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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue 3d Floor Stockton•CA 95202-2708 (209)468-3420•Fax:(209)4640138• Web:www.co.san-joaquin.caus/ehd / a NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: _ ��' �� , ��l L�L PA li: nC—UO 3 S9/ REPORT DATE: ,E4 0 0- 0 = Immcient e I = ImvRSan Joaquin County Development Title Chapter 9-1105, Section 9-1105.2 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.,,, y- 5— © ❑ 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 ir ❑ 2.1 Description of:depth to / © 3 groundwater,seasonal fluctuations of groundwater depth,directional flow and gradient. /� ❑ `f 2.2 DescriptioNdiscussion of any existing or potential groundwater contamination issues in the general location of the site. X91 Z/ ❑ 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. )O:y y 1.��..zrh•�J L.1,�, �a."Plf[Le�isc� Ur P 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 bad from these sources to the project site. & L ❑x ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. t /� ❑ ❑ 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. ry-& ® ❑ 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.n © ❑ 3.5 Calculated mass balance of nitrogen loadingconsideringall potential sources identified. Use of ' Hanztch/Finnemore,or other appropriate formula/model,if applicable.,V,4- 6 NL _ �i, 33 r.'V7/-Q ® ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells,rivers,lakes etc./7� f, —7� 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed project. b 6— MX ❑ 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 proiect site. 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION Fq ❑ 5.1 The report was signed,dated and stamped by a qualified environmental professional. I/foy- " ❑ 5.2 The attachments/appendices contain sufficient documentation to support claims made in the report. Reviewed By: _ Reviewed Date: ZZZ!2[_rl f EM 26-02- 2 Page 1 of 2 Sudwe&Sub Checkli t 7/14/2003