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SAN JOAQUIN <br />COUNTY <br />Environmental Health Department <br /> <br />TF004\ <br /> Greatness grows here. <br />PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST <br />SJC Ordinance Code, Title 9, Section 9-1105.2 <br />END Policy for Percolation Test Procedure 98-01 <br />Site Location: 2 3 vt ti ,,,y ri rt- 7' A Date: / (Yjiao W <br />Test Performed by: 1/./Ar el ShAtli Permit* 512OCVZ aj PA#: <br />SITE MAP <br />V <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 />, r Notes all water wells. <br />V/ Notes all man-made features (septic systems, drives, barns, outbuildings, animal pens, etc.) <br />v Notes all natural features (ephemeral drainage courses, large stands of trees, ponds, rivers, etc.) <br />P <br />ERC TEST PREPARATION PROTOCOL <br />\. Date and time of test hole preparation. \ <br />Diameter and depth of test hol 4" 12" dia eter and 4130, 2" depth). <br />Dimensions and depth of deep test hole 2" diame er and 42-25' or minimum 10' above seasonal high water table). <br />est hole preparation (scoring of sidewalls, removal of loose material). <br />conditions at time of testing (raining, windy, etc.) StAtil <br />V <br />' <br />V Weather <br />Soil type and condition encountered in test hole. C L <br />V Addition of 2" of coursza) or fine gravel to test hole. $G‘4•1-64-- 1 11 <br />V Pre-soak by addition of minimum 12" of water over gravel (24-hours before test). <br />, 7 PERC TEST CONDITIONS, MEASUREMENTS, AND REPORTING <br />Vz Condition of test hole after the 24-hour pre-soak (amount of water remaining in the hole, any soil sloughing noted). <br />V/ Correct amount of water used to refill hole (6" over gravel). Documented on the recordation sheet. <br />V Description of type of perc test procedure used based on conditions (Procedure #1, #2, or #3). <br />V Accurate recordings of drop and refill of water in same measurements. t& <br />Same fixed reference point used for each reading. Description of reference point used to be included in the final report. <br />Math calculations checked for accuracy. <br />V Beginning and end measurements of the last reading verified by REHS. All above reviewed and verified by REHS. <br />. / SOIL PROFILE <br />Y/ 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 indust standard e otocol. _using <br />COMMENTS * 0 Co 17i 4iite-S reit _rt., ck <br />REHS Name: <br />: <br />(Chri .6 ( 5 L.S3 L/C <br />Calculations Example <br />Last drop reading = .07' over 30 minutes time. <br />.07' x 12" = .84" (convert from feet to inches) <br />30 minutes ÷ .84" = 35.7 minutesfinch <br />Last drop reading = 1.2' over 10 minutes time. <br />1.2' x 12" = 14.4" (convert from feet to inches) <br />10 minutes ÷ 14.4" = .69 minutes/inch <br />EHD 4200-xx 8-1-2018 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com