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a <br /> SITE MITIGATION PROGRAM CHECKLIST <br /> SITE LOCATION: W yn ti S� <br /> FA#: Opy3SH PR# ®S`j '573 a1fOS <br /> DTE ACTIVITY INITIAL <br /> 0 Review submittal and make sure all documents/fees have been submitted. <br /> Request documents/fees not submitted. <br /> Provide MFR to Accounting to ensure project has a FA#and a PR#. The PR#for a <br /> /b (� project does not chage. If the le d agency changes, a new PR#must be created under <br /> / the existingFA. _ dc,.E /0 24 _ yw <br /> Issue SR for Work Plan R vie —Enter the data to the SR form in EC making sure <br /> p r to link the SR to the related FA. Generate an SR#and document on the permit form. If <br /> no permit form has been submitted, record the information on a golden rod Service <br /> Request form. Use this SR#on your DAR to track time spent obtaining documents/ <br /> fees, reviewing work plan, issuing permits, coordinating field work activities, reviewing <br /> subsequent report/sample results, making notifications/referrals. <br /> l 0 i Work Plan SR#: t7 0"1 g37_1 t <br /> (o jtir Review Work Plan to ensure scope of work matches the scope of work approved by L <br /> X0110 the lead agency and that the mw construction/destruction meets SJC Ordinance Code xx <br /> and well standards. <br /> Issue Permits- Enter permit information into WP form in EC, link to the FA#for the <br /> ID 31 project, and obtain a WP#. Use this WP#on DAR to track time spent in the field for the lX <br /> specific mw/boring activity specified on the permit. <br /> jO z1 WP#:007153 Scope: LJ �O,1 60r <br /> WP#: Scope: <br /> WP#: Scope: <br /> WP#: Scope: <br /> WP#: Scope: <br /> After scope of work on the well and boring permit WPs are complete, update the <br /> following fields in the Well Permit Approval Dates section of the WP form in EC: Plan <br /> Status—choose 'Finaled'; Final Inspection—enter date permit finaled. <br /> After all field work is complete, flag calendar to follow up on report of findings. <br /> Report Review: <br /> • Environmental Assessment Projects-Review report to determine if <br /> contamination was found. If contamination present, print out a 5021 and request a <br /> new PR# be issued under PE 2960. Provide 5021 to Accounting Office for <br /> processing. Complete a Prop 65 Notification. Send notification letter to CVRWQCB. <br /> • EHD Lead Oversight Projects -Review report to determine next phase of work to <br /> be conducted or if closure is appropriate. Complete Prop 65 for any new <br /> contaminants found at the site. <br /> • Other Lead Agency Projects -Review report to determine if any immediate public <br /> health issues are found. If public health concerns are found, notify supervisor <br /> immediately for follow up and further notifications. Complete Prop 65 for any new <br /> contaminants found at the site. <br /> After scope of work for the project SR is complete, update the following fields in the <br /> Service Request Approval Dates section of the SR form in EC: Plan Status—choose <br /> 'Finaled'; Final Inspection—enter date work finalized. <br /> EHD-29 8/15/17 Site Mitigation Program Checklist <br />