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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT .k 304 E Weber Avenue 3'd Floor Stockton•CA 95202-2708 • - ¢ • (209)468-3420-Fax:(209)464-0138 - Web:www.co.san-joaquin.ca.us/ehd SURFACE AND SUBSURFACE CONTAMINATION REPORT REQUIREMENT CHECKLIST SITE LOCATION: 27 S. DEL MAR AVENUE, STOCKTON PA#: 07-410(MS) REPORT DATE: 8/1/2007 S = sufficient San Joaquin County Development Title Chapter 9-905,Section 9-905.12 I = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ®✓ 1.1 Description of site(report must address all parcels), including current and/or proposed zoning information. ® ❑ 1.2 Description.of proposed development. 1.3 Parcel location map. ®� {� 1.4 Site map showing location of all items on parcel. (Examples:structures,drives,wells,septic systems,large trees, pastures, pools, natural drainage courses, ponds, waterways, etc.) 2.0 PAST, PRESENT AND PROPOSED FUTURE USES OF THE SITE SECTION ® V1 2.1 Discussion of past, present and proposed future uses at the site to assess potential problems. (Example sources of information: current and/or previous property owners, historical maps, insurance maps, previous land use applications,etc.) 3.0 IDENTIFICATION OF ALL PAST AND CURRENT SOURCES OF CONTAMINATION ®✓ 8 3.1 Discussions of the methods used to research and investigate the potential or known above and belowground sources of contamination at the project site. (Examples: Database search, EHD records search, agricultural chemical application search, site reconnaissance and survey, etc.) ® -❑- 3.2 Description of all past on-site potential and/or known above and below ground sources of contamination identified at the project site. (Examples: Agricultural chemical handling/storage/use,aboveground/underground tanks, septic systems, injection wells, unsealed wells, ponds/lagoons, vehicletmachine repair/painting, buried or stockpiled solid waste, etc.) ®/ -El3.3 Description of all current on-site potential and/or known above and below ground sources of contamination identified at the project site(see examples above). ®✓ Q 3.4 Description of all past off-site potential and/or known above and below ground sources of contamination identified in the area of the project site that has or may impact the project site. (Examples: Close proximity to a former landfill/former gasoline station, in area of known DBCPINitrate groundwater impact, etc.) 3.5 Description of all current off-site potential and/or known above and below ground sources of contamination ' identified in the area of the project site. 4.0 EVALUATION OF PAST AND CURRENT SOURCES OF CONTAMINATIO IDENTIFIED AT OR NEAR THE SITE AND RECOMMENDATIONS FOR FURTHER ACTION ® V ®- 4.1 Evaluation of each potential and/or known source of contamination identified (in the above section)for any real andlor potential threat to human health and the environment. This evaluation should take into consideration the ' proposed future uses of the project parcel. 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION ® � �] 5.1 Discussion of the above evaluation to either rule out each source as a real or potential threat or to recommend further action to mitigate or abate any real or potential threats identified. Recommendations may include additional site assessment(i.e. collection of soil/water samples)and/or mitigative measures(i.e., clean up of surface wastes). All recommendations for future work must include a time frame for implementation. ® -0- 5.2 The report was inclusive(i.e. all information referenced was included in this report-report should not reference other reports). ®V1 4Q- 5.3 The report was signed, dated and stamped by a qualified environmental professional. ® J EJ- 5.4 The report was prepared within six months of the date of the submittal of the land use application. ®� 0 5.5 The attachmentstappendices contain sufficient documentation to support claims made in report. Reviewed By: Michael F. Escotto Reviewed Date: 11/1/2007 EHD 26-02-061 Pagel of 2 surface&sub Checklist