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SAN JOAQUIN COUNTY EN VIRONMENTAL HEALTH DEPART n ENT 600 East Main Street, Stockton-CA 95202-3029 (209)468-3420 •Fax:(209)464-0138 - Web:www.co.san-joaquin.ca.uslehd �CrFgR! SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST ELOC ATION: REPORT DATE: S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 I = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION E ' ❑ 1.1 Description of site,including zoning information. ❑ 1.2 Description of proposed development. ❑ 1.3 Parcevl vicinity location map. ®- ❑ 1.4 Site map showing location of all items on parcels(i.e.,structures, drives, wells,septic systems, large trees, pastures, pools, natural drainage courses, ponds, waterways,etc.) 2.0 PRESENT AND PAST USES OF THE SITE SECTION (E. ❑ 2.1 Discussion noof-past and present uses at the site to assess potential problems. 3.0 EXISTING A D PROPOSED SEPTIC TANK USAGE SECTION I ❑ 3.1 Description of exiting on-site septic tank usage(system types,age,functioning/repair rates). ® ❑ 3.2 Site septic permit history(numberttypesldates of permits,age of system, permit numbers,copies in report). :Y ❑ 3.3 Discussion of one septic tank repair history. ❑ 3.4 Description of existing septic tank usage in the general area(system types,ages,functioning/repair rates, proximity to parcel).,:,�_ 14 ❑ 3.5 General area septic permit(s)history(numberAypes/dates of permits,age of system, permit numbers,copies in report). �6�_ L/. ❑ 3.6 Discussion general area septic tank repair history. E[ E] 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. a3 4.0 GROUWWA)TER INFORMATION SECTION n ❑ 4.1 Description of the depthhdd gradient of groundwater in the general area. ❑ 4.2 Descripti*ACI.ss o a y existing and/or potential groundwater contamination issues in the general location of the site. Id.3 ❑ 4.3 Description of loca'3ion(address/APN),type and construction of welt and location(well head/kitchen tap)where water sample(s)were obtained. "? ,-� cL 4vr�✓^ - b .4 Description of constituents being tested for in the water sample. W U .5 Description of how sample wasgbtained, handled,stored,and transported to the lab. (�� E] 6 Complete Chain of Custody document,including printed and signed name of third party sampler,conditioR''of sample and date and time the sample was submitted to the lab. For Laboratory samplers,complete laboratory report to include the above noted information. S.O SOIL PROFILE INFORMATION SECTION ❑ 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. El ❑ 5.2 Descriptiortwt5f soil profile pit including depth and dimensions. ® ❑ 5.3 Description Sf sit lithology as noted from test pit by appropriate professional using industry standard protocol. ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. EHD 26-02-003 Pagel of 3 Sail Suitability Checklist c ru nnna