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�u� pan ivumoer ),s-o98 Date Received 02/03/93 <br /> { Site Code: 1211 � <br /> Site Name: REGAL SERVI STATION Lead Agency: <br /> Address: 5425 PACIFIC AV Contact: GRACE KELLER <br /> City: STOCKTON Zip: 95207 Phone-. <br /> Pilling/responsible Party Information <br /> Billing Name: Rill Info DK? <br /> Address: <br /> City: State: Zip: <br /> Contact: Phone <br /> Property Owner/Operator <br /> Name: Phone: <br /> Address: <br /> City: State: Zip: <br /> ii. <br /> Client Information (if different from Owner/Operator) 1 <br /> Name: Phone: <br /> Address: .4 <br /> I City: State: Zip: <br /> Applicant' s name, date signed, title <br /> l <br /> Name: Date: <br /> t Title: <br /> t Consultant Company: WEGE <br /> Contact Name: Phone. ` <br /> Other Contact name or Info: Phone: f <br /> f f <br /> '1 Program Element: 3525 + Pilling Code: Assigned To: MM <br /> I <br /> Title of Submittal: QM REPORT E <br /> Date of Submittal : 01/25/93 j OT Request: N OT Request Date: a <br /> Type of Submittal : 9 Quarterly Report/Post-Remedial Monitoring <br /> Permit Fee Paid 0.00 <br /> 1 <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 i <br /> ��++Ack/Com Ltr Req Add. Info e s Srp Due f <br /> tAck/Com Ltr Recd Revisi sted , <br /> RWQCH Comments i Rep amp.2.��Ly�j ,_Ar Due <br /> Othr Agency Appr Fili - / FRP Due <br /> Add. Info Recvd Denied Revision Due <br /> 'Permit Type: Special Permit Issued: Oth Agency Due <br /> Wrkpin Revw Camp Comment Ltr Sent Project Complt <br />