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"''"` c SAN JOAQUIN COUNTY <br />z` .2 ENVIRONMENTAL HEALTH DEPARTMENT <br />Q:: 4 <br />1868 East Hazelton Ave Stockton, CA 95205 <br />(209) 468-3420 • Fax: (209) 464-0138 • Web: www.sjg v.org/ehd <br />q�/PORE <br />Soil Suitability study Requirements Checklist <br />RECORD ID: 5�V $56(10 <br />SITE LOCATION: 22)31b 0 'J, (t,-61-� ��-0 n � <br />REPORT DATE: <br />S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br />I = Insufficient <br />S / <br />I <br />1.0 <br />INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br />[/� <br />❑ <br />1.1 <br />Description of site, including zoning information. <br />Ey <br />/ <br />❑ <br />1.2 <br />Description of proposed development. <br />)v <br />3 If <br />FA <br />❑ <br />1.3 <br />Parcel vicinity location map. <br />[ <br />❑ <br />1.4 <br />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 />j❑ 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 />E/ ❑ 3.1 Description of exiting or <br />site septic tank usage (system types, age, functioning/re air rates). <br />ajaX Zxbo` �.�N�S 2X (N X kFxtopS <br />[ ❑ 3.2 Site septic permit history (number/types/dates of permits, age of system, permit numbers, copies in report). <br />1 d vJ '� S r, �,_ <br />f <br />PID ,�� p q,T,R, 5 <br />E/� ❑ 3.3 Discussion of on-site septic tank repair history. <br />E� ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br />proximity to parcel). S,A, <br />❑I ❑ 3.5 General area septic permit history (number/types/dates of permits, age of system, permit numbers, copies in <br />report). L �i� �_ V�. \.V'_j 4 S �_^ <br />E/J ❑ 3.6 Discussion of general area septic tank repair history. <br />[�] ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site. <br />4.0 GROUNDWATER INFORMATION SECTION <br />d❑ 4.1 Description of the depth and gradient of groundwater 'n the general area. <br />EHD 26-02-003 Page 1 of 3 Soil Suitability Checklist <br />7/14/2003 <br />