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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3�d Floor Stockton • CA 95202-2708 (209)468-3420 • Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd NITRATE LOADING STUDY REQUIREMENT CHECKLIST czt �1Q� PA#: EITEs OCATION: Cq/yp/& /�'Zf� REPORT DATE: S = Sufficient I = Insufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL [[� ❑ 1.1 Description of the chemical and physical properties of the soil Wnderlying the site. ❑ 1.2 Description of the mass transport properties of the soils underlying the site with respect to nitrate and/or any other constituent of concern identified for the project site. Pr� 2.0 GROUNDWATER ANALYSIS [ ❑ 2.1 Description of: depth to groundwater, seasonal fluptuations of groundwater depth, directional flow and gradient. ❑ 2.2 Description/discussion of any existing or po ential groundwater contamination issues in the general location of the site. )Dy-5-- ❑F-1 2.3 Description of the current use of groundwater at the site and of the future expected use of groundwater as related to the proposed development project. 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwater in the general up gradient area and the contribution of nitrate load from these sources to the project site.) �r E�( ❑ 3.2 Description of impact of rainfall contribution nitr�te load to the project site. F-13.3 Description of all current on-site sources of nrate to soil and groundwater and the contribution of nitrate load from these sources to the project site. pil"76 [vj( ❑ 3.4 Description of all proposed future on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from these sources to the project site. ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable.ie 7, ❑ ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed project. [! ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, and/or anv other constituent of concern, at and/or around the project site. 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION [►� ❑ 5.1 The report was signed, dated and stamped by a qualified environmental professional. [� ❑ 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. Reviewed By: /&"/ Reviewed Date: to ERD 26-02-002 Page 1 of 2 Nitrate Loading Study Checklist 7/14/2003