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ABOVEGROUND PETROLEUM STORAGE TANK <br />FILE COVER SHEET <br />FACILITY ID#: FA0017151 <br />PROGRAM RECORD #: PRO530511 <br />ADDRESS: 11961 W HWY 12 <br />FACILITY NAME (DBA): HWY 12 FARMS INC <br />FACILITY PHONE: (209) 483-5885 0 <br />FACILITY CONTACT: <br />OWNER NAME: HWY 12 FARMS INC <br />OWNER ADDRESS: 11961 W HWY 12 <br />P/E: 2830 DATE: 09/04/2009 <br />P/E: DATE: <br />P/E: DATE: <br />CITY: LODI <br />FACILITY FAX: <br />PHONE: <br />CITY: LODI <br />PHONE: <br />Water Service: <br />❑ Large PWS <br />❑ <br />Small PWS <br />❑ Domestic Well <br />Sewer Service: <br />❑ Public Sewer <br />❑ <br />OnSite WWTX <br />❑ OnSite Septic System <br />Stormwater: <br />❑ Street Drains <br />❑ <br />Street Ditches <br />❑ OnSite Ponds ❑ Other <br />Tank Record ID <br />Tank PE <br />Capacity <br />No of Compartments Additional Description <br />TA0518954 <br />2820 <br />1000 <br />DIESEL <br />TA0518955 <br />2820 <br />1000 <br />GAS 87 <br />TA0518956 <br />2820 <br />10000 <br />DIESEL <br />EH 00 18 rev 04/2008 <br />rpt # : APST New Owner: Create a New Cover Sheet/ Change Label of File <br />