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ABOVEGROUND PETROLEUM STORAGE TANK <br />FILE COVER SHEET <br />FACILITY ID#: FA0017000 <br />PROGRAM RECORD #: PR0529138 <br />ADDRESS: 11400 WALNUT GROVE RD <br />FACILITY NAME (DBA): DAVID K ISHIZUKA <br />FACILITY PHONE: (916) 796-5764 0 <br />FACILITY CONTACT: <br />OWNER NAME: DAVID K ISHIZUKA <br />OWNER ADDRESS: 11400 WALNUT GROVE RD <br />P/E: 2830 DATE: <br />P/E: DATE: <br />P/E: <br />DATE: <br />CITY: THORNTON <br />FACILITY FAX: <br />PHONE: <br />CITY: THORNTON <br />PHONE: <br />Water Service: <br />❑ Large PWS <br />❑ <br />Small PWS <br />❑ Domestic Well <br />Sewer Service: <br />❑ Public Sewer <br />❑ <br />OnSite WWTX <br />❑ OnSite Septic System <br />Stormwater: <br />❑ Street Drains <br />❑ <br />Street Ditches <br />❑ OnSite Ponds ❑ Other <br />Tank Record ID Tank PE Capacity <br />TA0517762 <br />2820 <br />500 <br />TA0517763 <br />2820 <br />500 <br />TA0517764 <br />2820 <br />500 <br />TA0517765 <br />2820 <br />500 <br />TA0517766 <br />2820 <br />500 <br />TA0517767 <br />2820 <br />250 <br />No of Compartments Additional Description <br />DIESEL <br />DIESEL <br />DIESEL <br />DIESEL <br />GAS 87 <br />WASTE OIL <br />EH 00 18 rev 04/2008 <br />rpt # : APST New Owner: Create a New Cover Sheet / Change Label of File <br />