4 What is the infiltrating surface area of the proposed BMP? ABMP sq-ft What land use activities are present in the tributary area (list all) 5 6 What land risk category is applicable? L M H If M or H, what pretreatment and source isolation BMPs have been considered and are proposed (describe all): 7 What minimum separation to mounded seasonally high 8 groundwater applies to the proposed BMP? 5 ft 10 ft See Section (circle one) Provide rationale for selection of applicable minimum separation to seasonally high mounded groundwater: 9 What is separation from the infiltrating surface to seasonally 10 SHGWT ft high groundwater? What is separation from the infiltrating surface to mounded Mounded 11 ft seasonally high groundwater? SHGWT Describe assumptions and methods used for mounding analysis: 12 13 Is the site within a plume protection boundary (See )? Y N N/A Is the site within a selenium source area or natural plume 14 Y N N/A area (See )? 15 Is the site within 250 feet of a contaminated site? Y N N/A
4 What is the infiltrating surface area of the proposed BMP? ABMP sq-ft 5 What land use activities are present in the tributary area (list all) 6 What land risk category is applicable? L M H 7 If M or H, what pretreatment and source isolation BMPs have been considered and are proposed (describe all): 8 What minimum separation to mounded seasonally high groundwater applies to the proposed BMP? See Section (circle one) 5 ft 10 ft 9 Provide rationale for selection of applicable minimum separation to seasonally high mounded groundwater: 10 What is separation from the infiltrating surface to seasonally high groundwater? SHGWT ft 11 What is separation from the infiltrating surface to mounded seasonally high groundwater? Mounded SHGWT ft 12 Describe assumptions and methods used for mounding analysis: 13 Is the site within a plume protection boundary (See )? Y N N/A 14 Is the site within a selenium source area or natural plume area (See )? Y N N/A 15 Is the site within 250 feet of a contaminated site? Y N N/A
OC_TGD_Appendices_5-19-11.docx