y occu r whe n th e delivery hos e i s disconnecte dfromth e fil l pip e ofth e tan k o r whe n th e nozzl e i s remove dfromth e vehicl e at th e dispenser . Corrosio n - Us e thi s caus e whe n ameta l tank , pipin g o r othe r componen t

ha s areleas e du e t o corrosio n (for

steel , corrosio n take s th e for mo f rust) . Thi s i s aspecifi c typ e o f physica l o r mechanica l damage . Installatio n Proble m- Us e thi s caus e whe n th e proble mi s determine dt o hav e occurre d specificall y becaus e th e undergroun dstorag e tan k syste mwas no t

installe dproperly . Not e tha t thes e problem s may b e difficul t t o determine . Physica l o r

Mechanica l Damag e - Us e thi s caus e for al l type s o f

physica l o r

mechanica l damag e excep t

corrosio n a s describe dabove . Some example s o f physica l o r

mechanica l damag e includ e apunctur e ofth e tan k o r piping , loos e fittings, broke n component s an dcomponent s that hav e change ddimensio n (for example , elongatio n o r

swelling) . Othe r - Us e thi s optio n whe n th e caus e i s know n bu t doe s not fit int o on e ofth e abov e categories . Fo r

example , release s fro mven t lines , vapo r

recovery line s an dfill line s woul db e include di n thi s category . Unknow n - Us e thi s optio n onl y whe n th e caus e i s notknowTi . SOURC EO FRELEAS EDESCRIPTION S Tan k - Thi s ter mmeans th e tan k that store s th e produc t

an di s part

ofth e undergroun dstorag e tan k system . Pipin g - Thi s ter mmean s th e pipin g an dconnector s runnin g fromth e tan k o r submersibl e turbin e pump t o th e dispense r o r othe r end-us e equipment . I t

doe s not includ e vent , vapo r recovery o r

fill lines . Dispense r

- Thi s terminclude s th e dispense r an dequipmen t

use dt o connec t

th e dispense r

t o th e piping . Fo r

example , areleas e fro masuctio n pump o r component s abov e th e shea r valv e woul d b e considere dareleas e fro mth e dispenser . Turbin e Pum p (STP ) - Thi s ter minclude s th e submersibl e turbin e pump hea d(typicall y locate di n th e tan k

sump) , th e lin e leak

detector , an dth e pipin g that connect s th e submersibl e turbin e pump t o th e tank . Deliver y Proble m- Thi s ter midentifie s release s tha t occu r durin g produc t

delivery t o th e tank . Typica l cause s associate dwiththi s sourc e ar e spill s an doverfills . Othe r - Us e thi s optio n whe n th e releas e sourc e doe s no t fit int o on e ofth e abov e categories . Fo r example , release s fro mven t lines , vapo r

recovery line s an dfill line s woul db e include di n thi s category . > . May200 7 Pag e 2 o f 2 DEQ-05-LQ-091 Ar 4|tAHiy'P|-' * ,.&H,"iJ«!l»«flWr-^,l?VW*-TrV*!Wf'V-.-.r"S«.IJl«-. !

### OREGO N DEPARTMEN TO F ENVIRONMENTA L QUALIT Y 

# P A DE Q UNDERGROUN D STORAG E TAN KPROGRA M statsofomgo n Cos t Recover yAgreemen t Departmen t o f Environmenta l Qualit y Thi s documen t

serve s a s a n agreemen t

betwee n th e undersigne d(hereinafter "you" ) an d th e Departmen t

o f Environmenta l Quality (DEQ ) regardin g DE Q revie w an doversigh t o f th e investigatio n and/o r

cleanu p o f

petroleu m(hazardou s substances ) a t th e property locate dat : Facilit y Name : •'--' ' ' - . • • • ' • •

