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SAN JOAQUIN COUNTY „ ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton •CA 95202-3029 411000` (209)468-3420 •Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST SITE LOCATION: Q/ A4e'-� � �d�p � PA#:00--z7(�L/S) a (((///1��0� REPORT DATE: SSufficient I Inullicient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 - S 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ❑ 1.1 Description of site, including zoning information. �] El 1.2 Descriptfon%of proposed development. �f ❑ 1.3 Parcel%-nitycati?nlmap (, i ❑ 1.4 Site map swing lotion of aiT items on parcels(i.e., structures, drives, wells, septic systems, large trees, pastures, pools,natural drainage courses, ponds, waterways, etc.) ip � t✓(;1,�Arz � 2.0 PRESENT-AND PAST USES OF THE SITE SECTION ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. h ,A- 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ® ❑ 3.1 Description of exiting on-site septic tank usage(system types, age, functioning/repair rates). [ ❑ 3.2 Site s/p6c permit history(number/types/dates of permits, age of system, permit numbers, copies in report). ❑ 3.3 Discu�;lon of on-site septic tank repair history. ❑ 3.4 Descripfo�I of existing septic tank usage in the general area(system types, ages,functioning/repair rates, proximity tofparfel). ❑ 3.5 General ark septic permit(s) history(number/types/dates of permits, age of system, permit numbers, copies in report). Z F] ❑ 3.6 Discussion of general area septic tank repair history. ❑ 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. 4.0 GROUNAiTER INFORMATION SECTION ❑ 4.1 Description of the depth and gradient of groundwater in the general area. Oki E] 4.2 Description/disw4ion of any existing and/or potential groundwater contamination issues in the general location of the site. ❑ 4.3 Description of location(address/APN),type and construction of well and location(well head/kitchen tap)where water sample(s)were�btained. E ❑ 4.4 Description of consmuents being tested for in the water sample. © F] 4.5 Description of how S(Inp e4as obtained, handled, stored, and transported to the lab. ❑ 4.6 Complete Chain of"togy document, including printed and signed name of third party sampler, condition 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. R . 5.0 SOIL PROFILE INFORMATION SECTION ❑ 5.1 Site map shgwing the location, with dimensions, of the soil profile pit on the parcel. ❑ 5.2 Descri on gf soil profile pit including depth and dimensions. ❑ 5.3 Descriptibi of;il lithology as noted from test pit by appropriate professional using industry standard protocol. ❑ 5.4 Discussiorj'o?rl lithology as related to future onsite septic uses. EHD 26-02-003 I(J Pagel of 3 Soil Suitability Checklist