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` Submttal plumber 93--048 Date HL5c0iveO 1.,.1/1D17- <br /> Site Code: 1409 <br /> Site Name: 7-11 FOOD STORE"2243-?07RD <br /> Lead Agency• OP <br /> Address: 455 W GRANTLINContact: AL t4 BETTY PEVA <br /> City: TRACY Zip: 95Phone: X}9/578-9761 y <br /> Billing/responsible Party lnfvrm tion <br /> Pilling Name: Rill Info OK? <br /> Address: <br /> City: State: Zip: <br /> Contact: Phone <br /> Property Owner/Operator <br /> Name: Phone: <br /> Address: <br /> li City: State: Zip: <br /> Client Information (if differenta,from Owner/Operator) <br /> Name: <br /> Phone- <br /> Address: <br /> City: State: Zip: <br /> Applicant' s name, date signed, .. title <br /> .e <br /> Name: Date: <br /> Title: ADDN TO RAP <br /> 4 <br /> Consultant Company: GTI <br /> Contact Name: " Phone: <br /> Other Contact name or Info: Phone: <br /> ,t <br /> Program Element: 3526 Pilling Code: Assigned To: MM <br /> Title of Submittal: ADDN TO .RAP <br /> Date of Submittal: 01/15/9q <br /> OT Request: N OT Request Date: <br /> I <br /> Type of Submittal: 5 Remedi,al Action Plan (RAP) j <br /> •k <br /> Permit Fee Paid 0.00 <br /> Check No. /Cash <br /> Date Paid <br /> I <br /> Permit Fee Paid 0.00 <br /> ' Check No. /Cash <br /> Date Paid <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> i <br /> Action Date Action Date Action Date E <br /> Ack/Cam Ltr Req Add. Info Req t Srp Due <br /> Ack/Com Ltr Recd Revisi:vr _ Due <br /> RWQCB Comments Re7 p„ a ! ar Due <br /> Othr Agency Appr File/ FRP Due <br /> Add. Info Recvd Denied Revision Due , <br /> Permit Type: Special st h Agency Due <br /> jWrkpin Revw Comp t Commen �n �F' o.ject Complt <br />