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rrr1LI Ype: is ;va4iift4lys Spmcial Permit Issued: Cath Agency, Due <br /> lark In Revw Comp � <br /> 04/28/93 Co t Ltr Sent Project `1 At <br /> Submttal Number 93-360 Date Received 04/22/93 � t <br /> i <br /> Site Code: 1118 i <br /> Site Name: BEACON STATION #494 Lead Agency: <br /> Address: 2185 E FREMONT ST Contact: <br /> City: STOCKTON Zip: 95205 Phone: <br /> Billing/responsible Party Information i <br /> Billing Name: _ Bill Info OK? <br /> Address: <br /> City: State: Zip: <br /> Contact : Phone <br /> Property Owner/Operator <br /> Name: Phone: <br /> Address: 3 <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> u <br /> Name: Phone: <br /> Address: <br /> City: State: Zip: <br /> i <br /> Applicant' s name, date signed, title <br /> Name: Date: <br /> Title: p <br /> Consultant Company: AEGIS <br /> Contact Name: Phone: I <br /> Other Contact name or Info: Phone: <br /> I <br /> I <br /> Program Element: 3528 Pilling Code: Assigned To: MI <br /> Title of Submittal: CSM REPORT <br /> Date of Submittal : 04/09/93 OT Request: N OT Request Date: <br /> Type of Submittal: 9 Quarterly Report/Post—Remedial Monitoring # <br /> Permit Fee Raid 0.00 k <br /> Check No. /Cash i <br /> Date Paid <br /> Permit Fee Paid 0.00 <br /> Check No. /Gash <br /> Date Paid <br /> I <br /> Staff Review Due: OT Scheduled: OT Completed: � <br /> Action Date Action Date Action -Date <br /> E <br /> Ack/Com Ltr Req Add. Info / Srp Due <br /> Ack/Com Ltr Recd Revis' Due <br /> RWOCB Comments Re R ComP Due <br /> Othr Agency Appr File Action P Due <br /> �. <br /> f]rirl TnF..n_ 0,nr.­r4 1� poky iGs.nn. ni1O <br />