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SAN JOAQUIN Environmental Health Department COUNTY fFO- Greatness grows here. PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST SJC Ordinance Code, Title 9, Section 9-1105.2 EHD Policy for Percolation Test Procedure 98-01 Site Location: RH ( Etwy '2—b Date: 11/5//Y Test Performed by: 1 Al P..-44,_ Permit#: 5e0 0 givis PA#: SITE MAP Includes perc test and soil profile locations with accurate measurements from a fixed reference point (must be able to locate the test hole areas in the future). Perc/soil profile holes must meet distance setbacks as noted in the sewage standards for septic system locations. Percolation test holes and soil profile pits must be conducted in the area proposed for future septic gstems. Notes any changes in elevation on the subject property. Notes all water wells. Notes all man-made features (septic systems, drives, barns, outbuildings, animal pens, etc.) Notes all natural features (ephemeral drainage courses, large stands of trees, ponds, rivers, etc.) PERC TEST PREPARATION PROTOCOL ,/ Date and time of test hole preparation. I I / ZOM -- Diameter and depth of test hole (4"-12" diameter and 36-42" depth). L.-'Dimensions l'ilmensions and depth of deep test hole (4"-12" diameter and 42-25' or minimum 10' above seasonal high water table) rid . on Test hole preparation (scoring of sidewalls, removal of loose material). Weather conditions at time of testing (raining, windy, etc.) Soil type and condition encountered in test hole. C I q k/ --Addition of 2" of course sand or fine gravel to test hole. Pre-soak by addition of minimum 12" of water over gravel (24-hours before test). PERC TEST CONDITIONS, MEASUREMENTS, AND REPORTING - Condition of test hole after the 24-hour pre-soak (amount of water remaining in the hole, any soil sloughing noted). '-- Correct amount of water used to refill hole (6" over gravel). Documented on the recordation sheet. Description of type of perc test procedure used based on conditions (Procedure #1, #2, or #3). (1 --11.0,-t r Accurate recordings of drop and refill of water in same measurements. ')4. Same fixed reference point used for each reading. Description of reference point used to be included in the final report. \----Math calculations checked for accuracy. Beginning and end measurements of the last reading verified by REHS. All above reviewed and verified by REHS. SOIL PROFILE Description of the date, time, and protocol used to prepare soil profile pit. Description of soil profile pit including depth and dimensions. Soil lithology described by appropriate professional using industvtandard protocol. COMMENTS A rcee_A _ wo no-I-- or , si--6z_ .i.--- I :4)0 i-üO r :ie7 T k- lort re,,t1exi t•4 I:7-0 avid r :$5,, /4/45tArect , eiy ela-citil 04-1- A-4) ek_ 1,01--geri e‘ 4A..2_ , Ac62._ 04,ti c,itv14'it9 fAt_ 40, ingv-ic ck, (-414 . Lc44- reo-ci t A4 P- 0/0,4<._ woi Gcritverli A .4.- ri-i- 410-14‘.1)S t t'S ' il' i kit co-I-4 7%3,4 -'' I ' 8_ i -t efrof tar 4-1.ty 1,..e4i 4 1.A4k teve oil iclitA-X 2s :la REHS Name: ri) bi-{0.. Agitd s o._ - clue -6 -go- y Kai-LI Calculations Examples: Last drop reading = .07' over 30 minutes time. .07' x 12" = .84" (convert from feet to inches) 30 minutes ÷ .84" = 35.7 minutes/inch Last drop reading = 1.2' over 10 minutes time. 1.2' x 12" = 14.4" (convert from feet to inches) 10 minutes ÷ 14.4" = .69 minutes/inch END 4200-xx 8-1-2018 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.conn