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SAN JOAQUIN COUNTY Er.-JIRONMENTAL HEALTH DEPAR i -ENT 600 East Main Street, Stockton■CA 95202-3029 . � (209)468-3420 •F=(209)464-0138• Web:www.co.san-joaquin.ca.us/ehd FoH� SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST FLocmiow ,1- PAM REPORT DATE: rjAN/9 S - Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 1 = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION ❑ 1.1 Description of site including zoning information. ❑ 1.2 Description o�rpposed development. ❑ ❑ 1.3 Parcel vidfiity location map. *` - ❑ 1.4 Site map showing location of all items on parcels(i.e.,structures, drives, wells,septic systems,large trees, pastures, pools, natural drainagecc urs�e pponds,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./2// 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION ® ❑ 3.1 Description of exiting on-site septic tank usage(system types, age,functioning/repair rates). C+�Z El 3.2 Site septic permit history(numberltypes/dates�f permits,age of system, permit numbers,copies in report). ❑ 3.3 Discussion of on-site septic tank repair history.a �( ❑ 3.4 Description of existing septic tank usage in the general area(system types,ages,functioning/repair rates, proximity to parcel). �2- ❑ 3.5 General area septic permits)history(number/types/dates of permits, age of system,permit numbers,copies in report). ❑ 3.6 Discussion of general area septic tank repair history. z ,®- ❑ 3.7 Descripti on of proposed or expected maximum(including second unit dwellings)septic tank usage on site. 4.0 GROCINrDWATER INFORMATION SECTION a ®_ ❑ 4.1 Description of the depth and gradgent of groundwater in the general area. ❑ 4.2 Description/discussion of anyttistng and/or potential groundwater contamination issues in the general location of the site. V I E] ❑ 4.3 Description of location(address/APN),type and construction of well and location(well head/kitchen tap)where water sample(s)were obtained. I ❑ 4.4 Description of constituents being tedted for in the water sample. t ❑ ❑ 4.5 Description of how sample was oT3taillr�.��e-d, handled, stored,and transported to the lab. y El— ❑ 4.6 Complete Chain of Custody documen, including printed and signed name of third party sampler,condition of sample and date and time the sample was submitted to the lab. For laboratory samplers,complete laboratory report to include the above noted information. '-.l t Afpa- L,�w 5.0 SOIL PROFILE INFORMATION SEC710� ❑ 5.1 Site map showing the location,with dimegsions,of the soil profile pit on the parcel. E] 5.2 Description of soil profile pit including dept7h and dimensions. V ❑ 5.3 DescriiKti Sof soil lithology as noted from test pit by appropriate professional using industry standard protocol. ❑ 5.4 Discus&n of soil lithology as related to future onsite septic uses. 2- -b EHD 26-02-003 G Pagel of 3 Soil Suitability Checklist -ill AI'I!1!1']