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ti <br /> J•./ SITE MITIGATION PROGRAM CHECKLIST Nw� <br /> SITE LOCATION: <br /> FA#: t90 Zw29 PR# [7 Z <br /> DATE ACTIVITY INITIAL <br /> to `-1 Review submittal and make sure all documents/fees have been submitted. (� ly <br /> W Request documents/fees not submitted. L____T <br /> Provide MFR to Accounting to ensure project has a FA#and a PR#. The PR#for a <br /> jp project does not change. If the lead agency changes, a new PR#must be created under C__(' <br /> I I the existing FA. <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 /> j J/LJ 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 t�Jf <br /> subsequent report/sample results, making notifications/referrals. <br /> 40/7,..7 Work Plan SR#: S-(?-to-1'yZ_A Z <br /> Review Work Plan to ensure scope of work matches the scope of work approved b <br /> W06 the lead agency and that the mw construction/destruction meets SJC Ordinance Code Z--X <br /> and well standards. <br /> Issue Permits - Enter permit information into WP form in EC, link to the FA#for the <br /> 10 I iK project, and obtain a WP#. Use this WP#on DAR to track time spent in the field for the <br /> specific mw/boring activity specified on the permit. <br /> fol, WP#: Oo'5'Wg1 Scope: ` � bon L�x <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 />