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Home My WebLink AboutVAN HILTON HOG PARLOR_MISC_20171231HL APR 1 lift Control Number County Number X, 37 GROUNDWATER POLLUTION SOURCE INVENTORY In—Source 6.51 NINE Name OWNERSHIP Q pPrivate 2 Municipal Source Address 0• SJr e-bn • Side,10 3 3 County 4 State City County Region D h 1 5 Federal 6 Military Owner/ perator } Quad Name u p eources aJCounty source s YES NO POTENTIAL SOURCE OF GROUNDWATER POLLUTION LOCATION OPERATION TYPE TYPE OF WASTE DISPOSAL FACILITY OTHER SOURCE 10 0 Facility 1 Municipal 1 Gasoline/diesel Lagoon, etc. 1 Agricultural Activity 2 Highway 2 Industrial 2 Other oil 2 Landfill-contro. 2 Salt water intrusion 3 Railroad 3 Agricultural 3 Solvents 3 Landfill-uncont. 3 Chemical stock pile 4 Waterway 4 Oil and gas 4 Corrosives 4 Land application 4 River infiltration 5 Pipeline 5 Mining 5 Other chemical 5 Abandoned site 5 Mine drainage 6 Dumpsite Other Source 0 Sewage/septage 6 Sewer system 6 Intentional dump 7 Other7) 7 Sludge 7 Septic tank 7 Spill 8 Leachate B Injection well B Leak --above ground 9 Other solids 9 Disposal well 9 Leak --underground 0 In use? 10 Gas ✓I WASTE; 'jiat is/w+ STATUS OF SOURCE: 2 Inactive li Pest/herbicides 3 Other 12 Fertilizers POLLUTION STATUS AND CROSS-REFERENCES GROUNDWATER POLLUTION FACILITY PERMITTED: Yes No 1 Confirmed O Rank 1 NPDES 6 Mining �otential 2 Tabulate No: 2 DEM Nondischarge ,. No: 7 Hazardous Waste (RCRA) MONITORING WELLS No: No: 1 No monitoring 2 State has data 3 Well Construction 8 Solid Waste (Landfill) 3 Data at facility No: No: Status unknown 4 Capacity Use 9 oil Terminal Registration DATABASE CROSS-REFERENCE No: No: 1 ERRIS (CERCLA) list 5 UIC 0 Air Quality ID: No: No: 2 Surface Impoundment (SIA) ID: Comments J,A9eor,5 Z) oZ0 X /00,x 3f deep 3 GW Pollution Source Inv. Date: 4 Other DEM investigation Date: Compiler: Date: u 0-57 FORM APPROVED fln 01 S37 OMB NO. 158—S78004 DATE PREPARED,, \-I U.S. ENVIRONMENTAL PROTECTION AGENCY SURFACE IMPOUNDMENT ASSESSMENT (SIA) LOCATION AND COUNT OF IMPOUNDMENTS SECTION I SERIAL NUMBER - -T MONTm . DAY YEAR lo 110 ............... 75 76 77 78 79 80 FACILITY IDENTIFICATION How many impoundments are STATE IDENTIFICATION NO. (Optional) STATE CN TY./C IT PLACE CATEGORY SIA SITE NUMBER located at this site? .......... 161 PIV 16 1016; 1 1 1 1 1 2 3 6 10 11 13 14 8 �fl 22 23 25 26 37 STANDARD INDUSTRIAL NPDES NUMBER CLASSIFICATION (SIC Code) SITE LOCATION ---- -- DEGREES MINUTES SECONDS 0." ftl no oFGREEs WOW ES SECONDS 0 N. I Djo LATITUDE -0- LONGITUDE -0- 0 3 47 38 46 50 51 52 53 54 55 56 59 60 61 162 63 OWNER NAME OF OWNER �xxw 5 22 9 OWNER'S MAILING ADDRESS (Street No. or P.O. Box) 22 5 9 CITY OR TOWN STATE ZIP CODE 4 C. 11z 22 52 53 54 55 59 OPERATOR NAME OF OPERATOR X. 5 27 59F: OPERATOR'S MAILING ADDRESS (Streqlt No. or P.O. Box) =b5>}}il 22 59 CITY OR TOWN STATE ZIP CODE 22 52 1 53 54 55 59 EPA Form 7500-44 (6-78) STATE COPY III. IMPOUNDMENT DESCRIPTION (Continued) &-,Average effluent for �7l.fi impoundment (gallons per day and year of record), i. Average daily influent forpiil impoundments at this facility (gallons per day and year j. Average daily effluent removed from �],,� impoundments and discharged to streams, lakes, ffi etc. (gallons per day and year of record). FORM APPROVED *U. S. GOVERNMENT PRINTING OFFICE: 1978-724-845 OM$ NO. 158-578004 U.S, ENVIRONMENTAL PROTECTION AGENCY SERIAL NUMBER " DATE PREPARED YEAR OF SURFACE IMPOUNDMENT ASSESSMENT (SIA) ' /J�) '9„w 2 OPERATIONAL FEATURES OF THE IMPOUNDMENT AND GROUND -WATER CONTAMINATION POTENTIAL Q <> MonlrH DAY YEAR '< SECTION II INSTRUCTIONS: This form is to be completed for one impoundment per site (facility) identified in Section I, Location and Count of Impoundments Form or for Otte impoundment per site selected via random sampling procedures. Complete multiple choice questions by entering the code number preceding the appropriate answer. O O o <-�.� � ! V � � #�>' 75 76 77 78 79 80 GAL5./DAY a.�nL,...ad s, a.:a;z*k'. 1. FACILITY IDENTIFICATION IL PURPOSE OF IMPOUNDMENT (Enter no. in block 23 STATE ;A.., CN7Y./CITY PLACE " _ o a: SIA SITE NUMBER CATEGORY IMPOUND ox, a?,a ;a+;o+ +ao °` 1. Waste Storage 2, Waste Disposal 3. Waste Treatment (Specify below) 4. Other - below) ., a L, .o- . ,: M E N T NO. �# snv (Specify . �xA.°sk; L/ --- - ., °}�� GALS./DAY -' -: o•: ` co t -^i: � : - Er RE R _ ! r - Ib j : afro- �; a / �P` - xi ae ?.00hs G.11.r �` ' __ 50 s s'e aa�° o'Ac cskao a4�ov co ..r `;ac .a:,y�.go-�aaic ;o.n s�*{n,2�srssxo c . 35 36 : a.aw a ,:...ze 37 d,a> , ,t 38 39 s , �� 02. Clay 05. Concrete 08. Polyethylene 1I. Hypalon Sheeting 14. Other Membrane type (Specify in blks. 28 - 39.) R l 22 :i oa �:!ac: - >.�,,�.f� jj ?lt. �` i 32 - 35 � /� 'J :.:N' }�`s,. 22:,'o, 24 25 27 ;: 28 39 :m Ga:., .- �o* 's,�,; ,u#' 5eot3�o+,.s,�,., 40 4%, ?�''::i "b� ,,eo-�a�, ¢+s,ca011-w ;«c,o ;w... ::oi,4 r.23 - :_;w's - � <m s,r,,aooz<. :ot�+.,o ; o,:Ca',a - 45 46 :A�11 z�� .0�o :...�:> ;,.:.. „ c ;0�,xo �x:.:�. �:.,,»r-;:�:,a. q#. �F?�`"��'°,�. �:s.I.GROUND--WATER +k' MONITORING V. GROUND -WATER DEGRADATION r a. HAVE SIGNIFICANT CHANGES IN GROUND -WATER QUALITY BEEN b. HAS THE GROUND -WATER QUALITY OF DRINKING WATER WELLS IN THE oring wells Baso- MONITORING WELLS. SPECIFY E C I F Y� AREA 13EENADVERSELY AFFECTED BY SEEPAGE FROM THIS this IMPOUNDMENT? (ff 'yes', explain below.)_ impoundment (if 10' ' enter and go to 1. None 4. Monthly 7. Yearly 1. Yes 2. No 3. Unknown 4" Not Applicable S 2 ,:.: 3 - 5 6 - 10 ^'`- i..;: 1 1 - 13 - _ 14 18�d'. �` _ )�+is;o} oax. aT; `'cs" 19 21 R>;20. 22-..w:.,�.,.s:�»., :roA,+Sr, 23 c,Av:."�.-..c:1, 24 - .�`.6. 34 t.<..x` «; III. IMPOUNDMENT DESCRIPTION a. 