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SAN JOAQUIN COUNTY <br /> � 1 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Avenue 3`d Floor Stockton-CA 95202-2708 <br /> mak' (209)468-3420 -Fax:(209)464-0135 • Web:www.co.san-joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: 10420 N. STATE ROUTE 99, $TOCKTON <br /> PA#: 07-260 &261(GP1ZR) <br /> REPORT DATE: 112007 <br /> S = Sufficient Ott <br /> I InsuffiSan Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> = <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> N ✓ ❑ 1.1 Description of site, including zoning information. <br /> I <br /> t ® ✓ ❑ 1.2 Description of proposed development. <br /> 0 ,/ ❑ 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 /> i 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> w <br /> ® ✓ ❑ 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 /> R ❑✓ 3.1 Description of exiting on-site septic tank usage(system types, age,functioning/repair rates). <br /> X776¢-b – sys /0— 7,6; 9 z;5 s– CfG12610 Xft <br /> ®✓ ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers,copies in report). <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 permit history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). <br /> N ✓ ❑ 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 /> ®✓ ❑ 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 /> ®�/ ❑ 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✓ ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab. <br /> ® y/ ❑ 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 /> �i��- ❑1✓ 5.1 Site map showing the location,with dimensions, of the soil profile pit on the parcel. <br /> �� ®� ✓ ❑ 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 litho logy as related to future onsite septic uses. <br /> EHD26-02-003 Pagel of 3 Soil Suitabilitylk[ist <br />