DSHW-2024-008796

CORRECTIVE ACTION SECTION – SITE VISIT REPORT
SITE NAME: _________________________________________ DATE: ______/_______/___________
EPA ID #: _________________________________________ UTCA ID#: ______________________
LOCATION: ___________________________________________________________________________
PROJECT MANAGER: ____________________________________________________________________
SITE STATUS
___ Active Investigation ___ Long-term Institutional Controls in-place
___ Long-term Groundwater Monitoring
___ Closed w/ No More Work Needed OTHER (describe):
PURPOSE OF SITE VISIT
___ Confirm Cleanup Completed
___ Confirm Integrity of Engineering Controls
___ Confirm SMP is Being Complied With
D2# for SMP: DSHW-________-_______________
___ Post-Closure Permit Verification
___ Document Change in Land Usage
___Drive-by (windshield survey)
___Sample Observation &/or Collection
___Site Investigation
___Cleanup Activities Inspection
___Confirm Current Land Usage
OTHER (describe):
FIELD OBSERVATIONS:
SAMPLE COLLECTION
Were Environmental Samples Collected per the approved Sampling & Analysis Plan?
YES ___ NO ___ N/A ___
COMMENTS:
Ongoing Cleanup Activities
Confirmation Sampling
Questart Gas Company's Orange Street Property 10 17 2024
UTCA-0004
246 South Orange Street
Jasin Olsen
4
4
4
4
2009 006804
The site is fenced and locked.
No excavations were noted.
Still used as a laydown yard.
No groundwater use observed.
4
Is the Work Being Performed in a Manner Consistent with the Approved Workplan(s)?
YES ___ NO ___ N/A ___ Unknown (Drive-By Inspection Only) ___
COMMENTS:
CURRENT LAND USAGE
___ Residential
___ Commercial
___ Industrial
___ Mixed Commercial w/ Residential
___ Under Construction &/or Development
___ Other: __________________________________
COMMENTS:
FUTURE LAND USAGE
___ Residential ___ Mixed Commercial w/ Residential
___ Commercial ___ Other: (describe below)
___ Industrial ___ Unknow at this time
COMMENTS:
POST-CLEANUP SITE VISITS
Is the Completed Cleanup Remedy Still Protective Based on Current Land Use?
YES ___ NO ___ Unknown (Drive-By Inspection Only) ___
COMMENTS:
LONG-TERM INSTITUTION CONTROL(S) VERIFICATION
Are Components or Restrictions of the SMP &/or EC Currently Being Complied with?
YES ___ NO ___ Unknown (Drive-By Inspection Only) ___
COMMENTS:
SITE VISIT CONCLUSIONS
RECOMMENDATIONS
ATTACHMENTS (PHOTOS, MAPS, FIGURES, TABLES, etc.) YES ___ NO ___
SIGNATURE:
4
4
4
Questar Gas laydown yard.
4
4
Questar Gas laydown yard.
4
Questar Gas laydown yard.
4
Questar Gas laydown yard.
The site is in compliance with the EC.
Revisit site next year.
4
Jasin Olsen