HomeMy WebLinkAboutWAYNE WINCHESTER UNION_MISC_20171231FAL APR 1 4 1988
Control Number
County Number
"41GROUNDWATER
POLLUTION SOURCE INVENTORY
C)d-,
Source Name
^RSHIP
WAVne
3rivate
Source AddrfeSS
0•
1
2 5. $IQe, 31S
2 Municipal
i D
6A V SQ
3 County
4 State
City
County
Region
lfill'O=�
Uin IV,
5 Federal
6 Military
Owner/ perator
Quad Name
"gultiple Sources a
County ource s
YES NO
POTENTIAL SOURCE OF GROUNDWATER POLLUTION
LOCATION
OPERATION TYPE
TYPE OF WASTE
DISPOSAL FACILITY
OTHER SOURCE
OFacility
1 Municipal
1 Gasoline/diesel
0 Lagoon, etc.
l
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
Other chemical
5 Abandoned site
5
Mine drainage
6 Dumpsite
6 Other Source
Sewage/septage
6 Sewer system
6
Intentional dump
7 Other
C7)
7 Sludge
7 Septic tank
7
Spill
B Leachate
8 Injection well
8
Leak --above ground
9 Other solids
9 Disposal well
9
Leak --underground
i� In use?
10 Gas
WASTE:
14+»gal Wasie Sw:He
bper&�'^
STATUS OF SOURCE: 2 Inactive
11 Pest/herbicides
3 Other
12 Fertilizers
POLLUTION STATUS AND CROSS-REFERENCES
GROUNDWATER POLLUTION
FACILITY PERMITTED: Yes No
1 Confirmed Rank
l NPDES
6 Mining
Potential 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:
OStatus 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)
Comments 1
��tGoe r► — /OD �X %O ' x 5 ' deep
J
10:23
3 GW Pollution Source Inv.
Date:
4 Other DEM investigation
Date:
Compiler:
Date:
'
�I
.r /'1 �1� n,4 ,r a17 OMB NO. 158-S78004
r DATE PREPARED
U.S, ENVIRONMENTAL PROTECTION AGENCY
SURFACE IMPOUNDMENT ASSESSMENT (SIA)
LOCATION AND COUNT OF IMPOUNDMENTS
SECTION I
SERIAL NUMBER
MONTH � [DAY YEAR
I
75 76 77 7S 79 60'
r'
FACILITY IDENTIFICATION How many impoundments are
4
STATE IDENTIFICATION NO. (Optional)
STATE CNTY./CITY PLACE CATEGORY SIA SITE NUMBER 1.rilocated at this site?
41311
#' 1 2 3 - 5
r.
6 - 10 11 - 13 14 - is 22 23 - 25
26 - 37
INDUSTRIAL 36TE LOCATION
NPDES NUMBERSTANDARD
CLASSIFICATION (SIC Gode)Rrrr MIN VTES SECONDS 7 ` GO * x tN 9 DEGREES MINUTES Si CONDS
-JEM LATITUDE -91-
LONGITUDEf
1150,
CJ
} t
3B _ 46 --� 47 _ 50 51 52 53 5'4j 55 56
OWNER
NAME OF OWNER
22 - 59
OWNER'S MAILING ADDRESS (Street No. or P.O. Box)
zx:.. 22 _ 59 %s g
CITY OR TOWN
STATE
ZIP CODE
F22
itsc:
r7�
.a-:
/
n
52
53 54
55 - 59:
OPERATOR
NAME OF OPERATOR
s
t�'
ii
`1
�
\�
1
rl
INA122
- 59
OPERATOR'S MAILING ADDRESS (Streelt No. or P.O. Box)
b
WOE
11
1
IT
22 59
CITY OR TOWN
---T--F=1
STATE
ZIP CODE
I
tl
I
I I
1 .711111
1
I I
52
153 54
1 55 -- 59
EPA Form 7500-44 (6-78) STATE COPY
;i
�SaSl��n �1
GROUND WATER DIVISION
OFFICE OF WATER AND AIR RESOURCES
DEPARTMENT OF NATURAL AND ECONOMIC RESOURCES
RECORD.OF GROUND WATER POLLUTION SOURCE
RECORD BY: ��%/.�.-F'_
(���.,�.-�
DATE 9Iz7I79
W.D. PERMIT N0,
TOWN: 7-1-"
COUNTY:
1ifn,a�
LO0AT?0;N' (SKETCH ON
BACK: 0.-7
a1 Jit C.
