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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave Stockton, CA 95205 <br />(209) 468-3420 - Fax: (209) 464-0138 • Web: www.sjaov.m,,/ehd <br />9�/FORS <br />Soil Suitability study Requirements Checklist <br />SITE LOCATION: �`�� �� , RECORD ID: <br />Iv REPORT DATE: <br />S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br />1 = Insufficient <br />S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br />M❑ 1.1 Description of site, including zoning information. <br />❑ 1.2 Description of proposed development. <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 />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 />F71 ❑ 3.1 Description of exiting on-site septic tank usage (system types, age, functioning/repair rates). <br />[� ❑ 3.2 Site septic permit history (number/types/dates of permits, age of system, permit numbers, copies in report). <br />E� ❑ 3.3 Discussion of on-site septic tank repair history. <br />[� ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br />proximity to parcel). <br />[%S ❑ 3.5 General area septic permit history (number/types/dates of permits, age of system, permit numbers, copies in <br />report). <br />❑ 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 />❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br />EHD 26-02-003 Page 1 of 2 Soil Suitability Checklist <br />7/14/2003 <br />