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Submttal Number 93-274 a Received 03/29/93 i Site Code: 1844 Site Name: MICHELOTTIS AUTO SERVICE Lead Agency: Address: 1876 COUNTRY CLUB BL Contact: 4 City: STOCKTON Zip: 95204 Phone: 4 Billing/responsible Party Information Billing Name: Bill Info OK? Address: City: State: Zip: Contact: Phone Property Owner/Operator Name: Phone: Address: i City: State: Zip: Client Information (if different from Owner/Operator) I Name: Phone: Address: i City: State: Zip: i i Applicant's name, date signed, title i Name: Date: Title: ., i Consultant Company: HUNTER Contact Name: Phone: Other„Contact name or Info: Phone: Program Element: 3527 Billing Code: Assigned To: MC Title of Submittal: WORKPLAN FOR SITE ASST Date of Submittal: 03/29/93 OT Request: N OT Request Date: Type of Submittal: 11 Work Plan for Permit Activity Permit -Fee Paid 89.00 Check No./Cash 0175 Date Paid 03/29/93 Permit Fee Paid 0.00 Check No./Cash Date Paid Staff Review Due: OT Scheduled: OT Completed: r Action Date Action Date Action Date Ack/Com Ltr Req Add rI Regstdp Due Ack/Com Ltr Recd Regsted :Par D e RWQCB Comments Comp L� 9 ue i