'Age of impound b. IS IMPOUNDMENT If answer to IILb is d. If answer to IIIb is PRESENTLY USED+yes', e. Surface gree of impoundment. fSurface area ofajiimpounndments eientin years, T give no. of 'no', give last year at this site (in acres). g. Average influent into jb,�a impoundment (gallons per day and year of record). I- Yes I- Nth 63 ..ears in oaeratin of operation. fin acresS III. IMPOUNDMENT DESCRIPTION (Continued) &-,Average effluent for �7l.fi impoundment (gallons per day and year of record), i. Average daily influent forpiil impoundments at this facility (gallons per day and year j. Average daily effluent removed from �],,� impoundments and discharged to streams, lakes, ffi etc. (gallons per day and year of record). :L a �. '�,.''?i- YEAR OF 9141 : x YEAR OF ' /J�) '9„w 2 YEAR OF GALS./DAY YEAR O F GAL5./DAY a.�nL,...ad s, a.:a;z*k'. - ,..;v,:, :.�: GALS./DAYRECORD a L, V L/ --- - ., °}�� GALS./DAY RECORD RE R j : afro- .9td+`i)'?#'$.' xi ae ?.00hs `o --" co: ti ' __ 50 .a:,y�.go-�aaic ;o.n s�*{n,2�srssxo c . 35 36 : a.aw a ,:...ze 37 d,a> , ,t 38 39 : 40 - 43 c 44 - 49: 02. Clay 05. Concrete 08. Polyethylene 1I. Hypalon Sheeting 14. Other Membrane type (Specify in blks. 28 - 39.) 56 22 :i oa �:!ac: - 23 31 32 - 35 III. IMPOUNDMENT DESCRIPTION (Continued) &-,Average effluent for �7l.fi impoundment (gallons per day and year of record), i. Average daily influent forpiil impoundments at this facility (gallons per day and year j. Average daily effluent removed from �],,� impoundments and discharged to streams, lakes, of record). etc. (gallons per day and year of record). YEAR OF YEAR OF YEAR OF GALS./DAY GAL5./DAY GALS./DAYRECORD RE RO RECORD j xi ae ?.00hs °Fs n 6rc- 58 - 61 5 % 62 - 70 ° 71 - 74 36 - 44 a 45 - 48 o : 44 - 57 ,% C;,,*off III. IMPOUNDMENT DESCRIPTION (Continued) k.*TYPE OF BOTTOM LINER (Enter no, from the types listed into blocks 23 and 24,) `,IF,CLAY LINER NO. 2.3 OR 4 IS SELECTED, GIVE THICKNESS IN INCHES (Enter in blocks 25 thru 27.) 1, FOR AGRICULTURAL IMPOUNDMENT GIVE AVERAGE DAILY NUMBER 0I. None 04. Chemically Modified Clay 07. Metal Io. Butyl Rubber Sheeting 13. Chlorinated Polyethylene (in blocks 40 thru 45) AND TYPE (in block46) OF LIVESTOCK. 02. Clay 05. Concrete 08. Polyethylene 1I. Hypalon Sheeting 14. Other Membrane type (Specify in blks. 28 - 39.) 1, Cattle 2. Hogs 3. Sheep 4. Poultry 5. Other 03. Bentonite Modified 06. Asphalt 09. Plasticized PVC 12. Ethylene Propylene 15. Other (Specify in blocks 28 thru 39,) .,St, ;o d+ �'�'@So#:o+ }�`s,. 22:,'o, 24 25 27 ;: 28 39 :m Ga:., .- �o* 's,�,; ,u#' 5eot3�o+,.s,�,., 40 4%, ?�''::i "b� ,,eo-�a�, ¢+s,ca011-w ;«c,o ;w... ::oi,4 r.23 - :_;w's - � <m s,r,,aooz<. :ot�+.,o ; o,:Ca',a - 45 46 :A�11 z�� .0�o :...�:> ;,.:.. „ c ;0�,xo �x:.:�. �:.,,»r-;:�:,a. q#. �F?�`"��'°,�. �:s.I.GROUND--WATER liated'with MONITORING V. GROUND -WATER DEGRADATION Number of muni- b. FREQUENCY OF GROUND -WATER QUALITY SAMPLING FROM a. HAVE SIGNIFICANT CHANGES IN GROUND -WATER QUALITY BEEN b. HAS THE GROUND -WATER QUALITY OF DRINKING WATER WELLS IN THE oring wells Baso- MONITORING WELLS. 