Get Case Management Case Closure Form

Completing the Case Management Case Closure Form online is an essential step in managing and documenting case closures effectively. This guide provides clear and detailed instructions for each section, ensuring a smooth process for all users.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in your online editor.
2. In the Agency Information section, accurately fill in the agency name, address, and responsible staff person’s title. Ensure for clarity that all details are correct.
3. Move to the Case Information section. Enter the site facility name, RWQCB case number, site facility address, and information regarding responsible parties. Include addresses and phone numbers where applicable.
4. In the Tank Information section, detail the tank number, size in gallons, contents, and indicate whether the tank was closed in place or removed.
5. Next, in the Release and Site Characterization Information section, provide details about the cause and type of release. Indicate if site characterization is complete and the date approved by the oversight agency.
6. List installed monitoring wells, including the number and proper screened interval. Document the highest and lowest groundwater depth below the ground surface and the flow direction.
7. Identify the most sensitive current groundwater use and whether drinking water wells or surface water are affected. Provide the name of the aquifer and the nearest affected surface water, if applicable.
8. Fill in the Treatment/Disposal Methods section by detailing the materials, amounts, and actions taken for treatment or disposal, including corresponding dates.
9. Document the maximum concentrations of contaminants before and after cleanup in the respective sections for both soil and water.
10. In the Closure section, answer yes or no to questions regarding the effectiveness of corrective actions and site management requirements. Also, note whether monitoring wells were destroyed or retained.
11. Complete the Local Agency Representative Data section with relevant agency information, including the address and responsible staff person’s title.
12. Add any additional comments in the provided section and ensure to include all necessary supporting documents as attachments.
13. Finally, ensure to fill in the Regional Board Certification by providing the executive officer's signature and date.
14. After completing all sections, save your changes, download the document, print it, or share it as needed.

Complete your Case Management Case Closure Form online today to ensure proper documentation and case management.