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oP°`''"' c SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Ave Stockton, CA 95205 •+i��, P (209)468-3420 • Fav:(209)464-0138 • Web:www.sjgov.org/ehd Soil Suitability study Requirements Checklist SITE LOCATION: 1901 PATTERSON AVENUE,STOCKTON RECORD ID: SR0082156 REPORT DATE: MAY 29,2020 S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 1 = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION 1.1 Description of site, including zoning information. ® ❑ 0 0.228 Acres • Existing out of service well 1.2 Description of proposed development. ® ❑ 0 Small 2 bedroom residence • Use existing well ® ❑ 1.3 Parcel vicinity location map. ® ❑ 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.) 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. 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 septic permit history(number/types/dates of permits,age of system, permit numbers, copies in report). ® ❑ 3.3 Discussion of on-site septic tank repair history. ® ❑ 3.4 Description of existing septic tank usage in the general area(system types, ages,functioning/repair rates, proximity to parcel). ® ❑ 3.5 General area septic permit history(number/types/dates of permits, age of system, permit numbers, copies in report). ® ❑ 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 GROUNDWATER INFORMATION SECTION ® ❑ 4.1 .Description of the depth and gradient of groundwater in the general area. 70-115 feet below grade ® ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination 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 obtained. • Well water not tested ❑ ® 4.4 Description of constituents being tested for in the water sample. ❑ ® 4.5 Description of how sample was obtained, handled,stored, and transported to the lab. ❑ ® 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 EHD 26-02-003 Pagel of 3 Soil Suitability Checklist