IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^....

20
fc 00 0 0 1 6 4 POTENTIAL HAZARDOUS WASTE SITE PRELIMINARY ASSESSMENT PART 1 -SITE INFORMATION AND ASSESSMENT t IDENTIFICATION 01 STATE 03 SITE NUMBER II. SITE NAME ANDLOCATION 01 02 STREET. ROUTE NO.. OR SPECIFIC LOCATION OENTIF IE R of 03 CITY 04 STATE XL 05 ZIP CODE \ 06 COUNTY L* ice 07COUNT> 08CONG COM DtST o«n 09 COORDINATES LATITUDE LONGITUDE So 55.i 1 0 DIRECTIONS TOSITE isurtny inmiM Lcoxs O*oK<£«-A*o 111. RESPONSIBLE PARTIES 01 OWNER (VtaMMj 02 STREET (•» 63 CITY 04 STATE XL 09 ZIP CODE 06 TELEPHONE NUMBER I » 07 OPERATOR ftfM«»naM«"•'»•«' M STREET »n«M*. <M»V. Si O9CITY 10 STATE IL 13 TYPE OF OWNERSHIP tCMct *»l D A. PRIVATE OB. FEDERAL: __. 11ZV>COOE 4ooQ5 12 TELEPHONE NUMBER OF. OTHER: D C. STATE DD.COUNTY DO. UNKNOWN E. MUNICIPAL 14 OWNERflOPERAtDR NOTIFICATION ON FILE (Owe* •»« D A. RCRA 3001 DATE RECEIVED: MONTH DAY VtAH DB.UNCONTROLLEOWASTESrTEicr«<a»t«iei DATE RECEIVED:. MONTH DAY YEAP 5.NONE IV. CHARACTERIZATION OF POTENTIAL HAZARD 01 ON SITE WSPECTION DATE OT/30/TS MONTH MV BYro»c* •!!»«»** DA.EPA O B. EPA CONTRACTOR DE. LOCAL HEALTH OFFICIAL DF. OTHER: _/ tfC. . STATE D D. OTHER CONTRACTOR / / -4 °* 7 / l V R3 **^ CONTRACTOR NAME(S): !SITESTATUSn>*c*i O A. ACTIVE I . INACTIVE D C. UNKNOWN 09 YEARS OF OPERATION O UNKNOWN KOMNIHO VCAft 04 DESCRIPTION OF SUBSTANCES POSSIBLY PRESENT. KNOWN. OR ALLEOED O i o AjTt C To K"» o / ts T RECEIVE? FEB 16 1984 05 DESCRIPTION OF POTENTIAL HAZARD TO ENVIRONMENT ANDSOR POPULATION C ^ ——— *- .PA D.LP-C- STATE OF ILLINO v. PRIORITY ASSESSMENT 01 PRIORITY FOR INSPECTION (Owe*, O A HKJH DC LOW DO NONE VI. INFORMATION AVAILABLE FROM 01 CONTACT .T. fl. O3 TELEPHONE NUMBER 04 PERSON RESPONSIBLE FOR ASSESSMENT a 05AQCNCV 06 OROANiZATION 07 TELEPHONE NUMBER 08 DATE /a. , MONTH OAT YEAN ETA FORM 20TO-12{7-«1|

Transcript of IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^....

Page 1: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

fc 00 0 0 1 6 4

POTENTIAL HAZARDOUS WASTE SITEPRELIMINARY ASSESSMENT

PART 1 -SITE INFORMATION AND ASSESSMENT

t IDENTIFICATION01 STATE 03 SITE NUMBER

II. SITE NAME AND LOCATION01 02 STREET. ROUTE NO.. OR SPECIFIC LOCATION OENTIF IE R

of03 CITY 04 STATE

XL05 ZIP CODE \ 06 COUNTY

L* ice07COUNT> 08CONG

COM DtSTo«n09 COORDINATES LATITUDE LONGITUDE

So 55.i1 0 DIRECTIONS TO SITE isurtny inmiM

Lcoxs O*oK<£«-A*o

111. RESPONSIBLE PARTIES01 OWNER (VtaMMj 02 STREET (•»

63 CITY 04 STATE

XL09 ZIP CODE 06 TELEPHONE NUMBER

I »

07 OPERATOR ftfM«»naM«"•'»•«' M STREET »n«M*. <M»V.

SiO9CITY 10 STATE

IL13 TYPE OF OWNERSHIP tCMct *»l

D A. PRIVATE OB. FEDERAL: __.

11ZV>COOE

4ooQ512 TELEPHONE NUMBER

OF. OTHER:

D C. STATE DD.COUNTY

DO. UNKNOWN

E. MUNICIPAL

14 OWNERflOPERAtDR NOTIFICATION ON FILE (Owe* •»«

D A. RCRA 3001 DATE RECEIVED:MONTH DAY VtAH

DB.UNCONTROLLEOWASTESrTEicr«<a»t«iei DATE RECEIVED:.MONTH DAY YEAP

5.NONE

IV. CHARACTERIZATION OF POTENTIAL HAZARD01 ON SITE WSPECTION

DATE OT/30/TSMONTH MV

BYro»c* •!!»«»**DA.EPA O B. EPA CONTRACTORDE. LOCAL HEALTH OFFICIAL DF. OTHER:

_/tfC.. STATE D D. OTHER CONTRACTOR

/ / -4°*7/lVR3 **^ CONTRACTOR NAME(S):

