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UNDERGROUND STORAGE TANK`.l1 <br /> DATE <br /> PHONEb g <br /> dA <br /> ji <br /> ADDRESS tCt�L A S CITY ITYV <br /> OPERATOR PHONE :76 <br /> OWNER PHONE <br /> ADDRESS <br /> i <br /> BILLING ADDRESS <br /> CONTACT ri'i PHONE 7 I <br /> ADDRESS <br /> APN LOT SIZE SHORT TERX APCDPERMIT <br /> WATER PURVEYOR S SANITARY DISTRICT U - <br /> FACILITY TYPE GAS S ?"/4 T� 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 DANK TANK # <br /> STATE ID JVD &L9 STATE ID SD(oDty-�C STATE ID STATE ID <br /> PRODUCT PRODUCT PRODUCT PRODUCT <br /> SIZE J� SIZE IZE _ SIZE i <br /> PIPINGre_S5AtLR IPTNG PIPING <br /> PIPING !'e. I��C.. ! <br /> MONITOR MONITOR �.Lr ONITOR MONITOR <br /> EH 23 030 8/89 <br />