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Jul-21 -03 10 :06A It P-02 SAN JOAQUIN COUNTY iILX)i z. ENVIRON .,.;• MEN'TAt. X31=.4!_TH DEPARTMENT 304 F Webcsr Avenue 3.1 Floor Stockton •CA 95202-2708 ` (209)469-3424•EKY:(209)464-()138Web.'138 Web.'www.co.san jvacluin.cz.us/chd SURFACE AND SUBSURFACE CONTAMINATION REPORT REQUIREMENT CHECXL1ST SrM LOCATION; PA#; REPORT DATE: S - Sulriac!t Saoa Joaquin County p I _ t„sul�icicnt n Jq my Oevela men!ids Chapter 9,905,Section 9.9x5.1 z 5 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION lb ❑ 1.1 Description of site(report Must address ail parcels), including current and/or proposed zoning information. V❑ ❑ 1.2 Description of proposed development. 6_010�OF ASE—VEI ❑ 1.3 Parcel location map. 1.4 Site map showing location of ail items on parcQi. (Examples:slnscturos,drives,wolfs,septic systems,large trees. AV L�PY�F paswres,pools,natural drainage courses, ponds,waterways,etc.) 2.0 PAST, PRESENT AND PROPOSED FUTURE USES OF THE SITE SECTION ❑ 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 1 �❑ ❑ 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, EHO records search,agricultural / r7chemical application search,site reconnaissance and survey,etc.) t/L�J� 3.2 Description of all past on-site potential and/or known alcove 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,pondsllagoons,vehictelmachine repair/painting,buried or Ll stockpiled Solid waste,etc.) /El .3 Description at au current on-site potential and/or known above and below ground sources of contamination identified at the project site(see examples above). f v,. ❑ ❑ 3.4 Description of all pzsi off-site potential and/or(mown above and below ground saurebs of contamination identified / in the area of tho project site that has or may impact the project site. (Examples: Close proxin ty to a former ✓ landfill/former gasoline station,in area of known OBCP/Nitrate groundwater impact,etc_) ❑ ❑ 3.5 Description of all current off-site potential andlor 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 J AT OR NEAR THE SITE AND RECOMMENDATIONS FOR FURTHER ACTION ❑ ❑ 4.1 Evafuntion of each potential andlor known source of contamination identified(in the above section)for any real and/or potential threat to human health and the environment. This evaluation should take into consideration the proposed future uses of the project parcel. 3.0 CONCLUSION$AND RECOMMENDATIONS SECTION �❑ ❑ 5.1 Discussion of the above evaluation to either rule out each source as a regi 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 soillwater sampleas)and/or mitigative measures(i.e_,clean up of surface wastes). All recommendations for future work must include a time frame for implementation, �❑ ❑ 5.2 The report was inclusive(i.e.all information referenced was Included in this report-report should not reference other reports). �❑ ❑ $.3 Tho raport was signed, dated and stamped by a qualified environmental professional. �❑ ❑ 5.4 The report was prepaied within six months of the dale of the submittal of the land use application. ❑ ❑ 5.5 The attachmentslappendices contain sutTrciont documentation to support claims made in report, Reviewed By: Reviewed Date: 0ED2"11 11 Page i of 2 S�.r�dE suek:i�li,k