' • • • - • • ' Address : ' ^_ _ USTCNo. : DE Q agree s t o revie w environmenta l document s submitte db y yo u o r o n you r behal f regardin g th e investigatio n and/o r cleanu p ofth e above-reference dsite . Additiona l detail s regardin g DE Q oversigh t wil l b e establishe dupo n revie w ofth e initia l site data . DE Q require s that

person s requestin g DE Q revie w an doversigh t o f investigatio n an d cleanu p activitie s agre e t o th e term s o f thi s cos t recovery agreemen t

an dpay projec t oversigh t costs . DE Q projec t

oversigh t

cost s wil l includ e direc t cost s an dindirec t

costs . Direc t

cost s includ e site-specifi c expense s an dlega l costs . Indirec t cost s are thos e genera l managemen t

an dsupport

cost s o f th e DEQ , includin g th e Lan dQuality Divisio n (LQ) , allocabl e t o DE Q oversigh t o f thi s agreemen t

an dnot charge da s direct , site-specifi c costs . Indirec t

charge s ar e basedo n apercentag e o f direc t persona l service s costs . Revie w an doversigh t

cost s shal l not

includ e an y unreasonabl e cost s o r cost s no t

otherwis e recoverabl e b y DE Q unde r OR S 465.255 . DE Q cost s ar e du e withi n thirt y (30 ) day s o f issuanc e o f

th e monthl y statement , b y a chec k mad e payabl e t o th e "Departmen t o f Environmenta l Quality" . Nin e percen t interes t shal l b e charge do n pas t

du e accounts . Electin g no t

t o ente r int o thi s agreemen t

doe s no t releas e yo u froman y responsibility tha t yo u migh t

hav e for an y reportin g requirements , investigatio n and/o r cleanu p o f

petroleu m (hazardou s substances ) at th e above reference dfacility . Thi s doe s not preclud e th e DE Q fro mconductin g audit s o r inspection s o f

al l o r portion s o f

th e investigatio n an dcleanu p activitie s associate dwit hthi s facility ; Enforcemen t actio n may b e initiate di f an y violatio n o f

Orego n Administrativ e Rule s (OARs ) o r Orego n Revise dStatute s (ORSs ) i s found . Januar y 200 8 Pag e 1 o f 2 05-LQ-086 AEithe r

DE Q o r yo u may terminat e thi s agreemen t b y givin g 1 5 day s advanc e writte n notic e t o th e other . Onl y thos e cost s incurre do r obligate db y DE Q prio r t o th e effectiv e dat e o f an y terminatio n o f

th e agreemen t

shal l b e recoverabl e unde r thi s agreement . Temiinatio n o f

thi s agreemen t

wil l not affec t an y othe r

righ t DE Q ma y hav e for

recovery o f cost s unde r

any applicabl e law . Yo u wil l hol dDE Q harmles s for an y claim s (includin g but not limite dt o claim s o f property damag e o r

persorial injury ) arisin g fromDE Q revie w and/o r oversigh t

activitie s unde r thi s agreement . Thi s agreemen t

i s not an dshal l not

b e construe dt o b e a

n admissio n b y yo u o f

an y liability unde r

OR S 465.25 5 o r

an y othe r

la w o r a s awaive r

b y yo u o f

an y defens e t o suc hliability . Thi s agreemen t i s not an dshal l no t

b e construe dt o b e awaiver , release , o r settlemen t o f claim s that

DE Q may hav e agains t

yo u o r any othe r

responsibl e perso n no r i s thi s agreemen t

awaive r o f any enforcemen t

authority that

DE Q may have . Th e DE Q Tank s Progra mwil l b e responsibl e for th e revie w an doversigh t o f th e investigatio n an dcleanu p activitie s associate dwithth e property . Pleas e refer al l site specifi c inquirie s t o th e US T Regiona l Office s i n Northwes t Regio n - Portland , Weste m Regio n - Sale man dEugen e an dEaste mRegio n - Th e Dalles . Fo r location s an dphon e number s o f

th e regiona l offices , pleas e se e th e US T Regiona l Offic e lis t at http://vyvyw.deq.state.or.us/about/locations.htm Al l inquirie s regardin g cos t recovery and/o r

invoice s shoul db e directe dt o Daw n Ismeri o a t 503-229-5812 . I f th e term s o f

thi s agreemen t

ar e acceptable , pleas e hav e i t execute db y a n authorize d officer i n th e spac e provide dbelow . I n orde r t o mor e effectivel y schedul e you r project , pleas e retu mthi s agreemen t withi n 3 0 day s o f

receip t t o th e regiona l offic e responsibl e for vou r site . Accepte dan dagree dt o thi s ' day o f . 2 0

B y : • " ' • ' •- - • - • - • ••^ : ' • • - - • • • Title : Pleas e provid e th e followin g informatio n a s t o wher e th e invoice s shoul db e sent .

