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Stutz-PS � 1�8� • <br /> AREA t"ooUNDERGROUND STORAGE TANK `� ' DATE <br /> DBA OM1 S LJr� t)c)2 5�neL PHONE g3R- -7(074 <br /> ADDRESS 1405' SII Worn lCl S{r�eef C TY L sro IQ�� <br /> OPERATOR Pa-{ncicu y- C4rl geese fu�s.-*- ,y,a'lQNE <br /> OWNER RobeY Lecis P. ([ Iasad -4 4-i ,...4,.'), PHONElk g-3 <br /> ADDRESS 1-79reL7 Ste_ Escu/-7, 9S-3de7558 <br /> BILLING ADDRESS IL-O�S- Ccthor r) IcL St-. , L`_Se Clan s7)zo <br /> CONTACT Pctty-3cPHONE 238- 7G7q <br /> ADDRESS <br /> APN 22-7-ow-31 LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR �,.p.� SANITARY DISTRICT C U.I✓ . <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 # 2— TANK # .3 TANK # O`'l <br /> STATE I D ( STATE I D IL6 gS-CcoZ STATE ID 14ES7-0co STATE ID <br /> PRODUCTL <br /> V.L . PRODUCT �i _ L_ PRODUCT �pflE PRODUCT L.�S�r Cd;) <br /> SIZE a SIZE ? SIZE va SIZE 1,) <br /> PIPING PIPING d PIPIN ; <br /> PIPING G� <br /> MONITO MONIT 5 MONITOR 5 MONITOR <br /> �OL <br /> E? <br /> � s <br /> w <br /> .4 <br /> • PUrnps <br /> unle�ed <br /> S-�orzE <br /> f <br /> 24 6/86 <br />