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SU0011665 SSNL
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SU0011665 SSNL
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Last modified
5/7/2020 11:35:19 AM
Creation date
9/4/2019 6:04:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011665
PE
2626
FACILITY_NAME
PA-1700268
STREET_NUMBER
20703
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
05121071, 72
ENTERED_DATE
2/12/2018 12:00:00 AM
SITE_LOCATION
20703 N ELLIOTT RD
RECEIVED_DATE
2/9/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ELLIOTT\20703\PA-1700268\SU0011665\SS_NL STUDY.PDF
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EHD - Public
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SAN JOAQUIN COUNTY <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q: <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> CqG!F O P��P <br /> SOIL SUITABILITTY//IISTUDY REQUIREMENTS CHECKLIST <br /> 7�l( OffREPO <br /> SITE LOCATION: <br /> REPORT DATE: <br /> S = Sufficient <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ja ❑ 1.1 Description of site, including zoning information. <br /> ❑ 1.2 Description of proposed development. <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 <br /> py ❑ 3.1 Description of exiting on-site septic tank usage(system types, age, functioning/repair rates). <br /> lf� ❑ 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 /> ❑ 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 10 y 1 <br /> ❑ 4.1 Description of the depth and gradient of groundwater in the general area. N <br /> ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> ❑ 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 /> © ❑ 6.4 Discussion of soil lithology as related to future onsite septic uses. <br /> atm 26-02-003 Page I of 3 Soil Suitability Checklist <br />
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