Laserfiche WebLink
' A. <br /> Iry"£ SAN JOAQUIN COUNTY <br /> r. ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 304 E Weber Avenue 3`d Floor Stockton a CA 95202-2708 <br /> (209)468-3420 • Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> 4<%CORN <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: I /� / ��� /�_ PA#: D0j,— �5 <br /> /00;/Y'ee y U7 REPORT DATE: �j <br /> S = Sufficient San Joaquin County Development Title Chapter 9--1105, Section 9-1105.2 <br /> I = Insufficient <br /> S I 7.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ® ❑ 1.1 Description of site, including zoning information. <br /> ® ❑ 1.2 Description of proposed development./ Z-) <br /> [Z ❑ 1.3 Parcel vicinity location map. i) <br /> [r7� ❑ 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 problemsc�Z) <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(9 Z I <br /> ® ❑ 3.2 Site septic permit history (number/types/dates of permits, age of system, permit numbers, copies in/report).2-) <br /> ® ❑ 3.3 Discussion of on-site septic tank repair history.((5 3� <br /> ® ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, <br /> proximity to parcel). ("�;1 <br /> ® ❑ 3.5 General area septic permit(s)history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). (PV <br /> E4 ❑ 3.6 Discussion of general area septic tank repair history. <br /> ® ❑ 3.7 Description of proposed or expected maximum (including second <br /> unit dwellings)septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> 8- ❑ 4.1 Description of the depth and gradient of groundwater in the general areata <br /> ❑ 4.2 Description/discussion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. I� �s�l <br /> ® F-14.3 Description of locatio (address/APN�,type and construction of well and location (well head/kitchen tap)where <br /> water sample(s)were obtained K ) <br /> ❑ 4.4 Description of constituents bein testa) for in the water sample. <br /> [`�- ❑ 4.5 Description of how sample was�faine))d, Ondd, stgred, and transported to the lab. <br /> 4.6 Complete Chain of Custody documentincgrinted and signed name of third party sampler, condition of <br /> sample and date and time the sample wasittedSo the lab For Laboratory samplers, complete laboratory <br /> report to include the above noted informati¢ 5 1 C <br /> 5.0 SOIL PROFILE INFORMATION SECTION <br /> [� ❑ 5.1 Site map showing the location,with dimensions, of the file,piton/\he parcel. <br /> ❑ 5.2 Description of soil profile pit including depth and dime n(s6y/� <br /> ❑ 5.3 Description of soil lithology as noted from test pit by appropYi Aey5ofessional using industry standard protocol. <br /> ❑ 5.4 Discussion of soil lithology as related to future onsite sep�uses.(A <br /> EHD 26-02-003 Pagel of 3 �[�' Sail Suitability Checklist <br />