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SAN JOAQUIN COUNTY ENNv.xONMENTAL HEALTH DEPARTM—AT 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/chd NITRATE LOADING STUDY REQUIREMENT CHECKLIST PA#: SITE LOCATION: REPORT DATE: S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 = Insufficient S 1 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOI �,�� k2� ! � E] 1.1 Description of the chemical and physical properties of the soils underlying the site e50A.'%Sas u ❑ 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.(�,- 2.0 GROUNDWATER ANALYSIS ❑ 2.1 Description of: depth to groun(jwater,3eap al uctuati ns of grouV ater depth, directional flow and gradient. ❑ 2.2 Description/discussion of any xlsting or otential groun wa er c mation issues in the general location of the site. /��— 1 er!,�„ H. 555 current use of groundwater at the site and of the future expected use of groundwater as related []� ❑ 2.3 Description of the j to the proposed development project. 3J 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 � �s contribution of nitrate lo3d fr m these sources to the project site. •� 3 �-. 3•H�ss5 [� ❑ 3.2 Description of impact of rainfall ca��uuti¢n r)itrate ad to the project site. ❑ 3.3 Description of all current on-site rcesJof rattee to soil and groundwater and the contribution of nitrate load from these sources to the project site ) d,0(' ❑ 3.4 Description of all proposed future on-site Soi?rces of nitr to to soil and groundwater and the contribution of nitrate I load from these sources to the project site.�L/? 7�-3) LS ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/F in ne more, or other appropriate formup�e`ct de[ if ap icable. �_/-&j C. ❑ 3.6 Calculated impact of nitrogen loading from site 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 project0 6j) ❑' [/ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and gro ndwater from nitrate, and/or anv other constituent of concern, at and/or around the project sitee -e-)[�,',7� 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION�-�z 211 ❑ 5.1 The report was signed, dated and stamped by a qualified environmental professional. t [� ❑ 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. Reviewed BY Reviewed Date: I� f EHD 26-02 Pagel of 2 Surface&Sub Checklist i 7/14/2003