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Fiubmttal Numoer '76-10:1 uaze neceivea vclvll�o <br /> Site Code: 90141 4 <br /> Site Name: DDRW—SHARPES Lead Agenc� S <br /> Address: 850 E ROTH RD Contact: 1 <br /> City: LATHROP Zip: 95331 Phone: 4 <br /> Billing/responsible Party Information <br /> Billing Name: Bill Info OK? <br /> Address: <br /> City: State: Zip: <br /> J Contact: Phone <br /> Property Owner/Operator <br /> Name: Phone: y <br /> Address: <br /> f 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: MONTGOMERY ENGINEERS y <br /> I Contact Name: Phone: ' <br /> 11 Other Contact name or Info: Phone: y <br /> Program Element: 0954 1 Billing Code: Assigned To: ML <br /> 11 <br /> Title of Submittal : DRAFT WORKPLAN GW TREATMENT <br /> ( Date of Submittal : 02/01/93 OT Request: N OT Request Date: <br /> 1! Type of Submittal : 112 ! <br /> {IL 4111 <br /> Permit Fee Paid 89.00 I �I <br /> Check No. /Cash 11384 <br /> ++ Date Paid 01/29/93 <br /> I <br /> Permit Fee Plaid 234.00 <br /> ++ Check No. /Cash 11384 SI� <br /> Date Paid 01/29/93 <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> IIAck/Com Ltr Req Add. Info Reqstd Srp Due , <br /> Ack/Cam Ltr Recd Revision Regsted PR Due , <br /> IyRWQCB Comments 'Report Revw Comp Par Due �y <br /> Othr Agency Appr File/No Action FRP Due <br /> t!{Add. Info Recvd Denied Revision Due <br /> {Permit Type: W 02/10/93 Special Permit Issued: Oth Agency Due 'I <br /> �++Wrkpin Revw Comp (Comment Ltr Sent 1 Project Complt '� <br />