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ABOVEGROUND PETROLEUM STORAGE TANK <br />FILE COVER SHEET <br />FACILITY ID#: FA0017445 <br />PROGRAM RECORD #: PR0530543 <br />ADDRESS: 15515 N PRESCOTT RD <br />FACILITY NAME (DBA): TRIPLE H FARMING <br />FACILITY PHONE: (209) 480-8130 0 <br />FACILITY CONTACT: <br />OWNER NAME: TRIPLE H FARMING <br />OWNER ADDRESS: 15515 N PRESCOTT RD <br />P/E: 2830 DATE: 09/04/2009 <br />P/E: DATE: <br />P/E: DATE: <br />CITY: MANTECA <br />FACILITY FAX: <br />PHONE: <br />CITY: MANTECA <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 Tank PE Capacity No of Compartments Additional Description <br />TA0518996 <br />2820 <br />350 <br />DIESEL <br />TA0518997 <br />2820 <br />500 <br />DIESEL <br />TA0518998 <br />2820 <br />500 <br />DIESEL <br />TA0518999 <br />2820 <br />250 <br />GAS 87 <br />EH 00 18 rev 04/2008 <br />rpt # : APST New Owner: Create a New Cover Sheet / Change Label of File <br />