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SITE MITIGATION PROGRAM CHECKLIST <br />SITE LOCATION: - 1 cc,A41,k -G-r-grIA0 Pr <br />FA#: '00233 tej PR# Os-L.0 gs-9 .21,1 10 0 <br />DATE ACTIVITY INITIAL <br />1 0 )0 )0 Review submittal and make sure all documents/fees have been submitted. <br />Pielil / Request documents/fees not submitted. <br />i wri 1 -1 <br />Provide MFR to Accounting to ensure project has a FA# and a PR#. The PR# for a <br />agency changes, a new PR# must be created under <br />- / 0 i, +0-..) t,rg-e-pei • <br />project does not ctj,ange. If the lead <br />the existing FA. - AO <br />161 1 / 1- . <br />i <br />Ill <br />Issue SR for Work Plan R view - Ester the data into the SR form in EC making sure <br />1- ")( <br />to link the SR to the related FA. Generate an SR# and document on the permit form. If <br />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 <br />subsequent report/sample results, making notifications/referrals. <br />Work Plan SR#: DO/ 1.--‘0 L , y <br />0 6 i ci <br />' <br /> Review Work Plan to ensure scope of work matches the scope of work approved by <br />construction/destruction meets SJC Ordinance Code i A the lead agency and that the mw <br />and well standards. <br />1°1 1 VW i 11 <br />Issue Permits - Enter permit information into SR form in EC, link to the FA# for the <br />this SR# on DAR to track time spent in the field for the <br />on the permit. <br />L ,A project, and obtain an SR#. Use <br />specific mw/boring activity specified <br />103 oili sa#: <br />tAi f 00'31 32 Scope: 5 y40,41, r)-(A„, , , L. -.)( ,..- t- y-,........,) <br />PI 30 )11 '''' or 04)115.5) Scope: „ <br />`yotl <br />, I <br />Z.- 17o,r ifn r <br />1‘)Ylolii wv 0 ol" 1 5-W Scope: , <br />4-1s, 1 - i <br />I tipi SR#: vivo 76 1,-- Scope: ,z, self g , <br />SR#: Scope: <br />After scope of work on the well and boring permit SRs are complete, update the <br />following fields in the Service Request Approval Dates section of the SR form in EC: <br />Plan 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 />Projects -Review report to determine if <br />present, print out a 5021 and request a <br />2960. Provide 5021 to Accounting Office for <br />65 Notification. Send notification letter to CVRWQCB. <br />-Review report to determine next phase of work to <br />appropriate. Complete Prop 65 for any new <br />-Review report to determine if any immediate public <br />health concerns are found, notify supervisor <br />further notifications. Complete Prop 65 for any new <br />Environmental Assessment <br />contamination was found. If contamination <br />new PR# be issued under PE <br />processing. Complete a Prop <br />EHD Lead Oversight Projects <br />be conducted or if closure is <br />contaminants found at the site. <br />Other Lead Agency Projects <br />health issues are found. If public <br />immediately for follow up and <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.