!SITESTATUSn>*c*iO A. ACTIVE I . INACTIVE D C. UNKNOWN

09 YEARS OF OPERATIONO UNKNOWN

KOMNIHO VCAft

04 DESCRIPTION OF SUBSTANCES POSSIBLY PRESENT. KNOWN. OR ALLEOED

O i o A jTt C To K"» o / ts T RECEIVE?FEB 16 198405 DESCRIPTION OF POTENTIAL HAZARD TO ENVIRONMENT ANDSOR POPULATION

C^ ——— *-

.PA — D.LP-C-STATE OF ILLINO

v. PRIORITY ASSESSMENT01 PRIORITY FOR INSPECTION (Owe*,

O A HKJH DC LOW DO NONE

VI. INFORMATION AVAILABLE FROM01 CONTACT

.T. fl.O3 TELEPHONE NUMBER

04 PERSON RESPONSIBLE FOR ASSESSMENT

a

05AQCNCV 06 OROANiZATION 07 TELEPHONE NUMBER 08 DATE/a. ,MONTH OAT YEAN

ETA FORM 20TO-12{7-«1|

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^ v-v* . POTENTIAL HAZARDOUS WASTE SITEAf~PA PRELIMINARY ASSESSMENTri-l *-l PART 2 -WASTE INFORMATION

1. IDENTIFICATION01 STATE 02 SfTE NUMBER

II. WASTE STATES, QUANTITIES. AND CHARACTERISTICS01 PHYSICAL STATES .&»rt*ti*uepi,i 02 WASTE QUANTITY AT SITE

^A SOLID -t SLURRY "" '"« *w*0*7»"':B POWDER FINES Vf LOUIO TONS W lt*J»vJ »^C SLUDGE G GAS t

CUBIC YARDS ....... A ... . ... .,. 0 OTHER ___ ___ . . \t

itoMrfrr NOOFORUMS. . . _ _ ___ . ...

03 WASTE CHARACTERISTICS 'OwOMwwacWri

i/A TOXIC V£ SOLUBLE . 1 MK3MLY VOLATILEB CORROSIVE • : f INFECTIOUS ! J EXPLOSIVEc RADIOACTIVE ; G FLAMMABLE K REACTIVE

«/D PERSISTENT . H CNITABLE L ^COMPATIBLE.J M NOT APPLICABLE

III. WASTE TYPECATEGORY

SLU

OLW

SOL

PSD

occHX

^ ACO

GAS

MES

SUBSTANCE NAME

SLUDGE

OILV WASTE

SOLVENTS

PESTICIDES

OTHER ORGANIC CHEMICALS

INORGANIC CHE MCALS

ACIDS

BASES

HEAVY METALS

01 GROSS AMOUNT

U rO \<*J &u •

*02 UNIT OF MEASURE 03 COMMENTS

Xeor^Ao Co*tk. L^-^fXCcCfiSC.0 i^ I^C^ t)«L^(LjC

i ep ft •',» V«LMC.M* .

»>• ^A\lfrt(jE. RtCA*L.OS «f

OAS~fe.JS ii*T lJt«-t

L*»M»ftU FJS

IV. HAZARDOUS SUBSTANCES .SMAW . to, ,,IhMHM«rCMff CAS MMNNW01 CATEGORY

OLU>

OLv/

02 SUBSTANCE NAME

P.c.fc.

T3 \ tJl te«-o b t*> ttjJt

03 CAS NUMBER

!33£-3t-3

[3«;-«Lf ->aH

O4 STOAAGE'DlSPOSAL METHOD

u*A»f;(Lfc» v

CAMafitleck *

OS CONCENTRATION

750

/¥ 0*0'

O6 MEASURE OFCONCENTRATION

1JO /a,* ^ U

~*/«^^ tf

E7FPfI VL.V-/1

rpg i^PA^

V. FEEDSTOCKS . A**^*, *-*™ wir»it vr

CATEGORY 01 FEEDSTOCKNAMC

FDS \

FDS ^iJ/flFDS / N^

FDS X^

02 CAS NUMBER CATEGORY 01 FEEDSTOCK NAME

FDS

-FDS

FDS

FDS

02 CAS NUMBER

VI. SOURCES OF INFORMATION icmiMcAc^r^ocM.** •««***•*«• •wyM.wMj

* SLp7~-~ ^^^c^^S -l.L7rru*(i«L^k*'*IL

WED.1 V ItfBbr

51^4* I3O**

D.LP-C.ILLINOIS

18 <7-ei)'

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&EPA POTENTIAL HAZARDOUS WASTE SITEPRELIMINARY ASSESSMENT

PART 3 - DESCRIPTION OF HAZARDOUS CONDITIONS AND INCIDENTS

l IOENTIFICAT'°N

01 STATEXL

02 SITE NUMBER

II. HAZARDOUS CONDITIONS AND INCIDENTS01 "/ A GROUNDWATER CONTAMINATION03 POPUUTON POTENTIALLY AFFECTED: __

02 D OBSERVED (DATE04 NARRATIVE DESCRIPTION

C POTENTIAL M ALLEGED

c. It

01 B SURFACE WATER CONTAMINATION03 POPULATION POTENTIALLY AFFECTED:

02 C OBSERVED (DATE: V-.lBrJ?04 NARRATIVE DESCRIPTION

C) POTENTIAL (/ALLEGED

AS

01 D C. CONTAMINATION OF Alfi03 POPULATION POTENTIALLY AFFECTED:

02 D OBSERVED (DATE:04 NARRATIVE DESCPJPDON

; : POTENTIAL C ALLEGED

01 D 0. FIRE/EXPLOSIVE CONDITIONS03 POPULATION POTENTIALLY AFFECTED:

02 D OBSERVED (DATE:O4 NARRATIVE DESCRPTON

U POTENTIAL D ALLEGED

01 9 E DIRECT CONTACT03 POPULATION POTENTIALLY AFFECTED B O

02 O OBSERVED (DATE: -04 NARRATIVE DESCRPDON

POTENTIAL ALLEGED

01 KF. CONTAMINATION OF SOIL03 AREA POTENTIALLY AFFECTED

-/- /u

02O OBSERVED(OATE _iJLlAi_ )04 NARRATIVE DESCRIPTION

LJ POTENTIAL I/ ALLEGED

6.3

0 1 U/G. DRWKING WATER CONTAMINATION03 POPULATION POTENTIALLY AFFECTED:

