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Submttal Number 93-421 Date Received 05/12/93 <br /> Site Code : 2498 <br /> f Site blame . DEL MOhITE/DISCO Lead Agency : <br /> Address : 110 N FILBERT ST Contact : <br /> City : STOCKTON Zip: 95205 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 /> 4 Address: <br /> City. State : Zip: <br /> Client Information ( if different from Owner/Operator) <br /> Name : Phone : <br /> Address : <br /> City : State : "Lip: <br /> Applicant' s name, date signed, title <br /> Name : Date : <br /> Title: <br /> ' Consultant Company : CHM2HILL <br /> Contact Mame : Phone : <br /> Other Contact name or Info : Phone : <br /> Program Element : 3526 Billing Code : Assigned To : MC <br /> Title of Submittal : QMR <br /> Date of Submittal : 05/06/93 OT Request : N OT ReqUest Date : <br /> i Type of Submittal : 9 Quarterly Report/Post-Remedial Monitoring <br /> Permit Fee Paid 0. 00 <br /> Check No. /Cash <br /> b Date Paid <br /> Permit Fee Paid 0. 00 <br /> i <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. In eqstd, Sr Due <br /> Ack/Com Ltr Recd Revi o R e <br /> RWOCB Comments Rep r - v ofnp { 3 Par 1_ie <br /> Othr Aoency Appr File ti n FRP _ie <br /> Add. Info Recvd Deni d vision Due <br /> Permit Type : Special Permit Issued : O� th Agency Due <br />} Wr•koln Revw Comp Comment Ltr Sent -I -Prro—iecct Complt <br />