Laserfiche WebLink
,'�3,,: �i'r§s°_`$ z. }.'4^ �•,�. :��„�'�.�:�._ .t _ K '°'°^�Ln 'arj r x .y- Et' `.�"•,�r' t=...,r.� " ver .�,+r <br /> MUNICIPAL UTILITIES DEPARTMENT <br /> REGIONAL WAS' 'WATER CONTROL FACILITY <br /> CAR 2500 NAVY DRIVE <br /> AgoSTOCKTON•CALIFORNIA 95206 <br /> Ct7Y OPST005CTt71�t 1209)466.5251 <br /> Part A - Application /Permit <br /> SECTION 1. APPLICATION <br /> Return the completed application by: <br /> Further Instructions:See reverse side. <br /> Al. Applicant Business Name ATLANTIC RICHFIELD COMPANY <br /> A2. Address of prerrusr;discharggin wastewater- <br /> A. Street 290° BENJAMIN F{)LT DRIVE <br /> City <br /> 51 <br /> A3. Business Address Zip, <br /> ., A. Street 2000 AI AtjEQA pF I AS PI;! <br /> CitySAN MATED CRL I FORM 1 A <br /> PMailing coo GETTLER - RYAN INC., 1492 NATIONAL AVENUE <br /> - y CitHAYWARD, 84545 <br /> E.,.". State CA Zip—• _ . <br /> A4, Chief Executive Officer <br /> A. Name J FF Y Y _ B.Title <br /> C. Mailing Address 1997 D. City—HAVARD State_GA ,Zip_ 94,;45 <br /> A5. Person to be contacted about this application <br /> A.Name JEFFREY M. RYAN B.Title VICE-PRESIDENT <br /> C.Phdhe 41 83 <br /> A6. Person to be contacted in case of emergency <br /> A. Name JEFFREY N. RYAN B,Title VICE-PRESIDENT <br /> Day phone 41S) 783-75oo Night Phone---(41 5) 783-7500 _ <br /> A7. CERTIFICATION: [certify that the information above and on the following parts is true and correct <br /> to the best of my knowledge. <br /> r <br /> Signature Date <br /> Print Name Title <br /> SECTION 2. 5 <br /> r CITY OF STOCKTON USE ONLY <br /> .J <br /> Date application mailed <br /> Date application received Permit Number: <br /> _ -- Date permit issued: SIC Number.. <br /> Permit'conditions: Yes , No_._, r <br /> Expiration date Permit fee: S <br /> Comments: <br /> y, <br />