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Undergrount,,)rage Tank Program - Farm .'ink Information Form <br /> FACILITY/L1TF INFORMATION (Complete this form for euch FARM TANK location.) <br /> M or ItUSINESS NAME CON'TAG"f NAME <br /> AT Manteca Vineyards Ron McManis <br /> DRESS(Street address of TANK location) <br /> ) PIIONE N (with area code) <br /> 29898 S. Air ort 209-599-6145 <br /> Y STATE "LIPCODE NL;TtES'1'CR0SSS"rREI-,f <br /> Manteca Ca. 95366 Division Rd . <br /> CHECK HEKE if This ADDRESS should be used for Legal Notification <br /> OPERATOR INFORMATION &ADDRESS (Complete If Information different from above.) <br /> O NAME <br /> OPERATOR CONTAC{',NAM13 , <br /> P Tri M Farms Ron McMahi''s <br /> RMAILING or STREET ADDRESS OPERAI'OR PHONE N (with area code) <br /> A 339 Industrial Ave . 209-599-6145 <br /> T CITY SI'A1'E 1UP CODE <br /> O Ripon Ca . 95366 <br /> R 'x CHECK HERE is this ADDRESS should be used for Legal Notification. <br /> PROPERTY OWNER INFORMATION &ADDRESS (Complete if different from above.) <br /> NAME O WNFR CONTACT NAME <br /> O Mac Enterprises , Inc . Ron McManis <br /> NMAILING or STREET ADDRESS OWNER PHONE N(with area tale) <br /> E 339 Industrial AVe . 209-599-6145 <br /> R CIT6ipon STATL ZIP CODE <br /> Ca . 95366 <br /> CHECK HERE if this ADDItISS should he used for Legal Notification <br /> CHECK APPROPRIATF.BOX <br /> .I. ACITVE FARM TANK SITE One or more underground TANKS > 1,1tN1 <br /> ( E ballon capacity) <br /> Y <br /> P EXEMPT FARM TANK SITE (ALL underground TANKS at site = to or < 1,100 gallon cal aci!y) <br /> H <br /> x PERMANENTLY CLOSED FARM TANK SITE (ALL underground TANKS at site removed or closed in place) <br /> 1 <br /> UNDERGROUND TANK INFORMATION (List additional tank Information on separate sheet If needed.) <br /> T TANKSI7J1 CHEMICALS SfOR11D USTI MAn;.D DA'IL LAST USEO METIIODOFCLOSUIIE DATE OP REMOVAL Olt <br /> A (GAUONS) CURRENTLY Olt PREVIOUSLY IFCURRENILY P.MPTY IF PERMANENTLY CLOSED CLOSURE IN PLACE <br /> N <br /> K unknow3i unknown unknown unknown unknown <br /> I unknowt unknown unknown unknown unknown <br /> N <br /> F <br /> O <br /> TRIS FORM 11 S URKN COMPLETED UNDER PENALTY OF PI?IUURY,AND TO TIIE IIESTOF MY KNOWLEDGE,IS TRUE AND CORRECT. <br /> Nnlvf l TITLE Partner DATE 6_14-91 <br /> OFFICE USF.ONLY <br /> SWlilTSN COMPO LOCMI)LDISTCODLNACI'IVh'lIG'1' MEXEMP'I'UGI' 0CLOUD UGI' Sw19iPS PI(GM/SUU CODE UA'I'li <br /> 1xl1 23(144(IZ/M) <br />