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� <br /> SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH D VIrSION <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG # - <br /> SITE ADDRESS LEAD AGENCY <br /> AGENCY CONTACT <br /> CONSULTANT CO <br /> / �/[[�� PHONE w/AREA CD <br /> CONTACT NAME ✓`/�! PHONE 2dy�7`Ls3S <br /> OTHER CONTACT N4 or INFO PHONE <br /> SITE CODE # C,'23 PROG/ELEMENT 2�.� BILLING CODE ASSIGNED TO f� <br /> TITLE OF SUBMITTAL:!! <br /> DATE RECEIVED O DATE ON SUBMITTAL �Q Z OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL 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 Y <br /> ASSESS RPT w/WKPLN 4 OTHER AGENCY REPORT 17 Y <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 5 <br /> QRTLY 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/ADOTNL INFO REQSTD SRP DUE <br /> ACKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD PR DUE <br /> RWQCB COMMENTS REPORT REVIEW COMPLETE PAR DUE <br /> OTHER AGENCY APPROVAL FILE/NO ACTION FRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED REVISION CUE <br /> PERMIT ISSUED W / B SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE COMMENT LTR SENT PROJECT CCMPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised 5/91) <br />