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Permit Type: Spec,al Permit Issued: Oth Agency Due <br /> Wrkpin Revw Comp Co 6 <br /> t Ltr Sent Project Wit <br /> Submttal Number 93-371 Date Received 04/26/93 ' <br /> Site Code: 2163 <br /> Site Name: MONTGOMERY WARD Lead Agency: <br /> Address: 5400 PACIFIC AV Contact : <br /> City: STOCKTON Zip: 95202 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: ENVIRONMENTAL AUDIT <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Program Element: 3527 Billing Code: Assigned To: MI <br /> Title of Submittal: PHASE V REPORT <br /> Date of Submittal: 04/21/93 OT Request: N OT Request Date: <br /> Type of Submittal : 3 Assessment Report <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 /> Rction Date Action Date Action Date <br /> Ack/Com Ltr Req Add. In st i ( Srp Due <br /> Ack/Com Ltr Recd RevisiR Due <br /> RWQCB Comments e w e L lar Due <br /> Othr Agency Appr File/No c FRP Due <br />