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°P4UIN' e SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton,CA 95202-3029 Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.sjgov.org/chd FORN NITRATE LOADING STUDY REQUIREMENT CHECKLIST PA#: SITE LOCATION: REPORT DATE: S = 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. P. ❑ 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. P, y� 2.0 GROUNDWATER ANALYSIS P ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth, directional flow and gradient. P4,c� ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. ?,� �] ❑ 2.3 Description of the current use of grdundwgter at the site and of the future expected use of groundwater as related to the proposed development project. r# ,� 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER P t� ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwaterthe general up gradient area and the contribution of nitrate load from these sources to the project site. ¢-71A,7/(J rVr ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. p-163 ❑ 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. 9,11iD ❑ 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. 74, W ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable. p,Bd ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. r 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL t,1-7- 4.1 ,`( Z4.1 Discussion of total nitrate impact from proposed project. pvt_ fG ❑ 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 oroiect site. P,IZ 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION r,Q_ Q ,. ❑ 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. Z-- Reviewed By: Reviewed Date: EHD 2&02 Page 1 of 2 surface&sub checklist 7/14/2003