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PQ U t" SAN JOAQUIN COUNTY z ? ENVIRONMENTAL HEALTH DEPARTMENT N. 1868 East Hazelton Avenue, Stockton, CA 95202-3029 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd NITRATE LOADING STUDY REQUIREMENT CHECKLIST 31 y S S-� 1� 3 j r PAM ,Lt —oaz�37CS>k� SITE LOCATION: 1'53p� � � REPORT DATE: L/ 1 71)_5 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. !!��- 2 ❑ 1.2 Description o4e 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 GROUNDO�� ATER ANALYSIS © ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater depth, directional flow and gradient. rp ❑ 2.2 Description/disdussiz n of any existing or potential groundwater contamination issues in the general location of the site. T�"q ® ❑ 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. 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. [� F-13.2 Description of of rainfall contribution of nitrate load to the project site. 2 ❑ 3.3 Descripkbr`i of�ll Ae 5 on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from these sources to the project site. © ❑ 3.4 Descriptio�l 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 Calculate(d6mass balance of nitrogen loading considering all potential sources identified. Use of Hanztch/Finne�re, or other appropriate formula/model, if applicable. �] ❑ 3.6 Calculated/A pact of nitrogen loading from site project to down gradient wells, rivers, lakes etc. 4.0 DISCUSS(1_6N OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD OF WASTEWATER DISPOSAL ❑ 4.1 Discussion of total nitrate impact from proposed project. II [ ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, and/or ann�v�other constituent of concern, at and/or around the oroiect 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: Ep cY'O AL -Reviewed Date: EHD 26-02 Page 1 of 2 Surface&Sub Checklist 7/14/2003