02 U OBSERVED (DATE04 NARRATIVE DESCRIPTION

K POTENTIAL C ALLEGED

01 rj H. WORKER EXPOSURE/INJURY03 WORKERS POTENTIALLY AFFECTED:

02 f J OBSERVED (DATE04 NARRATIVE DESCRIPTION

> u POTENTIAL n ALLEGED

01 (.POPULATION EXPOSURE/INJURY03 POPULATION POTENTIALLY AFFECTED:

02 CJ QMEBVEPlDATe04 NARRATIVE DESCRIPTION

tf POTENTIAL a AUEGEo

RECEIVEE 516 $84

E.PA - O.LP.&STATE OF ILLINOIS

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.-, - -- A POTENTIAL HAZARDOUS WASTE SITE 1- IDENTIFICATIONApP/X PREUMIW^^^' ** PART 3- DESCRIPTION OF HAZ

«Y ASSESSMENT 01 CTATE wsrre NUMBERARDOUS CONDITIONS AND INCIDENTS - D^®e5*°l°^-

i. HAZARDOUS CONDITIONS AND INCIDENTS .C<™H-«I01 D J DAMAGE TO FLORA04 NARRATIVE DESCRIPTION

01 O K. DAMAGE TO FAUNAO4 NARRATIVE DESCRIPTION tm>**~~<« «*»**•>

01 O L. CONTAMINATION OF FOOD CHAIN04 NARRATIVE DESCRIPTION

01 ^ M UNSTABLE CONTAINMENT OF WASTES

03 POPIH /STION POTEKT"*! I v AFF?pT£0 , .^oo'°

01 tf N DAMAGE TO OFFSTTE PROPERTY04 NARRATIVE DESCRIPTION /

^

Ot C 0. CONTAMINATION OF SEWERS. STORM DRAINS. WWTPt04 NARRATIVE DESCRIPTION

01 U P. ILLEGAL/UNAUTHORIZED DUMPINGO4 NARRATIVE DESCRIPTION

02 n OBSERVED (DATF } ffpOTFNTV-j P *4_LE GF.D

O2 n CMSERVED (DATF ' , . , ., ) ^ POTEMTIAI HAIIEGFD

02 n OKPRVFn (OATF ) H POTFNTIAI H Al 1 FftFn

02 H OBSERVED (OATF M~l~^V | D POTENTIAL J ALlfGFD

O4 NARRATIVE DESCRIPTION

o»r:oBSF«uPn(nATF /^-aV-S/) p POTFNTIAL /AtiFffFO*» * * ^^B 1. *

•*** " r O 9 1 ^L^ i ^ ^^^ t^*wft™ *•* C^

02 O OBSERVED (DATE: 1 D POTENTIAL O ALLEGED

02 U OBSERVED (DATE: ) D POTENTIAL D ALLEGED

05 DESCRIPTION OF ANY OTHER KNOWN. POTENTIAL, OR ALLEGED HAZARDS

ML TOTAL POPULATION POTENTIALLY AFFECTED: ____ iIV. COMMENTS

6,000

. * » ^ * ! • # •

V. SOURCES OF INFORMATION ic* MM* **«« . 0 MMMM .»MptflM rw. fVpfl fILU«« SPA f;tt ^^trJ/1 Cier"'<!.!lll RECEIVE!EPAfORM 2070-12(741) lb 1984

E.PA - D.LP-C.STATE OF ILLINOIS

Page 5: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

REFERENCE .....J!7< -

SITESITE ID

iff*_-

&EPA POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT

PART 1 - SITE LOCATION AND INSPECTION INFORMATION

1. IDENTIFICATION

«. CITE NAME AND LOCATION01 Srtf. NAML ***•', «•"«•« »«>MW«*

\\ fVNeo^mK MTeefc03 CffV I

f • £/.0* SI ATI

;<,OS X*1 COW M COUNTY

COOt DIS1

/oO* COORDINATES

TTTUOElOTYPt OF OWNERSHIP|CMC*ww.

DA PRIVATE OB DC.STATE DO.COUNTvJffE.MUNICIPAL—— O C UNKNOWN

HI. INSPECTION INFORMATION02 SHE STATUS

O ACTIVE03 YEARS OF OPERATION

/9J? t .UNKNOWN•ECHNNWCVEAfl ENDfNGVEAR

O4 AGENCY PERFORMING MSPECTOM «*-*•*•«

DA.EPA Ire EPACONTRACTOR ^OE- STATE OF. STATE CONTRACTOR

.

«ff CgfM^^grfimr D D MUNICIPAL CONTRACTOR,OTHER.

