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Submttal Number 93-301 DAw"Received 03/29/93 / <br /> Site Code: 1409 <br /> Site Name: 7-11 FOOD STORE 2243-20304 Lead Agency: <br /> Address: 455 W GRANTLINE RD Contact: <br /> City: TRACY Zip: 95376 Phone: <br /> Billing/responsible Party Information <br /> Billing Name: Bill 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: <br /> Applicant's name, date signed, title <br /> Name: Date: <br /> Title: <br /> Consultant Company: GTI <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Program Element: 3526 Billing Code: Assigned To: MM <br /> Title of Submittal: QM REPORT <br /> Date of Submittal: 03/22/93 OT Request: N OT Request Date: <br /> Type of Submittal: 9 Quarterly Report/Post-Remedial Monitoring <br /> Permit Fee Paid 0.00 <br /> Check No./Cash <br /> Date Paid <br /> Permit Fee Paid 0.00 <br /> Check No./Cash <br /> Date Paid <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> Ack/Com Ltr Req Add. Info /!` Srp Due <br /> Ack/Com Ltr Recd Re visio t {7 �ue <br /> RWQCB Comments Repor R Com (` �� Par -Dae <br />