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Op4uiN C SAN JOAQUIN COUNTY �sG � o2a tNVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3"1 Floor Stockton• CA 95202-2708 a Q (209)468-3420•Fax:(209)464-0138• Web:www.cosan joaquin.ca.us ehd S�/FOrt� NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: �J -.�/J . / REPORT DATE: S = Sufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 I = Insufficient S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL P/ ❑ 1.1 Description of the chemical and physical properties of the soils underlying the site. ❑ g 1.2 Description of the mass transport properties of the soils underlying the site with respect to nitrate and/or any other ponstituent of oncern identified for the project site. 2.^0 GROUTER ANALYSIS ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth,directional flow and gradient. [� ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. ❑ 5e 2.3 Description of the current use of groundwa a�tJha site and of the future expected use of groundwater as related to the proposed development project. � 3.0 SOURCES AND CALCUL D IMPACT OF NITRATE TO GROUNDWAT9_R ❑ 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 loa.td from these solUrcesstto t p ject s)te. _J/ 1-7yme , - m, tl ow cry !Z (an q/r o7 1�UGO1/Hc417Tf JL+ Tbyd ❑ ❑ 3.2 Description of pact of rainf I contribution nitrate load to the project site. „osv sf�- E( u�0 n0 �( ❑ 3.3 Descr tion II current ite sou ces of ultra a to soil and groundwater and the contribution of nitrate bad from these sou4s'to the project site. (� ❑ 3.4 Description of all proposed future on-site sources of it to soil and groundwater and a tribution of nitrate load from these sources to the project site. rye, l7�Pd 56eertt°S of Aj1 � s (� ❑ 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. 6� l R' ❑ 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 attachment di ntain sufficient documentation to support claims made in the report. Reviewed By: r�' O?� Reviewed Date: Eim 26-02-002 Page 1 of 2 Surface&Sub Checklist / r/14/2003