MCHCFMSKCTOR 2.'^

07 ORGANIZATION

£Tn iArV*s*+*1 '

M TELEPHONE NO

M OTHER WSPtCIORS 11 ORGANIZATION 12 TELEPHONE NO.'/

x-o-^l \ (*«- 1

C I

1 >liADORESS

At 1

l^ I*-1* TELEPHONE NO

1 >t )

i >

17 ACCESS GAMED BY i»Twtof WSPECTOW It WEATHER DONOmOHS

IV. INFORMATION AVAILABLE FROM02 OF MMF«P 03 TELEPHONE MO.

f>4 PERSON RESPONSIBLE Fonsm MSPECION FORM 05 AGENCY" TION 07 TELEPHONE NO. OtOATE

MO*"*) DM Yf A*

CPAFORM JDTO u (?^i)

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&EPAPOTENTIAL HAZARDOUS WASTE SITE

SITE INSPECTION REPORTPART 2 - WASTE INFORMATION

{.IDENTIFICATION01S1ATI lOfSTl NUMBER

II. WASTE STATES. QUANTITIES. AND CHARACTERISTICSotPwrtCAic

DB POWDEDC SLUDGE

CD OTHER

lATtfc «:••(.••«*:•*',)

DE BLURRYn.rMCS br LOUD

DC GAS

****"Ml. WASTE TYPECATEGOflv

SLU

OLW

COL

PSD

V J0^toeACO

•AS

MES

0? WASTE OUAHTHV AT BTC

r^r-vftp* ov\krt«^A*

JteTT 1OWC %T SOLUBLE (J 1 MCHLV VOLATvJ,OB CORHOSrvE Of.MfECTOUS D •» CXPLOSlVtDC MAOfOACTIVE D C FLAMMABLE D K ME ACTIVE

J^> KRSISTCK1 D H Own ABLE D L MCOMPATttLED M NO! APFUCABlE

SUBS1ANCC NAME

SLUDGE

OILY WASTE

SOLVENTS

PESTICIDES

OTHER ORGANIC CHEMICALS

MORGANC CHEMICALSACOS

BASES

HE AW METALS

01 OWS5 AMCHM1 BJUNTTOf MEASUR£ 03 COMMENTS

S£/ Attc^j

IV. HAZARDOUS SUBSTANCES rs« *~~«, *. «Mt M^ MOU *•— w01 CATEGORY

x-

0? SUBSTANCE NAME

~rl*,rt_ vi *& c*»of i-oQi iccty^^4-ti«

>t^c^Ji**< -{-J Se^-ffLCft-o ^Mc/c^Cr*

0 , J /C.** << 1C * *••

03 CAS NUMBER | CM STOMAGEJOISPOSAl MTTHOD

^\&\l«. .J-Cer^>^4l^^ Cev%Cer***vle^wve*£/r# i <.•/• 46tS st^* .s*c\J\\ if * P /3 '* ^/e - i

^€£JL f-fc/fb uM/r

05 CONCENTRATION

J

/ /« ^*> ^A

OE MEASURE OFCONCCNTRATlON

V.FECOSTOCKS AMAjM^.k.C4s*MMMjCATEGORY 01 FEEDSTOCK NAME

rosFDS

rosros

OJCAS NUMBER CATEOOMY

FDS

rosrosros

01 FEEDSTOCK NAME O2 CAS NUMBER

VL SOURCES OF INFORMATION KM «*cfc« .™r« .c _ *« »*•»*»»•« WM;

zreflj -£lc.i yA

/

Page 7: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT

PART 9 - DESCRIPTION OF HAZARDOUS CONDITIONS AND INCIDENTS

I. IDENTIFICATION

• HAZARDOUS CONDITIONS AND INCIDENTS ,o/g.o-f,OV$FA GROUNDWA1ER CONTAMINATION . . ..03 POPULATION POUNllALLY AFFECTED \ 1*7^

•4* Z.

.*~*

Oa^baSERVEPfPATE .>/.«-/«f iCM NARRATIVE DESCRIPTION «//z//t

Q POTENTIAL D ALLEGED

a

flWSOBSWVEDIDATE i**/l'-04 NARRATIVE DESCRIPTION

SURF ACE WATER CONT AMfNATON 3 <J JOST'OPULATION POTENTIALLY AFFECTED _£

ef

Q POTENTIAL D ALLEGED

03aC CONTAMIMATON Of AIR (5. *». T. oTOPUUATtONPOTEMTlAUV AFFECTED _ T ?O TO

02 D OBSERVED (DATE04 NAMAATlVE DESCRIPTION

J D POTENTUL

I. H

GED

01,03

4o

5. FAE.'EXPLOSiVE CONDITIONS>ULATION POTENTIALLY AFFECTED

02 O OBSERVED (DATE __04 NAWUTTrt.DESCRlPTON

T*J

_) D POTENTIAL Jfc ALLEGED

Ht Cei.uJ-c

0103

t»R£CT CONTACTLATION POTENTIALLY AFFECTED

O2 D OBSERVED fOATE04 NARRATIVE DESCRIPTION

i .JfPOTENTML D ALLEGED

,w(( Powc.ll

c.

O3. CONTAMINATION OF SOIL ( •*APOTENHAUV AFFECTED ' ^-

fOBSERVEO «>ATf f04 NARRATIVE DESCRIPTION

POTENTIAL D ALLEGED

01 G DRIMWNGWAIERCONTAMINATION03 TOPULATON POTENTIALLY AFFECTED

O? D OBSERVED ftiATE04 NARRATIVE DESCRIPTION

D ALLEGED

Ol KTH WORKER EXPOSUREANJURY03 WORKERS POTENTIALLY AFFECTED. *" ' J-t>

02 D OBSERVED (DATE:O4 NARRATIVE DESCRIPTION

,| >I>OTENnAL D ALLEGED

01<C I POPULATION EXPOSUREWJURY031PDPULATION POTENTIALLY AFFECTED.

