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SAN JOAQUIN COUNTY <br /> 2r ENVIRONMENTAT, HEALTH DEPARTMENT <br /> N• i 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . cP • Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> gG�FORi�� <br /> NITRATE L NG STUDY REQUIREMENT CHECKLIST <br /> SITE LOCATION: q — A' PA#: <br /> I ` _J �� VV Z REPORT DATE: �1 <br /> S = Sufficient San Joaquin County ment Title Chapter 9-1105,Section 9-1105.2 I <br /> 1 = Insufficient h C�v' ' <br /> S I 1.0 CHEMICAL AND PHYSICAL PROPERTIES OF SOIL <br /> [� ❑ 1.1 Description of the chemical and physical properties of the soils underlying the site. N'P_'~wJ <br /> ElC� ►ick <br /> 1.2 Description of the mass transport properties of the soils underlying the site with respect to nitrate and/or� y other <br /> constituent of concern identified for the project site. �// '►�,V 5.�n��j;, <br /> 2.0 GROUNDWATER ANALYSIS <br /> ❑ 2.1 Description of: depth to groundwater, seasonal fluctuations of groundwater dewdirectional flow and gradient. <br /> C2/'/ ❑ 2.2 Description/discussion of any existing or potential groundwater contamination issues in the general location of the <br /> site. <br /> ❑ 2.3 Description of the current use of groundwater at the site and of the future expected use of groundwater as related <br /> to the proposed development project. <br /> 3.0 SOURCES AND CALCULATED IMPACT OF NITRATE TO GROUNDWATER <br /> [� ❑ 3.1 Description of all current off-site sources of nitrate to soil and groundwater in the general up gradient area and the <br /> contribution of nitrate load from these sources to the project site. <br /> [.� ❑ 3.2 Description of impact of rainfall contribution of nitrate load to the project site. <br /> ❑ 3.3 Description of all current on-site sources of nitrate to soil and groundwater and the contribution of nitrate load from <br /> these sources to the project site. <br /> ❑ 3.4 Description of all proposed future on-site sources of nitrate to soil and groundwater and the contribution of nitrate <br /> load from these sources to the project site. U_;p P d <br /> ❑ 3.5 Calculated mass balance of nitrogen loading considering all potential so ices identifie ._Uselof � <br /> Hanztch/Finnemore, or other appropriate formula/model, if applicable. / /C• N / <br /> ❑ 3.6 Calculated impact of nitrogen loading from site project to down gradient wells,;IZrs, lakes etc. �` ✓iS/' �s <br /> 4.0 DISCUSSION OF NITRATE LOADING RESULTS RELATIVE TO PROPOSED METHOD <br /> OF WASTEWATER DISPOSAL j S <br /> ❑ 4.1 Discussion of total nitrate impact from proposed project. <br /> [V]� ❑ 4.2 Description of the methods proposed to mitigate any known or future impact to soil and groundwater from nitrate, <br /> and/or anv other constituent of concern, at and/or around the prosect site. <br /> 5.0 CONCLUSIONS AND RECOMMENDATIONS SECTION <br /> ❑ 5.1 The report was signed, dated and stamped by a qualified environmental professional. <br /> ❑ 5.2 The attachments/ap dices contai sufficient documentation to support claims made in the report. <br /> Reviewed By: /0 Reviewed Date: l-7 Z <br /> Wqm <br /> EHD 26-02-002 Page I of 2 Nitrate Loading Study Checklist <br /> 7/14/2003 <br />