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SAN .IOAOUIN fY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL . � <br /> SITE M11IEATION/ASSESANT SUBMITIAL LOG <br /> ERDDfRIESS <br /> AIL qT A LEAP AGEHC <br /> �i� AGENCY CONTACT <br /> CITY a ZIP PHONE w/AREA CD <br /> crosL f_TANT l!�[ CONTACT. <br /> OTHER CONTACT NAME or INFO <br /> UGT SITE 23. ASSESS—DHS / Rt1OCB 22. ENVIRON ASSES ?.2.48 PILO 23.,512 FUNQ SDUA S / F TASK f <br /> SWEEPS I/SITE CODE i 5 DIST LOC CD •2 ASSIGNED TO �S <br /> TITLE OF SUBMITTAL: -— <br /> _ <br /> DATE RECEIVED DATE OF SUBMITT ` l BILLING FORM INITIATED, /_/ OT AE IST I_I_ <br /> TYPE OF SUBMITTAL (PILOT) COD TYPE OF SUBMITTAL (OTHERI COD FEE PO CH 1/ DATE <br /> RE-EXCAV/SOIL CONTAMINATION NORKPLAI (SCWP) 1 PERMIT APPLICATION 10 1 <br /> SOIL CONTAMINATION REPORT/REMEDIATION PLAN ISRP) 2 WORKPLAN for PERMIT ACTIVITY it <br /> PRELIMINARY REPORT (PR) 3 ASSESS REPORT: 13 <br /> PR/with ADDTL MSS PROPOSAL A ASSESS AT/with WOMB(P m 14 <br /> PROBLEM ASSESSMENT REPORT (PARI 5 ORTLY/MONITORING REPORT . 15 <br /> PAR/with REMEDIAL ACTION PROPOSAL 6 OTHER WRILpL.IIN w/o PERMIT ACTIVITY 16 <br /> ADDITIONAL ASSES" PROPOSAL 1 <br /> FINAL''AF]1 IATIDN PLAN (FRP) B <br /> ORTLY REPORT/POST REMED NOWITOR q <br /> STAFF REVIEt1 Me I_ Of .SCHEDL< -0 1 I Of COMPLETED-1—/ <br /> ACTION DATE -ACTION 'DATE ACTION DATE <br /> ACKNOWLG/CWTMMT LIR REOSTD INCOMPLETE/ADDTNL INFO REDS It SRP BUE <br /> ACKNOWLS/COMMTMNT LTR RECVD REVISION REOSTO PR m <br /> RWOCB CammBTS REVIEW COMPLETE PAR DUE -. <br /> OTHER AGENCY APPROVAL /NO ACTION FRP DUE <br /> f <br /> f <br /> ADDEHOUM/ADDTNL IWO RECIIQ REVISION M. � <br /> , <br /> PERMIT ISSLEQ SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE. <br /> WORHPLAN APPROVED V 3 0 COMMENT LTR SENT BILLING FORM SUBMITTED <br /> LH 23-I17 89-51(IV112/89 PLNLOG � <br />