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MUNICIPAL UTILITIES DEPARTMENT <br /> EGIONAL WASTE,,,+TER CONTROL FACILITY ..� <br /> 2500 NAVY DRIVE a.. i •�`fy�Zy i 4t' ::�`" <br /> STOCKTON,CALIFORNIA 95206 <br /> (209)944-8750 <br /> CITY OF. sTQ;KTON_ (209)944-8760 ,.--.{_ .. ..,. . rt,/� -`'Appiicatiom/.-Permit <br /> SECTION 1. APPLICATION <br /> Return the completed application by: <br /> Further Instructions: See reverse side. <br /> Al. Applicant Business Name M- weber Fnterpxises, Tnc <br /> A2. Address of premise discharging wastewater:..._ Civic Center 2arking <br /> A. Street141 !forth E1 Dorado Street <br /> City <br /> --Syu-cKton Zip <br /> A3. Business Address <br /> A. Street 3757College Avenue <br /> City Sacramento Zip 95818 <br /> B. Mailing i050 Meiody Lane, Suite 160 r <br /> City Roseville, State CA Zip 95678 <br /> A4. Chief Executive Officer <br /> A. Name Mrs. %.M. Weber B. Title <br /> C. Mailing Address 3757 College Avenue D City Sacrament oState CA Zip 95818 <br /> A5. Person to be contacted about this application <br /> A. Name Sudhaxar Talanki B. Title Project Manager C. Phone (916) <br /> A6. Person to be contacted in case of emergency 782-2110 <br /> A. Name B. Title Drn�Pc`t- tumagPr _ <br /> Day Phone (916 ) 7d2"2110 Night Phone (916 ) 782-2110 <br /> A7. CERTIFICATION : Icertify that the information above and on the following parts is true and correct <br /> to the best of my knowledge. 9, 1 1 1 � <br /> Signature Date <br /> Sudhakar Talanxi Project manager <br /> Print Name Title <br /> SECTION 2. <br /> CITY OF STOCKTON USE ONLY <br /> Date application mailed Categorical Pretreatment Industry? <br /> Date application received If yes,.Federal Code Part? <br /> Date permit issued: SIC Number. ' <br /> Permit conditions: Yes . No <br /> Expiration date Permit fee: $ <br /> Comments: <br /> a <br /> a <br />