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, 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: A_L,0 %,e, \ -c\An 44,..I ym NciAs,pds? w4,5t.u .co I Date: _S \ \--\. .-ue.--LA <br />Test Performed by: I ,c L.\ <e Permit#: ..., Nica to PA#: <br />SITE MAP <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). Pert/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. •\--tv.,1‹,C2 (A.p.A.Z•v_, 2)(c).,-L-K.3->b tiv.a..4,,q,. <br />Notes all water wells. k6) N. 'CL ib.N5cA-A <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 preparation. <br />Diameter and depth of test hole (4"-12" diameter and 36"-42" depth). <br />A'=•%. 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 />\ Weather conditions at time of testing (raining, windy, etc.) <br />\ Soil type and condition encountered in test hole. 5f...-C?1/4-\ cct)49L— <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 />N. Condition of test hole after the 24-hour pre-soak (amount of water remaining in the hole, any soil sloughing noted). t• <br />-N Correct amount of water used to refill hole (6" over gravel). Documented on the recordation sheet. <br />N Description of type of perc test procedure used based on conditions (Procedure #1, #2, or #3). 4 <br />N 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 />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 />N Description of the date, time, and protocol used to prepare soil profile pit. <br />\ Description of soil profile pit including depth and dimensions. <br />`\NSoil lithology described by appropriate professional using industry standard protocol. <br />OMMENTS 1 It ,(N. (--Nr• <br />L 5 r <br /> <br />REHS Name: (-eZP.D.rN <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-x< 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