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a° o SAN.JOAQUIN COUNTY = z ENVIRONMENTAL HEALTH DEPARTMENT a � 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 p Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd �/PORN NITRATE LOADING STUDY REQUIREMENT CHECKLIST SITE LOCATION: 11-1173 W lcr/ck f'V cK PA#. ,�)3 _ �� REPORT DATE: / e211aCO-7— s = Sufficient I = Insufficient San 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 a,pd physical properties of the soils underlying the site. rl ❑ 1.2 Description of the mass traport properties of the soils underlying the site with respect to nitrate and/or any other constituent of concern identified for theproject ter N y, 2.0 GROUNDWATER ANALYSIS �� ®- ❑ 2.1 Description of: depth to groundwater, a serial fluctuations of groundwater depth, directional flow and gradient. ❑ 2.2 Description/discussion of any exis((Aor Ypotential groundwater contamination issues in the general location of the site. N :�' ® ❑ 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 proje��0 � � �) 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER a ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwater in the general up gradient area and the contriuti n of nitrate load from these sources to the project site. 0 ❑ 3.2 Description of impact of rainfall contsibu p pf nitrate load to the project site. (� ❑ 3.3 Description of all current on-site sources of JJnitrate to soil and groundwater and the contribution of nitrate load from these sources to the project site. ® ❑ 3.4 Description of all proposed future Ian-site solaces of ni rate to soil and groundwater and the contribution of nitrate load from these sources to the project site. ❑ 3.5 Calculated mass balance of nitrogen loadin�yeonsidering all potential sources identified. Use of Hanztch/Finnemore, or other appropriate formula/model, if applicable. ® ❑ 3.6 Calculated impact of nitrogen loading Qmisiila project to down gradient wells, rivers, lakes etc. 4.0 DISCUSSION OF NITRATE LOADIJJNG RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed projec(—ly ZAD FA ❑ 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 project site Z.c7j 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION ® ❑ 5.1 The reportsigned, dated and stamped by a qualified environmental professional. 22) ®' ❑ 5.2 The attach nts/appendices contain sufficient documentation to support claims made in the repr_�LI) Reviewed By: Reviewed Date: u 0 EHD 26-02 Page 1 of 2 Surface&Sub Checklist 7/14/2003