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0 0. Two <br /> SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALaTHIVa SIaaa, <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG St` H #� <br /> SITE ADDRESS /7 f`�) /-7 / /� LEAD AGENCY C) <br /> Lv9 � V /7 <br /> AGENCY CONTACT <br /> CONSULTANT CO <br /> PHONE W/AREA CD <br /> CONTACT NAME PNONE <br /> OTHER CONTACT NAME or INFO { PHONE <br /> SITE CODE # �� PROG/ELEMENT 2�Z._!2L I BILLING CODE �= ASSIGNED TO <br /> TITLE Of SUBMITTAL: „_/ <br /> DATE RECEIVED G/3 G� j DATE ON SUBMITTAL �: /T :T 1 OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMI4 AL CODE TYPE OF SUBMITTAL 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 $ <br /> ASSESSMENT REPORT 3 OTHER WRKPLN w/o PERMIT ACTIVITY 16 S <br /> ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 S <br /> REMED ACTION PLN (RAP) 5 LETTER 18 $ <br /> ASSESS RPT w/RAP 6 PUBLIC PART INFO 19 REVIEW FEE PD CK #/CASH DATE <br /> FINAL REMED PLN (FRP) 8 S <br /> ORTLY RPT/POST REMED MONITORING 9 S <br /> STAFF REVIEW DUE: _/_/_ OT SCHEDULED: -_/_/_ OT COMPLETED: <br /> ACTION DATE ACTION DATE ACTION DATE <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCCMPLETE/ADDTNL INFO REOSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REOSTD PR DUE <br /> RWQCB COMMENTS REPORT REVIEW COMPLETE PA UE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION ftlz FRP DU <br /> ADDENDUM/ADDTNL INFO RECVD DENIED 4 ON DUE <br /> PERMIT ISSUED W / B SPECIAL PERMIT ISSUED I OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT CCNPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />