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SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVi <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG <br /> SITE ADDRESS O �%_2,1776 _:J <br /> LEAD AGENCY <br /> AGENCY CONT T <br /> CONSULTANT CO <br /> PHONE u/AREA CD <br /> CONTACT NAME PHONE <br /> OTHER CONTACT NAME or INFO PHONE <br /> SITE CODE # PROG/ELEMENT 2 /OO BILLING CODE ' ASSIGNED T <br /> TITLE OF SUBMITTAL: IZg, <br /> •---JJJ <br /> DATE RECEIVED DATE ON SUBMITTAL l -- Of REQUEST Of REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE OF SUBMITTAL CODE <br /> RE-EXCAVATION WKPLN 1 PERMIT APPLICATION w/o WRKPLII 10 PERMIT FEE PD CK #/CASH DATE <br /> SITE ASSESS WKPLN 2 WORKPLAN for PERMIT ACTIVITY 11 $ <br /> ASSESSMENT REPORT 3 OTHER WRKPLH w/o PERMIT ACTIVITY 16 E <br /> ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 Y <br /> REMED ACTION PLN (RAP) 5 LETTER I8 S <br /> ASSESS RPT w/RAP 6 PUBLIC PART 111F0 19 REVIEW FEE PO CK #/CASH DATE <br /> FINAL REMED PLN (FRP) 8 S <br /> QRTLY RPT/POST REMED MONITORING x <br /> STAFF REVIEW DUE: / _/� OT SCHEDULED: /�/__- Of COMPLETED: <br /> ACTION DATE ACTION DATC: ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REOSTO INCCMPLETE/ADOTNL INFO REGSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTO PR DUE <br /> RWQCB C014MENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVALFILF./NO i' <br /> Tf/OHs}� 1 Isl_L� <br /> FRP DUE <br /> • <br /> ADDENDUM/ADDTNL INFO RECVD OENIEU REVISTCN DUE <br /> PERMIT ISSUED W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT CCMPLETE/FINAL DILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />