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AREA "sem UNDERGROUND STORAGE TANK DATE <br /> DBA PHONE Cgl(p) 17Y-416 a 9 <br /> ADDRESS a I (O vvu, 494CITY <br /> OPERATOR �1 PHONE _ <br /> / PHONE <br /> ADDRESS Q•o �ov� �laoo7 �s �a i po S}c�Q V/VV�4� L—jf� Ci> g0009 <br /> I <br /> BILLING ADDRESS <br /> CONTACT (�'qtc SNtff�S �Clz�co PHONE �16 9,29-S��j <br /> �/, `(oi6 <br /> ADDRESS q(o2IA <br /> APN LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT <br /> FACILITY TYPE C—,t)t)e rr\ EPTIC WELL <br /> TYPE 12D 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3• 4° 5 <br /> TANK # i TANK # TANK # TANK # <br /> STATE IDS ? 14Soo STATE ID STATE ID STATE ID <br /> PRODUCT A vtttltD PRODUCT PRODUCT PRODUCT <br /> SIZE SIZE SIZE SIZE <br /> PIPING p r` PIPING PIPING PIPING <br /> MONITOR MONITOR MONITOR MONITOR <br /> UST 24 6/86 <br />