02 D OBSERVED (DATE:04 NARRATIVE DESCRIPTION

pOTENTlAL D ALLEGED

Page 8: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

A r-r^M POTENTIAL HAZARDOUS WASTE SITEW tPA SITE INSPECTION REPORT^r *-• J~% rART f DESCRIPTION OF HAZARDOUS CONDITIONS AND INCIDENTS

I. IDE NT IF 1C At ION01 tiAti o? STI

HAZARDOUS CONDITIONS AND INCIDENTS **-**.<E TO FLORA

04 IARRATM DESCRIPTION02 D OBSERVED (DATE » ErPOTENTlAi D ALLEGED

/ //? <i

O1 Apt DAMAGE TO FAUNACM NARRATIVE DESCRIPTION

02 t>BSERVED (DATE ) D POTENTIAL D ALLEGED

c £r

Ol JP-T CONTAMINATION OF FOOD CHAINO4 JIAARATIVE DESCRIPTION

Cg n OfcSrKUfD l&ATf If POTENTIAL'

D ALLEGED

JtfMVJ

01 tfM UNSTABLl CONTAJNMEN1 OF WASTES>Tf fcm*. i v Atccrrpn

O? -OBSERVED fPATCl tTlP j 1

CM NARRATIVE DESCRJPT1ON

D POTENTIAL O ALLEGED

f

OVCl*N DAMAGE TO OFFSITE PROPERTY0**ARRAT1VE DESCWPTlON

O2^ OBSERVED (DATE i O POTENTIAL O ALLEGED

CONTAMINATION OF SEWERS. STORM DRAINS. WWTP» O2^OBSERVED (DATE: Jill!ii£i__ I D POTENTIAL D ALLEGED

i**

LLEGALAINAUTHORIZEDDUMPMGCM NARRATIVE DESCRTTON

02 O OBSERVED (DATE ) D POTENTIAL -CTALLEGED

Oft DESCRIPTION OF A"Y OTHER KNOWN. POTENTIAL. OR ALLEGED HAZARDS

•I. TOTAL POPULATION POTENTIALLY AFFECTED:IV. COMMENTS

V. SOURCES OF INFORMATION**««-*.-.«., . f .«m>Ni

Page 9: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

/EPA POTENTIAL HAZARDOUSSITE INSPECTION

PART 4 - PERMIT AND DESCRIPTIVE INFORMATION

MOtNTlF.CM.ON

/c

U. PERMIT INFORMATION01 Trn CX PIMMH ftSULC

DA NFDESDB INC

DC AWDD RCftADE RCKAMTEKIM STATUS

DF.DG SI ATI o .,,

DH

Dl.

NONEHI. «ITE DESCRIPTIONDlSlOnAGE'D<$»OSALiC*Mt«f««MMrJ

D A SURFACE IMPOUNDMENTOB PILES

'D C. DRUMS. ABOVE GROUNDD D. TANK. ABOVE GROUNDD E. TANK. BELOW GROUNDfc-f-.LANDFU.'C. G LANDFARMD H OPEN DUMP

02AMCXJWT 03 IW1 OF MCASUK CM IWAIMEin K*ttt*iM'«wVJ

D C CHEMICAL/PHYSICALD D. BIOLOGICALD E WASTE OIL PROCESSINGD T. SOLVENT RECOVERY

DM OTHER.

05O1MER

06A*EAOfWT£

0

IV. CONTAINMENT01 COK1AINMEKT OF WASTES IC*M««MJ

D A ADEQUATE. SECURE D 6 MODERATE D C. MADEOUATE. POOR MSECURE. UNSOUND. DANGEROUS

02M£CMnONOFDAUMS.MUNG.UNERS.

V. ACCESSIBILITY01 WASH CASHVACCCSS«l£

Ewre C ^ / / ,

VI. SOURCES OF INFORMATION

Page 10: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT

PART 6 - WATER. DEMOGRAPHIC. AND ENVIRONMENTAL DATA

I. RATIFICATIONDi CTATElO? 8TI NUMBER

/<-ft. DRINKING WATER SUPPLY

01 TYPE OF DUNKING SUPPLY

COMMUNITYNON-COMMUNITY

SURFACE

*C.D

WELL

02 STATUS

ENDANGERED AFFECTEDe GE C

MONTTOREDC Dr.D

03 DISTANCE TO STTE

HI. OROUNDWATER01 OROUNDWATER USE M VONTTV fCMct •«••

C A ONLY SOURCE FOR DRINKMS ^4f* DRINKINGr 1 rOwi*'Mve«M*M.

C C COMMERCIAL. WDUSTHIAL.PIRI&AT1ON D D NOT USED UNUS6ABLE-

COMMERCIAL MWSTWAL. VWQATIONWCMMMM

02 POPULATION SERVED Bv «HOUND WATER. //yoO4 DEPTH TO GROUN3WATE R o& DIRECTION or OROUNDWATEK PLOW

03 DISTANCE TO NEAREST DRINKING WATER WEU. _**. £o °c

O6 DEPTH TO AQUIFEROf CONGERS

07 POTEWTlAi VELDOF AQUIFER

M SOLE SOURCE AOlH ifi

DYES

f**f**ai> /* /,fti*x. Y** Htf^fi,.,^ — x, -*C <*f *£,/••€£**£*? f+>'rf-<-

rj(fH( 4e>4j*^

10 RECHARGE ARE A

DYES I COMMENTS

11 DISCHARGE AREA

C. COMMERCIAL. MDUSTR1AL D D. NOT CURRENTLY USED'A RESERVOm RECREATIONDRINKING WATER SOURCE

D 6 IRRIGATION. ECONOMICAL!VMPORT ANT RESOURCES

02 APFECTED'POTENTIAaV AFFECTED KXXES OF WATER

NAME AFFECTED

•0 P IT£Div\^\A Lf€€ K.

DISTANCE TO SHE

0 (m:i

tm.

