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SUbmttal NUmper y,5—U6ti uaie RvQeavt.!u LillIA/ 7J <br /> Site Code: 1356 I� <br /> Site Name: USA PETROLEUM COLead Agency: YLP <br /> Address: 2500 W LODI AV Contact: TURKATTE <br /> City: LODI Zip: 95240 phone: <br /> Billing/responsible party Information <br /> Billing Name: Bill Info OK? <br /> Address: <br /> City: State: Zip: <br /> Contact: Phone f <br /> Property Owner/Operator j <br /> Name: phone: <br /> Address: <br /> City: State: Zip.- <br /> Client <br /> ip:Client Information (if different .from Owner/Operator) <br /> Name: Phone. <br /> j Address: <br /> City: State: Zip: <br /> Applicant' s name, date signed, title <br /> Name; Date: <br /> Title: <br /> E <br /> E Consultant Company: WEG'E i <br /> Contact Name: phone: , <br /> a <br /> Other Contact name or Info: Phone: j <br /> E <br /> Program Element: 3526 Billing Code: Assigned To: LT i <br /> Title of Submittal: QM REPORT/WORKPLAN <br /> Date of Submittal: 01/04/93 OT Request: N OT Request Date: <br /> Type of Submittal : 11 Work Plan for Permit Activity <br /> Permit Fee Paid 89.00 <br /> Check No. /Cash 3650 j <br /> Date Paid 01/14/93 ,. <br /> I <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 I Action Date E <br /> Ill i <br /> Ack/Com Ltr Req Add. info Reqstd Srp Due ` <br /> Ack/Com Ltr Recd Revision Reqsted PR Due j <br /> RWQCB Comments Report Revw Comp Par Due <br /> Othr Agency Appr File/Nu Action FRP Due <br /> Add. Inf c 93 Denied Revision Due <br /> Permit pecial Permit Issued: Oth Agency Due <br /> -_._ 1 7 <br /> 6}rkpin Rev �n��� — comment Ltr Sent Project Complt <br />