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Op'pU1N, <br /> Q' .� S A N J 0 A 0 U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST <br /> S1C Ordinance Code,Title 9,Section 9-1105.2 <br /> EHD Policy for Percolation Test Procedure 98-01 <br /> Site Location: S o V;C r Date: 7-131,7-o v0 <br /> Test Performed b e✓ Permit#: I S Ke ol796 V PA#: <br /> SITE MAP <br /> Includes perc test and soil profile locations with accurate measurements from a fixed reference point(must be able to locate <br /> the test hole areas in the future). Perc/soil profile holes must meet distance setbacks as noted in the sewage standards for <br /> septic system locations. Percolation test holes and soil profile pits must be conducted in the area proposed for future septic <br /> systems. <br /> Notes any changes in elevation on the subject property. <br /> Notes all water wells. <br /> Notes all man-made features(septic sstems, drives, barns, outbuildings, animal pens, etc. <br /> Notes all natural features (ephemeral drainage courses, large stands of trees, ponds, rivers, etc. <br /> PERC TEST PREPARATION PROTOCOL <br /> U---Date and time of test hole preparation. 30 2420 <br /> Diameter and depth of test hole 4" 2' diameter and 36"-42"depth). 3 <br /> imensions and depth of deep test hole 4" 2")diameter and 42"-25'or minimum 10' above seasonal high water table). <br /> Jost hole preparation (scoring of sidewalls, removal of loose material). <br /> Weather conditions at time of testing (raining, windy, etc. <br /> Soil type and condition encountered in test hole. <br /> ition of 2"of course sand or fine gravel to test hole. <br /> Pre-soak by addition of minimum 12"of water over gravel 24-hours before test). <br /> PFRC TEST CONDITIONS, MEASUREMENTS,AND REPORTING <br /> Condition of test hole after the 24-hour re-soak amount of water remaining in the hole,any soil sloughing noted . <br /> orrect amount of water used to refill hole 6"over gravel). Documented on the recordation sheet. <br /> 'Description of type of perc test procedure used based on conditions Procedure#1,#2, r#3). <br /> k,Accurate recordings of drop and refill of water in same measurements. <br /> Same fixed reference point used for each reading. Description of reference point used to be included in the final report. <br /> calculations checked for accuracy. <br /> Beginning and end measurements of the last reading verified by REHS. All above reviewed and verified by REHS. <br /> SOIL PROFILE <br /> Description of the date,time, and protocol used to prepare soil profile pit. <br /> Description of soil profile pit including depth and dimensions. <br /> Soil lithology described by appropriate professional using industry standard protocol. <br /> COMMENTS �I l /� C � �P�t'C r- 6 h <br /> --rH who- -aSo Ain, n 4 , <br /> REHS Name:�])D'-ve-1 p— ke�r-4 C�— <br /> Calculations Examples. <br /> Last drop reading=.07'over 30 minutes time. Last drop reading=1.2'over 10 minutes time. <br /> .07'x 12"=.84"(convert from feet to inches) 1.2'x 12"=14.4"(convert from feet to inches) <br /> 30 minutes—.84"=35.7 minutes/inch 10 minutes_14.4"=.69 minutes/inch <br /> EHD 4200-xx 8-1-2018 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />