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Submttal Number 93-288 DattWkeceived 03/31/93 IWAW, <br /> Site Code: 1341 <br /> Site Name: ARCO STA #434 Lead Agency: <br /> Address: 501 W KETTLEMAN LN Contact: <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 <br /> Property Owner/Operator <br /> Name: Phone: <br /> Address: <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> Name: Phone: <br /> Address: <br /> City: State: Zip: <br /> Applicant's name, date signed, title <br /> Name: Date: <br /> Title: <br /> Consultant Company: B & C• <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Program Element: 3526 Billing Code: Assigned To: ML <br /> Title of Submittal: QM REPORT <br /> Date of Submittal: 03/26/93 OT Request: N OT Request Date: <br /> Type of Submittal: 9 Quarterly Report/Post-Remedial Monitoring <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 /> Action Date Action Date Action Date <br /> rAkC/ <br /> om Ltr Req Add. f9.Regstd --Srp Due <br /> oCommentacd Ret►' — 'r 3� P��DDue <br />