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HN"oo SAN JOAQUIN COUNTY y, ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton,CA 95202-3029 Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.sjgov.org/chd � FORS` NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: R '* /YCr o�tek" REPORT DATE: S = Sufficient San Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 1 = Insufficient S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL El ❑ 1.1 Description of the chemical and physical properties of the soils underlying 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. 2.0 GROUNDWATER ANALYSIS [� ❑ 2.1 Description of:depth to groundwater, seasonal fluctuations of groundwater depth,directional flow and gradient. z ® ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. Z 0 ❑ 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 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER E] ❑ 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. Z ® ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. ® ❑ 3.3 Description of all current on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from these sources to the project site. it E ❑ 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. J2- ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable. ® ❑ 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 any other constituent of concern,at and/or around the oroiect 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: 7//W/Z.,-1 E D 26-02 Page I of 2 Surface&Sub Checklist 7/14/2003