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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Ida : 600 East Main Street, Stockton -CA 95202-3029 <br /> (209)469-3420 •Far: (209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> Fo / SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITELOCATION: / ,��� ��.� rir L!?�y,(G GN"rP(, PA#: CHAT Ov�(57� .HS <br /> UUU/ � � (� REPORT DATE: <br /> r <br /> = Biu(ficiart imt <br /> I Isu <br /> nSan Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> = <br /> S I 1.0 INTRODUCTION B PROPOSED DEVELOPMENT SECTION <br /> ® ❑ 1.1 Description of site indyding zoning information. <br /> ®- ❑ 1.2 Des6ip$,tio ilof proposed development. <br /> ❑ 1.3 Pardel" iicipity,I i tion map. <br /> ® ❑ 1.4 Site map showing location of all items on parcels(i.e., structures, drives, wells, septic systems, large trees, <br /> pastures, poyl;, Mural drainage courses, ponds, waterways, etc.) <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> ® ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> G5s 2.- <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> {�] ❑ 3.1 Description of exiting on-site septic tank usage(system types, age, functioning/repair rates). <br /> rs <br /> Q ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers, copies in report). <br /> C�v <br /> ❑ 3.3 Discussion Of on-site septic tank repair history. <br /> © ❑ 3.4 Descnpilon of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br /> proximity <br /> yto,pparcel). <br /> ® F-13.5 General area septic permit(s)history(number/types/dates of permits, age of system, permit numbers,copies in <br /> report). i i <br /> ® ❑ 3.6 Discussion of general area septic tank repair history. <br /> tb <br /> ® ❑ 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 6i 3 <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ,Q ❑ 4.1 Descriptionol the depth and gradient of groundwater in the general area. <br /> ® F-14.2 Descriptickdiscussion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. <br /> ® ❑ 4.3 Description of location(address/APN),type and construction of well and location(well head/kitchen tap)where <br /> water sample(swere obtained. <br /> ® ❑ 4.4 Description rf'constituents being tested for in the water sample. <br /> ® ❑ 4.5 Description Aw sample was obtained, handled, stored, and transported to the lab. <br /> ®' F-14.6 Complete Chaln!xof 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 iPplude t e above noted information. <br /> 5.0 SOIL PILE INFORMATION SECTION <br /> ( ❑ 5.1 Site showing the location, with i ensions, of the soil profile piton the parcel. <br /> �f <br /> El5.2 Desc n of soir profile Ot ihCluding depth and dimensions. <br /> 6g <br /> ® ❑ 5.3 Desdripti7on of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> r <br /> �] ❑ 5.4 Discu/ssion of soil lithology as related to future onsite septic uses. <br /> erm 2e,02-003 /�6 ? Page ] of 3 Soil Suitability Checklist <br />