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SAN JOAQUIN COUNTY <br /> ENMONMENTAL HEALTH DEPARTN,ti T <br /> 304 E Weber Avenue 3rd Floor Stockton - CA 95202-2708 <br /> (209)468-3420 •Fax:(209)464-0138 . Web.www.co.san-joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> ESITELOCA:TICON:9084 E. HARNEY LANE, LODI PA#: 07-440(SA) <br /> REPORT DATE: 3,!3/2008 <br /> SSufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> 1 = Insufficient <br /> S I 1.0 INTRODUCTION S PROPOSED DEVELOPMENT SECTION <br /> ®✓ Q 1.1 Description of site, including zoning information. <br /> ® t% -❑ 1.2 Description of proposed development. <br /> ®V 1.3 Parcel vicinity location map. <br /> ® � 1.4 Site map showing location of all items on parcels(i.e., structures, drives, wells, septic systems, large trees, <br /> pastures, pools, natural 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 /> 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 /> ® <br /> 1, 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers, copies in report). <br /> ®> �] 3.3 Discussion of on-site septic tank repair history. <br /> ® {— 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 permit history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). <br /> ® ✓ 3.6 Discussion of general area septic tank repair history. <br /> ® ✓ El- 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ®� 4.1 Description of the depth and gradient of groundwater in the general area. <br /> ®f [ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> ® Q 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 /> ® 0 4.4 Description of constituents being tested for in the water sample. <br /> 01 -[a 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 /> ® ✓ {� 5.1 Site map showing the location,with dimensions, of the soil profile pit on the parcel. <br /> 5.2 Description of soil profile pit including depth and dimensions. <br /> ® d El 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> ®✓ 0- 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> FAM-26-W-003 Page 1 of 3 Soil Suitability Cbeckli-sl <br />