Laserfiche WebLink
.�.•-�5►�� $ SAW J•Qj� JI N` i.Q <br /> ;l'ttSi i - 11:e Sar: Joaquin Local Hsilth Dlatrict's_-Ttacic t <br /> �nQ_$lit.:will: : <br /> itst re ir[th its site identification nwAber. TtIft 'lyo*Ing Sheet is to.:be deturrtsd toy <br /> Loo�l Nealth District vithin <br /> . 30 days;of of the tank.: <br /> pclr:q <br /> 'facility.facil i ty. 12=1 r .. .9 ,. <br /> `Y <br /> -IjiDifl _Larcin's Service <br /> ; <br /> .! Un S: 2235�Cherckee Rnad' •Styckt40• CA <br /> '2Xi;QQQ, 9A.' oas tank mSite <br /> #1ss:#s!#rnsrs#:es**sa:##: ,e#s#ss#*�tstrs#sees*slstliR*:rtssst# :taselses ►s <br /> Y To be EiTl�edout by tank re�u&I cQntr cstor: <br /> ' <br /> � 7 d TT 7}AIDIc aI G &MIctog i JIM :HORPf OIL, <br /> Jc.l N. 6eCkltlin RQic#' • � tr ZI <br /> Fft <br /> ��• ,Ja ''' ,; <br /> EY '� `--��.�• - Date a.7nR- Nookwid - <br /> �rssfE�e:��esss::+es+es►#s!##slas#s+rte:�,*ayes*see*s�rsaats�e�e�e�ts�the�raeesR�af�s <br /> iM 3" -To be filled out by contractor <br /> Aontaninntian" Oontractor: JIM THORRE OIL, `�IlVC. / No��Ca?4€��t <br /> 351 N". BeEkman ,Itaad, Lodi,� t < � � " X95240 <br /> ' hard rep -esentative of contractor certifies a b <br /> ' ted in an apWoved awwws as y be r eY 9� p gr tc�f Ira�er i <br /> a` <br /> �« ti <br /> IF <br /> Vrice-Preside fi� •a::," �' <br /> fGm $� .. <br /> �d„ et�R�l+ss##ss##yes#�esx�e:tss:#i#�*s*:xslss#�t**�r*��es*fetes#sse�lsrls#Rpt#sir�e:e�efe�t�s:e�rfras#�e� �`. <br /> Ta be filled out and sign” <br /> � greet Dy.ar� autlxa;iamed <br /> e Or disposal facility aeceoti <br /> .{ tiii Ak", a s <br /> • T_ <br /> SCtIN ,,; <br /> 12000 MMIN <br /> w .. Zi <br /> ;l 91 ;? <br /> x*': <br /> Received• <br /> I T L <br /> -R. <br /> �" ': At11llDill�? SIGNk11AtB AND`�'ITx.E • . ,>r <br /> - �!!�.!lsss!!#.ttlfl#!!!!#1leltR#!fR!lRAlt.!!�*s:iRlt/1*!!ltl�le�lellRlttRfe#fe#�*Rs�l� ,r - <br /> f TI�ffi: P .D IN NA x. STAPM. lIX Itft-QAB'!#lSfi� •�� ` <br /> s SAN J0=1N EDM NM"- <br /> A,T N: TANN•PROMMP. <br /> 4. R <br /> f STOOCId�t,Cl 9520 <br /> �f t:• _� .. ? 'r'k{{ mak en�tx�aw yRrti .: `' .+ J*'� 1. <br /> 4t r x <br /> Aim <br /> / ^ r <br />