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I �� oPa"I N•co n SAN JOAQUIN COUNTY ('N Q za ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3`d Floor Stockton• CA 45202-2708 (209)46`8-3420 • Fax:(209)464-0138 ■ Web:www.co.san-joaquin.ca.us/ehd �1F0 { SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST PA#: 05-188 (MS) SITE LOCATION: 3222 E. COLLIER RD., ACAMPO, CA 11 REPORT DATE: 11/10105 S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 I = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ® of site, including zoning information. ❑ 1.1 Description oI ® ❑ 1.2 Description J 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, 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. , I` 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ® ❑ 3.1 Description o`f exiting on-site septic tank usage(system types, age,functioning/repair rates). ® ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers,copies in report). 3.3 Discussion of on-site septic tank repair history. ® ❑ IM ® ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, proximity to parcel). ® ❑ �l 3.5 General area septic permit history(number/types/dates 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 E ® ❑ 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 contamination issues in the general location of the site. I� I ® ❑ 4.3 Description of location (address/APN),type and construction of well and location(well head/kitchen tap)where water sample(s)were obtained. ® ❑ 4.4 Description b f constituents being tested for in the water sample. ® ❑ 4.5 Description 1of how sample was obtained, handled,stored,and transported to the lab. ® ❑ 4.6 Complete Chhain of Custody document,including printed and signed name of third party sampler,condition of sample and!date and time the sample was submitted to the iab. For Laboratory samplers,complete laboratory report to include the above noted information. I 5.0 SOIL PROFILE INFORMATION SECTION ® ❑ 5.1 Site maps owing 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 Descriptionl�of soil lithology as noted from test pit by appropriate professional using industry standard protocol. ® ❑ 5,4 Discussiontf soil lithology as related to future onsite septic uses. tun 14_nn nnl 11 Paee 1 of 3 Soil Suitability Checklist