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suotttai NEW 43-144 Date ReceivaL02/16/93 <br /> Site Code: 1%2 <br /> Site Nate: EXXON 74137 Lead Agency: <br /> Address: 1645 S EL lOWD ST Contact: <br /> City: STOCKTCN Zip: 95241 phone: <br /> Billing/responsible Party Information <br /> Billing bate: Bill Info CK? <br /> Address: <br /> City- State: Zip: <br /> Contact: Phone <br /> Property Owner/Cperator <br /> Nate: Phone: <br /> Address: <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> Name: Phone: <br /> Address: <br /> City= State: Zip: <br /> Applicant' s name, date signed, title <br /> i <br /> Name: Date: <br /> Title: <br /> I <br /> Consultant Company: AEGIS <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> I, <br /> Program Element: 35216 Billing Code: Assigned To: MI <br /> � J <br /> Title of Submittal: ADDN SITE ASST WORKPLAN <br /> i <br /> Dateof Submittal: 0 /03/93 OT Request: N OT Request Date: It <br /> Type of Submittal: 3 Assessment Report f <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> 6 <br /> Date Paid y <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash ! <br /> Date Paid <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> Ack/Com Ltr Req Add. Info Reqstd Srp Duel <br /> �Ack/Com Ltr, Recd Revision Reqsted PR Due <br /> RWQCB Comments Report Revw Comp Par Due <br /> Othr Agency Appr File/No Action FRP Due <br /> Add. Info .Recvd Denied Revision Due <br /> Permit Type: , Special Permit Issued: Oth Agency Due <br /> Wrkpin Revw Comp 2-1q-�3 Comment Ltr Sent Project Complt t <br />