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N <br />\It spole'" <br />SAN JOAQUIN <br />— COUNTY <br />Environmental Health Department <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: I% tlopii: : 4 1 i Alg. - cr)100440("k I Date: _ /.- i IS12 2_ <br />Test Performed by: QA- ex 9 : , 0 Permit#: 5w_ OoS q 6303 PA#: <br />SITE MAP <br />7, <br />V <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 />J/" Notes any changes in elevation on the subject property. <br />V Notes all water wells. <br />i/-Notes all man-made features (septic systems, drives, barns, outbuildings, animal pens, etc.) <br />-g -I\lotes 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 />1--"- Diameter and depth of test hole (4"-12" diameter and 36"-42" depth). <br />1/Dimensions and depth of deep test hole (4"-12" diameter and 42-25' or minimum 10' above seasonal high water table). <br />1 ---Test hole preparation (scoring of sidewalls, removal of loose material). <br />i.—Weather conditions at time of testing (raining, wind , . <br />i7S-oil type and condition encountered in test hole. <br />eV Addition of 2" of course sand or fine gravel to test hole. <br />.s/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 pre-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 />iv Accurate recordings of drop and refill of water in same measurements. <br />V 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 />i./ Beginning and end measurements of the last reading verified by REHS. All above reviewed and verified by REHS. <br />SOIL PROFILE <br />VDescription of the date, time, and protocol used to prepare soil profile pit. <br />V Description of soil profile pit including depth and dimensions. <br />/v . Soil lithology described by appropriate professional using industry standard protocol. <br />COMMENTS 0 <br />LOC- A q? 1 <br />(ii°3 LOU <br />3Z <br />9,16 <br />7 REHS Name: a-traj)ativvA55 . 11\ • 2-1? , L <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 www.sjcehd.com