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./.? • r SAN JOAQUIN <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST <br />SJC Ordinance Code, Title 9, Section 9-1105.2 <br />EH D Policy for Percolation Test Procedure 98-01 <br />Site Location: 1030r E, -K,-ve.tr —lat , Date: 2_ j LO"?_. <br />Test Performed by: 1e.,-6-ex -it occ 0 Permit#: 6tefe 8 "531 L PAM <br />SITE MAP <br />,s ' <br />(' <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 />X 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 />3( <br /> Diameter and depth of test hole (4"-12" diameter and 36%42" depth). <br />Dimensions and depth of deep test hole (4"-12" diameter and 42%25' or minimum 10' above seasonal high water table). <br />K Test hole preparation (scoring of sidewalls, removal of loose material). <br />>s- Weather conditions at time of testing (raining, windy, etc.) ScAiiriy <br />X Soil type and condition encountered in test hole. S H -fy 56,44' Li/ C <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 />>c Condition of test hole after the 24-hour pre-soak (amount of water remaining in the hole, any soil sloughing noted). <br />r '. <br />Correct amount of water used to refill hole (6" over gravel). Documented on the recordation sheet. <br />s Description of type of perc test procedure used based on conditions (Procedure #1, #2, or #3). <br />)‹Accurate recordings of drop and refill of water in same measurements. <br />)C- Same fixed reference point used for each reading. Description of reference point used to be included in the final report. <br />X Math 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 --for( 4-6-fe_ 5, 56 <br />3,13 I <br />5-.---REHS Name:77/C k6,ey( siA--'7c(61-- Zs <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. <br />1.2' x 12° = 14.4" (convert from feet to inches) <br />10 minutes ÷ 14.4" = .69 minutes/inch <br />D 4200-xx 8-1-2018 <br />1868 E. Hazelton Avenue Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 www.sjcehd.com