Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> 'y ENVIRONMENTAL HEALTH DEPARTMENT <br /> j 304 E Weber Avenue 3rd Floor Stockton• CA 95202-2708 <br /> 'p (209)468-3420 •Fax:(209)464-0138 • Web:www.co.san-joaquin.ca-us/chd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: 23350 N.JACK TONE ROAD,ACAMPO PA#: 12-226(MS) <br /> REPORT DATE: 3/13/2013 <br /> I = SuffiInsufficent <br /> ient <br /> San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> 1 = InsufScient <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 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 /> ® 1/ ❑ 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 /> N ❑✓ 3.1 Description of exiting on-site septic tank usage(system types, age,functioning/repair rates). <br /> N 1/ ❑ 3.2 Site septic permit history(number/types/dates of permits,age of system, permit numbers, copies in report). <br /> N jo/ ❑ 3.3 Discussion of on-site septic tank repair history. <br /> Z&/ ❑ 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 /> ® ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> N / ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> N ,/ ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> N✓ ❑ 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 /> N ✓ ❑ 4.4 Description of constituents being tested for in the water sample. <br /> N t/ ❑ 4.5 Description of how sample was obtained, handled, stored,and transported to the lab. <br /> N V ❑ 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 /> N ✓ ❑ 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. <br /> N,/ ❑ 5.2 Description of soil profile pit including depth and dimensions. <br /> N✓ ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> N ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> ERD 26.0M03 Page 1 of 3 soil Suitability Checklist <br />