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<br /> 6, Tank o-wr mum wbmh a Roily OW pian no 10...c,.l ageohy as pan of0w app! .aion rczpeet trr
<br /> To.n, i t r nnu _A,i at d wu.w.r-a6on h c nsf,ar c e,,,,.tat t, gid, }, ,. "s,s,ct re.cl. , ,., „t to On l c d ag=cy as post of the
<br /> a pt,union i t i etrcl t USE[sawn 20 I Ag I t t CCR”,
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<br /> 1 RacnI name and.,d .._ ,.knd l;r.., N A to undeTn at= .`i,
<br /> NOTa AdAmo MUST Woe'a v&A;;I'yy u..L-:1.a" ni cl ,_a.Q,er..f,..."0 v')*,. -
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<br /> 3, the a pr pr,aee Sol,f€ir TYPE P F SL"sT''ESS CAa fi C WINOf?,,i`CO ,INS, S,,. f:AL.,e,:to
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<br /> >z. PIR t�G`)E'C RiYC-1,1„tL.dt111 FO R>`, ATC t'),N&rFR<.',.,i> 5d t.c'. 0,I4,LL,L,.
<br /> Craq„7=_A A ,y 0 No n};s . .QC':aP Rotor am to nme.. 7R.,ON k If Fmw w0a, '`ate KI AS SITF an x`sIt.va.wn, Be atilt;
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<br /> CanTlasaaa,_<.<„i ,,,,a ., A,, Ams u a SECTLIN ,.if„. a Laos.ov Od SAME AS SITE”,"c= ntai,.,section Besur;
<br /> V 1)C):1iii.;OF EQUALIZATION 1,5T STi:i7 AC-,.:, i_ :.k({.OU < `','a, E I.OnST t :Ci}:1?:'z.. ` ED.SIEZ A 2TICLE 5,CHAPTER 6,75.
<br /> L14'IS;ON 20,CALIFORNIA HEALTH AND SAFETY CODE)
<br /> Ian€ems yam I3c3.a.d of Equallization(130E)UST mmate f e aeciull a iia iniv;, wh1h k rccfaked befort'y€;isr pem it aspplicwi m ani Ine processed,
<br /> Reptration with the BOE ca HI c mane An you u uRI nasivC a qaancdy storagf.fee ra€ani in reponinS the per gillon fee due on the nurahcr of
<br /> ZTOom;1N eel in ymm USt's. The BOE will wedetwnolncxcmp�,from i ),i S_'e <c> ;^e fee-0 ra turas uia4€of bca�e^=.. If you do not have an
<br /> acm:rt tia,ou,With=ice,3QE- r"f you p ot� � _,�at..€t:,11t,?me n e xi o `.r., &1 lyes„_.,the B(iE in 9 16--322,96,67 or wrne to the
<br /> 1102w the f fll a,.nS a3dmw A aad of Epa .,ah i,Fw!Mau CAL&,Pa Brag i,N 1 Summvmn CA 94DION1,
<br /> V. PETROLEUM E: ('FINANCIAL i,LSra.:!'tii>ilS1'..,T"t€ 9 1a.'. cit.".{.3).',l?..,~.,7`:,,,z;R)R z'aE lZf.`ISUM I.Ws ONLY SEE SECTIONS 1ONS 2:'I I (0I 1)
<br /> OF TIT LT_-13.C1I.•F`TFR 16,C"ALIF€:)saNI,,x CODF a F a`ERI LA IO S,i
<br /> ld,m ify the method(s)a cd by the owner ardent o'pefawn,in ne�zing the L`t Tara and State ound a1 r.za.ctas,r?iisty requinotnetits.LISTS owned by
<br /> any Faand or Stle apricy as wSH as nom I, ,a.,Ha, c,S b.0_X,,..q,i fnat 10 t 5.,� _.,.....aa
<br /> V1,LEGAL NOTIFICATION AND BiLILING ADDR ESS
<br /> (I�a.4IE ON BO Rx the aistix.is iia:ill be and QRC)TI I LEGAL,AND
<br /> TANK OWNER OR A T&It`,>'.M..?"i._a 3 M..SEN ..:>>14U ST SIGN:'s,Nl)DATE 11 a2i.T'C,1T?M AS INDICATED, [SEI”SFC IT4)NS 2711
<br /> (a)(13)OF TITLE 23 CHAPTER 16,CALIFORNIA CODE OF RECi t..rx°paC)Ns,]
<br /> INSTRU(7FION FOR THE LOCAL AGENMES
<br /> The cow ty and jgbdic6on numbers ane pwdeierntined and can be td,,t ailicd by ca11;rS,th,-,State: oard(916)227.430-1 The faeniiity nurniscr Ti ay
<br /> be a 5rped by the by al agency;late ;this nuonLe r, st Nr .itdf7t<niczl affil.,:.wot comain any alphabetical cha;acmrs. If t ie local agency
<br /> pru _y thy°State Beard to assign the fucif,y aui mt�at ica�e leave a:blank,
<br /> 1T IS THE RESPONSIBILITY OF THE LOCAL AC<xW?*iC"s 'T.1I A I aNSIPECTS THE ,ACH...ITY TO VERIFY TIIE ACCURACY OF THE
<br /> ITITS Al PLIC".1TH)N CANNOT 11F, FP"—,CFSSE5,.IF t:t?. T?O A_.,. I N i NU11 ER IS NOT FILLED LED Tib. THE (r
<br /> g� I C°AL
<br /> AGENCY 15 RESPONSIBLERESPONSIBLEFORCR THE +:.;)t�1PLETION O THE :..CY AGENCY ..URE <",==i`1L�r"° INFORMATION BOX. THE LOCAL
<br /> AGiE`€` ' StIC?L;I.,L) RE-1 AIN ITIS C:=iF,GINAL ) 'iCzL ,');Y c ,)t,IwS. THE; FINK COPY Sai'.)I LD BE RETAINED By THE E TANK
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