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o? '. SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />NITRATE LOADING STUDY REQUIREMENT CHECKLIST <br />1. I PA #: <br />IJP) <br />SITE LOCATION: fJ i I 1 p �^ Tna REPORT DATE: 2e, <br />S = Sufficient S <br />I = Insufficient an Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 <br />S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL <br />,D[- J, F-11.1 Description of the chemical and physical properties of the soils underlying the site. <br />E❑ 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 />EY ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth, directional flow and gradient. <br />❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the <br />site. <br />[� ❑ 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. <br />3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER <br />❑ 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 />❑ 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 />Reviewed By: n. cst Reviewed Date: 3 2 0 2_ <br />EBD 26-02 mage 1 of 2 Surface & Sub Checklist <br />7/14/2003 <br />these sources to the project site. <br />L� <br />❑ <br />3.4 <br />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 />❑ <br />3.5 <br />Calculated mass balance of nitrogen loading considering all potential sources identified. Use of <br />Hanztch/Finnemore, or other appropriate formula/model, if applicable. <br />[ <br />❑ <br />3.6 <br />Calculated impact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. <br />4.0 <br />DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD <br />OF WASTEWATER DISPOSAL <br />❑ <br />4.1 <br />Discussion of total nitrate impact from proposed project. <br />�� <br />❑ <br />4.2 <br />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 prosect site. <br />5.0 <br />CONCLUSIONS AND RECOMMENDATIONS SECTION <br />[� <br />❑ <br />5.1 <br />The report was signed, dated and stamped by a qualified environmental professional. <br />©� <br />❑ <br />5.2 <br />The attachments/appendices contain sufficient documentation to support claims made in the report. <br />Reviewed By: n. cst Reviewed Date: 3 2 0 2_ <br />EBD 26-02 mage 1 of 2 Surface & Sub Checklist <br />7/14/2003 <br />