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o.P`t"'N•.c SAN JOAQUIN COUNTY <br /> 2` 2 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ■! ;' 1868 East Hazelton Ave Stockton, CA 95205 <br /> • c e . (209)468-3420 • Fax:(209)464-0138 • Web:www.sjgov.ora/ehd <br /> A�tFOR� <br /> Soil Suitability study Requirements Checklist <br /> SITE LOCATION: 'l>�`� ���}��� j+ n �� RECORD ID: <br /> M� REPORT DATE: <br /> S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> 1 = Insufficient <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 /> [/( ❑ 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 /> EJ ❑ 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 /> N O Q�-a•-t-� «5 <br /> [� ❑ 3.3 Discussion of on-site septic tank repair history. <br /> "J0 IVrG <br /> [Al ❑ 3.4 Description of existing septic tank usage in the general area (system types, ages,functioning/repair rates, <br /> proximity to parcel). <br /> d ❑ 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 /> [� ❑ 3.7 Description of proposed or expected maximum (including second unit dwellings) septic tank usage on site. <br /> 4.0 GROUNDWATER INFORMATION SECTION1 1 <br /> b F- <br /> ❑ 4. Description of the depth and gradient of groundwater in the general area. <br /> EHD 26-02-003 Pagel of 3 Soil Suitability Checklist <br /> 7/14/2003 <br />