Individua l Name : Title : Compan y Name : Mai l Address : City , State , Zip: _ Phon e Number : Januar y 200 8 Pag e 2 o f 2 05-LQ-086 A

# ^^o ^ DE Q stat e of Orego n Depattn^nto f EnvtKinn»nta l QualH y 

### OREGO N DEPARTMEN

T O FENVIRONMENTA

LQUALIT

Y UNDERGROUN

D STORAG

ETAN K PROGRA M Initia l (Twent y Day ) Repor t For mfo r

US T Cleanu p Project s Thi s repor t

i s du e twent y (20 ) day s fro mtli e dat e ofth e release . DE Q UST C Fil e No. . DE Q Facilit yI D No. . Sit e Name : Sit e Address : 

### INITIA LCLEANUPINFORMATIO N (1 ) Typ e o f contaminatio n (chec k V al l tha t apply) : [ Gasolin e \

[Diese l _ _Wast e Oi l I Othe r(specify ) " : • ' ' ^ ' ' ^ Heatin g Oil , (2 ) Estimat e quantit yo f releas e (base d o n informatio n know n t o dat e - • selec t onl yone) : ( 2 ) <10 0 gal . Q ) 100-49 9 gal . Q ) 500-99 9 gal . Q 1,000-5,00 0 gal . Q >5,00 0 gal . 

### SIT EINFORMATIO N (chec k V ye s o r

V no ) YI I N Di d an ywate rente rth e excavation ? I f yes , pleas e describ e an d identifyth e dept h t o

groundwate ri n fee t belo wgroun d surface : • ''• '•• ' : • (3 ) (4 ) I I Y I——

I N Wa s a shee n o rodo robserve d o n an ywate ri n th e excavation ? Note : I f groundwate ri s encountered , soi l sample s fro m th e soil/wate rinterfac e mus t b e collecte d an d analyze d fo rBTE X an d b

yth e appropriat e TP H method . A t site s wher e diese l o rothe rnon-gasolin e product s hav e bee n released , th e wate rmayals o hav e t o b e screene d o rteste d fo rpolynuclea raromati chydrocarbon s (PAHs) . Pleas e refe rt o OA R 340-122-0218 . (5 ) I I Y I— I N Wa s wate rpumpe d fro m th e excavation ? I I Y I I N I f yes , di d groundwate rrecharg e withi n 2 4 hour s afte rpumping ? Pleas e describ e th e pumpin g procedur e an d disposa l optio n selecte d fo rth e purge d excavatio n water : (6 ) I I Y I——

I N Wer e an ywate rsample s collecte d fro m th e excavation ? I f yes , pleas e describe : (7 ) N Hav e an ysoi l and/o rwate rsampl e result s bee n receive d a t thi s time ? I f so , pleas e attac h an yla b reports . Januar y200 8 Pag e 1 o f 4 05-LQ-089 AInitia l (Twent yDay ) Report For m fo rUS TCleanu p Project s

I F GROUNDWATE R HA S BEE N ENCOUNTERED , PLEAS E ANSWE R QUESTION S #8-13 , BELOW .

I F N O WATE R HA S BEE N ENCOUNTERED , PLEAS E SKI P TO QUESTIO N #1 4 (8 ) Wha t ar e th e know n use s o f groundwate rwithi n a 500-foo t radiu s o f th e releas e sit e (chec k V al l tha t apply) ? industria l | [ agricultura l non-us e drinkin g suppl y, (9 ) I f groundwate ri n thi s are a i s bein g use d as- a drinkin g wate rsupply , pleas e chec k V th e type an d siz e o f populatio n serve d byth e supply : Communit y(communit ywel l use d fo rdrinkin g wate ryea rroun d - • selec t onl yone ) size : C ^

<1,00 0 peopl e C ^ 1,00 0 - 5,00 0 peopl e C ^ >5,00 0 peopl e Intermitten t us e (publi cwate ruse d fo rdrinkin g wate ronl yo n a part-tim e basis - • selec t onl yone ) size : (_ J <5 0 peopl e ^J ) 5 0 - 30 0 peopl e ( ^ > 30 0 peopl e [ _ | Privat e well s (individua l privat e wel l o rwell s use d fo rdrinkin g wate r- • selec t onl yone ) size : rj<1 0 peopl e (/ j 10-2 5 peopl e \/ j >2 5 peopl e (10 ) I I YI I N I s ther e an yevidenc e thi s wate rsuppl yha s bee n o ri s likel yt o b e impacte d fro m th e petroleu m produc t release ? I f yes , estimat e ho wdifficul t i t woul d b e t o replac e th e

• existin g supply : bottle d wate ri s th e onl yalternativ e on-sit e wate rtreatment ; bul k wate rdelivery ; ne wwells ar e availabl e 

# • I 'abl e t o connec t t o existin g wate rsuppl y I Ifi n no t kno wwha t alternative s woul d b e availabl e (11 ) I I YI _ J N Are/wer e vapor s presen t i n on-sit e o rnearb ybuildings ? I f yes : l

A . Ar e yo u monitorin g and/o rmitigatin g an ypotentia l fir e an d safet yhazard s pose d byvapor s an d fre e product ? Explain : " ^ : .

(12 )

(13 ) B . Estimat e th e numbe ro f peopl e potentiall yaffecte d b yvapor s - • selec t onl yone :

^ ] ^ 1- 2 peopl e r j 3-1 0 peopl e (_J ) >1 0 peopl e Y N Ar e vapor s o ri s petroleu m contaminatio n presen t i n th e utilit ycorridors ? I f yes , pleas e explain : Y N Ar e natura l area s locate d withi n 1/ 4 mil e ofth e site ? I f so , pleas e describ e type s (parks . rivers , wetlands , sensitiv e habitats , etc. ) an d proximity : (14 ) Y N I f groundwate rwa s no t encountere d i n th e excavation , d o yo u believ e tha t thi s cleanu p

projec t ca n b e conducte d unde rth e requirement s fo ra n US TCleanu p Matri xsite ? I f yes , the n refe rt o OA R 340-122-030 5 throug h 0360 . Januar y200 8 Pag e 2 o f 4 05-LQ-089 AInitia l (Twent yDay ) Report For m fo rLIS TCleanu p Project s

AREA/SIT ECONDITIONS : (15 ) Mea n annua l rainfall : f ^ <2 0 inche s C I 20-4 5 inche s r^ l >4 5 inche s (16 ) Soi l type(s ) ofth e naturall yoccurrin g soils , no t th e backfil l aroun d th e tank - • selec t onl yone :

\ ^ clays , compac t tills , shales , an d unfracture d metamorphi can d igneou s rock s 

# G sand yloams , loam ysands , silt yclays , cla yloams , moderatel ypermeabl e limestone , dolomite , sandstones , moderatel yfracture d igneou s an d metamorphi croc k 

# o fin e an d silt ysands , sand s an d gravels , highl yfracture d igneou s an d metamorphi crock , permeabl e basalt s an d lavas , kars t limestone s an d dolomite s SOI LMANAGEMEN T f soi l sampl e resi 

# • YD N (17 ) I f soi l sampl e result s hav e bee n received : Wil l th e leve l o f contaminatio n detecte d requir e remova l o f contaminate d soi l fo r treatmen t o rdisposal ? (18 ) Al l contaminate d soi l temporaril ystockpile d on-sit e prio rt o treatmen t o rdisposa l mus t b e containe d withi n a berme d area , kep t covered , an d th e entir e are a secure d t o preven t unauthorize d acces s byth e public . I f yo u haven' t don e this , pleas e explai n why :