V. DEMOGRAPHIC AND PROPERTY INFORMATION01 TOTAL POPJLATO* WTTMK

ONE(1)MIL£pFSITE

*o o*««ios;

TWOlZjMCESOFSTTEe_2Lf^<e_'

•lO IK lt«SOM

THREE (3) MILES OF STC

03 NUMBER OF BUUJMNGS WITHIN TWO (2) MILES OF STTE

02 DISTANCE TO NEAREST POPULATION

O4 OSTANCE TO NEAREST OFT-SHE BUILDING

*»*

OS POPULATION WTTMX VlONrrY QF SITE t**>iat »»twar, *•**•*•**»+*** ***•

EPAFORM 2070 13 (7-61)

Page 11: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT

PART S * WATER. DEMOGRAPHIC. AND ENVIRONMENTAL DATA

I. IDENTIFICATION01 CTATt

VI. ENVIRONMENTAL INFORMATION

DA 10-*- 10-»cm/*»L tXTB 10-'- 10-*cm'MC DC 10-'- 10-»em/»c DO GREATER THAN 10-»cm'§«c

02 PEAMLASi^nv (X BEOROC*.

C AtO"*e«»»:. J f fC~ 4 • IC7*•«••

D C -RELATIVELY PERMEABLE G D VERY PERME ABLE

03DEPTHTOBEDROC*

rm

(MDEPTHOf CONTAMINATEOSOtLZOW 05 SOIL PH

M NET PREOPflATlON 07 ONt YEAR 24 HOUR RAINFALL

-fln)

oe SLOPESITE SLOPEOH v

DIRECTION OF SITE SLOPE, TERRAIN AVERAGE SLOPE

OS FtOOD POTEKTHL.

Ot\k«kAujrJSITE B IN w^**w*' YEAR FLOODPiAfN

10

SITE SON »ARRJER ISLAND. COASTAL HIGH HAZARD AREA. IWVERJNE FLOOOWAY

11 DISTANCE TO WrrLANO&iS*

ESTUARINE OTHER

-|mi) .(mi)

120CSTANCE TOCftrTCAL HABITAT M.',

ENDANGERED SPECIES13 LAND USE K VIOTTt

DISTANCE TO

COMMERCIAL4NDUSTRIA1

.(mi)

RESIDENTIAL AREAS: NATlONAUSTATE PARKS.FORESTS. OR WILDLFE RESERVES

AGRCULTURAL LANDSPRIME AG LAND AG LAND

.(mi] D .(mi)

vn. SOURCES OF ^FORMATION ic«

toe //;/ ?/o/»/ t*J*chwef?C

CPA FOAM 2070 13|T-«1)

Page 12: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

&EPA POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT

PART e - SAMPLE AND FIELD INFORMATION

L DENttFtCATlOND' *ATi OJSnt NUMBER

H. CAMPLES TAKEN

Ml. FIELD MEASUREMENTS TAKEN01 TYPE

KJ

02COMMEKTS

IV. PHOTOGRAPHS AND MAPS

Ot TYPE -GROUND D AERIAL

03 MAPS-?

DNO

04 LOCATION OF MAPS

V. OTHER FIELD DATA COLLECTED "*»*• *•»*"» *****»>

VI. SOURCES OF INFORMATION^, ««.< .,.*»»•.. M«MM^M.IWM*I

EPAFOHM 207O-13 (7-61|

Page 13: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

A ._ _ _ POTENTIAL HAZAftfvFPA SITE INSPEC^^L.1 *-% PART7-OWNE

It. CURRENT OWNERfS)

"CSLlc^Sli.ol'iXfcc,^ 02 D+B NUMBER

03 STREET ADDRESS r*0 to> *fD».*«>

06 COY » STATE

01 NAME

04 SIC CODE

OT ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS f* O «u. Wo*. «c j

OS CTTY 06 STATE

OtNAME

04 SIC CODE

OT ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS /*0 to. WO.wtt

OS CITY 06 STATE

01 NAME

04 SIC CODE

07 ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS I'.Q to. W.wcf

OS CITY 06 STATE

04 SC CODE

07 ZIP CODE

Nl. PREVIOUS OWNEFKS) ™-- *.,01 NAME 02 D+B NUMBER

03 STREET ADDRESS tf.Q *ai.HfD*.Mt }

OS CITY 06 STATE

01 NAME

O4 SIC CODE

07 ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS f*.O to*. HfDf. me 1

OS Cm- 06 STATE

01 NAME

04 SC CODE

07 Zr CODE

02 D+B NUMBER

03 STREET ADDRESS If.Q to. HfDt.mci

OiOTY 06 STATE

V. SOURCES OF INFORMATION (CM.~*C ~*~™.

O4 SIC CODE

07 ZIP CODE

IDOUS WASTE SITE UDENT

TION REPORT 01*TAU

D lurnou ATimj _— jf^r

PARENT COMPANY „»«*-06 NAME

10STREET ADDRESS iro to. *rDt.«c ,

12 CITY 13STAT

*

06 NAME

10 STREET ADDRESS if o. to. <Wf>*. «tc j

12CTTY 13STA1

O6NAME

IOSTREETADDRESSfP.0 to. MFO.MCJ

12 CITY 13STAT

OB NAME

10STREET ADDRESSED to. MFC'.Mc;

12CTTY 13STAT

IV. REALTY OWNER(S) WWPK** «o4,*c** .01 NAME

03 STREET ADDRESS fro toi. *TD*.MC I

OSCfTY O6STAT

01 NAME

03 STREET ADDRESS fro to..WO*.«fc j

OSCTTY 06STAT

01 NAME

03 STREET ADDRESS IP.Q to.. RW». •« ^

oscrrv OCSTATI

.,.__*.. ~M~»..~m

FICATIONo; snt NUMBER

09 D+B NUMBER

IIStCCODE

£ 14 ZIP CODE

09 D+B NUMBER

11 SIC CODE

E 14ZPCODE

09 D+B NUMBER

11 SIC CODE

£ 14ZPCODE

09 D+B NUMBER

11SKCODE

E 14 ZIP CODE

02 0+6 NUMBER

04 SC CODE

E 07 ZIP CODE

02 D+B NUMBER

04 SIC CODE

E 07 ZIP CODE

02 D+B NUMBER

04 SIC CODE

E 07 ZIP CODE

£,•*•£. *,!<- % s /»* 4> j^. tyltbff*//

EPA FORM 2070-13 (T-61)

