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AREi <br /> -- �� UNDERGROUND STORAGE TANK . --- DATE <br /> DBA fan G�Oa <br /> ADDREPHONE <br /> SS CITY ,$ <br /> OPERATOR iG Or PHONE <br /> OWNER Crovcrr�on . Q9- PHONE <br /> ADDRESS <-Vn 9� <br /> BILLING,.,,ADDRESS ��� 2Z - E. r SXR s [� SSC 2aZ <br /> CONTACT24-07 5tmanUs <br /> (plon PHONE <br /> ADDRESM A E. zsw A-PC. St1C <br /> APN LOT SIZE SHORT TERM APCD PERMIT <br /> WATER PURVEYOR ANITARY DISTRICT C4 o-f- <br /> FACILITY TYPE SEPTIC WELL <br /> TYPE 1 3 4 5 TYPE 1 2 4 TYPE 1 - 3 4 5 TYPE 2 3 4 5 <br /> TANK # TANK # ��`� TANK # TANK # <br /> STATE I STATE ID &0 STATE 10 STATE ID <br /> PRODUCT PRODUCT PRODUCT PRODUCT <br /> SIZE _ SIZE ,*ggln SIZE SIZE <br /> PIPING <br /> PIPING PIPING PIPING <br /> MONITOR C-e�t' �,�: � MONITOR .- $ MONITOR MONITOR <br /> San tToa�,tii r� 51% <br /> V <br /> r Ki n 54-re cl- Le O r <br /> I <br /> (3as e mere L e�e-t ►s s� <br /> �veredxr l�►�n,9 . a A/7 <br /> .< <br /> 0 9aA <br /> Dt f, - <br /> �e��c!- Lwaf <br /> i 2Z. 6-�_ IA�e-r` <br /> ucT 9a 6/86 <br />