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SR0083989
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4200/4300 - Liquid Waste/Water Well Permits
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SR0083989
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Last modified
8/4/2021 4:44:33 PM
Creation date
8/4/2021 4:32:51 PM
Metadata
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Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0083989
PE
4222
STREET_NUMBER
22029
Direction
E
STREET_NAME
THIRD
STREET_TYPE
AVE
City
LINDEN
Zip
95236
APN
09348002
ENTERED_DATE
7/22/2021 12:00:00 AM
SITE_LOCATION
22029 E THIRD AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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aU1�� SAN -JOAQUIN p <br /> Environmental Health Department <br /> COUNTY <br /> Greotness arows 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: Z L o z--, I Date: Z <br /> Test Performed by: Permit#: 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 sstems,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). Z' <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 /> Weather conditions at time of testing(raining,windy,etc. <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 /> Condition of test hole after the 24-hour re-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 /> 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 /> Be innin and end measurements of the last reading verified by REHS.All above reviewed and verified by RENS, <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 rofessional using industry standard protocol. <br /> COMMENTS <br /> REHS Name: <br /> calculations Examples: <br /> Last drop reading=.07'over 30 minutes time. Last drop reading=1,2'over 10 minutes time, <br /> .07'x 12"=.84"(convert from feet to inches) 1.2'x 12"=14.4"(convert from feet to inches) <br /> 30 minutes+.84"=35.7 minutes/inch 10 minutes=14.4'=.69 minutesfinch <br /> EHD4200-roc 8-1-2018 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 vwwv.sjcehd.com <br />
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