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SAN JQAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIV <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG # <br /> SITE ADDRESS jlb��q LEAD AGENCY <br /> i <br /> AGENCY CONTACT <br /> CONSULTANT CO <br /> PHONE w/AREA CD <br /> CONTACT NAME PHONE <br /> OTHER CONTACT NAME or INFO PHONE <br /> SITE CODE T—PROG/ELEMENT BILLING CODE ASSIGNED TO <br /> TITLE OF SUBMIT <br /> DATE RECEIVED ..�� ATE ON SUBMITTAL `/ OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE OFF SUBMITTAL 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 S <br /> ASSESSMENT REPORT 3 OTHER WRKPLN w/o PERMIT ACTIVITY 16 S <br /> 'ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 S <br /> #REMED ACTION PLN (RAP) 5 LETTER 18 $ <br /> ?ASSESS RPT WRAP 6 PUBLIC PART INFO 19 C REVIEW rEE PD CK #/CASH DATE <br /> FINAL REMED PLN (FRP) 8 S <br /> 11 <br /> QRTLY RPT/POST REMED MONITORINGL 9 S <br /> STAFF REVIEW DUE: OT SCHEDULED: _J�_ OT COMPLETED: <br /> ACTION DATE ACTION DATE ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCOMPLETE/ADDTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWQCB COMMENTS REPORT REVIEW COMPLETE r PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED REVISION DUE <br /> PEERMIT ISSUED W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT COMPLETE/FINAL BILL <br /> EN 29 03 (PLNLOG revised 5/91) <br />