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ww Y, • <br /> AREA VDERGROUND STORAGE TANK �""� DATE 7 <br /> DBA PHONE _ <br /> ADDRESS Iaw�omr (�/1L� CITY l©bl� <br /> OPERATOR wm PHONE <br /> OWNER . 'PHONE- <br /> ADDRESS <br /> �f2 .. r�.vn S PHONE ADDRESS <br /> BILLING ADDRESS Sc�vn. ar..s owner <br /> CONTACT 9-5if4f.00— y Ll_Lt kr.,-5 PHONE dow <br /> 'ADDRESS --;� -5,_ c�1�A �_ r�a <br /> APN LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT <br /> -FACILITY TYPE 55� 1n' :!5%7rQttG SEPTIC WELL <br /> TYPE 1. 2 ® 4,,�S TYPE 1.2 3 4 5 TYPE1 2 3 4 5 TYPE 1 2 3 4 5 <br /> TANK # ` TANK # Z TANK # TANK # <br /> STATE ID $6ICOf STATE ID gfS'TrG/A?�''STATE ID &(9rvrb10STATE ID qs-S-QvoZ <br /> PRODUCT U ?7ie011- PRODUCT u �� PRODUCT ,b PRODUCT & <br /> SIZE 5ZO .69-6, SIZE $Sl�iDs _ SIZE SIZE 100004hre, <br /> PIPING PIPING PIPING !f O PIPINGZTO <br /> MONITORS MONITOR MONITOR MONI <br /> UST 24 6/86 <br />