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f i5`c SAIN JOAQUIN COUNT <br /> k bb <br /> ENVIR�?�t'"rte.x. <br /> 17aro <br /> SITE LocATtow. �— <br /> 5 = 5ufficiZ San Joaquin! <br /> I = insufficient <br /> S I 1.0 INTROI1� <br /> ❑ 1.1 Descriptioi <br /> ❑ ❑ 1.2 Description <br /> ❑ 1.3 Parcel vici <br /> FA <br /> f, <br /> l ❑ 1.4 Site map shy . ves,wells,septic systems, large trees, <br /> pastures,po ts.waterways, etc.) <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> ❑ 2.1 Discussion of past and present uses at the sire.a assess potential problems. <br /> i <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> 1 <br /> ® ❑ 3.1 Description of existing on-site septic tank usa;e (system types,age,functioning/repair rates). <br /> ❑ El 3.2 Site septic ermit history(number!tYPesldates o, ermits,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_enerai area(system types,ages,functioninglrepair rates, <br /> proximity to parcel). <br /> 21, ❑ 3.5 General area septic permit history(numberlt•;_?s.'dates of permits,age of system, permit numbers, copies in <br /> report). <br /> ® ❑ 3.6 Discussion of general area septic tank repair^.story. <br /> ® F-13.7 Description of proposed or expected maxima-(including second unit dwellings)septic tank usage on site. <br /> l: <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ❑ 4.1 Description of the depth and gradient of grour dwater in the general area. I <br /> ❑ ❑ 4.2 Descriplionldiscussion of any existing andlor Potential groundwater contaimination issues in the general location <br /> of the site. <br /> ® 4.3 Description of location(address/APN),type ar.d construction of well and location(well headNtchen tap)where <br /> water sample(s)were obtained. <br /> 0 ❑ 4,4 Description of constituents being tested for in the water sample. <br /> ❑ ❑ 4.5 Description of how sample was obtained,handed,stored, and transported to the lab. <br /> Zf ❑ 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 sa�mitted to the lab. For Laboratory samplers,complete laboratory <br /> report to include the above noted information. <br /> 5.0 SOIL PROFILE INFORMATION SECTION <br /> /❑ ❑ 5.1 Site map showing the location,with dimensions,of the soil profile piton the parcel, t <br /> I Vr <br /> El 5.2 Description of soil profile pit including depth and dimensions. � <br /> ❑ 5.3 Description of soil lithology as noted from tes'pit by appropriate professional using industry standard protocol. <br /> F-15.4 Discussion of soil lithology as related to futu-e onsite septic uses. P11- <br /> IEHD <br /> 26-02-003 Page i of 3 <br /> 7:I A.'_2003 <br /> A <br />