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IL <br /> SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISd1a�� <br /> SITE M1T(GATION/ASSES5MENT SUBMITTAL LOG 5 t I �jj 77 # - <br /> LZ <br /> L <br /> TE ADDRESS LEAD AGENCY <br /> AGENCY CONTACT j <br /> CONSULTANT CO <br /> PHONE w/AREA CD <br /> CONTACT NAME �/. PHONE <br /> OTHER CONTACT NAME or INFOF;-7 . i6d PHONE <br /> SITE CODE # � PROG/ELEMENT 2�, BILLING CODE ASSIGNED 70 <br /> TITLE OF SUBMITTAL: <br /> DATE RECEIVED DATE ON SUBMITTAL 'OT REQUEST OT REQUEST DATE <br /> TYPE OF S BMITT L CODE TYPE OF SU ITTAL CODE <br /> RE-EXCAVATION WKPLN 1 PERMIT APPLICATION w/o WRKP.LN 10 PERMIT FEE PD CK #/CASH DATE <br /> SITE ASSESS WKPLN 2 WORKPLAN for PERMIT ACTIVITY 11 5 <br /> ASSESSMENT REPORT 3 OTHER WRKPLN w/o PERMIT ACTIVITY 16 S <br /> ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 S <br /> if <br /> REMED ACTION PLM (RAP) 5 LETTER 18 S <br /> ASSESS RPT w/RAP 6 PUBLIC PART INFO 19 REVIEW FEE PD CK #/CASH DATE i <br /> FINAL REMED PLN (FRP) 8 S <br /> QRTLY RPT/POST REMED MONITORING 9 _ $ <br /> STAFF REVIEW DUE; /�/� OT SCHEDULED: ��/ OT COMPLETED: <br /> ACTION DATE .�. _ ACTIONL // Q ELI 4 ACTION DATE I <br /> ACKNOWLG/COMMTMNT LTR REQSTO INCCMPLETE/ADDTHL INFO REQS�TD SRP DUE ri <br /> II <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD w ,t #R DUE <br /> RWQCS COMMENTS REPORT REVIEW COMPLETE ! rL y` /PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DEN.1ED REVISION DUE <br /> } <br /> PERMIT ISSUED W. / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT.LTR,,SENT PROJECT CCMPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />