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--ALllll1444011 mAwurr- 73-13`tl vale KeCelvea w4/14/v6 i! . <br /> Site Code: 2404 Noof i <br /> Site Dame: LAIDLAW Lead Agency: i <br /> Address: 1444 TILLIF LEWIS RD Contact: <br /> City: STOCKTON Zip: 95206 phone: <br /> Billing/responsible party Information <br /> i <br /> i <br /> Billing Name: Bill Info OK? J <br /> Address: <br /> City: State: Zip: i <br /> Contact: phone <br /> Property Owner/Operator <br /> Name: v Phone: <br /> Address: <br /> i <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> Name: phone: <br /> Address: i <br /> i <br /> City: State: Zip: i <br /> Applicant' s name, date signed, title 1 <br /> Name: Date: <br /> Title: <br /> Consultant Company: RESNA <br /> Contact Name; Rhone. <br /> Other Contact name or Info: Phone: <br /> IFProgram Element. 3026 Billing Code: Assigned To: LT <br /> Title of Submittal: GSM REPORT <br /> Date of Submittal : 03/01/93 OT Request: N OT Request Date: p <br /> 4 <br /> Type of Submittal: '9 Quarterly Report/Post—Remedial Monitoring <br /> Permitee Paid d 0.00 <br /> Check No. /Cash <br /> Date Paid <br /> Permit Fee Paid 0. 00 <br /> Check No. /Cash <br /> Date Paid <br /> s <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> 'i <br /> Ack/Com Ltr Req Add. Info Reqstd Srp Due <br /> Ack/Cam Ltr Recd Revision Reqsted PR Due <br /> RWQCB Comments Report Revw Comp g17-4 Par Due <br /> Othr Agency Appr File/No Action FRP Due <br /> Add. Info Recvd Denie Revision Due <br /> Permit Type: S e _ ued: th Agency Due ' <br /> Wrkpin Revw CompF'ra. act Complt <br />