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0 0 <br /> SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG # <br /> SITE ADDRESS LEAD AGENCY <br /> �l. <br /> AGENCY CONTACT <br /> CONSULTANT CO � <br /> PHONE u/AREA CD <br /> CONTACT NAME PHONE <br /> OTHER CONTACT NAME or INFO ! / ( PHONE <br /> SITE CODE # G/r �'` - PROG/ELEMENT 12!L— / BILLING CODE �' ASSIGNED TO <br /> TITLE OF SUBMITTAL: <br /> DATE RECEIVED L DATE ON SUBMITTAL 7 OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE OF SUB14ITTAL 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 u/WKPLN 4 OTHER AGENCY REPORT 17 S <br /> REMED ACTION PLN (RAP) 5 LETTER 18 $ <br /> ASSESS RPT u/RAP 6 PUBLIC PART INFO 19 REVIEW FEE PD CK #/CASH DATE <br /> FINAL REMED PLN (FRP) 8 $ <br /> QRTLY RPT/POST REMED MONITORING 9 $ <br /> STAFF REVIEW DUE: _/_/� OT SCHEDULED: _/_/_ OT COMPLETED: <br /> ACTION DATE T ACTION DATE ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD 1NCCMPLETE/ADDTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWQCS COMMENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVAL F1LE/N0 ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED REVISION CUE <br /> PERMIT ISSUED W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT COMPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />