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{ ully SAN JOAQUIN COUNTY ENv LRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3rd Floor Stockton ■ CA 95202-2708 i ;:•� (209)468-3420 - Fax:(209)464-0138 - Web: www.co.san-joaquin,ca.us/ehd Q.... o �'. NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: 7 C q / c" j' /�, PA#: 0.365J REPORT DATE: S = Sufficient San y p p Joaquin Count Development Title Chapter 9-1105,Section 9-1105.2 I = Insufficient 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. ❑ 1.2 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. 2.0 GROUNDWATER ANALYSIS ❑ 2,1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth, directional flow and9 radient. ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the site. I ❑ 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. �� 5 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 theseur sa ces to the protect site. ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. ❑ 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. ❑ 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 U� Hanztch/Finnemore, or other appropriate formula/model,if applicable. i [ ❑ 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 i OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed project. �� ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, and/or any other constituent of concern,at and/or around the prosect 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: Reviewed Dat '/bS i EHD 26-02-002 Pagel of 2 Surface&Sub Checklist 1 7114/2003 jj