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F SERVREQ SERVICE REQUEST <br /> Facility ID Facility Name <br /> Record ID 013048 Location NW GRANTLINE/CORL HLW, OFFSITE <br /> Property� Owner CITY OF TRACY, PUBLIC WORKS <br /> Business Name <br /> Street humber Dir Street Name Type Unit <br /> 520 TRACY BLVD <br /> 2nd Address <br /> City TRACY, __ State CA Zip — <br /> Phone 1 209-831-4448 Ext APN <br /> Phone 2 — — Ext <br /> Census 000001 District 005 Location. 03 Citycode <br /> Requestor MARTIN BLOES, GEOMATRIX for <br /> Business Name BEYLIK DRILLNG, C-57 #306291 <br /> Address 1 3429 LONGVIEW DRIVE <br /> Address 2 <br /> City NORTH HIGHLANDS, state CA . Zip 95660— <br /> Pnon�e Number 916-485-0792 Ext <br /> Nature of Service Request — <br /> BORING PERMIT FOR OFF—SITE GROUNDWATER EXTRACTION WELLS IN CITY <br /> RIGHT OF WAY PER APPROVED COT ENCROACHMENT PERMIT #97-121 AND <br /> F=Find E"Enter U=Update D=Delete Page 1 <br /> 1= SERVREQ SERVICE REQUEST <br /> Comments — <br /> APPROVED WORKPLAN BY CVRWQCB/WENDY WYEL'S. MARTIN BLOES PRIVATE CHECK <br /> #1835. CONCURRENT WITH ONSITE PERMIT SRO 013039. <br /> Name Date Time <br /> Received By 0684 INFURNA, MICHAE 07/15/97 <br /> Assigned', To 0684 INFURNA, MICHAE 07/16/97 — <br /> Date Service Completed �i �/ Requires Further Action Y/N Y <br /> Amount paid 89. 00 Program/Element 2901 <br /> Due date <br /> i <br /> This record was entered on 07/16/97 By STAFF <br /> This record was last updated on 07/17/97 By STAFF ! <br /> F=Find E=Enter U=Update D=Delete Page 2 9 :36 :09a <br />