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SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HLALTH DIV <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG <br /> SITE ADDRESS CI Q C �� <� LEAD AGENCY W <br /> ` AGENCY CONTACT <br /> WWI <br /> CONSULTANT CO <br /> PHONE W/AREA CD <br /> CONTACT NAME 15 C) <br /> I^ PHONE � �j )�s <br /> OTHER CONTACT NAME or INFO v J PHONE <br /> SITE CODE 6r PROr,/ELEMENT ____ 91LLING CODE ASSIGNED TO <br /> iiL� <br /> TITLE OF SUBMITTAL: `r <br /> --t <br /> DATE I r fu I DATE ON SUBMITTAL jAp_S1q'q— OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE OF SUBMITTAL CODE <br /> RE-EXCAVATION WKPLN 1 PERMIT APPLICATION W/o WRKPLH 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 4 <br /> REMED ACTION PLN (RAP) 5 LETTER 18 $ <br /> ASSESS RPT W/RAP 6 PUBLIC PART INFO 19 REVIEW FEE PD CK #/CASII DATE <br /> FINAL REMED PLN (FRA) 8 8 <br /> QRTLY RPT/POST REMED MONITORING 9 f <br /> STAFF REVIEW DUE: ^/ / OT SCHEDULED: / _/ OT COMPLETED: <br /> ACTION DATE ACTION DlTF. ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCOMPLETE/ADDTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWQCB 0014MENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED REViSiCN DUE <br /> PERMIT ISSUED W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE CCII14ENT LTR SENT PROJECT CCMPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />