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�Q0.UtN c SAN JOAQUIN COUNTY � o ` q ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Avenue P Floor Stockton-CA 95202-2708 �,�.. (209)468-3420•Fax:(209)464-0138- Web:www.co.san-joaquin.ca.us/ehd NITRATE LOADING STUDY REQUIREMENT CHECKLIST r PA#: Q:g:—&e4 SITE LOCATION: ld Z0/' V/ 0 REPORT DATE: Al V, S = Sufficient San Joaquin County 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. Z ❑ 1.2 Description of the mass transport properties of the soils underlying the site with respect to nitrate and/or any other i constituent of concern identified for the project site. I: 2.0 GROUNDWATER ANALYSIS ❑ 2.1 Description of:depth to groundwater,seasonal fluctuations of groundwater depth,directional flow and gradient. b' i �' ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the Oe- 3 !!!"'------"' site. ❑ 2.3 Description of the current use of groundwater at the site and of the future expected use of groundwater as related p to the proposed development project. / 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 these sources to the project site. ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. 1 3.3 Description of all current on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from(j� ❑ 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 j load from these sources to the project site. ❑ ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential sources identified. Use of � Hanzteh/Finnemore,or other appropriate formula/model,if applicable. j ❑ ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells,rivers,lakes etc. 7 MJL IS i� 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD 1 OF WASTEWATER DISPOSAL f ❑ i 4.1 Discussion of total nitrate impact from proposed project. Z ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, I� and/or any other constituent of concern,at and/or around the project site. 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION I ❑ 5.1 The report was signed,dated and sta ed by a qualified environmental professional. f� ❑ 5.2 The attachmentslappendices tai efficient entati to support claims made in the report. Reviewed By: Reviewed Dater J I i �1 EHE)26-02_002 Page 1 of 2 Surface&Sub Checklist 7/14/2403 r t