Incidental release due to normal operation of motor vehicles A result of normal paving and maintenance of pavement 3. Background Groundwater Quality 22a-133k-3(a)(1)(B) and k-3(a)(2) Release Area (RA) ID #’s or Site-Wide Groundwater in GA area meets Background Groundwater Quality 22a-133k-3(a)(2) Background Water Quality not required (see 4a. below) 22a-133k-3(d) Exemption from Background due to Technical Impracticability 22a-133k-3(e)(1) 4. Compliance with Background 22a-133k-3(g)(2)(B) Release Area (RA) ID #’s or Site-Wide Sampling locations are representative of plume, and Analytical results ≤ Background concentration for groundwater OR (i) 12 consecutive monthly samples from each sampling location are ≤ 95% UCL (ii) Rem#: 4a. Compliance with Background not Required 22a-133k-3(d)(1) or (d)(2) Release Area (RA) ID #’s or Site-Wide GWPC, not Background, is applicable at site (All of the following must apply) 22a-133k-3(d)(1) The background concentration is ≤ GWPC; A public water distribution system is available within 200 feet of the subject parcel, parcels adjacent thereto, and any parcel within the areal extent of the plume; Such plume is not located in an Aquifer Protection Area; AND Such plume is not located within the area of influence of any public water supply well. Groundwater remediation to Background not required (All of the following must apply) 22a-133k-3(d)(2) All substances in plume ≤ GWPC prior to remediation The areal extent of the plume that exceeds applicable criteria is not increasing over time, The concentration of substances is not increasing over time, 5. Groundwater Protection Criteria (GWPC) 22a-133k-3(a)(2)(A) and k-3(d) Release Area (RA) ID #’s or Site-Wide Groundwater in GA area remediated to GWPC 22a-133k-3(d)(1)
analytical results ≤ applicable VolC, as determined by 22a-133k-3(c) OR Compliance with VolC in Soil Vapor (ii) Sampling locations and frequency are representative of soil vapor, including seasonal variability, and analytical results ≤ applicable VolC 11. Other Provisions Release Area (RA) ID #’s or Site-Wide Application of DEEP “Policy on Up-Gradient Contamination” (8/28/97) Variance of groundwater remediation due to Technical Impracticability (Commissioner approval) Approval date(s): 22a-133k-3(e)(2) Copy(s) of Approval(s) must be attached to VR Date Certificate of Title for recordation of ELUR submitted to Commissioner: Copy of Certificate of Title page (with volume, page, and date recorded) must be attached to VR Rem#: Part VI: Receptors Groundwater Class: Depth to Water Table: Surface Water Class: Name of and Distance to nearest downgradient surface water body: Abutting land uses (check all that apply): Industrial Commercial Residential Agriculture Sensitive receptor land use within 500 feet of site (check all that apply): school childcare facility healthcare facility recreational residential Sensitive Water Resource (e.g. shellfish beds, public fishing areas, significant wetland complexes, public water supplies) other (specify): If groundwater impacted, indicate number of water supply wells within 500 feet of site boundaries: Water Supply Well Receptor Survey completed and submitted to the Commissioner: Yes No Has a groundwater plume that originated on-site migrated off-site? Yes No Number of water supply wells impacted from releases originating from on-site source: Permanent potable water supply provided by: Water Main connection Date: Filtration Monitoring frequency: