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N <br />1,l J1 <br />344 East Weber Avenge, Third Floor, Stockton, California 95202 <br />Telephone: (209) 469-3410 Fax: (209) 468-3433 <br />APPLICATION FOR UNDERGROUND STORAGE TANK RETROFIT OR PIPING REPAIR PERMIT <br />FF '' TWS PSUff DARES 90 DAYS FMU THE APROVAL DATE. MND CATS PERYrr TYPE !! KLOW <br />UTMK WMORT HG REPAmU Emow �c REPAWRD�ORT <br />4 -- <br />indicate the responsfate party to be billed for additional EHD staff lane expended beyond permit Payment coverage per tank if <br />the party designated below is different than the Permit 2WKaRk a -g- property owner- the .party mast admmedge this <br />resoonsibi4thr for the bating by sbn and date below. <br />EH23DO38 (revrsed 8MM) <br />+' <br />indicate the responsfate party to be billed for additional EHD staff lane expended beyond permit Payment coverage per tank if <br />the party designated below is different than the Permit 2WKaRk a -g- property owner- the .party mast admmedge this <br />resoonsibi4thr for the bating by sbn and date below. <br />EH23DO38 (revrsed 8MM) <br />