Laserfiche WebLink
K REID <br /> SAN JCAQUIN- ,WdTY --PUBLIC HEALTH SERVICES/ENVIRONMENTAL iH DTVISIO?t , <br /> SITE MITIGATION SUBMITTAL <br /> DO NOT WRITE IN THIS AREA-AGENCY USE ONLY '� SUBMITTAL LOG MU14SER <br /> GT SITE 23. SSESS- DHS / RWQCBJ 22. NVIRON ASSE 22.48 THER (FROG/ELEMENT PILOT PROGRAM <br /> EEPS */SITE CODE # COMPUTER # DATES OF SERVICE .FROM _/_/` TO <br /> LOC CODE DISTRICT SSIGNED TO <br /> TYPE OF SUBMITTAL orS��l� � YPE <br /> ESCRIPTION OF SERVICE ODE <br /> DATE RECEIVED / �/ / DATE OF SUBMITTAL ,�/ 5—/n T REQUESTED ATE OT REQUESTED / / <br /> ERMIT FEE PD K#/CASH ATE y EVIEW FEE PD K#/CASH ATE <br /> STAFF REVIEW DUE _/�/_ OT SCHEDULED �_�� OT COMPLETED_/___/� <br /> ACTION DATE ACTION DATE ACTION DATE <br /> CKNOWLG/COMMTMNT LTR REQSTD INCOMPLETE/ADDTNL„INFO REQSTD SRP DUE <br /> CKNOWLG/COMMTMNT LTR RECVD REVISION REQSTD R DUE <br /> WQC8 COMMENTS REVIEW COMPLETE AR DUE <br /> THER AGENCY APPROVAL FILE/NO ACTION RP DUE <br /> DENDUM/ADOTNL INFO RECVD DENIED REVISION DUE <br /> ERMIT ISSUED SPECIAL PERMIT ISSUED 3THER AGENCY DUE DATE <br /> RKPLAN APPROVED COMMENT LTR SENT ILLING FORM SUBMITTED <br /> FOR AGENCY USE ONLY <br /> Fee is Due: Per Unit Per Site H.,expLanation <br /> fitting emittance Amount emit Checked <br /> Program Element Date Date emitted MOUNT DUE Amount <br /> GT Corrective Action Oversight <br /> State/Federal Authorized) 53.00/hr 5 hour minimum <br /> azardous Material Transmission <br /> ipeline Assessment Oversight 53.00/hr 5 hour minimum <br /> nvirormental Assessment Work Plan/ <br /> Report Review and Inspections 53.00/hr 3 hour minimum <br /> ther Government Oversight Work Plan/ <br /> eport Review and Inspections .� - 53.00/hr 3 hour minimum <br /> –J� <br /> Received By ate eceipt No. I– f <br /> ssuance Date ailed <br /> s <br /> PAGE TWO OF TWO <br /> EH 23074 (2/91) 89-006(VI)2/91 BILFRM12B <br /> s , <br />