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Z�lAplpGtiai�Uyuur- SJC2[.!c ;fAV%_t:1vCu <br /> Site Code: 1409 <br /> Site Name: 7-11 FOOD STORE 2243-20304 Lead Agency. <br /> Address: 455 W GRANTU NE RD Contact: <br /> City: TRACY Zip: 55375 Phone: <br /> Billing/responsible Party Information <br /> Billing Name: Still 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 of 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: 3525 Stilling Code: Assigned To: MM <br /> Title of Submittal: WORKPLAN FOR EXTRACTION SYSTEM <br /> Date of Submittal: 03/15/93 OT Request: N RT Request Date: <br /> T <br /> Type of Submittal: 11 Work Plan for Permit Activity <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> Elate Paid <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> Date Paid <br /> Staff Review Dues OT �Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> ik k <br /> Ack/Com Ltr Req Addlil� Info Regstd Srp Due <br /> Ack/Com Ltr Recd Revision Reqsted PR Due <br /> RW9CB Co nts Report Revw Comp Par Due <br /> Oth y App e./No Action FRP Due <br /> Den ed Revision Due <br /> r 5peca i Permit Issued. Oth Agency Due <br /> kp evw om , Co t Ltr Sent Project Complt <br /> Al <br />