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L SOIL SUITABILITY STUDY
<br /> REQUIREMENTS CHECKLIST
<br /> San Joaquin County Development Title n
<br /> Chapter 9-1105,Section 9-1105.2
<br /> SuSufficient SITE LOCATION: REPORT DATE:
<br /> ImInsufficlesufflelent
<br /> 1 INTRODUCTION & PROPOSED DEVELOPMENT SECTION
<br /> ICS Description of site,including zoning information.
<br /> [�] ❑ Description of proposed development.l,.. 'tom -��y„� (,11-IJ,�,�.Q
<br /> ❑ Parcel location map. r•
<br /> ❑ N' Site map showing location of all items on parcel (structures,drives,wells,septic systems, large trees, pastures,
<br /> pools, natural drainage courses, ponds,waterways,etc.)
<br /> PRESENT AND PAST USES OF THE SITE SECTION
<br /> ❑ R-71 Discussion of past and present uses at the site to assess potential problems.
<br /> EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION
<br /> ❑ EU Description of existing septic tank usage on site(system types,age,functioning/repair rates).
<br /> E!❑ Site septic permit history(number/types/dates of permits,age of system,permit numbers cooie )•
<br /> F ❑ Discussion of on-site septic tank repair history.
<br /> C ❑ Description of existing septic tank usage in the general area(system types,ages,functioning/repair rates, proximity to
<br /> parcel).
<br /> ❑ General area septic permit history(number/types/dates of permits,age of system, permit numbers, copies in
<br /> L i� Elreport).
<br /> Discussion of general area septic tank repair history.
<br /> S ❑ FI Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site.
<br /> GROUNDWATER INFORMATION SECTION Q
<br /> ❑ Description of the depth and A&nt of groundwater in the general area. i5 p r w
<br /> ��� ❑ Description/discussion of any existing or potential groundwater contamination issues in the general location of the site.
<br /> Description of location(address/APN),type and construction of well,and location(well head/kitchen tap)where
<br /> F� water samples were obtained.
<br /> Description of constituents being tested for in the water sample.
<br /> Description of how sample was obtained, handled,stored,and transported to the lab..
<br /> 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.
<br /> SOIL PROFILE INFORMATION SECTION
<br /> ❑ j Site showing the location,with dimensions,of the soil profile pitr�he parcel. 5,1 , I tZl b
<br /> ❑ fL�1 escription of soil profile pit including depth and dimensions. e
<br /> (',�h
<br /> ❑ escription of soil lithology as noted from test pit by appropriate professiona using industry standard protocol.
<br /> ❑ Discussion of soil lithology as related to future onsite septic uses.
<br /> PERCOLATION TEST INFORMATION SECTION
<br /> ❑ Site map showina the location.with concise and accurate dimensions,of the percolation test holes on the parcel.
<br /> 1� ❑ The minimum number of shallow and deep percolation tests were performed for each parcel.
<br /> ElDescription of the date,time and protocol used to prepare the test hole,including depth and dimensions of hole,
<br /> preparation of hole,and depth of water used to presoak(minimum 12 inches).
<br /> ❑ Description of the date,time and edition of the test hole after the 24 hour soak period (hole still intact, hole dry,
<br /> depth to water remaining in hole,etc.).
<br /> ❑ The test conformed to SJC Policy EHD 02-02(correct depth,diameter,2"gravel,6"water refill,correct readings
<br /> recorded).
<br /> ❑ Complete(including readings) Percolation Test Form was provided with REHS verification signature. The rate was
<br /> correctly calculated using the last reading.
<br /> r ❑ Discussion of any potential problems predicted and/or the need for an engineered or alternative septic system.
<br /> i ❑ Discussion of percolation rates in relation to the type and size of future leach fields needed at the site.
<br /> CONCLUSION SECTION
<br /> ❑ ❑ The report was signed and stamped by the appropriately registered individual.
<br /> REVIEWED BY:
<br /> REVIEWED DATE:
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