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o?q"tN' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Avenue 3`d Floor Stockton • CA 95202-2708 <br /> (209)468-3420-Fax.(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> �1FOR� <br /> NITRATE LOADING STUDY REQUIREMENT CHECKLIST <br /> 2 12> N, 5Qd 1 e r,SkrC ae, 14[c�w� PA#: <br /> SITE LOCATION: y REPORT DATE: f` <br /> S = Sufficient <br /> I = Insufficient San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL <br /> [� ❑ 1.1 Description of the chemical and physical properties of the soils underlying the site. <br /> © ❑ 1.2 Description of the mass transport properties of the soils underlying the site with respect to nitrate and/or any other <br /> constituent of concern identified for the project site. <br /> 2.0 GROUNDWATER ANALYSIS <br /> ET ❑ 2.1 Description of: depth to groundwater, seasonal fluctyations of groundwater depth, directional flow and gradient. <br /> /�' 3 ; e. s <br /> iEr ❑ 2.2 Description/discussion of an e4i)6g or potential groundwater contamination issues in the general location of the <br /> site. De e/' <br /> Ec ❑ 2.3 Description of the current use of groundwater at the site and of the future expected use of groundwater as related <br /> to the proposed development project. -K <br /> 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER <br /> 0 ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwater in the general up gradient area and the <br /> contribution of nitrate load from these sources to the project site. <br /> 13/ ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. <br /> © ❑ 3"3 Description of all current on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from <br /> these sources to the project site. <br /> [] ❑ 3.4 Description of all proposed future on-site sources of nitrate to soil and groundwater and the contribution of nitrate <br /> load from these sources to the project site. <br /> 0' ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of <br /> Hanztch/Finnemore,or other appropriate formula/model, if applicable. I%fes '//' <br /> © ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. <br /> x" <br /> 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD <br /> OF WASTEWATER DISPOSAL <br /> [T' ❑ 4.1 Discussion of total nitrate impact from proposed project. <br /> a ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, <br /> and/or anv other constituent of concern, at and/or around the proiect site. <br /> 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION <br /> 0'' ❑ 5.1 The report was signed, dated and stamped by a qualified environmental professional. <br /> a' ❑ 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. <br /> Reviewed By: �, r'.�- '�'AC> Reviewed Date: <br /> EHD 26-02-002 Page 1 of 2 Nitrate Loading Study Checklist <br /> 7/14/2003 <br />