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SAN JOAQUIN <br /> Environmental Health Department <br /> i COUJ \!T)' <br /> Greatness grows he e. <br /> ~ PERCOLATION TEST/SOIL PROFILE INSPECTION CHECKLIST <br /> SJC Ordinance Cede,Title 9,Section 9.1105.2 <br /> EHD Pollcy for Percolation Test Procedure 98-51 <br /> Site Location: Date: !� <br /> Test Performed b : 1. T Se Permit#: PA#: <br /> SITE MAP <br /> Includes pert test and soil profile locations with accurate measurements from a fixed reference point(must be able to locate <br /> the test hole areas in the future). Perclsoil profile holes must meet distance setbacks as noted in the sewage standards for <br /> septic system locations, Percolation test holes and soil profile pits must be conducted in the area proposed for future septic <br /> systems <br /> Notes any changes in elevation on the subject property. <br /> Notes all water wells. V el I r►- L I'D F4- <br /> Notes all man-made features(septic s stems,drives, barns,outbuildings,animal pens,etc. <br /> Notes all natural features(ephemeral drainage courses, large stands of trees, ponds,avers,etc. <br /> PERC TEST PREPARATION PROTOCOL <br /> Date and time of test hole preparation, <br /> Diameter and depth of test hole 4"-12"diameter and 35"-42"de th . <br /> Dimensions and depth of deep test hole 4%12"diameter and 42"-25'or minimum 10'above seasonal high water table). � <br /> Test hole preparation tscolring of sidewalls, removal of loose material). <br /> Weather conditions at time of testing(raining,windy,etc. <br /> Soil type and condition encountered in test hole. <br /> Addition of 2"of course sand or fine g ravel to test hole. <br /> Pre-soak by addition of minimum 12"of water fiver ravel 24-hours before test), <br /> PERC TEST CONDITIONS,MEASUREMENTS,AND REPORTING <br /> ondition of test hole after the 24-hour re-soak amount of water remaining in the hole,any soil sloughing noted). <br /> -Correct amount of water used to refill hole 6"over gravel). Documented on the recordation sheet. <br /> Descri ption of type of perc test p rocedure used based on conditions Procedure#1, 2,or#3 . <br /> Accurate recordings of drop and refill of water in same measurements. <br /> Same fixed reference point used for each reading. Descri ption of reference point used to be included in the final report. <br /> ath calculations checked for accuracy. <br /> Beginning and end measurements of the last reading verified by REHS.All above reviewed and verified by REHS. <br /> SOIL PROFILE <br /> Description of the date,time,and protocol used to prepare soil profile pit, <br /> Descri tion of soil profile pit including depth and dimensions. <br /> Soil lithology described by appropriate rofessional using industry standard protocol. <br /> COMMENTS (� Li P-0,-( -C�,�( - 0 <br /> REHS Name: fir` [� ►�� --$-+` <br /> calculations Examples: <br /> Last drop reading=.07'over 30 minutes time. Last drop reading=1.2'over 10 minutes time. <br /> .07'x 12'=.84"(convert from feet to inches) 1.2'x 12"=14.4"(convert tom feet to Inches) <br /> 30 minutes+.94"=35.7 minutes1iinch 10 minutes+14.4"_.69 minulesilnah <br /> EH04200-v 6-1-2018 <br /> 1868 E. Hazelton Avenue I Stockton, Caiifomia 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />