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SOIL SUITABILITY STUDY 4 REQUIREMENTS CHECKLIST San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 L PA#: S=Suffioient �y 1=lnsufflcient SITE LOCATION: V� REPORT DATE:� �*� lYJ ❑ J INTRODUCTION 8 PROPOSED DEVELOPMENT SECTION ra+ Description of site, including zoning information. n[� ❑ Description of proposed development. Vr❑ Parcel location map. Site map showing location of all items on parcel (structures, drives,wells se tics stems, large trees pastures I ❑ p Y g . pools, natural drainage courses, ponds,waterways,etc. "- PRESENT AND PAST USES OF THE SITE SECTION ❑ Discussion of past and present uses at the site to assess potential problems. j EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION Description of existing septic tank usage on site (system types, age,functioning/repair rates). �❑ Site septic permit history(number/types/dates of permits, age of system, permit numbers,copies in report). ❑ Discussion of on-site septic tank repair history. ❑ Description of existing septic tank usage in the general area (system types, ages,function ing/re pair rates, proximity to parcel). �❑ General area septic permit history(number/types/dates of permits, age of system, permit numbers, copies in ❑ report). Discussion of general area septic tank repair history. ❑ ❑ Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site. GROUNDWATER INFORMATION SECTION ❑ Description of the depth and gradient of groundwater in the general area 2r E] Descriptionidiscussion of any existing or potential groundwater contamination issues in the l �enerai location of the site. ❑ Description of location (a_ddress/APN),type and construction of well, and location(well head/kitchen tap)where water samples were obtained. � �, � �— ❑ Description of constituents being tested for in the water sample. ❑ Description of how sample was obtained, handled,stored, and transported to the lab.. ❑ ❑ Complete Chain of Custody document,including printed and signed name of thirda sam ler, condition of ,_12sample, and date and time the sample was submitted to the lab. SOIL PROFILE INFORMATION SECTION ❑ ❑ Site map showing the location,with dimensions,of the soil profile Aon the parcel. ❑ Description of soil profile pit including depth and dimensions. �'❑ Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. ❑ ❑ Discussion of soil lithology as related to future onsite septic uses. PERCOLATION TEST INFORMATION SECTION ❑ Site map showing the location,with concise and accurate dimensions,of the percolation test holes on the parcel. The minimum number of shallow and deep percolation tests were performed for each parcel. ❑ Description of the date,time and protocol used to prepare the test hole, including depth and dimensions of hole, preparation of hole, and depth of water used to presoak(minimum 12 inches). -716 ❑ Description of the date,time and condition of the test hole after the 24 hour soak period (hole still intact, 6�edrmy, epth to water remaining in hole,etc.). ❑ The test conformed to SJC Policy EHD 02-02 (correct depth, diameter,2"gravel, 6"water refill, correct readings recorded). �❑ Complete (including readings)Percolation Test�RF rrm was provided with REHS{verification signature. The rate was ` correctly calculated using the last reading. M r 0_ Discussion of any potential problems predicted and/ori the need for an engineered or alternative septic system. [. ❑ Discussion of percolation rates in relation to the type and size of future leach fields needed at the site. CONCLUSION SECTION ❑ The report was sign d and stamped by the appropriately registered individual. OutVA4 a REVIEWED BY: REVIEWED DATE: