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SAN JOAQLTIN COUNTY <br />�.+� •.o <br />'? ENVIRONMENTAL HEALTH DEPARTMENT <br />`- 1868 East Hazelton Ave Stockton, CA 95205 <br />(209) 468-3420 - Fax: (209) 464-0138 - Web: www.sjaov.ora/ehd <br />C9C/FO ** <br />Soil Suitability study Requirements Checklist <br />SITE LOCATION: ���� O <br />W �SiS �S�Q �� Q�,(AD RECORDID: '59,—c43 65 <br />REPORT DATE: <br />S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br />I = Insufficient <br />S <br />I <br />1.0 <br />INTRODUCTION & PROPOSED DEVELOPMENT SECTION <br />❑ <br />1.1 <br />Description of site, including zoning information. <br />4f\- A�3 <br />[� <br />❑ <br />1.2 <br />Description of proposed development. <br />[�] <br />❑ <br />1.3 <br />Parcel vicinity location map. <br />_ <br />[� <br />❑ <br />1.4 <br />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 />j❑ 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 />❑ 3.1 Description of exiting on-site septic tank usage (system types, age, functionin /repair rates . <br />5 Do k � l � 2, , / © & S $ F, W o PZf'P O(L azo p <br />AV 6vv 5e�71FC 3 4W 44�fa-' zoo& <br />[� ❑ 3.2 Site septic permit history (number/types/dates of permits, age OT system, permif numbers, copies in report). <br />[� ❑ 3.3 Discussion of on-site septic tank repair history. <br />d❑ 3.4 Description of existing septic tank usage in the general area (system types, ages, functioning/repair rates, <br />proximity to parcel). <br />❑ 3.5 General area septic permit history (number/types/dates of permits, age of system, permit numbers, copies in <br />report). <br />[] ❑ 3.6 Discussion of general area septic tank repair history. <br />F� ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site. <br />4.0 GROUNDWATER INFORMATION SECTION <br />[A, ❑ 4.1 Description of the depth and gradient of groundwater in the general area. <br />EHD 26-02-003 Pagel of 3 Soil Suitability Checklist <br />• llnnnnz <br />