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ite Code: 1811 <br /> Address: 17300 E JAHANT RD Contact : <br /> City: CLEMENTS Zip: 95227 Phone: <br /> Billing/responsible Party Information <br /> Billing Name: Bill Info OK? <br /> City: State : Zip: <br /> Cont <br /> act : Phone <br /> Property Owner/Operator <br /> Name: Phone: <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> Name: Phone : <br /> City: State: Zip: <br /> Applicant' s name, date signed, title <br /> Name: Date: <br /> Consultant Company: <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Pr gram Element : 3527 Billing Code: Assigned To." LT <br /> Title of Submittal : WORKPLAN FOR SOIL REMEDIATION <br /> Date of Submittal : 05/2S/93 I OT Request : N OT Request Date: <br /> Type of Submittal : 2 Site Assessment Work Plan <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 />