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SOIL SUITABILITY STUDY
<br /> REQUIREMENTS CHECKLIST
<br /> San Joaquin County Development Title
<br /> Chapter 9-1105,Section 9-1105.2 p�
<br /> v
<br /> PA#:
<br /> S=Sufficient SITE LOCATION: Zcj Cj �� N Ja r-� �V�t 0REPORT DATE: if _ Z
<br /> 1=Insufficient
<br /> ❑S 1 INTRODUCTION & PROPOSED DEVELOPMENT SECTION
<br /> Sr Description of site, including zoning information.
<br /> ❑.JK Description of proposed development.
<br /> ❑ Parcel location map.
<br /> ❑ ;K Site map showing location of all items on parcel (structures, drives,wells, septic systems, large trees, pastures,
<br /> j�T pools, natural drainage courses, ponds,waterways,etc.
<br /> PRESENT AND PAST USES OF THE SITE SECTION
<br /> ❑ Sr Discussion of past and present uses at the site to assess potential problems.
<br /> EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION
<br /> ❑ N7 Description of existing septic tank usage on site(system types, age,functioning/repair rates).
<br /> ❑ t� Site septic permit history(number/types/dates of permits,age of system, permit numbers,copies in report).
<br /> ❑ Discussion of on-site septic tank repair history.
<br /> ❑ Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, proximity to
<br /> parcel).
<br /> ❑ ®' General area septic permit history(number/types/dates of permits, age of system, permit numbers, copies in
<br /> report).
<br /> ❑ Discussion of general area septic tank repair history.
<br /> ❑ Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site.
<br /> GROUNDWATER INFORMATION SECTION
<br /> ❑ Description of the depth and gradient of groundwater in the general area.
<br /> ❑ �j Description/discussion of any existing or potential groundwater contamination issues in the general location of the site.
<br /> ❑ Description of location(address/APN),type and construction of well,and location (well head/kitchen tap)where
<br /> water samples were obtained.
<br /> Fv, ❑ Description of constituents being tested for in the water sample.
<br /> ❑ Description of how sample was obtained, handled,stored,and transported to the lab..
<br /> ❑ Complete Chain of Custody document, including printed and signed name of third party sampler,condition of
<br /> sample,and date and time the sample was submitted to the lab.
<br /> SOIL PROFILE INFORMATION SECTION
<br /> ❑ Site map showing the location,with dimensions,of the soil profile pit on the parcel.
<br /> ❑ Description of soil profile pit including depth and dimensions.
<br /> ❑ Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol.
<br /> '? Discussion of soil lithology as related to future onsite septic uses.
<br /> PERCOLATION TEST INFORMATION SECTION
<br /> ❑ ( Site map showinq the location,with concise and accurate dimensions,of the percolation test holes on the parcel.
<br /> �f ❑ ❑ The minimum number of shallow and deep percolation tests were performed for each parcel.
<br /> ❑ Description of the date,time and protocol used to prepare the test hole, including depth and dimensions of hole,
<br /> preparation of hole, and depth of water used to presoak(minimum 12 inches).
<br /> ❑ �] Description of the date,time and condition of the test hole after the 24 hour soak period (hole still intact, hole dry,
<br /> depth to water remaining in hole,etc.).
<br /> ❑ ❑ The test conformed to SJC Policy EHD 02-02(correct depth,diameter, 2"gravel, 6"water refill, correct readings
<br /> recorded).
<br /> ❑ ❑ Complete(including readings)Percolation Test Form was provided with REHS verification signature. The rate was
<br /> correctly calculated using the last reading.
<br /> ❑ Discussion of any potential problems predicted and/or the need for an engineered or alternative septic system.
<br /> ❑ Discussion of percolation rates in relation to the type and size of future leach fields needed at the site.
<br /> CONCLUSION SECTION
<br /> �❑ The report was signed and stamped by the appropria ly registered individual.
<br /> REVIEWED BY: yam• ( (/ A �/�E��l
<br /> REVIEWED DATE:
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