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1 � <br /> Opq�.•� �� SAN JOAQUIN COUNTY <br /> I"'•� <br /> :1� ENVIRONMENTAL-HEALTH DEPARTMENT <br /> 4 ! 304 E Weber Avenue TdFloor Stockton•CA 95202-2708 <br /> e' x:(209)4640138• Web:www.co.san-joaquin.ca.us/ehd <br /> (209)468-3420•Fa <br /> -ou <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> $RELOCATION' REPORT DATE: <br /> S - sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> 1 - Insufficient <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ❑ 1.1 Description of site,including zoning information.�' 7 a <br /> ❑ / r Z <br /> 1.2 Description of proposed development >?P.,awP �jc�'/.F-�Z�jpr��ir C �`5�� <br /> f ,uo I�We-,- <br /> ❑ 1.3 Parcel vicinity location map. <br /> ❑ 1.4 Site map showing location of all items on parcels(i.e., <br /> structures, <br /> )rives,wells,Septic systems,large trees, <br /> pastures,pools,natural drainage courses,ponds, Ys e <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION y9S <br /> 'PN6s 2 <br /> ❑ d 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 /> d ❑ 3.1 Description of existing on-site septic tank usage(system types,age,functioning/repair rates). <br /> ❑ 32 Site septic permit history(number/Wes/dates of permits,age of system,permit numbers,copies in report). <br /> 3.3 Discussion of on-site septic tank repair history. <br /> d ❑ 3.4 Description of existing septic tank usage in the general area(system types,ages,functioning/repair rates, <br /> proximity to parcel). <br /> ❑ 3.5 General area septic permits hitory(n berttypes/dates of permits,age off ystem,permit numbers,copies in <br /> report). 1>7c' fySYCi»S <br /> ❑ ❑ 3.6 Discussion of general area septic tank repair history. <br /> Al# F-1 El 3.7 Description of proposed or expected m��99mu/�(i udl99 d unit dwellings)septic tank usage on site. <br /> /� N07` Ncldlnr a, y 7af ll f fai: , ,emirs �rs yrir�// <br /> 4.0 GROUNDWATER INFOVAATION SECTION d n <br /> ❑ 4.1 Description of the depth and gradient of groundwater in the general area. L/�5r TO Glx� <br /> ❑ 42 Description/discussion of any existing and/or potential groundwater cane imiinationlissues m the general location.. <br /> ❑ of the site. <br /> 31 <br /> IBJ,( 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 /> ❑ 4.4 Description of constituents being tested for in the water sample. <br /> ❑ 4.5 Description of how sample 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 /> d❑ 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. <br /> ❑ 5.2 Description of sol profile pit including depth and dimensions. <br /> © ❑ 5.3 Descrip�oryof so lith logy as,poted from test pit by appropriate professional using industry standard protocol. <br /> N/I�k� ❑ F-15.4 Discussion of Soil lilhology as related to future onsite septic uses. <br /> EHD26-02-003 Page 1 of <br /> 7/14 007 <br />