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Submttal Number 93-095 Date Received 02/01/93 <br /> FSite Code: 1261 <br /> Site Name: UUIK STOP #120 Lead Agency: <br /> Address: 9321 THORNTON RD Contact: STEVE CHASE <br /> City: STOCKTON Zip: 95209 Phone: <br /> Billing/responsible Party Information <br /> Billing Name: Bill Info OK? <br /> City: State Zip: <br /> Contact: Phone <br /> Property Owner/Operator <br /> Name: Phone.� <br /> ity: State: Zip.- <br /> Client Information (if different from Owner/Operator), <br /> Name: Phone. <br /> Zip- <br /> Applicant' s name, date signed, title <br /> ' <br /> Name: Date: <br /> Consultant Company: RESNA <br /> Contact Name: Phone: <br /> Other Contact name or Info: 'Phone: <br /> i Element: 3526 Billing Code: Assigned To: LT <br /> if <br /> Title of Submittal: GM REPORT <br /> Date of Submittal: 01/01/93 OT Request: N OT ,!Request Date: if <br /> Type of Submittal : 9 Quarterly Report/Post-Remedia.1 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 /> ` <br /> \ <br /> ' <br /> Staff Review Due: OT Scheduled: ` OT Completed: ' <br /> Action Date Action Date Action Date <br /> RWQCB Comments Report Revw Comp : "Par Due <br /> Othr Agency Appr File/No Act ' on FRP Due <br /> Add. Info Recvd Denied evision Due <br /> Permit Type: [Spec h Agency Due <br /> ' . / <br />