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SITE MITIGATION PROGRAM CHECKLIST <br />SITE LOCATION: S-74.) i'V &I c...00,,re,.A , <br />FA#: () 0 4-M2-50 PR# OS42,21-t $ (DAtiP <br />DATE ACTIVITY INITIAL <br />/c/ Review submittal and make sure all documents/fees have been submitted. <br />Request documents/fees not submitted - ij (".- $)3 ph,t ` <br />,,, <br />rril-- <br />0 // <br />/ <br />Provide MFR to Accounting to ensure project has a F # andla PR#. The PF9for a <br />agency changes, a new PR# must be created under project dioes not change. If the lead <br />the ng FA. <br />10 ISolo <br />Issue SR for Work Plan Review - Enter the data into the SR form in EC making sure <br />L- Y <br />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 />i°6111 Work Plan SR#: DOA z,v7.- L -X <br />10 I i s, )11 <br />Review Work Plan to ensure scope of work matches the scope of work approved by <br />construction/destruction meets SJC Ordinance Code L )4, the lead agency and that the mw <br />and well standards. <br />, 1 <br />Issue Permits - Enter permit information into WP form in EC, link to the FA# for the <br />WP# on DAR to track time spent in the field for the <br />on the permit. <br />2._ --X project, and obtain a WP#. Use this <br />specific mw/boring activity specified <br />Ph y)11 WP#: 0 in ki-31441/1 i ,...- Scope: <br /> d 44 blv..A .•-• 1- Aw -, <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 />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 />EHD-29 8/15/17 <br /> Site Mitigation Program Checklist