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5ubmttal Number y6-1n1 Vate Received U2/1b1V6 <br /> Site Code: 9062 <br /> Site Name: SOUTHWEST HIDL Lead Agency: <br /> Address: 11651 PALM AV Contact: <br /> City: MANTECA Zip: Phone: <br /> Pilling/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: <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> t � <br /> Program Element: 2965 Billing Code: Assigned To: <br /> Title of Submittal: RB LETTER <br /> Date of Submittal: 02/10/93 OT Request: N OT Request Date: <br /> Type of Submittal: 18 Letter 1 <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> Date Paid + , <br /> Permit Fee Paid 11,00 <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. Info Reqstd Srp Due <br /> Ack/Com Ltr Recd Revision Reqsted PR Due <br /> RWQCB Comments Report Revw Comp Par Due <br /> Othr Agency Appr File/No Action FRP Due <br /> Add. Info Recvd Denied Revision Due y <br /> Permit Type: Special Permit Issued: 0th Agency Due <br /> Wrkpin Revw Comp Comment Ltr Sent Project Complt <br />