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oPgUIN .c SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N. _ `{ 1868 East Hazelton Ave Stockton, CA 95205 <br /> . ' (209)468-3420 • Fax:(209)464-0138 • Web:www.sisov.ors/ehd <br /> 6.gC/FOR��P <br /> Soil Suitability study Requirements Checklist <br /> SITE LOCATION: <br /> RECORD ID: S14 —U0 119 <br /> b'� ` S �-M4 V + REPORT DATE. 16v7-al Z6 <br /> S = Sufficient <br /> = San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> Insufficient <br /> S 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ❑� ❑ 1.1 Description of site, including zoning information. <br /> ❑ 1.2 Description of proposed development. <br /> EX ❑ 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 <br /> trees, pastures, pools, natural drainage courses, ponds,waterways, etc.) <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION <br /> [� ❑ 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 /> 14 ❑ 3.1 Description of exiting on-site septic tank usage (system types, age,functioning/repair rates). <br /> Ej ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report). <br /> ❑ 3.1 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 /> El ❑ 3.5 General area septic permit history(number/types/dates of permits, age of system, permit numbers, <br /> copies in report). <br /> d ❑ 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 <br /> site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general <br /> location of the site. <br /> EHD 26-02-003 Page 1 of 2 Soil Suitability Checklist <br /> 7/1V2003 <br />