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k <br /> 0"o -�-� <br /> PUBLIC HEALTH 9ERVIcE0 <br /> PUBLIC RECORD ttthnaE hEoubsT <br /> i. ftNjUENT AMUPAgE bATR <br /> 20, tt9QUE9Tt0d AdENcY S;c --o n SEP, STA: PlrONE No. A -s- <br /> 3. AdENCY Atib�EgN � L. n �T - <br /> ycC; i <br /> At INOIVIBUAL FZEQUEST1HG PHONE NO. ` -� <br /> S lubtVtbUAL AbbttESN <br /> kxL _AbbAts9, ITEM RE UE5 ED .•I)� PURPOSE OF AE(ZUE5T <br /> r <br /> U <br /> +� AgTErttglt t N� nt; urr"ITO t~ v copyjt <br /> --J� <br /> ►stcNA�Utt>�, til' ftE0ULEtiNd PARTY DATE <br /> 1?UELiC 119ALti# 19MVICE9 USE ONLY <br /> Plto,��C'�Eb �tEL�ASE bAT� <br /> sxGNA�U t� tlE MtAalma O> t:ICIAL DATE <br /> "AMI UP STW 9E14111399 INVOLVED M THE RgLEASf; AND MONITORING <br /> of m11E Atcdltb6 i <br /> Ell 0014 Wp <br /> v <br /> APR 26 X991 <br /> ENVRRONMENTAL HEALTH ' <br /> PERMIT/SERNACES <br />