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SAN JOA <br /> �4 •�`a, QUIN COUNTY <br /> Ei, JIRONMENTAL HEALTH DEPART iviENT <br /> 600 East Main Street Stockton - CA 95202-3029 <br /> 209 468-3420-Fax: 209 464-0138 - Web:www.co.san-joayuin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITELOCATION: -7 � �j�, �� , "1 PA#: .0-7--0c> ti33 <br /> REPORT DATE: AV 30JA <br /> S = sufficient San Y p p Joaquin Count Development Title Chapter 9-1105, Section 9-1105.2 <br /> I = Insufficient <br /> S1 1.0 INTRODUCTION A PROPOSED DEVELOPMENT SECTION <br /> 1 <br /> �. El 1.1 Descnp n of git, including zoning information. <br /> ❑ 1.2 Descrip n of prop�so Bevelent. <br /> ❑ 1.3 Parcel vi P ty loci y map. <br /> ❑ 7 ❑ 1.4 ' ite ma showing:location of all items on parcels(i.e., structures, drives, wells,septic systems, large trees, <br /> tures`pool natural drainage courses,ponds,waterways,etc.) <br /> 2.0 P ESENT AND PAST USES OF THE SITE SECTION <br /> ❑ 2.1 Discu ion o past and present uses at the site to assess potential problems. <br /> 3.0 EXIjNG AND PROPOSED SEPTIC TANK USAGE SECTION <br /> 9L ❑ 3.1 Desc ' ion of it' on-site septic tank usage(system types, age,functioning/repair rates). <br /> ® ❑ 3.2 Site�lp rZt history(number/types/dates of permits,age of system,permit numbers,copies in report). <br /> tea 2-' ) <br /> ❑ 3.3 Discu i of n�s septic tank repair history. <br /> ❑ 3.4 Descriptiocisti septic tank usage in the general area(system types,ages,functioning/repair rates, <br /> proximity to parcel). 1 <br /> ®' ❑ 3.5 General area.septic ai"it(s)history(number/types/dates of permits, age of system, permit numbers,copies in <br /> report). <br /> 'A ❑ 3.6 Discussion of generraai.area septic tank repair history. <br /> � JJ <br /> 91 ❑ 3.7 Description Kbpnsad or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 4.o GROUNDWATER INFORMATION SECTION <br /> ❑ 4.1 Description f t' <br /> a depth and gradient of groundwater in the general area. ' <br /> ® [❑ 4.2 Descriptio st� on of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. W i <br /> ❑ 4.3 Description ovation(address/APN),type and construction of well and location(well head/kitchen tap)where <br /> water samples)were obt�ineo❑ 7 ❑ 4.4 Description of constituenteing tested for in the water sample. <br /> ❑ 4.5 Description of`�how�agiple was obtained, handled,stored,and transported to the lab. <br /> 0- ❑ 4.6 Complete Ch f��Il��stody document, including printed and signed name of third party sampler,condition of <br /> sample and date and time the sample was submitted to the lab. For Laboratory samplers,complete laboratory <br /> report to}n�¢pth�abov� engted�ormation. i <br /> 5.0 SOIL P LE 1 ORIYIA ION SECTION <br /> ❑ 5.1 Site gjap showing the location,with dimensions,of the soil profile pit on the parcel. <br /> ❑ 5.2 Desc- n of soj'l profile pit including depth and dimensions. <br /> ® ❑ 5.3 Descripti of s5il,lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> ❑ 5.4 Discussio soilfit4ology as related to future onsite septic uses. <br /> Ery 26-02-003 Pagel of 3 Soil Suitability Checklist <br /> 1Annne i <br />