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UNDERGROUND STORAGE TADTK '� <br /> G'G' <br /> AREA � DATE rJ�'z <br /> DBA PHONE <br /> ADDRESS CITY 06e-AA<P j <br /> OPERATOR PHONE <br /> OWNER I/�/ IGEti/2_? R�jY PHONE 368 073 <br /> ADDRESS EZ&h`-r �/GE �2�,QJ� STDs K r�n1 G� �SzoS <br /> BILLING ADDRESS <br /> CONTACT PHONE <br /> ADDRESS <br /> APN LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT <br /> FACILITY TYPE SEPTIC WELL <br /> TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 <br /> TANK # TANK # TANK # TANK # <br /> STATE ID STATE ID STATE ID STATE ID <br /> PRODUCT PRODUCT PRODUCT PRODUCT <br /> SIZE SIZE SIZE SIZE <br /> PIPING PIPING PIPING PIPING <br /> MONITOR MONITOR MONITOR MONITOR <br /> Martin L. Ford <br /> Sampler/Courier <br /> EH 23 030 8/89 Stockton laboratory <br /> MPN�GEflS CESIGNERS,CpA51AiNItS <br /> Roy F. Weston, Inc. <br /> 212 Frank West Circle,A <br /> Stockton,California 95206 <br /> 209-983-1340• FAX 209-983.1340 <br />