SU0006292 SSNL - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3`d Floor Stockton • CA 95202-2708 JJ (209)468-3420 • Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/chd 9�IFOR? SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST PA ISITELoCATION: 32Z I Y yytl-} �F�{{ve c- REO 06 - s/y / } � REPORT DATE: j S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 1 = Insufficient S 1 1.0 INTRODUCTION B PROPOSED DEVELOPMENT SECTION VY ❑ 1.1 Description of site, including zoning information. P� ❑ 1.2 Description of proposed development. l P�Z^1 �. F-11.3 Parcel vicinity location map. L/ - k 2 } / ® ❑ 1.4 Site map showing location of all items on parcels(i.e., structures, drives, wells, septic systems, large trees, pastures, pools, natural drainage courses, ponds,waterways, etc.)(4L) ( 1 2.0 PRESENT AND PAST USES OF THE SITE SECTION ❑ 2.1 Discussion of past and present uses at the site to assess potential problem. =) 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ❑ 3.1 Description of exiting on-site septic tank usage (system types, age,functioning/repair ratE�).fp-23 ®. ❑ 3.2 Site septic permit3history (number/types/dates of permits, age of system, permit numbers, copies in report). ❑C ❑ 3.3 Discussion of on-site septic tank repair histor( _9�53) ® ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, proximity to parcel). ,�y 3) ® ❑ 3.5 General area septic permit(s)history(number/types/dates of permits, age of system, permit numbers,copies in report), 00-�j ® ❑ 3.6 Discussion of general area septic tank repair history, 4/) ®, ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site. 4.0 GROUNbWATER INFORMATION SECTION / ® ❑ 4.1 Description of the((de�pthyind gradient of groundwater in the general area/ P ❑p F] 4.2 Description/discuse�rf of 4ny existing and/or potential groundwater contamination issues in the general location of the site. q") ® ❑ 4.3 Description of location (address/APN),type and construction of well and location (well head/kitchen tap)where water sampl�ssy)� Vire obtained.,�,�,,,/�/ } ® ❑ 4.4 Descriptio _Aonstituents being tested for in the water sample. .. a ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lat( ❑ 4.6 Complete Chain of Custody 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. 5.0 SOIL PROFILE INFORMATION SECTION ❑ 5.1 Site map showing the location,with dimensions, of the soil profile pit oMarcel. Ma+ -m'j� )� e FF ® ❑ 5.2 Description of soil profile pit including depth and dimensions. Irb) ® ❑ 5.3 Description of soil lithglogy as�noted from test pit by appropriate professional using industry standard protocol. (/ 6 I [� ❑ 5.4 Discussion of soil lithoay as related to future onsite septic uses. EHD 2642-003 b/ Pagel of 3 Soil Suitability Checklist