s'cr� o-�- s,QI]IS
OWNERS) OF FACILITY OR INSTALLATION:
TY?H SOURCE: CLAMD FI LL, LAGOON, ETC)
Com,-= R -.CTER AIND QUANTITY OF POLLUTANTS: Xr'tAmA/ U/Rrle.r �n►.••� Sr.-.��_ �tF-.�/.',,,,
DESCRIPTION OF FACILITY (SKETCH ON BACK):
�-iYDROGEOLOGIC CONDITIONS AT SITE:
POLLUTION CONFIRMED BY ANALYSIS? DATE" ANALYST:
MO`,ITORING FACILITIES INSTALLED:
AMA ; A SCHEDULE:
NEAREST STREAM; REAM; u. ; a. DISTANCE Gq
�:E,.REST `rrATER SUPPLY WELL:
DISTANCE 6-00,
ANALYSES AND OTHER DATA AVAILABLE:
REMARKS:
pro i Gzinow
FORM GW -45
0
G R O U N D 1-1 A T E° P O L L U T I O N S O U R C E E V A L U A T I O N
RANKING CRITEP.IA
THREAT TO GROUNDWATER
,� THREAT TO PEOPLE OR ECONOMY
=THREAT OF POLLUTANTS
Probability of Groundwater Violations
How Hazardous to Health/Economy
How Toxic are Pollutants (use Sax)
3 Violations documented or highly probable
3 People or business advised of contamination
3 High value
® Default
® Default
Mod value
1 Violations unlikely
i No expected impacts on people or business
i Low or None value
Ext@nt of Groundwater Contamination
Number of Peoole at Risk
Quantity of Pollutants in Ground
3 Mappable. 'migrating plume
3 4 or more family units, or $10,000 loss
3 Reportable quantity of hazardous material
(CERCLA def.) or quantity of real concern
2 Default
® Default
Default
1 Insignificant contamination expected
1 No people or other interests at risk
1 Not of concern to regional office
Seriousness of Groundwater Threat
Seriousness of People Threat
Seriousness of Pollutant Treat
3 One of most serious in DEM region
3 Strong DEM concern over threat to people
3 One of most serious in OEM region
0 Default
2 Default
�./ Default
1 Not considered a serious problem
1 No threat to people or economy
1 Not a serious threat
8 FEASIBILITY FOR TAKING ACTION
FEASIBILITY OF RECLASSIFYING GROUNDWATER
RANK SCORE:
Feasibility for Remedial Action
Need to Reclassifv Croundwater
( 3) Remedial action -both feasible and desirable
Groundwater should be relassified RS or GC
Source ame:
2 Default
X33
( 2 JDefault
I No remedial action recommended
1 No reclass. nor remedial action recommended
Control Number: O
Desirability of Remedial Action
Desirability of Reclassification
3 One of top regional office priorities
3 ne of top reclassification priorities
County:
2 Default
2efault
Ranker.
1 Not a priority incident
1 Not a priority incident
Date:
NVtCM AYYKuYLU
*U. S. GOVERNMENT PRINTING OFFICE: 1978-724-845 OM$ NO, 158-S78004
EPA Farm 7500-44A (6-78) STATR COPY
1�
U.S. ENVIRONMENTAL PROTECTION AGENCY
SERIAL NUMBER
DATE PREPARED
SURFACE IMPOUNDMENT ASSESSMENT (SIA)
OPERATIONAL FEATURES OF THE IMPOUNDMENT AND GROUND -WATER CONTAMINATION POTENTIAL
p �q p
MONTH DAY YEAR=,
SECTION II
038408
form impoundment in Section Count Form
f
INSTRUCTIONS: This is to be completed for one per site (facility) identified I, Location and of Impoundments or for one
impoundment per site selected via random sampling procedures. Complete multiple choice questions by entering the code number preceding the appropriate answer,
75 76 77 78 79 80 t
u- I. FACILITY IDENTIFICATION II. PURPOSE OF IMPOUNDMENT (Enter no. in block 23
---
°".to-�aIMPOUND
xt@cy%a
ts<aR''ry,"
A, - STATE CNTY./CITY o'<+.
PLACE CATEGORY v"° t SIA SITE HUM13ER
e 1. Waste Store a 2. Waste Dia eel 3. Waste Treatmentbelow
gg s r g Disposal (Specify ) 4. Other (Specify below)
MENT NO
.c.
"..x.
S P E C#I- Y
18
3 5
6 10 11 13 14
19 22 23 3.
....
.
.......
- t3242
-4
�K»k3-�F .
III. IMPOUNDMENT DESCRIPTION
a. Age of impound
b. IS IMPOUNDMENT c. If answer to IlI.b is
d. If answer to III.b is
e. Surface area of impoundment.
f. Surface area ofd impoundments
ment in'years.
PRESENTLY USED? 'yes', give no. of
'no', give last year
at this site (in acres).
g. Average influent into jty,$ impoundment (gallons per day and year of record).
l'
1. Yes 2. NO years in operation.
of operation.
(in acres)
o{tr
I
w °} g` tcx
x'x.g.W -'
°'
a, ac
3:
KQ?
l
g.,
!n
) r
3s"{
'.a
�y
YEAR O F;
'�°-�-
V`6"1
.s, �'.�
:,t,
o`?°o- .c,`o-s
O
.xo-i :.a.. :o
w:
»�
`
taxi
L GALS./DAY
R OR
°
°ase °
x,
35 36
37
s ?° » �.° x
38 3.9
O, .oa o:
40 - 43
44 - 49
50 56
_z
22 .z x g 23 - 31 32 - 35
III. IMPOUNDMENT DESCRIPTION (Continued)
h. Average effluent for jjj^impoundment (gallons per day and year of record).
i. Average daily influent forAll 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 reeor ).
YEAR OF
YEAR OF
YEAR OF
GALS./DAY
GALS. /DAY
GALS./DAY
RE RD
RECORD
RECORD
36 44
as--oa`
4S
;jjKj o ?' 49 58 - 61
62 - 70 x
r a sat
71 - 74
-
- 48
- 57
III. IMPOUNDMENT DESCRIPTION (Continued)
k...T.YPE OF BOTTOM LINER (Enter no. from the types listed into blocks 23 and 24.) 1. FOR AGRICULTURAL IMPOUNDMENT GIVE AVERAGE DAILY NUMBER
.-'IF CLAY LINER_ NO. 2,3 OR 4 IS SELECTED, GIVE THICKNESS TN INCHES (Enter in blocks 25 thru 27.) {in Slacks 40 thru 45) AND TYPE (in b]ock46) OF LIVESTOCK.
01'.None _ 04. Chemically Modified Clay 07. Metal 10, Butyl Rubber Sheeting 13. Chlorinated Polyethylene
02.' 05. Concrete 08. Polyethylene 11. Hypalon Sheeting 14. Other Membrane type (Specify in blks. 28 - 39.)
-Clay
1. Cattle 2. Hags 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.)
"epi._
Oil ---",g„
22 a��i- 23 24 40
25 27 r..�.o`4ai'4 2B 39 '�'� 45 4
a�21-0
x-`0}-_ _ _ _
ca.AS�.. ..-,fir 6
�xo-:ra,.-lo- o6+tC'o.l*
IV. GROUND -WATER MONITORING
V. GROUND -WATER DEGRADATION
. Number of mord- 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 WAFER WELLS IN THE
oring wells asso- MONITORING WELLS.
OBSERVED IN ANALYSIS FROM MONITORING WELLS? (If 'yes', explain
AREA BEEN ADVERSELY AFFECTED BY SEEPAGE FROM THIS
fated with this
and describe below how the site was corrected.)
IMPOUNDMENT? (If 'yes', explain below.)
impoundment fif 10'
enter and go to 1. None 4. Monthly 7. yearly
1. Yes 2. No 3. Unknown 4. Not Applicable
A. Yea 2. No 3. Unknown 4. Not Applicable (Can only be used when there
uestion V.b,.).
- - - - - - - - - - - - - - - - - - - - - - - - --
- - - ,- - - _ are no welis within one mile of impoundrnent.)
-
- - - - '-" - - - "'
' 2. Daily 5. Quarterly 8. Other (Specify in blocks 50 thru 61.)
EXPLAIN:
-
EXPLAIN*
:-'t- 3_ Weekly 6. Semi -Annually
62
63
47 48 ° 49�. 50 - 61
VI. RATING OF THE GROUND -WATER CONTAMINATION POTENTIAL (See instruction manual EPA 570/9-78-003)
VII WASTE IDENTIFICATION NO.
STEP 1 STEP 2 STEP 3 STEP 4 STEP 5 STEP 6
MISCELLANEOUS
Enter the waste identification number
G W. CONTAM.
UNSAT. ZONE CONFIDENCE G.W. AVAIL. CONFIDENCE G.W. QUAL. ONFIDENCE WASTE CONFIDENCE EALTH HAZARD CONFIDENCE
IDENTIFIERS
for Part VI, Step 4,
POTENTIA
.�
�"t<:,<.,
ex:t�,(W:
&'d.'�:n�:,.>..#-.-.
L::�d_ s,'�C.
6
�.:
� ��r,.0':'O�`' '
�
:,
:_,,i.::..;:,
,,r.t. �__ .:`-'-.� :,:az-..,i..l
..�t�iR_..:, . �C
..-..-:{.aY_.:,,;: -,. _. ..u..: i.:.. .:,;,
a�.:A:-,,,.0'�.k':.::�.,�.'6'_ --:.,�,iQo..::.:'_k,�::n',:4:<
*.
1 •�', +�:`Y;,;.�:�CA.t:i:..�,?„.&.t_ Y:',
l-:
'��.+:,l:� ..'n:,�A..:.�9:`:'�'
�.� 5.�s�6.Ct::.;
2 26
$ 3722
3 35 36
3833 49
41 1
N'-
4425
.ASNR�
.-:-w_,,. ;.
:.
,I
27 2 .
:2'a,.
.'_2d.
_rSL.,::,.
..Rov.3.<'::.f:.._^-.
.::.-
31 2 34 m#
..�4:,.:
EPA Farm 7500-44A (6-78) STATR COPY
1�
--j- - .
`DATE 1IRLTIARLD
*u. S. GOVCRIhwi NT P1oN,nr4c. oFFICC... 1978-724-845 0,511f No. ISS- S78004
U.S. ENVIRONMENTAL I'IZOTECT[ON AC-ENCY
SURFACE IMPOUNDMENT ASSESSMENT (SIA)
OPERATIONAL FEATURES OF THE IMPOUNDMENT AND GROUND -WATER CONTAMINATION POTENTIAL
SECTION It
INil'HUUFIONS'. 1'11t: form is to be completed for one imptiundinont per site (facility) identified in Section Ip I,ocn%jon and Count of Inipotpirlmcnls Iorin or far one
ittlPOLIndment per site selected vin random s-oinplinV
prucud tires, Complete multiple choice question,; by entoring Hit: code number prQecding the uppropriate answer,
SERIAL NUM111" 'U
e37
I. 1, AC ILITY IDENTIFICATION
If. PURPOSE OF IMPOUNDNIFN,r (Enter no. in block 23)
C. If answer to IIIb is
d. It answer to Illb is
c Surface Arco of impoundment.
f. Surface nren ofLlilimpoundments
went in years.
PRESENTLY USED?
Yei" give no. of
IMPOUND -
at tfits site (in acres).
g. Average influent Into jbil Impoindment (gallons per day and your of record).
YEAR OF
1. Yes 2. NO
TATE
of operation.
CNTY./CITY
PLACE
CATEGORY
SIA SITE NUMBER
V.,
E. lvastc Storage 2, Wastt: Dispouril 3. War to Treatment (Specify below) 4, Other (Spvc1ly below)
MENT NO.
11
:o.LSJDAY
Aga;
I
I
YEAR OF
GALS./DAY
ITI
I
SPECIFY
I
I
I
GALSJOAY
T
-I
%gap fa
%
RECORD
RFCORD'
35 36
37
38 a.9
40
_Lj 44 49
to
11
18
19 21
3 Z 35
22
5M;04AW 23 %
24 34
45
sa 61
62
71
48
49 57
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ill. IMPOUNDMENT DF-SCRTPTTON
Age or impoumilb.
IS lMP0LJN1DNjP.NT
C. If answer to IIIb is
d. It answer to Illb is
c Surface Arco of impoundment.
f. Surface nren ofLlilimpoundments
went in years.
PRESENTLY USED?
Yei" give no. of
'no', give last year
at tfits site (in acres).
g. Average influent Into jbil Impoindment (gallons per day and your of record).
YEAR OF
1. Yes 2. NO
years in OperOtlon.
of operation.
(in acres)
V.,
YEAR OF
YEAR OF
11
:o.LSJDAY
2 GALS./DAY
I
I
YEAR OF
GALS./DAY
ITI
I
L
I
I
I
GALSJOAY
RECORD
RFCORD'
35 36
37
38 a.9
40
_Lj 44 49
50 56
22 2 3 31
3 Z 35
Ill. IMPOUNDMENT DESCRIPTION (Continued)
:average cffluQnt for thesis impoundment (gallons p or day and year of record).