013SERVED IN ANALYSIS FROM MONITORING WELLS? (If'yes', explain AREA 13EENADVERSELY AFFECTED BY SEEPAGE FROM THIS this and describe below how the site was corrected.) IMPOUNDMENT? (ff 'yes', explain below.)_ impoundment (if 10' ' enter and go to 1. None 4. Monthly 7. Yearly 1. Yes 2. No 3. Unknown 4" Not Applicable 1. Yes 2 No 3. Unknown 4. Not Applicable (Can only be used when there estion V.b.).- - - - - - - - - - - - - - - - - - - - - --- - - - are no wells within one mile of impovndment.)- 2, Daily 5" Quarterly 8. Other (Specify in blocks 50 thru 61.) EXPLAIN: - - EXP LA IPS_ '- 3, Weekly 6. Semi -Annually 62 63 .k 47 4$ rr nz__ 49 a¢ r. 50 - 61 �? :..::... VI. RATING OF THE GROUND -WATER CONTAMINATION POTENTIAL (See instruction manual EPA 574/9-78-003 VII, WASTE IDENTIFICATION N ' STEP 1 STEP 2 STEP 3 STEP 4 STEP 5 STEP 6 ate MISCELLANEOUS Enter the waste identification number " ' o,c G W. CONTAM. UNSAT, ZONE ONFIDENCE G.W. AVAIL. CONFIDENCE G.W. QUAL. CONFIDENCE WASTE ONFIDENCE EALTH HAZARD CONFIDENCE IDENTIFtERS for Part VI. Step 4. •• POTENTIA :... --:..,. �-. .',.'bit ,. .:- - t, � zx�s�,:, '--_--"• � : „.: ..-: ^o+,,.-, .,; ,.: -.: � ,s.•;- ��s:�a. {�;tos.-: .,;�-� .<os N.: . _.•� c: ;«-- a:. ,¢._.- ;«.. -.�':F:: b `: ... .ah:,/: -`�: '.: c. - .,. ..,,#:,-.. •�.:.:�: :2:-.-.: �-.,.-- �; ,. _:'Y: .:':..- .. :. 0 d,.._. # o;¢�o :1. 22 23 26 27 �',�: 'f^...o 29 30 36 `o 3$ ---.+�"'�- - >„t�.;::; 24 .<<�,�#. "„�.�,. 25 :� >.� , rtk,Na_ 28 ro--= .> o-:-..¢.� >: ., ,>. 31 ,-..��:.- 32 :: ,.¢ , ,:-,a 39 34 .�r,� ,� - 35 - �, 37 e'o:s,� aA�,�:<;�.:�t3 40 �C.-- ..:... u ,. .......... :.. x. ....., a..»,. ;a .... .- ,. s.,;-. .. .R,. ,n.u�. �.�:R>. a .�:.- ..:,,yo-... x+.. ic.,. EPA".Form 7500-44A (6-78) STATE COPY GROUND WATER DIVISION OFFICE OF WATER AND AIR RESOURCES DEPARTMENT OF NATURAL AND ECONOMIC RESOURCES RECORD DE GROUND WATER POLLUTION SOURCE RECORD BY : �/'%%- �r�w. DATE W.D. PERMIT NO. TOWN: COUNTY: LOCr; T I OiNl (SKETCH ON BACK) : o. sr,.:. �✓. o L La �c r �- .� a _ +�. S,' �� v 1 S fL ? 003 04-i-H?(S) OF FACILITY OR INSTALLATION: t'7= _ Sol.,;?! -E CLrR`D FILL. LAGOON'. ETC) r L�� ••� (zl �'' 7-0' x rvn' r 3' .---•— C'HA'R'..'.TER AND QUANTITY OF POLLUTANTS: A—'—/ r-��s D=SCRIPTION OF FACILITY (SKETCH ON BACK): HYDROGEOLOGIC CONDITIONS AT SITE: POLLUTION CONFIRMED BY ANALYSIS? DATE M0;41TORING FACILITIES INSTALLED: SCHEDULE: NEAR=s'i STREAM!^ L�M�r C�► DISTANCE NEAREST WATER SUPPLY WELL: DISTANCE ANALYSES AND OTHER. DATA AVAILABLE: REr•,n .�0-- � .,p .KS : Xr FORt; G;•i-46 ANALYST: `z-0 d, 3001 9 A r-1- I% U V (-,-J *U. S. GOVERNMENT PRINTING OFFICE: 1978-724.845 OAf13 NO. 158-S78004 -PA Form 7500-44A (6-78) EPA COPY U.S. ENVIRONM(,_'NTA1. PROTLCTION AGENCY SERIAL NUM13ER DATE PREI[)ARJ_D SURFACE IMPOUNDMENT ASSESSMENT (SIA) V, p"14, OPERATIONAL FEATURES OF THE IMPOUNDMENT AND GROUND -WATER CONTAMINATION POTENTIAL MONTH DAY YEAR SECTION If INSTRUCTIONS: This form is to be completed for 011V i1np0U11dMC11t per site (facility) identified in Section 1, Location and Count of Impoundments Form or for one impoundment per site selected via random simpling prticedures. Complete moltiple choice questions by entering t14 code number preceding the appropriate answer. 