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<br /> } a 304 E Weber Avenue 3r°Floor Stockton • CA 95202-2708
<br /> (209)468-3420 •Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd
<br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST
<br /> EECATION: 18327 E. ST RTE. 88, CLEMENTS, CA PA##: 03-569
<br /> REPORT DATE: APRIL, 2005
<br /> If S = Sufficient
<br /> f l = Insufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2
<br /> S T .0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION
<br /> El Description of site,including zoning information.
<br /> P 9 9
<br /> ® ❑ 1.2 Description of proposed development.
<br /> ® ❑ 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 trees,
<br /> pastures, pools,natural drainage courses,ponds,waterways,etc.)
<br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION
<br /> ❑ 22.1 Discussion of past and present uses at the site to assess potential Oroblems.
<br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION
<br /> 4 ❑ sr'_�3.1 Description of exiting on-site septic tank usage(system types,age,functioning/repair rates).
<br /> ❑ 3.2 Site septic permit history(number/types/dates of pen-nits,age of system, permit numbers, copies in report).
<br /> ❑ �3.3 Discussion of on-site septic tank repair history.
<br /> ❑ x/3.4 Description of existing septic tank usage in the general area(system types, ages,functioning/repair rates,
<br /> proximity to pardel).
<br /> ❑ EK,3.5 General area septic permit history(number/types/dates of permits, age of system, permit numbers, copies in
<br /> report).
<br /> ❑ [Ek"'�'3.6 Discussion of general area septic tank repair history.
<br />'r ❑ E� ..7 Description ofiproposed or expected maximum.(Inclu ding second unit dwellings)septic tank usage an site.
<br /> a.eee ter,.
<br /> -::, -
<br /> 4.0 GROUNDWATER INFORMATION SECTION
<br /> 'e--4-1 Descri tion of the depth and gradient of groundwater in the general area.
<br /> ❑ ® P P 9 9 9 �
<br /> ❑ 0--4.2 Descriptionldiscussion of any existing and/or potential groundwater contamination issues in the general location
<br /> of the site. e-2 r
<br /> 4.3 Description of location (address/APN),type and construction of well and location (well head/kitchen tap)where
<br /> water sample(s)were obtained.
<br /> -E} � 4.4 Description of constituents being to§ted for in the water sample(__'_L'_
<br /> �b C�r�, �Che..,'Ia`I
<br /> E"-®— 4.5 Description of how sample was obtained, han stored,and trans orte .
<br /> 4.6 Complete Chain of Custody document, including printeand.signed name of third party sampler, condition of
<br /> sample and date and time the sample was submitted to the lab. For Laboratory samplers,complete laboratory
<br /> report to include the above noted information.yl� c�
<br /> 5.0 SOIL PROFILE INFORMATION SECTION
<br /> ® ❑ 5.1 Site map showing the location,with dimensions, of the soil profile pit on the parcel.
<br /> ® ❑ 5.2 Description of soil profile pit including depth and dimensions.
<br /> i
<br /> ® ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol.
<br /> ® ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses.
<br /> EHD 26102-003 Page 1 of 3 Soil Suitability Checklist
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