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�REA <br /> Ui, LRGROUND STORAGE TANKr` DATE _ <br /> DBA S l7 Kin1 Cr, PHONE <br /> ADDRESS 4 .Q,(,J ri 2 CITY <br /> OPERATOR ilt 4 J �/ ff6/ ,/n/ r'+ PHONE <br /> I OWNER (�{y�,, "'�12(,�G (�S /y�C� PHONE_ /��_ <br /> ADDRESS <br /> BILLING ADDRESS <br /> �¢, o R � Itit ► PHONE <br /> CONTACT 6— I� <br /> ADDRESS 9J b 1n S �W <br /> APN LOT SIZE &/96*SHORT T RM APCO PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT <br /> FACILITY TYPE SEPTIC5 WELL <br /> TYPE 1J 3 4 5 TYPE 1023 4 5 TYPEr2 2 3 4 5 TYPE f 2 3 4 5 <br /> TANK # . ] O-9 TANK #._./, 4-94VO' ANK # TANK # <br /> STATE ID <br /> STATE I TATE ID __ STATE ID <br /> PRODUCTDI*f'Srw <br /> PRODUCT&a PRODUCT PRODUCT <br /> SIZE Q.600 SIZE (J1/N. r– IZE��—,,-- SIZE <br /> PIPING $k( _ <br /> PIPING -Ta W PI$�NG "L r � PIPING <br /> MONITOR MO To MONITOR MONITOR MONITOR _ <br /> S f �A� <br /> 77 <br /> TD, <br /> � <br /> �`l <br />