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UNDERGROUND STORAGE TANK DATE <br /> AREA Z� PHO14E <br /> DBAITY <br /> ADDRESS 1��2(L . <br /> ktC P 0 •(vex 808 Ct.. - <br /> PHONE <br /> OPERATOR PHONE 7 23- 3� <br /> OWNER <br /> ADDRESS <br /> BILLING ADDRESS ;' . PHONE <br /> CONTACT <br /> ADDRESS APCD PERMIT_______ <br /> APN LOT SIZE SHORT TERM <br /> WATER PURVEYOR SANITARY DISTRICT <br /> SEPTICWELL <br /> FACILITY TYPE TYPE 1 2 3 4 5 <br /> TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 <br /> T # <br /> TANK # TANK # <br /> TANK # TANK <br /> STATE ID STATE ID <br /> STATE ID STATE ID PRODUCT <br /> CT <br /> PRODUPRODUCT <br /> PRODUCT ' SIZE <br /> SIZE SIZE SIZE <br /> PIPING PIPING PIPING <br /> PIPING MONITOR <br /> MONITOR MONITOR MONITOR <br /> UST 24 6/86 <br />