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Submttal Number 93-338 Date Received 04/14/93 <br /> Site Code: 1211 `, \,/ <br /> Site Name: REGAL SERVICE STATION Lead Agency: <br /> Address: 6425 PACIFIC AV Contact: <br /> City: STOCKTON Zip: 95207 Phone: <br /> Billing/responsible Party Information <br /> Billing Name: Bill Info OK? <br /> Address: <br /> City: State: Zip: <br /> Contact: Phone <br /> Property Owner/Operator <br /> Name: 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 /> Name: Date: <br /> Title: <br /> Consultant Company: WEGE <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Program Element: 3526 Billing Code: Assigned To: MM <br /> Title of Submittal: QM REPORT <br /> Date of Submittal : 04/12/93 OT Request: N OT Request Date: <br /> Type of Submittal : 9 Quarterly Report/Post—Remedial Monitoring <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> Date Paid <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. I o Re p Due <br /> Ack/Com Ltr Recd Revis ' q �� PR Due <br /> RW(QCB Comments Re ` m 3 P r Due <br /> Othr Agency Appr F' on RP Due <br /> Add. Info Recvd ie Revision Due <br /> Permit Type: Special Permit Issued: 0th Agency Due <br /> Wrkpin Revw Comp Comment Ltr Sent Project Complt <br />