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I S U ()b#S I R COMPLEPING I w « <br /> GI,NERAL . PR[7 7ONSc <br /> L One FORM"I3"shalt be completed for each tank for all NEW.PE IS,PIERMrr C 1 GF-S, REMOVAI S and/or any <br /> other TANK 11? R `I'IO C HANG %' <br /> 2. This form should be completed by either the PE' P APPUCANT or the LOCAL AGFNCY UNDERGROUND TANK <br /> IiSPI R. <br /> %` 1 Please type or print clearly all requested information. <br /> 4. <br /> Use a 40,point w tin ,instru n yoaz�w,,k'sng 3 co i� ,. <br /> `' <br /> TOP()Ir R (3 ONE nim" <br /> L Mark an (X)in the box next to the item that best describes the reason the form is being completed. <br /> 2. Indicate the DBA or Facility name where the tank is installed. <br /> 1. TANK I)Ix 1#1'16 `V- ;. ' ?AL ITEMS-117 UNKNOWN-SO STECIFY <br /> A< Indicate owners tank ID #-If there is a tank number thaj is used by the owner to identify the tank(ex.AB70789). <br /> B. Indicate the name of the company that manufactured the talk(ex.A MFE'TAMC MFG.). <br /> C. Indicate the year the tarok was installed(ex. 1987), <br /> D. Indicate the tank capacity in gallons(ex.25;01 or 10.OW etc.). <br /> II. TANK C:O Eiq IS <br /> A. L If MOTOR VEHICLE FUEL,check box i and complete items B 1d: C. <br /> 2. If not MO'.I'()R VI; <br />