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SAN JOAQUIN COUNTY <br /> al ENVIRONMENTAL HEALTH DEPARTMENT <br /> y � Y; 304 E Weber Avenue 3`d Floor Stockton -CA 95202-2708 <br /> (209)468-3420 -Fax.(209)464-0138• Web.www.co.san joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION:375 N.ESCALON-BELLOTA,LINDEN PA#: 07-358(MS) <br /> 1 REPORT DATE: 11/12/2008 <br /> 1 = fi <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 /> N ✓ ❑ 1.1 Description of site,including zoning information. <br /> ® ✓ ❑ 1.2 Description of proposed development. <br /> N ?/ ❑ 1.3 Parcel vicinity location map. <br /> N j✓ ❑ 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 /> N{/ ❑ 3.1 Description of exiting on-site septic tank usage(system types, age,function!nglrepair rates). <br /> N(✓ ❑ 3.2 Site septic permit history(number/types/dates of permits,age of system, permit numbers,copies in report). <br /> N // ❑ 3.3 Discussion of on-site septic tank repair history. <br /> ® V1 ❑ 3.4 Description of existing septic tank usage in the general area(system types,ages,functioning/repair rates, <br /> proximity to parcel). <br /> 4N-_ ❑✓3.5 General area septic permit history(numberltypes/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 /> I <br /> i <br /> N ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> ®I/ ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> i <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 /> nJ�pti- 0 v ❑ 4.4 Description of constituents being tested for in the water sample. <br /> �j jr, N I✓ ❑ 4.5 Description of how sample was obtained, handled, stored,and transported to the lab. ! <br /> i <br /> to 1p� ® ✓ ❑ 4.6 Complete Chain of Custody document, including printed and signed name of third party sampler,condition of j <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 /> N✓ ❑ 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. <br /> N✓ ❑ 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 /> N ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> EHO 26-02-003 Pagel of 3 Sail Suitability Checklist <br />