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SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG <br /> SITE ADDRESS QiG- LEAD AGENCY <br /> AGENCY CONTACT <br /> 4 <br /> CONSULTANT CO <br /> PHONE w/AREA CO <br /> CONTACT NAME PHONE <br /> OTHER CONTACT 4M/OE or INF PHONE <br /> SITE CODE # PROG/ELEMENT 12"? BILLING CODE S ASSIGNED TO <br /> TITLE OF SUBMITTAL: ` <br /> DATE RECEIVED DATE ON SUBMITTAL OT REQUEST OT REQUEST DATE <br /> TYPE OF S SMITTAL CODE TYPE 0 SUBM TTAL CODE <br /> RE-EXCAVATION WKPLN 1 PERMIT APPLICATION w/o WRKPLN 10 PERMIT FEE PD CK #/CASH DATE <br /> SITE ASSESS WKPLN 2 WORKPLAN for PERMIT ACTIVITY 11 $ <br /> ASSESSMENT REPORT 3 OTHER WRKPLN w/o PERMIT ACTIVITY 16 S <br /> ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 $ <br /> REMED ACTION PLN (RAP) 5 LETTER 18 $ <br /> ASSESS RPT w/RAP 6 PUBLIC PART INFO 19 REVIEW FEE PD CK #/CASH DATE <br /> FINAL REMED PLN (FRP) 8 S <br /> ORTLY RPT/POST REMED MONITORING 9 $ <br /> STAFF REVIEW DUE: _/_/_ OT SCHEDULED: _/_/_ OT COMPLETED: <br /> ACTION DATE ACTION DATE ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCCMPLETE/ADDTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWQCB COMMENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED REVISION DUE <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 />