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� r --Submttal Number 93-242 Date ceived 03/05/93 � 1 Site Code: 1867 Site Name: PACIFIC BELL Lead Agency: Address: 345 N SAN JOAQUIN ST Contact: City: STOCKTON Zip: 95202 Phone: ti Billing/responsible party Information Billing Name: Bill Info OK? Address: City: State.: Zip: Contact: Phone Property Owner/Operator Name: Phone: Address: City: State: Zip: Client Information (if different from Owner/Operator) Name- Phone': Address: City: State: Zip: Applicant' s name, date signed, title Name: Date: Title: Consultant Company: IT CORP f Contact Name: Phone: Other Contact name or Info: Phones � I Program Element: 3526 Billing Code: Assigned To: MM Title of Submittal: CSN REPORT Date of Submittal: 01/01/93 CIT Request: N OT Request Date: Type of Submittal: 9 Quarterly Report/Fast-Remedial Monitoring Permit Fee Paid 0.00 Check No. /Cash Date Paid Permit Fee Paid 0.00 Check No. /Cash Date Paid Staff Review Due: OT Scheduled: OT Completed: Action Date Action Date Action Date Ack/Com Ltr Req Add. I fa Due Ack/Com Ltr Recd Rey' Regsted a RWQCP Comments Comp 3• I� P r Due ,11thr Agency Appr e F Add. Info Recvd Denie Revision Due Permit Type: Special Permit Issued: Oth Agency Due lWrkpin Revw_Comp )Comment Ltr Sent _Project Complt ;