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SU0009384 SSNL
Environmental Health - Public
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SU0009384 SSNL
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Last modified
5/7/2020 11:34:00 AM
Creation date
9/8/2019 12:41:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0009384
PE
2631
FACILITY_NAME
PA-1200200
STREET_NUMBER
2900
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01315031
ENTERED_DATE
10/29/2012 12:00:00 AM
SITE_LOCATION
2900 E PELTIER RD
RECEIVED_DATE
10/25/2012 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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\MIGRATIONS\P\PELTIER\2900\PA-1200200\SU0009384\NL STDY.PDF
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EHD - Public
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OQ'� lN'•c SAN JOAQUIN COUNTY <br /> �a ENVIRONMENTAL HEALTH DEPARTMENT <br /> A, 304E Weber Avenue 3rd Floor Stockton • CA 95202-2708 <br /> ` P (209)468-3420 ■Fax:(209)464-0138 - Web:www.co.san-joaquin,ca.us/ehd <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> SITE LOCATION:2900 E.PELTIER ROAD,ACANIPO PA#: 12-200(SA) <br /> REPORT DATE: 6/28/2013 <br /> S = Sufficient <br /> I = Insufficient <br /> San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> Z / ❑ 1.1 Description of site, including zoning information. <br /> ® / ❑ 1.2 Description of proposed development. <br /> 0/ ❑ 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 /> ® � ❑ 2.1 Discussion of past and present uses at the site to assess potential problems. <br /> 3.0 EXISTING AND PROPOSED SEPTIC TANK USAGE SECTION <br /> ® vl ❑ 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 permits, age of system,permit numbers, copies in report). <br /> ®t/ ❑ 3.3 Discussion of on-site septic tank repair history. <br /> ® ,/ ❑ 3.4 Description of existing septic tank usage in the general area(system types, ages,functioning/repair rates, <br /> proximity to parcel). <br /> ® v1 ❑ 3.5 General area septic permit history(numberltypes/dates of permits, age of system, permit numbers,copies in <br /> report). <br /> ®✓ ❑ 3.6 Discussion of general area septic tank repair history. <br /> ® 1/ ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings)septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> ® i/ ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br /> ®V ❑ 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> �b <br /> 0/ ❑ 4.3 Description of location (address/APN), pe nd construction of well and location (well head/kitchen tap)where <br /> water sample(s)were obtained. <br /> ®/ ❑ 4.4 Description of constituents being tested for in the water sample. <br /> ® ❑ 4.5 Description of how sample was obtained, handled, stored, and transported to the lab. <br /> ® ❑ 4.6 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. For Laboratory samplers, complete laboratory <br /> report to include the above noted information. <br /> / 5.0 SOIL PROFILE INFORMATION SECTION <br /> ED/ ❑ 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 /> ❑ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> -� 0 ❑ 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> EHD 26-02-003 Pagel of 3 Soil Suitability Checklist <br />
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