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COMPUTER H S SC,p'1 cn <br /> DBA , <br /> PREMISE ADDRESS: 'l S �l r S S <br /> BILLING NAME: <br /> BILLING ADDRESS: <br /> FEE INFORMATION: <br /> DATE AMOUNT PAID SURCHARGE FEE MISC, / DESCRIPTION <br /> 5 $ 150 $ $ <br /> i - is Di E i� $ $ / i7� - �yo5 <br /> TANK INFORMATION: <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDN / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> TANK H STATE IDH / STATUS <br /> FACILITY PERMIT APPRG.-il SURCHA,r► FFF RFIFASFD <br />