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Submttal Number 93-248 Date; ceived 03/12/933 <br /> Site Code: 1211 <br /> Site Nage: 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: 1 <br />{ Other Contact name or Info: Phone: { <br />+ Program Element: 3526 Billing Code: Assigned To: MM f <br />-title of Submittal : QM REPORTS — DEC92/JAN93 T <br />� f <br /> Date of Submittal : 12/22/92 OT Request: N OT Request Date: <br /> i� <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 /> i Action Date Action Date Action Da' <br /> Ack/Com Ltr Req Add. Info J Srp Due <br /> Ack/Cam Ltr Recd Bevis' ` JRP <br /> R Due <br /> RWQCB Courents Repo t p /,•((P. 3 ar Due <br /> Othr Agency Appr Fil ion Due <br /> Add. Info Recvd Deni Revision Due <br /> Permit Type: Special Per slued: 0th Agency I <br /> '4rknln Revw Como Comment Ltr Sent Project Com <br />