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SU0004363 SSNL
Environmental Health - Public
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PA-0200013
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SU0004363 SSNL
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Entry Properties
Last modified
5/7/2020 11:30:43 AM
Creation date
9/4/2019 10:42:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0004363
PE
2632
FACILITY_NAME
PA-0200013
STREET_NUMBER
17238
Direction
N
STREET_NAME
BRUELLA
STREET_TYPE
RD
City
LODI
APN
05109020
ENTERED_DATE
5/17/2004 12:00:00 AM
SITE_LOCATION
17238 N BRUELLA RD
RECEIVED_DATE
1/22/2002 12:00:00 AM
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\B\BRUELLA\17238\PA-0200013\SU0004363\NL STDY.PDF
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EHD - Public
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S surrIcient-W <br /> 1 = Insuflicicnt , <br /> S I 6.0 PERCOLATION TEST INFORMATION SECTION <br /> ❑ ❑✓ 6.1 Site map showing the location,with concise and accurate dimensions of the percolation test holes on the parcel. <br /> ❑✓ ❑ 6.2 The minimum number of shallow and deep percolation tests was performed for each parcel. <br /> ❑✓ ❑ 6.3 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 /> 0 ❑ 6A 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 /> ❑✓ ❑ 6.5 The test conformed to SJC Policy EHD 02-02(correct depth,diameter,2'gravel,6'water refill,correct readings <br /> recorded). <br /> ❑✓ ❑ 6.6 Complete Percolation Test Form(including readings)was provided with REHS verification signature. The rate <br /> was correctly calculated using the last reading. <br /> ✓❑ ❑ 6.7 Discussion of any potential problems predicted and/or the need for an engineered or alternative septic system. <br /> ❑✓ 0 6.8 . Discussion of percolation rates in relation to the type,size and location of future leach fields needed at the site. <br /> 7.0 CONCLUSION SECTION <br /> ❑✓ ❑ 7.1 The report was signed and stamped by`the appropriately registered individual <br /> Reviewed By: Lisa Medina, Sr. REHS Reviewed Date: 9/25/2003 <br /> Ettozb-O W Page-2 of <br /> M4=03 <br />
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