SU0005292_SSCRPT - Laserfiche WebLink

Home Browse Search

,oF �oG SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3rd Floor Stockton ■ CA 95202-2708 (209)468-3420 • Fax:(209)464-0138 • Web:www.co.san-Joaquin.ca.us/ehd SURFACE AND SUBSURFACE CONTAMINATION REPORT REQUIREMENT CHECKLIST /7 - PA#: Q—'�� EM1�ON: ��r ��/ _ ��' . �ti [ /Y REPORT DATE: S = sufficient San Joaquin County Development Title Chapter 9-905,Section 9-905.12 I = Insufficient S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION �`�� [] 1.1 Description of site (report must address all parcels), including current and/or proposed zoning information. ❑ [ 1.2 bescliption of proposed development, j] 1.3 Parcel location map. j�,�� ❑ 1.4 Site map showing location of all items on parcel. (Examples: strut'-r�cr!'H%iPc_waI1S-F52ntIC-sVsteR1S,.large trees,__ pastures, pools, natural drainage courses, ponds,waterways, etc.p 2.0 PAST, PRESENT AND PROPOSED FUTURE USES 2.1 Discussion of past, present and proposed future uses at the site tc / �� ❑ of information:current and/or previous property owners, historical applications, etc.) �c 3.0 IDENTIFICATION OF ALL PAST AND CURRENT S E3— ❑ 3.1 Discussions of the methods used to research and investigate the Y sources of contamination at the project site. (Examples: DatabaE. chemical application search, site reconnaissance and survey, etc, �� / ❑ 3.2 Description of all past on-site potential and/or known above and b at the project site, (Examples: Agricultural chemical handling/sto C septic systems, injection wells, unsealed wells, ponds/lagoons,ve stockpiled solid waste, etc.) @��2P� /�—/�� f ❑ 3.3 Description of all current on-site potential and/or known above ad, —l1 identified at the project site (see examples above). ❑ 3.4 Description of all past off-site potential and/or known above ar in the area of the project site that has or may impact the proje landfill/former gasoline station,in area of known DBCP/Nitrate C a� ❑ 3.5 Description of all current off-site potential and/or known above identified in the area of the project site. ' 4.0 EVALUATION OF PAST AND CURRENT SOUR AT OR NEAR THE SITE AND RECOMMENDATI X ��j.� ❑ 4.1 Evaluation of each potential and/or known source of contamiri and/or potential threat to human health and the environment.' proposed future uses of the project parcel. 5.0 CONCLUSIONS AND RECOMMENDATIONS SE �i � ❑ 5.1 Discussion of the above evaluation to either rule out each sora >� �X:� ��✓�-� a� further action to mitigate or abate any real or potential threats. additional site assessment(i.e. collection of soil/water sample � � ��, surface wastes). All recommendations for future work must it ❑ 5.2 The report was inclusive (i.e.all information referenced was it other reports). ❑ 5.3—The report was signed, dated and stamped by a qualified environmental-professional. ❑ 5.4 The report was prepared within six months of the date of the submittal of the land use application 8� ❑ 5.5 The attachments/appendices contain sufficient documentation to support claims made in report. 01-1� Reviewed By: Lisa Medina Sr. R.E.H.S. Reviewed Date: EHD 26-02-001 Pagel of 2 Surface&Sub Checklist