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SU0011280_SSNL
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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2600 - Land Use Program
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PA-1600194
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SU0011280_SSNL
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Last modified
11/19/2024 1:52:20 PM
Creation date
9/8/2019 12:55:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011280
PE
2626
FACILITY_NAME
PA-1600194
STREET_NUMBER
22420
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220-
APN
01319005
ENTERED_DATE
3/23/2017 12:00:00 AM
SITE_LOCATION
22420 N HWY 99
RECEIVED_DATE
3/21/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\22420\PA-1600194\SU0011280\SS_NL STDY .PDF
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EHD - Public
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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c'•: �; Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> SOIL SUITABILITY <br /> rSTUDY <br /> /]REQUIREMENTS CHECKLIST <br /> EITELOCATION-' �J 2 �2(/ �/. e A `�/ q PA#: ' ©0 R <br /> 5 = Sufficient San Joaquin County Development Title Chapter 9-1105, Secti <br /> I = Insuon 9-1105.2 �� 0��� ✓�. ,6 <br /> Insufficient <br /> SS/ 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> L� ❑ 1.1 Description of site, including zoning information. <br /> h ❑ 1.2 Description of proposed development. f "-1 <br /> L�/ ❑ 1.3 Parcel vicinity location map. <br /> ❑ [� 1.4 Site map showing location of all items on parcels(Le., 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 problems. <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION """ ��'�ff <br /> L/ F-13.1 Description of exiting on-site septic tank usage(system types, age,functioning/repair rates). ND_f y-!lG r'-P ' .� <br /> U ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers,copies in report). <br /> E]� . ❑ 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 /> [ ❑ 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 /> �]/ ❑ 4.2 Description/discussion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. <br /> 4.3 Description of location (address/ PNY,type-and-sons#u ocation (well head/kitchen tap)where <br /> water sample(s)were obtained. /�I�/�1 �-- S / <br /> ❑ 4.4 Description of constituents being tes sample. Ce <br /> ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab. <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. For Laboratory samplers,complete laboratory <br /> report to include the above noted information. <br /> EHD 26-03 Page l of 3 SOIL SUITABILITY STUDY CKLST <br /> 4/24/12 <br />
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