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03-03-2.001 08:2941 FRS" 70 3661651 P.M <br /> UNIFIED PROGRAM CON$CLIDATso FORM <br /> TANKS ; <br /> UNDERGROUND STORAGE TANKS - FACILITYtt�\\ <br /> ID�l Page Fer vy <br /> ftr �J <br /> y _ 7 <br /> Trost <br /> OF ACTE7Nr`}NEyi 3r RMAtr r x RaNewAL afiRNvr r x crANGc OF rsOa TCN rsP.an-F� r T.F9a+M1:fi"%L CLose_v. <br /> (Da.F. 1 r,TAN<REMdID «D <br /> rAAASOIDA6M <br /> TEAIFCRARy srTc OLGsuaE <br /> 1.FACI.TY/SCR INFORMATION <br /> e NESS NAMa(Gnv r FACIU a ORA 0"aua+u..A.l a FACILMY 10 a <br /> Tony Jockovich Trust <br /> +W..:67 CRC43STRE TFACILI GNTEA-.7p.E r 4 L0C:AGLNCYJCISTRICT• <br /> Orford Rd. r 1. CORPORATION r s OQLN AG:Ncr <br /> ` "SS a r +.wS STA7O.N r 3.FARM r a.=«uodmtc l6Npa. HNV*UA r a v.AT,+G:Ncr <br /> r S Cmmm;TDR r FRMaSSCR K E CTR 1 FARTNlR3MIF r T. FEoEGiA02Nc— 42 <br /> b5 <br /> Fp 4NW.5$ITETA Nom? •��MllewWfla xwrsrd us7 sewers ap.neF Rea.d+,ew.+:ar <br /> Crvuis+,rnvl a okn wMl Pprrr Wa UST. <br /> bri,y Ina i!M.xeaa P>sm b Ta 1aNl rRmb.l '. <br /> A 1 S iNl e W- � <br /> II.PROPERTY OWNER INFCRA471CM <br /> PNCNZ .oe <br /> Tony octovichTTrust (209)948-2482 <br /> X�ffi� 8567 Orford Rd. <br /> STATEa l as COO=_ Al2 <br /> Stockton, CA 95215 <br /> pROPE=Ty ONNeRT pe 2r 2. kbMOUAL d. LOCALAGINCY101STRICT r i. STA^A-4NCY •13 <br /> r i. CORPORATION r] FM'NeRs+P r a CWNTy AGENCY r T FEOEPF AGENCY <br /> III,TANK OWNER INFORMATION <br /> AIA RdNi a1* <br /> Tony Jockovich Trust , c/o Marie Lopez Trustee 2049-2482 <br /> (NAtL.NGcaa7asr AOORI= 4168567 Orford Rd. <br /> nF � L .. <br /> Stockton , CA I CA9521 .5 <br /> rX2. WWOQ L r a Lo7AOENcy,u,sTR,aT r I rAT_AOENcyFT" 'r <br /> r 1. CCRPMAT N r 2. FAR IlERSNa IF S CCVNVAGiXCy r 7 FEOIF.:AG:NCY <br /> TY(M.HQ f a a Call(916)321.6663 B questions arae <br /> 11iT1 x1 r t. aL'pAISNIfin r A. l RiT. woo 7. STATI Ft#M r 10 LOCALOOV.TMECI WPM <br /> r 2 GUARANTee r S. LETIRR OF CREDIT r 6 o?Ayl/NIDE Cp0 LETTER r w OT v <br /> 1 3 P.aURAIlCE r 0. EF.J'.Ti v'1 r 9 VAT!F'JW l G'7 4i <br /> DMa rw aarorAtm.tiN auetar lvld a.udbNFplmleaten>jro mako. r I. FADUTy r 2. M'.CPERM1 owwE 1a,x TAM(OveNlA. <br /> r VIL,I DDI ieuN SI(`NATIWR <br /> I GnaNEC[ I eEnTY TRIM rt/amaGen i�+EaO MYM u Fu Yfe EmYia to W O.tl 7 TV'ebu1E00a <br /> slowata <br /> VRL PNQ` <br /> Tfi ON[ <br /> 1Laa1l� LCNIT!8wD �-7 T ns FL.ov/r � nr <br /> sTA u�v NUM al ear wal•lT rj IGEa uPCRADe CeRT1FICATfi NLIa{K. ;Ibr k.x•JFOa p ae <br /> I � <br /> UPCF i 1/99;ewasM 5 Folm 'iy SWRCS=ern+A <br />