SU0006303 SSCRPT - Laserfiche WebLink

Home Browse Search

SAN-JOAQUIN COUNTY ENVIRONT MENTAL HEALTH DEPA I M_bN I h '1 304 E Weber Avenue P Floor Stockton-CA 95202-2708 'h • �' - J1 ,.(209)468-3420•Far.(209)454-0138. Web:Www.co,.san-joaquin.ca.us/ehd SURFACE AND SUBSURFACE CONTAMINATION REPORT REQUIREMENT CHECKLIST SITE LOCATION: S PA#: REPORT DATE: ZZ 2 p 5: SufficInsufficient ic nt 1 San Joaquln County Development Title Chapter 9-905,Section 9-905.12. a lasu S I 1.0 INTRODUCTION& PROPOSED DEVELOPMENT SECTION y� ❑ 1.1 Description of site(report must address all parcels),including current and/or proposed zoning information. l� / ❑ 1.2 Description of proposed development..Pit d ❑ / a 1.3 Parcel location map. ❑ 1.4 Site map showing location of all items on parcel. (Examples:structures,drives,wells,septic systems,large trees, pastures,pools,natural drainage courses,ponds,waterways,etc.) 2.0 PAST, PRESENT AND PROPOSED FUTURE USES OF THE SITE SECTION �L.J ❑ I 2.1 Discussion of past,present and proposed future uses at the site In assess potential problems. (Example sources of information:current andlor previous property owners,historical maps,insurance maps,previous land use applications,etc") 3.0 IDENTIFICATION OF ALL PAST AND CURRENT SOURCES OF CONTAMINATION ❑ 3.1 Discussions of the methods used to research and investigate the potential or known above and belowground sources of contamination at the project site. .(Examples: Database search,EHD records search,agricultural. chemical application search,site reconnaissance and survey,etc.) ❑ 3.2 Description of all past on-site potential and/or known above and below ground sources of contamination identified at,the project site. (Examples: Agricultural chemicat handfng/storagefuse,aboveground/undergro(ind tanks, septic systems,injection wells,unsealed wells,ponds/lagoons,vehidelmachine repairlpainling,buried or stockpiled solid waste,etc.) ❑ 3.3 Description of all current on-site potential andfor known above and below ground sources of contamination o; .Z— identified at the project site(see examples above). ❑ 3.4 Description of all past off-site potential and/or known above and below ground sources of contamination Identified in the area of the project site.that'has or may impact the project site. (Examples: Close proximity to a former landfill/former gasoline station,in'area of known DSCHN"te groundwater impact.etc.) ❑ 3.5 Description of all current off-site potential and/or known above and below ground sources of contamination/ 9� identified in the area of the project site. 4.0 EVALUATION OF PAST AND CURRENT SOURCES OF CONTAMINATIO IDENTIFIED AT OR NEAR THE SITE AND RECOMMENDATIONS FOR FURTHER ACTION ' ❑ 4.1 Evaluation of each potential and/or known source of contamination identified(n the above section)for any real p`f andfor potential threat to human health and the environment. This evaluation should take into consideration the proposed future uses of the project parcel. 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION 5.1 Discussion of the above evaluation to either rule out each source as areal or potential threat or to recommend further action to mitigate or abate any real or potential threats idenViied. Reoommendations may Include Z additional site assessment(.e.coAection of soiUwater samples)andfor mitigative measures{i.e.,dean up of surface wastes). All recommendations for future work must include a time frame for Implementation. ❑ 5-2 The report was inclusive(i.e.all information referenced was included in this report report should not reference � other reports). 3 ❑ 5.3 The report was signed,dated and stamped by a qualified environmental professional. lvo - r, ❑ 5.4 The report was prepared within six months of the date of the submittal of the land use application. r ❑ 5.5 The attachments/appe ces contain sufficient documentation to support claims made in report. � °Revie«ed By: . Reviewed Date: EHD 7"2-00 1 Page 1 of 2 suftsce&sub Checklist