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SAN JOAQUI N COUNTY <br /> EPI,.tRONMENTAL HEALTH DEPARTNw&4T <br /> 304 E Weber Avenue 3d 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 /> FFITELOCATION: 10967 N. HWY. 99, LODI PA#: 07-359 (GP) <br /> REPORT DATE: 10/22/2007 <br /> S = sufficient <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> S I 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ® ✓ -� 1.1 Description of site, including zoning information. <br /> ®✓ 1.2 Description of proposed development. <br /> N -8- 1.3 Parcel vicinity location map. <br /> N✓ -a 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 /> N I/ -B- 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 /> N ✓ $- 3.1 Description of exiting on-site septic tank usage(system types, age,functioning/repair rates). <br /> N t/ Q 3.2 Site septic permit history(number/types/dates of permits, age of system,permit numbers, copies in report). <br /> N ✓ 8 3.3 Discussion of on-site septic tank repair history. <br /> N $ 3.4 Description of existing septic tank usage in the general area(system types, ages,functioning/repair rates, <br /> / proximity to parcel). <br /> N y 3.5 General area septic permit history(number/types/dates of permits,age of system,permit numbers,copies in <br /> report). <br /> N✓ 3.6 Discussion of general area septic tank repair history. <br /> N� 3.7 Description of proposed or expected maximum(including second unit dwellings)septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION <br /> 4.1 Description of the depth and gradient of groundwater in the general area. <br /> N� 4.2 Description/discussion of any existing and/or potential groundwater contaimination issues in the general location <br /> of the site. <br /> N✓ 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 /> N / 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 /> Ntj f3 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 /> N✓ -8 5.1 Site map showing the location,with dimensions,of the soil profile pit on the parcel. <br /> N✓ {3 5.2 Description of soil profile pit including depth and dimensions. <br /> N✓ E[ 5.3 Description of soil lithology as noted from test pit by appropriate professional using industry standard protocol. <br /> N ✓ fl-- 5.4 Discussion of soil lithology as related to future onsite septic uses. <br /> EHD 26-02-003 Page 1 of 3 Soil Suitability Checklist <br />