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Submttal Number 93-118 Date Received 02/08/93 Site Code: 1953 Site Name: JEMCO VENETIAN CARDLOCK Lead Agency: Address: 4555 N PERSHING AV Contact: DON PELING 4 City: STOCKTON Zip: 95207 Phone: 209 473-8996 Billing/responsible Party Information { i Billing Name: Bill Info OK? Address: i City: State: Zip: Contact: Phone Property Owner/Operator Name: phone: Address: City: State:- Zip: Client Information of different from Owner/Operator) Name: Phone: Address: City: State: Zip.- Applicant' s ip:Applicant' s name, date signed, title Name: Date: Title: i, Consultant Company: MCLAREN HART Contact Name: Phone: i Other Contact name or Info: Phone: i Progra�► Element: 3527 1 Billing Code: Assigned To: MC `Title of Submittal: PRELIM ASST REPORT k Date of Submittal : 02/03/09 OT Request: N OT Request Date: f 1 Type of Submittal: 3 Assessment Report- Permit Fee Paid 0.00 I Check No. /Cash Date Paid Permit Fee Paid 0.00 Check No. /Cash Date Paid Staff Review Due: OT Scheduled: OT Completed: Action Date Action Date Action Date Ack/Com Ltr Req Add. Info R e iAck]Com Ltr Recd Revisi egsted 7PRDRWQCB CommentsRe fl� e Othr Agency Appr F' 1 FRP Due Add. Info Recvd De _ Revision Due Permit Type: Special Permit Issued: Oth Agency Due Wrkpin Revw Comp Comment Ltr went Project Complt �F