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lN�c� SAN JOA UIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd `R.Cr p'R�r NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: PA#: ��7 �, rs c� �1�- ice'. I REPORT DATE: I S = Insufficient ic I = 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. ❑ 1.2 Description of the mass transport properties of the soils underlying the site vtith 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. ct] ❑ 2.2 Desc site. tion/discussion of any existing or potential groundwater contamination issues in the general location of the [. ❑ 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. 3.1 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. ❑ 3.2 Descriptiorly impact of rainfall contribution of nitrate load to the project site. ll ] 1�� E] 3.3 Descri on of all curr�nt on-site source f 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. o ❑ 3.5 Calculated mass�ar�c6 of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other ppropriate formula/model,if applicable. i l . ❑ 3.6 Calculated impact owt'role0 to ing from site project to down gradient wells, rivers, lakes etc. 4.0 DISCUSSION OF�AITRAlfE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed project. ❑ 4.2 Des; on 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 project site. 5.0 CONCL LIONS AND RECOMMENDATIONS SECTION ❑ 5.1 The re 1po2rt was signed, dated and stamped by a qualified environmental professional. �- El 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. Reviewed By-:,,- �a 'u Reviewed Dater $ EHD 26-02 Pagel of 2 Surface A Sub Checklist 7/14/2003