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Ðaccepted€industry€standards/practices€and€further,€that€all€such€tasks€were€conducted€in€compliance€with€applicable€TCEQ€publishedÐ ° Ðrules,€guidelines€and€the€laws€of€the€State€of€Texas.€€I€have€reviewed€the€information€included€within€this€report,€and€consider€it€to€beÐ Ìt Ðcomplete,€accurate€and€representative€of€the€conditions€discovered€during€the€site€investigation.€€I€acknowledge€that€if€I€€intentionallyÐ 8 Ðor€knowingly€make€false€statements,€representations,€or€certifications€in€this€report,€I€may€be€subject€to€administrative,€civil,€and/orÐ Tü Ðcriminal€penalties.€€ò òI€certify€that€the€site€has€met€all€requirements€for€closure€and€that€closure€is€appropriate.Ô#†`&'%ò`ôîÄ­­#Ôó óÐ  À ÐÌÓÍÌÓProject€Manager:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€CAPM€No.:òò€€€€€€€€€€€€€€€€€€€€€óó€€Expiration€date:òòà€d%d%Wd%àóóˆÐ ¶ ^  ÐÌCompany:òòà€d%d%Wd%àóóˆÐ  ¶  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Ðlaws€of€the€State€of€Texas.€€Further,€that€the€information€presented€herein€is€considered€complete,€accurate€and€representative€of€theÐ æŽ Ðconditions€discovered€during€the€site€investigation.€I€acknowledge€that€if€I€intentionally€or€knowingly€make€false€statements,Ð ªR Ðrepresentations,€or€certifications€in€this€report,€I€may€be€subject€to€administrative,€civil,€and/or€criminal€penalties.€€ò òI€certify€that€theÐ n Ðsite€has€met€all€requirements€for€closure€and€that€closure€is€appropriate.Ô#†`&'%ò`ôîÄWµ#Ôó óÐ 4Ü ÐÌÓÍÌÓCorrective€Action€Specialist:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€CAS€No.:òò€€€€€€€€€€€€€€€€€€óó€Expiration€date:òòà€d%d%Wd%àˆÐ Îv Ðóó€€€€€€€€€€€€€€Ð z" ÐCompany:òòà€d%d%Wd%àóóˆÐ &Î ÐÌAddress:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€€City:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€€State:òò€€€€€€€€€€€óó€€Zip:òòà€d%d%Wd%àóóˆÐ ~&  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ÐÓÍÌÓò òÔ‡GôîÄòò`ôîÄÔI€certify€that€the€site€has€met€all€requirements€for€closure€and€that€closure€is€appropriate.ó óÔ#†`ôîÄòòGôîÄFÀ#ÔÐ ‚"* * ÐÔ#†`&'%ò`ôîÄ&½#ÔÌName€of€Responsible€Party€contact:òòà€d%d%Wd%àóóˆÐ É#q!, ÐÌTelephone€No.:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€€Fax€No.:òòà€d%d%Wd%àóóˆÐ !%É". ÐÌSignature:òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€€Date:òòà€d%d%Wd%àóóˆÐ y&!$0 ÐÓÍÌ1ÀÓÐ3)'%'Í$1 ¨0 Ø  //// 3Ðò òòòÌÌThe€following€items€must€be€submitted€with€this€form€if€not€previously€submitted:ó óóóÐ Ý)…'3 ÐÓŠUààX è@ ˜ ðH øP¨X °"%`'¸),h.À03p5È7 :x<Ð>à ,à„8îèÊ ` ˜ ‚Xhø‘XŠÓððà0 X àA€site€map€illustrating€the€locations€of€the€entire€UST€and/or€AST€system€(including€piping,€dispensers,€observation€wells,€etc.),Ð µ*](4 Ðall€soil€borings€and€monitoring€wells€and€all€other€sampling€points,€subsurface€utilities,€and€surface€water€within€500€feet.Ð+5)5Xø%Xø% Ðððà0 X àA€copy€of€the€latest€groundwater€gradient€map€(if€monitor€wells€were€completed).Ðe, *6Xø%Xø% Ðððà0 X àSummary€tables€of€all€soil,€groundwater€and€surface€water€analytical€results,€including€samples€collected€from€any€tank€removalÐ =-å*7 Ðfrom€service€activities,€tank€system€repair€activities,€and€those€collected€from€borings€and€monitor€wells.€€The€tables€mustÐ .½+8 Ðclearly€identify€the€sample€number,€date€of€collection,€sampling€locations,€depths€(if€applicable),€and€analytical€results.Ðí.•,9Xø%Xø% Ðððà0 X àCopies€of€any€manifests€or€other€waste€receipts,€and€any€other€documents€necessary€for€case€closure.