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+08-14-2001 02:40PIl FPom TO 4648349 P.01 <br /> ` �"15rNIFIED PROGRAM CONSOLIDATED`-eORM gtj <br /> TANKS <br /> I <br /> UNDERGROUND STORAGE TANKS - FACI ITY <br /> 7 S 7 �,>,2.rcl EanppeppR <br /> TYPE ACRON r 1.NEW SITE PERMIT r 3 RENEYal PERMIT r s CM.NOE OF WORMnigN(• >"I'Ame r r PERMANENTLv�f OSEO STE - <br /> Ed1PlMpq•61M muY) <br /> I] r 1 AMENDED PERMIT PM) I 6 TANK REMOVED .OG <br /> r 6.TEMPORARY SITE CLOSURE <br /> & I.FACILITY I SITE INFORMATION <br /> MF WOEA-O•T,P'EU•i,EFF NI s <br /> 8 .C-owacel <br /> NEAREs STREET , r . L ADEN <br /> Z I z -- - r ,. coRPORATIOR r s COVNTYAGENCr• <br /> r,.OA$:TATm ww#Aw -T''r�s�.commaRck r 2 mDIYEUAI <br /> ���11ER r 1 r <br /> r'2 DISTROXOR r..PROCESWR y Y).91r s. PARmRsmp r STATE AGENCY• <br /> FEDERAL AGENCr• <br /> TOTAL OFAWSh4,irlF w{s,f�, w 7o.YW aHSTis•R24A$~p afrAw <br /> REMAMTGATS(TE «piPl,waRFPMM•PR•IF•Tn•USTgJ� <br /> ri (TNeu Ae Fw utt pPRp IP 9P Rkr.OR«.) <br /> .011v F IG��rut- <br /> H.PROPERTY OWNER INFORMATION <br /> DYYNER NAI1E PHONE 911 <br /> i 'So t , %r�TX1C, •fie <br /> I Aly 7A <br /> IAAR ETREEl ADORES . /1 <br /> ,,, zwCOUlt <br /> I cS'Zo'z <br /> PROPERly RTME r E. P0N 0IpW ^. L AGOCY,DISTRICT r$ STATIC ADENCY 03 <br /> r, coRPDRATaR r s. RARFRER6N,P ( `pyNTYAGENCY r r mmwAI AGIRC'I <br /> HL TANK OWNER INFORMATION <br /> TAMC OTYNEII RNIIE 414 rtheme Ms <br /> i SCJ/•f. `�O,A G2(;tc A) �C-,AI 17� - <br /> VITT <br /> { Ala <br /> { 71 2 3 <br /> TAME <br /> r 1. COIIPORATIpi r 5. worvwtw r.sOCIyADENCY,OI6TRICT r 6 STATEAGENev .m <br /> r 3. PARTNERsmw r s. COUHttMERCY r T. F$DeaALAGENCY <br /> I <br /> TY(TI J NO 4 4 Call(918)332.9669 if Questions arise 421 <br /> METHOCKS) <br /> r , aELF� SURED r.. SURETY$OND rT STATEFUND ,D. LDCALGOV-TMECNANISM <br /> r 1 GUARANTEE r s. LETTER OF CREDIT r 6 STATE FUND dCFO LETTER r sa oTwEa <br /> r 7 INSURANCE r 6 EAEM►T ONr P STATE FONO t CD 422 <br /> Ooxp hOKMF w#KA•00'«,a1,oiAtl«v«Eb N9a-tlF«IIOeM•I,OTWp' r I FAC,urf r t. PROPERTY OTRIER r 7. TANK OYNYR m <br /> jwNI <br /> PH D0.1 w <br /> CMR'g6M' lan•T MTM $,Ptwaa T>MwrleEYe •'� <br /> SRi/lA O<APR DATE_ -s - AT. P J <br /> APRKJWT <br /> 42s TITL R'.11NT <br /> I <br /> TATEto <br /> MWeER(AYTAJIu«p,lP) W ,Pal VPGRADE R TE ,,, PI <br /> UPCF 0?9 revised) S FORTWr1y SY1NlCB Form A <br />