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SANsHAQUIN t. COUNTY <br />\Lit rF2e>"' <br />Environmental Health Department <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: 2..k6 tkti, 5, Caral H01\00,1 12,1 . Tracki <br />Test Performed by: -pc", ckv,sfte i Permit#: I ROC.)B -509S <br />Date: ) iii 01 <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 (septic systems, 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 />%S Date and time of test hole preparation. <br />I\ S Diameter and depth of test hole (4"-12" diameter and 36-42" depth). <br />t\ 5 Dimensions and depth of deep test hole (4"-12" diameter and 42"-25' or minimum 10' above seasonal high water table). <br />Af-) Test hole preparation (scoring of sidewalls, removal of loose material). <br />Weather conditions at time of testing (raining, windy, etc.) <br />AS 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 />..,`-• Condition of test hole after the 24-hour pre-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 recordation sheet. <br />Description of type of perc test procedure used based on conditions (Procedure #1, #2, or #3). <br />1,5 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 />VD . Math calculations checked for accuracy. <br />v., . Beginning and end measurements of the last reading verified by RENS. All above reviewed and verified by RENS. <br />SOIL PROFILE <br />1\5, Description of the date, time, and protocol used to prepare soil profile pit. <br />Pk.S Description of soil profile pit including depth and dimensions. <br />S. Soil lithology described by appropriate professional using industry standard protocol. <br />COMMENTS <br />vtc-ki (..\cr, -r-c: eA pti,s- ne <br />RENS Name: <br />Calculations Examples: <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. .ti <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