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SU0011787 SSNL
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SU0011787 SSNL
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Last modified
5/7/2020 11:35:26 AM
Creation date
9/4/2019 5:20:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011787
PE
2631
FACILITY_NAME
PA-1800093
STREET_NUMBER
21600
Direction
N
STREET_NAME
DAVIS
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
01308043
ENTERED_DATE
5/2/2018 12:00:00 AM
SITE_LOCATION
21600 N DAVIS RD
RECEIVED_DATE
5/1/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\D\DAVIS\21600\PA-1800093\SU0011787\SS_NL STUDY .PDF
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EHD - Public
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SAN JOAQUIN COUNTY <br /> / '1I ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST Q <br /> SITE LOCATION: p© 1� I _ , / y S PA#: I S <br /> V �N REPORT DATE: t l <br /> S - Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> 1 = Insufficient <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ❑ 1.1 Description of site, including zoning information. <br /> ❑ 1.2 Description of proposed development. �.� W <br /> [� ❑ 1.3 Parcel vicinity location map. <br /> ❑ 1.4 Site map showing location of all items on parcels (i.e., structures, drives,wells, septic systems, large trees, <br /> pastures, pools, natural drainage courses, ponds, waterways, etc.) <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> ❑✓ ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ( C� <br /> 3.1 Description of exiting on-site septic tank usage(system types, age, functioning/repair rates <br /> ❑ 3.2 Site septic permit historY(number/tYpes/dates of permits, age of system, permit numbers, copies in report). <br /> [✓ ❑ 3.3 Discussion of on-site septic tank repair history. <br /> d� ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, <br /> proximity to parcel). <br /> [ ❑ 3.5 General area septic permit history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). <br /> ❑ 3.6 Discussion of general area septic tank repair history. <br /> [� ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> Q ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> LK ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> 0 ❑ 4.3 Description of location (address/APN), type and construction of well and location (well head/kitchen tap)where <br /> water sample(s)were obtained. <br /> ❑ 4.4 Description of constituents being tested for in the water sample. <br /> [ ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab. <br /> [� ❑ 4.6 Complete Chain of Custody 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 include the above noted information. <br /> 5.0 SOIL PROFILE INFORMATION SECTION <br /> �] ❑ 5.1 Site map showing the location,with dimensions, of the soil profile pit on the parcel. <br /> ❑ 5.2 Description of soil profile pit including depth and dimensions. <br /> ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> [� ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> EHD 26-02-003 Page I of 3 Soil Suitability Checklist <br />
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