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) oc 64. <br />`csl iF00\ <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY— <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: (00 nr i/viii'.-Ee_ Lin Date: 3/3 l/-a2) <br />Test Performed by: j Pe --Fe4--- Permit#: 59_0 og34 11 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 />kV1(otes 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 />%./--Date and time of test hole prepar. ion. .2-72-4/20 2-) <br />k-Diameter and depth of test hol4 2" diameter and 36"-42" depth). -3. 55 ' cket-ii <br />Dimensions and depth of deep test hole (4"-12" diameter and 42"-25' or minimum 10' above seasonal high water table). <br />,---- Test hole preparation (scoring of sidewalls, removal of loose material). <br />s--- Weather conditions at time of testing (raining, windy, etc.) 5 c..t i,) vl. y <br />.' oil type and condition encountered in test hole. C.- ta- y <br />Addition of 2" of course sand or fine gravel to test hole. <br />..-e-soak by addition of minimum 12" of water over gravel (24-hours before test). <br />PERC TEST CONDITIONS, MEASUREMENTS, AND REPORTING <br />\--C-Ondition of test hole after the 24-hour pre-soak (amount of water remaining in the hole, any soil sloughing noted). .47 <br />...rs.prrect amount of water used to refill hole (6" over gravel). Documented on the recor tion sheet. <br />'-Description of type of perc test procedure used based on conditions (Procedure #1 #2 r#3). <br />‘./Accurate recordings of drop and refill of water in same measurements. <br />L-----Same fixed reference point used for each reading. Description of reference point used to be included in the final report. <br />'lath calculations checked for accuracy. <br />(-ginning 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 />0 COMMENTS -1, g6 rn,14/railn <br />, <br />REHS Name: et,/- i oL__ rt,5144 0L-- <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 />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.corn