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SAN JOAQUIN COUNTY -' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Ave Stockton, CA 95205 (209) 468-3420 • Fax: (209) 464-0138 • Web: www.sigov.org/ehd Soil Suitability study Requirements Checklist SITE LOCATION: RECORD ID: 5VD0 6S6�0 S �� REPORT DATE: IA I/l G1 't -0Z2 S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 I = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION 6 ❑ 1.1 Description of site, including zoning information. V❑ 1.2 Description of proposed development. 0 ❑ 1.3 Parcel vicinity location map. �f ❑ 1.4 Site map showing location of all items on parcels (i.e., structures, drives, wells, septic systems, large trees, pastures, pools, natural drainage courses, ponds, waterways, etc.) 2.0 PRESENT AND PAST USES OF THE SITE SECTION ❑ ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ❑ ❑ 3.1 Description of exiting on-sitelic,ank usage %sttem pes, age, functioning/repair rates). ❑ 3.2 Site sel�ti) permit history number/types/dates of permits, age of system, permit numbers, copies in report). [� ❑ 3.3 Discussion of on-site septic tank repair history. [d ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, proximity to parcel). [� ❑ 3.5 General area septic permit history (number/types/dates of permits, age of system, permit numbers, copies in report). [� ❑ 3.6 Discussion of general area septic tank repair history. ❑ 3.7 Description f propose or expected maxim m (in lIing second unit dwellings) septic tank usage on site. rL\v 0 � ��. Q. v 0.M - 00 p c� 4.0 GROUNDWATER INFORMATION SECTION P ❑ ❑ 4.1 Description of the depth and gradient of groundwater in the general area. to EHD 26-02-003 Page 1 of 3 Soil Suitability Checklist 7/14/9.003