Note : I t i s a violatio n t o stockpil e petroleu m contaminate d soi l (PCS ) on-sit e fo rgreate rtha n 3 0 day s withou t a DE Q Soli d Wast e Lette rAuthorizatio n (SWLA ) Permit . (19 ) I f contaminate d soi l i s currentl ystockpile d on-site , please indicat e whe n disposa l wil l occu ro rwhe n treatmen t will,begin : . : • ' • • • • • • (20 ) Estimate d volum e o f contaminate d soi l (specif yton s o rcubi cyards) : (21 ) Intende d dispositio n o f soil s (pleas e • selec t onl yone) :

r ^ On-site/off-sit e treatment . Soli d Wast e Lette rAuthorizatio n Permi t Applicatio n attached . 

# G Therma l treatmen t off-sit e a t a n authorize d facility . Facilit yname : Landfil l disposal . Nam e o f Landfill : Note : Pleas e attac h additiona l informatio n a s necessar yt o explai n an yunusua l circumstance s associate d wit h thi s project . Januar y200 8 Pag e 3 o f 4 05-LQ-089 AInitia l (Twent yDay ) Report For m fo rUS TCleanu p Project s

Thi s initia l report i s intende d t o provid e th e Departmen t wit h th e basi cinitia l informatio n abou t activitie s associate d wit h th e release . Futur e report s shoul d provid e a mor e detaile d an d complet e pictur e ofth e cleanu p project . Pleas e b e awar e tha t a DE Q permit/authorizatio n i s require d fo rth e followin g activities : 1 ) Soi l aeration , bioremediatio n (on-sit e o roff-site) , o ron-sit e therma l treatment . 2 ) Wate rdischarge s t o a stream/ston n drai n fro m th e excavatio n o rtreatmen t tank . I f thes e activitie s wil l b e include d i n you rcleanu p project , contac t th e regiona l DE Q offic e fo rth e appropriat e applicatio n forms , informatio n o n permi t fee s an d guidanc e documents . THI S REPOR T WA S PREPARE D BY : Individual : '

^ • " '''•^• - ' • ' ••' - ^

' • • • • •

• • - • : - Date : Company : -•

• :•"'• • ' ' • - • ' Phone : Address : "y:- ^

- ^ • • : •""--' • - •

- - ' . '•• ' . ••

•..-. • • •

City : - •• : '•- • • : - • •-•-"•••. • . :. - •:• : • : : • Stat e . : Zip .

1 . Pleas e retur n thi s for mt o th e regiona l offic e i n whic hth e site i s located . I f yo u hav e questions , cal l th e contac t perso n i n you r

regiona l ofiice . 2 . Fo r all tanks , excep t

heatin g oi l tanks , yo u mus t submi t a n US T Decommissionin g Checklis t an dSit e Assessmen t

Repor t t o th e appropriat e regiona l ofiic e withi n 3 0 day s of

th e US T decommissioning . Failur e t o d o s o ca n resul t i n delay s t o you r

projec t an d ma y resul t

i n continue dbillin g fo r

th e annua l tan k

permi t fees . 3 . Addresse s an dphon e number s fo r th e regiona l office s ca n b e foun di n th e US T Cleanu p Manua l o r viewe dan ddownloade dfro mthi s DE Q Webpage : http://www.deq.state.or.us/about/locations.ht m 4 . Copie s of

th e US T Cleanu p Manua l an dothe r US T progra mform s an dcheckUst s ca n b e viewe dan ddownloade dfro mDEQ' s Website : http://www.deq.state.or.us/lq/tanks/ust/index.ht m o r i n th e Portlan dare ab y callin g Stev e Paik o a t 503-229-665 2 o r outsid e th e Portlan dare aleavin g amessag e o n th e US T Hel p Lm e (toll-fre e i n Oregon ) a t 1-800-742-787 8 KEE PA COP Y O FTffl S REPOR T FO RYOU RFACILIT Y RECORD S V Januar y200 8 Pag e 4 o f 4 05-LQ-089 A

# i^ < ^

^ 

## DE Q stat e o f Orego n Departmen t o f Envfronmenta l Quafrt y OREGO N DEPARTMEN T O FENVIRONMENTA LQUALIT Y Undergroun dStorag e Tan k Progra m 

