or Site-Wide #’s Trihalomethanes resulting from releases of drinking water from public water supply system, or Metals, petroleum hydrocarbons, or semi-volatile substances, provided such pollution is due to: Incidental release due to normal operation of motor vehicles A result of normal paving and maintenance of pavement Release Area (RA) ID 3. Background Groundwater Quality 22a-133k-3(a)(1)(B) and k-3(a)(2) or Site-Wide #’s Groundwater in GA area meets Background Groundwater 22a-133k-3(a)(2) Quality Background Water Quality not required 22a-133k-3(d) (see 4a. below) Exemption from Background due to Technical 22a-133k-3(e)(1) Impracticability Lot: Block: Map: Town: Release Area (RA) ID 4. Compliance with Background 22a-133k-3(g)(2)(B) or Site-Wide #’s Sampling locations are representative of plume, and Analytical results Background concentration for groundwater OR (i) ≤ 12 consecutive monthly samples from each sampling location are ≤ (ii) 95% UCL Release Area (RA) ID 4a. Compliance with Background not Required 22a-133k-3(d)(1) or (d)(2) or Site-Wide #’s GWPC, is applicable at site not Background, 22a-133k-3(d)(1) (All of the following must apply) The background concentration is GWPC; ≤ A public water distribution system is available within 200 feet of the subject parcel, parcels adjacent thereto, and any parcel within the areal extent of the plume; Such plume is not located in an Aquifer Protection Area; AND Such plume is not located within the area of influence of any public water supply well. Groundwater remediation to Background not required 22a-133k-3(d)(2) (All ofthe following must apply) All substances in plume GWPC prior to remediation ≤ The areal extent of the plume that exceeds applicable criteria is not increasing over time, The concentration of substances is not increasing over time,
#’s or Site-Wide Trihalomethanes resulting from releases of drinking water from public water supply system, or Metals, petroleum hydrocarbons, or semi-volatile substances, provided such pollution is due to: Incidental release due to normal operation of motor vehicles A result of normal paving and maintenance of pavement 3. Background Groundwater Quality 22a-133k-3(a)(1)(B) and k-3(a)(2) Release Area (RA) ID #’s or Site-Wide Groundwater in GA area meets Background Groundwater Quality 22a-133k-3(a)(2) Background Water Quality not required (see 4a. below) 22a-133k-3(d) Exemption from Background due to Technical Impracticability 22a-133k-3(e)(1) Lot: Block: Map: Town: 4. Compliance with Background 22a-133k-3(g)(2)(B) Release Area (RA) ID #’s or Site-Wide Sampling locations are representative of plume, and Analytical results ≤ Background concentration for groundwater OR (i) 12 consecutive monthly samples from each sampling location are ≤ 95% UCL (ii) 4a. Compliance with Background not Required 22a-133k-3(d)(1) or (d)(2) Release Area (RA) ID #’s or Site-Wide GWPC, not Background, is applicable at site (All of the following must apply) 22a-133k-3(d)(1) The background concentration is ≤ GWPC; A public water distribution system is available within 200 feet of the subject parcel, parcels adjacent thereto, and any parcel within the areal extent of the plume; Such plume is not located in an Aquifer Protection Area; AND Such plume is not located within the area of influence of any public water supply well. Groundwater remediation to Background not required (All ofthe following must apply) 22a-133k-3(d)(2) All substances in plume ≤ GWPC prior to remediation The areal extent of the plume that exceeds applicable criteria is not increasing over time, The concentration of substances is not increasing over time,
form_iv_s_verification_business_only.docx