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A( <br /> SAN JOAQUIN COUNTY • PUBLIC HEALTH SERVICESIENVIRONMENTAL HEALTH IDIVISI <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG rl li.< <br /> SITE ADDRESS �,?_ cwt` t LEAD AGENCY <br /> AGENCY CONTACT <br /> CONSULTANT CO <br /> lal vz. <br /> PHONE io/AREA CD <br /> CONTACT NAME ' PHONE -^ <br /> OTHER CONTACT NAME oc:I.NFO PEtONE <br /> SITE CODE # PROGIELEMENT 2 � r� BILLING CODE ASSIGNEp TO <br /> TITLE OF SUBMI.TTAI : <br /> DATE RECEIVED JDAU:0t SUBMITTAL j , OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE OF SUBMITTAL CGDE <br /> RE•EXCAVATION. WKPIN 1 PERMIT APPLICATION w/o WRKPLN 10 PERMIT FEE PD CK #f CASH DATE <br /> SITE ASSESS WPM :2 WDRKPt.A1I for PERMIT ACTIVITY 11 S <br /> ASSESSMENT REPORT 3 OTH.WA RKPLN W/o.PERMIT ACTIVITY 16 s <br /> ASSRPT PLN ' 4 Txelt .AGENCY REPORT <br /> ESS WWX <br /> 17 S: <br /> REMEO ACTION PI.N IW) 5 LETTER 18 t <br /> ASSISS RPT w/RAP 6PUr#UC PART INFO 19 REVIEW FEE Pp CK #!CASH. DATE <br /> FINAL REMED PLN (FRP) <br /> QRTLY RPT/POST REMEp MONITORING 9 # <br /> STAFF REVIEW DUE: r JJ OT SCHEDULED: ! OT COMPLETED: <br /> ACTION DATE ACTION PATE ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCCMPLETE/ADDTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWOCS COMMENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVp DENIED REVISION DUE <br /> PERMIT ISSUEDf W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT CCMPLETE/FINAL BILL <br /> EN;29 03 (PLNLOG rcvi:sed'S/9:1) <br />