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State of California—California Environmental Protection Agency Department of Toxic Substances Control <br /> VOLUNTARY CLEANUP PROGRAM APPLICATION <br /> The purpose of this application is to obtain information necessary to determine the eligibility of the site <br /> for acceptance into the Voluntary Cleanup Program. Please use additional pages, as necessary, to <br /> complete your responses. <br /> SECTION 7 PROPONENT INFORMATION <br /> Proponent Name <br /> Principal Contact Name <br /> Phone <br /> Address <br /> Proponent's relationship to site <br /> ---------------------------------------------- <br /> ------------- <br /> Brief statement of why the proponent is interested in DTSC services related to site <br /> SECTION 2 SITE INFORMATION <br /> Is this site listed on Calsites? ❑ Yes ❑ No <br /> If Yes, provide specific name and number as listed <br /> Name of Site <br /> Address City County ZIP <br /> Please attach a copy of an appropriate ma a e <br /> DTSC 1254(3102) A-1 <br />