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WEST COAST EQUIP SALES 1 20" 668 9382 P. 03 <br /> (73/26/1998 09: 04 12095,V.152 WRICNT ENVIROr-w-NTAL PACE 0a <br /> SAN JOAQUI N COUNTY YUBLIC H ALTU SSA✓ICX5 <br /> RIYYCR0r4m 4TAL HEALTH MVIMOK <br /> UNDERGROGM STORAGE 'LANA DMOSMON TRACt3NG RECORD <br /> rM.rT.r.Ye. <br /> ..............rwwwMYYYw.\.TrYY Y\a,�l,ll�\w�wY.M•��.\Y�.�MArYrVrr\w\rM�r-\r�Y1r ww,.,.rw1..Yw <br /> SECITOK 1 - Publio Iicalth Sarvicas EAvftoturuysal Hahn Mvtsloa Tank Tw4ut Shwa sash accompaw each holt o f xtd <br /> vlth in site Identlflaadonaumbcr• The Tanit Truk as Shan is to Dt ttntraad m PVbISc Aeslth Smfeas Eavuaameatai Ftodth <br /> Division Within 30.ears of atceptsace of*x ta11Y,by tb/dwpmal or teeycUlg WhT. The permit holder a tnpoasiblc fOt <br /> rn Ust.zt toss 11th form L completed add rcow=d. <br /> PACIITY NAMZ:: l9 v ��.t cS ��rlSZ bit 1� 4 �Sii<� �KnC��1 •w <br /> FACTLITY ADORMZ: S C <br /> TntJK LD139 ,��I r{G j J TANK 37z9AL ho QLUmPRMOVS TANS CONT +E`M'S: •., err* n�i hf <br /> SLmON 2 - To be flllecl ow by tank Moral eoatracior l <br /> Trak Rtm�o/vhN.�C�.tmt�rx:vr. •civ —^-P^ �--•A���'�'t�`�s- <br /> nad:als .1 <br /> Date Tank Reufoved_ qn K '•CiA <br /> .....r..n.....4........Y r.. ....Y.Y\. <br /> SECTION 3 - To be filled out Dy coatTseror 'dew iaatfat tagle.: <br /> Csnk Ixroacarnlaazioa Cnwrxwr: t �t c,� <br /> v <br /> .address. <br /> Phone fi <br /> Awhonred retaesaatative of c==r=t&fWg through sirwlr4 belay that Tits tmk'.tae bern decoatLa=04 in as apPtovea <br /> maaast-u MuttW Dy Cst Z A. <br /> - Tide' <br /> SECTrw 3 - To tt4 trod and dated by m=dwrhtad rRptuotobn Of dte wmr c=6>tuayc.4r 4spatal wlir/ <br /> tcoopaa; MAX myon PWat, <br /> Addtcss: L ��..._'t�L. ` ' Q- Cly: �r •�••�o��.�,Z:ry: <br /> Phone X: (. 9 )T�. �.r�(S '�—�• 'SbG.a`��`ASj�, <br /> Date Trak Received: \l <br /> Dan <br /> .wrrni. ....w.r...��.w.w.rr.......r..r.+-.w..M."'•M+..rrr V..,RTYMMY.r.�M+.r........Pr•�r...rwlrw.'. <br /> 1,'H ;3 4•46 (Revised 9111,%) PsSc IU <br /> -- —.1 �..r�,ti•M1r+v.•..� nrr.w ZCTC7.FA£OlT ;a1,=i1, a6C;Cf[; : <br />