Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton•CA 95202-3029 <br /> (209)468-3420•Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.u&/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LocAmN: C� O �� n / f. /�j' PAM <br /> (x VBG v,�� /'••� Jl�/,I�7✓�_ REPORT DATE: 0 -1 l o <br /> S = Sufficient <br /> fficie <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <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 lotion-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 /> f9 ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> .7-- <br /> 3.0 <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> ❑ 3.1 Descriptior�exiting on-site septic tank usage(system types, age,functioning/repair rates). <br /> Ej ❑ 3.2 Site septic permit history(number/types/dates of permits,age of system, permit numbers,copies in report). <br /> 2- <br /> EE <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 permits)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 /> 3 <br /> a ❑ 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 4.o GROUNDWATER INFORMATION SECTION <br /> [R ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> ❑ 4.2 Description/discussion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. <br /> ® E] 4.3 Description of location ion(address/APN),type and construction of well and location(well head/kitchen tap)where <br /> water sample(s)were obtained <br /> 21 ❑ 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 rd <br /> , g Printed and si ned name of third artYsam on 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 /> 59— ❑ 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. <br /> ❑ 5.2 Descriptionsf oil profile pit including depth and dimensions. <br /> �I 5 <br /> [a ❑ 5.3 Description of soil litholog a's noted from test pit by appropriate professional using industry standard protocol. <br /> �] ❑ 5.4 Discussion of soil litholog as related to future onsite septic uses. <br /> EHD 26-02-003 Pagel of 3 Soil Suitability Checklist <br />