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%off''' -,� SAN JOAQUIN COUNTY <br /> . '�••.off, <br /> EiTvIRONMENTAL HEALTH DEPART-MENT <br /> `P_+•_ IIII;"<^' 600 East Main Street, Stockton •CA 95202-3029 <br /> ; ',_,_xI• (209)468-3420 •Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION: PJ 014 <br /> REPORT DATE: ';Vo <br /> )s <br /> S = Sufficient <br /> 1 = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 ��// <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ® ❑ 1.1 Descripkion of site, including zoning information. <br /> Ei, El1.2 Desc Ir p/tiof of proposed development. <br /> R ❑ 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 /> AT <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> S ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> 3.0 EXIS4nAlG AND PROPOSED SEPTIC TANK USAGE SECTION <br /> Ej ❑ 3.1 Des ription of exiting on-site septic tank usage(system types, age, functioning/repair rates). <br /> ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers, copies in report). <br /> Z <br /> ] ❑ 3.3 Discussion of on-site septic tank repair history. <br /> O[ ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br /> proximity to parcel). <br /> Z <br /> ❑ 3.5 General area septic permit(s)history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). _ <br /> [od ❑ 3.6 Discussion of general area septic tank repair history. <br /> )­_ , Art -0 <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 pth and gradient of groundwater in the general area. <br /> ❑ 4.2 Description/discu%sion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. /f <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 /> ® ❑ 4.4 Description of constituents being tested for in the water sample. <br /> _1 <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 /> 5.0 SOIL PROFILE INFORMATION SECTION <br /> ® ❑ 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 /> z- <br /> ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> y <br /> ® ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> Pte- <br /> EHD 26-02-003 Pagel Ot 3 Soil Suitability Checklist <br />