SU0004624 SSNL - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ? EA-&ONMENTAL HEALTH DEPARTMS4i!F 304 E Weber Avenue 3`d Floor Stockton • CA 95202-2708 (209)468-3420 • Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST SITE LOCATION: i //O 'j I Q %`i70`� PA#: CY1 —2175 REPORT DATE: ( ! $ 2DD�- s = Sufficient 1 = Insufficient San Joaquin County Development Title Chapter 9-11005, Section 9-1105.2 S 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ® ❑ 1.1 Description of site, including zoning infoorrmatio</',4,� ;� ® ❑ 1.2 Description of proposed development a- j) (z_4 ® ❑ 1.3 Parcel vicinity location map /i e,.. A,) ❑ 1.4 Site map showing location of"Sil items on parcels (i.e., structures, drives,wells, septic systems, large trees, pastures, pools, natural drainage courses, ponds,waterways, 2.0 PRESENT AND PAST USES OF THE SITE SECTION— 2 ❑ 2.1 Discussion of past and present uses at the site to assess potential problert(�_I 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ® ❑ 3.1 Description of it ng on-site septic tank usage (system types, age,functioning/repair rates). ❑ 3.2 Site septic-jn5yite history(number/types/dates of permits, age of system, permit numbers, copies in report). ❑ 3.3 Discussion septic tank repair history. ❑ 3.4 Descriptionxisting septic tank usage in the general area (system types,ages,functioning/repair rates, proximity to parcel)' a-) ® ❑ 3.5 General area septic permit(s)history(number/types/dates of permits, age of system, permit numbers,copies in report).(Wig orrvZ ,L) ❑ 3.6 Discussion of general area septic tank repair history ® ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site. 4.0 GROUNDWATER INFORMATION SECTION ® ❑ 4.1 Description of the depth and gradient of groundwater in the general areae [p'� ❑ 4.2 Description/cjiscu Sion of a��9��9JJJJYYYYYY existing and/or potential groundwater contamination issues in the general location of the site. (} �,( rz) 'ry'H) ® ❑ 4.3 Description of locati6n (ad( s/APN),type and construction of well and location (well head/kitchen tap)where water sample(s)were obtained.(Id^1) 1 ® ❑ 4.4 Description of constituents beingl�sted for in the water sample. 4J o[� ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the I T ❑ 4.6 Complete Chain of Custody document, including printed and signed name of third pa-ffy sampler, condition of sample and date and time the sample was submitted top the-lab. For Laboratory samplers, complete laboratory report to include the above noted information` 5.0 SOIL PROFILE INFORMATION SECTION ® ❑ 5.1 Site ( ho ing the location, with dimensions, of the soil profile pit on the parc4_t-ff"40, C-) IR ❑ 5.2 Desch' tion of soil profile pit including depth and dimensions. Arty, 1_ ,d. C�(/y2'. ❑ 5.3 Description of soil Jithology as noted from test pit by appropriate)'professionalsingindustry standard protocol. `rrj L as Z ❑ 5.4 Discussion of soil ' ology as related to future onsite septic uses. —.EHD 2602-003 age 1 of 3 sail Suitability Checklist