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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3`a Floor Stockton • CA 95202-2708 l (209)468-3420 • Fax:(209)464-0138 - Web:www.co.san-joaquin.ca.us/ehd SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST PA#: 04-454 (SU) SITE LOCATION: 9209 S. BIEDERMAN WAY, ESCALON REPORT DATE: 4115/2005 S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 I = Insufficient k S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ! ® ❑ 1.1 Description of site, including zoning information. ® ❑ 1.2 Description of proposed development. ® ❑ 1.3 Parcel vicinity location map. ® ❑ 1.4 Site map showing location of all items on parcels(i.e., structures, drives, wells, septic systems, large trees, III pastures, pools, natural drainage courses, ponds,waterways, etc.) a 2.0 PRESENT AND PAST USES OF THE SITE SECTION ® ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION l ® ❑ 3.1 Description of exiting on-site septic tank usage (system types, age,functioning/repair rates). l ® ❑ 3.2 Site septic permit history(numberltypesldates of permits, age of system, permit numbers, copies in report). r r ® ❑ 3.3 Discussion of on-site septic tank repair history. ® ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, r proximity to parcel). ® ❑ 3.5 General area septic permit history(numberltypesldates of permits, age of system, permit numbers, copies in report). ® ❑ 3.6 Discussion of general area septic tank repair history. ® ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site. 4.0 GROUNDWATER INFORMATION SECTION ® ❑ 4.1 Description of the depth and gradient of groundwater in the general area. ® ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location of the site. ® ❑ 4.3 Description of location (addresslAPN),type and construction of well and location (well head/kitchen tap)where water sample(s)were obtained. ® ❑ 4.4 Description of constituents being tested for in the water sample. ® ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab. N ® ❑ 4.6 Complete Chain of Custody document, including printed and signed name of third party sampler, condition of i sample and date and time the sample was submitted to the lab. For Laboratory samplers, complete laboratory report to include the above noted information. f 5.0 SOIL PROFILE INFORMATION SECTION ® ❑ 5.1 Site map showing the location, with dimensions, of the soil profile pit on the parcel. ® ❑ 5.2 Description of soil profile pit including depth and dimensions. ® ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. ® ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. r F11D 26-02-003 Pagel of 3 Soil Suitability Checklist