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R& 8BibliogrphyBibliography0....fE2Doc InitInitialize Document Style( "    ( !($0 ($0 0 (($0 0 0    A_ekqwDocumentDocument StyleI.1.A.a.(1)(a)i)a)jD4Tech InitInitialize Technical Style( $ ( CuyTechnicalTechnical Document Style11.11.1.11.1.1.11.1.1.1.11.1.1.1.1.11.1.1.1.1.1.11.1.1.1.1.1.1.1x?t2PleadingHeader for numbered pleading paper &  '(hX   8XXXhXXX?2('*dE*??2('*dE*?HH 1HH 2HH 3HH 4HH 5HH 6HH 7HH 8HH 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28  .+(_2$ H!hXX,   &$1* `(CG TimesScalable ,)hX   _& %XX*&qmX%& hX _TCEQ_Ԅ0017(40108) (_2$ H!hXX,   Page of 6 dTable_A&0 d d dTable_BTable_CTable_DTable_ETable_FTable_GTable_HTable_I Table_J  CRight ParRight-Aligned Paragraph NumbersI.A.1.a.(1)(a)i)a)3|S <6X9`("Courier 10cpiXx6X@8;X@* `(CG TimesScalable&&n P7&P* `(CG TimesScalableXXx P7XP(D$hXX,  \\ipp://pc2.tceq.state.tx.us\hp8150-04270308Z f77\ U'z Z6Times New Roman Regular H!hXX,   _,XhX+-8*qm*&Xdd8PXqmXXX3@ ) TEXASCOMMISSIONONENVIRONMENTALQUALITY , @3PRODUCTSTORAGETANK     @3FIELDACTIVITYREPORT    CompleteAllApplicableBlanks  . 󀀀r r ]% Date:򀀀  ` */0 ddd Xdd Xdd X%%,$ +  :111'oCoC : GENERALINFORMATION W111D,"  111 W_LPST_ԀIDNo.:򀀀󀀀Assigned_TCEQ_ԀCoordinator:d%d%sd% N211;#  111 qNFacilityIDNo.:d%d%sd% N211;#   q 211 qNResponsibleParty:򀀀d%d%sd% N211;# g  q 211 qNFacilityName:򀀀d%d%sd% N211;#  q 211 qNFacilityAddress:򀀀d%d%sd% N211;#{O  q 211 qNFacilityCity:򀀀8d%County:򀀀 J21117#  q 211 JActivity:AssessmentCAPImplementationCAPAddendumAbatement(checkappropriatebox)3)'c7 0   2111 3*_34 dd$ $/0%%_,$ +  :111'_3_3 : ASSESSMENT W111D,"  111 LWHowmany_borings_Ԁand/ormonitorwellshavebeeninstalled?d%d%sd% o d%d%sd% N111;#; L 111 NHastheextentofassessmentdirected/authorizedbythe_TCEQ_Ԁbeencompleted?  YES or NO (checkone)  Ifno,explain:d%d%sd%  d%d%sd%d%d%sd%d%d%sd%d%d%sd% J11117#"f! 111 JAreanyassessmentactivitiesongoing?  YES or NO (checkone)Ifyes,directedbywhom:d%d%sd% &$"  d%d%sd%Describeactivities:d%d%sd% '}&$ d%d%sd%d%d%sd%d%d%sd%3)'-,+ 0  1111 3  .-+ _CompleteAllApplicableBlanks. 󀀀 _LPST_ԀIDNo.: 򀀀 ^% Date:򀀀  , *_56 dd$ $34%%_,$ +  :111' : ASSESSMENT (continued) S1111@,"  111 SArethereanyproposedornecessaryassessmentactivities?  YES or NO (checkone)Ifyes,explain:d%d%sd% O# d%d%sd%d%d%sd%d%d%sd%d%d%sd%Ifanyadditionalmonitorwellsorsoil_borings_Ԁarenecessary,pleaseindicatetheproposedlocationsonasite   map.   3)'  0  1111 3 *_78 dd$ $56%%_,$ +  :111' : CAPIMPLEMENTATION W111D,j"  111 WDateCorrectiveActionPlanwassubmittedto_TCEQ_:d%d%sd% N111;#*  111 6NWastheCAPapprovedbythe_TCEQ_?  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YES or NO (checkone)Ifno,explain:d%d%sd% ~  d%d%sd%d%d%sd%d%d%sd%d%d%sd%d%d%sd%Proposedinstallationcostoftheremedialsystem:d%d%sd% -*), Actualinstallationcostoftheremedialsystem:d%d%sd% +*. 3)',+/ 0 2  2111 3  .-0 CompleteAllApplicableBlanks. 