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Greatness grnwhere. <br />Environmental Health Department <br />PERCOLATION TES/SOIL PROFILE INSPECTION CHECKLIST <br />SJC Ordinance Code, Title 9, Section 9-1105.2 <br />EH Policy for Percolation Test Procedure 98-01 <br />Site Location:a <br />Date: <br />2 <br />�Z <br />Test Performed by: <br />Permit#: <br />2 S <br />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 septics stems, 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 />Date and time of test hole preparation. <br />Diameter and depth of test hole (4"-12" diameter and 36"-42" depth). <br />imensions and depth of deep test hole 4"1 ' diameter and 42"-25' or minimum 10' above seasonal high water table), 1 <br />Test hole preparation scoring of sidewalls, removal of loose material). <br />Weather conditions at time of testing raining, windy, etc. 5&thYe <br />,L/ <br />Soil type and condition encountered in test hole. <br />Addition 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 />PERC TEST CONDITIONS, MEASUREMENTS, AND REPORTING <br />vo <br />Condition of test hole after the 24-hour pre-soak amount of water remaining in the hole, any soil slow hin noted). <br />C rect 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 #1L,#2, r#3 . <br />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 />Path 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 <br />S0; <br />REHS Name: <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 minutes/inch <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 � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 1 wvvw.sjcehd.com <br />