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0w-23-2261 68291=M FRCT1 TO 3681"a51 F. -' <br /> wA <br /> UNIFIED PROGRAM CCN$ OLIDAi E6 FOP A (UICIo-2 (0' <br /> V TANKS ;, <br /> UNDERGROUND STORAGE TANKS-5+V1 ITY <br /> b I o D7- rC^�ariF pFrKy ; <br /> FLw _ w — <br /> TYPsOFOLTP jY...Nviar•E Pemr r7.AS42 YPErwr r9:1•Awz OF moo rlom es rf HMlp.• r 7...RMN3SMLY CLOSEC SRE <br /> r MSIOROP[Aw, �YruM raT.µR.ReMOYED .co <br /> r 8 TBAOCRARY SRS CLOSURE <br /> 1.FAGLrY f 3rM INFORMATION <br /> eU81NESL NAMe(L..r r FA.:iLI a DaA•D.+y auurr A.) 7 FACiL: s I ;, <br /> Cherokee Memorial Park fl dDo3G b"f ? <br /> n i,CROSSSTREET G1xsL m~n r A LOCALAWNCY..VVRICT' <br /> 9TwTI0N <br /> riarne Ln. Z r 2 F.V W co r K=RPORAT" r t CowTvTC.:Nev- <br /> sLCRNS a r I.GAS X S.CONNCRCNL r 2. NOINOY.4 r& sTAve wzmcY <br /> r 2 CDiTR axnp r A FROCCsscR r s are. r a. A.RYNMSMIF r T. FEDERAL AGENC' 42 <br /> CO <br /> µNUPE TANN9 wrO1ry Oesn Rl.avLCM a N/R m UST•a"M aarr<J.nYr.of slP.n+c N <br /> ROUNNVIGAi SITE Cnar+.+.�.N n W.Nrdl oC. - tiv UST. <br /> Rbis ms:am Calm Iv SaIKLr.mEF.) <br /> 2 Yr 1X a .ae .a <br /> II.PROPERTY OWNER INFORMATION <br /> OMER N a .CT PNCNE AOE <br /> Cherokee Memorial Park <br /> MWNQ iiORE36 .oL <br /> P.O. Box 1000 <br /> j b�A.E 411 CIP QCOE 412 <br /> Lodi, CA 95241-1000 I <br /> _RT"OYrNCR TY.E gYa r 3. INOMOUAL r O. L=C AOaNCyjQ*,NCT r S. STATEACMCY 117 <br /> i' CORPORATION r 7.FMRlM1SNP r i COUNTY AGENCY r T FeGsML AGSNcY <br /> 111,TANK OWNER INFORMATION <br /> u: <br /> mg O�ER-AA4 NA <br /> Cherokee Memorial Park 1 (209)334-9613 <br /> I P 0. xo 1000 4' <br /> u .• <br /> .1 A 95241 1000 --7I <br /> Lodi <br /> got �vr 2. :NwcDU r . LOON.AGENCYlDtS'RICT I. Sur AGENC OL <br /> � <br /> Y11. CpPATICH r 3. PARTNERSHO r S. COUNTY A62290Y r 7. FSGLPAL AG:NDY <br /> u �Of INT MI <br /> Cali(916)32=A869 if questions arse W <br /> INCK.+TE NF�OOt3l j' ,. tLLF-PISURLO r A. SURSTY SONO eereee'''''i. stare NNO r to. LDCµCOV.T MECNANI?M <br /> r 2. GUARANTIM r --crvI cP CREOR L srATe/VNO ACRO LETTER r s G E 4- <br /> r] NSVRANC r e. eua3PnON 9 TIATE FURO LCC <br /> Mew <br /> eN.a N*xa..rdi Oexl.r YaJd Yua.Ply Ngr mNk.mn. r 1. F.GLm 2 PfNERTT Drmue r, TAKOYAdR M <br /> DaleolOttt Iarm TUlSu naN1 rurn A P.P.n a TY+na•AM1D• <br /> 1DNATVRe_ I ave 3/28/02 I(P )368-6175 <br /> vPKET, gftAeoes .se TMA OF apuawT 47 <br /> Richard Thor e Contractor-/Agent <br /> STAB i4.TY NUMK0.( oPW w.aM 4S( IM UMJupE CGP.TIFICATL NYgeR,'b Aaa.lm a.Y; GS <br /> S FOfTtl.1y SWFCS rern <br /> UPCF("a nv"M <br /> UAW, �r <br />