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oPqV l" SAN JOAQUIN COUNTY 2 ENVIRONMENTAL HEALTH DEPARTMENT N 1868 East Hazelton Avenue, Stockton, CA 95202-3029 c• ^.P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd 9�/FORS NITRATE LOADING STUDY REQUIREMENT CHECKLIST �" SITE LOCATION: I�p�jZ1 �I�a1�10 (xo,('r PA#: REPORT DATE: = Sufficient 1 = Insufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 I 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' 11 ® ❑ 1.2 Description of the mass transport properties of the soils underlying the site with Tespect 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. stil,'o l-y•1 Ko —Go' ® ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. tzd 3 ID9)Up14•,. ® ❑ 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. - N o dr�w�,M,l at,� c1 K 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. ne.w� by *,04r 4-A-r P'Y"�3 ® F-13.2 Description of impact of rainfall contribution of nitrate load to the project site. P-Y-"3 ❑ 3.3 Description of all current on-site sources of nitFate to soil and groundwater and the contribution of nitrate load rom these sources to the project site. ❑ 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. ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable. g ❑ 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. [jd ❑ 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 project 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: P* 5k-f iw^- r414`" ) Reviewed Date: EHD 26-02 Page 1 of 2 Surface&Sub Checklist 7/14/2003