Laserfiche WebLink
�Qr SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N 600 East Main Street, Stockton- CA 95202-3029 <br /> (209)468-3420 -Fav(209)464-0138 - Web:www.co.san-joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: PA#: /4 - ®6 <br /> �O /• ( " � a REPORT DATE: \\ <br /> Kc. �a7 <br /> 5 = sufficient San Joaquin Count Development Title Cha er 9-1105, Section 9-1105,2 <br /> I = Insufficient y Pt <br /> S I 1,0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ❑ 1.1 Description of site, including zoning information. <br /> ❑ 1.2 Description of proposed development. <br /> ❑ 1.3 Parcel vicinity I cat,ionn�map. <br /> ❑ 1.4 Site map shov�ninnocation of all items on parcels(i.e.,structures, drives,wells, septic systems,large trees, <br /> pastures pools,natural drainage courses, ponds, waterways,etc.) <br /> f 1 B r <br /> 2.0 PRESEiIT 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 /> 23 ❑ 3.1 Desci <br /> ption of exitin on-site septic tank usage(system types,age,functioning/repair rates). <br /> ❑ 3.2 Site septic pe i�ry(number/ty esldates of permits,age of system, permit numbers,copies in report). <br /> ❑ 3.3 Discussion of on-site septic t nk repair history. <br /> F] 3.4 Description of existing septic tank usage in the general area(system types,ages,functioningtrepair rates, <br /> proximity to parcel). <br /> E' ❑ 3.5 General/area septic permit(s)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 /> I <br /> ® ❑ 3.7 Description bf prb os or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 2- <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ® ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> 0. ❑ 4.2 Description/discussion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. 2- <br /> g]g] <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 /> [S ❑ 4.4 Description of constituents being tested for in the water sample. <br /> [a ❑ 4.5 Description of how sam pie 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 /> R ❑ 5.1 Site map shjow1,g the lotion,with dimensions,of the soil profile pit on the parcel. <br /> ® ❑ 5.2 Descrp or�'of s,6orifprofile 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 /> ❑ 5.4 Discuss of soil lithology as related to future onsite septic uses. <br /> EHD 26-02-003 Pagel of 3 soil suitability Checklist <br />