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SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DI I <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG ` <br /> SITE ADDRESS �2 - LEAD AGENCY r <br /> AGENCY CONTACT <br /> CONSULTANT CO <br /> PHONE ++/AREA CD <br /> CONTACT NAME PHONE r <br /> OTHER CONTACT NAME or INFO PHONE <br /> --TSITE CODE N l 3 PROD/ELEMENT BT LIIEG CODE ASSIGNED TO GT <br /> TITLE OF SUBMITTAL: <br /> DATE RECEIVED ?, <br /> DATE ON SUBMITTAL r} �+7 L OT REQUEST OT REQUEST DATE <br /> TYPE OF SUBMITTAL CODE TYPE'OF SUBMITTAL CODE <br /> RE-EXCAVATION WKPLN 1 PERMIT APPLICATION «/o WRKPLII 10 PERMIT FEE PD CK #/CASH DATE <br /> SITE ASSESS WKPLN 2 WORKPLAN for PERMIT ACTIVITY 11 $ <br /> ASSESSMENT REPORT 3 OTHER WRKPLII w/o PERMIT ACTIVITY 16 E ]]]� <br /> ASSESS RPT u/WKPLN 4 OTHER AGENCY REPORT 17 Y <br /> REMED ACTION PLN (RAP) 5 LETTER 'i8 $ <br /> ASSESS RPT WRAP b PUBLIC PART sNFO 19 REVIEW FEE PD CK N/CASH DATE <br /> FINAL REMED PLN (FRP) 8 S <br /> DRILY RPT/POST REMED MONITORING 9 s <br /> STAFF REVIEW DUE: _/ / OT SCHEDULED: /_�/ OT COMPLETED: <br /> ACTION DATE ACTION DAlr ACTION DATE <br /> iiil 1[ 1 <br /> ACKNOWLG/COMMTMNT LTR REQSTD INCCMPLETE/ADDTNL INFO REQSTD SRP {SUE <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 /> ADDENDUH/ADDTN N#A-RECVD DENIED REVISION DUE <br /> PE HIT .1 \ W SPECIAL PERMIT ISSUED OTHER AGENCY DUE DATE <br /> LARKPL LET v -CITU E,NT LTR SENT � rJECT CV(4?Li TE/FINAL QILL <br /> EN 29 03 (PLNLOG revised 5/91) <br />