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SITE MITIGATION PROGRAM CHECKLIST <br />SITE LOCATION: i I to LI Re„.".‘,,, 1_,,,e.... <br />FA#: 80 2-1, cs o 6 FR# 5l1)0 OC3 ,›Ptict) <br />DATE ACTIVITY INITIAL <br />Review submittal and make sure all documents/fees have been submitted. <br />41 iti Request documents/fees not submitted. N 6..., p.."-- cs, tive-p_ L —A' <br />ci (2 _, 1 it <br />Provide MFR to Accounting to ensure project has a FA# and a PR#. The PR# for a <br />L —X' project does not change. If the lead agency changes, a new PR# must be created under <br />the existing FA. <br />1 to 1 d <br />" <br />Issue SR for Work Plan Review — Enter the data into the SR form in EC making sure <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 />Lil t 7 Ii/ Work Plan SR#: 001 (-1.1 \ ‘ (--X <br />11514 <br />Review Work Plan to ensure scope of work matches the scope of work approved by <br />L X the lead agency and that the mw construction/destruction meets SJC Ordinance Code <br />and well standards. <br />Slitela <br />' <br />Issue Permits - Enter permit information into WP form in EC, link to the FA# for the , <br />L project, and obtain a WP#. Use this WP# on DAR to track time spent in the field for the <br />specific mw/boring activity specified on the permit. <br />1 te )1/6 <br />WP#: 0 0 3 - t, Scope: ) re..0 iv LArc, f- A..1-jtAA <br />WP#: Scope: <br />WP#: Scope: <br />WP#: Scope: <br />WP#: Scope: <br />After scope of work on the well and boring permit WPs are complete, update the <br />following fields in the Well Permit Approval Dates section of the WP form in EC: Plan <br />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 />Environmental Assessment Projects -Review report to determine if <br />contamination was found. If contamination present, print out a 5021 and request a <br />new PR# be issued under PE 2960. Provide 5021 to Accounting Office for <br />processing. Complete a Prop 65 Notification. Send notification letter to CVRWQCB. <br />EHD Lead Oversight Projects -Review report to determine next phase of work to <br />be Conducted or if closure is appropriate. Complete Prop 65 for any new <br />contaminants found at the site. <br />Other Lead Agency Projects -Review report to determine if any immediate public <br />health issues are found. If public health concerns are found, notify supervisor <br />immediately for follow up and further notifications. Complete Prop 65 for any new <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. <br />EHD-29 8/15/17 Site Mitigation Program Checklist