SU0004617_SSCRPT - Laserfiche WebLink

Home Browse Search

IN- SAN H- y _ SAN.TOAQUTN COUNTY ° r° EN,_,R0NMENTAL HEALTH DEPARTNV�� • NT •' r, 304E Weber Avenue 3"i Floor Stockton - CA 95202-2708 (209}468-3420-Fax:(209)464-0138� Www-co.san-joaquin.ca.us/ehd Web:www.co.san— uin.ca.us/ehd 9 SURFACE AND SUBSURFACE CONTAMINATION REPORT REQUIREMENT CHECKLIST SITE LOCATION: PA#: 7 REPORT DATE:I S = Sufficient San Joaquin County p p 1 = insufficient Q ty Development Title Chapter 9-90a, Section 9-X05.12 S 1 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 ❑ 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 ❑ 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.) i 3.0 IDENTIFICATION OF ALL PAST AND CURRENT SOURCES OF CONTAMINATION d 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 s arch, EHD records search, agricultural chemy'�1 application searc� to reconnaiss a and surve etc.) y v�crf�c� i _ �Y. i rx / /"'� O" 7Pl�-�� TiyY��3.2 Description of all past on-site potential and/or knowiti above and below ground sources of contamination id�n6t2i*� at the project site. (Examples: Agricultural chemical handling/storage/use,aboveground/underground tanks, septic systems, injection wells,unsealed wells, ponds/lagoons, vehicle/machine repair/painting, buried or stockpiled solid waste,etc.) �- ❑ 3.3 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). ❑ 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 DBCP/Nitrate groundwater impact, etc.) �>1 ❑ 3.5 Description of all current off-site potential and/or known above and below ground sources of contamination iRev 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 ❑ 4.1 Evaluation of each potential and/or 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. �"• � �e emA*?° '^p,',"- .e?� ' ;I''s�"'A' `',. r^- E -y�r< ^G iJ . "L�'. +•t�"'A-L Ire 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTI©N ❑' 5.1 Discussion of the above evaluation to either rule out each source as a real or potential thr at or to recommend further action to mitigate or abate any real or potential threats identified. Recommendations may include additional site assees ent(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. ❑ 5.2 the report was inclusive(i.e.all information referenced was included in this report—report should not reference 5 other reports). ❑ 5.3 The report was signed, dated and st�by a qualified environmental professional. p ❑ 5.4 The report was prepared within six months of the date of the submittal of the land use application. SIJ ❑ 5.5 The attach ments/appendice�s/contain sufficient documentation to support claims made in report. Reviewed By: `- Reviewed Date: EI{D 26-02-001 Page j of 2 Surface&Sub Checklist