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Submttal Number 93-299 Dat*%010'Received 03/29/93 <br /> Site Code: 1785 <br /> Site Name: PERSHING SHELL Lead Agency: <br /> Address: 4445 N PERSHING AV Contact: <br /> City: STOCKTON Zip: 95207 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: AEGIS <br /> Contact Name: Phone: <br /> Other Contact name or Info: Phone: <br /> Program Elements �3526Billing Code: Assigned To: MC <br /> Title of Submittal: QM REPORT <br /> Date of Submittal: 03/25/93 OT Request: N OT Request Date: <br /> Type of Submittal: 9 Quarterly Report/Past-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 /> F <br /> Date Action Date Action Date <br /> r Req Add. Info Regetd___ Srp Due <br /> r Recd Rem' egsted ~� . PR Due <br /> ments R 4w mp�/QI Par Due <br />