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COMPUTER H fL1 � 1 <br /> DBA <br /> '11 <br /> PREMISE ADDRESS: <br /> BILLING NAME: <br /> BILLING ADDRESS: <br /> FEE INFORMATION:__ <br /> DATE AMOUNT PAID SURCHARGE FEE MISC, / DESCRIPTION <br /> r,\ <br /> - L7 $ �7 S:-L\ $ y $ <br /> i4-3 r 9 $ 1 �1 b $ S �_ $ s/ 1 - l- g--2 l <br /> $ $ $ / <br /> TANK INFORMATION: <br /> TANK H i STATE IDH / STATUS <br /> TANK H STATE IDN / STATUS <br /> TANK N 3 STATE IDH / STATUS <br /> TANK N-Jj _ STATE IDH / STATUS <br /> TANK #-c STATE IDH / STATUS <br /> TANK N STATE IDH / STATUS <br /> TANK N STATE IDN / STATUS <br /> TANK N STATE IDN / STATUS <br /> TANK N STATE IDH / STATUS <br /> TANK H STATE IDN / STATUS <br /> FACILITY PERMIT APPROVO SURCHARO FEE RELEASED '� <br />