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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue Yd Floor Stockton -CA 95202-2708 (209)468-3420-Fax.(209)464-0138- Web:www-co-san-joaquin.ca.us/chd NITRATE LOADING STUDY REQUIREMENT CHECKLIST ! SITE LOCATION: 3 S = sufficient San Joaquin County Development Title Chapter 9-11os,Section 9-11x5.2 I = Insufficient tY S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL © ❑ 1.1 Description of the chemical and physical properties of the soils underlying the site. Pg 2, r.f i 0 ❑ 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 1.2 El ❑ 2.1 Description of.depth to groundwater,seasonal fluctuations of groundwater d o ❑ ❑ 9 depth,directional flow and gradient. Q` '� 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the , y site. 0 ❑ 2.3 Description of the current use of groundwater at the site and of the future expected use of groundwater as related �9 to the proposed development project. i i 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER 0 ❑ 3.1 Description of all current off-site sources of nitrate to soil andeneral u roundwater in the contribution of nitrate load from these sources to the project site.g p gradient area and the ❑ - , 3.2 Description of impact of rainfall contribution of nitrate load to the project site. ;lo� � 3 •a i ❑ ❑ _ 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. El ❑ 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. ❑ p� 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of = 3 1<10 Hanztch/Finnemore,or other appropriate fonnulalmodel,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 I OF WASTEWATER DISPOSAL i ❑r ❑ 4.1 Discussion of total nitrate impact from proposed project. t 0 ❑ 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 concem, at and/or around the project site_ fl)- 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION t Q g �� ` 0 ❑ 5.1 The report was signed,dated and stamped by a qualified environmental professional. ❑ ❑ 5.2 The attachments/appendi contain suffi " ni cu entation to support claims made in the report. Reviewed By: Reviewed Date: t 0,6 EM 26.02-002 Page I of 2 7114/2003 Surface R Sub Checklist