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1 l6 0 <br />/ADDRESS <br /> A UNDERGROUND STORAGE TANK DATE <br /> PHOTIE <br /> �88� f..t)e,P2 CITYRATORS (s -� PHONE <br /> OWNER.! CEJ PHONE <br /> --_-,-.-ADDRESS <br /> ~ 'BALLING ADDRESS 0 <br /> CONTACT - � HONE - b <br /> ADDRESSsv f: •�C �.�� � 5S ;.a <br /> APN _ LOT SIZE SHORT TERM APCO PERMIT <br /> MATER PURVEYOR M4 S tbcA_;��..CC• �,. SANITARY DISTRACT ,r <br /> FACILITY YPE � � SEPTIC r'4 WELL /V �4 <br /> TYPE 1 2 Z <br /> 3 4 5 TYPE'1 '� 3 4 5 TYPE 1 3 4 5 TYPE 1 �Z 3 4 5 <br /> TANK # TANK # 2— TANK # 7 T K #� <br /> STATE I D STAT ID -Z STATE ID �� 3 STATE ID o CC <br /> PRODUCT PRODUCT d PRODUCT V [— �Ut. PRODUCT <br /> v QCtsJ <br /> SIZE tb SIZE lo,o SIZE o SIZE 17- <br /> 0070e <br /> o <br /> PIPING PIPING PIPING PIPING <br /> MONI R MONITOR ` S� MONITS� MON ORS <br /> Tc <br /> 1-400a <br /> 0 <br /> ' . <br /> UST 24 6186 . <br />