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SAN JOAQUIN COUNTY <br /> h }� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-3029 <br /> .. ;P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �tFORN <br /> pp <br /> NITRATE LOADING STUDY REQUIREMENT CHECKLIST <br /> ��JG� 6 - �'CA mp x PA#: <br /> SITE LOCATION: <br /> REPORT DATE: D <br /> = sufficient <br /> I Insufficient <br /> San Joaquin County Development Title Chapter 9-1105,Section 9-1105.2 <br /> = <br /> S 1 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL <br /> P'9 3 <br /> N ❑ 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 /> ❑ 2.1 Description of: depth to groundwater, seasonal fluctua it orYs ofljroundwater depth, directional flow and gradient. <br /> 117�q <br /> ® ❑ 2.2 Description/discussion of any existing or potential grbulwater contamination issues in the general location of the <br /> site. yg <br /> ❑ ❑ 2.3 Description of the current use of groundwater at the site and of{fie future expected use of groundwater as related <br /> to the proposed development project. <br /> 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE (T(JJO�gqGROUNDWATER <br /> ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwa4eYrShe general up gradient area and the <br /> contribution of nitrate load from these sources to the project site. <br /> rV1 ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the pr jeet site. <br /> [� ❑ 3.3 Description of all current on-site sources of nitrate to soil and groundvhdteY and the contribution of nitrate load from <br /> these sources to the project site. P <br /> ❑ 3.4 Description of all proposed future on-site sources of nitrate torsi Ind gro n a r and the contribution of nitrate <br /> load from these sources to the project site. P>q 14 <br /> ❑ 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. <br /> Plafa 8 <br /> ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. <br /> 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD <br /> OF WASTEWATER DISPOSAL <br /> ® ❑ 4.1 Discussion of total nitrate impact from proposed project. I J T V <br /> [ ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwatef from nitrate, <br /> and/or anv other constituent of concern,at and/or around the oroiect site. <br /> 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION <br /> ❑ 5.1 The report was signed, dated and stamped by a qualified environmental professional. P� 9 <br /> ❑ 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. <br /> Reviewed By: &wM /Ffh _,r' ciReviewed Date: <br /> -4/? / <br /> EnD 26-02 Page 1 of 2 Surface&Sub Checktist <br /> 7/142003 <br />