78 79 CLO 1. FACILITY IDENTIFICATION It, PURPOSE OF IMPOUNDMENT (Enter no. in block 23) IMPOUND - a3 w STATE CNTY./CITY PLACECATFGORY SIA SITE NUMBER 1. Waste Storage 2. Waste Disposal 3. Waste Treatment (Specify below) 4. Other (Specify below) M E N T NO. ZISPECIFY 1 2 3 5 v 11 13 7 6 10 14 19 21 22 23 24 34 111. I&IPOUNDMENT DESCRIPTION a. Age of impo u rid- b. IS IMPOUNDVENT c. if answer to IIIb is d. if answer to.lIl.b is e. Surfact� area of impoundment. f. Surface areofimpoundments ment in years, PRESENTLY USED? 'yes', give no. of 'no', give last year .LU atthis 5 Ito (in acros). g. Average influent into lWa Impoundment (gallons per day and year of record). • 1. Yes 2. NO years In operation. of operation. (in acres) I lit _T� L,5,5- "I"il I 1 101 1, 2 IGALS YEAR OF 0 0 0 ./DA'Y RFC Rb 35 36 4 37 8 3 3.9 40 43 44 49 50 ;F; 2 2 2 3 31 I 32 111. IMPOUNDMENT DESCRIPTION (Continued) it. Average effluent for this impoundment (gallons per day and year of record). i. Averaliv doily Influent for all Impoundments at this facility (gallons per day and year j. Average doily effluent removed fromimpoundments and discharged to streams, takes, of record). (gallons per day and year of roca�li%. , YEAR OF YEAR OF -etc, YEAR OF GGALS./DAYGALSJDAY iRECORD GALS./DAY IRECOPO jRECQRQ V-� 36 44 NO= 45 48 49 57 62 70 71 74 111. IMPOUNDMENT DESCRIPTION (Continued) k. TYPE OF 13OTTONt LINER (Enter no. from the types listed into blocks 23 and 24.) IF CLAY LINER NO. 2,3 OR 4 iS SELECTED, GIVE THICKNESS IN INCHES (Enter In blacks 25 1hru 27.) L FOR AGRICULTURAL IMPOUNDMENT GIVE AVERAGE DAILY NuRiBER 01. None 04. Chemically Modified Clay 07. Metal 10. Butyl Rubber Sheeting 13, Chlorinated Polyethylene (in blocks 40 thru 45) AND TYPE (in block46) OF LIVESTOCK. 02. Clay 05. Concrete 08. Polyethylene 11. Hypalon Sheeting 14. other Membrane type (Specify in blks. 28 - 39.) 1. Cattle 2, Hogs 3. Sheep 4. Poultry 5. Other U3. Bentoritte Modified 06. Asphalt 09. Plasticized PVC 12. Ethylene Propylene 15. Other (Specify in blocks 28 ehrt; 39.) - 100A% e^:�.A 3 & o X_ A 0 777 7 22 23 24 25 Z7 2 8 39 40 45 46 IV. GROUND -WATER MONITORING V. GROUND -WATER DEGRADATION Number of moni- b. FREQUENCY OF GROUND -WATER QUALITY SAMPLING FROM a. HAVE SIGNIFICANT CHANGES IN GROUND -WATER QUALITY BE E N b. HAS THE GROUND -WATER QUALITY OF DRINKING WATER WELLS IN THE luring wells asso- MONITORING WELLS. 