1. AverflUc daily Influent for nil impoundments at this futility (gallons per day i2nd year
j. Average daily effill-nt removed from 'Llimpoundmertts arid discharged to streams, julicips,
of record),
etc, (gallons per dity and year of rector d).
YEAR OF
YEAR OF
YEAR OF
11
:o.LSJDAY
I
I
GALS./DAY
ITI
I
L
I
I
I
GALSJOAY
RECORD
RECORD
RECORD
36 44
45
sa 61
62
71
48
49 57
Ill. IMPOUNDMENT DESCRIPTION (Continued)
TYPE OF BOTTOM LINER (Enter no. from the types listed Into blocks 23 and 24.)
1. TOR AGRICULTURAL MIPOUNDMENT GIVE AVEIZAGF DAILY NUMBER
IF CLAY LINER No. 2,3 OR 4 IS SELECTED, GIVE THICKNESS IN INCHES (Enter In blocks 25 that 27.)
I- None 04. Chemically Modified Clay 07. Metal 10, Sutyl I -fibber Sheeting 13. Chlorinated Polyethylene
(in blocks 40 tbru 45) AND TYPE (ir? block4o) OF LIVESTOCK.
J2. Clay 05. Concrete 03. Polyethylene II. Hypolon Siieetlnc 14. Other Membrane type (Specify In blks, 28 39.)
1. Cottle 2. Rags 3, Sincep 4. Poultry 5. other
1j, BL -ritaritte Modified 06. Asphalt 09. Plasticized PVC 12. E thyl coc Propylene 15. Other (Specify in blocks 28 thru 39.)
3
FT
x
Zi 0
25
2 2 23 24 27
Z 6
7
4 0 45
41
�79
ma
-,� . -.1
1� 77 7
IV. GROUND -WATER MONITORING
V. CROUND-WATER DEGRADATION
Ntinb'er of monl-
b. FPI--'Qyjl-*NCY OF GI'OU.INID-WATER QUALITY SAMPLING FROMOM
i I AVE SIGNIFICANT CHANGES IN GROUND -WATER QUALITY BEEN
b. HAS THE GROUND -WATER QUALITY OF DRINKING WATER WELLS IN Tli H
alsauk o- uso-
%io-,,;1-1'6RING WLLLS.
(1I3S1-'RVLD IN ANAT.YSIS FROM MONITORING WELLS? (if 'Yc-Z,', I-PI"in
AREA ADVrRSFLY AVJlECTED By SLC PACE FIZOtl TRIS
With 1I:t a
u4d (1vsrr1bu Z-olow how the site wits corrocfcd.)
(If 'yos', oxplahi below.),
,;vr u.1d Cc to
1. None 4. Monthly 7. Yearly
Y.. No 3. TJ,�krtt 4. Not Aj�pllld-
Nat
1. ye. 2. No 3, unk.QW. 4. Not Ap[Olcriblc (C,jn only bo USQCJ fhgrtr
k1ro no W,%vithin orra trillc of Ir:tpoLmdr;vw.)
- -- - - - - - - - - - - - - - - .- - -
-L
2. Dolly 5. Quarterly 8. Other (Specify In blocks 50 11tru 61.)
T-� 11 LA I N:
XT, LTI r
3. Weekly 6. S v m t -A nnuri I I y
%
,
47 48
a9
g
50 GI -t4
G3
63
VT, RATING 01; THE GROUND -WATT 1, CONTAMINATION 1101-1-NTIA1,(3ca lnsInrclion manual 570/9-78-003)
VIT. WASTE DI: ]STU_jgA'fjQtJ 4Q.
linter r Ejv wuutc juenarivation nuinUcr
for Part VI, Step 4.
4,
STEP I
STEP P 2
STEP 3
STEP 4
STEP 5
STEP 6
�AISCELLANEOUS
UNSAT. ZONE ICONFIDENCE
G.W. AVAIL. CONFIDENCE
G.W. QUAL.
ON FIDENCE
WASTC CONFIDENCE
G.W. CONTAM.
HEALTIi FIAZARO
CONFIDENCE
IDIE-NTIFFIERS
P 02'
r7!7
.,
7-
1,
1
F I
22 �T
24
2 44-
� I
26 27
r��
35 3C
TPT 77
38 40 1 7M7
7,
41 44
7-,
_25 L
33 34
Form 7500-44A 0-761
i4'ACCPY WT,