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I, SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> V . 304 E Weber Avenue 3d Floor Stockton • CA 95202-2708 <br /> cP.. (209)468-3420 •Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> 9�IFORN <br /> SOIL SUITABILITY STUDY REQUIREMENTS CHECKLIST <br /> PA#: 05-.'/O <br /> REPORT DATE: / �C7fJ6 <br /> = Sufficient <br /> I = Insufficient <br /> San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br /> S 1 1.0 INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br /> ❑ 1.1 Description of site, including zoning information <br /> / ® ❑ 1.2 Description of proposed developmen& 1-' <br /> / ® ❑ 1.3 Parcel vicinity location map. IV\Ao a) <br /> / F-11.4 Site map show ing location of all iz's on parcels(i.e., structures, drives, wells, septic systems, large trees, <br /> do yF�A tHs pastures, pools, natural drainage courses, ponds,waterways, etc.) {' I ) - <'/C o <br /> At11 <br /> O µGTN` r' C <br /> 2.0 PRESENT AND PAST USES OF THE SITE SECTION r <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 /> �r �' ❑ 3.1 Description of exiting on-site septic tank usage (system types, age,functioning/repair rates) <br /> 'v uFd.'% veea�. <br /> N•�w ❑ 3.2 Site septic permit history(number/types/dates of permits, age of system, permit hurlers,mt co iea in rep ). <br /> ❑ 3.3 Discussion of on-site septic tank repair history.'G�F 3 i <br /> ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, <br /> proximity to parcel). /,t 3) <br /> /jK ❑ 3.5 General area septic permits)history(number/types/dates of permits, age of system, permit numbers, copies in <br /> report(,,3) <br /> �r® ❑ 3.6 Discussion of general area septic tank repair history. i <br /> �- ❑ 3.7 Description of proposed or expected maximum (including sec �u fliLdwellings) 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 /> ® ❑ 4.2 Description/¢¢¢'rrtssscussion of any existing and/or potential groundwater Conte ination issues in the general location <br /> lct� of the site. r I) <br /> /,,� ❑ 4.3 Description o ocation (address/APN),type and construction of well and location (well head/kitchen tap)where <br /> a•`"r water sample(s)were obtained. � G, // <br /> F14.4 Description of constituents being ested_/for in the water sample(-C-e <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. -44- <br /> 5.0 SOIL PROFILE INFORMATION SECTION <br /> ❑ 5.1 Site map showing the location,witdimensions, of the soil profile pit on the parcel.(s�ci.�c <br /> T S \ %u, <br /> F-15.2 Description of soil profile pit including depth and dimensions. B5 <br /> ❑ 5.3 Description of soil Iithology as noted from test pit by appropriate p�ea�ss�I using industry standard protocol. <br /> ✓[ ❑ 5.4 Discussion of soil Iithology as related to future onsite se� )l <br /> EFID 26-02-003 Page 1 of 3 Soil Suitability Checklist <br />