Laserfiche WebLink
Submtt 1 Number '53 -255 Late Rete. ived 03 / 17 / 93 <br /> ` Site Code : 1094 - -. . . <br /> Site Name : ARCO STA #k2130 Lead Agency : 4 <br /> Address : 7905 N EL DORADO ST Contact : <br /> City : STOCKTON Zip : 95210 phone : <br /> Billing / responsible party Information <br /> Billing Name : Rill 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 : 4 <br /> Applicant ' s name , date signed , title <br /> Name : Date : <br /> Title : <br /> _ Consultant Company : RESNR <br /> Contact Name : phone : <br /> Other Contact name or Info : Phone : <br /> Program Element : 3526 I Billing Code : Assigned To : M l <br /> Title of Submittal : QM REPORT <br /> + Date of Submittal : 03 / 12 / 43 O7 Request : N OT' Request Date : <br /> Type of Submittal : 9 Quarterly Report / Post — Remedial Monitoring �} <br /> Permit Fee Paid CIM 00 <br /> Check No . / Cash I' <br /> Date Paid <br /> 1 <br /> ` Permit Fee Paid 0 . 00 I j <br /> it Check No . / Cash II l+ <br /> NI Date Paid <br /> (( Staff Review Due : OT Scheduled : OT Completeds <br /> Action Date Action Date Action Date, <br /> �Ack / Com Ltr Req Add . I f Re td S 'p Due <br /> Rck / Com Ltr Recd o pR Due � It <br /> II� R4lQCB Comments epect Rev Comp <br /> ctio !ar Due Othr Agency Appr' Fi r o an Due <br /> Add . Info Recvd Denied Revision Duc (y <br /> Permit Type : Special ' ermit Issued : Oth Agency Due <br /> � Nrkpin Revw CompComment Ltr Sent � Project Complt <br /> -11 <br />