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SITE MITIGATION PROGRAM CHECKLIST <br />SITE LOCATION: / 0 yi-l‘i( Co. .(-0, of,) /lei; <br />FA#: op i ll 7Jv. PRiIQç5 477 <br />1 <br />/ <br />DATE ACTIVITY INITIAL <br />3 17 /17 Review submittal and make sure all documents/fees have been submitted. 1, <br />'3[7 / , a Request documents/fees not submitted. /I / <br />1./ I Gi r,1 l i <br />Provide MFR to Accounting to ensure project has a FA# and a PR#. The PR# for a <br />agency changes, a new PR# must be created under V-------- project i does not change. If the lead <br />$ <br />Issue SR for Work Plan Review - Enter the data into the SR form in EC making sure <br />to link the SR to the related FA. Generate an SR# and document on the permit form. If <br />I no permit form has been submitted, record the information on a golden rod Service <br />Request form.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 />Work Plan SR#: a 0 77 / / 5-- <br />IA <br />A .c <br />7 <br />\ <br />Review Work Plan to ensure scope of work matches the scope of work approved by <br />construction/destruction meets SJC Ordinance Code the lead agency and that the mw <br />and well standards. <br />Issue Permits - Enter permit information into SR form in EC, link to the FA# for the <br />this SR# on DAR to track time spent in the field for the <br />on the permit. <br />project, and obtain an SR#. Use <br />specific mw/boring activity specified <br />tfiqo SR#: Do 17 1 1./.z Scope: .6 ic).44-P,- i-w Ac + 13 I , -v.4. . . .Ati <br />SR#: Scope: i <br />SR#: Scope: <br />SR#: Scope: <br />SR#: Scope: <br />After scope of work on the well and boring permit SRs are complete, update the <br />following fields in the Service Request Approval Dates section of the SR form in EC: <br />Plan 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 />Projects -Review report to determine if <br />present, print out a 5021 and request a <br />2960. Provide 5021 to Accounting Office for <br />65 Notification. Send notification letter to CVRWQCB. <br />-Review report to determine next phase of work to <br />appropriate. Complete Prop 65 for any new <br />-Review report to determine if any immediate public <br />health concerns are found, notify supervisor <br />further notifications. Complete Prop 65 for any new <br />Environmental Assessment <br />contamination was found. If contamination <br />new PR# be issued under PE <br />processing. Complete a Prop <br />EHD Lead Oversight Projects <br />be conducted or if closure is <br />contaminants found at the site. <br />Other Lead Agency Projects <br />health issues are found. If public <br />immediately for follow up and <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 />PH11-9Q Rmoni Site Mitigation Program Chealist