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ti <br /> AREA D ��zJ UNDERGROUND STORAGE TANK DATE . <br /> DDA VA I r/ef'`S PHONE <br /> 2-,l/ <br /> ADDRESSJIL CITY Sz <br /> OPERATOR <br /> PHONE <br /> OWNER __ u n PHONE <br /> ADDRESS e. <br /> BILLING ADDRESS 149c <br /> CONTACT Q ONE cL ,,_ZS�/ <br /> ADDRESS 1Q a c p <br /> APN LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR �� �fgrV��ANITARY DISTRICT <br /> FACILITY TYPE SEPTIC SEPTIC ELL <br /> TYPE 1 g) 3 4 5 TYPE 1(j)3 4 5 TYPE 1 3 4 5 TYPE 1 2 3 4 <br /> TANK # ! TANK 2 TANK # 5- . TANK # <br /> STATE ID/,96-3-76ATE I D STATE ID STATE ID <br /> PRODUCT PRODUCTMPIPING <br /> ODUCT ( _Jo,rdeo PRODUCT uk <br /> SIZE SIZEZE SIZE Z 5 <br /> PIPING PIPING �� �r ,- PIPING QMONITOR moiMONITORNITOR - MONITOR �- <br /> Craw OU� <br /> qgol <br /> Olt 144 <br /> UST 24 6/86 <br />