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SAN iJ O A Q U I N Environmental Health Department <br /> \ '. COUNTY <br /> Greatness grows here. <br /> PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST <br /> SJC Ordinance Code,Title 9,Section 9-1105.2 <br /> EHD Policy for Percolation Test Procedure 98-01 <br /> Site Location: 26k <br /> Test Performed b i C 6W-6 Permit . 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 systems, drives, barns, outbuildings, animal pens,etc. <br /> Notes all natural features(ephemeral drainage courses, large stands of trees, ponds, rivers, etc. <br /> ERC TEST PREPARATION PROTOCOL <br /> ate and time of test hole preparation. <br /> Diameter and depth of test hole 4' 12"diameter and 36" 42" epth . <br /> Dimensions and depth of deep test hole 4"-12"diameter and 42"-25' or minimum 10' above seasonal high water table). <br /> Test hole preparation(scoring of sidewalls, removal of loose material). <br /> Bather conditions at time of testing (raining, windy,etc. S(� �✓ <br /> oil type and condition encountered in test hole. Sc; �7 - <br /> Addition of 2"of course sand or fine gravel to test hole. <br /> re-soak by addition of minimum 12"of water over gravel 24-hours before test). <br /> ERC 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 /> Correct amount of water used to refill hole 6"over gravel). Documented on the recor tion sheet. <br /> escri tion of type of perc test procedure used based on conditions Procedure# # or#3). <br /> _f�4Accurate 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 /> J\Aath 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 3 S �-I y 'J'1� v.tf S e V i/1" Ck/ �, '^V, Z') <br /> Sat I 'j-�"S tio(Sfi <br /> REHS Name: <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 /> EHD4200-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 />