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MUNICi. AL UTILITIES DEPARTMENT <br /> REGIONAL WASTEWATER CONTROL FACILITY <br /> iD <br /> 2500 NAVY DRIVE <br /> STOCKTON,CALIFORNIA 95206 <br /> (209) 466-5261 <br /> =Y OF STOCKTON Part A - Application / Permit <br /> SECTION 1. APPLICATION <br /> Return the completed application by: <br /> Further Instructions: See reverse side. <br /> Al. Applicant Business Name ('a1 i fnrnia Tank Lines, Inc <br /> A2. Address of premise discharging wastewater: 3105 S. El Dor ado S t. <br /> A. Street South El Dorado <br /> City Stockton, California Zip 95206 <br /> A3. Business Address <br /> A. Street 3105 S. El Dorado St. <br /> City Stockton Zip 95206 <br /> B. Mailing P-0_ Rnx 6245 <br /> City Stockton State CA Zip 95206 <br /> A4. Chief Executive Officer <br /> A. Name - Robert A. .1 1 i - jr - B. Title President <br /> C. Mailing Address P.O. Box: 6245 D. City Stockton State CA Zip 95206 <br /> A5. Person to be contacted about this application <br /> A. Name Rnhart- A- F.1 1 i c jr - B. Title Pra-i cjPnt C. Phone 466— -5 <br /> A6. Person to be contacted in case of emergency <br /> A. Name Robert A. Ellis Jr. B. Title President <br /> Day Phone (209) 466-3554 Night Phone (209) 951-7742 <br /> A7. CERTIFICATION : Icertify that the information above and on the following parts is true and correct <br /> to the best of my knowledge. <br /> Signature Date <br /> Rob r A. F.1 1 i s T _ Prec�i dpnt- <br /> Print Name Title <br /> SECTION 2. <br /> CITY OF STOCKTON USE ONLY <br /> Date application mailed <br /> Date application received Permit Number: <br /> Date permit issued: SIC Number: <br /> Permit conditions: Yes . No <br /> Expiration date Permit fee: $ <br /> Comments: <br /> 0 <br />