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SAN,i'JOAQUIN COUNTY - PUBLIC HEALTH'SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> SITE MITIGATION/ASSESSMENT SUBMITTAL LOG # �J� <br /> j <br /> SITE ADDRESS LEAD AGENCY <br /> l AGENCY CONTACT <br /> CONSULTANT CO <br /> PHONE w/AREA CD <br /> CONTACT NAME PHON <br /> OTHER CONTACT N or INFO PHONE <br /> s t <br /> SITE CODE # PROG/ELEMENT 12' _ HILLING CODE ASSIGNED TO <br /> TITLE OF SUBMITTAL: Are � <br /> DATE RECEIVED DATE ON SUBMITTAL .2. », OT REQUEST OT REQUEST DATE <br /> TYPE OF XUBMITTAi I CODE TYPE 7 SUBMITTAL CODE <br /> RE•EXCAVATION WKPLN 1 PERMIT APPLICATION.w/o WRKPLN 10 PERMIT FEE PD CK #/CASH DATE <br /> SITE ASSESS WXPLN 2 WORKPLAN for PERMIT ACTIVITY 11 $ <br /> ASSESSMENT REPORT I 3 OTHER WRKPLN w/o PERMIT ACTIVITY 16 f <br /> i <br /> ASSESS RPT w/WKPLN „ 4 OTHER AGENCY REPORT 17 $ <br /> 4 <br /> I <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 /> QRTLY RAT/POST REMED MONITORING 4 f <br /> STAFF REVIEW DUE: „/ / OT SCHEDULED: /�/_ OT COMPLETED: _/_/_ <br /> ACTION DATE [ACTION DATE ACTION DATE <br /> ACKN%1LG7COMMTMNT LTR REOSTD INCCMPLET:E/ADDTNL,INFO REOSID SRP DUE <br /> ACKNOULG/COMMTMNT LTR RECVD REVISION REQS TDPR DUE <br /> RWQCB COMMENTS REPORT REVIEW .COMPLETE - <br /> OTHER AGENCY APPROVAL FILE/NO ACTION :fRP DUE <br /> ADDENDUM/ADDTNL INFO RECVD DENIED R 5[ UE <br /> PERMIT ISSUED W ! B SPECIAL PERMIT ISSUED ER AGENCY DUE DATE <br /> WORKPLAN REVIEW COMPLETE i COMMENT LTR.:SENT PROJECT COMPLETE/FINAL BILL <br /> EH 29 03 (PLNLOG revised.5/91) <br /> I� - <br />