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t <br /> MUNICIPAL UTILITIES DEPARTMENT <br /> REGIONAL WASTEWATER CONTROL FACILITY <br /> 2500 NAVY DRIVE <br /> STOCKTON,GALlFORNlA 95206 <br /> (209)944-8750 <br /> mr DF STOCKTON (209)944.8760 Part A - Application /Permit <br /> SECTION 1 APPLICATION i <br /> E <br /> Return the completed application by _ t <br /> Further Instructions See reverse side # <br /> Al Applicant Business Name WICKLAND PROPERTIES <br /> A2 Address of lireinise discharging wastewater <br /> A. Street 6425 Pacific Avenue <br /> City Stockton , Zip <br /> A3 Business Address _ <br /> A Street ' 6425 Pac:Lf is Avenue <br /> City Stockton Zip <br /> B Mailing P . O. Box 13648 <br /> City Sacramento , State CA Zip 95853-4648 <br /> A4 Chief Executive Officer <br /> A Name J0hA-NargeWsk.% John A- Wickland B Title President <br /> C Mailing Address P . O. BOX 13648 D City SacramentState CA Zip 95853-4648 <br /> A5 Person to be contacted about this application <br /> A Name George L . Converse B Title Progect GeologistC phone (916) 668-5300 i <br /> A6 Person to be contacted in case of emergency <br /> A Name George L. Converse B Title Project Geologist <br /> Day Phone (916) 668-5300 Night Phone (916) 668-5300 <br /> �7 CERTIFICATION [certify that the information above and on the following parts is true and correct <br /> to the best of my knowledge Clay 16, 1994 <br /> Signature Date <br /> Daniel E. Hall Vice President <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 /> Fxpiratinn rrlata Parmit fao It <br /> Comments <br /> n <br /> M <br /> A <br />