# SOI LMATRI X CHECKLIS T AND SOI LMATRI X SCORESHEE T



# D



# • • 1 . Th e releas e o f petroleu mha s bee n reporte dt o th e DE Q (0220) . 2 . Th e matri x score shee t ha s bee n complete dfor

thi s site , unles s th e site i s cleane du p t o th e mos t stringent cleanu p leve l (0320) . 3 . Th e require dhydrocarbo n identificatio n tes t (NWTPH-HCID ) ha s bee n performe d(0335(3)) , and , i f detectabl e level s were found , th e appropriate analytical metho do r method s hav e bee n use dt o measure th e level s o f contaminatio n (0218) . 4 . A sketc hha s bee n mad e o f thi s site (0345(1) ) whic hclearl y shows : I I a . Thelocationofallbuildingsandotherke y features , bot hman-mad e an dnatural ; I I b . Th e name s ofadjacen t street s an dproperties ; I I c . Th e locatio n o f al l excavation s includin g thos e that were fo r th e removal o f

tank s an d associate dpipin g a s wel l a s thos e that wer e strictl y fo

r th e removal o f

contaminate dsoils ;

' I d . Th e locatio n o f al l produc t

storag e tanks , line s an ddispensers , includin g thos e that were decommissione da s wel l a s thos e that remai n o n th e site ; an d( 

# D Al l soi l an dwate r sampl e locations . 5 . I f any contaminate dsoi l exceedin g matri x limit s ha s bee n lef t o n site , th e reaso n fo

r leavin g thi s soi l ha s bee n explaine dan dth e requirement s o f 0340(l)(f ) an d0355(4 ) hav e bee n met . 6 . I f water wa s presen t

i n th e tan k

pit , th e Department

wa s notified , th e water

wa s pumpe dfi-omth e pit , an dth e requirement s o f

0340(4 ) hav e bee n met . 7 . Al l soi l and/o r

water sample s hav e bee n collected , coded , store dan dshippe da s specifie di n th e rules , an dprope r

chain-of-custody form s hav e bee n filledou t (0345) . 8 . I f areleas e from awaste oi l tan k wa s discovered , a

t leas t on e sampl e ha s bee n analyze db y th e method s specifie di n 0218(l)(b)(D) . • / > 9 . If atan k was decommissione di n place , th e Departmen t gav e prio r

approval for

asite-specifi c samplin g plan (0340(5)) . 10 . A report

ha s bee n prepare dwhic hinclude s adetaile ddescriptio n o f everythin g that

wa s observe dan dperforme da t th e site , contain s al l o f

th e infonnatio n require db y th e rule s (0360) , an dpresent s findings an drecommendation s whic hare consisten t withDepartment

regulations .

January 200 8 Pag e 1 o f 2 08-LQ-04 6SOI L MATRI X SCOR E SHEE T 1 . Dept

ht o Groundwater < 9 s fpp t

(]0 ^ 2 5 - 5 0 feet

(7 ) 51-10 0 feet

(4 ) > 100 feet (1 ) 2 . Mean Annual Precipitatio n

> 4 5 inche s (10 ) 2 0 - 4 5 inche s (4 ) < 2 0 inche s (1 ) 3 . Nativ e Soi l Typ e

Cours e sands , gravel s (10 ) Silts , fine sand s (5 ) Clay s (1 ) 4 . Sensitivit

y o f Uppermos t Aquifer (10 )

Sol e Sourc e (7 ) Current Potabl e (4 ) Future Potabl e (1 ) Non-potabl e 5 . Potential Receptor s

Many , nea

r (10 ) Mediu m- (5 ) Few , fa r (1 ) TOTALSCOR

E MATRI X SCORE Leve l 1 : >40pts . Leve l 2 : 25-40pts . Leve l 3 : <25pts . 

# 0 Cleanup Leve l (pp m1 PH ) Gasolin e 4 0 8 0 13 0 Diese l

10 0 50 0 1000

January 200 8 Pag e 2 of 2 08-LQ-04 6