|
PQ•u l"•• c SAN JOAQUIN COUNTY
<br />T, '•.o
<br />-"�' '? ENVIRONMENTAL HEALTH DEPARTMENT
<br />�.� 1868 E. Hazelton Ave, Stockton • CA 95202-3029
<br />,_ (209) 468-3420 • Fnz: (209) 464-0138 •Web: www.co.san joaquin.ca.us/ehd
<br />SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST
<br />SITE LOCATION: V��� St �aCl� `I��''�- /��, 6���<����
<br />PA#:
<br />REPORT DATE:
<br />S =Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2
<br />I = Insufficient
<br />S I 1.0 INTRODUCTION 8� PROPOSED DEVELOPMENT SECTION
<br />❑Q ❑ 1.1 Description of site, including zoning information.
<br />0 ❑ 1.2 Description of proposed development.
<br />,� / ❑ 1.3 Parcel vicinity location map.
<br />❑ 1.4 Site map showing location of all items on parcels (i.e., structures, drives, wells, septic systems, large trees,
<br />pastures, pools, natural drainage courses, ponds, waterways, etc.)
<br />2.0 PRESENT AND PAST USES OF THE SITE SECTION
<br />❑ ❑ 2.1 Discussion of past and present uses at the site to assess potential problems.
<br />3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION
<br />❑ ❑ 3.1 Description of exiting on-site septic tank usage (system types, age, functioning/repair rates).
<br />❑ ❑ 3.2 Site septic permit history (number/types/dates of permits, age of system, permit numbers, copies in report).
<br />❑ 3.3 Discussion of on-site septic tank repair history.
<br />❑ ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates,
<br />proximity to parcel).
<br />❑ ❑ 3.5 General area septic permits) history (number/types/dates of permits, age of system, permit numbers, copies in
<br />report).
<br />❑ ❑ 3.6 Discussion of general area septic tank repair history.
<br />❑ ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site.
<br />4.0 GROUNDWATER INFORMATION SECTION
<br />❑ ❑ 4.1 Description of the depth and gradient of groundwater in the general area.
<br />❑ 4.2 Description/discussion of any existing and/or potential groundwater contamination issues in the general location
<br />of the site.
<br />❑ ❑ 4.3 Description of location (address/APN), type and construction of well and location (well head/kitchen tap) where
<br />water samples) were obtained.
<br />❑ ❑ 4.4 Description of constituents being tested for in the water sample.
<br />❑ ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab.
<br />❑ ❑ 4.6 Complete Chain of Custody document, including printed and signed name of third party sampler, condition of
<br />sample and date and time the sample was submitted to the lab. For Laboratory samplers, complete laboratory
<br />report to include the above noted information.
<br />5.0 SOIL PROFILE INFORMATION SECTION
<br />❑ ❑ 5.1 Site map showing the location, with dimensions, of the soil profile pit on the parcel.
<br />❑ 5.2 Description of soil profile pit including depth and dimensions.
<br />❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol.
<br />❑� ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses.
<br />Pana 1 of 2 c,,a c..:..,ti,: r..., rt.,.,.t,t:,..
<br />
|