Page 14: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

- ___ POTENTIAL HAZAR^FPA SITE INSPECl^^ I—I /-% pART e . OPERAT

M. CURRENT OPERATOR i*~«.*«i*<MfcM.MW,Ot NAME . £1 fc. *^. S?lA t*lj& jttf &

6)^ S<J4soi r\t"TVi<-T

02

03 STREET ADDRESS 1*0. M*. ««*. mj

05 cmr OB STATE

D-*B NUMBER

04 H; CODE

orZJPCOOE

OB YEARS OF OPERATON O0 NAME OF OWNER

IIL PREVIOUS OPERATOR(S) *«««•••••«•*»«.-»•••*•«*» MfetMt *M»MM«O1 NAME 02D4BNUMBJER

03 STREET ADDRESS f.O. -. IW>*. «£f

os cmr • oe STATE

04 «C CODE

07ZJPCOOE

OBVEARSOFOPERATKM OS NAME Of OWNER DURING THtSPEROO

i\J^,i?ir*iG' ^fi^-f^/^ebff/ttt&i02 D+B NUMBER

03 STREET ADDRESSED •» «/«, MEJ

CM cmr oe STATE

04 SIC CODE

07ZJPCOOE

OB YEARS Of OPERATION OS NAME OF OWNER DURING THIS PERCO

O1 NAME 02 P-fB NUMBER

O3 STREET ADDRESSED •«. Are*. McJ

O6 cmr . oe STATE

04 EC CODE

07 ZIP CODE

OeVEARS OF OPERATION OB NAME OF OWNER DURING THIS PEWOD

DOUS WASTF SITF «• »OENT.FlCAT,ONrintJOPDftoT * 01 STATE orsnt NUMBERIUN HtrUH 1 . - - rt-j^, jp

•to ikfCr\r>ti A virNbi ' V 7 £l~t 3'^<-S' ** ^~

OPERATOR'S PARENT COMPANY p ,,.iriii;10NAML 1 1 O-* B NUMBER

12 STREET ADDRESS I*.O •M.JVO«.««J 13SCCODE

14 cmr . is STATE 162JFCODE

PREVIOUS OPERATORS' PARENT COMPANIES *•»**«10 NAME IID+BNUMBER

l2STREETADDHESSjP.O.BM.«re».«U 13SICCODE

14 CITY 15 SI AT£ 162JPCODE

10 NAME 1 1 D+ B NUMBER

IZSTREETADDRESSC.O.tM.'W.Mj 13 SC CODE

14 cmr is STATE 16 ZIP CODE

1O NAME 11 D-*B NUMBER

12 STREET ADDRESS f.O *M. Af0*.«cJ 13&CCOOE

14OTY 15 STATE 162JPCODE

IV. SOURCES OF INFORMATION /t>. ««^ -.'.'«.... B iMf* *.. •M^M^U.WMU

EPARWM 2070-13(7*1)

Page 15: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

-. — - . POTENTIAL HAZARDOUS WASTE SITESEFV\ SITE INSPECTION REPORT^^ B—l *-% pART g _ GENERATOOTIUNSPORTER INFORMATION -

