Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> z. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton-CA 95202-3029 <br /> (209)468-3420-Fax:(209)464-0138 - Web.www.co.san joaquin.ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LocATIOPI: PA#: )1- 00078 CA4S.) <br /> C= . Vi 1lr �ve . �sc�•�. <br /> REPORT DATE: <br /> S = Sufficient <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> S 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> I <br /> ❑ 1.1 Description of site, including zoning information. <br /> • I <br /> ❑ 1.2 Description of proposed development. <br /> ® ❑ 1.3 Parcel vicinity I o- ¢map <br /> W�c 1 l <br /> E§- ❑ 1.4 Site map sl in potation bfIII items on parcels(i.e.,structures,drives,wells,septic systems,large trees, <br /> pastures, pools, natural draijage courses, ponds, waterways,etc.) <br /> } t2?3 )/-() <br /> 2.0 PRESENT AND PXST USES OF THE SITE SECTION <br /> j ® ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> I 'A- <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> ® ❑ 3.1 Description of exiting on-site septic tank usage(system types, age,functioningirepair rates). <br /> i Z <br /> ® ❑ 3.2 Site septic permit story(numberltypes/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). 2-1 Arp <br /> 14 ❑ 3.5 General area septic permit(s)history(number/types/dates of permits, age of system,permit numbers,copies in <br /> i 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/discusion of any existing and/or potential groundwater contamination issues in the general location <br /> of the site. 3 <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 /> ^-' <br /> ® ❑ 4.4 Descri ' n of constituents being tested for in the water sample. <br /> 6J~ <br /> ❑ esc '4.5 Don of how sample was obtained, handled, stored,and transported to the lab. <br /> (� ❑ 4.6 Complet hain df Custody document,including printed and signed name of third party sampler,condition of <br /> sampl and date and time the sample was submitted to the lab. For Laboratory samplers,complete laboratory <br /> rep to include the above noted information. <br /> A/A <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 f soil profile pit including depth and dimensions. <br /> ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> ® ❑ 5.4 Discussion OT soiI Iithology as related to future onsite septic uses. <br /> EHD 26-02-003 Pagel of 3 Soil Suitability Checklist <br />