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1 <br /> AREA _ 3 IWDERGROUND STORAGE TANK DATE /- 3- o7 i <br /> DBA .� PH011E Zo? - 17/� <br /> ADDRESS S -Y - CITY <br /> OPERATOR U IZO O(A&C- N PHONE _�_��rg - ?7l/ <br /> OWNER `TXp PAO -- &)Re � � PHONE: <br /> ADDRESS 3�3 7e CP,Yr-,I-ee �—, Siu.� d�� .SG{�G�,y��ir -c, �C Fj-fy-1-7 <br /> BILLING ADDRESS <br /> CONTACT (� PHONE 00 9-J�1/_ 8,7// <br /> ADDRESS fS7/ : lfa-G� /Z �/ 7)r�CJ 6- <br /> APN LOT SIZE C�'TG f SHORT TERM APCD PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT lll/-l� <br /> FACILITY TYPE SEPTIC /i, WELL ho" /A:� � <br /> TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 4 5 wit <br /> TANK # r TANK # TANK # TANK # <br /> STATE ID 4 STATE ID STATE ID STATE ID <br /> PRODUCT PRODUCT PRODUCT PRODUCT <br /> SIZE SIZE SIZE SIZE <br /> PIPING �u PIPING PIPING PIPING <br /> MONITOR 5 MONITOR MONITOR MONITOR <br /> A",^ <br /> (Rrv� w sfi <br /> po <br /> s(-�� <br /> �V se H-T <br /> -TrJAR- <br /> WQ� <br /> o" i e--n <br />