Laserfiche WebLink
0 IVED <br /> rdaca�,Alff� 416 2°°� t phone:(2097744-0112"APR2014 <br /> p, <br /> yCa 0502 Fau )?".01 If <br /> owuor ani of D Vude and e T e1' I ENTAL HEALTH <br /> tail Understom of a3md • ' B -BEPARTMErT <br /> 4�ames Ywik Sery . Fa ° ty#: <br /> Add 954 W 11 d1 St TJt'tl i CA Ups Qrrarra t�ogt <br /> Fadlity Phone : CWV of Deftuatal OP=Vf <br /> ..• nlnw eed O <br /> DESKAaRD UST R I=FAMMARQL <br /> Y see Te4niciaat <br /> D ted t�r#Ws I1sm: `LAPiE NIMMt0 <br /> 8nsin Ara e: RDA,'i 99T ICC#: AUC <br /> Desipated operator's Pholm 744-0112 Expiration ea 313/16 <br /> AL NATE i <br /> Deftnated is Name: FELIX RAM= SuOi�ice Techn <br /> Businew Name: AFFORDA T i'r Icc ft UC <br /> Des" d Dperator's Mae'. rW744�-41X2 Twc�r�fs�n Date: 313/16 <br /> AIJERNATE 2 <br /> • <br /> Dedpatod Oporater's ttame: DAVW WINI CLIER Service Teohaiolsn <br /> Iltlsia e; A TEST <br /> 1CC#: 5 SDG <br /> Designated Operateeg Phone: 209-744-012 ir:' Liam. a/100 <br /> TE ATIF 3 T h tan <br /> ign ers s Name; R R <br /> NS Service Busines Nance: AFFORDA TEST ICC#: UC <br /> a�i'S Ph® 209-744-0112 Expiration Date, 3016 <br /> 1 cerWy that,for M ttdlitl tndiva e+d at the top vP CIO$PA90o th't+&viduala naftd aiwvc M dor a as gjr hma(ad M <br /> F ' rt°oTitus iadlvidaah wfd conduct and docameat m6oth1v T dlW' a0801 <br /> txatal�:in • . <br /> Mmudaaao With CV40 of logwatttons,tido 23,99011-$715(c)- <br /> 1rurtbemorg,b g dersUmd and aim in copprisn9 with dw requ"llments(statutm regulatidno,aad local <br /> a' ) appiicalble to underlinwaO stmar t>uW6 <br /> i, <br /> OF TANK OWNER( )% �► (t"'r <br /> S.TGNAT R19 OF TANK OWNM <br /> RATE: PHUN : [ o Q t. ' <br /> `* -v-• <br /> Non- 1)StE18Ml'i•1'M C(1MPl.R'Mtk FORK TO THE tddCA1. EhICY(NU'r )AFrFA"GNTMC.THE I.9C,AL <br /> AGENCY UST M AVAILARU AM, v tc wateunx M-Lbtmi. <br /> 2) NOTIFyTHI LOCAs.AGTs'1YCY OF ANY T9 TOM INFORMATION WPl` ]N 30 DAYS OF I'M <br /> C ANOL <br /> OFFICE.- "�. Dab Scanned: , <br /> County: Mate Few. <br /> i. Date lglt+t'atied <br /> Z0 Mvd 3AMS>11M �36t;g£$60� 6E:II0 bTId�1�LjE0 <br /> 69a1L VT@Z/LI1E@ C11303d <br />