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. �o^\ SAN JOAQUIN COUNTY w; ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-3029 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ebd NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: PA#: /na07y 9Or� �� t l REPORT DATE: 7- 3 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 4Ef� ❑ 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. i, z 2.0 GROUNDWATER ANALYSIS ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth,directional flow and gradient. z F-12.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. L ❑ 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. z 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER B ❑ 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 Description of impact of rainfall contribution of nitrate load to the project site. �- IT- dQ ❑ 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. y -T ❑ 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. 2 [g'_ ❑ 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_.l s ❑ 3.6 Calculated impact 6fpitrogen loading from site project to down gradient wells, rivers, lakes etc. 4.0 DISCUSSION5 6F NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nit to impact from proposed project. U� ❑ 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 Proiect 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: /c1,M c o?` Reviewed Date: El>n 26-02 Page 1 of 2 Surface&Sub Checklist 7/14/2003