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a4• U SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 P Telephone.(209)468-3420 Fax.(209)464-0138 Web:www.sjgov.org/ehd �rr:oa NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LocnnON: r � 6d-7 0f Y1^ie5 'lmiPA#: l� -co/9a L / 7Io REPORTDATE: �c 13� 24) = 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 soils underlying the site. 7 i- El ❑ 1.2 Description df 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. 7 6_ fD 2.0 GROUNDWATER ANALYSIS ❑ ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth,directional flow and gradient. ❑ ❑ 2.2 Description/discus salon of any existing or potential groundwater contamination issues in the general location of the site. 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. G 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. e7 jo 1/ © ❑ 3.2 Description df im�act of rainfall contribution of nitrate load to the project site. � rp tl ® ❑ 3.3 Description of)all cadent on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from these sources to the project site, 1 ® ❑ 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. I ❑ ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable. I r�r( © El 3.6 Calculated impact of nitrogen loading from site proj4ct town gradient wells, rivers, lakes etc. 4.0 DISCUSSION OF NITRATE LgAbING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ® ❑ 4.1 Discussion of total nitrate impact from proposed project. l�? 13 ❑ 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 proiect site. h, ')3 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: , r—Reviewed Date: /f EHD 26-02 Page I of 2 Su ffice&Sub Chmklist 7/142003