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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Ave Stockton, CA 95205 <br />(209) 468-3420 • Fax: (209) 464-0138 • Web: www .sjfzov .ore.lehd <br />Soil Suitability study Requirements Checklist <br />SITE LOCATION: e • c?....e.rEs,-s çiZ _ (zit) o • RECORD ID:5 $2-, b`..k---) (-4 <br />REPORT DATE: <br /> <br />S =Sufficient <br />I = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br />1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br />Ei 1.1 Description of site, including zoning information. <br />1.2 D1.9.4tion of proposed development. <br /> <br />1.3 Parcel vicinity location map. <br />1.4 Site map showing location of all items on parcels (i.e., structures, drives, wells, septic systems, large trees, <br />pastures, pools, natural drainage courses, ponds, waterways, etc.) <br />2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> <br />0 2.1 Discussion of past and present uses at the site to assess potential problems. <br />3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> <br />0 3.1 Description of exiting on-site septic tank usage (system types, age, functioning/repair rates). <br />177 '' 0 3.2 Site septic permit history (number/types/dates of permits, age of system, permit numbers, copies in report). <br />li- El 3.3 Discussion of on-site septic tank repair history. <br /> <br />iE] 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br />proximity to parcel). <br />17( 0 3.5 General area septic permit history (number/types/dates of permits, age of system, permit numbers, copies in <br />report). <br />17( 0 3.6 Discussion of general area septic tank repair history. <br />11( 0 3.7 Description of groposed or eApect,ed maximum (including second unit dwellings) septic tank usage on site. <br />14-6 <br />4.0 GROUNDWATER INFORMATION SECTION <br />11 0 4.1 Description of the depth and r dient of groundwater in the gen,er I area. <br />w /V. kV 6 m t WI III 4.2 Delirition/discussion of any existing and/or potential ground ater contaimination issues in the general location <br />of the site. <br />4.3 Description of location (address/APN), type and construction of well and location (well head/kitchen tap) where <br />water sample(s) were obtained. <br /> <br />4.4 Description of constituents being tested for in the water sample. <br /> <br />4.5 Description of how sample was obtained, handled, stored, and transported to the lab. <br />EHD 26-02-003 <br /> Page 1 of 3 <br />Soil Suitability Checklist <br />7/14/7(101