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SITE MITIGATION PROGRAM CHECKLIST <br />SITE LOCATION: (7.4 o 36:0,4,0t c1.0.4 c44,6 A kJ • <br />FA#: 0 g -2,4 (0 PR# , „to -, ovis--0 <br />DATE ACTIVITY INITIAL <br />/ Review submittal and make sure all documents/fees have been submitted. <br />Request documents/fees not submitted. rfiza_ Aka d r Lclitio..eic.. <br />4 ' 3 ) 7 <br />Provide MFR to Accounting to ensure project filas a FA# and PR#. ihe PR# for <br />agency changes, a new PR# must be created under project does not change. If the lead <br />the existing FA. <br />ii A , . , <br />) OP I <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 />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 />Vigo Work Plan SR#: 9_00-711,51, L ---,)( <br />81K/ <br />--• (1 <br />Review Work Plan to ensure scope of work matches the scope of work approved by <br />construction/destruction meets SJC Ordinance Code L - ---' the lead agency and that the mw <br />and well standards. <br />q Issue . <br />1 c---L A <br />-'/V I <br />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 />9-15.1)1 80t#, vo,90 37 .z. LI ti Scope: A <br />SR#: Scope: <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 />EFID 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 />E H D-29 6/23/2015 <br />Site Mitigation Program Checklist <br />A