1. IDENTIFICATION01 STATE 02 SITE NUMBER

£9i*0 yoo / o 2,

II. ON-SITE GENERATOR01 NAME 02 D+B NUMBER

03 STREET ADDRESS (*O fc» MFC'.MO

05 CITY 06 STATE

04 SIC CODE

07 ZIP CODE

III. OFF-SITE GENERATORS)OlKAME

- *n£i w *Ofe.Oc£C|a*\ V A/B«tv^>*f»»*t

02 D+B NUMBER

03 STREET ADDRESS CO «J JIFO*. MC.| ^ J

LA*v\.K*.,j,%.*»^ j05 CITY 06 STATE

01 NAME

04 SC CODE

07 ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS If.O *» ffrt>«. Me j

05CTTY 06 STATE

04 SIC CODE

07 ZIP CODE

01 NAME

03 STREET ADDRESS f*O •M.JW.MC)

05 CITY

01 NAME

03 STREET ADDRESS (f.O *». HfD*. we j

05CTTY

IV. TRANSPORTERS)01 NAME 02 D+B NUMBER

03 STREET ADDRESS (f.O *» HfD t. MC ;

05 C(TY 06 STATE

01 NAME

04 SC CODE

07 ZIP CODE

02 D+B NUMBER

03 STREET ADDRESS t?.O •u, HfD». «c .1

05 CITY 06 STATE

04 SIC CODE

07 ZIP CODE

02 D+B NUMBER

04 SIC CODE

O6 STATE 07 ZIP COPE

02 D+B NUMBER

04 SIC CODE

06 STATE 07 ZIP CODE

01 NAME

03 STREET ADDRESS (P.O •" *fDt. wc.J

oscmr

01 NAME

03 STREET ADDRESS ff.O ftu. *fD». Me I

05OTY

V. SOURCES OF INFORMATION (c..««c.c --««« .«.•»>•••» «> . *>,« w»j

02 D+ 6 NUMBER

04 SIC COO£

06 STATE 07 ZIP CODE

02 D+B NUMBER

04 SIC CODE

O6 STATE 07 ZIP CODE

EPA FORM 2070-13 (7-C1t

Page 16: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

^ POTENTIAL HAZARDOUS WASTE SITE ' »ENTIf tCATION

^^' ••»• V V MAf ASITE INSPECTION REPORT 01 *T*1E "v^J** ,/. ,

BT m. P*<:T DFfiPAM^r Af*TivmF«r .._/, f-__ o^mOJ0^'® C

ft. PAST RESPONSE ACTIVITIES01 D A WATER SUPPLY CLOSED

01 D B TEMPORARY WATER SUPPLY PROVIDEDO4 DESCRIPTION .

01 D C. PERMANENT WATER SUPPLY PROVIDED04 DESCRIPTION I

Nl/VO1 O D. SPILLED MATERIAL REMOVED04 DESCRIPTION (SJIA-

01 D E. CONTAMINATED SOIL REMOVED

01 D F. WASTE REPACKAGEDO4 DESCRIPTION Nl \ IW

01 D 0 WASTE DISPOSED ELSEWHERE04 DESCRIPTION i

N\/V01 D H ON SITE BURIAL04 DESCRIPTION i ^^

01 D I. M STTU CHEMICAL TREATMENTO4 DESCRIPTION t

01 D J. M STTU BIOLOGICAL TREATMENT

01 D K N SITU PHYSICAL TREATMENTO4 DESCRIPTION

IN \^VN01 O L ENCAPSULATIONO4DESCWPTX)N I .

O1 C M EMERGENCY WAbTE TREATMENTO4 DESCRIPTION .

01 O N CUTOFF WALLS

01 D O. EMERGENCY WKING'SURFACE WATER WViO4 DESCRIPTION ,

01 D P. CUTOFF TRENCHES/SUMPO4 DESCRIPTION

01 D O SUBSURFACE CUTOFF WALL04 DESCRIPTION . ~

0? DATE . . n* AGENCY

09 DATE. MABFNTY

09 DATE m AGENCY

0? P*Tf .,.. OS AGENCY

09 DATF (M AfiFNTV

n? DATE . A3 AGENCY

09 DATE , 03 AGENCY

0? PATF oa AGENCY

OJ DATf . , M AGENCY

02 D*TF . , f" AGENCY

O? DATE na AGFNCV

0? DATE Oa AGENCY

07 O*TP na AGFNCV

02 D*TE. m AGENCY

cBsunw 09 DATE , naAGFurv

09 DATE 0!» AfSFMTV

O? DfTf 01 AflFMTV

CPAFOHM20TO-1»(T-B1)

Page 17: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

&EPA POTENTIAL HAZARDOUS WASTE SITESITE INSPECTION REPORT10 - PAST RESPONSE ACTIVITIES

»• »ENTFICATION.'

ft 70 1-

N PAST RESPONSE ACTIVITIES (c=™^01 O R BARRIER WALLS CONSTRUCTED04 DESCRIPTION

02 DATE. CL1 AOFMT V

01 D S. CAPPINO'COVERING04 DESCRIPTION

02 DATE (M ASEWCV

01 D T. BULK TANKAGE REPAIRED04 DESCRIPTION

09 BATF 0.1 AQENCV

01 D U. GROUT CURTAIN CONSTRUCTEDO4 DESCRIPTION

O2DATF 03 AGENCY.

01 D V. BOTTOMO4 DESCRIPTION

01 O W. GAS CONTROL04 DESCRIPTION

02 DATE. 03 AGENCY.

01 D X. FIRE CONTROL04 DESCRIPTION

01 O Y. LEACHATE TREATMENT04 DESCRIPTION

O3 AGENCY.

01 O 2 AREA EVACUATED04 DESCRIPTION

02 DATE O3 AGENCY.

01 D 1. ACCESS TO SITE RESTRICTED04 DESCRIPTION

02 DATE. O3 AGENCY

01 D 2O4 DESCRIPTION

03 AGENCY.

01 D 304 DESCRIPTION

ML SOURCES OF INFORMATION «*• «»c*c »<»»>c«i •,., mm mu. **** »»«»•». mum-

EPAFORM2070-13(7-«1t

Page 18: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

&EPAPOTENTIAL HAZARDOUS WASTE SITE

SITE INSPECTION REPORTPART 11 - ENFORCEMENT INFORMATION

L IDENTIFICATION01 STATE

/L02 STE NUMBER

H. ENFORCEMENT INFORMATION

01 PAST HEGULATOflY/ENFORCEMEWT ACTON C YES

02 DESCRIPTION OF FEDERAL STATE. LOCAL WOULATOftY/ENFORCEMEWT ACTION

•1. SOURCES OF INFORMATION

Page 19: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

i ate Removal Action Chock Sheet

Tire and Explosion Hazard

Flammable Materials filltxlffk&utto?/

Explosives _______

Incompatable Chemicals

Direct Contact with Acutely Toxic Chemicals

Site Security sy u o-He . c«.

Leaking Drums or Tanks wl

Open Lagoons or pits

Materials on Surface s^. orcc

j jv

Proximity of Population M

Evidence of Casual Site Use

Contaminated Hater Supply

Exceeds 10 Day Snarl

Gross Taste or Odors

Alternate Water Available

Potential Contamination

High

Vs-

Is the site abandoned or active? c.^e- «

Moderate Low

-*.

Page 20: IL EPA PRELIMINARY ASSESSMENT FORM · preliminary assessment ... iv. hazardous substances .smaw^. to, ^,,ihmhm ... cg n ofcsrkufd l&atf if potential ' d alleged jtfm vj

vvauKeganand

N

Yeoman CreekArea

Jvck Bvnny

Junior High School

j[tfXf**ii B-ZW& \ %-.103 x>w?:. L-

Commonwealth Edison Co.

Landfill (refuse boundry)

Boring Locations

$-000 Monitor Wells (14)L-000 . Leachate Wells (5)0 -0 Boring, Backfilled (3)