󀀀 _LPST_ԀIDNo.: 򀀀 ^% Date:򀀀  , *_;< dd$ $9:%%_,$ +  :111' : CORRECTIVEACTIONPLANADDENDUM W111D,"  111 WReasonfortheCAPaddendum:d%d%sd% K d%d%sd%d%d%sd% N211;#  111 NWastheCAPaddendumrequestedbythe_TCEQ_?  YES or NO (checkone)Ifyes,indicatebywhomand    when:d%d%sd%   d%d%sd%d%d%sd% J21117#b6  211 JDiscusstheproposedchanges:d%d%sd%  d%d%sd%d%d%sd%d%d%sd%Projectedcostofaddendum:d%d%sd%  3)' 0  2111 3 *_=> dd$ $;<%%_,$ +  :111' : ABATEMENTMEASURES W111D,Z."  111 WProvideabriefdescriptionofthesituationrequiringabatementmeasures:d%d%sd%  d%d%sd%d%d%sd%d%d%sd%d%d%sd% J11117#$#% 111 JHaveallpotentialthreatstohumanhealthandsafetybeenabated?  YES or NO (checkone)Ifno, b&6%& describe:d%d%sd% E'&' d%d%sd%d%d%sd%d%d%sd%3)'e-9,. 0  1111 3  a/5./ CompleteAllApplicableBlanks. 󀀀 _LPST_ԀIDNo.: 򀀀 ^% Date:򀀀  , *_?@ dd$ $=>%%_,$ +  :111' : ABATEMENTMEASURES (continued) W111D,"  111 WMethodofabatement:d%d%sd% O# d%d%sd%d%d%sd%d%d%sd%d%d%sd%d%d%sd% N111;#  111 NProvideabriefdescriptionofequipmentinstalledorutilized:d%d%sd% W d%d%sd%d%d%sd%d%d%sd%d%d%sd% J11117#c7 111 JArethereanyproposedadditionalabatementmeasures?  YES or NO (checkone)Ifyes,describe:d%d%sd%  d%d%sd%d%d%sd%d%d%sd%d%d%sd%d%d%sd%3)'"n!$ 0  1111 3 *_AB dd$ $?@%%_,$ +  :111'$j#%$j# : WASTEDISPOSITION S1111@,>%$&"  111 SDiscussthemethodoftreatmentand/ordisposalforallwastesgenerated:d%d%sd% &%' d%d%sd%d%d%sd%d%d%sd%3)',+. 0   1111 3  .-/  CompleteAllApplicableBlanks. 󀀀 _LPST_ԀIDNo.: 򀀀 ^% Date:򀀀  , *_CD dd$ $AB%%_,$ +  :111' : REPORTPREPARATION W111D,"  111 WPreparedby:d%d%sd% K Company:d%d%sd%   Dateprepared:d%d%sd%  TelephoneNo.:d%d%sd%  _  FaxNo.:d%d%sd% K   Signature:d%d%sd%    J11117#  111 JNameofResponsiblePartycontact:d%d%sd% S TelephoneNo.:d%d%sd% ? FaxNo.:d%d%sd%  Date:d%d%sd%  Signature:d%d%sd% S 3)'_3 0  1111 3 3P&G%XPXqmProvideTheFollowingAttachmentsForTheCorrespondingCompletedSections:  ASSESSMENTS0  _%%  8   0  Ahydrocarbondistributionmap/groundwatergradientmapwithanalyticalresultsofallinstalled O# wells.Includeanyproposedboring/monitoringwelllocations%% 0 8 08%8%0%%Copiesofsoil_borings_/wellconstructiondiagramsforthenewlyinstalledsoil  boring/monitoringwellso %% 0 8 08%8%0%%Costbreakdownsheet(s)foranyproposedactivities_3!%% CAPIMPLEMENTATION ! $ 0 8 08%8%0%%Photographicdocumentationoftheinstalled_remediation_Ԁsystem0%%o"C!%%% 0 8 08%8%0%%Asbuiltconstructiondetailsoftheentire_remediation_Ԁsystem3#"&%% 0 8 08%8%0%%Costbreakdownsheet(s)oftheinstalled_remediation_Ԁsystem#"'%% 0 8  8%8% CAPADDENDUM0  %S$)%%  8     SupportingfieldtestdataforCAPAddendumifapplicable C&%* 0 8 08%8%0%%Costbreakdownsheet(s)foranyproposedactivities'%+%% ABATEMENTMEASURES (c'- 0 8 08%8%0%%ListofanalyticalresultsS)'(.%% 0 8 08%8%0%%Copiesofsignedlaboratoryreportsandchainofcustodydocumentation*(/%% 0 8 08%8%0%%Sitediagramwithsamplelocationsindicated*)0%% 0 8 08%8%0%%Costbreakdownsheetforanyproposedactivities+s*1%% 0 8 08%8%0%%Wastedisposal,treatmentorrecyclingdocumentation