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`U SAN JOAQUIN COUNTY <br /> c <br /> r.: <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ . 304 E Weber Avenue 3rd Floor Stockton • CA 95202-2708 <br /> q. (209)468-3420 • Fox:(209)464-0138 • Web: www.co.san-joaquin.ca.us/ehd <br /> L�FOR% <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: B3c�q / <br /> REPORT DATE: <br /> = Sufficient <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9.1105.2 <br /> S // 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> LK ❑ 1.1 Description of site, including zoning information. <br /> ❑ 1.2 Description of proposed development. <br /> Q/ ❑ 1.3. Parcel vicinity location map. <br /> ❑ 1.4 Site map showing location of II items on parc (�. structures, drives,wells, septic systems, large trees, <br /> pastures, pools, natural drainage courses, ponds, aterways, etc.) <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> _ <br /> L� ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. 's;_ <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/repair3tes). <br /> Ib <br /> [� ❑ 3.2 Site septic permit history (number/typealcia f permi s, age of system, permit numbers,copies in report). <br /> Q ❑ 3.3 Discussion of on-site septic tank repai 1,12. .. 15 (D <br /> E( ❑ 3.4 Description of existing septic tank usage in theeeheral area (system types, ages,functioning/repair rates, <br /> proximity to parcel). / u I j7 <br /> [� ❑ 3.5 General area septic permits) hil c ry(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). I � c 3 &- Iw-bD <br /> ❑ 3.6 Discussion of general area septic tank repair histor�6 j) <br /> ❑ 3.7 Description of proposed or expected maximum (including second unit G 6 ftseptic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION 0 /J1 <br /> ❑ 4.1 Description of the depth and gradient of groundw�ate\r In the general area p��Q�� _\ <br /> [� ❑ 4.2 Description/discussion of any existing and/pr poteh I groundwater co minaonssues inl the gener I location <br /> of the site. r I t..-s U9 M� JJJ .rl., 141 <br /> [� ❑ 4.3 Description of location (address/APN),N4 artJd construction of well i d_ location (well head/kitchen where <br /> water sample(s)were obtained. <br /> ❑ 4.4 Description of constituents being tested for in the water saple.l�( <br /> [� ❑ 4.5 Description of how sample was obtained, handled, stored, an transported(o thQra <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 Laboratory samplers, complete laboratory <br /> report to include the above noted information. �..`.'� F- <br /> 5.0 SOIL PROFILE INFORMATION SECTION ) ( 11 <br /> [3 ❑ 5.1 Site map showing the location, with dimensions, of The soil file pit n the parch. 6Y�J k lmexj <br /> L7 F-15.2 Description of soil profile pit including depth and dimensions. L- t� \ 1 <br /> u ❑ 5.3 Description of soil lithology as noted from test pit by appropriate pfdfessional using industry standard protocol. <br /> Lg' ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. 6r 5 <br /> END 2602.003 Page I of 3 Soil Suitability Checklist <br />