013SERVED IN ANALYSIS FROM MONITORING WELLS? (11 'yes', explain AREA BEEN ADVERSELY AFFECTED Dy SEEPAGE FROM THIS ,,i& -ted with this and cjosrribe below how the site was corrected,) IMPOUNDNIJENT? (11 'yes', explain below,). �IadOUndinOnt (it ! Wjd go to 1. None 4. Monthly 7. Yearly T. ye. 2. No 3. Unknown 4, Not Appt)CUbl& 1. Vag 2. No 3. Unknown 4, Not Applicable (Can only be u6od when thero. .jua&tion V.b.). - - - - - - - - - - - - - - - - - - - - - - - - - - are no wells within One Mile Of IMPOEMdrJ]V"t*) - - - - - - - - - - - - - - - - - - - - - - - - 2. Doily 5. Quarterly S. Other (Specify In blocks 50 11tru 61.) EXPLAIN: 14 XP LA IN: --- 3. Weekly 6. Semi -Annually ]41413 El 62 �63 U 49 so 61 77 77 77 VT. RATING OF THE GROUND -WATER CONTAMINATION POTENTIAL (See instruction manual EPA 57019-73-003) VII, WASTE IDENJIFIQAIION NO� STEP I STEP 2 STEP 3 STEP 4 STEP 5 STEP 6 MISCELLANEOUS Enter the waste identification number UNSAT. ZONE I-ONFIDENCE G.W. AVAIL. A; L. CONFIDENCE G.W. QUAL, CONFIDENCE WASTE CONFIDENCE G.W. CONTAM. HEALTH HAZARD CONFIDENCE n IDENTIFIERS for Part V1, Step 4. 1C OT A Eli k I 1 IN I 2 23 24 1 25 INIM, 2 6 2 �7 2 FIE 1,� #91 [0 SR.0, 35 3 4 W: 41 4 4d -?_L 8 29 31 1� 32 33 34 L,11, 36 37 4C -PA Form 7500-44A (6-78) EPA COPY G R 0 U N 0 1•1 A T E R P 0 L L U T 1 0 N S 0 U R C E E V A L U A T I O N RANKING CRITEP.IA THREAT TO GROUNDWATER Probability of Groundwater Violations 3 Violations documented or highly probable Default 1 Violations unlikely Ent of Groundwater Contamination 3 Mappable, migrating plume 2 Defaul t I Insignificant contamination expected Seriousness of Groundwater Threat 3 One of most serious in DEM region 26 Default 1 Not considered a serious problem FEASIBILITY FOR TAKING ACTION Feasibility for Remedial Action 0 Remedial action both feasible and desirable 2 Default 1 No remedial action recommended Desirability of Remedial Action 3 One of top regional office priorities l.J Default 1 Not a priority incident THREAT TO PEOPLE OR ECONOMY How Hazardous to Health/Economy 3 People or business advised of contamination Default I No expected impacts on people or business Number of People at Risk 3 4 or more family units, or $10,000 loss QDefault I No people or other interests at risk Seriousness of People Threat 3 Strong DEM concern over threat to people Default l No threat to people or economy _ r FEASIBILITY OF RECLASSIFYING GROUNDWATER Need to Reclassifv Groundwater 3 Groundwater should be reiassified RS or GC (2)Default I No reclass. nor remedial action recommended Desirability of Reclassification 3 One of top reclassification priorities 0 Default 1 Not a priority incident .:m� THREAT OF POLLUTANTS How Toxic are Pollutants (Use Sax) 3 High value 0 Mod value 1 Low or None value Quantity of Pollutants in Ground 3 Reportable quantity of hazardous material (CERCLA def.) or quantity of real concern Default I Not of concern to regional office Seriousness of Pollutant Threat �3 One of most serious in DEM region / 2 / Default 1 Not a serious threat RANK SCORE: Source ame: Control Number: County: Ranker. Date: A -